Overhead allocation methods

In manufacturing costs are incurred, these costs represents the cost of production that will be used in determining the price that will be charged by the company to make profit or to breakeven. There are two forms of costs Direct and indirect costs. Before one attempts to charge costs to cost centre or cost units it is important to consider why costs are incurred. Direct costs are costs that are traceable to a specific production center, service, products or department. Raw materials will be direct cost as regards the finished product, and a time clerk’s wages are a direct cost for a particular department.indirect cost is one which arise during the course of operations of the business but it is very difficult to attribute it specifically to a single unit. For example rates paid to a local authority is an expense which benefits a number of cost centre’s, and the time clerk’s wages referred to above would be an example of an indirect (wages) cost of the units produ ced by his department. Overhead allocation methods Direct costs normally present little difficulty in being allocated to cost units; materials requisitions and workers’ time-sheets will give sufficient indication of where the costs are to be changed.With indirect costs, however, whole items of costs may need to be divided between various cost centers and accumulated cost centre costs will then be allotted to costs units. These costs will first be classified according to function, i. e. production, general administration, marketing, research and development between functions. Each particular cost centre will then be allotted with its own costs and a cost centre total obtained. While apportioning indirect variable overhead to various production units or cost centers, cost and management accountants have many methods to use.One of the methods that is used is traditional methods and they give distorted costs where at times customers may be charged high prices due to over allocati on of the productions costs. They include method of allocating costs using direct labor, direct machine hours ,volume produced and other many other methods in most instances they give wrong results which at times may undervalue or overvalue produced units which may cause the firm to make less profits or abnormal profits from some units. It may also if they over value the produced product cause customers to shy away from the company.Therefore, the method used in apportionment of overhead used should be accurate in order to give the firm good profitability at the same time maintain the customers by charging them the right price. In order to overcome the shortcoming of the traditional method of cost allocation modern methods are used. One of the methods that assist in overhead allocation with minimal shortcomings is costs is activity based costing. Activity based costing reduces the shortcomings by focusing on individual activities as the fundamental cost objects in allocation of costs . An activity is defined as an event, task, or unit of work with a specified purpose; e.g. designing products, setting up machines, operating machines, and distributing products. This method uses costs of each activity and assigns this costs to costs units such as products or services as per the activities incurred while producing those units. Activity based costing focuses on individual costs, refining the assignment of indirect costs to departments, processes, products, and other cost objects that are to certain organization. To identify these activities, the company may organize a team from design, manufacturing, distribution, accounting and administration or in various production units such as product A, B, C, D and so on.This method uses the following producers in identifying the activities:- 1. Direct cost tracing – a feature of Activity based costing systems is aiming to indentify some costs or cost by subdividing existing cost pools. Costs in some new pools may qualif y as direct costs. Direct tracing of costs improves cost accuracy and is simpler because, unlike indirect costs, cost pool and allocation bases do not have to be identified. 2. Indirect cost pools- Activity based costing systems create smaller cost pools linked to the different activities. 3.The apportionment bases-activity of each cost pool is used to measure not the direct labor as the traditional method for the apportionment of indirect overhead. The level of activity therefore is an economic factor which affects the calculation of the unit costs of output produced. Since fixed and overhead costs remain constant as output fluctuates, the greater the output, the lower will be the fixed overhead cost per unit. This problem does not affect the variable overhead rate; variable costs per unit remain constant at all levels of activity, assuming always that prices remain stable.For management decision –making based on full unit costs, however, the level of activity is an importan t ingredient which must be taken into account when providing relevant information for such decisions. Based on an activity based costing allocation method of the overhead costs, each of the activity that goes into the product is computed its own overhead rate based on that activity’s driver which is the activity charge/unit. Given this overhead rate, the total overhead cost allocated to the production of the original version other system i. e. other than the overhead allocated using the direct labor hours method.From the foregoing discussion activity based costing approach method identifies activities and Cost centers that allocations with which costs may conveniently be associated for the purpose of product costing. Basically, there are two types of cost centers for which cost are accumulated – production and service cost centers. Production cost centers are those actually involved in production, such as machining and assembling departments. Service cost centers are t hose which exist to facilitate production, for example, maintenance, stores and canteen.The first stage in the allotment of the factory overheads costs to production costs centers is o collect and classifies factory overhead costs to production and service cost centers. Then it is apportioned the costs of the services cost centers to the production cost centers. If I assume that a firm has three service cost centers and two production cost centers, the apportionment of the service cost center costs involves selecting appropriate methods for apportioning these costs to the production cost centers. The accounting system of resource allocation am familiar with is activity based coating.Activity based accounting system is an accounting system that is used in resource allocation to various activities in multinational manufacturing firms and is yet to adopted by small firms. The allocation of total general overhead by this system is allocated based on direct labor hours and machine hours in my organization. The activities of production for the company are allocated the total overhead using calculated overhead rates per hour of machine and labour. Then the figure obtained is multiplied per the number of hours each activity is using. The Labour and machine hours are taken as cost drivers for each activity.This method has assisted the company reduce customer complains of over charging in prices. Activity based costing system of accounting considers a number of activities that takes place in various production units. It is considered the best method of allocating overhead within production unit. In my organization direct cost are those cost which are directly and easily costs that are attributable to production and indirect costs are those costs which arise during the existence of the business as whole. Indirect cost can not be attributed to any production unit it is only distributed various production units based on activity based system.The underlying principles, conv entions and objects of this method similar to other methods, but the application of those principle and the methods by which the objects are to be achieved must vary with circumstances. This does not mean, however, that the processes and procedures of a business must remain unaffected by the introduction of a system of cost accounts. This method of costing influences price because they affect supply. The lower the cost of producing a product relative to the price customers pays for it, the greater the quantity of a product the company is willing to supply.Managers who understand the cost of producing their companies’ products set prices that make the products attractive to customers while maximizing their companies’ operating incomes. In computing the relevant costs for a pricing decision the manager must consider relevant costs in all value. This method is also used in assessing the performance of manager responsible for running production units independently. The bes t criteria according to my view are the one without the allocation of indirect costs. This is because of manager should be held responsible for the costs that is under their direct control.They are free to make decisions that could increase or decrease the cost of operation of a unit. The efficiency and effectiveness of a manager should be judged from his ability to generate maximum revenue from operation and to keep the cost associated with this revenue at a minimum level. This will present a clearer picture to evaluate the performance of a manager of a unit. Although each unit produce certain amount of indirect costs but these cannot be directly attributed to the unit from which it had originated.So the company devised a formula of allocating this cost to each unit based on unit’s revenue producing capability. However as said earlier, there is no set criterion to allocate indirect cost to different units and it varies from business to business. This allocation of indirect c osts is discretionary and could create distortion in evaluating the performance of a manager. So in order to help manager accountable for results they are evaluated on the basis of operation under their direct control. Activity based costing considers a number of activities that takes place to allocate different types of costs unlike other methods.Activity based costing method is considered the best way in overhead allocation and allotment within production units. It considers a variety of activities and it gives a more accurate answer as compared to other methods of allocation. Case Study It is the policy of Dealogic, LLC to give their managers a high level of independence to make decisions for which they are held accountable for the results. That means they are free to run their units as they like. They are responsible to generate maximum revenue from unit under their command and to restrict cost incurred during the year.There are two type of costs generated at each unit. 1) Direc t costs ( Traceable consulting costs) 2) Indirect costs (Non-Traceable consulting costs) Direct costs in this case is that cost which can be directly and easily attributed to revenue generating operations of the business and indirect cost is one which arise during the course of operations of the business but it is very difficult to attribute it specifically to a single unit. So whole of the indirect costs from all the units are combined and then allocated a fair portion of this cost to each unit based on some criteria.In case of Dealogic, LLC, this criterion is based on revenue generation from each unit and indirect cost is then allocated to each unit depending upon the amount of revenue generated from each unit. This criterion varies from business to business. But the purpose is to allocate this indirect cost based on a criteria that has some direct relationship with this indirect costs. Conclusion The choice of one particular overhead rate as against the others may substantially a ffect the amount of overhead costs apportioned to a unit of product.Consequently, variations in full- product costs may result simply from the manner in which the overhead rate is selected. The rate to use depends on the particular circumstances facing the firm. The ‘direct labor cost, base is easy to use since the necessary information is usually readily available. There may be no relationship, however between direct labor costs and overhead costs; indeed, most factory overhead costs are incurred on a time basis and are not related to the labor payroll. However Activity based Accounting is the most appropriate has it allocates accurately than the other methods. ReferencesAtril, P. F. and McLaney, E. J. (2002). Management accounting for non-specialists, 3rd edn (financial times prentice Hall) pp. 102-108 Drury C; (2000); Management and cost Accounting;5th edition ,business press Thomson Learning78-85 Horngren, C. T. , Bhiman A. , foster G. , and Datar, S. M. (1999). Cost accou ntin: A managerial Emphasis, (prentice Hall Europe) pp. 135-160 Larson D, Kermit, Wild, J. john & Chippetta Barbara;(1996); fundamentals of accounting principle; London; Irwin. Wald J (2000) Biggs’s Cost accounting; The English Language Book Society and MacDonald and Evans Ltd London & Plymouth pp 98-136

