Law and Ethics, Patients Rights in Practice Essay

In particular, those aspects observed by the student relating to patients privacy, confidentiality and any situations which warranted a limitation to patient privacy will be described and discussed with reference to patients rights. Situations in the hospital setting where the student nurse viewed health professionals informing patients about treatment options, encouraging patients to take action in decisions about their health, and gaining informed, voluntary consent prior to procedures will be discussed. An explanation of reasons for selecting privacy and consent as two essential concepts which health providers must understand will be illustrated. The legal and ethical responsibility of health care providers in relation to the aforementioned fundamental principles of achieving patient privacy and gaining informed voluntary consent will be examined with a clear emphasis on patient’ rights. While on clinical placement, the student nurse observed health professionals maintaining patient privacy to a high standard by consistently shutting curtains around patient’s beds, lowering their voices when working with patients in rooms containing multiple beds, courteously requesting visitors to leave the room when procedures of a sensitive nature were preformed and closing patient’s doors to limit unwanted interference from hallways. In order to show patients respect, dignity and consideration, which are outlined as a fundamental patient right in the Queensland Health Public Patient’s Charter (2002), patients were consistently examined in areas that were as private as was possible at the time. This attempt by health care providers to maintain the physical privacy of all patients by consistently minimizing unwarranted outside attention is a clear demonstration of how health care providers maintained patient dignity, consideration and respect. According to the Ramsay Health Care/Cairns Private Hospital Patient Charter (nd. , patients have a right to be treated with courtesy throughout their hospital experience. The actions of the health care team correlate positively to this statement as through the maintenance of patient’s physical privacy, health care providers are demonstrating consideration for their patients and respecting their rights set forth in both the Queensland Health public patient charte r and the Ramsay health care charter. Throughout the clinical placement of the student nurse, the health care facility in question demonstrated exceptional adherence to national privacy principles 4. set forth in the Privacy Amendment Act (2000). Initiatives currently in place at Cairns Private Hospital ensure confidentiality of both patient’s medical records as well as patient’s personal details by limiting outside access to confidential information and preventing health care professionals from transmitting such information to the broader community. One such example observed by the student nurse involves the hospitals policy preventing nurses from leaving the hospital with materials used in nursing handovers that contain information regarding patient’s condition and personal details. The destruction of such material prevents the transmission of private information to the wider community and demonstrates the role of health care providers in maintaining patient privacy. According to the national privacy principle 4. 1 extracted from the Privacy Amendment (Private Sector) Act (2000, p. 9), â€Å"An organisation must take reasonable steps to protect the personal information it holds from misuse and loss and from unauthorised access, modification or disclosure. Therefore, by ensuring patients information is protected from unauthorised access and disclosure, Cairns Private Hospital is fulfilling the legal obligations set forth for private organizations in the Privacy Amendment Act (2000) principle 4. 1. Patient’s right to have their personal information kept private and confidential, as outlined in the Queensland Health Public Patient’s Charter (2002), was also exceptionally demonstrated by those nurses with whom the student nurse was in contact during c linical placement. Health care providers consistently maintained patient confidentiality by limiting discussion of patient’s condition to those situations where health care providers must share patient information to improve patient care. When the student nurse observed an exchange of information between health care providers pertaining to patient’s condition, it occurred in a manner such that other patients or visitors were unable to discern the content of discussion. This includes, but is not limited to, patient information related in nursing handovers. By treating patient’s personal information obtained in a professional capacity as confidential, nurses are adhering to the expected national standards for Australian nurses as stated in ANC Code of Professional Conduct for Nurses in Australia (nd. ). The importance of maintaining patient privacy is unquestionable. Patients belief that health care professionals will handle their personal information with respect, dignity and maintain their confidentiality not only illustrates the ethical and legal responsibilities of health care providers, but correlates positively with the formation of trust between patient and nurse. According to Stein-Parbury (2005 p. 42), â€Å"†¦ without trust, there is minimal self-disclosure and little chance that patients will share their experiences with nurses or that nurses will come to understand patients’ experiences. † Therefore, through the maintenance of patient privacy and confidentiality, the element of trust, which forms the basis of all nurse-patient relationships, is strengthened. Crisp and Taylor (2005), illustrated the importance of patient privacy and confidentiality as without these two essential components patients would not feel able to tell health care professionals their most intimate and private details. This potential hesitation to share personal information with health providers can have a negative impact on the provision of care and can ultimately lead to treatment that does not take into consideration essential aspects of patient’s health. The maintenance of patient’s privacy is essential in both building trust between nurse and patient and providing holistic nursing care. As stated previously, the maintenance of patient privacy has implications in both legal and ethical spheres and is paramount to the formation of the nurse-patient relationship. Student nurses must therefore gain an understanding of the importance of maintaining patient privacy to ensure that once qualified as a registered nurse, one will understand the reasons why legally and ethically we must adhere to the guidelines. In today’s health care setting, the emphasis of patient’s rights and understanding these rights is paramount if one wishes to practice safe appropriate care for all peoples. It is for these reasons that the central issue of patient privacy was selected for consideration. Although the importance of maintaining patient privacy is unquestionable, there are ertain situations that warrant the sharing of patient information. As observed by the student nurse, health care professionals continuously share patient information between themselves in attempts to allow allied health professionals to provide appropriate holistic patient care. In today’s hospitals, with shift work and the increasing specialization of various allied healt h workers, it is essential that patient information is shared to improve patients care and outcome. In order to achieve appropriate care for patient’s, this is a requirement and will not be considered as a breach of patient privacy. This team work approach to health care is viewed as of benefit to the patient and is absolutely essential is today’s health care facilities where health care professionals are increasingly working in more specialized fields. Throughout the entire clinical placement, the student nurse consistently observed health providers informing patients of their various treatment options, encouraging patients to take an active role in decisions about their health, and ultimately gaining informed voluntary consent prior to any procedure. As outlined in the Queensland Health Public Patients Charter (2002), and the Ramsay Health Care/Cairns Private Hospital Patient Charter (nd. ), patients have a right to easy to understand information about their condition, treatment options, risks, and expected outcomes. The health providers viewed by the student nurse exemplified exceptional adherence to the patients right to accurate information as nurses were observed directly informing patients wherever possible about their treatment options, risks, and choices available to them. Health care providers not only adhered to their legal obligation of providing treatment information to patients, but did so in a way that reflected nurses ability to use due care in support of their ethical responsibilities. According to the Ramsay Health Care/Cairns Private Hospital Patient Charter (nd. ), patients have a right to ask questions and seek clarification in regards to matters that concern them. The actions of the health care team exemplified good practice with reference to this patient right. Health care providers were willing at all times to respond to patients questions or concerns and faced each situation with enthusiasm and clear respect for patients right to ask questions and seek clarification. Patients right to take part in decisions about their health care as stated in the Queensland Public Health Charter ( 2002), was viewed by the student nurse to occur in conjunction with the aforementioned patient right to information about treatment. By providing patients with easy to understand information about their condition, it allowed patients to make informed choices regarding their treatment and overall health. Health professionals were observed to provide patients with the information they require such that patients could make their own decisions regarding their treatment options. By thoroughly providing patients with necessary information as well as encouraging patients to take an active role in decisions about their health, health providers were empowering patients and fostering patient’s autonomy. Autonomy, the freedom to decide and act (Stein-Parbury, 2005), can be enhanced when a patient is given information about their condition and encouraged to take an active role in making decisions about their health. Informing patients of various treatment options and encouraging patients to take an active role in decisions about their health are fundamental components of informed voluntary consent. Informed voluntary consent may be implied, written or verbally given. The student nurse observed various nurses obtaining implied consent from patients when performing routine procedures such as taking a blood pressure reading. The student also viewed health providers obtaining verbal consent from patients when preforming procedures such as showering and mobilizing patients. The health providers adhered to the legal requirements which state that consent must be voluntarily given and informed (Forrester & Griffiths, 2005). The actions of the health care team correlate positively to the statements set forth in both the Queensland Health Public Patients Charter (2002) and the ANMC Code of Ethics for Nurses in Australia (nd. ). The charter asserts that patients have the right to give their permission before they are treated. Whether consent was implied or verbal, the student nurse observed patients giving their permission prior to any procedure. According to Value Statement 2 in the Code of Nursing Ethics (nd. ), nurses must accept the rights of individuals to make informed choices in relation to their care. By ensuring that patients right to make informed choices in relation to their care and obtaining informed voluntary consent, health providers are meeting their legal and ethical obligations surrounding patients consent. It is essential that student nurses have an understanding of their moral and legal requirements surrounding patients consent. If a health provider performs a procedure without acquiring consent, there is a possibility that their actions legally may amount to assault or battery. According to Forrester and Griffiths (2005), battery involves the unlawful touching of a person without his or her consent. In charges of battery, there is no requirement that the patient sustains any injuries as a result of health professionals unlawful touching. Health providers must therefore have an understanding of the legal ramifications surrounding consent to ensure that they provide safe nursing care based on respecting patient’s legal rights. It is for this reason that the issue of patient’s consent was included for discussion in this paper. It is becoming increasingly important for health professionals to have an understanding of their legal and ethical responsibility for the maintenance of patient privacy and obtaining informed voluntary consent prior to preforming any procedure with patients. With the emphasis on patiens rights becoming more prevalent in the health care setting, it is essential that health care workers respect patient’s rights which include, but are not limited to, maintaining patient privacy and obtaining informed voluntary consent. The health providers present at the health care facility attended by the student nurse were observed to demonstrate good practice with respect to patients’ rights as set forth in the Queensland Health Public Patients Charter (2002).   

