Tag: policy

  • Pregnancy and breastfeeding during an Ebola virus outbreak

    Pregnancy and breastfeeding during an Ebola virus outbreak

    Women who are pregnant or breastfeeding in an Ebola outbreak face similar challenges as other population groups, but they have specific health needs which must be met.

    As the second largest Ebola outbreak in history continues in the Democratic Republic of Congo, WHO has released new clinical guidelines for healthcare providers supporting pregnant or breastfeeding women in the context of Ebola virus disease.

    Improving clinical care and reducing mortality

    92-4-000138-1Clear and coherent guidance is needed to meet the combined needs of women requiring Ebola treatment, pregnancy care and management of complications.

    Information on how to protect breastfeeding children and other members in the community from transmission of the disease is also critical.

    Limited scientific evidence on how to best manage these needs has previously been a challenge for affected countries. In addition, misconceptions that pregnant women have a higher mortality rate than other populations with Ebola may in some contexts have put pregnant women at risk of not receiving standard care.

    WHO’s Guideline on the management of pregnant and breastfeeding women in the context of Ebola virus reviews existing evidence and provides a single set of recommendations on the care continuum for women exposed to, diagnosed with, or recovered from Ebola.

    This will enable healthcare providers, emergency response teams and health policy-makers to improve prevention and treatment measures in an Ebola outbreak.

    Obstetric care at an Ebola Treatment Centre

    Optimal supportive care should be offered to all pregnant women with Ebola. Likewise, they should be offered experimental treatment and vaccination under the same conditions as non-pregnant populations.

    Ebola virus disease does increase the risk of miscarriage and early labour, requiring close clinical management at Ebola treatment centres. It is important to engage both obstetric providers and those trained in Ebola response.

    This dual expertise is also important because early Ebola and pregnancy-related symptoms can overlap. Pregnant women should be prioritised for testing to confirm an Ebola infection.

    Ebola virus can persist in pregnancy related fluids as well as breastmilk. If healthcare providers are not clear on how to manage Ebola infection risk, they may be less willing to provide care. This stigma can be life-threatening for women who experience complications during delivery.

    The new WHO guidelines advise healthcare workers on how to protect themselves while caring for pregnant women with Ebola virus disease. This includes induced labour or surgical procedures, which carry greater risk of transmission in cases of acute infection. Any invasive treatments should be carried out in full personal protective equipment.

    Breastfeeding recommendations in an Ebola outbreak

    WHO recommends that women with suspected or confirmed Ebola immediately stop breastfeeding and are prioritised for diagnostic testing. Any child exposed to Ebola through breast milk should be placed into safe care, closely monitored for symptoms over a 21-day period and fed with an appropriate breast milk substitute.  

    The guidelines strongly recommend that breastfeeding is only restarted following two consecutive negative tests of breast milk, separated by 24 hours.

    A breast milk substitute should be used even if infection is confirmed for both the mother and her child. Exceptions can be made for infants under 6 months of age who are already infected, if breast milk substitutes are not feasible, affordable, sustainable or safe and separation cannot be implemented safely.

    Women’s health and rights in a disease outbreak

    A disease outbreak does not change women’s and adolescent girls’ fundamental human right to sexual and reproductive healthcare, including evidence-based care during pregnancy and childbirth.

    Women need support to make informed reproductive health care choices for themselves and their children. Women living in an Ebola outbreak should have access to all relevant reproductive options, regardless of economic, cultural, racial or religious status, including contraception and safe abortion to the full extent of the law.

    Pregnant and breastfeeding women across affected communities need equitable and respectful care that considers the risks they face and supports the choices they make.

    Accessing the guidelines and further research

    These guidelines are now available online and may be freely downloaded. The executive summary will be available in French.

    WHO will closely monitor new data as it emerges, as there is still a pressing need to prioritise ongoing research related to Ebola virus transmission.

     

     

     

    Pregnancy and breastfeeding during an Ebola virus outbreak
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    https://www.who.int/news-room/detail/10-02-2020-pregnancy-and-breastfeeding-during-an-ebola-virus-outbreak

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  • WHO and FIND formalize strategic collaboration to drive universal access to essential diagnostics

    Geneva, Switzerland – 10 February 2020 – The World Health Organization (WHO) and the Foundation for Innovative New Diagnostics (FIND) announced today that a memorandum of understanding has been signed by the two organizations to formalize a strategic collaboration that will strengthen diagnosis in resource-poor countries by closing major diagnostic gaps at country level and bolstering disease surveillance that will inform public health initiatives and enhance outbreak preparedness and response.

