Ducati Essay Example for Free

Ducati Essay Patrick EnglandDucati individual write up #3 Management 495 2/7/2012 Can Ducati sustain its position in the sport segment? Can Honda and other Japanese manufactures stop its growth in this segment? The ability for Ducati to sustain its position in the sport segment of motorcycles is going to depend on management’s ability to stay focused on keeping their image and story alive and in the minds of the motorcycle community. If management continues its current trend I believe that they can sustain their position, although there are challenges posed by the Japanese firms and changes in Ducati itself can also play a role in their ability to maintain their growth and position as the high end advanced sport bikes. Ducati’s decision to move from a mechanical company to an entertainment company could be the source of its success or its failure. The company to this point in 2001 had become known for their exotic engineering and design, focusing on beating the completion by any means, even if it involved producing a bike that many might call ugly or not the traditional motorcycle, so Ducati was running the risk of turning away the very customers and removing the image that had built them to the company they had become. But the decision made by Minoli, to become more of an entertainment company and to produce products that could be attractable by a wider variety of customers could also spur growth and market share that the company desperately wanted and needed if it was going to continue to compete with the Japanese bikes. I believe that if the management at Ducati can continue to make this â€Å"turnaround† hold and follow through with the goals laid out in it, then yes they can sustain their position, although any deviation or getting lack in the respects of implementing these long term goals will in my opinion hurt them greatly, for it is the image and the brand that Ducati represents that makes their products wanted. If they try too hard to copy the functions and company structure of competitors they very well may be destroying their core competitive advantage of image and product uniqueness. Japanese manufactures have been pushing hard in the sport market and have the capital and business structure to make a full fledge effort to take market share in the sport division. Honda and others have the ability to mimic the aspects of Ducati that have made them so revered by customers (mainly new technology and exotic styling) while still maintain their reliability and cost advantage. They will still continue to struggle with the â€Å"cookie cutter† image that has plagued them throughout their history, and I believe that if they can try to separate products in their sport division and create the image of uniqueness and exoticness that people associate with Ducati, then they definitely can pose a serious threat.

Preventing Prolonged and Obstructed Labor

Preventing Prolonged and Obstructed Labor Prolonged labor and obstructed labor are major causes of maternal and newborn morbidity and mortality in india. One of the tools used to monitor labor and prevent prolonged and obstructed labor is the partograph, a single sheet printed paper on which labor observations are recorded. (Fistula care., 2011). The timing of interventions is the one of the crucial factors in active management of labor, whether these be amniotomy, augmentation, ceasarean section or transfer to a central unit. The maintenance of a partogram for the management of the labor helps to indicate, with its alert line and action lines, the optimum timing of these interventions and to clearly differentiate normal from abnormal progress in labor. The partogram could be used at all areas of obstetric care by basic care providers who are specially trained to assess dilatation of the cervix and when it used properly, helps to detect cases of abnormal labor without delay, thus allowing timely intervention. Partogram is a composite graphic record of cervical dilatation and descent of head against duration of labor in hours. It also provides information about fetal and maternal condition that are all recorded on a single sheet of paper. The modern partogram contains many relevant parameters related to labor, mother and the fetus. These parameters are cervical effacement and dilatation, descent of part which is present, fetal heart rate, duration and frequency of uterine contractions, color and quantity of amniotic fluid which is passed per vaginum, maternal parameters such as vital signs and drugs used during labour. This pictorial documentation of labor facilitates early recognition of poor progress. Plotting of cervical dilatation also enables prediction of the time of onset the recording of all relevant data on a single page, it facilitates the easy handing over of mothers, helps in early recognition of complications and highlights inefficient clinical practice. (James et al., 2001). The partogram is an observation chart that may be used to facilitate assessment of the progress of labor, including maternal and fetal well being. Historically progress is measured by linear progression along a prescribed time scale, whereby a curve of cervical dilatation is measured in centimeters plotted against time in hours (Friedman 1955), and descent of the head abdominally. Many modifications to the partogram have occurred, resulting in the introduction of alert line and action lines. Basically, the action line was 2 hrs to the right of the alert line, and augmentation instituted at this time. Once labor is confirmed as in the active phase, cervical dilatation is expected to progress at (Macdonald et al., 2011). An accurate record during labor provides the basis from which clinical improvements, progress or complications of the mother or fetus can be judged. For this reason the notes should be kept in chronological order. The maternity record is shared between the midwife and the