Catherine Booth Contribution to Christianity Essay

Catherine Booth has strongly contributed to the expression and development of Christianity. Through developing the organisation The Salvation Army, Booth addressed discriminatory issues present in the Christian church such as the inequality of women and exclusion of the lower class. Booth has influenced, and still continues to influence Christian society by displaying female equality in the church, workplace and home. Her charity work through The Salvation Army altered Christianity’s perspective of assisting all people in need and not distinguishing between â€Å"deserving† and â€Å"undeserving† poor. Booth adapted her church to make it more holy, sacred and appealing to all in society, she placed emphasis on accepting the poor so that more people can go back to god. Catherine Booth influenced the Christian Church’s belief of women’s rights. During her lifetime the Christian Church believed it was heretical to allow a woman to preach and teach adults. Booth began her work preaching in her home, then teaching in the Dockland parishes of Rotherhithe and Bermondsey1, and conducting evangelistic rallies. She was convinced that women had an equal right to preach and teach. This is displayed in her brochure â€Å"Female ministry; or woman’s right to preach† where she stated â€Å"Why should a woman be confined exclusively to the kitchen and the distaff, any more than man to the field and workshop. †2 Booth also pointed out that the first people who proclaimed the news of the resurrection of Jesus were women. Therefore, due to the strong leadership roles of women in Jesus’s life, women have as much responsibility for the gospel as men. During her work of preaching, Booth received much criticism from Christians and the church, but she also challenged a lot of minds and became a role model for female ministry. Booth was a full and equal partner in establishing the well know organisation, The Salvation Army, which was initially known as The Christian Mission3. Due to her strong role in creating this charity Booth was proclaimed with the title â€Å"Mother of an Army†. Yet again, the salvation army received much censure from the government and Christian variants such as the Church of England for allowing women to have the same rights as men. Lord Shaftesbury, an evangelist and politician in her time stated Booth was an â€Å"elevation of women to man’s status†4. The impact and influence of the Salvation Army and it’s strong role of women let the Church of England to fear another schism in Christianity. When Catherine married William Booth in 1865 he initially disagreed with her beliefs of equality, especially in the church. Although, it wasn’t long before the couple announced their relationship as equal5, William even stated in relation to Catherine’s role in the Salvation Amy â€Å"the best men in my army are the women. †6 Catherine Booth was, and continues to be an example of female equality in the church, workplace and home. Her actions in the 19th century influenced further Christian developments such as the feminist theology in the 20 and 21st century. Booth’s example continues to change and develop Christian beliefs in female equality; the majority of Christian churches now express women as equal and support their contribution in religious practices. Through her strong belief and acts on social justice, Catherine Booth has developed the expression of social justice in Christianity. She displayed how normal people, normal Christians can help and impact others by adhering to the two focus’ of social justice, direct aid and raising awareness to change unjust structures. Booth has always had this passion for social justice; when she was a child playing in her yard she watched the arrest of a drunken man. Instead of running away in disgust, Booth went and kept the man company, holding his until they reached the jail7. Moral stories like Catherine’s continue to influence many people of a significant Christian belief, accepting and helping people. Through the work of the Salvation Army Booth approached the direct aid focus of social justice by establishing food for million shops and improving work conditions for women and children. She was distinct from the other charities and churches of her time, as she did not distinguish between â€Å"deserving† and â€Å"undeserving† poor. This is evident through her successful campaigns, focusing on the raising awareness area of social justice, against the use of yellow phosphorus in matching making factories. Other campaigns included the injustice of â€Å"white slavery† (prostitution of young women) which resulted in raising the age of consent from thirteen to sixteen years, and supporting the temperance society. 8 Catherine Booth stated â€Å"It is a shameful scandal on those Christians andlords who keep their tenants in buildings unfit for dogs. †9 Booth’s passion for social justice has contributed to the expression of Christianity by displaying Jesus’ love for those in need and not distinguishing between the poor. In doing so, she has also influenced the way Christianity is perceived, this is evident through the high regard w hich the Salvation Army is now perceived in wider society. Booth’s passion for social justice also developed a determination to initiate a more accepting and holy church in the Christian community. She abandoned the Christian denominations that she saw as too immutable and middle class, and reached out to those who were excluded from these churches. In the Salvation Army churches, Booth placed an emphasis on holiness and went against the use of sacraments such as communion and baptism. To promote and attract the poor and needy to the church, the salvation army used popular music and theatrical styles such as those that were used in America, this form of ministry was more accessible and appealing to the poor and lower class. 0 The result of Booth’s campaigns were shown in a 1882 survey; on one weeknight 17 000 people were recorded to be worshiping with the salvation army in comparison to 11 000 involved in ordinary church. 11 This statistic challenged other Christian variants to alter their own forms of worship. The goal of the salvation army continues to be the promotion of the Christian faith. 12 By inspiring people to go back to god, Booth remains an important figure i n Christianity. She encouraged the Christian church to accept people over all social classes into their ministry, and now in modern times the church supports and helps the unfortunate in developing their faith in god. Catherine Booth’s impact on the development and expression of Christianity was immense. The acceptance and freedom of women and the lower class in Christian society is greatly due to Catherine Booth. She still continues to influence and contribute to Christianity to this day through her past examples of female equality and social justice. The Salvation Army remains Booth’s legacy that assists all people in developing faith in god.

Emerging Infectious Diseases Research Paper Example | Topics and Well Written Essays - 1250 words

Emerging Infectious Diseases - Research Paper Example Some emerging strains for instance avian influenza, resistant bacterial strains and respiratory tract viruses have become medically significant because of their high pathogenic nature and resistant new strains. Because of outbreaks and low preventive and medical measures, these emerging infectious diseases have a serious impact on the social, economic and agricultural impacts. Proper understanding about the disease, their clinical course, causative organisms and medical interventions are important to control and reduce their harmful effects on the mankind (Vaughan 2011). Emerging infectious diseases have become an interesting topic of research and study because of the vast medical knowledge they encompass and their conspicuous social, economic and medical impacts. A recent article in Los Angeles Times describes an astonishing aspect of urinary tract infections. The Canadian researchers have co-related the infection with ingestion of contaminated chicken. Beef and pork were less relat ed to urinary tract infections as compared to chicken which increases the risk for E.coli infection. The researchers have stated that the bacteria can enter the urinary tract from the intestine and the cause of contaminated chicken for urinary tract infections should always be considered. Hence, proper cooking and clean circumstances should be maintained while handling chicken. The chicken companies and chicken farms should be aware of this newly established yet important relation and perform strict sterilization and anti-contamination procedures to exclude any infection (Roan 2012). Zoonotic viruses also pose a serious threat to human immunity and are one of the emerging infectious diseases all over the world. A recent virus identified in a patient's blood was SFTSV virus that belonged to the Bunyaviridae family and was a phlebovirus. The virus causes a severe fever with thrombocytopenia syndrome (SFTS) and the disease manifests as fever with bleeding, gastrointestinal clinical fea tures and renal symptoms. The virus causing this infectious disease was found to be highly prevalent in China as it was positive in most of the provinces and a majority of population presented with positive results during the screening procedures. Mosquitoes and ticks are the vectors for this virus and molecular screening is suggested in the affected patients to identify this emerging zoonotic infectious disease. In China the prevalence of infectious diseases is also high because of the animals living in close relation to the human beings. Awareness about the zoonotic viruses, their vectors and the transmission is very important especially to the animal market professionals for the prevention and control of the disease. The economic factors of developing countries like Malaysia and China pose a major hindrance for the development of diagnostic techniques and molecular screening methods which are both specific and sensitive for the virus (Feldmann 2011). Outbreaks of Nipah virus in n orthern Bangladesh, affecting more than 30 people since the year 2011 has become prominent as an emerging infectious disease. With a mortality rate of 100% this disease has spread a wave of fear in the locals of northern Bangladesh. Fruit bats are the reservoirs for this virus and they spread the first Nipah virus infection through pig to

Reconstruction and Race Relations Paper Research

Reconstruction and Race Relations - Research Paper Example Another law was also passed which is the Disenfranchisement Law that deprived Afro Americans of their right to vote. The passage of the segregation law and disenfranchisement law meant the white and the black cannot be together on public places and public transportation. These oppressive laws were then implemented in various states and municipality mandating the segregation of the blacks and the whites not only on public transportation but also in other aspects of public life that include, schools, hospitals, parks, movie houses, hotels and even restrooms. The Disfranchisement Law as the name implies, remove the right of the Negro to exercise his civil liberty to vote by despite the guarantee of the Fourteenth and Fifteenth Amendments. This was evident with the exclusion of the blacks from the list of those who can vote in 1870 and made it more difficult for blacks to vote (if they can) by passing the poll tax law. Ridiculous as it may sound but a literacy requirement was also enacte d in 1890 that if a black person is allowed to vote, he or she must satisfy the â€Å"understanding clause† that they understood the constitution before the state registrar. Naturally, the determination of the black person’s fitness to vote became arbitrary that deprived many of them of their right to vote. Voting restrictions were also imposed to make it difficult for black people by stating deadlines of poll tax payment and voter registration unannounced. All of these were designed to make it difficult, if not impossible for a black person to vote. The Reconstruction and beyond The end of the civil war marked the reconstruction period in the South. There are many accounts and interpretation why the Reconstruction became a splendid failure but it converged on the idea that it did not achieve what it intended to achieve. One its failure was failure was the attempt to provide some civil rights such as the right to vote for African Americans (Fitzgerald, 2008). This was evident in the Dred Scott decision which the Supreme Court ruled that blacks â€Å"had no rights which a white man was bound to respect; and that the Negro might justly and lawfully be reduced to slavery for his benefit† (Freerepublic.com). In 1876 however, a change in political tide was seen when the Republicans gained control in Congress. From the repressive regime of the Democrats, the Republicans passed the Fourteenth Amendment to the United States Constitution where several civil rights bills were introduced which will give every Americans equal protection before the law (Cornell University Law School, nd). One of the laws that were also passed was the granting of the right to vote among African Americans. In effect, this would have also given the African Americans some civil rights and the benefit of equal protection before the law except that it was blocked in every way of its application. One particular right, of the four civil rights that was passed in Congress that was circumvented in its application was the protection of right to vote as expressed in the Fourteenth Amendment. The Democrats device several political implements to block the application of the African American right to vote which included imposition of poll taxes, literacy tests, grandfather clauses and Gerrymandering. The imposition of

Importance of Decision Making in Risk Management Essay

Importance of Decision Making in Risk Management - Essay Example The major social responsibilities are to defend the environment, uphold the safety of employees, and to make sure the products are safe and not dangerous for the customers. When making choice, these three social everyday jobs ought to be kept in mind. Environmental defense and conservation is a big concern for organizations. Numerous groups of populace have an interest in financial or in the presentation of a business, these dissimilar groups are recognized as stakeholders. Stakeholder scrutiny is important for winning implementation of projects and planned activities within any organization. Analyzing stakeholders is significant in order to appreciate them. Moreover, stakeholders are people who have an interest in a gainful unit. These can comprise the owners, employees, clientele, suppliers, and the government. Everyone plays a significant role in the completion and achievement of the strategy. The central focus of an organization's culture has developed approximately the organization's values. Organizational values are influential influences that differentiate one firm from another. Organizational values, a main measurement of the organizational culture, define the standards that direct the external and interior integration of organizations. In general, low levels of promise are thought to be dysfunctional to together the organization plus the individual. For the majority organizati... This shift involves together personal and organizational alteration. Creating a value driven organization can lead to numerous helpful rewards. How one adapts to the values can help for the ordinary good of society. E) Addressing objections, Social everyday jobs ought to be at the top of the list of organization plus the like. Concerns regarding the activities plus practices of large and influential private business that wield enormous financial resources and have significant financial, political, and social belongings in the U.S. and abroad is a major responsibility issue. F) Resolution implementation Management recounts the decisions plus actions of their employees to the targets that they are satisfying. Quite a few factors are involved by means of the implementation. The factors relate to the human, technological and monetary resources that are all separately of getting the job done (Rodewald 1987). Managers require the help of employees who labor and split the need to attain an organization's goals. Conclusion No doubt, this paper applied six ethical decision-making steps towards the communal everyday jobs of organizations. The six moral decision-making steps are as pursue: Issue clarification, Stakeholder analysis, Values identification, Issue resolution, Addressing objections, as well as Resolution implementation. No doubt, social liability is dangerous for organization's to do well ethically and to be seen as good business citizens. Positive impacts on civilization are an integral part of any trade. Businesses have to accommodate stakeholders throughout its process and activities. Work Cited Capozzoli, T.K. (1995). Conflict Resolution- a key ingredient

