Saturday, August 31, 2019
The main decisions are made by senior management, where little authority is passed down the organisation. advantages Ã¢â¬ ¢ decisions are made by experienced people with an overview of the company. Ã¢â¬ ¢ ensures policies are consistent throughout the company. Ã¢â¬ ¢ ensures quick decisions can be made without consultation. Ã¢â¬ ¢ procedures such as ordering and purchasing can be standardised throughout the company, leading to economies of scale. Ã¢â¬ ¢ in times of crisis the firm may need strong leadership by a central group of senior managers. disadvantages (mainly advantages of decentralisation) centralisation reduces the input of the day to day experts, e. g. , the shop floor staff, into the firms decision making. Ã¢â¬ ¢ it risks demoralising branch managers who may feel mistrusted or powerless. Decentralisation Decisions are made by junior management as authority is passed down the organisation, thereby accepting less uniformity in how things are down. There has been a trend in the 1980s and 1990s is to decentralise to provide greater flexibility. advantages Ã¢â¬ ¢ reduces the stress and burdens of senior management Ã¢â¬ ¢ it can empower local managers encouraging them to be more innovated and motivated. it reduces the volume of day to day communication between head office and the branches, therefore giving senior managers the time to consider long term strategy. Ã¢â¬ ¢ subordinates may have a better knowledge of local conditions affecting their areas of work. This should allow them to make more informed well judged choices, e. g. , salespersons have detailed knowledge of customers. Ã¢â¬ ¢ management at middle and junior levels are groomed to take over higher positions. They are given the experience of decision making when carrying out delegated tasks (management development). could allow greater flexibility and a quicker response to changes. If problems do not have to referred to senior management decision making will be quicker. Since decisions are quicker, they are easier to change in the light of unforeseen circumstances. disadvantages Ã¢â¬ ¢ reduction in uniformity may unsettle customers who expect every SainsburyÃ¢â¬â¢s to look the same or for every McDonaldÃ¢â¬â¢s hamburger to contain just one slice of gherkin. Ã¢â¬ ¢ head office is in a position to measure the success of every aspect of the product and sales mix, therefore its instructions may prove more profitable than local managerÃ¢â¬â¢s intuition. Conclusion It is unlikely there will ever be complete centralisation or decentralisation. Certain functions within a business will always be centralised because of their importance, e. g. , decisions about budget allocation are likely to be centralised as they affect the whole economy. The decision to distribute profits is also taken only by a few. Some delegation is necessary in all firms because the limits to the amount of work senior management can carry out. Even if authority is delegated to a subordinate it is usual for the manager to retain responsibility.
Vickie's house was on a corner, and they approached it from the side street. By now the sky was filled with heavy purple clouds. The light had an almost underwater quality. Ã¢â¬Å"Looks like it's going to storm,Ã¢â¬ Matt said. Bonnie glanced at Damon. Neither he nor Stefan liked bright light. And she could feel the Power emanating from him, like a low thrum just under the surface of his skin. He smiled without looking at her and said, Ã¢â¬Å"How about snow in June?Ã¢â¬ Bonnie clamped down on a shiver. She had looked Damon's way once or twice in the barn and found him listening to the story with an air of detached indifference. Unlike Stefan, his expression hadn't changed in the slightest when she mentioned Elena-or when she told about Sue's death. What did he really feel for Elena? He'd called up a snowstorm once and left her to freeze in it. What was he feeling now? Did he even care about catching the murderer? Ã¢â¬Å"That's Vickie's bedroom,Ã¢â¬ said Meredith. Ã¢â¬Å"The bay window in the back.Ã¢â¬ Stefan looked at Damon. Ã¢â¬Å"How many people in the house?Ã¢â¬ Ã¢â¬Å"Two. Man and woman. The woman's drunk.Ã¢â¬ Poor Mrs. Bennett, thought Bonnie. Ã¢â¬Å"I need them both asleep,Ã¢â¬ Stefan said. In spite of herself, Bonnie was fascinated by the surge of Power she felt from Damon. Her psychic abilities had never been strong enough to sense its raw essence before, but now they were. Now she could feel it as clearly as she could see the fading violet light or smell the honeysuckle outside Vickie's window. Damon shrugged. Ã¢â¬Å"They're asleep.Ã¢â¬ Stefan tapped lightly on the glass. There was no response, or at least none Bonnie could see. But Stefan and Damon looked at each other. Ã¢â¬Å"She's half tranced already,Ã¢â¬ Damon said. Ã¢â¬Å"She's scared. I'll do it; she knows me,Ã¢â¬ said Stefan. He put his fingertips on the window. Ã¢â¬Å"Vickie, it's Stefan Salvatore,Ã¢â¬ he said. Ã¢â¬Å"I'm here to help you. Come let me in.Ã¢â¬ His voice was quiet, nothing that should have been heard on the other side of the glass. But after a moment the curtains stirred and a face appeared. Bonnie gasped aloud. Vickie's long, light brown hair was disheveled, and her skin was chalky. There were huge black rings under her eyes. The eyes themselves were fixed and glassy. Her lips were rough and chapped. Ã¢â¬Å"She looks possessed,Ã¢â¬ Bonnie whispered back, unnerved. Stefan just said, Ã¢â¬Å"Vickie, open the window.Ã¢â¬ Mechanically, like a windup doll, Vickie cranked one of the side panels of the bay window open, and Stefan said, Ã¢â¬Å"Can I come in?Ã¢â¬ Vickie's glazed eyes swept over the group outside. For a moment Bonnie thought she didn't recognize any of them. But then she blinked and said slowly, Ã¢â¬Å"MeredithÃ¢â¬ ¦ BonnieÃ¢â¬ ¦ Stefan? You're back. What are you doing here?Ã¢â¬ Ã¢â¬Å"Ask me in, Vickie.Ã¢â¬ Stefan's voice was hypnotic. Ã¢â¬Å"StefanÃ¢â¬ ¦Ã¢â¬ There was a long pause and then: Ã¢â¬Å"Come in.Ã¢â¬ She stepped back as he put a hand on the sill and vaulted through. Matt followed him, then Meredith. Bonnie, who was wearing a mini, re-mained outside with Damon. She wished she'd worn jeans to school today, but then she hadn't known she'd be going on an expedition. Ã¢â¬Å"You shouldn't be here,Ã¢â¬ Vickie said to Stefan, almost calmly. Ã¢â¬Å"He's coming to get me. He'll get you too.Ã¢â¬ Meredith put an arm around her. Stefan just said, Ã¢â¬Å"Who?Ã¢â¬ Ã¢â¬Å"Him. He comes to me in my dreams. He killed Sue.Ã¢â¬ Vickie's matter-of-fact tone was more frightening than any hysteria could have been. Ã¢â¬Å"Vickie, we've come to help you,Ã¢â¬ Meredith said gently. Ã¢â¬Å"Everything's going to be all right now. We won't let him hurt you, I promise.Ã¢â¬ Vickie swung around to stare at her. She looked Meredith up and down as if Meredith had suddenly changed into something unbelievable. Then she began to laugh. It was awful, a hoarse burst of mirth like a hacking cough. It went on and on until Bonnie wanted to cover her ears. Finally Stefan said, Ã¢â¬Å"Vickie, stop it.Ã¢â¬ The laughter died into something like sobs, and when Vickie lifted her head again, she looked less glassy eyed but more genuinely upset. Ã¢â¬Å"You're all going to die, Stefan,Ã¢â¬ she said, shaking her head. Ã¢â¬Å"No one can fight him and live.Ã¢â¬ Ã¢â¬Å"We need to know about him so we can fight him. We need your help,Ã¢â¬ Stefan said. Ã¢â¬Å"Tell me what he looks like.Ã¢â¬ Ã¢â¬Å"I can't see him in my dreams. He's just a shadow without a face.Ã¢â¬ Vickie whispered it, her shoulders hunching. Ã¢â¬Å"But you saw him at Caroline's house,Ã¢â¬ Stefan said insistently. Ã¢â¬Å"Vickie, listen to me,Ã¢â¬ he added as the girl turned away sharply. Ã¢â¬Å"I know you're frightened, but this is important, more important than you can understand. We can't fight him unless we know what we're up against, and you are the only one, the only one right now who has the information we need. You have to help us.Ã¢â¬ Stefan's voice was unyielding. Ã¢â¬Å"I have a way to help you remember,Ã¢â¬ he said. Ã¢â¬Å"Will you let me try?Ã¢â¬ Seconds crawled by, then Vickie gave a long, bubbling sigh, her body sagging. Ã¢â¬Å"Do whatever you want,Ã¢â¬ she said indifferently. Ã¢â¬Å"I don't care. It won't make any difference.Ã¢â¬ Ã¢â¬Å"You're a brave girl. Now look at me, Vickie. I want you to relax. Just look at me and relax.Ã¢â¬ Stefan's voice dropped to a lulling murmur. It went on for a few minutes, and then Vickie's eyes drooped shut. Ã¢â¬Å"Sit down.Ã¢â¬ Stefan guided her to sit on the bed. He sat beside her, looking into her face. Ã¢â¬Å"Vickie, you feel calm and relaxed now. Nothing you remember will hurt you,Ã¢â¬ he said, his voice soothing. Ã¢â¬Å"Now, I need you to go back to Saturday night. You're upstairs, in the master bedroom of Caroline's house. Sue Carson is with you, and someone else. I need you to see-Ã¢â¬Å" Ã¢â¬Å"No!Ã¢â¬ Vickie twisted back and forth as if trying to escape something. Ã¢â¬Å"No! I can't -Ã¢â¬Å" Ã¢â¬Å"Vickie, calm down. He won't hurt you. He can't see you, but you can see him. Listen to me.Ã¢â¬ As Stefan spoke, Vickie's whimpers quieted. But she still thrashed and writhed. Ã¢â¬Å"You need to see him, Vickie. Help us fight him. What does he look like?Ã¢â¬ Ã¢â¬Å"He looks like the devil!Ã¢â¬ It was almost a scream. Meredith sat on Vickie's other side and took her hand. She looked out through the window at Bonnie, who looked back wide eyed and shrugged slightly. Bonnie had no idea what Vickie was talking about. Ã¢â¬Å"Tell me more,Ã¢â¬ Stefan said evenly. Vickie's mouth twisted. Her nostrils were flared as if she were smelling something awful. When she spoke, she got out each word separately, as if they were making her sick. Ã¢â¬Å"He wearsÃ¢â¬ ¦ an old raincoat. It flaps around his legs in the wind. He makes the wind blow. His hair is blond. Almost white. It stands up all over his head. His eyes are so blue-electric blue.Ã¢â¬ Vickie licked her lips and swallowed, looking nauseated. Ã¢â¬Å"Blue is the color of death.Ã¢â¬ Thunder rumbled and cracked in the sky. Damon glanced up quickly, then frowned, eyes narrowed. Ã¢â¬Å"He's tall. And he's laughing. He's reaching for me, laughing. But Sue screams Ã¢â¬ËNo, no' and tries to pull me away. So he takes her instead. The window's broken, and the balcony is right there. Sue's crying Ã¢â¬ËNo, please.' And then I watch him-I watch him throw herÃ¢â¬ ¦Ã¢â¬ Vickie's breath was hitching, her voice rising hysterically. Ã¢â¬Å"Oh, please, no-Sue! Sue! Sue!Ã¢â¬ Ã¢â¬Å"Vickie, stay with me. Listen. I need just one more thing. Look at him. Tell me if he's wearing a blue jewel-Ã¢â¬Å" But Vickie was whipping her head back and forth, sobbing, more hysterical each second. Ã¢â¬Å"No! No! I'm next! I'm next!Ã¢â¬ Suddenly, her eyes sprang open as she came out of the trance by herself, choking and gasping. Then her head jerked around. On the wall, a picture was rattling. It was picked up by the bamboo-framed mirror, then by perfume bottles and lipsticks on the dresser below. With a sound like popcorn, earrings began bursting from an earring tree. The rattling got louder and louder. A straw hat fell off a hook. Photos were showering down from the mirror. Tapes and CDs sprayed out of a rack and onto the floor like playing cards being dealt. Meredith was on her feet and so was Matt, fists clenched. Ã¢â¬Å"Make it stop! Make it stop!Ã¢â¬ Vickie cried wildly. But it didn't stop. Matt and Meredith looked around as new objects joined the dance. Everything movable was shaking, jittering, swaying. It was as if the room were caught in an earthquake. Ã¢â¬Å"Stop! Stop!Ã¢â¬ shrieked Vickie, her hands over her ears. Directly above the house thunder exploded. Bonnie jumped violently as she saw the zigzag of lightning shoot across the sky. Instinctively she grabbed for something to hang on to. As the lightning bolt flared a poster on Vickie's wall tore diagonally as if slashed by a phantom knife. Bonnie choked back a scream and clutched tighter. Then, as quickly as if someone had flicked a power switch off, all the noise stopped. Vickie's room was still. The fringe on the bedside lamp swayed slightly. The poster had curled up in two irregular pieces, top and bottom. Slowly, Vickie lowered her hands from her ears. Matt and Meredith looked around rather shakily. Bonnie shut her eyes and murmured something like a prayer. It wasn't until she opened them again that she realized what she had been hanging on to. It was the supple coolness of a leather jacket. It was Damon's arm. He hadn't moved away from her, though. He didn't move now. He was leaning forward slightly, eyes narrowed, watching the room intently. Ã¢â¬Å"Look at the mirror,Ã¢â¬ he said. On the glass surface of the bamboo mirror two words were scrawled in Vickie's hot coral lipstick. Goodnight, Sweetheart. Ã¢â¬Å"Oh, God,Ã¢â¬ Bonnie whispered. Stefan turned from the mirror to Vickie. There was something different about him, Bonnie thought-he was holding himself relaxed but poised, like a soldier who's just gotten confirmation of a battle. It was as if he'd accepted a personal challenge of some kind. He took something out of his back pocket and unfolded it, revealing sprigs of a plant with long green leaves and tiny lilac flowers. Ã¢â¬Å"This is vervain, fresh vervain,Ã¢â¬ he said quietly, his voice even and intense. Ã¢â¬Å"I picked it outside Florence; it's blooming there now.Ã¢â¬ He took Vickie's hand and pressed the packet into it. Ã¢â¬Å"I want you to hold on to this and keep it. Put some in every room of the house, and hide pieces somewhere in your parents' clothes if you can, so they'll have it near them. As long as you have this with you, he can't take over your mind. He can scare you, Vickie, but he can't make you do anything, like open a window or door for him. And listen, Vickie, because this is important.