Wednesday, October 30, 2019
TOPICS CHOOSEN BY WRITER IN ACCORDENCE WITH PAPER INSTRUCTIONS Essay
TOPICS CHOOSEN BY WRITER IN ACCORDENCE WITH PAPER INSTRUCTIONS - Essay Example The key question is that The USA has one of the highest poverty rates in the world and its getting worse for the nation, with a total population of almost 37 million Americans living below the official poverty line, living on less than the substantiated amount of funds required to fulfill their food, clothing and lodging needs, so how do they need to be helped? Despite efforts made by the government in countering this issue, poverty has seen to be increasing in the near future; since the time that the recession hit the country, almost 27% of the people have been living in doom. â€Å"The report warns that the numbers will continue to rise, because although the recession is technically over, its continued impact on cuts to welfare budgets and the quality of new, often poorly paid, jobs can be expected to force many more people in to poverty. It is also difficult for those already under water to get back up again.†(Geal, Chris) America has a diverse range of people living that fall under the vulnerable part of society and has not been able to recover them since the recession; this has led them to further tumble into a state of mass poverty, something they are not able to come out of. Their social security needs have not been taken care of the government on a large scale and this is leading the circle to simply grow larger. In the recent times, the country has also been hit by a large number of natural disasters like hurricanes which have caused widespread and mass levels of destruction – homes have been destroyed and what does not seem to help is the fact that it is the poor that have been targeted by this act of god more than the wealthy sections of society. Unemployment in the economy is another major issue that has led to rampant poverty; the lack of jobs in the country, despite the repeated efforts of the government and the President’s motivational speeches, have done nothing for those that fall below the poverty
Monday, October 28, 2019
The Mongols Essay Example for Free
The Mongols Essay The Mongols swept across Asia and Europe in a bloody rampage. Killing over 6,107,000 people from the years 1220-1258. Treating women like a piece of meat meant to fulfill the pleasure of men. But how Barbaric were the Mongols on a scale of one to ten? Well the Mongols were very barbaric because they were uncivilized, brutal, yet conquered much territory. â€Å"Come out so that we may count on you according to our custom.†And when the people come out to them they seek out artisans among them and kept these. But the others with the exception of those they wish to have as slaves, they kill with the axe†¦This statement proves in many ways that the Mongols were uncivilized. Also soldiers would execute prisoners by shooting them with arrows or by burying them alive upside down in the dirt and tying there arms so they cant dig themselves out. Causing a slow excruciating bereavement of suffocation. Even the Mongol Yasa (laws) and Bilik (rules) were barbaric men were allowed to cheat on women having as many wives as they please but women could only have one husband and if a dad was to die then it was okay to marry all of his wife’s except for his own mother. Could you imagine our society if Mongols were in control? (Doc: 5, 10) â€Å"†¦Severed the heads of the slain from their bodies and heaped them up on piles†¦Ã¢â‚¬ Sounds Brutal doesn’t it? Can you imagine the people who could kill someone cut there heads of then pile them up like some piece of rubbish? Well the Mongols sure were brutal no doubt about it. They were so brutal they killed over 6,107,000 people from the years 1220-1258. In fact, it was commanded that the town of Nishaphur should be laid waste in such a manner that the site could be ploughed upon; and that †¦. Not even cats and dogs should be left alive. Also thief’s, did not exist in the Mongol life because they were so scared of the consequences of robbery that even the poorest sole wouldn’t dare think about steeling. Could you imagine how scary it must have been to be a Mongol or even one of there rivals? (Doc: 4,7) Finally, Under Genghis Khan the Mongols were great conquerors. They subjugated over 4,860,000 square miles. The Mongols had revolutionary war tactics such as, before a fight they would surround the enemy. Having there people (men, women, children, and some times dummy’s) on horses to make the other army think they were fighting a huge crowd causing panic among them as the Mongols came closer and closer attacking their enemy. With this tactic and many others Mongols both brought an onslaught and conquered a large amount of Asia and Europe. No wonder why the Mongols ruled the largest empire known to men for nearly 300 years. (Doc: 1, 6, 3) In conclusion the Mongols on a scale of one to ten were about a seven when it came to how barbaric they really were. Mostly Because of there strategies of war, laws, rules, execution of prisoners, conquest, and finally how brutal all together they were as a group of people. This is true due to the fact the Mongols were crude, atrocious, yet conquered a great deal of terrain.
Saturday, October 26, 2019
Changes in the American Diet Essay -- essays research papers fc
I. Introduction A.     This paper will consider the adaptations of the United States to a changing diet, from the early to late twentieth century. B.     The purpose of this project is to research the evolution in American cuisine throughout the 1900s, towards a more convenience-based pattern of food consumption. The modernization of the United States, particularly in terms of the workforce, will be examined as it relates to a changing diet. Finally, some effects of these changes will be described. II.     Background: Early Twentieth Century Cooking III.     Modernization of the United States A.     Women in the Workforce B.     Technological Advances in Food Preparation C.     Less Time Spent in the Kitchen IV.     Changes in American Diet A.     Background: Early Twentieth Century Cuisine B.     The Rise of Convenience Foods 1.     Prepackaged and frozen foods 2.     Fast food industry 3.     Eating away from home C.     Nutrient Levels, 1900-present D.     Increase of Fats and Sugars in the American diet E.     Increased Food Consumption V.     Discussion A.     Qualifications B.     Conclusions C.     Suggestions for Further Study VII. Works Cited Introduction This paper will explore the culturally adaptive, yet physically maladaptive, changes in American diet from early to late twentieth century. A shift from traditional to convenience foods coincides with the general modernization of the United States, specifically in the role of women in the home and in the workforce. As America changes from a rural nation to one that is urban and industrialized, with rapidly increasing technology, more and more women are seen in the workforce. This increased activity allows less time for preparing meals, and modernization makes spending this time unnecessary. However, increased accessibility of food, and especially convenience food, leaves... ... and dietary adequacy.†Ecology of Food and Nutrition 14 (1984): 105-115. Bindon, JR. â€Å"Some implications of the Diet of Children in American Samoa.†Collective Anthropology 1 (1994): 7-15. Bowers DE. â€Å"Cooking trends echo changing roles of women.†Food Review 23 (2000): 23-30. Dortch S. â€Å"America weighs in.†American Demographics 6 (1997): 38-46. Dyson LK. â€Å"American cuisine in the 20th century.â€Å" Food Review 23 (2000):2-9. Goodman P. â€Å"Time capsule: dinners and entrees.†Frozen Food Age 51 (2002):37. Goungetas, B, and K Morgan. Snacking and eating away from home. In Peter F, What Is America Eating? Washington, D.C.: National Academy Press, 1986. Krebs-Smith J, SM Krebs-Smith, and H Smiciklas -Wright. Variety in Foods. In Peter F, What Is America Eating? Washington, D.C.: National Academy Press, 1986. Marcus MB, and A Spake. †A fat nation.†U.S. News and World Report Aug. 2002: 40. Schlosser E. Fast Food Nation: The Dark Side of the All-American Meal. New York: Perennial 2002. Tillotson JE. â€Å"Our ready-prepared ready-to-eat nation.†Nutrition Today 37 (2002): 36-39. U.S. Department of Labor. Employment Status of U.S. Civilians by Age and Sex. Bureau of Labor Statistics, 2001
Thursday, October 24, 2019
Plato Essay example -- essays research papers
The great philosopher, Plato, wrote two specific dialogues; the book Timaeus and the book Critias. Plato was a professional teacher who valued intelligence immensely. Plato founded the first Philosophical Academy in Athens in the early fourth century BC. He devoted his life to philosophy and the teachings of his friend Socrates. Plato learned from Socrates and passed on his knowledge to his students. After his friend's sudden death, Plato became dissatisfied with the government in Athens. He filtered away from his family and lived his dream of researching and teaching philosophy. Plato focused on many philosophical aspects and wrote numerous dialogues. In the book Timaeus, Plato spoke of the beginning of the world and the creation of living creatures. Plato believed the human body and soul were created with precise, divine planning.      In the book Timaeus, Plato described the Father of the universe as a very masterful being and a divine planner of the human body. Plato revealed that the Father told the other Gods to create mortal figures of them. Plato recalled the words of God, â€Å"There are three kinds of mortal creature yet uncreated, and unless they are created the world will be imperfect, as it will not have in it every kind of living creature which it must have if it is to be perfect†(57). The Father of the universe is very precise in the way the beings are created. He tells his Gods to use the mixture from the soul of the world to create the ...
Wednesday, October 23, 2019
Marriage Verses Living Together
I remember when my husband and I were dating and we both decided to move in with each other rather quickly. We both felt in order to really get to know one another; we had to see how compatible we both were. Because of this, in just a short three years, we were married but living together really proved to be a valuable lesson for the future. In today’s society many people are getting married and divorced at record rates which are really affecting people views psychologically when it comes to marriage vs. cohabitation; therefore, I plan on exploring both options to see how both of these options work. A marriage is a legally binding agreement that grants each partner a wider range of rights and responsibilities. Ending this type of relationship requires a legal procedure. Cohabitation is the act of living together without a legally recognized union. This allows individuals to part ways with less difficulty than if they were married. However, both kinds of couples do live together and therefore spend most of their time together. Married people and cohabiting people are in serious relationships, they don’t generally decide to cohabit with someone they are just casually dating. People who are married are extremely committed to one another but neither couple will be unsure of their relationship or in a relationship with someone they don’t know very well. Married or cohabiting couples don’t have to completely pool their resources; both kinds of couples do have a financial stake in the relationship. At the very least, both will pay half of the rent or mortgage on a house or apartment. This means that both people in both kinds of relationships have something tangible to lose should the relationship fail. Married and cohabiting people are in intimate relationships. This essentially always includes some sexual intimacy; if there is no sexual intimacy in a married or cohabiting relationship, then it is not really a marriage or even a romantic relationship. While some people date without living together and not having sex, couples who live together are almost always in sexual relationships, whether they’re married or not. People commonly insist that a piece of paper, referring to the marriage license, is the only difference between marriage and cohabitation, this is far from being true. A marriage license is a document that drastically alters a relationship. One major way that it does this is by preserving the relationship even if one or both partners walk away. Marriages do not simply dissolve because individuals do not like the way that things are going and wish to invest their energy elsewhere. Instead, a couple must go through a divorce and have a court terminate their relationship. When two people cohabit, they live according to an agreement that may be based on a number of factors, such as emotions or financial convenience, but generally there is no legal responsibility binding one to the other. If the moment arises when the situation no longer seems suitable, both parties can instantly sever their ties. In most jurisdictions, there is not a special body of law regulating how cohabitants’ property should be divided or how the least financially fit partner should be cared for after the break up. With married partners, however, these are major considerations. Another major difference between marriage and cohabitation is liberty. When people marry, they take vows, which are legal and usually religiously sanctioned promises. A married person is not free to enter into intimate relations with other people. In addition to the threat of divorce and the financial ramifications that it can have for the guilty party, it is also possible in many states for one spouse to sue another for adultery. When people cohabitate, relinquishing the liberty to intimately fraternize with others is a choice, and if a person act contrarily, it poses no legal threat. Marriage and cohabitation also differ with regards to the decision-making. Spouses belong to one another, and if there is a life or death decision to be made and one person is unable to do so, her partner will be called upon to act on her behalf. When individuals are cohabiting, they do not generally gain the right or responsibility of making decisions for their partners, no matter how long they stay together. While many people choose to live together, others still prefer marriage. Research has shown that couples who marry generally feel more secure and are more committed to making their relationship work. People should never move in together for convenience. It should be a well thought decision that is preceded by plenty of discussion and planning.
Tuesday, October 22, 2019
Analysis of the Discrimination Against Service Animals essays
Analysis of the Discrimination Against Service Animals essays Service animals perform a wide variety of services and tasks for people with disabilities, and many disabled people would not be able to function effectively without their animals. Initially, service animals were trained to help lead their blind owners through everyday tasks, from walking to work to negotiating around their homes. Called "guide dogs," many were trained by "Seeing Eye," Inc., and those dogs were known as "seeing-eye" dogs. Today, animals, not just dogs, provide a variety of services for the disabled and elderly. Guide dogs still help the blind, and service animals also are trained to help the deaf "hear," and aid wheelchair bound individuals by leading or pulling them, or helping them with balance and movement. They can also pick up and carry items, notify others if their owner is having a seizure, and even act as companions and therapy dogs for people with severe disorders such as autism. One expert writes, "Service dogs perform tasks such as operating light switches, retrieving items, pulling wheelchairs, and opening doors. Hearing dogs assist people who are deaf or hearing impaired by alerting them to sounds such as telephone rings, crying infants, alarms, and people calling them by name" (Henderson). Service animals are not pets, they are highly trained assistants who can make the difference between a disabled person living on their own or living in a group home or other assisted-living situation. Today, they are more than dogs. A variety of animals have been trained to assist the disabled, from miniature horses to pot-bellied pigs and beyond. The use of service animals is not a new idea. One researcher notes, "The use of animals to assist their ailing human counterparts dates to the early Greeks who gave horseback rides to raise the spirits of people who were incurably ill, and documentation from the seventeenth century makes medical reference to h...
