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Economics involves making choices based on maximization of utility, profit, or minimization of economic losses
Economics involves making choices based on maximization of utility, profit, or minimization of economic losses. In maximizing or minimizing economic factors in consumption or production or there are constraints to the achievement of economic goals and objectives. In economics, players act in self-interests to achieve various goals. This is extended in the bond market where various factor influence the demand and supply of bonds. The bond market usually fluctuates during various economic times though out the business cycle. Other economic factors change in different period such as during robust economic growth. Various factors that could change during the period of robust economy include default risk, wealth, as well as general business conditions. Changes on every one of these factors have influence on the supply and demand for bonds in the bond market. The influence on demand and supply of bonds come in when bond prices and bond yield changes. This aspect could be seen from the fact that bond prices seemingly fall during high economic growth but rises when economic growth is low. This paper analyses how the bond market is affected by economic fluctuation throughout the business cycle and especially during times of robust economic growth.
The law of demand and supply forms the fundamental economic laws. In the bond market, individuals selling bonds dictate their supply why buyers dictate the demand of the bonds. Bond suppliers usually supply bonds until a point is reached when profit is maximized with respect to the cost of selling the bonds in terms of interest rates, selling costs, and other related costs (Swedroe 2011). During robust economic growth, various economic factors also tend to improve greatly including wealth, improvement in risk factors, as well as positive changes in general business conditions. The factors affect the supply and demand for bonds. Wealth is an economic factor that influences the demand for assets generally. Bonds being assets are as well affected by wealth since it is a store of value.
During periods of high economic growth, risk factors are minimal and investors opt to store their increasing wealth in interest earning forms of wealth. The reason behind this is the evaluation of various factors in this kind of investment such as the relative returns, liquidity factors, and risk factors. During this time of economic growth people have high expectations and for various reasons, investors believe that the economy would be favourable and end up demanding more bonds thus increasing the demand for bonds (Conley 2013 ). Since the demand is very high at this time, market forces of demand and supply acts in a way to restore market equilibrium hence making prices to fall to equate bond demand and bond supply.
Default risk factors influence the demand and supply of bonds on a different perspective from wealth or business conditions. Default risk comes in when individuals and or organizations are unable to settle their debt obligations. This condition scares away bond issuers in fear that they may never get their debts settled. During periods of robust economic growth, businesses conditions seem favourable making bond suppliers have the will to sell their bonds in large quantities (Wright & Quadrini 2013). Bond suppliers are only taken aback by the falling prices of bonds during this time but hardly by the default risk factors. In the case of high default risk in the bond market, bond suppliers charge high interests as a way of mitigating the effects of default risk. While bond demand and supply is affected by wealth and default risk factors, expected inflation and general business conditions form the basis of the default risk and wealth influences on bond supply or demand (Swedroe 2011).
Inflation expatiations are responsible for lowering the value of money given that real income is nominal income compared to the prevailing price level in the economy (Stolper & Samuelson 1941). Inflation could be generated by increased government expenditure as part of general business conditions. The government may run out of funds and sell bonds increasing the supply bonds and hence increasing the yielding of bonds. On another aspect, favourable business condition may attract investors who may borrow money by selling bond. During the time of good business conditions, people want to invest in risk free assets whose returns are favourable (Gardiner 2013). Selling bonds could be a way of earning capital for investing in various areas of business. The effect of this is an increase in bond supply so that the price of bonds is forced to fall. As bond prices fall, bond yielding increases. This effect means that good business conditions are favouring factors to the bond market.
Holding a bond until maturity has no safety repercussion unless a government collapses or inflation strikes the economy. Inflation would have no effect if a given investment keeps pace with the inflation or does better than the effects obtained from the inflation. Inflation risk could be worsened by interest rate risk. Selling a bond before it matures would yield better returns if the prevailing interest rates were higher than the rates prevailing when purchasing the bond (Conley 2013 ). Since interest rate, an aspect of default risk, seems to influence bond demand and supply irrespective of the economic conditions, it follows that default risk is the best consideration a bond investor can make. Again, one has to understand that bonds are only agreement to repay a held debt and promises can be broken if a corporation or individual can go bankrupt. It is therefore wise to weigh the risks, which can be done using bond credit rating.
