What precisely is HRM and what evidence is there to support the Essay - 2

What precisely is HRM and what evidence is there to support the contention that it is linked in some way to improvements in a firms performance - Essay Example This field of management looks into the most effective utilisation of the employees to achieve organisational and individual goals. An important feature of this human resource management is that it is people oriented. It looks into the welfare of the employees and evolve the best arrangement for the employee and the organisation such that the organisational goals are met. It is a line responsibility. The human resource managers not only gives advice to their department regarding the issues relating to human resources but also to other departments. HRM is common to all organisations. It is not only a feature of the industrial world but it is hugely relevant in the fields of service, sports organisations, religious organisation, social organisations etc. Since HRM is mainly focussed on the issues relating to the people and due to the varying nature of the people the job of the human resource managers becomes a challenging task. It is a development oriented integrated approach. It not only tries to attain the individual goals of the employees but also the organisation and the society as a whole. (Randhawa, 2007) HRM is the integral part of the management activity. The objective of the HRM is to see the effectiveness and the efficiency of the organisation. This they can do by helping the organisation to reach its goals, employ the skills and ability of the work force efficiently, to provide the organisation with well trained employees, look after the employee’s job contentment and self actualisation. The most important is the communication with the employees so that the employees are aware of the various policies undertaken by the management. (Randhawa, 2007) There are several formal

Acc 556 Essay Example for Free

Acc 556 Essay Faculty and students/learners will be held responsible for understanding and adhering to all policies contained within the following two documents: †¢University policies: You must be logged into the student website to view this document. †¢Instructor policies: This document is posted in the Course Materials forum. University policies are subject to change. Be sure to read the policies at the beginning of each class. Policies may be slightly different depending on the modality in which you attend class. If you have recently changed modalities, read the policies governing your current class modality. Course Materials Louwers, T. J. , Ramsay, R. J. , Sinason, D. H. , Strawser, J. R. , Thibodeau, J. C. (2011). Auditing assurance services (4th ed. ). New York, NY: McGraw-Hill/Irwin. Mulford, C. W. , Comiskey, E. E. (2002). The financial numbers game: Detecting creative accounting practices. New York, NY: John Wiley Sons. Silverstone, H. , Sheetz, M. (2007). Forensic accounting and fraud investigation for non-experts (2nd ed. ). Pearson. Singleton, T. W. , Singleton, A. J. (2010). Fraud auditing and forensic accounting (4th ed. ). Hoboken, NJ: John Wiley Sons. Wells, J. (2011). Principles of fraud examination (3rd ed. ). Hoboken, NJ: Wiley. All electronic materials are available on the student website. Supplemental Resources Apollo Shoes Casebook Web-Based Version http://highered. mcgraw-hill. com/sites/0078136644/student_view0/apollo_shoes_case. html Week One: Overview of Fraud and Abuse DetailsDuePoints Objectives1. 1Identify the impact of occupational fraud and abuse on the organization. 1. 2Describe U. S. governmental oversight of accounting fraud and abuse. 1. Define categories of corruption. 1. 