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Introduction to Multiple Sclerosis
Multiple Sclerosis
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Introduction to Multiple Sclerosis
Notably, diseases are the primary cause of disabilities and mortality among humans since their civilizations. Conditions and disorders present in various forms targeting various organ systems hence interfering with the normal physiology. Multiple sclerosis is one of the significant chronic inflammatory diseases. Ideally, the main characteristic of the disease is the presence of lesions on the central nervous system (CNS) and, in turn, results in cognitive as well as physical disabilities. The main cause and condition’s progress remain unclear. However, different studies have tried to map the disease’s pathogenesis, diagnosis, factors, and treatment plans.
Studies by Ghasemi, Razavi & Nikzad. (2017) have demonstrated the multiple factors in MS’s etiology and pathogenesis. Importantly, their studies highlighted the role of environmental factors and the genetic predisposition in the disease onset. There is a need to understand the etiology, pathogenesis, prevalence, and the various diagnostic approaches for the disease. The understanding would be relevant in enriching the existing body of knowledge and preventing and managing the disease.
Incidence of Multiple Sclerosis and Impacts it has on the Society
In line with its names, a multiple sclerosis is primarily a form of a demyelinating condition. The condition gained interest in the last two decades, where scientists focused on understanding the primary cause of disabilities in human beings’ lives. This has also been an approach to developing various pharmacological agents to targets certain conditions and alleviate suffering in the individual’s lives (Boru et al., 2018). Most cases present MS as an autoimmune disease and the most prevalent illness in neurological disabilities. People suffering from the condition have the low cognitive ability, physical incapacitation. The most devastating aspect is the emerge of the during the early adulthood phase; the disease lowers the quality of life and results in dependency to perform necessary daily activities.
MS appears as chronic inflammation and damage to the white matter in the CNS myelin. It is still unclear as to why the disease does no cause inflammation of the peripheral nervous system. In the united states, there are about 400,000 people affected by the condition (Boru et al., 2018). Gender, in most cases, influence the pathogenesis of a disease. The presence of defective chromosomes in males does not spare them from inheritable conditions.
On the other hand, the two XX chromosomes’ presence may exacerbate the genes’ translation resulting in the disease. For MS, more women than men suffer from the condition. Notably, some highlights indicate that the typical onset of the illness is between ages 30 and 40 (Boru et al., 2018). Studies by Boru et al. 2018 have highlighted the significant aspect of its prevalence in the world. Boru et al. (2018) noted that there had been a considerable increase in the number of cases globally, with about 2 million people living with the condition. Boru et al. 2018 points out that the disease is quite prevalent in the Mediterranean region in a country like Turkey. Boru et al. carried studies in turkey to understand the prevalence of the disease in the community. The result presented important information about the disease, with most cities having a prevalence of 41-101/100,000 (Boru et al., 2018). This helps us understand the distribution of the disease in these countries. Also, the condition is prevalent among people of northern European ancestry and less common among Asiatic groups (Norris & Lalchandani, 2018). Prevalence in these regions appears to align with the immigration of people with some defective genes.
Impacts on the Society
Multiple sclerosis is a long-life condition that interferes with the normal functions of the patient’s body. The disease increases the risk of cardiovascular diseases, coordination challenges, mental and emotional, sexual dysfunction. The condition improves the years of living with disability and predominantly increase dependency for daily life activities (DLA) (Eades et al., 2014). Patients living with mental and physical needs must have people take care of their well-being, such as feeding—the disease condition increases suffering in society; the disease causes economic struggle in families. Sometimes the disease affects a family’s breadwinners, resulting in some extents of poverty in the families.
Significantly, it interferes with the community’s overall wellness as people have to focus on understanding how to handle the condition in challenging times. The disease affects the well-being of the patients; most of the patients feel demoralized due to disabilities (Eades et al., 2014). The disease affects an individual’s sex life; therefore, getting a supportive partner is crucial in helping patients go through challenging conditions (Eades et al., 2014). Due to multiple sclerosis’s overall health implications, there is a shift in roles for partners, which sometimes calls for some understanding levels. If the relationship previously suffered from commotions, the disease presence can result in some people deserting their lovers.
Discussing the impacts of multiple sclerosis with parents and partners is crucial. This helps prepare them psychologically for the challenges that occur with the disease (Eades et al., 2014). These discussions are relevant as they help prepare parents and other family members for the presenting difficulties. Families are crucial in providing support in chronic disease conditions. Preparing the family for the ailment ensures that one has full support if they develop some forms of physical disabilities (Eades et al., 2014). This is crucial in improving patients’ well-being and boosting their morale to living with the condition. Multiple sclerosis impacts patients’ social life; for instance, some of the disease manifestations prevent them from engaging in specific activities such as running. The main challenge that would appear is maintaining an active life despite the disabilities that present. Patients may feel uncomfortable in various places if they have unique treatments. Such feelings increase anxiety and distress among patients; the family must stand with their ailing relative in the disease course.
Pathophysiology of Multiple Sclerosis
Etiology
The chronic demyelinating condition occurs due to the damage and degradation of the myelin sheath. Multiple factors contribute to the deterioration of the myelin sheath, which increases the oligodendrocyte damage, particularly in the presence of type 1 steroid receptors. Studies highlight the role of steroid receptors in the development of the condition. The rising number of unbound Vitamin D receptors in the brain predispose people to develop multiple sclerosis (Lundsgaard, 2017). Regarding the receptor’s role, excess receptors lead to aggregates and which sometimes results in a massive release of zinc.
Zinc, on the other hand, plays a crucial role in the hyperphosphorylation proteins found in the neurons (Tau proteins). The presence of steroid receptors in the cytoplasm plays an essential role in the pathogenesis of the condition. These receptors are predominant in people with sex hormone problems attributed to multiple sclerosis. Such understanding provides a detailed picture of pharmacological agents’ role to disintegrate the steroid receptors in the brain (Lundsgaard, 2017). Some theories counteract MS is an autoimmune condition. However, there is a belief that oligodendrocytes’ internal changes and damage to myelin elicit immunological reaction within the central nervous system. Family history plays an essential role in predicting if one will get trapped by the condition. Notably, family history increases the chances of an individual developing MS by about 10 to 20 percent. Another factor that promotes an increase in the condition’ risk is the halotype for human leukocyte antigen HLA-DR2.
