Answer the following questions that pertain to the last phase, the Electron Transport Chain/System:

1. In the electron transport system, H+ ions are pumped across the mitochondrial membrane, and then they come back through what important protein/enzyme?

2. What is the job of oxygen?

3. How is water produced?

Stage

Glycolysis

Citric Acid Cycle

Transition

Electron Transport

Chain/System

Location Product that comes out of this stage

Reactant that enters this stage

# of ATP generated

(net)

# of NADH/FADH2

generated

Pyruvate

NADH and FADH2

Zero

N/A

Assignment 5: Cell Respiration

The video link of the embedded video in the assignment folder is also available here: https://vimeo.com/161758622 After watching the video, complete the table and three questions below by filling in the blank spaces provided. Then, save the file and upload to the assignment folder.

R1:
R3:
L2:
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P1:
P2:
P3:
P4:
A4:
A3:
A1:
N3:
L1:
Q1: Answer:
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EXAMPLE BUSINESS AND MANAGEMENT BRP

1. Title

Online and offline customer loyalty, and its presence amongst apparel retailers.

2. Research Questions

To what extent does customer loyalty among apparel retailers using both online and offline channels differ from those using only one of the channels?

To what extent does the brand image of an offline apparel retailer effect their online customer loyalty?

3.1 Customer loyalty

Customer loyalty is viewed by Dick and Basu (1994) as the strength of the relationship between an individual’s attitude and repeat custom. Chaudhuri and Holbrook (2001), cited in Hung (2008) suggest that higher customer loyalty implies a higher market share; which results in the ability to demand higher prices than those of competitors in the same industry. In addition, Dick and Basu (1994) suggest that loyal customers encourage the development of positive wordof‐mouth promotion; and the importance placed on their loyalty is supported by Zeithaml et al (1996), who proposed that loyalty factors are the most reliable indicator of success within an organisation. However, factors influencing customer loyalty, which Hung (2008) describes as value, service quality, relationship marketing, corporate image, satisfaction and trust, may differ depending on the channel the customer is viewing from – online or in a physical store. For example, Srinivasan, Anderson and Ponnavolu (2002) proposed a different set of factors that were suggested to impact e-loyalty: customization, contact interactivity, cultivation, care, community, choice, convenience, and character; antecedents that they believe e-retailers need to have an understanding of in order to reap the benefits of a loyal customer base.

3.2 Brand Image

Brand image is defined as a ‘cluster of attributes and associations that consumers connect to the name’ (Biel 1993). Hung (2008) suggested that brand image as an ‘attitude’ has an influence on customer loyalty; an idea supported by Keller (1993), who proposed that loyalty is present when said favourable ‘attitudes’ are expressed in the repeat buying behaviour of the customer. Other scholars believe that the more favourable the image of the brand, the higher the perceived quality, value, satisfaction and customer loyalty (Johnson et al., 2001; Andreassen and Lindestand, 1998). Attitudinal and behavioural responses from consumers can also be provoked by brand image; these include responses such as customer loyalty, which in turn may create a willingness to pay a price premium, or lead to a strong affiliation with the brand (Dube et al., 1995; Merilees and Miller, 2001). This evidence highlights that there is a likely strong correlation between positive brand image and customer loyalty; however a gap in the literature is evident when looking specifically into apparel retail.

Kim (2000) notes that well-known, well-regarded brands can act as a ‘halo’ to the product that carries the brand name – a suggestion supported by Kwon and Lennon (2009), who believe that a prior offline brand image of a retailer using both channels exerts the said ‘halo’ effect, biasing customers perceptions of the retailers online channel. However, research has remained scant in the investigation linking the possible effect offline brand image has on the retailer’s online customer loyalty – specifically in the apparel industry.

