Research Paper for Meyers Briggs Essay

According to the Myers Briggs Type Indicator, I am classified as an ESFJ—Extraverted, Sensing, Feeling, and Judging. I scored 56% on extravert—being outgoing, loud, non-secretive. I prefer to sense things rather than trusting my intuition by only 12%. I scored highest on the feeling over thinking category with 62% towards feeling. There was only an 11% difference between judging vs. perceiving. â€Å"Guardians of birthdays, holidays and celebrations, ESFJs are generous entertainers. They enjoy and joyfully observe traditions and are liberal in giving, especially where custom prescribes. All else being equal, ESFJs enjoy being in charge. They see problems clearly and delegate easily, work hard and play with zest. ESFJs, as do most SJs, bear strong allegiance to rights of seniority. They willingly provide service (which embodies life’s meaning) and expect the same from others.† (Joe Butt, Extraverted Sensing Feeling Judging). I first heard about the test abo ut a year ago when my sister had to take it for her work, so I had a decent guess of what my results would be, if I ever got the chance to take the test. I pegged myself pretty well. The only thing that really did surprise me though, were the numbers of how strong/weak I was in each field. After finishing the test, I reviewed the article about the most common careers for ESFJs. It states; â€Å"ESFJs often find themselves in occupations that either involve a lot of direct interaction with other people (e.g. clients, other staff members) or involve responsibility for critical tasks (e.g. require thorough attention or may have serious consequences), or both† (Career Choices For Your Life). Ever since I was little I have wanted to study zoology in college. The description of an ESFJ’s career is somewhat accurate to my dream career of being a zoologist. I will not have direct interaction with people as much as I will with animals. One of the responsibilities of a zoologist is to assess the dietary needs of the animals—planning what a tiger eats for dinner is a critical task that could very well have serious and even fatal consequences. The results of my test fueled my drive to master zoology throughout my college career. These types of tests are always very interesting to me, I love learning new things about myself, and how I process information. The combined knowledge of the results of every test—personality, learning style, etc.—will help me to become more successful in life. Also, knowing how I learn and process information helps me understand that other people mightlearn differently than I do. Being able to comprehend my learning and personality styles at such an early age will give me more time to learn ways to teach, understand, and work with others who have a different style than I do. One of the most interesting things I learned by taking this test, was finding out the famous people who were ESFJs too, I had no clue that Martin Luther King and Eleanor Roosevelt were ESFJs! Knowing that these inspirational people understood things the same way that I do enlightens me to know that I too can be as big of an inspiration as they were. Works Cited Butt, Joe. â€Å"Extraverted Sensing Feeling Judging.† 16 October 2009. typelogic.com. Article. 7 August 2013. â€Å"Career Choices For You.† n.d. www.humanmetrics.com. Article. 7 August 2013.

Trade Issues Between Developed and Developing Nations

Trade Problems 1 Trade Issues between Developed and Developing Nations Friday, January 22, 2010 Trade Problems 2 There are trade problems that exist for a less developed nation when trading with a more developed nation. These trade problems can prevent the less developed nations from maximizing possible gains from international trade. Some of these problems are temporary and resolved in time, while others are more stubborn and unable to be resolved. I will discuss the type of issues developing nations come across when trading with developed nations. Developing countries participating in trade lack an organized and strong monetary policy. Developing nations have problems forecasting money demand. Central banks have problems keeping records for managing monetary policy because the banks are not independent of the government. Some developing countries adopt policies such as dollarization, which allows for financial stability and lower inflation. Inventory problems in developing nations are another issue. In developing countries, inventory may be agricultural products instead of industrial products. Most of the inventory problems have to do with the food security and livelihood of the people. Developing nations have to stabilize food prices and production. They also have to balance the domestic and imported supply of agricultural products. In Mexico, pollution has increased since NAFTA was signed into law and trade between the U. S. and Mexico began. Despite its governments initial attention to Trade Problems 3 environmental issues associated with economic growth, the government did not follow through on its intentions to take care of the environment. In 1994, â€Å"real spending on environmental protection†¦declined 45%† (Gallagher, 2004). Further, inspections fell by â€Å"45% over the same period† (Gallagher, 2004). Ten years later, in 2004, there is nothing to suggest that pollution has decreased. If Mexico does not act on protecting its environment, further â€Å"environmental degradation† will continue. With Mexico’s comparative advantage of â€Å"an abundance of unskilled labor†, most firms will stay close to their â€Å"production markets† and pay the costs of environmental regulation, which are small, compared to relocating their businesses elsewhere (Gallagher, 2004). Knowing implementing regulations and enforcing them will not jeopardize â€Å"direct foreign investment† is one of the most important reasons why Mexico can and should reduce pollution and other â€Å"environmental degradation† within its borders (Gallagher, 2004). Trade Problems 4 References Bigman, D, (1986, February). The Journal of the Operational Research Society, Research on Inventory Problems in Developing Countries. Retrieved Friday, January 22, 2010 from http://www. jstor. org/pss/2582717 Gallagher, K (2004, September). Free Trade and the Environment: Mexico, NAFTA, and Beyond. Retrieved Friday, January 22, 2010 from http://ase. tufts. edu/gdae/Pubs/rp/NAFTAEnviroKGAmerProgSep04. pdf Wikipedia, (2010, January). Monetary Policy, Developing Countries. Retrieved Friday, January 22, 2010 from http://en. wikipedia. org/wiki/Monetary_policy

“August Houseplant”: A Commentary Essay

‘August Houseplant’ details the encounter of a beautiful and wild philodendron by the protagonist in his backyard. Astounded by the plant’s beauty and wilderness, the protagonist establishes an emotional connection with the plant and contemplates bringing it into his home to protect it from the autumn cold. The narrative perspective and concrete language of the August Houseplant serves to present his themes as experiences associated with society, resulting in highly original and symbolic body of work charged with semantic associations that must be intuitively comprehended by the reader. The first aspect a reader notices about â€Å"August Houseplant† is its irregular structure. August Houseplant is a ‘concrete poem’, in which its poetic structure is used to represent the structural pattern of a philodendron plant. To achieve this irregular structure Levertov generously uses enjambment and caesuras. The purpose of a scattered structure could also be argued to be a rebellion against the neat structure of a regular poem, thus making irregularity an equivalent to the plant’s wilderness. Through the poet’s diction, use of stylistic devices such as personification, enjambment, structure, and the use of vivid sensory imagery, the poet beautifully depicts the wilderness of the philodendron plant and suggests that the intention of forcefully domesticating the wild would only prove to be naà ¯Ã‚ ¿Ã‚ ½ve and futile, (even if the intention were good), as it is unnatural to displace the wild of its natural environment. We are first exposed to the plant’s beauty and wilderness in the opening stanza in which the author anxiously questions what may be lurking in his backyard, â€Å"Is there someone, an intruder, in my backyard?† We later realize that the intruder is a wild philodendron plant, and this immediate image brings an aura of â€Å"wilderness†; of something that is â€Å"untamed†, uncultivated, undisciplined and uncontrollable: it summers on the deck, touches the floor, feels the chair and explores new ground, as if it were a wild animal craving for more space to reside in. The wilderness of the plant is a sharp contrast to the impression of the protagonist’s backyard in which the plant enters. The protagonist’s backyard is a private and domesticated sanctuary, complete with a â€Å"deck, a floor, a chair†-all elements pointing to cultivation and civilization, and immediately we sense that the plant has been displaced out of its natural habitat. We are also drawn by the sheer size of the plant; as the first part of the plant that is seen by the protagonist is its leaves, (â€Å"Ah! It’s you, dear leaves†). With this, Levertov has now established the main features of the plant, that it is wild, displaced and large, which leads us to empathize with it when the protagonist contemplates bringing it in for the winter-The fact that the narrator wants to believe that the mouse has actually become his pet, and wants to imagine that it no longer fears him, says more about the narrator than the mouse. He wants the mouse to trust him, and to feel like he is a care-taking figure to it, when perhaps he realizes that it can not perceive him as such. The narrator states: â€Å"And when you’re maneuvered in, how small the room will become; how can I set you where your green questions won’t lean over human shoulders†¦to enquire, mutely patient, about the walls?† In other words, â€Å"Is my plant more comfortable with me now than before?† Here Levertov suggests that the plant might accept captivity, but it is not certain. When the mouse disappears, the narrator is troubled because he feels protective of the mouse, fears for its safety from hawks, owls, snakes and cats. He sees these threats as negative influences, which demonstrates his naivetà ¯Ã‚ ¿Ã‚ ½ and simplicity, for the fear of them teaches the mouse how to survive. The â€Å"hawks† are an essential part of life; even humans cannot live without the existence of threats. Throughout the poem the protagonist has a tone of awe and anxiety. He is fascinated at the sight of the beautiful plant: (â€Å"Ah! It’s you, dear leaves,† / â€Å"As if you knew fall is coming, you seem to desire everything that surrounds you, all of air, all of light, all of shade.†) and his thought of bringing the plant in also suggests to the fact that he is fascinated by its beauty. This fascination for the plant establishes an emotional attachment of the protagonist for the plant; he begins to worry what will become of the plant when it gets cold. â€Å"How am I going to carry you in, when it gets cold?† This tone of anxiety is parallel to the tone a protective parent would feel for his child, which ironically, we reject entirely: Levertov has established that the plant is wild, large and already displaced out of its home when in the protagonist’s backyard, yet if the protagonist brings the plant into his home, it is perhaps more likely to be because of his fascination for it, instead of his wanting to protect it; domesticating something that is born wild would do more harm than good to it. Moreover, we realize that the protagonist is aware that the plant is wild and would not adapt to his small home, he states, â€Å"It’s those long, ever-longer, reaching arms that don’t fit through the door† This protection is both forceful and naive-the plant is wild and won’t â€Å"fit through the door†, thus the protagonist’s intention of domesticating the plant is a naive The plant is personified; The plant is personified, By allowing the philodendron to plant to have such This personification not only establishes a feeling a wilderness of the plant but also establishes the persona’s emotional attachment to the plant. Finding the plant so beautiful, the protagonist deliberates how he can bring the plant indoors, fearing that it will be cold once autumn arrives (-cold: â€Å"How am I going to carry you in, when it gets cold?†). September 19, 2008 Angelica Tong, 12BJ â€Å"August Houseplant† (Levertov) from A Door in the Hive (1989) English A1 HL (CYeo)

Information technology ethics Essay Example | Topics and Well Written Essays - 750 words

Information technology ethics - Essay Example On the other hand the biggest pessimistic use of a computer is for crime purposes. As people make use of the computers they typically think that their activities are confidential and also their personal information is protected. For instance, web sites of business nature often gather details from many visitors; later on many web sites sell these personal details against the desires of the visitors (Turban, Rainer and Potter; NCSI-Net). This is a kind of computer crime. There are many other kinds of a crime which are performed using a computer however most of the computer crimes are covered under the term ‘phishing’. In their book, (Laudon and Laudon 147) define â€Å"computer crime as the unlawful activities by making use of a computer or against a computer system. The Internet's user-friendliness and convenience have fashioned modern ways for computer crime, well-known forms of which is phishing.† Additionally, the computer crimes appear in a wide variety of ways and also cause a number of serious problems for different people. For instance, nowadays online frauds or frauds using the Internet are modern form of the online criminal activities in which an authorized person (normally acknowledged as a hacker) hacks some useful data and information and later on use it to conduct illegal and criminal tasks, such as cash related scandals. In this scenario, the basic intentions of criminals are to earn money, tease other or play games with others. In fact, the Internet is open for everyone which gives the opportunities to criminal people, to steal, new ways to steal them, and new techniques to harm others (Laudon and Laudon 147). As discussed above, there are many kinds of a computer crime and criminals do it intentionally. For instance, sometimes a dissatisfied employee or terminated worker can be dangerous to an organization. In this scenario, these people want to damage business with their extensive criminal activities (Parker; Turban, Rainer a nd Potter). Therefore, employers should properly scrutinize the background of persons being connected with critical computer related tasks. Some people falsify resume to get jobs. Also, the company should hire trustworthy personnel to minimize crimes related to computers. In addition, Hacker and Cracker are most widely used terms in computer crimes. In this scenario, Hacker is an external person who can break through a computer system, typically with no illegal intention. On the other hand, a Cracker is a nasty hacker, who may perhaps produce a stern crisis for the organization (Parker; Turban, Rainer and Potter). Moreover, Phishing is an emerging problem regarding online data security and information safety. There are a number of cases of identity theft and online frauds using Phishing and other hacking techniques. At the present, Phishing is normally carried out through E-mail or the instant messaging. In many cases its basic purpose is to direct online traffic to a particular web site whose appearance or interface are approximately similar to the actual one. Even though server cannot differentiate between false and original web site so a hacker successfully passes through these security walls. Normally, Phishing techniques are aimed at making fool to the internet users, and making use of the attractive usability of present web expertise. In this scenario,

Energy Resources in the Gulf Cooperation Council Countries Essay

Energy Resources in the Gulf Cooperation Council Countries - Essay Example Saudi Arabia exists as the largest state among the GCC countries with the Shi’i population placed on the oil producing gulf coast of eastern province. The discovery of oil dates back to 1930s with its commercial production beginning shortly after the Second World War. Saudi Arabia became the largest producer of oil by 1993. Similarly, Kuwait became an oil producer ever since 1946 before gaining its independence from Britain in 1961. The country received independence before massive revenues from oil could be concentrated on the hands of the ruling family possessing overwhelming power. As well, cohesion and the historical organization of unique merchant families had significant contributions. Bahrain emerged as the first oil producing country among the six GCC countries with initial production occurring in 1932. The oil wealth possessed by Bahrain from the beginning gave it a head start to develop social and educational institutions. As a result, this contributed significantly t o its status as the best socially liberal over its neighbors in the GCC countries. However, Bahrain’s current oil reserves remain almost exhausted. By contrast, tourism and finance service industries play the main role in Bahrain’s present day economy (Gause 5-8). Abu Dhabi, Fujayra, Dubai, Ajman, Ra’s al-Khayma, ’Um al-Qaywayn and Sharjah constitute the seven emirates making up the federation of the UAE. Large production of oil began in the 1960s within the UAE mainly in Dubai, Abu Dhabi and Shaarjah. UAE’s per capita national income remains among the highest worldwide. Most notable would be Dubai which continues to develop into a regional communications, services and business center.

