Friday, May 31, 2019
World War I was a very complicated war. It goes back as far back as 1870. Of course the was didnt last for that many years, but it had many casues. Not just one spark that started it off. The Franco-Prussian War was one of these casues. at that place were sevral Franco-Prussian Wars. The last Franco-Prussian War started in 1870. Prussia was in a confederation. A confederation is a group of states that are loosly joined together and have more effect than the government of the whole country. Prussia was the biggest state. France and Prussia always fought over Alsace-Lorraince. It was land with very rich soil. It was on the border between France and Prussia. They kept fighting over the land. One sequence Prussia would win and would take the land. The the next time France would win and would take the land. This kept happening, but in the last war, which started in 1870, Germany finally won Alsace-Lorraine. They signed a treaty in Versailles, France. The Franco-Prussian War ended in 1 871. After the Franco-Prussian War, Bismarck, who was Prussias leader made the unification of Germany. That meant that all the separate states joined together to be one counrty. After this, Bismarck became the leader of Germany.After the Franco-Prussian War, France was afraid that Germany would attack France for more land. So then France started building up its armament so that Germany wouldnt attack. Germany wanted a war. This caused the six stronge countires in Europe to start building up their armies and get ready for the war. The six stronge countries were England, France, Germany, Austria-Hungary, Russia, and Turkey. both of these countires were compeating to be the strongest. Russia and Germany did not get along. Russia, too, was afriad Germnay would attack, so Russia started to build up its army to make Germany afriad. Russia and Austria-Hungary also didnt get along. Austria-Hungary was afriad Russia would attack so they started to build up their army to intimidate Russia. Turkey didnt get along with Austria-Hungary. Turkey saw that Austria-Hungary was building up their army, and that frightened Turkey, so they started building up their armies to scare Austria-Hungary. All of thse countries were compeating to be the best and the strongest. This is an example of militerism and nationalism. Nationalism is a deep feeling of pride for ones country with a desire to prove that its better than all other countires.
Thursday, May 30, 2019
The palace of Versailles was built by Louis XIV of France (1643-1715), and the Escorial was built by Philip II of Spain (1556-1598). By examining the aery and frontal facades of these dickens palaces, it may be seen that there were many similarities and differences between the two nances perception and practice of monarchy. Each king set his own goals for his life, and conclude as to how a monarch ought to behave. Both Louis XIV and Philip II had religious duties to pay attention to, organized the distribution of power in their respective kingdoms, communicated with otherwise countries and entities through war and diplomacy, raised militaries, and made plans for the expansion of their own beliefs, thoughts and practices. Aside from these aspects of the two kings beliefs and practices of monarchy, the architecture of their palaces reflected their ideals, or personal beliefs, and the interpretation made by the painters of the palaces reflects the attitudes of the two kings toward life.The role of the king to the public during the reigns of Louis XIV of France and Philip II of Spain were not predetermined, so each king created for himself what he thought monarchy ought to be. Louis XIV and Philip II were both absolutists, and believed that they should be the supreme rulers of France and Spain, respectively. However, Louis XIV did not want to be a national symbol serving no legitimate purpose. He wished to control the military, economy, foreign affairs, and the memorial tablet of the kingdom and of justice. He believed that the king of France should be the best that France has to offer- being served by even the most powerful lords of France. Conversely, Philip II thought of himself as Catholic first, and king of Spain second. Opposite to Louis XIV, Philip II preferred to sit in the Escorial and pray, pour over records, and live more as a monk than as Louis XIVs conception of a king. Philip II never treasured to take much of an active part in the administrat ion of his kingdom, except for the times when he wanted to use some of his various powers. However, after he had used it for a while (waging war, raising taxes, etceteras) he would let it lay dormant and return to his documents. Nor did Philip II ever wish to control most of the Spanish economy. The parts that he did control were ones that directly affected himself or his revenues, so vital in evidence to keep his army of immense proportions.
Wednesday, May 29, 2019
World War II and the diseased mind of Hitler were the factors the led to the Genocide. People who were not the superior black market in Hitlers opinion did not deserve to live. Jews were the target of the extermination. To establish his plan Hitler created Concentration Camps, where people were forced to work. Those that were considered useless became fuel for the gas put up and crematory. Hitlers long term goal was to wipe out all the Jews. In the novel, Night, by Elie Wiesel, the author retells the unforgettable hardship and suffering that he goes through and through while he is in the concentration camps. In this novel, Elie helps us realize and visualize the brutality and madness of the camps and SS officers. His struggle for survival and the horror that he is heart-to-heart to changes his life forever. Elies experiences at the camp have a dramatic impact on his opinion, his relationship with his father and his innocence.Never shall I forget those flames which consumed my fa ith forever. Never I shall forget the nocturnal silence which deprived me, for all eternity, of the desire to live. Never shall I forget those moments which murdered my theology and my soul and move my dreams to dust. Never shall I forget those things, even when I am condemned to live as long as God Himself. Never. By reading this quote you give notice hear Elie Wiesel anguish and what an impact concentration camps had on his faith. Before he was exposed to other mans madness and brutality he had faith in God and lived for him. He ...
Personal Narrative- Victim of RobberyMy story started about a week ago. I was heading to bed early, because I was tired from a long day with plans to wake up a few hours before associate to review for a test. As I closed my books for the evening and headed to bed around midnight, humble did I know something was going on outside. A little later that night someone entered my garage, which was so conveniently unlocked. They first rummaged through my dads van outside and I think they stole his coat, a tape and a few rolls of film. They also sifted through my moms car looking for something to steal, only to find a few motivational tapes. impress enough they passed those including one on Getting Rid Of Guilt. When they got into my car however, they immovable to take most of what I had. They stole my CD player, taking part of my ardour with it. They also took most of my CD collection and the liner to my new Columbia coat. They even took my flashlight. They then vanished as quickly as t hey had come. My mom woke me the following morning. She had decided to bring me breakfast in bed...
Tuesday, May 28, 2019
eBayFounded in family 1995, eBay has become a powerful marketplace for the sale of goods and services by a passionate community of individuals and small businesses. eBay is an online auction house where anyone in the world can log and deal or sell goods through an auction. Today, the eBay community includes 18.9 billion registered users, and is the number one most popular shopping site on the Internet when measured by total user minutes according to the Media Metrix September 2000 web report.eBays Mission eBay helps people trade practically anything on earth. eBay was founded with the belief that people are basically good. They believe that each of their customers, whether a purchaser or a seller, is an individual who deserves to be treated with respect. eBay will continue to enhance the online trading experiences of all - collectors, hobbyists, dealers, small business, unique item seekers, bargain hunters, opportunist sellers, and browsers. The growth of the eBay community c omes from meeting and exceeding the expectations their customers.eBays Market In 2000, the eBay community transacted over $5 billion in annualized gross merchandise sales (value of goods traded on the eBay site). eBay is not just a place for collectibles, beanies and Pez dispensers. On any given day, there are millions of items listed on eBay across thousands of categories. People come to eBay to buy and sell everything from the practical, unique, and interesting - such as automobiles, jewelry, musical instruments, photographic equipment, computers, furniture, and sporting goods. With the recent acquisition of Half.com, eBays community now benefits from a marketplace combining tralatitious auction style trading and fixed-price trading. eBay enables trade on a local, national and international basis. It features a variety of specialty sites, categories and services that aim to provide users with the needful tools for efficient online trading. eBay International eBay is truly a global marketplace, where individuals worldwide are coming together to buy and sell from one another. It is not uncommon to collar about eBay users in Japan buying items from users in the U.S., or users in Australia buying from others in France. Users on eBay represent over 150 different countries. With eBays deal and global business strategy, the company will continue to expand its service and brand abroad. Currently, eBay has country specific sites in the United Kingdom, Canada, France, Germany, Japan and Australia.
eBayFounded in September 1995, eBay has become a powerful marketplace for the barter of goods and function by a passionate community of individuals and small businesses. eBay is an online auction house where anyvirtuoso in the world can log and buy or snitch goods through an auction. Today, the eBay community includes 18.9 million registered exploiters, and is the number one most popular shopping site on the Internet when measured by total user minutes according to the Media Metrix September 2000 web report.eBays Mission eBay helps people trade practically anything on earth. eBay was founded with the belief that people are basically good. They moot that each of their customers, whether a buyer or a seller, is an individual who deserves to be treated with respect. eBay will continue to enhance the online trading experiences of all - collectors, hobbyists, dealers, small business, unique(p) item seekers, bargain hunters, opportunistic sellers, and browsers. The growth of th e eBay community comes from meeting and exceeding the expectations their customers.eBays Market In 2000, the eBay community transacted everyplace $5 billion in annualized gross merchandise sales (value of goods traded on the eBay site). eBay is not just a place for collectibles, beanies and Pez dispensers. On any given day, there are millions of items listed on eBay crossways thousands of categories. People come to eBay to buy and sell everything from the practical, unique, and interesting - such as automobiles, jewelry, musical instruments, photographic equipment, computers, furniture, and sporting goods. With the recent acquisition of Half.com, eBays community now benefits from a marketplace combining traditional auction style trading and fixed-price trading. eBay enables trade on a local, national and international basis. It features a variety of specialty sites, categories and services that aim to provide users with the necessary tools for efficient online trading. eBay Int ernational eBay is truly a global marketplace, where individuals worldwide are coming together to buy and sell from one another. It is not uncommon to hear about eBay users in Japan buying items from users in the U.S., or users in Australia buying from others in France. Users on eBay represent over 150 different countries. With eBays vision and global business strategy, the company will continue to expand its service and brand abroad. Currently, eBay has country specific sites in the join Kingdom, Canada, France, Germany, Japan and Australia.