3.3 Online and Offline/Physical Stores

Alba et al (Cited in Degeratu, Rangaswamy & Wu, 2000) highlight that a key difference between online and offline shopping is the capability of online customers to obtain more information about price and other attributes – a difference which may result in their own perception of the brand being formulated quicker than it may offline. When considering the relationship between brand image and online and offline retail operations, the synergy between the two channels is seen to enrich the customer’s experience with the retailer, strengthening the brand image and nurturing customer loyalty in both channels (Bailer, 2006, Gefen, 2000 & Harvin, 2000). It has been proposed that consumers faced with a lack of product availability in one channel (e.g. a physical store) tend to seek out an alternative through an affiliated channel (e.g. online), rather than a competing firm; if such an option is perceived to be easily accessible (Bendoly et al., 2005). This research suggests that there may be a link between customer loyalty and retailers who use both online and offline channels, however there is insufficient research investigating how strongly these two variables correlate – if at all in apparel retail. The more traditional, in store operations need to constantly adapt to the competitive rules put in place by online sales (Bendoly et al., 2005). However, in comparison to the smaller number of competition among these physical stores, e-retailers compete with millions of websites, not necessarily in the apparel industry, for the recognition of the customer; having only a tenuous hold at best on the customer’s attention (Srinivasan, Anderson & Ponnavolu, 2002). Thus, the more traditional, in store operations need to constantly adapt to competitive rules put in place by online sales (Bendoly et al., 2005); suggesting that retailers using only offline channels may struggle to keep pace – which in turn may affect the loyalty of the customer.

3.4 Customer Loyalty and Apparel Retailers

Previous research into relevant literature has shown that within a multi-channel retail environment, online and offline brand images of the retailer seem to affect consumer loyalty (Kwon and Lennon, 2009); however, knowledge on the processes, and to what extent these effects occur remains limited; and is extremely scant within the apparel industry. Macintosh and Lockshin (1997) noted that research into relationships within retail is not extensive, despite many retail stores introducing schemes to enhance store loyalty (Zimmerrnan, 1992). This highlights the scarcity of research on the linkage between customer loyalty and apparel retailers.

Therefore it is necessary to propose a new idea, looking into online and offline customer loyalty, and its presence amongst apparel retailers by investigating the following two questions; to what extent does customer loyalty among apparel retailers using both online and offline channels differ from those using only one of the channels? And to what extent does the brand image of an offline apparel retailer effect their online customer loyalty?

4.1 Methodology

Research philosophy is described as the overall term that relates to the development of knowledge and the nature of that knowledge in relation to research (Lewis & Saunders, 2012), and encompasses certain philosophical strands such as interpretivism and positivism, mentioned in the “philosophies” layer of the research onion (Lewis, Saunders & Thornhill, 2008). It seems appropriate to consider taking an interpretivist approach to this research; a method based on the idealism that the world exists, but people can construe it in different ways – where researchers search for constants in human behaviour, looking to interpret phenomenon’s through the eyes of others (Walliman, 2011). This relates to the nature of the research as customer loyalty and brand image are very much focused around the aspect of customer attitude (Dick & Basu, 1994; Hung, 2008); concentrating on the thoughts and opinions of the customers as opposed to the quantitative data they may provide. A positivist approach would not be appropriate in this circumstance as no hypothesis or predictions are being made, and quantitative methods are not being used for data collection (Walliman, 2011). With this in mind, data will be collected in a qualitative manner, where the aim is to understand views rather than predicting an outcome (Lewis & Saunders, 2012); a necessity for gaging an insight into the reasons for customer loyalty and consumers own views of brand image, information which may be difficult to analyse from quantitative data. An inductive approach will be used, which involves development of a theory as a result of analysing data already collected (Lewis & Saunders, 2012); the proposed research involves looking at previous literature related to customer loyalty, brand image and online/offline channels, and developing a new theory in line with these and their links with apparel retailers.

4.2 Method

An exploratory study, aiming to gain new insights and asses a topic in a new light (Lewis & Saunders, 2012) will be used in the form of focus groups, which are used for generating information on consumer views, and the meanings behind them (Chadwick, Gill, Stewart & Treasure, 2008). For this particular research, the key data to be collected will be the opinions of customers – and focus groups will enable the researcher to access group norms and gain an insight into the formation of said opinions (Lewin & Somekh, 2005); an important factor which will help to determine which elements consumers consider influencing customer loyalty in different contexts. Focus groups also concentrate in depth on a particular theme with an element of interaction – made up of people who have particular knowledge on the subject (Walliman, 2011). Using knowledgeable participants means the data collected is likely to be more relevant to the research, and the group atmosphere means participants both query and explain themselves to each other (Morgan, 1996); thus, creating more valuable data. The optimum size for a focus group, and the number which will be used within this research is six to eight; as smaller groups risk limited discussion, and larger groups can become chaotic (Chadwick et al., 2008). The study will aim to run 14 focus groups; totalling between 84-112 participants. This figure is appropriate in order to gain a general insight into the thoughts of customers. In addition, stranger groups will be chosen to participate as Chadwick et al (2008) suggests they speak more freely as there is likely to be little fear of repercussion, and challenges to other participants may be more inquisitive – leading to richer data.