Virgil's prologue from Aeneid Essay Example | Topics and Well Written Essays - 250 words

Virgil's prologue from Aeneid - Essay Example epics; the parallel with Homer’s works can be found in Virgil’s attempt to define the two parts of the story as an odyssey and a tale of war--though in reverse of Homer’s story structure. Because of the widespread use of Latin, Virgil succeeded in reaching a large audience and, as a result, was able to share and expand on the idea of the Roman hero. The storyline of Aeneid explores the challenging journey of a pious, selfless warrior chosen by destiny to found the city of Rome. There are a variety of themes running through the story: the conflict of order vs. chaos; the superiority of the Roman hero; and the role of destiny in shaping a man’s actions. The reader can find these references within the prologue, as Virgil paints a vivid picture of the epic story to follow. The central theme of order vs. chaos can be found in Virgil’s description of Aeneas’ journey across the treacherous seas. â€Å"A fugitive, this captain, buffeted/ Cruelly on land as on the sea/ By blows from powers of the air--behind them, / Baleful Juno in her sleepless rage† illustrates the representation of chaos--Juno being the embodiment of emotional rage--stirring the weather and causing havoc. Order is found in the presence of Aeneas as he fights to reach Rome--the land of rational thought and law. Another theme is the ideal figure of the Roman hero; Aeneas is presented as the perfect example of Roman self-sacrifice, piety and clear-minded purpose. When Virgil states: â€Å"A man apart, devoted to his mission--/ To undergo so many perilous days/ And enter on so many trials† he is telling the reader of the exceptional strength--of both mind and body--found in his main protagonist. The role of destiny plays a major role in Aeneas’ story. At the start of the prologue, we learn that â€Å"He came to Italy by destiny† and the reader understands the important nature of Aeneas’ assignment and purpose. Virgil ends his prologue with the following lines: â€Å"They wandered as

Stem cell research and should it be federally funded Paper

Stem cell and should it be federally funded - Research Paper Example The present enthusiasm over prospective stem cell-produced remedies radiates from the new innovations of genetic biology. Though one cannot forecast the results from basic research, there is enough information available to suggest that a good deal of this enthusiasm is justified. This enthusiasm is not shared by those of the religious right. This faction is opposed to embryonic stem cell research which they claim as immoral and characterize as devaluing human life, much the same as does abortion, drawing a link between the two. This discussion will provide a brief overview of stem cell research and its benefits to society, the debate surrounding the issue and the arguments for continued research. Embryonic stem cells possess the ability to restore defective or damaged tissues which would heal or regenerate organs which have been adversely affected by a degenerative disease. Cell therapy has the very real potential to provide new cures for diabetes, cancer, kidney disease, macular deg eneration, multiple sclerosis and many other kinds of diseases. Cell therapy has also demonstrated a great potential to help repair and regenerate spinal cord injuries which would help paralyzed patients recapture lost body functions. The possibilities are limitless including greatly advancing the human lifespan because aging organs could be replenished. â€Å"We may even have the ability one day to grow our own organs for transplantation from our own stem cells, eliminating the danger of organ rejection.† 1 The three main objectives given for pursuing stem cell research are obtaining vital scientific information about embryonic development; curing incapacitating ailments and for testing new drugs instead of having to use animals. The scientific techniques for obtaining stem cells could lead to unparalleled advances and even cures for these and other ailments. It has been substantiated from animal research that stem cells can be differentiated into cells that will behave appr opriately in their transplanted location. For example, the transplantation of stem cells following treatments for cancer has found much success for many years. There are numerous potential sources. The first is bone marrow stem cells. This type of stem cell is probably the most recognized of the stem cells. It has been used routinely to treat a variety of blood and bone marrow diseases, blood cancers and immune disorders. Leukemia is the most recognized disease that has been treated with a bone marrow transplant. New evidence suggests that bone marrow stem cells may be able to differentiate (the process by which an unspecialized cell acquires the features of a specialized cell) into cells that make up tissues outside of the blood such as liver and muscle. 2 The second type of stem cell is the adult stem cell. An adult stem cell is thought to be an undifferentiated cell, found among differentiated cells in tissues or organs. These cells can renew themselves and can differentiate to b ecome some or all of the major specialized cells types in the tissue and muscle it resides in. The primary function of this type of stem cell is to maintain and repair the tissue in which they reside. Because there are a very limited number of adult stem cells in each tissue coupled with their limited capacity to divide; making generation of large quantities of these cells is

Article Critique Example | Topics and Well Written Essays - 1000 words

Critique - Article Example ectively in the beginning of the study, as it is evident in the following line, â€Å"The purpose of this study was to obtain the first-person perspective of the students themselves, a perspective†¦about the academic experience of black students† (Davis et al, 2004, p. 420). The literature appears to be pertinent and all-encompassing for the purpose of the study. In a comprehensive way, Davis et al reviewed the literatures that relates the purpose of this study and outlined its salient features. It mainly covers the following areas of the study: a. a full statistical view of the population of black students in the universities if the countries (American Council on Education, 1988; U.S. Census Bureau, 1993), b. the discrepancy between the enrollments of white students and black students (Echols, 1998; Steele, 1999), c. nature of the prevailing â€Å"atmosphere for minority student learning† (Davis et al, 2004, p. 420) in the educational institutions (Sue et al, 1999; Katz & Hass, 1988), d. attitude of white students to black students (Bjerklie, 2001), e. â€Å"important aspects of the black college experience† (Davis et al, 2004, p. 422). These broad descriptions and findings of the literatures assisted Davis et al to prepare the outline of their investigation. The procedure of the study appears to in fair concordance with the subjective purpose. Davis et al approached the participants of the study with phenomenological interviewing process. In the first place, they justified their decision -of using phenomenological interview- by focusing on the salient features of the interviewing process as Davis et al asserted that their interview mainly â€Å"concerns the â€Å"what† of an experience and seeks to capture the specific meanings uniquely characterizing that experience† (Davis et al, 2004, p. 423). Their investigation was based on the clues found within the proceeding of the interview, as they said, â€Å"After the initial question is asked, a phenomenological interview

Gender Development Essay Example | Topics and Well Written Essays - 1000 words

Gender Development - Essay Example d mostly make action packed games for the males and only a few computer games are targeting the women community since boys are keener in playing computer games compared to girls. The more emphasize given to the interests of male community is actually steering away girls from computers. Internet and video game operators/manufacturers should focus more on creating games suitable to the needs of the girls also. Online puzzles and interactive activities related to everyday problems may attract more female community towards internet and computers. It is a fact that both males and females have different tastes as far as their leisure activities are concerned. Boys always like action packed activities because of their muscular dominance whereas girls look for developing their soft skills which are connected to beauty and aesthetic concepts. The article calls the video game manufacturers to make more games suitable for the taste of girls in order to stick the women community in front of the computer. At the same time we must remember that such segregation of male and female are not visible in other areas of our social life. Nowadays women are capable and willing to do any type of jobs which were earlier dominated by the male community. This article is right in claiming that boys and girls have different perceptions about relationships. But, I am not sure whether the same thing is right in the case of technology also. Even for the space exploration cases, in most of the missions, women are involved. If women are capable of undert aking such risky jobs, there is no point in generalizing that women have different perceptions about technology. This article generalizes so many things with respect to the attitude of males and females towards computers and internet. It is a fact that different individuals have different tastes. There are males who don’t have many interests in action packed computer games. At the same time there are many females who are interested in action

Reflective Manager Essay Example | Topics and Well Written Essays - 1000 words

Reflective Manager - Essay Example As Wiesen (2011) states, â€Å"the purpose of employee development is for workers at a company to learn skills that they can use within the workplace†. Learning is considered a key phase in the employee development process which not only improves the performance of employees but also makes them able to overcome global competition challenges successfully. Learning in organizations holds an important place because of a large number of associated benefits. Learning is basically related to the improvement in skills, abilities, and knowledge of employees through training, coaching, and direct observation. Managers and employees all benefit from the reflective process of learning. The first stage of the reflective process is awareness which leads to the critical analysis. The critical analysis plays the role of a link between past experiences and the future. The last step of the reflective learning process is learning which helps managers and employees in improving their skills, abi lities, and job performances. Learning through coaching can help Comet in many ways. As Chakravarthy (2011) states, â€Å"the coach has to help the person learn the requisite attitude, behavior and skills needed to perform the job successfully†. ... The importance of learning in organizations cannot be denied in today’s world of ongoing competition. If we talk about the levels of reflection from learning perspective, we can say that at the lowest level, learning is task-specific and usually helps in problem-solving, whereas the highest level of the reflective process of learning helps managers and employees in overcoming challenges underlying attitudes, beliefs, and assumptions. Learning helps employees grasp more knowledge about the way they should perform their job responsibilities, as well as help them grow in their professional careers. Learning also helps managers in managing their entire job related activities and responsibilities in an effective manner (Peter 2012). Some of the main learning methods that can use to achieve the goals of improved organizational performance and strategic agility include on the job training, off the job training, small group discussions, and cross training. On-The-Job learning plays a vital role in boosting the learning process for employees and managers. This method focuses on improving employee efficiency using the approach of activity-based learning. Use of direct learning and temporary work rotations help managers in dealing with changing scenarios in an effective manner. Another thing which goes side by side with learning is the need to increase the level of confidence of people. Learning brings in the required level on confidence in people which is critical for increasing job productivity and performance. â€Å"Organizational learning allows for teams to learn exactly what is relevant to their specific tasks and specialties† (Silberman 2013). Along with increasing confidence of managers and employees, on-the-job learning also helps them in reducing

Extreme Ice Essay Example for Free

Extreme Ice Essay In this documentary film, â€Å"Extreme Ice,† produced by PBS TV, 2009, James and scientists shows how glacier ice is melting. James Balog, a photographer, wanted to document and help scientists to understand mountain monumental changes. So he surveyed the ice and went to the places such as Alaska, Green land, etc. The project team which called â€Å"Extreme ice† discovered that there were very serious problems. The sun was the most reason of ice melting. But now, such as Industrial revolution and fossil fuels output green house gases alter the planet. For example, Columbia bay where is the fastest melting ice in the world, the ice is going to be collapsed faster than before. Scientists eventually discover about the mystery of the fast-melting ice at Columbia Bay. They announced that high temperature create more water and the water is melting ice because high pressure water cracked ice open and collapse. So Dr. Tad Pfeffer who is the one of the researchers suspected that if mountain glaciers are continuous melting, then people like living in Asia could not drink water. Frozen ice core record also support the reason. They have periodical ice in National Ice Core Lab in Colorado and it can distinguish between bubbles and pack of air. Late 1990s, Greenland is the hardest so far. But when they visited there, they figured out so many water drained out and it goes booming ice. Approximately 100million people will see to exist the melting ice on coastal countries such as Florida, Bangladesh, and Vietnam. Thats because the film Extreme Ice might mean quickly disappearing the ice and land increasingly.

American Colonies Essay Example for Free

American Colonies Essay The journey to America by Christopher Columbus in 1492 marked a new path for explorers from all over the world. England was one of those countries to explore the Newfoundland and settled into colonial America. By the 1700’s, Britain’s settlers divided into three distinct cultures within America. The New England, Middle, and Southern colonies were formed because of their differences in religious beliefs, geographic aspects, and occupation types. The variety of religious view in the New England, Middle, and Southern colonies helped evolve the differences between them. The New England colonies heavily practiced puritanism. Puritanism was a strict religion that’s main ideal was â€Å"everything you do affects all of us.† The puritans highly prioritized work ethic and were not afraid to publicly shun their members if the puritans disapproved of their actions. They believed their religion should be involved in all aspects of their life. The puritans strongly opposed the Quakers who, by the 1700’s, had settled into the Middle colonies. Quakers, also called the Religious Society of Friends, greatly differed to New England’s religious beliefs. The Quakers were a diverse group of people of deep conviction. They were advocates of passive resistance, but also devoted democratic people. The Quakers believed that they were all children in the sight of God. To the Puritans, the Bible supplied all religious authority, but Quakers believed that God could and did speak directly to the people. The Southern colonies largely supported the Church of England. The Church of England, whose members are called Anglicans, clung to a faith less severe and worldlier than the Puritanical New England. All three religions in all three different societies differed majorly in their beliefs. The Puritans strict ways clashed with the Quakers diverse and open views. The Church of England conflicted with the goal of the Puritans to purify the Church. The varied beliefs of the people divided them into the three colonies in early America. In addition, the distinct geography of each colony furthered the separation of their societies. The heavily glaciated soil in New England colony was filled with rocks. This rocky soil left New England less ethnically mixed. European immigrants were not attracted to the rocky soil of New England and decided to move elsewhere. Unlike the rocky soil of the New England  colonies, the Middle colonies became known as the â€Å"breadbasket† colonies because of the fertile soil and heavily exports of grain. Rivers also played a vital role in the difference of the Middle colonies from the others. The broad streams like the Susquehanna, Delaware and Hudson attracted fur trade and some adventurous spirits of the colonists. Unlike the New England’s many waterfalls, the Middle colonies waterways allowed little power with a water wheel. The Southern soil created a major difference to the rest of the colonies. The soil of the South was rich and fertile. Unlike New England’s hot summers and cruelly cold winters, the Southern heat was very humid and made the Southern colonies perfect for farming. The geographic differences between the colonies, including the variances of soil, rivers and weather, caused each colony to become more unique. As a result of the geographic aspects of the three colonies, specific occupations were found more often in certain colonies. The New England soil and climate created a diverse agriculture and industry. Unable to farm on rocks, some New England people turned to the harbors for fishing while others turned to dense forests, to work on cutting down trees and building ships. These jobs created a town-like atmosphere in the New England colony. The Middle colonies occupations proved very similar to the New England colonies. With the dense Virginal forest many became a lumberjacks or a ship builders. However, the Southern colonies fertile soil and humid weather created a farming franchise. Men had big farms called plantations. They grew crops to get cash and sold these crops to Great Britain. Because of the demanding work of owning a plantation, many slaves from Africa worked for the English farmers. The spread of slavery in the South created major gaps in their social structure. At the top of social ladder stood the small group of powerful plantation owners. Beneath them were small farmers, the biggest social group. Still lower on the social ladder were the landless whites, and beneath them were the indentured servants who were soon replaced with black slaves. The South created a separation between them and the other colonies because of their immigration of slaves. The variety of occupation types in each colony created majorly different societies. The major differences in each society helped evolve three distinct colonies. Each society had different beliefs and religions. The strict ways of the New England puritans clashed with the free spirit of the Quakers in the Middle colonies and the Anglican ways of the Southern colonies. The variety of soil, rivers, and weather helped create three distinct colonies. The rocky soil in the New England colonies, large rivers in the Middle colonies, and good soil and humid weather in the Southern colonies also helped create a vast assortment of occupations in each colony. With lumberjacks and ship builders in the New England and Middle colonies, and farming in the South, the jobs of the people in each society were majorly varied. The difference in each colony allowed groups of people to regulate their own lives. This later the creation of different states and governments, further separated the America. This separation in beliefs helped cause the civil war. The early difference in society in the 1700’s helped pave the way for many other conflicted views later on in America.