4Assess the types of accounting evidence. ReadingRead the section â€Å"Fraud Examination Methodology† in Ch. 1 of Principles of Fraud Examination. ReadingRead Ch. 10 of Principles of Fraud Examination. ReadingRead Ch. 16 of Principles of Fraud Examination. ReadingRead Ch. 4 of The Financial Numbers Game. ReadingRead Ch. 11 of Fraud Auditing and Forensic Accounting. ParticipationParticipate in class discus sion. See Policies2 Discussion QuestionsRespond to weekly discussion questions. DQ1 – Day 2 DQ2 – Day 4 DQ3 – Day 62 Individual Internal Accountant’s Report to ManagementYou are the internal accountant at a company that is preparing for an upcoming government contract bid. The management in your company is deciding if it is necessary for the company to perform a full financial status review prior to the bid. As an internal accountant, prepare a report for management that provides supporting information for a full financial status review prior to the bid. Write a paper of no more than 1,050 words that includes the following sections: †¢Section I: The effect of occupational fraud and abuse on the company †¢Section II: U. S. overnmental oversight of accounting fraud and abuse and its effect on the company †¢Section III: Potential corruption schemes to be aware of in the company †¢Section IV: Recommendation of types of accounting evidence and methods of gathering such evidence to support the financial status review Format your paper consistent with APA guidelines. Day 714 Week Two: Fore nsic Evidence DetailsDuePoints Objectives2. 1Explain procedures for collecting accounting evidence. 2. 2Explain the use of sampling in performing an examination. 2. 3Evaluate accounting evidence using analytical and inferential tools. ReadingRead Ch. of Forensic Accounting and Fraud Investigation for Non-Experts. ReadingRead Ch. 9 of Forensic Accounting and Fraud Investigation for Non-Experts. ReadingRead Ch. 10 of Forensic Accounting and Fraud Investigation for Non-Experts. ReadingRead Ch. 11 of Forensic Accounting and Fraud Investigation for Non-Experts. ReadingRead Ch. 12 of Forensic Accounting and Fraud Investigation for Non-Experts. ReadingRead Module E of Auditing Assurance Services. ReadingRead Module F of Auditing Assurance Services. ReadingRead Module G of Auditing Assurance Services. ReadingRead the Apollo Shoes Casebook Road Map. ReadingReview the Apollo Shoes Casebook. ParticipationParticipate in class discussion. See Policies1. 5 Discussion QuestionsRespond to weekly discussion questions. DQ1 – Day 2 DQ2 – Day 4 DQ3 – Day 61. 5 Individual Procedures in Collecting Forensic EvidenceAs corporate controller for Apollo Shoes, you are tasked to find and explain any irregularities in the Apollo Shoes Case. Resource: Apollo Shoes Casebook Define the process you will use and address the following questions: †¢What procedures will you use to collect accounting evidence? †¢What sampling tools and techniques will you use for the examination? How will you use analytical and inferential tools to evaluate accounting evidence? Submit your assignment to the facilitator. Note. APA formatting is not required for this assignment. Use a title and reference page where appropriate. Consider using a checklist or flowchart to outline your process. Day 78 Learning Team Weekly ReflectionDiscuss this wee k’s objectives with your team. Your discussion should include the topics you feel comfortable with, any topics you struggled with, and how the weekly topics relate to application in your field. Prepare a 350- to 1,050-word paper detailing the findings of your discussion. Day 71 Week Three: Substantive Procedures for Cash Outflow Irregularities DetailsDuePoints Objectives3. 1Design substantive procedures for detecting irregularities in cash. 3. 2Design substantive procedures for detecting irregularities in accounts payable. 3. 3Design substantive procedures for detecting irregularities in payroll. ReadingsRead Ch. 2 of Principles of Fraud Examination. ReadingsRead Ch. 3 of Principles of Fraud Examination. ReadingsRead Ch. 5 of Principles of Fraud Examination. ReadingsRead Ch. 6 of Principles of Fraud Examination. ReadingsRead Ch. 7 of Principles of Fraud Examination. ReadingsRead Ch. of Principles of Fraud Examination. ReadingsRead the sections â€Å"Audit Programs† â€Å"Audit Procedures for Obtaining Audit Evidence† in Ch. 3 of Auditing Assurance Services. ReadingsReview the Apollo Shoes Casebook. ParticipationParticipate in class discussion. See Policies1. 5 Discussion QuestionsRespond to weekly discussion questions. DQ1 – Da y 2 DQ2 – Day 4 DQ3 – Day 61. 