The Changes in Healthcare Industry Research Paper

The Changes in Healthcare Industry - Research Paper Example This paper explores the changes that the healthcare industry has experienced in the last decade and also assesses possible challenges the industry is likely to face in the next ten years. It is no secret that the healthcare industry has undergone an extensive change in the previous decade. The healthcare industry has in the last ten years experienced numerous ups and downs. The life expectancy of individuals has increased amazing compared to that in 1980s. There have been numerous medical breakthroughs both in terms of health equipment and drugs. The advancement in technology has seen health care delivery services become better each year, increasing the overall efficiency of the healthcare industry. The healthcare industry has grown from less efficient to the efficient industry through technological innovations. Computers have resulted in a massive reduction in medical errors. Health records are now processed and stored in electronic form eliminating massive paperwork and minimizing possible errors altogether. Competition has also heightened in the last decade pushing health care providers to fine-tune the services they offer to clients (Ginsburg, 2005). However, the industry has not been without its downs. The cost of health care has escalated over the years. It is now more expensive to obtain quality health care than it was ten years ago. The increasing number of uninsured indicates how expensive health care has become. Healthcare has become evidently unaffordable to many people over the last decade. Nonetheless, the government has been doing its best to curb this undesirable scenario. For instance, Obama care, though faced with numerous challenges, is aimed at making health care affordable to all people. Healthcare industry is likely to experience numerous changes in the next decade. Of all the likely changes, improvement in technology stands to be the biggest change in the next ten years. The advancement in technology has been on the positive side and the healthcare industry is likely to benefit from this in the next decade.  Ã‚  

Workplace Change Over the Last 1015 Years Essay

Workplace Change Over the Last 1015 Years - Essay Example In addition, 63 percent of the executives also said that technology is also the future enabler of working styles in the future. Nevertheless, technology ranked fourth among the priority list of these executives in as far as the driving of businesses is concerned; after better productivity, culture, and cost reduction. According to these executives, VoIP, wi-fi, and ultra-mobile PC's are some of the technologies that will greatly impact on the workplaces in the next five years (Carr 2006). In this regard, flexible working is slowly becoming a common culture in some of the technologically-oriented companies. Whereas close to 91 percent of these organizations let their employees to work from home, a further 67 percent are still reliant on office attendance. For the latter group, 55 percent of the executives interviewed were optimistic that this trend will soon change (Carr 2006). Only just about 50 percent of the respondents believe that in the next five years, their workforce will still be commuting from home. Information technology has proved to be of fundamental importance in as far as organizational change is concerned. The business landscape will always have to change in line with the technological innovations in the workplace, pressure from competitors, and consumer preferences. As such, a lot of companies are now embracing information technology to streamline operations, improve business processes, increase profitability, and cut costs. The impact that information technology has had on organizational change cut across all the sections of an organization. Thus, the structure of the organization, process change, employee skill base, product delivery, and methodologies in marketing, all have to change as a response to information technology. Weber, Taylor and Fayol, as well as a couple of other theorists were of the opinion that there does exist a single and best way through which organizations can be structured. Nevertheless, organizations still vary greatly with regard to structural attributes, and this has led to the carrying out of numerous researches with a view to understanding the determinants of such variations. A lot of organizations are now becoming aware of the need to have relationships and social interactions at the workplace (Klein et al 2001). The understanding of such a phenomenon and the implications that it will have at the workplace is already proving to be a challenge to many organizations. Today, a lot of organizations struggle to keep pace with changes in the economy and the marketplace, while at the same time also seeking out for ways through which they can best enhance their financial profitability, while also enhancing the performances for their employees. Lin (2001) has described the theory of social capital in reference to the investments that organizations make in social relations, while also expecting to make returns in the marketplace. Such organizations usually embrace the culture and ethics of