    “This collaboration is an inspiring development that will take us a long way towards ensuring access to diagnostics to all who need them,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Global health challenges such as the ongoing novel coronavirus (2019-nCoV) outbreak demonstrates that without these essential elements of health systems, we cannot hope to promote health, keep the world safe, and serve the vulnerable. I look forward to working closely with FIND to determine what countries need and to forge a path to deliver these innovations so that no one is left behind.”

    Diagnosis is a driver of patient, financial and health systems impact, and a critical enabler of universal health coverage, but it is also the weakest link in the care cascade. This is especially true in primary healthcare settings in low- and middle-income countries. A unique and unprecedented opportunity exists to expand the role and impact of diagnostics to fully realize their potential to address major health security threats and evolving disease burdens through technological and digital advances.

    FIND has been an active partner with WHO since 2008 and a WHO Collaborating Centre since 2014, acting in the areas of laboratory strengthening and diagnostic technology evaluation. This expanded collaboration will put in place the building blocks necessary to enable transformative change in a move toward a country-led diagnostics alliance. Initial workstreams will focus on demand-driven access to essential diagnostics and the development of national Essential Diagnostics Lists, alongside collection of data that assist the scale up of diagnostics to support low- and middle-income countries on their paths to universal health coverage.

    “Each and every person has the right to a quality, timely diagnosis,” said Catharina Boehme, CEO of FIND. “Comprehensive diagnostic services underpin functional and efficient health systems not only to manage day-to-day healthcare needs, but also to ensure new disease outbreaks can be spotted and contained quickly. Working closely with WHO as part of a country-led alliance, we will strive to ensure that low- and middle-income countries have what they need to develop their own comprehensive, data-driven diagnostic strategies that enable universal health coverage and empower disease surveillance. Our ambition is that all patients, providers and decision-makers have access to the diagnostic solutions needed for optimal health outcomes.”

    The strategic collaboration agreement will initially run for a period of 5 years, until 2025.

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    About FIND

    FIND is a global non-profit organization that drives innovation in the development and delivery of diagnostics to combat major diseases affecting the world’s poorest populations. Our work bridges R&D to access, overcoming scientific barriers to technology development; generating evidence for regulators and policy-makers; addressing market failures; and enabling accelerated uptake and access to diagnostics in low- and middle-income countries (LMICs). Since 2003, we have been instrumental in the development of 24 new diagnostic tools used in 150 LMICs. Over 50 million FIND-supported products have been provided to our target markets since the start of 2015. A WHO Collaborating Centre, we work with more than 200 academic, industry, governmental, and civil society partners worldwide, on over 70 active projects that cross six priority disease areas. FIND is committed to a future in which diagnostics underpin treatment decisions and provide the foundation for disease surveillance, control and prevention. For more information, please visit www.finddx.org

     

    About WHO

    The World Health Organization is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends. WHO is committed to the enjoyment of the highest attainable standard of health as one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition. WHO’s current global programme of work sets out three interconnected strategic priorities: ensuring healthy lives and well-being for all at all ages; achieving universal health coverage; and addressing health emergencies and promoting healthier populations. These priorities are linked to three ambitious targets, the “triple billion”: one billion more people to benefit from universal health coverage; one billion more people better protected from health emergencies; and one billion more people enjoying better health and well-being.

     

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  • Female Genital Mutilation Hurts Women and Economies

    Female Genital Mutilation Hurts Women and Economies

    Female genital mutilation (FGM) exacts a crippling economic as well as human cost, according to World Health Organization (WHO).

    “FGM is not only a catastrophic abuse of human rights that significantly harms the physical and mental health of millions of girls and women; it is also a drain on a country’s vital economic resources,” said Dr Ian Askew, Director of WHO’s Department of Sexual and Reproductive Health and Research. “More investment is urgently needed to stop FGM and end the suffering it inflicts.”

    New modelling reveals that the total costs of treating the health impacts of FGM would amount to USD 1.4 billion globally per year, if all resulting medical needs were addressed. For individual countries, these costs would near 10% of their entire yearly expenditure on health on average; in some countries, this figure rises to as much as 30%.

    The interactive modelling tool that generated these data was launched on the International Day of Zero Tolerance for Female Genital Mutilation.

    Severe physical and mental health impacts for women and girls

    Women and girls living with FGM face serious risks to their health and well-being. These include immediate consequences after being cut, such as infections, bleeding or psychological trauma, as well as chronic health conditions that can occur throughout life.

