The Tempest Essay -- essays research papers

Throughout the play The Tempest there is a relationship that pits master and slave in a harmony that benefits both parties. Though it may sound strange, these slaves sometimes have a goal or expectation that they hope to have fulfilled. Although rarely realized by its by its participants, the Master--Slave, Slave--Master relationship is a balance of expectation and fear by the slaves to the master; and a perceived since of power by that of the master over the slaves.   Ã‚  Ã‚  Ã‚  Ã‚  The relationship between the slave and master is one of expectation and perceived fear. Expectation in a sense that a slave with a perceived future expectation will tend to work harder and more diligently for their master then a slave that does not have these expectations for hope of reaching their ultimate goal. For instance Ariel is more willing to do Prospero’s bidding for he believes that are some future date he will be set free, and will not longer have to serve as a slave to prospero. For instance in this passage we are confronted with this expectation of freedom: Prospero: †¦What is’t thou canst demand Ariel: My Liberty Prospero: Before the time be out? No more Ariel: I prithee, remember I have done thee worthy service, told thee no lies, made no mistakings, served without grudge or grumbling. Thou did promise to bate me a full year (Act I, Scene II, 245-249) Showing that the slave, Ariel, is willing to do what ever is asked of him in the hope that in due time he will be set free, and to serve no one any longer. However, this expectation is one sided; since, the expectation of freedom I dependent on how prospero perceives the tasks that have been completed and those that are to be done. Thus, Ariel may never be set free if prospero never feels satisfied. On the other hand, if there is no expectation by a slave of future rewards then the future expectation of rewards is removed and the slave feels only oppression from the master, nothing more. For Caliban is a prime example. Caliban is not expecting to be set free or have his land restored to him. So Caliban has an extreme hatred for his master, Prospero, which all he can do is curse the man that made him this way, and hope for his demise. â€Å"All the infections that the sun sucks up from bogs, fens, flats, on Prosper fall, and make him by inchmeal a disease†¦His spirits hear me, a nd yet I needs must curse†(Act... ...ith humane care, and lodged their in mine own cell, till thou did’st seek to violate the honour of my child†(Act I, Scene II, 343-348). Prospero believed that Caliban had this coming to him, and should he had been a vengeful man could have killed him. From these examples we see that Prospero perceives his power over all since he had spared them from horrible existences and given then a taste of the civilized world. Lastly, Prospero believed so deeply that since he was the first noble to set foot on the island that it was his right to claim it as his own. For before him this isle was nothing till he brought his language, education, and culture to it.   Ã‚  Ã‚  Ã‚  Ã‚  For there is a delicate balance between the master—slave relationship, and the slave—master relationship. Neither can exist without the other. The master laying claim to all that he can survey, and bringing order to those around him as Prospero did for his ailing people. The slave fearing for life, or an expectation that one-day he shall be free to do as he pleases. For this delicate balance cannot be maintained without the two groups co-existing in a state where one need the other for ultimate survival.

Hotel Repositioning

{draw:frame} University of Derby/Buxton Hospitality Management MA Hotel Renovation A Tool For Repositioning In the Hotel Industry Submission Date: 7th May 2009 Business Analysis and Decision Making Student: Nana Yaa Addo Module Leader: Norman Dindsdale Introduction The hospitality industry has grown phenomenally since 2001 and has been driven by both leisure and business demand (kloppers 2005). The needs of the consumer have now become dynamic rather than static. Consumers today have a strong desire for luxury in every sense of the word be it travel, goods or even a night stay in a hotel, thereby creating a competitive environment among business owners and organisations to come up with innovative ways to increase and also retain their business. Altstiel and Grow (2005 p. 28) similarly states that â€Å"people do not buy things but rather a satisfaction of their wants and needs. Therefore the hospitality industry being a service sector is not an exception as the industry must also meet challenges by formulating and implementing strategies that will meet today’s economic conditions and also satisfy customer needs. This report focuses on how hotel renovation can be used as a tool for repositioning in hotel operations. It will explore the theory behind repositioning and test the theory by looking at some case studies within the industry, it will also try to identify its challenges and successes and see how it could be undertaken in the fu ture. Main body The term repositioning has been used side by side with positioning, branding or new product development and has a wide range of definition, as a result it has no exclusive accepted definition. For example, the work of Hassien and Baum (2002p146) give the following definitions of the term which perceives a greater understanding. (Lovelock,1996;Lewis et al;1995) define the term as the changing of the existing position without referring to its implementation (Hart and Stapleton, 1987; Collin, 1989; Jefkins, 1987; Ries and Trout,1986) define it as an advertising trategy by which the company can change the image of its product and the perception of people about it. Booz, Allen and Hamilton (1982) define the term as one of the six categories of new products in terms of their newness to the company and to the marketplace, as being the process of targeting the existing products to new markets or market segment. In addition the business dictionary also defines it as changing a brands status i n comparison to that of the competing brands. Furthermore Hassien and Baum go on to say that â€Å"an in-depth review of its literature identifies that there is a general agreement in most of these definitions, that repositioning involves a change to the image of a product in the market through changing the perception of the customer†(p. 146) and finally define the term as â€Å"the marketing management process of changing, partially or totally, the perception of the public about a firm through any modification or addition to one or more of its controllable variables (eg. Customer, competition, technology, coporate, etc. ) in order to retain, expand or change its target markets†(p. 147) From the above definitions it is obvious that repositioning involves the modification of a product to make it more appealing in order to attract existing customers or new market segments The Concept Of Repositioning. Due to intensifying global competition, a constantly changing environment, current consumer trends and modern technology, repositioning like any other marketing tool adopts a strategy in order to be successful. For instance Macmillan (2000, p45) states that ‘conditions in the global business environment demands that established firms adopt entrepreneurial strategies’. Johnson and Scholes(2002 p10) have defined strategy as â€Å" the direction and scope of an organisation over the long term which achieves advantage for the organisation through its configuration of resources