5 Individual CPA Examination ReviewResource: Week Three Student Guide Access the Wiley CPA Examination Review website from the link on the student website. Use the Week Three Student Guide to complete the Wiley CPA Examination assignment. Day 72 Learning Team Substantive Procedures for Cash Outflow IrregularitiesResource: Apollo Shoes Casebook Outline substantive procedures by using the Apollo Shoes Casebook for detecting irregularities in each of the following audit cycles: †¢Cash †¢Accounts payable †¢Payroll Design an audit program for the cycle in no more than 1,050 words. Consider using a checklist or flowchart to outline your process. Format your audit program consistent with APA guidelines. Day 712 Week Four: Substantive Procedures for Cash Asset Irregularities DetailsDuePoints Objectives4. 1Design substantive procedures for detecting irregularities in accounts receivable. 4. Design substantive procedures for detecting inventory irregularities. 4. 3Design substantive procedures for detecting irregularities in fixed assets. ReadingsRead Ch. 4 of Principles of Fraud Examination. ReadingsRead Ch. 9 of Principles of Fraud Examination. ReadingsRead Ch. 7 of The Financial Numbers Game: Detecting Creative Accounting Practice s. ReadingsReview the Apollo Shoes Casebook. ParticipationParticipate in class discussion. See Policies1. 5 Discussion QuestionsRespond to weekly discussion questions. DQ1 – Day 2 DQ2 – Day 4 DQ3 – Day 61. 5 Learning Team Substantive Procedures for Asset IrregularitiesResource: Apollo Shoes Casebook Outline substantive procedures by using the Apollo Shoes Casebook for detecting irregularities in each of the following audit cycles: †¢Accounts receivable †¢Inventory †¢Fixed assets Design an audit program for the cycle in no more than 1,050 words. Consider using a checklist or flowchart to outline your process. Format your audit program consistent with APA guidelines. Day 711 Week Five: Financial Statement Fraud DetailsDuePoints Objectives5. 1Analyze the relationship between financial accounting principles and fraud. 5. 2Analyze schemes used in financial statement fraud. ReadingsRead Ch. 11 of Principles of Fraud Examination. ReadingsRead Ch. 12 of Principles of Fraud Examination. ReadingsReview the Apollo Shoes Casebook. ParticipationParticipate in class discussion. See Policies1. 5 Discussion QuestionsRespond to weekly discussion questions. DQ1 – Day 2 DQ2 – Day 4 DQ3 – Day 61. 5 Individual Financial Statement Fraud SchemesYou are the investigator assigned to Apollo Shoes. Based on the nature of the company and the evidence provided to you, you must determine which financial statement fraud schemes would likely be present in the company. Resource: Apollo Shoes Casebook Identify potential financial statement fraud schemes by using the Apollo Shoes Casebook. Describe the types of evidence you would look for to determine whether fraud is occurring. Write a business brief of no more than 1,050 words that outlines how you will use the substantive procedures discussed in Weeks Three and Four to analyze potential schemes. Format your business brief consistent with APA guidelines. Day 720 Learning Team Weekly ReflectionDiscuss this week’s objectives with your team. Your discussion should include the topics you feel comfortable with, any topics you struggled with, and how the weekly topics relate to application in your field. Prepare a 350- to 1,050-word paper detailing the findings of your discussion. Day 71 Week Six: Examination Reporting DetailsDuePoints Objective6. 1Create documentation to present investigation findings. ReadingsRead Ch. 13 of Forensic Accounting and Fraud Investigation for Non-Experts. ReadingsRead the section â€Å"Attestation Engagements† in Module A of Auditing Assurance Services. ParticipationParticipate in class discussion. See Policies2 Discussion QuestionsRespond to weekly discussion questions. DQ1 – Day 2 DQ2 – Day 4 DQ3 – Day 62 Individual CPA Examination ReviewResource: Week Six Student Road Map Access the Wiley CPA Examination Review website from the link on the student website. Use the Week Six Student Guide to complete the Wiley CPA Examination assignment. Day 72 Individual Report on Financial Statement Fraud SchemeResource: Ch. 12 of Principles of Fraud