obstetrician. The obstetrician makes notes of his or her findings, timing of visits and may prescriptions made. The same standards apply to all practitioners. The midwife usually enters the summary of labor and initial details about the baby. In recent years the partogram or partograph has been widely accepted as an effective means of recording the progress of labor. It is chart on which the salient features of the labor are entered in a pictorial form and therefore provides the opportunity for early identification of deviations from normal labour. (Fraser et al., 2007). The best clinical tool that diagnoses the poor progress of labor is the partogram (even in higher centers) and will always help in early detection of the abnormal labor. It is very handy, easy to use and easily reproducible too. The use of a partograph in labor was associated with reduction in prolonged labor and decreased caesarean section rate. Another advantage of the use of a partograph was improvements in fetal and maternal morbidity in a significant manner. (Kamini., 2011). The cervicograph is the pictorial representation of the cervical dilatation charted against the hours of labour. Studies have shown (Friedman and Sachtleben 1965 pearson 1981)that the cervical dilatation time of normal labor has a significant sigmoid curve which can be divided into two distinct parts such as the latent phase and the active phase. (Bennett et al., 2001). In some cases the partogram may allow space for a certain amount of comment but usually the midwife will keep a separate written account in which she records her observations of the women’s psychological condition and any other details not included on the graph. If any changes in the birth plan become necessary ,the midwife will note down how these were discussed with the women and her partner and with what outcome.In this way the women will feel involved in any decisions made, which encourages feelings of being in control and enhance the birth experiences. (Ali et al., 2010). The midwife can verify the progress of labor effectively through the use of graphic charts (partograms) on which one plot cervical dilation and station (descent), this type of graphic charting assists in early identification of deviations from expected labor patterns. (Lowdermilk, et al 1997 ). NEED FOR THE STUDY The latest available data on MMR india is 212 per 100,000 live births and IMR is 44 per 1000 live births. Out of 180 countries now india ia ranked 126 when countries are arranged in an ascending order for MMR and 45 out of 195 countries in IMR. (Petterson, 2004). The obstructed labor stands one of the five major causes of maternal morbidity and mortality in developing countries like india. About 4% and 70% of all maternal deaths is due to obstructed labour or rupture of the uterus, accounting to a maternal mortality rate as high as 410/100,000 live births. (S. Quenby et al., 2003). Introduction of partograph in the management of labor(WHO 1994) has reduced the incidence of prolonged labor and caesarean section. There is improvement in maternal morbidity, fetal morbidity and mortality. (Dutta., 2013). The development of the partograph (or partogram) provides a graphical overview of the labor to allow early identification and easy diagnosis of the pathological labor for health care providers. Emanuel Friedman was the first obstetrician who provide an accurate tool for the study of individual labours. In the 1970’s partographs starts getting popularity and today majority of delivery and labour units use them. A large number of literature shows that their correct use reduced the rates of prolonged labors and many complications which arises during labour. There is also a suggestion that the use of the partograph results in fewer surgical interventions such as Caesarean sections. Nowadays the electronic partographs are becoming popular and it can be made into medical records systems. The use of partographs is very common in hospitals. A study has been conducted on health care workers and midwives who works in delivery units of Nigeria found that only 10% of caregivers used the partograph while conducting labour, and only few used it properly. The study found that the correct use of partograph may be restricted by training, time, and caregiver skill level. In many of the cases, literacy and numeracy are major problems to use it. Finally, the study concludes that the health workers requires training about partograph for the early identification of deviation from normal labour. (Neison et al.,2005) The partograph provides information about deviations from the normal progress of labor and about various abnormalities of maternal or fetal condition during labor. It may alters providers when a woman needs an intervention and which facilitates throughout evaluation of the effects of those interventions. (Fistula care., 2011). The partograph helps to reduce the time midwives spent on writing notes, while helps them to keep detailed and accurate records. It also allow them to provide an emotional support to the women in labour. Hence, the investigator who has done the research feels that it is very imperative to train the nurses working in maternity unit and to improve the knowledge and skill in the use of partograph. This would help the nurses to provide a comprehensive intrapartum care to the mothers in labour with early identification and prevention of complication arising during labour, So said that the partograph plays an important role in reducing the maternal mortality and morbidity due to labour. (Arez et al., 2009). In maternal health care, it is imperative that a skilled attendant be present at each delivery. According to WHO, a skilled attendant at birth is one of the most effective interventions to reduce maternal mortality. Among various interventions which have proven valuable in maternal health care is the partograph, which should be used in health