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Thank you for providing the background information of your company. Based on the information provided, there appears to be deficiencies in the control systems implemented within the operation. These control deficiencies were one of the main causes that allowed unintended individuals to gain unlawful control over Atlanta Home Loan. In order to prevent this from happening again, it is important to identify the main issues that caused the company to fall, generate alternatives to apply in the future, and evaluate these alternatives to see which controls would be most valuable to your future business.

Control System Analysis

Before attended the EMBA, your main system of control was action and result controls. Action controls were demonstrated in several control areas: direct monitoring of the credit inquiry of each loan application; close monitoring of the loan application/lead ratios and their trends to identify any irregularities; receiving funds directly from the proceeds at closing; receiving brokers’ checks overnight at AHL’s office or direct wiring of money to AHL’s general account. Result controls were demonstrated through AHL’s compensations to the loan officers based on who originated the deal.

Since the school started, in addition to the existing controls, you have set up remote monitoring system to keep track of employees’ daily activities as well as forwarded all corporate mails to California. These are also forms of action control. Provided that Wilbur generates revenues to the company, you compensate him through commissions. This is a result control.

Generally, there are four types of common controls a firm can utilize when setting up their internal control systems: results, action, and personnel/cultural controls. As per the above analysis, it appears that AHL primarily used only action and result controls and lacked the use of the personnel and cultural controls. Action controls heavily rely on your personal effort in monitoring the behaviors of your employees; it does not promote goal congruence within the firm. Result controls provide autonomy or motivation for employees to strive better as a team, but the linkage between results and actions may not always be perfect.

In the case of AHL, action and result controls are susceptible to fraudulent acts as they are evaluated based on the observation or outcome the company; they are more of reactive than proactive control systems. For example, there is a lack of monitoring of loan applications once they are past the loan officer level. In addition, there was a lack of segregation of duties within the departments of your firm.

Wilbur had the use and privileges of AHL, as well, he was able to conduct human resources function at the same time have the authority to pay any office expenses. Further, signed blank checks were made available to the company management during your absence. These are control deficiencies that are visible for staff and are easy targets for misappropriations.

Besides several weaknesses in controls, AHL does not have a sound company strategy. It is important to develop a corporate-level strategy by establishing a functional organizational structure as well as strengthen your business unit strategy by setting up a mission statement or a vision for your employees to realize.

Preventing the Same Mistake from Happening

We have identified the current controls implemented at AHL, some of the
controls need improvements in order to prevent the same problems from happening. AHL should to consider strengthening your action controls by implementing the electronic links to the processors’ files so you can see the entire loan application process remotely instead of only checking the status at the loan officers’ level. In addition, Segregation of duties should be enforced by having separate individual personnel handling loan applications, loan submissions, paying office expenses, human resources, approving payments, and signing checks, etc.

This would require the coordination of personnel controls which helps an organization find the right people, giving them a good working environment and the necessary resources to do their work. AHL should have a trained recruiting manager or an experienced staff to conduct the hiring and firing process. In addition, AHL should continue to establish a more effective motivational compensation plan (through its result controls) that not only rewards the outperforming staff, but also encourages synergy and goal congruence for the organization.

This will be complemented through the implementation of cultural controls. AHL can set company code of conducts and statements of values, create an ethical tone at the top and promote employees in thinking more socially responsible. A company’s culture can unite its employees or attract new employees as they share a similar set of values. The alternative controls in place could help prevent your past mistakes and assist in hiring and rewarding trustworthy employees.

Recommendations

Action, personnel, and cultural controls are three key controls that should be in place to reduce the probability of the case events reoccurring. If you can tighten the current action controls via the help of technology or an independent monitoring system, then the loan application to leads ratio could be significantly increased as it reduces the likelihood of any loan officers privately absorbing the loan applications without reporting them to the firm.

A solid action control cannot be solely performed by your (one person), so implementation of personnel controls is essential which will allow you to recruit talented and trustworthy employees that prevent theft or fraud from reoccurring. Setting a clear mission statement and company corporate governance policy will provide an overall cultural support to the
company that will complement the application of action and personnel controls. I hope the above memo can be a useful guidance for you in the future.

Karen is working with a small group of children who have brought a toy in from home and have been asked to talk about it to the rest of the group. Ben is from Wales and has a very broad accent which is different from other children in the group, who are from London. When Ben stands and starts to talk a girl in the group starts laughing with her friend and tries to imitate him. What should Karen do? Why is it important not to ignore the pupils who laugh? Karen should talk to the girls who were laughing and explain that every person is a unique individual and we all have differences.

They may not have intended to upset Ben or realise the impact their behaviour could have on him. She should ask the girls how they would feel if somebody laughed at them because of their accent or their appearance or other factor that is beyond their control. Considering the feelings of other people should always be encouraged. It is extremely important not to ignore this behaviour as pupils may think that it is acceptable to do this. Ben could become upset and feel isolated, which could have a serious impact on his self-confidence.

His work may also be affected, he may not want to attend school, become withdrawn or even start to display unacceptable behaviour himself. To help promote diversity, Ben should be encouraged to talk to his peers about where he is from. If Ben speaks Welsh, he could teach a few basic words to the class. At Meadow View, some teachers encourage children to answer the register in a different language. A situation like this would be ideal to educate students about Ben’s background and hopefully make him feel included and accepted amongst his classmates.

Abstract

Management of a Chronic HIV patient at home involves enormous dedication, effort and is stressful. The psychological, spiritual and financial needs of the caregivers are largely ignored. Reeling under enormous financial strain, compounded by the lack of support network, African women are forced to singlehandedly manage care delivery for the HIV patient and are stretched to breaking points. Stigmatization and social isolation that arise out of HIV care giving make them even more isolated and overwhelmed. The present study clearly highlights these failures. It is very clear that financial woes are among the biggest followed by the lack of support services. The Zimbabwean government is unstable and social welfare programs are hardly functioning. Even for those support services that are maintained and run by the Government, bureaucratic difficulties have made them inaccessible and out of reach of the poor caregiver. There is clear indication that support networks do not exist or atleast they are inaccessible. A collaborative action involving government, NGOs and other health agencies is called for. Home based carers should be trained, supported and counseled and policy level initiatives must be practically implemented. Only then could the quality of life for the patients as well as for the carers improve.