within a changing environment and to fulfil stakeholder expectations. † Bowie and Butler (2004 p. 06) state the following reasons as to why a company may be forced to reposition; Falling sales (often a symptom of customer dissatisfaction) An opportunity to service an emerging market segment The threat of competing for market share. As a result Jobber in the book of Enew and Waite (2007 p. 165), identifies four basic repositioning strategies and they are listed as follows Image repositioning- This means keeping the product and target market the same but changing the image of the product. Product repositioning –This means that the product has been modified to meet more fully the expectations of the target group. Intangible repositioning-An organisation targets a new market segment with existing products but places the emphasis on a different ,less tangible aspect of the product. Tangible repositioning-In some market sectors there is the need to change both product and target market moving upmarket or downmarket through the introduction of a new range of products often demands a comprehensive repositioning strategy. Similarly a study by Kotler et al 1993 cited in Crompton 2000 pp70-72) offers three strategies that can also be used to achieve repositioning and they are as follows; Real repositiong: which means that an agency changes what it does so that desired community priority needs are met through its offerings Competitive repositioning which means altering stakeholders’ beliefs about what an agency’s competitors do. Psychogical repositioning which means altering stakeholders beliefs about what an agency currently does From the above, it can be deduced that; Repositioning is used to alter perceptions of the consumer It is used by organisations to ensure they exceed the expectations of the consumer in order to retain themselves in the business environment It is used to identify growth and opportunities. It must however be noted that whatever strategy that is employed ,must be realistic, achievable, results focused and must also take into account which strategy best fits the needs of the business as well as that of the consumer. However for the purpose of this report the attention is on renovation as a tool for repositioning in the hotel industry in other words the focus is on the use of renovation to develop or improve existing and new product lines. Renovation Definition According to Hassien and Baum (2001p. 148), renovation may be defined as â€Å"the process of retaining or improving the hotel image by modifying the tangible product, due to a variety of reasons, through any changes in the hotel layout (e. g. Property structure-new extension) and/or any additions or replacement of materials and furniture, fixture and equipment†. It may also be defined as â€Å"a facility for which a substantial amount of the equipment, structure or other components is replaced or modified and which may expand capacity and/improve the process of the facility† (CII 2006, P1) From the above it can be noted that renovation as a process involves a lot of activity which can either be upgrading of the design, decor etc of the property layout or the development of an entirely new product. Types of renovation Renovations may be classed as major or minor depending on the amount of work involved in each type. For instance a renovation that involves the renewal or replacement of all equipment, furnishings and finishes in order to improve or change the image of the physical layout of the hotel may be termed as a major renovation, whiles a renovation that involves the upgrading or replacement of soft goods such as carpets, drapes, beddings etc without changing the physical layout of the property. The property must be in a market not sustaining the desired level of operation There must be an alternate market not being served Change in the market they serve Furthermore Hassien and Baum (2002p. 148) cite these reasons; To keep up with the competition To maintain or increase market share by satisfying current or potential customers To improve the operational efficiency of the hotel that will lead to an increase in both productivity and long term savings in operational expenses To maintain corporate image and standards To upgrade the hotel to a higher category (eg. From 4 to 5) To comply with the new trends and technology in the market The process of renovation while its clear a renovation or brand conversion is intended as an improvement on your investment, managing a long list of decisions will make for a shortfall in revenue without the right plan in place†(sansone et al 2009 p. 20). It must be noted that renovation is constantly an ongoing process in hotels and it employs certain decision making factors to ensure its success. These decisions if undermined can cost hoteliers a great deal of money and if taken seriously can reap re wards in other words renovation can either pose a financial challenge if not planned well or reflect profitability if planned well. There is nothing worse than being in a hotel when these processes are on going, the noise, the uncertainty and the feeling that you are experiencing ‘second best’. The following decisions have been identified through research that renovation undergoes the following processes. Planning In the planning process, elements such as team, budget, timing and marketing are taken into consideration. Team: It has been argued that the very first step when the decision on renovation has been taken is the selection of a team usually comprising experts and project managers. Rowe and Megan1995,Hassien and Baum 2002). These people are usually charged with the responsibility of providing expertise in the accomplishment of budgets, contingencies and scheduling from the start till finish of the project and can be a complete waste of time and money if they are not involved in the renovation project(Sansone et al 2009 ). Budget: This usually involves taking into consideration a realistic amou nt of money that is believed to be enough to finance the project. It is also the most important and critical aspect pertaining to the project. It is usually based on criteria such as the time value of money, wealth maximisation and risk accommodation. Timing: Recognising when to undertake a renovation is also very important in the decision making process. This is because hoteliers must carry out such projects when occupancy is low so that renovation can be carried out with less disruptions and minimise risk in terms of safety Bowe and Megan 1995 ) It is also interesting to note that there aside the above decisions taken during the renovation process, key areas of long term decision making is that of investment. The decision to carry out these important changes must, of course, involve a much more complex set of criteria. The key concept of finance being the first that is reviewed and factored in terms of risk. It is assumed that the objective of any financial investment is to maximise economic benefits. Hence â€Å"projects which pass through the preliminary screening phase become candidates for rigorous financial appraisal to ascertain if they would add value to the firm (Dayananda et al 2002 p. 7). Four investment appraisal techniques namely, ARR(average rate of return, Payback, NPV(Net present value)and IRR(Internal rate of return)are usually considered in the decision making process in large companies with Payback and NPV proving to be the most popular(Lamminmaki et al cited in Guilding 2005 p. 205) To touch briefly on the above; ARR- measures the incremental operating income