The Intelligent Civil Rights Activist By Frederick Douglass

The intelligent civil rights activist Frederick Douglass was born into slavery in Maryland on February 1818. His born given name, Frederick Augustus Washington Bailey, seemed to be a fairytale name to an unusual life because his father was a white planation owner who was most likely Douglass s first slave master, named Captain Anthony. Possibly it was Harriet Bailey who gave her son Frederick such a distinguished name wishing that his life would be superior than hers. His mother couldn’t imagine that her son s life would continue to be a foundation of awareness and motivation for all abolitionists. It would be hard to find anyone who symbolizes the Black History Month theme, like Frederick Douglass when he fled the terrors of slavery to relish a life of liberty and freedom, but his exceptional personal ambition to attain justice and freedom for slaves and all Africans led him to dedicate his life to the abolition of slavery and the crusade for civil rights. His outrageous orat ory skills and unexpected achievements shaped a legacy that leads his inspiration across the centuries, making Frederick Douglass a role model for the rest of eternity, especially to those who saw him as savior like figure. When it comes to slave history in America, Frederick Douglass should be the first name to pop into your head. One reason Douglass s story remains to prosper is that his life symbolizes the American dream of overcoming difficulties and reaching greatness. At a young age heShow MoreRelatedFrederick Douglass And The Fight For Women s Suffrage1357 Words   |  6 PagesFrederick Douglass was a major black-male voice in the fight for women’s suffrage. Douglass unlike many men believed that women too were people and deserved all of the rights a man was given. He believed this because black men were previously apart from the equality of all men, and they too should be apart in gaining this equality for all. Douglass, along with other strong willed women, Elizabeth Cady Stanton, Susan B. Anthony, Lucretia Mott, Sojourner Truth, among others, they became the forefrontRead MoreEssay about The Virtrues of Benjamin Franklin and Frederick Douglass543 Words   |  3 PagesThe Autobiography of Benjamin Franklin seem to prove to everyone how articulate, intelligent and sophisticated this man w as. He wrote about the trials he underwent to become the writer he is known as today. He even was so intelligent he sought out to publish in his autobiography what virtues would have you â€Å"arriving at the door of moral perfection† (90). He wanted to show everyone that becoming perfect wasnt as arduous as everyone had thought. Benjamin Franklin was true Renaissance Man born at aRead MoreBiography of Fredrick Douglass1294 Words   |  5 Pagesthe people that fought for equality. Fredrick Douglass arguably had the greatest impact on American society, especially African American society, in the nineteenth century. Douglass is credited as being an abolitionist, author, editor, and diplomat. He used literature, books, newspapers, and even speeches, to leave a long lasting mark on our society. Douglass advised presidents and lectured to thousands about different causes, including women’s rights. A cause he felt a strong connection with wasRead MoreFrederick Douglass : A Old Man At The Age Of 201654 Words   |  7 PagesFrederick Douglass, The History Frederick Douglass was one of the staples in African American history and was a well-educated anti-slavery activist that was passionate in African American’s freedom. At a young age, Douglass was thrust into the world of slavery but, nevertheless, was able to escape enslavement and become a powerful, anti-slavery and civil rights activist. Born Frederick Augustus Washington Bailey, the abolitionist who was able to finally become a free man at the age of 20, was aRead MoreThe Meaning Of Freedom940 Words   |  4 PagesDespite disagreements about rights given to black Americans after the Civil War, white Americans and black Americans agreed on the meaning of freedom during and after the Civil War to a moderate extent. However, there were many ambivalent feelings in the ways in which the two groups agreed and disagreed. Foremost, one must consider the meaning of freedom. Throughout the Civil War, the meaning of freedom, and the meaning of equality, kept changing. This can be seen through the passage of the thirteenthRead MoreThe New Land Of America Essay1619 Words   |  7 PagesThere were those that were for slavery and those that were against. These conflicting points of view were one of the reasons for the Civil War. There was the North who was the proponents for free people and there was the South that was unwilling to abolish slavery. Both the North and the South fought eventually leading to the North’s victory over the south; after the Civil War slavery officially abolished but the ideologies of slavery still lingered in America and with the people creating problems forRead MoreElizabeth Cady Stanton : Women s Rights1922 Words   |  8 Pagesof America by succeeding in her work to guarantee rights for women and slaves. Elizabeth Cady Stanton was a leader in the 19th century for women ’s activist and women’s suffrage leader. As an active American abolitionist, she gave many lectures and wrote books. Among those fighting for women’s rights, she was a primary leader. Though she was interested in women’s rights from many perspectives, Elizabeth realized that success hinged on women’s right to vote. Elizabeth often worked with Susan B. AnthonyRead MoreEssay Life and Work of Martin Luther King Jr.2061 Words   |  9 PagesMartin Luther King Jr. was a civil rights activist from the 1950’s to 1968 with a strong religious background. A strong advocator for all minorities, King did all in his power to end barriers of community; poverty, racism and militarism. The principle he focused more on, however, was racism. King defined racism as prejudice, apartheid, ethnic conflict, anti-Semitism, sexism, colonialism, homophobia, ageism, or discrimination against disabled groups and stereotypes. Later turning his efforts toRead MoreE ssay on Anna Julia Cooper2476 Words   |  10 Pagesdevelopments in African-American and Ameri can life during the century following emancipation. Like W.E.B. DuBois, Coopers life is framed by especially momentous years in U.S. history: the final years of slavery and the climactic years of the Civil Rights Movement of the 1960s. Coopers eclect ic and influential career mirrored the times. Although her life was privileged in relation to those of the majority of African-Americans, Cooper shared in the experiences of wrenching change, elevating promiseRead MoreOne Significant Change That Has Occurred in the World Between 1900 and 2005. Explain the Impact This Change Has Made on Our Lives and Why It Is an Important Change.163893 Words   |  656 PagesMichael Adas for the American Historical Association TEMPLE UNIVERSITY PRESS PHILADELPHIA Temple University Press 1601 North Broad Street Philadelphia, Pennsylvania 19122 www.temple.edu/tempress Copyright  © 2010 by Temple University All rights reserved Published 2010 Library of Congress Cataloging-in-Publication Data Essays on twentieth century history / edited by Michael Peter Adas for the American Historical Association. p. cm.—(Critical perspectives on the past) Includes bibliographical

Essay on Smoking In Public Places Should Be Banned

Smoking In Public Places Should Be Banned There should be rules enforced for smoking in public places. Smokers just do not know the negative influence they are spreading. A puff of cigarette can harm a smokers health. When I go to a restaurant I do not like to leave smelling like smoke. It is the same going to a garbage dump, and smelling like garbage. I am not a smoker, and I cannot stand having the stench of smoke on my clothes. The smell of smoke is not harmful, but secondhand smoke is. Smokers should not be able to smoke in the public vicinity. Smokers are spreading harmful chemicals into my lungs. Smokers should respect a non-smokers health. The risk of cigarette smoke is deadly to an human beings lungs. For a smoker to be†¦show more content†¦Those who tried their first cigarette did so under the influence. If the smokers were not around the public smoking, I believe we would see less people try their first cigarette. Someone who tried their first cigarette did so because they felt pressured when around all th e smokers. Smoking is addictive and smokers cannot go within an hour of not smoking a cigarette. If smokers did not have an area where they could smoke then less people would smoke, and influence another individual to smoke also. The effects of a smoker can damage someone’s health, habit, and life. The average person consumes smoke without even taking a puff of the cigarette. There are many risks when people smoke in front of a non-smoker’s face such as liver disease, cancer, and a bad colon. An average person breathes in smoke unconsciously, and secondhand smoke has become a major issue in America. Being in the presence of non-smoker can he harmful, and some people do not even realize it. Although some people are comfortable with a smoker blowing smoke in their face, what they do not realize is the consequence of their health. Smokers should be aware of how they affecting a person’s lungs. In conclusion, smokers should not smoke in public, or around non-smokers . Smokers do not care about the smoke that comes from their cigarette is affecting another life. Just because you are in a non-smoking section, it doesShow MoreRelatedShould Smoking Be Banned Public Places?941 Words   |  4 Pagesindividuals get older they try to cope with the stresses of everyday life by continuing to smoking. It makes them feel more relaxed and at ease. Whatever the reason is, it is a hard habit to break once one starts. For many smokers today it is getting hard to find a place to smoke. Comedians joke about going to another planet just to light up. Smoking should be banned in public places because smoking is just as bad for nonsmokers as it is for smokers. The effects of secondhand smoke orRead MoreShould Smoking Be Banned Public Places?864 Words   |  4 PagesSmoking is one of the practices which is considered highly dangerous to our health because it impacts the smoker and the people around them. There are approximately one billion smokers. Smoking is a big issue that the nonsmoker faces. For example, when the smokers smoke in public places like restaurants, universities and other public places it hurts the non-smoker. The non-smoker breathing the cigarette, marijuana or hookah smoke from the smoker do both of them are breathing toxic chemicals. In aRead MoreShould Smoking Be Banned Public Places?950 Words   |  4 Pagesday I walk in to public place with a friend right away we sat down to eat, we were having a conversation later we smell cigarette smoke in the air. I start coughing from the smell of smoke. I also notice a lot of customers who like eating dinner at a public place smoking cigarette. Smoking is a big health p roblem I feel it is not fair to take away cigarette for people who smoke in American who desire smoke cigarette. Even thought the same as the concession is able to be taking place on this topicRead MoreShould Smoking Be Banned Public Places?885 Words   |  4 Pagesday I walk into public place with a friend right away we sat down to eat, we were having a conversation later we smell cigarette smoke in the air. I start coughing from the smell of smoke. I also notice a lot of customers who like eating dinner at a public place smoking cigarette. Smoking is a big health problem I feel it is not fair to take away cigarette for people who smoke in American who desire smoke cigarette. Even thought the same as the concession is able to be taking place on this topicRead MoreSmoking in Public Places Should Be Banned Essay474 Words   |  2 PagesSmoking in Public Places Should Be Banned I feel very strongly that smoking in public places should be banned. I will list my reasons for my thinking below and explain why I think this. I cannot stand walking down a street behind someone who is smoking. Every time they exhale I then have to walk into a cloud of their smoke. My clothes smell, because they have been saturated with the smoke, it gets into my hair too. It also affects my health. It was found that sevenRead MoreSmoking Should be Banned in Public Places Essays1464 Words   |  6 PagesDuring the past few decades it has come to light that smoking kills. The federal government mandates that every pack of cigarettes carry a warning on it that smoking can lead to health problems including death. But the messages are rather clinical, for example: â€Å"Smoking Causes Lung Cancer, Heart Disease, Emphysema, and May Complicate Pregnancy.† Smoking is a danger to one’s own health but there is now evidence that smoking can affect others as well. Second hand smoke has been shown to cause cancerRead MoreEssay Smoking Should NOT Be Banned in Public Places730 Words   |  3 PagesSmoking Should Not Be Banned in Restaurants      Ã‚  Ã‚  Ã‚   In the perfect situation, smoking policy would be set by bar or restaurant owners, and customers would patronize the establishments with the policy they prefer. Customers would decide-without the governments help-if they want to avoid smoke-filled rooms or enter them. They might even choose to sit in an area sectioned off for smokers or non-smokers, but the ultimate issue is choice (Ruwart 1). When the government starts telling restaurantRead MoreEssay about Smoking In Public Places Should be Banned766 Words   |  4 Pages Do you mind people smoking around you in public places? According to the pro-smoking group Air Initiative 7 in 10 of you do. Do you think it is fair to discriminate against smokers, forcing them to stand outside and smoke? On the other hand is it fair that non-smokers should have to inhale second hand smoke which can dame their health? (Do you support this ban or do you oppose it?) Personally I oppose it as I believe that non-smokers shouldn†™t be subjected to a smoky environment on a night out.Read MoreNationwide Smoking Ban: Smoking Should be Banned in All Public Places899 Words   |  4 Pagesthe public about its dangers in 1972 (Schick Glantz, 2005). Do people knowingly have the right to put others’ health at risk? No, they do not. Exposure to cigarette smoke is a public health risk. Therefore, smoking should be banned in all public places, nationwide. There has been no attempt to impose a national smoking ban by the U.S. government. All current bans are in place because of state and local legislation. Americans for Nonsmokers’ Rights lists the various state and local smoking lawsRead MoreEssay about Smoking Should be Banned in All Public Places1133 Words   |  5 PagesSmoking Should be Banned in All Public Places Every year thousands of people die because of having cancer or other tobacco related illnesses due to smoking. Smoking is seen everywhere from our own television screens to even the world wide web; the internet. Tobacco is the substance that is in these cigarettes. These tobacco products are promoted through tobacco ads that are found almost everywhere you turn. They are in magazines, television screens, on the internet