Decisison Making Assignment Example | Topics and Well Written Essays - 500 words

Decisison Making - Assignment Example In tactical operations, MIS helps in organizing information that pertains to resource levels and production capacities of an organization (Bagad, V.S.2009, 39). This may help in instilling efficiency in a supply chain. In operational strategies, the MIS may help in gathering data for items such as attendance, schedules, and types of equipment. This may help in organizing employee trainings (Sousa, K., & Oz, E. 2014, 89). The network can follow three paths. To begin with, the A activity may occur first, followed by the B activity, and finally the F activity. Alternatively, the activities may occur in the A, B, D, and G sequence. Lastly, the activities may occur in the B, E, and G sequence. All these three paths qualify as critical paths. Following the three paths saves on time that would be spent on following the seven activities sequentially. ARR (Average Rate of Return) and NPV (Net Present Value) are measures of appraisal that accords the value of a project before it commences. These measures deal with projections rather than real-time recording of data. ARR is a measure of profitability that relates income to investments. In this sense, both income and investments are measured in accounting terms (Harris, E. 2012, 78). ARR occurs by dividing average income, after depreciation, by the initial investment. NPV is a time-adjusted appraisal measure that discounts the present value of future cash flows (Rogers, M., & Duffy, A. 2012, 102). NPV equals the sum of the present value of future returns associated with a

Chapter 12 question Essay Example | Topics and Well Written Essays - 500 words

Chapter 12 question - Essay Example al include sources from accrued profits which are retained and reinvested in the business and lastly spontaneous financing which increase as the business’s sales increase. In a nutshell the total sources of financing are equal to the total asset requirements. The formula AFN = (Ao*/So)(∆S) -(Lo*/So)(∆S) - MS1(1 - POR) means Additional Funds Needed equals required increase in assets less spontaneous increase in liabilities and increase in retained earnings. The assumptions when using the additional funds needed equation include the assumption that the business was operating at a full capacity in the year, the assets to sales ratios remain the same, spontaneous to sales ratios remains the same and the profit margin is unchanged. The assumptions may sometimes not be true because a business may make large amounts of earnings in profits or dividends but still lack the cash to invest; profit and cash are not the same. In addition the calculation of profit in this case is only considering the fixed operating costs and not the variable operating expenses which change proportionally with the sales. This is the maximum rate of growth a firm can achieve without accessing external capital. It is influenced by business’s capital intensity ratio; in this case the more assets a firm needs to achieve high sales level, the lower the rate of its sustainable growth. Self supporting growth rate is related to AFN formulae because the higher the AFN the higher the lower the self supporting growth rate. It will result in the zero (0) when used in the AFN equation. = $200,000 the additional funds needed for the coming years is two hundred thousand dollars. The AFN is different from the previous questions because the company has high internal source of funds unshared resulting in high level of retained earnings hence reducing the amount of AFN. Assets/Sales (A*/S) = $1,200,000/$2,500,000 = 48%. While L*/Sales = $375,000/$2,500,000 = 15%, therefore, AFN = (A*/S) (∆S) -

Pediatric radiography discussion Case Study Example | Topics and Well Written Essays - 750 words

Pediatric radiography discussion - Case Study Example age receptor is then placed on the holder mount and the device is able to rotate the image in the posterior and the anterior positions without actually moving the child. The digital version has the image recorded in the flat panel detector, hence it does not require a cassette holder. When stockinettes are used, they are to be made in a tubular manner. The device comes in various sizes, where the 3 inch one is recommended for the small infants, whereas the 4 inch one is recommended for larger children. The device should be doubled and placed on the patient’s arms to cover the arms up to the shoulders. A part from being used to immobilize the arms, it is also used to act as a pillow. There are several types of gentle tapes that are used for surgical and immobilization procedures and sensitive skins. Adhesive tapes should not be used as it may show on the radiograph and create artifact that could obscure the anatomic parts of interest. Some patients also have a reaction to the adhesive tape. Adhesive tapes can also injure the fragile skin of the infants. Therefore, the tape should be twisted so that the adhesive surface is not against the skin. Gauze pads can also be placed between the skin and adhesive tape so that the ape is used effectively. Most of the sandbags are used as weights or immobilization devices for bigger children. These bags should be made specifically for immobilization of pediatric patients so as to be effective for this purpose. A strong canvas type material and children’s coarse sterilized playing sand should be used. The coarse sand is usually recommended so that, in case the bag can break open, the sand becomes more easily cleaned up, hence the chances of causing artifacts on the radiograph s are minimized. Two sandbags are recommended, but the sandbags should not be overfilled with sand since this will make the bag stiff. The bag needs to be pliable enough to mold to the part when placed on the child’s limb. During pediatric

Language, Culture and Communication Essay Example | Topics and Well Written Essays - 750 words

Language, Culture and Communication - Essay Example In both paintings, light is important in focusing the attention on central and peripheral matter, bringing them to prominence. The subjects are both well-rounded women with dark hair and eyes, and their positions show the artist intended the viewer to focus on them. They both seem to be of similar age and both compositions are triangular. Their eyes are downcast and mouths are slightly pursed, representing different moods. Differences in technique and intent, with light coming from outside the paintings, bring motion to the pictures, creating light and dark. The complementary light and dark colours show the moods. Both wear white and again light and shadow add texture to the clothing. Both seem to be thinking of making a decision, with Gabrielle's being about what jewel to wear, and how she looks in the mirror, while the Brooding Woman has something more serious on her mind. From the way they are both sitting, the feeling comes across that they both trusted the artists who were paint ing them. The contrasts are more in the style of painting than the main subjects. Looking first at the women, their expressions of thoughtfulness create the mood, but the differences lie in the intention of the painter. Gabrielle is comfortable, almost cosy, with a less important decision to bother her, while the Brooding Woman has something heavy on her mind. She is more sad and lost, her shoulders sag, and their position can also be seen on the dog in the background. She is fully clothed, while Gabrielle is happy to be half-undressed. The Brooding Woman seems to be looking into herself for answers and Gabrielle looks outward towards her mirror. Symbolism is another contrast, because the background in Gaugin's picture seems to have something to do with the woman's state of mind, and her dejected body

Histort Essay on Globalization Example | Topics and Well Written Essays - 1500 words

Histort on Globalization - Essay Example The Internet has made products more accessible to people all around the world and corporations are willing to dip their hands in the pockets of other countries. Globalization is basically an effort for a business to provide a product on a multinational effort in search for profit from wherever they can possibly get it, even if that includes having products manufactured for little cost overseas. This then has resulted in a lack of jobs in the United States due to globalization and has ultimately led to an economic downward spiral. Corporations thrive on the globalization of their business, able to make millions and offer their goods to developing companies. Occupy Wall Street is an anti-globalization group that currently protests shipping jobs overseas and keep the work here in the United States. It ks a movement designed to completely protest globalization because they expect for economic movements to stay local within our own government here in the United States. The western worlds currently dominate the majority of the world's economy and the United Nations plays a huge role when it comes to globalization. The United States plays a huge part in the United Nations due to the country being a giant in the corporate and developing realms of business. Alternately, globalization is also impacted on by embargoes that are set up in other parts of the world that can otherwise effect the rest of the world that are unable to trade goods. The economy as a whole is deeply affected in a negative way, particularly in the United States while there is a huge economic crisis going on. The value of a dollar is going down and will also affect other areas in the world and exchange rates which then also effects People on the political left have the tendency to want change while the people on the right wing do not want change. Conflicting visions are typically the topic of most political issues. Globalization is just another means for conflict in politics. It also results in a stru ggle between states. Some states have different resources to offer than others so globalization can effect the local economy as well as the overall national economy. The current Obama administration has the same policy that was passed from the Bush administration. Obama's stimulus package also plays a huge role in globalization not just in the United States, but also in other parts of the world because many other countries rely on the United States. Though it appears that Obama has tried to impact the economy, when looking at the bigger picture, there are still major issues in the United States that lead to unemployment, the middle class is the suffering class, and therefore contributing to the issue of globalization. It may have been a gesture of collective action but it was not quite effective enough or at least Americans are still feeling the burn of globalization's effects. The lack of jobs seems to be the largest sour idea when it comes to globalization, from the perspective of an American. Corporations not only are making money off of high priced items, but are shipping their jobs overseas to be performed at extremely low costs. Additionally, globalization is changing the world. Change does not just make the United States uneasy, but people in other economies do not know what to expect either. As a giant powerhouse of a country, many of the moves of other countries are impacted by the decisions of the United States. 2. The United States is struggling from economic recession and though it is the

