Case Study Analysis Ppaer Essay Example for Free

Case Study Analysis Ppaer Essay Introduction A number of problems were made during the recent hiring process. This case Study is an attempt to identify and recommend ways to improve this process. From the information that has been obtained, I believe that a lack of employee experience and a lack of prior planning and follow up resulted in a failure to accomplish all the task necessary to hire the new employees in a timely fashion. ?Background Carol Robins, a new campus recruiter for ABC, Inc. , in early April he was able to hire 15 new trainees who were destined to work for Monica Carrolls,  the operations supervisor. From the interviews that were conducted, it appears that Carl was unable to accomplish all of the tasks necessary so that the new hires could begin work. These tasks included documentation, drug testing, material preparation for the orientation, and facility scheduling. Monica Carrolls did contact Carl on May 15 concerning his process with the hiring process. Other employees had failed to keep the paper copy of the master orientation manual current so that it can be quickly copied. Another factor appears the rapid expansion of the company. Alternatives With more than one problem a major focus on a number of different Solutions, such as, Prior planning by Carl could have eliminated some of the issues; however, Carls in experience would probably still have resulted in there being some problems. The company has failed to provide relatively inexperienced employees, like Carl, with comprehensive procedures and job practices. Under the topic of supervision, Monica Carrolls could have made contact more often with Carl. But her job, as operations manager, does not include his supervision. Another solution to the supervision problem could be to increase the staff in the human resources department. However, on examination this does not appear to be the most efficient solution due to the increased costs. Another solution would be to maintain the master New Employee Orientation manual in electronic format. Having the manual in electronic form allows for easy updating of the policy and procedures, and prevents inadvertent loss or damage to that document. This method is cost effective and easily implemented. ?Proposed Solutions. A New Employee Checklist will be created with all pre-employed tasks listed on it. ?The Employee Orientation manual will be maintained in an electronic format. ?Some of the pre-employment tasks will become the responsibility of the potential employees to accomplish. Potential employees will report when the tasks have been completed. A member of the human resource staff will confirm that the task has been completed correctly. ?Employees like, Carl Robins, will be required to submit weekly reports detailing the current status of all potential employees. ?Recommendations New employees are the only way the work of this organization gets accomplished. Everyone efforts to sustain the continued growth and profits of this company cannot be ignored. With the continued growth of the company the proposed solutions that the employee will make on that day may need to be modified as the company becomes larger. I would recommend that a periodic review of the hiring process; looking for ways to improve it. And also a review should be done on an annual basis.

Complications of Endoscopic Sinus Surgery

Complications of Endoscopic Sinus Surgery INTRODUCTION: Endoscopic sinus surgery, a widely used method in the treatment of chronic sinus disease can lead to major (0-1,5 %) and minor (1,1-20,8% ) complications. These complications are still important nowadays. Central nervous system (CNS) fistula, hemorrhage, meningitis, orbital injury and even death are major pathologies. These are usually the result of injury of fovea ethmoidalis or orbital structures [1-4]. If the skull base anatomy and its possible variations are well known these risks will be minimized. ‘Fovea ethmoidalis’ which seperates ethmoid cells from anterior cranial fossa forms the roof of ethmoidal labrynth [5, 6]. Fovea ethmoidalis adheres to lateral lamella of cribriform plate which is a medially located very thin bone [7]. Keros [8] classified the depth of olfactory fossa as the height of lateral lamella in 1962. According to his classification if the height of lateral lamella MATERIAL-METHOD Two hundred paranasal sinus computed tomographies performed for various reasons as a total of 400 hemisides of paranasal region were analyzed retrospectively. Patients under 18 years of age, with a history of prior surgery, trauma which led to massive destruction of bones and patients with congenital anomalies were excluded from the study. A hundred of the patients were female (18-77 years old, mean age: 36,91) and 100 male (18-76 years old, mean age:34,25), respectively. MDCT scanner (Siemens Medical Solutions, Enlargen, Germany) with consecutive 1mm thick sections were obtained and coronal multiplanar reconstructions were performed. Bone algorithm was used. In our study , we measured that the depths of olfactory fossa, identifying Keros types, the distances of the ethmoidal roof from hard palate, the distances between upper and lower limits of the orbita bilateraly. The height of ethmoid roof was calculated by measuring the distance between ethmoid roof and the upper limit of orbit a. Measurements in coronal sections were performed at the level of the optic nerve just posterior to the orbital globe. Also the shapes of the bone from the confluence of ethmoidal fovea with lateral lamella are called type 1 if its shape looks like a broken arrow (broken wing) and type 2 if its shape is flat (flattening) and forms of the asymmetry were investigated. Keros typing, ethmoid roof height and asymmetric shape of the fovea were investigated in both sexes whether there is a relationship between them. NCSS statistical analysis (Number Cruncher Statistical System) 2007 Statistical Software (Utah, USA) was performed with the package program. Data were evaluated by descriptive statistical methods (mean, standard deviation), as well as comparisons between groups one-way analysis of variance, in the sub-group comparisons Tukeys multiple comparison test, in the binary comparisons of groups and independent t test, in the qualitative comparisons of data chi-square and weighted kapp a compatibility test was used. Results significances were evaluated at p RESULTS: According to the classification of Keros, 3.75% of the patients Keros type I (n = 15), 59.5% Keros type II (n = 238), 36.75% Keros type III (n = 147). Keros type III is more common in males (n=86, 43%) than females (n=61, 30.5%) (p = 0.017). The shapes of fovea ethmoidalis in 97.25% (n = 389) of the patients were the broken arrows (type 1), while 2.75% (n = 11) of the shapes were flat (type 2) . In 54 cases (13.5%) an olfactory fossa Keros type asymmetry, in 11 cases (2.75%) foveal shape asymmetry was found. In seven patients (3.5%) as well as the foveal shape asymmetry also Keros olfactory fossa type asymmetry