Essay about Shakespeares Othello Jealousy Sexual in Nature Essay Example For Students

Essay about Shakespeares Othello: Jealousy Sexual in Nature Essay Othello: Jealousy Sexual in Nature  Ã‚        Ã‚   William Shakespeare’s tragedy Othello manifests a lot of activity motivated by a variety of passions, some good and others not so. Let’s analyze what many critics consider to be the dominant passion on the part of the protagonist’s most significant actions.    A. C. Bradley, in his book of literary criticism, Shakespearean Tragedy, describes the dominant motivating passion in Othello:    In the second place, there is no subject more exciting than sexual jealousy rising to the pitch of passion; and there can hardly be any spectacle at once so engrossing and so painful as that of a great nature suffering the torment of this passion, and driven by it to a crime which is also a hideous blunder. . . . But jealousy, and especially sexual jealousy, brings with it a sense of shame and humiliation. For this reason it is generally hidden; if we perceive it we ourselves are ashamed and turn our eyes away; and when it is not hidden it commonly stirs contempt as well as pity. Nor is this all. Such jealousy as Othello’s converts human nature into chaos, and liberates the beast in man; and it does this in relation to one of the most intense and also the most ideal of human feelings. (169)    H. S. Wilson in his book of literary criticism, On the Design of Shakespearean Tragedy, discusses the place of jealousy in the play:    Under the deft ministrations of Iago, we witness a remarkable transformation in him. The man of judgment, the commander â€Å"whom passion could not shake,† becomes a credulous fool, transported with jealous fury, so infatuated that while he demands evidence of Desdemona’s guilt he never sees anything save through Iago’s suggestion, so beguiled that he. . gic Heroes. New York: Barnes and Noble, Inc., 1970.    Ferguson, Francis. â€Å"Two Worldviews Echo Each Other.† Readings on The Tragedies. Ed. Clarice Swisher. San Diego: Greenhaven Press, 1996. Reprint from Shakespeare: The Pattern in His Carpet. N.p. : n.p., 1970.    Gardner, Helen. â€Å"Othello: A Tragedy of Beauty and Fortune.† Readings on The Tragedies. Ed. Clarice Swisher. San Diego: Greenhaven Press, 1996. Reprint from â€Å"The Noble Moor.† British Academy Lectures, no. 9, 1955.    Jorgensen, Paul A. William Shakespeare: The Tragedies. Boston: Twayne Publishers, 1985.    Shakespeare, William. Othello. In The Electric Shakespeare. Princeton University. 1996. http://www.eiu.edu/~multilit/studyabroad/othello/othello_all.html No line nos.      Wilson, H. S. On the Design of Shakespearean Tragedy. Canada: University of Toronto Press, 1957.

Modernization Poised Between History and Prophecy

Many personalities have contributed immensely towards the understanding of the concept of development. Economic development is one of the major pillars that are used in analysing the developmental status of a given nation or continent. A number of theories have been advanced to explain the general economic growth pattern.Advertising We will write a custom article sample on Modernization Poised Between History and Prophecy specifically for you for only $16.05 $11/page Learn More This paper seeks to provide a summary of the content of Chapter 6 in Gilbert Rist’s book, â€Å"The History of Development: From Western Origins to Global Faith†, written by Rostow. The essay will review Rostow’s theory of economic growth which he has categorised into five key stages. Furthermore, it will also highlight Rostow’s opinion on anti-communism versus Marxism without Marx. Finally, two more people, besides Rostow, with different perspectives o f economic growth will be mentioned; Francois Perroux and Dudley Seers. Rostow’s work, just like other theorists, was very influential on policy development especially in the early 1960s. His theory developed initially from lectures that he used to deliver at Cambridge University in 1958 (Rist 93). The focus of the work was on addressing the challenges that were faced then, including European economy, and the impact of the then decolonised states on economy and development. Rostow’s aim was to ensure that a clear pattern of progress was developed towards successful modernisation by the countries of the world. As a result, a philosophy of history focusing on Rostow’s stages of economic growth was developed (Rist 94). The five categories in which a given society can lie are: the traditional society, the preconditions for take-off, the take-off, the drive to maturity, and the age of high mass-consumption. His witty use of words to create ‘development’ jargon contributed to the success of the book. Firstly, according to Rostow, traditional society is a form of degree zero of history corresponding to a natural state of ‘underdevelopment’ (Rist 95). He claims that this stage is characterised by the negligence of modern technology by some countries or regions resulting in significantly low-level production compared to other industrialised societies. ‘Primitive’ societies are depicted as fighting against scarcity and thus their need to embrace modern technological means of production. Secondly, the stage of ‘preconditions of take-off’ is characterised by the spread of the idea of the possibility of economic prosperity which is a necessity for other desired societal conditions (Rist 96). This belief results in the disintegration of the traditional societies leading to the creation of a ‘modern culture’. Take-off is the third stage in Rostow’s economic growth model. This stage i s an interval between the old obstacles to steady progress and the eventual triumph (Rist 97). The take-off stage paves way for a steady economic growth in the society. The rise in commercialised production and extensive use of modern technology is a characteristic of the take-off stage.Advertising Looking for article on history? Let's see if we can help you! Get your first paper with 15% OFF Learn More Fourthly, there is the ‘drive to maturity’ stage which comes immediately after the end of take-off with a period of about forty years in between before maturity is attained. At this level, the society has completely overcome the challenges faced at the traditional level, thanks to the use of new technologies (Rist 97). The last stage of economic growth, in Rostow’s opinion, is ‘the stage of high mass-consumption’. Here, most of the gains from increased productivity are distributed to workers with an aim of increasing consumption (Rist 98 ). Europe and Japan, according to Rostow, entered this stage in the 1960s, a time during which the Soviet Union was striving to achieve. With the belief that growth has no limit, Rostow attempted to superficially offer an explanation of what happens after the ‘final stage’. He said that the future of a given society should fall within the trajectory defined by past experiences. Furthermore, Rostow, in his book, tries to demonstrate how the situation in USSR in the late 1950s ‘deviated’ from the general theory of modernization (Rist 99). He believes that the Soviet Union disintegrated when, instead of entering the stage of mass-consumption, it tried to impose communism on its people. USSR resorted to investing 20% in arms race, and creating a police state to threaten its citizens (Rist 100). Such a situation was only possible for workers in a capitalist state, according to Marx. The response by the nationalists, according to Rostow, helped create the present day Russia. He goes ahead to explain the concept of Marxism and economic growth. Rostow’s stages of economic growth were very popular during his time and were perceived as a prophetic book for the world. However, there were other personalities, though not very popular, who had different perspectives on economic growth and related issues. Francois Perroux exerted significant impact on theories of ‘development’ in France. He criticised classical and neo-classical economics on the basis of their mechanistic concepts of equilibrium which disregards the inequality between actors (Rist 104). He contributed a method of analysing real economics rather than the use of abstract models.Advertising We will write a custom article sample on Modernization Poised Between History and Prophecy specifically for you for only $16.05 $11/page Learn More Dudley Seers is another individual who made notable contribution in the field of economic development. He argued that the economics taught in Universities were based on the state of ‘developed’ countries and thus could not be applied in examining the economic growth of ‘underdeveloped’ countries. He strongly objected the universal validity of some economic claims (Rist 106). Seer’s critique was so tough to such an extent that the corporation f economists opted not to respond and avoided controversy (Rist 108). The essay has summarized Rostow’s five stages of economic growth as well the concept of anti-communism versus Marxism in relation to economic growth. It has also mentioned the theoretical contributions of two individuals during Rostow’s time. Work Cited Rist, G. The history of development: from western origins to global faith. Zed Books, 2002, Pp. 93-108. This article on Modernization Poised Between History and Prophecy was written and submitted by user Karla Gibson to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Goldman Sachs Essays