Monday, October 21, 2019
Five Spelling Rules for Silent Final E
Five Spelling Rules for Silent Final E Five Spelling Rules for Silent Final E Five Spelling Rules for Silent Final E By Maeve Maddox Many English words end in the letter e. In an earlier stage of the language, many of these final es were pronounced. Now, however, unless the word is a foreign borrowing, the final e is silent. Although final e is silent, it usually has a job to do. Here are the five rules for the use of silent final e. 1. Silent final e makes the vowel say its name. Compare the pronunciation of the following pairs of words: con cone cut cute mat mate In cone, the e makes the o say O. In cute, the e makes the u say U. In mate, the e makes the a say A. This first and most common kind of silent final e makes the letter say its name. 2. English words dont end in v or u. The e at the end of have and blue do not affect pronunciation. The e is there because the words would otherwise end in v or u. Impromptu is one of the few exceptions to this rule. 3. Silent E after the letters C and G soften their sounds. The letter C can represent the sounds of either /k/ as in cat or /s/ as in cent. The letter G can represent the sounds of either /g/ as in gum or /j/ as in gym. Silent final e after C and G indicates that the sounds are /s/ and /j/. Ex. lance and charge. Without the silent final e, these words would represent the pronunciations /lank/ and /charg/. 4. Every syllable must have a vowel. In words like candle, pickle, and people, the final syllable can be pronounced without a vowel, but in English, every syllable must have a vowel. (Would we really want to write pebbl or littl?) 5. Sometimes the silent final e has no purpose whatever. In words like are, and ore, the silent final e does not affect the pronunciation or provide a missing vowel, or keep a word from ending in v or u. This is the e that Mrs. Spalding (Romalda Spalding, The Writing Road to Reading) calls no-job e. Like Everest, its there. The word resumà © is often spelled in English with the French accent aigu to indicate the untypical pronunciation. The final e at the end of the Italian musical borrowing forte (loudly, powerfully) is pronounced like a long a: /for-tay/. Ex. This measure is marked forte. The final e at the end of the French borrowing forte (strength, strong point) is silent, although many speakers pronounce this word the same way they do the musical term. Ex. Cooking is not my forte. Industrious critics will point out exceptions that Ive failed to mention, but in most cases, the five rules apply and are useful to know. Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Spelling category, check our popular posts, or choose a related post below:12 Signs and Symbols You Should KnowHow to spell "in lieu of"Nominalized Verbs
Sunday, October 20, 2019
The Sinai Peninsula From Ancient Times to Today
The Sinai Peninsula From Ancient Times to Today Egypts Sinai Peninsula, also known as the Land of Fayrouz meaning turquoise, is a triangular formation at the northeastern end of Egypt and the southwestern end of Israel, it looks like a corkscrew-like cap at the top of the Red Sea and forms a land bridge between the Asian and African land masses. History The Sinai Peninsula has been inhabited since pre-historic times and has always been a trade route. The peninsula has been a part of Egypt since the First Dynasty of ancient Egypt, circa 3,100 B.C., although there have been periods of foreign occupation over the past 5,000 years. Sinai was called Mafkat or country of turquoise by the ancient Egyptians, which was mined in the peninsula. In ancient times, like its surrounding regions, it has been the treadmill of evaders and conquerors, including, according to biblical legend, the Jews of Moses Exodus escaping Egypt and the ancient Roman, Byzantine and Assyrian Empires. Geography The Suez Canal and the Gulf of Suez border the Sinai Peninsula to the west. Israels Negev Desert borders it to the northeast and the Gulf of Aqaba laps at its shores to the southeast. The hot, arid, desert-dominated peninsula covers 23,500 square miles. Sinai is also one of the coldest provinces in Egypt because of its high altitudes and mountainous topographies. Winter temperatures in some of Sinais cities and towns can dip to 3 degrees Fahrenheit. Population and Tourism In 1960, the Egyptian census of Sinai listed a population of about 50,000. Currently, thanks in large part to the tourism industry, the populations is currently estimated at 1.4 million. The peninsulas bedouin population, once the majority, became the minority. Sinai has become a tourist destination due to its natural setting, rich coral reefs offshore and biblical history. Mount Sinai is one of the most religiously significant places in the Abrahamic faiths. Rich in pastel cliffs and canyons, arid valleys and startling green oases, the desert meets the sparkling sea in a long string of secluded beaches and vivid coral reefs that attract a wealth of underwater life, wrote David Shipler in 1981, The New York Times bureau chief in Jerusalem. Other popular tourist destinations are St Catherines Monastery, which is considered to be the oldest working Christian monastery in the world, and the beach resorts towns of Sharm el-Sheikh, Dahab, Nuweiba and Taba. Most tourists arrive at Sharm el-Sheikh International Airport, through Eilat, Israel, and the Taba Border Crossing, by road from Cairo or by ferry from Aqaba in Jordan. Recent Foreign Occupations In periods of foreign occupation, the Sinai was, like the rest of Egypt, also occupied and controlled by foreign empires, in more recent history the Ottoman Empire from 1517 to 1867  and the United Kingdom from 1882 to 1956. Israel invaded and occupied Sinai during the Suez Crisis of 1956 and during the Six-Day War of 1967. In 1973, Egypt launched the Yom Kippur War to retake the peninsula, which was the site of fierce fighting between Egyptian and Israeli forces. By 1982, as a result of the Israel–Egypt Peace Treaty of 1979, Israel had withdrawn from all of the Sinai Peninsula except the contentious territory of Taba, which Israel later returned to Egypt in 1989.
Saturday, October 19, 2019
Apple versus PC Essay Example | Topics and Well Written Essays - 750 words
Apple versus PC - Essay Example With such distinctions being many questions have arisen in regards to which machine is truly superior. Through a consideration of a variety of components of each machine, this essay demonstrates why the Mac truly has higher quality than the PC. When consider computer technology one of the primary considerations that individuals make is in regards to cost. Oftentimes the Mac is derided in relation to the PC because of the significant cost differential between the two machines, with the Apple Macintosh generally costing a few hundred dollars more than the traditional PC. While these are valid complaints, ultimately they prove erroneous when one notes that the Macintoshes’ hardware warrants the cost differential. A recent study was conducted that compared the top of the line Dell Computer to the Apple Macbook Pro in terms of cost and efficiency. The study indicated that, Dell's Inspiron line doesn't currently offer processing power equaling that of the MacBook Pro. To get a 2.33- GHz Core 2 Duo processor (a 2.4-GHz version isn't available yet), you have to move up to Dell's more expensive XPS M1710 with Vista Home Premium. Once I did that, though, and tricked out the M1710 with only those extras it had to have to compete with the MacBook Pro, I was surprised to see the Dell come in at a whopping $3,459, some $650 more than the Apple product (Finnie). In these regards, the study indicates that when adding the same hardware technology to the PC that the Mac already has included, the Mac demonstrates significantly more value. This demonstrates that while ostensibly the PC is cheaper, in reality the Mac comes with significantly more value and quality. Another major consideration that one makes when considering the effectiveness of computer technology is the computer’s overall efficiency. Many PC users remain unfamiliar with the intricacies of computer technology and contend that the PC actually is a more efficient machine than the Mac. Still, when examini ng this question more thoroughly one discovers that in reality the Mac is a significantly more quality machine. Consider the parts that are used within the Mac as compared to the PC. A general qualitative investigation demonstrates that the Mac has a sleeker design that doesn’t bend and creek like PC plastic compartments. Another prominent element in terms of efficiency is the operating system. The PC only allows users the option of implementing Windows, while the Mac is equipped to run both Windows and OS X. This difference allows Mac users to tailor the operating system for the specific task, greatly improving computer quality and efficiency. It’s clear then that the Mac is better than the PC in terms of overall efficiency. A final consideration that is made regarding Mac and PC’s is within the realm of general useability. Oftentimes PC users claim that the Macintosh is an inferior product because it is purposely made more difficult to use as a means of differ entiating itself. In reality, this is an erroneous assumption and that Macintosh is an overall more useable machine. Consider a number of specific different between the computers. One of the major differences between the machines is the fast and effective boot time in the Apple. While having to wait an extra-minute or for a computer to load may seem like an insignificant problem, when this element is
Friday, October 18, 2019
Case Study eassy on Weight Watcher INC Essay Example | Topics and Well Written Essays - 1250 words
Case Study eassy on Weight Watcher INC - Essay Example The main competitors of Weight Watcher are Nutrisystem, Jenny Craig and eDiets. According to the report the weight management industry came to light in the late 1990s., from 2006 onwards there is a promising upwards trend in the world diet control market. Generally there are two distinct kinds of strategies associated with the diet control industry, one is the strategy for long term growth of the organization and the second one is retention of the customer base to maintain their involvement . During the span of last 20 years, there is a continuous trend of the growth in the population. With the growing trend of population obesity as well as overweight also increased during this time span. The importance of the physical exercise , awareness of health benefit , loosing weight all these parameters now have a huge demand in the world population. So along with the time, the weight management industry is also growing along with the time. But in the recent time, there are also some negative impact in the weight management industry. According to the report, the industry rose to $ 59.7 billion in the year 2009 which was only about 2% growth YOY. But it was failing to close in with historical 6% growth rate. (Taber et.al, 2010, p. 8). There are also different challenges associated with the growth of weight watchers. Being one of the leading organizations in the market it is now facing a tough competition from others, moreover it is also facing a challenge to develop a forward focus diet plan for the 21st century. According to this report, during the year 2011, Weight Watchers tried to represent themselves in the markets of USA and abroad. Their focus also shifted from women centric to cover all the gender across the society, launching new and innovated diet program to capture the market potential. General Factors and Industry Environments that Affect Weight Watcher’s Choice of Strategy The weight Watcher’s business strategy is based on different parameters like the any top organization. Being a top performing company in this sector their strategy was also very up to date and for a long span of time they remain the sole dominant force in this field. To decide on the strategy, they rely on following points. They believe in giving to the customer what they want not what they need, they have designed their strategy based on marketing the feelings of loosing weight not the product. Different factors like creating exclusive products for different age groups, different weight groups. At the very beginning the main focus of the organization was to target the women to reduce and maintain their weight as the obesity was one of the key disease in the country. To reach up to the maximum number of people, they have designed online course material as well as several live campaigns in different places to ensure that they can reach up to the every corner of the society for every class. General factors which are associated with their strategy are like giving their customer what they want in a scientific and standard way so that customer remains interested in their services. Their customer centric approach increased the customer base drastically. The general factors and the environment related to the strategy of the organization is governed by porter’s five force model. Hill and Jones (2010), in their analysis mentioned Porter’
How to Maximize Club Capital Essay Example | Topics and Well Written Essays - 2000 words
How to Maximize Club Capital - Essay Example Soccer is one the most common games worldwide that is played with the feet and a ball and consists of two teams with each 11 players battling it out to score goals of which the one with most wins. They obviously follow a set of rules and regulations laid down by the worlds soccer governing body FIFA (Federation Internationale de Football Association) whose memberships consists of 209 national associations (www.deloitte.com). Discussion Soccer is usually played for fun as a sport but when clubs are associated, this is where finance and soccer get into crossheads. Friends, workmates or just groups of people with the purpose of having fun initially formed soccer clubs but as professionalism came into play and larger numbers of crowds and fans became associated, â€Å"Soccer clubs then became considered as limited companies that can make profits and play in soccer leagues that are present all over the world†(Booth 78-90). So as we have seen soccer clubs do make profit and hereby we see the relationship between finance and soccer. Now we have to look at how these clubs generate their incomes and how they maximize on it. Most professional soccer clubs have academies where talent is nurtured from youth levels and the players get promoted to the next level as they grow up and also how good they get in the game. At one time, â€Å"most of the youth players make the first team squad but the rest who do not are usually sold to other clubs to further their careers†(http://soccerlens.com). â€Å"The club is responsible for providing all the necessary equipment needed for training of the players inclusive of gyms and fitness instructors as well as club doctors†(Walter 56-77). So how does a club earn income to cater for all of these expenses including paying the players wages? Well first we look at advertising. All professional soccer clubs have sponsors. These sponsors are mostly big companies or corporations. They give certain amount of money to the club and in return the soccer clubs put the sponsor’s name in front on their jerseys. This is a way of advertising. If we take examples of real-world soccer clubs that are well known and their sponsors like FC Barcelona, Qatar Airways sponsor which is a Spanish based club, Real Madrid also Spanish club is sponsored by Emirates Airline. Emirates has also sponsored other clubs such as Arsenal FC, an English based club; AC Milan, Italian based; Paris Saint-Germain(PSG), a French-based club among others. Soccer clubs can also have many sponsors, for examples the sports company that makes their jerseys and shoes. For examples Nike has sponsored FC Barcelona, Manchester United, Juventus etc while Adidas has sponsored Real Madrid, Bayern Munich, Chelsea etc. The players are also sponsored by different sports company that provide things like shoes for example, Lionel Messi (considered as the world’s best soccer player) is sponsored by Adidas. This sponsorship is separate from the clubs sponsorship. Other sponsors are like beverage companies that provide energy drinks for the players, motor companies that provide the players with luxury cars and so. All of these sponsorships earn the club a large amount of income which is used to pay the players’ wages and pay other bills. Another way of a club earning money is through the selling of players. A player that plays for a club is considered as an asset of the club and can be sold to make profits.Â
