Vitamin D in Saudi Arabia Literature review Example | Topics and Well Written Essays - 2750 words

Vitamin D in Saudi Arabia - Literature review Example Vitamin D deficiency affects both phosphorus and calcium digestion. The main role of vitamin D is to regulate calcium levels within acceptable ranges. It achieves this by increasing intestinal calcium absorption. In a vitamin D deficiency state, 10-15 % of dietary calcium is absorbed by the intestine (Brown, Ignatius, Amling, & Barvencik 2013, p.1733-1742). In a vitamin D sufficient state, 30% of dietary calcium is absorbed and during pregnancy, growth or lactation, the absorption can go as high as 80% with increased demand for calcium. In circumstances of vitamin D deficiency, low ionized calcium concentrations espouse the secretion of parathyroid hormone. The parathyroid hormone increases calcium reabsorption in renal tubes and increases 1, 25-1-hydroxylase activity, which results in increased 1, 25- dihydroxy vitamin D (1, 25(OH) 2-D) production (Azhar 2009, p.19-25).   Pregnant women and infants in Saudi Arabia suffer so much of these conditions. Secondly, during old age, men t end to have weaker bones due to reduced calcium and phosphorus concentrations. Increased PTH concentrations result in the loss of phosphorous within the urine. Decreased levels of phosphorus and calcium results in reduced bone mineralization. In addition, reduced phosphorus concentrations lead to failure of the expected apoptosis of hypertrophied chondrocytes.  Ã‚   Calcification delay of osteoid causes osteomalacia in established bones. Osteomalacia in undeveloped bones is known as rickets (Azhar 2009 p.19-25).     Rickets is a description of the abnormal organization growth of the cartilaginous growth plate (Hovsepian 2011, p. 3). The clinical description of vitamin D deficiency that results in rickets is based on bone deformity signs and pain and may be related to hypocalcemia. This condition in Saudi Arabia affects both adults and young people.  

Montefiore Medical Centre Case Study Example | Topics and Well Written Essays - 1250 words

Montefiore Medical Centre - Case Study Example In this particular case , one of the fundamental issues that had to be tackled before the introduction of any new system was the introduction and implementation of proper motivational schemes due to the layoffs which had created a demotivated environment for the remaining workforce. And wages were already an issue as the hospital was facing an issue of merit payment non-payments as a result of financial issues which had made such payments impossibility. However, during the year 1999, the hospital had thought along the lines of providing the Senior Executives 20% bonuses in case the hospital was not able to meet its targets. However, these measures should not be used in those circumstances when the hospital when is facing financial crunch which it is at present and hence, this would not be the best of motivational schemes to introduce. An alternative to using money as a motivational technique would be using non-financial motivational techniques such as praising the work of the workforce, giving awards to the best performer, having better communication lines in order to allow the worker a chance to voice their concerns and creating a friendly environment in which the workers were made to feel like a part of a team rather than people who were being used as guinea pigs in some experiment. The second question dealt with the issue of the way the management dealt with the issue. The management would have to change its current operational strategy as that has resulted in creating a misunderstanding between it and the workers who not are unaware of what is required of them but also the purpose as to why the management is doing what is doing. Hence, this not only shows a severe breakdown in communication but also outlines the vast differences that exist in terms of the hierarchical structure. In order to overcome these, the management would have to take greater interest in the workforce and listen to their viewpoints and make them feel like they are actually part of a team instead of merely having meetings. The meetings were surely not successful when the workforce was still being left in the dark as to be required of them; hence the management would have to do a complete overhaul of its communication and co-ordination policy. The third question dealt with the issue of implementing the balanced score card and whether it was actually a wise decision on the behalf on the management to introduce it or whether it resulted in aggravating the situation even further. In terms of the effectiveness of balanced scorecard, it allowed Brennan to create a focused system in which the financials were aligned with the goals of the company, the performance measure which would allow the medical centre to become an interactive centre which would be connected to the external environment. At the same time, it would be outline the cost, quality and cycle of the clinical and administrative measures. Considering the sort of investment that this tool took and the sort of feedback that it received despite having met fierce resistance in the initial times, this tool is certainly worthy enough to become a real and animated technique adopted by the centre. However, in order for it to be successful proper communication and