Business Intelligence - BI, mining, analytics, and data warehousing Research Paper

Business Intelligence - BI, mining, analytics, and data warehousing - Research Paper Example Moreover, the management of Caesars Entertainment is dedicated to environmental energy and sustainability protection and it recognizes the significance of being responsible steward of the environment (Caesars License Company, LLC.; EDGAR). Since the business of Caesars Entertainment is always expanding, its management has decided to implement a new technology based structure in an attempt to manage business operations successfully and effectively. For this purpose, Caesars Entertainment will make use of latest tools and technologies such as BI (Business Intelligence), mining, analytics, and data warehousing to better manage and control business operations. This report presents a detailed analysis of some of the important aspects and areas of Caesars Entertainment business where BI solutions can be implemented. At the present, almost all the organizations make use of latest tools and technologies to leverage and augment their business capabilities. For instance, many business organizations use Teradata and IBM Cognos solutions to improve their marketing strategies and customer satisfaction level by means of a closed-loop technology based systems. In the same way, with modern technology based solution such as Teradata, Harrah Entertainment enlarged its usage of IBM Cognos business intelligence software to extract and drill additional and deeper customers’ data. Moreover, by making use of these innovative technologies business is able to effectively extract and segment customers’ data into many profiles as well as utilize this extracted and filtered customer segmentation data to extend targeted campaigns to extract preferred customers’ behavior. For instance, it can help Harrah Entertainment know about clients who have not visited for over 6 months and implement strategi es to bring those customers back. As well, business uses business intelligence and data warehousing to promote innovative games by determining

Computer Forensic Tools Term Paper Example | Topics and Well Written Essays - 750 words

Computer Forensic Tools - Term Paper Example The program recovers files in various operating systems such as vista, windows 7, Xp and different server. Recuva enables the recovery of files with sheer minimal footprint on the disk. The program can be downloaded freely from the internet and is easy to install and run. In addition, the software is able to recover the files that have been emptied from the recycle bin. The program can also be used to recover files in tablet computers. Pandora on the other hand enables the recovery of files that are in NTFS and FAT-formatted volumes. It works by scanning the hard drive and creating an index both existing and deleted files and directory on the logical drive of the computer. The scanning will provides retrieve all the deleted files where you will choose one’s to recover. Unlike the Racuva, Pandora provides a preview of the files in case you can to refer to it shortly. The software is also downloaded freely. However, a version with more robust function is obtained by subscribing $500. The software is exceedingly straightforward to use. Glary undelete is a hybrid file recovery software that enables recovery of files in NTFS, NTFS + EFS, FAT, compressed files, encrypted files, compressed, fragmented and files in removable devices. The program has a remarkably easy user. The software supports both dynamic and basic volumes. Like the other two, the software can be obtained free by downloading from the internet. The most prevalent tools used to extract forensic evidence from mobile phones are Flasher Box and PmExplorer. The devices are extremely effective and therefore used by the security agencies such as the police. According to Heiser & Kruse (2011), the two devices are hugely expensive. In addition, one requires a personal computer such as a laptop to use the device. The latest model of Flasher Box cost approximately $10000. This cost does not include the other supporting hardware and software. You also have to buy a set of cables that are used to connect to different mobile phones. A laptop that runs remarkable software for analysis the evidence is also needed. In total, price of a complete Flasher Box system is almost 12000 dollars. PmExplorer is relatively cheaper. It comes with an ensuite of all required software and hardware. According to Solomon & Barrett (2012), the total price is approximately $8000. This explains why the system is more common compared to Flasher Box. The cost hiring a professional computer forensic expert is extremely high. A profound trial lawyer and Technologist computer forensic examiner based in UK charges between 500 to 1000 dollars per hour to examine a computer system that contains digital evidence. The expert charges the client according to the magnitude of the crime committed and the size of the company. To perform the operation for a large business organization, the expert can charge over a thousand dollars. In addition, the expert also charges some extra $500 for his security. Research has shown tha t the expert has experience in the field. In fact, he has been conducting several government investigations (Vacca, 2005). The investigations were successful and he has helped the government deal with cyber criminal. Though there are other forensic experts, the quality of services they offer is low. I would recommend any organization which needs to hire a forensic expert with experience. In addition, they should be registered with HTCIA. There was a case in the court which involved

Facebook: A Useful Communication Tool

Facebook: A Useful Communication Tool This report provides an analysis about Facebook, which has become an important source of communication now days. The report starts with an introduction of Facebook, history of Facebook and its importance now days. The report then moves on the use of the social network as a communication tool, entertainment, business and information. The report also tells about the usage of Facebook among different people of different regions and different ages. The report then covers the main advantages and disadvantages of Facebook and then finally discusses how to make the usage of Facebook limited and safe. 1.0 Introduction A social network is defined as an internet based service that allows its users to create a public or private profile in which they could list their personal details, hobbies, relationships and share it with people they want to share their personal details with. Most popular social networks now days are Facebook, Twitter, Linked in, My Space and Google Plus. This research is carried out to provide information about Facebook, the importance of Facebook now days and to mention advantages and disadvantages of Facebook. Facebook was found on 4th February 2004 by a teenage boy Mark Zuckerberg in Stanford. The companys first name was thefacebook.com, after a month company shifted its platform of functions to Florida and Palo Alta. The company bought its name Facebook from the website Facebook.com in 2005 for $200,000. After 8 years Facebook has become one of the most famous website on the internet, even from a school boy to a busy business man everybody seems to be addicted to Facebook. Thi s research tells us about the use of Facebook by different people of different ages and regions. People of different ages use Facebook for different purposes children and teenagers mostly use this network for communication and entertainment, Business men use this for multiple purposes such as communication, information, and marketing and also as an entertainment. According to research carried out Facebook is used in every country of the world. The report then finally discusses what problems have risen as a result of excess use of Facebook and its effect on International media and daily life of people. 2.0 Importance of Facebook now days: According to this research Facebook is a lawful activity in every country of the world, and from a small child to a busy professional business man Facebook is an addiction to all of them. Facebook has become a part of daily routine of people and for some people part of their hourly routine, people of all ages use Facebook for following different purposes. 2.1 Communication: The main purpose of this social network is communication; the main logo of Facebook is connect and share with the people in your life. Facebook allows its users to chat, talk and share their daily life activities with their friends and family. 2.2 Entertainment Due to the advance features of this network entertainment has become as equal purpose as communication; as a member logs into his Facebook account his attention is readily diverted towards different entertainment stuff like time line applications, online game applications, picture jokes, funny videos and other interesting content. 2.3 Source of Earning Facebook is also used as a source of earning by people i.e. Facebook is one of the most visited websites on internet so it is an excellent website for advertisement and offers about brands and products, therefore Facebook is also used for marketing of business and hence it assists people in earning money. 2.4 Data Storage and Information Some people also use Facebook as data storage i.e. to store their memorable photos and videos on internet as in case their compute data gets corrupt or lost. Facebook is also sometimes used to obtain information about famous people, locations, cultures and events. Facebook also keeps people up to date about the world. 3.0 Usage of Facebook by people of different ages and different regions According to the research carried out Facebook population is made up of Millions of people around the globe. As compared to males, females lead the population on Facebook; young adults aged 18 to 25, possess the most population of the Facebook due to their interests in chatting, entertainment, cyber dating and other youth stuff. After this age sector Facebook is heavily populated from people aged 26 to 34, due to the same interests as of young adults. The rest of the population is covered by people of different ages including children and people over 45. Coming to the regional statics of Facebook usage, Facebook is a lawful activity in every country of the world. America has the most Facebook users of the world, Brazil has the second most users of Facebook in the World and third country with most Facebook users is India. Ireland possesses 59th position in relevance to the Facebook population. All these statistics show that Facebook is huge and on the present day it is the most popula r social network and one of the most visited website on internet. 4.0 Advantages and disadvantages of Facebook: Today the world has become a place of instant communication with the help of social networks like Facebook, twitter, Google plus etc. and by other means of communication like emails and telephones. Facebook is the most popular social network on internet and its use is rapidly increasing, according to research carried out Facebook is the most popular communication tool used, followed by SMS and email. Facebook is the most popular social network in the world, with over 350 million users, so it should come as no surprise to discover that people are using it as a primary tool for communication, said Hazel Butters, CEO of Prompt Communications. As far as communication and sharing Facebook is considered as an excellent tool, but problems arise when Facebook becomes an addiction. Facebook has become a part of daily routine of people and for some people part of their hourly routine and hence they are moving away from their daily healthy activities by spending hours on Facebook. Teens especially are being accused of constantly logged in their account, some specialists narrate that this develops social skills in them which are essential in practical life. But other people believe that this disturbs their studies and their healthy outdoor activities. Privacy is another issue with Facebook, although the social network offers the users full control of their private information still there is insecurity with many different features of Facebook, also hacking is another threat for users, if some account gets hacked all the personal details and stuff of the user will be leaked. Another drawback of Facebook is fraud and fake accounts, a ccording to the stats 83 million accounts on Facebook are fake or duplicate, this creates a lot of confusion among the users e.g. people may not be talking or sharing their details with the person they think they actually are, sometimes people are fooled into funding or sharing money for the name of some well-known company or fund raisers by fake accounts. Facebook an incredible place for young boys and girls in relevance of dating sometimes becomes a goldmine for identity theft and dating Sometimes people are in love with person they dont even know that exists or not. Cyber bullying is another major problem with Facebook, people often criticize others on Facebook and sometimes a group targets an individual and insult the person in front of their friends or even family. This causes mental stress to people, makes them victim of complex and diverts their attention from their carrier or studies. With all these problems it is hard decided that Facebook is a beneficial or not, but inste ad of criticizing a solution should be found. Facebook was found for communication and entertainment purpose so it should be kept that way, Facebook should not be taken as an addiction and there should be a small time period for it. Facebook should not be preferred over studies, outdoor activities or work. Moral Values should be followed on Facebook one must not abuse somebodys privacy, should not cheat anybody on Facebook or criticize any other person on Facebook. This way we can make Facebook beneficial. 5.0 Conclusion: The research carried out tells us that Facebook has become an important part of our lives by means of communication, entertainment and business all around the globe, but it is misused by people and therefore it is losing its reputation. But instead of walking out from Facebook it should be used properly to avoid the loss of a very useful communication and entertainment tool. Contents Geekosystem.com, 2012, to prove a point dating site steals 250,000 profiles on Facebook, 2012, http://www.geekosystem.com/dating-site-stole-facebook-profiles/, accessed on 25/11/2012. Katin Rogers, 2012, Facebook users raise privacy concerns as company tweaks security settings, 15/10/2012, http://www.guardian.co.uk/technology/2012/oct/15/facebook-users-privacy-concerns-security, accessed on 25/11/2012. Social Bakers, 2012, Facebook Statistics, 2012, http://www.socialbakers.com/facebook-statistics, accessed on 25/11/2012. History of Facebook, 2012, History of Facebook, 2012, http://www.historyoffacebook.com/, accessed on 25/11/2012. Mike Sachoff, 2009, Survey found Facebook most useful communication tool, 11/12/2009, http://www.webpronews.com/survey-finds-facebook-most-popular-communication-tool-2009-12, accessed on 25/11/2012.