Bibliography
Robert Wright & Vincenzo Quadrini. 2013. What causes the supply and demand for bonds to shift? Retrieved February 22, 2013, from Money and Banking: http://catalog.flatworldknowledge.com/bookhub/reader/30?e=wright-ch05_s02
Conley, P. 2013. The Risks of Bond Investing: Understanding Dangers in Fixed-Income Investing. Retrieved February 22, 2013 , from bonds.about.com: http://bonds.about.com/od/bonds101/a/bondrisk.htm
Gardiner, K. 2013, February 15. Taking the easy way out? Retrieved February 22, 2013, from barclayswealthblog.com: http://barclayswealthblog.com/
Stolper, W. F., & Samuelson, P. A. 1941. Protection and Real Wages. The Review of Economic Studies, Vol. 9, No. 1 , 58–74.
Swedroe, L. 2011, December 7. A long-term look at default risk in bond markets. Retrieved February 22, 2013, from MoneyWatch: HYPERLINK “http://www.cbsnews.com/8301-505123_162-” http://www.cbsnews.com/8301-505123_162-57337933/a-long-term-look-at-default-risk-in-bond-markets/
Healthcare-Associated Infections as the Quality Safety Problem
Healthcare-Associated Infections as the Quality Safety Problem
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Healthcare-Associated Infections as the Quality Safety Problem
Introduction
Healthcare-associated infections have become a contemporary issue in healthcare delivery in hospitals. It occurs when modern medical devices get applied by doctors and medical officers while treating patients but causing diseases and infections. Majorly, infections occur after surgical procedures, making patients suffer from several illnesses. Common illnesses that occur through healthcare-associated infections include central line-associated bloodstream infections, ventilator-associated pneumonia, and catheter-associated urinary tract infections. An individual doctor should work towards preventing any associated infections during service delivery to the patients. Therefore, the paper analyses the common types of healthcare-associated infections, their potential solutions, and the personal impression regarding the infections based on past learning experiences and the course content.
Central Line-Associated Bloodstream Infections
Central line-associated bloodstream infections occur when the bloodstream gets infected by the germs which enter through the central line. It is also an infection that is laboratory confirmed by the doctors but has no relationship with the infection being treated hence developing within forty-eight hours of the central line placements. Thousands of deaths have occurred in the medical field due to central line-associated bloodstream infections. As such, it has led to a medical burden. Notably, most infections are preventable through several measures. The common central line-associated bloodstream infections include gram-positive organisms, which are the coagulase-negative staphylococci, Staphylococcus aureus, and enterococci (Haddadin & Regunath, 2019). Also, the gram-negative related to central line-associated bloodstream infections are the Pseudomonas, Acinetobacter, Candida, and Enterobacter.
Consequently, central line-associated bloodstream infections lead to a prolonged hospital stay in patients, increasing healthcare costs. Same e infections are related to the presence of intravascular devices. In the United States of America, 0.081% of healthcare-associated infections occur as central line-associated bloodstream infections. Also, they are found outside the intensive care units (Haddadin & Regunath, 2019). Most importantly, the risk factors which intensify central line-associated bloodstream infections are chronic illnesses like gastrointestinal tract disorder, malignancy, hemodialysis, and pulmonary hypertension.
Also, the immune suppressed states like diabetes mellitus and organ transplant, malnutrition, total parental nutrition, prolonged hospitalization before the insertion of the central line, extreme age, and skin burn intensify the infections. Femoral central venous continues to escalate the central line-associated bloodstream infections, followed by the subclavian catheters and the internal jugular. Other associated risk factors include the conditions of the insertion of the medical operations, the skillful nature of the operators, and the catheter care. With prolonged administration of broad-spectrum antibiotics, hematologic malignancy creates resistance to the anti-microbial therapy (Haddadin & Regunath, 2019). The clinical manifestation of central line-associated bloodstream infections varies based on the state of the illness. The common manifestations include fever and chill, which are masked by the patient’s immune-compromise nature. The patient may also report pain, discharge from the exit site, and swelling.
Potential Solution of the Central Line-Associated Bloodstream Infections
After the suspecting central line-associated bloodstream infections, empiric therapy should be administered based on the most probable organism and the clinical picture. The healthcare provider should institute empiric treatment by covering the gram-positive and the gram-negative. Healthcare providers should also enhance hand hygiene and apply appropriate skin antiseptic for prevention. The sin prep agent should be completely dry before inserting into the central line (Haddadin & Regunath, 2019). During the insertion, the healthcare provider should use the cap, the mask, sterile glove, sterile gown, and the sizeable sterile drape. The patients should research the hospital to learn about central line-associated bloodstream infections. They should also speak on the concerns to enable the healthcare personnel to follow the appropriate precaution for mitigating the detriment. Avoiding ouches on the tubing by the patient will create a hygienic environment hence preventing infections (Haddadin & Regunath, 2019). Every patient must wash her hands before and after visitations.