Pathogenesis
Multifocal inflammation in the CNS due to various immunological cells’ infiltration plays an essential role in the disease progression. Immunological cells affect the function of the oligodendrocytes (Norris & Lalchandani, 2018). These cells increase the inflammation in the CNS’ gray matter, causing nerve fibers’ demyelination. The inflammatory process results in the formation of plaques in the brain that interferes with impulses conduction, which increases neuronal dysfunction. The effects of the inflammatory process interfere with the conduction of impulses in the sensorimotor and the autonomic nervous system (Norris & Lalchandani, 2018). Development of neuropathies in these branches of the CNS results in manifestations such as sexual dysfunction, fatigue, irritability and instability of emotions, physical disabilities, and visual disturbances.
The role of immune cells and various cytokines is elaborate in the disease progression. The most predominant is the release of triggers of immune reactions, including interleukins and cytokine following the CD4+ cells’ infiltration and the T-helper cells (Ghasemi, Razavi & Nikzad, 2017). Constant reactions induce the building of an adaptive immune response. Cells in the gray matter present various receptors, such as type I steroid receptors (Ghasemi, Razavi & Nikzad, 2017). Immunological cells such as the T lymphocytes bind to these cells and release cytokines and interleukin, which attract other cell types into the target region.
Binding of antigen-presenting cells (APCs) by CD4 and the T lymphocyte promotes interleukin production (IL)-12, IL-4, and IL-23 (Ghasemi, Razavi & Nikzad, 2017). These interleukins promote the proliferation and the differentiation of the CD4+; this leads to Th1 and 2, respectively. T help cells formed can produce cytokines (Ghasemi, Razavi & Nikzad, 2017). On the other hand, these cells release interferon-gamma and other pro-inflammatory chemicals, promoting the inflammatory process. CD8+ is crucial in the roles in the formation of the MS lesion in the CNS.
The proposed model of action of these cells includes the formation of cytolytic cells upon binding APCs. The oligodendrocytes in patients with MS present various antigens, binding of the CD8+ increases apoptosis of these cells, implicated in the disease progress (Ghasemi, Razavi & Nikzad, 2017). Fas ligand secreted by the lymphocytes binds on the tumor necrotic factor receptors (TNF) appearing on the oligodendrocytes, thus initiating apoptosis (Ghasemi, Razavi & Nikzad, 2017). The high rates of apoptosis of the oligodendrocytes decrease the number of cells synthesizing myelin sheath and increase demyelination.
Environmental Factors
Exposure to various diseases and condition exacerbates the development of multiple sclerosis. People with a direction to viral agents such as the Epstein Barr Virus (EBV), the mycoplasma, herpes simplex virus 6, smoking, and deficiency of specific vitamins have elevated chances of developing MS (Ghasemi, Razavi & Nikzad, 2017). The intruding elements, in some cases, have proteins with structures homologous to the myelin sheath. The proteins elicit an immune response and latter increase the risk of an individual’s immune cells attacking the myelin cells, forming lesions. Nitric oxide and carbon monoxide from smoking are toxic to the oligodendrocytes, which interferes with myelin sheath synthesis (Ghasemi, Razavi & Nikzad, 2017). Genetic factors also play a crucial role in the etiology and progress of the disease.
Clinical Manifestation
MS results in the demyelination of essential nerve fibers in the gray matter and the CNS. Fiber demyelination decreases the impulse’s transmittance from various receptors or organs in the body with the brain (Norris & Lalchandani, 2018). Besides, demyelinated fibers reduced the velocity of impulse from different locations to the brain; this, in turn, results in various abnormalities. The manifestation of the disease depends on the nerve fibers affected (Koriem, 2016). If the lesion occurs in the region involved in controlling the limb’s movement, physical disabilities develop. Sometimes the damage of optical nerves by the inflammatory activities results in vision problems.
Lesions on the corticospinal tract interfere with the muscle activities while on the cerebellar lot increases gastrointestinal tract dysfunction. In the extremities, peripheral neuropathies develop with a burning sensation, tingling, numbness, among others—the symptom of MS range from asymptomatic to severe cases (Koriem, 2016). The interference of impulse’s conduction affects different regions and may present sexual and bladder dysfunction, corrupted gain (Norris & Lalchandani, 2018). There are occasional relapse of the disease symptoms and the deterioration of the sign as the disease progress. Continuous damage to the nervous fibers increases individuals’ vulnerability, affecting the different presentations of the condition.
Diagnosis for Multiple Sclerosis
The diagnosis of MS is crucial in enabling people to develop the best management program. Ideally, there is no single ideal diagnosis approach for the condition. A multitude of the test must be available to validate the presence of the disease in individuals (Norris & Lalchandani, 2018). The advanced cerebrospinal fluid analysis is a significant example of tests used to unmask the presence of MS. An MRI scan had made it possible for a pathologist to diagnose the condition. The evidence of specific symptoms such as those recorded in a clinical history with symptoms persisting for more than six months. MRI scans are crucial in identifying lesions on the brain, which may appear familiar with the use of computed tomography. Computed-MRI helps in the identification and establishment of the sizes of the lesions (Norris & Lalchandani, 2018). This is crucial in understanding the disease’s progress.
The documentation and analysis of the lesion is possible through the use of CT and electrophysiological evaluation (Norris & Lalchandani, 2018). These approaches should be supported by the laboratory analysis of the cerebrospinal fluid. Laboratory analysis should present and elevation of the immunoglobulin G (Koriem, 2016). Further evaluation should establish specific proteins in the CSF, markers of the inflammatory process within the cranium region.
Advancements in laboratory technologies have enhanced diagnosis of MS. The main role of using differential diagnosis is focus on the disease by ruling out other conditions that cause lesion in the brain. Relapse is crucial in establishing if a condition is MS (Ömerhoca, Akkaş & İçen, 2018). CT and MRI scan can be crucial in establishing these patterns. MRI that can capture inflammatory demyelinating data could be crucial for patients without relapse. MRI scan can help in analysis of lesions could be crucial in differentiating them from Schilder’s disease lesions (Ömerhoca, Akkaş & İçen, 2018). A combination of MRI and various laboratory analysis are crucial in differentiating MS from other conditions such as paraneoplastic neurological syndrome and Sjogren syndrome.
Collaborative Treatment/ Management of MS
The prominent approach in this disease condition involves managing the symptoms. Treatment of the state becomes difficult with the lack of a single diagnostic method and the tricky aspect of the disease. There is no need for promoting therapy in asymptomatic patients. These patients, however, should avoid factors that exacerbate the disease condition (Norris & Lalchandani, 2018). They should ensure that they lead a healthy lifestyle, such as observing the nutritional requirement. For instance, these patients should ensure that they have adequate vitamin D levels as it has a vital role in modulating the immune system.