was seen . Keros type I patients’ orbital maximal height average were measured 33.07  ± 1.24 mm, Keros type II patients 32.57  ± 1.97 mm, Keros Type III patients 33.31  ± 2.11 mm respectively. In the male patients , the average heights of the orbits of Keros III group were significantly higher than Keros group II (p = 0.034). The olfactory fossa depth was measured at an average 6.45  ± 2.16 mm on the right , 6.39  ± 2.21 mm on the left. The average depth of the olfactory fossa in males (6.7  ± 2.45 mm) was higher than in females (6.13  ± 1.84 mm) (p = 0.01). There was no significant difference between the olfactory fossa depth between type 1 or type 2 foveal shape. Right and left olfactory fossa depth which were used for detection of Keros typing was compared. In 93 patients (46.5%) from the total of 200 patients asymmetry was detected. In 55 patients > 1 mm (27.5%), in 38 patients had > 2 mm (19%) difference was found. Forty-eight of them female and 45 were male. In seven of the same patients showed foveal shape asymmetry also. Average right ethmoid roof height 7.59  ± 2.25 mm ,average left ethmoid roof height was measured 7.75  ± 2.38 mm. In men with type 2 foveal shape the groups average height of the ethmoid roof (9.59  ± 2.77 mm) was higher than the foveal shape of type 1 group (7.66  ± 2.36 mm) (p = 0.042). In women, the average height of the ethmoid roof of type 2 group (8.75  ± 1.76 mm) was higher than type 1 group (7.34  ± 2.11 mm) (p = 0.03). There was no statistically significant difference was observed between the averages of heights of ethmoid roofs in Keros type I, II and III patients. Right and left ethmoid roof heigh ts were compared in total of 200 patients. There was an asymetry between left and right sides in 93 patients (46.5%) . In 55 patients > 1 mm difference (27.5%), in 38 patients had > 2 mm difference (19%) was found. Forty-nine of them were female, 44 of them were male. Five of the same patients showed asymmetry in the shape of the fovea also. In 54 patients (27%), asymmetry was observed in both ethmoid roof height and olfactory fossa depth . Twenty-nine of them were female, twenty-five of them were male. In the same group; the foveal shape in four patients showed asymmetry also. For the Keros type I patients both sides of the olfactory fossa depth asymmetry ratio was found to be more (53,3%) than the other types. For the same measurement, the ratios were found 40,8% and 29,4 % with Keros type II and type III respectively. Kerosian ethmoid roof height of both sides in patients with type I, asymmetry ratio was found to be greater (40.0%). For the same measurement, the results were 33.3% and 29.4% in Keros type III and type II respectively. In the Keros type I patients foveal shape asymmetry was found to be greater (20.0%) than the other types . The foveal shape asymetry for Keros type II was 4.2% and 4.08% for Keros type III respectively. DISCUSSION: The ethmoid sinuses have special importance especially in patients undergoing sinus surgery . Because these sinuses are close to vital organs such as the anterior cranial fossa, dura, orbita, optic nerve and anterior ethmoid artery [12, 13]. During endoscopic sinus surgery, the maximum likelihood of injury of the skull base is in Keros type III cases in which olfactory fossa are deep [9]. In 1962, in Keros’ study with 450 patients, type II patients at a rate of 70.16% (which was the most common type in that study), type III 18.25% and type I 11.59% of the patients [8]. In our study 3.75% of the patients were Keros type I (Figure 1), 59.5% of the patients were Keros type II (Figure 2), 36.75% of the patients were Keros type III (Figure 3) . After the point of the junction of fovea ethmoidalis with cribriform plate as well as the depth; the shape and symmetry of these structures are also important . In our study, in 93 patients (46.5%), olfactory fossa height asymmetry was detected and in another 93 patients (46.5%) foveal shape asymmetry was found. In 54 cases with height asymmetry there was also shape asymmetry (27%). In a study made by Basak et al. [14] in Turkey on 64 children with Keros type I, type II and type III incidences were explained in the following way; 9%, 53% and 38% . Anderhub et al. [15] researched 272 cases of German children for the analysis of cases of ethmoid roof . The results of their study were as follows: 14.2% of the patients Keros type 1, 70.6% of the patients Keros type II, 15.2% of the patients Keros type III . In Jang and his collegues study [16], on 205 adult patients, type II was the most common (69,5%). In Alazzaw and his collegues study [17] on 150 patients with 3 separate ethnic group type I 80%, type II 20% and type III 0% of the patients were detected. In a study made by Elwany and et al. [18] on 300 Egyptian 42,5% of type I, 56,8% type II and 1,4% type III were found respectively. In this study, the type II olfactory fossa was the commonest type in men (66.7%), while the type I fossa was commonest in women (53%). In a study made by Souza et al. [19] on 200 Brazilian with type I 26,3%, type II 73,3% and type III, 0,5% of reported cases. Solares et al. [20] in United States examined 50 cases, 83% of the cases type I, 15% type II and %2 type III respectively. In a study in Turkey Erdem et al. [21] showed 8,1% in 136 patients with type 1, 59,6% type II, 32,3% type III; Sahin et al. [22] in 100 cases detected 10% of the patients type I, 61% type II, 29% type III. Dr. Satish Nair [23], found that 77,2% of type II in the study, 17,2% of type I and 5,6%. of type III 5,6% respectively. As seen in the studies, differences are observed between different countries. In a study by Lebowitz et al. [24] 200 paranasal tomographies were interpreted. In 86 of the cases, olfactory fossa shapes were symmetric and their heights were the same. Ninety-six cases had shape asymmetry, 19 cases had height asymmetry in olfactory fossa, one case had both shape and height asymmetry. In a study made by Dessi et al. [11] on 150 Italian patients, 10% identified asymmetry of the height of the olfactory fossa. In Fan and et al. [25] studies’ on 160 Chinese patients, 15,6% of cases showed olfactory fossa height asymmetry, 38,75% of cases had foveal shape asymmetry. Souza et al. [19] showed ethmoid roof height asymmetry in 12% of the cases, contour asymmetry in 48,5% of the cases. Michael Reiss et al. [26] studied 644 patients, of which 31 % was detected height asymmetry. Kizilkaya et al. [2] reported that in 37,95% patients was detected height asymmetry. Dr. Satish Nair [23] identified height asymmetry in 11,7% of the cases. In the same study, ethmoid roof heigh t and contour asymmetry was found in patients at the highest rate with type I (67,8%); than 32,3% and 40% with type II and type III followed. In a study made by Kaplanoglu et al. [27] on 500 patients ; in 80% of cases was found height asymmetry, the foveal shape asymmetry was detected in 35% of the patients in the same study. Our current study in patients with Keros type I both olfactory fossa depth and height of the ethmoid roof