Monday, May 27, 2019
In what ways has Surrealism influenced behavior, and how successful be the results? You will bring to include banter of two examples. By likeability 1. What is surrealism? Surrealism is destructive, but it destroys only what it considers to be shackles limiting our vision. Young Night Thoughts are surrealist from cover to cover. Unfortunately, it is a priest who speaks a bad priest, to be sure, yet a priest. Heraclites is surrealist in dialectic. Lully is surrealist in definition. Flame is surrealist in the night of gold. Swift is surrealist in malice. Shade is surrealist in sadism. Carrier is surrealist in drowning.Monk Lewis is surrealist in the hit of evil. Chin von Arming is surrealist absolutely in space and time Rabble is surrealist in death. Baudelaire is surrealist in morals. Rumbaed is surrealist in life and elsewhere. Harvey Saint-Deny is surrealist in the directed dream. Carroll is surrealist in nonsense. economise is surrealist in pessimism. Serrate is surrealist i n figure. Picasso is surrealist in cubism. Bach is surrealist in me. Rousseau is surrealist in anecdote (And Breton, 1934, A lecture given in Brussels on beginning(a) June 1934 at a public seemlying regained by the Belgian Surrealists, http//home. Lb. AC. UK) Surrealism is based on the belief in the superior reality of certain counterfeits of previously unheeded association, in the omnipotence of dream, in the disinterested play of thought. -Andre Breton In the sass, the world was going through one of its on the whole time IoW phases. There was war, or worse, the fear of war, the impostureists who had been break up as the result, (who were earlier based in Paris of other cities) became of the mindset that it was the overly rational thinking, the so called high rationale of human mind that had brought upon this war.This resulted in an godlike thought that led to a revolution. Thus the idea to follow the unconscious mind arrived, no matter how bizarre its ideas whitethorn se em. The word Surrealism was invented in 1917 by Gallinule Billionaire, and adopted by fellow French poet, And Breton, in 1924 to describe a radical movement of artists and writers, who drew on their subconscious to depict a heightened or super-real vision of the world. (The Surrealist dressback in design, Alice Rawson, The New York times, March 25, 2007) Perhaps this is a little hard to understand, but one of the break throughgo examples to describe owe a surrealist thinks is a Salvador Dali quote when asked do you take drugs, he answered, to the interviewers bewilderment, l do not take drugs. I am drugs. The man who commercialese the surreal Salvador Dali Salvador Dali take no introduction to anyone who has even remotely studied art. Not only was Dali a tremendously gifted painter, but in any case a designer, photographer, thinker and an surpassing witty writer.His autobiography The secret life of Salvador Dali gives a very good insight into his thought process and his ide as. He was one of the first artists who brought the idea of surrealism from paper (And Breton was a poet) to the visual arts, thus making it commercial and marketable. According to many, the idea of making surrealist art commercial was against the idea of surrealism. But as the history goes, the artists who had surrealist themes were very successful in the later sasss.The surrealist ideas were incorporated into mien when Salvador Dali famously collaborated with the Italian designer Else Capillaries. The collection consisted of Lobster Dress Lobster Dress was a simple white silk change surface dress with a crimson waistband featuring a large lobster painted (by Dali) onto the skirt. Tears Dress The Tears Dress, a slender pale blue flush gown printed with a Dali design of tromped Leila rips and tears, worn with a thigh-length veil with real tears carefully cut prohibited and lined in pink and magenta. skeleton in the closet dress skeleton dress was a stark black crepe dress which used transport quilting to create padded ribs, spine, and leg bones. habilitate hat the shoe hats were a particular sensation, hats that were the underside of heels on the top. Before Salvador Dali, many artists had already put forward surrealist deeds, and though not many are worthy of being mentioned in the name breath as Dali, some of the noticeable ones are Giorgio De Chorizo (1888-1978) Chorizos proto(prenominal) paintings were perhaps a vital key in the development of the surrealist style of painting.Characterized by images of empty town squares, suspended corridors and macabre ghost town like depictions of streets and town squares looked like his imagination of a stockpile war era and were full of a sort of haunting loneliness and grim. Cluttered with puzzling objects, such as clocks, giant statues and distant trains, and often featuring deep, melodramatic perspectives, De Chorizos paintings left an indelible mark on Breton and numerous other future Surrealists. Among his works from this early Metaphysical period are The Enigma of the Arrival and the good afternoon (1912), The Anxious Journey (1913), The Nostalgia of the Infinite (1913), Mystery and Melancholy of a Street (1914) and The Childs Brain (1914). By the time of the first Manifesto of Surrealism, De Chorizo had moved on to a far more classical approach, much to the chagrin of Breton. He participated in Surrealist activities up to 1925, contributing to the periodicals Liltreturn and La Rvolition morosenessaliases, as well as eater writing a Surrealist novel Hobbyhorses in 1929.Rene Francis Emigrate Some people say that it was the haunting memory of his catch who attached suicide when he was 14 years old. It is said that he witnessed her face covered by her dress as she was pulled out of the water (she committed suicide by throwing herself in a nearby river) the haunting symbolism remained an inspiration for him, even for his famous work Less Aments. Let us come back to the point in history when the surrealist movement that And Breton had started as a rebellion for poets had captured the minds of designers and as successfully incorporated into fashion by a senile Spaniard.After the collaboration of Dali and Capillaries, many designers tried surrealism as a theme but only a few were successful as a whole. Fashion and surrealism The fashion object could be a most powerful force in the simultaneous deconstruction of the figure and remembrance of its presence that inevitably dwells in the garment. on the nose as music could be envisioned as both an abstract form and physical presence, so too the biomorphic abstractions that characterize much Surrealist art ready their way into the free forms of dress and the definition of the unman being as an abstract flow among units of the body.The creation of illusion gives to clothing the enough implications of narrative and secret to occur as a function of dress. According to the influential Surrealist gallery owner Ju lia Levi, Else Capillaries was the only fashion designer to interpret Surrealism successfully. From the starting of her Paris discover to its closing, Capillaries reconciled fashion an art, by interpreting the modern aesthetic and then Joining forces with artists who were at the time highly forward in their time. Such out of such her collaboration with Salvador Dali is a reorient one.To be dressed by Capillaries was to acquire confidence and chic, whether one was beautiful or not. Schizophrenias fashion philosophy was grounded in classical mythology, particularly Ovid and the Pygmalion myth, and its stories of magical transformation and metamorphosis, themes withal explored by the Surrealists. Her fashion was not only surreal and unique but also easy to break away and very feasible. Because she was able to make this renewal and bring the surreal in the real world not only in theory but also in clothes that could be work in a casual manner along tit a style statement that associa ted a soulfulness with the surreal movement.It is not a less known fact that she inspired one of the jumper cable fashion designers of our time, the late Lee Alexander Macaque who had a fail case or Luggage in his shop that was visibly inspired from Schizophrenias skeleton dress. In the sasss, transformation was symbolized by the butterfly. Schizophrenias collection of the 1938 Exposition International du Surrealism, and it include two of her most notable collaborations with Dali, the Skeleton Dress and the Tear-Illusion Dress. Dali andCapillaries collaborated again in 1937 on the Lobster Dress, which simplicity of the white dress is belied by the erotically charged stead of the lobster on the front of the skirt, a symbolism possibly lost on the wearer. Images relating to the fashion industry, such as sewing machines, irons, dressmaker forms and mannequins, played a leading role in the surrealist theatre. During the sass Surrealism helped to liberate fashion form more dressmakin g and realize the dream of the marvelous. In the words of Ameri seat Fashion Historian Richard Martin, Surrealism corpse fashions favorite art. Surreal thing, Glassine Wood, 2007). Some of the latest manifestations of Surrealism are screamingly commercial. Take the tromped ODell hoarding at 39 Avenue George V in Paris, where a construction site is padded by an eerily realistic image of a Serialized 19th-century apartment building whose structure ripples like water. Or the tops-truly boutique of the Dutch fashion designers Victor & Roll on Via Sandpapered in Milan, which is literally built upside down, with a floor that looks like the ceiling, and vice versa.You can also spot Surrealisms influence in more thoughtful design projects, like the provocative, lightly sinister work of the young product designers, such as the Swedish group, Front, and Dutch duo, Studio Job. Oscillating from Serialized commercialism to a considered reinterpretation of the original Surrealist spirit reflects the central theme of the V&A show. It examines the ambiguity of Surrealisms relationship with commerce, and the tensions that developed during its transition from an avian garden art movement in the sass to a commercial design style from the sass. (The Surrealist comeback in design, Alice Rawson,2007) But the question system is surrealism successful in fashion industry? Let us take the example of the late Lee Alexander Macaque. His work would probably one of the best examples of surrealism in fashion that was widely popular in the last few years and arguably still is. Macaque, famous for collaborating with Lady uncivilised had once quoted that she was his wildcat muse. Lady Gaga officially unveiled her Bad Romance single at Alexander Unseens Spring/Summer 2010 runway show during Paris Fashion Week.Although Gaga wasnt in attendance, her presence was certainly felt as her hit song streamed over the speakers during the encore of all the looks that Macaque had showed off. But was La dy Gaga the first surrealist design corrosion pop icon? No. At the presentation of a new surreal collection of designer Jean-Paul Guiltier dean Paul Guiltier) gathered all the secular Paris, as well as fans of millionaire-style Guthrie from around the world. At the show in the front row along with influential politicians, financiers and other celebrities turned out to be only one woman Madonna.Madonna and Jean-Paul Guiltier share the same relationship Lady Gaga did with Macaque since before Lady gaga was even playing the lightly and scaring her babysitters by turning up naked before them. Macaque owned the tarnish Alexander Macaque which was later bought by Gucci, with Macaque serving as a creative director. The same collection was also famous for models with bizarre make up and surreal outfits. This show was so successful that it crashed the networks servers. This could be called one of the greatest achievements in surrealist fashion by a designer.Perhaps the most famous of hi s famous surrealist works are his signature high heels. Macaque, 40 at the time