Managing Diversity Essays -- International Management

International management refers to the pursuit of organizational objectives in more than one nation. International management has evolved as a discipline of increasing importance in recent years. The underlying reason is that the corporate community is becoming more and more diverse. Improvements in transportation and communications and lower production costs in many countries around the world have made global markets more accessible. Although United States-based firms have immediate access to huge domestic markets, they have steadily increased the proportion of their foreign markets. It has been estimated that about 10 percent of all jobs in North America are dependent upon export and import trade. Other indicators, including foreign investments, profits earned overseas, and fees and royalties paid to firms abroad, point to an increase in corporate internationaliza ¬tion. Next we will look at some of the challenges facing managers who work in an international environment. CHALLENGES AND PROBLEMS FACING THE INTERNATIONAL MANAGER A host of interacting and overlapping forces create problems for the manager in an international setting that are infrequently faced by the manager who works for a company doing business in only one country. The term infrequently is chosen because some countries are so large geographically that they contain radically different subcultures within their own boundaries. We will summarize 11 factors that the international manager may have to m...

Discuss how Elizabethan audiences would have reacted to the first Act of Macbeth Essay

Shakespeare wrote Macbeth during an age in which the supernatural was a part of everyday life for the people of England. Prior to the wave of Christianity that swept through England, local chieftains and ordinary citizens had been firm believers in witchcraft, spells and fairies. King James had written books on the subject, giving the subject credibility in the eyes of his people. The idea of demons and witches tempting good people to do bad things was widely accepted, especially since the Bible itself made references to the devil. The introduction of the witches in the very first scene of Macbeth would have created a very intriguing effect and would have been accepted by the audience. Another fact that played an important role in the way Shakespeare’s audiences reacted to his plot was the social order and the hierarchy of the spectators who watched his plays. Only three classes existed which were the rich, the merchant middle class and the poor class. Shakespeare’s plays were performed at the Globe theatre which acted as a model for other theatres around the country. It is said that the balconies on top were the most expensive seats and these seats were occupied by the rich and noble people at the time. The next sets were the rows of seats on either side of the stage which the merchant and middle class would view the play from. The lowest category of people occupied the area immediately in front of the stage, an area which stretched far back into the theater where the view was obscured by walls and other obstacles. Crowds were often herded tightly to fit in as many as possible in the smallest amount of space. This was the method of seating at the time. We deduce that all three classes of society had gone to the theatre to watch the play for various different reasons. It is clear that each segment of the audience would have viewed Macbeth from different perspectives to the first Act of the play. The first scene of the first act would not have been a familiar theme to the educated and rich people in the balconies as they lived in a world of wealth, money and luxury far from witch craft, demons, hatred and evil. The dark and gloomy stage in this scene would have been very different from their well-lit, large and luxurious homes It is something they would not have been able to relate to except the fact that they knew that it was just a play which was based on supernatural elements that were common in that era. On the other hand, the middle and lower classes would have focused more on the dramatic structure and elements in the scene. For example, â€Å"In thunder, lightning or in rain?† (Act 1 Sc.1 Ln. 2) gives an audience a feeling of iniquity because in those days the belief was that bad weather was a sign from God showing unhappiness and anger. â€Å"When the hurly burly’s done when the battles lost and won† (Act 1 Sc. 1 Ln. 4), the unnatural rhyming conversation would have all conveyed to an exciting sense of horror. Another factor of the scene that should be taken into consideration is that not all of the conversation makes sense for example if you take â€Å"Fair is foul, and foul is fair †¦Ã¢â‚¬  (Act 1 Sc. 1 Ln. 12),The audience are also told that the witches will return, this eccentric way of speaking gets the audience thinking and brings a sense of eagerness to see what happens next. Moreover, this scene would also have reminded them of their own streets, with poor lighting, and the small dark homes they lived in. Similarly the three segments of the audience would have reacted differently to Lady Macbeth’s soliloquy. As she finishes reading the letter from her husband, various feelings of greed and temptation enter her mind. She also has feelings of doubt and uncertainty she felt that Macbeth lacked courage and would not commit such an atrocious act, â€Å"yet do I fear thy nature, It is too full o’th’milk of human kindness†¦.† (Act 1 Sc. 5 Ln. 15). She then calls upon evil to remove her femininity from her. The intensity of this speech must have given all three segments of the audience a sense of trepidation and for some an enormous sense of rage and disgust. â€Å"The raven himself is hoarse†¦Ã¢â‚¬  (Act 1 Sc 5 Ln. 7),She uses raven which is recognized as an evil bird. â€Å"unsex me here†¦Ã¢â‚¬ (Act 1 Sc.5 Ln.9), She wanted all the characteristics a woman had to have in those days, removed from her. Women were expected to be meek and gentle, no matter what the husband did. So if any female protested, she was immediately branded a ‘bad’ woman in the mind’s of society. Some noble classes in the audience would be able to understand this as they too were probably experiencing similar situations in their lives. It was known that the audience lived in a patriarchy where woman had no power of their own. These women who were married to rich and superior men would often bully them for the married couple to rise in the hierarchy because that was the only way a woman could get a significant amount of power. Thus it would have appeared natural to the wealthier audience that this strong woman was able to force her husband to commit the ultimate crime, murder. It is likely that many in the audience would have also sympathized with Macbeth. It is also likely that some women in the audience were women who accepted the patriarchy system and did not question their husbands and were always willing to stay at the bottom of the hierarchy. These women would have found it difficult to imagine that such women existed. The other two segments of the audience would not have questioned the fact that Lady Macbeth could drive her husband to murder their king. These were people who never had any power and even the smallest possible notion of them being king would drive them into an immeasurable amount of temptation. The poor audiences, which would have certainly included men and women from the criminal classes, may have already committed heinous crimes before, would have had no problem with the idea of killing the king. Macbeth’s long speech, in which he battles with the enormity of the crime he is going to commit, would certainly have obtained different reactions from the audience. In his speech he has an enormous amount of uncertainty in him. His confidence is almost destroyed as he tries to fight his conscience. As I have said before, religion was a key factor in those days. They did believe that committing an act as immense as killing the king, was such a heinous crime, because to the audience it was going against God himself. â€Å"So clear in his great office, that his virtues will plead like angels, trumpet – tongued against the deep damnation of his taking off.†(Act 1 Sc. 7 Ln.20), In those days people were firm believers in the ‘divine right of kings’. It was a belief that said that only God could choose the king and nobody else. Macbeth never refers to the crime he is about to commit as murder. He alters the word by using various less dissonant synonyms like â€Å"assassination†, â€Å"surcease†, â€Å"bear the knife† and â€Å"taking off†. The educated audiences would have recognized the speech and reacted accordingly to the significance of the lines and Macbeth’s guilt overcoming him. In my opinion, it is very likely that the middle and lower classes would soon have got bored due to the length of this speech, which does not have much excitement and horror as the soliloquy of Lady Macbeth. No matter which category the audience belonged, the use of magic and supernatural features on stage would have been a thrilling source of entertainment! The witches, thunder and lightening and murder would have delighted Shakespeare’s audiences as much as today’s ideas of aliens existing and high-tech special effects thrill us! In conclusion, it can be said that the Shakespearean audience cannot be classified as of one type only. Social backgrounds, levels of education and religious elements all played a role in the way each spectator reacted to Macbeth and his actions.