facilities everywhere for monitoring labor and preventing complications. (Dangal., 2006). In a WHO multicenter trial conducted in southeast Asia which includes 35 484 women. The study shows that the introduction of the partograph during labor management significantly reduced both prolonged labor from 6.4 to 3.4 % of labors and the percentage of labors which requiring augmentation which is from 20.7 to 9.9% to 8.7 %, There was also a reduction in the mean number of vaginal examinations during labor probably leads to the drop in cases of postpartum sepsis by 59%. Improvement in maternal morbidity and fetal mortality which took place among both multiparous and nulliparous women. The participants in WHO trial agreed that the partogram improved the discipline communication about management of labor and freed midwives time, this may be an important element of the partograms success as more time can be devoted to ‘companionship’. The WHO trial points the way towards effective management of labor where reduced but timely intervention is the key to success. (James et al., 2011). Partographs are tools that allow labor progress to be graphically recorded and assessed visually . Partograph helps in early detection of abnormal progress of labour and are credited with decreasing rates of prolonged labor, oxytocin use, cesareans, and intrapartum morbidity or mortality as compared to regular care. Eventhen, partograph is not so used widely but only rarely in countires like U.S. A. A research team has made a partograph which is physiologically based for hospital use in assessing the labors of nulliparous women with spontaneous onset of labour. They shows that their tool greatly improves the outcome which in turn, optimize the safety of the mother and the fetus during labour. (Neal et al., 2011). A study conducted to evaluate the Partogram programme in the University Center of Health Science in Cameroon, Africa and Yaounde. It ia a retrospective study with 686 patients and a prospective study with 1045 patients . The institution which has this program shows that the perinatal mortality has been reduced by 10 deaths per 1000 births because of use of partograph and it provides accurate and reliable results for early identification of abnormal labor. About two-thirds of the morbidity and mortality related to labour and 72% of deliveries with medical or surgical conditions has also occurred in the clinical area where the labor curve crossed the action line in the partograph. (Drouin et al., 1979). STATEMENT OF THE PROBLEM A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE, ATTITUDE AND SKILL REGARDING PARTOGRAPH AMONG MULTIPURPOSE HEALTH WORKERS IN SELECTED MATERNITY CENTRES IN COIMBATORE. OBJECTIVES To assess the level of knowledge, attitude and skill regarding partograph among multipurpose health workers in selected maternity centres. To identify the effect of structured teaching programme on knowledge, attitude and skill among multipurpose health workers in maternity centres. To associate the findings with demographic variables. OPERATIONAL DEFINITION STRUCTURED TEACHING PROGRAMME Refers to a well planned instruction which is designed to improve knowledge, attitude and skill. KNOWLEDGE It refers to the actual understanding of Mutipurpose health workers on partograph as elicited by knowledge questionnaire. SKILL It refers to the ability to use partograph which is assessed by using checklist. ATTITUDE It refers to the belief of the multipurpose health workers towards partograph. PARTOGRAM The progress of labour depicted in the form of graphs. LABOUR The process of child birth. HYPOTHESIS H1: There will be a significant difference in the knowledge level of multipurpose health workers regarding partograph before and after administration of Planned Teaching Programme. H2: There will be a significant difference in the attitude level of multipurpose health workers regarding partograph before and after administration of Planned Teaching Programme. H3: There will be a significant difference in the skill level of multipurpose health workers regarding partograph before and after administration of Planned Teaching Programme. ASSUMPTION Multipurpose health workers may have previous knowledge on partogram. Planned Teaching programme will enhance the level of knowledge ,skill and attitude among Multipurpose health workers. CONCEPTUAL FRAMEWORK A conceptual framework or models is a set of concepts, assumptions, principles and rules which provides an outline for conducting research. Thus the investigator adopted Donabedian’s Program Evaluation Model (1982). Avedis Donabedian a physician and health services researcher at theUniversity of Michigan, developed the original model in 1966. This model consists of three aspects such as structure, process and outcome. 1. Structure: Structure includes all the factors that affect the context in which care is delivered. It includes infrastructure, equipments, supplies, manpower etc. In this present study the infrastructure is the selected corporation maternity centres in Coimbatore where the teaching has been taken place. Equipments and supplies are the audio visuals aids used for teaching (pamphlet handout). The human resources are the multipurpose health workers 2. Process: It is the activities carried out with the help of structure to achieve the outcome. In this study, it is the structured teaching program regarding partograph done by the investigator with pamphlet and handout. Outcome: It is the result of execution of the process through the structure. In this study, the outcome is the improvement in knowledge, attitude and skill regarding partograph among multipurpose health workers. If the outcome is positive, it ensures that both the structure and process is functioning effectively. In this study the result shows that the teaching has improved the knowledge, attitude and skill regarding partograph among multipurpose health workers.