How Important Is Postgraduate Education Education Essay

First, Jie Liu believes that it is critical for every graduate student selling instruction supplier to understand the three features of a graduate student selling pupil which are motivations, outlooks and readiness. Liu divided the factors that may possibly actuate pupils to take postgraduate selling instruction into intrinsic, extrinsic and calling related. In a research executed by Liu where questionnaires were distributed to marketing pupils of four different British universities, the consequence depicted that what motivated pupils for marketing graduate student surveies were intrinsic and calling related factors. This means that pupils chose the postgraduate selling plan at their ain will so that it could assist them construct a calling and supply them with greater chances. This is the ground why there are legion international pupils in the United Kingdom as several pupils from developing states such as India and China believe that analyzing abroad can assist them achieve suited occupations. â€Å" It is promoting to happen that far more of the Chinese pupils, who have invested so much in footings of household fundss and attempt to travel to the UK to analyze, were optimistic instead than pessimistic about their calling chances † ( Counsell 2011:71 ) . In respects to outlooks, Liu states that all pupils expected that they would be provided with theoretical every bit good as practical cognition on the topic. Graduate student pupils have high outlooks that the programme will learn them a batch which will be of significance in their hereafter. Furthermore, Liu identifies the feature of readiness to be indispensable. Postgraduate pupils need to be prepared, holding an apprehension of the class and a series of accomplishments to assist them get by with their graduate student instruction. Liu so distinguished place and international pupils in respects to preparedness after transporting out a farther analysis. The consequences showed that international pupi ls were less prepared than place pupils. There are assorted grounds as to why an international pupil could be less prepared such as different larning techniques, trouble in understanding the linguistic communication, civilization daze and non being able to accommodate to the British environment. Therefore, Liu seeks to supply cognition about graduate student selling instruction in the United Kingdom by mensurating the motivations, outlooks and readiness of graduate student selling pupils. Second, the article written by Liu has its ain strengths and failings. The extreme advantage of the article is that it focuses on a peculiar field which is postgraduate selling instruction. This could help other selling research workers and leaders with their survey as there are limited researches stressing on graduate student selling programme. In add-on, Liu succeeds in making an understanding about motivations, outlooks and readiness of graduate student selling pupils which would back up graduate student selling suppliers to plan their programme consequently. With these assets, the article does keep out defects every bit good. The research prepared by Liu where questionnaires were given out to marketing pupils of four British universities did lend accurate replies but there were restrictions. As stated in the article, the research was made utilizing the questionnaires returned by 90 five pupils which is comparatively a little figure for a research made for graduate student selling instruction and the four British universities surveyed were all set in a peculiar geographical country in the United Kingdom. Furthermore, Liu references that a individual quantitative method is used in informations aggregation and that there is no qualitative attack practised in the research. Even so, Liu points out differences between place and international pupils which could be imprecise as with such a little study it is non plausible to carry through a clear and broad image. â€Å" Provision of higher instruction for international pupils has become an of import beginning of income for Western universities and these pupils have attracted research attending † ( Huang 2008:1003 ) . Therefore, even with an copiousness of facts, the article seems uncomplete and lacks preciseness. Third, Liu decidedly recognises the turning importance of graduate student selling instruction and wants postgraduate selling pupils every bit good as the graduate student selling suppliers in the United Kingdom to profit from the programme. Since international pupils constitute bulk of the programme, Liu believes that these international pupils should have maximal advantage. Marketing instruction suppliers should be able to assist, back up, and understand international pupils so as to better the experience for pupils which would back up United Kingdom to keep onto its prima place in the instruction market globally. â€Å" At a clip when higher instruction establishments are developing schemes to spread out the Numberss of graduate student pupils, placing the academic and societal demands of full-time graduate student pupils is of paramount importance † ( Humphrey and McCarthy, 1999:371 ) . To reason, Liu mentions that international pupils come all the manner to the United Kingdom, paying a monolithic sum of fee, therefore, there money should be valued and they should be provided with a theoretical and practical cognition experience. This would present an advantage to the pupils and the instruction suppliers in the United Kingdom.

Nauryz

NAURYZ Once the Kazakh people lived in spacious steppes and at that time yet there were no calendars. They defined arrival of spring intuitively if warm sunshine started to get into the top opening of a yurta, means, to long frosty winter there came the end. According to old chronology this day usually coincided with March 21. Was considered that in day of arrival of spring there is an updating of the nature which was symbolized usually by a spring thunder. These days kidneys on trees started to bulk up, and the steppe was gradually painted by bright flowers and young greens.Holiday Nauryz – one of the most ancient holidays on Earth. He is marked out already more than five thousand years as a holiday of spring and nature updating by many people of Forward and Central Asia. The name of a holiday coincides with the name of month as Nauryz in a translation from Kazakh means – March. Kazakhs had a special custom – if in March the girl was born, it was named by Nauryz gul or simply Nauryz. The boys born this month, it was accepted to call Nauryzbek or Nauryzbay.Was considered that in March the most beautiful boys and girls as their skin was similar to the soft snow-white snow which is dropping out this month are born. In day of a holiday it was accepted to cover â€Å"dastarkhan† – a spacious cloth on which every possible viands were put. The main festive course called â€Å"Nauryz kozhe†, which was preparing from 7 ingredients: was: water, meat, salt, 7 types of grain: rice, perlovka, oats, buckwheat, corn, millet, wheat and milk. To festive â€Å"table† invited neighbors therefore on the eve of a celebration it was necessary to order housing.On one of traditions it was necessary to repay all debts, then all next year a family will be well off and in anything not to need. In day of a holiday all were kind with each other, presented with the warmest and light wishes that with approach of spring they were avoided by dis eases and troubles. Many traditions of this holiday are similar to celebration of modern New year. Kazakhs also tried to dress all new, to fill the house with tasty food and to present a part of heat to relatives that future season passed without are necessary also misfortunes.This day by all means it was necessary to address congratulations to the younger brother and all native. Than more guests came to the house, bigger wellbeing expected subjects a family next year. Today Nauryz became a public holiday of spring, work and unity. Today this holiday is equally expensive to all people living in multinational Kazakhstan. The ancient holiday Nauryz was harmoniously transformed to modern life, having kept continuity of traditions of an antiquity.

Technology Essay Example | Topics and Well Written Essays - 250 words - 7

Technology - Essay Example Although keeping up with the high cost that these tools require places a heavy burden upon the system as well as upon the bottom line, the fact of the matter is that in order to continue to integrate with business and the patient, the new applications and software packages are demanded (Chunhau et al, 2009). Moreover, the industry standards that must be met also demand a level of standardization that goes beyond convenience and cost equations. Accordingly, one can understand that the information needs that a given health care organization may have relates to the storage of patient data, the encoding of insurance paperwork, billing in all forms, transcription needs, recording of changes to patient health and treatment, as well as a litany of others (G. L., 2012). It can be definitively said that the flow of information across HIT within my given organization greatly increases and supports evidence based practice due to the fact that it allows the healthcare professional ease of access to a great deal of patient information with regards to any single given case. Of course the downside to this is that the training curve to integrating these approaches with new staff is oftentimes long and involved; however, the rewards are manifest in a higher quality of care and treatment that such a proliferation of HIT can provide. Reddy, M., McDonald, D. W., Pratt, W., & Shabot, M. M. (2005).Technology, work, and information flows: Lessons from the implementation of a wireless alert pager system. Journal of Biomedical Informatics, 38(3),

Outline how private banks and wealth management firms segment their Essay

Outline how private banks and wealth management firms segment their clients and outline the new approaches to client segmentation - Essay Example Attempts at segmenting the large number of clientele for institutions like Banks are bound to be laborious and costly. However, the rewards for such efforts are attractive enough to justify these efforts. Very often the segmentation exercises would throw up results that may be surprising and upsetting to the previous assumptions, (Maude, 2006). Segmentation, like a mirror, will show that the actual cost of servicing the highly valuable customers is far less in comparison to the rewards generated, and it will also show the behavioral patterns of those customers, which, in turn, will help to plan and implement balancing strategies that can optimize the results. The recent Global Financial Crisis has brought in its wake a few upheavals in the Banking and Financial Service Industries. The most significant of these is a total re-thinking on Customer service, particularly in the sector of Asset/Wealth Management Advice, where European Banks were, till recently, enjoying an advantage, (Reinartz, Krafft, and Hoyer, 2004). The entry of several new Financial Services Companies into this sector has caused the re-thinking on strategies even though the actual number of Asset Management Clients has expanded recently. In the competition for customers, the existing Client Segmentation has been side stepped and the admission threshold for Asser Management Service has been lowered. The emergence of new High Net Worth Individuals all across Asia and Latin America has added to the stress. The burgeoning new clientele has spurred the creation of many new innovative investment products and services targeting them. European Banks, reluctant to lose the strategic advantage they had enjoyed in the sector, are gearing up to face the competition from new entrants, including Retail Bankers and International Providers, (Landberg, 2001). Consolidation of some European Banks is a distinct possibility in the prevailing conditions. Small Boutique Banks with limited number of High Net

Managing Conflict in the Workplace Term Paper Example | Topics and Well Written Essays - 500 words

Managing Conflict in the Workplace - Term Paper Example This paper offers a brief overview of a conflict I have observed in my workplace and how it impacted the work environment. A script on how to give feedback to employees when conflicts arise is also outlined in this paper, as well as ways I would enlist HRs help in managing this situation. Two of the nurse in my workplace were once involved in a conflict. It happened that one of the nurses had forwarded an email consisting of pornographic material and the recipient of the email found it inappropriate. The recipient of the email responded through confronting the sender and this turned into a heated argument. The recipient felt embarrassed and felt insulted. What followed is the two nurses could not even engage in a decent conversation as a result of the argument. Teamwork is highly valued in my workplace and hence the two nurses at one point had to work together. Their engagement was low as communication was limited between them solely as a result of the argument they had. As a nurse manager, it was my obligation to give feedback to the sender of the email in regard to the unacceptable behavior in the workplace. The steps involved in giving feedback as outlined by Manion (2011) include "Stating your positive intention, sharing your observation, including impact of an action, asking the intent, adding empathy, and indicating what needs to change" (p. 340) respectively .A script of the conversation I would have with the sender of the email would be as follows: Positive intention: You are one of the top performers in this department and your contribution is highly valued. This department highly relies on you to be a role model for our newly employed nurses. My observation: Yesterday you sent a pornographic email to your colleague and she felt embarrassing hence she confronted you for an explanation. I am sure you two are finding it difficult to engage in your activities as a team. Needed change:

High tech building design Essay Example | Topics and Well Written Essays - 2750 words