    Women who have undergone the procedure are more likely to experience life-threatening complications during childbirth. They may face mental health disorders or suffer chronic infections. They may also have pain or problems when they menstruate, urinate or have sexual intercourse. 

    All of these conditions warrant much-needed medical attention and care.

    “High healthcare costs for countries mount because of the tragic personal impacts on women and girls. Governments have a moral responsibility to help end this harmful practice,” says Dr Prosper Tumusiime, Acting Director for Universal Health Coverage and the Life Course in the African Regional Office of WHO. “FGM hurts girls, imposes lifelong health risks on the women they become, and strains the healthcare systems that need to treat them.”

    Preventing FGM brings major benefits for women, girls, communities and economies

    Using data from 27 high-prevalence countries, the Cost Calculator demonstrates clear economic benefits from ending FGM. If it were abandoned now, it shows that the associated savings in health costs would be more than 60% by 2050.

    In contrast, if no action is taken, it is estimated that these costs will soar by 50% over the same time period, as populations grow and as more girls undergo the procedure.

    Since 1997, great efforts have been made to end FGM, through work within communities, research, and changes in legislation and policy. 26 countries in Africa and the Middle East now explicitly legislate against FGM, as well as 33 other countries with migrant populations from FGM-practicing countries.

    WHO is also working with countries to raise awareness of the harmful impacts of the practice among their health workers, and to engage them in prevention efforts.

    “Many countries and communities are showing that abandoning female genital mutilation is possible,” states Dr Christina Pallitto, scientist at WHO. “If countries invest to end female genital mutilation, they can prevent their girls from undergoing this harmful practice and promote the health, rights and well-being of women and girls.”

    Female genital mutilation is internationally recognized as a human rights violation. It has no medical benefits and causes only harm. WHO’s position is that FGM must never be carried out.

    Further information

    The FGM Cost Calculator will be available here, as of 00:30 CET 6 February 2020:
    www.who.int/news-room/detail/06-02-2020-economic-cost-of-female-genital-mutilation

    More on FGM

    Notes for Editors

    About FGM

    FGM includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. More than 200 million girls and women alive today are estimated to have undergone the practice across 30 countries in Africa, the Middle East and Asia where FGM is concentrated.

    FGM is mostly carried out on young girls between infancy and 15 years of age.

    About the FGM Cost Calculator

    The WHO FGM Cost Calculator shows the economic cost of treating the health complications caused by FGM across 27 high-prevalence countries. These costs were calculated using the WHO One Health tool and other available scientific evidence.

    Users of the tool can calculate costs by country in a ‘business as usual’ scenario; a scenario of partial abandonment of FGM, and full abandonment of FGM over a 30-year period. In addition, the distribution of costs by different types of health complications is presented by country.

    The tool does not consider other indirect costs that hit families and communities, or the socio-economic impacts of the practice, which would be significantly higher still.

    The 27 countries modelled include Benin, Burkina Faso, Central African Republic, Còte d’Ivoire, Cameroon, Chad, Djibouti, Egypt, Eritrea, Ethiopia, Ghana, Guinea, Gambia, Guinea-Bissau, Iraq, Kenya, Mali, Mauritania, Niger, Nigeria, Soudan, Senegal, Sierra Leone, Somalia, Togo, United Republic of Tanzania, Yemen.

    Female Genital Mutilation Hurts Women and Economies
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    https://www.who.int/news-room/detail/06-02-2020-female-genital-mutilation-hurts-women-and-economies

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  • Changes needed to increase access to colorectal cancer screening

    Changes needed to increase access to colorectal cancer screening

    Colorectal cancer is the second highest cause of cancer death in the United States, expected to claim the lives of an estimated 49,190 people in 2016. The Affordable Care Act (ACA) aimed to increase access to CRC screening by not holding patients responsible for all costs of the procedure, yet current Medicare insurance beneficiaries lacking supplemental insurance may not be able to afford colon cancer screening and treatment. This policy disproportionally puts low-income Americans at risk and adds unnecessary strains on overall health care costs, according to a commentary in the May issue of the journal Gastroenterology.

    “Study after study shows that screening saves lives,” said Chyke A. Doubeni, MD, MPH, chair and the Presidential Associate Professor of Family Medicine and Community Health at the Perelman School of Medicine at the University of Pennsylvania, and lead author of the commentary. “Yet many of those in the group most affected by this deadly disease are unable to afford the screening they critically need. We must renew efforts to ensure equitable access to and use of disease prevention, detection, and treatment services for colorectal cancer.”