Examination Choose one of the following financial fraud scheme cases from Ch. 12 of Principles of Fraud Examination. (You may also choose a fraud scheme case that is not in the text, with instructor approval. ) †¢Case Study: That Way Lies Madness †¢Case Study: The Importance of Timing †¢Case Study: All on the Surface Write a letter or memo in no more than 1,050 words to the organization’s management and communicate the examination findings explained in the case. Refer to this week’s assigned readings for assistance with formatting a letter or memo to management. Include the following in your letter or memo: †¢A summary of the matter under investigation †¢The scope of the examination †¢A summary of conclusions †¢The factors that aided the examination †¢The limitations on the examination Format your assignment consistent with APA guidelines. Day 78 Learning Team Weekly ReflectionDiscuss this week’s objectives with your team. Your discussion should include the topics you feel comfortable with, any topics you struggled with, and how the weekly topics relate to application in your field. Prepare a 350- to 1,050-word paper detailing the findings of your discussion. Day 71 Copyright University of Phoenix ® is a registered trademark of Apollo Group, Inc. in the United States and/or other countries. Microsoft ®, Windows ®, and Windows NT ® are registered trademarks of Microsoft Corporation in the United States and/or other countries. All other company and product names are trademarks or registered trademarks of their respective companies. Use of these marks is not intended to imply endorsement, sponsorship, or affiliation. Edited in accordance with University of Phoenix ® editorial standards and practices.

I Am Woman!!! :: Personal Narrative Essay Example

I Am Woman!!! So, why don't gynecologists have contests to make it at least interesting? I mean, while you're lying there, legs splayed to the world, why not move things along with a touch of frivolity? Count-the-Holes-In-The-Ceiling-Tiles or Count-How-Many-Miles-'Til-He-Reaches-China or even How-Many-Organs-Will-Still-Be-Intact? The act of submitting oneself to the humiliation of inspection has, since the first cavewoman squatted in childbirth, loomed in the female consciousness as a unifying force likely to explode in repressed rage. Women have been prodded, probed, peered at, pared down, palpated, pregnant, penetrated and pawed since the dawn of civilization. From the information I have gathered over my years of blooming womanhood, the paradigm should be shifting as least as much as breasts to gravity. I am not alone. In locker rooms, sorority dorms, at Tupperware parties and at PTA meetings, sisterhood has been built on the collective misery from the malfunctioning and misfiring of the female anatomy. I have heard stories that would send television producers running for a time slot to resurrect "Queen for a Day." Who wouldn't be moved by the woman in Syracuse who felt like she had the flu--no energy, aching back and stomach cramps? To her surprise she delivered a nine-pound baby boy on the Simonized kitchen floor of her double-wide mobile home. That is some flu. Maybe, by now, there is a scientific name for it (so the condition can be recognized by the AMA for possible funding). Something like the Haagen-Daz Syndrome or Gherkin-itis would help these women and their doctors differentiate between the flu and pregnancy. Then there's the woman in Des Moines who, at the age of 75, gave birth to triplets and then sued her doctor for malpractice. The birth-control pills he had prescribed for her were not the correct dosage. So say her lawyers. It goes on and on. The sponsors of the show could give out huge prizes ranging from a year's supply of feminine pads to a gross of Midol. The grand prize, after the battle of the bulges, could be a trip to the Smithsonian Institution to view gynecological instruments from the period of Western expansion of the United States. That would cheer up the most distended and distraught among us. Nothing builds solidarity like good old-fashioned trouble. Women, blamed for being distracted by instinct, have a penchant for tracking the woes of their sisters.