asymmetries had greater percentage. But in our population Keros type I is less seen. However, most of the skull base injuries were seen in Keros type III cases at a prevalance of 36,75% in our study in which olfactory fossa depth and height of the ethmoid roof asymmetry rates were quite high (respectively 40,8%, 33,3%). Preoperative computed tomography must be interpreted in detail. Especially Keros typing must be done and all the variations should be evaluated carefully. CONCLUSION In patients undergoing endoscopic sinus surgery; knowledge of anatomic details and average lengths of skull base and their neighbouring structures and the possible variations of anatomical structures are very important for the prevention of complications that may occur during the operation. Therefore, the preoperative evaluation of paranasal sinus CT by considering the various possibilities is necessary and inevitable. REFERENCES 1. Hemmerdinger SA, Jacobs JB, Lebowitz RA. Accuracy and cost analysis of image-guided sinà ¼s surgery. Otolaryngol Clin North Am. 2005; 38:453–60. 2. E. Kizilkaya, M. Kantarci, C. C. Basekim et al., â€Å"Asymmetry of the height of the ethmoid roof in relationship to handedness,† Laterality, vol. 11, no. 4, pp. 297–303, 2006. 3. May M, Levine HL, Mester SJ, Schaitkin B (1994) Complications of endoscopic sinus surgery: Analysis of 2108 patients incidence and prevention. Laryngoscope 104: 1080-1083. 4. Ulualp SO. Complications of endoscopic sinus surgery: appropriate management of complications. Curr Opin Otolaryngol Head Neck Surg 2008; 16: 252-9. 5. Stammberger HR, Kennedy DW; Anatomic Terminology Group. Paranasal sinuses: anatomic terminology and nomenclature. Ann Otol Rhinol Laryngol Suppl 1995; 167: 7-16. 6. Stammberger H (1993) Endoscopic anatomy of lateral wall and ethmoidal  sinuses. St. Louis Mosby-Year Book 13-42. 7. Terrier F, Weber W, Ruefenacht D, Porcellini B. Anatomy of the ethmoid: CT, endoscopic and macroscopic. AJR Am J Roentgenol 1995; 144: 493-500. 8. Keros P. On the practical value of differences in the level of the lamina cribrosa of the ethmoid. Z Laryngol Rhinol Otol. 1962; 41:809–813. 9. Ohnishi T, Yanagisawa E. Lateral lamella of the cribriform plate – an important high-risk area in endoscopic sinus surgery. Ear Nose Throat J. 1995;74:688–90. 10. Lee JC, Song YJ, Chung YS, Lee BJ, Jang YJ, et al. (2007) Height and shape of the skull base as risk factors for skull base penetration during endoscopic sinus surgery. Ann Otol Rhinol Laryngol 116: 199-205. 11. Dessi P, Moulin G, Triglia JM, et al. Difference in the height of the right and left ethmoidal roofs: a possible risk factor for ethmoidal surgery. Prospective study of 150 CT scans. J Laryngol Otol. 1994;108:261–2. 12. Zacharek MA, Han JK, Allen R, Weissman JL, Hwang PH. (2005)Sagittal and coronal dimensions of the ethmoid roof: a radioanatomic study. Am J Rhinol 19: 348-52. 13. Ohnishi T, Tachibana T, Kaneko Y, Esaki S (1993)High-risk areas in endoscopic sinus surgery and prevention of complications. Laryngoscope 103:1181-1185. 14. Basak S, Akdilli A, Karaman CZ, et al. Assessment of some important anatomical variations and dangerous areas of the paranasal sinuses by computed tomography in children. Int J Pediatr Otorhinolaryngol. 2000;55:81–9. 15. Anderhuber W, Walch C, Fock C. Configuration of ethmoid roof in children 0-14 years of age. Laryngorhinootologie. 2001;80:509–11. 16. Jang YJ, Park HM, Kim HG. The radiographic incidence of bony defects in the lateral lamella of the cribriform plate. Clin Otolaryngol Allied Sci. 1999;24:440–2. 17. Alazzawi S, Omar R, Rahmat K, Alli K. Radiological analysis of the ethmoid roof in the Malaysian population. Auris Nasus Larynx 2012; 39: 393-6. 18. Elwany S, Medanni A, Eid M, Aly A, El-Daly A, Ammar SR. Radiological observations on the olfactory fossa and ethmoid roof. J Laryngol Otol 2010; 124: 1251-6. 19. Souza SA, Souza MMA, Idagawa M, Wolosker AMB, Ajzen SA. Computed tomography assessment of the ethmoid roof: a relevant region at risk in endoscopic sinus surgery. Radiol Bras 2008; 4: 143-7. 20. Solares CA, Lee WT, Batra PS, Citardi MJ. Lateral Lamella of the cribriform plate. Software-enabled computed tomographic analysis and its clinical relevance in skull base surgery. Arch Otolaryngol Head Neck Surg 2008; 134: 285-9. 21. Erdem G, Erdem T, Miman MC, Ozturan O. A radiological anatomic study of the cribriform plate compared with constant structures. Rhinology 2004; 42: 225-9. 22. Ã…Å ¾ahin C, YÄ ±lmaz YF, Titiz A, Ozcan M, Ozlugedik S, Unal A. Analysis of Ethmoid Roof and Cranial Base in Turkish Population. KBB ve BBC Dergisi 2007; 15: 1-6. 23. Nair S (2012) Importance of Ethmoidal Roof in Endoscopic Sinus Surgery. Open Access Scientific Reports; 1: 251. 24. Lebowitz RA, Terk A, Jacobs JB, et al. Asymmetry of the ethmoid roof: analysis using coronal computed tomography. Laryngoscope. 2001;111: 2122–4. 25. Fan J, Wu J, Wang H, Lang J, Lin S. Imaging analysis of the ethmoid roof. Ling Chuang Er Bi Yan Hou Ke Za Zai 2005; 69-71. 26. Reis M, Reis G. Height of Right and Left Ethmoid Roofs: Aspects of Laterality in 644 Patients. Int J Otolaryngol 2011; 508907. 27. Hatice Kaplanoglu, Veysel Kaplanoglu, Alper Dilli, Ugur Toprak, Baki HekimoÄÅ ¸lu. An Analysis of the Anatomic Variations of the Paranasal Sinuses and Ethmoid Roof Using Computed Tomography. Eurasian J Med 2013; 45: 115-25. 1

Choctaw indians :: essays research papers

The Choctaw Indians   Ã‚  Ã‚  Ã‚  Ã‚  The Choctaw Indians is a tribe of Musksgean stock .The Choctaws were once part of a larger tribe that included the Greeks and Seminoles and are considered one of the five civilized tribes (Cherokees , Greeks, Choctaws , Seminoles, and Chickasaws) . At one time Choctaw territory extended from Mississippi to Georgia, but by the time Europeans began to arrive in North America they were primarily in Mississippi and Louisiana.   Ã‚  Ã‚  Ã‚  Ã‚  The Choctaw Indians were into cultivation , they hunted and raised corn along with a host of other crops. One of their chief religious ceremonies was a harvest celebration called , â€Å"The green corn dance.† According to one legend, the Choctaw were created at a sacred mound called Nanih Waiya, near Noxapater ,Mississippi.   Ã‚  Ã‚  Ã‚  Ã‚  In 1540, the Spanish explorer Hernando De Soto led the first European expedition through Choctaw territory. Fighting broke out after the Choctaw refused to supply the Spaniards with a guide and transportation. The Spaniards were in the wrong because the Choctaw Indians were friendly especially with the French and allied with them during the intercolonial wars between France and England . Some Choctaws fought with Jackson at New Orleans against the British.   Ã‚  Ã‚  Ã‚  Ã‚  In 1830, the United States Government passed the Indian removal Act. This act called for Eastern Indians to be moved West to make room for white settlers. The Government then forced the Choctaw to sign the Treaty of Dancing Rabbit Creek. The Treaty exchanged the Tribe’s Eastern land for an area in the Indian territory, in what is now Oklahoma.