Thursday, October 17, 2019
Spatial City Park and Ride Transport Planning Essay
Spatial City Park and Ride Transport Planning - Essay Example The system is meant to have people park their cars, motorcycles and bicycles at a given place the take a ride in larger vehicle like a bus to complete their journey. The destinations include offices, market places, banks, schools, hospitals, residential areas, entertainment spots, leisure parks, airports, railway stations and city exit highways among others. The transport system must therefore be designed in a way that enables a smooth transition from a personal to a collective mode of transport (Rondanini, 1981, 42). It is important to note that buses used for this purpose are big and clumsy vehicles that need lots of space to turn, park and take off as the services they offer may demand. The main advantage of buses is that they are cheap to move in because they carry a lot of people at a go thus the passengers benefit from economies of scale. Moreover, despite their clumsiness, they are far more versatile than trams and trains which need more room and rails in order to run. They are therefore an integral part of city transport planning (Le Corbusier, 1985, 81). All the same due to their clumsiness, one of the things to avoid in planning is the idea of the Park and Ride buses moving everywhere in the town thus causing snarl ups and a general bad temper among motorists and pedestrians alike. Buses must have specific routes that they use so as to avoid this unpleasant eventuality. However, these routes will prove to be of little use if they do not get the passengers as close to where they wish to go as possible (Le Corbusier, 1985, 81). The London Park and Ride System Plan A close look at the London Plan reveals that all these factors were taken into consideration when the transport system was being designed. Though it is not a building, a road design still has to adhere to the three tenets of architecture identified by the Roman architect Vitruvius being firmitas, utilitas, venustas (durability, utility and beauty) (Rowland & Howe,1999, 2). For the transport system, durability depends on utility in that the roads must continue to serve their purposes without the need to change them. The system also needs to be well made overall for aesthetic value (Rowland & Howe,1999, 2). The London bus plan seen in Fig 1 below was actually set up to ensure that all the major areas were either served directly by bus and other light transit forms such as small goods trucks or the transport was available as close to them as possible. The main transit line cuts right across the city from Notting Hill in the west to Liverpool Street in the east across the river Thames. Links were created along this main line connecting other parts of the city northwards and southwards. The East London transit phase connected the transit lines in the east of the city while the several extensions that were made later connected other areas to the north and south. Tramlinks at The Bus Route System Fig. 1 London Bus Routes (Courtesy of Maps of the World, 2011, Croydon, Purley and Sutton to the south served a similar purpose of connecting the southern areas of t he city (The London Plan, 2011). As seen in Fig 1 above most of the bus routes are concentrated around the center of the city between the Marble Arch and Trafalgar Square. This is because the center of the city is naturally where most of the business and tour activities take place hence a high number of visitors. As stated earlier, the design of these transport system cannot fail to take into consideration the aesthetic value and general heritage of the city. The routes were strategically designed to pas as close as possible to the major landmarks of the city. The landmarks include the Buckingham Palace, Westminster Cathedral, Trafalgar Square, The London Bridge and the three parks of Regent’
Corruption happened in China Essay Example | Topics and Well Written Essays - 500 words
Corruption happened in China - Essay Example He said the government spent 3 billion to build the government building but because the people worked in the construction sector were venal, the accurate amount of money spent on the construction was just about 3 million. "The quality of the building was worrying", he said. Corruption had already affected too many people. In my town, a number of people who were in government and in charge of the city were venal, and many things which were their responsibility could not go on towards normal procedures. They would work for you only if you give them money. Also they would work for you no matter the things you asked them were legal or not. Many people are breaking the law everyday yet they think it is a normal practice. In my opinion, in order to stop this situation, we have to make the people in government aware of this situation and let them solve this problem, because as ordinary citizens we can barely do anything about it. I think we can gather a group of people to put out a protest. This protest needs to be carried out in a very silent way so that the mileage is good and the result discernable. I hope the people who went through the consequence of corruption could do whatever they can to stop this menace. This shall essentially set the basis for doing things the right way within China and bring an end to the immoral practices which are being compromised upon in this day and
Wednesday, October 16, 2019
Spatial City Park and Ride Transport Planning Essay
Spatial City Park and Ride Transport Planning - Essay Example The system is meant to have people park their cars, motorcycles and bicycles at a given place the take a ride in larger vehicle like a bus to complete their journey. The destinations include offices, market places, banks, schools, hospitals, residential areas, entertainment spots, leisure parks, airports, railway stations and city exit highways among others. The transport system must therefore be designed in a way that enables a smooth transition from a personal to a collective mode of transport (Rondanini, 1981, 42). It is important to note that buses used for this purpose are big and clumsy vehicles that need lots of space to turn, park and take off as the services they offer may demand. The main advantage of buses is that they are cheap to move in because they carry a lot of people at a go thus the passengers benefit from economies of scale. Moreover, despite their clumsiness, they are far more versatile than trams and trains which need more room and rails in order to run. They are therefore an integral part of city transport planning (Le Corbusier, 1985, 81). All the same due to their clumsiness, one of the things to avoid in planning is the idea of the Park and Ride buses moving everywhere in the town thus causing snarl ups and a general bad temper among motorists and pedestrians alike. Buses must have specific routes that they use so as to avoid this unpleasant eventuality. However, these routes will prove to be of little use if they do not get the passengers as close to where they wish to go as possible (Le Corbusier, 1985, 81). The London Park and Ride System Plan A close look at the London Plan reveals that all these factors were taken into consideration when the transport system was being designed. Though it is not a building, a road design still has to adhere to the three tenets of architecture identified by the Roman architect Vitruvius being firmitas, utilitas, venustas (durability, utility and beauty) (Rowland & Howe,1999, 2). For the transport system, durability depends on utility in that the roads must continue to serve their purposes without the need to change them. The system also needs to be well made overall for aesthetic value (Rowland & Howe,1999, 2). The London bus plan seen in Fig 1 below was actually set up to ensure that all the major areas were either served directly by bus and other light transit forms such as small goods trucks or the transport was available as close to them as possible. The main transit line cuts right across the city from Notting Hill in the west to Liverpool Street in the east across the river Thames. Links were created along this main line connecting other parts of the city northwards and southwards. The East London transit phase connected the transit lines in the east of the city while the several extensions that were made later connected other areas to the north and south. Tramlinks at The Bus Route System Fig. 1 London Bus Routes (Courtesy of Maps of the World, 2011, Croydon, Purley and Sutton to the south served a similar purpose of connecting the southern areas of t he city (The London Plan, 2011). As seen in Fig 1 above most of the bus routes are concentrated around the center of the city between the Marble Arch and Trafalgar Square. This is because the center of the city is naturally where most of the business and tour activities take place hence a high number of visitors. As stated earlier, the design of these transport system cannot fail to take into consideration the aesthetic value and general heritage of the city. The routes were strategically designed to pas as close as possible to the major landmarks of the city. The landmarks include the Buckingham Palace, Westminster Cathedral, Trafalgar Square, The London Bridge and the three parks of Regent’
Tuesday, October 15, 2019
Write a feature article about Travel, great places to go to in the Essay
Write a feature article about Travel, great places to go to in the world, Muslim woman in different countries, comparing different cultures to Saudi - Essay Example Today, global economic organisations and institutions have come up with several laws and regulations that have made the cross-border transfer of people from one place to another, which used to be very difficult in the time past very easy and simple now. Because of this, a lot more people are now able to travel easily to other places regardless of cultural or religious differences. Having established the point that cross-border traveling has now been made simple, the next aspect of discussion to look at is the choice of place to visit. Without any doubt, there are several excellent places a person may choose to visit for whatever leisured intentions the person may have. Most of these places are major cities of the world and they offer almost everything that makes a person’s stay away from home a memorable one. Talk of natural land sites, sports events and infrastructure, education and academic excellence, cultural integration, economic enhancement, historical symbolism, architectural innovations and technological advancements: there are countless number of cities to visit to have a feel of all these. Happily, each continent in this world can boast of a number of cities and countries that will readily give a person all of such travel expectations. The freedom to travel and abundance of choice notwithstanding, there are a number of factors that really aff ect the conduct of a particular traveller to and from different places of the world. One of such factors is religious and moral differences. A typical case can be given with Muslim women who may want to travel to some of the world’s most renowned destination. Making Europe the first point of call, one place that cannot be left out as an exquisite destination is Madrid. Sabina (2011) notes that ‘’the city of Madrid is located in the Community of Madrid (La Comunidad de Madrid).  The Community of Madrid is located almost exactly in the centre of Spain.’’ This is a
The Microsoft Case Essay Example for Free
The Microsoft Case Essay Why was Microsoft investigated for antitrust behavior? Microsoft is a huge, established, well known computer software manufacturer. They were investigated for antitrust behavior after allegedly abusing their powerful position as the leading suppliers of computer operating systems. Microsoft developed a monopoly market structure because the software which they created was only compatible with Microsoft Windows operating systems. Back when the internet was introduced to the public, Microsoft provided Internet Explorer for free, bundled with Windows operating systems. This was a strategy to eliminate any competitors so they were obviously not perfectly competitive, therefore their case involved imperfect competition. Microsoft’s monopoly was protected by the applications barrier to entry so many competitors feared to try to enter the market. Microsoft also had the ability to increase their prices above marginal costs without losing many customers so they were the price makers, and they also had market power. With that being said, some people may say that Microsoft was a pure monopoly because they were the sole producers of the computer software market and there were no close substitutes. On the other hand, some may say that Microsoft was a natural monopoly because they earned their powerful position by over driving their free market competitors. Before Microsoft grew so big, there were some economic observers that claimed that economies of scale would give Microsoft an unassailable lead that would result in monopoly. (Economides, 2003) I agree that Microsoft was trying to gain monopoly power in the computer software industry due to all of the evidence. Microsoft totally dominated the computer software industry for which they had great strategies to do so. Monopolies can cause many negative effects on our economy such as higher prices, less jobs, it can put other companies out of business, and it can cause producers to be intimidated to enter the same industry. Monopolies can also cause productive inefficiency, allocated inefficiency, diseconomies of scale, and x inefficiency. However, a monopoly can be a good thing, especially for a business. Being the leader or the giant of a particular industry can make owners, managers, and employees feel very secure with their company. Although a monopoly can cause overpricing, it can also cause price reduction for which would cause other companies to not be able to compete. A monopoly can also be a good thing because the high profit can be used to fund research capital investment spending. Lastly, economies of scale, international competition, and they have the power to be the price makers.