Ã¢â¬ Vickie was shivering, her face crumpled. Stefan took both her hands and made her look at him, speaking slowly and distinctly. Ã¢â¬Å"If I'm right, Vickie, he can't get in unless you let him. So talk to your parents. Tell them it's important that they don't ask any stranger inside the house. In fact, I can have Damon put that suggestion in their mind right now.Ã¢â¬ He glanced at Damon, who shrugged slightly and nodded, looking as if his attention was somewhere else. Self-consciously, Bonnie removed her hand from his jacket. Vickie's head was bent over the vervain. Ã¢â¬Å"He'll get in somehow,Ã¢â¬ she said softly, with terrible certainty. Ã¢â¬Å"No. Vickie, listen to me. From now on, we're going to watch your house; we're going to be waiting for him.Ã¢â¬ Ã¢â¬Å"It doesn't matter,Ã¢â¬ Vickie said. Ã¢â¬Å"You can't stop him.Ã¢â¬ She began to laugh and cry at the same time. Ã¢â¬Å"We're going to try,Ã¢â¬ Stefan said. He looked at Meredith and Matt, who nodded. Ã¢â¬Å"Right. From this moment on, you will never be alone. There will always be one or more of us outside watching you.Ã¢â¬ Vickie just shook her bent head. Meredith gave her arm a squeeze and stood as Stefan tilted his head toward the window. When she and Matt joined him there, Stefan spoke to all of them in a low voice. Ã¢â¬Å"I don't want to leave her unguarded, but I can't stay myself right now. There's something I have to do, and I need one of the girls with me. On the other hand, I don't want to leave either Bonnie or Meredith alone here.Ã¢â¬ He turned to Matt. Ã¢â¬Å"Matt, will youÃ¢â¬ ¦Ã¢â¬ Everyone looked at him, startled. Ã¢â¬Å"Well, it's the logical solution, isn't it?Ã¢â¬ Damon seemed amused. Ã¢â¬Å"After all, what do you expect one of them to do against him anyway?Ã¢â¬ Ã¢â¬Å"They can call for me. I can monitor their thoughts that far,Ã¢â¬ Stefan said, not giving one inch. Ã¢â¬Å"Well,Ã¢â¬ Damon said whimsically, Ã¢â¬Å"I can call for you too, little brother, if I get into trouble. I'm getting bored with this investigation of yours anyway. I might as well stay here as anywhere.Ã¢â¬ Ã¢â¬Å"Vickie needs to be protected, not abused,Ã¢â¬ Stefan said. Damon's smile was charming. Ã¢â¬Å"Her?Ã¢â¬ He nodded toward the girl who sat on the bed, rocking over the vervain. From disheveled hair to bare feet, Vickie was not a pretty picture. Ã¢â¬Å"Take my word for it, brother, I can do better than that.Ã¢â¬ For just an instant Bonnie thought those dark eyes flicked sideways toward her. Ã¢â¬Å"You're always saying how you'd like to trust me, anyway,Ã¢â¬ Damon added. Ã¢â¬Å"Here's your chance to prove it.Ã¢â¬ Stefan looked as if he wanted to trust, as if he were tempted. He also looked suspicious. Damon said nothing, merely smiled in that taunting, enigmatic way. Practically asking to be mistrusted, Bonnie thought. The two brothers stood looking at each other while the silence and the tension stretched out between them. Just then Bonnie could see the family resemblance in their faces, one serious and intense, the other bland and faintly mocking, but both inhumanly beautiful. Stefan let his breath out slowly. Ã¢â¬Å"All right,Ã¢â¬ he said quietly at last. Bonnie and Matt and Meredith were all staring at him, but he didn't seem to notice. He spoke to Damon as if they were the only two people there. Ã¢â¬Å"You stay here, outside the house where you won't be seen. I'll come back and take over when I'm finished with what I'm doing.Ã¢â¬ Meredith's eyebrows were in her hair, but she made no comment. Neither did Matt. Bonnie tried to quell her own feelings of unease. Stefan must know what he's doing, she told herself. Anyway, he'd better. Ã¢â¬Å"Don't take too long,Ã¢â¬ Damon said dismissively. And that was how they left it, with Damon blending in with the darkness in the shadow of the black walnut trees in Vickie's backyard and Vickie herself in her room, rocking endlessly. In the car, Meredith said, Ã¢â¬Å"Where next?Ã¢â¬ Ã¢â¬Å"I need to test a theory,Ã¢â¬ said Stefan briefly. Ã¢â¬Å"That the killer is a vampire?Ã¢â¬ Matt said from the back, where he sat with Bonnie. Stefan glanced at him sharply. Ã¢â¬Å"Yes.Ã¢â¬ Ã¢â¬Å"That's why you told Vickie not to invite anyone in,Ã¢â¬ Meredith added, not to be outdone in the reasoning department. Vampires, Bonnie remembered, couldn't enter a place where humans lived and slept unless they were invited. Ã¢â¬Å"And that's why you asked if the man was wearing a blue stone.Ã¢â¬ Ã¢â¬Å"An amulet against daylight,Ã¢â¬ Stefan said, spreading his right hand. On the third finger there was a silver ring set with lapis lazuli. Ã¢â¬Å"Without one of these, direct exposure to the sun kills us. If the murderer is a vampire, he keeps a stone like this somewhere on him.Ã¢â¬ As if by instinct, Stefan reached up to briefly touch something under his T-shirt. After a moment Bonnie realized what it must be. Elena's ring. Stefan had given it to her in the first place, and after she died he'd taken it to wear on a chain around his neck. So that part of her would be with him always, he'd said. When Bonnie looked at Matt beside her, she saw his eyes were closed. Ã¢â¬Å"So how can we tell if he's a vampire?Ã¢â¬ Meredith asked. Ã¢â¬Å"There's only one way I can think of, and it isn't very pleasant. But it's got to be done.Ã¢â¬ Bonnie's heart sank. If Stefan thought it wasn't very pleasant, she was sure she was going to find it even less so. Ã¢â¬Å"What is it?Ã¢â¬ she said unenthusiastically. Ã¢â¬Å"I need to get a look at Sue's body.Ã¢â¬ There was dead silence. Even Meredith, normally so unflappable, looked appalled. Matt turned away, leaning his forehead against the window glass. Ã¢â¬Å"You've got to be kidding,Ã¢â¬ Bonnie said. Ã¢â¬Å"I wish I were.Ã¢â¬ Ã¢â¬Å"But-for God's sake, Stefan. We can't. They won't let us. I mean, what are we going to say? Ã¢â¬ËExcuse me while I examine this corpse for holes'?Ã¢â¬ Ã¢â¬Å"Bonnie, stop it,Ã¢â¬ Meredith said. Ã¢â¬Å"I can't help it,Ã¢â¬ Bonnie snapped back shakily. Ã¢â¬Å"It's an awful idea. And besides, the police already checked her body. There wasn't a mark on it except the cuts she got in the fall.Ã¢â¬ Ã¢â¬Å"The police don't know what to look for,Ã¢â¬ Stefan said. His voice was steely. Hearing it brought something home to Bonnie, something she tended to forget. Stefan was one of them. One of the hunters. He'd seen dead people before. He might even have killed some. He drinks blood, she thought, and shuddered. Ã¢â¬Å"Well?Ã¢â¬ said Stefan. Ã¢â¬Å"Are you still with me?Ã¢â¬ Bonnie tried to make herself small in the backseat. Meredith's hands were tight on the steering wheel. It was Matt who spoke, turning back from the window. Bonnie tried to make herself small in the backseat. Meredith's hands were tight on the steering wheel. It was Matt who spoke, turning back from the window. Ã¢â¬Å"There's a viewing of the body from seven to ten at the funeral home,Ã¢â¬ Meredith added, her voice low. Ã¢â¬Å"We'll have to wait until after the viewing, then. After they close the funeral home, when we can be alone with her,Ã¢â¬ said Stefan. Ã¢â¬Å"This is the most gruesome thing I've ever had to do,Ã¢â¬ Bonnie whispered wretchedly. The funeral chapel was dark and cold. Stefan had sprung the locks on the outside door with a thin piece of flexible metal. The viewing room was thickly carpeted, its walls covered with somber oak panels. It would have been a depressing place even with the lights on. In the dark it seemed close and suffocating and crowded with grotesque shapes. It looked as if someone might be crouching behind each of the many standing flower arrangements. Ã¢â¬Å"I don't want to be here,Ã¢â¬ Bonnie moaned. Ã¢â¬Å"Let's just get it over with, okay?Ã¢â¬ Matt said through his teeth. When he snapped the flashlight on, Bonnie looked anywhere but where it was pointing. She didn't want to see the coffin, she didn't. She stared at the flowers, at a heart made of pink roses. Outside, thunder grumbled like a sleeping animal. Ã¢â¬Å"Let me get this open-here,Ã¢â¬ Stefan was saying. In spite of her resolve not to, Bonnie looked. The casket was white, lined with pale pink satin. Sue's blond hair shone against it like the hair of a sleeping princess in a fairy tale. But Sue didn't look as if she were sleeping. She was too pale, too still. Like a waxwork. Bonnie crept closer, her eyes fixed on Sue's face. That's why it's so cold in here, she told herself staunchly. To keep the wax from melting. It helped a little. Stefan reached down to touch Sue's high-necked pink blouse. He undid the top button. Ã¢â¬Å"For God's sake,Ã¢â¬ Bonnie whispered, outraged. Ã¢â¬Å"What do you think we're here for?Ã¢â¬ Stefan hissed back. But his fingers paused on the second button. Bonnie watched a minute and then made her decision. Ã¢â¬Å"Get out of the way,Ã¢â¬ she said, and when Stefan didn't move immediately, she gave him a shove. Meredith drew up close to her and they formed a phalanx between Sue and the boys. Their eyes met with understanding. If they had to actually remove the blouse, the guys were going out. Bonnie undid the small buttons while Meredith held the light. Sue's skin felt as waxy as it looked, cool against her fingertips. Awkwardly, she folded the blouse back to reveal a lacy white slip. Then she made herself push Sue's shining gold hair off the pale neck. The hair was stiff with spray. Ã¢â¬Å"No,Ã¢â¬ said Stefan oddly. Ã¢â¬Å"But there's something else. Look at this.Ã¢â¬ Gently, he reached around Bonnie to point out a cut, pale and bloodless as the skin around it, but visible as a faint line running from collarbone to breast. Over the heart. Stefan's long finger traced the air above it and Bonnie stiffened, ready to smack the hand away if he touched. Ã¢â¬Å"What is it?Ã¢â¬ asked Meredith, puzzled. Ã¢â¬Å"A mystery,Ã¢â¬ Stefan said. His voice was still odd. Ã¢â¬Å"If I saw a mark like that on a vampire, it would mean the vampire was giving blood to a human. That's how it's done. Human teeth can't pierce our skin, so we cut ourselves if we want to share blood. But Sue wasn't a vampire.Ã¢â¬ Ã¢â¬Å"She certainly wasn't!Ã¢â¬ said Bonnie. She tried to fight off the image her mind wanted to show her, of Elena bending to a cut like that on Stefan's chest and sucking, drinkingÃ¢â¬ ¦ She shuddered and realized her eyes were shut. Ã¢â¬Å"Is there anything else you need to see?Ã¢â¬ she said, opening them. Ã¢â¬Å"No. That's all.Ã¢â¬ Bonnie did up the buttons. She rearranged Sue's hair. Then, while Meredith and Stefan eased the lid of the casket back down, she walked quickly out of the viewing room and to the outside door. She stood there, arms wrapped around herself. A hand touched her elbow lightly. It was Matt. Ã¢â¬Å"You're tougher than you look,Ã¢â¬ he said. Ã¢â¬Å"Yes, wellÃ¢â¬ ¦Ã¢â¬ She tried to shrug. And then suddenly she was crying, crying hard. Matt put his arms around her. Ã¢â¬Å"I know,Ã¢â¬ he said. Just that. Not Ã¢â¬Å"Don't cryÃ¢â¬ or Ã¢â¬Å"Take it easyÃ¢â¬ or Ã¢â¬Å"Everything's going to be all right.Ã¢â¬ Just Ã¢â¬Å"I know.Ã¢â¬ His voice was as desolate as she felt. Ã¢â¬Å"They've got hair spray in her hair,Ã¢â¬ she sobbed. Ã¢â¬Å"Sue never used hair spray. It's awful.Ã¢â¬ Somehow, just then, this seemed the worst thing of all. He simply held her. After a while Bonnie got her breath. She found she was holding on to Matt almost painfully tightly and loosened her arms. Ã¢â¬Å"I got your shirt all wet,Ã¢â¬ she said apologetically, sniffling. Ã¢â¬Å"It doesn't matter.Ã¢â¬ Something in his voice made her step back and look at him. He looked the way he had in the high school parking lot. So lost, soÃ¢â¬ ¦ hopeless. Ã¢â¬Å"Matt, what is it?Ã¢â¬ she whispered. Ã¢â¬Å"Please.Ã¢â¬ Ã¢â¬Å"I'm not so sure.Ã¢â¬ Bonnie didn't even think she wanted to. It was too scary. But she was overwhelmed by an urge to comfort him, to wipe that lost look from his eyes. Ã¢â¬Å"Matt, I-Ã¢â¬Å" Ã¢â¬Å"We're finished,Ã¢â¬ Stefan said from behind them. As Matt looked toward the voice the lost look seemed to intensify. Ã¢â¬Å"Sometimes I think we're all finished,Ã¢â¬ Matt said, moving away from Bonnie, but he didn't explain what he meant by that. Ã¢â¬Å"Let's go.Ã¢â¬
Friday, August 30, 2019