Free Macbeth Essays: Foreshadowing the Apparitions -- GCSE Coursework

Foreshadowing the Apparitions in MacBeth One would question the credibility of the enigmatic apparitions within Macbeth's renowned Act IV, Scene i. Shakespeare gains the audience's acceptance of the three mystically summoned apparitions through methodically foreshadowing a supernatural event is about to occur. Each stance of Shakespeare's foreshadowing -- cauldron potions, Hecate, the second witch's awareness of MacBeth, and stage direction -- contributes to the believability of the apparitions' appearance in the play. The fact the witches were mixing a "poisoned (IV,i,5)" concoction upon the entrance of MacBeth implies "trouble (IV,i,10)." Three witches circling around a cauldron, throwing in items such as "baboon's blood (IV,i,37)" foreshadows something dark and mysterious will happen. Hecate, the queen of the witches, "commends (IV,i,39)" the witches for their "pains (IV,i,39)," upon entrance to the witchery drenched stage. Hecate also uses a device similar to the royal we. She implies that the entirety of the populous will benefit from the outcome of the p...

Crushing the Native Americans

After the Civil War, Indians inhabited almost half of the United States. White Americans were urged to move west and settle, not taking regard that Native Americans already lived there. By the late 1800s most Indians had lost their land and had been driven onto reservations. Eastern Indians had already been forced to the west. A number of tribes weren't cooperative with moving onto reservations and changing their customs. This caused many battles between whites and Native Americans.During the Gold Rush of 1849, a lot of Native Americans were killed by white disease and minors burning their villages. These events were significant because they contributed to an up rise between white Americans and Indians. On November 29, 1864, Colonel John M. Chivington led an attack on the Cheyeane and Arapaho. They killed and scalped men, women, and children. I believe this was important because it showed the disregard for the tribes and how ruthless the whites were against them, but also warranted a treaty. The Fetterman massacre that took place in December 1866 was a big part of theSioux War of 1865-1867. Red Cloud, the Sioux Chief, lured Fetterman's army into an ambush and wiped out all of them. This took place again because of gold rush invasion and only shows the results of someone trying to take another's homeland. http://www. indians. org/articles/native-american-indians. html The Native American Indians were forced out of their homeland, resulting in many issues and events including the Trail of Tears. Most of them eventually converted to the European way of life by dressing the same and changing their religion to Christianity.

Mrs. Beth Namara

Encouraging an individual to communicate their needs, preferences and personal beliefs affecting their personal care is very important in health and social care. As care workers we have to always consider people’s preferences even if it is not what we would like as individuals. There may be cultural considerations that I might need to think about as a person but this does not stop me from encouraging an individual to communicate what they want.When I realize that the service user is not able to communicate their needs, preferences and personal beliefs with ease, I am always patient and give them more time or use other methods of communication to find out. (58. 1. 1) As a care worker it is my responsibility to promote effective communication at work by being able to understand both verbal and non verbal messages the service users use. I know how to communicate well with the service users and to listen to their needs attentively in order to understand the message they put forwar d for me.For example I maintain eye contact all the time with the person I am talking to, listen carefully, use my body gestures to show them that I am listening and interested in what they are telling me. This gives them the assurance that I am listening to what they are telling me and I respect what they are telling me. (58. 1. 1) Sometimes I ask the family, friends or previous care workers for advice or seek for information about their needs, preferences and personal beliefs. For instance some service users prefer a bath to a shower or a strip wash, I have to respect that even If I feel that it is more practical to have a shower than a bath.Some service users prefer to have a bath three times a week I respect their choice and do exactly what pleases them as long as it is what they want and it is their choice. I avoid imposing my own views on them even if their choices conflict with what I feel is right. (58. 1. 1) Some service users have their religious beliefs or cultural needs regarding their personal care , It is my responsibility to always find out about these beliefs and respect them to avoid offending the service users I support and their family without intending to do so.There are some service users who prefer care workers to be of the same gender as them. For example there is a female service user who does not accept male carer workers in her house. This is respected by the company I work for and every service provided to her has to be a female because that is what she prefers (58. 1. 1) In conclusion , by listening to what the service users want or prefer , following their choices or getting information and advice from their family and friends is very important in health and social. By doing this, the service users will be satisfied with the level of the care they receive.In order to be able to provide support for personal care safely, care workers have to know how to help the individuals understand the reasons for hygiene and safety precautions. S ource of support in personal care can influence people’s habits and values, for instance some service users bathe or shower daily while for others it is twice a week or once. People’s attitudes to the care of their teeth, hair, nails, shaving also differs and it my duty as a care worker to explain to them the reasons for hygiene and safety precautions. (58. 2.1) Service users who usually have little contact with the public are not so much into grooming themselves like those who keep going out to mix with others. Those who stay home most of the time are usually less motivated to pay attention to personal hygiene. For example one of the service users I support is disabled but very active, he is involved in many charity organisations and loves going out to socialize at different events. He pays too much attention to his hair, teeth, nails and shaving so that he can look his best all the time.When ever I am doing his personal care I do everything according to his choice as longer as it is in line with the safety and hygiene policy of health and social care. As a care worker it is my responsibility to promote healthy and safe practice in relation to hygiene rather than imposing my own standards to service users I support daily. (58. 2. 1) I do make sure that the skin of an individual is washed and kept clean because any breaks to it leads to a risk of infections entering the body.I know very well that the outer layer of the skin is constantly being renewed, the shed cells are replaced with new cells. The skin also produces sweat and sebaceous glands that produce sweat and other oily substances that maintains the water proofing of the skin. If I do not take good care of it the dried sweat, dead skin and sebum can build up and be a breeding area of a range of bacteria or leading to bad smell which can be unpleasant. (58. 2. 1) I always make sure that the teeth of the service users are cleaned at least twice a day so that food particles can be  removed .If the teeth are not cleaned properly this can lead to mouth infection, tooth decay and gum disease caused by the decomposed food particles. It is my responsibility as a care worker to support the individual to understand the reason for keeping their teeth clean or oral care hygiene. (58. 2. 1) I do make sure their hair is washed and dried properly, most of the people I support are aged and their hair is dry and more brittle. I use mild shampoo with conditioner mostly to wash the hair then rinse it well and dry it.Some prefer their hair to be dried with the hand drier and others demand that I use the towel to dry it. Some service users get hair care services from hair dressers and it is my responsibility to ring and book for them hair appointments. (58. 2. 