Vulnerability: Disability and Family Reform Act

The Association of Directors of Social Services (1991) defined a vulnerable adult by the client group: the elderly and frail, those with a mental illness (including dementia), those with a sensory, physical or learning disability, and those with severe physical disability. The current definition, in the Department of Health guidance â€Å"No secrets†, states that a vulnerable adult is â€Å"a person who is or may be in need of community care services by reason of mental or other disability, age or illness; and who may be unable to take care of him or herself, or unable to protect themselves against harm or exploitation† (DOH, 2000).The age of majority (becoming an adult) was identified by The Family Reform act in 1969 as 18 years or older. Leffers et al (2004) summarises that the concept of vulnerability in healthcare refers to those who are susceptible to harm. It is often perceived as the opposite of power (Phillips and Bramlett, 1994). Vulnerability is an important i n that the majority of nursing practice is spent helping those who are in a vulnerable position, or helping them avoid vulnerability.Spiers (2000) recognises that nursing has been slow in developing theoretical constructs of vulnerability. In healthcare it should be considered on an individual basis. Rogers (1992) developed a system which focuses on the person as a constituent of their environment, which is relevant as a nursing framework for addressing vulnerability. Vulnerability is important due to its implications for health. Being vulnerable can lead to stress and anxiety, which has an effect on a person’s physical, social, psychological, and environmental well-being. Vulnerability: Disability and Family Reform Act The Association of Directors of Social Services (1991) defined a vulnerable adult by the client group: the elderly and frail, those with a mental illness (including dementia), those with a sensory, physical or learning disability, and those with severe physical disability. The current definition, in the Department of Health guidance â€Å"No secrets†, states that a vulnerable adult is â€Å"a person who is or may be in need of community care services by reason of mental or other disability, age or illness; and who may be unable to take care of him or herself, or unable to protect themselves against harm or exploitation† (DOH, 2000).The age of majority (becoming an adult) was identified by The Family Reform act in 1969 as 18 years or older. Leffers et al (2004) summarises that the concept of vulnerability in healthcare refers to those who are susceptible to harm. It is often perceived as the opposite of power (Phillips and Bramlett, 1994). Vulnerability is an important i n that the majority of nursing practice is spent helping those who are in a vulnerable position, or helping them avoid vulnerability.Spiers (2000) recognises that nursing has been slow in developing theoretical constructs of vulnerability. In healthcare it should be considered on an individual basis. Rogers (1992) developed a system which focuses on the person as a constituent of their environment, which is relevant as a nursing framework for addressing vulnerability. Vulnerability is important due to its implications for health. Being vulnerable can lead to stress and anxiety, which has an effect on a person’s physical, social, psychological, and environmental well-being.

Evidence Based Practice Essay

The following ssion of this assignment attempts to critically appraise the venUS III randomised control trial (RTC) published in the British Medical Journal. As a student/healthcare worker who is new to critical appraisal I am aware that I do not fully understand some of the calculations involved in reporting of findings, however Greenhalgh (2006) argued, ‘all you really need to know is what the best test is to apply in given circumstances, what it does and what might affect its validity/appropriateness’. When caring for patients it is essential that Healthcare Professionals are using current best practice. To determine what this is they must be able to read research, as not all research is of the same quality or standard therefore Healthcare Professionals should not simply take research at face value simply because it has been published (Cullum and Droogan, 1999; Rolit and Beck, 2006). I am completing this assignment to cultivate the skills at enable me to effectively assess the validity of research that may shape my practice. There are numerous tools available to help reviewers to critique research studies (Tanner 2003). I have elected to use the Critical Appraisal Skills Programme (CASP) tool. I chose CASP as it is simple, directive and appropriate to quantitative research. The research article had a clear concise and easily understandable title and abstract. Titles should be 10/15 words long and should clearly identify for the reader the purpose of the study (Connell Meehan, 1999). Titles that are too long or too short can be confusing or misleading (Parahoo, 2006). From the abstract the reader should be able to determine if the study is of interest and whether or not to continue reading (Parahoo, 2006). The author(s’) qualifications