High tech building design - Essay Example This research will begin with the statement that hi-tech building design refers to architectural designs and services that involve the use of advanced technology thereby improving the functionality of the final product. In simple terms, it is a particular style of building. In industries, it involves the use of machines to attain quality products. These machines use modern technology like computers, electronics and robots to help companies achieve their goal. Hi-tech building design has risen from modern architecture, incorporating elements of the latest technology in building designs. These include; prominent show of building techniques and functional components, decent alignment and use of sophisticated materials such as metals, glass and futuristic shapes. In the past, building industry has applied technologies that made building designs complicated, these made it difficult for man to design buildings of their needs. Heat regulation systems in these houses were very poor since the ventilations provided were insufficient and could not effectively control internal temperatures. With regards to hi-tech designs, several equipments have been invented to effectively solve the problem of heat in buildings and have also helped solve issues of human thermal complaints both at homes and in offices. Thermal complaint had been declared a major drawback to economic development. People claimed that it was because of thermal problem that they did not perform well in their endeavors and this called for a pragmatic approach towards this nuisance. Fans have been installed in buildings to regulate heat in regions where there have been a lot of heat; heaters have also been installed in the buildings which experienced a lot of cold like the Polar Regions. These products of hi-tech design have rendered redundant, thermal disruptions which are now considered a thing of the past. Representation and function Architects rely entirely on this technology for production of feasible stru ctures. It is also applied in industries, transport, flight, communication and space travel. It aims at eliminating burdensome materials such as; bricks, concrete blocks used in the construction industry and introduce steel which increases the life span of the structures. Glass, which is responsible for the aesthetic aspects, is also embraced by this technology. The introduction of steel and glass was meant to enhance the function of the final product in order to catch up with the technologies of other sectors, which keep on improving each day depending on the core materials used for production in those sectors. Buildings have always lagged behind since the materials used in productions are inflexible and not easily changeable. For instance, concrete has proven to be the most suitable material used in construction, even though it withstands compression, it fears tension and must therefore be reinforced using steel. Originally, hi tech technology was termed as malicious, ill motive i ntended to dislodge employees from their duties. With time though, its good intentions have conspicuously come to light and has quickly been embraced the world over. It has played a major role in employing double the number that was initially engaged in these particular sectors of the economy. Moreover in the building industry,

Costco warehouse corp in 2012 Case Study Example | Topics and Well Written Essays - 1500 words

Costco warehouse corp in 2012 - Case Study Example This paper is going to analyze the success story behind this company and how it has managed to be very successful in 2012. 1. One of the strategy that this company has been able to utilize in order to attain success is to establishment of good employee relations. As a CEO Jim Sinegal managed to visit most of their stores. In a day he would visit 8-10 stores daily. As a CEO he was in charge to be a producer, director, and knowledgeable critic. The second strategy that this company has managed to use is the pricing. Following their mission, their pricing was aimed at encouraging customers to come to their shops. This means that their prices are always low. It is argued that the strong business relationship that Sinegal has with Wal-Marts CEO is a contributing factor to using this strategy. This is because Wal-Mart the largest merchandise producer in the US also utilizes similar pricing strategy. For quite a long time the pricing strategy for this company is to cap its markup brand name merchandise at 14% compared to other supermarkets which markup their merchandises at 20-50%. The company managed to desig n most of the basic products especially food to be equal or better quality than national brands. This was aimed at ensuring that the company provided quality goods at the least prices (Barrera). This strategy has been criticized by Wall Street Journalists as lowering the shareholders profits. However, the CEO of the company argues that their strategy caters for both the shareholders and stakeholders by providing them with quality products at the least costs while the company still makes higher profits. The other strategy that this company uses is the price selection. Most of the supermarkets like Wal-Mart would stock 40,000 or even 150,000. However, Costco’s strategy was to deploy only 3,600 active items in their shelves.

Catering for a variety of learners Essay Example | Topics and Well Written Essays - 500 words

Catering for a variety of learners - Essay Example With the tremendous pace of globalization it is seen that multilingual students exist all over the world and this has created a subject for research. It is believed by many that these multilingual students are at a loss if they do not excel in the primary language which is being used in schools and universities. However this belief is denied by many when it comes to excellence and perfection. This essay would further analyze the works of Cummins and Clarkson in relation to these aspects (Cummins 2006; Clarkson 2006). Multilingual and Bilingual students are able to speak two or more languages which gives them an edge over others who can speak only one language. English is primarily used for educational curriculums and hence these multilingual students are encouraged to excel in that specific language. In many schools English as a language is promoted for these multilingual students whereby their mother language is ignored. The teachers in these schools believe that English as a primary language is more important than other languages when it comes to studies. However this is denied by several researches done by Cummins and Clarkson. It is seen that Cummins in his researches is denying these beliefs and stating that it is necessary for students to learn all the languages and excel in them accordingly. According to his researches it is seen that students who have a grip on different languages are able to build up excellent rational critical techniques (Cummins 1979; Cummins 2006) These techniques he lp them to excel in education and further improve their base. Clarkson affirms this view by researching on Australian Vietnamese students and how their bilinguals help in developing their rationality of mind. Mathematics is a subject of thought and being bilingual helps these students to think even more. The research by Clarkson showed that students who had a grip on many languages showed more positivity when it came to studying mathematics in the

How Much Co2 Lab Essay Example for Free

How Much Co2 Lab Essay Experimental: An Alka-Seltzer tablet was accurately weighed and recorded using a weighing boat and analytical balance. A fragmented piece between 0. 2100g and 0. 2800g was also weighed and recorded. 500mL of water was placed in a 600mL beaker. 80mL of water was then mixed with 20mL of 6M HCl in a 150mL beaker to create 1. 2M HCl. A 1. 5g piece of Alka-Seltzer tablet was then added to the HCl solution. After complete evolution of CO2, gravity filtration was used to catch all of the starch produced from the reaction. The buret was filled with the filtrated solution and the glass tube end of a rubber tube was inserted about 2 inches into the mouth of the buret. While keeping a finger over the buret mouth, the entire buret was quickly inverted and the tubing and mouth completely submerged into the water in the 600mL beaker. The buret was then clamped into place while double checking the buret mouth was under the water level and the rubber tubing was not pinched. The stopcock was then opened extremely slowly until the water level in the buret dropped close to the 50. 00mL mark. This level was then recorded. 25mL of the prepared HCl solution was added to a 125mL Erlenmeyer flask, along with a 0. 5-1. 0g piece of Alka-Seltzer tablet. After complete evolution of CO2, the neck of the flask and rubber stopper were completely dried. The tablet fragment earlier weighed (between 0. 21-0. 28g) was then added to the flask followed by immediate insertion of the stopper to ensure a tight seal. 5 minutes after the CO2 has been generated, the new water level of the buret was recorded, along with the distance in inches between the buret and beaker’s water levels. Lastly, the prevailing atmospheric pressure, temperature of the water, and approximate volume of the room was recorded. Results and Calculations Table 1 Experimental Values Experimental Values| Measurements| Current pressure of the room| 29. 3 in. Hg| Mass of entire tablet| 3. 2545 g| Mass of fragment| 0. 2524 g| Buret water level (start)| 45. 62 mL| Buret water level (end)| 7. 50 mL| Distance between buret and beaker water level| 3. 625 inches| Temperature of the water/room| 21. 8Â °C| Pressure of water at 21. 8Â °C| 19. 587 torr| Length, width, height of the room| 1463cm, 792cm, 366cm | Conversions: Temperature of the Room: 21. 8Â °C + 273. 15 = 294. 95K Volume of the room: (l? w? h) = (1463cm)(792cm)(366cm) = 424 x 108 cm3 = 424073L Pressure of room: 29. 3 in. Hg x 760 mmHg x 760 torr = 744. 3 torr 29. 92 in. Hg 760 mmHg 29. 3 in. Hg x 1 atm = 0. 97927 atm 29. 92 in. Hg Calculations: PÂ °atm = Patm – ( in. of H2O )( 1. 87 torr/in. of H2O ) = (744. 3 torr) – (3. 625 in. )(1. 87 torr/in. ) = 737. 521 torr PCO2 = PÂ °atm – PH2O = (737. 521 torr) – (19. 87 torr) = 717. 934 torr x 1 atm = 0. 94465 atm 760 torr VCO2 = 45. 62mL – 7. 50mL = 38. 12mL = 38. 12mL x (1L/1000mL) = 0. 03812 L NCO2 = PCO2VCO2/RT = ( 0. 94465atm )( 0. 03812L ) = 0. 0014873 mol CO2 ( 0. 08206 L? atm/mol? K )(294. 95 K) Moles of CO2 one tablet produces: (moles CO2) x (mass tablet/mass fragment) = (0. 0014873 mol CO2) x (3. 2545g / 0. 2524g) = 0. 019178 moles CO2 in tablet Moles of the room: Nroom = ProomV room/RT = (0. 9727atm)(424073L)/(0. 08206 L? atm/mol? K )(294. 95 K) = 17,042. 7 moles in room of tablets required to fill room: (moles of room) / (moles of CO2 per tablet) = (17,042. 7 moles) / (0. 019178 mol CO2) = 8. 887 x 105 tablets Mass of NaHCO3 needed to fill room with CO2: = 8. 887 x 105 tablets x 0. 019178 moles CO2 x 1 mol NaHCO3 x 84. 01g NaHCO3 1 tablet 1 mol CO2 1 mol NaHCO3 = 1. 432 x 106 g NaHCO3 Discussion In order to find the number of tablets needed to produce enough CO2 to fill the room, the ideal gas law was required first to solve for the number of moles of CO2 in one tablet and second the number of moles of the room. To use the ideal gas law, the atmospheric pressure was adjusted for due to the lower pressure in the buret when compared to the outer atmospheric pressure. This unequalization of pressures, although corrected, may still be slightly off, thus potentially causing later calculation error when using the ideal gas law to solve for the moles of CO2. Difficulties in the experiment arose when inverting the buret and completely submerging it into the beaker of water. This is a likely place for error because keeping a finger over the mouth of the buret and sealing the mouth tightly enough during the inverting process was very difficult. If too much of the solution inside the buret leaked out, one would not have enough volume to start with (before the CO2 evolution) and thus would have to remake the solution and repeat the process. Another potential source of error would be the measurement of the size of the room. With so many objects (lab tables, carts, ceiling structures) that also occupy the space, it was very difficult to determine an accurate volume of the room. Thus, the actual number of tablets required to fill the room might be a little bit less when the objects taking up space in the room are considered. Additionally, if the gravity filtration failed to filtrate all of the starch from the HCl solution, the leftover starch could potentially cause a problem in the reaction when the tablet fragment is added to the solution, thus providing more possible sources of error. Another minor source is the sensitive nature of the analytical balance, possibly leading to incorrect weight measurements of the tablet fragments. Another is general human error, such as reading the volume on the buret when determining the amount of CO2 evolved from the fragment. Conclusion In conclusion, the overall experiment proved to be successful; depending on the calculated size of the room, the number of Alka-Seltzer tablets required to produce enough CO2 gas to fill it was able to be determined. The mass of NaHCO3 needed to produce enough CO2 was also able to be calculated due to the fact that one mole of NaHCO3 is equal to one mole of CO2. Using the ideal gas law, Dalton’s law of partial pressure, stoichiometry, and conversions, a result was calculated, thus proving that future experiments dealing with the calculation of CO2 evolved from Alka-Seltzer by using an inverted buret can be done successfully.