Introduction

HIV/AIDS is one of the most pandemic diseases in the world with an estimated 34 million people infected with the HIV virus. (amfAR, 2012) Zimbabwe, in particular, has been worst hit by the HIV epidemic with more than 27% of the adult population diagnosed with HIV in 1997. Currently though, the prevalence rates have reduced significantly to 14% of the adult population (National AIDS Council, 2012). However, this decline is largely attributed to the significant number of deaths of people with HIV. Persistent political turmoil and the resultant economic decline have further contributed to the literal collapse of the Zimbabwean health care system. The failure of the Public health care system has cast the major burden of health care provision to private agencies, NGOs and Home based care has become the indispensible and only feasible model under the prevailing circumstances. Statistics suggest that of the 35,000 children in the country that needed ‘Antiretroviral Therapy’ (ART) only 17,000 have had access to the drugs (UNICEF, 2009). Though the availability of ART has vastly improved from just 15% in 2007 to around 80% by 2010, (National AIDS Council, 2011) there is still a huge unmet demand. Zimbabwean government’s opposing attitude towards NGOs and its accusations about the NGO funds being used for anti governmental activities has further limited the already strained financial aid flowing into the country for AIDS care. Amidst these tiring circumstances, family based care giving has become the central strategy for the national HIV/AIDS management programs. This paper attempts to study the impact of HIV/AIDS care delivered in the family based setting and how such care provision affects the care giver. In particular, this paper strives to highlight the issues such as the psychosocial impact on caregivers and using the caregiver’s views assesses their coping and support mechanisms.

Home Based Care

A brief outlook into what constitutes home based care is appropriate before we proceed further. The World Health Organization defines home based care as “ a programme that through regular visits, offers health care services to support the care process in the home environment of the person with HIV infection. Home visits may be the only service provided or be part of an integrated programme which offers the patient and his/her family services in the home, hospital and community”. Ministry of Health and Child Welfare,(2004). From the definition it is clear that home based care is considered a holistic care solution that addresses the needs of both the care receiver as well as the care giver. This understanding is crucial for the successful implementation of the home based care delivery model.

Literature Review

Family based care provision is proving to be the important model in the delivery of care to chronic illnesses such as AIDS. Particularly in Zimbabwe, where decades of political and economic turmoil have weakened the health care system, the role of family based care provision could not be more emphasized. The political friction between the West and the Mugabe government, and the accusations about the political motives of the NGO operations in the country, led to a sharp decline in the active healthcare interventions in the country. NGO funding to Zimbabwe for its healthcare programmes reached a record low in 2006. During this year, the average aid money for HIV care per person in Zimbabwe was limited to $ 4 which when compared to the average aid money allotted per person in Zambia ($184) is a meager amount (Matimba, 2010). However, since 2008, the aid to Zimbabwe is again on the rise with the USAID and DFID being the two key contributors. The USAID contributed 26.4 million in 2008 while the DFID pledged in 2010 to contribute $40 million over a five year period. Despite this the total aid money that Zimbabwe received for its HIV healthcare operations during this period is just one tenth of the aid money received by neighboring Zambia and one fourth that of the aid amount received by Namibia in the corresponding periods (AVERT, 2012). These statistics project the grim scenario from the financial standpoint in delivering HIV care in Zimbabwe where HIV has assumed endemic proportions.

HIV being a chronic condition, patients have to undergo continuous care for a protracted period of time and the hospital setting cannot handle the enormous demand. Statistics suggest that in Zimbabwe roughly 70% of all hospital admissions are connected to HIV care. Statistics also suggest that even a 5% increase in the number of HIV patients would result in a 25% increased demand for hospital beds. The figures indicate that hospitals, as care provision centers, for a country such as Zimbabwe where there is a swelling HIV population, is a highly unviable model and therefore community and home based care provision assume great significance. The policy stance of the Zimbabwean government to promote home based care provision could be understood based on these ground realities. The Zimbabwean government has been actively promoting care giver training by employing community nurses as trainers for these family care givers. With funding limitations, even the training and support provided by the community nurses to the family care givers has been affected making them vulnerable to the enormous pressure of managing the care provision all by themselves (Matimba, 2010).

National Community Home-Based Care Standards (2004)

The enormity of the HIV problem and the limited nature of the government health care resources forced the home care system of care delivery in Zimbabwe. However, the quality of life of the HIV infected patient depends a lot on quality of the home care givers. In most cases these home based care providers have absolutely no training at all and even lack the knowledge to protect themselves from accidental exposure to HIV infection. To improve the quality of home based care delivery, support services must also be improved. With this in view the government of Zimbabwe set up the ‘National Community Home-Based Care Standards’ in 2004 that included the following important features

Care and Support for patients and Family
Team Service Provision
Governance and Management
Training , information and Education
Monitoring and evaluation

The main objective of establishing the standards for home based care delivery is to change home care from being perceived as a third rate care provision by improving its overall quality. It should be noted that Home care is not just about the patients but also about the care giver. The national standards for Home care therefore lay this stress on providing holistic care support through an established standard. The process involves training, education, monitoring and continuous evaluation. The National Community Home-Based Care Standards (2004) neatly defines its purpose as “Provision of a support system through the development of strong partnerships with the community, family and patient, home-based caregivers, and the health system, thus assuring patients an acceptable quality of life until death”. (Ministry of Health and Child Welfare, 2004). The definition also considers the aspects of support provided for the carer and other family members including ” emotional, spiritual and other psychosocial support, bereavement counseling, and other appropriate assistance that meets their special needs” (Ministry of Health and Child Welfare, 2004).

Psychosocial Impact of Caregiving

Literature is abound with studies that analyze the impact of care giving for a HIV patient, on the care-giver. Almost all of these studies indicate that care giving results in enormous psycho social impact on the provider. Typically, the family care giver maybe overcome with emotions ranging from , depression, anxiety, fear, anger , helplessness along with the overwhelming financial burden that is involved with HIV care provision. Lindsey et al., (2003) explored the effects of care giving on older and younger women in Botswana who were caring for family members with chronic HIV. The authors of the study identified that older women, in particular, were overwhelmed with the physical and mental demands of care giving. These women had to manage demanding tasks such as caring for the patient with frequent episodes of vomiting, incontinence and confusion. Care giving family women had to do all this along with their household chores and this creates enormous physical hardships not to mention the emotional drain. Furthermore, in many cases, care providing women are subjected to economic strains when the productive member of their family is affected by HIV (Lindsey et al., 2003).