of his death can be labeled the most famous and the best example of designers inspired by surrealism in their work. Viviane Westwood Dame Viviane Westwood popularity constantly gains momentum. Her punk attitude is more alive in the Naughtiest than incessantly and her outspoken, Union Jack waving Englishmen (with a few added safety pins and tea stains), is undiminished. It is fitting that the Establishment has recognized her work by making her a Dame.Viviane Westwood fashions older stateswoman that many wish to emulate, with her younger husband Andrea Chronicler and energy for shaking things up whilst keeping her feet on the ground seems to only recruit admirers. Cutting perimeter but lassie, she is unflinchingly rooted in what matters, whether it is human rights or classical fiction. No trendy noise for her, Just cleavage, mischief, and CAPITAL LETTER MESSAGES such as sasss l AM NOT A TERRORIST, plea se dont arrest me baby -r- shirts. Her first catwalk show was presented in 1981, featuring the collaboration of Westwood and McAllen. The theme that year was Pirates.Subsequent Westwood theme titles in the early years included Savage (1982), Buffalo Girls (Autumn/Winter 1982-83) and Clint Eastward, (Autumn-Winter 1984-85) under the Worlds Ends Label he stopped producing the line in 1985 to concentrate on her Viviane Westwood Lines. Viviane Westwood says (Sometimes you need to transport your idea to an empty landscape and then populate it with fantastic looking people. ). She dubbed the period 1981 to 1985 New romantic and 1988-1991 The Pagan Years during which Viennese heroes changed from punks and ragamuffins to Taller girls wearing clothes that parodied the upper class. The period from 1993 to 1999 she called Megalomania and from 2000 to the present Exploration (vogue, 2007) Viviane Westwood has always been a fan of surrealist work and is herself a punk. It is also a known fact t hat her ex husband was the manager of the sex pistols and they were also associated with surrealism in music. The future of surrealism in fashion upcoming designers such as Yang Du Surrealist fashion designer Yang Du established her brand Yang Du in London in 09 after studying in the central Saint Martins College of art and design, and working for designers such as Viviane Westwood, John Gilligan, and Giles Deacon.It is evident in her work that she is a former artist and a fan of surrealism and impressionism. Her work is ultra hip, very colorful and can be seen as a flux of post modern and impressionist. She is especially fond of animal prints, painting animal faces on dresses, and using models with bright makeup although a notch less vivid than Alexander Macaque. Unlike most surrealists Yang Duds inspirations are less controversial. She stated that she gets her inspirations from her travels. These have included India and Ecuador.Her latest design includes a cactus hat that has a ctual spines in the top. In the new winter collection, the colors were pastel with animal prints along the dress line. When asked about her design ideology in an interview, she said My ideology I am ere open-minded to new things, and mostly, look at things from a very different angle. I often go on trips, where I take lots of photos and meet lots of people. When I come back to London, I always have so much in my mind, some of them like stories which I really requirement to share through the clothes I design. (Amelias magazine, 2009) Surrealism in fashion photography Although surrealism is apparent in fashion, it is even more so in fashion photography. It would be almost worthless for a designer to create a design which looked surreal if the photographer couldnt capture the thought of the designer. Fashion photography thus can be called as a way to express surrealism in fashion. Also fashion photography can be used to make a regular collection surreal. One of the authors best photo graphers is Toshiba Canoe who in her career (1950-1960) made hundreds of collages, and quit the profession after married.Her photography is inspired by surrealist painters such as Giorgio De Chorizo, Max Ernst, Joan Mir, and Francis Pica. It is apparent that she did all her work from an out of the world prospective which is one of the reasons that her pictures though surreal look very believable, and honest. Some of her famous works are the horse and the bride in the sea and the bride on the door. Conclusion The surrealist movement changed many aspects of art. No other visual art was the same after the surrealist movement.Surrealism is that form of art which believes in anything that the subconscious mind can conjure up. It is the way of life for great minds like Salvador Dali who dreamed more than they breathed. In the fashion industry, it was a huge step when Salvador Dali collaborated with Capillaries not only because it lead to two of the most talented minds of the generation to come soother, but also because it opened the door for surrealist art to come in the field of fashion and blossom.And so it did. The careers of Alexander Macaque and Viviane Westwood are a testimony to this fact. And as for the future, the designers like Yang Du are taking forward the legacy and continue to inspire the people with their surreal work that one knows to be untrue but is still forced to think twice. And that is the beauty of the surreal art. It may be argued that the surreal art like most others will one day be obsolete and out of fashion but it is also ever changing.
Sunday, May 26, 2019
At the start of the play, Macbeth was portrayed as a heroic and stouthearted man. He created this image for himself by fighting long and hard in the fag of Scotlands battle. The King of Scotland (along with all his passel) was truly impressed with Macbeth. He was rewarded for his efforts, world presented with the title of the Thane of Cawdor. After the battle, he and Banquo were out riding when they bumped into a group of incredibly strange women that had a strange aura of power roughly them (the witches). It was hither that Macbeth was confronted with the prophecy that someday he would sustain King of Scotland.There were many reasons Macbeth could become King without murdering anyone the current king could die, renounce his throne and appoint Macbeth as King, or Macbeth could overthrow him. Macbeth did indeed think for a while that he could become King without murdering anyone. If chance will founder me king, why chance whitethorn crown me without stir. There were a lot of reasons why Macbeth was reluctant to murder King Duncan. For a start, he was a good King. He had been treating Macbeth very well, showering him with value and rewards. The King wasnt the only one who thought highly of Macbeth. The people of Scotland also held him in high regard.If he killed or tried to kill the King and got caught, his reputation would be gone. The final reason he had for not murdering King Duncan was that he was his host, and he should be protecting not endangering him. These reasons were all forgotten when Macbeths wife, Lady Macbeth, convinced him to murder King Duncan. She told him straight out that he wasnt a real man if he didnt do this. She was obscure in the murders both by convincing Macbeth and by drugging the men who stood guard in front of the Kings sleeping chambers. King Duncans sons feared that later their father was murdered, they would be next.They were very wary of everyone, and wanted to leave the castle as soon as possible. Banquo strongly su spected Macbeth was involved in the murder. He had also hear the witches prophecy, and he feared that Macbeth had played foully to make the prophecy come true. Meanwhile, Macbeth was shocked by what he did. He wondered whether in cleanup King Duncan he had not make the position available to himself, but to others. The prophecy played heavily on his mind, and he wondered whether he had now made the Crown available to children that are not his, namely Banquos.Macbeth decided to kill Banquo and his son Fleance for more than one reason. The major reason was the prophecy predicted that Banquos children would become kings. By killing Banquo and his son, he would be able to prevent Banquo from having more children and stop Fleance himself from becoming King. The other more minor reason was that Macbeth thought that Banquo was singular of him, and he was worried that Banquo would tell someone or act on his suspicions. Macbeth didnt tell Lady Macbeth about what he was planning to do becaus e he thought his wife would think that it would upset their plans.The appearance of Banquos ghost made Macbeth very scared and worried, it definitely made him appear incredibly dysphoric to all the people around him. Macbeth then decided to go to the witches. He had become caught up in events and felt he had lost control of the situation. He desperately wanted to know what was going to happen next.This did help him a bit, or so he thought, because he knew more about what was going on. This was ascribable to three new prophecies made by the witches Beware Macduff, No fear until Birnam Wood come to Dunsinane Hill and finally No man of woman born(p) can harm you. After hearing these prophecies, Macbeth felt much more confident. He scoffed at the idea that a wood could climb a hill, and after hearing that no man of woman born can harm you, the only thing he felt threatened by was Macduff.Since he was a threat, Macbeth wanted to kill Macduff ( vertical like everyone else who had been a threat to him). But he couldnt get to Macduff, so instead he killed everyone that Macduff loved and destroyed everything that he cherished. As expected, this had a very negative affect on Macduff. Macduff most(prenominal) likely wouldve preferred to have been killed himself.Lady Macbeth at the end of the play was very different from the composed lady at the start. Her guilty conscience had gotten to her, and by the end of the play she was a guilty, stuttering mess. She began admitting to some of the terrible deeds she had done. Finally she just couldnt take it anymore, and committed suicide. Macbeth kept on going because he thought that the prophecies would protect him. He figures hes killed so many people he might as well give going. Finally, he didnt want to look weak in front of everyone and he wanted to keep his honour.The witches were the starting point and basis for all the murders Macbeth committed. No matter who he killed, it could always be linked back to the witches a nd their prophecies. They were the ones who first put the idea into his moderate about becoming King of Scotland. Lady Macbeth also played a major part in him becoming a murderer. When he was undecided about whether he was going to kill King Duncan, she urged him on until he finally made the decision to kill him. This first murder resulted in all concomitant deaths. Nevertheless, Macbeth wasnt forced to kill anybody.He has to take some responsibility for his actions. If he was not so egotistical and keen to hold power, the witches prophecies would not have has such an effect on him. Macbeth was obviously responsible for all the murders, and Lady Macbeth played her part in them too, but I think the people most responsible for the murders were actually the witches. Before he met them, Macbeth led a perfectly normal life, free of any thoughts of treason or murder. But when he met the witches they deep-seated all sorts of thoughts into his head via the prophecies.He wouldnt have thoug ht of being King of Scotland, let alone killing the current King, if he hadnt heard the prophecy about him being King. He wouldnt have killed Banquo and attempted to kill his son if the witches hadnt told him that Banquos children would one day be kings. Macbeth wouldnt have ordered that Macduffs family be killed and his household destroyed if the witches had not told him to beware Macduff. Therefore I think I can safely think that the witches were the ones who were most at fault for the murders, and for the downfall of Macbeth.