Handle Information in Health and Social Care Setting

CU2470 Handle information in Health and Social care settings 1. 1 The legislation that relates to recording storage and sharing of information known as care plans is the Data Protection Act 1998. There are 8 principles to be followed when gathering data 1) processed fairly and lawfully 2) processed only for 1 or more lawful purpose 3) adequate and relevant 4) accurate and up to date 5) kept for no longer than necessary 6) processed in line with the right of the individual 7) secured against loss or damage 8) not transferred to countries out of EEA. . 2 It is important to have secure systems for recording and storing information to prevent personal information from being misused. Any information that has been gathered is confidential but written evidence may be required by other professionals on occasions. Also if new staff members arrive they can read the care plans to gain all the information needed. 2. 1 I would follow my company’s policies and procedures for guidance and ad vice about handling information but would also speak to my directors or Human resources office.Information can also be gained from government websites for advice or other professionals. 2. 2 If there are concerns over the recording storing or sharing of information i would document and report my concerns and secure all the information immediately. 3. 1 Agreed ways of working relates to the company’s and government policies in relation to Care Plans. All documents should be evaluated and reviewed regularly, updated as required, completed and legible so others are able to decipher them. 3. 2 Agreed ways of working when ) Recording information; would be to follow the company’s and government policies to ensure all information gathered is accurate, legible, complete and confidential. b) Storing information; all information that is gathered should be stored in locked filing cabinets that are only accessible to the persons requiring access to information. c) Sharing informat ion; Company and government policies need to be followed with regard to sharing information to prevent fraudulent use and confidential information being disclosed inappropriately. Data protection codes should be adhered to at all times.

Electricity Production and Consumption in the US

Electricity Production and Consumption in the US Electricity production in the US consumes over 40% of the total energy produced within the continent. Given the high percentage of energy consumption in electricity, the concept forms a significant segment of consumers’ environmental footprint. Fossils fuels such as coal, natural gas, and oil are the key generators of electricity in the US.Advertising We will write a custom essay sample on Electricity Production and Consumption in the US specifically for you for only $16.05 $11/page Learn More According to Environmental Impact Assessment’s data of 2011, coal contributes 42.3%, as natural gas contributes 24.7% of US total electricity generation. In the same year, 4 trillion kilowatt-hours of electricity came from coal, and 42% of the US population consumed this portion (Batagol). The United States produced 1,094.3 million short tons of coal from the 25 coalmine states. Wyoming, which is in the Western Coal Region, produces the largest amount of coal in the US followed by West Virginia. Comparatively, electricity production and consumption in the US using steam engines has been on the rising trend given that the 3,856 billion Kilowatt-hours (kWh) in 2011 is 13 times higher than the consumption in 1950. Major mining zones in the US include the Western Coal Region, the Appalachian Coal Region, and the Interior Coal Region, which agree that production and conversion of coal to useful energy is relatively cheaper than other forms of energy. Nuclear energy has also dominated electricity generation with 19.3%. Uranium, U-235, is available in the mines of western United States. There are 65 power plants in the US; they are located in 31 states. The three populous states of New York, Texas and California have been using more of the one-fifth US electricity that Nuclear Plants have been producing yearly since 1990. Currently, development in power plants saw the US Nuclear Regulatory Commission accepts the building and operation of u nits 3 and 4 of the Vogtle plant, which may start operating in 2016. In 2002, US commercial reactors sites stored 51,002 short tons, and an estimate value reported 12.2 billion kilowatt-hours (kWh) as the amount of electricity that a single power plant can generate.Advertising Looking for essay on environmental studies? Let's see if we can help you! Get your first paper with 15% OFF Learn More In terms of production, nuclear reactors do not emit harmful products like CO2 and SO2; however, the process of manufacturing large amounts of metals and concrete as well as mining and refining uranium ore require large amount of energy (Batagol). Since radioactive materials are harmful to human health, those handling uranium are prone to infections. People have to adhere strictly to disposal regulations given that the elements always remain active for several years. Apt safety measures should be in place to control nuclear reaction in the reactor in order to avert inci dences like the 1986 Chernobyl disaster in Ukraine and the 2011 Fukushima Daiichi nuclear plant in Japan. Although this source of energy has harmful effects, it is highly likely that it will continue growing to eliminate coal as the main source of energy production given its eco-friendly nature. Besides, countries are moving towards using eco-friendly processes in order to avert the climate change menace. The changing climate implies that most countries will divert to eco-friendly sources to produce electricity, and nuclear energy is capable of producing large quantity of electricity. Renewable energy sources like geothermal, solar, wood, water, and organic wastes produced 12% of US’s electricity in 2012. Hydropower has been the major producer of electricity among the renewable electricity generators. Since coal is the main electricity producer, it has great chances of growth albeit the effects that it posses to the environment. China tops in usage of renewable energy followe d closely by the United States; the US still uses more of coal than the renewable energy due to the higher cost of constructing and operating renewable energy power plants than coal and natural gas plants. Besides, the geographical remoteness of the renewable energy sources also implicates extra costs, as the process requires constructing transmission lines to metropolitan areas from remote regions. Even though there are high possibilities of growth for coal as a key energy producer in the US, it faces criticism from environmental agencies given its negative impact on the state of the environment and human health.Advertising We will write a custom essay sample on Electricity Production and Consumption in the US specifically for you for only $16.05 $11/page Learn More For instance, emissions from burning coal such as CO2, SO2, mercury, and particulates cause acidic rain and smog, which are harmful to the environment and cause respiratory complications (Davis and Keegan). This is a great contrary to nuclear energy as it is environmentally friendly in terms of emissions. Construction of nuclear power plants can have temporary or permanent effects on the environment. For instance, the construction equipment emits pollutants into air, land, and water since they occupy space in these areas. With the construction occupying spaces, it does away with any future use of the land for production purposes. Apart from construction effects, license renewal for nuclear plants may necessitate use of extra pieces of land for removing old components and staging new components. Such operations may expose workers to radiation, which are hazardous health effects. Therefore, plants must adhere to the allowable radioactive exposure so that the source does not become harmful to the human health and the environment. Uranium being a radioactive element can increase cancer incidences, that is, if limits of radon 226RN and 222Rn- concentration surpass the permissi ble limit (El-Hinnawi par 6). In addition, during mining, exposure to dust and radiation can result in respiratory diseases and cancerous growths in the body. Wind erosion can blow piles of mills into rivers, thus causing leaching. The toxic nature of fluorine and hydrogen fluoride that produces uranium hexafluoride poses serious health threats. Workers should protect themselves from the highly corrosive UF6 in order to avoid dangerous exposures. In operating nuclear plants, the fuel element retains most of the radioactive products, and the liquid and gas waste-processing system removes the radioactive releases. Comparably, gaseous emissions from nuclear reactors are negligible to fossil-fuel-operated plants. However, the plant releases a lot of heat during operation, and directs them to the cooling water. Accidents are possible with the operation of a nuclear reactor; however, necessary safety practices and devices have been integrated into the reactor to protect workers and the pu blic incase of malfunctions (Davis and Keegan). In case of chemical leakage to the environment, radioactive elements can cause adverse effects on fauna and flora.Advertising Looking for essay on environmental studies? Let's see if we can help you! Get your first paper with 15% OFF Learn More For instance, in the Fukushima disaster, radioactive elements caused mass water and soil pollution to the extent that the locals had to stop using water from taps and certain products. A nuclear plant requires stringent procedures and monitoring during construction and operation since it uses extremely harmful chemicals that can stay long in a human’s body and the environment. Radioactive elements reduce soil fertility thereby killing plants growth. Nuclear energy is an extremely delicate source of energy, as it requires a complex safety system and highly skilled personnel in order to operate at cost-effective terms. The high demand for electricity world over and constant advocation for a clean environment by many organizations make nuclear energy to be a preferred choice to coal. The Clean Energy Standard Act of 2012 advocates the use of energy sources that do not produce greenhouse gases (El-Hinnawi par. 4). Clearly, this makes coal lose preference to nuclear energy, as it limits global warming. Since the nuclear energy industry has been able to account for all its wastes, it remains a vibrant and best option in for the current world, which struggles to prevent adverse effects to the environment. Batagol, Cheryl. Clean Energy | US EPA. US Environmental Protection Agency. N.p., n.d. Web. Davis, Dave, and Michael J Keegan. Nonrenewable Energy Sources. U.S. Energy Information Administration (EIA). N.p., n.d. Web. El-Hinnawi, Essam E. Review of the Environmental Impact of Nuclear Energy. International Atomic Energy Agency. N.p., n.d. Web.