Goldman Sachs Essays Goldman Sachs Essay Goldman Sachs Essay The Goldman Abacus Fund: Ethics You Can Count On Or Ethics That Don’t Add Up Set Up Imagine a physician is on the golf course with one of his colleagues, who happens to be a cardiologist. Somewhere on the back nine the cardiologist begins to tell the physician about one of his patients, a 52 year old man with blood pressure of 145/99, who is 40 lbs. overweight, chain smokes, and enjoys 7 to 8 martinis a day. In spite of medications, in the words of the cardiologist, the patient is â€Å"a ticking time bomb. The first physician asks for his friend’s patient’s personal information, and after the golf game, goes to see his State farm agent, where he takes out a 1 million dollar life insurance policy on the ‘time bomb† guy. Are the actions of the physician ethical? Taking out such a policy is of course illegal, as the doctor does not have what is known as an insurable interest. But assuming the doctor took no steps to encourage th e man’s death, under the theory of rational egoism his actions would be justified. Furthermore, as macabre as the doctor might seem in betting on the death of another human being, Sternberg would consider his actions to be within the realm of ordinary decency. In 2007, amid historic economic development, a scenario emerged similar to the one just described. Although the players and events were quite different, the same philosophical question was raised: is it ethical to benefit from someone else’s demise. Living in a society riddled with envy and resentment, many onlookers thought so. Two parties in particular did not. They were John Paulson Co. , a hedge fund company established in 1994, and Goldman Sachs Co. a global investment banking and securities firm founded in 1869. The Events The story has its beginnings in 2005 when 49 year old Paulson, a man with a Wall Street reputation of mediocrity, hired an out of work analyst, Paolo Pellegrini. Pellegrini’s job was to crunch numbers on a befuddling trend which â€Å"everyone† seemed to be maki ng money on except Paulson (Zuckerman). After a year’s worth of late nights, Pellegrini determined that not only were housing prices soaring independently of interest rates and well beyond the pace of inflation, but that when the bubble did pop, it would send home prices down more than 40%. : When Pellegrini showed his charts and figures, Paulson couldn’t believe his eyes. Finally the housing market boom made sense to him. What also made sense to him was the market’s inevitable crash. Paulson had to find a way to make money on this prediction. Initially Paulson and Co. bought large lots of credit default swaps, which in effect were insurance policies against â€Å"risky† subprime mortgage debt (Zuckerman). Paulson was paying up to an 8% premium to guarantee against the default of mortgages he didn’t even own. Paulson and Co. spent months accumulating these mortgage insurance policies before deciding that the process was too slow. Paulson needed another way to short the housing market, preferably one with great leverage. A collateralized debt obligation seemed to be the perfect means to Paulson’s desired end. To understand how Paulson was able to make a $15 billion profit on his market prediction, a closer look at the 3 main financial instruments used is needed. Residential Mortgage Backed Securities (RMBS), Collateralized Debt Obligations, and Credit Default Swaps are all financial instruments used by both commercial and investment banks. RBMSs are bonds which are backed by a pool of residential mortgages. These bonds have different ratings based on the default risk of the varied prime and subprime mortgages. Even though the initiating bank may continue to service the loan to the homeowner, the mortgage itself will likely end up being sold again and again, often being pooled as an asset base to compose a RMBS. Collateralized Debt Obligations are securities collateralized by debt. Basically, a CDO is where a financial institution bundles a bunch of debt and sells it as a package to other financial institutions (Stephen D. Simpson). CDOs commonly take RMBSs a step further by packaging a series of them into one portfolio. The CDO collects cash from the pool of bonds it contains, and from this cash, distributes interest and principle payments to the CDO’s investors. If the underlying securities fail (as in the case of a defaulted subprime mortgage), the investors lose the money they put into the CDO. In the case of the Goldman Sachs Abacus deal, rather than a cash-based CDO, a synthetic CDO was packaged. A synthetic CDO differs from a CDO in that it does not own the underlying asset (portfolio of bonds). Instead it uses credit default swaps to mimic the risk associated with the assets (bonds) listed in the portfolio. A credit default swap is a means to achieve risk transfer from the bond holder to another party. When a bond holder buys a CDS, he is buying insurance against the bond defaulting, by paying a series of premiums to the CDS seller. In the event of default, the CDS seller must compensate the bond holder with the face value of the bond. Back in 2006, these vehicles were viewed as free money. Many economists and banking institutions believed the U. S. had reached a period of indefinite, sustained growth, meaning the likelihood of mortgage default, even at the subprime level, was low. The top banks, with presumably the most savvy, sophisticated money managers in the world, took advantage of this by heavily participating in these high leverage instruments. In 2005, senior traders from Bear Sterns to Goldman Sachs shared the sentiment that the housing market was solid and in no danger of collapse. By December of 2006 however, though not going public with its stance, Goldman decidedly turned bearish on the mortgage industry. Early in 2007, Paulson approach Goldman requesting that they structure a CDO with (allegedly) the inclusion of 123 hand-picked RBMSs which Paulson believed to be most likely to default (Quinn). He also asked Goldman to help him find another party who would take the other side of his desired market position. Goldman agreed, was paid $15m in fees by Paulson and Co. , and Abacus was born. Goldman assigned 29 year old a junior bond trader named Fabrice Tourre with managing and promoting Abacus to investors. Tourre approached IKB Deutsche Industriebank, who expressed interest only if a third party choose the RMBS. As such, Goldman enlisted ACA management to choose the RMBS which would compose Abacus. At this point, Tourre allegedly led ACA to believe that Paulson was going to invest $200M into Abacus. Thinking this, ACA also directly invested $42m into Abacus and took on the role of insuring $909M worth of credit default swaps; (unknown to ACA, Paulson was on the other side). With a third party (ACA) now selecting the RMBS, Tourre convinced IKB to invest $150M into Abacus. Ultimately these were the events which led the SEC to file charges against Goldman on April 16, 2010. The Outcome A year after Abacus was assembled and marketed, Paulson’s prediction came true. 99% of the CDO had been downgraded, rocketing the value of the credit default swaps he bought. John Paulson netted $1bn. n what Gregory Zuckerman of the Wall Street Journal would call â€Å"the perfect trade. † IKB lost nearly its entire investment of $150M. ACA Management lost $841M. When the dust settled, eyebrows were raised and eventually charges were filed. Goldman was charged with fraud in structuring and marketing of a CDO which was secretly intended to fail. The fraud charge alleged that Goldman allo wed Paulson to strongly influence ACA in selecting the RMBS which would make up Abacus. The charge also alleges that ACA was deceived to think that Paulson had an interest in the CDO’s success rather than failure. Paulson was not charged and has maintained that ACA â€Å"had sole authority over the selection of RMBS in the CDO (Quinn). The Facts ACA Management was both the portfolio selector and the largest investor to Abacus. Owned by one of the largest banks in Europe, ABN Amro, ACA management specialized in CDOs and portfolio selection. Put another way, they knew exactly what they were getting into, they just happened to be wrong. Paulson had been unsuccessfully â€Å"betting against† the housing markets since 2005. During 2006-2007 insurance against defaulting mortgages (CDS) became extremely cheap. During the period, many banks were selling CDS to collect what they saw as low risk insurance premiums. ACA was to collect $1,545,300 in premiums per year through insuring Abacus. Paulson’s role in Abacus was not made clear to investors, but the anonymity he maintained is both legal and commonplace on Wall Street. All the players at the table were among the most sophisticated banking institutions in the world, which could not be better equipped with experts to perform the due diligence of investigating a prospective investment. Ethical Analysis In a 2009 Rolling Stone article, Matt Taibbi accused Goldman Sachs of being â€Å"a great vampire squid wrapped around the face of humanity,† Goldman he states, was the cause of the housing bubble through creation and use of financial instruments such as CDOs and CDSs (TAIBBI). The dramatic description hardly instills an image of ethical behavior. But is it true? Taibbi has it backwards. The Housing and Community Development Acts of 1974, 1982, and 1987 had been making mortgages easier to obtain long before the 1994 invention of Credit Default Swaps, (although the first CDO was issued by Drexel Burnham Lambert in 1987) (Frej). It is because we live in a society where there exists too much envy and resentment that media figures such as Matt Taibbi point the finger at those who succeed, and scream â€Å"hey, that’s not fair! † When people defaulted on their home mortgages, it was not because of Paulson or anyone else making money. It was because of their own greed and desire. People acted like children giving in to the impulse to grab the â€Å"shiny object† i. e. large mortgage, when in fact it was their responsibility to perform due diligence and conclude whether or not such mortgages were financially feasible. Was it unethical for Goldman/Paulson to benefit by means of others’ demise? Just as in the opening example of the patient who was certain to die, so too were historical numbers of mortgages destined for foreclosure. And while wealth creation is not a zero sum game, equity trading often is; every buyer needs a seller. ACA management and IKB were trying to profit by knowingly taking risks. They lost. For Goldman and John Paulson, it was â€Å"just business. † There were no intentions beyond profit maximizing, nor did they act in any unfair or unethical way. Goldman and Paulson did their best to maximize the long term value for their investors in a business designed around risk. In the end it was Paulson and Company’s countless hours of research and study which led them to the decisions they made. Had anyone else done the same, they likely would have gained similar compensation. This would be in line with Sternberg’s principle of distributive justice. Conclusion There has been recent talk from the likes of Warren Buffet to Barack Obama about the evils of complex financial instruments. They say CDOs and CSOs should be banned or at least controlled with more regulation. This is a much too simple solution to the problem of financial responsibility. If CDOs and CSOs get banned, another instrument with the same potential effect (good or bad), will be right around the corner. Living in a period of record government hand-outs, it is no wonder people think everything either is free or obtainable with minimal effort i. e. mortgages. Financial responsibility must be taught at an early age, whether at home or at school. The path away from any future financial crisis will be seen when people have an understanding of money and make gains through distributive justice.

Why are Nursing Home Jobs Getting Tougher to Find

Why are Nursing Home Jobs Getting Tougher to Find There’s constant buzz about the shortage of healthcare providers and bustling job market as we enter an era in which people over the age of 65 will account for nearly 20 percent of the population by the year 2030, according to the Administration on Aging. Picturing a society full of nursing homes overflowing with white-haired seniors? Think again. Nursing homes have been steadily on the decline in this county for years, and there’s no indication of a reversal in sight. Declining along with them? Nursing home jobs. Let’s take a closer look at this phenomenon, and what it means for nurses and other nursing home professionals.The 411 on Nursing Home JobsNursing home and residential care facility jobs fell by a whopping 4,800 jobs this past March, continuing a trend in that sector. The majority of these jobs were in nursing homes - the sole sector that’s seen a decline over the past year.However, health care overall added 22,300 jobs last month, largely drive n by outpatient care options, according to the U.S. Bureau of Labor statistics. While jobs for nurses and physicians continued to experience growth, nursing homes positions remained the one stagnant area.Why the Decline?Today’s seniors want different things for their retirement, and the stigma of nursing homes weighs heavily upon them. Because people want care that’s closer to home and less â€Å"institutional† in feel, outpatient settings are experiencing significant growth. While this increases the demand for healthcare professionals in ambulatory roles, it decreases jobs for nursing home workers.It’s not exactly a surprise that the decline in nursing home jobs corresponds to other related declines, both in terms of nursing homes as well as older patients in nursing homes. Many healthcare professionals hoping to land nursing home jobs are finding themselves in an unexpected predicament: without job prospects in one of the most sought after sectors.This doesn’t mean they have to settle for the unemployment line, however. Instead, it may mean expanding their search parameters to different settings which offer similar care to older patients.The â€Å"New† Nursing HomePartly in response to demand from patients and partly due to the shrinking of Medicaid financing, many nursing homes are turning to a new model: Managed Care at Home programs. Also referred to as PACE (â€Å"Program of All-INclusive Care for the Elderly,†) this option includes many responsibilities that overlap with those in traditional nursing homes while allowing patients to stay at home. In short: long-term care no longer must take place in a nursing home; rather seniors can now gain access to 24-hour care at home. Many believe that patients can not only gain access to equally quality of care with these Managed Care at Home programs, but will also pay less. It’s no surprise, then, that these programs are expected to continue to grow.While n ursing homes are unlikely to ever disappear completely, competition for nursing home positions will grow steeper. Meanwhile, new career options will skyrocket thanks to a number of factors, including the increasing senior population, the influx of patients into the American healthcare system due to the Affordable Care Act, and the rise in managed care at home programs designed to meet financial concerns and patient needs alike. Trained and flexible healthcare workers will have plenty of options from which to choose.