The Keepers of the House Essay Example for Free

The Keepers of the House Essay There is an interesting part of history that goes unnoticed. The treatment of blacks in the South during the time of slavery plays an intricate part of America’s history, which gets frequently overlooked. The Keepers of the House by Shirley Ann Grau sheds light on this time period, following a family, living in rural Alabama in the 1960’s. Grau explains this family: â€Å"All in all the Howland’s thrived. They farmed and hunted; they made whiskey and rum and took it to market down the Providence River to Mobile (Grau 12). The story follows three generations of the Howland family living in a community that ultimately turns on them. Grau takes inspiration from the time period along with having multiple themes to craft an interesting and impactful Pulitzer Prize novel. The Howland’s were a family that lived in the same area for many years. William Howland, the fifth, lost his wife, leaving him to take care of his young daughter Abigail and a son William who dies shortly after. Abigail then marries a man who leaves her with her own daughter Abigail. William’s daughter dies and leaves him with a granddaughter to take care of. Soon after, William hires an African American, Margaret, woman as a housekeeper. Abigail talks of the lasting affects William and Margaret left on her: â€Å"I am caught and tangled around by their doings. It is as if their lives left a weaving of indivisible threads in the air of this house, of this town, of this county. And I stumbled and fell into them† (Grau 6). Around town, she became know as his mistress and mother of his other children. In secret, they marry for the children’s sake. Later, after the children grew up, they were sent up north so they could live as normal white citizens. Abigail later marries a man named John Tolliver who aligns with the Klu Klux Klan during his run for governor. Robert, the eldest of the Howland brothers was outraged by this and released an article hurting Tolliver’s cam paign. Tolliver and Abigail end their marriage near after. Back where the Howland’s live, the town is still outraged about the marriage between William Howland and the African American homemaker Margaret. Even though both of them had died, the town gathered and lit the barn on fire and killed many of their livestock. Grau writes, â€Å"The Howland they wanted was dead. His Negro wife was dead. Their children disappeared. And so they were wrecking the only thing that was left of him, of them. First the barn and then the house† (Grau 285). The novel comes full circle when Abigail gets revenge on the town’s people and ruins the entire local economy along with the town. It seems as though Shirley Ann Grau took inspiration from the history of this time period along with what it may have been like growing up at that time in that place to set a scene of exactly what this time period may have looked and felt like. Showing what the Howland family went through, along with the way they were treated set a scene for not only a family struggle but a national struggle as well. The way she describes the scenery, puts you there in at time. Grau writes, â€Å"November evenings are quiet and still and dry. The frost-stripped trees and the bleached grasses glisten and shine in the small light (Grau 1). As well as the scenery, Grau uses her deep characters in the story to highlight how people were affect by this issue. Abigail is the main character narrating this story. Grau tells the happenings of this time through her eyes as well as through the actions of William Howland, Margaret, John Tolliver and Robert Howland. Each of these characters makes an impact on this story, as well as the main character Abigail. For example, Abigail’s husband John Tolliver shapes her character into a tough skinned woman. He treats her unfairly as a wife but she learns from that and takes it with her. Grau writes, â€Å"I knew what John meant: I was the perfect wife for a candidate. He had chosen and trained me well (Grau 257). This marriage helps toughen up Abigail for the future as she fights for her family. There are two main themes taken from this novel: racism and family. Racism is a clear theme throughout this novel given the time period and scenario that takes place with a secret African American maid, wife and mother. Racism is shown through the scenario when Tolliver bashes blacks during his campaign for governor. Tolliver talks about African Americans in vulgar and horrible ways. When talking about William and Margaret’s children he says, â€Å"He couldn’t let his children be bastards, even if their mother was a Negro† (Grau 271). This is just one example of the way African Americans are talked about at this time. Also, the area where the Howland’s live, do not take the news of William marrying Margaret lightly just because she is African American. Family is another theme portrayed in this novel. The Howland’s go through trials and tribulations that test their family as a whole. For example, like stated before, the town completely turns on the Howland’s when they find that William and Margaret had married. Abigail takes a stand for her family and fights back. She stands up for her family and the house they have lived in for so many years. Grau shows just how much Abigail cares for her family and home. She writes, â€Å"Child, I thought you don’t even know, its possible to love a house and land that much (Grau 274). These two themes play a role in teaching readers about the time period and the struggles it caused. The Keepers of the House by Shirley Ann Grau sheds light on an issue sometimes forgotten about in society today: the treatment of African Americans in the 1960’s. Using things like history from this time and family themes, Grau establishes that this issue was serious and did exist. Abigail Howland ultimately stands up for what she believes in and protects her family but also puts a small dent in this civil rights movement. As her journey comes to an end she says, â€Å"I stood on that cold windy grass and saw what I had done. I saw that it wasn’t bravery or hate. It was, like my grandfather said, necessity. And that’s pretty poor comfort but at times its all you’ve got† (Grau 290). Abigail’s narration of her family’s story along with the use of strong and deep characters, shape for a wonderful Pulitzer Prize novel.

Achilles Tendon Sprain Case Study

Achilles Tendon Sprain Case Study Name: Lani Thompson Age: 26 Sex: Female Occupation: Merchandiser Height: 179 Weight:77.8, BMI: Diet: Mixed Family: She lives with her partner, no kids. Medical History: No history of Hypertension, Cardiovascular, Diabetics mellitus, pulmonary or any chronic disease. Footwear: A comfortable, properly fitted footwear should be used. Avoid High heels. Daily activities: Usually she goes to Gym thrice in a week, occasionally she goes for swimming. Balance: Muscle performance: No muscle wasting. Posture: Circumferential measurement: Alignment: There is no difference in alignment while she walks. History: Lani Thompson is a hockey and rugby player. About 4 months back, while she was training rugby she had a right ankle sprain. The Incident was happening around 7 in the night. Soon after she was shifted to the hospital and consulted with the doctor. On the same day she had undergone several investigations and examinations, including X-Ray and ultrasound. No evidence of any fracture on the x-ray and was diagnosed as an Achilles tendon sprain. Initial 2 weeks she was in a brace, subsequently she started ankle exercises. Later she exercised with Theraband and had started physiotherapy treatment for 2 weeks, eventually continued her exercises at home. Past Medical History: She has never been hospitalized for any chronic diseases. No history of Diabetes mellitus, Hypertension, Heart diseases, Asthma, Hepatitis, Sexually transmitted diseases or Tuberculosis. She regularly takes medications for depression/anxiety and for contraception. Medication: Venlafaxine, Quitiepine and a contraceptive pill. Surgical Intervention: No surgical interference. Gait pattern: Altered, limping of right leg. Range of Motion (ROM): Normal on left side, right ankle ROM is slightly altered, No muscle stiffness. Palpation: No tenderness or any abnormalities. Anatomy of the Ankle joint: The ankle joint mainly consists of two joints, the subtalar and the true ankle joint. The subtalar joint comprises three bones, the tibia, the fibula and the talus. The mechanism of the ankle joint is very complex. True ankle is responsible for the up and down movements of the foot. The subtalar joint is positioned under the true ankle joint and consists with two bones, the calcaneus and the talus. This joint is responsible for the side to side movement of the foot. The joint is covered with a cartilage known as articular cartilage. The articular joint is lubricated with synovial fluid. Many ligaments connect the ankle bones together, they are anterior fibular ligament, which attaches the fibula to the tibial bone. The second ligament is known as the lateral collateral ligament, which connects calcaneus bone with the fibula and the tibial bone and the third one is deltoid ligament, it connects calcaneus and the talus bones together to the tibia. Many tendons attach the muscles of the lower limb and the bones of the ankle, they are the Achilles, the flexor hallicus longus, the flexor digitorium, the peroneal tendons, the posterior tibialis and the anterior tibialis tendons. Among these tendons the Achilles tendon is considered to be the strongest tendons in the human body. It is located at the posterior of the leg and connects the calcaneus bone to the gastrocnemius ,solens and plantarius muscles. The Achilles tendon is about six inches long and can withstand around four time of body mass during walking and almost eight times while running. Achilles Tendonitis: It is the inflammation of the calcaneus tendon.Over use of the tendon causes pain and stiffness, for instance running up hill or climbing up stairs. Achilles Rupture: asdf†¦Ã¢â‚¬ ¦.. Exercises: Group 1 Exercise: Evertion/ Invertion isometric exercises. Evertion: This exercise can be performed by placing the injured foot adjacent to a door or the leg of a table and gradually push extremely to the lateral side of the foot. Inversion: This exercise can be done by placing the medial aspect of the foot to any fixed objects such as a table leg or a door, then to push gently outward –in for two to three seconds. Evertion/Invertion with an exercise band: Evertion: The client has to sit and fix the leg straight, with the help of an elastic band One end of the elastic band is attached to a table leg and other to the foot and then gradually turns the foot outwards. Invertion: Rotate the foot inwards by reversing the position of the band .The movement of the foot should be apart from the leg of the table. The client can proceed to the group two exercises, if he tolerates to do group one exercise. Group 2 exercises: Gastrocnemius stretch: The patient has to bend forward and push the wall with his hands. The injured leg should be placed just behind the other foot, keeping the foot firmly to the floor for about 30 seconds. Soleus Stretch: Place the non injured foot behind the injured foot and bend the other knee joint. The heel should be raised while stretching. Weight bearing exercises: The client should stand on the floor with the affected leg and bend the other leg, so that the whole body weight should bear on the injured leg for 30 seconds and then lift the heel up and down. Injured leg stand with a cloth: The client is asked to stand on a 2inches thick cloth with the injured leg for 30 seconds. The client can proceed to the group three exercises, if he tolerates to do group two exercises. Group 3 exercises: Lateral step and bound exercise. This exercise is performed by placing a folded towel on the floor and to stand beside the towel and client steps on the folded towel. Other foot should be placed firmly on the floor. Repeat the same exercise with other leg. As the pain allows, increase the repetitions and speed accordingly. Hop exercise: It is performed by placing a folded towel on a floor and the client is asked to stand beside the towel and bound over the folded towel and to rest on the other foot. Then reverse the entire exercise with the other leg.As the pain allows, slowly raise the speed and hops. Rehabilitation: Range of movement: Stretching of the calf muscle: When the patient will be able to sand comfortably with an injured leg, he is asked to move back the injured foot and move the hip gradually forward, so that the calf muscle is stretched. Hold for 20 seconds and repeat for at least 2 times per day. Alphabet writing: The patient has to write alphabets with his greater toe at least 2 times per day. Balance training exercises: By holding a fixed object firmly with one hand and stand on a single leg, keeping the other knee folded. Repeat the same with the other foot as well. As the patients balance improves, he is encouraged to repeat the same exercise with eyes shut. GOALS: Short term: Phase 1 and 2 Improve joint range of motion and flexibility Increase ankle strength Gain normal gait pattern Progressive Proprioception and motor coordination Long term: Phase 3 and 4 Improve cardiovascular endurance Return to complete sports activity Rehabilitation program involves: Stretching of the calf muscle and around the ankle muscle Strengthening exercise Deep massage techniques Cardiovascular endurance exercise Agility training Phase 1: T o gain range of motion Stretching- Calf plantar fascia stretch: Sit on the floor with leg extended and knees straight Loop a towel around the affected leg and grip the end of towel on each hand. Affected leg should be in straight and pull the towel near the body Hold the position as same for 30 seconds and relax Repetition: 3 to 5 Calf muscle stretching: Open kinetic chain exercise: Toe curls Marble pickups Four-plane surgical tubing exercises Sub maximal Isokinetics in short arc Strengthening exercise: Plantar flexion exercises with Theraband Inversion and eversion exercise isometric exercise Flexibility: Grade 1 and 2 mobilization Alphabet ROM Proprioceptive: Stork standing Single plane tilt board Biomechanical ankle platform system in non-partial Weight bearing position. Cardiac endurance exercise: Pool therapy Stationary cycling. PHASE 2: Stretching: Achilles stretches in sitting and standing positions Open kinetic chain exercise: full –arc ISO kinetics Close kinetic chain exercise: Shuttle squats Heel raises Toe raises Tubing lunge steps Proprioception: Wobble board work Walking on uneven surface Biomechanical ankle platform system with partial Cardiac endurance training: Treadmill Stairmaster PHASE 3: Program in this phase should be considered according to the Strength and progression of the client. The program involves dynamic and functional tolerance of the patient. Start up with increase weight bearing force on the ankle joint Stretching of Achilles tendon in a supinated position Eccentric heel drop with knee straight Eccentric heel drop with knee bent Lunges and squats Step ups Side step ups with weight bearing To focus on lateral stability –up and down sideways movement Back pedalling exercise Caricos Plyomettric drills Proprioception: Ladder drill Netball throwing and catching with Standing on the affected leg moving to catch the ball and return to land on the same leg. Four square hopping drills Agility training: Shuttle running with changing the direction Zigzagging or figure of 8 runs Phase 4: functional rehabilitation activities such as tip toe walking. Polymeric progressions –hopping, bounding, depth jumps and box drills Sport-specific training Unstable surface training Stationary cross country skier Ensure normal plantar to dorsiflexion strength ratios and muscle balance Careful increase in training regimens