Open Primary Definition and List of Open Primary States

Open Primary Definition and List of Open Primary States A primary is the method political parties use in the U.S. to nominate candidates for elected office. The winners of the primaries in the two-party system become the party nominees, and they face each other in the election, which is held in November in even-numbered years.   But not all primaries are the same. There are open primaries and closed primaries, and several  kinds of primaries in between the two. Perhaps the most talked-about primary in modern history is the open primary, which advocates say encourages voter participation. More than a dozen states hold open primaries. An open primary is one in which voters can take part in either the Democratic or Republican nominating contests regardless of their party affiliation, as long as they are registered to vote. Voters registered with third-parties and independents are also allowed to take part in open primaries.   An open primary is the opposite of a closed primary, in which only registered members of that party can take part. In a closed primary, in other words, registered Republicans are allowed to vote only in the Republican primary, and registered Democrats are allowed to vote only in the Democratic primary. Voters registered with third-parties and independents are not permitted to take part in closed primaries. Support for Open Primaries Supporters of the open primary system argue that it encourages voter participation and leads to greater turnout at the polls. A growing segment of the U.S. population is not affiliated with either the Republican or Democratic parties, and is therefore blocked from taking part in closed presidential primaries. Supporters also argue that holding an open primary leads to the nomination of more centrist and less ideologically pure candidates who have broad appeal. Mischief in Open Primary States Allowing voters of any party to take part in either the Republican or Democratic presidential primary often invites mischief, commonly referred to as party-crashing. Party-crashing occurs when voters of one party support the most polarizing candidate in the other partys primary to bolster the chances that it will nominate someone unelectable to general election voters in November, according to the nonpartisan Center for Voting and Democracy in Maryland. In the 2012 Republican primaries, for example, Democratic activists launched a somewhat organized effort to prolong the GOP nomination process by voting for Rick Santorum, an underdog, in states that held open primaries. That effort, called Operation Hilarity, was organized by activist Markos Moulitsas Zuniga, the founder and publisher of , a popular blog among liberals and Democrats. The longer this GOP primary drags on, the better the numbers for Team Blue, Moulitsas wrote. In 2008, many Republicans voted for Hillary Clinton in the 2008 Democratic presidential primary because they felt she had less of a chance of defeating presumed Republican nominee John McCain, a U.S. senator from Arizona. 15 Open Primary States There are 15 states that allow voters to privately selected which primaries in which to participate. A registered Democrat, for example, could choose to cross party lines and vote for a Republican candidate. Critics argue that the open primary dilutes the parties’ ability to nominate. Supporters say this system gives voters maximal flexibility- allowing them to cross party lines- and maintains their privacy, according to the National Conference of State Legislatures. Those 15 states are:    AlabamaArkansasGeorgiaHawaiiMichiganMinnesotaMississippiMissouriMontanaNorth DakotaSouth  CarolinaTexasVermontVirginiaWisconsin 9 Closed Primary States There are nine states that require primary voters to be registered with the party in whose primary they are participating. These closed-primary states also prohibit independent and third-party voters from voting in primaries and helping the parties choose their nominees. This system generally contributes to a strong party organization, according to the National Conference of State Legislatures. These closed-primary states are:    DelawareFloridaKentuckyMarylandNevadaNew MexicoNew YorkOregonPennsylvania Other Types of Primaries There are other, more hybrid types of primaries that are neither fully open or completely closed. Heres a look at how those primaries work and the states that use these methods. Partially Closed Primaries: Some states leave it up to the parties themselves, which operate the primaries, to decide if independent and third-party voters can participate. These states include Alaska;  Connecticut;  Connecticut;  Idaho; North Carolina;  Oklahoma; South Dakota; and Utah. Nine other states allow independents to vote in party primaries:  Arizona; Colorado; Kansas; Maine; Massachusetts; New Hampshire; New Jersey; Rhode Island; and West Virginia.   Partially Open  Primaries: Voters in partially open primary states are allowed to choose which partys candidates they are nominating, but they must either publicly declare their selection or register with the party in whose primary they are participating. These states include: Illinois; Indiana; Iowa; Ohio; Tennessee; and Wyoming.

America and Vietnam Essay Example for Free

America and Vietnam Essay Olsen and Roberts are both history professors who are fascinated with the ways by which the American government made the situation of the war with Vietnam a fearful yet victorious even for the reputation of the said country. The authors were then able to contribute their thoughts about the situation thus seeing the situation of the past wars a manifestation of the reputation of the American society in the world account of recognized countries of war and reconciliation. Their book â€Å"Where the Domino Fell† actually pictures the actual situations that happened during the American-Vietnamese war during the 1960’s and how the said history particularly affects the relationship of the two countries involved. About the Book [Content and Summary] The overall content of the book is highly recommended for reading and teaching as it gives a clear yet critical approach in assessing the US policy that controlled the Vietnam society from then until the present. Undeniably, the book of Olsen and Roberts is an awakening material that helps the human mind realize the importance of being diplomatic and lawful even when in the middle of distress. Surprisingly, the American society was able to steel a fine reputation out from all the oppression that they have already implicated upon the Vietnamese society during the war years. Through the critical assessment of the situation, the authors intended to give the readers a fine picture not only of what is or what has been obvious but also a glimpse of the truth behind the scenes of historical accounts written in books today. Implications of the Reading As it has been noted earlier, the reading gave a clear depiction of what has happened and why the said events happened during the American-Vietnamese war in the 1960’s. With the insightful informations that the authors posted through their book, they were able to help readers realize what the facts are and how they particularly affect the present relationship that exists between the said countries. Critique of the Writing Approach As for the writing approach of the authors, it is undeniable that the informations that they posted through the reading were carefully assessed thus giving out validated facts that support their explanations of the said historical event. The clarity of the implications of the reading has been strengthened by the documentations that the authors used to show the authenticity of the reading. The utilization of other researches that supported their claims and opinions made the book a must read not only for professors and students, but also for those individuals who endeavor reading books under the typical yet critical approach of understanding history and American politics. Within the context of the book lies a less-traveled path among the historians of the present times. Olsen and Roberts certainly made it clear that history is a human account needed to be understood and learned from through critical observation of the past. Reference: James S. Olson and Randy Roberts. (2006). Where the Domino Fell: America and Vietnam 1945-2006 [ILLUSTRATED]. Blackwell Publishing Limited; 5 edition. America and Vietnam. (2017, May 10).

Administer & Monitor Medications in Work Environment Assignment - 1

Administer & Monitor Medications in Work Environment - Assignment Example er pregnancy unless the doctor measures Prothrombin frequently, ask if patient is under other drugs for treatment of TB, prevent blood clots, supplements containing vitamin K and antidepressant Binding to insulin receptors on cells in the body by making cells in liver, muscles and fat tissues to raise the uptake of glucose from the bloodstream and reduce the production of glucose by the liver hence controlling the glucose level Hypoglycaemia (common), skin thickening or pitting, redness, swelling at injection site, Excessive fluid retention (oedema), visual challenges and skin reactions such as itching, hives or rash. May be affected by ACE inhibitors like captopril, anabolic steroids e.g. stanozol, disopyramide, fibrates e.g. germfibrozil As a medical administrator I have to be certain that the physician’s order is complete and correct. I understand a compete order as a composition of the drugs’ name, dosage, frequency and route administration. An incomplete and unclear order should never be assumed and hence I have to consult with the ordering physician before proceeding (Bullock, & Galbraith, 2007). I have to be certain of the expiry date of drugs and ascertain that it is yet to expire. I always scrutinize the labels against the order. I ensure that I have proactively scrutinized medication features. I always discard the unclear medication that always found to appear cloudy and replace effectively (Bullock, & Galbraith, 2007). I should ensure that drugs that appear in single dose are sealed as required without tempering and not to store excess medications from single doses. I will always be keen to note that patients are prescribed a range of drugs simultaneously. Before I administer a particular I will check the drug interactions for each medication and validate with the patient’s chart to gauge contraindications or special precautions to be altered (Crisp & Taylor, 2009). In addition I do note the history of patient previous anaphylactic

Value of Planning in the Urban Development Essay - 2

Value of Planning in the Urban Development - Essay Example Traditionally, planning concentrated on improving the physical conditions of the houses and streets with response to prevailing circumstances whereby this contrasted with the new aspects of urban planning. City planning process is highly a complex matter, as it must put into account characteristics together with the long-range welfare of people of that particular urban area or city (Barney, 2006). It follows a systematic process that involves series of studies and surveys, land-use development plan, transportation system plan, budget preparation, not forgetting that it has to receive a unified master plan approval from several agencies or legislative bodies. The history of urban development is a controversial subject in the States. Many planners at the beginning of 19th century used to consider total costs of urban planning as opposed to its benefits and this drew a very different picture. However, as time went by, urban community planning took a turning point with a progressive approach where planners concentrated on maximizing the difference between costs and benefits and did not necessarily consider minimizing costs. This was in response to the fact that minimizing costs and at the same time minimizing benefits was of no value, not to the planners nor the country. The history of America reveals that American cities increased and expanded in the early decades of the 19th century. Due to their expansion, geography born rise to city planning as most of the vital roads by then existed for two centuries earlier. As a result, they winded up in erratic areas in local ways and around topographic areas. Afterward, the presence of equipment for construction permitted straighter roads hence planners persisted in establishing a good framework for developing the urban community transportation network (Weiner, 2008).  

Noahs Ark Education Plan Essay Example | Topics and Well Written Essays - 3000 words

Noahs Ark Education Plan - Essay Example Noah’s Ark is one of the most-loved bible stories of children. The story is rich in concepts and values. Children get to learn about different animals, family members, transportation, weather, and obedience. It is laden with actions, colors and sounds that children can re-enact and enjoy. In doing activities related to the story, children retain the concepts and skills learned better. The activities planned for this curriculum are balanced with quiet listening and perceiving and active participation. Activities are both educational and enjoyable – a perfect mix for a developmentally-appropriate curriculum for very young children. †¢ Watching the video of Noah’s Ark. This wonderful book introduces the children to a variety of creative dramatics ideas on the story of Noah’s Ark. The characters in the story are likewise little children who improvise on props (ex. Use a big box for the â€Å"ark†; sprinkling cut-out papers to symbolize the rain; using stuffed animals for the role of animals in the ark)

Renaissance and Mannerism in Architecture Essay Example | Topics and Well Written Essays - 750 words

Renaissance and Mannerism in Architecture - Essay Example Renaissance was initiated by Brunelleschi a great Italian mind. The architect came up with the concept of linear perspective. This was made possible through the blending of architectural and optics designs (Kostof, Spiro). In the year 1425 Brunelleschi conducted experiments that were mathematically based aimed at discovering illusion in two dimensions. This solution involved placing three-dimensional surfaces on two dimension backgrounds so as to establish a vanishing point which was essentially the focal point of an architectural masterpiece. Through linear perspective, Brunelleschi was able to create a grid on which objects in any artwork were precisely placed such that one was able to calculate the ratios. Linear perspective is the main reason why an admirer of any piece of art is able to admire an architectural piece from a single viewpoint. This is exemplified by the Florencian cathedral that has a dome-shaped base that spans about 140 feet. The structure could not have used old styles during its constructions thus necessitating the rebirth of architectural ideas. Donato Bramante who in the year 1505 designed the new Saint Peters Cathedral in Rome made use of innovative central plan designs that were based on classical sources that drew inspiration from the Roman temples that were circular and the Tholoi. Amongst the works that Bramante is renowned for being the Tempietto San Pietro in Rome. Alberti who essentially was an architectural theorist also made major contributions in architectural renaissance by initiating the need for artistic value. He emphasized that every art type be it paintings should have both mathematical and optical accuracy. He insisted on the need to have harmony amongst all the elements to be used in architectural design. Ghiberti was another scientist in the renaissance period that further developed linear perspectives.  