    For CRC screening, a full colonoscopy is necessary, where the doctor inspects the rectum and entire colon through a flexible lighted tube, and can remove any abnormal growth. The entire colon has to be cleansed before the colonoscopy, for which the patient is usually sedated

    There are currently an estimated 55.5 million Medicare beneficiaries in the U.S. A 2010 Kaiser Family Foundation survey found that 14 percent lacked supplemental coverage. Until recently, colon cancer screening has been viewed as a one-time activity, while in practice, screening is a series of clinical activities to identify and test patients and perform diagnostic confirmation when necessary. This series of tests and steps include a diagnostic workup, which can include a biopsy to obtain a tissue sample or polypectomy, in which polyps are removed to prevent them from becoming cancerous.

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  • Study analyzes impact of switch from nuclear power to coal, suggests directions for policy

    Study analyzes impact of switch from nuclear power to coal, suggests directions for policy

    Since incidents at Three Mile Island, Chernobyl, and Fukushima, many countries have switched from nuclear power to electricity production fired by fossil fuels, despite the environmental consequences of burning fuels such as coal. A new study used data from the United States to analyze the costs and benefits of electricity production from coal-fired versus nuclear sources. The study’s authors conclude that policymakers should look at nuclear power as a low-carbon electricity source, but that utilities will need to have incentives to do so.

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  • Stopping Employee Theft in Your Coffee Business

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    Regardless to how good of an employer you are, and even if you treat your employees well, understand that employee theft is a reality, and you need to control it. While it may only be a very small percentage of your staff that might steal from you, it can have a significant financial impact on your coffee business. If it goes unnoticed, employees will usually become even more brazen in their activities.

    When it comes to theft, your employees are likely to fall into one of the following four categories:

    Mr./Ms. honest – these are people who would never think of taking anything if it doesn’t belong to them. If they happen to go home with one of your ballpoint pens, they’ll bring it back the next day, and feel guilty that they took it home, even though it was unintentional.

    Incidental theft – these are people that will take home your pen by accident, and will keep it. And, they may scarf a piece of cheesecake occasionally when you aren’t looking, even though they know they shouldn’t. Because these items have minimal value, they have no great sense of guilt related to their activities.

    Theft because of need and opportunity – this is when you have an employee who is perhaps living on the edge financially, and because they have the need, and because your security may be lax, they’ll take advantage of an opportune situation to take something.

    Compulsive theft – this is the person who is always looking for something to steal, and they have absolutely no conscience about it. They typically rationalize the theft in their own mind. They consider you to be the rich, fat cat, and feel that they are over worked and under paid, so stealing from you is justified.

    Employee theft probably exists to some extent within your operation, whether you are aware of it or not. You can most likely live with incidental theft, provided it doesn’t get out of control. Theft related to need and opportunity is, in reality, your fault. These people would probably not steal from you normally, but a lack of security procedures has created the temptation and means for them to do so. Compulsive theft must be discovered, stopped, and you must eliminate the person(s) responsible.

    Losing product due to theft:

    Your employees may have no desire or need for a sleeve of 12oz. paper cups, Java Jackets, or a roll of toilet paper… but they might like a frozen cake, gallon of chocolate sauce, 6-pack of beer, or a bottle of wine.

    There are some simple things you can do to greatly reduce the chance of being ripped-off. First, don’t allow your employees to store their jackets, backpacks, and purses near where you store products. This makes it incredibly simple for someone to slide something into their bag or jacket pocket when no one is watching. I always had my employees store their personal belongings in the cabinet under the cash register (where someone would always be watching), or in my office, under lock & and key.

    Second, keep the back door of your store locked with a key at all times (you or your supervisor being the only ones having a key). If customers regularly enter through your back door, this may not be an option. If your back door is an emergency fire exit (and it probably is), you’ll need to install an alarmed breaker-bar. The whole point is that you don’t want your employees to be able to flow in and out of the back door without you knowing about it. Carrying product out the back door to their car, a hiding place for later pick-up, or an awaiting friend, is one of the most common ways products will exit your store.

    Once you have made it more difficult to stash things in their personal belongings, or carry them out the back door, employees may resort to hiding items in the trashcan. Of course you will unlock the back door to let them take out the trash. If they have hidden something in the trashcan, a dumpster-diving expedition will certainly be planned for after-hours to recover their treasure.