Financial Accounting Midterm Project Essay Example | Topics and Well Written Essays - 2000 words

Financial Accounting Midterm Project - Essay Example Meanwhile, managerial accounting reports are designed to serve specific needs of the management. They make use of both historical data and estimated data. While financial accounting reports have to be prepared according to the Generally Accepted Accounting Principles (GAAP), the same does not hold true with managerial accounting reports. (Warren, Reeve, etc., 1987, pp. 2-4) A job opening in the field of financial accounting at the Monster website states that "the Accounting Manager is responsible and accountable for the entire Company's Accounting Department." As such, he/she will manage and provide direction to the accounting department personnel as well as direct and lead all accounting functions to ensure that all accounting, financial and tax information are properly disseminated and reported. The job requirements include a bachelor's degree in Accounting, experience in cost accounting and the preparation of cash flow statements and skills in preparing tax returns and audit revie ws. (Monster 2010) Meanwhile, a job opening in the field of managerial accounting requires a Revenue Accounting Manager who will have the following main duty: "continuously work to understand the various revenue streams to ensure the highest levels of revenue recognition." (Monster 2010) Similarly, the job requirements include a bachelor's degree in Accounting. In contrast to the job opening for a financial accountant, however, this one requires "strong project management and planning skills" and an "analytical mind which is able to process information logically delivering value added analysis." These stuffs are definitely necessary in the domain of managerial accounting. 2. According to history, accounting was first established by Luca Pacioli - an Italian Renaissance mathematician, a close friend and tutor to Leonardo da Vince and a contemporary of Christopher Columbus. Pacioli described in his work entitled "Summa de Arithmetica, Geometria, Proportione et Proportionalite" a syste m that served to make sure that financial information were efficiently kept in accurate records. This basic system eventually became established as the way to note down all transactions of businesses. (Weygandt, Kieso, etc. 2009, pp. 5-6) 3. The following are the liquidity ratios of Microsoft Corporation (MSFT) and Apple Inc. (AAPL) for the year 2010: MSFT AAPL Current Ratio 2.5 1.8 Acid Test Ratio 2.2 1.6 These ratios show that both MSFT and AAPL have sufficient liquid resources to pay up their short-term liabilities. Of the two, MSFT is the company with the higher level of liquidity. The current ratios indicate that their current assets can well be utilized to fully settle their current liabilities. Meanwhile, the acid test ratios indicate that the two companies would be able to fully settle all their short-term liabilities by using only the most liquid of their assets - namely: cash, marketable securities and accounts receivable. 4. The following are the activity measures of Micr osoft Corporation (MSFT) and Apple Inc. (AAPL) for the year 2010: Asset Management Ratios MSFT AAPL Inventory Turnover (# of times) 19.2 63.9 Accounts Receivable Turnover 5.5 16.7 Fixed Assets Turnover 8.8 17.0 Total Assets Turnover 0.8 1.1 The above

Business Ethics - Disussion Questions Case Study

Business Ethics - Disussion Questions - Case Study Example ork ethics will be formulated with an emphasis on loyalty and respect, a workable agreement on fair dealings, built trust, well-informed decisions on values rather than beliefs among other features. It will be important to therefore study, understand the country with its cultures and beliefs, and interact with the societies in order to deploy better relationships with the environment. The trans-cultural integrated ethical decision-making entails the aspects of addressing the need for including cultural factors in the process of ethical dilemma resolution. This trans-cultural model incorporates well-defined concepts from multicultural theories into ethical decision-making models that can be adapted primarily from an integrated model deployed. This approach is presented in a format that can be used by counselors facing ethical challenges within a variety of settings and within different cultural groups (De, 2012). The benefits of developing a transcultural corporate ethic entail the aspect of improving the welfare of a society and the interests of the organization. The social responsibility in organizations will also be improved and this will enhance the course of an organization. The management has within its power the capacity to develop a transcultural corporate ethics. They have the ability to also strive to develop a strategy that embodies a jointly developed transcultural virtues, with this virtues forming a common bond through all cultural difference. It is, therefore, important to understand that profits and ethics are essential elements in the process of evaluating an organizations activity. During profits major on showing organizations results from a quantitative viewpoint, ethics also reflects the quality of these results. In relation to this study, total is a gas company that competes with the Shell group with both being gas companies. Shell group amongst other things provides that all people should at all costs avoid conflicts of interests between