This essay will explore the main features in both the Ã¢â¬Å"Human Relation ApproachÃ¢â¬ & Ã¢â¬Å"Classical ApproachÃ¢â¬ to the management of organisations. The essay will compare both approaches and explain why? In my view, the human relation approach is superior to the classical approach in the management of organisations. Before we can declare that the human relation approach is superior to the classic approach in the management of organisations, we must first explore the main features of the two approaches. The Classical Approach The classical approach to management began to come to the fore of management in the first half of the 20th century as organisations looked for more ways in which to improve the number of issues that were surrounding industrial management from that time. Management were striving to find new ways in which to increase productivity, lower costs, increase quality of their products, improve employee/manager relationships and increase efficiency at their factories. The main concern for management using the classical management approach was to find the Ã¢â¬Å"Best Possible WayÃ¢â¬ in which employees were to perform and manage their daily tasks. What were to come from this were 3 separate branches of the classical approach to management. The 3 branches were as follows, Bureaucratic Management, Classical Scientific Management and Classical Administrative Management. Each of these branches had the one goal of finding the Ã¢â¬Å"Best Possible WayÃ¢â¬ . Bureaucratic Management The example I will use to explain Bureaucratic Management is Max WebberÃ¢â¬â¢s theory on bureaucracy. In the late 1800Ã¢â¬â¢s Max Webber criticised organisations because of the way they ran their companies, in some cases like a huge extended family. An example of a company running the business like this would be for a manager to promote a family member for a jobÃ position over another employee simply because he is a relation. The other employee may even be better skilled to carryout the job on offer but this wonÃ¢â¬â¢t make a difference when the decision is being made. Another scenario would be for management to pick an employee for promotion simply because he gets along with this employee better than he does with the other employees. Webber believes this informal organisation of supervisors and employees inhibited the potential success of a company because power was misplaced. Webber believed in a formal rigid structure of organisation called bureaucracy. This non-personal view of an organisation follows a certain structure of rules, authority and competence. Webber believed that a supervisorÃ¢â¬â¢s power within an organisation should only be based on the individualÃ¢â¬â¢s position within the organisation, the level of professional competence and the supervisorÃ¢â¬â¢s adherence to the organisations rules and regulations. In other words if a company was to make you a supervisor it would be on merit alone or to reverse an old saying Ã¢â¬Å"itÃ¢â¬â¢s not who you know itÃ¢â¬â¢s what you knowÃ¢â¬ . Following the organisations rules and regulations will ensure that an organisation follows the correct procedures that facilitate consistency in management practices. An example of these rules and regulations would be when an employee calls in sick, the employee must follow the correct procedure i.e. call supervisor before 10am, all employees are expected to follow this procedure and the supervisor is expected to enforce it. The division of labour and work specification was another one of Webbers theories. If an organisation has a workforce of 50 people and management had 4 specific jobs to carry out, the organisation would distribute the jobs to the employees who had the most experience in the specific field in which the job required. Impersonal management was also an important part of WebberÃ¢â¬â¢s theory. He believed that while management should be friendly and active with employees they should maintain an impersonal relationship as to promote fair and equal treatment of employees so that unbiased decisions can be made. Classical Scientific Management This branch of classical management focused on the methods and theories in the creation of specialized work processes and workforce skills to completeÃ a number of the organisations production tasks efficiently. Frederick Taylor, Henry Grant and Frank & Lillian Gilbreth are some of the people who pioneered the classical scientific management theory. They spent their time researching how specific jobs in their companies were being carried out, what steps were taken by an employee to complete the work and the amount of time it took for the worker to complete a task using different methods. These steps were used to determine which way was the most effective. This research led to the 4 principles of scientific management. Number 1, management provide employees with a precise, scientific approach for how a worker completes individual tasks. Number 2, management should choose and train each employee on one specific task. Number 3, management must communicate with staff and ensure the method used to complete the task is in fact the most efficient way to do a task. Number 4, management should create the appropriate division of labour. Following these 4 principles ensured that any organisation that used classical scientific management was left with Ã¢â¬Å"Best Possible WayÃ¢â¬ of doing things The division of labour allowed management to break down complex and difficult tasks into much smaller and manageable jobs and tasks that single employees could complete. Each employee is given precise instructions and training, specifically in how to best perform their jobs and tasks, each tasks is then watched closely by management who will ensure that the method used is the most efficient method for completing the task. When management is happy with all the methods being used they will watch as the product is passed on from employee to employee. If you think of an assembly line in a factory were each worker has one single job to do over and over in the production of a product on an assembly line, the product is finally ready for sale after each worker completes their specific tasks along the assembly line. Henry FordÃ¢â¬â¢s mass production of the Model T car is a great example of how the assembly line really worked within an organisation. Ford used theÃ classical scientific management theory along with his own engineering background to determine the Ã¢â¬Å"Best Possible WayÃ¢â¬ in which he could mass produce the Model T car using the assembly line. First he rationalized the most effective way to build the car based on the size of parts. He then determined the best order to assemble similar sized parts. Workers were trained in assembling these parts on an assembly line. Once the process was defined in only took 93 minutes to produce a Model T car using the assembly line. This allowed Ford to mass produce the car. Classical Administrative Management When systematic management grew in popularity, the number of people who where interested in defining and improving the practice, the likes of Max Weber & Henry Fayol to name a few were among the theorists who sought an alternative more general approach from the specialized functions of scientific management. Where scientific management focused on the workers productivity, administrative management focused on management processes and principles of the organisation. The goal of management theory shifted from exact work methods to the development of managerial principles, which in turn led to the birth of administrative management. The administrative theorist tackled the idea of management from many angles with the goal to designating management as a profession the can be taught to companies anywhere in the world. Weber & Fayol researched topics such as organisational principles, philosophy of management & organizational structure to list a few in order to make management a legitimate force within organisations. For Weber & Fayol management was a profession and an important role within an organisation. Scientific management focused on how to best get a job done administrative management focused on the best way to pull all the jobs together to organise a business. Simply put scientific management was concerned on the parts and administrative management was concerned on the sum. Human Relation Approach As a result of developing the classical management theory by the likes ofÃ Frederick Taylor, Henry Grant and Frank & Lillian Gilbreth was that critics began questioning classical management theory for the potentially harmful effects on employees. It was not so much the way in which management went about finding the most effective way to complete a task that concerned critics, but the assumption of classical management theorist that management and workers would meet half way on their attitudes on standardisation. Many believe that the emphasis on standardisation had in avertedly created an attitude among managers that employees were merely just the clogs in a machine, in this case the organisation. While machines and processes could be standardised, it was unrealistic to expect that standardisation among emotional human beings. Instead the 2 needed to be looked at individually. While Taylor and other classical management theorist continued to study and rollout the standardisation of jobs and processes, others began to look at a new research and approaches that involved the employee. This led to the creation of the human relation approach. The human relation approach attempted to incorporate the behavioural sciences into management thought in order to solve the problems that were encountered when incorporating the classical approach to management. The theory behind this idea was that the roll of management was to use employees to get the work done in organisations, rather than focus on production, structures or technology the human relation approach was concerned with the workers. Human relation theorists concentrated on questions that concerned how to best way to motivate structure and support employees within the organisations. A study during this time called the Hawthorn study was originally devised by a company called Western Electronics and was carried out by their own industrial engineers in 1924. The company was the manufacturing division of the American Telephone and Telegraph Company. The Hawthorn Works employed up to 30000 people and at the time was considered a prime example of the techniques and processes that are involved in the mass production of products and the work organisation methods that were advocated by the likes of Fredrick Taylor and Henry Ford. However, there was a difference mainly being the companyÃ¢â¬â¢s personal and welfare policies that included pensions, medical care, disability benefits and recreational facilities. The first phase of the study aimed at examining the effects of various lighting levels in the workplace and how these lighting levels could affect workers productivity. They divided workers into 2 groups, one that would have the light varied in the room and one that would have a constant illumination level in the room. Engineers expected to see various results in the group with changing light levels in order to determine the correct level of light, however the opposite happened. The group with the changing light levels in their room surprised engineers by actually increasing their output. The only time their work actually decreased was when the light in the room was actually so dim that the work could not continue. Even more startling was that the group with the same constant light levels also increased their work output. The second phase of the study wanted to establish the effects on productivity with increased rest periods, for example shorter working days, reduced working week, refreshments and better friendly communication between workers and supervisors. They tested a group of 6 women in an assembly test room and gave them the new privileges. The initial results were noted by Gillespie (1991:59) [Their] privileged status and a modicum of control over work days brought about a strong identification with the test room among the workers . . . With the introduction of refreshments during the morning rest period, the womenÃ¢â¬â¢s status soared higher still. Within 2 years of phase 2 starting productivity in the group of 6 had increased up to 30%. This led to the commissions of even more tests being carried out on various groups of people using the new techniques of reducing working hours and providing better care for their employees. The great results in output and employee job satisfaction undermined the assumptions regarding human behaviour that had been previously perceived by other classical management theorists. The study concluded that it was not the changes in the environment such as lighting and refreshments that had improved the production output in the group, but it was in fact the personal and special attention that the workers were receiving that made them perform better. It was in fact that they were being studied that made them improveÃ performance. This later became known as the Ã¢â¬Å"Hawthorn EffectÃ¢â¬ . This was the reason why the group had that had same consistent lighting in there room also showed increased performance levels. They also felt special because they were being studied which led to them wanting to impress the people who were studying them. Two major propositions came from the core of the Human Relations approach. The first proposition related to the importance of informal groups within organisations. The Hawthorn Study had proved that employees performed better when they worked as a collective force that cooperated throughout the organisation with no barriers between higher management and the employees. The second proposition was that humans are emotional beings who have a deep need for recognition and the feeling of belonging to something or someone. The Hawthorn Study found that employeeÃ¢â¬â¢s performance and attitude can change dramatically once these needs are met. This also did not go un noticed by the organisations who also needed to gain the collaboration of these new working groups if they were to get the best performance from their employees. Conclusion For me the Human Relation Approach to management is by far the most rewarding and fair approach between the two. Using this approach to management is both rewarding to the employee and the organisations for which they are working for. The employees get the job satisfaction, acknowledgment and felling of belonging to an organisation through this type of management. The employees will feel proud and honoured by the work that they carryout for the company and will feel secure and happy by the rewards offered. For the organisations, they get a work force that is happy to work for an organisation that treats its employees so well and fair. The production levels increase as a result of this. We as human beings need to be acknowledged in the work place and made to feel we belong to something, in turn we will continue o perform to the best of our abilities. References Bernard Burns (2009). Managing Change a Strategic Approach to Organisational Dynamics. 5th ed. Harlow England: Pearson Education Limited. P9-90. Bureaucracy: Max WeberÃ¢â¬â¢s Theory of Impersonal Management, Education Portal, YouTube 9th October 2014, Viewed 11th November 2014 https://www.youtube.com/watch?v=buJcTq2b6sE Classical Management Theory, Education Portal, YouTube 31st December 2013, Viewed 02 November 2014, https://www.youtube.com/watch?v=kE9XvUWgwaI Classical Management Theory, Education Portal, YouTube 9th October 2013, Viewed 04 November 2014, https://www.youtube.com/watch?v=PTBAMdA7YGg Classical Administrative School of Management, Education Portal, YouTube 14th October 2014, Viewed 10 November 2014 https://www.youtube.com/watch?v=vOhJtRlFgno Classical Administrative School of Management, Education Portal, YouTube 14th October 2014, Viewed 15th November https://www.youtube.com/watch?v=vOhJtRlFgno Neoclassical Theory of Management: The Human Relations Approach, Education Portal, YouTube 14th October 2014, Viewed 16th November 2014 https://www.youtube.com/watch?v=nhSJplS8tPY