Case Study of China Aviation Oil Corporation Ltd

Case Study of China Aviation Oil Corporation Ltd Risk Management and Corporate Governance A Case Study of China Aviation Oil Corporation Ltd. Background introduction to CAO China Aviation Oil (Singapore) Corporation Ltd (CAO) is the Singapore subsidiary of China Aviation Oil. CAO was established in 1993 and its main business were jet fuel (kerosene) purchase for Chinese airports and international trading of fuels. CAO developed really fast and achieved 92% market share of the procurement of imported jet fuel for Chinas civil aviation industry by 2001. However, it was then involved in a big scandal which lead to its failure. In November 2004, CAO declared a total loss of $550 million and filed for bankruptcy. timeline of critical events Q1 2003 CAO enters into speculative option trades on oil prices with a bullish view Q4 2003 CAO changed its strategy and started trading speculative option trades taking a bearish view. Oct 2004 à ¢Ã¢â€š ¬Ã‚  international oil prices rose steeply, leaving CAO facing significant margin calls on its open (short) derivative positions. Nov 2004 in a press release CAO stated it was unable to meet some of the margin calls arising from speculative derivative trades. The total derivative losses amounted to $550m. Mar 2006 à ¢Ã¢â€š ¬Ã‚  CEO Mr. Chen Jiulin was arrested with the charge of insider trading, fined and sentenced to 51 months imprisonment. Literature Review option-based strategies There are two types of options: call and put option. One can either long or short the two options to gain profit (speculating) or mitigate risk(hedging) from price changes. In this case, CAO started its option trading in 2002 initially to hedge its jet fuel risk thorough. derivatives of futures and swaps. However, in the mid 2003, CAO started trading in speculative derivative options. hedging A hedge is needed to mitigate the risk from potential unfavorable swings in commodities. However, considering the cost and benefit effect, a hedge is not always necessary. One needs to understand the risks to be hedged, evaluate the severity and timing of downside risks properly, consider the financial instruments available and costs of certain instruments to determine the most cost-effective way to hedge. risk management and corporate governance Risk management is the identification, assessment, and prioritization of risks followed by coordinated and economical application of resources to minimize, monitor, and control the probability and/or impact of unfortunate events or to maximize the realization of opportunities. Risks can come from various sources including uncertainty in financial markets, threats from project failures, legal liabilities, credit risk, accidents, natural causes and disasters, or uncertain events, etc. The Board should establish appropriate guidelines for trading and ensured that they were consistent with the companys fundamental risk management policies, management capabilities and expertise, and overall risk appetite and tolerance. Senior managers (including executive members of the board) should formulate the major policies and guidelines of an institution. There should be a separation of duties between those who generate financial risks and those who manage and control these risks. Analysis CAOs trading strategies escalating bets As mentioned above, the companys trading strategy changing from hedging risks in 2002 to speculation with bullish strategy (bought calls and sold puts)in Q1 2003, which proved to be an accurate prediction. However, CAO then took a bearish view of the trend in oil prices in the fourth quarter of 2003, and began to sell calls and buy puts, with the result that it was in a short position at the end of the quarter. As the assumption was that oil prices would fall, it was further assumed that the counterparties would not extend the options, and these would therefore lapse to the benefit of the company. However, the price went further upward this time. The rise in oil prices resulted in the counterparties exercising the extendible features on options, and with the calls that were sold, the company faced the real risk of having to sell the contracted number of barrels at the strike price and realizing substantial loss. incorrect option valuation methodology The Special Auditor from PwC assigned by SGX discovered that the company used the wrong MTM valuation method by ignoring the time value, which lead to the misestimation of oil price and the wrong speculation strategy. While CAO had the chance to remedy the mistake by comparing the pricing with counterparties but the company met the margin calls without protest until it lost the financial capacity to do so at the end of September 2004. motivations behind Financial: the company developed fast and became monopoly in the market since 2000. In order to bolster its profile as well as boost investors confidence and generate more profit, the company was willing to take high risk. Political: according to exhibit 8, the year 2003 saw the burst of Gulf War. The company may want to take advantage of the war so that higher risk is acceptable as fuel is a critical resource during wars. Corporational: the lack of risk management knowledge of the CEO, insufficient management environment within the company and the inefficient external audit, as will be discussed in detail in the next section, further accelerated the fall of the big company. CAOs risk management and corporate governance In its 2003 annual report, CAO indicated that it had a formal system of rigorous internal controls over three layers. Meanwhile, other sources of control includes China Securities Regulatory Commission and External Audits. It seems that the company should have a stringent risk appetite. However, according to PwCs report, despite a continuing significant loss in 2004, in order to avoid recording and reporting losses, the company adopted a much larger risk exposure by selling longà ¢Ã¢â€š ¬Ã‚ term options with extremely high risk profiles to raise the premiums to cover the cost of closing out the lossà ¢Ã¢â€š ¬Ã‚ making option contracts (Exhibit 1). So in effect, CAO coveredà ¢Ã¢â€š ¬Ã‚ up the losses that were realized when closing out the lossà ¢Ã¢â€š ¬Ã‚ making nearà ¢Ã¢â€š ¬Ã‚ dated options. Exhibit 1 It was unclear why the companys directors did not question or object to this contravention of regulations. The Audit Committee did not carry out its function of identifying and monitoring the financial risks involved in options trading, and investigating whether the risk management framework and safeguards were sufficient for dealing with the business. Follow-up Development Restructuring outcome: In response to the investigation results by PwC, CAO indicated in a press statement that it intended to form a committee to study the results and to recommend the company on specific remedial or disciplinary improvements. It also expressed the willingness to be more honest on past events and to move forward with the debt and equity restructuring exercise in a positive manner. The company then called for a creditor meeting to approve its latest debt restructuring plan on June 8. As far as I am concerned, with the resources of the parent company, both from the aspects of finance and entrepreneurship, the support from Chinese government, and the establishment of a strict risk management framework, CAO can still gain back confidence from stakeholders, which may need time and effort. Conclusion Improper application of accounting principles, lack of oversight, inadequate knowledge of market and ineffective risk management systems for the speculative options deal were the major contributing factors towards CAOs failure. We should learn a lesson from the case as factors are similar and equally applicable to different business contexts so it is important to avoid certain mistakes. References Li, S., Nadeem, M. (2010). Risk Management and Internal Control: A case study of China Aviation Oil Corporation Ltd. Farhan. (2016, April 10). China Aviation Oil (Singapore) Corporation Limiteds Jet Fuel Scandal (2005) Casestudy. Retrieved January 15, 2017, from https://financetrainingcourse.com/education/2014/04/china-aviation-oil-singapore-corporation-limiteds-jet-fuel-scandal-2005-casestudy/ Yeo, A. (2014). China Aviation(Singapore) Limited- Sliding down a Slippery Slope: The $550m Derivative Trading Loss on November 2004.

Pheromones Essay examples -- essays research papers

Pheromones Do you often wonder what makes someone attracted to you or what makes you attracted to that other person? Sometimes you can look at the person and not even be attracted to their looks, but you feel compelled to talk to them or just contact them in any form. These urges could be induced by a compound group most commonly called "Pheromones." Pheromones{fair'-uh-mohn} (from the Greek pher, "to carry" and horman "to stimulate") are chemicals released by organisms into the environment, where they serve as signals or messages to alter behavior in other organisms of the same species. Pheromones are a class of compounds that insects and animals produce to attract members of their own species. These compounds are secreted by the body in very small amounts but are never-the-less effective in producing instinctive behavior when detected by the nose. In insects and animals, most sexual and social behavior is controlled by pheromones. Humans have used perfumes for thousands of years, but there is a basic difference between perfume and pheromones. Pheromones are produced by the body and usually do not smell at all pleasant, whereas perfumes are either synthesized or extracted from natural products and are employed because of their pleasant smell. Scientific research suggests that there are human pheromones for both the male a...

What is the Relationship Between the Formation of a Modern Chinese Iden

From September 18th, 1931, the date of undeclared Japanese invasion into Manchuria, to August 14th, 1945 marking the end of the War of Resistance, China experienced unprecedented suffering and loss in its struggle for survival. Throughout this time, social, economic, and political conditions underwent severe changes. In the eyes of the world, the Japanese committed sins beyond repentance, and half a century later, no development is evident in this respect. Yet, the War of Resistance gave rise to an invaluable aspect of Chinese culture that defines the nation today. Dr. Sun Yat Sen talked of a nation divided, four hundred million people who shared customs, habits and race, but could not advance in the face of the international world without one truly essential attribute â€Å"...in the world today what position do we occupy?... we should †¦ be advancing in the front rank with the nations of Europe and America. But the Chinese people have only family and clan solidarity; they do not have national spirit. Therefore even though we have four hundred million people gathered together in one China, in reality they are just a heap of loose sand.† (Tamura, 1998, pp.148). It was the Opium Wars, where Western technological development exposed China's military weakness and the subsequent broken treaties of 1922 and 1928, when China’s Western allies failed to intervene in Japan's invasion of Manchuria in September 1931 (Lin, 1936, pp.368) that forced the issue of â€Å"nationalism† on China during latter half of the 19th century. In the decades following the humiliation suffered at the hands of the ‘barbarians’ during the Opium wars, influential and progressive thinkers such as Feng Guifen and Zou Rong, among others, threw themselves passionately into th... ... the history of modern China. Historical Journal, pp.523--543. Spence, J. (2013). The search for modern China. 3rd ed. New York: Norton, pp.137-387. Spitzer, K. (2012). Why Japan is still not sorry enough. [online] Available at: http://nation.time.com/2012/12/11/why-japan-is-still-not-sorry-enough/ [Accessed 1 May. 2014]. Tamura, E. (1998). China - understanding its past. 1st ed. Honolulu: Univ. of Hawai'i Press. Taylor, J. (2009). The generalissimo. 1st ed. Cambridge, Mass.: Belknap Press of Harvard University Press. The Economist, (2013). The Legacy of the Sino-Japanese War- An Interview with Rana Mitter. [video] Available at: http://www.economist.com/news/books-and-arts/21579797-how-struggle-against-japans-brutal-occupation-shaped-modern-china-start-history [Accessed 30 Apr. 2014]. Yeh, W. (2000). Becoming Chinese. 1st ed. Berkeley: University of California Press.

The Epidemic of Post-Traumatic Stress Disorder (PTSD) Essay -- Post-Tr

The human brain is extremely complex, top scientists and surgeons still struggle to comprehend how it works. The way that the brain can process information and help a person to problem solve is amazing, but another part of the brain can hold memories. Some are good--like a memory of a family vacation or of family holidays--but there are also frightening memories that can haunt a person until his or her death, if they don’t get help. For a very long time researchers have focused on combatant PTSD, for very good reason, but now a problem has risen among civilians, and they have not been focused on the growth of PTSD right here in regular everyday people’s lives. Not just soldiers can be affected; civilian men, women, and children can be affected by the things they see every day. It can be the paramedic that is first on the scene or it could be the child who watches a robbery goes wrong and a loved one is caught in the cross-fire. Either way these people are all just as im portant to the american society as the soldiers. The importance of the military is massive, and yes I agree that we should help the soldiers who suffer from PTSD, I even have my own personal connections. My uncle went to Vietnam for the Vietnam war and when he came back he was paranoid and scared of anything that reminded him of Vietnam. He like so many other soldiers then and now has PTSD from what he had seen while overseas. The only problem with helping the soldiers is that we don’t focus on the others who also need help getting through their PTSD. There are so many research projects on how to help soldiers get through their PTSD, but their are a limited amount of PTSD research papers on the civilian side. Researchers will only focus on certain things, and pr... ... 07 Dec. 2013. Marais, Adele, et al. â€Å"Domestic Violence in patients visiting general practitioners: Prevalence, phenomenology and association with psychopathy.† SAMJ South African Medical Journal 89.6 (1999): 635-640. Web. 07 Dec. 2013. Schwarz, Eitan D., and Janice M. Kowalski. "Malignant memories: PTSD in children and adults after a school shooting." Journal of the American Academy of Child & Adolescent Psychiatry 30.6 (1991): 936-944. Web. 07 Dec. 2013. "Survivor Care." LOVE146. LOVE146. Web. 06 Dec. 2013. Tarrier, Nicholas, and Lynsey Gregg. â€Å"Suicide risk in civilian PTSD patients.† Social psychiatry and psychiatric epidemiology 39.8 (2004): 655-661. Web. 07 Dec. 2013. The Amazing Spider-Man. Dir. Marc Webb. Perf. Andrew Garfield, Rhys Ifans, Martin Sheen, Emma Stone, Denis Leary, and Sally Field. Sony Pictures, 2012. DVD. 07 Dec. 2013.