The Catheter-Associated Urinary Tract Infections (CAUTI)
Catheter-Associated Urinary Tract Infections are illnesses acquired in hospitals and occur due to the prolonged use of urinary catheters. The infections affect the urinary systems like the bladder, uterus, kidney, and urethra. As such, the illness gets referred to as urinary tract infections. The tube insertion into the bladder through the urethra to drain the urine has caused 75% of the infections. The infection occurs in the patients admitted to the intensive care unit hence the prolonged hospital stay makes control difficult. The common etiological agents are the gram-positive bacteria like the Enterococcus faecalis and the gram-negative bacteria like the Pseudomonas species and the Proteus mirabilis (Su et al., 2020). Healthcare providers frequently report Yeast infections like the candida species. Common drug resistance development, which occurs with urinary tract infections, has led to the growth of pathogens. Other causes include extreme age, the female gender, diabetes mellitus, dwelling urinary devices, and immunosuppressive therapy.
Potential Solutions to the Catheter-Associated Urinary Tract Infections
Healthcare providers should enhance hygiene by hand washing and avoiding the use of urine drain tubes. If the urine drains tubes are used by the doctor, they shod be appropriately inserted and put in only, when necessary, as soon as needed. The core preventive strategies are leaving the catheters in place when needed, ensuring that the trained catheters implement the insertion and the maintenance of the catheters, following the aseptic insertion and maintenance of the hand and the standard hygiene (Su et al., 2020). The doctors should also avoid using urinary catheters in nursing homes and inpatients for incontinence management. Healthcare providers must research before using catheters to prevent skin breakdown. Medical service providers should consider using external catheters to replace indwelling catheters for male patients with no urinary retention. The healthcare providers should maintain the unobstructed urine flow and follow the aseptic insertion while maintaining the closed drainage system (Su et al., 2020). Furthermore, healthcare service providers should use sterile gloves, drapes, sponges, and sterile solutions to clean the peri-urethral.
Ventilator-associated Pneumonia
Ventilator-associatedPneumoniaa isPneumoniaa acquired from e hospital through the use of ventilators. It occurs 48 hours after the mechanical ventilation, where the ventilator has a high mortality rate. It causes the patient to have challenges with weaning off the ventilators and longer duration of the hospital stay (Wanat et al., 2020). Therefore, it causes a financial burden and the demand for medical resources. Ventilator-associated pneumonia symptoms are fever, worsening oxygenation, increased tracheal secretions, and an increase in white blood cell counts. The diagnosis is based on the clinical presentation, positive blood culture, and chest x-rays. Bronchoscopic sampling in the lower respiratory tract combined with the quantitative gram strains and culture helps diagnose. Treatment is made using antibiotics (Wanat et al., 2020). The risk factors include endotracheal intubation, which beaches the airway’s defenses, impairing the mucociliary clearance and facilitating the microaspiration of the bacteria-laden secretin. Consequently, bacteria may form the biofilm within and on the endotracheal tube, which protects them from the host defense and the antibiotics. The common pathogens include pseudomonas aeruginosa and the methicillin-sensitive Staphylococcus aureus.
Potential Solutions for the Ventilator-associated Pneumonia
Upright positioning reduces aspiration compared to recumbent positioning; hence, doctors should consider using semi-upright positioning during service delivery to the patients. Healthcare providers should also use noninvasive ventilators with continuous positive airways and bi-level positive airway pressure to prevent the beaching of the airway defense, which may occur with endotracheal intubation (Wanat et al., 2020). Also, the repeated aspiration of the subglottic secretin through a designed endotracheal tube with a suction device to reduce the microaspiration and VAP incidents prevents infections. Moreover, decontamination of the oropharynx using colistin, gentamicin, and vancomycin cream should be voided due to the possibility of developing resistant strains.