Comment 3 Assignment Example | Topics and Well Written Essays - 250 words - 1

Comment 3 - Assignment Example The work gives much attention to concepts that govern appropriate data collection. It can also be noticed that the author has indicated the two main types of research as either qualitative or quantitative. The supportive facts used to strengthen the viewpoint of the author in respect of using effective communication in data collection are convincing. This is in respect of the common knowledge that oral interview or questionnaires tend to be successful on sound communication skills and proper structure. Observation as a method of data collection has also been given significant focus in regard to the need for total involvement by the researcher (Easterby-Smith, Thorpe and Jackson, 2012). Adoption of a particular methodology on choice of method for data collection and analysis serves to estimate sample population and match the objective of the study. The flow of ideas from introduction on data collection, methodology and conclusion that tackles hypothesis sheds much light on research methods to a layman. This makes this work stand out is representative of the widely used research study

Philip II Of Spain Essay Example for Free

Philip II Of Spain Essay King Philip II of Spain (1527-1598) has cast a lengthy shadow over Spanish and European history for centuries. Though this might seem fitting, given that he was the first man to rule a truly global empire on which the sun never set, it is not entirely appropriate, for Philips enduring fame stems not so much from his achievements, as it does from misconceptions about his character and legacy. Within Spain itself, Philip can still be remembered to this day as a brooding, reclusive workaholic, who, despite his best intentions, poised his nation and empire on the brink of a precipitous and inevitable decline. Beyond Spains borders, Philips shadow has long been perceived as exceedingly dark and menacing. After all, how many other monarchs can claim the unhappy role of top villain in one of Schillers tragedies, or in a major opera, such as Verdis Don Carlo, which set the gloomy myth to music? In the English-speaking world Philip reigned supreme for nearly three centuries as the ultimate embodiment of the Black Legend: a sinister figure, cruel and devious beyond measure, a religious fanatic who could only be viewed through the smoke of the Armadas cannons and of the Inquisitions pyres. Philip II was present in Brussels when his father resigned to him the government of the Netherlands (October 1555) as well as of Spain itself (January 1556). International matters, mainly his marriage to Queen Mary of England and the war against France, kept him in northern Europe. In August 1557 the Spanish forces in Flanders, directed by the duke of Savoy and the count of Egmont, crossed the frontier into France and caused a crushing defeat on the French at St Quentin. Philip arrived in time to congratulate his army, however failed to follow up the advantage; negotiations started and were interrupted by the death of Mary in November 1558. Finally peace was agreed at Cateau-Cambresis in April 1559, one of the circumstances being the marriage of Philip to the daughter of Henry II of France, Elizabeth of Valois. The king sailed from the Netherlands in August 1559 and landed at Laredo in September. He never left the peninsula again. Domestic politics lapse into relative quietness during the reign, in order that events seem to depend more than usual on the personality of the king. Philip, though, was no less devoted to the problems of internal government than to the weighty matters of foreign policy. (R. Trevor Davies, 1957) Aged 28th at his accession, he was already an experienced ruler, having been regent for his father sporadically since 1543. His fair hair and blue eyes betrayed his Habsburg origin; however no ruler could have been more Spanish. Brought up in Castile and trained by brilliant tutors, he preferred Spaniards as advisers and spoke merely Castilian fluently, though he had a working knowledge of Latin. Pensive by disposition, and always unwilling to rush into decisionshence the tag of prudent kinghe had a deep sense of duty which governed both his personal and public life. His stern side as headed at the top by the council of State, shorn since 1559 of its non-Castilian members. The councils chief secretary until his death in 1566 was Gonzalo Perez, a cleric of converso origin; thereafter the post was divided between Gonzalos son Antonio as secretary for the south and Gabriel de Zayas for the north. True to his fathers policy of allowing differing views to develop, Philip tolerated a conflict of opinions, not always with fruitful consequences. The chief rivals in the council of State were the kings long-standing friend the Portuguese Ruy Gomez de Silva, and the duke of Alba. Ruy Gomez, created prince of Eboli and duke of Pastrana, married into the powerful Mendoza