Globalization, Culture and Indigenous Societies Essay

Globalization describe by Richard Wilk is the world wide impact of industrialization and its socioeconomic, political, and cultural consequences on the world, which include migration of labor, increaing spread of industrial technology. Technology is moving at a rapid pace, that when a indivdual purchases a computer of the shelf, the technology is already obsolete. With the advancement of technology, it is causing countries to become modernizied. Such as inda, which was at one point a third world, but is now becoming mecha, for new businesses. But with monderization, comes dependency, such as with the invetion of the car, we have become depenent on oil, such so that we no longer get the majority of our oil from america, but from other countries. Companys the exxion, pay a certain amount of money for this oil, and will sell it to the consumer for 3 or 5 times the amount they paid, knowing the that consumer will pay the price set by the company, thus exploiting the consumer. Companys our now exploiting other countries, like china, they will out source products to be built in china, and charge the chinese worker a wage of lets say 50 cents an hour, instead or the americans work $9. 25 an hour to make the same product. With the rapid expansion of globalization, has change a lot of countries, it has in some cases, destroyed cultures, mainly for the countires resources. With epansion can come cultural change, someimes it is forced, case in point the mbuti tribe. The Mbuti, had been in contact with ousiders for centuries, but chose to retain their tradional way of life. During the colonial peroid, government officials tried to resettle the mbuti. The resettling was a disaster. It isnt the first time a government has tried to move a society of peole, one such case is the native american of north america. The united states put the native amerians on reservation, one such tribe would be the navajo indians. Globalization has had negative impact on a lot of small societys. It has destroyed their culture, their land, the people themselves to some extent. But in bigger societys, it has caused a triving oasis. But the downfalls our dependency. If we were to gradually, incorpate globalization of what bigger societys, in to smaller societys it would allow the intergration of the old and new, to eventually over time, it would evolve into something new. Such inda, and its marriage practices, the man works the women takes care of the home, but there our some women who want to work and take care of the home. Chapter Globalization in latin america, africa and the caribbean Globlization had a major impact in latin amercia in the 1500s. During this time, a man named hernado, cortes a spanierd, help start a rebellion, in the aztec empire. He gave the aztects non native weapons such as guns, to rebel against their ruler, Montezuma. The aztec state quickly crumpled. But it didnt stop their, the spanish wanted more territory, with the help of their native americans, the went to conquer mesoamerica, including Mexico, Honduras, and guatemala as well as parts of norh amercia, such as california. They exploited the people and land, by developing mining, commercial agricuture, and live stock raising and trading. This drastically transformed the sociocultural systems of the the americas. In Africa, societies exploited the country but use of slavery. In Africa this system included slaves who were attached to the extended families and be came part of the domestic social unit and as such could marry, own property and were protected from mutilation and murder.. But in western countries thought of them as property and did not have personal rights, could never be incorporated into the owners domestic family or social system. In the Caribbean islands because they did not have a large agricutrual resource, the colonial powers intrduced commercialized agricutrual usually in the form of sugrar plantations. In some cases, globalization can back fire, is various parts of south america, revolts started happing, and with the migration of various, peoples, south america become intermingled. Religions evolved, as well as devolved. The globalization of africa and south america, drasically change its land scape and its people forever. Many people lost their homes as well as their heritage. The africans lost a country when they were brought to the americas to become slaves. They lost many freedoms.. Chapter 15 Globalization in the middle east and asia. Just as in latin america, africa and the Caribbean, globalization had a negative impact for coutries in the middle east and in asia. With colonization, can dieses, and death. At one point weastern societies, tried to change the religion of many countries in the middle east as well as in various countries in asia. For the most part they did not succeed. Just as in south america, when came to colonization in the middle east and in asia, there came revolution. But some were more peace then others such as mohandas gahdis protests for indias independence from the British. Unlike china’s protests which were more violent, which lead to china forming a communist movement. These revolts and protects, change many countries, thus forming newer countries in the process. When these countries changed, some became very wealth while others became poor, for example, some countries in the middle east, had oil, many others did not. In the middle east, the Islamic tradition and Arab culture influence the patterns of family life and gender. With the globalization of the middle east and asia, came change, but mostly the change was met with revolution and for the most part it was a very violet one. Some countries tried to isolate them selves such as china, from the rest of the outside world. When you have a society that is trying to drastically change another culture it is almost always going to be met with hostility. But what comes out of it, when the dust settles, it could be go or band. But usually the change eventually turns out to be good.

Ib Biology Hl Notes

Genes and Genetics 1. 2. each chromosome exists as two genetically identical chromatids attached to their centromere. Each chromosome appears as two chromatids attached to a centromere. In the first meiotic division chromosomes align in homologous pairs. Points of contact form between members of the same homologous pair. The points of contact or crossing over between members of a homologous pair are the chiasmata. 3. The homologous pairs move to the equator of the cell. Equal lengths of the chromatids of the same homologous pair have broken off and crossed over. The chromosomes align at random and independantly.Only one possible arrangement is shown. 4. Homologous pairs align at random at the equator of the cell. This shows the early separation of the chromosomes of each of the homologous pairs. 5. Homologous pairs are separated. This shows the cell at an early stage of meiotic division. The cell membrane is starting to pinch inwards. 6. The cell divides to form two cells each with a haploid set of chromosomes. Cell division is complete and two cells containing a haploid set of chromosomes are formed. 7. In the second meiotic division the chromosomes in each cell align independently and randomly at the equator of the cell. . The chromatids in each cell are separated. The chromatids are pulled towards the opposite poles of the cell. 9. The cells divide. The cell membrane is starting to pinch inwards. 10. Cell division is complete, resulting in the formation of four cells each with the haploid number. 11. Meiosis – Functions ? ? Halving the chromosome number – meiosis consists of two nuclear divisions (meiosis I and meiosis II) but the chromosomes replicate once. Producing four daughter cells. Each are haploid Producing Genetic Variety – through prophase I and through random assortment during metaphase I.In addition, random fertilisation also produces variety since any gamete has an equal chance on combining. Crossing Over – during pro phase one, homologous chromosomes combine to form bivalent so maternal and paternal chromosomes are adjacent. Homologous pairs contain same genes but different alleles. They line up and non-sister chromatids break then they rejoin in corresponding position on other chromatid. Region this occurs is called the chiasma (chiasmata). Point where this is in random but not all chromatids form a chiasma and some dont happen at all. Therefore, chromatids keep alleles.Monohybrid and Dihybrid Inheritance0 There Codominance – both alleles have an effect on a phenotype neither allele is recessive multiple allels – 3 alleles in blood typed these are Ia , Ib and ‘i' (Io) these 3 alleles make up the phenotype and genotypes in the blood gene. Sex Link Genes Autosome (normal chromosome) pairs are said to be linked. Meaning they contain the same locus on a gene. HOMEWORK 2 b) Genotypes Gametes F1 Genotypes Phenotypes – AB BO A B B O AB AO BB BO AB, A, -B, B 4 b) Bw Tl Male G ametes- B,w T,l ww ll Female Gametes – w,w,l,l B w w Bw Bw w ww ww ) Polygenic inheritance of skin colour – Depends on the amount of pigment that is produced in the skin. Melanin synthesis is controlled by genes. The degree of pigmentation can range from very dark to very pale. Several genes are involved in skin colour determination and these produce continuous variation. Each gene has two alleles so there are numerous outcomes for example when three genes are involved there are seven outcomes. One allele M contributes to melanin. 7. 4. 6 ? ? ? ? ? ? ? ? ? ? ? Ribosomes are made of two subunits, large and small Small subunits binds to the first codon on the mRNA.This is the initiation part of translation. The first codon is usually AUG and codes for the amino acid methionine. Large Sub-units will now bind and two binding sites for tRNA sit over the first two codons Transfer RNA with the correct with the correct anticodon will lock into the first tRNA binding site and f orm hydrodgen bonds to the first codon. The second tRNA will now enter into the second binding site as it has the correct anti-codon Each tRNA has its own specific amino acid, and now a peptide bond forms between these amino acids.This is the beginning of elongation ( joining amino acids to make a polypeptide) the first tRNA now breaks away and moves into the exit site and now the next codon has to be read. the small subunit shifts down the mRNA in a 5†² 3†² direction followed by the large subunit the second tRNA now moves down into the neighbouring binding site and the third tRNA can now move onto the mRNA and locks them to the exposed binding site another peptide bond is formed this process of the ribosome moving along the mRNA is called translocation eventually the ribosome reaches the last codon and it has no corresponding anti-codon so no tRNA will bind. This is a biological full-stop and this is termination.The ribosome sub units break apart, releasing the polypeptid e chain, which will now coil into its secondary and tertiary structures to form a protein. CroCrossing Over (p237) ? ? ? ? Crossing over occurs during prophase one. Chromosomes shorten and coil and homologous pairs of chromosomes come together form a bivalent Chromosomes ontain the same genes but have different alleles. Two segments then rejoin from broken chromatids at corresponding positions. Mendel's law of Independent assortment When gametes are formed, the separation of one pair of alleles into the new cells is independent of the separation of any other pairs. or; either pair of alleles is equally likely to be inherited with either of another pair. production but m does not making MMMMMM the darkest and mmmmmmm the palest. Polymerase chain reaction is used to copy and amplify minute quantities of DNA.It can be useful when only a small amount of DNA is available but a large amount is required to undergo testing. We can use DNA from blood, semen, tissues and so on from crime scen es for example. The PCR requires high temperature and a DNA polymerase enzyme from Thermus aquaticus (a bacterium that lives in hot springs). Sample is heated which denatures DNA and separates into two strands. Thermophlils Aquaticus is a bacterium which Polymerase increases rate of base pair creation. Replication in a few hours 4. 4. In gel electrophoresis, fragments of DNA move in an electrical field and are separated according to their size. Electric charge separatees DNA and allows to see natural variation in DNA Restriction Enzymes cut to produce varying fragment sizes. magnetic field so all DNA (-ve charged) move different distances and then are stained. this leaves a DNA profile Chamber, power supply, gel it doesn't mater 4. 4. 4 Organisms have short sequences of bases which are repeated many times. These are called satellite DNA. These repeated sequences vary in length from person to person.The DNA is copied using PCRand then cut up into small fragments using restriction enz ymes. Gel electrophoresis separates fragmented pieces of DNA according to their size and charge. This gives a pattern of bands on a gel which is unlikely to be the same for two individuals. This is called DNA profiling. DNA profiling can be used to determine paternity and also in forensic investigations to get evidence to be used in a court case for example. Human Genome ? It is now easier to study how genes influence human development. ? It helps identify genetic iseases. ? It allows the production of new drugs based on DNA base sequences of genes or the structure of proteins coded for by these genes. ? It will give us more information on the origins, evolution and migration of humans. ? 20,000 – 25,000 ? Carried out in 1990 to map entire DNA base sequence the whole genome. 3 billion pairs in 2003. ? Spots added to a solid surface. Can determine levels of thousands of genes by measuring mRNA spots on microarray. Generating profile of expression on a cell Pharmacogenomics â⠂¬â€œ drugs which target specific genomes.