Thursday, August 29, 2019
Marketing Management - Assignment Example Coca-Cola offers more than 500 brands in 200 countries serving 1.7 billion each day. The target market of Coca-Cola is not restricted to any area, gender or age. In fact, it is globally present and serves homes, offices, bars and restaurants; it identifies with youngsters, while is also targets the older age groups. The selling concept was exemplified in the thinking of Coca-Cola former vice president Sergio Zyman who said Ã¢â¬Å"the main objective of marketing was to sell more stuff to more people more often for more money to gain more profits.Ã¢â¬ (Yoffie and Wang, 2002) Coca Cola uses two varieties - one with sugar and another for all users. The product packaging incorporates the contour bottle design and the dynamic ribbon, shape and form. The bottle sometimes includes the native language of the region and it is designed in the same size as the beverage bottles or cans. Pepsi is the main rival of Coca Cola and many local brands compete with Coke in various regions as well. Coca-Cola produces more than 35,000 beverages. The company uses multi-brand marketing strategy, offering a wide range of beverage products to ensure customers a wide choice. The major brands launched are Coca-Cola, Fanta, Sprite and Diet Coke. Diet beverage was launched in 2001. Moreover, fruit drinks, coffees, teas and other forms of drinks were also introduced. Mineral water Kinley was launched soon afterwards (Dawar and Dai, 2003). Additionally, syrups and concentrates are also part of the product line up. For health conscious customers, energy drinks such as Powerade have been launched too. Coca Cola are packaged into 2 litres, 1.25 litres, 600 ml and 300 ml packages and these are also available in 375 ml aluminium cans. Coca-Cola favoured differentiated pricing model. Meet-the-competition pricing and psychological pricing models are used, which is suitable for varying customer segments and there are many products in a
Wednesday, August 28, 2019
MF Global - Research Paper Example The executives by the end of that month made it official that over 700 million USD had been transferred. They, however, could not pay back this capital with their revenue making it plummet into more debt. At the end of the liquidation period, customers of MF Global made losses that totalled over 1.6 billion dollars, and a majority have not received their funds till today. Difference between conducting fraud and financial audit Audits are done to ensure the smooth running of operations. They may be done after some time as per the organizationÃ¢â¬â¢s request, as in the case of financial auditing. Furthermore, they may be arbitrary and without warning, as in the case of fraud auditing. There are different types of audits, carried out for different purposes. There are reasons that surround each of these audits. One main reason is the accuracy of financial information in the organization. This is one reason why financial audits are carried out, and they can be done by a qualified, indep endent party or government unit. Fraud auditing is often done to discover some of the hidden figures in the financial data of an organization (Hagan, 2012). This means that, outside parties may be brought in to conduct a fraud audit, but internal auditors of an organization may be responsible for financial auditing. ... If there is the confirmation of fraud, serious legal ramifications may result (Hagan, 2012). There must be a level of responsibility for the auditing firm in both cases. If there are any financial discrepancies in the financial departments or operations, it is up to them to disclose this information. This may lead to the saving of capital that would have otherwise been lost in data. Fraud auditing may need a little more time and effort to identify what information may be missing that is crucial in the financial docket. A code of ethics needs to guide all the parties involved to ensure their tasks are carried out accordingly. The obligation of corporate CEOs to shareholders and employees about the firmÃ¢â¬â¢s financial activity The growth of an organization means that the CEO may have a daunting task of keeping an eye on everything that goes on in the firm. They must delegate some of the duties to subordinates. This helps in ensuring that there is a chain of command that is followed before getting to the top. However, they may not have full control over what subordinates may do, so it is up to them to ensure all matters relating to the financial sectors of the firm are reported directly to them. The shareholders of the organization are the most crucial part of the firm. CEOÃ¢â¬â¢s should be the voice of the organization and any financial activity going on should be reported to the people involved (Hagan, 2012). The CEO needs to tell the shareholders of the people in charge of the activities, and what they need to do if they have any complaints or suggestions. As CEO, it is oneÃ¢â¬â¢s job to understand what goes on in the firm in
Tuesday, August 27, 2019
Publicly traded corporation - Assignment Example By doing so, when customers go for shopping, they get quality products and quality assistance from the attendants thereby making the customers feel delighted and satisfied (Karen, 2001). With this vision, Woolworth ensures that the customers make repeat sales. The organizations vision is Ã¢â¬Å"to continue to drive its retail business, bring to customers greater convenience, quality, lower prices and better value, range, freshness and service.Ã¢â¬ The whole reason for an organization to have a vision is to remain relevant in the industry and to ensure its sustainability in the future. With this vision, Woolworth has embarked on industry and market research in order to ensure its survival in the industry. Its survival depends on the growth of the company, the growth of its employees, satisfaction of its customer base, quality and durable products, affordable and competitive prices, innovation, creativity and better customer service. (Comyns, 2000). The stakeholders also have an imp act on the success of any organization. Stakeholders are people who have interests in an organization. Stake holders in an organization include investors, shareholders, staff suppliers, customers, governing bodies and suppliers, business partners, trade associations and the community that surrounds the organization. All these stakeholders have to be satisfied by the company, thus Woolworth as an organization with stakeholders has to work hard towards the satisfaction of its stakeholders, and when they are satisfied, it means that the business is successful. Stakeholders play an important role in the success of the company, thus Woolworth aims at appreciating the importance of the stakeholders in the organization. Apart from this, the organization involves the stakeholders in the development, implementation and managing of business goals and objectives. Woolworth also informs the stake holders of culture associated with the company. Furthermore, Woolworth ensures a good relationship with the stake holders to avoid any disruption of the business. When a section of the stakeholders demand a resource, the company plans for the particular resource, ensures the particular stake holder is satisfied and that the business continues with its smooth operation. Woolworth also ensures flow of communication between the company and the stakeholders at all times when something happens. Lastly, Woolworth arranges for community development projects, medical camps and educational sessions for the stakeholders (Anderson, 2005). All these are done to satisfy the stakeholders as they are important to the success of the company. Five forces of competition to determine how they impact the company Rivalry in the industry Woolworth faces competition from four major competitors namely Sears, Wal-Mart, Kmart and Kholac Corporation. These are the main players in the industry each with a large customer base. Since these five companies are the main players, the industry has been slow in gro wth because the market has been dominated by these retail giants. Woolworth has to compete with these other equally successful organizations. It therefore has to up its game in terms of employee satisfaction and motivation, customer delight and satisfaction and innovation (Institution, 2011). Woolworth has to ensure that the products it holds in its shelves
Monday, August 26, 2019
Effects of Western global expansion after 1500 C.E - Essay Example This is too harsh. While negative things certainly happened during this time, wonderful things happened too. New cultures were introduced to one another. Although this process started unequally, it was the beginning of globalization, a process that has brought great prosperity to all parts of the world. It is now seventeen years since I came to serve these princes with the Enterprise of the Indies. They made me pass eight of them in discussion, and at the end rejected it as a thing of jest. Nevertheless, I persisted therein... Over there I have placed under their sovereignty more land than there is in Africa and Europe, and more than 1,700 islands... In seven years I, by the divine will, made that conquest (Morison, 576) One man could conquer all of this territory and bring back to Spain all the riches of these islands. It is an extraordinary story. However, Spain was not the only country involved: its efforts were mostly limited to the Caribbean (Paine, xvi). It was driven in large part by the changes Europe was undergoing. First, came discovery, and then came exploitation. Mercantilism developed in Europe in the 18th century (Duiker, et al, 320). This was one of the dominant economic doctrines of the time. It led European powers to seek out new markets across the world. These were often less developed countries that had some sort of resource the Europeans could exploit. The wealth generated from these conquests allowed Europeans to build massive public works such as the French palace at Versailles (326). While this was clearly a form of greed at the time, these buildings were truly beautiful. It is easy to argue that this period in world history was filled only with calumny and misery. However, much of the economic activity at the time laid the groundwork for the current global economy, which provides so much prosperity to us all. Certain countries needed to become rich so
Sunday, August 25, 2019
Advancements in Molecular Imaging - Research Paper Example r imaging involves many processes, hence, it encompasses many fields; target discovery, cell biology, chemistry, disease modeling, data processing, imaging and clinical research. The field is undergoing a lot of advancements that would enable it perform other tasks. Currently, further research efforts have been concentrated towards ensuring that the technology can bring about discovery of newer and more efficient ways to treat diseases and various pathologies in living organisms. With emergency of new tools, researchers are now able to solve problems that were previously difficult to solve. There are now different various molecular imaging tools that have enabled scientists to experiment on gene products in vivo. Notable technological advancements in this field include the discovery of new optical imaging techniques which is a forward step in molecular imaging in that, researchers are now able to work efficiently and proficiently (Baldwin, 2010). Some latest advancement in molecular imaging includes MRI, PET and optical imaging. Pet has ensured that there is an improvement in tumor detection so that tumors are treated and managed early and better. New MRI systems that have been developed have an improved field strength and enhanced radiofrequency. Tumor detection and management has also been made moirÃ © efficient through the technology of monoclonal antibody imaging. This is one of the latest discoveries in the field, and it has ensured that researchers of tumors are able to come up with better ways of discovering and treating tumor cases. This has revolutionalised clinical diagnosis of tumors (Baldwin, 2010). This is also referred to as radioimmunoscintigraphy (RIS) and it involves the use of laboratory developed molecules (monoclonal antibodies) that are able to attach themselves to particular cancer cells. From this, it is possible to visualize the pictures of the cancer cells inside the body. The monoclonal antibody is usually labeled with a radioactive atom
Saturday, August 24, 2019