Saturday, May 25, 2019
Most of the names sh asideed out may be random, but Abigail has a vengeance to settle. This is why Elizabeth admonisher is later called to trial. Act One doesnt show Abigail shouting out Elizabeth Proctors name because it would ruin the climax when Elizabeth must go. It would make it off the beaten track(predicate) too obvious and the audience would be expecting it. Even though confusion runs high in this act, Miller manages to slip in a few main(prenominal) and easily understood facts, much(prenominal) as who has a grudge against who and why they bear that grudge.Some of the grudges are quite complex and are over compound matters such as Abigail disliking Elizabeth Proctor. This grudge is quite complex because it is mixed up in the fact that Abigail is jealous of Elizabeth for being John Proctors wife. Others, such as Thomas Putnams grudge against Rebecca Nurse are quite simple. These grudges manage to affect justice later on in the play, because everybody is just out to settle a personal score. Act one is a good introduction to this. Each character adds the influence of their personality.They also bring forth their make piece of information to the story. Each character has a small, domestic story line which is eventually shown to give an extra insight into the story. Each character adds strain to the story line in the shape of what information and dramatical influence they have to give to the play. One other question is that of witchcraft. Did the girls actually do anything magic in the forest or were they just mucking around and pretending that what happened was worse than it actually was, just to get a bit of attention? There are counterpoint statements about what they were doing.At the beginning Abigail is saying that all they did was dance. Then, slightly later, Mrs Putnam says that her daughter, Ruth, was trying to conjure up the spirits of her seven dead babies. Also, when Betty wakes, she talks about Abigail alcoholism blood and making a charm to kill Elizabeth Proctor. It is also mentioned that Tituba did more or less of her Barbados magic. With these different explanations, the reader and audience must rely on attitudes and deportment to give them the answer. Mary Warren, for instance, is very nervous and this must be for a reason.Also, Abigail gets very tetchy and defensive to start with whenever witchcraft is mentioned. It is here that the phrase theres no smoke without fire comes into play. The girls were obviously doing something which wasnt allowed otherwise they wouldnt act so anxiously around the subject. The film had an interesting fritter away on the opening sequence. Whereas in the book, the girls were supposed to have been dancing in the forest to Titubas songs, the film shows them performing proper black magic. They have a cauldron and are standing in a circle around it.One by one they drop a herb or some flowers into the mixture before, finally, Tituba kills a bird and puts that in as well. This was a n interesting way to start the film as it makes it look as if the girls were actually dabbling in the occult. This is some other example of how Miller uses confusion constructively as it makes you think about whats really happening. This play has roots on many different levels, not least in the domestic family life Most referred to in Act One and Act Two. It is a kind of commentary on family life, neighbourly feuds and shrouded affairs gone public.Millers play tells a story of guilt, regret, darkness, anger, vengeance, mass hysteria, hope, benevolence among the unscrupulous and heroism. In his lavish text Miller makes sure that there is always at least one emotion which you can relate to and that there is always a saving-grace for each character, something to make you sympathise with them-if only a little. Show preview only The above preview is unformatted text This student written piece of work is one of many that can be set in motion in our GCSE Arthur Miller section.
Friday, May 24, 2019
Moses Williams NURS 450 Professor Peggy Melloh Introduction Catheter-associated urinary tract infection (CAUTI) is a fairly common branching in hospitalized endurings. Nosocomial infection prevention and patient safety promotion has been issued and many re searches have been conducted to improve patients quality of life. In this term, perfection et al. (2005) hypothesize that using a paper-based urinary catheter monitor lizard wad humiliate the incidence of urinary catheterization, and consequently this will enhance the patients safety. Critique Part 1 Research Questions or HypothesesThe orbit and significance of this study atomic number 18 priggishly presented in the introduction. The research question is presented at the end of the introduction of this article. Saint et al. (2005) come up the research question based on the scientific backgrounds they selected and reviewed Is a urinary catheter admonisher effective in reducing the incidence of indwell urethral catheteri zation in the hospitalized patients? (p. 456). The Independent variable is a urinary catheter reminder and the dependent variable is the incidence of indwelling urethral catheterization. The research question appropriately states the relationship betwixt a urinary catheter reminder and the incidence of indwelling urethral catheterization, thus the research question is specific to one relationship. The research question is generated from PICO information which government agency population, intervention, comparison, and outcome (LoBiondo-Wood & Haber, 2010, p. 63). In this study, population is the hospitalized patients in the University of Michigan Medical Center and a total of 5,678 patients participate in the study. Intervention is using a catheter reminder and comparison is not using a catheter reminder.Outcome is the effectiveness of a engagement of the reminder. Although hypothesis is not directly written in the article, Saint et al. (2005) imply that a paper-based reminder o f indwelling urinary catheter might help reduce improper catheterization. The research question is not placed in a theoretical manikin however, the conceptual framework is enclosed in the literature review of the article. deuce conceptual frameworks are applied to develop the research question one is patient safety promotion and the other one is infection prevention.The rate of catheter-associated urinary tract infection (CAUTI) is relatively high among the nosocomial infections. Although indwelling urinary catheters are common and essential for near hospitalized patients, sometime these are un unavoidably applied. In this paper, a simple written reminder might cut down the use of indwelling urinary catheters and consequently this can reduce the rate of CAUTI and improve patient safety. The purpose of this study is not directly stated, but it can be inferred from the research question.The purpose of this study is to test the effectiveness of a indwelling catheter reminder in decre asing the use of indwelling urinary catheter. The level of demonstrate of the research does not explain the significance of the study completely, but this is one of the skills that can assist the readers to evaluate the strengths and weaknesses of a research (LoBiondo-Wood & Haber, 2010). This research is Level tether because of its quasi-experimental design which tests cause-and-effect relationships. Saint et al. (2005) investigate the relationship between the use of a urinary catheter reminder and the incidence of indwelling urethral catheterization.In order to apply try out in practice, the nurses should assess the potential for applicability first. Saint et al. (2005) bring up the problem that indwelling urinary catheter-associated infection accounts for up to 40% of nosocomial infections. some other problem they find is that many physicians are often un sensitive of urinary catheterization in their patients. Unfortunately, these overlooked catheters are unnecessarily appli ed in some patients, and past the rate of CAUTI can be increased. Based on these findings, Saint et al. 2005) hypothesize that a written reminder can help the physicians remember that their patients have indwelling urinary catheter, so this awareness of urinary catheterization can reduce the incidence of indwelling urinary catheter. Review of the Literature This article does not provide the search strategy including a number of databases and other resources which identify key make and unpublished research. In this article, both the primary sources and the theoretical literatures are collected and appraised in order to generate the research question and to conduct knowledge-based research.In the section of the literature review, nineteen professional articles are appraised in order to provide the significance and background of the study. Saint develops the research question based on these analyses. Catheter-associated urinary tract infections in surgical patients A swayled study o n the excess morbidity and cost is one of the primary sources written by Givens and Wenzel who conduct and analyze this study. In addition, Clinical and economic consequences of nosocomial catheter-related bacteriuria is a review of a literature article which is the secondary source.Although many studies state that patient safety is a top priority and CAUTI can be controlled by the caution of health care providers, the infection rate is relatively high among other nosocomial infections. One of the reasons Saint and colleagues uncovered is unawareness and negligence by health care providers. In judge the literatures, Saint finds over one-third of attending physicians were unaware that their own hospitalized patients had indwelling urinary catheter (2005, p. 456). This article was published in 2005.Among thirty two resources, eighteen articles were published before 2000 and twelve articles were published within past five years. In this paper, the oldest article Saint et al. (2005) re viewed is Factors predisposing to bacteriuria during indwelling urethral catheterization which was published in 1974. This implies that indwelling urinary catheter-associated infection has been issued for more than forty years, and many researchers still work on this topic. The literature review is coherently organized so that the readers can understand square why this study is planned. Saint et al. 2005) state prevalent and essential use of indwelling urinary catheter in hospitalized patients, and then they question its safety. They point out some problems caused by indwelling urinary catheter, including indwelling urinary catheter-associated infection, the patient discomfort, and increased health care cost.In some patients, the indwelling urinary catheters are not necessarily applied due to a lack of awareness of physicians. Therefore, Saint et al. (2005) come up with the idea that a simple and written reminder assists physicians to be aware of the indwelling catheterization in t heir atients, so the chances of catheterization will be reduced and the rate of the indwelling urinary catheter-associated infection will be decreased simultaneously. Saint et al. reiterate the literature review by stating, an innovative system-wide administrative intervention designed to remind physicians that their patient has an indwelling catheter in place might help reduce inappropriate catheterization (2005, p. 456). In addition, this logical summary makes them develop the research question appropriately. Internal and External ValidityThis study barely has a potential threat to impertinent validity. On the contrary, the external validity of the findings might be increased because Saint et al. (2005) apply the intervention in a real hospital setting, then the findings can be generalized and applied to other hospital setting. In order to reduce the threats to internal validity, the independent variable is only manipulated in the intervention group. In other words, the interven tion group only gets a urinary catheter reminder to test effectiveness of it.The baseline of differences in age, sex, length of hospital stay, and catheterization is adjusted. The intervention faithfulness is maintained throughout the study. Everyday, one nurse gathers information on catheter status, reason for catheterization, and recatheterization (Saint et al. , 2005, p. 457). Also, the time and method of collecting data is constantly maintained. The enhancement strategy such(prenominal) as email, use of tap flag, and paging is used in order to minimize physicians ignorance with a reminder and to increase physicians response. Research DesignThe study uses a pretest-posttest design with a nonequivalent control group, which is one of the quasi-experimental designs. Four hospital wards are selected and separate in two groups. Two wards are assigned to the intervention group to which the reminders are offered, and the other two wards are assigned to the control group. Data is collec ted for sixteen months, and sixteen months is divided into two eight-month periods which is pre- and post-intervention (Saint et al. 2005, p. 456). A nonequivalent control group design is adequate for this study because the esearcher can observe the effectiveness or ineffectiveness of a reminder by comparing the outcomes between intervention group and control group. Also, during pre-intervention periods, baseline data can be collected in both intervention and control group which will decrease bias. However, the researcher can simply assume that the condition of both groups is similar at the beginning of the research (LoBiondo-Wood & Haber, 2010). Therefore, the quasi-experimental design is proper to conduct this study in order to answer the research question.References American psychological Association. (2002). Publication Manual of the American Psychological Association. Washington, DC American Psychological Association. LoBiondo-Wood, G. , & Haber, J. (2010). Nursing Research Met hods and Critical Appraisal for Evidence-Based Practice (7th ed. ). St. Louis, MO Mosby Elsevier. Saint, S. , Kaufman, S. , Thompson, M. , Rogers, M. , & Chenoweth, C. (2005). A Reminder Reduces Urinary Catheterization in Hospitalized Patients. Journal on Quality and Patient Safety. 31(8), 455-462.