that will be generated per dollar of investment in other words it measures profitability by comparing the required investment to future annual earnings(Oliver& Amacom 1999p. 11, Dayananda et al 2002 p43) Payback-It attempts to forecast how long it will take for the expected net cash inflows to payback the investment outlays (Glautier and Underdown 2001 p. 448) NPV- The excess of the present value (PV) of cash inflows generated by the project over the amount of the initial investment (Shim&Siegel 2007 p. 209) IRR- It represents the true interest rate earned on an investment over the course of its economic life (Colin Drury 2004 p. 501. For the following the NPV and IRR are used as being the most important in the individual case studies. This does not mean the others would not work, simply these were the most appropriate. Informed assumptions are made within the case studies as only outline information was available from the companies Case study 1 January 18-24, 2004 Crown Plaza Owners of the hotel invested 7 million dollars to renovate the crown plaza in Philadelphia to restore the hotels reputation which owners believed have suffered as a place for corporate meetings and stays as well as well as to target the SMERF market(social, military, educational, religious, fraternal bookings). Hotel owners updated rooms ,with a redone lobby, restaurant, common areas and meeting rooms. The hotel is located on city avenue and is a walking distance from the new target store, that brought with it a host of smaller retailers including chipotle grill, sandwich works and California pizza. â€Å"I’m not sure how it affects business, but guests like to walk to a restaurant which is definitely a convenience for guests†. Calculating IRR IRR=A+(Na/Na-Nb)*(B-A) Where A =Lower DF (10%), B = Higher DF (20%), Na=NPV at 10% Nb= NPV at 20%. Therefore; IRR= 10+ (0. 662/0. 662-1. 02) * (20-10) IRR= 10+ (-O. 2) *(10) IRR=9. 98 Case study 2 The Grand Hyatt (New York) July 15, 2004 To reaffirm the brand as a leader in the multi purpose hotels, the Grand Hyatt under took a 55million dollar renovation project. The project touched every area of the hotel with more emphasis on guest room and meeting spaces. The guest rooms were designed to give them a more international look with desig n elements including a colour palette of golds and taupe with blue accents. Roman shades dug in into the window wells to replace traditional draperies, an all new cabling and wired smoke detection and emergency communication system. Work and play amenities include a 27- inch flat screen T. V, a standard workstation with ergonomic chair, CD- clock radio. Bathrooms were upgraded with porcelain tiles, black granite pedestal sinks, stone flooring and curved shower rods. An entire floor was upgraded into a high tech conference centre targeting financial companies that needed the latest technology as well as privacy to do their business. Therefore calculating the NPV for case study 1 is illustrated below In evaluating both studies it is obvious that the main reasons for undertaking these renovation projects was to: Compete against other hotels Satisfy their customers Increase profitability by attracting customers. The basic rule underlying NPV is that if the present value of the returns exceed the present value of costs then the project should go ahead since it will increase profits. (Atkinson and Miller p. 315). In other words the project should be carried out if the NPV is positive. In case study 1 an initial investment of 7million dollars in year 0 is assumed to give rise to inflows of 2million dollars for each of years 1 to 5 So in this case an NPV of 0. 662 and 1. 02 respectively are both positive figures and hence the project will be profitable. However this same projects could be risky because of it’s IRR. For instance Finnerty(2005 p. 157) is of the view that ifthe IRR exceeds the project’s cost of capital then the projects should be undertaken but in this case an IRR of 9. 98 is less than both the lower and higher discount factors of 10% and 20% respectively and therefore will be in the interest of decision makers to forgo the project. In case study 2 an initial investment of 55million dollars in year 0 is assumed to give rise to inflows of 12million dollars for each of years 1 to 5. In this case an NPV of 9. 52 also indicates a positive figure hence a profitable project. This suggest that higher is better for both NPV and IRR in other words investments with higher rates of return are more profitable than investments with lower rates of return but it can be argued that â€Å"since the economic environment is dynamic the cost of capital can be influenced by such changes,(Watson &Head 2007) rather it will be better if business owners sought to maximise shareholders wealth through considering their investment value in monetary terms rather than focusing so much on it’s immediate return. Moreover both the NPV and IRR have its merits as well as its demerits. Atkinson and Miller(1998 p. 18)give the following merits for the NPV; Gives a clear quantitative result Emphasises the time value of money and makes it superior to methods which do not involve discounting. Involves maximisation of present values of future cash flows thereby maximising shareholder wealth. Despite its merits ,Siddiqui (2005 p. 325,Rashid, Raj & Walters 2008p. 194) of the view tha t ; It is not helpful in comparing two projects with different cash flows It may be misleading in comparing projects of unequal lives It is complicated to estimate the values of cash inflows and outflows over the life of a project. Alternatively, (Capon& Disbury 2004 p. 224) state that the IRR has the following merits; It results in a clear percentage return required on investment since emphasis is placed on liquidity in calculation. It’s the measure of the intensity of capital use and also gives a return for risks Takes into consideration the time value of money and deals with discount cash flows. Several authors strongly oppose and cite reasons as to why the IRR may not be the best financial appraisal. For example ( Dyson 2004, Mclaney& Atrill 2007) give the following reasons It does not maximise shareholders’ wealth There is difficulty in handling projects with unconventional cash flows It gives only an approximate rate of return It can be misleading especially where there are negative net cash flows in subsequent years and when one project has to be opted for in favour of another i. e. mutually exclusive project. Conclusion Hotel renovation is an inevitable process especially if hoteliers wish to secure their positions in the marketplace and also keep up with the constantly changing needs of the consumer. The two investment appraisal methods i. e the NPV and IRR usually used by decision makers Moreover the customer be it a business traveller or holiday maker is the most important element to the hospitality industry, to such a customer, the most important criteria are an appealing image, safety and security, standard of service and most of all value for money. Leaders in the industry must in no uncertain terms ensure that they meet expectations. So regardless of the financial appraisal techniques considered in the decision making process, hotel renovations are a must unless hoteliers are looking to reposition further down the market for instance choosing to go two star(2) or three(3) then they could be justified if they chose not to renovate otherwise they should be aware that they stand the chance of loosing market share if they do not renovate when required. Reccommendations