The Discovery of White Collar Crime Essay Example | Topics and Well Written Essays - 1000 words

The Discovery of White Collar Crime - Essay Example â€Å"White collar crime tends to refer to crimes committed at a business by a businessman or woman†, (Conjecture Corporation, 2011). Sutherland, in his December 27, 1939 speech, asserted the fact that when people are surrounding by individuals who have criminal behavior, they are more likely to get involved in criminal activities. This called for the justice system to pose punishments upon these white collar criminals; however, these punishments will be mush lenient from those given to violent criminals because white collar criminals are not actually aggressive criminals who commit crime in series. Schlegel and Weisburd (1994, p.4) state that when Sutherland brought forward the concept, he was himself very much confused about the idea because he used words like â€Å"respectability, high social status, and occupation†, in his definition. ... ed either through computer or through paper, is often committed by people belonging to the middle class or the upper class because people get influenced by their origins. And since they belong to high social status, the crime may go undetected and if at all detected, then the criminals are able to hire expensive lawyers to defend their cases and they are also kept in prisons that have minimum security measures. Thus, they enjoy freedom even in their prisons. Why a white collar crime is considered as less punishable than violent crimes is still questionable because many white collar crimes tend to be more harmful to the people. If a white collar criminal steals all the funds that included people’s savings of their lives, then the victims are made to lose everything if the money is not recovered. But they are still punished less and are given many concessions as compared to other criminals because they belong to a higher socio-economic status. According to FBI, â€Å"White-coll ar crimes cost the United States more than $300 billion annually† (Karri & Associates, 2006). The concept of white collar crimes changes the way criminologists studied crime. Before this phenomenon, they looked at crime as an activity which can only be performed by street muggers and people belonging to lower social class. But after this concept was introduced, the rich and the poor, all were considered equal in the case of criminal activities. Thus, Sutherland was able to bring the powerful people at an equal status with the poor in the eyes of the Court of Justice and made sure that the rich people do not escape punishment due to their powerful political connections and strong financial position. Sutherland and His Contributions Sutherland pondered upon the concept when he took his sociological

Literature Research and PICO Question Annotated Bibliography

Literature Research and PICO Question - Annotated Bibliography Example Indeed, the authors argued that ascertaining the wishes or choices of the patient for their care is a fundamental requirement in establishing an effective care plan. The study found that around 42% of the 380 participants with advanced cancer preferred palliative care of a more conservative nature, with the said percentage of patients actually choosing only one or two modes of treatment. Still, in addition to this preference, the authors also looked at what demographic characteristics predict the possibility of a choice between CPM and AAMM. Maida, et al. (2010) found that younger, non-Caucasian cancer patients who have with them substitute decision makers (SDM) are more likely to prefer more aggressive means of coping with the disease condition. This study was chosen as a significant literature because it aimed to quantify the characteristics and preferences of patients with their end-of-life care. By doing so, the study provides a rich background for the PIO question exploring which could be more effective in providing comfort at the end of life, CPM or AAMM, as perceived by the patients themselves. Rose, J. H., O’Toole, E. E., Dawson, N. V., Lawrence, R., Gurley, D., Thomas, C., et al. (2004). Perspectives, Preferences, Care Practices, and Outcomes Among Older and Middle-Aged Patients With Late-Stage Cancer. Journal of Clinical Oncology, 22 (24), 4907-4917. Much like the earlier study by Maida, et al. (2010), this research aimed to look into the preferences of terminal cancer patients in their care at the end of life. However, this study took a more qualitative approach, actually exploring the preferences for the care of the patients, and the degree by which these preferences were perceived to have provided comfort to the patient before their death. By utilizing a more in-depth exploration of the perceived effectiveness of different palliative methods, the researchers were able to point out which methods were most effective in promoting comfort

The Discovery of White Collar Crime Essay Example | Topics and Well Written Essays - 1000 words

The Discovery of White Collar Crime - Essay Example â€Å"White collar crime tends to refer to crimes committed at a business by a businessman or woman†, (Conjecture Corporation, 2011). Sutherland, in his December 27, 1939 speech, asserted the fact that when people are surrounding by individuals who have criminal behavior, they are more likely to get involved in criminal activities. This called for the justice system to pose punishments upon these white collar criminals; however, these punishments will be mush lenient from those given to violent criminals because white collar criminals are not actually aggressive criminals who commit crime in series. Schlegel and Weisburd (1994, p.4) state that when Sutherland brought forward the concept, he was himself very much confused about the idea because he used words like â€Å"respectability, high social status, and occupation†, in his definition. ... ed either through computer or through paper, is often committed by people belonging to the middle class or the upper class because people get influenced by their origins. And since they belong to high social status, the crime may go undetected and if at all detected, then the criminals are able to hire expensive lawyers to defend their cases and they are also kept in prisons that have minimum security measures. Thus, they enjoy freedom even in their prisons. Why a white collar crime is considered as less punishable than violent crimes is still questionable because many white collar crimes tend to be more harmful to the people. If a white collar criminal steals all the funds that included people’s savings of their lives, then the victims are made to lose everything if the money is not recovered. But they are still punished less and are given many concessions as compared to other criminals because they belong to a higher socio-economic status. According to FBI, â€Å"White-coll ar crimes cost the United States more than $300 billion annually† (Karri & Associates, 2006). The concept of white collar crimes changes the way criminologists studied crime. Before this phenomenon, they looked at crime as an activity which can only be performed by street muggers and people belonging to lower social class. But after this concept was introduced, the rich and the poor, all were considered equal in the case of criminal activities. Thus, Sutherland was able to bring the powerful people at an equal status with the poor in the eyes of the Court of Justice and made sure that the rich people do not escape punishment due to their powerful political connections and strong financial position. Sutherland and His Contributions Sutherland pondered upon the concept when he took his sociological