An Analysis Of The Extended Mind Philosophy Essay

An Analysis Of The Extended Mind Philosophy Essay à ¢Ã¢â€š ¬Ã‚ ¦ Minds like ours can (without the need for any radically new techniques, technologies, or interventions) extend into the world (Clark, 2010, p. 81). Evaluate this statement with reference to the literature on extended cognition. This essay aims to study the extended mind, without any need of completely adapting new techniques, technology, or interventions the minds like ours can launch into the world (Clark, 2010). The focus of the essay will be on internal and external representation of the mind and will evaluate the statement made by Clark (2010) with reference to other literature on extended cognition. Cognitive science believes that the mind has mental representations which are similar to computer data structures and computational procedures analogous and computational algorithms. Cognitive researchers have put forward that the mind holds mental representations as rules, images, logical proposition, and concepts (Dawson 1998). According to Norman (1988, 1993) cognition is viewed as terms of knowledge in the head and knowledge in the world. According to Clark (2010) one of the most significant current discussions in legal and moral philosophy is the extended mind, which refers to the concept between the mind and the environment, from the thesis of Clark and Chalmers (1998) active externalism or Hypothesis of Extended Cognition (HEC). The extended mind commences with the inquiry of where does the mind stop and the rest of the world begin? in respond to the question Clark and Chalmers (1998) present an alternative view with Hypothesis of Extended cognition (HEC). This is to be distinguished from the more traditional externalism meaning from the writing of (Putnam, 1975 Burge, 1986). Clark is asking for people to visualize that individuals could rotate images of geometrical shapes on a computer screen, by the use of a neural implant in their heads or by using a rotate button in the world. Clark affirmed that the implant perspective is evidently cognitive; therefore the button perspective is as well, in spite of either if they are carried out in the head or in the world (cited in Clark 2008). For this reason, it can be argued that the mind extends into the world which was Clarks belief in technology, physical objects, chips and CD-ROMs, as external memory stores that individuals can consult as needs dictate sort of coupled systems (Clark and Chalmers 1998). According to Dartnall (2007); (Schegloff, 1992, cite Alterman, 2007), Clark and Chalmers (1998) admitted that the processes in the world might be seen as individual, truly mental states-experiences, desires, emotions, beliefs, and so on might be in the mind. Nevertheless when it is performed in the head, it should also add up as cognitive when it is carried out in the world, Dartnall (2005) affirmed that the mind leaks or loops into the world. Clark and Chalmers (1998) argued that cognitive processes extend into the world when an individual uses pen and paper to solve a problem, using language to work or to solve a problem and the use of computers. Zhang and Norman (1994) draw our attention to internal representations as being intrinsic to many cognitive tasks and not just input and stimuli to the internal mind. This means that all these researchers thesis show a supportive argument toward Clark (2010) stating that the human mind can be extended into the world. Clark and Chalmers (1998) made such arguments as cognitive states being Parity argument by the things in the environment, in which they identify a number of possible objections to this argument such as the cognitive and the conscious, portability and reliability. They demonstrate two untrue characters to support their argument that the mind can extend into the world, using the example of Otto and Inga, who were both interested in art. Inga has a normal functioning brain, while Otto suffers from Alzheimers disease. They hear about an exhibition at different times and places and they both decide to go, Otto consults his notebook, which says that the museum is on 53rd street so he went to 53rd street to the museum. Whereas Inga recalls that the museum is on 53rd street and walks to the exhibition, as a result of this case Clark and Chalmers (1998) stated that the notebook plays the same role for Otto that biological memory plays for everyone else. They concluded for this reason that som e external objects execute this duty, and that some of our cognitive processes transcend the boundaries of skin and skull (Clark 2008). The HEC has been thoroughly criticized by Adams and Aizawa (2001) defenders of brainbound or organismbound approach to cognition. Clark and Chalmers, (1998) maintain their argument by pointing out to what extreme the mind extended, if someone hardly ever takes relevant action without consulting their Filofax, for instance, their cognitive system will be like that of the notebook in Ottos. Nevertheless if the individual frequently acted without consulting themselves, for example if the individual sometimes answers important questions with I do not know then the information in it counts less as part of individual belief system. Also if someone is relying on the internet is likely to fail on multiple counts, unless the individual is unusually computer reliant, facile with the technology, and trusting, but information on certain files on the individual computer may qualify (cited in Clark 2008). Dartnall, (2005) who argues for internalism and its epistemological implication that an individual can execute actions mentally that someone could typically carry out in the world. These are naturally achieved on inner analogues of external substance, which means that there is a leakage in both ways such as from world to mind, from mind to world. This parity argument has epistemological inference; if the individual can make an empirical discovery in the world using a procedure, then that procedure will also lead to empirical discovery when carried out in the head. For instance if a person walks into a room and sees a partially completed jigsaw puzzle on the table, looks at the puzzle and leaves the room. The person then mentally rotates one of the pieces and discovers where it fits into the puzzle. They have discovered something new, where the piece fits in the jigsaw puzzle, but how has the person done this? Not by straightforward empirical discovery, they did not have the direct en try to the puzzle when they solved it, or if they might have remember it when they walk into the room, because they did not know where it fitted when they were in the room and Shepard Metzler, (1971) also in support of this work also is consistent with Clark (2010) statement. A number of studies have highlighted that our mind extends into the world in support of Clark and Chalmers (1998); Clark (2010); Kosslyn (2006); Zhang and Patel (2006), (Baddeley, 1986; Smith and Jonides, 1997) (cited in Kosslyn 2006). In addition, Kosslyn argues that you are not restricted to whats in your head, but also includes things around you, including other people. Consequently, the self becomes distributed over other people who function as long term social prosthetic devices, cited in (Kosslyn 2006). Rupert (2004) developed a methodology for the hypothesis of extended cognition (HEC) which he called hypothesis of embedded cognition (HEMC), they are two divergent holds on cognitive scheme and their composition and their position in cognitive processing. HEC could more or less correspond to the viewpoint implemented by Clark (2008) those cognitive processes factually extends into the environment, while the traditional HEMC persists that cognitive organism is bound. According to the HEMC rely on cognitive processes, instead of being constituted by the external mechanism and strategy for cognition to happen without the external element being a factual part of the cognitive process. Rupert (2010) opposes Clark (2010), but does not fully reject the HEC. Thus, the HEMC has further empirical support and descriptive worth than HEC (cited in Dahlback, Stjernberg, Kristansson and Skagerlund, 2010). A recent study by Dahlback et al (2010), reviews the hypothesis of the extended mind and in order for them to support Clark and Chalmers (1998), they conducted an empirical study. They developed a definition of what cognitive processes are and how to examine cognitive systems, for instance how external memory support is actually used in elderly peoples everyday life. The participants were four elderly people with mild memory impairments and were diagnosed with Alzheimers disease, and some with a form of dementia. It was observe that one of the women kept the disposed plastic envelopes for the medicine she used and clipped it on her kitchen table. The woman stated that the envelope is a way of reminding her that a home healthcare practitioner as visited her as she will not remember. Dahlback, et al. (2010), pointed out that the plastic envelop is part of the womans memory system from an active internal process, since an already existing material artefact is put to use to improve her m emory, because they is no need to create a material artefact to improve the womans internal function any more. While Clark and Chalmers state that the mind can extend into the world through active externalism, that if process counts as cognitive when carried out in the head, then it could be also counted as cognitive when someone uses object as external memory via a notebook. Bs note were on the inside of her door, for her not to open the door for strangers, just like Otto, but Otto carries her own every were she goes. C uses a shopping list, because she forgets things all the time, while F has an appointment at podiatrist, which she has written and posted on her fridge, she then rewrites the note and the information has been mixed up. Dahlback, et al. (2010), Clark and Chalmers (1998), the imagination of Otto is not as straightforward as they may think in real life. Hence external memory support in this context is of question on how information finds its way into the external memory with participant Fs memory support functions. Dahlback et al (2010) concluded that extended mind hypothesis of Clark and Chalmers had been argued in isolation, for instance the hypothesis was not looked at in a wider theoretical framework surrounding all variety of cognition. In addition, the empirical debate has been slight be being limited to a few paradigms. Consequently, they supported Clark and Chalmers, but proposed alternative theoretical framework that Activity Theory could be used to illuminate some problems brought up in the debate. Activity Theory cognition is first and foremost organism centered and biologically evident in examples alternative from Clark and Chalmers, (1998). Hutchins (1995) argued that cognition is culturally and socially processed. The Activity Theory which is derived from Vygotskys (1978) cultural historical psychology, that the human mind is essentially associated to the interaction linked to the world and the human being. According to the Activity Theory, culture may not only be external which might have power over the human mind, instead is an underlying producing power that is an element of the extraordinarily manufacture of the mind. This finding is consistent with Clarks (2010) thesis, even though they have a different idea. Vygotsky (1978) is also debated Clark and Chalmers (1998) thesis, stating that the human mind is social in nature; that people are shaped by their language, how they are construed and by their culture as well, also that human beings live in a social and communal w orld. Although they has been critics such as Adams and Aizawa (2001) claiming that there might be a crucial difference between a real extended cognitive process where some external artifact in the world is element of an actual cognitive process and process that permit some process. They ask Clark a question: Why did the pencil think that 2 + 2 =4? And Clark answered because it was coupled with a mathematician. According to Adams and Aizawa (2010) in respond to Clarks answer they stated that, there were problems with Clarks extended mind hypothesis. They stated that Clark had no right explanation of the cognitive and the coupling constitution fallacy, so they made a theory mark of the cognitive, which may well prove that cognitive processes in fact are extended. Adams and Aizawa (2001) illustrated some artifact pencil and paper, in which they explain when using pen and paper and at the same time as carry out arithmetic which is rather difficult, the individual may not be able to work out the problem when using just their head and that the person needs to pass information onto the paper. They state that the paper and pen merely permitted a little cognitive process or else may be unattainable. While Menary (2010) feels that the mark of the cognitive is too limited. Adams and Aizawa (2010) propose an explanatory work, that cognition is constituted through underlying processes that involve non-derived content. They offer this in two ways, chemistry, and physics and by psychological laws. They stated that particular psychophysical laws, like Webers law, and psychological laws central memory formation and recall. Consequently they projected that the weight of empirical evidence supports the view that, since an object is of conditional empirical fact, that there are some processes that are identifiable cognitive, which happened in the brain and cannot cross from the brain into the external world. Clark (2010) argued that Adams and Aizawas (2010) argument is not strong enough, mark of the cognition, that cognition should be noticed not by its causes, but by its effects, which means Clark is arguing for a different cognition science which is the coupling constitution fallacy. Nevertheless Adams and Aizawa (2010) believe that Clark cannot come understand the view they had that cognition is a fundamental processing concerning non-derived content. As a result their work did not provoke Clark to address the problem of the most widespread problems with extracranial and transcranial theories of tool use. According to them, Clark did not offer a response to the coupling constitution fallacy and he gives a hint at what he thinks distinguishes the cognitive from the non cognitive. In conclusion this essay has given an account of and the reasons for the widespread extended mind debate and the statement made by (Clark 2010, p. 18) that minds like ours can (without the need for any radically new techniques, technologies, or interventions) extend into the world. It is possible to state that external representation has shown an option to the classical thesis of Clark (2010) view of all cognition taking place in the head. In addition, how it can be practical to be of assistance in real-world problem solving and arrangement of tasks, hence it provides insight into the association between human internal and external worlds and the nature of the mind itself. Furthermore other researches such as Clark, 2003, Clark and Chalmers, 1998, Dennett, 1996, Donald, 1991, Hutchins 1995 (cited in Dartnall, 2005) state that, cognitive processes extend into the world when individuals use pen and paper to work something out or the use of a computer. These findings suggest that the statement made by Clark with reference to other literature on extended cognition has brought new areas to be looked into like the need of technologies. Finally, a number of important limitations need to be considered, first Adams and Aizawa (2010) (cited in Clark 2008) which were the ones who attempted to argue what was wrong with the extended mind hypothesis and Clark stated that they fall short to successfully undermine the argument for the extended mind, because it seems that everyone agreed with Clark, but also bring alternative explanations. However, Adams and Aizawa (2010) argued that Clark was not able to address their theory of the mark of the cognitive, on the other hand Clark and Chalmers attempt to tackle the pervasive coupling constitution fallacy and set out a reasonable theory of what differentiates the cognitive from the non cognitive. The statement made by Clark and Chalmers (1998) has thrown up many questions in need of further investigation with empirical evidence to support the statement.