Although investment decisions are carried out in the hope of generating future returns, the most important question hoteliers should be concerned with is whether they will be in business if they compromised their standards and quality of service by not repositioning as a result of lack of funds. The following suggestions have been given to serve as a guide to hoteliers wishing to renovate in the near future. Due to the costly nature of renovation, hoteliers could consider alternative sources of capital such as loans that offer low interest rates and low down payments that are unlikely to change during the period of the loan. Also hoteliers must endeavour to give priority to areas that need immediate attention, they can achieve this by segmenting the market in order to identify the needs of the market that way they are able to know what to accomplish in the shortest possible time without breaking the bank. Again in the present downturn, hoteliers must find ways to cut down on renovation expenses. For example if there is a choice of choosing between minor renovations such as the changing of bedding, drapes, curtains etc to major renovations that deal with heavy equipments, hoteliers will be better off going for minor renovations. Moreover they could also seek advice (in terms of selecting contractors and experts that are willing to offer reasonable rates) from hoteliers that may have undertaken a similar project. In addition, Harris & Joanne (2003) advice that the best time to undertaken renovations should be less busy periods. Executive Summary The concept of repositioning was looked at in terms of two hotels. It looked at the repositioning and renovation concept. It was realised that the main reasons for carrying out these renovations was to satisfy the customer in order to ensure repeat business, differentiate form other competitors to maintain a leading position, open new markets, and also increase profitability. In order to achieve this certain decisions had to be carried out, emphasis was placed on two investment appraisal methods i. e the NPV (Net present value) and IRR (Internal rate of return) since hotel renovation involved a great deal of budgeting. It was realised that regardless of the investment appraisal methods, hotel renovations was inevitable. The conclusion was hoteliers had to renovate if they wanted secure the business in the constantly changing environment and also if they wanted to meet the changing needs of the consumer. It may be that they repositioned by default? Journals Ahmed Hassien, Tom Baum(2002) Hotel repositioning through property renovation. Tourism and hospitality research Vol. 4 p. 144 Beirne, Mike(2004) Crown plaza’s bed time story Brand week Vol. 45 ,pp. 12-12 Brennan, Kate(2001) Lodging hospitality Vol. 57, p. 36 Construction industry institute(2006), ‘definition for renovation’. Available from: http://www. Construction institute . org/ script content/cfm. Assessed [April 1 2009] Crompton, John L. (2009) Strategies for implementing repositioning of leisure services Vol. 14, pp. 87-111 Foong, Keat(2009) Multi- housing news Vol. 44 pp. 14-15 Harris ,Joanne (2003) Motel management Vol. 218 p. 36 Hermann, Daniel (2008) Repositioning for the future. Long term living for the continuing care. Vol 57 p. 3 John W. O’Neill, Anna S. Mattila (2006) Strategic hotel development and positioning: The effects of revenue drivers on profitability. Cornell hotel and restaurant administration quarterly pp. 7; 146 Jonathan C. Nehmer, Donald A. Noveau(2005) Renovate or Reposition know the difference. Us international journal pp1-3 Patel, Ashwen ‘Ash’(2008)Credit crunch may disrupt renovation plans. Hotel and motel management, Vol. 223 p10-10 Rowe, Megan. (1995)Renovation has it’s risk. Lodging hospitality. Vol 51 p. 40 Watkins, Ed(2004) New York dresses up. Lodging hospitality Vol. 60 p. 36 Books Bowie D. & Butler F. (2004) Hospitality marketing. Butterworth-Heinemann Capon C. & Disbury A. (2004) Understanding organisational context. 2 nd edition. Pearson education. p. 224 Enew C. Waite N. (2007) Financial services marketing: an international guide to principles and practice. Butterworth-Heinemann Drury C. (Management cost accounting). 6 th edition. Engage learning Glautier M. W. E & Underdown B. (2001) Accounting theory and practice. 7 th edition. Pearson education. Gruen R. & Howarth A. (2005) Financial management in health services. Mcgraw- Hill international Guilding C. (2002) Financial management for hospitality. Butterworth-Heinemann Jain P. K. &Khan M. Y. (2005) Basic financial management. 2 nd edition. Tata Mcgraw pp. 61-63 Mclaney E. J. & Atrill P. 2007) Accounting: An introduction. 4 th edition. Pearson education. Schim J. & Siegel J. G. (2007) Schaum’s outline of financial management. 3 rd edition. Mcgraw-Hill Stevens R. E et al Marketing opp ortunity analysis. Harworth press p. 105 Watson D. & Head A. (2007) Corporate finance: Principles and practice. {text:change} {text:change} {text:change} {text:change} {text:change} {text:change} {text:change} {text:change} {text:change} {text:change} {text:change} {text:change} {text:change} {text:change} {text:change} {text:change} {text:change} {text:change} {text:change} {text:change} {text:change}

Difference Between America and South Korea Health Care Essay

Each country has a different procedure when it comes to their health care and their care with pre and postnatal. Some countries can spend a great amount of money on their health care (such as the United States) but still might not have the best health care in the world. Others have special arrangements that new mothers and infants can go through to make sure that they start off their life in a good and healthy environment. In this paper I am going to compare and contrast the infant health care and the overall prenatal care in the United States and South Korea by referencing multiple articles and textbooks that focus on this subject. Both countries have various ways in which they handle their health system and the care of their newborns. There are many factors that determine the health of a newborn such as the nutrition that the soon to be mother consumes, the environment that the mother and the child live in, and the hospital that the child is born in. Throughout the years each of these countries have been putting time and money into their health system with the goal of having the most outstanding health care system in the world. Their progress can be recorded in many different ways which will be discussed within this paper. Also the United States and South Korea both have very different systems when dealing with prenatal and infant care. One way that the infant care of a country is measured is through the mortality rate of the infants. In fact (Bae et al. , 2011), â€Å"Neonatal mortality rate (NMR) and infant mortality rate (IMR) are two of the most important indices reflecting the level of public health of a country† (Abstract Section Para. 1). Without measuring and keeping track of these mortality rates, researches would not be able to figure out what countries are working towards a better health care service and which countries need help. Even though the United States is a developed country, and unlike less developed countries, it should have a high mortality rate. In all actuality the United States has one of the worst mortality rates compared to other counties. According to Levine and Munsch (2012), â€Å"Despite the wealth and the availability of (but not always access to) world-class edical facilities, the United States has the same or worse