Culver City Essay Example for Free

Culver City Essay Because of the changes that have taken place in the nursing home industry throughout the past decade, service area competitor analyses have become an increasingly important aspect of environmental analysis. The process of service area competitor analysis involves first of all an identification of the service category for analysis. It then moves on to include identifying of competitors, determining the strengths and weaknesses of rivals, and anticipating their moves based on the analysis of the data collected. The service area selected for this particular analysis is the Culver City nursing home industry. The market for nursing home care in Culver City, California is changing rapidly and has been considered a buyer’s market for specialty care. The population of Culver City in relation to the number of senior citizens is an important consideration in the decision to enter the nursing home market in this city. The number of persons each nursing home usually takes is in the range of 80 to 85% of its carrying capacity (Pandya, 2001). One must not forget that â€Å"the demand for nursing home care [is] driven by the availability of financing† (Willging, 2003). Also notable is that approximately 36% of seniors have been financing nursing-home care out of pocket (2001). In carrying out a service area competitor analysis upon this city, it is necessary to take a look at such aspects as its financial and economic situation, the demographics, and the trends that might derive from them. It will also be necessary to assess the strategies being pursued by the nursing homes that service the area and the consumer reaction to these policies. According to the analysis of the Culver City finance budget, the city began a period of economic growth in the late 1990’s where the property taxes began reflecting an increase in the value of real estate and overall taxes represented a general increase in per capita income. Over the period the city was able to sustain both low inflation and unemployment rates. Investment grew almost three fold, according to the Dow Jones Industrial, S P 500, and the Nasdaq composite charts (City of Culver City, 485-86). However, economic growth has plateauxed since 2001, and the employment rate that had fallen from 9 to 3. 9 percent, has risen up to approximately six percent (485). Across the United States, the health care industry has had to cope with economic changes resulting from rising medical costs. The Culver City population sustained a growth of 47% between the years 1990 and 2000 (â€Å"City Population,† p. 2). The records of the Culver City Redevelopment Agency reveal that the population of the city is 39,119. On average, there are about 16,826 households represented in the area, and the income for the average household is about $76,013 per annum. The income for the average family household amounts to $90,930. The Culver City trade area extends beyond this. If the area considered extends to a three mile radius beyond the hub of the city, the population increases 305,287 and boasts an average family income of $79,689. Within a five mile radius live about 852,147 people, and the inclusion of this population brings the average household income back up to $87,820. The median age of Culver City is 40, and 84% of all the adults of this city have attained at least a high school education. Thirty five percent of these adults have also attained at least a bachelor’s degree in higher education. The population is distributed mainly among persons of Caucasian, Hispanic, African American and Asian origins. Forty-six percent of the inhabitants are white, 25% are Hispanic, 12% are Asian and another 12% are African American. The remaining 5% are of unknown or â€Å"other† origin (â€Å"Demographics†). In Culver City is a rather prosperous community. Only 2. 96% of the population earns less than $20,000 per year. Those who live on an amount between $20,000 and $50,000 amount to 13. 46% and another 22. 37% live within the next tier level, between $50,000 and $75,000. Seventeen percent live on $75,001 to $100,000, and a third of all the people live on an income higher than $100,000. Approximately 16% of the Culver City residents are over sixty years old (â€Å"Demographics†). For strategic management purposes it is dangerous to consider the over-65 group as a homogeneous one (Willging, 2003). Shifts in demographic and increases in lifespan have changed the make-up and the desires of the aging population (Ginter, et al. 2006, p. 6). The senior citizens and retiree demographic in Culver City has been divided into three groups for the sake of consumer analysis. The retirement group has a median income of approximately $53,000 which is about $11,000 higher than the national average. Non-whites are represent about 43% of this group and approximately 35% of this group has attained a bachelor’s (or higher) degree. This group is likely on average to spend a mid-to-high amount on entertainment, but spends a bit lower on average on health care, presumably because not all retirees are senior citizens (Artsmarket, 2002, p. 12-13). The active senior singles group has a median income of $32,000, which is also higher than the national median. They participate in many health activities and have a medium-to-high likelihood of spending money on health. The portion of none whites in this group is approximately 22%, and 25. 7% percent of the members of the active senior singles group have attained college degrees (Artsmarket, 2002, p. 14-15). The prosperous older couples group has a median income of approximately $67,500, which is an astounding $32,000 higher than the national median. Thirty percent of these have attained bachelor’s degrees (or higher) and people of color make up 29 % of the group. Their likelihood of spending on health care is in the high range (Artsmarket, 2002, p. 16-17). The city’s economic situation presents costs and benefits to any prospective nursing-home business venture. The fixed costs of entering the market would be considerable, but the increased unemployment rate (up from 3. 9 percent) would make the price of labor a little more affordable than in recent years. A favorable thing for businesses is the tax rebate program that has been instituted by the city to encourage new business. This grants them tax relief from either business or utility users’ tax (â€Å"City of Culver City, 489). A new entrant into the nursing home industry in Culver City must consider the quality of care that is to be provided by that business entity. The general problems with funding being experienced by nursing homes across the country has led not just to many law suits and eventual bankruptcy, but to the loss of customers to competitors (Day, 2005). Culver City customers also require not just a variety but quality of service. Variety will be an asset; however, as there is great intensity of rivalry among existing organizations, and the nursing home industry is experiencing rapid growth driven by the demographic and social trends mentioned above. It must be noted, for example, that a good portion of the seniors are educated, and â€Å"educated seniors tend to be more knowledgeable and have higher expectations of a facility† (Willging, 2003). The significant portion of non-whites must also be considered and real attempts made to cater and appeal to them. In addition, it must be noted that a vast majority of these seniors have lived active lives; therefore, facilities which cater to this would be magnetic to their tastes. The competitors in the Culver City nursing home industry, though they provide adequate care and the necessary facilities, can be categorized into four groups that denote they quality of service they offer as well as the level of reimbursement that they require for those services. For this service area nursing home facilities are pursuing four basic strategies: high price with highly specialized services (strategic group 1), low price with few ancillary services (strategic group 2), medium price with some services, (strategic group 3), and high price with many services (strategic group 4). Customers who seek the attributes of one strategic group, such as highly specialized rehabilitation services, are unlikely to be attracted to another strategic group. A good idea for a newcomer in the nursing home market is to choose the group to which it is best able to cater, and possibly to diversify the scope of the service by offering one or two (not many) extra services. Then, concentrate on providing the best service possible in that group. Diversity does exist in the consumer groups, but this information must be acted upon with care. Early retirees, for example, who might need nursing home care, may not yet qualify for state or federal assisted care (Clinton, 1993). Medicare and Medicaid provide full coverage to only about 9% of seniors, and many are forced to pay out of pocket (Day, 2005). The figures have shown that many Culver City seniors can afford this, but paying out of pocket means that the consumers will be even more unlikely to accept less than the best care. This look at the nursing home industry as it exists in Culver City has revealed that, though a â€Å"buyers’ market† exists and the competition is very high, a newcomer in the market might still have a chance to win a significant market share. This must be done by paying attention to the demographic as well as the economic situations that have the power to affect the market. The psychographic and demographic aspects show that a diversity of services must be offered and that any newcomer desiring be successful in such a competitive and demanding market must be willing to (carefully) diversify. References ArtsMarket. (2002). City of Culver City: Acorn Cluster Lifestyles and Local Profiles. Bozeman: Author. www. artmarket. com City of Culver City. (2004). â€Å"Fiscal 2004-05 Adopted City Budget. † Budget and Finance. Author. http://www. culvercity. org/citygov/budgetfinance/depts_budgfinanc. html â€Å"City Population. † (2001). Redistricting Committee. Oregon State Legislature. http://www. leg. state. or. us/comm/redistricting/citypop. pdf Clinton, Bill. (1993). Remarks and a question-and-answer session with the AARP on health care in Culver City, California. Weekly compilation of presidential documents. News and Society. http://www. findarticles. com/p/articles/mi_m2889/is_n40_v29/ai_14550594 Day, Thomas. (2005). â€Å"About Nursing Homes. † Guide to long term care planning. National Care Planning Council. http://www. longtermcarelink. net/about_nursing_homes. html â€Å"Demographics. † City of Culver City. http://www. culvercity. org Ginter, P. M. , Swayne, L. E. and Duncan, W. J. (2006). Strategic management of health care organizations. 4th ed. Malden: Blackwell. Pandya, Sheel. â€Å"Nursing Homes. † Policy and research for professionals in aging. AARP. http://www. aarp. org/research/longtermcare/nursinghomes/aresearch-import-669- FS10R. html Redevelopment Agency of Culver City. â€Å"Community Profile. † City of Culver City. Culver City: Government. http://www. culvercity. org/citygov/redevelop/demogr. html Willging, Paul. R. (2003). â€Å"Don’t let demographics fool you. † Nursing Homes. Aug. 2003. http://www. findarticles. com/p/articles/mi_m3830/is_8_52/ai_108198554