Management of People in Healthcare Organizations - Essay Example Managers in healthcare organizations usually display leadership coordination and supervision of employees. This is because the nature of job and its complexity is such that employees cannot achieve tasks on an individual basis. These managers must not only take the critical decisions of ensuring that patients receive timely and efficient services but also address performance targets set for the employees. With globalization and the information age, the level of technological innovation has increased in the healthcare sector along with increased clinical specialization. On the contrary, there is a focus towards reducing costs worldwide, which requires doing away with traditional hierarchical structures and working in teams in both managerial and clinical setups. Integrated solutions can then be reached by these cross-disciplinary teams. This is in contrast to the traditional paradigm whereby there was a conflict between the general managers and health care service clinicians. It is im portant to understand that the healthcare service delivery process comprises of inputs in the form of medicines, equipment/technology and other health systems and the outcome of patientÃ¢â¬â¢s well-being. The role of healthcare service employees is quintessential in the intertwining Ã¢â¬Å"processÃ¢â¬ since health care is a people-oriented job and cannot be done with automated techniques. The personalized nature of job, therefore, makes the contribution and management of these professionals critical to the achievement of organizational outcomes. For healthcare employees, employees may be considered as internal customers whose satisfaction is equally necessary to guarantee organizational success. One of the most important techniques to ensure employee commitment and satisfaction is to indulge in cross-training. Cross-training is practiced in healthcare organisations as job rotation is highly demanded by healthcare jobs. For instance, a file clerk, a data entry expert and a secre tary may work in each otherÃ¢â¬â¢s roles in case either of them is ill or on a vacation or during times of heavy workload or emergencies (Fallon & McConnell, 2007). Cross-training is, therefore, extremely necessary considering the demand for flexibility in todayÃ¢â¬â¢s globalised world. On the other hand, most healthcare managers may simply hand over folders of information to be reviewed by the new employee which is a poor way of learning and results in low levels of information absorption. This is mostly done on the grounds that managers cannot devote sufficient time for training of new staff. This problem can be overcome by cross-functional training as people other than the manager (who are skilled at particular tasks) can be used to train the newcomer. Furthermore, the compensation plans of health care employees may also require management. Since the compensation of people in healthcare organisations constitutes the major part of expenses, organisations find it lucrative to r educe the pay and/or size of its staff in order to provide affordable healthcare to patients. In the modern age, however, techniques for managing employee pay and compensation has changed with third-party reimbursements tracking the nursing hours per visit, technological expenses and services utilized by clinicians. Furthermore, health care organisations mostly insist on offering Ã¢â¬Å"bonusesÃ¢â¬ as a primary incentive for enhancing performance of healthcare service professionals (Hernandez & O'Connor, 2009). Also, benefits in the
Friday, August 23, 2019
Critical Literature Review (50%) - each student will choose a particular International Marketing topic from the syllabus (severa - Essay Example The marketing mix commonly referred to as the 4Ps includes product, price, place, and promotion. It is noted that for a company to satisfy the needs of its customers, it must ensure that products of the right quality and quantity are developed, charged reasonable prices, found at the right place, as well as ensuring that the existence of the goods is made known to customers through promotion. This paper will discuss the marketing mix (4Ps) as well as the importance of the augmented product model with reference to the real world examples (Gitman and McDaniel 2008, p.13). Product The 4Ps of the marketing mix consist of the product, price, place, and promotion. The poduct is one of the most fundamental elements of the marketing mix that managers must take into consideration when making marketing decisions. The product in this case is the physical service or good that a company offers to customers. The basic elements of a product include function, packaging, appearance, and warranty amon g others. Therefore, the product that a company intends to deal with should satisfy the customerÃ¢â¬â¢s requirements in terms of quality, quantity, and appearance. Ensuring that these basic elements of a product are met will make a company competitive because of the fact that many customers will prefer the companyÃ¢â¬â¢s products to those of other competitors in the market (Lamb, Hair, and MacDaniel 2008, p.56). Samsung is one of the electronic companies that operate in a very competitive environment. As such, the company understands that to remain competitive, it must offer products that compete favorable with other companies. To achieve this, Samsung has focused on manufacturing high quality products that satisfy the needs of its customers. Most of SamsungÃ¢â¬â¢s products are said to be of high quality with regards to proper functionality and appearance. In addition, the company provides a warranty of not less than one year for all its products. For example, one of the compa nyÃ¢â¬â¢s latest iPhone 5 is just amazing in terms of quality and functionally. The company reveals that the iPhone 5 started receiving orders even before its launch because of its quality and functionality (Page, 2013). General Motors is another company that performs very well in the automobile industry due to the high performance of its products. General Motors operates in a very competitive environment. As such, the only way to remain relevant is to concentrate on the manufacture of cars of high quality that satisfies the need of customers. According to Tehrani (2008 p. 8) a product is best described in three concentric circles namely the core product, augmented product and the Uber product. He observed that the core product is found at the center of the concentric circle and is meant to satisfy the pressing needs for which the product in developed. Then there is the augmented product consisting of the core product and other features that ensure that the product become more fun ctional. Finally, there is the Uber product, which consists of all other intangible features added to the product such as the brand promise. The concentric model of a product can be illustrated using the mobile phone marketing. In this regard, the mobile phone becomes the core product while the augmented products will include other features such as the product warranty and after sales services. The Uber product in this case could include the customization of the
Thursday, August 22, 2019
Business Management Theory - Research Paper Example However, his efforts were supported by other professionals such as Frank and Lillian Gilbreth. In the year 1991, he made several contributions towards the management theory that are still in existence up to date as discussed below. The book of Management, Bus. Rev 3rd edition by Patrick J Montana and Bruce H Charnov states that Fredrick W Tailor was the first to make a formal attempt in the creation of management theory. He made wise decisions such as the decision to advocate an application of scientific method so as to work analysis and develop functional ways of putting the theories to work(Dale, 44). Long time before Tailor came up with theories, there was a common belief among the people that leaders not not made but are born. This belief was a great challenge to the formulated theories since the people could not support them. It became very cumbersome to speak of the aspect of theory management in such an environment whereby the fact that leaders could be trained was totally una cceptable. Towards the end of 19th century, the industry had greatly expanded and became complex therefore creating the need for better better understanding on matters to do with the management theory as well as the managerial technique development (Dale, 44). Due to the fact that Tailor got support from other professionals, Lillian Gilbreth and Frank who were pioneers in the area of motion studies on the job analysis and improvement in work efficiency. Franck used the term of therbligs to describe about seventeen motions that were different and were meant for the purpose of doing the job. Through listing the therbligs, Frank was capable of analyzing the job actions and seek to gain efficiency (Dale, 44). Taylor also played a big role in trying to motivate the workers through his theories, he advocated a piece rate so as to motivate the workers. He knew that motivating employees would enable them to be more productive, he therefore introduced a Gantt Chart as a management tool for t he purpose of scheduling work. The Gantt Chart accelerated the use of piece rate so as to record a normal production and a production bonus for motivating workers be more productive above the expected norm (Dale, 44) The Administrative theory that was created had five functions that characterized management as organizing, planning, commanding, controlling and coordinating. Fredrick Taylor, together with his colleagues in the management science movement came up with a theory which stipulated that workers had no intention to work , were very lazy, required a close supervision, had to be pushed by various threatening so as to be productive, lacked creativity and usually got challenged by the work (Montana, 23). However, the theory was opposed by the theory of McGregor which states that workers have a positive attitude towards work, practice high level of creativity, are ready to welcome various challenges, are more responsible and not be challenged by the work. As a result, the McGrego ry theory was more optimistic as compared to the Taylor`s theory since was a rather pessimistic assessment (Montana, 23) In the year 1991, Fredrick W Tailor made various contributions to the management theory as discussed in the book Ã¢â¬ËHandbook of Media Management and Economics by Alan B AlbarranÃ¢â¬â¢, Michael O Wirth and Chan-Olmsted. From this book, he made contributions on the management th
Ermo Essay Ermo, directed by Zhou Xiaowen in 1994, takes place in the 1980Ã¢â¬â¢s when China first began to actively accept the concept of globalization. Ã¢â¬Å"Ermo, where the title character as the strong-willed wife of an emasculated husbandÃ¢â¬ (Tang 654), explores the issues of being a matriarch as well as an individual with her own interests and desires. Compared with traditional Chinese women who were relegated to taking care of the household, Ermo is drastically different because she is the one who attends to the financial needs of her family by selling twisty noodles. Although she is a poor, peasant woman whose life revolves around the responsibilities of taking care of of her family, Ermo harbors secret ambitions which she longs to someday achieve. Fueled by her ambitions, Ermo works day and night to fulfill her aims even as she attends to her loved oneÃ¢â¬â¢s needs. Her characteristic as responsible matriarch can also be seen when she risks her health by selling large quantities of her blood in order to earn quick money. In the film, every action that Ermo takes is a result of her free will; she is not forced or coerced to do so. Everything that she does, she does for the love of her family. The female lead in the movie is willing to do anything to support her family, which is a marked characteristic of contemporary Chinese films. The role of Ermo is a strong departure from the traditional roles of women in Chinese society. ErmoÃ¢â¬â¢s profession is examined in two ways: Noodle seller during the day and noodle maker during the night. In the very beginning of the film, the shot shows her as a noodle-seller on the street, peddling bunches of twisty noodles that she herself made. She yells Ã¢â¬Å"mai mahua mian louÃ¢â¬ (twisty noodle for sale) (Ciecko 2) constantly. This scene particularly emphasizes her profession and skills for selling twisty noodles. There are also several close-up shots of her foot while she is making noodle dough. Ermo kneads flour with her feet, and she does it expertly, never dropping any of flour. This shot makes a statement as to the technical skills her work requires and the passion and dedication with which Ermo does her job. While generally regarded as a lowly job, it is actually a very demanding job requiring sophisticated skills. The opportunity to pursue a rewarding career among Chinese women is a fairly recent development because the women in China never had the opportunity to choose their job. ErmoÃ¢â¬â¢s desire can be read in various ways: desire for a better life, desire for a fulfilling sexual relationship, and desire for self-determination. ErmoÃ¢â¬â¢s Ã¢â¬Å"wish for a new life with a [Blindman, the richest guy in the town] after an amorous night halfway between town and village, expresses her desire to desire and constitutes an inspired revision of realityÃ¢â¬ (Tang, 668). This satisfies both her sexual desire and desire for better life. She also desires for having the biggest TV in her town, which at first may seem materialistic, but may actually be construed for her need to achieve and be acknowledged for her accomplishments. Although she says that she needs to buy the TV for her son so that he does not have to go to their neighborÃ¢â¬â¢s house to watch, it is really her own aspiration to show people who she really is. Based on strong Confucian society, Chinese women have been traditionally relegated to the sidelines, but as China begins to open itself to changes, so do Chinese women begin to evolve and come out into their own. As examined above, Ã¢â¬Å"the central events in Ermo reflect a new stage in the development of contemporary Chinese societyÃ¢â¬ (Tang, 663). As portrayed in this modern Chinese film, women are able to attend to their family without necessarily having to sacrifice their own dreams and ambitions in the process.