family, headed by the duke of Infantado, and thereby became linked with a clan of nobles from the highest grandee families, the Zuniga, Velasco and Guzman. Fernando Alvarez de Toledo, third duke of Alba and Philips most distinguished general, was head of the house of Toledo and had similar powerful connexions. The division in the council between these two a normal rivalry between clans, of the sort common both at government and at local levelalso extended to the secretaries, Antonio Perez being allied to Eboli and Zayas to Alba. Differences between the groups, as with all political factions, arose primarily out of a struggle for power. Given the complex problems that faced the Spanish monarchy, there were occasionally issues on which some took a hard line: Alba, as Charles V had warned Philip, was inclined to be authoritarian. It is however not convincing to categorise one groupAlbasas the war party, and its opponents as the peace party; even less, as we shall see, is it possible to distinguish any real difference of approach to constitutional problems. The problem over which the factions took most issue was the revolt of the Netherlands, which precipitated the famous affair of Antonio Perez. Immediately after Philips return to Spain in 1559 he began a massive effort to put the country into an adequate state of defence: Turkish expansion in the 1560s inevitably made foreign policy the first concern of government. At the same time difficulties in the Netherlands were brought to him in person when the count of Egmont arrived in Madrid in February 1565. From this period Spain was burdened by a dual commitment to northern Europe and to the Mediterranean, and the numerous mistakes made by Philip in his dealings with the Netherlanders can in part be blamed on priority given to affairs in the south. Aware, none the less, of his obligations, the king made preparations to visit Flanders in 1567. He was dissuaded from this by Alba, and in 1568 two personal crisesthe death of Don Carlos in July and then of Elizabeth of Valois in Octoberforced him to remain in the peninsula, where on Christmas Eve a major uprising of the Granada Moriscos began. The death of Ruy Gomez in 1573 made Antonio Perez effective head of the Eboli faction at court. A contemporary noted that Perez climbed so high that His Majesty would not do anything save what the said Antonio Perez marked out for him. Philip depended heavily for advice and policy on this brilliant and sinister young man whose fortunes were linked with those of Ana de Mendoza, princess of Eboli, the beautiful one-eyed widow of Ruy Gomez. Perezs arm stretched as far as Flanders, where the kings half brother, the famous Don Juan of Austria, was acting as governor. Don Juans personal secretary, Juan de Escobedo, had been a protege of Perez, who expected to be kept reliably informed of the plans and ambitions of the governor of the Netherlands. Don Juans proposals for policy in the north, however, were at variance with government intentions in Madrid, and Perez and Escobedo soon found themselves opposed to each other on a number of issues. Philip in turn was wary of the ambitions of his half-brother, the victor of Lepanto. Suspicious of the way his plans for Flanders were being blocked by Madrid, Don Juan sent Escobedo to Spain in 1577 to make enquiries. On arriving at the court it appeared to Escobedo that Perez had been duping Don Juan and presenting his case in an unfavourable light to the king. He apparently issued threats against Perez, accusing him rightly or wrongly of a liaison with the princess of Eboli, and of betraying state secrets. But Perez had already managed to convince Philip that Escobedo was the malign influence in the affairs of Flanders and in the end he persuaded the king that the only solution was to eliminate Don Juans secretary. In March 1578 hired assassins murdered Escobedo in a street in Madrid. (Townsend Miller, 1963) Popular rumour instantly pointed to Perez as the assassin, and Escobedos family, aided by Perezs rival the kings private secretary (from 1573) Mateo Vazquez, demanded justice for the murdered man. No action was taken, clearly because the king himself was implicated and had acted on reliable advice. In the spring of 1579, however, Philip was sent the private papers of Don Juan, who had died the previous October. On reading them Philip discovered that Perez had deceived him and that his brother and Escobedo were guiltless of the imputations against them. He encouraged Vazquez to make a secret enquiry into Perezs actions in office, and determined to make a clean sweep of his minister. Since his return from the Netherlands in 1573 the duke of Alba had been active in the councils at Madrid, but in 1579 was placed under house arrest for letting his son make an unauthorised marriage: he was called out only to undertake the invasion of Portugal. His disgrace was followed by Philips decision to place the direction of affairs in the hands of the Burgundian Antoine Perrenot, cardinal Granvelle, who had been withdrawn from the Netherlands in 1564 but had since served the crown with distinction in Italy. On 28 July 1579, the very day that Granvelle reached Madrid, Perez and the princess of Eboli were arrested.