Thursday, May 23, 2019
In the pursuit to deliver exceptional product software for internal users of the company, the selection of an appropriate growth methodology is imperative. One of the departments noticed that the input data in the companys internal systems did not ring the actual data in other department systems. A project team was developed to create a new upgraded system that will hold in data from both departments successfully and accurately. The project scope of the project was to focus on the characteristics of each department particulars and merge into a workable system.The project make up certain obstacles that made the decision to which methodology processes to implement an important one. Some of these obstacles were one of the departments incoming data that did not take the selfsame(prenominal) route compared to other departments to enter the main database. This posed a problem to making sure that the updated software was able to obtain and sustain the data correctly. In addition, the findings had concluded that this particular issue was one of the main reasons for the discrepancies in the old system.The actual discrepancies of data incoming into the old system automatically would cause deceit across all departments that ended up causing quite of confusion. Therefore, the need to use the appropriate process is critical to ensure that the around difficult obstacles unknowns to most would need to be addressed effectively. The process chosen was from the Project Management Institute that uses the concept of Initiate- Plan Execute Control Close to complete the project. The PMI process demonstrated all the areas of focus to better identify, resolve and complete the needed tasks successfully.The usage of the processes created an opportunity to interact with the team members more directly on proper(postnominal) areas that are yet defined. Due to the complex implementation of technology software that needed to communicate data from two different vantage focuss, th e PMI processes methodology allowed for marrow to dissect certain components effectively. The first stage of the PMI processes to initiate is actually a way to develop a research agenda, in order, to detect any unforeseen issues or concerns.The research is an area that allows all team members to address certain concerns of the project. The IT department played a pivotal role in providing their vantage point of the technology side for a measure to meet in the final analysis. The research initiative provided an opportunity to see thru the different points of view from a skillful aspect that could be misinterpreted thru a different means of project processes. The research format provides the opening to deter any misconception previously connected to the IT department or other departments that could create road-blocks.The PMI process to beginning with the initiating of the project allows for the identification of all criterias leading up to subsequent kinds. Therefore, the activity definition went hand in hand with the research portion of the project because it reenforces the identification of the desired deliverables to stakeholders. Thereafter the focus on planning allows for the findings from the research to be a smooth inflection to designate on whom, what, and when to go further. The actual planning stage assists in being able to separate the tasks from the dependent tasks to ensure completion of the deliverables.The planning stages reinforce the documented data thru the initiation for any pitfalls in successfully implementing a major system upgrade that will support over 5,000 employees. The planning pattern guarantees that the next phase of execution by the team members will be conducted in an orderly process due to the initiation on researching the project. Furthermore, the control phase will secure a means to not go over budget on a major and complex project due to initiation previously set in place. The close of the project will assist in the con trol phases due to the ability to pull all resources together in a timely matter and on target.
Wednesday, May 22, 2019
The American on Tokugen Numatakas private line sounded anxious.Mr. Numataka-I only pass on a moment.Fine. I trust you have both pass- attains.There go out be a small delay, the American answered.Unacceptable, Numataka hissed. You said I would have them by the end of todayThere is one loose end.Is Tankado dead?Yes, the voice said. My man killed Mr. Tankado, but he failed to get the pass-key. Tankado gave it away before he died. To a tourist.Outrageous Numataka bellowed. Then how can you promise me exclusive-Relax, the American soothed. You will have exclusive rights. That is my guarantee. As soon as the missing pass-key is found, Digital Fortress will be yours.But the pass-key could be copiedAnyone who has seen the key will be eliminated.There was a long silence. Finally Numataka spoke. Where is the key now?All you need to cognize is that it will be found.How can you be so certain?Because I am not the only one looking for it. American Intelligence has caught plait of the missing k ey. For obvious reasons they would like to prevent the release of Digital Fortress. They have sent a man to locate the key. His name is David Becker.How do you know this?That is irrelevant.Numataka paused. And if Mr. Becker locates the key?My man will take it from him.And after that?You neednt be concerned, the American said coldly. When Mr. Becker finds the key, he will be properly rewarded.
Tuesday, May 21, 2019
merely he heard the outburst.117The West Wing was usually quiet at this hour, moreover the prexys unexpected emergence in his bathrobe and slippers had rustled the aides and on-site staff out of their day-magaziner beds and on-site sleeping quarters.I cant find her, Mr. President, a young aide said, speed after him into the Oval Office. He had looked everywhere. Ms. Tench is non answering her pager or mobile phone.The President looked exasperated. Have you looked in the-She left the building, sir, another aide announced, hurrying in. She signed out about an hour ago. We think she may have gone to the NRO. bingle of the operators says she and Pickering were talking tonight.William Pickering? The President sounded baffled. Tench and Pickering were anything solely social. Have you called him?Hes not answering either, sir. NRO switchboard cant reach him. They say Pickerings cellphone isnt even ringing. Its like hes dropped off the face of the earth.Herney stared at his aides for a moment and then walked to the public house and poured himself a bourbon. As he raised the glass to his lips, a Secret Serviceman hurried in.Mr. President? I wasnt going to wake you, but you should be aware that there was a car outpouring at the FDR Memorial tonight.What Herney almost dropped his drink. When?An hour ago. His face was grim. And the FBI just identified the victim 118Delta-Threes foot screamed in pain. He felt himself floating through a muddled consciousness. Is this death? He tested to pass out-of-door but felt paralyzed, barely up to(p) to breathe. He saw only blurred shapes. His mind reeled back, recalling the explosion of the Crestliner out at sea, seeing the irritation in Michael Tollands eyeball as the oceanographer stood over him, holding the volatile pole to his throat.Certainly Tolland killed meAnd yet the searing pain in Delta-Threes just foot told him he was very some(prenominal) alive. Slowly it came back. On hearing the explosion of the Crestline r, Tolland had let out a cry of anguished rage for his lost friend. Then, turning his ravaged eyes to Delta-Three, Tolland had arched as if preparing to ram the retinal rod through Delta-Threes throat. But as he did, he seemed to hesitate, as if his own morality were holding him back. With brutal frustration and fury, Tolland yanked the rod away and drove his boot down on Delta-Threes tattered foot.The last thing Delta-Three remembered was vomiting in agony as his whole world drifted into a black delirium. Now he was coming to, with no idea how long he had been unconscious. He could feel his arms tied rotter his back in a knot so tight it could only have been tied by a sailor. His legs were alike bound, bent behind him and tied to his wrists, leaving him in an immobilized backward arch. He tried to call out, but no sound came. His mouth was stuffed with something.Delta-Three could not imagine what was going on. It was then he felt the assuredness breeze and saw the bright lights. He completed he was up on the Goyas main deck. He twisted to look for help and was met by a frightful sight, his own reflection-bulbous and misshapen in the brooding Plexiglas bubble of the Goyas deepwater submersible. The sub hung right in front of him, and Delta-Three realized he was fictionalisation on a elephantine trapdoor in the deck. This was not nearly as unsettling as the most obvious question.If Im on deck then where is Delta-Two?Delta-Two had grown uneasy.Despite his partners CrypTalk transmission claiming he was fine, the single gunshot had not been that of a machine gun. Obviously, Tolland or Rachel Sexton had fired a weapon. Delta-Two moved over to peer down the rage where his partner had descended, and he saw blood.Weapon raised, he had descended belowdecks, where he followed the trail of blood along a catwalk to the bow of the ship. Here, the trail of blood had led him back up another ramp to the main deck. It was deserted. With ontogeny wariness, Delta-Two ha d followed the long crimson smear along the sideboard deck back toward the rear of the ship, where it passed the opening to the skipper ramp he had descended.What the hell is going on? The smear seemed to travel in a giant circle.Moving cautiously, his gun trained ahead of him, Delta-Two passed the entrance to the laboratory section of the ship. The smear continued toward the back end deck. Carefully he swung wide, rounding the corner. His eye traced the trail.Then he saw it.Jesus ChristDelta-Three was lying there-bound and gagged-dumped unceremoniously directly in front of the Goyas small submersible. Even from a distance, Delta-Two could see that his partner was miss a good portion of his right foot.Wary of a trap, Delta-Two raised his gun and moved forward. Delta-Three was squirm now, trying to speak. Ironically, the way the man had been bound-with his knees sharply bent behind him-was probably saving his life the shed blood in his foot appeared to have slowed.As Delta-Two a pproached the submersible, he appreciated the rare luxury of being able to watch his own back the entire deck of the ship was reflected in the subs rounded cockpit dome. Delta-Two arrived at his seek partner. He saw the warning in his eyes too late.The flash of silver came out of nowhere.One of the Tritons manipulator claws suddenly leaped forward and secureed down on Delta-Twos left thigh with crushing force. He tried to pull away, but the claw bore down. He screamed in pain, feeling a bone break. His eyes shot to the subs cockpit. Peering through the reflection of the deck, Delta-Two could now see him, ensconced in the shadows of the Tritons interior.Michael Tolland was inside the sub, at the controls.Bad idea, Delta-Two seethed, block out his pain and shouldering his machine gun. He aimed up and to the left at Tollands chest, only three feet away on the other side of the subs Plexiglas dome. He pulled the trigger, and the gun roared. Wild with rage at having been tricked, Del ta-Two held the trigger back until the last of his shells clattered to the deck and his gun clicked empty. Breathless, he dropped the weapon and glared at the shredded dome in front of him.Dead the soldier hissed, straining to pull his leg from the clamp. As he twisted, the metal clamp severed his skin, opening a large gash. Fuck He reached now for the CrypTalk on his belt. But as he raised it to his lips, a second robotic arm snapped open in front of him and lunged forward, clamping around his right arm. The CrypTalk fell to the deck.It was then that Delta-Two saw the ghost in the window before him. A pale kisser leaning sideways and peering out through an unscathed edge of glass. Stunned, Delta-Two looked at the center of the dome and realized the bullets had not even come close to penetrating the thick shell. The dome was cratered with pockmarks.An instant later, the topside portal on the sub opened, and Michael Tolland emerged. He looked shaky but unscathed. Climbing down the a luminum gangway, Tolland stepped onto the deck and eyed his subs finished dome window.Ten thousand pounds per square inch, Tolland said. Looks like you need a bigger gun.Inside the hydrolab, Rachel knew time was running out. She had heard the gunshots out on the deck and was praying that everything had happened exactly as Tolland had planned. She no longer cared who was behind the meteorite deception-the NASA administrator, Marjorie Tench, or the President himself-none of it mattered anymore.They will not get away with this. Whoever it is, the truth will be told.The irritate on Rachels arm had stopped bleeding, and the adrenaline coursing through her body had muted the pain and modify her focus. Finding a pen and paper, she scrawled a two-line message. The words were blunt and awkward, but eloquence was not a luxury she had time for at the moment. She added the note to the incriminating stack of papers in her hand-the GPR printout, images of Bathynomous giganteus, photos and arti cles regarding oceanic chondrules, an negatron microscan printout. The meteorite was a fake, and this was the proof.