    Periodic trashcan checks should eliminate this problem, or make it a far less appealing option to anyone considering this method to smuggle things out of your store. Buy a long handle 3-prong garden rake. When employees ask to take out the trash, accompany them, and have them hold the can up on the edge of the dumpster while you rake out the trashcan contents. What you are looking for are things that might have been hidden in the trash, but you can tell your employees that you are merely making sure that small wares aren’t being accidentally thrown away. During the 15-years I owned and managed restaurants, I discovered everything from six-packs of beer, bottles of wine, and packages of steaks hidden in the trash!

    Another situation that will create an ideal opportunity for employees to steal from you is having only one person working in your store. If your baker comes in each morning a hour before you or the next employee, or if one person is left to clean and lock-up the place at the end of the day, opportunities for theft abound. As the old saying goes: when the cat’s away…

    Always try to have at least two people in your store at all times. If there is not justification for having a second employee on the clock, then you will need to be that second person. If this requires you going from a 60-hour workweek to 80-hours, then this may not be a tolerable option. If this is the case, then at least invest a couple of hours more each day for a week or two to do some detective work.

    During those times of day when only one employee is working, park at the far end of the parking lot, or across the street, so that you will reduce the chance of being noticed by your employee. If they are familiar with your vehicle, use your spouse’s or friend’s vehicle for a few days. Watch carefully (with binoculars if necessary). I know this all sounds a little CSI – like, but better to rest-easy, feeling fairly assured that your employee isn’t carrying away your store when you’re not watching. If I had the time, I could tell you countless stories of my experiences in catching employees red handed, loading the trunks of their cars.

    If you suspect that theft of product might be occurring, but you’ve seen no direct evidence of it, then conducting a daily key item inventory may shed some light on the situation. Write down a list of 15 to 20 products that you think would be most appealing for someone to steal. In your coffee business, this might include items such as coffee, syrups and sauces, smoothie puree, biscotti, cookies, and desserts, sandwich meats & cheeses, and of course beer & wine (if you serve those from your operation). Then take an inventory of these items every day. Your employees don’t need to know what you are doing, and if they ask, simply tell them you are taking an inventory for ordering purposes.

    What you are looking for are anomalies in usage. For example, let’s say that from your daily inventories you assess that you use about half a gallon of chocolate sauce per day. Then, one day you notice you used 1 1/2 gallons of chocolate the previous day. This should send up a red flag! Why did you go through an extra gallon of chocolate? Were you significantly busier yesterday, or did you featuring several drink specials which contained chocolate sauce? A quick review of individual item sales from yesterday’s cash register report should provide you with the answer. If you average one ounce of chocolate per beverage, then using 1 1/2 gallons means you should have sold approximately 192 beverages containing chocolate (128 oz. per gal. x 1.5 = 192). If this was the case, no problem. But, if you discover that you only sold 64 beverages containing chocolate, then 128 oz. (or 1 gallon) is unaccounted for and missing! A good indication that it probably walked out the door. If this happens, keep track of who was working on the day of the shortage. If this happens continually, eventually you will discover that the same person or persons were working every time.

    Theft of money by employees:

    Hopefully, none of your employees will have the desire to steal products from you, but some will be tempted by the lure of cold, hard, cash. Everyone could use an extra $20 a day. Employees who steal money from you will definitely hurt your bottom line, and must be eliminated.

    The first way to reduce cash theft is to have a cash handling policy in place that will discourage theft. If multiple employees are using the cash register, and no one person is responsible, then I can almost guarantee that your cash drawer will keep coming up short on a regular basis. The fact that no one person can be held responsible for the shortages, will make grabbing a bill or two easy and appealing.

    Implement a policy that one, and only one person is responsible for the cash register for the entire shift. They should count the drawer at the beginning of their shift to verify that they are starting with the designated change bank. Then, they should be the only person to ring up sales and make change. Even you, the owner/manger, should keep your hands out of their cash drawer. Finally, at the end of their shift, they should set aside the amount they started with in the change drawer, and total all the remaining cash, checks, and charges, and balance against what was rung up on the register. If they started with the right amount of money in the cash drawer, rang everything up, took all the money, counted back all the change, and they end up short… who’s fault is it? It can only be theirs. By implementing this simple policy, I once took an operation that was coming up $100 a day ($3,000 a month) cash short, and reduced it to $3 a day, in just 30 days! That’s over a $2,900 bottom line improvement, (in case you didn’t do the math)!

    The other common method that a cashier might use to steal money from you is by using a method called, building a bank. This is the process of not ringing up items on the cash register, while still taking money from the customers, and then pocketing that money. Typically, they will obscure the view of the cash register display on the customer’s side with something like a flower, retail merchandise, or by turning the display so that it cannot be easily seen. Then, they will pretend to ring up an item, but will hit the no sale key instead, popping the drawer open so they can take the cash and make change, but in reality, they haven’t rung up anything. The other thing they might do when it is busy is to just not shut the drawer between transactions. They simply convey verbally the cost of items ordered by customers and take the cash, but once again, nothing has been rung up.