Another study by Ssengonzi (2007) explored the impact of care giving on Ugandan older women. The results of this study also chimed in with the findings of the previous study with the elderly Ugandan women reporting that care giving left them financially affected due to three main reasons

The ill relatives and the consequent loss of family income
the negative effect of care giving on the employment opportunities of the care provider
Expenses incurred on procuring medicine for the patient under their care

The care giving women also expressed social isolation as a result of their inability to participate in the usual social activities (Ssengonzi,2007).

One study by Thomas F (2006) that assessed the impact of home based care giving for HIV patients in Namibia again reported that financial constraints due to care giving is a serious problem. This study collected information from both the patient as well as the care giver in the form of solicited diaries. The study found that the inability to provide for family created severe emotional strain for the care giver. Significantly, the study also reported that the quality of care provision is affected over time when the worsening financial situation in the household coupled with the lack of recovery of the patient lead to escalating tensions and emotional upheavals in the house (Thomas F (2006).

One urban study conducted in Kinshasa, the capital of the republic of Congo, involved self reported health and emotional status of 80 spouses and caregivers of HIV infected men in the region. What surprised the researchers was that despite this being an urban study with better hospitals and home care support networks, around 94% of the women caregivers expressed that care-giving was very difficult for them and 99% reported that it affected their social lives. Importantly, 90% of these women care givers stated that they were stigmatized by friends and their husband’s employers. This study clearly highlights that the stigma of AIDS care could further contribute to the emotional strain of HIV care. As a revealing study on the psychosocial impact of care giving, this research found that 48% of these care providing women were so unhappy with their circumstances that they lost interest in their life and expressed the lack of interest and energy to continue. Furthermore, 94% of these women had some form of physical ailment including frequent headaches, fatigue, body pain, lack of appetite, anorexia, etc (Kipp et al., 2006).

Studies done elsewhere in the developed countries also reflect similar feelings from the care givers. For instance one earlier study by Flaskerud & Tabora (1998) based on low income female care givers in California who provided care for heterosexual and homosexual HIV patients attested to the findings from the African studies. These women expressed the same concerns as the previously listed studies including depression due to poor functional outcome of the patient, loneliness due to uncooperative and unsupportive friends and relatives, etc. Around 59% of the care giving women also reported that their physical health was affected considerably due to the prolonged period of care giving. Worn out by their care-giving duties these women were moody and even expressed their anger at the patients as their irresponsible behavior put them in this place. Last but not the least, the women subjects of this study welcomed being interviewed for the study as it provided an emotional vent for them to lay out their feelings which they could not so far share with anyone due to the absence of an appropriate support network. (Flaskerud & Tabora, 1998).

One recent South African study by Hlabyago et al. (2009) focused on one of the important problems faced by care givers of terminally ill HIV/AIDS patients. This problem is the caring for the orphaned children of the parents who succumbed to HIV. As per 2010 data, more than a third of the 50 million or more orphaned children in Sub Saharan Africa lost either one or both their parents to HIV. Given the huge scale of the problem, this study by Hlabyago assumes great significance in terms of policy formulations and also with respect to assessing the impact on family caregivers. The researchers of this study employed one on one interview technique which sought answers to the following important question from the care givers – “Would you please tell me your experiences as a family caregiver concerning your care of the orphans?” (Hlabyago et al., 2009). The Interviews were conducted for nine subjects who were home caregivers recruited from the Hoekfontein Clinic in South Africa. The demographic details of the subjects were noted down. Six out of the 9 (63%) care givers were grand mothers, 2 of them were aunties and one of them sister to the orphaned children. Thematic analysis of the data resulted in the observations that are listed in the following table.

As could be inferred from the above results table, financial constrain is a major problem for care givers affecting 77% (7 out of 9) of the study subjects. However, one concern that is uniformly expressed by all the care givers involved in the study was that of the existence of Bureaucratic difficulties and the lack of social support services. Though the government has programs to support orphans in the form of orphan grants, accessibility problems and processing delays and the lack of proactive approach within the social works departments hinder the outreach of such programs to the people. For instance, one of the caregiver, who was the grand mother of the orphaned child, expressed her helplessness stating, “I got the heart to help this child by applying for this orphan grant. I am still waiting for the money because it is not yet released. I sent the documents a long time ago. The social worker has since told me that they will send someone at home and I am still waiting. I wish that money can come so that I can save some for him (the orphan) because I am old – anytime I can die, you see”. (Hlabyago et al., 2009).

The study also revealed that lack of support from family members is a pressing issue. One of the care giver subjects who were interviewed for the study reported that she received little support from her husband in taking care of the orphaned Children. “The day Johanna died he came and found me struggling with her, he came into the room and walked out, and when he came back again the child was already dead” (Hlabyago et al., 2009). Some of the care givers expressed concern about the rebellious attitude of the orphaned kids while some of them expressed concerns about the growing family conflicts due to the care giving. “I decided to take him in and care for him. I think that she (the orphan’s biological grandmother) is thinking that because I am receiving this child’s orphan grant, she is not sending anything for this child who is basically her responsibility” (Hlabyago et al., 2009). The literature reviewed so far clearly highlighted that caregiving for HIV patients could be a stressful event and debilitate the care giver in the absence of suitable support mechanisms.

Methodology

The following sections will revolve around a questionnaire based primary study in which 15 subjects who were care providers for HIV patients in Zimbabwe were provided with 6 questions with various choices and their answers analyzed for themes. The choice of questionnaire was due to its informal nature and usefulness in gaining valuable data. The use of open ended questions helps in ascertaining more information from the subject whenever appropriate. Though initially I had sent my questionnaires to 15 recipients only 10 of them returned the completed information. All the 10 subjects were properly apprised of the nature of the study. Though the respondents knew that the study was purely for academic purposes they were delighted in providing the valuable information for the study. All the subjects were assured of the confidentiality of their responses and that their responses would be used purely for academic knowledge improvement purposes. Thematic analysis was employed to discern useful themes and patterns about the various aspects of caregiving.