History and Overview of Pulse Oximetry

History and Overview of Pulse Oximetry Pulse Oximetery Leslie Bruchey Introduction to Pulse Oximetry Pulse oximetry has changed the medical field for eternity. The ability to be able to monitor a patient’s oxygen saturation noninvasively has become a standard of care for those who are in the hospital. Pulse oximetry is the ability to measure the oxygen saturation of arterial blood using a pulse oximeter (Pulse oximetry,n.d†). This allows the body to be externally monitored and help maintain the oxygen saturation. The pulse oximeter allows for someone’s oxygen saturation to be measured in a matter of seconds instead of drawling an arterial blood gas which requires a needle and about fifteen minutes to have the results (Arterial Blood Gas, n.d.). History of the Pulse Oximeter A pulse oximeter is a device that allows for noninvasive measurement of a person’s oxygen saturation within their body to make sure their body has adequate oxygenation to prevent fatigue, shortness of breath, becoming disoriented or even leave the body with permanent damage (Brite, 2010). Glenn Milikan was able to create a â€Å"light-weight optical device† that was able to be placed on the earlobe to monitor pilots oxygen levels while flying during World War II (Tremper, n.d). When Milikan developed this device he used Beer- Lambert’s law which believes that using light and wave length can determine that concentration of a solution (Tremper, n.d). In this case, this theory was able to revolutionize the pulse oximeter. This new technology was able to help give doctors and scientists the ability to look inside the body without making the person uncomfortable, or affect their performance in the pilot’s case. In 1964 a surgeon in San Francisco continued to de velop the pulse oximeter and then it started to be distributed by Hewlett Packard in the 1970’s. This pulse oximeter was the first one to be used in a hospital setting and was a large, bulky 35lbs piece of equipment. Not only was it large and bulky, it also cost about ten thousand dollars. (History of Pulse Oximetry, 2002).The pulse oximeter has come a long way over the years and has become crucial in the medical field. How the Pulse Oximeter Works When thinking about pulse oximetry, one may wonder how a pulse oximeter works. This technology allows the health care professionals to see how well someone is oxygenating their blood. The blood is oxygenated through the lungs and then the blood is pumped from the heart throughout the body to organs and tissues to provide the needed oxygenation (A Patients Guide to Heart, n.d.). The way the pulse oximeter works is it looks at how oxygenated the blood is. Blood that is holding onto more hemoglobin absorbs more of the light that is provided by the pulse oximeter and allows more red light to pass through. Blood that has less oxygen will not absorb as much, leading to a lower oxygen saturation percentage (Principles of Pulse Oximetry, 2002). Types of Pulse Oximeters Today’s society, pulse oximeters can come in all different shapes and sizes. In the hospital setting, they can be portable with just as big as a D battery. This type just slips on a finger or ear and then is turned on to have a reading of the person’s oxygen saturation and pulse rate. Another type that is common in a hospital setting is one that is hooked to a monitor in the room and is a piece of tape that can be wrapped around the finger to continuously monitor the oxygen situation. This type is great in an Intensive Care Unit or someone who needs to be monitored closely. Not only are pulse oximeters used in the health care facility, but there also used for personal use, especially for someone who already has compromised lungs and needs to be able to monitor their own oxygen saturation whenever they may feel short of breath or are experiencing other symptoms of low oxygenation. Pulse oximters are easy to obtain online or through a medical supply company. Online a port able pulse oximeter can range from twenty dollars to several hundreds of dollars depending on the brand and the other options that not only pertain to measuring oxygen saturation (How Much Does a Pulse, n.d.). Reasons to Monitor Oxygen Saturation Some of the reasons that oxygen saturation would be tested is for surgery, procedures that involve sedation, diseases such as COPD, anemia, lung cancer and anything that may compromise the effectiveness of the lungs that would prevent adequate oxygenation of the blood (Oximetry, n.d.).With the health care professionals being able to monitor someone’s oxygen saturation, they are able to intervene sooner and prevent further complications. Oxygen Saturation The normal range for a person’s oxygen saturation should be between 96% to 99% in someone who has no respiratory issues. For someone who has mild respiratory trouble, their range should be anywhere from 90% and above. When one’s oxygen level becomes less than 90 for an extended period of time, they need to seek medical attention to prevent further complications (Pulse oximeter readings, 2010). If someone is experiencing low oxygen saturation, some of the symptoms they could be experiencing are shortness of breath and cyanosis which means the skin may have a blue appearance due to the lack of oxygen rich blood (Veach, 2011). If someone is experiencing these symptoms, they should seek medical attention. Interventions for Low Oxygen Saturations If someone is suffering from inadequate oxygenation, there a few different ways to intervene. One way is to place an oxygen mask on the patient. This will allow extra oxygen to support the persons lungs in providing more oxygen and preventing them from working harder to breath (Bateman Leach, 1998). Also if the situation is not remedied, other inventions may include an invasive arterial blood gas, BIPAP/ CPAP, which will push air into the lungs and support the lungs. All these interventions are imitated based on pulse oximetry monitoring of a patient’s oxygen saturation. Conclusion Pulse oximetery has become a revolutionary change in medicine over the years. Now that health care professionals are able to monitor a patient’s oxygen saturation noninvasively at any given time, early intervention can be put in place such as supplemental oxygen to prevent complications or even death. With the invention of the pulse oximeter and the ability to monitor the oxygen saturation without being invasive to the person has become a great contribution. If pulse oximetery and the pulse oximeter were never invented, what would happen to people in the hospital? Would everyone have to be stuck just to find out a basic measurement every few hours? This invention, has allowed people to keep their comfort, while allowing others to have access to needed data to treat them properly. The pulse oximeter has changed the way hospitals and the health care professionals monitor oxygen saturation forever. Works Cited A patients guide to heart surgery. (n.d.). Retrieved from University of Southern California website: http://www.cts.usc.edu/ Arterial blood gas. (n.d.). Retrieved from http://almostadoctor.co.uk Bateman, N., Leach, R. (1998). Acute oxygen therapy. Retrieved from http://www.ncbi.nlm.nih.gov Brite, S. (2010). Importance of oxygen monitoring. Retrieved from http://ezinearticles.com/ History of pulse oximetry. (2002, September 10). Retrieved from Oximetry.org website: http://www.oximetry.org/ How much does a pulse oximeter cost. (n.d.). Retrieved January 19, 2014, from Google website: http://www.google.com Oximetry. (n.d.). Retrieved from http://www.hopkinsmedicine.org Principles of pulse oximetry technology. (2002, September 10). Retrieved from Oximetry.org website: http://www.oximetry.org Pulse oximetry. (n.d.). Retrieved from http://medical-dictionary.thefreedictionary.com Pulse oximeter readings. (2010). Retrieved from http://www.amperorassociates.co.uk Tremper, K. n.d. Pulse oximetry. Retrieved from http://journal.publications.chestnet.org Veach, M. (2011, March 10). What are effects of low blood oxygen levels?. Retrieved from www.livestrong.com