The Australian Legal Systems

The Australian Legal Systems The Australian legal system is based on a fundamental belief in the rule of law, justice and the independence of the judiciary. All people of Australia and non-Australians are treated equally before the law and safeguards exist to ensure that people are not treated arbitrarily or unfairly by governments or officials. Principles such as procedural fairness, judicial precedent and the separation of powers are fundamental to Australias legal system. The common law system, as developed in the United Kingdom, forms the basis of Australian jurisprudence. It is distinct from the civil law systems that operate in Europe, South America and Japan, which are derived from Roman law. Other countries that employ variations of the common law system are the United States, Canada, New Zealand, Malaysia and India. The chief feature of the common law system is that judges decisions in pending cases are informed by the decisions of previously settled cases. Consitution of Australia The United Kingdom passed the Commonwealth of Australian Constitution Act 1900. The significant of the Act was that it created a federal Commonwealth compraising the Commonwealth of Australia and the states. It also incorporated the constitution which came in to effect on January 1901. The Australian Constitution of 1901 established a federal system of government, under which powers are distributed between the federal government and the states Itdefined exclusive powers (investing the federal government with the exclusive power to make laws on matters such as trade and commerce, taxation, defence, external affairs, and immigration and citizenship) and concurrent powers (where both tiers of government are able to enact laws). Thestates and territories have independent legislative power in all matters not specifically assigned to the federal government. Where there is any inconsistency between federal and state or territory laws, federal laws prevail. Federal laws apply to the whole of Australia. Seperation of powers Governing Australia needs lots of power. The Constitution says that this power is divided between three groups of people so they can balance each other. Each group checks the power of the other two. This division of power stops one person or group of people taking over all the power to govern Australia. Legislative power means the power to make laws and is concentrated in the Parliament. Executive power means the power to implement laws and is given to the government. Judicial power gives the High Court power to decide whether laws are legal according to the Constitution. Division of Powers The law making powers which are not stated in the constitution as belonging to the commonwealth remains with the state .The powers are divided between the State Parliament and the Commonwealth parliament.There are some areas where both the commonwealth and the states have power to make laws these are concurrent powers,for example ,the taxation power. The state can however be excluded from these areas if their law are in consistant with those of the commonwealth. Some powers are stated to be exclusive to common wealth. These includes defence powers , the power to impose exercise and customs dudies , the currency, coin age and legal tender power and making of law for the government of a territory. The commonwealth is irestricted on areas for which it can make laws, the state can make laws on the commonwealth areas as long as they are with in the juristiction of the state,where a commonwealth has not been specifically given a power to legislate, then those remaining powers are exclusive to the states , for instance motor law , Criminal law and contract law. Most business law are made as state laws The Commonwealth Parliament The Parliament is at the very heart of the Australian national government. The Parliament consists of the Queen ,represented by the Governor General and two Houses (the Senate and the House of Representatives). These three elements make Australia a constitutional monarchy and parliamentary democracy. There are five important functions of parliament: to provide for the formation of a government; to legislate; to provide the funds needed for government; to provide a forum for popular representation; and to scrutinise the actions of government. The Governor-General The Governor-General is appointed by the Queen on the advice of the Prime Minister. The Governor-General performs a large number of functions which are defined by the Constitution, but fall roughly into three categories: constitutional and statutory duties, formal ceremonial duties, and non-ceremonial social duties. On virtually all matters, however, the Governor-General acts on the advice of the Ministry. The Senate The Senate has 76 Senators 12 are elected for each of the 6 states, and 2 each for the Australian Capital Territory and the Northern Territory. State Senators are elected for 6 year terms, territory Senators for 3 year terms. Historically, the Senate has been regarded as a States House: the States enjoy equal representation in the Senate, regardless of their population, and State matters are still important to Senators. The modern Senate is a very powerful Chamber. Bills cannot become law unless they are agreed to in the same terms by each House, except in the rare circumstances of a double dissolution followed by a joint sitting of both the houses The Senate has a highly developed committee system and Senators spend much of their time on committee work. The House of Representatives The House of Representatives has 150 Members each representing a separate electoral division. Members are elected for terms of up to 3 years. The most distinctive feature of the House is that the party or group with majority support in the House forms the Government. The accountability of the Government is illustrated every sitting day, especially during Question Time. Members have many other functions. They are involved in law making, committee work and in representing their electors. Executive Government The Prime Minister is appointed by the Governor-General, who by convention under the Constitution, must appoint the parliamentary leader of the party, or coalition of parties, which has a majority of seats in the House of Representatives. This majority party becomes the government and provides the ministers, all of whom must be members of Parliament. The Federal Executive Council, referred to in the Constitution, comprises all ministers, with the Governor-General presiding. Its principal functions are to receive ministerial advice and approve the signing of formal documents such as proclamations, regulations, ordinances and statutory appointments. Federal Judicature The Constitution provides for the establishment of the High Court of Australia and such other courts as Parliament may create. The judges of the High Court are appointed by the Governor-General in Council (acting on advice of the Federal Executive Council). The functions of the High Court are to interpret and apply the law of Australia; to decide cases of special federal significance including challenges to the constitutional validity of laws; and to hear appeals, by special leave, from Federal, State and Territory courts State and territory courts. Australian state and territory courts have jurisdiction in all matters brought under state or territory laws. They also handle some matters arising under federal laws, where jurisdiction has been conferred by the federal parliament. State and territory courts deal with most criminal matters, whether arising under federal, state or territory law.Each state and territory court system operates independently.