Results

The data from the questionnaires answered by the 10 subjects who participated in the study were analyzed to identify the emergent themes. In all, six questions with varied responses to each question were provided to the subjects. These questions were particularly relevant to understanding the wide impact that care giving has on the home based care providers. The results revealed some of the important psychosocial aspects of caregiving. The repetitive themes that were identified from the data attested to the key findings reported in the literature review early in this paper. These common themes suggest the need for urgent action.

Care giving challenges

The data from the questionnaires revealed some demographic profile about the subjects. Most of the carergivers in the study were relatives of the HIV Patient and on an average care provision period lasted between 2 and 3 years. 80% of the caregivers were elderly females. Economic difficulties dominated the challenges that were reported by the caregivers with almost 90% of the subjects reporting financial constrains as a serious issue involved in prolonged caregiving for the HIV patient. As discussed earlier in the paper this may stem from loss of income if the patient was a productive member of the family. Caregivers are also constrained by the fact that they could not be gainfully employed when they are tied down with caring for the patient.

One other important aspect pertaining to caregiving at home was the lack of adequate transport services. 80% of the caregivers opined that they find transporting the patient to the hospital during times of emergency a huge problem as the Ambulance services are not prompt. Subjects also complained that the ambulance services charge them for the fuel costs.Most of the subjects stated that they took the responsibility of caregiving out of love and compassion to the patients. When asked about the support services that could have helped them a lot with their care giving almost all the subjects mentioned transportation as an important feature. 30% of the subjects felt that providing food care for the patients and opportunities for part time employment for themselves would have been greatly helpful. 40% of the caregivers also expressed their concern that the scarcity of water in rural Zimbabwe added more problems to them as they could not walk several kilometers to fetch water leaving their sick patients at home. This is a very relevant issue as Zimbabwe is one of the African countries that is hard hit by water crisis, and more often than not, functional borewells that are the only nearby sources of water would be several kilometers away. There were also concerns about the medication supply with 40% of the caregivers complaining about shortage and availability of ‘Anti retroviral Drugs’ at the local dispensary. The continuous availability of ART is critical for HIV patients in order to prolong their life.

It was also interesting and informative to note down that 7 out of the 10 subjects felt that this small questionnaire project, though it was done for educational purposes, provided them with an opportunity to discuss the problems involved in care giving. The seven care providers felt that the questionnaire provided them an emotional purge as they hsd not had a chance to discuss their difficulties with anyone else. They all felt that there was a complete lack of support mechanisms available for carers and that this made them feel helpless and emotionally dissipated time to time.

Conclusion

Caregivers undergo enormous stress during the protracted period of care giving that is involved in managing a chronic HIV patient. Just as care givers provide so much of love, effort and care to the patients they look after, their needs should also be looked after. The psychological, spiritual and financial support that caregivers require are however largely unfulfilled. Especially when there is political and economical turmoil in a country, such as that seen in Zimbabwe, the needs of the home based care provider is more likely to be ignored.

As the numerous studies that were discussed in the paper reported care givers are mostly women and predominantly elderly women. Reeling under enormous financial strain, compounded by the lack of support network, African women are forced to singlehandedly manage care delivery for the HIV patient and are stretched to breaking points. Stigmatization and social isolation that arise out of HIV care giving make them even more isolated and overwhelmed.

The present study based on the information gathered from caregivers in Zimbabwe clearly highlights the plight of the caregivers. It is very clear that financial woes are among the most important to the caregiver, followed by the lack of support services. Zimbabwean government is unstable and social welfare programs are hardly functioning. Even for those support services that are maintained and run by the Government, bureaucratic difficulties have made them inaccessible and out of reach of the poor caregiver. Counseling support services for caregivers are distinctly lacking. Based on the opinion gathered from the study and other relevant literature, it is clear that holistic care as advocated in the National Community Home-Based Care Standards (2004) is still far from reality. There is clear indication that support networks do not exist or are inaccessible. Based on these findings this paper concludes that family based care givers are struggling without access to support services. A collaborative action involving government, NGOs and other health agencies is required to correct the defects. Home based carers should be trained, supported and counseled, and policy level initiative must be practically implemented. Only then could the quality of life for the patients as well as for the carers improve.

Bibliography

AVERT, (2012), HIV and AIDS in Zimbabwe, viewed Jan 1st 2012,

< http://www.avert.org/aids-zimbabwe.htm#contentTable5>

amfAR, (2012), Statistics Worldwide, viewed January 1st 2012

Hlabyago KE & Ogunbanjo GA (2009), The experiences of family care givers concerning their care of HIV/AIDS Orphans, SA FAM PRACT Vol 51, no 6 pg 506-511.

Kipp W, Matakula Nkosi T, Laing L, Jhangri GS, (2006), Care burden and self-reported health status of informal women caregivers of HIV/AIDS patients in Kinshasa, Democratic Republic of Congo. AIDS Care, Oct; 18(7):694-7

Lindsey E, Hirschfelf M, Tlou S, Ncube E. (2003), Home based care in Botswana: experiences of older women and young girls. Health Care for Women International; 24: 486-501

Ministry of Health and Child Welfare, (2004), National Community Home based Care Standards, viewed Jan 1st 2012,

< http://www.jsieurope.org/docs/national_community_hbc_standard.pdf>

Natsayi Matinba, (2010), The Psycho Social impact of Care-Giving on the Family Care-Givers of Chronically ill AIDS/HIV Patients in Home based Care. Research Report, University of Witwatersrand, SA.