An Inspector Call :: English Literature

An Inspector Call Responsibility n being responsible; a moral obligation or duty; a charge or trust; a thing one is responsible for. Responsibility is very important in the play, because no body was actually officially fully blamed. So Priestley leaves it up to the audience to decide who is to blame, if anyone. If the so-called Eva Smith really existed, and if the inspector was really. Gerald:"That man wasn't a police officer." (Page 62) Birling:"There you are! Proof positive. The whole story's just a lot of moonshine" (Page 70) At the time Priestley wrote this book there was very large boundaries between the rich and the poor where huge. So he wrote this book on responsibility. So from what I know, I think the reason why Priestley used a rich family to base the play around is because wealthy people thought they were on a morally different plane. They felt were not accountable for anything, so Priestly made them vulnerable to show they were human and so had to conform to the same morals and ethics. Sheila: "he knows. Of course he knows. And I hate to think how much he knows that we don't know yet." (Page 26) This gives the play more power, knowing the rich are vulnerable, even though they have threatened and attempted to bribe the Inspector to get out of trouble. Birling: "How do you get on with our Chief Constable, Colonel Roberts? I see him fairly frequently. We play golf together" (Page 16) This extra punch is given because; at the time it was made the rich were still almost invulnerable, they could not be touched by a commoner, and yet in this play a complete stranger - who is obviously less affluent than them, practically demolishes their lives. The life-style of the poor in that era was extremely bad - they worked extortionate hours for low pay and lived I slums. This meant the poor never had a glimmer of happiness: Gerald: "she was desperately hard up and at that moment was actually hungry" (Page 36) The play is the tale of a rich family, that are accosted by a man claiming to be a police inspector. The family members have sometime bad to a woman two of them were called Eva Smith and Daisy Renton. Inspector Goole pulls all of these incidents together and bluffs his way through the family's questions until they believe that it was a singular girl. The family then move through a process of blaming each other for pushing this girl to commit suicide, and thinking that their lives and family name is ruined. Then the family discover that Mr Goole is in

A LIFETIME COMMITMENT TO PHYSICAL FITNESS :: Essays Papers

A LIFETIME COMMITMENT TO PHYSICAL FITNESS A lifetime commitment to physical fitness can no longer be considered a luxury. It is indeed a necessity. What could be worse than the sight of a physically bankrupt forty-year-old executive recovering from his first major heart attack? With the aid of modern technology and a little hard work, a motivated person can become physically fit and avoid this catastrophe. I firmly believe in the lifetime commitment to physical fitness, and practice it as well. Fitness will not only help you physically, but mentally and financially as well. Most Americans abide by what can be referred to as the law of beauty. If it looks good, it must be good. We need to erase this from our minds when dealing with physical fitness. More often than not, the people who get quick results for beauty are the ones who cut corners. Cutting corners can be very dangerous from a physical standpoint, and is not what the commitment to physical fitness is about. To name a few guilty parties, steroid abusers, anorexics, and bulemics are tops on the list. Although steroids provide big muscles quickly, and anorexia and bulimia provide a thin waist promptly, usually the party involved doesn't realize what's at stake. The long-term effects of theses habits are more severe than a body abuser may have ever imagined. Steroids may cause cancer, elephantitis, and internal organ damage. Side effects of anorexia and bulimia include loss of skin and tooth color, and internal organ damage as well. These paths are taken by those who cut corners and are surely not concerned with a lifetime commitment to anything. The commitment involves a combination of things, that done properly can greatly increase your health. Most importantly, you need to establish a proper diet for yourself. Sadly, most people do everything right but neglect their body nutritionally. The proper diet establishes a strong base for training. Next, you need to set up a workout routine that will combine cardiovascular training with strength and conditioning exercises. Most people avoid this because they feel they will have to put in three hours every day in a hot gym for the rest of their lives. In actuality, a program that provides these types of exercises will only take about 45 minutes every other day. Lastly, you need to motivate yourself to do this. If the sight of you recovering from a heart attack at 40 (because you were lazy) doesn't motivate you, then you're obviously content with where you are and needn't bother reading further.

Explain the Purpose of Hermeneutics

The primary need of Hermeneutics is to determine and understand the meaning of Biblical text. The purpose of Hermeneutics is to bridge the gap between our minds and the minds of the Biblical writers through a thorough knowledge of the original languages, ancient history and the comparison of Scripture with Scripture. Through Hermeneutics, Biblical Interpretation can be achieved in three ways; historically, the message and the doctrine. The Bible is totally authoritive and inspired by God, however is it propositional or not? To be propositional means that God reveals certain truths at which we respond in accepting these truths. These certain truths may be found in scripture, creeds and or the teachings of the church. Non-propositional approach emphasise God revealing himself at which we respond with faith being a personal belief in God, resulting in us developing specific ideas and or propositions about God. A non-propositional view believes the Bible is a source book of many different accounts of human response to the divine. In Hermeneutics, there are three, among many, significant schools of thought which we are principally concerned; fundamentalism, liberal approach, and traditional interpretations of Scripture. Fundamentalism was first used in the beginning of the 20th century, whose aim was to preserve what they saw as the ‘fundamentals’ of the Christian faith from being eroded by liberal thinking. The fundamentals included the following beliefs; the divinity of Jesus; meaning he was fully God, that God’s ultimate judgement and the existence of heaven and hell and the physical resurrection of Jesus, among others. Fundamentalists believed in the doctrine of plenary verbal inspiration, this is the understanding that, the Bible is the actual word of God to the extent that it was dictated by God, word for word, to the people who wrote it down. To the fundamentals, the Bible is seen as being ‘inspired’ or ‘breathed’ by God in a direct and ‘unmediated’ fashion, meaning the actual writers of the Bible are just conduits and God is the actual author as it is God’s words that they are included, and so God is the words of the writers. Fundamentalists would declare that their view of the Bible can be found in the words of the Bible itself. Similarly Fundamentalists may argue that the Bible itself makes a clear statement of its own dependability. Since the Bible is regarded as being entirely the work of God and that God is the author it is inerrant meaning it can never be changed, questioned or challenged, to do so means you’re challenging God himself. With this idea that the Bible goes without error goes beyond the concept that it is with theological error. Rather the belief of inerrancy includes freedom from geographical, historical and scientific error as well. The second school of interpretation is Liberalism. This grew out of the discussion amongst rationalism and authoritarianism. The Liberal system of Hermeneutics suggests that the modern mentality was to govern someone’s approach to scripture, such as, if anything was not in harmony with ‘educated’ morality, it was rejected, for example Biblical concepts such as hell, sin and depravity as they offend moral sensitivities, and could not believe that their God could punish them in such a way. The Liberal method of Hermeneutics allows the Bible to be open for criticism like any other scripture, for example, miracles are not always to be accepted as they are not of certain truths and are not scientific. Another approach the Liberal system suggest is that the scripture’s text itself could be rearranged, for instance in authoritive order the law comes first however it may be argued that shouldn’t it be ordered by the times in which they were written? The reason behind this approach is that the Liberal method rejects all forms of inspiration. For a Liberal interpreter of the Biblical, the concept of revelation is redefined to mean human insight into religious truth. One of the consequences of the liberal school of interpretation is that the content of doctrinal and theological are not binding, this results to the belief that religious experience is therefore fundamental and that theology is an afterthought. The Liberals believe that the writers of the Bible accommodated their recipients and hence the Bible is not binding on us. Non propositional theology is often favoured by liberal theologians because it places the emphasis on human experience and rationality. The third school of interpretation is Traditionalism. Traditionalists maintain that the Bible is full of truth, God is revealed within the Bible and that it is inspired by the Holy Spirit. One of the key characteristics of their approach to the Bible is its emphasis on the need to understand the nature of the different types of literature within the bible. However, traditionalists would not accept the fundamentalist’s notion of inerrancy as many would acknowledge that there are mistakes in the Bible. These are seen as a reflection of both the historical context in which they are written and the human fallibility f the authors. As with Liberals, traditionalists believe that some aspects of the Bible need to be reinterpreted for today. Traditionalists place a lot of emphasis on the process of exegesis. However, after establishing the intended meaning of the author the next step in the traditional approach is the question of how it should be applied to Christian today. However, whereas fundamentalists believe that the true meaning of a text should be clear to each reader; traditionalists believe that exegesis is more of a complex process. Another characteristic of the traditionalists is that they are open to a range of different forms of scholarship, for instance, open to forms of textual and historical analysis. However unlike the liberal approach such scholarship is generally used to support conservative positions. Unlike fundamentalists, traditional approaches appreciate both the human involvement in the authorship of Biblical books and the historical/literary process through which the books were developed. However, although they acknowledge this human and historical process they do see it also as inspired by God as they recognise that there is something distinct and authoritive about the canon of scripture. Hermeneutics is the science, as it is guided by rules, and the art, the application of these rules, of Biblical interpretation. The description of Hermeneutics as the ‘art of understanding’ comes from a 19th century theologian, Fredrich Schleiermacher. In interpretation, we approach a text, with either, some kind of prior understanding, prejudgement or a pre-conceived idea in order to read out of the text, known as exegesis. Or openly reading the text, to discover something about it which we would not of known before, known as eisegesis. Eisegesis, is most faithful to text, as you have no opinion on the text at hand, however this is also most confusing as it results in a variety of information. One major scholar, as mentioned, is theologian Friedrich Schleiermacher, a founder of modern Hermeneutics, which within his work Biblical teachings are emphasized. Schleiermacher was the first person to introduce a philosophical theory of interpretation, which is appropriate to the Bible along with other texts. He emphasized the affective or emotions as a source of religious experience which is ultimately different from the purely rational approach of philosophy. Schleiermacher also argued that what makes Christianity very special is the historical event of Jesus whose life was one of perfect God-consciousness. It is this which the early authors attempted to capture in their writings. Schleiermacher believed that as religious propositions can only be made known through language the role of Hermeneutics is to unlock the original experience. Using Kant, Schleiermacher argued that the mind seeks to organise different experiences, which can be seen in the different categories or styles of literature contained within the Bible. One of the purposes of hermeneutics for Schleiermacher is to therefore ensure that the right literary genre is applied to the text. Another major scholar along with Schleiermacher is Paul Ricoeur a great philosopher of the 20th century. Unlike Schleiermacher Ricoeur argued that the author is not important in interpretation of texts, only the reader as he develops a view of the world which is enriched and enhanced through his engagement with the text. Ricoeur established between semantic meaning, what the text says, that can me verifiable and the symbolic meaning, what the text means. It is this symbolic meaning which is the purpose of hermeneutics, as symbols go beyond language to the world itself and to human truths and human experience. Ricoeur argued that in modernity the message of symbols have been forgotten, so the hermeneutical task is to restore the original meanings to symbols. Hermeneutics is therefore the philosophy of finding meaning in life; language not only conveys meanings but Meaning of existence. The world itself, it can be argued, may be considered a text in which we can find the meaning; however the advantage of a written text is its existence which makes it independent from an author and his culture therefore allows us the freedom to question it but to also be questioned by it. However we do not need to believe in the world that the symbols of the text refer to, but we can participate as we have the imagination to do so. Therefore the goal of hermeneutics is the understanding.