1) When I am doing hair care, i check for head lice which can be easily spread between people who have close head to head contact. Well conditioned hair makes it more difficult for the eggs to latch on to the hair. In conclusion, personal hygiene is not only about preventing the spread of infection, it also improves the way people feel about themselves.Service users usually feel better when I give them a bath or a shower, washed hair and cleaned boost their self esteem. The feedback I get from them shows that they really feel good after a nice bath, creaming, hair care, oral care and clean clothing. As a care worker it is my duty to promote and demonstrate good hygiene practices and be positive role models. Some service users I support need to be sensitively reminded and educated about hygiene and I do that when I see it is necessary the person has no idea about the importance of hygiene. (58. 2. 1)It is very important that I use protective equipments, protective clothing and hygiene techniques all the time when I am doing personal care in order to minimize the risk of infection. Germs can spread very easily from one person to another especially if they get onto clothes, hair, beddings and other materials. Therefore, it is my responsibility to limit the spread of infection by making sure I use correct precautions such as washing and protective equipment, gloves and aprons when supporting people with personal care to reduce the spread of infection.Most of the service users I support are aware of these universal precautions that they are in place to protect them and everyone involved from infections. I also apply hand gel to clean my hands and rinse my hands when I remove gloves and put them in the correct bin provided according to waste disposal policy. (58. 2. 2) I use protective equipments all the time when dealing with bodily fluids, clinical wastes or hazardous substances . Then after I dispose all used personal protective clothing either in the bag supplied by health services or in a plastic bag which I tie up and place in the main bin.I also make sure that I put the dirty laundry such as soiled bedding or clothes in the correct laundry bag provided to use. I avoid putting the dir ty laundry or the soiled linen on the floor because the soiled linen can spread infection. More to that , I always use people’s own toiletries when helping them with personal care, I do this mostly when I am supporting some one in a communal or a sheltered home. Germs can harbor in creams, make up, combs, hair bands, hats, hair nets and can easily spread from person to person if shared.Sharing toiletries and equipments among so many people also compromises a person’s individuality. As a care worker my own hygiene has also to be of high standard, I make sure I wear clean clothes each day which have been washed and ironed properly. After worker I change into a clean wear to go in home and this helps to reduce the spread of infections. Each day work clothes are washed separately from other clothes in the house, I use a hot wash and conditioner to kill all the germs and bacteria. (58. 2. 2)Reporting concerns about the safety and hygiene of equipments or facilities used for personal care to the manager or any body else concerned is very important not only for the safety of the service user but for the carer and others people involved. (58. 2. 3) Facilities and equipments used for personal care have to be in good working order, safe and clean to use otherwise, there can be accidents. As a care worker I also have a responsibility under health and safety law to ensure the safety of all people using the premises, I have to be observant so that I do not put anyone at risk of danger or harm.I have to make sure that equipments are checked regularly and all electrical equipments are tested and confirmed to be safe. As a care worker I have to be familiar with the correct working of equipment, such as the hoist, the chair lift, the electric bath chair and others because this will help me to know when things are not right. (58. 2. 3) I do make sure that I check every equipment before use and I do not use anything that might cause harm. If I check and notice that the equipment is faulty, I take them out of use make report and record the faulty as my employer’s policy or social and health care policy requires me to do.I know very well that dripping taps can be a hazard and if hot water drips from a tap while a person is bathing the service user can suffer serious burns. I also report other concerns like those of sharp edges on bath seats which can cause skin tears not only to the service user but to the carer and other people. (58. 2. 3) I do also report Items such as dirty or unhygienic bath mat, commodes, bath hoists, electric bath chairs and other unclean items that can easily spread infections to my manager or any other appropriate person.For the dirty bath tub, I do make sure that I scrub it with the cleaning materials before using it, this reduces the level of infection and makes the bathing place clean and pleasant to use. During the induction, I was told the benefit of reporting any concern about the safety and hygiene of equi pments or facilities, If I do not report it, that means I will be answerable in case of any thing, therefore, in order for me to cover my back in case of anything happens, I have to make sure I report to my manager or supervisor about any concern. (58. 2. 3)Control and exposure to hazardous waste is taken seriously in health and social care, this is about protecting the carer workers, the service users and others against hazardous substances such as the bleach, incontinence materials and other body wastes. COSHH is an abbreviation for Control of substances Hazardous to Health, the dangers of using such substances can be skin irritation, nose and throat irritation, allergic reactions and inhalation. (58. 2. 5) Waste materials I encounter during my daily care job include urine, feaces, incontinence pads, catheter and stoma bags, sanitary items, sputum, vomit and blood.During the induction it was clearly explained to me and other carer workers who attended that such body wastes should not pose any risk therefore, it should be wrapped properly, ensure that it is free from any excess liquid and disposed off properly. (58. 2. 5) All waste materials have to be handled with care because there are risks involved such as contracting gastrointestinal infections resulting in diarrhea and vomiting.The policy also emphasizes that all care workers  should know that it is important to safely dispose the waste because other people have to deal with it after it is disposed. Therefore, it is my duty as a care worker to make sure all the waste is wrapped and disposed in a bag or container provided. According to my work place policy, bags containing wastes should not be overfilled as these can be a risk to moving and handling as well as splitting open and contamination. Therefore, I always make sure the waste bags are filled up to the right and recommended level then tie them properly and make them ready for disposal.Keeping people safe is my priority as a care worker , liquid w astes such as urine, feaces, vomit and blood I dispose them in any normal sewage system, Incontinence pads, sanitary items, wound dressings, used gloves and aprons I dispose them in the yellow bag, soiled foul linen in the red bag which has inner dissolvable liner. I put the linen in the white bag which is usually provided for it, dispose house hold waste in the black bag and the sharp equipments such as needled and pins in the yellow sharps box.I make sure before I handle any wastes, I wear my apron, gloves and after I wash my hands properly. (58. 2. 5) Supporting individuals to make themselves clean and tidy after using toilet facilities is my responsibility as a care worker. After assisting service users to use toilet facilities, I have to make sure that, I support them to cleanse thoroughly to prevent them from becoming sore. I know very well, if the traces of feaces and urine are not cleaned properly can cause soreness and infections.I always make sure that there is enough toil et paper and wipe the service user from front to back, this is referred to as the correct way because it prevents traces of feaces being drawn towards the vagina and urethra which can cause infections. (58. 3. 2) There are individuals who always ask for running water to cleanse themselves after using the toilet this is either their culture or it is according to their religious faith. This is very common with service users who are Muslims by faith or have a culture of washing themselves after toileting rather than using toilet tissue.When the bidet facilities are not available, I provide them with water in small buckets or big bottles to wash themselves after using the toilet. Some of the service users I support prefer using moist baby wipes or toilet tissues after suing the toilet. (58. 