Monday, May 20, 2019
I burn, I pine, I perish this is a quote from the cinema 10 things I hate about you and a happen made by William Shakespeare called Taming of the Shrew. The movie 10 things I hate about you was originated from a encounter from William Shakespeare called Taming of the Shrew. The director of the movie is Gil Junger. In 10 things I hate about you, a sunrise(prenominal) boy in school called Cameron falls in love with a girl called Bianca and tries to date her, just her father doesnt allow Bianca to date anyone before Katherine, who is called a shrew because of her behaviors, does.Cameron persuades Joey to pay Patrick to date Katherine, so he can date Bianca. After some time, Patrick and Katherine fall in love with each separate and Cameron checks out with Bianca in the end. The movie is an adaptation of the play and the author has changed to suit the audience, because the target audience of this movie is modern people, not people in Elizabethan English. To get audiences attention , it has used several filming techniques.thither were lots of usages of filming techniques in the movie. For example, at the flick when Katherine was about to kiss Patrick, extreme close-up was applied to the scene in order to capture the emotion of the two characters. Also, Tracking is applied at the scene when Michael shows Joey round the school in order to involve the audience in the action and to show the environment.Both of these filming techniques were used in order to keep the audiences attention and to involve audiences into the scene in order to make the audiences feel the way that the director wants them to feel. In the movie, there were more techniques that were used. For most of the time in the movie, the alter that they have used are bright colors, such as pink, yellow. The lighting is usually bright, but in the scene where Bianca kisses Cameron, the lighting is very mild, like a moonlight, which has romantic connotation.
Sunday, May 19, 2019
Dissertation Project Report On criterion of prime(prenominal) at Apollo Hospitals exploitation Servqual Submitted by Richa Kumari A0102208164 MBA (M&S) 2010 Under the Supervision of ability Mentor Prof. (Dr. ) P. K. Bansal Faculty Amity Business groom AMITY origin SCHOOL AMITY UNIVERSITY UTTAR PRADESH SECTOR 125, NOIDA 201303, UTTAR PRADESH, INDIA 2010 resolutionI Richa Kumari, student of Master of Business Administration (Marketing &Sales), severalize of 2010from Amity Business School, Amity University, Uttar Pradesh hereby declargon that the dissertation d single by me on the case Measurement of part at Apollo Hospital using Servqual is true to my knowledge. The in puddleation collected by me is current & is done with selective information analytic thinking & interpretation & I sport a thorough knowledge of the project. The matter of this report is found on the information collected from visiting Indraprastha Apollo infirmarys in Delhi.I nevertheless declargon that the matter corporate in this project report has non been submitted to any other university or institute for the award of any percentage send or diploma. PLACE Noida DATE Richa Kumari Amity Business School Amity University, Uttar Pradesh CERTIFICATE FROM FACULTY GUIDE This is to certify that Richa kumari, student of MBA (M&S), Amity Business School, Amity University Uttar Pradesh has supremacyfully completed the dissertation project under my guidance.The project report and selective information submitted by her is authentic and un forelandable to my knowledge. Prof. Dr. P. K. Bansal Faculty line Faculty, Amity Business School Amity University, Uttar Pradesh ACKNOWLEDGEMENT It takes immense pleasure for me to decl atomic identification number 18 my sincere gratitude to only the patroning down I had during my dissertation. The Project was done by me under the guidelines of my Faculty Guide Prof. Dr. P. K. Bansal was a source of enormous discipline for me.I am exceed ingly compel to him for their free burning unconditional support & guidelines. A special word of thanks from me to all the respondents whose cooperation and interaction was a gravid avail. As a student of AMITY BUSINESS SCHOOL, NOIDA I got the golden prospect to work on the topic Measurement of character of Apollo Hospital using Servqual. I also feel highly obliged to my program leader Mrs. Aparna Goel and roughly of the faculties in ABS who in several g everywherenment agencys were my inspiration & helped me to put in the scoop up of my efforts.I am deeply indebted to my p bents, family members & friends for their support during the course of my dissertation. Last scarcely non the least the report was completed successfully because of the g track of God. Richa Kumari Amity Business School EXECUTIVE summary table dish out firms like other administrations are realizing the signifi clearce of guest-centered philosophies and are turning to look pressment liftes to he lp manage their barteres. This paper starts with the concept of all overhaul feeling and demonstrates the model of swear out tone sallys.SERVQUAL as an effectual approach has been studied and its role in the analysis of the diversity amongst guest lores and expectations has been highlighted with support of mensuration of feel at Apollo Hospital. solutions of the study surfaceline the fact that although SERQUAL could close one of the primary(prenominal) profit spirit gaps associated with foreign node military servicing, it could be extended to close other major gaps and and so, it could be developed in sanctify to be applied for infixed clients, i. e. mployees and assistance providers. whole tone wellness complaintis an achievement of optimum physical and mental salutaryness with gatewayible, cost-effective look at that is based on best evidence, is antiphonary to the indispensablenesss and preferences of affected roles and populations, and is res pectful of patients families, individualized values and beliefs. The report covers the survey of Apollo Hospital swear outs, Delhi. It pointes on the dynamics of the the boilersuit suffice provided, the trends over a period of time, and the describe challenges faced by the intentness. TABLE OF CONTENTS DECLARATION I * CERTIFICATE FROM FACULTY MENTOR II * ACKNOWLEDGEMENT III * EXECUTIVE SUMMARY IV * CHAPTER 1 INTRODUCTION * CHAPTER 2 LITERATURE REVIEW * CHAPTER 3 methodology * SAMPLE DESIGN * head word DESIGN * info COLLECTION METHOD * SAMPLE SIZE CHAPTER 4 DATA INTERPRETATION * DATA ANALYSIS * FINDINGS * LIMITATIONS * CHAPTER 5 CONCLUSION &RECOMMENDATION * APPENDICES V * REFERENCES VI * BIBLIOGRAPHY VII CHAPTER 1 INTRODUCTION forward in the health check literature, the caliber of dish up i. e. thecharacteristics that shape the experience of deal was rarely discussed beyond expert contendnce.This query musical rhythms and analyzes much or less routine encount ers in Apollo, a hospital of international standard from a service whole tone pointof view. The study has led to the following two premises First, if high- prime(a) service had a great presencein practices and institutions, it would improve clinicaloutcomes and increased satisfaction of patient and doctors while reducingcost. It leave behind also create competitive advantage for those whoare expert in its application. Second, many other industriesin the service sector begin taken service prize to a high level,their techniques are readily transferable to health aid, and caring for patients butt learn from them. Health flush industryThe health upkeep industry in India comprising of hospital and allied sectors, is projected to grow at 23 per cent per annum and to touch US$ 77 billion by 2012 from the current estimated size of US$ 35 billion, according to a Yes Bank and ASSOCHAM report. The sector has registered a growth of 9. 3 per cent between 2000-2009, when compared with t he growth rate of other emerging economies such(prenominal)(prenominal)(prenominal) as China, Brazil and Mexico. According to the report, the growth in the sector would be driven by health care facilities, cloistered and man sector, medical symptomatic and pathlabs and the medical insurance sector. Today Hospital industry is an important component of the value chain in Indian Healthcare industry. It renders function and is recognized as health care lurch segment of the health care industry.It is growing at an annual rate of 14%. The hospital industry depicts for half the healthcare sectors revenues and was estimated to be worth USD $25 billion in 2008. The grimy performance by the Indian government in providing healthcare base of operations has created tremendous opportunities in the private sector. The huge pent up demand for select healthcare and increase in healthcare expenditure in the long-term are fundamentally strong drivers in this securities industry. The facto rs contributing to its bright future is based on increased healthcareconsumption, increasing instances of lifestyle- cogitate diseases, medical tourism, and growinghealthinsurance.The key challenges for the industry take significant capital requirements and a shortage of medical professionals. Ensuring high prime(prenominal) of healthcare service is other key issue for service providers. Healthcare spending in India accounts for over 5 per cent of the demesnes GDP. Of which the public spending in percentage is around 1 per cent of GDP. The presence of public health care is not only weak but also under-utilized and inefficient. Meanwhile, private sector is sooner dominant in the healthcare sector. Around 80 percent of total spending on healthcare in India comes from the private sector. Inadequate public investment in health infrastructure has given an opportunity to private hospitals to capture a larger deal of the market place.In addition the demand for hospital services has b een increasing due to the rise in lifestyle associate diseases that accompany prosperity. Hospitals serve an important blend in Indias healthcare agreement. They provide in-patient and out-patient services and also support the readying of health workers and search. Indian hospitals can be broadly classified as public hospitals, private and not-for-profit hospitals. Corporate hospital put up that provide tertiary healthcare services in large towns and cities have also been established. However, the number of hospital beds in India is around 1. 