Application to Mark Littered Areas and Locate Trashcans

Application to Mark Littered Areas and Locate Trashcans Abstract To encourage cleanliness drive by using technology to promote proper use and maintenance of trash cans by providing location specific details using a GPS and feedback about garbage disposal facilities and a step forward for Swacch Bharat Abhiyan. All around the globe, the world is taking a note of Indias economic growth. However, we must acknowledge, if there is any aspect in which India or Indians have not moved forward or moved very sluggishly, is in the field of environmental cleanliness and taking care of the surroundings. If we look around, trash and litter is everywhere. Nobody seems to care about the waste, and how we discard it. If anything, we add to the garbage that is already abundant in the open and is everywhere. Littering a plastic cup on the road-side, after we done using it, is the norm. No one realize anything wrong with it. Throwing our waste on the street, and right outside our own house is a part of the daily routines. Unhygienic conditions are one of the major root cause of diseases / illness. Any disease or illness has financial impact both in terms of expenditure and potential revenue earning. Swachh Bharat Mission, which is our ultimate aim, will have positive impact on Indias health care sector As per estimates, inadequate sanitation cost India almost $54 billion or 6.4% of the countrys GDP in 2006. Over 70% of this economic impact or about $38.5 billion was health-related, with diarrhea followed by acute lower respiratory infections accounting for 12% of the health-related impacts. Evidence suggests that all water and sanitation improvements are cost-beneficial in all developing world subregions. Moreover, India is a land of cultural heritage and rich history. Tourism generate approximately 6.6% of Indias GDP and 39.5 Million Indians are directly employed in this sector. Tourism can generate employment for up to 5% of Indias population i.e. 62.5 Million people. It has potential to generate 23 Million additional job opportunities or 2.3 Cr people will get job. I have taken 5% employment fig which is very conservative after studying tourism model of countries which focus on tourism. The biggest limitation for India to promote tourism is cleanliness. Foreign tourists are very particular about hygiene and cleanliness. Besides employment, Tourism will help bring foreign money to India which will boost Indias GDP. A clean India will help in generating employment through Tourism and boost Indias GDP. We can make all the progress, we can make all the economic strides alongside the rich nations, but we can only go so far if we are surrounded by the smelly dirt piles and garbage. Financial and economic breakthroughs are good. However, along the way, what we really need is a change in our mentality to care for our environment, to care for our own surroundings. And, we need to realize this at personal level, sooner than later. This project uses Global Positioning System (GPS) or the Provider-based location services of a device to determine the current position of the user so that the user can mark a place on the map as not clean. This will be forwarded to the authorities and so that the particular marker can be removed from the map after the area has been cleaned. Another part of this project is that a user can check the location of the closest dustbins on map from his position in case he/she has something to throw away. This feature promotes cleanliness and puts a break on littering. A. Literature Survey Following are the existing systems which are similar to the specifications of our project : Smart bins developed by polish engineers: The trash is put into the bin and Bin-e identifies, categorizes, sorts and stores the trash. Moreover, when its filled, it informs the companies, which are responsible for waste collection. Bin-e recognizes what we really disposed of and it does a pre-treatment, e.g. it crushes the plastic, so it is able to use the entire space of the container. In addition, Bin-e constantly learns new parameters of the waste, which we throw away. Because of the knowledge accumulated in the cloud, it can recognize the type of waste and properly categorize it. SINGAPORE Smart bins that act as Wi-Fi hot spots and which send alerts for them to be cleared when they are almost full. These intelligent bins have sensors that detect how full they are and can later send e-mail or text message alerts to the cell phones of cleaners. The bins also have a compactor that can crunch rubbish so that the capacity of the smart bins can be eight times more than that of a normal bin. Sensors for smart city waste management system are means of providing a system which informs the municipal about a dustbin which is full using sensors. Systems are available working on projects to use GPS location to provide shorter route for municipal to the dustbin for cleaning. Swachh Bharat App: An app provided by the government of India to facilitate the cleanliness by giving an opportunity to the citizens for filing of complain about the waste dumps. The person using the app can take the picture of an area which is not clean and upload it on the app. The picture will be tagged with its geo location and the time of upload. The authorities can decide and tag the picture based on the severity of the conditions in the area and take the required actions. CITIZEN GAGE: Citizengage is a Bangalore based start-up which is working on waste management. Their main clientele are restaurants and commercial space. There are two apps one for the customer and one for the workers. The user registers and sets the location on the app. The agent will come to the users location, attach a sticker on the door. The agent will come daily and collect the waste. The waste is separated on the location and the agent app has option to fill a form which takes data about the kind of waste and the weight of it. This process is repeated daily for houses and restaurants. iClean India: It is an app developed by a Delhi based start up for social cause. It has three pages concerned with marking and posting pictures of dirty localities, another page for checking which photo belongs to which area and another page which is concerned with inviting people or your friends to clean the area and we can put the clean pictures of the area on the app. B. Drawback of current System No such localized system exists. Littering is a huge problem all over India. Not only it damages Indias reputation in front of tourists but also houses breeding place for many disease-causing germs and bacteria. Sensors for smart city waste management system are means of providing a system which informs the municipal about a dustbin which is full using sensors. Systems are available working on projects to use GPS location to provide shorter route for municipal to the dustbin for cleaning. None of these provides a one stop solution aimed at a clean India. C. Proposed System Application takes the help of Global Positioning System or Provider based location service in correctly detecting the current location of the user so that he/she can mark the area unclean and submit his/her complaint. After the successful submission of the complaint, same is being forwarded to authorities. Authorities can remove the marker after clearing the area. Another feature of the application is to locate the nearest trashcans if user wants to dispose any waste. In this way littering can be controlled to some extend and this also encourages every citizen to contribute little towards better India. Fig (1) Swim-lane diagram of the proposed system The swim lane diagram shows the two lanes of the proposed system which are the user and the administrator. The user is responsible for marking of unclean areas on the map. The proposed system also helps the user to find nearby bins to dispose something which the user wants and thus restricting the problem of littering in the country. The user may also fill up a feedback form about the complaint registered and also may file grievance complaint if the complaint has not been serviced properly and within the particular boundary of time. The second lane in the swim-lane diagram is the administrator who is responsible for servicing of complaints as well as addition of new bin coordinates to the database of available bins. The advantages of the proposed system are: It provides the users with a system where people can point on map and submit complaint about garbage dumps in public places. The complaint will be forwarded to the concerned authorities so that the place can be cleaned up and the marker will be removed from map after the place becomes clean. Login ID and a verification method will be in place to suppress false complaints. The problem of littering will be addressed by providing bins and people can find the location of the closest garbage bin on the map with one touch on their smart phones. Maps will guide them to the nearest bin. 1: As it can be seen in Fig (2) that when the application is opened first the application directs the user to the location settings page of the device so to intimate the user to turn of the GPS of the device for better location detection as GPS provided location is more accurate compared to network provided location. The first activity of the application, shown in Fig (3) contains two image buttons and one button for feedback. The first image button captioned as Tap to Mark redirects the user to the complaint submission location information gatherer activity. The next image button captioned as Tap for garbage bins redirects the user to the location page which will automatically detect the location of the user and shows the nearby bins located nearer to him/her. The third button redirects the user from the application to the browser where the user needs to fill up his/her unique id and the contact number registered with the id in order to fill up the feedback form. Fig (2) Enable location services settings on device Fig (3) Launch activity of the application 2. When the user clicks the button captioned as Tap to mark, shown in Fig (3), the user will be redirected to this current activity which will load a Google Map to begin with. The user needs to click the location enabled button on the top right corner of the activity which will in turn get his/her current location coordinated from the GPS reading via the Location Listener interface. After the current location coordinates of the user is captured the user needs to enter the nearest available landmark which will be used to refine the location coordinates available even though the coordinates captured are almost accurate. After the location of the user gets captured followed by entering the landmark the user is expected to click the button named PIN, shown in Fig (4) which will redirect the user to the next activity in which the user needs to enter the necessary details required in order to submit the complaint. Fig (4) Getting the location coordinates of the user 3. Once the users location gets captured followed by the user entering the nearest landmark available, shown in Fig (4), the user will be redirected to the current activity[Fig (5)]. In this activity the user is required to fill up the necessary details required in order to submit the complaint. The details which the user needs to fill are the users name followed by the users contact information such as the contact number and the e-mail of the user. The contact number will be required to suppress false complaints as the user will receive a verification code which will be used to verify the user of the complaint. On entering the necessary details followed by the contact number and the verification code the complaint will get submitted and a unique complaint id will get generated. Fig (5) Activity for user to enter his/her contact info 4. Once the user clicks on the button captioned as Tap for garbage bins, shown in Fig(3) the user will be redirected to this to this activity[Fig (6)] which will load a Google Map in which the user needs to click the location enabled button on the right top corner of the activity. The code which implements the location listener interface will get the current location coordinates of the user by reading the GPS of the users device. When the user clicks the button named as FIND, the application will look into an online database and find the nearest bin coordinates from the database and show them on the map using a modified marker which will show a bin in place of a default Google map marker. The user can click on a dustbin marker according to his/her route and use the Googles inbuilt navigation features to find the nearest route to the dustbin. The user can also toggle between different views such as Map view, satellite view etc. Fig (6) Getting locations of the nearest bins 5. When the user clicks on the submit feedback button on the first activity [Fig (3)] of the application this activity will be shown. The activity will prompt the browser on the users device to load a hardcoded link which will contain the feedback form. The feedback form will contain fields such as contact number, complaint ID, a few relevant questions with options which the user is required to fill the correct responses for. The unique complaint id and contact number pair is used as a verification procedure so that not anyone can fill up random feedback forms and only the unique user who filed the complaint is allowed to fill the feedback. After answering all the questions using the options provided the user can also add comment or suggestions with a predefined character limit. The feedback submitted by the user will be used to increase the quality of the services offered. Fig (7) Snapshot of the feedback form 6. This is the administrator side application which is meant to be used by the system administrator. The application when opened first will prompt the location services settings similar to the one shown in Fig (2) on the phone so that the user turns on the GPS assistance on the device. This will help in getting a better location accuracy when compared to network provided services. The first activity of the application contains two image buttons as show in Fig(8). The first image button is captioned as Tap to find complaints which will take the administrator to the next activity which will load the complaints registered nearer to the location of the device of the administrator. The administrators device needs to be near the registered location of the complaint in a predefined range in order to remove the complaint marker from the map. The second image button is captioned as Tap to add new bins which will take the administrator to the activity which will add coordinates of new bins to a database. Fig (8) Launch activity for administrator application 7. On clicking the image button captioned as Tap to find complaints, shown in Fig (8), the administrator will be redirected to this activity[Fig (9)]. The activity will load a Google map activity which will contain a location enabled button on the top right corner and on tapping this button the code running in the background will get the location coordinates of the user. On clicking the find button the code running on the background thread will connect to the database which stores the registered complaints and retrieve the complaints near to the administrators device. The administrator needs to service the complaint and then tap on the complaint to see the complaint id which the administrator needs to use in order to clear the marker of the complaint from the map. The administrators device needs to be within a predefined range from the complaint in order to remove the complaint marker from the map. Fig (9) Showing the registered complaints 8. When the administrator clicks the second image button on the launch activity of the application, shown in Fig(8) captioned as Tap to add new bins the administrator will be redirected to this current activity. When the administrator adds a new garbage bin, he/she needs to use this current activity in order to add a new garbage bin on the map. This activity consists of two text fields where the administrator needs to enter the coordinates of the newly added bin and press submit button in order for the background thread running within the application to add the entered coordinates in the database [Fig (10)]. When the user accesses the user side application to check for nearest bin the newly added bin to the database will also be reflected in the results. Fig (10) Adding new bins to database [1] http://www.straitstimes.com/singapore/solar-powered-smart-bins-that-act-as-wi-fi-hotspots-launched-at-orchard-road?utm_campaign=Echoboxutm_medium=Socialutm_source=Facebookxtor=CS1-10#link_time=1479202704 [2] http://www.iotleague.com/smart-bin-from-poland-will-revolutionize-waste-segregation-recycling/ [3]www.isprs.org/208_XXXVI-part6/