    A cash register that prints out the order on a remote receipt printer to the person who will be preparing the item, can eliminate this problem. Quite simply, if the item isn’t rung-up, it won’t print out. If your barista or cook won’t prepare anything without a receipt (and they shouldn’t!), it will force your cashier to ring everything up.

    If you observe that the cash register’s display has been blocked from the customer’s view, or there are an excessive number of no sale indications on your cash register’s detail tape, or notice that your cashier is not shutting the drawer between transactions, beware! While these may not be indisputable proof that your cashier is stealing from you, they should certainly heighten your vigilance to find out if something is going on.

    If your coffee business only warrants having one employee working at a time, perhaps because you own a cart, kiosk, or low volume drive-through operation, then how do you go about keeping your employee from building a bank and stealing from you? The best solution I’ve seen is to turn your customers in to watchdogs. Affix a sign to the front of your cash register, in plain sight of the customer, that reads: If you don’t receive a receipt with your order, it’s FREE! This will force your cashier to hand each customer a receipt for their purchase. If they are building a bank, this means they will have to hand the customer a receipt that says – NO SALE; something they probably won’t fell comfortable doing!

    The financial impact of theft of money can be extremely damaging, for example: Let’s say you have a cashier who is skimming off $20 a day by not ringing things up, and then pocketing the money. Not only did you loose the stolen $20, but the $7 of ingredients that were probably used to produce the ordered products; ($20 x 35% ingredient cost = $7.00). So in reality, you lost $27, and it will take an additional $41.54 in sales, to recover this loss; ($41.54 x 65% gross profit = $27). $27 a day lost to theft, X 21 days worked by the employee = $567 lost cash & product per month; $872 extra sales required to offset this loss. (Annual loss, $6,804; $10,468 in additional income required to offset loss.) You must stop theft of money!

    Theft of money management:

    If you have a manger running your operation for you, this can really create an opportunity for cash theft. Just about anyone who has ever run a food service operation (self included), probably felt that they were over-worked and under-paid. Some are tempted to grant themselves an unapproved raise. Your manger has the control key to the cash register, which means they have the ability to back off items that were sold. You would be wise to check your cash register detail tapes on a regular basis. If you see multiple items backed off in groups, or more worrisome yet, all backed off at the very end of the shift, beware!

    A good way to keep this from happening is to establish a policy that no over-rings are to be backed off of sales on the cash register with the management control key. Instead, when the cashier makes an over-ring, they should take the receipt, write over-ring on it, sign it, and put it in the cash drawer. At the end of the shift, the total of all over-rings should be manually backed off of the sales total indicated on the cash register report.

    Many years ago I had a manager that was stealing money from me in another creative way. This manager, who opened the store each day, would reset the cash register by Z-ing it out after the first half hour of business. He would then pocket the proceeds earned during that first half hour. Because additional sales were generated during the second half hour, the cash register hourly sales report would always show sales for the first hour of operation, thus eliminating any suspicion that something might be going on.

    It wasn’t until I was doing a routine audit of cash register Z tapes that I noticed something wasn’t right. When you run a Z report, which resets the cash register at the end of each day, a multi-digit number will usually be printed somewhere on that tape. The next time you Z the register, that number will advance by one digit. I noticed that even though the tapes were sequential in date, every other number was missing. This tipped me off that the register was being Z-ed twice a day! When I confronted my manager with the tapes, his look of panic spoke volumes.

    If you are doubting the honesty of any of your employees or managers, one way you can verify or eliminate your suspicion is by baiting the cash drawer. Slip an extra $20 bill in the drawer sometime during the day when they aren’t watching. If they don’t end up reporting at the end of their shift that they were $20 cash-over, I’ll do it a second time (just to make sure). If they don’t report it a second time, you should have no doubts that they are indeed, dishonest.

    NEVER accuse an employee or manger of stealing unless you catch them red-handed (actually stuffing money into their pockets). Even though the circumstantial evidence may be overwhelming, unless you actually catch them in the act, they are likely to deny your accusations, and will probably file a complaint against you with the department of labor! The brief moment of satisfaction you will gain from letting them know you are aware of what they’ve been doing, will be quickly overwhelmed by the legal predicament you will find yourself in. You will be far better off to not make accusations. Simply terminate their employment. In many states, you do not need to provide a reason as to why you are letting them go. When they ask for an explanation as to why you are firing them, simply say: I don’t need to give you a reason, I’m just letting you go, goodbye!