The Review Of Randomised Control Trials

The Review Of Randomised Control Trials The effectiveness of the methodological approach used in any study most certainly determines the accuracy and reliability of the research hence the need to select the most viable methodology. Subsequent studies indicate that the use of a poor methodology is not only misleading but it could also lead to detrimental consequences in the event that the results of the study are used as a basis for decision making or implementation of recommendations. Further, different methodologies are expected to be more effective in particular experiments only. The use of Randomised Control Trials Research is highly popular in nursing and medicine due to its effectiveness in obtaining outcomes that are relevant, mostly in testing the safety of treatments and drugs before they can be fully utilized in the health care system. RCT as Randomised Control Trials Research is often abbreviated is popular because unlike other methodologies, allocation bias is minimised and prognostic factors that are known or u nknown to the researcher are balanced, thus giving accurate results. This paper seeks to critique Randomised Control Trials Research with a view of establish its philosophical foundation and its application in research. In this regard, the paper also includes a critique of three experiments that were done using Randomised Control Trials Research. Methodological review The history of Randomised Control Trials can be traced back to about 600 B.C. It was first recorded by Daniel Judah, whose research is probably the earliest as far as clinical research is concerned. He sought to establish the effects of royal Babylonian diet and the vegetarian diet for a time period of 10 days (Stolberg, Norman Trop, 2004). While his research was devoid of contemporary medical standards such as ascertainment bias, allocation bias and confounding by divine intervention, the research has remained an influential record in the history of Randomised Control Trials. Major advancements were recorded in the 19th century. The credit for modern CRT is attributable to Sir Austin Bradford Hill. This was witnessed during the Medical Research Council trials which sought to test streptomycins effectiveness in treating pulmonary tuberculosis. The research is considered a landmark research in medicine and since Hills achievement, the use of randomised control trials has grown except ionally (Stolberg, Norman Trop, 2004). RCT are actually considered the basis for evidence-based medicine. Randomised Control Trials are used in modern day health care and medical trials in assessing the effectiveness of interventions such as drugs and medical procedures. Randomised Control Trials Research is a methodology that is highly popular in the medical and health services sector and which has been used in testing the efficacy of drugs, treatments and health care services such as nursing and medicine (Rosenberger Lachin, 1993; Jadad, 1998). Randomised Control Trials Research (RCT) is distinguished by the fact that once the eligible study subjects have been identified, they are put through one or other of the studys alternative treatments before the intervention to be studied begins. Once the study groups are randomized, they are followed up in exactly the same way and specific care standards are given to each study group depending on the research being performed (Edwards, Lilford Hewison, 1998). The use of Randomised Control Trials Research is considered highly effective because it minimises allocation bias to a significant level. Further it is possible to balance the known and unknown prognostic factors such that the treatments are more accu rate unbiased and reliable. A significant characteristic of Randomised Control Trials Research is that tests usually include a control experiment alongside the main treatment (Charlton, 1995). These are known as placebo-controlled studies and they are used in comparing changes recorded in the active treatment group in order to ascertain that the study group that was not included in the treatment does not react in a similar manner. This serves the purpose of proving whether the active treatment actually had an impact on the active study group. RCTs are occasionally known as randomised controlled clinical trials when they are used for clinical research (Charlton, 1995). Besides their use in medical research however, RCTs are also used in education, criminology, international development and social work. The use of RCT is mostly popular because of randomisation. This involves the selection of random samples and it has been identified as an effective approach because of various advantages as follows. Firstly, it eliminates bias because the researcher selects the participants from a random sample as opposed to convenience thus eliminating the possibility of researcher bias and confounding (Edwards, Lilford Hewison, 1998). Secondly, the use of RCT enhances blinding or masking of the treatments