Nurses are at the forefront of an evolutionary wave in health care. Whether we take leadership or not will determine nursing’s future.These ten trends can revitalize nursing if nurses break free from the confines of the medical model and use their education and skills to become wave riders.1. Aging Boomers
Boomers are living longer. Quantity of life is driving a desire for better quality of life. This generation wants to learn how to stay vital, mobile, healthy and productive. They are looking for guidance in health promotion and wellness, not only disease prevention and treatment.2. A 2nd Boom
Boomers Grandchildren are driving a huge demand for family health information and support for new and working moms. From birthing to family health education and sick child care, family systems need and want professional advice and innovative strategies to raise a brighter, stronger next generation.3. Information explosion
Internet access provides health consumers with tons of information, but not the knowledge or wisdom to know how to use it without getting confused. They need knowledgeable health professionals as gatekeepers, trusted advisors, or health system navigators.4. Holism
People are increasingly spending out of pocket dollars for alternative and complementary health care. Nursing education focuses on systems, whole person, life cycle perspectives that can guide in selecting appropriate options along a continuum of care.5. Consumer driven health care
As consumers rely less on employer health coverage and more on personal health spending, they are seeking innovative and home based solutions for care including advanced home monitoring, telephone consultation, personalized care, and individualized treatment.6. High Tech – High Touch
The need for personal connection, listening, and caring has never been higher. Nurses consistently rank first in every consumer poll for most trusted professional.7. Shortages and Cost Containment
Professional shortages and a drive to contain costs, creates a push to use mid-level and low-level providers for technical care. Nurses will continue to be driven away from the institutional bed side. With decreasing numbers of people in institutional care, face to face professional health care will be delivered in the home and community.8. Accessibility
Health information and care will be delivered on a global, mobile, remote, phone and internet basis. Nursing phone advice lines are increasingly popular with consumers.9. Back to Basics
With increased interest in information and coaching on proper food and nutrition, supplements, stretching, meditation, simplicity, life balance, joy in work, and relationships wellness and health coaching is a growing field.10. Self-Care/Self-Responsibility
People are realizing that doctors, medication and illness care are not going to keep them well. Employers, third party payers and common sense are driving consumers to take health care into their own hands. This trend will continue to drive an increase in self care information and reduction in in-patient and long term care.Tomorrow’s nurses are not working under a doctor’s direction, or in an institution. To remain viable, nursing will have to think beyond the institutional medical care box.Consumers are desperate for professional nurses to fill the need for proactive community
and home based health care.Tomorrow’s nurses will be innovative community health leaders, who develop and deliver services directly meeting the changing needs of health consumers.Progressive, professional nurses will form cooperatives, and creative health delivery systems that support families throughout the life span. They will provide continuity of health information and care while supporting people to navigate an ever more specialized and complex techno-medical system.Grab A Board – Surfs Up!© Aila Accad, RN

According to the 2012 report, Global Trends 2030: Alternative Worlds, published the US National Intelligence Council, four technology arenas will shape global economic, social and military developments by 2030. They are information technologies, automation and manufacturing technologies, resource technologies, and health technologies.Information technologiesThree technological developments with an IT focus have the power to change the way we will live, do business and protect ourselves before 2030.1. Solutions for storage and processing large quantities of data, including “big data”, will provide increased opportunities for governments and commercial organizations to “know” their customers better. The technology is here but customers may object to collection of so much data. In any event, these solutions will likely herald a coming economic boom in North America.2. Social networking technologies help individual users to form online social networks with other users. They are becoming part of the fabric of online existence, as leading services integrate social functions into everything else an individual might do online. Social networks enable useful as well as dangerous communications across diverse user groups and geopolitical boundaries.3. Smart cities are urban environments that leverage information technology-based solutions to maximize citizens’ economic productivity and quality of life while minimizing resources consumption and environmental degradation.Automation and manufacturing technologiesAs manufacturing has gone global in the last two decades, a global ecosystem of manufacturers, suppliers, and logistics companies has formed. New manufacturing and automation technologies have the potential to change work patterns in both the developed and developing worlds.1. Robotics is today in use in a range of civil and military applications. Over 1.2 million industrial robots are already in daily operations round the world and there are increasing applications for non-industrial robots. The US military has thousands of robots in battlefields, home robots vacuum homes and cut lawns, and hospital robots patrol corridors and distribute supplies. Their use will increase in the coming years, and with enhanced cognitive capabilities, robotics could be hugely disruptive to the current global supply chain system and the traditional job allocations along supply chains.2. 