Eastern Meditation Meets Christianity Essay Example | Topics and Well Written Essays - 2250 words

Eastern Meditation Meets Christianity - Essay Example This type of meditation is a practical way to achieve real peace of mind, and leads to a deeper wisdom and clearer understanding of the truth. Misconceptions: There are some common misconceptions about meditation in Western countries. Some people think that "meditation is not for them because they are Christians, or that meditation is about just sitting and thinking nothing." In fact, meditation is about reality-seeing things as they are. There are no beliefs to adopt which might conflict with one's religion. Although there are some differences between Christian and Eastern spiritual practice, both of them share many similarities in the practice of listening to the spirit, the method of prayer and meditation and the spiritual and mental changes these bring about. All religious traditions, not only Buddhism and Christianity have different processes, movements and transformations for seeking answers from spiritual sources. Each faith tradition has grown over so many centuries and has been practiced in different societies and cultures. There is a fundamental difference between Christianity and Buddhism. The Buddha teaches people to remain fully in the realm of human experience, but Christ offers us a hope outside ourselves. The hope of a Christian is to have faith in God and Jesus Christ, but not in man or the earthly life. One of the main goals of meditation is to learn by observing what is going on in our bodies, our feelings, our mind and our worlds. The continual process of meditation greatly enhances our understanding of things around us. However, Christians mainly focus on developing more faith and a better relationship with God and Jesus Christ through prayer, using this to communicate with God, and possibly receive a personal revelation from Him, described sometimes as the Spirit of the Lord. But if we look at how people participate in meditation and prayer, we can highlight the similarities between the Buddhist and Christian approaches to spiritual practices. Meditation can lead to spiritual communion with God through the Holy Spirit. President David O. McKay (date) from the Church of Jesus Christ of the Latter-Day Saints explains We pay too little attention to the value of meditation, a principle of devotion. Meditation is the language of the soul. It is defined as a form of private devotion, or spiritual exercise, consisting in deep, continued refection on some religious theme. Even Jesus Christ also meditated during the forty days of fasting; he communed with himself and his father, and contemplated upon the responsibility of his great mission. One result of this spiritual communion was such strength as enabled him to say to temper "...Get thee hence, Satan: for it is written, Thou shalt worship the Lord thy God, and him only salt thou serve." (Matthew 4:10.) What is Meditation: In Buddhism, meditation plays an important role in developing peace, compassion and awareness. Challenges and afflictions in life make the Kositjaroenkul 3 heart yearn for the a perfection of peace, a pure love from someone, and compassion flowing through our hearts. When beginning the process of meditation, a person will focus on clearing the minds from everything around them. It is a moment of peace, calmness and mindfulness. The next part of the

Microsoft Corporation as an Example of a Monopoly Assignment

Microsoft Corporation as an Example of a Monopoly - Assignment Example The author of the paper states that as a protagonist of monopoly championed this practice for cartels as they maintain that its existence leads to an increase in the number of research and development projects as they earn more profits. Although, the companies operate solely in the market and get the high return it does not invest the funds for research and development. Microsoft Corporation as an example of a monopoly has not shown considerable investment in the field of research and development as thought (Jones and Sufrin 573). On the contrary, as a result of obtaining patent rights companies that operate under monopoly, including Microsoft do not have any incentives to innovate other new varieties of products that specialize in the one. Because of these, many countries impose a limit on the number of years companies can hold to their patent of rights (Salanià © 188).  Microsoft’s research and development is mainly because of its competitors but once these competitors wh o operate server operating system market stops Microsoft Company will also no longer see the benefit of carrying out more research and development as it has already come up with a lock-in effect strategy on its customers. Through this strategy, Microsoft can effectively engage its customers in homogenous solutions made by Microsoft worldwide. It is, therefore, definite that monopoly companies do not wish to spend the large amounts of profits it accumulates in research and development. Without a doubt, these monopoly companies would be adamant to produce only those products that are conducive and acceptable to the consumer rather than being innovative and make new products for its customers.

The Effects on Cyberbullying Essay Example for Free

The Effects on Cyberbullying Essay Studies show that cyberbullying incidents have quadrupled in past five years (Ross). Cyberbullying has become a huge issue recently. Every time you turn on the news there is another bullying, or a suicide related to bullying, incident being reported. â€Å"Love is louder† has been a common phrase among celebrities and influential figures lately. They are trying to send out a message to their followers saying that bullying is not right and should not be tolerated. The growth of communication technologies is widening the way bully’s can torture their victims. The fact of the matter is, technology is not going anywhere, so we need to figure out a way to put an end to cyberbullies. Cyberbullying is becoming a major problem and we all need to do our parts in figuring out what can be done to stop cyberbullies in their tracks. Cyberbullies will continue to be a threat to today’s youth until we take preventive measures against them. Before putting a stop to cyberbullying we must understand why and how a cyberbully works. After researching and analyzing informative articles on the topic, this research paper aims to inform and answer questions such as: what a cyberbully is, how they work, whom they target, and how to stop them. By understanding how a cyberbully works we will be able to better protect youth populations as technology grows. Just about half of U. S. students are impacted by traditional bullying each school day (Ross). Cyberbullying is technology powered and as technology expands it is getting harder and harder to see and prevent bullying from happening. Bullying over the Internet makes it easy for the bully to get away with their destructive behavior without any consequences. The article, â€Å"What is Cyberbullying: Bullying Comes Home† states, â€Å"Bullying is not new but thanks to the Internet teens are now being bullied at home. Online harassment is a serious problem† (Hardcaslte). Although the Internet has opened many doors to new opportunities, it has unfortunately taken bullying to another level. As the article, â€Å"Cyber Bullying Facts† states, â€Å"as the number of households with Internet access approaches saturation and cell phone ownership expands to the 100 million mark, so do the ways kids bully each other† (Ross). Anything sent out into cyberspace is very difficult, sometimes impossible, to remove. Therefore, being cyberbullied can sometimes be much more severe than traditional bullying. Ann Frisen in he article, â€Å"Cyberbullying: A Growing Problem† states, â€Å"This type of bullying can be more serious than conventional bullying. At least with conventional bullying the victim is left alone on evenings and weekends† (ScienceDaily). What exactly is ‘cyberbulling’? The author of the article, â€Å"What is Cyberbullying: Bullying Comes Home† explains it as, â€Å"any harassment that occurs through the Internet† (Hardcastle). Cyber-bulling messages can be sent through text, e-mails, instant messaging, web pages, blogs, chat rooms, or any other information communication technologies. For example, Michigan’s assistant attorney general, who is a grown adult, has been harassing the University of Michigan’s openly gay student body president. Andrew Shirvell, assistant Michigan attorney general, created a blog in April of 2010 targeting Chris Armstrong, University of Michigan’s student body president. On this blog he has posted many rude, untrue, and unnecessary comments towards Chris Armstrong, along with distorted pictures. According to the article, â€Å"Assistant Michigan AG targets openly gay college student† the author states, â€Å"Shirvell has published blog posts that accuse Armstrong of engaging in ‘flagrant sexual promiscuity’ with another male member of the student government; sexually seducing and influencing ‘a previously conservative male student’ so much so that the student, according to Shirvell, ‘morphed into a proponent of the radical homosexual agenda’† (Steward). Mr. Shirvell is clearly a first-hand example of a cyber-bully and this article goes to show that it’s not just kids bullying each other in school anymore; it’s much bigger than that. There have been at least three teen suicides in September after experiencing homophobic cyber-bullying. Who are the main victims targeted by cyber-bullies? According to the article, â€Å"Cyber-bullying Facts† Middle school and High school girls are twice as likely as boys to display cyber-bullying behaviors in the form of email, text, and chat, and only 20% of cyber-bullying victims tell their parents about the incident (Ross). Cyber-bullies target students, coworkers, neighbors, and even friends. Lately, there have been many reports of suicides related to bullying. For example, the recent death of Tyler Clementi, a freshman at Rutgers University, is an extreme case of cyber-bullying. The article, â€Å"Rutgers student death: Has Digital Age made students callous† informs, â€Å"Mr. Clementi killed himself on September 22nd, 2010. According to prosecutors, a few days earlier his roommate, Dharun Ravi, and another student, Molley Wei, used a Web cam to secretly transmit images of a sexual encounter between Clementi and another man. They intended to do so again on September 21† (Khadaroo). With cyber-bullying a bully can pick on people with less risk of being caught. People who you would not see bullying someone in school don’t have a problem using the Internet to bully their victims because you can’t see their initial reaction. Bullying cannot only hurt the victim emotionally it can also cause them to have frequent headaches, indigestion and vomiting, loss of sleep, loss of appetite, paranoia, and suicide. In Tyler Clementi’s case he was so overwhelmed by what had been done to him that he jumped off of the George-Washington Bridge. It is important for college campuses to promote tolerance for differences, including homosexuality. From the article, â€Å"Rutgers student death: Has Digital Age made students callous† the author states, â€Å"We are tempted to think that social-media technology drove the behavior, but as a truly ethical matter, the behavior has to be and should be considered human-driven, not technology driven† (Foulkrod). Harrisburg University of Science and Technology in Pennsylvania recently blocked the use of social media for a week to prompt discussions about its role in everyday life. Nobody wants to see this happen again; therefore, we need to come up with a solution to the problem. Some observers of today’s youth and media culture believe that today’s media environment could be desensitizing young people to the hurtful effects of their actions. What can be done to prevent cyber-bullying? Parents can start by talking specifically about cyber-bullying and explain that is harmful and unacceptable behavior. Talk regularly with your child about on-line activities he or she is involved in, keep your home computer in easily viewable places, such as a family room or kitchen, and consider installing a filtering or blocking system (Ross). Also, you can â€Å"outline your expectations for responsible online behavior and clearly explain the consequences for inappropriate behavior† (Ross). The most important thing that can be done to stop a cyber-bully harassing you is to just not respond to the bully. Do not play into the bully’s games. Ignore the bully and tell a parent or teacher. While ignoring the bullying make sure to save all of the evidence so that if police need to be involved you will have it ready. In the article, â€Å"What is Cyberbullying: Bullying Comes Home† states, â€Å"Repeated or excessive harassment via email, forums or chat rooms is harassment and should involve the police. Threats of violence should also be reported to the police. Try to save all messages as evidence† (Hardcastle). Treat a cyber-bully like you would any other bully and they will lose their power. Another important way to prevent cyber-bullying attacks is if you see something going on don’t just be a bystander and let it happen, report it before anyone gets hurt. In conclusion, with the expansion of the Internet and social networking technologies cyber-bullying is becoming more common and more severe. The information presented in this research paper should give people a better understanding of what a cyber-bully is, how harmful they can really be, and how to prevent cyber-bullying from happening. This paper can be used to help victims realize they are not alone and should not give into a bully’s dangerous behaviors. This research paper is to inform society about what has been going on lately and how unacceptable and dangerous it is. Kids are killing themselves over photos, web posts, and videos posted by bullies using the Internet. Cyber-bullying is technology powered and will only get worse as technology becomes more widespread. Hopefully, this paper will help to inform today’s youth and parents. If you see any kind of bullying happening in front of you, stop it if possible, and then report it.