3. 2) Most of the female service users use feminine wipes because they are soft, gentle and non irritant to clean their genitals after using the toilet. I always make sure a hand washing liquid is re adily available and I encourage the service users to use it to wash their hands properly.Some of my service users do not like to wash their hands after using the toilet, in this case I do remind them about the importance of washing hands. It is my responsibility to ensure that soap and hand washing liquid is provided at all the sinks in the house to make it easy for the service users to wash thoroughly, then a hand towel is provided for drying the wet hands. In conclusion, it my duty as a care worker to support individuals to make themselves clean and tidy after using toilet facilities. (58. 3. 2)Whenever, I enter service user’s home, after checking if the individual is ok, I check the room temperature to make sure it is ok for the person I am going to support. Sometimes I do ask them if the temperature is the right one or there is need to regulate it. This depends on what they want at that time, I usually do this in winter season or when the weather is too cold for the indiv idual. I also make sure the area where personal care is going to take place is warm and free from draughts. First, I close the windows then after prepare and make sure the heating is on to warm the room.  (58. 4. 1)After a bath or a wash most service users feel cold , therefore, it is my duty to make sure that I keep their bodies warm. I usually spread their towels and clothes on the sides of the radiator to take the chill off and make sure they are not too hot. I also ensure that the spread clothes are just on the sides and do not block the warm air flow from the radiator into the room. When ever I am running baths, I run the cold water first and then the hot water last, the reason why I do this is because hot water can cause serious burns or scalds to service users.I was warned by my manager to be careful when running hot water in the bath because a number of burns accidents or scalds in the health and social care sector have been reported to the health and safety Executives. (5 8. 4. 1) The hand book about guidelines on safe water temperatures were handed to all the care workers who attended the induction with me. The people I support are vulnerable and more at risk of burns, some of them have dementia, others are old with health problems like diabetes. All those mentioned may not be able to judge or control the water temperatures on their own.Most of the people I support have limited mobility and cannot be able to get out of the bath quickly if the water is to hot, therefore it is my duty to always do risk assessment before taking anyone for a bath and take measures to reduce the risks. I make sure the water is at an appropriate temperature, for the bath it has to be 44 °C, for the shower it has to be 41 °C, for the wash basin it has to be 41 °C and 38 °C for a bidet. Thermometers are provided for the care workers to check the water temperature, it is my duty to report the water that is not within the recommended temperatures.It is also my respons ibility not to leave the tap running because this does not only waste water but can also cause scalds. Service users do not only need support in baths but also in oral care to prevent tooth decay and other dental problems. (58. 4. 1) As a care workers, It is my responsibility to encourage and support service users to manage their own personal care so that they are independent as much as possible. Supporting personal hygiene activities in ways that maintain comfort, respect, dignity and promoting active participation is very important in health and social care.It is my responsibility to find out how much a service user can do independently, I usually get this information from their care plan , family or friends and by being observant as individuals’ condition and needs keep changing. (58. 5. 1) I encourage service users to participate actively and help them by giving the right level of support. For example, those who can manage to clean themselves after toileting I let them do it independently and some who are not able to, I give them the required support while maintaining respect and dignity.I avoid giving less support to those who need it because this leads to individuals feeling neglected or not supported. I know very well it is also not good to give too much support that is not required because this takes away individuals independence. I make sure whatever I do for the service user shows respect and dignity, I avoid taking over their independence because this shows disrespect or devaluing an individual. (58. 5. 1) I make sure that I offer the service users the opportunity to use toilet facilities before they wash, bathe or get a shower, this helps in minimizing unnecessary hustle or pain that can be caused by movements.I ensure that individuals, who are experiencing pain, do not move unnecessarily and the prescribed pain killers are given to them before the shower, bath or any wash. By doing this I am maintaining comfort, showing maximum respect and dignity. (58. 5. 1) I always make sure that the area where the personal hygiene is going to take place is private, I get all the required materials to use ready before hand, offer the service users a choice to decide on their own what they prefer, either a bath or a shower and I respect their cultural and religious beliefs.When it comes to toileting I always ask them to find out which kind of toiletries they like to use, I ensure all the equipments for use are safe and in good order. I do find out how much the service user can do independently, make sure the person knows how to call for help in case they need it and I do not rush them. Last but not least I give them maximum respect and dignity which is very important because this makes them feel secure, loved and cared for properly. Some times an occupational therapist can be needed to offer the service user advice on how to use some equipments and how they can manage independently.  (58. 5. 1)Most of the individuals I support liv e in their own homes and some are in sheltered accommodation but in separate apartments. After doing laundry work, I sort clothes properly, put all the clean ones neatly on hangers and in drawers. I always make sure that service users’ hair combs and brushes are kept clean after use, sometimes I encourage service users to remove any hair in them as a way of killing boredom.For example last week I used the following sentences to encourage Mrs. T to clean her hair equipments â€Å"It seems your combs needs your attention Mrs.  T, can you have a look† she laughed so loud and immediately started to remove the hair and dust from them. (58. 5. 2) I do make sure that all the old creams and make up are discarded because they can harbor germs and cause infections. Some of the service users do no like throwing away their stuff, therefore in this case i use persuasive words such as â€Å"Mrs. J, don’t you think this old cream or make up will cause an irritation on your skin, it is not advisable to use any cream if it is expired†.I always make sure that I hand a tissue to the service user to use and remind them that make up can create stains on clothes which can be difficult to remove or wash clean. For example, Ms. L was putting nail vanish on her finger nails, I gave her a napkin to protect her skirt from the vanish spills, at first she did not want to use it, but I said to her with a smile that â€Å"Ms L, let me hope you this skirt will not be in the bin on Friday†. She asked me, why? I replied to her, I do not this vanish we will be able to remove this vanish from this fabric once it spills there.She immediately asked for the napkin to protect her beautiful skirt from the vanish stains. (58. 5. 2) I do make sure individuals I support use clean razors which are in working order and foils of electric and safety razors used for wet shaves are clean and not blunt. Some service users have a tendency of not discarding their razors even if they are blunt, in this case I use my persuasive communication language to help me sensitize them about the dangers of using such gadgets.For instance Mr.  G had an attachment to his Phillips old shaving razor despite of the fact that it was blunt and not working properly, I said to him in a calm and polite way that his razor was responsible for his blisters that come up after every shave. He defended his razor and suggested changing the after shave, I made it clear to him that his idea will not solve the problem unless the new razor was bought. I gave him the names of places like Argos where he can get the same razor on sale and cheap, he listened to my advice and replaced the old one. (58. 