under study from the participants, investigators and assessors thus reducing the possibility of bias and irregularities (Charlton, 1995). The use of randomisation further permits the researchers to use probability theory in expressing that differences in outcome could have resulted from chance. Despite the efficacy of Randomised Control Trials Research, the method has raised various ethical issues that are said to limit the authenticity of the research methodology. To begin with, the Zelens design used in various RCTs is considered unethical because it randomizes the subject prior to obtaining their consent (Edwards, Lilford Hewison, 1998). This unethical aspect of this design however is mostly considered where screening and selected therapies are used as opposed to common therapeutic trials. The principle of clinical equipoise is common in defending the ethics of Randomised Control Trials. The principle which represents the genuine uncertainty about a preferred treatment within the expert medical community is used as a justification for the use of RCT (Gifford, 1995). On the other hand however, the clinical equipoise also raises ethical concerns, with suggestions being put forth that equipoise cannot generally justify RCT because it is likely to conflict with the unavaila bility of personal equipoise where a person believes that a particular intervention is effective (Gifford, 1995; Edwards, Lilford Hewison, 1998). Other limitations of RCT apart from ethical issues mostly concern external validity. They include differences in where RCT is performed such that one treatment works in a particular country and fails to work in another; characteristics of the patients such that there may be differences in their natural features; study procedures, for example where RCT patients are likely to receive more intensive treatment and care, which would certainly be impossible to achieve in the real world; and incomplete reports of adverse effects recorded during the interventions (Jadad, 1998). RCTs can also be highly expensive and are therefore considered inapplicable where financial resources are limited. Stolberg, Norman and Trop (2004) further notes that RCTs cannot be used in all types of trials. They note that there are a significant number of situations in which the use RCT is not appropriate, feasible or necessary in solving the said problems. Examples include cancer screening, ability to cease smoki ng and assessment of interventions that are likely to have rare outcomes or whose outcome takes long to develop. Critical discussion The use of randomised control trials research in nursing is undoubtedly relevant in that it aids in obtaining the desired results of the interventions used. It can be established that the use of random samples helps greatly in ensuring that authenticity of data is assured. As noted by Altman, Machin and Bagant (2000), data authenticity can only be assured if it can be established that there is no bias in the selection of the sample. Furthermore, unscrupulous researchers have been known to manipulate the research samples in order to ensure that the outcome of their studies favour the desired outcome. It is also clear that there is a limited possibility of coming up with false results because randomised control trials are mostly done hand in hand with control tests. This ensures that comparison of results yields the differences that exist between the two study groups. It is these differences that can determine for sure that the active group actually underwent a change as a result of a particular treatment. In Altman, Machin and Bagant (2000) definition of a control experiment, he notes that a control experiment serves as proof that the changes recorded in the active experiment is actually true and that the effect should not be recorded in the control experiment if the results are indeed true. Further, the status of the two study groups should have been the same at the beginning of the experiment. The use of randomised control trials in nursing promises the possibility of obtaining highly reliable results. This is because the research groups can be easily sought from medical records as opposed to where the researchers have to obtain samples from highly dispersed populations (Altman, Machin Bagant 2000). Furthermore, randomised control trials unlike other forms of research do not limit the researcher to a particular geographical region but only to persons with similar characteristics to be used for the study. This could however be disadvantageous in that the inability to locate the required sample population may result in inadequate results. Such an occurrence is likely to occur in cases where potential participants refuse to take part in the study for one reason or the other. An example is where the researcher seeks to experiment a certain medication with individuals suffering from HIV/AIDS and potential participants are unwilling to participate. According to Jadad (1998), ma ny individuals actually have