National AIDS Council, (2011), UNAIDS highlights Zimbabwes progress in response to AIDS, viewed January 1st 2012,

< http://www.nac.org.zw/news/unaids-highlights-zimbabwe%E2%80%99s-progress-responding-aids-0>

Ssengonzi R. J. (2007), The plight of older persons as caregivers to people infected/affected by HIV/AIDS: evidence from Uganda. J Cross Cult Gerontol; 22: 339-353

Thomas F. (2006), Stigma, fatigue and social breakdown: Exploring the impacts of HIV/AIDS on patient and carer well-being in the Caprivi Region, Namibia. Social Science and Medicine 63: 3174-3187

UNICEF, (2009), HIV and AIDS Issues, viewed January 1st 2012,

< http://www.unicef.org/zimbabwe/hiv_aids.html>

1. Keep the door closed. Ever time you open it the temperature drop about 20 degrees
2. Cook several dishes at the one time. If you are cooking small items use the frypan.
3. When cooking small quantities use one sauce pan with dividers.
4. Keep food warm at 70-80 deg(c) Higher temperatures waste electricity and over cook food.
5. Use oven heat for plate warming.
6. Use utensils with flat bottoms and well fitting lids.
7. Make sure they cover hotplates. To cook vegetables the water doesn’t need to be boiling furiously – a gentle simmer is enough.
8. Fan type ovens reduce cooking costs.
9. Use bright clean hotplate reflectors to send the heat upwards where it is wanted.
10. Pressure cookers can save up to 25% of power.
11. Use small appliances eg. griller,crockpot,wok,etc for appropriate foods.
12. Thaw frozen foods before cooking – this saves about 15 minutes cooking per 450 grams (one pound).
13. A microwave is very economical for suitable functions -it is excellent for reconstituting food.
14. Don’t use grill-boiler plate on top of range for utensils not large enough to covert.
15. Don’t boil water on a hotplate – use an electric kettle.
16. Make sure your oven door seals properly.
17. Have the ceiling insulated with at least 50mm of fibrous or foam insulation.
18. In timber framed or brick homes the walls should also be insulated. Block off any chimneys not being used – A lot of heat is lost there.
19. Unless you have full home conditioning close the doors of the room/s being heated or cooled. Doors and windows should fit well because draughts can waste a lot of energy. Close curtains to stop heat escaping.
20. See that air- conditioner filters and condenser coils are kept clean.
21. Reverse cycle air-conditioners provide 2 to 2. 5 times as much heat as an element type heater for the same electricity consumption.
22. Zoning of a house conditioned by a ducted system can cut energy consumption to a half or even third.
23. Shade windows during summer to keep sun of the glass.
24. Don’t leave heating or cooling appliances on when rooms are unoccupied.
25. Use personal fans and ceiling fans for relief from hot weather. Fans cost much less to run than air conditioners.
26. Many air- conditioning systems operate at 22 deg (c). You will still be comfortable if you set the control for 24-25 deg (c) in summer and 18-19 deg (c) in inter and you will use a lot less electricity.
27. Leave room conditioner “fresh air ” and “exhaust air ” controls in the closed positions unless you want to freshen thew room air.
28. Set fan at high speed for a room conditioner to work most efficiently.
29. Evaporative coolers are very effective when installed correctly. The operating cost of an evaporative cooler is only a fraction of that of a refrigerated unit.
30. A student can be kept warm with a 150 watt infra red lamp fitted under the desk.
31. Localised under carpet heating gives economical armchair comfort.
32. People heating is more economical than space heating. use radiators multi-heat radiant heaters, wall strip heaters ,fan heaters.
33. Electric blankets are the cheapest form of bedroom heating.
34. Select a fridge that uses waste heat for defrosting etc. These fridges are usually cheaper to operate.
35. Buy the size you need extra capacity uses extra power.
36. If you already have a chest or upright freezer buy an “all though ” refrigerator instead of a fridge freezer combination.
37. Defrost before the ice build up is 1 cm thick.
38. Open the door only when necessary.
39. Make sure the door seals well. If a piece of paper will slide easily between the abinet and the door seal is not good enough.
40. Keep dust and fluff brushed off the coils on the back or bottom of the fridge.
41. Put the fridge in a well ventilated position.
42. Place your fridge away from direct sunlight or any source of heat. Don’t put hot food into a fridge or freezer.
43. Don’t buy a large machine if you don’t need it. For the occasional big wash an extra cycle or two is cheaper than under using a large washer.
44. Adjust the water level to economically wash a partial load. Otherwise it is better to wait until you have a full load. But don’t overload your machine.
45. Your washer may have features than can save your money. Soak cycles remove stubborn stains in wash cycle. Suds savers allow you to re use hot water.
46. Use correct type of detergent and cold or tepid water will wash clothes effectively.
47. Good lighting means avoiding glare and gloom by using the right amount of light in the right way.
48. Use light translucent shades- opaque or dark shades require bigger lamps.
49. Use a good local light near the task. It is more effective and more efficient than a large central light.
50. Use fluorescent tubes . they use about a quarter of electricity used by ordinary lobes and they last about eight times as long. They CAN be switched on and off as often as you need without affecting operating cost.
51. Use solar energy to dry your clothes -it costs nothing.
52. Operate your dryer using the fan alone. Only switch the heater on if it is really necessary. Vent the dryer outside the house and don’t let lint block the vent.
53. Never overload or underload the dryer – you get most economical operation with the correct load.
54. Switch off when the clothes are dry enough – over drying makes them feel harsh and waste electricity.
55. Tumble dryers are more effective than cabinet dryers.
56. Off peak low pressure storage heaters are generally the cheapest overall.
57. Don’t allow dripping taps . Sixty drips a minutes means about 1200 litres a month drown the drain. And you have paid for it to be heated.
58. Water restrictors and low flow shower nozzles will help to save water
59. Insulate hot water pipes from storage heaters for at least a metre from the heater as heat can be conducted along these pipes and lost to the atmosphere.
60. Install a storage heater of 125 litres or more to run off peak tariff – which is bout half the normal rate.
61. Normally you will use less water for shower than bath.
62. Fill your electric kettle or jug from the cold tap. Running off a lot of cold water from the hot pipes is wasteful and expensive.
63. Don’t have you hot water set too 70 deg (c) is usually hot enough . Otherwise it costs more to heat the water and it loses more heat while being stored.
64. Dimmers save power and enable you to obtain pleasant changes of mood in your lighting.
65. Use plug-in timers to control such things as frying pans, crockpots, radiators. lights and air conditioners.

My dream house is simply unimaginable. The home I desire is most beautiful and great in splendor is like a dreamland. A. The exterior of my home has great large beams trimmed in gold. There is a large picture window that covers the lower portion of the house.

B. The home has high ceilings and large windows all through out the home. C. It sits on top of one acre of beautiful rolling hills and meadows. 1. There is a beautiful garden in the backyard with a large pond. 2.