Patients should adopt a relaxed mode to maintain a healthy lifestyle; however, they should engage in non-straining activities. Patients with muscle problems should engage in some physical exercises to enhance muscle relaxation and tone (Norris & Lalchandani, 2018). On the other hand, patients should seek family members and counselors support if they have psychological problems such as emotional stress. Moreover, they should make an effort to lead a stress-free life and avoiding extreme environmental factors.
Pharmacological agents also play an essential role in the management of MS. The physician should focus on agents that restore the myelin sheath and also decrease incidences of pain. Most of the treatment plans use corticosteroids as the first-line agent in the treatment of MS. The use of these agents should be short-term to avoid the harmful effects of the disease. Intravenous immunoglobulin may also decrease symptoms of the condition (Norris & Lalchandani, 2018). A physician may also promote the use of disease course modifying agents, including glatiramer acetate and beta interferons. Products with immunomodulatory effects may also be relevant in patients; these include products such as Mitoxantrone. Caregivers may also recommend using an agent that reduces constipation, such a diet rich in fibers.
References
Börü, Ü. T., Bilgiç, A. B., Köseoğlu Toksoy, C., Yılmaz, A. Y., Tasdemir, M., Sensöz, N. P., … & Bölük, C. (2018). Prevalence of multiple sclerosis in a Turkish city bordering an iron and steel factory. Journal of Clinical Neurology, 14(2), 234-241.
Ghasemi, N., Razavi, S., & Nikzad, E. (2017). Multiple sclerosis: pathogenesis, symptoms, diagnoses and cell-based therapy. Cell Journal (Yakhteh), 19(1), 1.
Koriem, K. M. M. (2016). Multiple sclerosis: New insights and trends. Asian Pacific Journal of Tropical Biomedicine, 6(5), 429-440.
Lundsgaard, E. (2017). Etiology of Multiple Sclerosis. Mul Scler, 4(214), 2376-0389.
Norris, T. L., & Lalchandani, R. (2018). Porth’s Pathophysiology: Concepts of Altered Health States. Lippincott Williams & Wilkins.
Ömerhoca, S., Akkaş, S. Y., & İçen, N. K. (2018). Multiple sclerosis: diagnosis and differential diagnosis. Archives of Neuropsychiatry, 55(Suppl 1), S1.
Eades, J., Graham, A., Gray, T., Hayworth, P., Hoenen, S., Katona, J., … & McRae, W. H. (2014). Multiple Sclerosis Society of Canada 1979, 1982, 1984, 1986, 1988, 1991, 1992, revised 1998, 2000, 2001, 2005, 2008, 2012 and 2014. Printed in Canada© 2014 Multiple Sclerosis Society of Canada Original text by Deanna Groetzinger.
This essay outlines the social and cultural factors that may have influenced the increasing rate of asthma morbidity within N
Morbidity (Asthma In NZ)
This essay outlines the social and cultural factors that may have influenced the increasing rate of asthma morbidity within New Zealand. The issues that will be discussed at length include the latest facts and statistics of asthmatics provided by the New Zealand Asthma & Respiratory Foundation, the characteristics and symptoms of asthma and the socio economic problems that are often associated with the disease.
Asthma, disorder of the respiratory system in which the passages that enable air to pass into and out of the lungs periodically narrow, causing coughing, wheezing, and shortness of breath. This narrowing is typically temporary and reversible, but in severe attacks, asthma may result in death. Asthma most commonly refers to bronchial asthma, an inflammation of the airways (Marieb, 2001).
To understand asthma, it is important to have a basic understanding of how we breathe and the anatomy of the lungs. We breathe in air through the nose and mouth and the mucosal lining of these areas are warm and moist. This means the air we breathe in is warmed and moistened before it reaches the lungs. Additionally, mucous traps all foreign particles so as to prevent them from entering the lungs, which could cause infection. (Marieb, 2001).
In New Zealand, The Asthma & Respiratory Foundation (1999) has stated that the morbidity of asthma has increased predominately amongst children and young adult sectors of the population, although the reasons for this still remain unexplained. An international study spanning 56 countries revealed that New Zealand has the second highest rate of asthma in the world, particularly among fourteen year olds at a rate of 30.2 percent, second only to the United Kingdom at a rate of 32.2 percent. Australia follows having the third highest rate of 29.4 percent (Asthma & Respiratory Foundation, 1999).
The International Study of Asthma and Allergies in Children showed a tendency for a higher incidence of asthma in more economically developed western countries as opposed to poorer, under developed countries. Studies are currently being conducted to understand and identify reasons for this. Economic conditions, our diets, immunisation programmes, climate conditions, community health care standards and rates of Tuberculosis and other respiratory infections are being investigated and compared to other countries with lower morbidity statistics (Asthma & Respiratory Foundation).
The burden of asthma in New Zealand outlines the extent and impact of asthma, and presents compelling evidence that the condition needs to be taken more seriously. Asthma affects approximately one in six New Zealanders usually beginning in childhood (Asthma & Respiratory Foundation, 1999). It is a concern that although it is part of a world wide trend, the prevalence of childhood asthma in New Zealand has increased over the past 20 to 30 years. An estimated 44 percent of New Zealand children experience asthma symptoms at sometime before they reach the age of fifteen. Reasons for this still remain unclear. Fortunately however, few New Zealand children die from asthma, statistically every year one to four children die from asthma. It is said that improved medication and clinical management has played a major role in the prevention of deaths (Asthma & Respiratory Foundation, 1999).
Statistics supplied by the New Zealand Asthma & Respiratory Foundation (1999) state that in our country around 450,000 people in 1993 were diagnosed with asthma. Of these, 170,000 were children aged 0 to fourteen. The rate of increase is estimated to be 50 percent every ten to fifteen years.
Asthma costs New Zealand an estimated $825 million per year in total. This accounts for the 450,000 New Zealanders who have been diagnosed with asthma, the direct costs of health services, and the indirect costs due to lost productivity within the work force. It’s estimated that an enormous 990,000 days are lost due to asthma each year. In 1997, 10,539 people in total were hospitalised due to asthma. Statistics show that children have over three times the hospitalisation rate of adults. (Asthma & Respiratory Foundation, 1999).
The average cost of an asthma admission in 1991 was $1,594. Every year, there are around 6000 hospital admissions for asthma among children alone. Using these figures the cost to New Zealand of hospitalisation for childhood asthma is at least $9.5 million each year. Up to 75 percent of children with asthma continue to suffer from the disorder through puberty and adulthood (Asthma & Respiratory Foundation, 1999).