the fear of being used as guinea pigs without the knowledge on whether the results will have positive or negative effects on them. Case studies Further critical analysis of the randomised control trials is done through the use of various case studies in the medical field as indicated below: In a study by Dulin, Hatcher, Sasser and Baringer (2006), they sought to prove that an over the counter supplement known as Policosanol used in the treatment of elevated cholesterol levels was ineffective. The study made use of Randomised Control Trials to examine the effectiveness of Policosanol derived from sugarcane; which had not been tested since its effectiveness was questioned. The objective of the study was to examine the efficacy of the sugar cane-derived policosanol in improving the health conditions of adults with mild hypercholesterolemia. The study would take eight weeks and it involved observing the percentage change in cholesterol level among the participants. The researchers studied the total cholesterol change, triacylglycerols and lipoprotein as well as the dietary habits, blood pressure and weight of the participants. A group of 40 healthy adults with mild hypercholesterolemia were included in the study and they were to receive 20mg of policosanol orally or placebo for the 8 weeks. The results of the study indicated that no significant changes were witnessed in cholesterol levels between the 20 adults under policosanol treatment and the 20 adults under placebo. The same applied to triaclyglycerol and other components tested for. In conclusion therefore, policosanol was ineffective in altering the serum lipid profile of individuals and therefore not effective in reducing cholesterol levels. Richardson and Montgomery (2005) sought to experiment the effectiveness of a dietary supplement for use by children who suffered from developmental coordination disorder. This is a form of disorder affecting approximately 5 percent of school going children and results in learning and behaviour difficulties as well as psychosocial adjustments that are likely to be evident even in adulthood. The researchers sought to experiment whether the use of a supplement to replace the polyunsaturated fatty acids whose absence are said to cause the disorder could help in treating the disorder. The basis for this experiment was that there was insufficient evidence-based treatment for the disorder; such that experimenting with the fatty acid supplements would provide useful information for use in treating developmental coordination disorder and treating motor skills. Richardson and Montgomery (2005) used a randomised controlled trial of the dietary supplementation which consisted of -3 and -6 fatty acids. The test was compared with Placebo and included 117 children with the developmental coordination disorder, aged between 5 and 12 years. This augurs well with Jadad (1998) who explains that a Randomised Control Trials Research should include the population under study as well as a control group to be used for comparing the outcome of the research. The research which took three months included a parallel observation of the two groups in order to establish any changes in the population. This was followed by a 1-way crossover in which the placebo group was changed to active treatment for another three months. The results of the study indicated that while there was no effect on motor skills treatment, students who received active treatment showed a significant improvement in spelling, reading and behaviour. The same was observed when the placebo group was put under active treatment; while the children continuing with active treatment continued to improve or maintain improvement. I t was thus concluded that the fatty acid supplements could be used in take care of educational and behavioural challenges for children who suffer from developmental coordination disorder. In the third example of the use of CRT in medical practice, the study by Blinkhorn, Gratix, Holloway, Wainwrit-Stringer and Worthington (2003) sought to determine the importance of health educators in enhancing general dental care. The question was on whether dental health educators should be placed to educate parents of at-risk children in order to advance dental care. The study involved 269 mothers who received tooth-brushing advice, sugar control and the use of fluoride toothpaste for 2 years at intervals of 4 months each. 334 pre-school students were included in the study. 