Following A Dream Toward Freedom :: essays research papers

Following A Dream Toward Freedom Freedom was and still is the dream of every American. Freedom is defined as the liberty of choice or action, self-determination of rational beings, the right to enjoy privileges of membership or citizenship, and independence. The natural rights of all men have been stated as "life, liberty, and the puruit of happiness." In order for freedom to exist, people must take on the responsibility to pursue and maintain their dream. The dream of freedom requires people to take responsibility to govern themselves in a way in which freedom can succeed without chaos. Civilizations have used governmental law and social rules to regulate their citizens. People must maintain a direct hold on their government and society through their laws and social structure, allowing for each individual within their citizenship to keep their own identity while participating in the civilization as a whole. When people take on the responsibility of their citizenship and follow the laws and rules founded for them, freedom is allowed to work for everyone. "In the future days, which we seek to make secure, we look forward to a world founded upon four essential human freedoms," stated Franklin Roosevelt in his 1941 President's Annual Address to Congress. "The first is freedom of speech and expression-everywhere in the world. The second is freedom of every person to worship God in his own way-everywhere in the world. The third is freedom want-which, translated into world terms, means economic understandings which will secure to every nation a healthy peacetime life for its inhabitants- everywhere in the world. The forth is freedom from fear-which, translated into world terms, means a world-wide reduction of armaments to such a point and in such a through fashion that no nation will be in a position to commit an act of physical aggrestion against any neighbor-anywhere in the world," stated President Roosevelt. The first Americans followed their dream toward freedom by coming to America and founding the colonies which have evoled into the cities and towns present to this day. The officers and soldiers of our great country followed their dream toward freedom by fighting and sacrificing their lives for the

Essay --

Investigating the effect of caffeine concentration on the heart rate of Daphnia Introduction Daphnia, commonly known as water fleas, are tiny crustaceans which live in water. The diameter of adult female bodies is approximately 3-5 mm. The upper skeleton is transparent, making the internal organs visible. This allows the heart rate of the Daphnia to be calculated by observing them under a microscope. Background Caffeine occurs naturally in some plants such as coffee beans and tea leaves. Caffeine is also added to other beverages. Beverage containing caffeine (100ml) Amount of caffeine (mg) Caffeine per 1ml of beverage Coffee 55 0.55mg Tea 35 0.35mg Coca Cola 15 0.15mg Caffeine is medically known as trimethylzanthine. Caffeine acts as a cardiac stimulant which means that it increases heart rate. Adenosine is a natural chemical found in the body which binds to respective adenosine receptors in the sinoatrial node and slows down the activity of the nerve cells. Caffeine also binds to these receptors which results in the activity of these nerve cells to increase. Caffeine consumption also causes the adrenaline hormone to be released into the body, further increasing the speed of bodily functions. Caffeine also constricts blood vessels which is why some headache medicine and painkillers contain sources of caffeine. 2 cups of strong coffee has been shown to increase heart rate in humans by about 15 beats per minute. Hypothesis As the caffeine concentration increases, so does the heart rate of the daphnia. Prediction The prediction for this experiment is that the higher the concentration of the caffeine, the higher the heart rate in beats per minute. This is because caffeine acts as a stimulant, causing the adrenaline hormone b... ...d by the lamp being on cannot be easily controlled and could be a factor for the increasing heart rate. The heart rate may also increase as a result of the efforts of the Daphnia in escaping from the cavity slide due to limited water supply. Conclusion The results of the experiment indicate that the initial hypothesis was acceptable as the higher the caffeine concentration, the higher the heart rate of the Daphnia. The results do not show this link in all cases; this could be down to temperature rise because of the heat produced by the microscope lamp, leading to the heart rate of the Daphnia increasing. This could explain the results for the 0.2% caffeine concentration. To improve the accuracy of the results, the same person should conduct all of the experiments as different people may count the heart rate at different speeds, leading to variation in the results.