An Urge to Write :: Personal Narratives Writing Essays

An Urge to Write Everyone seems to have a reason for liking or disliking writing. It seems to stem from past experiences, or things writing has done for someone or not done for someone. For me, writing is a privilege and I enjoy writing immensely. It’s hard to put my finger on one distinct reason I take pleasure in writing but I think one of the causes for my appreciation of writing stems back to about two years ago. I was a sophomore in high school, and it was basically a tradition that my friend Jess and I would get together sporadically on various Friday nights. She would come to my house in the early evening hours, and we would start our walk. As soon as we would turn the corner of my block I’d light up my cigarette and we’d begin our recollection of the week’s events. On one particular Friday in October we began our walk as we had any other. The air had a cool brisk quality about it but we weren’t really bothered by the sudden chill and just kept walking. We walked throughout town for a few hours just walking and talking, laughing and acting hysterical and crazy over the most minute details of that week’s happenings. We walked till the street lights shown bright on the black streets before us and then we went to our usual stop after our walk. We entered the restaurant just like we had so many times before. We took our seat at the regular booth with the torn vinyl and wooden sides etched with the signatures of the many who had sat in the booth before us. The air reeked of grease and cigarette smoke and was polluted by the sound of senseless chatter from the thirty or so people that crowded this tiny room the size of a large closet. Yet, neither the smell, or the noise or the dà ©cor of dollar bills littering the walls bothered us. This was our tradition as corny and juvenile as it was we knew we would always treasure this special and unusual little place. We sat at our little booth and began our own little chatter fest there.

Actions of Goneril in Shakespeares King Lear Essay example -- Shakesp

Actions of Goneril in Shakespeare's King Lear Whenever the issue of power allocation arises, there usually emerge a few individuals who, given only a moderate amount of authority, overstep their bounds to exert more dominance than they rightfully own; such is the case with Goneril. Yet, although Goneril certainly errs in betraying the very father that bestowed a large dominion upon her, King Lear deserves much of the blame for Goneril's haughtiness. After grossly misinterpreting the reticence of his heretofore prized daughter Cordelia, Lear divides his kingdom between the mendacious Goneril and the scheming Regan, thereby leaving the fate of the land at their unskilled mercies. Naturally, Goneril relishes her newfound control, so when Lear comes to visit her with all of his knights in tow, she perceives him as encroaching upon the power that he has since relinquished. Additionally, Goneril notes (albeit in an exaggerated manner) the inconvenience that she incurs by housing these hundred men. Despite the outrage that one mig ht feel at the thought of a daughter mistreating h...

Essay --

Miner1 Shawna Pergeson Miss Miner English II 18 March 2014 Holocaust Experiments People all over the world go through a lot of hardship. Starvation, abuse, wars, bombing raids, genocide. People would suffer over the fallen economy. In Europe and even here in the United States, many people struggled to survive through the Holocaust Era. It’s weary out there. The people who had it the worse were the Polish, Russians, Gypsies, and especially the Holocaust victims; the Jewish Population. They were kicked out of their homes, shoved into cattle cars, killed, and made to work in a concentration camps and many other terrible things. The worst of all, they were experimented on. The following pages are going to tell you how the concentration camps were built, who ran the experiment camps. Also about the experiments and what the effects were. Shawna Pergeson Miner2 Miss Miner English II 18 March 2014 The medical experiments started in World War II. Buchenwald was one of the first camps built in the summer of 1937. The prisoners were made to carry very large rocks to build it during their â€Å"free time†. Prisoners were used for Virus Researches like Typhus and were infused with numerous types of pathogens to reveal the strengths of the vaccines. Usually killing the subjects, forced prisoners like the Jews and Gypsies were force to take part. The Buchenwald Camp was freed April 11, 1945. The day after that, President Franklin Roosevelt died. Soviets then used the camp as another concentration camp, not for civilians, but for their own enemies in Germany. The doctors during... ...ctors put in the tuberculosis bacteria in the prisoners at camp Neuengamme. Around two hundred adults died from this. They also cut off legs and shoulders from prisoners at Ravensbruck to attach them onto other subjects. This also included parts of bones, muscles, and nerves to analyze the healing process for the body parts. The result of the experiments were horrid pain, mutilation, disability, and death. Doctors of the Concentration Camps also experimented on birth effects. They meant to radiate and sterilize young men and study the changes in the reproduction organs. Women had substances unwillingly implanted their cervix or uterus which caused pain, bleeding, and spasms. Women were forced into artificial insemination. The subjects were told that they have monsters in their wombs and were cross bred from animals. This was probably the worse of the experiments.