A Sequence for Academic Writing Essay

The purpose of this website of The National Abortion and Reproductive Rights Action League (NARAL) Pro-choice America, is to to show their advocacy for the right of a woman to choose and her right to privacy with regards to reproductive health. The exclusivity of the issues tackled in this site suggest that their concern is concentrated on specific subject matters affecting the conditions of women in the society such as abortion, use of birth control, teen-pregnancy, reproductive health issues of women of color and legislation about the advancement of the right of a woman to choose. Also, the site offers different means on how women with these kind of problems can understand and take action. 2. What is the subject matter of this site? The subject matter of this site is about the right of every woman to choose and her right to privacy regarding women’s reproductive health. 3. What is the purpose of the site? The purpose of this site is to empower women about their sexuality. They aim is to promote the freedom of women to decide for themselves without being scrutinized or discriminated by the society. Also, the website provides many information about the pro-choice legislation and policies for women, research, campaigns and other advocate organizations to educate visitors about the mentioned subject matter. 4. Is this site for, against, or neutral as far as the subject matter is concerned? This site is evidently pro-choice and for the privacy of women. One of the site’s objective is the prevention of unintended pregnancies by provding women more access to birth control and sex education to lessen the occurence of abortion. But they believe that abortion should be made legal and safe to give options to women whether they want to puruse their pregnancy or not regardless of their reasons. 5. Does the site offer anything unique? Does it tell you more than you could find out in an encyclopedia? This site offers a variety of information ranging from research done by NARAL Pro-choice America to government legislations and policies. The media center of the site is composed of choice-related topics from other publications or websites such as The Buffalo News, Fox News and Colorado Springs Gazette. Other sources are background materials, quotes, and story ideas or experiences of women. 6. Did you learn anything? Was the site worth visiting? In this site, I have learned the dilemmas experienced by women particularly when it comes to their reproductive health and choices. In these kind of situations, women are torn between choosing the right thing or what is for their best interest. Moreover, this site really gives a comprehensive outlook about the fight to advance the rights of woment to choose and privacy. Visitors of this website will really have an elightening experience when they read the content. 7. If you were compiling a bibliography of sources about the subject matter of this site, would you include or exclude it from your final list? Yes, I would use this website as one my sources if I am writing a research about the subject mater because it has a single point of view which is supported by many arguments which are valid and practical. Writing Exercise 2 Analyze the Web site National Right to Life. 1. As stated on page 295 of A Sequence for Academic Writing, â€Å"Web pages generally fall into one of six types, each with a different purpose: (1) entertainment, (2) business/marketing, (3) reference/information, (4) news, (5) advocacy of a particular point of view or program, (6) personal page. † What type is this site? Why do you think this? This is an advocay website that upholds the importance and presenrvation of life. They are against any act that would endanger any human life such as abortion. 2. What is the subject matter of this site? The subject of this website is focused on protecting and giving importance to all human life. In line with this, the information contained on the website clearly suggest that the organizers, National Right to Life Committee, are opposed to abortion and issues related to medical ethics such as euthanasia and infanticide. However, the site does not tackle and does not provide any opinions or views on contraception, sex education, capital punishment, and national defense. 3. What is the purpose of the site? The purpose of this site is to encourage visitors of the website to patronize their advocacy which is to disseminate information and at the same time convince people about the negative effects of abortion, infanticide, and euthanasia to an individual and to the society 4. Is this site for, against, or neutral as far as the subject matter is concerned? This site is against the promotion, advocacy and conduct of abortion, infanticide, and euthanasia but the site also advocates the propagation of the notion that human life is valuable so any act that tries to eliminate it should be punishable by law. 5. Does the site offer anything unique? Does it tell you more than you could find out in an encyclopedia? The site of the National Right to Life Committee used different data to support their objective. Its extensive database is focused on these three aspects: abortion, infanticide, and euthanasia. The site includes other realted links from other websites as well, media press releases and current legislation updates about the subject matter. 6. Did you learn anything? Was the site worth visiting? I have learned that even though the US has a liberated culture, many citizens still possess conservative views specfically about the protection of human life whether that individual is an infant or an adult. 7. If you were compiling a bibliography of sources about the subject matter of this site, would you include or exclude it from your final list? Yes, I would definitely use this website as a bibliography source if I were to tackle the subject matter. The website contains many informative data from their own database and outside sources as wells such as information from orgazations with similar objectives, the US government and media publications. Having all these information would make my research very substatntial and extensive. Revision Activity 1 Go to: Handwriting Analysis Read the article analyzing the sample of handwriting provided. Answer the following questions regarding the analysis. 1. What is the author’s initial impression of Walter Railey’s handwriting? The analyst’s initial impression on Walter Railey’s handwriting is that Railey has self-control but his emotions are repressed. These characteristics were presumed by the analyst as an indication of having a compulsive personality. 2. What are three of the particular elements of Railey’s handwriting the author analyzes? The author analyzed the writing strokes, spaces between the letters and hand pressure which became the three major foundations in analyzing the personality of Railey. 3. What element of Railey’s handwriting does the author thinks reveals his weak self image? According to the analyst, the â€Å"diminished and sometimes near threaded middle zone, small compared to upper and lower zones, together with an insignificant and defensive ppI, represent his weak self-image† (Arnold â€Å"Walker Railey†). 4. Explain what analytical tool the author is using in order to analyze Railey’s handwriting. Is the author credible in applying this analytical tool? The author searched for patterns in Raile’s handwriting. Then, the changes in these patterns are noted and analyzed in accordance with the personality of the subject. Moreover, based on the findings, the author was able to make a detailed analysis of the handwriting indicating his/her expertise about it. Also, the patterns of the handwriting helped the author to determine the elements that would expose the individuality of Railey. 5. Once the analysis is complete the author offers a summary of his findings. Are his summary findings concurrent with his initial impressions? The summary part is the synthesis of all the findings regarding the handwriting of Railey. With regards with the concurrence of the initial impression with the summary is that both were able to provide similar information. However, in the initial impression the descriptiom is brief but in the summary it is a little bit more detailed. 6. At the end of the page you will find a link to a short biography of Walter Railey. Follow the link and read the biography. How accurate is the author’s analysis of Walter Railey’s character, based on his handwriting analysis? After reading the biography of Walker and comparing it with the results of handwriting analysis, the former made some very accurate portrayal of the real Walter Raileys. In the analysis, Railey was rendered as selfish, emotionally repressed, and having dual personality which were all apparent in his historical background. Railey was selfish because he only cared about himself and he ignored his family and friends. Also, his emotional repression was shown when he tried to kill his wife and commit suicide. More so, his dual personality was demonstrated when he was charaterized as a charismatic religous leader and also as a controlling and indifferent individual. Revision Activity 1 Go to: Handwriting Analysis Read the article analyzing the sample of handwriting provided. Answer the following questions regarding the analysis. 1. What does the analysis say that the dark strokes represent about Bill Clinton? According to the analyst, the dark strokes of Clinton’s handwriting indicate â€Å"a great deal of energy and an ability to work hard and for long periods of time† (Canoles â€Å"Bill Clinton†). 2. What does the analysis say about the â€Å"little tents† under Clinton’s words? The little tents suggest â€Å"how firm, and even stubborn, Clinton can become once his mind is made up† (Canoles â€Å"Bill Clinton†). 3. How accurate do you find the analysis comments from what you know about Bill Clinton? Based on his administration when he was president and my impression about Bill Clinton, I could say that the handwriting analysis was close to my ideas. Since Clinton was elected as president for two consecutive terms, it suggested that he was well-liked by his consitutents and that he did a great job in doing his taks as head of the state which is very similar with the report of the author’s analysis that Clinton is â€Å"fair and objective when working on initiatives or with people† (Canoles â€Å"Bill Clinton†). 4. Go to: Clinton Biography Read a short biography on Bill Clinton. What comments from the analysis seem accurate according to the short biography? According to the first short biogrphy that I read, Clinton achieved numerous accomplishemnts dugin his term as President of the United States. Some of these were the increase of employment for Americans, reductionsof tax for businesses and many others. In the handwriting analysis, Clinton was depicted as â€Å"direct, efficient, can prioritize easily,† detail-oriented and a â€Å"pragmatic idealist† which are characteristics needed in order to make positive accomplishments. (Canoles â€Å"Bill Clinton†). These qualifyers corresponded with the characteristics of Clinton shown on the biography. 5. Go to: Handwriting Analysis Read a second short analysis of Bill Clinton. How do the two analyses compare/contrast? According to the second short biogrphy that I read, Clinton was described as an intelligent and a charismatic political leader loved by the people. However, he was involved in a sex controversy that influenced many people to question his credibility. But after being found not guilty from the charges against him, he gradually redeemed himself by initiating productive changes in the US and in the international scene. When the handwriting analysis was compared to the biography, the fomer made accurate descriptions of Clinton solely based on his handwriting that matched the information from the latter. But there were some information that were not confirmed by the biography such as the early emotional hurt experienced by Clinton that caused him to have a protective cautin. Nothing was said in his biography about any incident that might have a negative impact on him. So this piece of data still remain questionable. Nevertheless, the majority of information in the handwriting analysis were similar to the actual personal and historical background of Bill Clinton. Write Journal ( Two paragraphs only): Find an advertisement in U. S. a magazine and a) describe the ad, then b) analyze it by discussing all of the following: the colors in the ad, the message (or words) of the ad, and who or what is the focal point of the ad. How do all of these aspects work together to try to get you to buy the product? In the rainbow ad by Skittles, the texts incorporated stated, â€Å"If you filled all the world’s maracas with skittle, no one would ever know. † This literally means that the maracas would not be heard because people are going to eat the Skittles which will supposedly make the sound for the maracas. These texts were colored using all the rainbow colors which are also the colors of the Skittle candies. It was like the ad was bursting with colors which insinuated that if a someone eats a Skittle, the flavors would also burst inside the mouth. More so, in a caption below the ad which says, â€Å"Hear the rainbow, taste the rainbow,† suggests that the appealing look of the Skittles is also transcended to the taste which is composed of different flavors similar with the colors of the window. When all these elements are combined, the ad makes a powerful visual that is both enticing and informative. Works Cited Arnold, Rosemay. â€Å"Walker Railey. † 2006. Handwriting. org. 14 July 2008 . Canoles, June. â€Å"Bill Clinton. † 2006. Handwriting. org. 14 July 2008 .