There is also a huge deck, perfect for picnics and other social gatherings. II. The Front Exterior D.As you walk up the cobblestone walkway, the first things you see is two large beams trimmed in gold. E. Just behind the beams sit a set of gold French style double doors that give entrance into the elaborate home. III.

Interior F. As you enter into the foyer, you encounter a large marble of sculpture of Eve that sits in the center. G. Directly behind the sculpture sits a grand staircase that leads to the second level of the home. H. Just to the left is a beautiful family room, perfect for family gatherings. I.

To the right there is a dining room that seats more than ten people. . There is a cherry wood table seated in the middle of the room with matching chairs 4. Above the table hangs an elaborate crystal chandelier. J. In the dining room, there is a doorway that gives access to the huge kitchen. 5.

In the center of the kitchen sits an island. 1. On the granite top of the island is a stove with six burners and a grill 2. Off to the left sits a double oven. 3. Next to the oven, there is a huge refrigerator. 4.

In the corner sits a breakfast nook surrounded by windows that overlooks the beautiful hills and meadow.This is where most meals will take place. K. As you walk up the grand staircase and walk down the hallway, you’ll past four bedrooms before reaching the master bedroom. 6. When walking into the bedroom, you notice the California Kind sized bed. 7.

Just past the bed sits huge sliding door that open onto the balcony that overlooks the beautiful views. 8. Walking back into the bedroom, to the right there is the master bathroom. 5. Walking into the bathroom you notice the heated marble floor. 6. Inside the bathroom there are his and her marble sinks.

. Across from the sinks sit a huge standing marble shower with glass doors. 8. Also in the bathroom is a separate Jacuzzi style bathtubs. IV. Exterior: Back yard L. Right outside the back doors is a patio.

On the patio sits a bar and a built in grill. M. In the backyard there is an Olympic sized pool. Surrounding the pool are beach chairs. N. Further back, there is a garden and a large bond. V.

Conclusion O. Now that I have describe in great detail to you my dreamland, I hope that you all will come visit me when my dreamland becomes a reality.

In this survey effectivity means betterment in measured results. Outcomes which are traveling to be measured in this survey are physical public presentation ( lower appendage muscular strength and hand-grip strength ) and functional capacity ( balance and walking-timed up and travel ) .

For lower appendage muscular strength the chair stand trial normally used. The chair stand trial is a physical public presentation trial used to measure lower-extremity map. A 5 repeat trial is a step of strength ( Ward et al. , 2010 ) . Subjects ‘ manus clasp force mark in their left and right custodies will be recorded. Individual patients whose grip strength is less than the lower bound of the assurance intervals can be considered to be impaired clasp ( Bohannon, Peolsson, Massy-Westropp, Desrosiers, & A ; Bear-Lehman, 2006 ) .

In add-on, balance and walking ( functional capacity ) and physical public presentation before and after exercising plan are measured including: ( a ) Berg Balance Scale ( BBS ) , which rated the public presentation of 14 specific undertakings ; ( B ) the Timed Up-and-Go Test ( TUG ) , which measures the clip required to acquire up from a seated place and walk 3 m ( two tests are allowed and the clip required in two tests is averaged ) . Furthermore, physical public presentation in each topic will be assessed by both the Chair Stand Test ( CST ) and Hand Grip Strength ( HGS ) . The chair stand trial is a physical public presentation trial used to measure lower-extremity map and manus clasp strength assesses clients ‘ manus force and strength.

Justify why you wanted to analyze place based exercising intercession?

The demand for a home-based preparation exercising plan to forestall falls among frail aged people is felt by some research workers ( Kamide, Shiba, & A ; Shibata, 2009 ) . There are promoting informations to demo effectivity of home-based exercising among aged people in maintaining and increasing functional and wellness position, when carried out right ( Hinrich 2009 ) . Nelson et al 2004 summarized that a home-based exercising plan in community-dwelling seniors with functional damage is executable and effectual in bettering functional public presentation, despite limited supervising. They besides added that home-based exercising plans that focus on strength and balance preparation improve functional public presentation in aged people and should be promoted by the allied wellness community ( Nelson et al 2004 ) . A more recent RCT emphasized on feasibleness of home-based exercising plan for aged people populating in community ( Matsuda, Shumway-Cook, & A ; Ciol, 2010 ) . In add-on home-based exercising plan can get the better of the job of center-base plans including, deficiency of public handiness of hi-tech installation in developing courtiers, transit barriers for aged, the job of cost-benefit and cost effectivity of any hi-tech plan ( Nelson et al. , 2004 ) .

Conformity, which is a major job in centered-based exercising among aged people, can be achieved by home-based plans. Previous researches accent that attachment to any exercising plan is low among aged people particularly in long tally ( Campbell et al. , 1997 ; Dishman, 1991 ; Gobbi et al. , 2009 ; Sturnieks, St George, & A ; Lord, 2008 ; Sun et al. , 2005 ) . Blanchard 2008 stated that less than 15 per centum of aged people participate in center-based exercising plan. He added that to accomplish a larger figure of participants, there has been a displacement toward implementing home-based rehabilitation plans. Home-based muscular strength preparation can be considered as an option to expensive and low conformity clinical-based musculus preparation ( Blanchard, 2008 ) . Many research workers have suggested more community tests designed to get the better of barriers and supply support for inactive aged people to get down exercising plans ( Judge, 2003 ) ; nevertheless, merely a few randomized controlled intercessions studied on falls have investigated the effects of home-based preparation intercession among the community-dwelling elderly people.

A home-based preparation exercising should be directed toward beef uping weak musculuss and balance. The effect of muscular failing and co-contraction is lack of assurance ( Tinetti, Richman, & A ; Powell, 1990 ) which makes aged people loss their assurance and fright of falls ( Hill, Schwarz, Kalogeropoulos, & A ; Gibson, 1996 ) . Fear of falling deteriorates the balance reactions and leads to increased hazard of falls and increased hazard of hurt ( Okada, Hirakawa, Takada, & A ; Kinoshita, 2001 ) . Loss of assurance among aged people consequences in functional restrictions and may do limitation in activity due to fear of falling, which is really common job among community-dwelling older grownups with or without experience of falls ( Hansma, Emmelot-Vonk, & A ; Verhaar, 2010 ) . So, it is logical that improved muscular strength can ensue in assurance, cut down fright of falls, addition balance and lessening hazard of falls.