5.2) I encourage individuals who prefer doing their personal care independently to keep their combs, shaving razors, make up, creams and clothes in their respective places because this makes their rooms to look neat and organized. By giving them praises such as well done Ms. L your bathroom and bed room look very beautiful today and everything is in order, such statements motivate them. For those who cannot tidy their rooms or bathrooms, it is my responsibility to do it for them the way they like them to be. Some Individuals like their personal care items to be near them all the time or on the table next to their chair.If it is their choice I do respect it as longer as they are safe and will not be harmed by any item. (58. 5. 2) During the training and the induction as care workers we were trained to tell what is normal for an individual and what is not, this helps in preventing discomfort or any serious health problem happening. Because of individuality, what is normal to Mr. J can be abnormal to Mrs. M and it is always my duty to notice and note any changes or concerns and report immediately. Since my work involves providing daily support to service users, I can easily tell if there is even any slight change in some oneshealth. (58. 6. 2) For instance I know the nor mal urine has to be clear and straw coloured, however it usually stronger in the morning and appears more yellowish or orange. I understand very well that passing urine should be pain less and normal, if I observe that the individual is finding it difficult, I report to the manager immediately. If I realize the individual’s urine is cloudy and smells fishy, this is a sign that the individual has an infection. I report this immediately to the manager and write it down in the log sheet.Sometimes I do contact the individual’s doctor to book an appointment for the service user to be examined. For example some months ago I noticed that Mr. D’s colour of urine had traces of blood, I informed my manger who told me to ring the service user’s GP and book a medical appointment for him. Later on it was found out that he had the infection in his urethra which was treated and his urine colour is normal now. (58. 6. 2) I always record any abnormal urine colour in the l og sheet and report to my manager or the supervisor the concerns immediately.I make sure the service user is informed of any abnormality or changes in their urine and for those who are independent I always keep reminding them to check the colour of their urine and inform me if they have any concerns. As with urine, what is normal feaces with one service user may be abnormal for another, therefore, it very important that i keep an eye on the colour and texture of their feaces. If I observe that the feaces of the service user are dry that means they are constipated, then I have to encourage them to take fluids and to eat plenty of fruits and vegetables.During the food and nutrition course, we were trained that it is important to give service users a diet of food with enough fibre to prevent constipation. (58. 6. 2) Laxatives have been prescribed to some service users with constipation problem, I was advised to always record the food and drink taken by each service user. I usually ask the service how their stool nature is and if they are going toilet normally. Doctors have often been referring service users to dieticians so that they can recommend changes to their diets.Since most of the people I support are elderly, I have not been encountering women of child bearing age who need help with their menstruation periods. But still I do support ladies to keep themselves hygienically clean as women. I support them to wear panty liner or incontinence pads. to keep themselves clean. (58. 6. 2) Recording and reporting on an individual’s personal care in agreed ways is very important in health and social care. According to my work place, all care workers must record any personal care if necessary they can be asked to report what has been done as personal care .It is vey important to record accurately on any sort of support that I give service users and note down all the health changes that I notice. The organisation I work for provided each service user with a care plan and a log sheet. It is the log sheet where each and every task done daily has to be recorded down and the name of the carer signed against it.. (58. 6. 3) As a care work I have to make sure that the recorded information is accurate because there could be serious consequences as a result of poor record keeping.For example one service user declined a bath and I recorded it down, but when the social worker came to visit him, he complained that he has not been getting personal care. The recorded bit of information worked against him because I had put down all the excuses he was giving me to avoid a bath. When they read for him what was in the log sheet he remembered that he was the one who declined a bath but not me the care worker who did not do my duty properly. By recording all that information saved me so much or else I could have faced the disciplinary committee or expelled from work. (58. 6.  3)According to my work place policy all the recorded information has to be true, for instance there is a care worker who was suspended because of recording what he had not done. He recorded what was to be done on Friday in the log sheet on Wednesday, unfortunately the service user was rushed to the hospital on Thursday night by the ambulance. On Friday morning the carer did not turn up because he had to do his private business, the office was called by the family member of that service user to inform them that his door locked door was locked and is in the hospital the carer should not go in on Friday.When the social worker read the information in the service user’s log book was showing the carer was in the house Friday and found the service user ok which was not true. The manager was informed about the contradicting information in the log book then the care worker was called to the office to come and explain what exactly happened and found all the inaccurate information, it was considered to be fraud because the care worker wanted to earn money he had not worked for. Dishonesty is not allowed when recording information and he was warned after facing the disciplinary committee. (58. 6. 3)

Launching Strategy Essay

Purpose: Alpen Bank is facing potential growth opportunities in terms of launching a credit card to the Romanian market. The overall goal is to increase annual profit by â‚ ¬5 million within two years of launch. Selection of the right target audience, while applying the appropriate launching strategy is the direction of our focus. Our goal is to extend the Alpen Bank premium service to customers via a new product market. Predictions of economic growth in Romania, proves that the market is growing increasingly ripe for credit cards. Therefore, the issue is not whether or not Alpine Bank should launch a credit card in Romania. The concern of Alpine Bank should be when to launch said services in Romania. Current models, statistics, and research are conclusive; the time to invest in Romania is now. Position Statement: The recommendation standing and supported by enclosed financial statements are as follows: Launching a credit card in the Romanian market would meet the stated purpose by targeting the affluent and most affluent audience (Exhibit 1). The marketing approach will consist of direct sales in conjunction with branch cross selling (Exhibit 2). Also the use of magazine and television advertising strategies will enhance our position. This approach will add support for the recommendation of taking advantage of a primarily non-penetrated market. Reason: The opportunity to invest in the Romanian credit card market yields potential revenue growth, along with increasing the life time value of each customer, new and existing. With Romania entering the European Union, Alpen Bank has been prompted to re-visit its previous credit card approach in the emerging economy. Additionally, there has been an increase in luxury products and purchases, displaying increased consumer purchasing power, a potential indicator of an increased interest in credit card. Furthermore, Romania is in a transition period, with cards gaining favorability over cash payments. Alpen Bank hopes to build upon prior methods explored in Romania by competing banks in penetrating the credit card market. Decision Options (Exhibit 6): 1.Launch a credit card in Romania. 