Wednesday, August 21, 2019
Shape Memory Alloys Manufacturing Processes Smart materials have been one of the fastest growing materials needed for medical device manufacturing. Smart materials, according to the McGraw-Hill Dictionary of Scientific Technical Terms, are defined as Materials that can significantly change their mechanical properties (such as shape, stiffness, and viscosity), or their thermal, optical, or electromagnetic properties, in a predictable or controllable manner in response to their environment. It is this property of changing according to its material that makes smart materials very valuable in manufacturing today. Perhaps one of the most useful smart materials comes in the form of memory shape alloys, specifically nitinol. Memory shape alloys have many applications in medical devices used today. They are highly prized for their exceptional superelasticity, their shape memory, their good resistance to fatigue and wear, and their relatively good biocompatibility. This makes them the perfect candidate for many in-vivo medical devices . Origin The shape-memory effect was first observed in copper-zinc and copper-tin alloys by Greninger and Mooradian in 1938, but it was only in the early 1960s that Buehler and his colleagues discovered and patented nitinol, a nickel-titanium alloy created in the Naval Ordnance Laboratory (NOL). This lab was formerly located in White Oak, Maryland and was the site of considerable work that has had useful impact upon world technology. The White Oak site of NOL has now been taken over by the Food and Drug Administration but has still left its legacy in the name nitinol (nickel + titanium + NOL- the initials of the Naval Ordinance Laboratory) (Gautam, et al. 2008). Their smart metal alloy, however, is 55% nickel by weight and may thus have allergic, toxic, or carcinogenic effects. For short-term use, in-vitro and clinical data strongly support nitinol as a safe biomaterial which is at least as good as stainless steel or titanium alloys also available to designers. Medical Applications of Shape Memory Alloys Muscles are the power of the body, used to turn energy into movement and motion. Shape memory alloys can be used to in their solid-state phase to make devices from muscle wires. Applications of shape memory alloys in the medical field are numerous. Their flexibility at one temperature and one way shape memory effect when heated to their transformation temperature make these alloys key materials for various medical methods. The inability of shape memory materials to combine to other metals requires some adaptation to be developed. A common material for this is nickel-titanium. Nickel-titanium has an excellent torque transfer characteristic which is just one of the many reasons this material is used for fabricating medical equipment (Yoshida, et al. 2010). A few notable applications are catheters, medical guide wires, bone plates and stents. Bone plates comprised of shape memory alloys, assist in repairing broken bones by making use of the bodys natural temperature to contract and maintain pressure for proper healing. (Georgia Inst. Of Tech, 2007) Catheters Catheters are used in a number of procedures such as therapeutics, diagnostics, and ablative procedures. Used in the medical field for administration of fluids, drainage, and provide a method to insert surgical instruments, catheters are tubes that can be placed in a body cavity, vessel, or duct. In the case of blood vessels, the catheter must move around the bends and angles to reach the desired destination. Stiff materials would not be flexible enough for this procedure and may cause a rupture in the vessel. Due to heat restrictions and risk of damage, only specific shape memory alloys can be used for many of these delicate processes. A solution for this problem is provided by the R-phase transformation, which is a specific type of martensite transformation that occurs in certain nickel-rich Ni-Ti alloys (Langelaar, et al. 2010). Travelling through the vessels is a difficult task, so a steering mechanism is implemented into a catheter to maneuver throughout the body. Currently catheters are equipped with integrated micro-actuators that allow controlled bending, which yields enhanced maneuverability compared to conventional catheters. Actuators consist of guide wires that bend when energy runs through them such as an electric current that heat the shape memory material. The simplistic designs of the actuator allows for high strains and stresses needed for a process. There are few actuating mechanisms which produce more useful work per unit volume than nitinol (Williams, et al. 1999). Guiding wires also known as pull wires or shaping wires, are located along the tube to allow for motion in many directions. Above: This demonstrates that shape memory alloys are more effective in actuators than many of the current materials on the market. Guide wires provide flexibility, shape memory, and pseudoelasticity. When a greater stiffness is required, the thickness of the wire may be increased to meet performance standards. Shape memory alloys allow for the catheter to return to its original geometry when the tension in the wire is removed. One adaptation formed due to the lack of metallurgical joining is a stainless steel sleeve, known as a crimp sleeve, to hold the wires to the catheter (Stoeckel, 2010). The sleeve brings up the problem of increasing the diameter of the catheter. To prevent breakage in a material, more flexibility and ductility is ideal. In medical applications, nitinol has higher ductility allowing more plastic deformation without fracturing due to the temperature of the human body. At body temperature (310K), nitinol will have a high percentage of strain at low stress meaning more ductility. Stents One of the largest medical uses for shape memory alloys is in stents. A stent is a tube that is inserted into an artery to hold it open. Stents are needed when the walls of the artery are not strong enough to remain open and need support to ensure that blood is able to flow. The stent is put in place during a procedure called an angioplasty (Stent Facts, 2010). In order to get the stent into the artery, it needs to be collapsed and inserted into a catheter. Shape memory alloys allow doctors to collapse the stent to a much smaller diameter, and have it return to its original shape after leaving the catheter inside the artery. The original use of shape memory alloys in stents was in the form of a simple coil. The coil was tightly wound in the catheter and then expanded once it was inserted into the artery and warmed. The expanded size of the coil is chosen to be slightly larger than the inner diameter of the target vessel, which means the coil will not be able to fully expand inside th e artery. The shape memory alloy, in its warmed state, will continue to attempt to expand, which will put a continuous outward pressure on the walls of the artery. This will ensure that the artery remains open. In more recent times, simple coil stents are used more for non-vascular applications such as preventing bladder obstruction. The simple coil stents that are still in use today are used in vascular cases where easy retrieval is required. The shape memory alloy allows the stent to hold its form in the body, but still be easy to deform back to a straight wire for removal (Sutou, et al. 2006). More modern shape memory alloy stents are made in forms other than a coil. The shape memory alloy can be formed into a braided or knitted coil. The downside of this is that the points where the wires cross form thicker walls, which are undesirable in a stent. Although the braided and knitted shape memory alloy stents were a step up in functionality from the simple coils, the thicker walls made them undesirable for many cases. The next level of shape memory alloy stents occurred once scientists determined how to make the alloys in flat sheets rather than just wire. Laser cutting a pattern into a flat sheet of the alloy, then rolling and welding it at various points creates a stent with no overlapping wires at the walls. Sheet style stents are thin, but also structurally supportive when heated to body temperature. This gives them more flexibility than the simple coil models and is a better use of the shape memory alloys characteristics (Sutou, et al. 2006). An older style coil stent in both its compressed and expanded forms Examples of sheet style stents: Top- Jostent SelfX (made by Jomed), Bottom- Dynalink (made by Guidant) Examples of braided style stents: Left- ZA Stent (made by Cook), Right- Symphony Stent (made by Boston Scientific) General Hazards General hazards of inhaling Nitinol include irritation, coughing, and shortness of breath. If ingested gastrointestinal disorders are possible. Skin contact and eye contact include irritation with possible redness and pain. None of these side effects are chronic. (SMDS 2008) Complications of Nickel-Titanium in Medical Applications Of the wide range of alloys that contain the properties of shape memory alloys, nickel-titanium and copper-based alloys hold the most value commercially. Nickel-titanium, also known as nitinol, is an equi-atomic mixture of the two metals. Concerns have risen over this alloy for the fear of nickel being released into the body (Williams, et al. 1999). It is important in medical equipment for the materials to be biocompatible, or the ability of the material to perform with a necessary response. In most medical procedures no response is typically desired. To determine if nitinol meets these criteria, the properties of titanium, nickel, and the combination of the two can be looked at. Titanium is a metal with a high resistance to corrosion. It is not particularly reactive and therefore is effective for medical uses where the device needs to be in the human body for an extended period of time (Lagoudas, 2010). It contains no characteristics of toxicity. Titanium is also a very strong material, however it is rarer and more difficult to manufacture than other materials. This makes titanium expensive compared to other alternatives. Nickel is a metal which is extremely reactive. Nickel is toxic to the human body and may cause massive inflammation and interaction with proteins. These properties raise questions on whether nitinol alloy is safe for medical uses. The benefits of using nickel in medical devices is that nickel increases flexibility and lowers the expense when alloyed with more expensive materials such as titanium (Langelaar, et. al. 2010 ). The properties when nickel and titanium are alloyed together usually take on those of titanium. During the manufacturing process an outer layer of titanium oxide forms. Although some nickel will still exist on the exterior, the toxicity is greatly reduced. When choosing a material for medical instruments, a risk/benefit analysis controls which alloy will be used. Nitinol is chosen because it holds great benefits and is very safe to use. Extensive testing of this material has been done and is still occurring to limit complications (Yoshida, et al. 2010). Safety During Medical Application When considering the use of shape memory alloys (such as nitinol), in medical applications, it becomes necessary to evaluate the safety of the materials for use in the human body. Biocompatibility and corrosion are two factors that come into play when considering placement into humans. Properly treated nitinol implants are corrosion resistant and compatible in humans. These implants form a surface oxide layer that protects the base material from most corrosion. There are some concerns of the nickel content dissolving from the Nitinol and causing adverse affects. However, other alloys containing high levels of nickel, such as MP35N or 300 series stainless steel, have been used in orthodontics, orthopedics, and cardiovascular applications, all the while displaying good biocompatibility. (Stoeckel, et al. 2003) Studies have shown that in vitro dissolution of nitinol dental archwires in saliva released an average of 13.05 mg/day nickel. This number is significantly lower than the average dietary intake of 200-300 mg/day. There was no increase in the nickel blood level