A great figure of surveies have proposed that merely extra research with frail aged persons will assist reply if home-based preparation would better balance in older ages ( Nelson et al. , 2004 ; Baker et al. , 2001 ) .

What are the issues / job with place based intercession exercising?

There have been some jobs in old home-based plans. They still rely on most adept forces who closely supervise their patients and supply them with high criterion attention at their place ( Gardner, Robertson, McGee, & A ; Campbell, 2002 ; Nelson et al. , 2004 ; Luukinen et al. , 2007 ) . The others emphasize on individualized tailored plans ( Clemson et al. , 2010 ) which raises the cost of intercession plan. Furthermore, these plans, although were reported to be effectual, deficiency in big scale randomisation was the chief restriction of the surveies ( Nelson et al. , 2004 ) . In add-on, because of low wellness literacy among Persian aged population, any home-based preparation intercession without proper supervising and attachment will non be able to accomplish its aims ( Carpenter, 2010 ) . A good cited survey suggested that aged people need supervising to better strength in a home-based scene ( Baker et al. , 2001 ) . To get the better of the job of wellness illiteracy among aged people we planned to affect participants ‘ grownup kids who have the most interaction with the client in developing plan to oversee him/her during preparation and make full up the log books.

How would command external factors in place based intercession?

To command external factors of the intercession, the survey will be done on falls high hazard aged people in urban countries who are cared by a female attention givers for the exercising plan ( homogeneousness of attention givers is an of import issue and is discussed in inquiry 6 ) .

Some features of the participants such as age, gender, degree of instruction, matrimonial position, occupation, economic position, Activity of Daily Life ( ADL ) and IADL, Medications, Mental position, self-rated wellness are controlled in this survey.

How would you find that the respondents will follow instructions given?

In order to corroborate truth of participants and attention giver ‘s public presentation ( monitoring and recording ) , orientation session and regular place visit are planned.

Orientation session: Each participant is instructed to execute the instructions right. The first session of direction is allocated to teaching the participants and their attention givers how to execute the exercisings. A household member as attention giver patterns make fulling the log book in the plan in presence of research worker before beginning of the preparation.

Home visit: Researcher will go to at participants ‘ place in exercising session one time a month ( three times in 12 hebdomads ) .

To be assured about participants ‘ conformity, a female close household member will be instructed to make full the log books which reflect the sum of exercising aged client has done. Each log book is filled during each session and submitted to researcher at the terminal of month. Subjects ‘ household member will be allowed to name the research worker during the plan to inquire their inquiries. Furthermore, the research worker will name them semiweekly to guarantee proper public presentation of the preparation plan.

How would you command for homogeneousness of sample/ respondents in your survey?

Participitants will be recruited from about 1200 aged people in part. Random sampling will be applied to delegate at least participants ( N=60 ) into intercession and control groups. The survey is planned to enroll at least 30 topics in each groups. Because of likely abrasion, trying will go on to accomplish at least 60 participants complete the 12 hebdomads exercising.

To increase the homogeneousness of the participants all participants will be recruited from abode of urban countries. All topics should be 60 old ages old and above, had old experience of falls in last 12 months. Furthermore, they should hold a female household member as a attention giver ( aged 18-50 ) who has wellness literacy. Health literacy will be tested by a criterion questionnaire called Rapid Estimates of Adult Literacy in Medicine ( REALM ) . In order to keep homogeneousness of attention givers, merely female attention givers are included.

Exclusion standards are acute cardiorespiratory diseases ( approved by a heart specialist ) , terrible dementedness ( MMSE ) , audile lack, vestibular change, impaired vision, hearing and motor coordination restricting exercising ( approved by a brain doctor ) , unable to walk independently more than 10m, old hip replacing surgery, old history of lower appendages fracture in last 12 month, terrible articular engagement restricting physical activity and exclusion for any ground by orthopaedic sawbones. Furthermore, aged people with high vigorous degree of activity in last 12 months will be excluded from the survey.

All topics will be matched and indiscriminately assigned in intercession and control groups, utilizing random figure tabular array. To make random allotment, after baseline appraisal, topics will be divided into two groups based on features, harmonizing to random Numbers table. Thereafter, one group will be allocated to the intercession and the other group to the control.

What is the exact exercising protocol that you would utilize to mensurate effectivity?

Exercise protocol is designed by American Heart Association ‘s ( AHA ) recommendation for maintain musculus strength, balance and falls bars in 2007. This protocol is planned to better musculus strength and balance among high hazard community aged people for falls. The same instructions with some differences are recommended by research workers in New Zealand in Otago survey.

Intervention group will have 12 hebdomads exercising preparation in presence of their household attention givers. The first session after randomisation for intercession group will be held in client ‘s place to teach participant and his/her attention giver how to make the exercisings. Since there is no demand for any excess device, all the exercising can be demonstrated in a client ‘s ain place. The plan is non separately tailored, but will be done separately at place. In add-on to face to confront instruction, participants will be given a pictural brochure of all preparation exercising. They will be instructed how to utilize the preparation brochure. A flexible timetable ( harmonizing to participants ‘ penchant ) in a log book will be arranged for the topics to apportion 40-50 proceedings for exercising three times a hebdomad. Each session consists of a 5-10 proceedings warm-up, 30 minute strength preparation, and 5-10 minute cool-down preparation. They will be instructed to follow sequences of the preparation as warm up, exercising and cool down.

What would the sample size be, taking into considerations attrition rates etc. Decidedly 30 is non plenty. Cells will be empty.

In most of old intercessions sample size is less than 70 ( Kameide et al 2009 ) . However, in this survey random sampling will be applied to delegate participants ( N=100 ) into intercession and control groups. The survey is planned to enroll at least 50 topics in each groups. To increase the homogeneousness of the participants all participants will be recruited from abode of urban countries.

A Since, a big figure of community aged people in Iran are illiterate and are non able to enter their exercising in log books, this survey will inquire for aid of a attention giver. Care givers will be recruited from participant ‘s interested close female household member. All attention givers will be recruited from household members who are populating with their parents or able to see them often at their place ( at least one time every other twenty-four hours for one hr ) . They will be tested for wellness literacy to be able to make full in the log books. To guarantee homogeneousness of attention givers, they will be recruited from female household members, between 18 to 50 old ages old, able to see the participant freely and are willing to assist the participant. Both participant and attention giver should accept and subscribe the informed consent to be involved in research procedure.