Measurement of Sevice Quality of Apollo Using Servqual

Dissertation Project Report On Measurement of Quality at Apollo Hospitals using Servqual Submitted by Richa Kumari A0102208164 MBA (M&S) 2010 Under the Supervision of Faculty Mentor Prof. (Dr. ) P. K. Bansal Faculty Amity Business School AMITY BUSINESS SCHOOL AMITY UNIVERSITY UTTAR PRADESH SECTOR 125, NOIDA – 201303, UTTAR PRADESH, INDIA 2010 DECLARATION I Richa Kumari, student of Master of Business Administration (Marketing &Sales), Class of 2010from Amity Business School, Amity University, Uttar Pradesh hereby declare that the dissertation done by me on the topic â€Å"Measurement of Quality at Apollo Hospital using Servqual† is true to my knowledge. The information collected by me is authentic & is done through data analysis & interpretation & I have a thorough knowledge of the project. The content of this report is based on the information collected from visiting Indraprastha Apollo hospitals in Delhi. I further declare that the matter embodied in this project report has not been submitted to any other university or institute for the award of any degree or diploma. PLACE: Noida DATE : Richa Kumari Amity Business School Amity University, Uttar Pradesh CERTIFICATE FROM FACULTY GUIDE This is to certify that Richa kumari, student of MBA (M&S), Amity Business School, Amity University; Uttar Pradesh has successfully completed the dissertation project under my guidance. The project report and data submitted by her is authentic and genuine to my knowledge. Prof. Dr. P. K. Bansal Faculty guide Faculty, Amity Business School Amity University, Uttar Pradesh ACKNOWLEDGEMENT It takes immense pleasure for me to express my sincere gratitude to all the helping experience I had during my dissertation. The Project was done by me under the guidelines of my Faculty Guide Prof. Dr. P. K. Bansal was a source of enormous learning for me. I am highly obliged to him for their continuous unconditional support & guidelines. A special word of thanks from me to all the respondents whose cooperation and interaction was a great help. As a student of AMITY BUSINESS SCHOOL, NOIDA I got the golden opportunity to work on the topic â€Å"Measurement of Quality of Apollo Hospital using Servqual†. I also feel highly obliged to my program leader Mrs. Aparna Goel and some of the faculties in ABS who in several ways were my inspiration & helped me to put in the best of my efforts. I am deeply indebted to my parents, family members & friends for their support during the course of my dissertation. Last but not the least; the report was completed successfully because of the grace of God. Richa Kumari Amity Business School EXECUTIVE SUMMARY Service firms like other organizations are realizing the significance of customer-centered philosophies and are turning to quality management approaches to help manage their businesses. This paper starts with the concept of service quality and demonstrates the model of service quality gaps. SERVQUAL as an effective approach has been studied and its role in the analysis of the difference between customer perceptions and expectations has been highlighted with support of measurement of quality at Apollo Hospital. Outcomes of the study outline the fact that although SERQUAL could close one of the important service quality gaps associated with external customer services, it could be extended to close other major gaps and therefore, it could be developed in order to be applied for internal customers, i. e. mployees and service providers. Quality Health Care  is an achievement of optimal physical and mental health through accessible, cost-effective care that is based on best evidence, is responsive to the needs and preferences of patients and populations, and is respectful of patients’ families, personal values and beliefs. The report covers the survey of Apollo Hospital Services, Delhi. It focuses on the dynamics of the the overall service provided, the trends over a period of time, and the key challenges faced by the industry. TABLE OF CONTENTS DECLARATION I * CERTIFICATE FROM FACULTY MENTOR II * ACKNOWLEDGEMENT III * EXECUTIVE SUMMARY IV * CHAPTER 1 INTRODUCTION * CHAPTER 2 LITERATURE REVIEW * CHAPTER 3 METHODOLOGY * SAMPLE DESIGN * RESEARCH DESIGN * DATA COLLECTION METHOD * SAMPLE SIZE CHAPTER 4 DATA INTERPRETATION * DATA ANALYSIS * FINDINGS * LIMITATIONS * CHAPTER 5 CONCLUSION &RECOMMENDATION * APPENDICES V * REFERENCES VI * BIBLIOGRAPHY VII CHAPTER 1 INTRODUCTION Earlier in the medical literature, the quality of service i. e. the  characteristics that shape the experience of care was rarely discussed beyond technical  competence. This research measures and analyzes  some routine encounters in Apollo, a hospital of international standard from a service quality point  of view. The study has led to the following two premises: First, if high-quality service had a greater presence  in practices and institutions, it would improve clinical  outcomes and increased satisfaction of patient and doctors while reducing  cost. It will also create competitive advantage for those who  are expert in its application. Second, many other industries  in the service sector have taken service quality to a high level,  their techniques are readily transferable to health care, and caring for patients can learn from them. Healthcare industry The healthcare industry in India comprising of hospital and allied sectors, is projected to grow at 23 per cent per annum and to touch US$ 77 billion by 2012 from the current estimated size of US$ 35 billion, according to a Yes Bank and ASSOCHAM report. The sector has registered a growth of 9. 3 per cent between 2000-2009, when compared with the growth rate of other emerging economies such as China, Brazil and Mexico. According to the report, the growth in the sector would be driven by healthcare facilities, private and public sector, medical diagnostic and pathlabs and the medical insurance sector. Today Hospital industry is an important component of the value chain in Indian Healthcare industry. It renders services and is recognized as healthcare delivery segment of the healthcare industry. It is growing at an annual rate of 14%. The hospital industry accounts for half the healthcare sector’s revenues and was estimated to be worth USD $25 billion in 2008. The dismal performance by the Indian government in providing healthcare infrastructure has created tremendous opportunities in the private sector. The huge pent up demand for quality healthcare and increase in healthcare spending in the long-term are fundamentally strong drivers in this market. The factors contributing to its bright future is based on increased healthcare  consumption, increasing instances of lifestyle-related diseases, medical tourism, and growing  health  insurance. The key challenges for the industry include significant capital requirements and a shortage of medical professionals. Ensuring high quality of healthcare service is another key issue for service providers. Healthcare spending in India accounts for over 5 per cent of the country’s GDP. Of which the public spending in percentage is around 1 per cent of GDP. The presence of public health care is not only weak but also under-utilized and inefficient. Meanwhile, private sector is quite dominant in the healthcare sector. Around 80 percent of total spending on healthcare in India comes from the private sector. Inadequate public investment in health infrastructure has given an opportunity to private hospitals to capture a larger share of the market. In addition the demand for hospital services has been increasing due to the rise in lifestyle related diseases that accompany prosperity. Hospitals serve an important function in India’s healthcare system. They provide in-patient and out-patient services and also support the training of health workers and research. Indian hospitals can be broadly classified as public hospitals, private and not-for-profit hospitals. Corporate hospital chains that provide tertiary healthcare services in large towns and cities have also been established. However, the number of hospital beds in India is around 1. 1 per thousand people. This is significantly lower when compared to most developed economies. The current outlook for the hospital services is positive. Technological innovations in service delivery, increased affordability, improved service quality and supportive government policy initiatives are some of the factors that are likely to impact growth of the sector. This is a pointer to significant opportunities that exist for service providers. Moreover, the future of healthcare is not restricted to the large domestic market alone. Emerging trend of medical tourism indicates the possibility of Indian healthcare services opening to the whole world. Health Care and Service delivery Health  Service delivery  refers to the way inputs such as finance, staff, treatment, equipment and drugs all deliver a range of health interventions to consumers seeking to access health care. Improving Service delivery  depends on having key resources that are well organized and managed. Health services include personal health services that are preventive, diagnostic, therapeutic or rehabilitative; whilst non-personal services cover areas such as mass health education/ promotion programs, health legislation and the provision of basic sanitation facilities. Incompetence or breakdown in the process of care-giving may be the result of problems in practice, products, procedures or systems. A key issue facing development agencies is the utilization of health services as they are often inaccessible or mistrusted by consumers. Lack of managerial capacity at all levels of the health system is increasingly cited as a binding constraint to scaling up services and achieving the Millennium Development Goals. Apollo Hospitals With over  8065 beds across 46 hospitals in India and overseas, neighborhood diagnostic clinics, an extensive chain of Apollo Pharmacies, medical BPO as well as health insurance services and clinical research divisions working on the cutting edge of medical science, Apollo Hospitals is a healthcare powerhouse one can trust with their life. Apollo Hospitals, India is a union of exceptional clinical success rates and superior technology with centuries-old traditions of Eastern care and warmth, with 16 million patients from 55 countries. Apollo Hospitals Group is at the Forefront of Medical Tourism to make India the Global Healthcare Destination. Its mission is to bring healthcare of international standards within the reach of every individual. They are committed to the achievement and maintenance of excellence in education, research and healthcare for the benefit of humanity. Dr. Prathap C Reddy is the Founder & Chairman, Apollo Hospitals Group. Led by Apollo Hospitals Group, Indian Healthcare today has developed International delivery capabilities and has demonstrated International excellence in all specialties with major cost advantages for people from overseas. Apollo Hospitals has successfully treated over 60000 foreign patients from across the world in last five years and the numbers are looking up every year. By constantly measuring our deliverables, they have succeeded in creating infrastructure that meets the needs of the future that incorporates the latest technology and provides superior healthcare delivery systems. Their immediate agenda includes setting up of healthcare facilities in all major Indian cities, 23-hour hospitals, pharmacies, a pharmaceuticals business and finally, a Health Maintenance Organization that will give millions of people access to all these facilities. The telemedicine technology that has been successfully introduced by Dr. Reddy in India will be a key enabler in transforming the healthcare delivery in India. His blueprint for the nation includes setting up of many rural hospitals. Apollo Hospitals Group is the acknowledged leader in bringing super speciality world-class healthcare to India. It is presently the largest integrated healthcare company in Asia. Apollo Hospital  would mean any of the hospitals owned by  Apollo Hospitals, a  healthcare  corporation that operates 38 hospitals in South Asia. It is the largest healthcare provider in Asia and the third largest in the world and is headquartered in  Chennai, India. Apollo Hospital  Delhi  is the first hospital in India to be accredited by the JCAHO and is affiliated with  Johns Hopkins  international, the  Mayo Clinic, and many major hospitals in the United States and Europe. In addition to hospitals, Apollo operates Nursing and Hospital Management colleges,  pharmacies, diagnostic clinics, medical transcription, third-party administration and telemedicine. Through its wholly owned subsidiary, Apollo Health and Life Science Limited, the Apollo Group has set up a chain of nearly 60 branded day-to-day retail clinics on a franchised basis across India and the  Middle East. This is the first time healthcare delivery has been successfully franchised in India. Indraprastha Apollo Hospitals, the largest healthcare group in Asia. Indraprastha Apollo is one of the largest corporate hospitals in the world. It is the third super specialty tertiary care hospital set by the Apollo Hospitals Group, jointly with the Government of New Delhi, India's capital. It is a 695 bedded hospital, with the provision for expansion to 1000 beds in future. The hospital is at the forefront of medical technology and expertise. It provides a complete range of latest diagnostic, medical and surgical facilities for the care of its patients. The hospital started functioning from July 1996, its mission being Medical Excellence with a Human Touch. Cost of treatment Apollo Hospitals is considered one of the most expensive treatment facilities when compared to their local counterparts. A similar treatment and care in a regular hospital would cost significantly lesser. However, their facilities, infrastructure and quality of medical faculty are far superior to anything else in the country, seemingly justifying this increased cost. Medical Milestones * Employs over 4000 specialists and super-specialists and 3000 medical officers spanning 53 clinical departments in patient care * Achieved a 99. 6% success rate in cardiac bypass surgeries, over 91% of these were beating heart surgeries * Conducted over 55,000 cardiac surgeries First Indian hospital group to introduce new techniques in Coronary Angioplasty, Stereotactic Radiotherapy and Radiosurgery. Performed over 7,50,000 major surgeries and over 10,00,000 minor surgical procedures with exceptional clinical outcomes * Pioneered orthopaedic procedures like hip and knee replacements, the Illizarov procedure and the Birmingham hip re-surfacing technique * Pioneered the concept of preventive healthcare in India * First ho spital group to bring the 64 Slice CT-Angio scan system * First hospital group in South-East Asia to introduce the 16 Slice PET-CT Scan * First to perform liver, multi-organ and cord blood transplants in India * Equipped with the largest and most sophisticated sleep laboratory in the world CHAPTER 2 LITERATURE REVIEW Kotler (1999) points out an unchangeable principle for a successful business are to satisfy the customers’ need. Consumer service is closely related to customer satisfaction and consumer satisfaction has a critical influence on the profits and performance of institutions and organizations (Fornell, 1992; Mittal & Lassar, 1998; Wong, 2000). That is why organizations emphasize the importance of consumer service and satisfaction. Just as the dashboard of a car provides timely feedback on vital performance measures, so should an organization’s dashboards inform decision makers and board members on where the organization is headed and how it is progressing toward its strategic objectives. The consumer service perspective is closely associated with the evolution of the business strategies in the Health Care industry. To manage and improve quality, these successful organizations are coming to the conclusion that quality must be measured. This ensures accurate measurement of customer satisfaction versus that delivered by competitors. Service Quality is a service that is consistent with customer expectations and stated obligation in Customer Care, performance & Value. Quality itself has been defined as fundamentally relational:   ‘Quality is the ongoing process of building and sustaining relationships by assessing, anticipating, and fulfilling stated and implied needs. ‘ One cannot separate the process and the human factor, therefore there is a believe that Quality, when built into a product, generates emotions and feelings within those who have taken part in it's creation. Quality is doing the right things right and is uniquely defined by each individual. Error-free, value-added care and service that meets and/or exceeds both the needs and legitimate expectations of those served as well as those within the Medical Center. Organizations that constantly measure themselves in relation to competitors are able to quickly capitalize on their emerging strengths and address weaknesses before they become problems. Service Quality Quality applies to every product either it is physical product, information product or service product. But when Service Quality is talked about it is all about satisfying the targeted customers through meeting their requirements (Zulfikar Ali). Quality cannot be measured without a clear definition or standard. Likewise, Measuring Quality leads directly to the identification of areas for improvement or enhancement—the first step in Improving Quality. Service Quality models There are a number of models which try to capture and define Service Quality. Each has their strengths, and weaknesses. The core definition of Service Quality is â€Å"Customers thinking they're getting better service than expected†. This is often referred to as the perception gap, i. e. the gap between what the customer expects and what they think they got. It's worth noting that both sides of the gap are in the customers mind. You may actually deliver better Service then your competitors, but if the customer thinks that your Service is worse then that's all that matters. Because the perception gap is based on the difference between what a customer expects to receive from a Service and what they think they received both sides of the gap are â€Å"soft† – they are based on customer impressions rather than a â€Å"hard† definable quality. This means the perception gap is difficult to measure, difficult to manage and is likely to change with time and experience. Nevertheless it's vital to business success. Elements of the model A management model should identify and relate those key elements that require systematic management attention (Brogowicz et al. , 1990). The elements proposed to fit in the model are: * Management’s perceptions of customer expectations and perceptions about the service; * Vision, mission, service strategy and directions to eliminate the gaps; * Service analysis, translation of perceptions into service quality specifications and service design; * Financial and human resources (HR) management; * External communication; * Service delivery system (production, delivery and ‘part-time’ marketing). Some models which are the result of some significant research are: The KANO Model states â€Å"What do customers expect as a minimum standard†, and â€Å"what actually makes a difference if the service provider does it better†. Professor Noriaki Kano (1984, the Japanese quality guru), introduced a two-factor quality model, commonly known as â€Å"Kano's Curve†. The curve illustrates the difference between must-be attractive and linear quality elements. The strength of the Kano model is that it identifies that some aspects of service are simply required to be there whereas others serve to genuinely provide competitive advantage and that there are diminishing returns to be gained from simply focusing on must-be qualities. However Kano does not provide diagnostic tools to identify or measure the different aspects, and suggested the changes with time or environment. The PZB Service Quality Model The service quality model and the role of consumers’ and learners’ satisfaction is an essential part of service quality studies. The â€Å"GAP† model of service quality from Parasuraman et al. (Zithaml & Bitner 1996) offers an integrated view of the consumer-company relationship. It is based on substantial research amongst a number of service providers. According to the PZB model, there are five gaps. The first gap refers to the difference between customers’ expected service and management’s perceptions of customers’ expectations. This gap means that management may not correctly perceive customer expectations. The second gap refers to the difference between management perceptions of customers’ expectations and service quality specifications. This gap means that although the people in management level may perceive the correct expectations of the customers, they may not have suitable and sufficient service quality specifications. The third gap refers to the difference