throughout the study. A comparative in vitro cell culture study was performed to measure nickel release from nitinol and 316L stainless steel in fibroblast and osteoblast cell culture media. The nickel content was higher in the nitinol group for the first day, but rapidly decreased over time to achieve similar levels as the stainless steel. The nickel content never reached toxic levels in the nitinol and did not interfere with the cell growth. It was found that samples prepared by mechanical polishing released higher amounts of Ni-ions than those prepared by electropolishing. In order to evaluate the effect of polishing on nickel release, mechanically polished and electropolished samples of nitinol, MP35N, and 316L stainless st eel were immersed in solution for a period of over 1000 hours. Samples prepared by electropolishing released smaller amounts of Ni-ions than those with mechanical polishing. The electropolishing process removes excess nickel from the surface and forms an enriched layer of titanium. (Stoechel, et al. 2003) A study on blood compatibility was conducted on nitinol and stainless steel stents using an ex vivo, AV-shunt porcine model. It was concluded that nitinol is significantly less thrombogenic than stainless steel, meaning that when used in the human body it has a much lower chance of causing blood clots. It is thought that the titanium-oxide rich surface layer on the nitinol prevents denaturation of fibrinogen and minimizes platelet-rich thrombus formation within the stent after implantation. (Thierry, et al. 2000) Comparison of Shape Memory Alloy Nickel-Titanium to Stainless Steel The ability of shape memory alloys to return to their original position after large strains are induced is similar to that of rubber. However, unlike rubber, shape memory alloys are strong and noncorrosive much like stainless steel. Both nickel-titanium and stainless steel have long fatigue life. Many stainless steels contain nickel to maintain an austenitic structure. Higher nickel content guarantees superior resistance to corrosive cracking. Stainless steel has a relatively lower cost compared to nitinol mainly due to larger production numbers. Only about two hundred tons were produced in 1998 compared to a few hundred thousand tons of stainless steel (Lagoudas, 2010). Alloying a metal raises the production expenditure but changes the tensile and shear strength of the initial metals. The properties of shape memory alloys are better than those of stainless steel and therefore are the chosen material for certain applications. Above: Shape memory alloys have two phases, each with a different crystal structure andÃ properties. One is the high temperature phase, called austenite, and the other is the low temperature phase, martensite. Each martensitic crystal formed can have a different orientation direction, called a variant. The assembly of martensitic variants can exist in two forms. Twinned martensite, which is formed by a combination of self-accommodated martensitic variants and detwinned or reoriented martensite in which a specific variant is dominant (Lagoudas, 2010). Costs of Shape Memory Alloys such as Nickel-Titanium Alloys such as nitinol have poor formability in the manufacturing process which increases the production costs of such materials. The complex behavior of the material makes the development of shape memory alloys adaptive structures a challenging task. In this case, it is generally accepted that systematic, model-based design approaches and design optimization techniques can be of great assistance (Langelaar et al. 2010). However, as more applications for these materials are needed, the price will decrease. Currently, shape memory alloys are commercially available from a limited number of producers. When more production of these alloys begins, production costs will reduce. World production is small in contrast to other metal commodities. Competition drives prices lower in a market. Newer technology in manufacturing will also make the production more effective. Prices for shape memory alloys were over one dollar per gram of material in the 1990s. Today, the costs are roughly ninety percent lower. Whatever the cost may be, shape memory alloys such as nickel-titanium are one of the only materials capable of such miniscule instrumentation with the desired properties. Shape memory alloys are effective for their cost due to reliability and multiple functions (Stoeckel, 2010). Many applications of shape memory alloys only require a small amount of material. With prices around that of similar steels, shape memory alloys are gaining more attention in a variety of applications. Above: The best material lies towards the upper left corner as it corresponds to low material costÃ for the same output work (Lagoudas, 2010). It indicates that CuZnAl is the best, while Ni-Ti is the least. However, it may be more advantageous to use Ni-Ti because of reduced voltage requirements due to much higher resistivity, which results in cheaper equipment in cyclic applications. Copper based alloys are less stable and more brittle than Ni-Ti. Although less expensive, copper based alloys have found little approval for applications. Future Trends Current studies at the University of OULU have been conducted in order to demonstrate that bone modeling can be controlled by using a functional implant such as a NiTi nail which can be used to bend a normal shaft of the long bone. The method could also be applied inversely, such as straightening a deformed bone. Fractures and especially frequent fractures lead to angular deformity and bowing of long bones. Operative treatment has usually consisted of cortical osteotomies with cast, internal fixation, or external fixation (Kujala, 2003). However, these are relatively large operations with much postoperative pain and a risk for complications. Implantation of a bending rod would be a much smaller operation for the patient with reduced postoperative recovery. It might even be possible to insert the nails using minimally invasive techniques which would require a minute incision. Thus, the functional nail presented might provide an easier, quicker, cheaper, and less painful way to correct such bone deformities in the future. In addition, Prototype piping in nuclear reactors has been wound with pre-stretched Ni-Ti wire, which leaves very high compressive stresses in the pipe. Tennis racket strings have been tested in China and the USA with both countries claiming performance superior to existing string materials (Deurig, 1995). Furthermore, a variety of damping applications are being examined including such motivated projects as railroad wheel tires and damping mechanisms for suspension bridges. Moreover, the maximum Ms temperature achieved in Ni-Ti binary alloys is 100 degrees Celsius and for several years scientists have searched extensively for ways to increase this. Ms temperature or Martensite start temperature is the temperature at which the transformation from austenite to martensite begins on cooling. Until just two years ago the only alloys showing hope were extremely expensive alloys such as Ti- Pd-Ni and Ti-Pt-Ni. Recently, however two new alloys are showing a great deal of promise, Ni-Ti-Hf and Ni-Ti-Zr31. These alloys prove that transformation temperatures of over 300 degrees C are possible (Deurig, 1995). However, it is too early to know what the cost of the alloys will be and if other properties will be as good as the original alloys. Luckily, these first indications seem positive. One advantage if such an Ms temperature is possible would include the use of nitinol in circuit breakers and in automotive applications. Conclusion Shape memory alloys are quickly becoming a common material used in medical applications today. The adverse uses of alloys, such as nitinol, allow for improved stents, catheters, bone plates, medical procedures, and more. These advanced materials are helping to shape medical technology for the future. Through their durability and unusual prowess for changing shape they have become the future of medical material.
Tuesday, August 20, 2019
Monday, August 19, 2019
Violence and Power Within Dracula's Grasp Throughout many types of literature, violence exists to enhance the readers interest in order to add a sense of excitement or conflict to a novel. This statement withholds much truthfulness due to the fact that without violence in a piece of literature such as Dracula by Bram Stoker, the plot would not have the same impact if it was lacking violence. Dracula's power and evilness led to the violent happenings which began with the conflict of Jonathan's inner struggle, as compared to the conflict which blossomed later on with good versus evil. One case of violence that had occurred, not just for its own sake, happened in chapter seven, where it stated in the log of the "Demeter", "On 14 July was somewhat anxious about crew. Men all steady fellows, who sailed with me before. Mate could not make out what was wrong; they only told him there was something, and crossed themselves. Mate lost temper with one of them that day and struck him. Expected fierce quarrel, but all was quiet"(pg.87). Therefore, this type of violence rarely ever occurred before; thus, this action was foreshadowing evil. Eventually, this evil took place when poor old Mr. Swales was found dead with his neck broken. Mina Murry wrote in her journal about the incident, "...poor old Mr. Swales was found dead this morning on our seat, his neck being broken. He had evidently, as the doctor sa...
Sunday, August 18, 2019
Immorality and the Friar in The Canterbury TalesÃ Ã It is a sad commentary on the clergy that, in the Middle Ages, this class that was responsible for morality was often the class most marked by corruption. Few works of the times satirically highlight this phenomenon as well as The Canterbury Tales, by Geoffrey Chaucer. ChaucerÃ¢â¬â¢s "General Prologue" introduces us to a cast of clergy, or "Second Estate" folk, who range in nature from pious to corrupt. The Friar seems to be an excellent example of the corrupt nature of many low-level clergymen of the times- while his activities were not heretical or heinous, his behavior is certainly not in accord with the selfless moral teachings he is supposed to espouse. According to the NarratorÃ¢â¬â¢s account, he is a snob, corrupted by greed, and acts in very un-Christian ways. It is clear that he is a man of low moral standards. When we are first introduced to the Friar, we are told that he possesses a level of social grace far above his station in life. We are told that in the four begging orders, there is no one as knowledgeable in fair language and sociability as he (lines 210-211, Norton), and that he is a very ceremonious fellow (line 209). This seems out of step with a man who is supposed to make a living by begging, a man who is supposed to go through life without a roof over his head. This level of breeding and affinity for ceremony has likely come from an aristocratic birth- often, the younger sons and daughters of nobles who could not be provided for simply entered the clergy. This contributed to a large body of clergy members who came to the church not because they felt a divine calling, but simply because that is what was expected of them (his fellow pilgrim, the Prioress, als... ...th money from those who can barely afford bread. This FriarÃ¢â¬â¢s morals are much closer to vice than virtue; any doubts that he is a man of low morals are now completely swept away. ChaucerÃ¢â¬â¢s "General Prologue" is remarkable in that it allows us to see not only what characters may claim to represent, but also how they really are inside. ChaucerÃ¢â¬â¢s depiction of the Friar, who should be a man of upstanding piety and virtue, makes it readily apparent that he is quite the opposite. The FriarÃ¢â¬â¢s elitist background and behavior, his begging-supported greed, and the vices that oppose true Christianity prove that he is a man of low moral standards. Certainly, Chaucer paints a masterful contrast of image vs. reality. Bibliography The Norton Anthology of English Literature: Sixth Edition, Volume 1. M.H. Abrams, et al, Editor. W.W. Norton and Company. New York: 1993.