Potential issues may arise when an individual’s view is different to that of the group; they may choose to conceal their opinions or exaggerate their opposing view (Barbour & Schostak, 2004). To overcome this, the observing researcher could choose to hand out notes on the topics of discussion prior to the event, in order to put participants at ease, and encourage honest, thoughtful answers.

4.3 Sampling Strategy

Field (2005) describes sampling as a “smaller (but hopefully representative) collection of units from a population used to determine truths about that population”. The sample of this study will be those in the age range to be considered a Millennial; born in or after 1980, up to the year 2000 (15-35 years old), who use both online and offline apparel retailers (Burke, 2014). This sample was chosen via purposive sampling, the most common form of non-probability sampling, where the researcher chooses their sample based on who will best be able to answer the research questions (Lewis & Saunders, 2012). This particular age range was chosen on the basis of the finding that 45% of Millennials spend at least an hour a day browsing retail-orientated websites, with 47% shopping for clothing more than two times a month (Burke, 2015). The younger generation are also known for their online activity, and those at the lower end of the spectrum are likely to have additional free time – increasing the likelihood of their participation in a focus group discussion. A potential problem of the use of purposive sampling may be the chance of inaccuracy in the researcher’s criteria and resulting sample selections; better data may have been collected from a different or smaller age range.

5. Ethics

Ethical considerations must be taken into account before conducting any primary research. Participants must be informed fully about the purpose, method and intended uses of the research, what their participation involves and made aware of any risks (Research Ethics, 2015). An important aspect as to whether participants take part is the quality of information they receive, which enables them to make a fair assessment on giving informed consent (Walliman, 2011). It will be made clear to participants that their contribution is voluntary, within consent forms delivered to participants prior to their involvement. Where appropriate, methods for preserving anonymity should be used, which includes the removal of identifiers (Statement of Ethical Practice, 2002). Participants will be assigned numbers as opposed to names in order to retain privacy. Threats to confidentially should be anticipated (Statement of Ethical Practice, 2002), and any data collected will be stored in a password protected computer file.

6. Reference List

Bendoly, E., Blocher, J., Bretthauer, K., Krishnan, S., & Venkataramanan, M. (2005). Online/In-Store Integration and Customer Retention. Journal of Service Research, 7(4). Retrieved from http://jsr.sagepub.com/content/7/4/313.full.pdf+html

British Sociological Association. (2002). Statement of Ethical Practice for the British Sociological Association. Unpublished intranet document.

Burke, C. (2015). Understanding how millennials shop online. Retrieved from http://www.nanigans.com/2015/01/14/understanding-how-millennials-shop-online/

Chadwick, B., Gill, P., Stewart, K., & Treasure, E. (2008). Methods of data collection in qualitative research: interviews and focus groups. British Dental Journal, 204(291-295). Retrieved from http://www.nature.com/bdj/journal/v204/n6/full/bdj.2008.192.html

Chung, L., & Hsieh, A. (2008). The moderating effect of brand image on public relations perception and customer loyalty. Marketing Intelligence and Planning, 26(1). Retrieved from http://www.emeraldinsight.com/doi/pdfplus/10.1108/02634500810847138

Degeratu, A., Rangaswamy, A., & Wu, J. (2000). Consumer choice behavior in online and traditional supermarkets: The effects of brand name, price, and other search attributes. International Journal of Research in Marketing, 17(1). Retrieved from http://www.sciencedirect.com/science/article/pii/S0167811600000057

Dick, A., & Basu, K. (1994). Customer Loyalty: Toward an Integrated Conceptual Framework. Journal of the Academy of Marketing Science, 22(2). Retrieved from http://jam.sagepub.com/content/22/2/99.short

Research Ethics. (2015). Retrieved from the University of Portsmouth website http://www.port.ac.uk/research/ethics/

Hung, C. (2008). The Effect of Brand Image on Public Relation Perceptions and Customer Loyalty. International Journal of Management, 25(2). Retrieved from http://192.192.107.208/FileUpload/upfile/4514120982008910113623IJMprc.pdf

Kim, H. (2000). Examination of brand personality and brand attitude within the apparel product category. Journal of Fashion Marketing and Management: An International Journal, 4(3). Retrieved from http://www.emeraldinsight.com/doi/pdfplus/10.1108/eb022593