Monday, October 14, 2019
The Value Of Reducing Carbon Footprints Environmental Sciences Essay
The Value Of Reducing Carbon Footprints Environmental Sciences Essay This report examines the concept and value of measuring and reducing a business or product carbon footprint as well some renewable energy systems available, that could contribute to Carbon reduction and energy efficiency. Guides and legislation already exist. In anticipation of future developments, regarding sustainable practices and strict mandatory requirements for organizations and businesses, it is important to take action. Finally, several renewable energy systems are presented and evaluated with recommendations for the companys building. Introduction  The last three decades the detrimental human impact on the environment became the subject of extensive study. Today it is internationally acknowledged that the extensive use of fossil fuel and overexploitation of earths resources has led us into an environmental crisis. Greenhouse Gas (GHG) emissions produced by the burning of fossil fuel are the most threatening factor to Climate Change (IPCC, 2007). The international commitments concerning carbon reduction emissions, at the recent Climate Change Summit in December 2009, show the need for quick and effective measures. To meet this challenge the industry and commerce sectors must also take action. Today the quantification and makeup of GHG emissions is expressed by the term Carbon Footprint. This report analyses the composition of a businesss Carbon Footprint in relation to its activities, products and properties. Moreover, its explained why this course of action is necessary and how it could benefit the whole business and its production process. Finally, some of the most typical renewable energy technologies are examined and suggested for the companys office premises located in Athens Greece. The definition of carbon footprint. Throughout time there were many attempts to define what a carbon footprint is. Nowadays, the definition of Wiedmann and Minx (2007, p.4) is what is widely accepted: The carbon footprint is a measure of the exclusive total amount of carbon dioxide emissions that is directly and indirectly caused by an activity or is accumulated over the life stages of a product. This includes of individuals, populations, governments, companies, organizations, processes, industry sectors etc. Products include goods and services. In any case all direct (on-site, internal) and indirect emissions (off-site, external, embodied, upstream, downstream) need to be taken into account. The above reference to carbon dioxide (CO2) emissions includes all six Kyoto Protocol (1997, Annex A) Green House Gases (GHGs). These gases, besides Carbon Dioxide, (CO2) are Methane (CH4), Nitrous Oxide (N2O), Hydrofluorocarbons (HFCs), Perfluorocarbons (PFCs) and Sulfur hexafluoride (SF6). They are all aggregated and quantified in tonnages of CO2 equivalent (CO2e). The conversion is based in each gass Global Warming Potential (GWP) over a period of 100 years. The GWP is defined as the relative impact of a GHG compared to Carbon Dioxide (CO2) over a given period of time. The Intergovernmental Panel on Climate change (IPCC) in its 3rd Assessment Report (2001) provides the values as well as the calculation method. Carbon Footprint for business, companies and organizations. There are two types of Carbon Footprint for a business or an organization. Organizational carbon footprint Product carbon footprint Organizational carbon footprint The Organizational carbon footprint is made up from all direct and indirect GHG emissions caused by the organizations activities (Carbon Trust, 2010).According to the Greenhouse Gas Protocol the direct and indirect greenhouse gas emissions are divided into three scopes (categories) (WBCSD WRI, 2004). Scope 1: Direct greenhouse gas emissions These are emissions created by the organizations assets and production processes e.g. on site fuel use for production process, vehicle use for transportation of employees, materials, products and waste, refrigerant loses, oil and fuel leakages, physical or chemical processing etc. Generally, emissions resulting from the organizations activities. Scope 2: Indirect GHG emissions Emissions created by the use of electricity, heat and steam purchased for in premises use of the company or organization. (The energy suppliers emissions). Scope 3: Indirect GHG emissions other than the Scope 2 category Emissions created from activities needed for the company to function but not made buy the company or organization itself. Extraction and transportation of raw material from suppliers, commuting of employees, transportation of fuel for use, recycling, waste transfer and disposal are examples of what is included in this category. Generally any product or service purchased by the company necessary for its production process except from electricity and heat (scope 2). Product carbon footprint The product (goods or services) carbon footprint is made up from the emissions of its life cycle. This includes all the emissions generated from the extraction of raw materials, manufacturing or service provision, use, reuse and finally its recycling and disposal as waste. Those emissions are generated similarly like the organizational carbon footprint by the use of energy, fuel combustion for manufacturing and transportation, and losses and leakages that emit directly to the environment like refrigerants, gases (methane) etc (Carbon Trust, 2011). Caution is necessary when calculations of both the organizational and product carbon footprint are made so as to not undercount or over count its quantity due to the complexity of these calculations. The necessity of carbon footprint calculation and reduction. There are many reasons why a business or organization should develop a management system for the reduction of its carbon footprint. As mentioned above there are two types of carbon footprint organizational and product (goods and/or services) Its noteworthy that the calculation of either or both footprints sets a reference point for the comparison and evaluation of progress made (Carbon Trust, 2010). Organizational carbon footprint reductions The organizational carbon management and reduction will lighten the environmental burden of a businesss activities. Uncontrolled anthropogenic GHG emissions from usage of fossil fuel, deforestation, manufacturing, industrial procedures (steel, iron, cement production) and other activities thicken the greenhouse gas layer. This layer traps more re-radiated solar energy from the earths surface into the lowest atmospheric layer the Troposphere. This results to global warming (Denman K.L et al, 2007). Furthermore the quantification of the carbon footprint helps managers and employees to recognize the areas which have the greatest potential for further reductions and cost savings over time (Carbon Trust, 2010) . Another major reason is to report the reductions to third parties concerned with GHG emissions. According to the Carbon Trust Carbon Footprinting guide (2010), this should be done in order to: Display social conscientiousness or for marketing purposes Answer requests of businesses, customers, investors for carbon emission data Show compliance with mandatory climate change legislation such as the Carbon Reduction Commitment (CRC) (2010) or European Union (EU) Emissions Trading Scheme (ETS) (2008) Provide information by the companys participation to initiatives that have a purpose to help organizations, investors, governments, consultants, academics and generally anyone concerned, develop energy and emission policies, reduce their carbon footprint and make research. An example is the Carbon Disclosure Project CDP (2001). To enforce a carbon reduction strategy or purchase or sell carbon offsets. Carbon Offset transactions are made based on the Clean Development Mechanism (CDM) of the Kyoto Protocol (1997). Product carbon footprint reductions Many of the benefits from the reduction of the product carbon footprint result from the way these reductions take place. In order to reduce its products carbon footprint, the company should monitor and try to make changes to its whole manufacturing process. Emissions come from the whole life cycle of the product. Thus, reductions should be made in every stage of this cycle, to every input and output. Correct selection of materials and suppliers, product design and manufacturing and decreased energy consumption, are all key contributors to effective carbon management. As a result, aside from environmental benefits and reduced costs, the organization will ultimately drive change to the whole supply chain. Furthermore, develop better relationship with its suppliers and help them identify and reduce their own inefficiencies (Carbon Trust, 2010) There are also advantages for the market and public image of an organization. Public conscience and awareness about environmental friendly practices and sustainability has grown notably the past two decades. The reduction of a products carbon footprint can enhance a brand name and attract more customers and shareholders (Carbon Trust, 2010). This is a result of the differentiation from other products, which have not yet developed carbon management programs or have bigger footprints. Current common practice and approach to calculation, reduction and publication of carbon data is by the use of the GHG Protocol and Publicly available specification (PAS) 2050 for organizations and products respectively. Independent validations and certificates for greenhouse gas emissions denote transparency of the organization, could attract interest and provide reassurance to stakeholders. Continuous progress is necessary for both the organizational and product carbon footprint in anticipation of future (and stricter) legislation and tougher competition. The companys carbon footprint. An indication of the companys carbon footprint in Athens Greece, can be given by the annual energy consumption of its building. In 2010 the energy consumption of natural gas and electricity was 225230kWh and 379125kWh respectively. The Greek Regulation of Building Energy Performance in table B.1 (2010, p.5336) gives values of 0,989kgCO2/kWh for electricity and 0.196kgCO2/kWh for natural gas. This means, that approximately 419 tones of CO2 per year are produced by the companys office premises alone. Renewable energy technologies Renewable energy comes from natural sources abundant in our environment. Solar, wind, rain, waves, heat from earth and newly produced organic material are all used to provide zero carbon energy. The most common applications are passive solar designs, solar photovoltaic (PV), solar thermal, biomass heating, ground source heating and wind power generation. Other Low Carbon technologies such as absorption cooling and combined heat and power (CHP) can also be incorporated with the use of this technology. Considerations should be made relative to different building types and locations as well as costs. Passive solar designs use the buildings design and structure (orientation, design, shading, window glazing and thermal insulation) to store or deduct heat and provide ventilation. The basic concept is to optimize the direct use of the energy available from the buildings environment. Although best suited for new buildings, existing could use some of its concepts. The benefits from such an application include better working environments, less temperature fluctuation, natural air ventilation and less dependence and use of mechanical means for heating and lighting. This results to, increased productivity, low maintenance, higher asset value, lower energy bills and emissions (SEEDA). Photovoltaic systems, convert solar radiation to electricity. The systems consist of a set of PV cell panels, inverters and wiring. PV cells are made from semiconductor material abundant in earth like silicon. The panels can be installed in either the roof and/or sides of a building, or directly on the land. The effectiveness and efficiency of such an application depends a lot from the available area, its orientation as well as from the shading of neighboring buildings and other obstacles. They have low maintenance requirements, long warranties and even longer life expectancy. Still they have high initial capital costs. These systems are mostly recommended when correct conditions like lighting, orientation and available area exist and/or grants from governments. It is anticipated that soon these systems will be highly competitive due to fuel price increments and continuous evolution and optimization of the technology (SEEDA). For a 750Kwh /year system prices average at  £6000 minus any grants and tax returns that may exist. Solar thermal water heating, is a system, installed on roofs, that collects the suns radiation to heat a non corrosive (antifreeze and water mixture) liquid. This liquid runs through a coil in a water cylinder and transfers its heat to the water (Menzies, G.F, 2009) The Carbon Trust (2005) reports that approximately 60 % of hot water demand could be covered by solar water heating. Its considered one of the most effective and cheap solutions for carbon reduction and cost savings. Menzies (2009) reports 1-3% carbon reductions for commercial applications sized to cover 50% of hot water demand. Biomass heating, uses boilers that burn organic material from plant and animal matter to produce heat, fuel or electricity. The system typically consists of a furnace with piping that transfers heat for space or water. It is considered as carbon neutral because the CO2 and CH4 are part of the active carbon cycle (accumulated from plants and animals recently and now put back in nature, unlike the carbon emitted from the burning of fossil fuel which was out of the system for millions of years)( Menzies, G.F 2009). Biomass Boiler fuel comes cheaper than electricity, oil, LPG heating (Menzies, G.F, 2009). More so, flexibility to convert to heat, fuel or electricity is also a plus. Still, high initial costs, space requirements for fuel storage and availability of suppliers should be carefully considered. Its typically best for businesses with organic byproduct material as result of their industrial process and/or for longer hours of operation than usual. Payback periods usually range from 3 to 9 years depending on the replaced system ( Carbon Trust, 2011) Ground Source heat pumps, use the relatively constant underground temperature, for space and water heating purposes. These systems are not considered carbon neutral (but low carbon) because, pumps use electricity or gas to convert the gathered low level heat to useable high-grade. Still carbon reductions could be substantial for non domestic applications especially if used for the whole heating demands. Carbon reductions of 14%-27% and 16%-23% have been reported for new build and retrofit applications respectively though, 100% demand coverage may be impossible for large buildings (Menzies, G.F, 2009). One the downside these systems have high initial capital costs for installation