Manzana Insurance

Operations Management ____________________________________________________________ _________________________ Case Study Manzana Insurance [pic] Presented to: Prof B. Mahadevan Submitted By Group 12 (Section B) Peeyush Razdan (0811115) Shalekh Banka (0811124) Shalem Anand Tirkey (0811125) Shreshth Sharma (0811128) Sumeet Mittal (0811131) Manzana Insurance As per the case facts, Manzana Insurance’s Fruitvale branch is the least performing branch and the senior VP seeks a report on the same. Their competitor Golden Gate (backed by its corporate parent generated a price war to gain market) is performing much better in terms of most metrics of Insurance business. 1) Problems faced by Manzana Insurance (Fruitvale branch) a) High Turn Around Time (TAT) Agents in the insurance sector are mediators who act as an interface between the client and the insurer. Hence, the quality of service, measured by average TAT, to the agents (who are common to the competitors) is of primary importance. TAT for Fruitvale has deteriorated to 6 days (1991) from 5 days (1990), while Golden Gate’s offer of 1 day TAT is luring agents away from Manzana. The number of late renewals is also increasing and quite high compared to Golden Gate. b) Geographic/Territorial Allocation to Underwriting Teams Leads to an Uneven Task Distribution We observe that the geographic allocation of agents to the underwriting teams is not optimal. This method has an inherent problem; there can be a surge in requests from a geography which might overload that particular team while the other teams might be idle due to lack of requests from their geography. Hence, their pooling should be rather than using the geographic allocation. c) Primary focus on RUNs rather than RERUNs and Increasing late Renewals Currently, Fruitvale is focusing on RUNs for getting new customers and compromising the service towards the RERUN requests for the existing customers. Loss of focus on RERUNs has led to increase in its TAT causing agents to move towards Golden Gate. The number of late Renewals has increased from 20% to 44% over the last year which has led to a significant increase in the Renewal loss rate from 33% to 47%. Renewal is a low premium – high volume business. Exhibit 5(in case) shows that a new policy and policy renewal give similar revenues of $6724 and $6205 respectively. The commission given to agents is 25% and 7% respectively. So in fact renewal of old insurance brings more revenue due to reduced commission percentage. Also, the time taken for renewal of policies is less, thus more renewals can be done in a given time. d) FCFS Scheduling may not be always optimum Most of the departments follow FCFS scheduling which may not be optimum. Ex. a policy with an effort of 4 hrs would delay all the other smaller policies behind it, effectively delaying 10 simple requests for serving one difficult one. Moreover, the scheduling policy followed across various departments is not same. While some strictly follow FCFS others do it on type of policy ex: RUN preferred over RERUNs. Also, The RAP is given preference over RERUNs by the rating team. The RAPs in fact take more time for processing than RERUNs. Also, only 15% of all quotes result in new policies. Thus, the Manzana Fruitvale branch seems to be servicing RAPs at the cost of RERUNs. e) Huge backlog of policies The existing backlog of policies is quite high, due to which any new policy received is not attended instantly (due to FCFS) further adding on to existing backlog, essentially creating a cascading effect. 2) Process Flow and Capacity Analysis We have used process flow, capacity analysis, Lead Time Analysis and Average daily Workload Analysis to analyze the current situation at Manzana’s Fruitvale Branch. ) Process Flow Exhibit 1 shows the process flow diagram with the existing capacity across the four major team Distribution clerks, Underwriter teams, Raters, Policy writers. b) Capacity Analysis Usage of Mean time for capacity analysis is ideally favored over 95% Standard Completion Time (SCT) parameter as 95% SCT is a highly conservative. It assumes every request to be of longer duration (95th percentile with respect to request duration) and does not take into acco unt the time saved while executing smaller requests. Mean on the other hand takes into account that fact that time consumed on longer jobs is compensated by the time saved on smaller jobs. Capacity analysis based on Mean Time (Exhibit 2) shows the bottleneck for RUNs is the Distribution step, for RAPs is underwriting, for RAINs is again Distribution and for RERUNs is policy writing. The same capacity analysis when done using 95% SCT (Exhibit 3) shows Underwriting step to be bottleneck for all the 4 types of policy requests. We observe that there is high standard deviation for most of the steps (especially Underwriting Step) and is comparable to mean value itself. Ex: For RERUNs Underwriting step mean is 18. 7min while the standard deviation is 19. 8min. Hence we are using 95% SCT for determining bottleneck step. And thus we consider Underwriting Stage as the bottleneck for the whole system. c) Lead (Service) Time Analysis Using Little’s Formula we have done Lead Time Analysis (Exhibit 4) which shows that on an average Lead Time is approximately 2 days (2. 10). As we have seen, throughput on the other hand is approximately 6 days which is much higher than the average Lead Time. This suggests that the longer throughput time is because of allocation problems described later. d) Average Daily Workload Analysis The argument of allocation problem is further strengthened by our Average Daily Workload Analysis (Exhibit 5). This analysis has been done taking into account the relative proportions of various types of requests on a daily basis. On the basis on mean processing time for all the steps it comes out that the average daily workload for each step is less than 7. 5 hrs (the stipulated working time). Inferences Above analysis shows that problem at Fruitvale branch is not due to capacity constraint but it is actually due to allocation issue. Predominantly, allocation problems are in underwriting step. Currently allocation is done on the basis of Geographical/territorial lines which lead to uneven workload over time as well as inefficient allocation leading to longer TPUT time. Exhibit 5 shows that RUNs on an average take 50% (Exhibit 6) more processing time than RERUNs hence territory1 which is heavily loaded with RUNs has a higher RERUN loss even though overall it is least loaded. This necessitates a better allocation scheme rather than FIFO. Shortest Job First Scheduling may be used to minimize TPUT but it may delay a high priority request (ex a RERUN close to expiry) and also requires a priori estimation of various time factors. Currently, the system follows FCFS though not strictly, since some departments prioritize based on type of request ex: Underwriting favors RUNs over RERUNs. We would suggest an improved priority scheduling over FIFO which would be determined based on the type of request, agent’s importance, client importance, expiry time etc. et across uniformly across the steps. 3) Recommendations a) Distribution of reports to teams based on priority rather than territorial As found in previous section the current workforce should suffice the existing requirements if there are no backlogs and even if there are, it should not take more than 2 days. The problem was identified in the allocation of the policy request based on territory. We recomm end a collective (instead of territorial) request processing system with more intelligence added to the distribution system, which were also identified as bottlenecks for RUN and RAIN. This distribution system would first prioritize the requests and then allocate them to the underwriting team on an optimal basis ensuring even distribution of total requests, individual requests RUN, RERUN etc. This would remove the existing anomaly of having an overloaded team and an idle team concurrently. They should also keep monitoring the progress of the process and remove blocking issues that may result in a further delay of other policies. To expedite this process, it can also be automated by the help of computers. These changes should substantially reduce the TAT and the delayed RERUNs. The priority should be decided based on the following factors instead of current system purely on the type of request 1) Type of request – RERUN, RUN, RAP, RAIN 2) Already waited time – request that have waited for a long time should be upgraded 3) Estimate of total time required 4) Agent’s priority 5) Client’s priority 6) Expiry Time (Incase of RERUNs) 7) Other factors determining the business value of the request Hence overall, this would reduce the intensity of bottlenecks at DC and UT. b) Increase focus on RERUNs RERUNs, which generate maximum revenue, should be given a higher priority based on their proximity to the expiry date. This ensures customer retention and gives sufficient time to agents for renewal. c) Reduce Backlogs Reduction in current backlogs to minimum will help Fruitvale achieve a day’s TAT as explained. This can be done by working overtime, getting temporary teams possibly from other branches, and increase number of working days temporarily. d) Use Mean instead of SCT We observe that SCT is not a correct approach to evaluate the process flow since the 95th percentile customer’s time considered as a benchmark to set up the system results in very conservative estimates. Initially, other statistical methods like mean + n times standard deviation etc. can be used to achieve desired level of service. Following that, a record including TAT for each request should be maintained so that it can be used for future reference and for reducing the noise in mean that we recommend to be used in future. Exhibits Exhibit 1: Process Flow Diagram Exhibit 2: Capacity Analysis based on Mean Processing time |Capacity |RUNs |RAPs |RAINs |RERUNs | |Distribution |26. 8 |36. 00 |41. 38 |64. 29 | |Underwriting |30. 96 |35. 53 |59. 73 |72. 19 | |Rating |47. 68 |55. 64 |54. 96 |47. 68 | |Policy Writing |31. 69 |NA |41. 67 |44. 91 | *darkened cells show the bottleneck Exhibit 3: Capacity Analysis based of 95% Standard Completion Time Capacity |RUNs |RAPs |RAINs |RERUNs | |Distribution |14. 05 |16. 70 |26. 43 |41. 67 | |Underwriting |12. 59 |15. 43 |27. 33 |21. 50 | |Rating |32. 06 |40. 59 |40. 27 |39. 05 | |Policy Writing |25. 20 |NA |31. 65 |33. 58 | *darkened cells show the bottleneck Exhibit 4: Lead (Service) Time Analysis using Little’s Formula |Requests in progress |82 | |Requests served per day (in steady state) |39 | |Lead /Service Time (Requests in progress/Requests served per day) |2. 1 | Exhibit 5: Average Daily Workload Analysis |Demand Analysis |Requests in 120 days (1991) |Demand per Day | |RUNs |624 |5. | |RAPs |1524 |12. 7 | |RAINs |451 |3. 758333 | |RERUNs |2081 |17. 34167 | |Total |4680 |39 | |Mean Processing Time |RUNS |RAPS |RAINS |RERUNS |Workers/Teams | |Â   |(5. 0) |(12. 70) |(3. 75) |(17. 34) |Total Time |hrs per day | |Distribution |356. 20 |635. 00 |163. 13 |485. 52 |1,639. 85 |6. 83 | |Underwriting |226. 72 |482. 60 |84. 75 |324. 26 |1,118. 33 |6. 21 | |Rating |392. 60 |821. 69 |245. 63 |1,309. 17 |2,769. 09 |5. 77 | |Policy Writing |369. 20 |N. A. |202. 50 |868. 73 |1,440. 43 |4. 0 | Exhibit 6: Uneven distribution due to territorial allocation |Policies |Total |% diff with avg |RUNs |% diff with avg |RERUNs |% diff with avg |Rene wal lost | |/Territory | |1315 | |208 | |693 | | |1 |1151 |14. 24% less |274 |31. 73% more |636 |8. 2% less |403 | |2 |1393 |5. 93% more |179 |13. 94% less |840 |21. % more |227 | |3 |1402 |6. 66% more |171 |17. 7% less |605 |14. 54% less |296 | | | | | | | | | | | | | | | | | | | | | | | | | | | | Processing Time (using mean values) | |Distribution |Underwriting |Rating |Writing |Total |Baselined (w. r. t. minimum) |Baselined (w. r. t. RERUN) | |RUN |68. 5 |43. 6 |75. 5 |71 |258. 6 |169. 35 |150. 09 | |RAP |50 |38 |64. 7 |NA |152. 7 |100. 00 |88. 62 | |RAIN |43. 5 |22. 6 |65. 5 |54 |185. 6 |121. 55 |107. 72 | |RERUN |28 |18. 7 |75. 5 |50. 1 |172. 3 |112. 84 |100. 00 | | ———————– Distribution clerks Number : 4 Capacity: Runs 26. 27 (58. 63), Raps 36 (72. 28), Rains 41. 37(195. 65), Reruns 64. 28(290. 32) Underwriter teams Number: 3 Capacity: Runs 30. 96(12. 59), Raps 35. 52(15. 42), Rains 59. 73(27. 32), Reruns 72. 19(21. 49) New Requests, Renewal requests Request for underwriting Policy writers Number: 4 Capacity: Runs 31. 69(25. 19), Raps NA, Rains 41. 67(31. 64), Reruns 44. 91(33. 58) Raters Number: 4 Capacity: Runs 47. 68(32. 05), Raps 55. 64(40. 58), Rains 54. 96(40. 26), Reruns 47. 68(39. 