3D printing (additive manufacturing) technologies allow a machine to build an object by adding one layer of material at a time. 3D printing is already in use to make models from plastics in sectors such as consumers products and the automobile and aerospace industries. By 2030, 3D printing could replace some conventional mass production, particularly for short production runs or where mass customization has high value.3. Autonomous vehicles are mostly in use today in the military and for specific tasks e.g. in the mining industry. By 2030, autonomous vehicles could transform military operations, conflict resolution, transportation and geo-prospecting, while simultaneously presenting novel security risks that could be difficult to address. At the consumer level, Google has been testing for the past few years a driverless car.Resource technologiesTechnological advances will be required to accommodate increasing demand for resources owing to global population growth and economic advances in today’s underdeveloped countries. Such advances can affect the food, water and energy nexus by improving agricultural productivity through a broad range of technologies including precision farming and genetically modified crops for food and fuel. New resource technologies can also enhance water management through desalination and irrigation efficiency; and increase the availability of energy through enhanced oil and gas extraction and alternative energy sources such as solar and wind power, and bio-fuels. Widespread communication technologies will make the potential effect of these technologies on the environment, climate and health well known to the increasingly educated populations.Health technologiesTwo sets of health technologies are highlighted below.1. Disease management will become more effective, more personalized and less costly through such new enabling technologies as diagnostic and pathogen-detection devices. For example, molecular diagnostic devices will provide rapid means of testing for both genetic and pathogenic diseases during surgeries. Readily available genetic testing will hasten disease diagnosis and help physicians decide on the optimal treatment for each patient. Advances in regenerative medicine almost certainly will parallel these developments in diagnostic and treatment protocols. Replacement organs such as kidneys and livers could be developed by 2030. These new disease management technologies will increase the longevity and quality of life of the world’s ageing populations.2. Human augmentation technologies, ranging from implants and prosthetic and powered exoskeleton to brains enhancements, could allow civilian and military people to work more effectively, and in environments that were previously inaccessible. Elderly people may benefit from powered exoskeletons that assist wearers with simple walking and lifting activities, improving the health and quality of life for aging populations. Progress in human augmentation technologies will likely face moral and ethical challenges.ConclusionThe US National Intelligence Council report asserts that “a shift in the technological center of gravity from West to East, which has already begun, almost certainly will continue as the flows of companies, ideas, entrepreneurs, and capital from the developed world to the developing markets increase”. I am not convinced that this shift will “almost certainly” happen. While the East, in particular Asia, will likely see the majority of technological applications, the current innovations are taking place mainly in the West. And I don’t think it is a sure bet that the center of gravity for technological innovation will shift to the East.

The investment services industry can be daunting and ambiguous for individuals who seek a return on their capital. After working hard earning your wealth, it is important to understand the different services offered by professionals and what solutions fit you personally. One of the main questions we get asked here is:”What is the difference between investment management and stockbrokers?”Firstly, let’s discuss what stockbrokers are – we all have a much better, clearer, idea of what they do and who they represent. Stockbrokers are regulated firms that offer financial advice to their clients. A stockbroker buys and sells equities and other securities like bonds, CFDs, Futures and Options on behalf of their clients in return for a fee or commission. A brokerage / stockbroker will receive a fee on each transaction, whether the idea is profitable or not.A brokerage can specialise in any investment niche they wish for example:
FTSE All-Share stocks,
AIM stocks,
European Stocks,
Asian Stocks,
US Stocks
Combinations of the above
Straight equities,
Straight derivative trading (CFDs, Futures & Options)
The main reason why investors choose stockbrokers over any other professional investment service is simply down to control. Due to the nature of a brokerage firm, they can only execute a trade after you instruct them to do so. This means it is impossible for a brokerage to keep buying and selling securities without you knowing – known as churning for commission. This doesn’t however prevent stockbrokers providing you with several new ideas a week and switching your positions to a new idea.However, there are natural flaws with the brokerage industry is that because trading ideas can only be executed after being instructed to list a few flaws;-
you may miss out of good opportunities due to moves in the market,
you may get in a couple of days later because you were busy and not make any money after fees,
you may receive a call to close a position but unable to without your say so.