infant mortality rates compared with 37 other industrialized countries (Hoover Institution, 2007)† (p. 176). There are reasons for the high mortality rate, such as the fact there are many different races, ethnicities, and social statuses within the United States. Race and ethnicity do have an input in a person’s health and their life style. Some races (such as Asians) have a higher life expectancy and a lower mortality rate throughout their race because of the way that they are raised and the traditions that they fallow. The social statuses of the expecting mothers also have an impact on the future children because when the parent is part of a higher social status, it is assumed that they have a higher level of education and therefore know more about how they should care for themselves and their infants. The opposite goes for people who are part of a lower social status. The United States has been lowering the number of infant mortality rates by putting programs in affect to try and help out the health system. Some of these programs are (Bae et al. , 2011), †¦execution of Medicaid (1965), Medicare (1965), Supplemental Security Income (social health care security programs for children and pregnant women of the lower income group), provision of State Children’s Health Insurance Programs, Children Vaccine Program, Health Start Program (1991, Early Head Start Program, full day care service, parent education, case management, Community Resource Assistant)†¦Ã¢â‚¬  (Discussion Section para. ) and much more. The United States has more programs to help reduce the risk of infant mortality and various diseases, they are also working on other ways to help out the infant mortality rate by focusing on premature and low-birth weight babies. According to Levine and Munsch (2012), â€Å"Birth data compiled by the Centers for Disease Control and Prevention (2007a) for 2005 found that the rate of premature births in the United States is 12. 7% or 525,000 babies annually† (p. 178). This number is high for premature births and these programs that are being put into place should help lower it. Even with all of these programs working toward a better health system, South Korea has less of an infant mortality rate. South Korea has improved its health system throughout the years and it has shown in their child care. Their country includes programs such as (Bae et al. , 2011), †¦tests for inborn error of metabolism and care for sick infants (1991), registration of pre-term and congenital abnormal neonates and medical expense support 2000), early diagnosis of deafness (2007), campaign for preventing blindness of preschoolers (2000), prevention of maternal hepatitis B infection (2002†¦(Discussion Section Para. 1) and much more. There are also more programs that are scheduled to appear throughout the fallowing years. As mentioned before it is easier for South Korea to keep their infant mortality rate down because they do not have to focus on many different nati onalities in their country, most of the population in South Korea are Korean. If you compare the two countries and the programs that they are producing it is shown the South Korea has been receiving more advances in the 2000’s while the United States had a breakthrough in their health care in the 1900’s. Copyright  © 2011 The Korean Academy of Medical Sciences. This chart shows that South Korea started off with a higher mortality rate and it had a drastic decline. The United States had a decline in the 1900’s and during the 2000’s it started to stabilize. Copyright  © 2011 The Korean Academy of Medical Sciences. This Chart gives a better understanding as to where the United States and South Korea stand with other countries. Neither of them are the best or the worst country, however they are on opposite sides of the scale. It is expected for the United States to have a lower mortality rate because of the amount of money put into their health care system, but according to the chart this does not appear to be true. South Korea has a lot of respect when it comes to their infants. They see their children as the future to their country and they are willing to do anything to make sure that their infants are well taken care of. This is shown through the data on the chart above because South Korea is closer to the bottom of the scale instead of the top. Both South Korea and the United States have a different hospital system. South Korea has a post-natal care facility called a sanhujoriwon. According to Yeon-soo (2013), Dozens of mothers and newborns stay together in such facilities and more than half of the places operate as non-medical institutions, leading to occasional problems with hygienic management. To prevent mass infection among babies at sanhujoriwons, the government recently beefed up disease surveillance of workers there and instituted a standard terms of use (Para. 2) South Korea is the only country that has these facilities available for their new mothers. Many pregnant women from all over the world come to South Korea just to get this treatment after they give birth. However, this facility is expensive, so not everyone can afford this luxury. According to Yeon-soo (2013), â€Å"The cost of using an upscale sanhujoriwon is 5 million (4,730 U.  S. dollars) to 10 million won (9,460 dollars) for a two-week stay, but the facility is so popular that a reservation might not be possible if not made six to seven months prior to childbirth† (para. 4). That is the price for the most expensive and luxurious places; other places can be thousands of dollars cheaper. In these facilities the nurses make sure that the patients get the right exercise (such as light yoga) and eat the correct food so that their recovery after birth will be as pleasant and beneficial as possible. They also care for the newborn and make sure that they get the nutrients that they need in the first couple of weeks. This helps out the new mother because they have time to relax and recover while their baby is getting the necessary care that is needed. When the mother is ready to go home after a couple of weeks they have a better time adjusting to their new life with a baby because they had the rest and help that they needed. In the United States they do not have these same accommodations but they to do have systems to help out the new mother. The United States has many medical professionals to help with neonatal and postnatal care. Some of those occupations include (Link, Jakubeez, & Temple, 2013), â€Å"†¦neonatologist, neonatal nurse practitioners, bedside nurses, a clinical pharmacist, neonatal respiratory therapists, a nutritionist, a social worker, medical residents, and medical students† (Backgroud Section Para. 1). With a hospital consisting of these medical professionals the patients are likely to get the help that they need while going through the birthing process. Also many hospitals are expanding in the United States to include more room for neonatal care. The Hillcrest Hospital in Cleveland, Ohio expanded their hospital and included (Link, Jakubeez, & Temple, 2013),†¦Ã¢â‚¬ a new 24 bed level 3 neonatal intensive care unit (NICU) and additional beds to accommodate high-risk maternal medicine patients† (Background Section para. 1). They expanded their hospital so that they could care for more patients at once; also so that the patients got the opportunity to receive the best care available to them. Usually after a mother gives birth (depending on the birthing method), the mother will stay at the hospital for a couple of days, and then return home. While at the hospital