Leader Styles Essay

Style Kimberly Burrow HCS 457 May 20, 2013 Dalynn Campbell Leadership Style This essay is on the different leadership style from a historical person of my choosing. The successful management styles of this person also the leadership styles. The score of my Leadership and Team Self-Management Assessment the class was asked to perform. The leadership styles and traits of my historical person. The traits that I can learn from my historical person and the traits and styles my historical person can learn from me. Historical person Leonard D. Schaeffer was a successful leader in Blue Cross of California. He was the president and CEO who helped orchestrate the transition into Wellpoint, which is the second largest publicly traded health care company in the United States. By 2004, Schaeffer built Wellpoint into a 19 billion dollar operation. Schaeffer oversaw the merger with Anthem Health Care. Schaeffer brought a wealth of public policy and experience and government knowledge to the board as senior adviser to Texas Pacific Group (TPG). He served as an Administrator of the United States Health Care Financing Administration, Centers for Medicare and Medicaid Services (Harvard Business School, n. d. ). Successful management style The management theory Schaeffer uses in 1986 when he was recruited for president and CEO at Blue Cross of California. Schaeffer was the visionary of making the company the 40 million dollars that he was informed the company should make that year he became president and CEO. He fired 3,000 employees, the CFO, and sold everything that was not nailed down. Schaeffer tarted HMOs in Blue Cross of California, his theory was, â€Å"if you look at Americans, they don’t know much about health policy, but they know a lot about the rights and privileges of consumers† (A conversation with Leonard Schaeffer p. 27). He went public with WellPoint, sold 20% to the public. That gave the company capital, acquisition capital, and stock. The company began to diversify risk, economic regions, differ ent regulators, and different opportunities. This style of management is in the influence of culture. Schaeffer stated † You need different management techniques at different times. If you look back on the history of our company, the first stage is the turnaround. You need top-down, autocratic, â€Å"Here’s what you are going to do. † â€Å"Why? † â€Å"Because I told you to do it. † Top-down, directed, tell people what to do. You don’t have to be right, you just have to keep moving (A conversation with Leonard Schaeffer p. 27). Successful leadership style The leadership theory Schaeffer used was the democratic leadership. With the motivation with internal drives and impulses. He made decisions, set goals, worked toward achievement, and informed task to be done. The autocratic leadership Schaeffer used had little trust in employees and systematically exclude them from decision making. His leadership behavior helped the organization achieve its objective. When individuals gets to the point he or she realizes they can not run a company alone that is participative management. They bring people in that add and create value. Autocratic style is occurs when leaders have meetings and members suggest things and the leader takes the best suggestions and uses it without members voting. Leaders should shifts from internal concerns to external concerns to ensure the company is running well and is providing consumers with the companies product. With external concerns the leaders should give up the day-to-day control. They may impact and control the company but they can not control the external environment (Schaeffer). The score of my Leadership and Team Self-Management Assessment My score for the leadership and team self-management assessment was 50. The score total explains that I have excellent team leadership skills. Leading a team, management needs to bring together diverse talent, define goals, arrange efforts, and manage the relationships between team members (McBride, 2012). The team leader with skills in authority to set directions, democratic leadership if the team is successful, and the ability to re-establish team relationships if there is an issue. A good leader can find the teams strengths and outline the purpose of the team. Each member is unique in his or her own way rather it is their age, race, their motivation, or his or her ethnicity that brings diversity to the team. A manager should listen to the members of a team and offer their thoughts to lead a positive discussion. Keeping up-to-date with training will help leaders or manager with teams on the projects of his or her organization. Leonard Schaeffer leadership styles and traits In Schaeffer’s early career his leadership style was â€Å"Autocratic Leadership. † He realized that autocracy is the most painful, least enjoyable, and has its place if in a turnaround situation (Schaeffer, 2002). After his autocratic leadership in turning around the company, he realized he had to change his leadership style. The company began to focus on creating innovative products and excellent customer service, along with any decision instead of no decision. His role to ensure the organizations long-term success when the company changed so he had to change. Schaeffer changed from autocratic leadership to participative leadership style. The participative leadership style at the company they set four or five clear goals for the team to meet and gave them free rein to meet those goal as long as they stayed on budget. He laid out specific strategies for each goal. Managers had to take responsibility for meeting these goals. Researcher Rinsis Likert from the University of Michigan explanation what â€Å"Participative Leadership Style† is, â€Å"requires that the CEO receive suf? cient information from employees to make important strategic decisions but that he or she leave the implementation of strategy up to the line managers† (as stated in the Leadership Journey). Schaeffer changed his style of leadership when the company could deliver on its promises to customers and investors. Schoeffer’s style changed to â€Å"The Reformer† that demonstrates what is possible. He has several meeting with people outside the company to discuss health care practices, policies, and government representatives. As reformer he is the point person for tough questions. During his leadership journey Schoeffer has created concrete goals, and has wore different leadership caps that alter the way he assess a business situation. Even though past leadership styles worked each new situation is different. He has learned to pay attention to the teams dedicated to fulfill the goals. The traits from Leonard Schaeffer I can learn Throughout the years Schaeffer has developed different traits on leadership and learned from the traits and advanced to better trait. The traits that I can learn from is the participative leadership style. The participative style is to set several goals and let the team work on the project as he or she wishes. The traits Leonard Schaeffer can learn from me I know that with each situation there is a different leadership style that can be used to completer the project. The traits that Schaeffer can learn from my leadership is empathy for those who work report to him. When leaders treat employees with empathy the team there tend to be a better influential in getting the team to take initiative. If there is bad behavior in the team a good leader knows how to guide the team. This essay is on the different leadership style that Leonard Schaeffer used throughout his career. He started with a company that was on the verge of bankrupt and turned the company around. Schaeffer management style was democratic in the beginning and at the end his style was autocratic of his career at Blue Cross of California. My score on the Leadership and Team Self-Management Assessment was a 50, which is an excellent team leadership skills. The skill of diversity in leading a team is good behavior skill. Schaeffers leadership style and traits started with autocratic leadership changed to participative leadership style and ended with Schaeffer’s style as the reformer. The trait I can learn from Schaeffer is participative style, and the style Schaeffer can learn from me is empathy. References Harvard Business School. (n. d. ). Great American Business Leaders Of The Twentieth Century. Retrieved from http://www. bs. edu/leadership/database/leaders/leonard_d_schaeffer. html McBride, S. (2012). Team Leadership Skills. Retrieved from http://www. themanagersguide. co. uk/team-leadership-skills. html Porter-O’Grady, T. ; Malloch, K. (2007). Managing for success in health care. St. Louis, Mo: Mosby, Elsevier. Shortell, D. S. (n. d. ). A Conversation with Leonard Schaeffer. Retrieved from http://s ph. berkeley. edu/pubs/magazine/mag_sp06/pdf/schaeffer. pdf Sullivan, E. J. ; Decker, P. J. (2009). Effective leadership and management in nursing. (7th ed. ). Upper Saddle River, NJ: Pearson Prentice Hall.