Saturday, August 17, 2019
The study conducted by Frederickson et al. was able to show the need to use a Bladder Scanner for the accurate and efficient assessment of bladder volume in postoperative care. The bladder distention that will be experienced by the patients can cause complications and health problems if appropriate measures will not be taken. The traditional solution which is to insert a catheter into the urethra of the patient is no longer a viable option because it increases patient discomfort as well as increases the rate of infections. The solution therefore is to use ultrasound technology such as the Bladder Scanner that will accurately and efficiently assess bladder volume. The accurate assessment will lead to the reduced usage of catheterization in postoperative care this will also allow for the reduction in the rates of infection, the cost of treating UTI, increase the efficiency of the nurses. This will ease the burden of the nurses and make them more effective in focusing on other tasks this will also ease the psychological and physical discomfort of the patients. The Implementation of Bedside Bladder Ultrasound Technology: Effects on Patient and Cost Postoperative Outcomes in Tertiary Care: A Critique of the Study In postoperative care it is common to encounter the problem of urinary retention. It can be said that one of the side effects of drugs, especially the use of anesthesia is bladder distention. This is characterized by the patientÃ¢â¬â¢s inability to distinguish if he or she has a full bladder and need to empty it. Bladder distention can cause complications and needless to say health workers must do their best to regularly empty the bladder. Since there is no way of knowing if the bladder is about to be void or not the usual method of dealing with this problem is intermittent catheterization but it is an invasive procedure that is not only a cause for discomfort for the patient, added cost to healthcare and demands more time from the nurses. Aside from all these problems, catheterization can also cause urinary tract information or UTI. There is therefore the need to have another alternative solution to urinary retention and distention. One of the most practical solutions is the use of a Bladder Scan It was determined that in postoperative care the effects of anesthesia and medication can cause distention. The patient loses the ability to feel that his or her bladder is already full and therefore realizes that it is time to empty the bladder. There is no need to elaborate on the fact that if this will continue then there would be harmful effects on the body as the bladder is a major component of the excretory system. Without the capability to Ã¢â¬Å"voidÃ¢â¬ then the patient will increase the risk of developing complications. The solution was to use catheterization. This is a procedure where tubes are inserted into the urethra of the patient. This is a painful process not to mention that it can humiliate the patient especially those who are not comfortable with the procedure. Aside from that the procedure is known to be the major cause of urinary tract infections. As a foreign object is inserted into the human body there is an increase in the probability that microorganisms can also be introduced into the system. This is the reason why the rate of infections shoots up whenever catheterization is regularly used in postoperative care. Health workers created a solution to this problem and it is to apply Ã¢â¬Å"timed intermittent catheterization. Ã¢â¬ This simply means that a catheter is not permanently attached to the patient but only in a prescribed time. The period when it is optimal to insert a catheter can be divided into two. The first one is called Ã¢â¬Å"due to voidÃ¢â¬ meaning that after a long period of time the bladder can be expected to be full. The second time when catheterization is expected is called Ã¢â¬Å"void with residualÃ¢â¬ this means that the patient was able to empty the bladder but there is still a Ã¢â¬Å"residualÃ¢â¬ and since there is no way to determine the exact volume of the residual, catheterization is required. The solution therefore is ultrasound technology. This allows for the accurate assessment of bladder volume to determine if catheterization is required or not. The Bladder Scan comes in two models the Bladder Volume Instrument BVI 2000 and BVI 2500. It uses ultrasound technology and this simply means that the device emits waves in the same way that a submarine uses sonar or a bat emits sound to determine the distance and shape of solid objects that cannot be seen by the naked eye. Therefore, when the Bladder Scan is placed near the bladder area the machine can generate a three dimensional image that will allow the health care worker to assess bladder volume. If there is a way for an accurate assessment of bladder volume then the number of catheterization can be reduced and therefore one can also reduce the rate of infections, the cost of treating UTI, and increase the productivity of nurses. 1. What is the study problem? Intermittent catheterization is the major intervention used to ensure that the bladder is emptied in Ã¢â¬Å"due to voidÃ¢â¬ cases and in cases where there is postvoid residual and yet incomplete emptying has occurred. But there is one only problem, catheterization increases the rate of UTI. It is also a waste of nurseÃ¢â¬â¢s time and effort not to mention that patients complain of psychological and physical discomfort when catheterization is used. There is therefore a need to find a way to minimize unnecessary catheterization. A bladder scan VBI 2500 will be tested for its effectiveness and efficiency in tertiary postoperative populations. 2. What is the study purpose? It was determined that one possible solution is to use bedside bladder ultrasound technology, specifically, the BVI 2500 Bladder Volume Instrument. In this regard the purpose of the study was to determine the effect of ultrasound assessment of bladder volume on patient and cost outcomes for patients needing postoperative catheterization. 3. Is the literature review presented? Previous studies were identified and cited as a basis for the research. The most significant review of literature was a study made using a similar instrument. Ouslander and associates were cited as having performed an experiment using the Bladder Volume Instrument BVI 2000 and BVI 2500. The relevance of the review of literature was also seen in the discussion on the accuracy of the BVI 2000 and BVI 2500 in measuring bladder volume. It can also be seen from the discussion of the accuracy of the instrument when measuring postvoid residual. Aside from the relevance of the literature it was also ascertained that the references were current. Moreover, the author did not only discuss what were the pertinent information that can be found in the said references but also critiqued the said studies by saying that although results favor the use of a bladder scanner but a clinical study is needed to determine its effectiveness and cost in tertiary postoperative populations. The author was able to do this by making a summary of the current knowledge provided by the references cited. As stated earlier part of the summary includes the discussion on the success of the bladder scanner in nursing homes and in an outpatient clinic but there is no data when it comes to its effectiveness and efficiency in tertiary postoperative settings. 4. Is a study framework identified? The study framework was identified and listed in the form of research questions: ? What is the accuracy of ultrasound assessment of bladder volume? ? Does ultrasound assessment of bladder volume result in less frequent catheterization for Ã¢â¬Å"due to voidÃ¢â¬ and Ã¢â¬Å"residualÃ¢â¬ events? ? Is there a difference in frequency of catheterization when bladder ultrasound assessment is used rather than standard catheterization procedure? ? Does ultrasound assessment of bladder volume versus standard catheterization result in decreased tract infections? ? Does ultrasound assessment of bladder fullness versus standard catheterization result in decreased health care cost? ? What is the patient and staff satisfaction with bladder ultrasound technology? 5. Are research objectives, questions or hypotheses used to direct the conduct of the study? The aforementioned research objectives can be used to direct the conduct of the study. Its main focus is the determination of the accuracy and efficiency of the BVI 2500 bladder scanner in tertiary postoperative populations as well as to find out the satisfaction levels of patients and the nurses. 6. Are the major variables or concepts identified and defined (conceptually and operationally? Identify and define the appropriate variables. The variables were: 1) the number of catheterizations avoided; 2)infection rates; 3) cost analysis of catheter acquisition; and 4) patient/provider satisfaction. The dependent variable is the number of catheterizations while the independent variable is the use of the bladder scanner as a tool to assess bladder fullness. Another dependent variable is the rate of UTI infections, the cost analysis of catheterization equipment and the satisfaction of patient and provider. 7. What attribute or demographic variables are examined in the study? An example of a demographic variable is the age of the subjects, age and surgical procedure that they had to go through. 8. Is the research design clearly addressed? The research design was clearly addressed because the author made clear from the onset that this study is about an intervention, specifically the avoidance of catheterization which in turn will reduce the rate of infections. The author was also able to clarify how this can be achieved Ã¢â¬â by using a bladders scanner and for the control group the use of straight timed intermittent catheterization. The subjects were not randomly assigned there was a deliberate plan to use four surgical units as data collection sites. From these four surgical units the proponents of the study divided the 132 samples into two groups. The first group contains 50 samples who had urologic, colon and gynecologic surgery while the second group contains 82 having total joint replacement and spine surgery. It is clear that the subjects were divided based on the type of surgeries that they went through. An explanation for this can be extracted from the review of literature wherein it says that bladder distention can be caused by anesthesia and medication. Thus, in order to minimize error it is best to group the subjects into the type of surgery that they went through. But this type of grouping can result in the creation of extraneous variables. For instance even though there are surgeries that fall under general surgery such as urology and operation on the colon these two deal with different parts of the body. Urology for instance deal with the urinary tracts of males and females therefore it can have an effect on the bladder or the rate of infections in the urinary tracts of the patients. Another extraneous variable is the skill level of the nurses that were assigned to operate the bladder scanner. There were no pilot studies conducted beforehand. All the necessary information needed for the design of the study were taken from the review of related literature. 9. Are the following elements of the sample described? The inclusion criteria includes patients who had undergone general and orthopaedic surgery. Exclusion criteria includes patients that had dermal ulcers, nephrotomy, obesity, confirmed pregnancy, in incision in a location that precludes ultrasound exam, or a known pelvic mass greater than 2 cm. The sampling frame includes only those who are patients in a particular large tertiary care hospital chosen by the proponents and satisfy the following conditions: ? they had undergone general surgery; or ? they had undergone orthopaedic surgery. Based on the sample frame the sample size was determined to be 132. Power analysis was done after the experiment. The proponents wanted to find out if there age, gender and type of surgery had an effect on the test results. They were able to determine that only age and type of surgery had an impact on the test results whereas there was no significant difference when it comes to gender. With the general surgical unit all were approved but with the orthopedic surgical unit only 53 was approved and therefor the attrition rate for the orthopaedic surgical unit was 39%. Before the patients were allowed to participate in the experiment the hospitalÃ¢â¬â¢s Human Subjects Review Board had to approve the study protocol and all patients who had the stated surgeries and were Ã¢â¬Å"due to voidÃ¢â¬ or Ã¢â¬Å"void with residualÃ¢â¬ assessment were screened for exclusion criteria and then approached for consent. All consenting patients on the general surgical unit were cleared to undergo ultrasound assessment of bladder volume. Those who were approved to participate from the orthopaedic surgical unit were catheterized or assessed with the ultrasound technology. The setting was appropriate for the conduct of the study because it is a large tertiary postoperative facility and that the patients under their care needed to be catheterized especially those who are due to void or void with residual. 10. Are the measurements strategies described? The study used the Likert format having five anchors ranging from not satisfied to very satisfied. This measurement strategy was developed by Rensis Likert and this was used to determine the level of satisfaction felt by the patient as well as the provider when it comes to the usage of bladder scanner. Another measurement strategy utilized in the study was the t-test, Chi Square and Pearson correlation. The t-test and Chi Square were used to examine difference between groups while the Pearson correlation was used to examine relationships between two variables. In the Likert system the level of measurement was ordinal. While the rest of the measurement strategies that were used in the study, the level of measurement was a ratio. The measurement strategies used in this study were all reliable especially when it was reinforced by the use of the Statistical Package for the Social Sciences Ã¢â¬â a computer program that allows for quick but accurate computations. In the previous study or the experiment described in the literature review, the proponents used Test-Retest Reliability measurement. This measurement strategy is not as reliable as the measurement strategies used in the current study. It is simply a retesting of the same subjects but at a different time period. If the design of the experiment was flawed to begin with the Test-Retest Reliability measurement will not be able to determine this type of error. 11. How were study procedures implemented and date collected during the study? The study procedures were implemented using standard timed intermittent catheterization protocol as well as ultrasound protocols. In the former there was a strict schedule to be followed and in the latter bladder scanners were used to assess bladder volume and from there make a decision to catheterize the patient or refrain from doing so. 12. What statistical analyses are included in the research report? The Statistical Package fro the Social Sciences was used for analysis and an alpha level of 0. 5 was chosen as a level of significance. 13. What is the researcherÃ¢â¬â¢s interpretation of the findings? The researcher was pleased with the findings. Aside from the fact that the proponent was very confident of the reliability and accuracy of the data, the result also closely resembled the results of previous studies as seen in the literature review. 14. Are the limitations of the study identified by the researcher? The researchers were able to point out the limitations of the study. First of all there was a problem with the sampling. The sample size was very small and because of this predicament the proponent of the stud was unable to make random selection of patients. For instance there were 50 patients in the general surgical unit and everyone were included in the experiment. There were also other factors that needed to be tested such as the type of surgeries that the subjects went through were varied especially in the general surgery group. 15. What conclusions did the researcher identify based on this study and previous research? The proponent of the study was able to determine that ultrasound technology is an accurate and efficient way to assess bladder volume. But they were also able to ascertain that it would be better if a portable scanner will be used instead of a bigger and bulkier machine. 16. How does the researcher generalize the findings? The researcher made the generalization that the Bladder scanner is accurate and efficient. This is based on the results that say it was able to detect even low levels of urine in the Ã¢â¬Å"void with residualÃ¢â¬ category. Researchers were also able to generalize that patient and provider were both highly satisfied with the use of the Bladder Scanner. 17. What implications do the findings have for nursing practice? This device can definitely help health workers to maximize their time and be more efficient. Standard timed intermittent catheterization requires for the insertion of a catheter on a regular basis and this will easily consume their time as well as increase the discomfort of the patients. 18. What suggestions are made for further studies? There is a need to look into the age difference of the subjects. The researcher pointed out that age is a demographic factor that is significantly related to number of catheterizations required. In future studies there is a need to have a larger sample to so that the age of the subjects can be varied. 19. What are the missing elements of the study? One missing element is that there was no discussion regarding the warranty of the device. There was a generalization that it is cost-efficient to use the Bladder Scanner because it reduced the number of catheterization, the rates of infection and reduces the time needed for nurses to take care of UTI and intermittent catheterizations. But there was no discussion regarding the ability of the Bladder Scanner to withstand repeated abuse. It was made clear that it would take 2. 9 years of continuous usage before one can recover the investment on the Bladder Scanner, there is a need to know if it is sturdy enough to last beyond a three-year period. 20. Is the description of the study sufficiently clear to allow for replication? The description of the study is sufficiently clear to allow for replication. The protocols that were established beforehand is a major reason why this study can be replicated. The study conducted by Frederickson et al. was able to show the need for a Bladder Scanner or similar device in postoperative care. The bladder distention that will be experienced by the patients can cause complications and health problems if appropriate measures will not be taken. The traditional solution which is to insert a catheter into the urethra of the patient is no longer a viable option because it increases patient discomfort as well as increases the rate of infections. The innovate solution of using standard time intermittent catheterization is not a very good solution because it still cannot eliminate the problems discussed earlier although it can slightly reduce the total amount of time that catheterization is used. The solution therefore is to use ultrasound technology such as the Bladder Scanner that will accurately and efficiently assess bladder volume. The accurate assessment will lead to the reduced usage of catheterization in postoperative care this will also allow for the reduction in the rates of infection, the cost of treating UTI, increase the efficiency of the nurses. This will ease the burden of the nurses and make them more effective in focusing on other tasks this will also ease the psychological and physical discomfort of the patients. References Frederickson, M. et al. The Implementation of Bedside Bladder Ultrasound Technology: Effects on Patient and Cost postoperative Outcomes in Tertiary Care. Orthopaedic Nursing. 19(3): 79-87. Warner, A. J. et al. Postoperative Bladder Distention Measurement with Bladder Ultrasonograph. Journal of Perianesthesia Nursing 15(1): 20-5.