the nurses will help the mother with nursing, feeding, and changing the child. They will also make sure that the mother is recovering well after the birthing process. Both in the United States and in South Korea, they have programs to help mothers and infants after birth. However, the system in South Korea is more advanced because it keeps the mother and infants for a longer period of time which is more beneficial to their health. Nutrition to a pregnant women is a very important factor. If the mother does not get the correct nutrition than they are putting themselves at risks for multiple diseases. Also they are not only putting themselves at risk but they are also putting their unborn baby at risk. Some diseases that the mother can catch from bad nutrition are gestational diabetes, gestational hyptertension, and preeclampsia. Gestational diabetes when not looked after turns into gestational hyptertension; the worst out of the three that were mentioned is preeclampsia. This is because (Sizer & Whitney, 2011), â€Å"Preeclampsia affects almost all of the mother’s organs—the circulatory system, liver, kidneys, and brain† (p. 508). If all of these organs are affected than the baby is at a serious risk of getting hurt. Most of these diseases will disappear after giving birth, but it raises the risk for the mother to catch another serious disease, such as type two diabetes. When a pregnant women is diagnosed with having gestational diabetes they are more likely to catch type two diabetes later on in life. It might not be right away but it could happen a couple of years later. Also they are more likely to be diagnosed with gestational diabetes again if they ever become pregnant again. Being overweight and pregnant is a big risk during pregnancy. In fact (Chen et al. , 2013), â€Å"Metabolic impairments in maternal obesity and gestational diabetes (GDM) induce an abnormal environment in peripheral blood and cause vascular structure alterations which affect the placental development and function† (Abstract section Para. 1). As mentioned before it does not only affect the mother but it also affects the unborn child, but it also affects the child after they are born. Using APA, 2013), â€Å"The historical poor outcomes of pre-gestational diabetes are testimony to the harmful effects of high glucose in early pregnancy as manifest by congenital malformations and in later pregnancy as evidenced by LGA [large-for-gestational-age] and its consequences. † (para. 2). The reason why this is more of a problem in the United States is because they have a higher obesity record than South Korea has. So more women throughout the United States are developing these diseases than women in South Korea. (Amamoto et al. 005) â€Å"Comparison of body mass index (BMI) distributions in Japan and Korea showed the highest value in the normal category (74%) together with a very low obesity rate (1. 2%)† (Results section para. 1). Since South Korea has a low obesity rate within their, they are less likely to give birth to large babies. However, the opposite goes for Women who live in the United States and are obese. This is a problem because (Sizer & Whitney, 2011), â€Å"The infant of an obese mother may be larger than normal and may be large even if born prematurely. The large early baby may not be recognized as premature and thus may not receive the special medical care required† (p. 492). A premature baby might not be completely developed and need medical assistance after the birth. If the doctors don’t know that the baby has developmental problems than the newborn runs the risk of dying. This could also explained for the high mortality rate in the United States since they have a higher rate of obesity and it is difficult to label a child as premature and unhealthy if they are at a healthy weight. The environment that the pregnant women is living in is very crucial to her and her unborn child’s health. There are many illnesses that a woman can pass on to her child from environments that are hazards. When a mother is in her embryonic stage her baby is at a point of rapid development. This is a very crucial stage because the baby is starting to grow their organs, however they are also more likely to catch a disease which could cause a deformity during this stage. If the mother catches a disease than they are more likely during this stage to pass it to their baby which could cause a miscarriage or deformities. The issue of the environment is more of a problem for South Korea because of all the pollution that is in the air. South Korea is a very overpopulated country (especially in Seoul) and with all the cars and factories the air gets easily polluted. According to Sizer and Whitney (2011), â€Å"Pregnant women who are exposed to contaminants such as lead often bear low-birthweight infants with delayed mental and psychomotor developments† (p. 04). This is also an issue in some part of the United States, but it depends on where the person lives. If a pregnant women lives next to a factory that produces hazardous smoke than they are more likely to give birth to a baby with deformities. However, in South Korea many pregnant women are exposed to polluted air for most of their pregnancy and some of their babies are born with serious skin pro blems. There is air pollution everywhere a pregnant women goes but if the pollution is high than they are putting the baby more at risk. There are many factors that play into the prenatal and postnatal health. South Korea and the United States both work hard to make their health system the best that it can be. They have many programs in place and many more programs to come in the future. They are working on their hospitals to make sure they are as convenient as possible so that the mothers and newborns can have the best possible health care. Both countries are working towards lowering their mortality rate and lessening the amount of premature and low-birth-weight children. There is also the nutrition and the environment that the mother is exposed too. A simple factor as being obese can cause serious damage to the mother and the unborn child. Many expecting mothers do not understand that concept so they do not see the risk in it. Of course one country has a better health care system then the other, however they both have pros and cons to their countries. The United States has more funds to deal with and has more medical professionals working in their hospitals so that their patients can receive the best care possible. The negative aspect of the United States is that they have a high obesity rate and a high mortality rate. They also need to work on more programs to lower their mortality rate so that they can have the best possible health care. South Korea has excellent postnatal care, which many people around the world want to experience and be a part of. Also they have a low level of obesity so they are not as likely as the United States to get the diseases that come along with being overweight. The negative aspect of Korea is that their environment is not the best because of the pollution that is surrounding the air. South Korea is an overpopulated country so the air is filled with pollutants that are not good for a pregnant woman and can cause low-birth weight and birth defects. Overall both countries have areas in their health care system that they have to work on and areas outside of their health care system that they need to address. However, as of right now South Korea has a more exceptional health care system than the United States, especially when it comes to infant care.