My Experience with Biology :: Personal Narrative Writing

My Experience with Biology To all who know me, they know how I can’t stand anything that is gross and slimy, or possibly get me in any way, shape, or form dirty. (I can’t stand to be dirty at all!) When I go to the doctors, I can’t even stand to see the nurses poke my arm with a long, cold, sharp needle, so they can get a blood sample. I can’t even stand to watch the shows on the Discovery channel where they are operating on any part of the human body and there is blood oozing from the open flesh of a human being. I find it very hard to swallow when I even get a glimpse of it on television. This has always been my feeling ever since I was little, but when I entered high school and took a College Prep Biology course my feelings on things that are gross and slimy changed quite a bit. In high school I took a Biology class as every high school student has to do. I felt a little smarter than some of the others, because I was not only taking Biology, but I was taking college prep Biology. The only drawback to the class was I was going to have to a lot of dissecting to do. Now, I know in Biology everyone had to dissect the traditional earthworms and frogs, which I can handle without any problems. The problem I encountered after I entered the Biology class was not the fact that I had to dissect worms and frogs, but I had to actually dissect a fetal pig. I was not looking forward to this part of the class; I was even considering transferring into the normal, calm Biology class every one of my sane friends had done, but it was too late to turn back now. I vividly remember my teacher passing out the syllabus of his course and talking in a very excited manner about the dissecting of the fetal pig. â€Å"Now class, I know the tradition is to just dissect earthworms and frogs, which we will do, but I am anxious to get to the dissection of the fetal pig section of the class.

Lady Liberty

It was 1885 in New York City. A little boy named Frederick Bloomsmen was hurrying down the streets to get to his master's shop. â€Å"Mayhap if I hurry, I'll get to see Lady Liberty,† Frederick thought. But as he ran along, he heard the town clock strike 6:00. â€Å"Oh no! I've got to make haste!† Frederick said desperately. Frederick had been delivering a saddle to the cart builder and had spent too long talking to the cart builder's son. Slam! The door to his master's store opened and shut as Frederick ran in. â€Å"Where have you been† Mr. Ezra (for that was Frederick's master's name) roared. â€Å"Delivering the saddle, sir, just as you asked me to,† Frederick answered timidly. â€Å"Well, you're late!† Mr. Ezra boomed. It was finally Saturday, Frederick's day off. He ran down the streets, as if racing the wind to see who could get to Lady Liberty skeleton first. Suddenly, he stopped still, for in a shop window sat the loveliest carved figure of Lady Liberty herself! His eyebrows slid up. He ran into the shop. â€Å"Excuse me, sir, how much money is that figure of Lady Liberty?† Frederick asked. â€Å"Well laddie, it's worth 15 cents but I'm lowering the price to 10 cents.† â€Å"Ten cents,† Frederick's head rang out as he ran home, â€Å"Where can I get such a fortune?† The next Monday, Frederick had almost forgotten the figurine. â€Å"Mr. Ezra, sir, may I please have my wages?† â€Å"All right, lad, but only because you haven't been sassin' me.† He opened the cash register and dropped a nickle into Frederick's outstretched palm. Halfway there! Frederick's head seemed to yell out with joy. Now he thought about how pretty that figure would look on Mama's mantle. † I'll give it to her for her next birthday,† he said aloud. â€Å"What was that, boy?† Mr. Ezra said. â€Å"Nothing,† Frederick said quickly, blushing bright red. The next morning after his chores were done, Frederick ran to the shop where the figure of Lady Liberty sat, to see if she was still there. Phew! There it was, looking as gorgeous as ever. The next week, Frederick got his wages. Another nickle! He finally had 10 cents. But as he walked down the roads he thought, â€Å"What if they need just 10 more cents to finish the Statue of Liberty?† And so silently he headed for the donation box. He listened to the cling as the coins dropped into the box. As the months flew by, Frederick's birthday was drawing nearer. One day, as he was running down the streets to see the Statue of Liberty, a shopkeeper (actually the very one that carried the figurine of Lady Liberty) called out from his shop. â€Å"Frederick! Wait! I've got a birthday present for you!† So Frederick stopped and went inside the shop. The shopkeeper handed him a small box. â€Å"Open it,† he urged. As Frederick did so, his eyebrows slid up as his mouth went down. For there, beautifully arranged in a pile of white tissue paper, sat the figurine of Lady Liberty! Frederick felt dizzy with happiness as he left the shop. Mama's birthday came just as quickly as Frederick's had. Frederick re-wrapped Mama's birthday present. When the time came for her to open it, her mouth dropped in surprise. â€Å"Why Frederick, where did you get this?† she asked in bewilderment, â€Å"It's beautiful! I absolutely love it! I'll put it on the mantle.† Frederick had to tell her the entire story, which was similar to the one I have just finished telling you now.

Adv & Disadvantages of Leadership Development Methods Essay

Professional qualifications that require refreshing will be supported if they are an essential criteria for the post| * Trust induction * Trust Essential Update training * Manual Handling * Professional re-registration training * PRINCE2, MSP, LEAN| * Provides an understanding of how the Trust works * Provides health and safety training * Sends out a clear message that professional registration is recognised, important and is supported| * Trust induction training tends to be very generic and does not necessarily relate to the job role * Training for re-registration is not always timely * Is dependent on funding * Cost implications of ensuring that the training budget can cover training| Elective Learning| Courses that are not part of the essential criteria for the post will be deemed to be elective and will be subject to the trust policy on supported learning| * Courses identified as part of the personal development plan * Influencing skills * Negotiating skills * MS Project/Other IT Skills * Meets specific needs for the individual * Can be delivered by others in the team or by a generic course * Ensures that leaders are given requisite skills| * Some generic courses do not cover specific requirements * Is dependent on funding being available| Work Assignments| Work assignments will be seen as an opportunity to help leaders develop specific competencies or practice key behaviours. * Specific goals will be set as part of personal development plans * Feedback on progress will be done either via formal appraisal or by 1:1 feedback with line managers| * Reiterates the message that lessons can always be learned * Gives leaders the growth opportunities to put theories and models into practice * Learning by doing| * Unless well managed there is a tendency to concentrate on ‘getting the job done’ * Opportunities are not always recognised or used to the full advantage| Special Assignments/Initiatives| Involvement in short-term assignments or initiatives either generated from within the team or as part of a project team| * Attendance at programme or project board meetings * Involvement in assignments/initiatives