    Finally, don’t over look technology to help you with security. Surveillance cameras linked to a DVR (digital video recorder) can provide you with peace of mind, or evidence of theft. These systems have become very affordable, and many are easy to install. The value of these cameras go beyond having a video record of operations. The mere fact that employees understand that their activities are being video recorded, will usually discourage them from doing things that they might not think twice about, if no one was watching.

    I think it’s important to not be paranoid about employee theft. Certainly, you don’t want to be constantly obsessed with the suspicion that everyone is stealing from you. In reality, the majority of your employees are probably honest people. But, you would be wise to establish some simple safeguards, and maintain a watchful eye.

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    Source by Ed Arvidson

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  • Here Is Why Everyone Needs Health Insurance

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    Today, healthcare insurance is one of the hottest political topics. Everyone is asking who should be able to have health insurance, what will be the costs of it, can you survive without insurance and what will be the penalty? In this article, we are going to help you know the reasons why everyone needs health insurance.

    Life is Unpredictable

    While the spontaneity of life is pleasant, know that your health and budget may be hit hard due to unpredictable circumstances. Major health illnesses like diabetes, cancer or HIV have high medical costs. If you don’t have health insurance, the cost of these medical treatments may ruin your credit rating. As a matter of fact, medical bills is one of the reasons why many people go bankrupt.

    Regardless of your circumstances, it’s important that you have insurance. You have no idea what is going to happen in your life down the road. We hope that nothing bad is going to happen in your life but it’s great to have peace of mind by signing up for an insurance policy. This will give you the peace of mind that your medical bills will be covered, and that you won’t go bankrupt.

    Maintain Your Health

    In your life, your most valuable asset is your health. Most of us take insurance as a type of financial support we get in the event of an accident or illness. However, it’s important to keep in mind that it’s equally important to maintain good health. If you eat well, you can stay in good shape.

    If you don’t have insurance, you won’t need to go to a doctor for medical checkups. Actually, a health insurance policy enables you to benefit from the “preventive care”, which is part of most plans. What you can do is see your qualified doctor for checkups and take part in other benefits like health screenings. This can help you maintain your health. Also, the insurance policy plan you have chosen can help you find out what is included.

    Reduce Your Costs

    It’s important to keep in mind that insurance providers offer special rates for doctors who are part of their network. So, if you have health insurance, you can reduce your medical costs significantly.

    Avoid a Penalty

    Aside from saving on your health care costs, an insurance plan can help you avoid a penalty as well. Today’s health insurance laws have a requirement that you should have a health insurance plan or you may have to pay a penalty for the month for which you or your partner or your tax dependants don’t show that they have the minimum coverage. And typically, this fee is based on a person or household income whichever is higher. This penalty can be avoided if you have health insurance.

    It’s important for everyone to have health insurance. After all, you have no idea what is going to happen in the future. You can enjoy the best health care provided you get the right insurance policy.

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    Source by Shalini M

    Views: 0

  • Enterpriship – The Art and Science of Entrepreneurship, Leadership, and Management

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    Every individual who starts, owns, or is a member of the management team of an enterprise, should strive to build sustainable advantage. Sustainable advantage is essential to value creation because cash flows become predictable and reliable over long periods of time. As a consequence, it is easier to plan for investments in new endeavors and to maintain contingency reserves for downturns.

    Building sustainable advantage requires proficiency in the disciplines of entrepreneurship, leadership, and management. Collectively, these three disciplines embrace “enterpriship.”

    Enterpriship is both an art and a science. Art is an occupation that requires both knowledge and skills; science is method for systematizing knowledge. Through both knowledge and skills, enterpriship provides a systematized approach to building sustainable enterprises by employing the techniques of entrepreneurship, leadership, and management.

    Entrepreneurship is a competency for starting, developing, and assuming risk for an enterprise. Leadership is a competency for aspiring, inspiring, and motivating others. Management is a competency for directing and controlling events and activities – management as a “team” has the authority and responsibility for the enterprise.

    Being proficient in all three competencies requires experience. Entrepreneurs may lack the leadership and management competencies, leaders may lack entrepreneurial and management competencies, and managers may lack the entrepreneurial and leadership competencies to build a sustainable enterprise.