Kwon, W., & Lennon, S. (2009). What induces online loyalty? Online versus offline brand. Journal of Business Research, 62(5). Retrieved from http://www.sciencedirect.com/science/article/pii/S0148296308001719

Lewin, C., & Somekh, B. (2005). Research Methods in the Social Sciences. Retrieved from https://books.google.co.uk/books?hl=en&lr=&id=Trfg5iWB22MC&oi=fnd&pg=PA41&dq=focus+groups+honesty&ots=q 31VLBrJmh&sig=1Nb8rK1g9lRfHqgtrAvOAJHYhos#v=onepage&q&f=false

Lewis, P., & Saunders, M. (2012). Doing Research in Business and Management: An Essential Guide to Planning Your Project. http://lib.myilibrary.com/Open.aspx?id=564217#

Lockshin, L., & Macintosh, G. (1997). Retail relationships and store loyalty: A multi-level perspective. International Journal of Research in Marketing, 14(5). Retrieved from http://ac.els-cdn.com/S016781169700030X/1-s2.0S016781169700030X-main.pdf?_tid=e39a9840-d4a7-11e4-90ed00000aacb361&acdnat=1427478007_33eaef33a6692c6023304aae819ac5f4

Lohse, G., & Spiller, P. (2006). Internet retail store design: How the user interface influences traffic and sales. Journal of Computer-Mediated Communication, 5(2). Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.10836101.1999.tb00339.x/full

Morgan, D. (1996). Focus Groups. Annual Review of Sociology, 22(129-152). Retrieved from http://www.jstor.org/stable/pdf/2083427.pdf

Srinivasan, S., Anderson, R., & Ponnavolu, K. (2002). Customer loyalty in e-commerce: an exploration of its antecedents and consequences. Journal of Retailing, 78(1). Retrieved from http://www.sciencedirect.com/science/article/pii/S0022435901000653

Walliman, N. (2011). Research Methods: The Basics. Retrieved from https://books.google.co.uk/books?hl=en&lr=&id=DRWs AgAAQBAJ&oi=fnd&pg=PP1&dq=walliman+nick+2011&ots=_QszxlOA6S&sig=FRn9tCf1o9tG4bX4bDsSI7eW1rk#v=o nepage&q&f=false

THE END RESULT SHOULD BE A 1-2 PAGE TYPED PAPER, ORIGINAL WORK, APA FORMAT

The student is to choose an incident that occurred during one of the clinical days this week.  The issue can be from the patient’s pathophysiology, education needs, psychosocial needs, socioeconomic conditions, cultural/religious concerns, or a combination of these factors.  It can be an incident like a cardiopulmonary arrest, a procedure like a dressing change or bladder catheterization, or an interaction (positive or negative) with a family member, staff person, or physician.

 

Paragraph 1:  Briefly describe the scenario.

I went to the Operating Room (OR) on Monday afternoon (4 pm -8:30 pm the surgery lasted) and was able to witness and observe a surgery by a Gynecologic Oncologist who removed a mass from the pelvic area on a female patient in her 50’s. prior to meeting the surgeon the surgical team get the room prepped for sterile field, do the counts of all instruments, gauzes, pads, drapes and sutures and they write on a dry erase board. He was assisted by (2) residents. However during the course of the surgery the mass was found and removed and the attendees assumed they were done and could close the patient up. However, the surgeon new the mass he removed was not the place of origin of the cancer. He went up to her abdomen and begin inspecting the large intestine (while showing me and stating what I was looking at in hands was the transverse colon) and he went all the wat to the small intestine and there he found what was the source of her cancer that obviously metastasized to her pelvic region. Due to regulations of the hospital he asked the OR nurse to contact a trauma surgeon or the surgeon in the ER. Because of the time there were no surgeons available and the one that was on call contacted back in OR room and stated it would take him about 20 min to back to the hospital (that doesn’t include the time it would take him to scrub in). The surgeon over the phone gave my surgeon permission to go ahead and cut out the tumor in the small intestine and that we he came back tomorrow he would make an addendum to the patients chart stating he gave the surgeon I was watching permission to resection her small intestine. The residents as well as I and everyone else in the room was impressed how he knew that the cancer did not originate in her pelvic region. He let us know he’s been doing this so long that it comes with time and that the residents would get there to eventually after they have did hundreds upon hundreds of surgery’s. Since the patient was under for quite some time the anesthesiologist had to order a pint of blood to infuse into her since the surgery became much more complicated than expected. So I was able to witness them place the order in from their computer screen warm it in a warmer machine than piggy back it on her IV. Finally when the residents were told to close her up (I witnessed the internal suturing (dissolvable sutures) which would dissolve without her coming back to have them removed) and then they begin to staple her stomach on top and they were almost done until the surgical nurse and the OR nurse noticed the discrepancy on the sponge count. There was supposed to be 24 total that’s what was write on the board but the surgical nurse only counted 23 as well as the OR nurse did too! The surgeon told the residents to open the patient back up and low and behold a sponge was left inside the patient! They removed and redid all the suturing and stapling again. Finally the patient was closed up all the way now and the count for the surgical needle holders was off. So now the OR nurse had to call X-ray and I was able witness the portable x-ray team take an x-ray of the patients abdomen and pelvic area where the surgeon and resident were working to see if the needle holders were in her stomach. We than had to wait from confirmation from the cardiologist (who was on staff) to approve the x-ray that there was no instrument left in the patients abdomen. It was cleared and the needle holders somehow I think were found in the trash. Finally she was ready to come off sedation and a post op team came in to transfer to recovery. I t was a very eye opening experience for me. But it did prove to me that I absolutely love being in the operating room. I can’t wait to go back.