or retrofitting. Generally, they difficult to apply because of the required ground surveying, long piping, large collectors and empty space (Carbon Trust, 2005). Wind power generation, comes from the conversion of wind energy to electricity or kinetic energy (wind mills, water pumps) through wind turbines (Menzies, G.F, 2009). They come in varying sizes to suit energy demands. The viability of this option depends largely on wind speed, direction, as well as sufficient wind data and lack of obstacles. Noise and vibration should also be taken in consideration (SEEDA). For roof applications there could be prohibiting building regulations or planning permissions needed (Carbon Trust, 2005). Their initial cost as well as the high probability of obstacles (e.g. neighboring buildings) and unpredictable wind patterns, of most urban locations makes the investment unsuitable for most buildings. On the contrary, well chosen sites with sufficient meteorological data could be highly energy efficient and lucrative plus enhance the company profile. Application to the companys buildings in Greece. The Greek Ministry of Environment Energy and Climate Change (MEECC) (2009), reports that Buildings in Greece are responsible for 36% of the domestic energy use. This waste of energy happens, due the lack of use of modern technologies, the old age of most buildings and the lack of legislation concerning insulation standards (up until recently). Moreover, electricity in Greece is the most carbon intensive energy, produced mainly by coal and lignite. This means, that by saving electricity or using an alternative energy source (renewable or other fossil fuel such as natural gas), has the greatest potential for CO2 emissions reduction. Furthermore, extensive sunshine periods make the use of solar energy a very efficient sustainable practice. The companys offices in Athens Greece (3600m2, 95 employees) are considered a mix of a naturally ventilated open plan and air-conditioned standard type (Action Energy, 2003). An investment for a 40kWp solar PV system as well as a solar hot water system of 8m2 (500lt) would result to emission reductions of approximately 15% (Appendix). These, combined by passive solar upgrades (insulation, window glazing, sunshades) could achieve an even greater reduction of CO2 emissions. Overall the use of renewable energy sources, will upgrade the energy performance certificate of the companys building, enhance its public image, asset value and reduce costs (after the investment payback period). Conclusions As outlined above, sustainable practices are not only an obligation towards our environment and future generations. The incorporation of carbon management systems and renewable energy sources is actually an investment which will yield profits for all areas of the production and commercial process. Furthermore, this course of action is anticipated to be adopted generally and enforced legally. Thus, it is clear that its in a businesss interest to develop sustainable low carbon development strategies and policies as soon as possible. List of references Action Energy, (2003) Energy Consumption Guide 19 Energy use in offices. Revised Edition. London: Carbon Trust [ available at http://www.carbontrust.co.uk/Publications/pages/publicationdetail.aspx?id=ECG01 9 ][viewed on 20/02/2011]. Carbon Trust, (2005) New and Renewable Energy Fact Sheet (GIL137). London: Carbon Trust [available at: http://www.carbontrust.co.uk/Publications/pages/publicationdetail.aspx?id=GIL137 ] [accessed on 17/02/2011]. Carbon Trust (2010) Carbon footprinting The next step to reducing your emissions (CTV043). London: Carbon Trust [available at: http://www.carbontrust.co.uk/publications/pages/publicationdetail.aspx%3fid%3dCTV043 ] [viewed on 12/02/2011]. Carbon Trust (2011) Carbon footprinting http://www.carbontrust.co.uk/cut-carbon-reduce-costs/calculate/carbon-footprinting/pages/carbon-footprinting.aspx [accessed on 12th February 2011]. Carbon Trust (2011) Renewables http://www.carbontrust.co.uk/cut-carbon-reduce-costs/products-services/technology-advice/renewables/Pages/renewables.aspx [accessed on 28/02/2011]. Chartered Institution of Building Services Engineers (CIBSE) (1986) Estimation of Plant Capacity, Section A9 of the CIBSE guide. CIBSE, London. Denman, K.L., G. Brasseur, A. Chidthaisong, P. Ciais, P.M. Cox, R.E. Dickinson, D. Hauglustaine, C. Heinze, E. Holland, D. Jacob, U. Lohmann, S Ramachandran, P.L. da Silva Dias, S.C. Wofsy and X. Zhang, 2007: Couplings Between Changes in the Climate System and Biogeochemistry. In: Climate Change 2007: The Physical Science Basis. Contribution of Working Group I to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change [Solomon, S., D. Qin, M. Manning, Z. Chen, M. Marquis, K.B. Averyt, M.Tignor and H.L. Miller (eds.)]. Cambridge University Press, Cambridge, United Kingdom and New York, NY, USA [available at: http://www.ipcc.ch/publications_and_data/ar4/wg1/en/ch7.html] [accessed on 15/01/2011]. Greece. (2009), Ministry of Environment, Energy and Climate Change. ÃŽÂ Ã Â Ã Å’ÃŽÂ ³Ãƒ  Î ±ÃƒÅ½Ã‚ ¼ÃƒÅ½Ã‚ ¼ÃƒÅ½Ã‚ ± Ά¢ÃƒÅ½Ã‚ ¾ÃƒÅ½Ã‚ ¿ÃƒÅ½Ã‚ ¹ÃƒÅ½Ã‚ ºÃƒÅ½Ã‚ ¿ÃƒÅ½Ã‚ ½Ãƒ Å’ÃŽÂ ¼ÃƒÅ½Ã‚ ·Ãƒ Æ’ÃŽÂ · ÃŽÅ ¡ÃƒÅ½Ã‚ ±Ãƒ „ ÃŽÅ ¸ÃƒÅ½Ã‚ ¯ÃƒÅ½Ã‚ ºÃƒÅ½Ã‚ ¿ÃƒÅ½Ã‚ ½ (Energy Savings Program for Buildings). http://www.ypeka.gr/Default.aspx?tabid=526locale=el-GRlanguage=en-US [accessed on 20/02/2011]. Greece. Government Newspaper of the Hellenic Republic. 2nd issue, paper no 407, 9 April 2010. Regulation of building energy performance, Athens (GR): National Printing Establishment, pp.5333-5356, [available at http://portal.tee.gr/portal/page/portal/TEE_HOME/D6-5825%20KENAK-FEK%20407-B-2010.pdf ] [accessed on 25/02/2011]. Greece. Government Newspaper of the Hellenic Republic. 1st issue, paper no 85, 4 June 2010. Regulation of building energy performance, Athens (GR): National Printing Establishment, pp.1753-1780, [available at http://www.cres.gr/kape/neos%20nomos%20RES_N3851_2010.pdf ] [accessed on 25/02/2011]. Wiedmann, T. and Minx, J. (2007, p.4), A Definition of Carbon Footprint. Durham (UK): ISAUK Research Consulting [available at: http://www.censa.org.uk/docs/ISA-UK_Report_07-01_carbon_footprint.pdf ] [viewed on 11/02/2011]. Menzies, G.F, (2009, pp. 127-147) Sustainable Practices in Facilities Management [D31SF]. Revised Edition. Riccarton Edinburgh: Herriot Watt University: School of the built environment World Resources Institute (WRI) World Business Council for Sustainable Development (WBCSD), (2004) The Greenhouse Gas Protocol A corporate Accounting and Reporting Standard. Revised Edition. USA: WRI and WBCSD [available at http://www.ghgprotocol.org/files/ghg-protocol-revised.pdf] [accessed on 14/02/2011].
Sunday, October 13, 2019
Critique On Advertising In Our Society :: essays research papers
Critique On Advertising In Our Society A critique on the impact of advertising in our society. Consider visuals and verbal or written language. (1000 words) The impact of advertising on our society is a fiercely debated topic, and has been ever since the conception of advertising in its most basic form. There are negative and positive social and economic impacts upon society from advertising in its various forms. For instance, advertising promoting public welfare has a positive social impact upon society, whereas advertising portraying women as sex objects has negative social impacts. There are also positive economic impacts on society such as providing funding for the media and stimulating an active, competitive economy. There are a number of proven ways to persuade the consumer that he or she needs the product being advertised. These methods of persuasion, instead of concentrating on the actual product, usually concentrate on the benefits that will be brought to the consumer. These benefits may include the hope of more money and better jobs, popularity and personal prestige, praise from others, more comfort, social advancement, improved appearance, or better health. For example, an automobile advertisement, as well as mentioning the mechanical attributes of the car, would most likely focus on the excitement, prestige and social advancement it may bring the buyer. This social advancement is very often sexual, or involving attraction of the other sex– so the car advertisement may also mention the glamorous women/men that the consumer will attract with his/her fancy car. Advertising has been blamed for a great variety of negative social impacts. One of the major criticisms received by advertising is that it forces people to buy things they don't really need, often by projecting negative emotions such as fear, anxiety or guilt upon the consumer. It is claimed that advertising plays with our basic human emotions and takes advantage of them, using them as merely another technique to sell goods or services. Advertising also encourages people to buy products by making them think that purchasing and consuming are the major activities of their lives. It is said to also evoke fears of inferiority upon the consumer by depicting the ‘normal' person as young, attractive, wealthy and successful. This may encourage a person to act on his or her desire for success and, for instance, go out and purchase that particular brand of make-up or deodorant hoping to emulate the seeming success of the person depicted in the advertisement. In opposition, advertisers state that the public is intelligent enough to, and quite capable of, making up its own mind and will definitely not buy anything they don't want or need.
Friday, October 11, 2019
Christmas Song Essay -- Analysis, Christmas Carol
To many people a warm crackling fire brings about memories of the Christmas season. By listening to some of the Christmas carols played throughout the festive holiday season, it is easy to pick up on this. In one such Christmas carol, they mention â€Å"chestnuts roasting on an open fire†in this line fire is the provider of warmth light, and good spirits. By roasting the chestnuts the fire gives food and allows people to share with one another in a warm comfortable atmosphere. A second popular Christmas carol that mentions fire it â€Å"Let it Snow†. In this song, one of the main verses is â€Å"Oh, the weather outside is frightful, but the fire is so delightful, And since we've no place to go, let it snow, let it snow, let it snow†. In this verse fire is representative of the winter time and gives delight, along with warmth and light, to the person singing the song. Light is something that goes hand in hand with the Christmas holiday, but something that is not a common thought when it comes to Christmas is darkness. The example of fire and light also holds true for Charles Dickens’s A Christmas Carol. Before the miserly Ebenezer Scrooge is visited by the spirits of his seven years dead business partner Jacob Marley, and the Ghosts of Christmas’s past, present, and future, he despises Christmas and everything about it, almost forcing his clerk, Bob Cratchit to work Christmas day. Even his always cheerful nephew Fred cannot seem to break through the hatred. But while Scrooge worked as an apprentice for Mr. Fezziwig, the hatred was not present. But through the series of events that happened in his life. Scrooge grew to hate the whole Christmas season. After he is shown what will happen to him if he doesn’t change his ways, Scrooge wakes up the ne... ...Christmas Carol reflects how much love and generosity of spirit are present among people: the greater the â€Å"good cheer†the brighter the scene, the more greed, self-centeredness, or hostility, the more absolute the darkness. An example discussed in the novel was the amount of light and therefore, spirit, love and generosity, present in the moor where the miners work. In contrast to the miners light, was the gloom surrounding Scrooge before he was visited by the three ghosts. Although Scrooge was surrounded by murkiness, greed and self-centeredness before the ghosts visited him, by the time he went to his nephew Fred’s party there much more light, love and generosity present. Fire light and warmth play an important role in The Christmas Carol but darkness and gloom play an equally important role in representing the characteristics of people in the scene.
How to Become a Effective Teacher Essay
In general, education is a term often used to refer to formal education, which covers a range of experiences, from formal learning to the building of understanding and knowledge through day-to-day experiences. In fact, individuals receive informal education from a variety of sources, such as family members, peers, books and mass media. All of them have exerted a strong influence on informal education of the individual. On the other hand, throughout the processes of teaching and learning, education can also refer to a wide variety of discipline such as computer science, chemistry, health science, society and linguistics, etc. Undoubtedly, in almost all societies, attending school and receiving an education is extremely vital and necessary if one wants to achieve success or even want to obtain an entrance ticket to a better social ranking; however, common sense is sometimes hard to learn from the books directly ¾one can have all the book knowledge in certain professional field, but formal education wont get him or her far if a individual dont know how to behave with his or her co-workers, superiors, and or even family members. In my understandings, education should be comprised by formal and informal studies, and should be carried out in the process through out ones lifetime. More importantly, education cannot be succeeded without motivation. A high-quality education is really essential for an individuals success in todays society. Without a good quality education how would the next generation be able to compete for jobs? Todays new technologies are becoming more and more intricate to run. Life is not easy; if you dont have the knowledge as everyone else dose. Most likely, you will not be as successful as the one with the higher education. According to Bonnie Neff, my high school English teacher, knowledge is the key to success! As for me, I know that the knowledge I gained will be a great tool to implement later in the future. Comprehending something new, will let me visualize and expand the knowledge that I already have to a greater extent. There was a discussion in one of my class last year, one of my teachers was telling me about why there were so many students failing, and falling behind on the required subjects. Teachers are confronted with the problem of keeping up with the fast pace at which kids are expected to learn today. That one particular discussion made me wondered what it is like to become a teacher?And what approach does to a teacher have to take to get to students, to come up with ideas to help their student to stay on the right track? With a strong effort by teachers even the most limited student can have a higher education. Now, that Im tutoring in an elementary, kindergarten to be exact. Ive been helping Mrs. Le with her students for about two months. In her classroom, I was