Although asthma is very common in New Zealand and a wide range of New Zealanders are affected by it, Fergusson (1997) comments that patients admitted to hospital with acute asthma are often severely economically disadvantaged. Thirty three percent of patients receive a social welfare benefit as their only means of support, forty percent postpone going to the doctor because of the expense. A further twenty six percent have difficulty managing an asthma attack due to concerns they have about taking time off work (Fergusson,1997).
Those economically disadvantaged are more likely to seek a health professional at the beginning of a week. There is no clinical reason for the day of the week itself being responsible for triggering an asthma attack however, it is argued that patients tend to wait the duration of the weekend simply because the cost of after hours healthcare is too costly (Fergusson, 1997), With a community services card, visiting a healthcare professional equates to forty dollars during the weekend, on the other hand, with out a community services card, the total cost amounts to fifty-five dollars taking into account that these figures do not include prescriptions (Primecare, 2002).Therefore its suggested that they tend to seek help during normal consulting hours where the expense is less. It is also assumed that the delay in seeking medical attention during weekends could be due to the patient preferring to wait till his or her own general practitioner is available (Kljakovic & Salmond, 1996).
The latest findings from a survey done on lower socio-economic people by Crampton, Salmond, Blakely & Chapman (2000) found that this portion of society had poorer health than their wealthier counterparts. Their findings also point out that it is not just the level of poverty that affects a person’s health, but also the available resources in society. No matter how rich or prosperous a population or country may be, a social gradient of health will always be obvious, as those economically lower down the scale are more likely to have health of inferior quality than those above them.
A health survey conducted in 1996/1997 showed that the rate of asthma in New Zealanders was only slightly higher in Maori than non-Maori, particularly for Maori men (16.4 percent compared to non-Maori men 13.3 percent). Of Maori women surveyed, 20 percent has asthma compared to 18.7 percent of non-Maori women. This was an improvement for statistics gathered in 1994 that showed Maori were almost 50 percent more likely to develop asthma than non-Maori. In 1997, the rate of hospitalisation for Maori was twice as high as the rate of non-maori. Those of pacific decent however, had relatively low rates of asthma in the 1996/1997 health survey (Asthma & Respiratory Foundation, 1999).
Despite worldwide research, The New Zealand Asthma & Respiratory Foundation (1999) say there is as yet no definitive answer why some people suffer from asthma and others don’t, though links have been made to diet and overexposure to dust mites and other allergens. Approximately 70-80% of asthma in New Zealand is associated with allergy. Sometimes more than one part of the body can be affected, which is why people with asthma often also suffer from hay-fever and eczema (Allergy Centre, 2002).
The most common causes of asthma attacks are extremely small and lightweight particles transported through the air and inhaled into the lungs. When they enter the airways, these particles, known as environmental triggers, cause an inflammatory response in the airway walls, resulting in an asthma attack (DuBuske, 1999).
In many people, an asthma attack may be brought on by exposure to allergens, substances that can trigger allergic reactions in susceptible people. Pollen grains, cigarette smoking, house dust, and dust mites are some of the most common and pervasive allergens (DuBuske, 1999). The dust mite is a microscopic insect that lives in human homes, where it feeds on the dust produced by human and animal skin. Dust mites are not harmful in themselves, but their droppings, which contain left-over digestive enzymes, are a significant cause of asthma and other allergic diseases (Lowhagen, 1999).
According to the Asthma & Respiratory Foundation (1999) statistics, one third of ten to fourteen year olds report some form of exposure to tobacco smoke at home. They also state that children exposed to tobacco smoke are 50 percent more likely to suffer from asthma than children not exposed and have estimated, that if no adult smoked when near children, 15,000 fewer New Zealand children would suffer from asthma. Laugesen (1996) makes the point that this cycle is likely to continue as children whose parents smoke are also more likely to take up cigarette smoking.
Asthma also occurs in people who do not have allergies. In these people, chemical irritants trigger an inflammatory response that is initiated in a different way than in allergen triggered asthma. For example, some people are sensitive to certain common chemical irritants, such as perfume, hairspray, cosmetics, and household cleaners. Other chemical irritants include industrial chemicals and plastics, as well as many forms of air pollution, such as exposure to high levels of ozone, car exhaust, wood smoke, and sulphur dioxide. Current research seeks to determine whether indoor pollutants also contribute to the development of asthma (Lowhagen, 1999).
Research also suggests that genetic factors may increase the risk of developing the disorder. Children with a family history of asthma are more likely to develop asthma than other children. Despite this apparent genetic link, many people without a family history of asthma are still eligible to develop the disorder, scientists continue to investigate additional causes (Valacer, 2000).
A recent paper presented by the Wellington Asthma Research Group showed that antibiotic use, especially in the first year of life, is associated with a fourfold increase in the likelihood of asthma (Asthma & Respiratory Foundation, 1999). Many Parents become concerned when they learn their child needs asthma medicines, particularly when they are required several times each day. They worry that the medicine will harm their child and that they may become addicted to them or that the medicines loose the effectiveness through repeated use (Sears, 1989).
Fergusson (1997) states that asthma educators need to acknowledge the influence of social, economic and psychological factors on education initiatives. Its argued that these factors need to be recognised and incorporated into educational programmes for a reduction in morbidity to occur. This approach would enable a patient to understand their specific patterns and early warning signs and implement improved self-management actions to reduce the severity of future attacks. It is vital that treatment programmes are targeted to meet the specific needs of the patient, allowing them to have a role in decision making about such treatment (Stodart, 1995). It is also vital that treatment programmes are targeted to meet specific needs of the patient, which could mean allowing them to have a role in decision making concerning treatments.
Dickson (1992) concurs that to establish good asthma control, it is important that a child receives regular check-ups by a health professional. It is also important that the family is taught how to monitor symptoms and know at which point to take action. The aim of asthma management is to enable normal participation in activities such as exercise, minimising school absences as 550,000 school days are lost per year due to asthma (Asthma & Respiratory Foundation, 1999), eliminating symptoms such as a night cough, and by encouraging normal healthy growth and development (Dickinson, 1992).
Educating a person with asthma means assessing them and finding out what they need at the present time, rather than just passing on a lot of information, which the patient may or may not be ready to hear. Working with the person with asthma could, among other things, involve counselling or helping them to gain access to other services (Stodart, 1995).
Stodart (1995) reflects that asthma education is not just physical care. One of the problems an educator can have working with people with asthma, is seeing the difficult social situations some are in and the problems they have in getting the help they need, such as prescriptions and doctors visits. A person may have numerous problems of which asthma is just one. An educator’s main role is to teach preventative strategies. However where appropriate, other social service agencies should be suggested for assistance with any other problems the client might have that may be impacting on their illness.