138 families and 172 children were included in the test group and 131 families and 162 children were used as a control. Mothers in the test group were required to visit a dental health educator while the rest were used as a control group. After 2 years, 271 children and 248 mothers were remaining in the study. The end result indicated that there was increased general knowledge, tooth-brushing skills and attitud es among parents who had visited a dental educator. Children in the test group however showed little difference in terms of caries experience in relation to the control group. Accordingly, primary care trusts are expected to consider the cost of sending dental health educators in relation to the outcome. According to the study, Â £40 was used in every 2 hour session for counselling 10 parents. Critique of the articles It can be established that the use of randomized control trial research is effective in testing the outcome of various treatments and interventions, mostly through the use of a placebo study group. Similarly, the use of random study groups represents the authenticity of the researches identified above as far as the randomised control trials are concerned. The use of randomised control trials main characteristic is the use of a random sample in testing the efficacy of a certain subject or practice. This is well exhibited in all the three studies where the researchers note that they selected the samples randomly. This most definitely played an imperative role in ensuring that there was no bias in the study and that the results obtained could effectively be used in representing the entire population (Altman, Machin Bagant, 1998). As noted by Jadad (1998), the nature of randomised control trial research ensures that the subjects of the study are not in any way related to the researcher and that results are not manipulated to suit the researchers purpose. The research by Dulin, Hatcher, Sasser and Baringer (2006) represents a well researched paper which is characterised by a well designed methodology. It represents a true picture of how randomized control trial research should be done in order to achieve the most desirable results. Notably, Richardson and Montgomery (2005) make use of an active group study and a placebo group. According to Altman, Machin and Bagant (1998), the use of a control group in RCT is highly imperative as it helps in establishing the authenticity of the research and in comparing the eventual results. The same is witnessed in the study by Richardson and Montgomery (2005) and Blinkhorn, Gratix, Holloway, Wainwrit-Stringer and Worthington (2003) who made use of control groups to establish whether the results obtained in their studies were actually a true representation of the real picture. Richardson and Montgomery (2005) and Dulin, Hatcher, Sasser and Baringer (2006) and Blinkhorn, Gratix, Holloway, Wainwrit-Str inger and Worthington (2003) however fail in that they make use of different sample sizes for the active participants and placebo groups. Richardson and Montgomery (2005) use 117 children indicating that the number was uneven between the control group and the placebo group. The same applies for Dulin, Hatcher, Sasser and Baringer (2006) and Blinkhorn, Gratix, Holloway, Wainwrit-Stringer and Worthington (2003) who used 138 families and 172 children in the test group and 131 families and 162 children as a control. According to Charlton (1995), such differences in the study sample are likely to cause biased outcomes because the population sample in each case does not equal the other, thus defeating the rationality of comparison. The study by Dulin, Hatcher, Sasser and Baringer (2006) consistently defines the variables and shows how the population sample was obtained. This is one of the requirements for ensuring consistency and authenticity as defined by Altman, Machin and Bagant (1998). This is because with the ability to define the population sample and how it was obtained determines the overall outcome of the study. Richardson and Montgomery (2005) also define their population samples thus giving authenticity to the study. It is notable however that in Blinkhorn, Gratix, Holloway, Wainwrit-Stringer and Worthington (2003), only the sample size is given and there is limited information on how the 269 mothers and 334 pre-school children were obtained. Conclusion Randomised control trials research proves to be an effective methodology in enhancing nursing research. This can be evidenced by the use of randomised control trials in various medical and clinical researches, aimed at determining the efficacy of certain interventions in treating various complications. It can be established that through the use of random samples and a control group, the use of randomised control trials is expected to produce highly authentic results which can be used as a basis to introduce the intervention to the rest of the population. Notably however, there are disadvantages associated with randomised control trials research methodology as well as ethical issues related to the methodology. Common limitations include external validity in the research and the justification of the use of randomised control trials in complicated cases. In conclusion however, there is no study methodology without its own limitations and randomised control trials are no exception. This means that the benefits associated with the research methodology should be given more attention as opposed to the cons in conducting effective studies in nursing research.