Paragraph 2:  Explain the issue.

The issues was the surgery was more complex than expected to be; gauze (sponge) was left inside the patient’s body and possible needle holders.

Paragraph 3:  Use the Critical Incident Analysis Model below, and reflect on what occurred.  Address only the relevant questions.

Critical Incident Analysis Model

1 What was I trying to achieve?

2 Why did I respond like I did?

3 What strengths and /or limitations did I      demonstrate in this situation?

4 What were the consequences of this for the patient, others, myself? The consequences are for the patient and staff. If they would have left the gauze pad inside the patients abdomen that would have eventually if not immediately caused the patient to get an infection (due to a foreign body left inside her) and may cause her to go septic. The consequences that would have affected the staff and surgeon. If they had not did the count and left the gauze inside her they could have been sued as well as the hospital when she began to show signs of illness.

5 How was this person (or persons) feeling? I know patient was going through divorce

6 How did I know that? When the patient was getting closed up the surgeon scrubbed out and let us know he was going out to talk with the family to inform them of how the surgery went. That’s when one of the OR nurses stated she was going through divorce and that when she came out of surgery they were to contact her sister and she would come up.

7 How did I feel in this situation? I felt very bad for the patient. I did not get to speak to her prior to the surgery nor after. However, when the nurse stated that to the surgeon I could only imagine the stress she must be going through. She just recently got diagnosed with cancer and at the same time she is going through divorce. I can only pray she has a great support system to get through everything. Even the surgeon felt bad when he was told.

8 What internal factors were influencing me including attitudes about working with patients of diverse backgrounds?

9 How did my actions match my beliefs?

10 What factors made me act in incongruent ways?

11 What knowledge did or should have informed me?

12 How does this connect with previous experiences?

13 Could I handle this better in similar situations?

14 What would be the consequence of alternative actions for the patient, others, and myself? The consequences the patient would either have gotten very ill or died. The staff and surgeon along with hospital could have been sued by either the patient or her family (if she passed away because of simple medical error.)

15 How do I feel now about the experience? As stated above I absolutely loved my experience. In a crazy way it felt like a television show.

16 Can I support myself and others better as a consequence?

17 Has this changed my way of knowing?

Select an active bill at the state or federal level that impacts the professional practice of nursing. In a 56 page paper (excluding the title and reference pages), summarize the provisions of the bill and clearly explain what the bill will accomplish. The paper should be at least 56 pages, typed in Times New Roman using 12-point font, and double-spaced with 1″ margins.

Your review of a bill paper should:

Discuss the major provisions of the bill.
Demonstrate an in-depth understanding of the legislation by explaining the background and all relevant facts.
Discuss any relevant history related to the legislation, pertinent votes, and issues that are stalling the legislation, etc.
Use primary sources for this information.
Identify key supporters and those who do not support the bill. Explain why some of these individuals support the bill and why some do not.
Explore the positions of the key stakeholders in the bill, both pros and cons. Do not make assumptions about potential key stakeholders. Examine this area carefully so you are correctly reflecting the stakeholders positions.
Discuss how the bill would impact a nurses ability to provide safe and quality care or to practice to the highest scope of the nursing license.
Explain specific actions that nurses can take to assist with the passage or defeat of the legislation
Use APA format, correct grammar, and references as appropriate.