04) Policy issuing request Rating request Manzana Insurance Operations Management ____________________________________________________________ _________________________ Case Study Manzana Insurance [pic] Presented to: Prof B. Mahadevan Submitted By Group 12 (Section B) Peeyush Razdan (0811115) Shalekh Banka (0811124) Shalem Anand Tirkey (0811125) Shreshth Sharma (0811128) Sumeet Mittal (0811131) Manzana Insurance As per the case facts, Manzana Insurance’s Fruitvale branch is the least performing branch and the senior VP seeks a report on the same. Their competitor Golden Gate (backed by its corporate parent generated a price war to gain market) is performing much better in terms of most metrics of Insurance business. 1) Problems faced by Manzana Insurance (Fruitvale branch) a) High Turn Around Time (TAT) Agents in the insurance sector are mediators who act as an interface between the client and the insurer. Hence, the quality of service, measured by average TAT, to the agents (who are common to the competitors) is of primary importance. TAT for Fruitvale has deteriorated to 6 days (1991) from 5 days (1990), while Golden Gate’s offer of 1 day TAT is luring agents away from Manzana. The number of late renewals is also increasing and quite high compared to Golden Gate. b) Geographic/Territorial Allocation to Underwriting Teams Leads to an Uneven Task Distribution We observe that the geographic allocation of agents to the underwriting teams is not optimal. This method has an inherent problem; there can be a surge in requests from a geography which might overload that particular team while the other teams might be idle due to lack of requests from their geography. Hence, their pooling should be rather than using the geographic allocation. c) Primary focus on RUNs rather than RERUNs and Increasing late Renewals Currently, Fruitvale is focusing on RUNs for getting new customers and compromising the service towards the RERUN requests for the existing customers. Loss of focus on RERUNs has led to increase in its TAT causing agents to move towards Golden Gate. The number of late Renewals has increased from 20% to 44% over the last year which has led to a significant increase in the Renewal loss rate from 33% to 47%. Renewal is a low premium – high volume business. Exhibit 5(in case) shows that a new policy and policy renewal give similar revenues of $6724 and $6205 respectively. The commission given to agents is 25% and 7% respectively. So in fact renewal of old insurance brings more revenue due to reduced commission percentage. Also, the time taken for renewal of policies is less, thus more renewals can be done in a given time. d) FCFS Scheduling may not be always optimum Most of the departments follow FCFS scheduling which may not be optimum. Ex. a policy with an effort of 4 hrs would delay all the other smaller policies behind it, effectively delaying 10 simple requests for serving one difficult one. Moreover, the scheduling policy followed across various departments is not same. While some strictly follow FCFS others do it on type of policy ex: RUN preferred over RERUNs. Also, The RAP is given preference over RERUNs by the rating team. The RAPs in fact take more time for processing than RERUNs. Also, only 15% of all quotes result in new policies. Thus, the Manzana Fruitvale branch seems to be servicing RAPs at the cost of RERUNs. e) Huge backlog of policies The existing backlog of policies is quite high, due to which any new policy received is not attended instantly (due to FCFS) further adding on to existing backlog, essentially creating a cascading effect. 2) Process Flow and Capacity Analysis We have used process flow, capacity analysis, Lead Time Analysis and Average daily Workload Analysis to analyze the current situation at Manzana’s Fruitvale Branch. ) Process Flow Exhibit 1 shows the process flow diagram with the existing capacity across the four major team Distribution clerks, Underwriter teams, Raters, Policy writers. b) Capacity Analysis Usage of Mean time for capacity analysis is ideally favored over 95% Standard Completion Time (SCT) parameter as 95% SCT is a highly conservative. It assumes every request to be of longer duration (95th percentile with respect to request duration) and does not take into acco unt the time saved while executing smaller requests. Mean on the other hand takes into account that fact that time consumed on longer jobs is compensated by the time saved on smaller jobs. Capacity analysis based on Mean Time (Exhibit 2) shows the bottleneck for RUNs is the Distribution step, for RAPs is underwriting, for RAINs is again Distribution and for RERUNs is policy writing. The same capacity analysis when done using 95% SCT (Exhibit 3) shows Underwriting step to be bottleneck for all the 4 types of policy requests. We observe that there is high standard deviation for most of the steps (especially Underwriting Step) and is comparable to mean value itself. Ex: For RERUNs Underwriting step mean is 18. 7min while the standard deviation is 19. 8min. Hence we are using 95% SCT for determining bottleneck step. And thus we consider Underwriting Stage as the bottleneck for the whole system. c) Lead (Service) Time Analysis Using Little’s Formula we have done Lead Time Analysis (Exhibit 4) which shows that on an average Lead Time is approximately 2 days (2. 10). As we have seen, throughput on the other hand is approximately 6 days which is much higher than the average Lead Time. This suggests that the longer throughput time is because of allocation problems described later. d) Average Daily Workload Analysis The argument of allocation problem is further strengthened by our Average Daily Workload Analysis (Exhibit 5). This analysis has been done taking into account the relative proportions of various types of requests on a daily basis. On the basis on mean processing time for all the steps it comes out that the average daily workload for each step is less than 7. 5 hrs (the stipulated working time). Inferences Above analysis shows that problem at Fruitvale branch is not due to capacity constraint but it is actually due to allocation issue. Predominantly, allocation problems are in underwriting step. Currently allocation is done on the basis of Geographical/territorial lines which lead to uneven workload over time as well as inefficient allocation leading to longer TPUT time. Exhibit 5 shows that RUNs on an average take 50% (Exhibit 6) more processing time than RERUNs hence territory1 which is heavily loaded with RUNs has a higher RERUN loss even though overall it is least loaded. This necessitates a better allocation scheme rather than FIFO. Shortest Job First Scheduling may be used to minimize TPUT but it may delay a high priority request (ex a RERUN close to expiry) and also requires a priori estimation of various time factors. Currently, the system follows FCFS though not strictly, since some departments prioritize based on type of request ex: Underwriting favors RUNs over RERUNs. We would suggest an improved priority scheduling over FIFO which would be determined based on the type of request, agent’s importance, client importance, expiry time etc. et across uniformly across the steps. 3) Recommendations a) Distribution of reports to teams based on priority rather than territorial As found in previous section the current workforce should suffice the existing requirements if there are no backlogs and even if there are, it should not take more than 2 days. The problem was identified in the allocation of the policy request based on territory. We recomm end a collective (instead of territorial) request processing system with more intelligence added to the distribution system, which were also identified as bottlenecks for RUN and RAIN. This distribution system would first prioritize the requests and then allocate them to the underwriting team on an optimal basis ensuring even distribution of total requests, individual requests RUN, RERUN etc. This would remove the existing anomaly of having an overloaded team and an idle team concurrently. They should also keep monitoring the progress of the process and remove blocking issues that may result in a further delay of other policies. To expedite this process, it can also be automated by the help of computers. These changes should substantially reduce the TAT and the delayed RERUNs. The priority should be decided based on the following factors instead of current system purely on the type of request 1) Type of request – RERUN, RUN, RAP, RAIN 2) Already waited time – request that have waited for a long time should be upgraded 3) Estimate of total time required 4) Agent’s priority 5) Client’s priority 6) Expiry Time (Incase of RERUNs) 7) Other factors determining the business value of the request Hence overall, this would reduce the intensity of bottlenecks at DC and UT. b) Increase focus on RERUNs RERUNs, which generate maximum revenue, should be given a higher priority based on their proximity to the expiry date. This ensures customer retention and gives sufficient time to agents for renewal. c) Reduce Backlogs Reduction in current backlogs to minimum will help Fruitvale achieve a day’s TAT as explained. This can be done by working overtime, getting temporary teams possibly from other branches, and increase number of working days temporarily. d) Use Mean instead of SCT We observe that SCT is not a correct approach to evaluate the process flow since the 95th percentile customer’s time considered as a benchmark to set up the system results in very conservative estimates. Initially, other statistical methods like mean + n times standard deviation etc. can be used to achieve desired level of service. Following that, a record including TAT for each request should be maintained so that it can be used for future reference and for reducing the noise in mean that we recommend to be used in future. Exhibits Exhibit 1: Process Flow Diagram Exhibit 2: Capacity Analysis based on Mean Processing time |Capacity |RUNs |RAPs |RAINs |RERUNs | |Distribution |26. 8 |36. 00 |41. 38 |64. 29 | |Underwriting |30. 96 |35. 53 |59. 73 |72. 19 | |Rating |47. 68 |55. 64 |54. 96 |47. 68 | |Policy Writing |31. 69 |NA |41. 67 |44. 91 | *darkened cells show the bottleneck Exhibit 3: Capacity Analysis based of 95% Standard Completion Time Capacity |RUNs |RAPs |RAINs |RERUNs | |Distribution |14. 05 |16. 70 |26. 43 |41. 67 | |Underwriting |12. 59 |15. 43 |27. 33 |21. 50 | |Rating |32. 06 |40. 59 |40. 27 |39. 05 | |Policy Writing |25. 20 |NA |31. 65 |33. 58 | *darkened cells show the bottleneck Exhibit 4: Lead (Service) Time Analysis using Little’s Formula |Requests in progress |82 | |Requests served per day (in steady state) |39 | |Lead /Service Time (Requests in progress/Requests served per day) |2. 1 | Exhibit 5: Average Daily Workload Analysis |Demand Analysis |Requests in 120 days (1991) |Demand per Day | |RUNs |624 |5. | |RAPs |1524 |12. 7 | |RAINs |451 |3. 758333 | |RERUNs |2081 |17. 34167 | |Total |4680 |39 | |Mean Processing Time |RUNS |RAPS |RAINS |RERUNS |Workers/Teams | |Â   |(5. 0) |(12. 70) |(3. 75) |(17. 34) |Total Time |hrs per day | |Distribution |356. 20 |635. 00 |163. 13 |485. 52 |1,639. 85 |6. 83 | |Underwriting |226. 72 |482. 60 |84. 75 |324. 26 |1,118. 33 |6. 21 | |Rating |392. 60 |821. 69 |245. 63 |1,309. 17 |2,769. 09 |5. 77 | |Policy Writing |369. 20 |N. A. |202. 50 |868. 73 |1,440. 43 |4. 0 | Exhibit 6: Uneven distribution due to territorial allocation |Policies |Total |% diff with avg |RUNs |% diff with avg |RERUNs |% diff with avg |Rene wal lost | |/Territory | |1315 | |208 | |693 | | |1 |1151 |14. 24% less |274 |31. 73% more |636 |8. 2% less |403 | |2 |1393 |5. 93% more |179 |13. 94% less |840 |21. % more |227 | |3 |1402 |6. 66% more |171 |17. 7% less |605 |14. 54% less |296 | | | | | | | | | | | | | | | | | | | | | | | | | | | | Processing Time (using mean values) | |Distribution |Underwriting |Rating |Writing |Total |Baselined (w. r. t. minimum) |Baselined (w. r. t. RERUN) | |RUN |68. 5 |43. 6 |75. 5 |71 |258. 6 |169. 35 |150. 09 | |RAP |50 |38 |64. 7 |NA |152. 7 |100. 00 |88. 62 | |RAIN |43. 5 |22. 6 |65. 5 |54 |185. 6 |121. 55 |107. 72 | |RERUN |28 |18. 7 |75. 5 |50. 1 |172. 3 |112. 84 |100. 00 | | ———————– Distribution clerks Number : 4 Capacity: Runs 26. 27 (58. 63), Raps 36 (72. 28), Rains 41. 37(195. 65), Reruns 64. 28(290. 32) Underwriter teams Number: 3 Capacity: Runs 30. 96(12. 59), Raps 35. 52(15. 42), Rains 59. 73(27. 32), Reruns 72. 19(21. 49) New Requests, Renewal requests Request for underwriting Policy writers Number: 4 Capacity: Runs 31. 69(25. 19), Raps NA, Rains 41. 67(31. 64), Reruns 44. 91(33. 58) Raters Number: 4 Capacity: Runs 47. 68(32. 05), Raps 55. 64(40. 58), Rains 54. 96(40. 26), Reruns 47. 68(39. 04) Policy issuing request Rating request