The above are examples that can happen when investing with brokerage firms, but this is due to the reliance of gaining authorisation from their clients. So if you are ultra busy or travel a lot then you could potentially miss out on opportunities to buy or sell.What are investment managers?Now we understand what stockbrokers / brokerage firms are about, let’s discuss what investment management services can do for individuals.Investment management firms run differently to brokerages. The core aspect to these services is that the professional investment managers use their discretion to make investment decisions. As a client of an investment management firm you will go through a rigorous client on boarding process (just like a brokerage firm) to understand your investment goals, understanding of the services being used, risk profile, angering to the investment mandate and allowing the service to manage your equity portfolio. The sign up with the service may seem long winded but it’s in your best interest to ensure the service is suitable and appropriate for you. In reality, it’s not a long winded process at all. Once you agree to the services offered then you will only be updated on the on-going account data and portfolio reporting in a timely manner. This means no phone calls to disrupt your day-to-day activities and allows the professionals to focus on your portfolio.Investment management firms usually have specific portfolios with a track record, into which you can invest your capital according to you appetite for risk. These portfolios will focus on specific securities, economies, risk and type of investing (income, capital growth or balanced). All of this would be discussed prior or during the application process.Another method used by investment management firms is different strategies implemented by their portfolio managers. These strategies are systematic and go through thorough analysis before investment decisions are made.The fees usually associated with investment management firms can vary from each firm. There are three common types of fees and are usually combined, fees can be;-
Assets Under Management Fee – This is where you pay a percentage of the portfolio per year to the firm, usually an annual fee. E.g) 1% AUM Fee on £1,000,000 is £10,000 per year.
Transaction Fee – This is a fee associated with each transaction made through your portfolio – similar to the brokerage firm’s commission.
Percentage of Profits Fee – This is where any closed profits generated over a set time will be charged to the firm. E.g) 10% PoP Fee – the firm generates you closed profit of £10,000 in one quarter – you will be charged £1,000.
The main benefits provided from investment management firms is that after the service understands your needs and tailors the service around you, it is their job to build a portfolio around you. It is also the job of the investment management firm to adhere to the investment mandate you agreed on, we’ll take about this later, so you understand of the time frame given what you should expect. Another bonus why high-net worth individuals choose investment management services is because they are not hassled by phone calls every other day with a new investment idea.The difference… The main difference between investment management and stockbroking firms is:
Investment Managers offers discretionary services; no regular phone calls about stock ideas.
Stockbrokers give you more control as you can personally filter out ideas you think won’t work.
Investment Managers offer an investment mandate; this is where the investment management service provides a document of what they are offering you in return of managing your portfolio. You will understand what exactly they are targeting over the year, based on what risk, and should they achieve it – then they have fulfilled their service. E.g) the mandate could state that the strategies used and based on 8% volatility (risk), they seek to achieve 14% capital return.
Stockbrokers do not offer an future agreements but look to deliver growth during the time you are with them. They are not bound by their performances like investment managers.
Investment management firms have a track record for all of the strategies and services used, stockbrokers do not.
Which to choose?Both services provide professional approaches to investing in the stock markets. Stockbrokers are chosen over investment managers by people who like to be in control and receive financial advice. Stockbrokers generally do not have a systematic approach to the markets but use selective top-down approaches to select stocks.Investment managers are chosen by investors who want an agreement on their performances over the year and understand the risk up-front. Usually more sophisticated investors that wish to take advantage of the track-record and gain an understanding of the systematic approach used by the investment management firm.Feel free to learn more.DISCLAIMER: The above is not considered financial advice or any endorsement to use any particular service. If you wish to use any of the services mentioned, please seek independent advice.RISK WARNING: Spread betting, CFD, futures and options trading carries a high level of risk to your capital and can result in losses that exceed your initial deposit. They may not be suitable for everyone, so please ensure that you fully understand the risks involved. Past performance of a managed service is not a guide to future performance.