A Critical Evaluation Of Total Quality Management Management Essay

A Critical Evaluation Of Total Quality Management Management Essay Quality has become the focus for many healthcare organisations in the world. The economic and organisational benefits such as increased customer satisfaction, improved processes and efficiency can be derived from quality management. The implementation of Quality Management strategies provides the framework for the establishment of systems; procedures and activities needed to achieve quality. The implementation of quality management in health care organisation provides an opportunity to deliver consistent, high quality and cost effective health care to customers. In its Health Sector Reform programme for Trinidad and Tobago, the Ministry of Health (MoH) identified Quality of health care services as a key issue to be addressed .The MoH strategic direction for quality was presented in their guiding document Quality 2001 A Reality which was geared in the direction of making quality a priority. The strategy was broad and aimed towards improving quality of health care services, creating a quality culture and emphasising value for money as goals for improving health care services. One of their specific key objectives was the introducing of framework for developing a Total Quality Management system at the public healthcare institutions. The decentralisation of health services and the enactment of the Regional Health Authorities (RHAs) Act No.5, 1994 represented the Governments intention to institute efficient health care systems for Trinidad and Tobago. The MoH would retain responsibility for policy, planning and regulation of health care. The formation of five (5) Regional Health Authorities (RHAs) would have responsibility for the provision of health care services and implementation of management strategies to achieve improved performance. The North Central Regional Authority (NCRHA) is one of the largest statutory bodies providing healthcare services in the country. Its remit includes three (3) major hospitals, two (2) district health facilities and fourteen (14) health centres. 1.3 Problem Definition: The public confidence in the quality of health care services delivered by the public health sector is very low. The NCRHA in recent years has been the centre of media attention due to matters allegedly related to medical negligence. The increase in adverse events and medical care complaints at its hospitals has been disturbing. According to MoH data there were at least seventeen (17) reported Adverse Events occurring at our nations hospital for the period 2004 to 2011 which resulted in patient injury, disability or death. Health care trends such as rapid advancements in public health management, shifts in customer demand for health service delivery and population health concerns have changed the national social landscape.These trends have resulted in a more informed customer accessing services therefore demanding reduced waiting time for services, improved medical care, enhanced facilities and overall quality health care from their service providers. The recent change in government in May 2010 has also brought about strategic transformation. The Governments Seven Development Pillars (Pillars 1, 6) emphasizes the bringing together of all stakeholders to ensure that public services, especially essential services like health care, are affordable, accessible and of the highest quality. These current issues have strategic implications for public health sector organisations such as the RHAs. Therefore current TQM strategies should be critically assessed and a new structured approach to the implementation of Quality Management must be proposed. Medical Care related complaints data received at the health care facilities NCRHA for the period 2008-2010: Institution 2008/09 2009/10 2010/2011 Total Arima Health Facility 53 181 148 382 Caura Hospital 142 165 124 431 Chaguanas Health Facility 74 114 181 369 Eric Williams Medical Sciences Complex 711 925 1305 2941 Mt Hope Womens Hospital 148 128 106 382 Primary Care Health Center 50 30 35 115 Total 1178 1543 1899 4620 Figure 1 NCRHA Complaints Data Source: NCRHA Quality Department 1.4 Rationale: The strengthening of public confidence in the quality of health care services at NCRHA is critical to the organisations future survival. The MoH is currently in its final drafting of legislation for the Establishment of a Health Service Accreditation Bill (2009), that would provide the framework for health care quality and accountability. The Act would facilitate the institution of the Health Services Accreditation Council Trinidad and Tobago (HSACTT) which is a pre-requisite to the introduction of National Health Insurance. The MoH in its policy statements to inform legislation for the HSACTT identified that both RHAs and private hospitals must be complaint with this Act. The MoH made further recommendations in its document, that the state would not provide funding or enter into any arrangements for procurement with un-accredited health facilities. The financing of public health sector organisation is highly dependent on government funding therefore RHAs must deliver quality healthc are to access public funding and gain a competitive advantage. The World Health Organisation (WHO) has also set targets and key indicators to monitor quality of care in developing countries as part of their Millennium Development Goals (MDGs) 2015, examples such as the MDG (4) improved maternal healthcare and MDG (5) reduced infant mortality rates. The NCRHA has recently received negative publicity from alleged medical care negligence complaints regarding quality of maternal and infant care at their medical facilities. The MoH has mandated that a critical strategic issue for all RHAs is the improvement of maternal and infant health care; this is part of their efforts towards achieving MDGs target for Trinidad and Tobago. 1.5 Research Question: How can NCRHA use their Quality Management Strategy to deliver quality health care and gain competitive advantage? 1.6 Objectives: 1. To critically evaluate current Quality Management strategies used at the NCRHA to deliver quality health care to their customers 2. To ascertain any gaps by benchmarking current strategies against theoretical framework for TQM implementation 3. To design a framework for the implementation of a total quality management strategy for NCRHA 1.7 Aim: To synthesize a comprehensive Quality Management Strategy to enable the NCRHA to progress from a state of quality awareness to quality readiness, thus enabling NCRHA to improve quality health care and gain competitive advantage in the Public Health Sector. 2.0 Literature Review 2.1 Quality Management Defined: The concept of quality revolves around meeting and exceeding the customer expectation. The customers needs are ever changing and the demand for high quality requires a systems approach towards improved quality. The idea of quality management is not derived from one single source but is a collection of ideas that has been called by various names. According to lynch (2003) Total Quality Management (TQM) can be define as the modern strategic approach to quality management. ASQ (2006) has indicated that the term TQM has lost its flavor and in recent years has been subsumed under the term Quality Management. This can be further argued by Hannagan (2002) who suggest that the approach can be recognized by either title of TQM or strategic quality management. However it can be agreed that TQM is a strategic approach to achieving quality and a sustainable competitive advantage for an organization. There have been many theorists who have contributed to the quality movement and has also has infl uenced the TQM philosophy. 2.2 TQM Theories: TQM can be described as a management philosophy, characterized by a common set of principles, practices and techniques Dean Bowen (1994) however it tends to be examined by numerous authors from different perspectives. The perspectives of three main founding TQM philosophers or Quality gurus would be discussed and their supporting TQM methods. It is theorised by Crosby (1979) that quality is conformance to requirements therefore one arrives at the concept of zero defects. He also focuses on organisational factors such as leadership, culture and training. Deming (1986) was considered one of the founders of TQM his philosophy can be summarised in his fourteen management principles. These would include management commitment to quality; raise quality awareness, employee empowerment and training. The underpinning theory being that quality is a process and not a program therefore it should be ongoing in the organisation. Juran (1989) focuses on quality planning, quality control and quality improvement. There can be three levels of quality management defined which are strategic quality management, operational quality and workforce that concerns its self with work process (Juran 1989). The philosophies of these quality gurus can be summarised as a management system that involves management commitment for a customer focused organisation in which all employees participates in continual improvement. The system integrates the use of strategy, culture, training and effective communication to achieve TQM. 2.3 TQM Elements: ASQ(2006) identified essential elements to TQM that organisations must define either in their core values or principles on which the organisation operates. These elements would be discussed with the purpose of understanding the key concepts that must be considered in quality management implementation. An analysis of literature provides an exhaustive list of key elements however critical components would be discussed. While TQM is viewed through different perspectives what is written about TQM is based on a common set or sub-set of key components (Harris, 1995). The fundamental assumption of TQM is planning for the design and delivery of products and services that fulfil the needs of the customers (Dean and Bowen 1994). The customer ultimately decides whether the efforts are worthwhile. According to Waldman (1995) in order to create a quality culture all members of the organisation must be involved in the quality process. The involvement of employees in the quality process is critical to its success in the organisation. The formulation of a strategic plan which encompasses the systems approach to quality management is a core component. The TQM process is supported by continual process improvement in the organisation. All key activities in the organisation should be measured so that their improvement can be demonstrated and the benefits achieved. According to ASQ(2006) in times of organisational change, effective communication plays an important role in maintaining employee morale and motivation Training and education play a critical role in the TQM organisation, Juran (1986) postulates that training is required when undertaking a quality effort in an organisation in order to teach employees how to think about quality Figure 2 Elements of TQM in the organisation 2.4 TQM Implementation Approaches: The ASQ(2006) states that there is no one solution for implementing TQM for all situations therefore organisations TQM strategies would vary since culture, management practices are unique however the key elements discussed must be present in some format also there is a suggested generic model for implementation. Generic model for implementing TQM 1 Top management learns about and decides to commit to TQM. TQM is identified as one of the organisations strategies 2 The organisation assess current culture, customer satisfaction and quality management system 3 Top management identifies core values and principles to be used and communicates them 4 A TQM master plan is developed on basis of steps 1, 2 and 3 5 The organisation identifies and prioritizes customer demands and aligns products and services to meet those demands 6 Management maps the critical processes through which the organisation meets its customers needs. 7 Management oversees the formation of teams for process improvement efforts 8 The momentum of the TQM effort is managed by the steering committee 9 Managers contribute individually to effort through hoshin planning, training, coaching, or other methods. 10 Daily process management and standardisation take place 11 Progress is evaluated and the plan revisited as needed 12 Constant employee awareness and feedback on status are provided and a reward/recognition process is established Figure 3 Model for implementing TQM The review of literature on TQM revealed that an attempt towards TQM will not succeed unless the discussed elements are applied and maintained in the TQM strategy. There is extensive literature that provides an understanding of the ideal TQM program however more research is needed to determine how all its factors fit together to form a theory that provides a maximum understanding of what TQM really is (Waldrnan 1993). This is further supported by Powell (1995) that although TQM became part of business theory, its role as a strategic resource seems to have remained virtually unexamined in strategic management. 2.5 TQM in Healthcare: The issue of quality has become even more pressing for healthcare organisations. In a time of economic slowdown and financial constraints by government, the NCRHA is now faced with budget cuts and increased workload for human resources. There is a growing demand for quality in health care and for mechanisms such as quality management strategies and accreditation programs to maintain quality health services. The direct implications of poor quality in healthcare such as medication errors, increased infection rates and deaths are severe. According to Segonin (2005) developing countries are adapting quality management and accreditation standards in healthcare in order to work towards standardising healthcare services and to ensure high quality of healthcare for citizens. Vretveit (2001) suggest that some countries are conducting programs that consist of quality strategies and accreditation however little research is available to show evidence of efficacy. The available research on TQM im plementation in public healthcare systems in developing countries is sparse and provides anecdotal information. 2.7 TQM Healthcare Best Practices: The implementation of TQM in healthcare organisations is important for improving quality of clinical care to patients but also to satisfy accreditation requirements. Mayer et.al (1994) suggests benchmarking is the practice of regularly comparing oneself to other performing similar activities for continuously quality improvement (CQI). It is postulated by Campbell (1994) that until recently benchmarking has scarcely been used in the clinical setting primarily because of a limited knowledge of TQM methods and lack of support for initiatives. Underwood (1994) refers to a case study of Lloyd Noland Hospital continuous quality improvement initiatives in clinical management of pneumonia patients using benchmarking process with a TQM approach in an effort to achieve improved outcomes for pneumonia patients. The hospital formulated a cross functional team in order to successfully benchmark and develop a total patient care process. The team utilised quality tools such as brain storming, flowcharting clinical pathways, monitoring and documentation. The teams findings on the quality improvement process were clinical benchmarking is a TQM tool that attempts to improve patient outcomes which is a data driven TQM/CQI practice in healthcare that is current and a future reality. 