In conclusion, many psychosocial factors influence increased morbidity in New Zealand. There is a need for an integrated approach to asthma management, and for increased co-ordination between secondary care and primary care services. We know that good medical advice, appropriate medication and education used within the framework of a written asthma self-management plan can significantly reduce morbidity from asthma among adults and children within New Zealand. Adequate funding needs to be available to ensure that people with asthma can access this regardless of their financial situation. Educators must also ensure that both social and cultural issues are taken into account when assessing the needs of children and adults with asthma. Only then, can we hope to achieve the positive results of an improvement within New Zealand amongst asthma sufferers.
Bibliography:
Allergy Centre, worldwide web retrieved September 28 2002 www.asthmanz.co.nz
Asthma and Respiratory Foundation of New Zealand. (1999) Latest facts and statistics, June 1.
Blakely, T, Chapman, HP, Crampton, P, & Salmond, C.
(2000). Social Inequalities in health. New Ethicals Journal,(3),11.
DuBuske, LM. (1999). The link between allergy and asthma. Allergy & Asthma Proceedings, 20:341-5.
Fergusson, W. (1997). Promoting effective asthma education. KaiTaiki: Nursing New Zealand,3,(10)13-15.
Kljakovic, M. & Salmond, C. (1996). The pattern of consultations for asthma in general practice over 5 years. New Zealand medical journal,1016,(109),48-50.
Laugesen, M. (1996). Asthma in New Zealand facts and statistics. Health New Zealand, August, 3-5.
Lowhagen, O. (1999). Asthma and asthma-like disorders. Respiratory Medicine,93:851-5.
Marieb, E.N, (2001) Fifth edition Human Anatomy & Physiology,23:876.
Primcare, Information retrieved October 2nd 2002.
Sears, M. (1989). Asthma in infancy and childhood No 3. Wellington: Madison.
Stodart, K. (1995). Building a foundation – asthma a special supplement. Kaitaiki: Nursing New Zealand,1,(1), 16-17.
Stodart, K. (1995). Teaching what’s needed – asthma a special supplement. Kaitaiki: Nursing New Zealand,1, 16-17
Valacer, D.J, (2000). Causes, epidemiological factors and complication Childhood Asthma, 59: 43-45.
PD Ratio of McDonalds
Module Title
Table of Contents
TOC o “1-3” h z u 1. P:D Ratio of McDonalds PAGEREF _Toc93917646 h 11.1 Evaluation of the Current Production Strategy PAGEREF _Toc93917647 h 11.2 Impact of the JIT on Forecasting, Capacity and Inventory Management PAGEREF _Toc93917648 h 12. Fluctuating Demand Pattern PAGEREF _Toc93917649 h 22.1 Options The Company Has To Improve Its Ability To Meet This Demand PAGEREF _Toc93917650 h 32.2 Recommended Option PAGEREF _Toc93917651 h 43.0 Logistics & Operations Management PAGEREF _Toc93917652 h 43.1 Definition of Logistics PAGEREF _Toc93917653 h 53.1.1 Product Lifecycle PAGEREF _Toc93917654 h 53.1.2 Logistics Process PAGEREF _Toc93917655 h 53.2 Right Product PAGEREF _Toc93917656 h 64. Cloud ERP (Enterprise Resource Planning) PAGEREF _Toc93917657 h 64.1 Advantages of Cloud ERP PAGEREF _Toc93917658 h 74.2 Significant Actions to take to Ensure Success in Implementing the Cloud System PAGEREF _Toc93917659 h 8
1. P:D Ratio of McDonaldsThe P:D ration of any operation with respect to the organization is the demand time ratio obtained through considering the customer wait time between request and receiving the same. It also looks at the complete time production of the said activity. Therefore, it also considers the length of operation in terms of processing information and materials from customer to the organization and back. McDonald’s P-D ratio is relatively low, meaning that the company takes less time to produce compared to what the consumer demands. McDonald’s has a 1:1 P:D ratio classifying the organization as a just-in-time company.
1.1 Evaluation of the Current Production StrategyIn inventory management, the term “just-in-time” refers to a technique in which products are ordered and delivered at the precise moment they are required in the manufacturing process. Ultimately, the purpose of this strategy is to lower the amount of money spent on overhead inventory charges in order to reduce costs as much as possible. The ability of a company to accurately estimate demand for its products and services is critical to the success of the just-in-time strategy. If we’re talking about the manufacturing industry, the “pull” style of inventory management is what is referred to in the expression just-in-time inventory system (Rivera-Gómez et al., 2019). The inventory is “drawn” and fresh manufacturing supplies are purchased to match the demand when sales activity necessitates an increase in production output. In turn, manufacturing works more smoothly, resulting in an overall reduction in inventory expenses. This method is based on signals that are sent out at various stages throughout the manufacturing process to inform the manufacturer when to begin production on the next part, and it is used to determine when to begin production on the following part. As inventory levels begin to deplete, it becomes important to place orders for new parts. When a just-in-time inventory management system is implemented, cash that would have been spent on inventory expenditures may now be employed elsewhere, resulting in significant savings. To give an example, facilities that were formerly used only for inventory storage are now available for use in manufacturing or for a variety of other purposes within the organization. Increasing revenues for the company is achieved through the reduction of waste and the lowering of inventory expenses.
1.2 Impact of the JIT on Forecasting, Capacity and Inventory ManagementJust-in-time (JIT) inventory systems are a technology that allows suppliers to integrate raw-material orders directly with production schedules when it comes to inventory management, in particular. They are employed by businesses in an effort to boost efficiency and reduce waste by procuring products only as they are required for the manufacturing process, therefore decreasing inventories and the related expenses associated with storage. In order to reduce inventory while also improving overall efficiency, JIT inventory solutions are used. Inventory costs are reduced in JIT manufacturing systems because companies only purchase materials and parts when they are necessary for production and do not have to pay storage fees (Rivera-Gómez et al., 2019). This reduces the amount of money spent on inventory. Furthermore, if an order is canceled or a project does not end on time as anticipated, manufacturers are not left with unsold inventory.