Case Analysis: Medical Center of Southern Indiana Essay

Introduction The Medical Center of Southern Indiana (MCSI) has had a turbulent tenure as a hospital since its inception in 1973. Unprofitable from the very beginning, MCSI has gone through multiple ownership changes, creating a distrusting atmosphere between Clark County, IN residents, the local medical community, and MCSI. The city of Charlestown purchased the hospital at the end of 1991 in the hopes of turning the facility into a profitable medical center offering key services to the community. An aggressive expansion strategy was developed by management contractor American MedTrust in 1992 and this led to an operating profit in 1998 of $480,545. This marked a turning point for MCSI, as it was the first year in a very long time that the hospital had turned a profit. As they look to the future, MCSI needs to determine if it should continue with the aggressive strategy of expanding services or slow its expansion pace and focus on providing excellent service within its current capacity and looking for ways to reduce cost and enhance revenues. Key Demographics and Facts Certain elements of the MCSI case are essential in determining the appropriate strategy to pursue in the future. The external community general hospital environment has not been thriving during this time period. Of the roughly 5,000 community hospitals in the United States in 1997, 22% had bed capacity of 50-99. From the year 1980 to 1997, the number of hospitals with 50-99 beds decreased by 24%. As a 96 bed facility, the national trend does not bode well for MCSI. When the hospital was purchased by the city of Charlestown, American MedTrust came in with its aggressive â€Å"revitalization initiatives† to help MCSI become profitable. Under American MedTrust’s leadership, MCSI spent more than $3 million from 1992 to 1998 to accomplish these aggressive strategies. Two key elements of those initiatives involved expanding the services offered and rebuilding relationships with insurance companies and the local medical community. As a full-service hospital, MCSI already offered a variety of medical services. Because of a consistently low census (occupancy rate around 45%), developing ways to attract new patients was vital. A new inpatient geropsychiatric unit, skilled nursing facility, and a home health agency were added to the mix when hospital executives determined that there was a need in the community for these services and that the competition was not offering these services. By 1998, all three new service lines were bringing in at least $1 million in gross revenue. Other key investments included the creation of an outpatient mall, purchasing new technology, and the creation of satellite specialty and primary care clinics. Finding and expanding sources of revenue was also a key feature in the aggressive strategic plan. MCSI knew that to enhance revenue, the hospital had to contract with managed care companies. Because of sour relationships between MCSI and the insurance companies, MCSI enlisted the help of the state legislature and the state insurance commissioner to pass the Any Willing Provider bill that required insurance companies to work with providers like MCSI and provide written explanations for any declinations of contracts. In 1994, MCSI had two managed care contracts; there were twenty-five managed care contracts in 1998. With 65% of its patient base on Medicare, it was essential for MCSI to increase these managed care contracts if the organiza tion hoped to expand their revenue stream. Because of the enhanced services offered, the number of full time equivalent employees also increased from 183 in 1994 to 270 in 1998. MCSI has benefited from a low 11% employee turnover and a lean organizational structure. Even with these systems in place however, the salary and wage expense has nearly tripled from $3.3 million in 1992 to $9.88 million in 1998. Of the 270 FTE employees, there are 75 active members of the medical staff. Gross revenue generated by physician was a bit lopsided in 1998 with 11 out of 75 physicians generating almost 75% of the gross revenue. As MCSI plans for the future, revenues generated by physician, by department, and the related salary expenses need to be carefully examined to determine the optimal mix of services provided to the Clark County community. The location and demographics of Clark County continue to provide challenges for MCSI and the creation of future strategic plans. Clark County is a rural  area with the majority of its population living in the southern half of the county, near the Indiana and Kentucky border. While Clark County does enjoy a low 2.7% unemployment rate, the average county household income was a middling $36, 726 in 1997. Only 11% of Clark County residents had earned a bachelor’s degree as of 1998, thus the probability of the average household income increasing by any great degree was small. 65% of the MCSI patient base in 1998 was a Medicare patient. MCSI is located in the north central section of Clark County. Its closest competitor is Clark Memorial Hospital in the southern half of the county. Clark Memorial has about 3 times the number of beds as MCSI and the majority of the county’s population lives closer to Clark Memorial. Louisville, KY is about 15 miles from MCSI. Any future expansion plans must include a close analysis of the population growth trends in the area and an analysis of the service mix offered by both competitors, Clark Memorial and the Louisville-area health systems. Both of these competitors are better positioned to capitalize on any growth trends in the area and have the financial resources to aggressively expand to meet these trends. Even though MCSI has posted an operating profit for the first time in many years, the majority of MCSI’s assets are tied up in receivables. The current ratio and days cash on hand are well below industry standards. With increasing salary expenses and various interest expenses increasing, investing in capital expenditures or investing large sums of money in new service lines might cause MCSI’s operating profits be negative. Recommendations The Medical Center of Southern Indiana should continue to grow and improve the service lines that are currently offered such as home health, skilled nursing, and geropsychiatric services. These services have been marginally profitable in the past for the facility. The home health agency has seen a tremendous growth increasing from $422,000 to $1.75 million in four years. Skilled nursing facility revenues have grown in four years from $1.07 to $4.7 million. In order to keep these existing service lines thriving, MSCI should plan moderate renovations that keep the facility up to date with current service lines. Renovations should be similar to the $300,000 remodeling that was done to the outpatient service mall and should include the purchase of medical supply equipment that will help MCSI stay up to date  with its competitors. Large capital expenditures should be avoided at this time. Additionally, MCSI should expand its marketing campaign to target the local populations and keep patients from the surrounding five counties from migrating into the Louisville area to receive care. This has been a problem for the facility in the past, and has led to losses in revenues. Another point of emphasis that should be addressed is the inclusion of the Ivy Tech College population and the Indiana University Southeast population. This population of students has yet to be targeted by the facility, and are a large source of potential revenue. The marketing strategy should also focus on the recruitment and retention of physicians. Recruitment has been an issue in the past and recruiting and retaining quality physicians is a key component to the success of a facility. Currently, a minority of physicians bring in a majority of the revenues. Having quality physicians that provide services that the community wants and needs will also help enhance revenues. Because so much of the patient population is on Medicare, these revenue enhancement strategies need to be complemented by cost saving strategies. MCSI has a bit more control over their expenses than it does over their revenue sources. After years of having a defender style of strategic plan, this aggressive prospector strategy has allowed MCSI to have the resources to better meet the needs of the community and find a way to be profitable. However, at this point, it would be best to take a step back and shift to analyzer mode before continuing in an aggressive manner. Data The Medical Center of Southern Indiana created a decision matrix to identify decision criteria in pursuing a solution going forward. MCSI choose to analyze physician partnership, its top service lines, expansion of market campaign, and expansion of the Ivy Tech population in order to decide whether or not it should continue its aggressive expansion campaign. Major criteria areas taken into account included market position, competition, potential profitability, and alignment with MCSI’s mission. As shown in Figure 1, it was recommended for MCSI to continue building physician partnership and enhancing its top three service lines (home health agency, skilled nursing facility, and geropsychiatric services). There was the  recommendation to possibly pursue expansion of its marketing campaign and Ivy Tech population. MCSI should slow down its aggressive expansion strategy of adding new services and consolidate gains from those presently in place. In doing so, MCSI would shift from a prospector to an analyzer. MCSI achieved its largest operating profit of $480,545 in 1998. Looking to continue aggressive expansion could potentially lower its operating profit going forward. Overexpansion of services may lead to a dilution in the quality of care. The hospital is already structured as lean to help control costs. With such a low operating profit, MCSI does not have the resources to continue their expansion. As an analyzer, MCSI will look to enhance its existing resources and wait to see what the competition does. Improvements can be made to MCSI’s top three services lines. Allocating resources for future renovations and purchases of equipment will help keep these areas successful and allow them to continue generating profit. These three service lines respond to the needs of the Medicare patient base. For physician partnership, MCSI must keep its physicians who represent a majority of gross revenue. There is a large disparity for both gross revenue brought in and patients seen amongst physicians. Keeping MCSI’s top physicians while also looking to recruit other good physicians can lead to an increased efficiency of patient care and a reduction of cost. Involving the physicians in issues central to care and day-to-day operations is needed for a high physician retention rate for MCSI. It is important to have physicians included in the processes because they are the ones caring for the patients. If MCSI has the available resources, it should pursue expanding its marketing campaign and look into expansion of the Ivy Tech population. The solution for MCSI to focus on its current service lines instead of continued aggressive expansion will require coordination amongst a wide-range of sections within the medical center. Kevin J. Miller, the President and Chief Executive Officer of MCSI is responsible for asserting leadership of the planning and implementation of this solution. He must be involved in the process to avoid disengagement within MCSI. It is critical for him to be a leader, but not take over the entire process. The next step would be defining and communicating the responsibilities and roles of the  organizational leaders in the various departments of the medical center through the Board of Directors and Board of Trustees. It is their role to provide oversight and then let the organization take control. Physician partnership through Independent Practice Association (IPA), home health agency, skilled nursing facility, and geropsychiatric services would involve those under the Physician Affiliates, Chief Nursing Officer, and Assistant Administrator of Specialty Services, respectively. Expansion of marketing campaign and Ivy Tech population would involve those under the Director of Human Resources and Director of Business Development. Those under the Chief Quality Officer are then responsible for insuring the facilities are up-to-date through renovations for these service lines. Those under the Chief Financial Officer would be responsible for keeping track of the records and looking at the profitability from services already in place. All of these areas of MCSI must work with each other through active communication. It is necessary to have strategic plan schedules in order for the solution to be successful. Starting with monitoring day-to-day activities, MCSI should complete a full strategic planning process every three years with annual updates on each of the areas in the decision matrix. MCSI must have the resources to provide for this solution. The solution identified by the decision matrix is responsible for MCSI’s ability to earn and increase annual profit. Collecting data in these areas in addition to monitoring the internal and external environment can allow for MCSI to evaluate effectiveness of consolidating gains from services already in place in the future. Current Status of the Medical Center of Southern Indiana The Medical Center of Southern Indiana became a subsidiary of Saint Catherine Healthcare LLC on May 1, 2006. Questions from the end of the Case: 1.Should MCSI slow down its aggressive expansion strategy of adding new services and consolidate the gains from those presently in place, or continue the aggressive expansion strategy of adding and investing in even more services? We feel that MCSI should not continue its aggressive expansion strategy. Rather, they should focus on continuing the upkeep of their current service lines that have been so profitable for them the past  four years (home health, skilled nursing facilities, and geropsychiatric services) Continuing to expand these existing services is what has allowed MCSI to grow and beat out competitors in some areas. Instead of focusing on expanding the service lines any further, money should be invested to keep existing facilities â€Å"top of the line†. 2.Should MCSI reassess present services and retrench those that are not yet breaking even? MCSI should definitely carefully consider all present services, especially those that are not yet breaking even. Certain service lines will never break even, but are required as part of the community hospital services. However, reducing or retrenching these services could possibly be the best strategy moving forward. 3.Should MCSI change its fiscal orientation and focus on cost reduction versus revenue enhancement? With 65% of the patient base on Medicare, revenue enhancement might not be guaranteed. A combination of cost minimization and revenue enhancement strategies through increasing the number of managed care contracts would be the best orientation for MCSI. 4.Should MCSI pursue a joint venture with physicians in limited partnerships? Yes, MCSI should pursue a joint venture with physicians in limited partnerships. In 1998, 4 of MCSI’s 75 physicians brought in 44% of the gross revenue and 11 physicians brought in almost 75% of the gross revenue, which was $39,679,356. It is critical to identify the top earning physicians and keep them at MCSI. Part of MCSI’s mission is to â€Å"increase physician recruitment, retention, and collaboration.† MCSI must continue to involve the physicians in issues central to quality and their day-to-day operations.