between service quality specifications and the real service delivery. This gap means that although the service providers may have suitable and sufficient service quality specifications, they may not have the satisfactory service delivery in the real situation. That may be because service providers lack well-trained employees to deliver satisfactory service. The fourth gap refers to the difference between the service delivered and external communication about the service with customers. That is, the service providers may not have suitable and sufficient communication with the customers or the service providers may have commitments that exceed what they can do or they may not sufficiently inform the customers of what they have done. The fifth gap is the difference between consumer expectation and their perception of service quality – measured by the difference between what customers expect and what customers perceive about the service. In addition, gap 5 is a function of gap 1, gap 2, gap 3, and gap 4; that is, Gap 5= f (gap1, gap2, gap3, gap4). This means that the service quality is closely related to management perception, marketing, personnel management, communications with customers, service specifications and delivery. Based on theoretical development of the PZB Service Quality Model, the SERVQUAL (SERVice QUALity) instrument was proposed. RATER A complementary analysis of the perception gap is the RATER model also produced by Zeithaml (1990). RATER identifies the 5 key areas which together form the qualities of a service offering from a customer perspective. Where the Gap model describes how the provider can minimize the perception gap. RATER focuses on the dimensions of customers expectations. The RATER factors help provide specific dimensions which can be used to analyse and measure customer expectation. Figure 1: PZB Service Quality Model A Conceptual Model of Service Quality and its Implications for Future Research. Journal of Marketing, 49(4), 41-50. Source: Parasuraman, A. , Zeithaml, V. A. & Berry, L. L. (1985). | RATER dimensions sorted by relative importance (Zeithaml 1990)| Dimension| Description| Relative importance| Reliability| Ability to perform the promised service dependably and accurately| 32%| Responsiveness | Willingness to help customers and provide prompt service| 22%| Assurance | Knowledge and courtesy of employees and their ability to convey trust and confidence| 19%| Empathy| Caring individualised attention the firm provides its customers| 16%| Tangibles | Appearance of physical facilities, equipment, personnel and communication materials| 11%| THE ASSESSMENT INSTRUMENTS-The SERVQUAL and SERVPERF Based on preliminary knowledge about the service quality model and the consumer satisfaction concept, there are two major assessment instruments (SERVQUAL and SERVPERF). The SERVQUAL (SERVice QUALity) instrument was proposed by the Parasuraman et al. (1988). They initially developed a 97-item instrument to measure the service quality attribute. After eliminating the items with low correlation, they extracted five factors (tangibles, reliability, responsiveness, assurance, and empathy) with 22 service quality items, and claimed the generic nature of the five-dimension instrument. Because the disconfirmation-based SERVQUAL instrument has advantages such as better diagnostic power (Jain & Gupta, 2004), and the parsimony of the instrument (Rohini & Mahadevappa, 2006), most researchers in the service quality area tend to prefer the disconfirmation-based SERVQUAL instrument (Abdullah, 2006; Brady, 2001). However, some researchers have been questioning its drawbacks related to the disconfirmation-based model (Redman & Mathews, 1998), process orientation, dimensionality, measuring scale, and the gap scores (Buttle, 1996; Coulthard, 2004; Clewes, 2003; Wetzels, Ruyter, & Lemmink, 2000). To resolve problems related to the disconfirmation-based SERVQUAL instrument, Cronin and Taylor (1992) propose the performance-only SERVPERF (SERVice PERFormance) instrument to measure service quality. Comparing the validity and reliability of the SERVPERF with that of the disconfirmation-based SERVQUAL, they claim that SERVPERF is better than SERVQUAL in overall service quality measurement in empirical tests (Cronin & Taylor, 1992; Brady, Cronin, Brand, 2002; Jain & Gupta, 2004). The debate related to adoption of SERVQUAL or SERVPERF in service quality studies is not yet resolved. SERVPERF has better explanatory power in overall service quality measurement. On the other hand, SERVQUAL has better diagnostic power because of the P-E score measurement. Thus, selection of the service quality instruments will be determined by the intention of the researchers, service providers or decision-makers (Jain & Gupta, 2004). Research Papers â€Å"Provider Competition and Health Care Quality: Challenges and Opportunities for Research†, by HERBERT S. WONG, PEGGY, M NAMARA states that during the last several years, health care quality issues have emerged as important considerations in developing and implementing public policy. This report highlighted health care delivery problems, patient safety concerns, and health disparities issues. Health care quality is difficult to define because different audiences view health care quality from. Clinicians may define quality based on medical outcomes or processes. Economists may define quality based on concepts of social welfare and may include features that consumers happen to care about, but that clinicians do not (e. g. , the appearance and size of hospital rooms). Health plans may further differ and focus on concepts of preventive care or organizational efficiencies. Researchers need to understand what their measures are capturing and should interpret their findings accordingly. Once health care quality has been defined, investigators interested in conducting applied empirical research are confronted with the challenges of creating proxy measures that capture the essence of the health care quality of interest. An initial problem is whether data even exist to create proxy measures for quality. The physician services market was one of the two health care provider groups on which the conference focused. However, the lack of available data about the care administered by physicians has stymied research on physician competition and quality. With literally hundreds of thousands of patient care physicians, current data systems are not structured in a way that makes accessing data and using data for research purposes pragmatic. Even if data were available, researchers must still overcome the challenges of how best to measure physician quality—an area that is currently not well understood. Patient satisfaction measures, which seek to quantify patients’ experiences with healthcare services, represent another dimension of quality still in the developmental stages. The article by Patrick Romano and Ryan Mutter in this supplement documents the studies that examined hospital competition and hospital quality, identifies the variety of hospital quality measures employed, and highlights the challenges of measuring hospital quality. As Romano and Mutter noted, the science of creating hospital quality measures has focused primarily on the clinical definition of quality, and such research is still largely in its infancy. At the heart of the challenges confronting researchers is determining whether observed differences in hospital quality measures are â€Å"true† differences. Confounding factors that may influence their accuracies include severity of illness, underlying patient risk, and the hospital’s overall case mix. Moreover, how well specific data elements are coded varies widely and ultimately affects the accuracy of the corresponding hospital quality measures. Many observers of medical markets believe that hospitals should compete on the basis of health care quality. However historically, hospital merger cases have focused on their effects on prices, costs, and the nature of the competitive environment, largely discounting health care quality issues. Health care markets are unique and extremely complex. While this invitational conference focused only on hospital and physician providers, the research opportunities and challenges outlined here apply to other health care markets as well. Mark Pauly’s article provides some preliminary thoughts on the concepts and the history of the relationship between competition and quality in health care markets. Health care markets are complex. Hospitals compete with one another, physicians compete with one another, and hospitals and physicians interact in many ways. Multiple external factors may influence hospital and physician competitive behavior. Measurement Challenges As mentioned earlier, the science of quality measurement is largely in its infancy and will continue to develop. The main challenges confronting researchers are determining the validity of the current set of measures and improving or developing new measures. The research field involved in inpatient quality measurement appears to be moving in three broad directions. First, researchers are exploring ways to further evaluate and validate the current set of inpatient quality measures. One approach being considered compares existing inpatient quality measures based on administrative data with information from medical records. Organizations such as individual health plans and veterans’ hospitals often have access to a richer source of clinical information, which could be used for this type of assessment. Second, current inpatient quality measures could be improved if the quality of the information collected is better. For example, in their article, Patrick Romano and Ryan Provider Competition And Health Care Quality Mutter mentioned that external-cause-of-injury codes (i. e. , â€Å"E Codes†) are sometimes under reported and vary substantially across the different organizations collecting such data. Many inpatient quality measures rely on accurate coding to identify the relevant observations. Existing measures could be improved if E Codes are collected more consistently. Finally, another broad approach is to supplement current administrative information with additional clinical information that could be used to refine or to create new measures. The availability of this clinical information could be used to improve measures of quality. As the science for better quality measures advances, analysts face a number of important research questions. While some critics argue that existing measures do not capture all clinical information, proponents argue that if there are no systematic biases across hospitals, precise patient-level information may not be needed. Consequently, is the science of quality measurement â€Å"good enough† for aggregate studies of competition and quality? Are they good enough for individual hospital comparisons? How will new measures with better information compare with existing measures? The Evolving Science of Quality Measurement for Hospitals: Implications for Studies of Competition and Consolidation PATRICK S. ROMANO The literature on hospital quality is young; most studies have focused on few conditions and outcomes. Measures of in-hospital mortality and complications are susceptible to bias from unmeasured severity and transfer/discharge practices. We describe the strengths and limitations of various approaches to quality measurement; summarize how quality has been operationalized in studies of hospital competition. three mechanisms by which competition may affect hospital quality, and propose measures appropriate for testing each mechanism. To evaluate the effects of competition and consolidation in health care markets on quality of care, it is essential to understand the capabilities and limitations of the tools currently available for measuring quality. The number and scope of these tools have grown considerably over the past two decades. These developments have created new opportunities to understand how competition and consolidation affect quality of care, although critics may still challenge the validity of any particular quality measure. The fundamental problem is that quality of care has multiple dimensions, and organizations that perform well on one dimension may not perform well on others. It is all too easy to arrive at the wrong conclusion if one focuses on a single measure, or even on multiple measures of a single dimension. In this paper, a standard definition of health care quality and an associated typology of quality problems is set. It describes the three general approaches to quality measurement, focusing on their strengths and limitations for studies of the impact of hospital competition and consolidation. Next summarizes how these measures have been applied in previous studies, and how the authors of those studies have dealt with concerns about confounding and endogeneity. It describes a conceptual framework that may be helpful in identifying promising measures for future studies in this area. 1. Definitions of Quality and Quality Problems In this paper, they have adopted a clinical perspective on quality of care. Avedis Donabedian (1980), one of the founders of the modern science of health care quality measurement, defined the quality of medical care as â€Å"the management that is expected to achieve the best balance of health benefits and risks (taking) into account the patient’s wishes, expectations, valuations, and means the social distribution of that benefit within the population. † The American Medical Association (1984) defined high-quality care more narrowly as care that â€Å"consistently contributes to the improvement or maintenance of the quality and/or duration of life. Perhaps the most authoritative definition was published by the Institute of Medicine (1990), which defined quality of care as â€Å"the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with curren t professional knowledge. † All of these definitions attempt to distinguish between quality and other non-price aspects of service, which might be classified as â€Å"amenities. † Amenities include aspects of appearance, comfort, and convenience, such as the number of television channels available to hospital patients, the number of menu choices, and the quality of decoration. In making this distinction, they acknowledge that the line between amenities and quality may become blurred, especially with important patient-centered measures such as telephone response time, wait time for appointments, clinic hours, prompt complaint resolution and claims payment, and patient satisfaction. Nonetheless, this distinction is useful because it focuses attention on whether provider organizations expend resources in ways that were likely to improve patient outcomes, or in ways that are designed to give the appearance of quality. this paper, also follow the Institute of Medicine’s (1999) typology of quality problems (Chassin et al. , 1998) as involving inappropriate overuse (i. e. too much care), inappropriate underuse (i. e. , too little care), and misuse. Although this conceptualization may state Pauly’s (2003) definition of quality as â€Å"everything about some good or service relevant to consumers’ well-being that is not measured by quantity,â⠂¬  we prefer to place all provider judgments and recommendations regarding appropriate care in the category of â€Å"quality† rather than â€Å"quantity. † 2. Approaches to Quality Measurement Donabedian (2003) has described the three broad approaches to quality measurement as structure, process, and outcomes. This useful schema has been widely adopted by the health services research and quality improvement communities. Structural measures describe the conditions under which care is provided, and encompass material resources such as facilities and equipment, human resources such as the credentials and experience of health care providers, and organizational characteristics such as patient volume and team nursing. Process measures describe the content of health care, and encompass health care providers’ activities in the realms of screening, diagnosis, pharmacotherapy, surgery, rehabilitation, patient education, and prevention. Finally, outcome measures describe changes attributable to health care, and encompass mortality, morbidity, functional status and pain, as well as patients’ health-related knowledge, behaviors, and satisfaction. Although this schema remains conceptually useful, it is sometimes difficult to apply. For example, the shared features of â€Å"high-reliability organizations† (Reason, 2000) include both the structural conditions under which professionals work and how that work is performed. 3. Integrating Outcome and Process Measures of Quality Given that quality of care is a complex and multidimensional concept, no single measure of either process or outcome is likely to provide an adequate summary of the effects of competition and consolidation. Hospitals that perform well on risk-adjusted outcomes for one condition often perform poorly for unrelated conditions (Rosenthal, 1997; Chassin et al. , 1989), making it useful to consider a spectrum of conditions. Similarly, explicit process measures must be developed and implemented on a condition-specific basis (Ashton et al. , 1994). It may be particularly useful to consider outcome and process measures together, as an integrated approach would offer a more complete assessment of quality and elucidate the pathways by which market forces affect patient outcomes. Observed agreement between process and outcome measures at the provider level would support the construct validity of each measure. Disagreement would suggest: (1) information bias attributable to misclassification on either measure; (2) confounding of outcome measures due to unmeasured severity of illness; (3) selection bias due to selective enrollment or dropout of high-risk patients; or (4) an incorrect conceptual model, based on an assumed process-outcome linkage that does not actually exist Competition in Medical Services and the Quality of Care: Concepts and History MARK V. PAULY Consumers of medical services care about both the price they pay (directly, or indirectly through insurance) for that care and the quality of the care for which they pay. While both an unambiguous measurement of quality and the process by which quality is produced are in many ways unknown, it is surely possible for producers, consumers, and regulators to detect and analyze large (enough) variations in relevant qualitative characteristics. Sometimes, in some places, and with some providers, quality is higher than at other times, places, and providers. To some extent the final level of quality is (from an analyst’s perspective) going to be random; some quality variation is bound to be due to unknown forces and accidents. However, to some extent as well the supplier decisions which affect quality are explicit and rational, and likewise the consumer choices about which provider or which supplier to use depends on perceived quality. Economically Efficient (Optimal) Quality From an economist’s perspective, â€Å"quality† in its most general sense just means anything and everything about some good or service relevant to consumers’ (actual and perceived) well being that is not measured by quantity. Since the definition of quantity is somewhat arbitrary—for hospitalization for example, is it the number of hospital admissions, the number of hospital days, or some amalgam of inpatient services and outpatient services? the definition of quality will depend on how we define quantity. If we define quantity by surgical admissions, then average length of stay would be one dimension of quality, prevalence of wound infections would be another, and patient satisfaction would be a third. Th ere can also be qualities that do not have this ordering—for example, the color of the walls, the temperature of the room, or even the length of stay—but these factors are usually not very important. It is focus on â€Å"ordered† qualities. However, just because people prefer more of some characteristic to less does not necessarily mean (or even usually mean) that the market will or should â€Å"maximize quality† in that dimension. If we think of some unequivocally-ordered characteristic, from an economic viewpoint the optimal level of quality, given some total quantity, is that level at which the marginal benefit from additional quality (measured in money) just equals the marginal cost of adding to quality. The optimal length of stay is not infinite, the optimal amount of space in a patient’s room is not enormous, the optimal number of medical errors is not zero (though it could be much lower than at present). Of course, it is possible, indeed, likely, that optimal quality will be different at different quantities (quality and quantity can be substitutes or complements). It is certain that the optimal level of quality, given quantity, will be different for different people, depending on the value they attach to quality. The â€Å"right† quality depends on the patient as well as on the illness or procedure, and it depends on the patient’s preferences (backed up by ability to pay) as well as on the patient’s physiological state. A more complex question is the optimal variety of quality levels when people have different preferences but it is too costly to produce a different quality level for each person. This definition of optimal quality when applied to medical services certainly includes everything that would be embodied in a clinical definition of quality. However, there are some differences between the economic and what we might call the â€Å"health services research† perspective. One difference is that the economic definition will probably include more features (that consumers happen to care about but clinicians do not). One can think of cases in which consumer preferences about such things as â€Å"travel time,† â€Å"bedside manner,† â€Å"respect,† and â€Å"discomfort† do become important. The other difference is that the economic definition will probably require a more careful consideration of marginal cost relative to marginal benefit than would be embodied in the clinical view of â€Å"ideal quality. † 2. Quality Options with Inefficient Suppliers: A Diagrammatic Analysis Although the foregoing seems fairly basic, there are some aspects of the normative notion of optimal quality that may be controversial in both health policy and health services research, and some aspects of the positive aspects of market supply that are both confusing and contentious. A key issue for much of the literature is that of the existence of tradeoffs. The previous discussion implicitly assumed that higher quality costs more—that cost (which really just represents an index of the sacrifice of all other goods consumers value) and quality trade off. Yet many observers of medical care markets in the United States have the strong opinion that cost and quality don’t usually trade off—that higher quality implies lower cost or that it is at least an open question (Leatherman et al. ,2003). Improving the Service Quality of Distance Education( Rui-Ting Huang,USA / Taiwan) states that the success of a distance learning program is dependent on the quality of supporting services. This research relates to services, gaps in service, business models, continuous quality improvement, and maintaining a competitive edge. Distance Learning has become an important learning option for education systems (Yilmaz, 2005) and training solutions in the Human Resource Development (HRD) area (Felix, 2006). The growth of the distance learning industry has been faster than expected (Huynh, Umesh & Valacich, 2003). Most importantly, in terms of organizational training, an investigation from the Fortune-500 companies indicates that over 80% of companies use distance learning or plan to do so (Hammond, 2001). Through distance learning, organizations have a more convenient, practical and cost-effective way to train the employees (Hammond, 2001; Whitney, 2006; David, 2006). Due to the growth and competition in the distance learning market (Huynh, Umesh & Valacich, 2003), DL research includes the study f consumer aspects such as consumer services and satisfaction (Shaik, 2005; Granitz & Greene, 2003; Huynh, Umesh & Valacich, 2003). Feedback from learner give the instructor important data to determine how well the instr uctional program satisfies individual learner needs (Steyn & Schulze, 2003; Long, Tricker, Rangecroft, Gilroy, 1999). This in turn offers service providers in the marketplace important information to streamline the business process to improve the quality of distance learning services (Granitz & Greene, 2003; Steyn & Schulze, 2003). Quality services and support will help the service providers, institutions and organizations in DL get a competitive advantage in the marketplace (Shaik, 2005). As the distance learning industry has become mature in the educational marketplace (Huynh, Umesh & Valacich, 2003), it is providing learners with convenient and flexible learning alternatives (Alexander, 1999; Tarr, 1998). It is also giving organizations alternative cost-effective and timely training solution to effectively and efficiently implement the human resource development plans (Hammond, 2001; Whitney, 2006; David, 2006). ). The focus on consumer service may offer the service providers new insights (Moisio & Smeds, 2004) to help them streamline the business process, improve the quality of future service in distance learning (Granitz & Greene, 2003; Steyn & Schulze, 2003) and gain long-term competitive advantages (Shaik, 2005). Mary Nugent ( 2002, vice president and general manager of Subscription Services for BMC Software Inc. a leading provider of enterprise management)said that an increasing number of companies are relying on service providers to manage their mission-critic al applications, service providers are realizing that they need an improved method for consistently delivering reliable and highly available service at a competitive cost. Measuring the performance and availability of Web and enterprise applications is inherently difficult. Without accurate and timely measurements it is all but impossible to measure customer satisfaction and Quality of Service (QoS). Due to the cost of developing and implementing such a solution, service providers are finding they need to partner with others in the marketplace to ensure service level agreements (SLAs) are being met and the end-user experience is optimized. A quality end-user experience is what service provider clients require service providers must deliver in order to survive. Online shoppers are not tied by brand loyalty since they can get what they need at many different sites. Companies that want to achieve customer loyalty must deliver value through the customer experience. By outsourcing to service providers for this expertise, companies are entrusting their business and reputation on the solutions they offer. This makes it doubly important that service providers choose solutions that deliver on their SLAs. Principles Of Quality Customer Service 1. Quality Service Standards -Publish a statement that outlines the nature and quality of service which customers can expect, and display it prominently at the point of service delivery. 2. Equality/Diversity -Ensure the rights to equal treatment established by equality legislation, and accommodate diversity, so as to contribute to equality for the groups covered by the equality legislation (under the grounds of gender, marital status, family status, sexual orientation, religious belief, age, disability, race and membership of the Traveller Community). Identify and work to eliminate barriers to access to services for people experiencing poverty and social exclusion, and for those facing geographic barriers to services. 3. Physical Access -Provide clean, accessible public offices that ensure privacy, comply with occupational and safety standards and, as part of this, facilitate access for people with disabilities and others with specific needs. 4. Information -Take a proactive approach in providing information that is clear, timely and accurate, is available at all points of contact, and meets the requirements of people with specific needs. Ensure that the potential offered by Information Technology is fully availed of and that the information available on public service websites follows the guidelines on web publication. Continue the drive for simplification of rules, regulations, forms, information leaflets and procedures. 5. Timeliness and Courtesy -Deliver quality services with courtesy, sensitivity and the minimum delay, fostering a climate of mutual respect between provider and customer. Give contact names in all communications to ensure ease of ongoing transactions. 6. Complaints -Maintain a well-publicised, accessible, transparent and simple-to-use system of dealing with complaints about the quality of service provided. 7. Appeals -Similarly, maintain a formalised, well-publicised, accessible, transparent and simple-to-use system of appeal/review for customers who are dissatisfied with decisions in relation to services. 8. Consultation and Evaluation -Provide a structured approach to meaningful consultation with, and participation by, the customer in relation to the development, delivery and review of services. Ensure meaningful evaluation of service delivery. 9. Choice -Provide choice, where feasible, in service delivery including payment methods, location of contact points, opening hours and delivery times. Use available and emerging technologies to ensure maximum access and choice, and quality of delivery. 10. Internal Customer -Ensure staff are recognised as internal customers and that they are properly supported and consulted with regard to service delivery issues. Performance measurement In Health care, the patients’ satisfaction has been widely used as a critical dependent variable to evaluate success of the service provider. The patient is one of the important stakeholders in the health care arena (Yeung, 2001; Yang & Cornelious, 2004). And it is reasonable that the patients’ perception will be considered as a crucial indicator to evaluate the quality of service(Steyn & Schulze, 2003). In the business area, consumer satisfaction often denotes whether the service provider met the consumers’ need (Steyn, & Schulze, 2003). Anderson, Fornell and Lehman (1994) propose there are at least two viewpoints in the definition of consumer satisfaction. The first viewpoint is a transaction-specific perspective, which refers to the consumers’ post-purchase appraisal or judgment of the products or service based on expectations at the specific purchasing time or location. The second viewpoint is cumulative satisfaction, which refers to consumers’ overall appraisal of purchasing and consuming experience toward the products or service. Therefore, we may regard patients’ satisfaction as the patients’ overall post-use evaluation toward the health care service. Performance measurement is a fundamental building block of TQM and a total quality organisation. Historically, organisations have always measured performance in some way through the financial performance, be this success by profit or failure through liquidation. However, they do not map process performance and improvements seen by the customer. In a successful total quality organisation, performance will be measured by the improvements seen by the customer as well as by the results delivered to other stakeholders, such as the shareholders. A simple performance measurement framework includes more than just measuring, but also defining and understanding metrics, collecting and analysing data, then prioritising and taking improvement actions. It is important to know where the strengths and weaknesses of the organisation lie, and measurement plays a key role in quality and productivity improvement activities. The main reasons it is needed are: to ensure customer requirements have been met, to be able to set sensible objectives and comply with them, to provide standards for establishing comparisons, to provide visibility and a â€Å"scoreboard† for people to monitor their own performance level, to highlight quality problems and determine areas for priority attention,to provide feedback for driving the improvement effort Quality-related activities that will incur costs may be split into prevention costs, appraisal costs and failure costs. Prevention costs are associated with the design, implementation and maintenance of the TQM system. They are planned and incurred before actual operation, and could include: Product or service requirements – setting specifications for incoming materials, processes, finished Products/services;Quality planning – creation of plans for quality, reliability, operational, production, inspection; Quality assurance – creation and maintenance of the quality system; Training – development, preparation and maintenance of programmes. Appraisal costs are associated with the suppliers’ and customers’ evaluation of purchased materials, processes, products and services to ensure they conform to specifications. They could include: Verification – checking of incoming material, process set-up, products against agreed specifications; Quality audits – check that the quality system is functioning correctly; Vendor rating – assessment and approval of suppliers, for products and services. Failure costs can be split into those resulting from internal and external failure. Internal failure costs occur when the results of work fail to reach designed quality standards and are detected before they are transferred to the customer. They could include: Waste – doing unnecessary work or holding stocks as a result of errors, poor organisation or communication; Scrap – defective product or material that cannot be repaired, used or sold; Rework or rectification – the correction of defective material or errors; Failure analysis – activity required to establish the causes of internal product or service failure. External failure costs occur when the products or services fail to reach design quality standards, but are not detected until after transfer to the customer. They could include: Repairs and servicing – of returned products or those in the field; Warranty claims – failed product that are replaced or services re-performed under a guarantee; Complaints – all work and costs associated with handling and servicing customers’ complaints; Returns – handling and investigation of rejected or recalled products, including transport costs Effective quality improvements should result in a future stream of benefits, such as: †¢ Reduced failure costs †¢ Lower appraisal costs †¢ Increased market share †¢ Increased customer base †¢ More productive workforce Service Quality Management (SQM) Service quality can be defined as â€Å"the collective effect of service performances which determine the degree of satisfaction of a user of the service†. In other words, quality is the customer’s perception of a delivered service. Service-quality management, refers to the monitoring and maintenance of end-to-end services for specific customers or classes of customers. As larger varieties of services are offered to customers, the impact of network performance on the quality of service will be more complex. It is vital that service engineers identify network-performance issues that impact customer service. They also must quantify revenue lost due to service degradation. The service-mapping tool comes in next. Performance data is mapped onto service-quality data. Take a customer using Multimedia Messaging Services, or MMS. If a video download is interrupted many times during a session, the customer will lose interest. The operator’s revenue will be lost with it. To avoid this situation, key quality indicators (KQIs) like availability can monitor the QoS offered to customers. From a customer’s point of view, the availability KQI measures how successfully he or she can access and use the MMS service. With the service mapping tool, it’s possible to combine KQIs from multiple key performance indicators (KPIs) across different service resources. KPIs measure a specific aspect of the performance of either a service resource or a group of service resources of the same type. A KPI is restricted to a specific resource type and derived from network measurements. By following this top-down approach, the service-mapping tool provides several benefits. It helps operators manage end-to-end quality of service from a customer’s perspective. It also allows them to reuse key performance indicators and key quality indicators across services and products. Lastly, it helps operators drill down to the service elements that are responsible for quality degradations. Service quality also demands a simple and easy-to-use user interface. With this interface, Network Operations Center (NOC) staff and service managers can monitor service-quality objectives against thresholds. These thresholds may be internal targets for the network operator. Or they could be derived from Service Level Agreement (SLA) definitions. When the service quality falls below the contracted levels, managers could then initiate corrective actions. They could focus on the service degradations that affect the greatest number of customers. A set of standard reports for different user communities should also be available. For new services, marketing and sales may be interested in reports on service usage and service uptake. National regulators may also request historical service quality against given service objectives. CHAPTER 3 METHODOLOGY Cooper and Emory (1995) defined research as a systematic inquiry aimed at providing information to solve problem. This chapter will present a detailed idea about how the research will be conducted. In this chapter research methodology, the sample selection methods, data collection methods & data extraction from the Questionnaire and data analysis will be studied and explained. At the end of this chapter validity and reliability issues will be discussed to follow the quality standards of the research. Research strategy will be a general plan of how researcher will go about answering the research questions that has been set by researcher. It will contain clear objectives, derived from research questions specify the sources from which researcher intend to collect data and consider the constraints that researcher will inevitably have such as access to data, time, location and money, ethical issues. (Thornhill et. al. , 2003) Based on three conditions 1) form of research question 2) requires control over behavioral events and 3) focus on contemporary events Yin (1994) identified five research strategies in social science. These are – experiments, surveys, archival analysis, histories and case studies Most important condition for selecting research strategy is to identify the type of research question being asked. â€Å"Who†, â€Å"What†, â€Å"Where†, â€Å"how† and â€Å"Why† are the categorization scheme for the types of research questions. Two possibilities need to investigate by asking the â€Å"what† question. First, some types of what questions are justifiable for conducting an exploratory study and the goal is to develop pertinent hypotheses and propositions for further inquiry. Any of the five research strategies can be used in that situation- exploratory survey, exploratory experiment, or an exploratory case study. The second type of what question is actually form a â€Å"how many† or â€Å" how much† line of inquiry and the outcomes from a particular situation. The survey or archival analysis is more favorable than other strategies. If the researcher needs to know the â€Å"how† question, the better strategy will be doing history or a case study. (Yin 1994) Research Purpose Research can be classified in terms of their purpose. Accordingly, they are most often classified as exploratory, descriptive or explanatory (Saunders, Lewis & Thornhill 2003). Exploratory research is useful when the research questions are vague or when there is little theory available to guide predictions. At times, researcher may find it impossible to formulate a basic statement of the research problem. Exploratory research is used to develop a better understanding (Hair, Babin, Money & Samouel 2003). Exploratory studies are a valuable means of finding out what is happening, to seek new insight, to ask questions and to assess phenomena in a new light. It is particularly useful if researcher wish to clarify the understanding of a problem. There are three principle ways of conducting exploratory research: a search of the literature, talking to experts in the subject, conducting focus group interviews (Saunders, Lewis & Thornhill 2003). Descriptive research describes some situation. Generally things are described by providing measures of an event or activity. Descriptive research designs are usually structured and specifically designed to measure the characteristics described in a research question. Hypotheses, derived from the theory, usually serve to guide the process and provide a list of what needs to be measured (Hair, Babin, Money & Samouel 2003). The object of descriptive research is to portray an accurate profile of persons, events of situations. It is necessary to have a clear picture of the phenomena on which researcher wish to collect data prior to the collection of the data (Saunders, Lewis & Thornhill 2003). Explanatory Research establishes causal relationships between variables. The emphasis here is on studying a situation or a problem on order to explain the relationship between variables (Saunders, Lewis & Thornhill 2003). Explanatory studies are designed to test whether one event causes another (Hair, Babin, Money & Samouel 2003). The purpose of the research is mainly descriptive and explanatory. It is descriptive because descriptive data has been collected through detailed interviews and it is also explanatory since we will explain the relationship between the service quality variables and customer satisfaction and how these dimensions affect customer satisfaction. It is somewhat exploratory nature since Data Collection Method Data was collected by primary as well as by secondary data c