    Upwardly mobile entrepreneurs have to demonstrate to investors that they can build large markets. Lifestyle business enterprise owners, such as dry cleaners, hairdressers, professional service providers, restaurateurs, and retailers, are responsible for everything in their businesses. Executives and managers in larger enterprises are under constant pressure from investors to generate quality earnings on an ongoing basis.

    The enterprise depends upon the use of all three enterpriship competencies as do the employees, customers, suppliers and investors.

    When entrepreneurs start enterprises, they tend to focus on the benefits and features of their products and/or services. Intrapreneurs, who are agents of change in established enterprises, tend to do the same thing. However, focusing on products and/or services alone is insufficient for building sustainable advantage over time.

    Without people there is nothing in business. Processes must be effective and efficient at delivering quality products and/or services conveniently. If an enterprise can’t deliver, a competitor will.

    Hence, the management team collectively must be proficient in entrepreneurial, leadership, and managerial roles that dictate successful people-oriented, process-oriented, and product and/or service capabilities.

    The entrepreneurial role is both process-oriented and product-oriented, through which innovative ideas are transformed into value at every stage of an enterprise’s development.

    The leadership role is people-oriented, through which direction is set that others will follow to achieve results – equally applicable to top-level executives, team leaders within functions, or anywhere in between.

    The managerial role is process-oriented, through which resources (time, materials, and supplies) are applied to activities to achieve results.

    These three roles embrace the planning and policy development, deployment and execution, and performance measurement activities of the enterprise. Deployment means positioning the resources of the enterprise in the best markets for its products and/or services. Execution means getting things done through people and processes effectively and efficiently.

    Unless the management team employs these three enterpriship competencies collectively to address people, process, and product and/or service capabilities, the enterprise will be unable to build sustainable advantage over time, and will ultimately decline, and maybe fail.

    If the management team can systematize building sustainable advantage through the effective and efficient use of people and processes, then there more time to spend on developing the benefits and features of products and/or services. Enterpriship provides the approach…

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    Source by Nigel Brooks

    Views: 1

  • Drug Addiction in Senior Citizens

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    Drug addiction in senior citizens is a significant and growing problem in the United States that few people are aware of. In fact, addiction that occurs later in life can be difficult to detect, and sometimes the person suffering from this disease might not even know that they are physically and emotionally dependent on a particular substance. Therefore, a policy of education about the dangers of addiction in older people is essential in order for those who are close to them to recognize any problem and know what options are available to get help. This is especially important considering that recent increases in the amount of older people entering drug rehab programs indicate this problem is probably far worse than we might think.

    The primary way that seniors get addicted to drugs is as a result of chronic pain management. Even under strict medical supervision, addiction to pain medications can and does still occur. This is because these types of narcotics work the same for everyone: they initially manage pain well, then the body develops tolerance and more of the drug is required. With an increase in dosage and consistent use, tolerance increases and eventually leads to physical dependence. Physical dependence almost invariably leads to outright addiction at a mental and emotional level. Therefore, seniors who are taking pain medications regularly are at increased risk for addiction. And because these medications are prescribed by doctors, most people consider them harmless and don’t think that addiction will ever become an issue. However, once it sets in, addiction is a lifelong affliction that can cause serious health issues.

    Another primary reason that older people become addicted to drugs or alcohol is as a result of lifestyle changes. These changes include the celebration of a life of toil and work, but can lead to some very bad habits. For instance, frequent dinners that include wine or beer can quickly become problematic. Before a person knows it, they’re having cocktails with lunch and dinner, and eventually Mimosas or Bloody Mary’s with breakfast.

    As a result of inactivity after a lifetime of working, some seniors have difficulty sleeping. Medications designed to help people get to sleep are extremely addicting and can lead to significant problems with memory loss. Older people who are addicted to sleeping pills often engage in strange or erratic behavior while having no recollection of doing so. And because sleep aids can lead to a persistent state of confusion, it can be difficult for a person to understand that they have a problem.

    Grief and depression is often a significant problem for senior citizens. As people get older their friends, family and associates age as well, and the loss of these people becomes a common occurrence. This combined with decreased levels of activity can lead to a state of depression that some people might seek to self-medicate with drugs or alcohol. Boredom and lack of exercise serve to exacerbate these problems.

    If you have an older loved one with a drug or alcohol problem, their very life could depend on you. The following options are readily available:

    Individual Therapy/Counseling

    Intervention

    Outpatient Rehab

    Inpatient Rehab

    Group and Family Therapy

    Don’t wait a moment longer to take action; the earlier addiction or alcoholism is treated, the higher the likelihood of success.

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    Source by Jim Debbies

    Views: 0