The chief function of household member attention giver is to supervise the participant during exercising and record the exercising in logbook. Furthermore, they can name the research worker to inquire any inquiry about any likely job in any phase of the survey.

Aims

This survey is planned to look into the relationship between muscular strength to hazard of autumn among community dweller aged people. To accomplish this aim, the following specific ends are followed:

To depict the topics ‘ muscular strength, self-efficacy, fright of falls and balance before and after intercession

To analyze the relationship between topics ‘ muscular strength and hazard of falls before and after intercession

To analyze the relationship between topics ‘ background variables, muscular strength, self-efficacy and fright of falls before and after intercession

Conceptual Model

This survey will be conducted based on a modern biologic theory called “ wear and tear ” theory and Orem ‘s self-care theory. In this survey the wear and tear theory is used to explicate why muscular strength and balance deteriorates during old ages. Orem ‘s self-care theory is utilized to explicate how self-care through exercising can keep and better an old individual ‘s ability for balance and cut down the hazard of falls. Furthermore, Bandura ‘s self-efficacy explains the moderating function of self-efficacy between muscular strength, fright of falls and balance to hazard of falls among aged people.

The following excerpt is from The Staff of Entrepreneur Media’s book . 

The two key parts of your restaurant are the produc­tion area, where the food is prepared, and the public area, where your customers either dine or make their carryout purchases. The major factors to think about in terms of a restaurant’s design are the size and layout of the dining room, kitchen space, storage areas and office. Dining space will occupy most of your facility, followed by the kitchen and preparation area and then by storage. If you have an office on the premises — and you should — that will most likely take up the smallest percentage of your space.

The customer service area is important because it determines the first impression your restaurant will make on your guests. It must accurately convey the atmosphere of the restaurant in a way that takes advantage of the space available. Your customer service area should include a waiting area for customers, a cashier’s station, public restrooms and a bar, if you choose to have one. Other than fast-food or quick-serve establishments, most restaurants have bars or at least serve beer or wine.

Most upscale restaurants don’t have a cashier area where patrons walk up and pay. Instead, the waitstaff typically collects the payment at the table and takes it to the bar cash register. They then bring the change back to the table or return with the credit card slip to be signed.

You can use your cashier’s station as the host or hostess station, or you can set up a separate station at the threshold between the customer service and dining areas. A host or hostess stand usually consists of a small wooden podium with a ledger or computer keyboard and monitor for recording the names of waiting guests.

Dining area

This is where you’ll be making the bulk of your money, so don’t cut corners when designing and decorating your dining room. Much of your dining room design will depend on your concept. It might help to know that studies indicate that 40 to 50 percent of all sit-down customers arrive in pairs, 30 percent come alone or in parties of three and 20 percent come in groups of four or more.

To accommodate various party sizes, use tables for two that can be pushed together in areas where there’s ample floor space. This gives you flexibility in accommodating both small and large parties. Place booths for four to six people along the walls.

The space required per seat varies according to the type of restaurant and size of the establishment. For a small casual-dining restaurant, you’ll need to provide about 15 to 18 square feet per seat to assure comfortable seating and enough aisle space so servers have room to move between the tables. People don’t like being crowded together with other diners. Keep in mind that while you want to get in as many people as possible, you also want return customers. It is often said that 80 percent of business comes from return customers. If people are crammed in and don’t enjoy their dining experience, they won’t be likely to return.

Production area

Too often, the production area in a restaurant is inefficiently designed, and the result is a poorly organized kitchen and less-than-top-notch service. Your floor plan should be streamlined to provide the most efficient delivery of food to the dining area.

Generally, you’ll need to allow approximately 35 percent of your total space for your production area. Include space for food preparation, cooking, dishwashing, trash disposal, receiving, inventory storage, employee facilities and an area for a small office where daily management duties can be performed. Allow about 12 percent of your total space for food preparation and cooking areas.

Keep your menu in mind as you determine each element in the production area. You’ll need to include space for food preparation, cooking, dishwashing, trash disposal, receiving, inventory storage and employee facilities, plus your office area.

The food preparation, cooking and baking areas are where the actual production of food will take place. You’ll need room for prep and steam tables, fryers, a cooking range with griddle top, small refrigerators that you’ll place under the prep and steam tables, a freezer for storing perishable goods, soft drink and milk dispensers, an ice bin, a broiler, exhaust fans for the ventilation system and other items, depending on your particular operation.

Arrange this area so everything is only a couple of steps away from the cook. You should also design it in such a way that two or more cooks can work side by side during your busiest hours.

You’ll want to devote about 4 percent of your total space to the dishwashing and trash areas. Place your dishwashing area toward the rear of the kitchen. You can usually set this up in a corner so it doesn’t get in the way of the cooks and servers. Set up the dishwashing area so the washer can develop a production line.

To make your production area as efficient as possible, keep the following tips in mind:

• Plan the shortest route from entrance to exit for ingredients and baked goods.
• Minimize handling by having as many duties as possible performed at each stop — that is, at each point the item or dish stops in the production process.
• Eliminate bottlenecks in the production process caused by delays at strategic loca­tions. When things aren’t flowing smoothly, figure out why. Be sure your equipment is adequate, well-maintained and located in the proper place for the task.
• Recognize that the misuse of space is as damaging to your operation as the misuse of machinery and labor.
• Eliminate backtracking, the overlapping of work and unnecessary inspection by constantly considering possibilities for new sequences and combinations of steps in food preparation.
• Set up the dishwashing area so the washer can develop a production line. The per­son responsible for washing dishes should rinse them in a double sink, then place them into racks on a small landing area next to the sink. From the landing area, the racks full of dishes are put through the commercial dishwasher, then placed on a table for drying. The size and capacity of your dishwasher will depend on the needs of your operation.

Receiving and inventory storage spaces will take up to about 8 percent of your total space. These areas should be located so they’re accessible to delivery vehicles. Use double doors at your receiving port, and always keep a dolly or hand truck available. Locate your dry-storage area and walk-in refrigerator and freezer adjacent to the receiving area.