1 per thousand masses. This is significantly demoralize when compared to about developed economies. The current prospect for the hospital services is positive.Technological innovations in service bringing, increased affordability, improved service role and substantiating government policy initiatives are some of the factors that are likely to impact growth of the sector. This is a cursor to significant opportunities that exist for service providers. Moreover, the future of healthcare is not restricted to the large domestic market alone. Emerging trend of medical tourism indicates the possibility of Indian healthcare services opening to the full- length gentlemans gentleman. Health Care and aid delivery Health aid deliveryrefers to the way inputs such as finance, rung, treatment, equipment and drugs all deliver a crop of health interventions to consumers testing to access health care. Improving Service deliverydepends on having key resources that are well organized and managed.Health services take personal health services that are preventive, diagnostic, therapeutic or rehabilitative whilst non-personal services cover areas such as mass health education/ promotion programs, health legislation and the provision of basic sanitation facilities. incompetency or breakdown in the branch of care-giving may be the result of difficultys in practice, returns, procedures or governances. A key issue facing d evelopment agencies is the utilization of health services as they are lots inaccessible or mis self-assuranceed by consumers. Lack of music directorial capacity at all levels of the health system is increasingly cited as a binding constraint to scaling up services and achieving the Millennium breeding Goals. Apollo HospitalsWith over8065 beds crosswise 46 hospitals in India and overseas, neighborhood diagnostic clinics, an extensive chain of Apollo Pharmacies, medical BPO as well as health insurance services and clinical research divisions working on the trimming edge of medical science, Apollo Hospitals is a healthcare posthouse one can trust with their life. Apollo Hospitals, India is a sexual union of exceptional clinical success rates and superior technology with centuries-old traditions of Eastern care and warmth, with 16 jillion patients from 55 countries. Apollo Hospitals meeting is at the Forefront of medical checkup Tourism to make India the Global Healthcare Desti nation. Its charge is to bring healthcare of international standards within the pass along of every individual. They are committed to the achievement and caution of excellence in education, research and healthcare for the benefit of humanity. Dr. Prathap C Reddy is the Founder & Chairman, Apollo Hospitals Group.Led by Apollo Hospitals Group, Indian Healthcare today has developed International delivery capabilities and has demonstrated International excellence in all specialties with major cost advantages for people from overseas. Apollo Hospitals has successfully treated over 60000 foreign patients from across the world in last five years and the numbers are looking up every year. By everlastingly measuring our deliverables, they have succeeded in creating infrastructure that meets the needs of the future that incorporates the latest technology and provides superior healthcare delivery systems. Their immediate agenda allows disciplineting up of healthcare facilities in all maj or Indian cities, 23-hour hospitals, pharmacies, a pharmaceuticals commerce and finally, a Health Maintenance Organization that bequeath give millions of people access to all these facilities.The telemedicine technology that has been successfully introduced by Dr. Reddy in India testament be a key enabler in transforming the healthcare delivery in India. His blueprint for the nation includes setting up of many rural hospitals. Apollo Hospitals Group is the acknowledged leader in bringing super speciality world-class healthcare to India. It is presently the largest incorporated healthcare company in Asia. Apollo Hospitalwould mean any of the hospitals owned byApollo Hospitals, ahealthcarecorporation that operates 38 hospitals in South Asia. It is the largest healthcare provider in Asia and the third largest in the world and is headquartered inChennai, India.Apollo HospitalDelhiis the first hospital in India to be accredited by the JCAHO and is affiliated withJohns Hopkinsinternati onal, themayonnaise Clinic, and many major hospitals in the United States and Europe. In addition to hospitals, Apollo operates Nursing and Hospital Management colleges,pharmacies, diagnostic clinics, medical transcription, third-party administration and telemedicine. Through its wholly owned subsidiary, Apollo Health and Life acquirement Limited, the Apollo Group has set up a chain of nearly 60 branded day-to-day retail clinics on a franchised basis across India and theMiddle East. This is the first time healthcare delivery has been successfully franchised in India. Indraprastha Apollo Hospitals, the largest healthcare theme in Asia. Indraprastha Apollo is one of the largest corporate hospitals in the world.It is the third super specialty tertiary care hospital set by the Apollo Hospitals Group, jointly with the Government of New Delhi, Indias capital. It is a 695 bedded hospital, with the provision for refinement to 1000 beds in future. The hospital is at the forefront of medic al technology and expertise. It provides a complete range of latest diagnostic, medical and surgical facilities for the care of its patients. The hospital started functioning from July 1996, its mission being medical rock-steadyness with a Human Touch. Cost of treatment Apollo Hospitals is considered one of the most expensive treatment facilities when compared to their local counterparts.A similar treatment and care in a regular hospital would cost significantly lesser. However, their facilities, infrastructure and quality of medical faculty are far superior to anything else in the country, seemingly reasonableifying this increased cost. Medical Milestones * Employs over 4000 specialists and super-specialists and 3000 medical officers spanning 53 clinical departments in patient care * Achieved a 99. 6% success rate in cardiac bypass surgeries, over 91% of these were beating heart surgeries * Conducted over 55,000 cardiac surgeries First Indian hospital assemblage to introduce ne w techniques in Coronary Angioplasty, Stereotactic Radiotherapy and Radiosurgery. Performed over 7,50,000 major surgeries and over 10,00,000 minor surgical procedures with exceptional clinical outcomes * Pioneered orthopaedic procedures like hip and human knee re centerments, the Illizarov procedure and the Birmingham hip re-surfacing technique * Pioneered the concept of preventive healthcare in India * First hospital group to bring the 64 Slice CT-Angio scan system * First hospital group in atomic number 34 Asia to introduce the 16 Slice PET-CT Scan * First to perform liver, multi-organ and cord blood transplants in India * supply with the largest and most sophisticated sleep laboratory in the world CHAPTER 2 LITERATURE REVIEW Kotler (1999) points out an unchangeable principle for a successful business are to satisfy the customers need.Consumer service is closely related to customer satisfaction and consumer satisfaction has a decisive influence on the profits and performance of institutions and organizations (Fornell, 1992 Mittal & Lassar, 1998 Wong, 2000). That is wherefore organizations emphasize the importance of consumer service and satisfaction. Just as the dashboard of a car provides timely feedback on vital performance measures, so should an organizations dashboards inform decision makers and board members on where the organization is headed and how it is progressing toward its strategic objectives. The consumer service thought is closely associated with the evolution of the business strategies in the Health Care industry.To manage and improve quality, these successful organizations are coming to the conclusion that quality must be measured. This ensures accurate beat of customer satisfaction versus that delivered by competitors. Service feeling is a service that is consistent with customer expectations and give tongue to obligation in Customer Care, performance & Value. Quality itself has been narrowd as fundamentally relational Quality is t he ongoing process of building and sustaining relationships by assessing, anticipating, and fulfilling stated and implied needs. One cannot separate the process and the human factor, thitherfore there is a bank that Quality, when built into a harvesting, generates emotions and feelings within those who have taken part in its creation.Quality is doing the right things right and is uniquely defined by each individual. Error-free, value-added care and service that meets and/or exceeds both(prenominal)(prenominal) the needs and legitimate expectations of those served as well as those within the Medical Center. Organizations that constantly measure themselves in relation to competitors are able to quickly capitalize on their emerging strengths and address weaknesses sooner they become problems. Service Quality Quality applies to every convergence either it is physical product, information product or service product. But when Service Quality is talked about it is all about satisfyi ng the targeted customers through meeting their requirements (Zulfikar Ali).Quality cannot be measured without a clear definition or standard. Likewise, Measuring Quality leads directly to the identification of areas for improvement or enhancementthe first step in Improving Quality. Service Quality models There are a number of models which try to capture and define Service Quality. all(prenominal) has their strengths, and weaknesses. The core definition of Service Quality is Customers thinking theyre getting interrupt service than expected. This is a great deal referred to as the light gap, i. e. the gap between what the customer expects and what they think they got. Its worth noting that both sides of the gap are in the customers mind.You may actually deliver weaken Service then your competitors, but if the customer thinks that your Service is worse then thats all that matters. Because the percept gap is based on the remnant between what a customer expects to receive from a S ervice and what they think they received both sides of the gap are diffuse they are based on customer impressions rather than a hard definable quality. This means the perception gap is difficult to measure, difficult to manage and is likely to change with time and experience. Nevertheless its vital to business success. Elements of the model A focus model should unwrap and relate those key elements that require systematic management attention (Brogowicz et al. , 1990).The elements jut outd to fit in the model are * Managements perceptions of customer expectations and perceptions about the service * Vision, mission, service dodge and directions to eliminate the gaps * Service analysis, translation of perceptions into service quality specifications and service design * financial and human resources (HR) management * External conference * Service delivery system (production, delivery and part-time merchandising). roughly models which are the result of some significant research are The KANO Model states What do customers expect as a minimum standard, and what actually makes a difference if the service provider does it better. professor Noriaki Kano (1984, the Japanese quality guru), introduced a two-factor quality model, commonly known as Kanos Curve. The curve illustrates the difference between must-be attractive and linear quality elements.The strength of the Kano model is that it identifies that some aspects of service are merely required to be there whereas others serve to genuinely provide competitive advantage and that there are diminishing returns to be gained from simply focusing on must-be qualities. However Kano does not provide diagnostic alikels to identify or measure the opposite aspects, and suggested the changes with time or environment. The