and job can be a useful indicator into the researcher(s’) knowledge of the area under investigation and ability to ask the appropriate questions (Conkin Dale, 2005). The authors of the venUS III trial were from a range of academic and clinical backgrounds and are considered experts in their fields. The VenUS  III RTC clearly set out its objective to consider the clinical effectiveness of weekly high frequency ultrasound on hard to heal venous leg ulcers, (hard to heal was defined). In cases where participants had more than one venous leg ulcer the largest ulcer would be tracked if ultrasound treatment was allocated this site received the treatment. Outcomes to be considered where clearly outlined and method of measurement/collection defined. The study screened 1488 people with leg ulcers and 337 people became participants (22. %) Participants were randomised and evenly distributed, 168 to ultrasound therapy (dependant variable) plus standard care (experimental group) and 169 to standard care only (control group) This is reported as being the largest trial undertaken on the subject of therapeutic ultrasound for wound healing and earlier studies are referenced in support this statement. The study was cross-sectional, its population was taken from both community and district nur se led services as well as hospital outpatient clinics. The 12 care settings used where taken from both rural and urban settings. A â€Å"good† sample is one that is representative of the population from which it was selected (Gay 1996) Venous leg ulcers rates rise sharply with age with an estimated 1 in 50 people over the age of 80 developing venous leg ulcers (NHS choices 2012). The age of the participants in the study ranged from 20-98 years old, however the median age overall was 71. 85 and the mean age was 69. 44 years old across the study, well below the age range where venous leg ulcers are most seen. The assignment of participant’s treatment was equally randomised: treatment was blindly allocated: 168 to ultrasound therapy plus standard care and 169 to standard care only. Randomisation was conducted by an independent agency (York trials Unit) The lack of attrition bias was a strong positive for the venUS III trial, it had a low loss to follow up rate. The nurses providing treatment where not blind to which treatment had been allocated, this may impact on construct validity as in some cases it is suggested that control subjects are compensated in some way by healthcare staff or family for not receiving research intervention (Barker 2010). Nurses who were blinded were employed to trace the ulcers. Participating patients were not blind to the treatment/s. As one of the measured outcomes was patients perceptions of health, assessed by a questionnaire (SF-12) it is reasonable to conceive that this assessment may have been influenced by the patients awareness of the treatment type they were receiving thus creating the possibility for assessment bias. Construct validity may also be impacted on peoples behaviours as a response to being observed or to the treatment because they believe it will have a positive effect. Barker 2010) Healing date was assessed remotely by independent assessors who where blind to the treatment allocation this guards against assessment bias. Overall both treatment groups were equal in size. Both treatment groups had an almost equal average age of study participants, this is important because inequality in age between the groups would represent a heterogeneous population (Barker 2010). Venous leg ulc eration is more common in woman than men in those below 85 year of age (Moffat 2004) the trial participants had a female majority. Probably the weakest element of the study was the probability of performance bias. Standard care comprised of low adherent dressings and four-layer bandaging that was high compression, reduced compression or no compression depending upon the participant’s tolerance. Any changes to the regime where recorded and where made at the discretion of the treating clinician. Standard care was practiced in accordance with local protocol and could have varied between locations the quality of standard care given may be considered to be a confounding variable. Surveys of reported practice of leg ulcer care by nurses have demonstrated that knowledge often falls far short of that which is ideal (Bell 1994, Moffat 2004, Roe 1994) and that there is a wide variation in the nursing management of people with leg ulcers in the United Kingdom (UK) (Elliot 1996, Moffat 2004, Roe 1994). Large variation in healing rates according to trial centre is a further indicator that standard care is so variable that it potentially affects the reliability of results. No treatment fidelity checks were undertaken and no observation regime beyond usual practice of the treating nurse’s practice was implemented despite nurses being new to ultrasound application. Nurses were deemed competent after one day of training, these nurses where then also considered competent to train other local nurses who would be providing treatment. The ultrasound treatment given during the venous III trial did not give any additional effect on ulcer healing or