pretty amazed by the way how her students were so eager and enthusiastic while learning something new. Ive realized that once you pull off the difficult challenge of providing the student needs, its a breather to know that, youve done your job. Now, your student feels like he can accomplish any goals he or she sets for. In my opinion, I think that this is why teachers love their job because theyre passing down the knowledge that he or she had collected and are making a difference in their students life. It takes a lot of hard work to become a good teacher. Good teachers must not only know their subject matter extremely well but also be sensitive to their students feelings to ensure that everyone in the class feels that they can be successful. (Calhoun 11). A successful teacher starts with the proper credentials. The road to become a competent and certificated teacher is both challenging and rewarding. (Shockley and Cutlip 21). In order, for you to become a teacher you have to decide upon a major and a minor teaching field. Your major is the area of the studies in which you will become most expert on. It requires more courses, more time, more work, and more attention but it will pay off to a great extent in the future. (Shockley, and Cutlip 43). You need to make a choice on the grade level or subject area for your major. You can either choose to teach in an elementary school, secondary school, or college. During the years of college you have to take curriculum requirements such as: general education, fine arts, humanities, history, science, mathematics, and social science. A typical college, which operates on a semester basis, requires 123 total credits hours for a bachelors degree. (Shockley, and Cutlip 22). In addition, prospect teachers face challenge during the early years of teaching. Getting accustomed to the hard work required in the classroom and responsibilities involved in teaching can be extremely tough for new teachers. (Calhoun 8). There are specific traits and qualities that can be useful to help and understand what the students are going through. You must have patience, creativity, preparation, and discipline. Last, to get an insight view of being a tutor I had an interview with Gabriel Melano, a Communication studies tutor in Sacramento City College and readying tutor at the Sacramento Unified District. Whether, you deiced to teach in an elementary school, high school or in college just have in mind that you need to have patience and creativity with all of your students. When you are trying to help someone learn, having patience is an essential necessity (Calhoun 14). These students are undergoing vast developmental changes that require a lot of attention and sensitivity. (Calhoun 22). At the early childhood level, teaching these youngsters is less focused on curriculum and content and more on motivating the children to learn and influencing their self esteem. The teacher must establish an environment conducive to learning on which developing mind can grow and expand. (Calhoun 20). Teaching in high school filled with teenagers is a bit different than teaching younger kids. Not just the age different, but also they way these teens think of themselves. You must understand that, during this stage of development, teens are seek their own personal style and identity. (Calhoun 24). A High school teacher must be able to inspire and motivate so that the learning will continue to take place despite all of the other challenges that the students are facing. (Calhoun 25). Having a keen understanding of this age group and being familiar to how students develop affects his or her learning style. Some student might be afraid to speak up to ask for help. By having patience is a way to gain the insight thought of your students need of learning. Every child learns differently so donÂ’t ever come to a conclusion. Youngster absorbs information and develops skills at his or her pace. (Keogh 3). Youngster might be confused with the way how you are trying to teach a specific subject. By being creative and trying to figure out tiny ways to help your students to comprehend show that youre willing to do what it takes for him or her to learn. The activities are much more teacher-directed as in the rest of the school program, and pencil-and- paper tasks are required for sustained period of time. (Calhoun 57). Letters names, letter recognition, colors, shapes, sizes, games, and other relationships are expected of kindergarten students. (Calhoun 57). If a student is a visual learner teacher can use flash cards with pictures to get through a point of what they are trying to get them to know. Teachers can make teaching fundamental for students. Teachers can use different ideas of how to approach something they are trying to teach and find many different ways to help students learn. Students know the name of the subject, and they can use their imagination to present the material in the way that student can understand. (Calhoun 14). By having, creativity is what makes the classroom come alive, and it is what helps student learn and appreciate learning. (Calhoun 15). Teachers who are models of organization and preplanning not only help their students learn but also show them how to be organized themselves. (Calhoun 16). When a teacher shows that he or she know what is important, then the student will be more responsible in doing their work. Designing a good lesson plan help put with time consuming because you already got everything all set. As students grew older you might have to be more discipline. This age of groups is extremely active, and the learning environment must be challenging for them. (Calhoun 22 and 23). If a student tends to get bored, they can find their own avenues for relieving themselves from boredom. They usually, take the form of some kind of classroom disruption. When this happens, you have to find a way to prevent this from happening again. For younger kids, all it takes for them to stop playing or goofing around is when you tell them that you plan on calling his or her parents and have a little talk with them with the way how he or she is behaving inappropriate. So, once a young kid hears that treat about calling her or his parents the kid usually start to pay attention again. When it comes to high school teenager it doesnt work that way. In ways, high school teenagers need more discipline to control their behavior. This is the age where they feel to overwhelm with everything. Having a good communication with the teenager can help you understand why they tend to act up in the classroom. On my interview with Gabriel Melano I had asked him a few questions about being a mentor. The first question that I had asked him was, what inspired you to become a tutor? He responded, During elementary school I started helping other students out and it made me felt good inside about myself. Knowing that you make a difference on someone elses life and their gratitude just makes me feel like I have a good purpose in life. The next question that I had asked him was, What has been his biggest challenge so far? He responded, My biggest challenge as a tutor has been motivating children who many have given up on. There are students who set their mind and wont even try to learn. It makes me sad to see someone so young being pessimistic. The next question that I had asked was, Do you feel like you have accomplished anything so far? Gabriel, I am happy to say that every time when a student succeeds I succeed. I also learn a great deal from every student to work with. Last, question that I had asked Mr. Gabriel, Do you have any type of skills to make teaching easier? His answer: Patience with kids.Teachers are the people who are able to bring out the best in others. These are the people that can be able to combines two important types of learning and making the best out of it. When students feel unsuccessful and under-appreciated, they can lose their desire to work hard and can begin to believed that they are less talented or worthy than their classmates. (Calhoun 11). Teachers who possess quality by having patience, creativity, and discipline often receive visits and letter of gratitude from their students long after they have graduated. Teachers should be more appreciated from all those hard work that they put us through. Our teachers wanted us the students to feel more prepare as we go on with the next challenge ahead of us. They were leading our hand to face the Reality of this world called life. Thank you so much for all the things that youve done for us to be where we are at right now.
Thursday, October 10, 2019
Shouldice Hospital Limited. Case Study Analysis
EXHIBIT 1 Acceltion,s Service Guarantee Quaury oF Srnvlcn GueneNTEE TheAccelIionQualitvofServiceGuaranteedefines,AcceI1ion,sassurance*, Ifj:r:fl†. ‘,f†,iljtm3;:ru:mlFj *-Hiri,†††dil;;affi,. irn †1. Perfonnance Guarantee a†ri,,iuo. , or'te-. *r,sea ne. â€Å"i,, is the same as Accellion guarantees that the performance of the. Net-work uproading and downloading content, Accellion service' will be no t*t p†. â€Å"*t of that w1n hich';;. hr;†*d by a benchmik origin as a resurt of usine the site being accessejfrom r. ‘ ‘r††‘ibii , ffi,ltji'fi ::,Ti:T:t ‘u p†‘f†‘††ilffi, p†,ro. *u,'††*iTly*il? ::T::#? 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Security and privacy policy ,o any inquiry in re,a,ion,o Accellion has comolete respect for the Customer's privac y and that of any custome,r data stored in Accellion service does not require Acce,ion servers. The Customers i†prtJa†i†y;a:lr'r†i;;te servers' All information provided details for the data being stored on the to a†. â€Å"uio†iy' tLr†c†. r. i',†r';;;r†i'i;, he Customer,, ;il:ilT I†v r,u,,†u†t†,, ,or†b†r,†rit. A,ccerion w,I not hat the Disclosure of Customer's itrtt'†‘ti. †5. iui]'i. A. â€Å"†[ion's ;t;il:;,,, &:i:T††,t:ffi:1nir. ;r',1;li:ffi;d##Hi; ilJ'A'ff1†³Ã¢â‚¬ËœX;1T'. |,H:†fiH^dr:1[:o'aut, to possession shalr i-tu†t *'†. ifntI . ,*p. ffity onlybe made where such disclosure is *a to the terms or use or â€Å",,]o,†Accellion will ensure-that th†ct'stom††s informatiorr and data [areJ ke{1cur9 or imProPer use' which includes t'trqg;ii*r;uur†rt†p, io rr. ri,fil,tr1r,. mer,s adenrity d protected from unauthorized access i before granring access. EXHllBlr Dear Team, 2 orAcclrionEmail to All Accellion staff Announcing the Launch of the oos Guarantee [T X':i'ji:#:ffi11:;J:T? ,i? :]†#t'^Y^:l:1*8 vua,ry ot ervlce guarantee read it over very carefully. vo†iulLri†Ji;;;;;1/†;†*u16 Quarirvof service suarantee (Qos). prease Please ancr puts t ‘†ownership o in this company to deliver. C†r,o. â€Å"†. , ompanf c ustomers aon,r wen+ . â€Å"J9,flT? ‘L†l31d irt nuts *he -o*r,†rrnipi†n ever d o,. ,;t;;t-;1q6btcDDrve' ;†;;;;†,;;h#; theirnetwo'rkrip;*;;irr†rilrhcfi–,*–. –. ,f1. ‘-t-â€Å",LevelAgreement(sLA);ttruy;†rt**i *::::;ilffl:r. H,ffi :Slfl a*Xi A;::#J:ffi â€Å"‘,,*:mf :'†**:*;$ii+,r,fr;y:'^,'†j,:nTffi 18,. #,†l*iF:iqd-. i††;'ffi â€Å"H? ::1H:J:†H:'†;T†;1f 3†³tr:; As a member of the Accellion –Lt, vl\_. 1. team, you are key to our client,s satisfaction. Thanks in advance for your suPport in making our clients and ourselves successful. |.. 4? j:|ir!. -. ‘!. ii. ‘,l:*||-:i;:1:†|:|i||::l.. ;:::1,;:::;:;j::i. ];::|:i:]i::::::jl:]]j:::::]:. :::]] L. what is the marketing impact of a well-designed guarantee? 2. Eaaluate Exhibit the_ seraice design of Acceilion,s guarantee shown in r-. How ffictiae wilr it ui rn communicating seraice exceuence to potentiar and current customers? would you recommend any changes to its design or imple_ mentation? 3†² will he guarantee be successfut in creating a curture for seraice exceilence within Aiceilion? whit erse may be needed for achieoing such a culture? . Do you 4' think customers mEht take adaantage of this guarantee and â€Å"stage†seraice f;ilures to inaokeTlrr'grorantee? If yes, how could Acceuion minimize potentiar iheating on its guarantee? The Accellion Service Guaran tee Sg1r Case 16 Shouldic e Ho spit al Limite d (Abri dge d) JeuEs Hpsrprr AND Rocnn HellowELL A Canadian hospital specializing in hernia operations is considering whether and how to expand the reach of its seraices, including expansion into other specialty areas.Various proposals haae been adaanced to increase the capacity of the hospital without demotiaating the staff or losing control oaer seraice quality, which, in addition to achieoing excellent medical outcomes, has created a aery deaoted base of patient â€Å"alumni. †Options include adding Saturday surgical operations, building an extension, and constructing a neTD hospital in another location, perhaps in the United States. TWo shadowy figures, enrobed and in slippers, walked slowly down the semi-darkened hall of the Shouldice Hospital. They didn't notice Alan O'Dell, the hospital's managing director, and his guest.Once they were out of earshot, O'Dell remarked good nature dLy, â€Å"By the way they act, you'd think our patients own this place. And while they're here, in a way they do. †Following a visit to the five operating rooms, O'Dell and his visitor once again encountered the same pair of patients still engrossed in discussi. g their hernia operations, which had been performed the previous morning. HrsroRY An attractive brochure that was recently printed, although neither dated nor distributed to prospective patients, described Dr. Earle Shouldice, the founder of the hospital: Dr. Shouldice's interest in early ambulation stemmed, ffi:.? :T,]1;5,T? j:T]:J†H-â€Å",H,::,T#|'^# the girl's subsequent refusal to stay quietly in bed. In spite of her activity, no harm was done, and the experience recalled to the doctor the postoperative actions of animals upon which he had performed sur gery. They had all moved about freely with no ill effects. By 1,940, Shouldice had given extensive thought to several factors that contributed to early ambulation following surgery. Among them were the use of a local anesthetic, the nature of the surgical procedure itself, the design of a facility to encourage movement without unnecessarily causing discomfort, and the postoperative egimen. With these things in mind, he began to develop a surgical technique for repairing herniasl that was superior to others; word of his early success generated demand. Dr. Shouldice's medical license permitted him to operate anywhere, even on a kitchen table. However, as more and more patients requested operations, Dr. Shouldice created new facilities by buying a rambling 130acre estate with a 17,}}0-square foot main house in the Toronto suburb of Thornhill. After some years of planning, a large wing was added to provide a total capacity of 89 beds. Dr. Shouldice died in 1965. At that time, ShouldiceHospital Limited was formed to operate both the hospital and clinical facilities under the surgical direction of Dr. Nicholas Obney. In 1999, Dr. Casim Degani, an internationally-rec o g nrzed autho rity, b ecame surge on-inchief. By 2004,7,600 operations were performed per year. THr SHouLDtcE METHoD Only external (vs. internal) abdominal hernias were repaired at Shouldice Hospital. Thus most first-time repairs, â€Å"primaries,†were straightforward operations requiring about 45 minutes. The remaini. g procedures involved patients suffering recurrences of hernias previously repaired elsewhere. Many of the recurrences and very difficult hernia repairs required 90 minutes or more. In the Shouldice method, the muscles of the abdominal wall were affanged in three distinct layers, and the opening was repaired-each layer in turn-by overlapping its margins as the edges of a coat might be overlapped when buttoned. The end result reinforced the muscular wall of the abdomen with six rows of sutures (stitches) under the skin cover, which was then closed with clamps that were later removed. (Other methods might not separate muscle layers, often involved feH,er :ilil';,†#:1â⠂¬ ³3i*:ffi':T,'†:nvorvedtheinsertionotCoPyright O 2004 President and Fellows of Harvard College. To order copies or request permission to reproduce materials, call 1-800515-7685, write Harvard Business School Publishing, Boston, MA021,63, or go to http://www. hbsp. harvard. edu. No part of this publication may be reproduced, stored in a retrieval system, used in a spreadshee! or transmitted in any form or by any means–electronic, mechanical, photocopying, recording, or otherwise-without the permission of Harvard Business School. Professor James Heskett prepared the original version of this case, â€Å"Shouldice Hospital Limited,†HBS No. 583-068.This version was prepared jointly by Professor James Heskett and Roger Hallowell (MBA 1989, DBAI997). HBS cases are developed solely as the basis for class discussion. Cases are not intended to serve as endorsements, sources of primary data, or illusfrations of effective or ineffective management. 