ATM systems

ATM systems One of the most important part to designing the ATM usage is to make it as use r-centred as possible. According to Benyon, 2005, the PACT which is stand for People, Activities, Contexts, and Technologies as a useful framework for thinking about a design situation in relation to an interactive system. Performing a PACT analysis would be useful for both analysis and design activities, understanding the current situations, seeing where possible improvements can be made and envisioning future situations. The results of the PACT analysis are presented below. People The users groups for this technology include all people with bank accounts, especially UMS students, staff and lecturers. In the established user group, age and sex are not a factor. The technology does assume some previous knowledge and its functions could prove difficult for first time users. Most ATMs translate all signs and button into braille, making it usable by those without eyesight. This specific machine could create difficulties for those with disabilities because of the height of the keypad and its relatively flat orientation on the machine. People with children could also find the placement of the machine inconvenient, as its location is directly next to a main entrance. In addition, the machine have many language options, it is easier for users to use the machine. Activities Based on the study, the verification of banking details and the removal of money from ones account. The sub activities include inserting a credit card, entering ones pin number, selecting the amount desired, checking account balances and retrieving receipts. We observed the machine being used often, with one person using it every five minutes. It is important to this system works quickly, as it is meant to be a quick stop and there are often a line of people waiting to use the machine. Besides that, for security purposes, it is unsafe for a user s account information to stay up too long, as it could be target for theft. The machine is used by individuals, who must be aware of their surroundings, protect their pin number as they enter it. The ATM itself is designed so that important account information that might be printed on a receipt or shown on screen is obscured or not written out in full. If someone wrongfully inputs their pin number, for example, the transaction will be cancell ed and they will receive their card back. In some cases, a user could forget their card in the machine, which could result in theft if the card is taken immediately after the user leaves. Otherwise, the machine will retract the card and store it. Also, if a user somehow forgets to take their money, it could be stolen. The current machine performs the basic activities and sub activities well. It works quickly and efficiently to dispense users money. The functions, however, are very basic and only the simplest functions can be performed. The location and design of the machine do pose some security risks. The machine is also in a high-traffic area and is open on all sides. Contexts An ATM machine location could prove to be a significant factor in the ease of its use. If a machine is located outside, there is the potential for distraction if there is heavy rain, posing security risks. Also, bright sunlight could obscure the display, making it more difficult to use. ATM use tends to be in an open, public area, which goes against the general context and use of banking; it is generally considered to be a private activity. It could include a more private space for the machine. It should also be installed indoors if possible to reduce the potential for distraction and thus reduce security risks. The current system does not take privacy into account; the machine is located directly next to a main entrance. There are also bright lights that cause glare on the display, making it more difficult to read. Technologies The input mechanism in the form of a key pad and either a touch screen or buttons adjacent to options on screen are the easiest ways for users to input information, and is the setup of most ATMs. Banking options should be easily visible to users once their identity is verified by the machine. The key pad should be more obscured so that when users input information, privacy is not compromised. ATMs in general, are used by those standing up. However, this poses issues for those in wheelchairs and thus a design idea is to place an additional screen and keypad down lower for those with disabilities. In terms of output, we cannot see any flaws with the current use of a screen to display information. However, one innovation that could be helpful to users is to have receipts e-mailed to them instead of receiving paper receipts that tend to be discarded immediately. Communication is a big factor for ATMs, which need to be able to connect with banks to verify users, account balances, and so o n. The content central to this function is the account information being traded between user and machine, as well as between the machine and the banks. Based on the observation, the ATM does not have ideal key pad placement, possibly creating security concerns. Besides that, instructions about card insertion are unclear, the sign above the card slot says to insert the card with the numbers up, while the computer screen asks the user to insert the card with the magnetic strip up. The screen performs the necessary functions, and is convenient for most users, who use the machine standing up. It is not ideal, though, for those with disabilities as the key pad and card slot are a bit too high. The machine communicates with the banks quickly and easily, making money retrieval from this machine a rapid and simple task. As conclusion, in implementing a new ATM system, the current system employed by most machines is functional and effective. However, there are some concerns with its ease of use when it comes to those with disabilities; many are meant for users standing up, while those in wheelchairs would struggle with the horizontal orientation of the key pad and its height. Additionally, the placement of ATMs should be a key factor when implementing the system. Their ideal location is indoors where distractions like sunlight, weather and noise are mitigated. It is also important for users to have a sense of privacy or enclosure while they conduct their banking. The language a machine employs is also vital to its successful use; limited language capabilities make it difficult for a wide swath of the population to use the system.