reoccurrence rate and it did not affect quality of life. As the study only looked at one ultra sound regime extrapolation of the results was not possible, a between-subjects designed study may have provided data that was of further function. Treatment effect was measured precisely; the primary outcome measured was the time that the venous leg ulcer took to heal, this was measured in days and adjustments were made in order to account for baseline ulcer area (larger ulcer would be expected to take longer to heal than smaller ulcers). A fully healed ulcer was clearly defined and the ulcers were photographed every four weeks, at the point of healing and seven days after full healing has occurred, assessment of the ulcer was completed by two blind independent assessors and where required a third assessor was used if outcome was inconclusive. In some cases no photographs were available for patients in this case the treating nurse assessed healing date, no explanation why photographs would not be available is given. 7. 8% of the sample were assessed by an unblinded nurse this presented some risk of assessment bias. The trial also considered how many patients had fully healed ulcers within 12 months. Reduction in ulcer size was measured by area, by a blinded nurse who took acetate traces of the ulcers every four weeks the method of which was considered to be accurate and reliable and its provenance clearly referenced. Quality of life was also measured with a standardised questionnaire (SF-12) which looked at both physical and mental elements. As there is no evidence to support the use of ultrasound therapy in addition to standard treatment therefore no current change in practice is indicated and standard practice should continue. The study reported significant heterogeneity in healing rates among the treatment centres. Centres that treated the most patients produced better healing overall, if there is a correlation between volume of patients treated and positive outcomes this hypothesis has the potential to impact upon the way care is delivered in the future. The trial considered not only medical outcomes but also considered changes in patient quality of life (both physical and mental). Beauchamp and Childress (2001) identify four fundamental moral principles: autonomy, non-maleficence, beneficence and justice. Autonomy infers that an individual has the right to freely decide to participate in a research study without fear of coercion and with a full knowledge of what is being investigated. Participants gave written, informed consent and recruiting nurses were trained in consent procedures. Non- maleficence implies an intention of not harming and preventing harm occurring to participants both of a physical and psychological nature (Parahoo 2006). Patients who had a high probability of being harmed if they received the ultrasound where excluded from the trial, the exclusion criteria took into account contraindications. Initially it was planned to exclude those unable to tolerate compression bandaging but after ethical consideration this was removed as these patients were identified as being particularly in need of the chance to benefit from ultrasound therapy. Beneficence is interpreted as the research benefiting the participant and society as a whole (Beauchamp and Childress, 2001). The annual cost to the NHS is estimated at ? 230-400 million (NHS Centre for Reviews and Dissemination, 1997; Bosanquet, 1992; Baker et al. 991) some individual health authorities are spending ? 0. 9m to ? 2. 1 million (Carr et al 1999). There are psychological implications to the patient in that the ulcer increases social isolation through limited mobility, uncontrolled exudate and odour, together with pain (Lindholm et al. 1993; Charles1995). Justice is concerned with all participants being treated as equals and no one group of individuals receiving preferential treatment (Parahoo, 2006). There is no evidence to sugg est that any of the participants were discriminated against. The following section attempts to discuss how evidence based health care enhances health care- looking at the evidence base within health care Evidence-based practice (EBP) is one of the most important developments in decades for the helping professions—including medicine, nursing, social work, psychology, public health, counselling, and all the other health and human service professions (Briggs & Rzepnicki, 2004; Brownson et al. , 2002; Dawes et al. , 1999; Dobson & Craig, 1998a, 1998b; Gilgun, 2005; Roberts & Yeager, 2004; Sackett et al. ,2000). That is because evidence-based practice holds out the hope for practitioners that we can be at least as successful in helping our clients as the current available information on helping allows us to be. Evidence-based health care is the conscientious use of current best evidence in making decisions about the care of individual patients or the delivery of health services. Current best evidence is up-to-date information from relevant, valid research about the effects of different forms of health care, the potential for harm from exposure to particular agents, the accuracy of diagnostic tests, and the predictive power of prognostic factors