In addition to providing manufacturers with the ability to keep production runs short and migrate quickly and easily to new commodities if the need arises, just-in-time (JIT) offers a number of other benefits. Because of the advent of just-in-time delivery, organizations no longer need to retain a large amount of warehouse space to hold excess goods. In addition to saving money on raw materials for manufacturing, a corporation can use its cash flow for other reasons rather than spending significant quantities of money on raw materials. Notably, just-in-time inventory management ensures that inventory arrives only when it is required for manufacturing or to fulfill consumer demand, and that it does not arrive any earlier than that. Finally, but certainly not least, you want to eliminate waste while also boosting the efficiency of your operational processes. In order to achieve just-in-time delivery, long-term agreements with trustworthy suppliers are sometimes required. This is because quality, rather than the lowest price, is often the primary goal. A lean management method is what is referred to as just-in-time (JIT) manufacturing in the manufacturing industry. Everyone involved in the production or service system that is just in time (JIT), including humans, are interconnected during the course of a JIT manufacturing or service system (Rivera-Gómez et al., 2019). They work together and rely on one another in order to achieve effective results.
Supply chain disruptions can occur as a result of just-in-time inventory levels, which are maintained at optimal levels. According to industry experts, a single supplier of raw materials experiencing a breakdown and being unable to produce the items on time is sufficient to bring a manufacturer’s entire manufacturing process to a grinding halt. A sudden and unexpected surge in client demand for items that surpasses the company’s expectations may result in a scarcity of parts, which can result in severe delays in the delivery of finished products to all customers.
2. Fluctuating Demand PatternDemand in any sector is described as fluctuating significantly where changes in the economy and changes in consumer spending habits emerge. When it comes to customer demand, the only thing that is constant is its unpredictability. The ability to effectively estimate customer demand is a difficult problem for many firms. There have been moments of extreme overcapacity and difficulties finding adequate employment for owners of all types of service-based firms (Brunner et al., 2020). Both of these circumstances might be extremely damaging for a company’s bottom line. The capacity of a company may force it to turn away additional business since it will be unable to satisfy the deadlines. It’s possible that this will result in a loss of revenue for you. When there is not enough work, resources that are compensated but do not generate money for the organization can readily be identified as the cost of inefficiency, which can be calculated. It is for this reason that when the popularity of a product fluctuates over time, it is referred to as “demand fluctuation.” Changes in demand, whether direct or indirect, have an effect on purchasing behavior in a variety of ways. The demand for goods and services is influenced by a variety of factors such as seasonality, taxation, availability of products, and pricing. This is in direct conflict with the fact that demand remains stable.
2.1 Options The Company Has To Improve Its Ability To Meet This DemandInventory management is made much easier with a little amount of trial and error on the part of the manager. This is especially true when it comes to businesses that deal with strong demand during peak seasons or throughout the year. Businesses, both online and offline, are affected by seasonal fluctuations in the same way. When a product is in season, the supply of that commodity may run out quickly. In contrast, when the season or holiday season draws to a close, demand may begin to decline quickly.
Determine and categorize seasonal inventory as the first step in boosting a company’s capacity to meet this demand in order to increase profitability. Inventory may be separated into two categories: seasonal products and perennial products. Seasonal products are sold all year long, however seasonal demand spikes occur during certain seasons, making it easier to distinguish between the two types of products (Kantari et al., 2021). Fresh cream sales are particularly brisk during the holidays and Thanksgiving, owing to the fact that it pairs well with sweets such as pavlova, trifle, and pumpkin pie. However, if every other business in the industry followed similar, it is possible that customer rivalry would expand. To begin, you must determine how long your busiest periods will last in order to manage your schedule accordingly. Throughout the season, you will be able to assess your ability to respond to product sales and make adjustments as needed. The shorter the seasons, the more probable it is that you’ll have all of the goods you need on hand at the same time. When it comes to Valentine’s Day, the demand for roses in the color red increases significantly. It is possible to replenish products such as sun hats, sunscreen, and ice cream more regularly during the course of the year if the season is not too short. To effectively manage your inventory, you must ensure that your online sales correspond to the amount of physical product you have on hand. Websites should not list an item as “out of stock” if it is not actually unavailable. Provide customers with information in the case that an item is temporarily out of stock, such as whether or not another shipment is on its way. When customers discover that things they’ve added to their shopping basket are no longer available, they’re more inclined to switch to a competitor’s website.
Another way for improving demand forecasting accuracy is to employ demand forecasting and delay tactics in conjunction with one another. Predicting demand for seasonal inventory control is the most difficult aspect of the process. Despite the great range of seasonal forecasting techniques that are available, the best a company can hope for is an educated guess as to how many sales it should expect over a specific period of time It is particularly effective for recognizing possible problems with year-round perennial product replenishment and then using that knowledge to define minimum stock levels because historical data and seasonal swings may be evaluated. By switching to ATO production, it is possible to postpone the start of Make-to-Order (Assemble-to-Order) manufacturing (Kantari et al., 2021). Smaller firms that retain inventory at the sub-assembly level and only create products in response to specific customer requests have greater flexibility than larger businesses. An acceptable use for this would be the construction of numerous finished things from a single sub-assembly (or a group of sub-assemblies). Firms that go through this transition will be better able to adapt to and respond to changes in the marketplace. A number of sectors have already begun to include this into their overall supply chain strategy as a result. It is possible that switching from MTS to ATO is not the best option for many businesses. Before deciding to implement a delay plan, it is critical to conduct a thorough analysis of the company’s supply chain characteristics, including the degree to which sub-assembled goods can be interchanged, the length of manufacturing cycle durations, and the expectations of customers regarding delivery times. The ability of a supply chain to respond swiftly to changes in demand may be improved as a result of such a strategy shift, but the cost of implementing it may be prohibitively expensive. Making the move to assemble products on demand may need a firm to invest a large amount of money in making modifications to its supply chain activities (such as manufacturing, shipping, and so on), as well as its supporting systems and processes, in order to be successful.
Other options include keeping a supply of the substance on hand in case of an emergency. According to some experts, unpredictability in demand can be managed by storing a substantial number of commodities. When you have a sufficient amount of inventory on hand, demand swings are absorbed by the inventory. When it came to ensuring that there was adequate merchandise on hand in advance, this had traditionally been the standard corporate practice. Overstocking, on the other hand, depletes supply chain resources and increases operating expenses to levels that are no longer economically sustainable in today’s market (Brunner et al., 2020). Products with short life cycles and high obsolescence costs, such as those found in the high-tech industry, make it more difficult to deal with this problem. It is possible that an organization’s bottom line will suffer significantly if it retains an excessive amount of goods on hand during these circumstances.