592 A typical first-tim e repair could be completed with the use of preoperative sedation (sleeping pill) and analgesic (pain killer) plus a local anesthetic, an injection of Novocain in the region of the incision. This allowed immediate post-operative patient ambulation and facilitated rapid recovery. THe PaTIENTS' ExpERIENcEMost potential Shouldice patients learned about the hos- pital from previous shouldice patients. Although thousands of doctors had referred patients, doctors were less likely to recommend shouldice because of the generally regarded simplicity of the surgery, often considered a â€Å"bread and butter†operation. Typically, many patients had their problem diagnosed by upersonal physician and then contacted Shouldice directly. Many *tru made this diagnosis themselves. The process experienced by shouldice patients depended on whether or not they lived close enough to the hospital to visit the facility to obtain a diagnosis.Approximately 10% of shouldice patients came from outside t he province of ontario, most of these from the United States. Anoth er 60†³/o of patients lived beyond the Toronto area. These out-of-own patients often were diagnosed by mail using the Medical Information Questionnaire shown in Exhibit L. Based on information in the questionnaire, a shouldice surgeon would determine the type of hernia the respondent had and whether there were signs that some risk might be associated with surgery (for example, an overweight or heart condition, or a patient who had suffered a heart attack or a stroke n the past six months to a year, or whether a general or local anesthetic was required). At this point, a patient was given a operating date and sent a brochure describing the hospital and the shouldice method. If necess ary, a sheet outlining a weight-loss program prior to surgery was also sent. A small proportion was refused treatment, either because they were overweight, represented an undue medical risk, or because it was determined that they di d not have a hernia. Arriving at the clinic between 1:00 p. M. and 3:00 p. M. the duy before the operation, a patient joined other atients in the waiting room. He or she was soon examined in one of six examination rooms staffed by surgeons who had completed their operating schedules for the day. This examination required no more than 20 minutes, unless the patient needed reassurance. (patients typic ally exhibited a moderate level of anxiety until their operation was completed. ) At this point it occasionally was discovered that a patient had not corrected his or her weight problem; others might be found not to have a hernia at all. In either case, the patient was sent home. After checking administrative details, about an hour fter arrivin 8 at the hospital, a patient was directed to the room number shown on his or her wrist band. Throughout the process, patients were asked to keep their luggage (usually light) with them. All patient rooms at the hospital were semiprivate, containi^ g two beds. patients with similar jobs, backgrounds, or interests were assigned to the same room to the extent possible. upon reaching their rooms, patients busied themselves unpack ing, getting acquainted with roommates, shaving themselves in the area of the opera- tion, and changing into pajamas. At 4:30 P. M. , a nurse's orientation provided the roup of incoming patients with information about what to expect, including the need for exercise after the opera- tion and the daily routine. Accordi. g to Alan OiDell, â€Å"Half are so nervous they don't remember much. ,, Dinner was then served, followed by further recreation, and tea and cookies at 9:00 p. M. Nurses emphasized the importance of attendance at that time because it provided an opportunity for preoperative patients to talk with those whose operations had been completed earlier that same duy. Patients to be operated on early were awakened at 5:30 A. M. tcl be given preop sedation. An attempt was ade to schedule operations for roommates at approximately the same time. patients were taken to the preoperating room where the circulating nurse administered Demerol, an analgesic, 45 minutes before surgery. A few minutes prior to the first operation at 7:20 A. M. , the surgeon assigned to each patient administered Novocain, a local anesthetic, in the operati. g room. This was in contrast to the typical hospital procedure in which patients were sedated in their rooms prior to being taken to the operating rooms. upon the completion of their operation, during which a few patients were â€Å"cha tty', and fuily aware of hat was going on, patients were invited to get off the operating table and walk to the post-operating room with the help of their surgeons. According to the director of nursing: Ninety-nine percent accept the surgeon,s invitation. while we use wheelchairs to return them to their rooms/ the walk from the operating table is for psychological as well as physiologicai [blood pressure, respiratory] reasons. patients prove to themselves that they can do it, and they start their all-important exercise immediately. Throughout the day after their operation, patients were encouraged to exercise by nurses and housekeepers alike. By 9:00 P. M. n the duy of their operations, all patients were ready and able to walk down to the dining room for tea and cookies, even if it meant climbing stairs, to help indoctrinate the new â€Å"crass†admitted that duy. on the fourth morning, patients were ready for dis- charge. During their stay, patients were encouraged to take advantage of the opportunity to explore the premises and make new friends. Some members of the staff felt that the patients and their attitudes were the most important shouldice Hospital Limited (Abridged) 593 (HIBIT ;†EF 1 Medical lnformation O,uestionnai re 5 ‘n,ti,rBER (or Rural Route or P. O. Box) Province/StateTown/City SHOULDICE HOSPITAL 7750 Bayview Avenue Box 379, Thornhill, Ontario L3T 4A3 Canada Ph one (418) 889-1 125 Telephone # (Thornhill – One Mile North Metro Toronto) tq-Frhrr. 1^i il3$-1- rr=CBlv'lATlON: Please give name of lnsurance Company and Numbers. MEDICAL .nS,-IANCE: (Please bring hospital certificates) INFORMATION nLR3r:,r- ‘. a – r. l IJCE: (Please bring insurance certificates) OTHEH SURGICAL INSURANCE Patients who live at a distance often prefer their examination, admission and operation to be arranged all on a single visit – to save making two lengthy journeys. The whole kEl&anr:r Name of Business Are you the owner? f Retired Yes – purpose of this questionnaire is to make such arrangements possible, although, of course, it cannot replace the examination in any way. Its completion and return will not put you Former Occupation No under any obligation. Do you smoke? Please be sure to fill in both sides. tr-! n? -? : asr,ssrcn date? (Please give as much advance notice as possible) ry*esi:,-s =-(–, Sa:-‘:a;' cr Sunday. ffiEr h ,s *crJ FOR OFFICE USE ONLY Type of Hernia This information will be treated as confidential. ;I†EXIEEIEEIRIE: ffi iMEfrgles ory' cqJd n=trr [email protected] :rE] cr*en rr d yotrr operatirn a tir lrctrr ru=ight EXHIBIT 1 (ConttnueolPLEASEBEACCURATE! :Misleadrngfuures.. *fiâ‚ ¬rl. cFeoxâ‚ ¬Ã¢â€š ¬]r3†² admissionday,couldmeanposFonementolyqJropeGlhontrlll†,yc'-,,[e,Etri Waist (muscles THIS IS YOUR CHART – PLEASE MARK IT! APPROXIMATE SIZE. †Walnut (or less) Hen's Egg or Lemon GraPefruit (or more) INFORMATION ESSENTIAL EXTRA and put that apply to your hernias Use only the sections v. lu H a / in each relaxed)††††††††††††‘ins' is your health now E treatment: Pressure Excess bodY fluids Chest Pain (â€Å"angina†) lrregular Heartbeat Ulcers Anticoagulants (to delaY blood-clotting or to â€Å"thin the blood†) F t ‘ Name of anY Prescnbe: pills, tab lets or caPsutres 1otake regularlY – A nY condition Please tick regular for which You are having Diabetes Asthma & Bronchitis Y ,JI GOOD ; Blood ,JI Chest (not exPancld' il il t] t] I il I il still be finished in time for a 12:30 P. M. lunch in the staff dining room. Upon finishing lunch, surgeons not scheduled to operate in the afternoon examined incoming patients. A surgeon's day ended by 4:00 P. M. In addition, a surgeon could expect to be on call one weekday night in ten and one weekend in ten. Alan O'Dell commented that the position appealed to doctors who â€Å"want to watch their children grow up. A doctor on call is rarely called to the element of the Shouldice Program.Accordi^g to Dr. Byrnes Shouldice, son of the founder, a surgeon on the staff, and a 50% owner of the hospital: Patients sometimes ask to stay an extr a day. Why? Well, think about it. They are basically well to begin with. But they arrive with a problem and a certain amount of nervousness, tension, an d anxiety about their surgery. Their first morning here they're oPerated on and experience a Sense of relief from Something that's been botheri. g them for a long time. hospital and has regular hours. †Accordi. g to Dr. They are immediately able to get around, and they've got a three -duy holiday ahead of them with a Per- Obney:When I interview ProsPective surgeons, I look for experience and a good education. I try to gain some insight into their domestic situation and personal interests and habits. I also try to find out why a surgeon wants to switch positions. And I try to determine if he's willing to perform the repair exactly as ,::it i ? ffi : †'il†JilI% IL:x *,x'*#: have the run of the 3 patients, make friends easily, and hospital. In summer, the most common after-effect from the surgery is sunburn. he's told. This is no place for prima donnas. Tue NuRsEs' ExPERtENcE Dr. Shouldice added: 34 full-time-equivalent nurses staffed Shouldice each 24 hour period.H owever, during non-oPerating hours, only six full-time-equivalent nurses were on the premises at any given time. While the Canadian acutecare hospital average ratio of nurses to patients was 1,:4, at Shouldice the ratio was 1:15. Shouldice nurses spent an unusually large proPortion of their time in counseli. g activities. As one suPervisor commented, â€Å"We don't use bedpans. †According to a manager, â€Å"shouldice has a waiting list of nurses wanting to be hired, while other hospitals in Toronto are short-staffed and perpetually junior resident in surgery performs. Hernia repair Tiaditionally recruiting. †hernia is often the first operation thatThe hospital employed 10 full-time surgeons and other major operations. This is quite wrong, ES is borne out by the resulting high recurrence rate. It is a tricky anatomical area and occasionally very complicated, especially to the novice or those doing very fer*hernia repairs each year. But at Shouldice Hospital a surgeon learns the Shouldice technique over a periol of several months. He learns when he can go fast anc when he must go slow. He develops a pace and a L?. xli;J!. T,:i'††*11:1†²-x1'*:1i#;il'It;. TJ: geons. We teach each other and try to encourage a 8 each duy. a scrubbing scheduled operation at 7:30 A. M. hortly before the first If the first operation was routine, it usually was completed by 8:15 A. M. At its conclusion, the surgical team helped the patient walk from the room and summoned the next patient. After scrubbrng, the surgeon could be ready to operate again at 8:30 A. M. Surgeons were advised to take a coffee break after their second or third operation. Even So, a surgeon could complete three routine operations and a fourth involving a recurrence and Shouldice Hospital Limited (Abridged) tr– achieve absolute perfection. Excellence is the eneml' of good. part-time assistant surgeons. TWo anesthetists were also on site.The anesthetists floated among cases e xcept when general anesthesia was in use. Each operating team required a surgeon, an assistant Surgeofl, d scrub nurse, and a circulating nurse. The operatirg load varied from 30 to 36 operations per duy. As a result, each surgeon typically performed three or four oPerations A typical surgeon's duy started with a L' regarded as a relatively simple operation compared to group effort. And he learns not to take risks Tne DocroRs' ExPERIENcE 595 ‘ a Chief Surgeon Degani assigned surgeons to an oPerating room on a daily basis by noon of the preceding da1†² This allowed surgeons to examine the specific patienE hat they were to operate on. Surgeons and assistants H-ere rotated every few days. Cases were assigned to give do. tors a non-routine operation (often involving a recurrencâ‚ ¬ several times a week. More complex Procedures ^'erâ‚ ¬ assigned to more senior and experienced members of th†staff. Dr. Obney commented: If something goes wrong, we want to make sure t ha: we have an experienced surgeon in charge. Experience is most important. The typical general surgeon mai perform 25 to 50 hernia operations per yeaL Ours Perform 750 or more. The L0 full-time surgeons were paid a straight salan' typically fi,aa,000. In addition, bonuses to doctors 'ere distributed monthly. These depended on Profit, indir-icual productivity, and performance. The total bonus Pc-‘i paid to the surgeons in a recent year was aPProximate-‘r $400,000. Total surgeon compensation (including benefir was approximately 15% more than the average income for kitchen staff several times a d,ay, and the hospitar staff to o'D efi, â€Å"weuse arl fresh ingredients and prepare the food from scratch in the kitchen. ,, The director of housekeeping pointed out: a surgeon in Ontario. Training in the shouldice technique was important eat together. Accordi^g to ecause the procedure could not be varied. It was accomplished through direct supervision by one or more of the seni or surgeons. The rotation of teams and frequent consultations allowed for an ongoing opportunity to appraise performance and take corrective action. where possibre, I former shouldice patients suffering recurrences were assigned to the doctor who performed the first operation â€Å"to allow the doctor to rearn from his mistake. ,, Dr. obney commented on being a shouldice surgeon: ilH:*XX##'#Hlti:iJf mx;^:†x$::: ing notes [for confidence], e.. oriaging eachither, and walking around, getting exercis.. briourse, e,re in the rooms straightenirg ,p throughout the day. This gives the housekeepers ; chancl to josh with the patients and to encourage them to exercise. A doctor must decide after several years whether he to do this for the rest of his liie because, just a Iultt in other speciarties-for exampre, radiology_h. s loses touch with other medical disciplines. If h; stays for five years, he doesn't leave. Even among younger doctors , few elect to leave. ?,. i. |. 