hHCS 405 WK Individual Assignment Essay

Reducing agency staff, I choose this budget cut because it leaves more positions open for the facilities own staff and this form of help is a high cost, twice as high a regular hospital staff but each open job is continually monitored to determine if that position needs to be filled. Changing the skill mix, this option allows for unlicensed assistive personnel to address economic realities. This cost cutting choice option allows for nurse to be able to delegate minor jobs in order focus on more complicated ones (University of Phoenix, 2013). Which loan option did you select? Why? Loan option 1, this loan actually allowed for a longer period of repaying the loan, even if it has 9.45% interest rate, as option 2 does not give you the ability for the three month loan closure and it needs to be repaid in six months’ time. Being that this is a facility which needs flexibility option 1 provides the best possible alternative for achieving substantial financial grounds (University of Phoenix, 2013). What was the outcome of your decision? The outcome for my decision was that it was in good health for EFC. The decision to reduce a portion of agency contract staff was good because it decreases outflow of cash through expenses without hurting or decreasing the facilities actual revenue by saving on premiums it pays to staffing agencies and their management fees so it is a huge cost saver. Changing the skill mix made for a good budget saver for Elijah Heart Center because it helps save the company money in the long haul. There will be an increase in costs in the beginning in regards to the less o hospital training, but overall workers can assist with the registered nurses with simple tasks like, feeding and the moving of patients. Licensed nurses can focus more on the more complicated task such as those directly affecting or related to patient care. As for my loan option it was the best choice for solving the hospital’s capital shortfall because EHC will receive $2,300,000 as payments from Medicare and other managed care organizations within three months. This will undoubtly solve Elijah Heart Center cash flow problem, were as option two could not be prepaid in six months (University of Phoenix, 2013). Phase II: Funding Options for Equipment Acquisition Which cost-effective equipment selections did you make? Why? High speed-CT Scanner Refurbished Equipment Loan, this option I felt was best because the technology advancement for this machine is not expected to change much and the cost is high to buy new $750,000 and its life expectancy is around 10 years if brought new. Therefore buying new can greatly affect the hospital’s finances and getting equipment that is refurbished is much more cost saving with a 30 – 50 percent cheaper sale tag and it decreases staff training costs. X-Ray Machine-Capital Lease, seems to be the best option for this equipment because the likely hood of needing to be upgraded or changed is low and it life expectancy is 15 right around years the cost of this machine is 320,000, so a capital lease just makes more sense than the rest plus this form of leasing allows the company to be able to have the option to purchase the equipment at a bargain purchase option and the; lease itself is transferred at the end of the lease automatically. & Ultrasound System-Operating Lease, this is the best option for this equipment because this can be a device equipment that can have an technical advancement or change in the long run and using other methods could make purchasing this equipment worthless in the future event of advances in technology so it would be a loss cause or investment to have reflect on the balance sheet or to buy new or refurbished. This form of obtaining the equipment is treated s a rental and is not included on the balance sheet as with a capital lease and there is no bargain purchase option either (University of Phoenix, 2013). What was the outcome of your decision? The outcome of my decision was the best possible choices for the company as the high speed CT scanner being refurbished allowed for the equipment to be purchased cheaper than being brought new. As for getting the x-ray machine on a capital lease makes this the best option because higher present value compared to the operating lease or buying refurbished equipment and the business has the option of buying the equipment at a bargain price or taking up a new lease and with the life expectancy of this machine being 15 years with little or low possibility of change it makes for a good investment and means of saving finances in the long run. Last on the list is the ultrasound system getting an operating lease is best suited for the company because it allows for an upgrade. The option of the operating lease helps in taking care of technological obsolescence (University of Phoenix, 2013). Phase III: Funding Options for Capital Expansion Which source of funding did you select? Why? HUD 242 Loan Insurance Program I choose because the hospital can payoff this loan before its time without precautions and it allows the facility to be able to do this after eight years. Although its rate were cheaper than a private bank loan and higher than the tax-exempt and revenue bonds it allowed for a year advantage of loan payoff over tax-exempt, as well as not putting a limit on the period of use for the funds interest rate is lower than both other options setting at a 3.90 percent and tax-exempt is 4.18 percent, and private bank funding is 4.50 percent (University of Phoenix, 2013). What was the outcome of your selection? The outcome for my decision was that this funding option was a healthy choice, as well as the best possible option for Elijah Heart Center (EHC). Benefits were that the option was callable after years instead of tens and that if the interest rates were to decrease it would be possible for the organization to buy back the bonds and reissue the debt making it more profitable for Elijah Heart Center (University of Phoenix, 2013). Summary and Conclusions What did you learn from this simulation? I learned that buy choosing the best options for the business I am able to better provide equipment, workers, and finances for acquiring equipment, expansion and staffing of the facility. What would you do differently if you performed the simulation again? If I were to reduce this again I would not change anything as the other options badly affected the budget and other mixtures were not good ones they decreased cost but keep dipping as months went by, which would ultimately affect the overall finances for the business thus creating issues such as down-sizing being a reality and or the reduction of benefits to staff and reducing length of stay really does not have an effect on saving or benefiting the company at all. How will you apply what you learned at your current or future job? I could apply what I have learned at my future job by keeping the result and notes for my simulation as a guide for planning and determining how to spend revenue earned or needed to keep my business operational. As well as being able to suggest possible ways and ideas for saving my current business money were equipment and loans are of use. In my future job/business I plan on running my own CMA/CNA facility this can help me with determining the best loans to get for equipment, supplies, and materials needed to run a fully functioning and profitable business. I can sue this simulation to decide on the best way to get those supplies, equipment by determining the cost for leasing or buying new or used equipment. I will be allowed to make a more clear and informed decision about my current and future business ventures. Once I get into a medical facility and staff thoughts and decisions are taken into consideration for future changes I will be able to give an realistic suggestion or idea for changes that can affect staff’s jobs, future positions, benefits, and care and treatment of patients. . Reference University of Phoenix. (2013). Analyzing Financial Indicators for Decision Making [Multimedia]. Retrieved from University of Phoenix, HCS/405 Health Care Financial Accounting website.