aslkdj Essays

aslkdj Essays aslkdj Paper aslkdj Paper but the Great Rift Valley served as an interior passageway. The Mediterranean and Red seas provided trade routes to places in southwest Asia and present-day Europe. Resources Spur Trade Africa had a lot of minerals. Salt, gold, iron, and copper especially were valuable, so many continents wanted to trade with Africa. Transportation was generally hard ecause of the vast deserts, but there was the introduction of the camel, which were called the ships of the desert. Camel caravans created new trade networks, because they could carry heavy loads and go without water. The Sahara Dries Out Neolithic villages started to appear in the Sahara. Back then, (about 5500 B. C. ) the Sahara was a well watered area covered with rich grasslands and savanna. In about 2500 B. C. , the climate change slowly dried the Sahara. Desertification destroyed thousands of acres of cropland and pastureland. The desertification caused migration for people who were seeking new ways to maintain their life. The Bantu Migrations The migrations contributed to the diversity of Africa over thousands of years. The West African peoples spoke a variety of languages that came from one common language. This common language is called Bantu, and this migrations is called the Bantu migrations. As they migrated to Southern Africa, the Bantu speakers spread their skills in farming, ironworking, and domesticating animals. The existing cultures merged with those of the Bantu speakers. Nubia Rivals Egypt Trade led to contact between Nubia and Egypt, but also rivalry between who would control the trade in the region. By 1500 B. C. , Nubians were under the Egyptians control, and so the Nubians adapted many of the Egyptians traditions. They modeled palaces and pyramids based on the Egyptians and worshipped Egyptian gods. By 1100 B. C. , the power of the Egyptians were declining and Nubia gained independence. In about 730 B. C. , the Nubian king Piankhi conquered Egypt. However, in 670 B. C. , Nubia was invaded by the Assyrians from Southwest Asia. The superior iron weapons of these invaders were unmatchable, so the Nubian armies were forced to retreat from Egypt and they returned to the South. Meroe Masters Trade and Iron By 500 B. C. , Assyrian invaders forced Nubian rulers to move their capital from Napata to Meroe. Meroe eventually dominated both the Niles north-south trade route and animal skins, perfumes, and enslaved people to the Mediterranean world and Southwest Asia. Meroes location was one of the main reasons why it was a successful center for trade. The regions resources were also important. They were rich in iron ore. They had large quantities of timber, which fueled the smelting furnaces. This produced the iron tools and weaponry needed to feed, control, and defend the kingdom. Splendor and Decline Even though Nubia absorbed a lot of things from Egypt, Nubia later followed its own course. After gaining independence from Egypt, Nubians worshipped their own gods, including Apedemak, a lion-headed warrior god. The artistic styles reflected a greater sense of freedom that the Egyptians. The Nubians also created their own system of writing, but it is still yet to be deciphered. After the reign of 0th King Natakamani and Queen Amanitere in the first century A. D. , the golden age of Nubia dimmed, and finally was overwhelmed by King Ezanas armies from the kingdom of Axum to its outh. Phoenicians Build Carthage As Nubia was thriving along the Nile, Carthage was rising as a great North African power. Founded by Phoenician traders as a port on the Mediterranean coast, Carthage came to dominate western Mediterranean trade. From 800 B. C. to 146 B. C. , it forged an empire that stretched from present-day Tunisia, Algeria, and Morocco to southern Europe. Trade rivalries between Rome and Carthage eventually led to a series of conflicts called the Punic Wars. At the end of the Third Punic War, the Romans literally burned Carthage to the ground. Rome Rules North Africa After defeating Carthage, Rome gained control of the narrow strip of North Africa between the Mediterranean coast and the Sahara. There, they built roads, dams, aqueducts, and cities. The Romans developed and utilized North Africas farmlands as a granary, a region that produces much grain, to feed the Roman empire. North Africa provided soldiers for the Roman army, including Septimius Severus who would later become an emperor of Rome. Under Roman rule, Christianity spread to the cities of North Africa. In fact, St. Augustine, the most influential Christian thinker of the late Roman Empire, was born in present-day Algeria. From A. D. 395 to A. D. 430, Augustine was bishop of Hippo, a city located near the ruins of ancient Carthage. Islam Spreads Into Africa In the 690s, Muslim Arabs conquered and occupied the cities of North Africa. By the early 700s, the Berbers, a largely nomadic North African people, were conquered. Christianity was eventually replaced by Islam as the dominant religion of North Africa under Arab rule. Also, the Arabic replaced Latin as its language. Over time, Muslim traders from North Africa carried Islam to West Africa. Trading centers like that of the city of Gao developed over time throughout Africa as rade extended beyond village borders. Some of the medieval cities became wealthy international commercial centers. Between 800 and 1600, several powerful kingdoms won control of these prosperous cities and their trade. Trade in Sahara Salt was a highly prized item because it was important to human health, but very rare. The earliest development of trade in the region was tied to agriculture. Surplus Leads to Trade As the Sahara dried out, some Neolithic people migrated southward into the savanna, an area of grasslands that was good for farming. By A. D. 100, settled agricultural illages were expanding, especially along the Senegal and Niger rivers around Lake Chad. This expansion from farming villages to towns was due to the development of trade. Farming villages began to produce a surplus, more than they needed. They traded their surplus food for products from other villages. Gradually, a trade network linked the savanna to forest lands in the south and then funneled goods across the Sahara to civilizations along the Mediterranean and in Southwest Asia. From West Africa, caravans crossed the Sahara carrying leather goods, kola nuts, cotton cloth, and enslaved people. From North Africa, Arab and Berber merchants brought silk, metal, beads, and horses. Trading Gold for Salt Two products, gold and salt, dominated the Sahara trade. Gold was widely available in the area of present-day Ghana, Nigeria, and Senegal. In exchange, West Africans traded for an equally important commodity, or valuable product, salt. The Sahara had an abundance of salt. As farming and trade prospered, cities developed on the northern edges of the savanna. Soon strong monarchs arose, gained control of the most profitable trade routes, and built powerful kingdoms. Ghana: The Land of Gold The ancient kingdom of Ghana was located in the fertile, broad V made by the Niger and Senegal rivers in present-day Mali. From there, the king controlled gold-salt trade routes across West Africa. The two streams of trade met in the marketplaces of Ghana, where the king collected tolls on all goods entering or leaving his land. So great was the flow of gold that Arab writers called Ghana the land of gold Cities of Splendor The capital of Ghana was Kumbi Saleh, which was made up of two separate walled towns some six miles apart. The first town was dominated by the royal palace, which as surrounded by a complex of domed buildings. Here, in a court noted for its wealth and splendor, the king of Ghana presided over elaborate ceremonies. To his people, he was a godlike figure who administered Justice and kept order. In the second town of Kumbi Saleh, prosperous Muslim merchants from north of the Sahara merchants helped make Kumbi Saleh a bustling center of trade. Influence of Islam Muslim merchants brought their Muslim faiths with them to the kingdom of Ghana. The king hired them as counselors and officials, and gradually incorporated some of their military technology and ideas about government. Muslims also introduced their written language, coinage, and business methods. Although Islam spread slowly at first, in time, a few early dwellers adopted the religion. However, most of the Soninke people continued to follow their own traditional beliefs. About 1050, Almoravids, pious Muslims of North Africa, launched a campaign to take control of Ghanas trade routes. They eventually overwhelmed Ghana, but were unable to maintain control over their extended empire for long. In time, Ghana was swallowed up by a rising new power, the West African kingdom of Mali. The Rise of the Germanic Kingdoms The Germanic tribes that conquered parts of the Roman empire included the Goths, Vandals, Saxons, and Franks. Their culture was very different from that of the Romans. They were mostly farmers and herders so they had no cities or written laws. Instead, they lived in small communities governed by unwritten customs. Kings were elected by tribal councils. Warriors swore loyalty to the king in exchange for weapons and a share in the plunder taken from conquered people. Between 400 and 700, these Germanic tribes carved Western Europe into small kingdoms. The Franks Extend Their Power One of these kingdoms was that of the Franks. In 486, Clovis, king of the Franks, conquered the former Roman province of Gaul, which later became the kingdom of France. He ruled his new lands according to Frankish custom but preserved much of the Roman legacy. Clovis took an important step when he converted to Christianity, the religion of his subjects in Gaul. Not only did he earn their support, but he also gained a powerful ally in the pope, leader of the Christian Church of Rome. A Muslim Empire Threatens Europe As the Franks and other Germanic peoples carved up Europe, a new power was merging across the Mediterranean. The religion of Islam began in Arabia in the 600s. From there, Muslims, or believers in Islam, created a new civilization and built a huge and expanding empire. Leaders of the Church and of Christian lands from Palestine to North Africa to present-day Spain. When a Muslim army crossed into France, Charles Martel rallied Frankish warriors. At the battle of Tours in 732, Christian warriors triumphed. To them, the victory was a sign that God was on their side. Muslims advanced no farther into Western Europe, although they continued to ule most of what is now Spain. This nearby Muslim presence remained a source of anxiety to many European Christian leaders. In time, however, medieval Europeans would trade with Muslims, whose learning in many areas exceeded their own. In 768, the grandson of Charles Martel became king of the Franks. He briefly united Western Europe when he built an empire reaching across what is now France, Germany, and part of Italy. Also named Charles, he became known as Charlemagne, or Charles the Great. Charlemagne spent much of his 46-year reign fighting Muslims n Spain, Saxtons in the north, Avars and Slavs in the east, and Lombards in Italy. His conquests reunited much of the old western Roman empire. A New Emperor of the Romans In 799, Pope Leo Ill asked Charlemagne for help against rebellious nobles in Rome. The delegation that Charlemagne sent to Rome arrested Leo Alexander Greek Artistic Influence Alexanders conquests helped spread Greek culture throughout the empire. The influence of the assimilated culture is frequently found in art such as the sitting Buddha who is portrayed with flowing robes in the classical Greek style.