2.Do not launch a credit card in Romania. Decision Option 1 a.Add a new market: Alpen Bank can continue its successful venture in Romania by adding a credit card to its portfolio. This will foster a continuing growth in an increasingly affluent Romanian upper class. As purchasing power is determined by income level and accumulated wealth, the affluent class is more able than the middle class to make purchases on credit. b.Increase revenue: Current models and predictions indicate a strong opportunity to significantly increase the yearly revenue by investing in the credit card market. Calculations display how the venture will increase the life time value of each customer, ensuring future growth. (Exhibit 1) Decision Option 2 a.Focus on existing markets: Venturing into the credit card market could draw resources away from core Alpen Banking services already in effect for the Romanian market. b.Assure no potential risk: All investments come with inherent risks. By investing substantially into an exploratory market, Alpen Bank is running the risk of not meeting the expected outcome. The potential monetary risk could run into the millions of dollars, along with an incalculable risk to reputation. How to measure Decision Option 1 a.Establish a customer base with the affluent and most affluent: By building upon the currently excising clientele, along with attracting untapped segments of the prosperous Romanian upper class. By comparing the actual number of clients utilizing the Alpen Bank credit card with the models and predictions made pre-credit card launch. (Exhibit 4) b.Increasing revenue from the credit card launch: Expected revenue from the credit card enterprise is projected to be â‚ ¬6,698,391 within two years (Exhibit 2). By updating current calculation models with on-going information as the enterprise proceeds allows for ongoing monitoring of predicted return on investment. The lifetime value of customers will also be assessed on a yearly basis, predicting the value of loyal, long term users of credit cards. How to measure Decision Option 2 a.Projecting further growth without credit card. Venturing into the Romanian credit card market taps resources away from current banking business. Investments could also be put to use in other areas, such as higher frequency of branches opening or improving services currently offered. b.Customer awareness of the bank’s premium brand: By investing in already offered business services. Alpine Bank is committed to improving our superior line of service currently offered to the Romanian clientele. Critique of Decision Options 1 Per limitations of senior management, the investment into the Romanian credit card market must prove itself profitable within two years, yielding at least five million euro. Investing in developing a profitable line of credit cards comes with several risk factors. Predictions of profit could be erroneous, leading to a less than expected return on investments. This in turn could lead to revocable and irrevocable damage to reputation, potentially resulting in a net loss of customer over short and long term. Projections of the positive effects of Romania’s’ recent acceptance into the European Union could also be incorrect. By investing time and energy into a new business venture, current banking services could suffer from subconscious neglect by employees involved in both enterprises. Critique of Decision Option 2 A decision not to invest in the Romanian credit card market will be a hinder of growth. Currently, competing banks are investing and have invested in the growing credit card market. By delaying a venture, Alpen Bank is permitting competitors to gain establishment and credit market branding. Alpen Bank currently holds the potential necessary for a successful venture into the credit card market. By failing to employ said resources, Alpine Bank is neglecting talent and opportunity, which could lead to failure in expected profitability. Being accepted into European Union brings increasing prospect of higher return on investments in the credit card market. By choosing to stay out of the market, Alpine Bank is also forcing excising customers to other banks for credit card services. As experienced in other emerging markets in developing countries, credit card customers are less likely to switch from one credit card to another. Therefore, failing to introduce a line of credit cards now will make it increasingly difficult to attract customers when Alpen Bank eventually starts its credit card venture. Action plan: Goals: †¢Launch a credit card †¢Reach the affluent and most affluent †¢Launch marketing and adverting that appeals to our audience Action Steps: Short term †¢Marketing Plan: Release a Premium Marketing Plan that is focused, achievable, compelling, and simple. As evident by exhibit 1, the chosen target group is the affluent and most affluent segments of the Romanian population. By ensuring a proper understanding of the dynamic characterizing the targeted demographic, we are able to construct the appropriate marketing plan. This will instill the programs, tactics, incentives, and budgets necessary for a strong image and a consistent message reaching the targeted customers. †¢Marketing: Investing in direct sales and branch cross-selling holds the highest effective rate of potential customers reached. These two methods also have the lowest cost per customer. Combined they ensure the most effective tactic in recruiting customers to Alpen Bank’s credit card. (Exhibit 2) †¢Advertising: Magazine and television advertisements. Our advertising goal is to capture the attention of perspective applicants as well as converting prospects involved with other credit card venues. Establishing a clear message for the audience is essential in launching advertising Alpen Bank’s advertising campaign. â€Å"A premium clientele deserves a premium banking experience.† The launch of the campaign considers the sophisticated, vernacular culture of our Romanian clientele. The goal is to assure the same quality experience in our established bank while adding an innovative credit card product to allocate more options for our clientele. -Magazine advertisements could feature admired Romanian model Diana Dondoe, to highlight Alpen Bank’s image of being an upscale and exclusive provider of banking services. -Television advertisements could consist of 30 second runs of a Romanian couple being picked up by their driver and dropped off at the premier launch of the credit card. These are some alternatives in order to illustrate how the product could be marketed. †¢Launch of promotional events by the Alpen Bank’s public relations department. Evening events could be held at elegant local venues for charitable fundraising purposes. Long term †¢Continuing growth in the Romanian market, with special focus on the credit card market. †¢Attracting customers to Alpen Bank by focusing on its premium image and superior services. †¢Expansion in the credit card market, to have established a customer base of 200,000 customers five years following initial launch. †¢As the Romanian economy is growing, the percentage of population with a disposable income is increasing. Alpen Bank will focus on attracting new members of the affluent segment of the population. †¢Increase the lifetime value of each customer, by further expansion of the financial services offered. †¢Increase credit card utilization by informing clientele of benefits associated with credit card purchases, along with temporary potential incentives offered in order to change consumer habits. Risk and Countermeasures †¢The chosen target demographic of affluent and most affluent Romanians could prove itself too limited for effective penetration. However, as the Romanian economy is growing, the targeted demographic is also expected to expand in size. Therefore, even if the current market niche is too limited, it is expected to grow substantially over the next two to three years. †¢The expected profit of five million could not be achieved within the timeframe of two years. As limitations set by senior management calls for a substantial profit to be made within a relatively short amount of time, there is a risk of the time restraints not being met. Yet these restrictions add a clear vision, enabling a structured approach in order to meet the expected outcome within the set timeframe. Final recommendation and conclusion By venturing into the Romanian credit card market, Alpen Bank is capitalizing on a ripe product opportunity. Current predictions and models consistently indicate that by pursuing the recommended strategy, Alpen Bank will see profits grow by a minimum of â‚ ¬6.6 million over two years. Romania’s recent acceptance into the European Union, accompanied with an increase in purchasing power among the affluent fragment of the population will ensure a substantial return on investment. (Exhibit 4, 5)