One Flew over the Cuckoo’s Nest Essay

In the novel, One Flew over the Cuckoo’s Nest, the author, Ken Kesey, chose a patient suffering from schizophrenia to narrate the story that is based on Kesey’s own experiences. The first-person narrative of a patient, Chief Bromden, makes the asylum setting ordinary, and encourages the reader to invest in the personalities of its inhabitants instead of perceiving the characters as mere poke and shallow. Kasey’s inclusion of Bromden’s delusions within the narrative itself, which are at first a disruption to the reader used to linear narratives of the real, become merely another narrative model for the reader as the novel progresses. Demonstration thought allows the reader to discover that while Bromden’s disability makes him different, it is not debilitating for him as a narrator, nor, more importantly, as a man. Such insights into Bromden and the others initiate in the reader a reassessment of potentially unexamined perceptions of mental institutions, their inhabitants, and lead the reader to review the origins of concepts such as blind and speechless. The novel is seen through the eye of Chief Bromden and how he interprets the world he lives in, which he calls â€Å"the Combine. Bromden has a very observant eye and gives detailed descriptions. His peer’s false assumption of Bromden’s hearing gives Chief the ability to spy, revealing foreshadowing details. Although these characteristics make him a reliable source and a high-quality narrator, because of Chief’s hallucinations and paranoia, some of his opinions and visions are misleading. If the story were told through a sane characte r, such as Randal McMurphy, the distinction between reality and illusion would have been more lucid. Using Chief Bromden as a narrator puts limitations on the reader’s interpretations, but also gives a very reliable and creative perspective of the events in Ken Kesey’s, One Flew over the Cuckoo’s Nest. Very detailed descriptions make a scene seem more real. Chief Bromden is a very descriptive narrator and he describes his world uniquely. â€Å"It’s still hard for me to have clear mind thinking on it. But it’s the truth even if it didn’t happen (13),† said Bromden. Though what he describes sounds unrealistic and impossible, it, metaphorically, is true and gives the reader a better understanding of the context, even if it didn’t actually happen. When Nurse Ratched became very intense, Bromden described her as â€Å"swelling up, swells till her back’s splitting out of the white uniform (11). † A person cannot swell and rip out of their cloths in a matter of seconds and this example shows how exaggerated and animated Bromden narrates. This description gives the reader a clear picture of how mad and furious this woman can get. When Bromden witnesses McMurphy encounter the nurse in the hallway wearing only a towel, Chief describes the big nurse’s reaction as he interprets it. Bromden explains the nurse’s reaction as going from a beastly scary size to a small intimidated size. â€Å"Just as she’s rolling along at her biggest and meanest, McMurphy steps out of the latrine door right in front of her, holding a towel around his hips-stops her dead! She shrinks to about head-high to where that towel covers him, and he’s grinning down on her. Her own grin is giving way, sagging at the edges (86). † Bromden explains how the nurse felt extremely threatened by McMurphy exposed sexuality in a very creative and effective way. Metaphorically, what he saw is true. Bromden’s unique way of understanding and then explaining events helps emphasize important details in the novel and having this ability makes him an informative narrator. Along with his unique eye, Bromden has a very interesting way of eavesdropping that also makes him a great narrator. Chief Bromden’s lack of speech created the impression that Chief was â€Å"deaf and dumb† to the other patients and workers on the ward. â€Å"Just a bi-big deaf Indian,†(26) this is how the stuttering Billy Bibbit describes Bromden to the sane Randal McMurphy. Little do they know the quite and discreet patient listens in on the surrounding conversations as he sweeps the corridors. The Chief’s secret sense of hearing gives him the advantage not just the advantage of self informative but an advantage to all of the gossip within the ward and that makes him a knowledgeable character. The knowledge that Bromden overhears is one of the reasons he makes a good narrator. Such important discussions would not be held around other characters because others know they are capable of hearing. â€Å"If I signed up it’d be the same as coming right out and telling everybody I wasn’t deaf. If I’d been hearing all this talk about boats and fishing it’d show I’d been hearing everything else that’d had been said in confidence around me for the past ten years†¦ I had to keep on acting deaf if wanted to hear it all (178). † Bromden liked being able to listen in on Nurse