The Personal Impression Regarding the Infections based on the Past Learning Experiences and the Course Content
As a student of healthcare, the healthcare patient safety course has enabled me to understand healthcare-associated infections. Understanding the healthcare-associated infection has created comprehensive knowledge through which I can determine the symptoms associated with the ventilators associated pneumonia, catheter-associated urinary tract infections, and central line bloodstream infection. Also, the study and the identification of healthcare patient infection has created a mechanism of conceptualizing the ideas which help determine the possible solutions. The possible standard solutions to combined healthcare patient infections are the maintenance of hygiene, like washing hands and using appropriate medical procedures. Notably, past learning provides the knowledge through which I can quickly determine the instances of healthcare-associated infections. The safety of medical procedures and medical machines and instruments like ventilators play a significant role in enhancing medical sustainability and delivering medical services.
References
Haddadin, Y., & Regunath, H. (2019). Central line-associated bloodstream infections (CLABSI). StatPearls. StatPearls Publishing.
Su, M., Jia, Y., Li, Y., Zhou, D., & Jia, J. (2020). Probiotics for the prevention of ventilator-associatedPneumoniaa: a meta-analysis of randomized controlled trials. Respiratory care, 65(5), 673-685. http://rc.rcjournal.com/content/65/5/673.shortWanat, M., Borek, A. J., Atkins, L., Sallis, A., Ashiru-Oredope, D., Beech, E., … & Tonkin-Crine, S. (2020). Optimizing interventions for catheter-associated urinary tract infections (CAUTI) in primary, secondary, and care home settings. Antibiotics, 9(7), 419. https://www.mdpi.com/772250
Economics case study. Various theories have been advanced in regard to the origin of commodity money
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Economics case study
Various theories have been advanced in regard to the origin of commodity money. In this case, a critical assessment of Cigarette as one of the widely used item of trade in the Prisoner of war camps is under focus. Past literature indicates that during the World War II, there was intensive consumption of cigarettes among the soldiers, and this made it become one of the most coveted commodities in military camps. It is worth note, therefore, that, in the event, some of the soldiers were captured and held in POW camps; cigarette got even more use. The mechanism of interaction between the prisoners and the wardens facilitated conversion of cigarette as the medium of exchanging different items for survival in such camps. In response to the limited cigarette supply in the camps, its market generated a concept of commodity money as it was adopted as the item of acquiring other basic needs like food among others. There are some characteristics that qualified cigarette as a medium of exchange (Welch, Patrick, and Gerry 228). A former prisoner of war R.A. Radford authored an article Economica highlighting the concepts surrounding cigarette and its general acceptance within the camps as commodity money. Cigarette was relatively uniform within the camp economy, desirable, and had light weight for portability.
With increasing trade volume across different regions within the POW camps, complex case, arose and cigarette supply began to dwindle. The Red Cross that was the sole supplier of cigarettes began to bring pipe tobacco in lieu of cigarettes forcing the prisoners to alter their quantity by squeezing out some. The ensuing repackaging was a case of debasement and traders began to lose confidence in using cigarette as commodity money. The change in supply of cigarette was based on the prevailing war climate which in turn affected cigarettes issued by Red Cross and forces of demand and supply hence influenced inflation and deflation.
In the Island of stone, the increasing need for other products led to the adoption of the stone as medium of exchange. Although the stone had some evident disqualifications of being money, it was still generally accepted, and this certified its adoption. Use of the voluminous stone in Yap provides a good ground to understand what money is. Although an item may not meet all the characteristics of the US dollar for instance, it may still be used as a medium of exchange therefore qualifies to be money. The strange case of this stone is that it sunk below the ocean but was still considered to be holding a given unit of wealth and therefore continue to be used to exchange goods (Lal, Brij, and Kate 140). This stone can be compared to the contemporary virtual money that just exchange hands online but cannot be physically touched. Take the case of electricity bill clearance online where only figures change on the individual account balance; so is the case of stone which was used as a medium of exchange despite physical absence. In respect of this case, FEI qualifies as money since it’s held in trust of the people by authorized agency and generally accepted as a safe mode of transaction. It is worth to note that FEI is fiat money since it is considered legal as medium of exchange by the socio-political and economic authorities. Despite non-universality, it serves given section of society in the world as a legal tender hence its qualification as Fiat money. It is imperative to underscore the significance of confidence people hold on Fei its usefulness as Fiat money.
Works Cited
Lal, Brij V, and Kate Fortune. The Pacific Islands: An Encyclopedia. Honolulu: the University of Hawai’i Press, 2000. Print. 140
Welch, Patrick J, and Gerry F. Welch. Economics: Theory and Practice. Hoboken, N.J: Wiley, 2009. Print.228