2.8 Summary Based on the literature reviewed conducted thus far the researcher would attempt to critically assess the TQM practices at the NCRHA using the above theoretically implementation framework. The findings of this analysis would be synthesised and gaps would be identified. This data would assist in a design of a strategy for TQM implementation at the NCRHA. This study would provide fresh insights in the areas of total quality management in public health sector organisations in developing countries. 3.0 Research Design 3.1 Research Paradigm: Epistemology is concerned with what constitutes acceptable knowledge and the nature of knowledge itself (Saunders, 2009). In contrast ontology can be define as being concerned with the nature of reality and the assumptions the researcher have about the way the world operates and a commitment to a particular view (Saunder,2009). This study would be based on subjectivism epistemological or interpretative stance in that the researcher would be eliciting the views and opinions of senior management, operational managers, medical staff and support staff in the organisation. The researcher would adopt a phenomenological paradigm since it would require understanding the point of view of the research subjects.Considering the relatively new development of TQM research, in Trinidad and Tobago public health care as well as the applicability of private sector research, an inductive approach was chosen. According to Saunders (2009) inductive approach is particularly concerned with the context in w hich the event takes place. A qualitative approach would be followed since a case study research design would be adopted this is supported by Yin (1989) who advocates that variables under study cannot be manipulated but somewhat observed and data extrapolated from them. 3.2 Research Methodology: The exploratory approach was found to be most suitable for this study given the lack of research regarding TQM implementation in the public health care sector (Eisenhardt, 1989b). The utilization of a case study strategy is proposed to evaluate the TQM practices of NCRHA. The NCRHA constitutes three (3) tertiary hospitals, two district health facilities and fourteen (14) health centres, this research would be examining the sub-units within the organisation and an embedded case study would be constructed. This approach would give the researcher an opportunity to study and evaluate a phenomenon that few have considered. The design described would provide the advantage for real life issues to be brought to the forefront. The NCRHA was chosen for the case study since there are current TQM strategies implemented in the organisation. Once the organisations ethic committee gives approval for the research and the Quality Department Manager is informed a letter of request would be forwarded r equesting facilitation by the various health facilities Quality Coordinators (QC). The researcher would use a triangulation method since different data collection techniques would be used in this study to ensure the data telling what is being said. The combination of interviews, focus groups, archival documentation and observations techniques would be utilised by the researcher. There would be interviews conducted with senior managers and hospital administrator focused on TQM leadership and current status of initiatives. Documentation would be reviewed such as accreditation plans, quality plans and vision, mission of the company. Since TQM must have employee involvement a focus group would be administered to gauge employees awareness and observation would be conducted outside of these activities. Due to time constraints for this study a cross sectional studies would be conducted over a stipulated period time. Saunders (2009) postulates that cross sectional studies may be used in qua litative methods since many case studies data techniques such as interviews are conducted over a short period of time. 3.3 Research Technique/Method: 3.3.1 Data Collection: 3.3.2 Primary Data Sources: Interviews: The data source of this research would include semi-structured interviews with hospitals administrators and senior executive team. This approach was taken to allow the researcher an opportunity to explore necessary issues without inhibiting the interviewee to volunteer important information. Data would be collected on areas such as organisation leadership, culture and quality management systems for qualitative analysis. Documentation: Documentation would be reviewed from to verify involvement in TQM process. This would include accreditation plan, quality plans, vision and mission. Finally material substantiating a TQM initiative would be reviewed. These documentations would be sourced from quality department and CEOs office. Observations: There would be researcher observations conducted to find evidence of TQM such as posters, banners and customer service interactions. This would serve to corroborate the interview and documentation findings. Focus Groups: The researcher would conduct employee focus groups to obtain views on TQM implementation activities in the organisation since employee involvement and awareness is critical to its success. These groups would be interviewer-led structure and kept to 6-8 persons to allow for moderator /researcher control to maintain focus. This technique would be conducted several times with similar participants to establish trend and patterns for data collection and analysis. 3.3.3 Secondary Data Sources: The literature review for this research proposal thus far used several secondary data sources. This data was assessed for authority and reputation of the source. The review of written materials from industry experts or gurus, journals, organisations records and government publications would be accessed and referenced as part of this study. This approach would allow for more time for analysis and interpretation of data. 3.3.4 Sample size and sampling method: Since a case study approach was taken the use of non-probability sampling would be applied by the researcher so that sample selection can be made based on subjective judgement. This view is supported by Saunders(2009) that within business research such as case study this may either be not possible or appropriate for answering the research question. The use of purposive sampling technique would enable the researcher to use judgement in selecting cases that would enable the research question and objectives to be answered. According to Saunders (2009) is form of sample is often used in case study research and when a selection of cases would particularly informative. It is also further suggested for a general study a suitable sample size of between 25 to interviews are undertaken (Creswell 2007). 3.3.5 Data Analysis: A qualitative analysis on this data would be conducted, this would require the condensing, categorising and also restructuring as narrative to support for significant analysis to be derived. The interviews with respondents would be audio recorded and reproduced via word processing. It would also be noted during transcribing the tone and non-verbal communication of the participants. A process of data sampling would be used to reduce time for audio transcribing since this would allow for the researcher to list sections pertinent to the study. The interviews conducted would be saved in separate word documents and filename maintained for confidentiality. The recommendation by Silverman (2007) on list of useful transcription symbols would be used for this study. The precise work format for NVivo software would be utilised to ensure accurate analysis can be conducted. 3.3.6 Qualitative Analysis: Analytical induction approach was adopted since it would allow for an intensive explanation of the case study so as to empirically establish the causes of a specific phenomenon (Saunders2009). This would be most appropriate since the researcher case study sampling took a purposive approach which would allow for the phenomena to be explored. The use of thematic analysis would be utilised to identify data that relate to classified patterns these would be catalogued into sub-themes for emerging patterns. This would lead to building a compelling argument derived from the literature reviewed. 3.3.7 Ethics: Research ethics is the defined as a question of how we formulate and clarify our research area, design, gain access to data and write up our research findings in a moral and responsible way (Saunder2009). The researcher proposes the following ethical issues during this study. The researcher would have to submit a research proposal for approval from the NCRHA ethics committee before this study can be conducted. Informed consent would be solicited from participant for possible privacy and confidentiality issues Participants would be informed of its voluntary nature and the right to withdraw from the process. The data generated during this study would have transcript symbols to maintain confidentiality The researcher would be cognisant of the ethical concerns with regards to qualitative research since objectivity must be observed during analysis so the data is not misrepresented. 3.3.8 Reliability and Validation: Validity in research must be considered when conducting a case study research since it is concerned with whether findings are really what they appear. The researcher must be careful of generalisabilty particular when the case study is conducted in one organisation (Saunders2009). The research design for this study incorporated triangulation so that different data techniques can be used within one study which allows for cross verification. The researcher would also consult peer consultation prior to final draft of the report. According to Yin(2003) construct validity is especially problematic in case study research and it can be a source of criticism due to its subjectivity it is further recommended the use of case study protocol to achieve reliability. The researcher prior to data collection would develop a case study protocol that includes more than one survey instrument and procedure to be followed in using the instrument. 3.3.9 Limitations to Methodology: The researcher may not provide a representative population for the case study. This research methodology can be time consuming and costly There is a potential for researcher bias during the study The study in also reliant on subject participation in the research data collection 3.3.10 Resources Required: This study would require a number of resources such an audio recording device for interviews, purchase if NVivo software, internet and computer capabilities to complete this report. There would be a need to access secondary data such as journals, written text and peer view materials for further literature review. 4.0 Plan The research study would require an ongoing literature review and write-up as the study progress. The research proposal would require ethics approval from the organisation and university ethics committee this would be key milestone in this project. The appointment of dissertation supervisor and the gathering of resources for this research should be completed. The planning of interviews, focus groups, documentation reviews have some schedule over lap since meeting with senior managers would require some coordination. Due to the time consuming process involved in qualitative analysis the researcher would plan to conduct most interviews with-in a 4 weeks time frame The collation of data would be concurrent since interviews would be transcribed after being conducted. The data analysis would be key milestone in the project since critical analysis would be required for this study. The researcher would aim for a completed draft six weeks before submission to allow for editing and additional research work. This would allow supervisor review and approval prior to submission. Please attached Gnatt chart of activities and timescales. 5.0 References American Society for Quality, 2006 the Certified Manager of Quality /Organizational Excellence Hand Book. 3rd Ed. Russell T. Westcott Crobsy, P.B. (1979). Quality is free. New York: Mc Graw Hill Creswell, J. (2007) Qualitative injury and Research Design: Choosing among Five Approaches 2nd Ed. Thousand Oaks, CA: sage Dean, James and David Bowen (1994). Management Theory and Total Quality: Improving Research and Practice through Theory Development. Academy of Management Review, (19:30) 392-418 Deming, E. W. (1986). Out of the Crisis. Cambridge, MA, MIT Center for Advanced Engineering Eisenhardt, K. M. (1989b). Building theories from case study research. Academy of management Review, 14, 532-550 Hannagan, T., 2002 Management Concepts and Practices. 3rd Ed. FT Prentice Hall Harris, C.R. (1995). The Evolution of the Quality Management: An Overview of the TQM Literature. Canadian Journal of Administrative Sciences, (12:2), 95-105 Juran, J. M. (1989). Juran on Leadership for Quality: An Executive handbook. New York: The Free Press Lynch, R., 2003 Corporate Strategy. 3rd Ed. Harlow: FT Prentice Hall Ministry of Health, Quality 2001 A Reality, A strategy for implementing and monitoring a continuous Quality Improvement Programme for the Health Sector in Trinidad and Tobago, Original Draft-May, 1997, Ratified by HSQC- March 1998, Ministry of Health Government Printer 1999 Ministry of Health, Regional Health Authorities (RHAs) Act No.5 1994, Ministry of Health, Government Printer Ministry of Health 3rd Draft Adverse Events Policy and Guidelines, Directorate of Quality Management, January 2011 Ministry of Health March 2009, White Paper for the establishment of the Health Services Accreditation Council of Trinidad and Tobago Saunders, M., (2009) Research methods for business students. 5th Ed., FT Prentice Hall Segouin, C. (2005). Globalization in Health Care: Is International Standardization of Quality a Step Towards Outsourcing. International Journal for Quality in Health Care, 17 (4), 277-279.Shin, Y.S. (1995). Hospital Accreditation A Universal Perspective. World Hospitals,.31 (1), 22-28 Silverman, D. 92007) A Very Short, Fairly Interesting and Reasonably Cheap Book about Qualitative Research. London: Sage The Peoples Partnership Governments Seven Development Pillars (Pillars 1, 6), 2010 Prosperity for all manifesto of the PP for United People to achieve sustainable development for Trinidad and Tobago Waldman, D. A. (1993). A theoretical consideration of the leadership and total quality management. Leadership Quarterly, 4, 65-79 Yin, R. (1989). Case study research. Beverley Hills, CA: Sage Publications Yin, R.K. (2003) Case study Research: Design and Methods 3rd