2.2 Recommended OptionCompanies should utilize strategies to shorten cycle times as a final step. It is vital to lower the entire supply chain cycle times in order to accelerate the flow of information throughout the supply chain. Companies with shorter supply chains can share information and respond to changes more quickly than those with longer supply networks, owing to the shorter cycle times. When a corporation has this skill, it can better accommodate the desires of its customers more quickly. The entire supply-chain cycle time is computed by adding together the manufacturing and transit time components. When seeking to reduce cycle time throughout the supply chain, both of these considerations should be taken into consideration. Lean manufacturing strategies have been found to assist organizations cut cycle times by decreasing the amount of non-value-added tasks in the manufacturing supply chain. Advanced systems, which incorporate automation and analytical skills, can assist planners in making timely decisions by shortening the planning period and making it easier for them to develop many plans at the same time. Modern planning systems incorporate constraint-based planning methodologies, which enable firms to predict and alleviate supply chain bottlenecks before they become a major problem. As a result, the overall cycle time is lowered.
3.0 Logistics & Operations ManagementLogistics is a term that used while discussing the management of commodities during their journey from their point of origin to their site of consumption in order to suit the needs of customers or enterprises (Cambridge Dictionary, 2018). Material resources such as food, raw materials, animals, and machinery, as well as more abstract concepts such as time, data, and energy, are all managed under the aegis of resource management. It also includes the administration of information technology resources. Because of the use of logistical tactics, it is possible to accomplish this. Logistics encompasses a wide range of operations that are involved in the movement of tangible commodities (Alkhatib, Darlington, & Nguyen, 2015). Information flow, material handling, manufacturing, packing, inventory management and shipping are just a few of the activities that fall under the category of logistics. Specialized simulation technologies can be used to simulate and assess logistic operations, as well as to visualize and optimize them, in order to increase overall efficiency and reduce costs. When it comes to import and export logistics, the goal of preserving as many resources as possible is always at the forefront of everyone’s mind. Supply chain managers are responsible for developing sourcing and supply management plans for their products throughout the product lifecycle, from launch to end of life, and for ensuring that these plans are followed. Furthermore, they have the responsibility of ensuring that their items are delivered on time, if not early. Employees gain important insight into the marketing, operational, and financial performance of their company as a result of the planning and decision-making processes involved with lifecycle management, as well as into their own personal growth and development prospects. Managing and minimising risks connected with the supply chain can be more easily accomplished when providers adhere to the same set of selection and management requirements throughout the supply chain.
3.1 Definition of LogisticsWhen the term logistics is used in a professional setting, it refers to the control of product flow from the point of origin to the point of consumption in order to suit the needs of customers or enterprises (Chartered Institute of Logistics and Transport (CILT), 2018). The name logistics is derived from the Latin word for “flow.” According to its original meaning, the term logistics derives from a Greek word that literally translates as flow (Cambridge Dictionary, 2018). On top of that, logistics is responsible for the transportation of intangible things such as time and knowledge, in addition to the transportation of actual commodities. In many cases, the components of physical item logistics are the same across all of them. These include information flow, material handling and handling of products throughout production and packaging, as well as inventories and shipping and storage, to name a few instances of common components.
3.1.1 Product LifecycleAccording to the product, product lifespans can range anywhere from a few months to several years, depending on the product. In general, the life expectancy of an industrial metering valve, variable-speed motor, or vacuum pump is two to three years, which is considered to be the industry norm. Consumer goods that are driven by technological breakthroughs, such as computer monitors, e-readers, and snowplows, are examples of commodities that are only available during specific seasons or that are driven by technological advancements. Over the course of the twentieth and twenty-first centuries, the importance of supply chain management and customer demand has expanded in parallel with the expansion of the global economy. As the global economy continues to grow, both customer needs and supply chain management are becoming increasingly important components.
3.1.2 Logistics ProcessIn recent years, the introduction of logistics management, which has only been around for a little more than two decades, has raised the possibility of things reaching or exceeding client demand to a greater extent than in the past. In order to reduce costs while simultaneously increasing production and efficiency, corporations concluded that handling logistics on a system-wide basis was the most effective strategy, which they implemented. It is possible to optimize the logistics of delivering items to customers through coordination with suppliers, shipping providers, and warehousers (Council of Supply Chain Management Professionals, 2013). These services can then be merged via automated methods, which will help to lower overall expenses. As a result, prices are decreased, and delivery times are shortened. When determining the quantity of resources that will be necessary, effective strategic planning is vital. If this is not done, the estimate will be incorrect. When it comes to meeting the needs of its clients on time, it is vital for the company to acquire supplies as soon as possible and adhere to strict manufacturing deadlines. A thorough understanding of the logistics process from start to finish is required. For the purpose of developing a workflow plan that reduces expenses while simultaneously increasing visibility and improving general understanding of business requirements, it is critical to streamline communication and services across multiple departments. This is especially true when it comes to large organizations. When designing a workflow plan for a large organization, this is very critical. Businesses can save money by improving inventory management, reducing storage costs, expediting delivery to the end user, and purchasing based on supply forecasts, to name a few of the cost-saving strategies available today.
3.2 Right ProductA significant increase in customer expectations for faster product delivery has arisen as a result of the power of the Internet and social media to connect the global economy, which has resulted in a significant increase in customer expectations. When developing logistics strategies, it is critical to consider the location of facilities as well as the use of contemporary software systems that allow firms to receive purchase orders in seconds rather than minutes or hours. A vital component of achieving the best possible balance between reducing shipping costs and assuring on-time delivery of products or services is selecting the most appropriate mode(s) of transportation, and this is especially true for international shipping (Alkhatib, Darlington, & Nguyen, 2015). In order to supply end-user products and provide exceptional customer service, a comprehensive logistics management system must emphasize the importance of warehousing and transportation in the supply chain. These procedures and methodologies, on the other hand, are essential to the operation of a successful logistics management system.
The logistics role of supply chain management is always evolving in order to meet the expectations of consumers. Consumers often place orders for goods using their iPods, iPhones, cellphones, and tablets, and they expect to get their purchases within 24 to 48 hours of placing the order. Customers anticipate fast order fulfillment and speedy delivery of their purchases, and supply chain logistics must be enhanced in order to match these expectations. The most dependable, cost-effective, and timely delivery methods must be utilized. By establishing a successful supply chain logistics strategy, you can ensure that each component of the design is focused, that expenses are reduced to a bare minimum, and that the supply chain runs swiftly and efficiently, eventually increasing consumer satisfaction with the product or service (Council of Supply Chain Management Professionals, 2013). In terms of understanding the core indications and operations of their supply chains, as well as determining how to deliver the suitable product to the appropriate location at the appropriate time, it is probable that supply chain logistics will prove highly advantageous for enterprises.