Apollo Hospital Essay Example

Apollo Hospital Essay Example Apollo Hospital Essay Apollo Hospital Essay The ‘‘wow’’ factor in service relies on constant innovation and demands continuous and sensitive focus on all issues that may affect the patient’s stay in a hospital. Every touch point of the hospital needs to be ‘‘alive’’ and the client must be able to feel the warmth offered. The culture of service is imperative in today’s scenario, where the differentiators could just be the manner in which services are offered. All the major players could replicate infrastructure within a short span of time, but not the service culture. Dr. Umapathy Panyala, Chief Executive Officer, Apollo Hospitals, Bangalore (March 2013) Dr. Panyala, CEO, Apollo Hospitals, Bangalore believed that in the future, the hospitality aspect of hospitals- the service provided to patients- would differentiate Apollo Hospitals from a large number of equally competent competitors in the growing Indian healthcare industry. He had set up a quality department at the Apollo Hospital in Bangalore, headed by Dr. Ananth Rao. Apart from being an expert on Metabolic Diseases and Biochemistry, Dr. Rao was also a Lean Six-Sigma black belt from the Indian Statistical Institute, Chennai. You can’t manage what you don’t measure- although this may sound cliched; I am still a firm believer of this philosophy and want to apply this, especially in the hospitality part of hospitals. Clinical benchmarking is a compulsory requirement and is taken care of; however, patients have so many other touch points in their stay at hospitals- the hospitality part. Some of the world-class hotels (such as the Ritz–Carlton) have performed benchmarking to standardise their hospitality offerings; at the same time, its employees are allowed to use their judgment to provide whatever delights the customer in every visit. 1 We want to internalise this in our culture as well. – Dr. Ananth Rao, Head–Quality Department, Apollo Hospital, Bangalore (March 2013) Dr. Rao also believed that the hospitality aspect would differentiate Apollo Hospitals from its competitors. Patient cure and care played very important roles in hospitals. Many patients were generally anxious when in a hospital and the sense of disservice increased their anxiety level very easily. Integrating healthcare and hospitality was essential for creating patient-focused care. Hospitality aspects included a smooth admission procedure, friendly medical and non-medical staff, comfortable furniture, varied choices on the food menu, attractive surroundings, recreational facilities, privacy, clear signposting, adequate provisions for visitors, and so on. 2 Important aspects of hospitality were managed by the nursing staff and other non-medical staff, which meant inherent variability of service owingto human interventions. Dr. Panyala and Dr. Rao wanted to measure the hospitality aspects at Apollo Hospitals and improve hospitality to create a world-class hospital. Dr. Rao and his team collected feedback every day from the patients and received a number of complaints, ranging from not having a TV remote to long response time on the part of nursing staff in attending to requests from patients. For Apollo Hospitals, it was important that the patients’ experience in the hospital was not compromised, since it could have a significant financial impact. Managing the hospitality elements of the hospital was as important as managing the clinical aspects. Apollo Hospitals had a stringent process in place to take care of clinical aspects. Dr. Rao wanted to improve the hospitality at Apollo Hospitals by reducing the 1 Hall, J. M. and Johnson, M. E. , When should a process be art, not science, Harvard Business Review, 2009, 1–9. Hepple, J. ,Kipps, M. and Thomson, J. , The concept of hospitality and an evaluation of its applicability to the experience of hospital patients, International Journal of Hospitality Management, 1990, 9(4),305–318. 2 Suhruta Kulkarni, Kripa Makhija and U Dinesh Kumar, Professor of Quantitative Methods and Information Systems, prepared this case for classroom discussion. V Sandeep assisted in data collection and analysis. This case is not intended to serve as an endorsement or source of primary data, or to show effective or inefficient handling of decision or business processes. Copyright  © 2013 by the Indian Institute of Management Bangalore. No part of the publication may be reproduced or transmitted in any form or by any means – electronic, mechanical, photocopying, recording, or otherwise (including internet) – without the permission of Indian Institute of Management Bangalore. This document is authorized for use only by NIKITA VAIDYA in Nutrition 346 taught by Carol Blindauer, at Dominican University Illinois from January 2015 to May 2015. For the exclusive use of N. VAIDYA, 2015. Apollo Hospitals: Differentiation through Hospitality Page 2 of 20 number of complaints from patients; he also wanted to achieve significant improvement in sigma levels measured through the Six Sigma performance scale. According to Dr. Ananth Rao: The immediate challenge is to understand the patients’ sentiment towards the hospitality provided and to design a process improvement plan that is affordable. Apollo takes feedback from patients every day and the quality department staff interviews many patients every week to understand their needs. Dr. Rao was aware that improving hospitality at Apollo Hospitals was going to be a continuous exercise in improvement; collecting feedback was one way of approaching the process of continuous improvement. He treated every complaint as a â€Å"defect† and planned to use lean Six Sigma concepts to eliminate defects. Implementing Six Sigma in all departments was likely to be a challenge since departments such as housekeeping faced high attrition rates. His immediate objective was to introduce a system where future complaints related to hospitality could be reduced. Also, how much importance should be given to hospitality by Apollo Hospital was one of the dilemmas faced by Dr Rao and he wanted to set a realistic target for Sigma level in hospitality at Apollo. APOLLO HOSPITALS: THE TRENDSETTER Dr. Prathap C. Reddy, founder of Apollo Hospital Enterprises Ltd. (AHEL) had accomplished a successful medical career in the United States. He returned to India in 1972 to contribute to the healthcare system in India. Health infrastructure in India was very poorly developed in the 1970s. In 1971, there were 3,862 hospitals and 12,180 dispensaries with a total of 348,6553 beds for a population of 548,159,6524- a ratio of 6. 36 beds per 10,000 people as against the ratio of 9 beds per 10,000 people in 2011. 5 India’s first National Health Policy was declared in 1983,6 almost 36 years after independence, which was an indication of the neglect faced by the health sector in the country since independence. Dr. Reddy had set up a good medical practice in India and used to send patients outside the country for specific treatments. However, in 1979, a young patient died as he could not arrange the money for treatment in the United States. Dr. Reddy then decided to provide the best of medical treatment from the West to patients in India with an emotional touch, calling it â€Å"High Tech with High Touch. † Apollo was a doctor-promoted enterprise- 10,000 Indian doctors, 4,700 U. S. -based doctors, and 60 doctors from the United Kingdom invested approximately USD 5,000 to start the venture. Dr. Reddy selected the best of the talent available to ensure the best possible service and care. He also ensured that a clear distinction was maintained between business management and clinical management. 7Apollo pioneered world-class healthcare in India, which was later emulated by several other hospitals. Apollo focused on technological excellence and garnered many firsts to its credit in the country. Apollo was the first not only in India but also in South Asia to launch Oncological Robotic Surgery, G4 Cyberknife Robotic Radiosurgery System, 320-slice computed tomography scanner, 64-slice positron emission tomography-computed scan system, full-field digital mammography with tomosynthesis, and many such technologies. 8 According to Dr. Rao, Apollo intended to carry forward technological excellence in hospitality to provide patients with the best cure and care services. Dr Preetha Reddy, Managing Director, Apollo Hospitals Enterprises Limited has been the pioneer and chief architect of the tender loving care –TLC ‘‘mantra’’, a pillar of the Apollo way, which is affectionately applied to every patient at Apollo Hospitals. â€Å"The patients and staff comprehend this language better,† she points out. The concept of TLC integrates service delivery with clinical outcomes resulting in exceptional patient experiences9,10. 3 Background Papers: Financing and Delivery of Healthcare Services in India, National Commission on Macroeconomics and Health, Ministry of Health and Family Welfare Government of India, 2005, p. 47. 4 Source: http://cyberjournalist. org. in/census/cenpop. html, accessed on March11, 2013. 5 Source: globalhealthfacts. org/data/topic/map. aspx? ind=78, accessed on March11, 2013. 6 Health Research Policy, Indian Council of Medical Research, New Delhi, (October 2007). 7 Mitra, M. , The Apollo Mission, Corporate Dossier with The Economic Times, June 1, 2012. 8 Apollo Investor Presentation, www. apollohospitals. com, accessed in January 2013. 9 N Amarnath, and D Ghosh, The Voyage to Excellence: The Ascent of 21 Women Leaders of India Inc. , Pustak Mahal, pp. 80-95. 10 apollohospitals. com/apollo_pdf/dr_preetha_reddy_managing_director. pdf This document is authorized for use only by NIKITA VAIDYA in Nutrition 346 taught by Carol Blindauer, at Dominican University Illinois from January 2015 to May 2015. For the exclusive use of N. VAIDYA, 2015. Apollo Hospitals: Differentiation through Hospitality Page 3 of 20. CLINICAL BENCHMARKING Apollo Hospitals had been using a clinical score card called [emailprotected] (Apollo Clinical Excellence), which measured and monitored clinical excellence among the group’s hospitals. [emailprotected] measured 25 clinical parameters (Exhibit 1) every month, which were benchmarked against global standards. [emailprotected] was launched on September18, 2008 and used across 32 hospitals of the group. Clinical benchmarks were published by various institutions and bodies such as Cleveland Clinic, Mayo Clinic, and National Healthcare Safety Network (NHSN), among others. Hospitals were grouped according to their bed strengths, locations, services offered, and so on. Group A hospitals had to report 25 parameters- 23 were common parameters, while two were location-specific. Group B and Group C hospitals had to report 15 and 10 parameters, respectively, out of which two were location-specific. [emailprotected] was an internally developed clinical scorecard, created by drawing upon the wealth of expertise available within Apollo. An audit committee at the corporate level was set up to validate the data, methodology, and definitions followed at each location. According to Sangita Reddy, Executive Director, Apollo Hospitals Group: We needed a yardstick like [emailprotected] that would pit us against international institutes like Cleveland Clinic, Mayo Clinic, and others, and position us on the global healthcare firmament for excellence in clinical quality. This also enables us to assess where we stand and where we need to 11 be, while pursuing excellence in clinical quality. Apart from this internal benchmarking exercise, seven of Apollo’s hospitals were accredited by the Joint Commission International (JCI); and it was the largest group in South Asia to be accredited by the JCI. The JCI was a U. S. -based accreditation body dedicated to improving healthcare quality and safety around the world and recognized as the gold standard for hospitals. Apollo was also accorded the Superbrand status by the Indian Consumer Superbrands Council, which recognised that the best practices were used in the brand. Apollo was the 12 only hospital that was accorded the Superbrand status in India. There were other accreditations that several Apollo hospitals had achieved (Exhibit 2). According to Dr. Panyala, Living the brand should be our focus in every initiative or activity we perform. Apollo Hospitals has been one of the consistent names among the Superbrands. The perceived value of a brand like Apollo Hospitals is set very high in the backdrop of the decades of service and excellence it has offered. Clients need to see and experience that value, and the gap between perceived value and obtained value must be zero at best or at a bare minimum. PATIENTS’ FEEDBACK AND REAL-TIME ACTION On average, a patient spends 80% of the time in hospital for the care part rather than the cure, and we need to focus on care to ensure speedy recovery and maximum satisfaction. Hospitality is critical in healthcare as the patient and his/her attendants are already distraught and highly anxious. Hospitality is driven mainly by human interventions- in nursing, housekeeping, as well as food and beverages. It is very difficult to ensure consistency of quality and hence, we want to benchmark these to ensure we provide the best quality of hospitality all the time. –Dr. Ananth Rao, Head–Quality Department, Apollo Hospital, Bangalore (December 2012) Dr. Rao believed that although clinical services formed the core of Apollo’s services and brand image, hospitality would support the brand, and in the long run, both would merge to form the Apollo brand (as shown in Exhibit 3). All services that did not require core clinical expertise were classified as hospitality services, including services such as billing, dietician service, food beverages, facility, housekeeping, nursing, facility, and overall operations. Each service was executed through a variety of processes. All the processes included in each service were identified and defined with regard to the procedure, timelines, required output, and so on. All the processes were mapped and the quality measures defined; these would be used as Sigma metrics. 11 12 Express Healthcare, (2010), http://healthcare. financialexpress. com/201009/strategy01. shtml Source: http://kolkata. apollohospitals. com/newsroom/271-apollo-hospitals-only-healthcare-super-brand-in-india. html This document is authorized for use only by NIKITA VAIDYA in Nutrition 346 taught by Carol Blindauer, at Dominican University Illinois from January 2015 to May 2015. For the exclusive use of N. VAIDYA, 2015. Apollo Hospitals: Differentiation through Hospitality Page 4 of 20 The Quality Department, established under the leadership of Dr. Rao, comprised two dedicated staff- Soumi Dutta and Nisha Maria- who looked after a variety of quality-related issues. Soumi and Nisha collected feedback from the patients between March 2011 and December 2012using the form presented in Exhibit 4. Patients were asked to rate each department on a scale of 1 to 10. Additionally, open-ended feedback such as patients’ comments, opinions, or suggestions was also collected. A schedule was developed for collecting feedback, which ensured that Soumi and Nisha collected feedback from a cross-section of patients; this also ensured that no biases crept into the feedback. The feedback collection methodology is shown in Exhibit 5. Soumi and Nisha were trained to collect frank, free-flowing feedback from the patients. If they received complaints while collecting feedback, they would immediately inform the department concerned and get the errors rectified, whenever possible; or ensure that the complaints were addressed to the patient’s satisfaction in real time. One of them recollected the following anecdote: A patient had complained that the door was not getting locked properly. I got in touch with the facility personnel and they worked on the door and the lock and fixed the problem- all in a matter of 25 minutes from the moment it was brought to my attention. The patient was satisfied with the immediate solution. However, we did not stop there. We teamed up with the facility team and checked every door of the hospital and repaired them if required. We wanted to ensure that such complaints were not repeated. The feedback collection process served multiple objectives such as collecting open-ended feedback from patients, resolving the issues in real time, and further auditing the actions of the service departments. The real-time escalation flowchart is shown in Exhibit 6. The feedback was saved on an MS Excel spread sheet, and stored on a monthly basis for easy retrieval. The data was then analyzed using various parameters and trends were plotted for each service. At Apollo, each service was related to a department; hence, it was easier to deal with the complaints and determine monthly improvements. FEEDBACK ANALYSIS From March 2011 to December 2012, 1,434 complaints were received from among the 1,38,600 in-patients treated during that period (approximately 1. 