Ratched and other workers’ conversations and his clandestine way of doing it made him a dependable, important character to the plot. Some of the information the Chief overhears foreshadows events. Nurse Ratched would often say confidential things around him because she too believed he was deaf. One day while Chief was sweeping the corridors, he overheard doctors in the staff meeting deciding how McMurphy should be handled due to his disruptive behavior. The doctors were debating whether or not to send him to the disturbed branch of the hospital. Nurse Ratched had a very interesting attitude toward this option and Bromden overheard: â€Å"He is simply a man and no more, and is subject to all fears and all the cowardice and all the timidity that any other man is subject to. Given a few more days, I have a strong feeling that he will prove this, to us as well as the rest of the patients. If we keep him on the ward I am certain his brashness will subside, his self-made rebellion will dwindle to nothing, and our redheaded hero will cut himself down to something patients will all recognize and lose respect for (136)†. This segment is very significant for foreshadowing the fact that McMurphy will receive a lobotomy later in the novel. This part of the novel helps lead up to the climax. Bromden’s ability to discretely listen into conversations allows supplying information to the reader as well as advancing the plot. Although Bromden does have many advantages as the narrator, there are also many limitations due to his illness. Chief Bromden’s schizophrenia creates problems for the reader. His schizophrenia causes him to hallucinate. A hallucination is a mistaken idea or an allusion. Sometimes Chief Bromden described things that could have been a hallucination but also could have been real because of his creative way of explaining. This can cause confusion for the reader. When Blastic died, Bromden described the death in a way that gave the impression it was a hallucination. He goes to the bed and with one hand grabs the old vegetable Blastic by the heel and lifts him straight up like Blastic don’t weight more’s a few pounds†¦ The worker takes a scalpel and slices up the front of old Blastic with a clean swing†¦ I expect to be sick, but there’s no blood or innards falling out like I was looking to see-just a shower of rust and ashes, and now and then a piece o f wire or glass (80, 81). † Realistically, if Blastic were sliced open Bromden would see blood and bowels, but because Bromden describes what he sees as rust and wires, it gives the idea that this is only a hallucination. Surprisingly, though this seems unrealistic, Blastic did die during this scene of the novel but not how Bromden described it. This scene also seems like a hallucination because Bromden mentions retreating into â€Å"the fog. † He imagines that the staff controls a number of fog machines throughout the ward, and they are turned on whenever he is frightened. â€Å"They start the fog machine again and it’s snowing down cold and white all over me like skim milk (13),† describes Bromden before he receives electroshock therapy. The fog represents a safe haven for Bromden that makes him feel invisible to others when he is afraid. The fog limits the reader’s understanding of world inside the Mental Hospital because it allows Bromden to ignore reality. Abuse in Bromden’s world, which he calls â€Å"the Combine,† could have been even more shocking if we had been able to understand what was actually happening while Bromden was â€Å"hiding in the fog. † As a narrator, Bromden’s hallucinations and paranoia create limitations on his abilities to explain frightening details and can even cause confusion for the reader. The chief sees things in literal metaphors, he sees McMurphy as being really big in size because he is so brave (and big in spirit). The chief compares McMurphy to his father, because they were both such strong people. His father fought for a long time to save his land from the government, but eventually was made to give it up, this reduced him to wasting the rest of his life drinking and becoming a shadow of the man he once was. Using Chief Bromden as narrator has many ups and downs. He acts as an informational guide throughout the novel because he can secretly listen in on confidential conversations that foreshadow upcoming events. His ability to explain an event in such an effective manner also helps the reader better understands the story. Although, Chief Bromden’s mental illness does create defects. His paranoia causes him to often retreat into â€Å"the fog† as an escape from reality which can limit the readers understanding of atmosphere in the mental ward. The hallucinations also can make it difficult for the reader to differentiate a hallucination and reality. Ken Kesey’s experiences in the 1950’s are expressed very well in his novel, One Flew over the Cuckoo’s Nest, through the main character and narrator, Chief Bromden.