4. Cloud ERP (Enterprise Resource Planning)Cloud ERP (enterprise resource planning), which relies on a vendor’s cloud platform rather than on-premises networks, allows organizations to access data from any location at any time. An enterprise resource planning (ERP) system can be used to produce a single source of truth for all areas of a company’s financial and operational operations, such as inventory management and order and supply chain management, procurement, manufacturing, distribution, and fulfilment (Bhatt et al., 2021). It is also possible to automate and streamline financial and operational procedures using enterprise resource planning software. A web browser and an internet connection are required in order to use the software, which is due to the fact that it is a web-based application. The same or superior capabilities than traditional on-premises systems are provided by ERP software supplied as a service, which is hosted by the ERP provider. Specifically, when it comes to enterprise resource planning (ERP) software and solutions, the phrase cloud ERP refers to software and solutions that are hosted and managed in the cloud rather than on premise (Bibi, Katsaros, & Bozanis, 2010). It is true that all businesses face the same difficulty when it comes to competing effectively in today’s market: they must be able to innovate, scale, and develop quickly in order to remain relevant. They are looking for software tools and systems that will allow them to dedicate their time and resources to growth targets rather than to the day-to-day management of information technology infrastructure and infrastructure management.
4.1 Advantages of Cloud ERPWhen it comes to cloud ERP, one of the most significant advantages is its ability to be updated and upgraded in a relatively short amount of time. Because of the availability of cloud ERP, ERP software and tools may be updated and upgraded in real time, resulting in increased efficiency and productivity. This offers the advantage of removing any uncertainty regarding whether or not the business is implementing cutting-edge technology to achieve its objectives in a timely manner. An on-demand ERP system eliminates the need to spend significant time and money updating systems, or to contract a third party to perform these tasks for you.
Because of the lower initial and ongoing investment in cloud ERP, businesses can realize long-term savings, which is another advantage of the technology (Costan and Pascu, 2019). For cloud ERP solutions, the total cost of ownership is less expensive than the total cost of ownership for on-premise ERP systems. Aside from server acquisition and maintenance, other costs associated with software installation on a company’s premises include database creation and management, initial deployment costs (including IT staff), energy costs (including electricity), security and backup costs, and any other costs associated with the software installation process (including tapes). Therefore, implementing cloud ERP is less expensive than implementing traditional ERP because the service provider handles upgrades, maintenance, and data protection for the customer (Razzaq and Mohammed, 2020). In order to implement an in-house ERP solution in your firm, you must first purchase software, licenses, and hardware. These are all important steps in the process. A professional will also be required for the purposes of installation and maintenance, as will be explained further below. A large number of small and medium-sized businesses (SMBs) may be unable to maintain their current levels of information technology spending as a result of the increasing expenses. Cloud-based ERPs, on the other hand, are typically less expensive to implement than traditional ERP systems because they only require a monthly subscription fee. If the situation cannot be solved by one service provider, there may be a variety of other options. It is possible to reduce your total cost of ownership after aligning your operating expenses and revenue streams, but this is not always the case.
Furthermore, it has the ability to be implemented in a short period of time. A cloud-based enterprise resource planning system can be up and running in a fraction of the time it takes to implement a traditional on-premises system. Businesses that use on-premises ERP must take a number of factors into consideration, including equipment selection and acquisition, IT employee training, potential staff expansion, the implementation of new data-security policies, as well as ensuring that everyone on the team has consistent access to tools that will aid the company in its growth (Berić et al., 2018). The usage of ERP on-premises ERP Cloud ERP makes it feasible to set up and implement software in a shorter amount of time than is otherwise possible. Access to real-time data from anywhere is a big advantage in terms of cloud-based software dependability when it comes to the reliability of cloud-based software deployment. Because of this, everyone in the team is more equipped to collaborate and perform better in their individual tasks as a group.
Furthermore, companies reap the benefits of improved access, mobility, and usability for their consumers and employees. Cloud ERP offers a number of advantages over its traditional ERP competitors, including the ability to scale. The fact that your ERP system is cloud-based and international-ready allows your employees to access the resources they demand from any area they have access to a mobile phone and an Internet connection. It is possible to make critical business decisions in real time because information is readily available in real time. This eliminates the need to wait for everyone in the same room or to access your ERP system from the same location before taking action (AlBar and Hoque, 2019). When this is spoken instead of being said, it leads to the formation of a more adaptable group of people. Increased internal and external productivity have resulted as a result of the increased emphasis placed on quick accessibility and stronger collaboration.
Another advantage of cloud ERP is that it enhances system availability and disaster recovery in the case of a disaster, which is particularly important in the financial sector. Data security is now a must-have concern for any corporation that conducts business online in today’s world. In exchange for your decision to use their service, cloud ERP providers are responsible for protecting your system from potential threats or vulnerabilities that may arise (Costan and Pascu, 2019). Vendors invest in world-class infrastructure and security to protect your system and free up your time so that you can devote your attention to other aspects of your company’s business operations.
Finally, because cloud ERP is hosted on the internet, it is both secure and compliant with regulatory standards. The disadvantage of in-house ERP solutions is that they must be configured and maintained on a continuous basis in order to function properly. If even one of these steps is skipped, it is probable that performance will suffer as a result of this. If you opt for a cloud-based solution, the service provider is responsible for hosting the service on their servers, which you are not accountable for. The result is that your ERP will work at its best since you will be confident that it is being maintained by qualified personnel. The fact that cloud-based ERP businesses provide their customers with greater security support and protection has already been mentioned (Razzaq and Mohammed, 2020). The importance of end-to-end and all-encompassing security has been emphasized throughout Epicor’s development. Every tier of our enterprise resource planning software includes physical network interface cards, user passwords, and round-the-clock system monitoring as standard features. Because our comprehensive approach to security assists us in detecting and mitigating interruptions, customers benefit from better uptime and more peace of mind.
4.2 Significant Actions to take to Ensure Success in Implementing the Cloud SystemIdentifying the total cost of ownership, evaluating cloud options, developing a migration/transition plan, planning the data migration, and developing change management approaches are the most important actions that the company must take in order to successfully implement the cloud system. These actions are in addition to improving their current systems. Among the first phases in the process mapping process is a comparison of what is required and what is already available in the marketplace (Zaslavskaya et al., 2018). Almost every company has a set of policies and procedures, some of which have been defined in advance and written, and others which have formed organically over time. You should identify the most important business processes and map out the relevant configurations in accordance with industry best practices before shifting to the cloud, rather than replicating your on-premises methods. An Oracle partner can often assist you in completing this investment more quickly and efficiently, while also protecting your firm from being accused of “paving cow paths” and aligning your operations with industry standards and best practices, among other benefits.
The next stage is the