03%). A Pareto chart was plotted for these complaints (as shown in Exhibit 7). The housekeeping department received the maximum number of complaints, while the dietary service had the least number of complaints. The department-wise spread of complaints is shown in Exhibit 7. Some of the complaints were genuine concerns while some were related to minor discomfort. A few of the complaints were very specific, while some were generic. All of these were analyzed, which would enable the hospital to work towards reducing the overall number of complaints. Some of the sample complaints from each department are provided in Exhibit 8. According to Dr. Rao, Every complaint is an opportunity to improve. We keep looking for the smallest of the complaints, which will help us in improving our quality by several levels. Sometimes it is difficult to interpret the complaints and it is even more complex to develop strategies that will enable a better patient experience. The complete data set was analyzed to determine the word frequency count in the complaints section. The significant words with their frequencies are shown in Exhibit 9. This analysis was used to focus on specific tasks to ensure reduction in the number of complaints. For example, the most significant word was â€Å"time† and it was associated with delays in response time for the various services. The twenty-fourth most frequent word was â€Å"late,† which is again related to response time. Thus, the word frequency technique helped in focusing on problem areas. Based on the results of the analysis, benchmarks were set in consultation with the respective department for the response time of each service as shown in Exhibit 10. Apart from this quantitative analysis, another approach was used to analyze the feedback and obtain deeper insights for quality improvements. Dr. Rao used the term â€Å"defect-defective† from the Six Sigma methodology- one â€Å"defective† product/service could be caused by one or several â€Å"defects†. According to Dr. Rao, This document is authorized for use only by NIKITA VAIDYA in Nutrition 346 taught by Carol Blindauer, at Dominican University Illinois from January 2015 to May 2015. For the exclusive use of N. VAIDYA, 2015. Apollo Hospitals: Differentiation through Hospitality. Page 5 of 20 Any complaint from a patient is considered as a ‘‘defective’’. For example, consider the complaint: ‘‘Food is not served on time’’. This complaint may arise due to several reasons such as food not being prepared in time, food not being delivered on time, patient changing his/her order, etc. It is essential to identify these defects in order to eliminate the defective. On receiving a complaint from the patient, which was termed as â€Å"defective,† defects that led to the defective (complaint) were identified. Root-cause analysis was performed on all the processes of the identified defects. The processes were re-engineered to eliminate all the defects and a pilot study was conducted using the â€Å"Define Measure Analyse Improve Control† (DMAIC) cycle. Once the process was found acceptable, it was then deployed across locations. This was followed by routine and surprise audits to ensure that the process was being followed as defined to ensure customer satisfaction. The flowchart is shown in Exhibit 11a and b. All feedback related to medical services was escalated to the Medical Director’s office. In addition to this, the Quality Department at Apollo Bangalore developed a methodology called the Daily Point Average © or DPA ©. The ratings provided by patients for different departments were used to calculate the DPA ©. The departments had to improve these ratings over a period of time. The DPA © effectively captured the â€Å"mind of the customers† since the feedback was collected during the patients’ stay and not at the time of discharge. BENCHMARKING OF HOSPITALITY Hospitality required high human involvement and was very specific not only to local cultures but also to each individual. Since a patient had to stay in a hospital to get cured, hospitality automatically came into the picture. Hospitality in various hospitals was very different owing to the surroundings and differences in customer (patient) requirements. Patients did not walk into a hospital out of volition- they came in only because there was some problem. Under such conditions, the patient would be very agitated and any small thing that was out of place would become a big issue. Any kind of delay would be extremely intolerable and all the services had to be perfect all the time. Even in the hotel industry, hospitality was not standardized and benchmarks were not available. The Ritz–Carlton hotels, which are considered the gold standard in the hospitality industry, had used Six Sigma and benchmarking for their hospitality business. 13 Although benchmarks for clinical services were well-established, those for hospitality in hospitals were yet to be established. Apollo Bangalore developed benchmarks for several common complaints with three levels of services (as shown in Exhibit 10) by adopting the Kano model, which was developed by Noriaki Kano (Exhibit 12). This model was used across service industries and it helped in understanding customer expectations from any product or service. The threshold or the basic quality was the minimum requirement of the customer, which would be taken for granted even if it were present; however, if it were not there, the customer would complain about its absence. Normal or performance quality was something that the customer would expect because these were stated either by the product/service provider or by the customer as a requirement. This quality was observed by the customer and its absence would cause discomfort and disappointment. Exciting quality of the service or product was something that would not disappoint the customer; the presence of this would delight the customer, since the customer did not expect this quality. With time, the exciting quality would become performance quality and the performance quality would become a basic quality. Hence, the manufacturer or the service provider should always strive to provide new exciting qualities. Accordingly, several metrics were defined for benchmarking. For example, patients were informed that routine hospital-provided meals would be served within 10 to 20 minutes of every mealtime. This became a performance attribute. The threshold requirement of the patient would be that meals should be served within 20 minutes after placing the order. If the meal was served within 10 minutes, the patient would be delighted. However, if this customer (patient) were to come to the hospital again, she/he would expect the meal to be delivered within 10 minutes; this then would become a performance quality for her/him. 13 Source: qfdi. org/newsletters/six_sigma_qfd_hotel_application. html This document is authorized for use only by NIKITA VAIDYA in Nutrition 346 taught by Carol Blindauer, at Dominican University Illinois from January 2015 to May 2015. For the exclusive use of N. VAIDYA, 2015. Apollo Hospitals: Differentiation through Hospitality Page 6 of 20 FINANCIAL IMPLICATIONS The Quality Department required funding for data collection, analysis, and other related activities. These expenses affected the bottom line of the hospital. However, from March 2011 to December 2012, the number of re-visits increased, which implied that customer loyalty had increased. There was a 15% increase in the number of inpatients. Earlier, high discounts had been offered to dissatisfied patients owing to errors in service or poor quality of service. Gradually, there was a reduction in the discounts provided, which was a direct result of better satisfied patients. Additionally, owing to better processes, cost of quality (in terms of re-work and consumable wastage) had reduced, which helped in improving the bottom line. Further, owing to better service and higher levels of satisfaction, the patients acted as brand ambassadors for Apollo and provided word-of-mouth publicity, which improved the top line. Another example of decreased turnaround time and a resultant increase in profitability was seen in the Biochemistry Lab at the Apollo Bangalore Hospital. Dr. Rao headed this lab and he understood the patients’ requirement of receiving diagnostics reports in two hours instead of three. Dr. Rao and his team redesigned the process using 5S and lean concepts and managed to reach a turnaround time of two hours. Profits from the Biochemistry Lab nearly doubled after the decrease in turnaround time; while the cost of consumables increased by only 11%. Even though the Apollo team was trying to improve customer satisfaction, it still faced the question of how much satisfaction could be actually provided to the customer considering the room tariffs that were charged. As seen from Exhibit 13, the charges at the Apollo Bangalore Hospital ranged from USD 25 for a basic room to USD 120 for the Platinum Suite. A Ritz–Carlton basic room would cost USD 799 at Washington, U. S. A. and USD 165 at Kuala Lumpur, Malaysia (per person, per night). 14 The Apollo team might be able to provide high quality hospitality to patients in the Platinum Suites. However, the aspiration to provide the same service to patients in other rooms might not be financially feasible. The team was trying to build high levels of service for the Platinum Suites. However, the volumes in the other rooms were too high to be ignored, especially in the Indian context. Additionally, customer loyalty was extremely important to Apollo; in Dr. Panyala’s words, Customer loyalty and not mere retention is what we need to focus on. It is important to think ahead of the customer to identify issues that may compromise the experience. QUANTIFYING HOSPITALITY ACROSS APOLLO According to Dr. Rao, Once, we develop the benchmarks and the Sigma metrics, we want to replicate the system across all Apollo hospitals in the country. Each hospital will have to devise its own benchmark and Sigma metrics. However, we want to provide a framework for developing these and then measuring the outcomes. All the hospitals would then be compared by equalisation of scores and would benefit from one another’s learning†. After collecting the feedback and attempting to set benchmarks, Dr. Rao knew that he needed to go deeper and analyze each service through the complaints, set up relevant benchmarks, and target certain Sigma levels for each benchmark. He wondered whether they could collect and analyze data in a better manner. He wanted to arrive at the basis for the cost-benefit analysis of this activity. Looking at the complaints and the analysis, Dr. Rao had two major questions on his mind: 1. 2. 14 What strategy should be used to reduce the number of complaints and sustain the culture of excellence at Apollo Hospitals, Bangalore under the leadership of Dr. Panyala? Given the manual intensive processes involved in addressing the hospitality issues, what is a good Sigma level? Could Apollo set a target for Sigma level in hospitality? Source: www. ritzcarlton. com, accessed on April 15, 2013. This document is authorized for use only by NIKITA VAIDYA in Nutrition 346 taught by Carol Blindauer, at Dominican University Illinois from January 2015 to May 2015. For the exclusive use of N. VAIDYA, 2015. Apollo Hospitals: Differentiation through Hospitality Page 7 of 20 Exhibit 1 [emailprotected] parameters Sl. Parameter No. 1 Coronary artery bypass grafting (CABG) mortality rate. 2 Complication rate post coronary intervention(percutaneous transluminal coronary angioplasty; PTCA) 3 Average length of stay (ALOS) post angioplasty 4 Average length of stay (ALOS) post total hip replacement (THR) 5 Average length of stay (ALOS) post total knee replacement (TKR) 6 Complication rate for total knee replacement (TKR) 7 Average length of stay (ALOS) post renal transplant 8 Average turnaround per dialysis chair per day 9 Average length of stay (ALOS) post transurethral resection of the prostate(TURP) 10 Complication rate transurethral resection of the prostate(TURP) 11 Endoscopy complication rate. 12 Patient satisfaction with pain management 13 Door to thrombolysis time in ischemic stroke in emergency room (ER) 14 Percentage conversion of coronary angiographies to coronary artery bypass grafting (CABG) 15 Catheter-related blood stream infection (CR-BSI) 16 Ventilator associated pneumonia (VAP) 17 Catheter-related urinary tract infection (CR-UTI) 18 Average length of stay (ALOS) in hospital 19 Average length of stay (ALOS) in intensive care unit (ICU) 20 Door to CT time in stroke cases in emergency room (ER) 21 Surgical site infection (SSI – Clean wound) 22 Medication errors. 23 Average length of stay (ALOS) post modified radical mastectomy (MRM) 24 Average length of stay (ALOS) post microdisectomy 25 Average urea reduction ratio* 26 Percentage of patients achieving/maintaining haemoglobin level of 11gram or higher after 3 months of dialysis in end stage renal disease (ESRD) *Optional This document is authorized for use only by NIKITA VAIDYA in Nutrition 346 taught by Carol Blindauer, at Dominican University Illinois from January 2015 to May 2015. For the exclusive use of N. VAIDYA, 2015. Apollo Hospitals: Differentiation through Hospitality. Page 8 of 20 Exhibit 2 Accreditation of Apollo Hospitals Accreditation Joint Commission International (JCI) Delhi, Apollo Hospital Location Chennai, Hyderabad, Ludhiana, Bangalore, Kolkata, Dhaka National Accreditation Board for Hospitals Madurai, Chennai Healthcare Providers (NABH) National Accreditation Board for Laboratories (NABL) Chennai ISO 9002 Chennai Source: Apollo Investor Presentation (retrieved from www. apollohospitals. com in January 2013) Exhibit 3 Apollo Brand–Clinical and Hospitality Services Core Clinical Services Hospitality Source: Interview with Dr. Ananth Rao. This document is authorized for use only by NIKITA VAIDYA in Nutrition 346 taught by Carol Blindauer, at Dominican University Illinois from January 2015 to May 2015. For the exclusive use of N. VAIDYA, 2015. Apollo Hospitals: Differentiation through Hospitality Page 9 of 20 Exhibit 4 Feedback Form YOUR FEEDBACK Thank you for choosing Apollo Hospitals for your healthcare needs. As a quality improvement initiative, we are looking for improvements in parameters towards ‘‘Service Excellence’’ of our hospital. Please provide a few minutes of your valuable time for a personal interaction. How satisfied are you with your experience and the services provided by our hospital on a scale of 1 to 10? 1. MEDICAL SERVICES 1 2 3 4 5 6 Poor 2. NURSING SERVICES 1 2 3 7 8 Good 4 5 6 3. OPERATIONS ADMINISTRATION 1 2 3 8 5 6 7 1 2 3 1 2 4 3 5 6 7 1 2 3 10 Excellent 8 9 10 Good 4 5 6 Poor 6. FACILITY MAINTENANCE 9 Good Poor 5. HOUSEKEEPING SERVICES 10 Excellent 8 Poor 4. FOOD BEVERAGES 9 Good 4 7 Excellent 8 9 Good 4 Poor 5 6 10 Excellent 7 Poor 9 7 10 Excellent 8 Good 9 10 Excellent COMMENTS (OVERALL): Patient Name (Optional): UHID: Date of Admission: Room No: Signature: Date: This document is authorized for use only by NIKITA VAIDYA in Nutrition 346 taught by Carol Blindauer, at Dominican University Illinois from January 2015 to May 2015. For the exclusive use of N. VAIDYA, 2015. Apollo Hospitals: Differentiation through Hospitality Page 10 of 20 Exhibit 5 Feedback collection methodology A Typical Process Map: DPA Daily Data Collection Method 1:00pm–2:30pm Data consolidated; DPA Score developed* 11:00am–1:00pm Survey conducted Point of Data Colle ction Score given to IT Dept. disseminated to individual stakeholders via.