Health Care Law Changes Reimbursement Systems Research Paper

Health Care Law Changes Reimbursement Systems - Research Paper Example This study evaluates the benefits and disadvantages of these proposed reforms. On the one hand, the reforms could improve quality of service by providing incentive for hospitals and increasing competition among them but on the other hand, ordinary citizens could also be affected because many expenses that were earlier applied against FSA and HSA accounts may no longer be possible. Medical reimbursement in the United States Introduction: The costs of health care in the United States are prohibitive and only a few people in the country can afford to avail of health care without any form of insurance. Private health insur4ance plans are available in the country and most employees have access to some form of health insurance through group insurance plans that are offered by their employers. Most people in the United States however, fall under the category of Medicare or Medicaid insurance plans to cover their health care costs. Medicaid is available to individuals who are from the poorer socio economic backgrounds and have no insurance at all. Medicare is the public health insurance program which has been formulated to provide for the health care of the elderly and the disabled. It covers individuals who are aged 65 or over, or under 65 but with certain disabilities and those of any age with permanent kidney failure (www.medicare.gov). In the year 2003, Medicare expenses cost the U.S. Government a sum of $271 billion, representing 13% of the federal budget (Frankes and Evans, 2006). The program comprises two parts – Part A which covers hospitalization and nursing facilities, and Part B which covers physician and outpatient services, laboratory charges and medical equipment. Since costs for the Medicare program were turning out to be prohibitive, changes were introduced to the reimbursement policies in 2008, in an effort to reduce some of the expenditures and thereby bring about some trimming of the federal government budget on health care. The sweeping chang es proposed reduced payments for complex medical treatment procedures by 20 to 30%. Some of the major changes which were introduced and came into legal existence in 2008 were as follows (www.seniorjournal.com): (a) reducing reimbursement for procedures such an angioplasties and implanting of drug coated stents by 33% (b) reducing reimbursement for implanting defibrillators by 23% (c) Reducing reimbursements for hip and knee replacements by 10% Reimbursement for other diseases was also cut down; hospitals and health care professionals fully reimbursed only if their patients were suffering from one of 13 diseases which have been listed. The Medicare reimbursement policies for Inpatient Rehabilitation Facilities were revised further in 2009, validated legally from 2010. The patients are classified into different categories based upon their clinical symptoms and payments for clinical conditions that are secondary to the major one are no longer reimbursed (Ingenix, 2009). Cost outliner p ayments have also been readjusted to 3% of total estimated payments for Inpatient rehabilitation facilities. Coverage criteria were further revised for inpatient rehabilitation facilities with several pre-conditions being exposed, such as mandating therapy treatments to begin with 36 hours of the midnight of the day the patient was admitted.(Ingenix, 2009). It may be noted that the changes which had

Descriptive Statistics in Research Domains Essay - 1

Descriptive Statistics in Research Domains - Essay Example In the simplest terms, the mean represents the average of a group of data and is the most widely used descriptive statistic since further statistical analysis tends to depend on the mean and its variance (Leedy & Ormrod, 2010). The research under analysis examined the medical home model for its robustness as a predictor of â€Å"decreased utilization of health services and increased patient satisfaction† (Cooley, McAllister, Sherrieb, & Kuhlthau, 2009). Data was collected through 43 differentiated care practices that were being implemented under 7 different medical home model regimes in 5 different states in the United States. The overall sample set consisted of 42 children though most children were affected by more than one condition including chronic medical problems. The study is more exploratory than experimental since it seeks to establish the efficacy of an already implemented medical care system. The Medical Health Index (MHI) was utilized to measure the â€Å"medical homeness† of each medical home concept model (Cooley, McAllister, Sherrieb, & Kuhlthau, 2009). The research investigated various independent variables such as organizational capacity, condition management, care coordinatio n etc. in order to measure the MHI for each model. It was found that a higher MHI signified a more effective medical home concept model. Overall the study was easy to read and the assumptions were clearly spelt out to aid understanding. The mean is typically utilized in conjunction with the standard deviation to express the conformance of data to a centralized average. The internal validity of data can be established if the collected data tends to exhibit with a mean with a low standard deviation (Creswell, 2009). The mean was employed throughout the research being analysed for describing the total outcome for various variables and correlation levels. The mean for a particular variable is calculated by using the overall sample set and calculating its average.  

Community Policing Paper Research Example | Topics and Well Written Essays - 1000 words

Community Policing - Research Paper Example COP creates unity between communities and officers but is not practical in lower economies where citizens focus on working to attain sustainability. POP focuses on problems that may recur and has the limitation of requiring technical knowledge for proper implementation. Crimes such as home burglaries, substance abuse and prostitution have been eradicated using both POP and COP. POP and COP entail officers working with the community to prevent evil. However, POP focuses on problems and how they can be solved after careful scanning, analysis, and assessments. Everyone in the community is involved in problem solving when COP is under implementation. Police departments encounter such challenges as inadequate resources, conservatism and lack of technical knowledge in implementing POP and COP. Definition, description, strengths and weaknesses of COP According to Palmiotto (2011), community-oriented policing is a philosophy that combines traditional aspects of law enforcement with deterrenc e measures, problem resolution, community engagement and partnerships. It seeks to unite the police and the public thus facilitates the identification of criminal issues and solutions. In this arrangement, police officers discover determinants of crime and disorder consequently solving problems in their communities. The strengths are evident when officers design a network of personal contacts by foot, bike, or horse patrol in and out of their departments. This supports the crime prevention efforts and teaches residents how to help themselves by reporting crime in the neighborhood. Citizens engage in regular patrols and awareness programs to achieve the goals of prevention. Community-oriented policing has the following weaknesses. Indeed, low-income communities are not able to achieve because adults work multiple jobs at odd hours. It is also challenging neighbors to know and care about each other comfortably (Palmiotto, 2011). Definition, description, strengths and weaknesses of POP According to Goldstein (2011), POP is a policing strategy that includes classification and scrutiny of precise crime and disorder activities to design effective response strategies accompanied by ongoing assessment. Emphasis is on research to prevent the re-occurring of crimes and involvement of public and private groups that are qualified to solve problems. POP Scanning-identification of problems, Analysis-asking questions to understand the problem, Response-after careful analysis; designing a suitable response, Assessment evaluating the problem and establish a suitable solution. The strengths of POP incorporate gaining popularity among police administrators and city officials because it is practical, winning public favor which results to job securities for administrators and elected officials. There is also increased communication with the public who influence police activities. POP enables officers to link with public and private agencies to help communities. Weaknesses of POP a re conflicts that arise when officers feel subordinated and get afraid of losing their jobs since they feel that other professionals involved in policing might replace them in service delivery. Furthermore, controversies between priorities of the community and what officers feel is important to them. This is because people feel that it is not their duty to prevent crime. There is also lack of expert knowledge to employ technical mechanisms involved in