1.. lrt|ii;. ; |ii|:. :. ||::)|:|ii||. |i::|||||:. :|::||:::|:::|:::::::::::::::::::::::::::::::::: The shouldice Hospital contained two facilities in one uilding-the hospital and the clinic. On its first-level, the hospital contained the kitchen and dining rooms. The sec_ ond level contained a large, open tounge area,the admis_ sions offices, patient rooms, and a spacious grass-covered Florida room. The third revel had aaaitiond fatient rooms and recreational areas. patients could be seln visiting in each others'rooms, walking up and down hallways, loung_ irg in the sunroom, and making use of light recreational facilities ranging from a pool table to an exercycle. Alan o'Dell pointed out some of the features of the hospital: The rooms contain no telephone or television ets. If a patient needs to make a call or wants to watch terevi_ sion, he or she has to take a walk. The steps are designed specialry with a smalr rise to alow patients recently operated on to negotiate the stairs without undue dis comfort. E-â€Å"†Iy rqluru foot of the hospital is carpeted to reduce the hospital feeling and the possi_ bility of a fall. Carpetir,g urro gives tf,e phce a smell other than that of disinfJctant. ‘ This- facility was designed by an architect with input from Dr. Byrnes shouldice and Mrs. w. H. uiquhart (the daughter of the founder). The facility was discussed for years and many changes in the lans were made before the first concrete was poured. A number of unique policies were also instituted. For example, parents accompanying children here for an operation stay free.. you may wonder why we can do it, but we learned that *. rrre more in nursing costs than we spend for the parent's room and board. have- only three on my housekeeping staff for the entire facility. one of the reasons for ; f†* housekeep_ that we don't need to change rinens during a ::? ,tr patient's four- duy stay. Arso, the medical staff doesln,t The clinic housed five operating rooms, a labor ator y, and the patient-recovery room. In totar, the stimated cost to furnish an operating room was $30,000. This was con_ siderably less than for other hospitals requiring a bank of equipment with which to administer anesthetics for each room. At shourdice, two mobile units were used by the anesthetists when needed. In addition, the complex had one â€Å"crash cart†per floor for use rf a patient should suffer a heart attack or stroke. ilin|,4|'i|4? l|:j:i|'i|:|j|!. :||i:|. |::::::|||:::;:i. :|:::):':|::::::|::::|::::):::::::::':1: Alan O'Dell described his job: we try to meet people's needs and make this as good a place to work as possible. There is a strong concern or employees here. Nobody is fired. [This was later reinfor. â€Å"-d by Dr. shouldice, who described a situa_ tion involvirg two employees who confessed to theft in the hospital. They agreed to seek psychiatric help and were allowed to remain on the itu. l As a resurt, turnover is low. our administrative and suppor t staff are non_ union,. b†, we try to maintain a pay scale higher than the union scale for comparabl. Jou, in the area. we have a profit-sharing prin that i, ,. prrate from the docto*: year the administrative and support -LTt staff divided up $60,000. If work needs to be done, peopre pitch in to herp each other.A unique aspect oi o,,r, administration is that I insist that each secretary is trained to do another's work and in an emergency is able to switch to another function immediatlly. we don,t have an organization chart. A chart tends io make people think they're boxed in jobs . a r try to stay one night a week, having dinner and ristening to the patientJto find out how things are really goinf uro. rnd here. Patients and staff were served food prepared in the same kitchen, and staff members picked up iood from a cafeteria line placed in the very .. r,t. , of the kitchen. This pro'ided an opportunity for everyone to chat with he Operating Costs The 2004 budgets for the hosp ital and clinic were close to $8. 5 millions and $3. 5 million, respectively. 6 Shouldice Hospital Limited (Abridged) Sgz EXH lB lT FIoor Supenisor 2 Organization Chart Lab (4) Operating Laundry Room Housekeeping Office Accounting Medical Grounds (3) (2) Supervisor I Head Head Nurse urse (2) Record (2) Dietary (r7) I5 (2) (3) i al[eets three limes a year or as needed. bUeets as needed (usually twice a month). lnformallv reports to Executive Committee. Physical Surgeons Assistant Plant (12) Surgeons (7) Anesthetist (t) pared to an average charge of $5,240 for operations per_ ormed elsewhere. if. l. rlii. ,i. l. ,,:::. ::i:ll|::::l. ::. :::l:.. ::::|:. :|:::|::. :::::|:'. ::|::):|::::::::::: Hernia operations were among the most common per_ formed on mares. In 2000 an estimated r. ,000,000 such operations were performed in the united states alone. Round-trip fares for traver to Toronto from various major cities on the North American continent ranged from roughly $20A to $600. when our backlog of scheduled operations gets too large, we The hospitar arso provided annual checkups to alumni, free of charg.. Muny occurred at the time of the According to Dr. Shouldice: wonder patient reunion. The most recent eunion, featuring dinner and a floor show, was held at afirst-class hotel in down_ town Toronto and was attende d by 1,000 former patients, many from outside Canada. ho* many peopre decide instead to p†rfor* the operation. Every have their rocal doctor time we've expandea o11 capacity, th†backrog has declined briefly, onry to climb or,. u again. Right now at 2,400,]1 ir rarger than it has ever been and is grow_ irg by 100 every six months. The hospitar relied entirely on word-of-mouth adver_ tising, the importance of which was suggested by the results of a poil carried out by i. :i|,i. ]||,)|:i. ||. ;|,. ii:. ||:||:. |,. )||:|:||. :||,.. |:|||::::||:::'. ::::::::::::: when asked about major questions confronting the man_ agement of the hospital, Dr. s hourdice cited I aesire to seek ways of increasing the hospitals capacity while at the same time maintaining . oriror over the quatity of service delivered, the future role of government in the operations of the hospital, and the use of the shouldice name by potential competitors. As Dr. shouldice put it: Im a doctor first and an entrepreneur second. For students of Depaul lrxiriuit 3 shows a portion results). Although little systematic data about university as part of a project of these atients had been collected, Alan o'Dell remarked that ,,if we had to rery on wearthy patients onry, our practice would be much smaller. ,, Patients were attracted to the hos pitar, in part,by its reasonable rates. Charges for a typical operation were four days of hospital sta y at $? 20 p. iau anda $650 surgical fee for a prim ary inguinar (the most common example, we courd refuse permission to other doctors ah. – hospitar. The y may copy our technique and Tisappry it or misinform *,. i. pati ents about the use of it. rni, resurts in failure, and we are f, who want to visit hernia). An additional fee of $300 was assessed f generar anesthesia was required (in about 20% of cases). These charges com_ ExHlBlr Direction: you. 5. B concerned that the technique will be blamed. But Shourdice Hospitar Annuar Patient Reunion Data For each question, please place a check mark as it applies to 4 /7 22 Nationalitv Directions: please place a check mark in nation you represent and please write in your province, state or country where it applies. Canada America Europe J6 -]] province sate a†*r, ee 2 /o ua'rl ,o/ // 63% 5 /6 /960 7 5†² %dt 39. 54% 5/. /6% fl. 63% 4/. 56% 30. 23% /6. 26% occupation Ilave you been overnight in a hospital other than u*@' houldice befone your operation? !* j! _ No lZ What brought Shouidice Hospital to your attention? Friend 8†² ,1 Doctor Rerative . . , 6r. 1//o _0. %% EzW,/. rticre ,9 , Did you have a si',gle 26; or double /6 other 4 ,iiJ†#Zw hernia operation? 56,/4% fi. s6% 9. Is this your first Annual Reunion? yes No fi .10 . , If no, how many reunions have you iiM ,,a†fz',fl ^tt 10. Do you feel that Shouldice Hospital to, ,* * – per,son? â€Å"r††0 Most definitely Definitety 6 JZ Very iittle Not 66,05% /a%% 7 Z_. reaubrc _fl 42. 6J% 6-/0 ruo,rn,re – 5 z17J% !:;::::; :'r'; #, at all Shouldice Hospital Limited (Abridged) 599 EXHIBIT 3 (Continued) fhat impressed you the most about your stay at Shouldice? check one answer for each of the following. for operation and hospital P1ease s Not Somewhat 27. 9d1 Imporiant /4 Somewhat Imporbant 32. 56% // Somewhat Important 25. 5/l /5 Somewhat Important 34. 5E% Not 7 /6. 26% Important 32. 56% Not ImPortant 6 /S,6dl 3 6,96% Not 27,9/k Somewhat 5 /0 Important 25 Important n. fi% 23,2fl1 56. /5% †sbouldice Hospital hardly seemed like a hospital at all. †Somewhat Very 5 /3 Importani 25 Importani Important //. 63% 30. 23% 55. /4% gi ve the MAIN REASON why you reiurned for this annual In a few words, reunion. Very Important 2 4. 65% SomewhaiVery 39. 53% Friendships witb Patients Not Important / 2. 3? l Not Important 3 6'96% Not ImporLant we're doctors, and it is our obligation to help other Alan O'Dell added his own concerns: surgeons learn. On the other hand , it's quite clear that others arc tfying to emulate us. Look at this ad. [The advertisement is shown in Exhibit 4. ) This makes me believe that we should add to our capacity, either here or elsewhere. Here, we could go to Saturday operations and increase our caPacity by 2O%. Throughout the year, no oPerations are sched- How should we be marketing our services? Right now we don't advertise directly to patients.We're uled for Saturdays or Sundays, although patients whose operations are scheduled late in the week remain in the hospital over the weekend. Or, with an investment of perhaps $4 million in new sPace/ we even afraid to send out this new brochure we' ve pu: together, unless a potential patient specificallrrequests it, for fear it will generate too much demand. Our records show that just under 1% of our EXHIBIT 4 Advertisement by a Shouldice Competitor could expand our number of beds by 50%, and schedule the operating rooms more heavily. On the other hand, given Sovernment regulation, do we want to invest more in Toronto?Or should we establish another hospital with similar design, perhaps in the United States? There is also the possibility that we could diversify into other specialties offering similar opportunities such as eye surgerf, yancose veins, or diagnostic services (e. 9. , colonoscopies). For now we're also beginnirg the process of groomirg someone to succeed Dr. Degani when he retires. He's in his early 60s, but at some point we'll have to address this issue. And for good reason, he's resisted changing certain successful procedures that I think we could improve on. We had quite a time changing the schedule for the admi nistration ofDemerol to patients to increase their comfort level during the operation. Dr. Degani has oPPosed a Satutday operating program on the premise that he won'tbe here and won't be able to maintain proper control. 500 Shouldice Hospital Limited (Abridged) Canadian Hernra Ctinic Hernias (Ruptures) Required Under local anesthesia as by Canadian method. No Overnight Hospital Stay, Co nsult atio n s Witho ut Char ge 23061St. Rd. 7 BOCA R{ION, FLA. 33433 482-7755 patients are medical doctors, a significantly high percentage. How should we capttahze on that? I'm also concerned about this talk of Saturday operations.We are already getting good utrltzation of this facility. And if we expand further, it will be very difficult to maintain the same kind of working relationships and attitudes. Already there are rumors floatirg around among the staff about it. And the staff is not pleased. The matter of Saturday operations had been a topic of conversation among the doctors as well. Four o f the older doctors were opposed to it. While most of the younger doctors were indifferent or supportive , at least two who had been at the hospital for some time were particularly concerned about the possibility that the issue would drive wedge between the two groups. As one put it, â€Å"I'd hate to see the practice split over the issue. †EruDNOTES Most hernias, knows as external abdominal hernias, are protrusions of some part of the abdominal contents through a hole or slit in the muscular layers of the abdominal wall which is supposed to contain them. Well over 90% of these hernias occur in the groin area. Of thes e,by far the most common are inguinal hernias, many of which are caused by u slight weakness in the muscle layers brought about by the passage of the testicles in male babies through the groin area shortly before birth.Aging also contributes to the development of inguinal hernias. Because of the cause of the affliction, 85oh of all hernias occur in males. 2. Ba sed on tracking of patients over more than 30 years, the gross recurrence rate for all operations performed at Shouldice was 0. 8%. Recurrence rates reported in 1†³. the literature f or these types of hernia varied greatly. However, one text stated, â€Å"In the United States the gross rate of recurrence for groin hernias approaches 70†³/†. †monet ary references in the case are to Canadian dollars. $1 US equaled $1. 33 Canadian on February 23, 3. A11 2004. n Exhibit 2 was prepared by the casewriter, based on conversations with hospital personnel. 4. The chart 5. This figure included a provincially mandated return 6. on investment. The latter figure included the bonus pool for doctors. SIUDY OuEsrtoNs L. What is the market for this seraice? Hout successful is 2. Shouldice Hospital? Define the seraice model for Shouldice. How does each of its elements contribute to the hospital's success? 3. As Dr. Shouldice, what actions, if any, would you take to expand the h ospital's capacity and how utould you implement such changes? Shouldice Hospital Limited (Abridged) 601
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