PZB Service Quality Model The service quality model and the role of consumers and apprentices satisfaction is an indwelling part of service quality studies. The GAP model of service quality from P arasuraman et al. (Zithaml & Bitner 1996) pleads an integrated view of the consumer-company relationship. It is based on substantial research amongst a number of service providers.According to the PZB model, there are five gaps. The first gap refers to the difference between customers expected service and managements perceptions of customers expectations. This gap means that management may not aright perceive customer expectations. The second gap refers to the difference between management perceptions of customers expectations and service quality specifications. This gap means that although the people in management level may perceive the correct expectations of the customers, they may not have qualified and sufficient service quality specifications. The third gap refers to the difference between service quality specifications and the real service delivery.This gap means that although the service providers may have suitable and sufficient service quality specifications, they may n ot have the satisfactory service delivery in the real situation. That may be because service providers want well-trained employees to deliver satisfactory service. The fourth gap refers to the difference between the service delivered and external communication about the service with customers. That is, the service providers may not have suitable and sufficient communication with the customers or the service providers may have commitments that exceed what they can do or they may not sufficiently inform the customers of what they have done.The fifth gap is the difference between consumer expectation and their perception of service quality measured by the difference between what customers expect and what customers perceive about the service. In addition, gap 5 is a function of gap 1, gap 2, gap 3, and gap 4 that is, Gap 5= f (gap1, gap2, gap3, gap4). This means that the service quality is closely related to management perception, marketing, military force management, communications with customers, service specifications and delivery. Based on theoretical development of the PZB Service Quality Model, the SERVQUAL (SERVice QUALity) operator was proposed. RATER A complementary analysis of the perception gap is the RATER model also wind by Zeithaml (1990).RATER identifies the 5 key areas which together form the qualities of a service offering from a customer perspective. Where the Gap model describes how the provider can minimize the perception gap. RATER focuses on the dimensions of customers expectations. The RATER factors help provide specific dimensions which can be used to analyse and measure customer expectation. Figure 1 PZB Service Quality Model A Conceptual Model of Service Quality and its Implications for Future Research. Journal of Marketing, 49(4), 41-50. Source Parasuraman, A. , Zeithaml, V. A. & Berry, L. L. (1985). RATER dimensions sorted by relative importance (Zeithaml 1990) Dimension Description sex act importanceReliability Ability to perfor m the promised service dependably and accurately 32% Responsiveness Willingness to help customers and provide prompt service 22% Assurance Knowledge and courtesy of employees and their ability to convey trust and confidence 19% Empathy Caring individualised attention the firm provides its customers 16% Tangibles Appearance of physical facilities, equipment, personnel and communication materials 11% THE ASSESSMENT INSTRUMENTS-The SERVQUAL and SERVPERF Based on preliminary knowledge about the service quality model and the consumer satisfaction concept, there are two major assessment instruments (SERVQUAL and SERVPERF). The SERVQUAL (SERVice QUALity) instrument was proposed by the Parasuraman et al. (1988).They ab initio developed a 97-item instrument to measure the service quality attribute. After eliminating the items with low correlation, they extracted five factors (tangibles, reliability, responsiveness, assurance, and empathy) with 22 service quality items, and claimed the ge neric nature of the five-dimension instrument. Because the disconfirmation-based SERVQUAL instrument has advantages such as better diagnostic federal agency (Jain & Gupta, 2004), and the parsimony of the instrument (Rohini & Mahadevappa, 2006), most researchers in the service quality area tend to prefer the disconfirmation-based SERVQUAL instrument (Abdullah, 2006 Brady, 2001).However, some researchers have been questioning its drawbacks related to the disconfirmation-based model (Redman & Mathews, 1998), process orientation, dimensionality, measuring scale, and the gap pisss (Buttle, 1996 Coulthard, 2004 Clewes, 2003 Wetzels, Ruyter, & Lemmink, 2000). To aim problems related to the disconfirmation-based SERVQUAL instrument, Cronin and Taylor (1992) propose the performance-only SERVPERF (SERVice PERFormance) instrument to measure service quality. Comparing the validity and reliability of the SERVPERF with that of the disconfirmation-based SERVQUAL, they claim that SERVPERF is bet ter than SERVQUAL in overall service quality measurement in empirical tests (Cronin & Taylor, 1992 Brady, Cronin, Brand, 2002 Jain & Gupta, 2004).The debate related to adoption of SERVQUAL or SERVPERF in service quality studies is not yet re puzzle outd. SERVPERF has better explanatory power in overall service quality measurement. On the other hand, SERVQUAL has better diagnostic power because of the P-E score measurement. Thus, selection of the service quality instruments leave be determined by the intention of the researchers, service providers or decision-makers (Jain & Gupta, 2004). Research Papers Provider Competition and Health Care Quality Challenges and Opportunities for Research, by HERBERT S. WONG, PEGGY, M NAMARA states that during the last several years, health care quality issues have emerged as important considerations in develop and implementing public policy.This report highlighted health care delivery problems, patient rubber eraser concerns, and health dispariti es issues. Health care quality is difficult to define because different audiences view health care quality from. Clinicians may define quality based on medical outcomes or processes. Economists may define quality based on concepts of cordial welfare and may include features that consumers happen to care about, but that clinicians do not (e. g. , the expression and size of hospital rooms). Health plans may further differ and focus on concepts of preventive care or organizational efficiencies. Researchers need to understand what their measures are capturing and should interpret their findings accordingly.Once health care quality has been defined, investigators interested in conducting applied empirical research are confronted with the challenges of creating proxy measures that capture the essence of the health care quality of interest. An initial problem is whether data even exist to create proxy measures for quality. The atomic number 101 services market was one of the two health care provider groups on which the conference pore. However, the lack of available data about the care administered by physicians has stymied research on physician disceptation and quality. With literally hundreds of thousands of patient care physicians, current data systems are not integrated in a way that makes accessing data and using data for research purposes pragmatic.Even if data were available, researchers must still overcome the challenges of how best to measure physician qualityan area that is currently not well understood. Patient satisfaction measures, which prove to quantify patients experiences with healthcare services, represent some other dimension of quality still in the developmental stages. The clause by Patrick Romano and Ryan Mutter in this supplement documents the studies that examined hospital competition and hospital quality, identifies the variety of hospital quality measures employed, and highlights the challenges of measuring hospital quality. As Roman o and Mutter noted, the science of creating hospital quality measures has focused primarily on the clinical definition of quality, and such research is still largely in its infancy.At the heart of the challenges confronting researchers is determine whether observed differences in hospital quality measures are true differences. Confounding factors that may influence their accuracies include rigorousness of illness, underlying patient risk, and the hospitals overall case mix. Moreover, how well specific data elements are coded varies widely and ultimately affects the accuracy of the corresponding hospital quality measures. Many observers of medical markets believe that hospitals should compete on the basis of health care quality. However historically, hospital merger cases have focused on their set up on prices, costs, and the nature of the competitive environment, largely discounting health care quality issues. Health care markets are unique and extremely complex.While this invita tional conference focused only on hospital and physician providers, the research opportunities and challenges outlined here apply to other health care markets as well. Mark Paulys article provides some preliminary thoughts on the concepts and the history of the relationship between competition and quality in health care markets. Health care markets are complex. Hospitals compete with one another, physicians compete with one another, and hospitals and physicians interact in many ways. Multiple external factors may influence hospital and physician competitive behavior. Measurement Challenges As mentioned earlier, the science of quality measurement is largely in its infancy and leave behind continue to develop.The main challenges confronting researchers are determining the validity of the current set of measures and improving or growth new measures. The research field involved in inpatient quality measurement appears to be sorrowful in three broad directions. First, researchers are exploring ways to further evaluate and validate the current set of inpatient quality measures. One approach being considered compares existing inpatient quality measures based on administrative data with information from medical records. Organizations such as individual health plans and veterans hospitals often have access to a richer source of clinical information, which could be used for this type of assessment.Second, current inpatient quality measures could be improved if the quality of the information collected is better. For example, in their article, Patrick Romano and Ryan Provider Competition And Health Care Quality Mutter mentioned that external-cause-of-injury codes (i. e. , E Codes) are sometimes under reported and vary substantially across the different organizations collecting such data. Many inpatient quality measures rely on accurate coding to identify the relevant observations. Existing measures could be improved if E Codes are collected more than consistently. Fi nally, another broad approach is to supplement current administrative information with additional clinical information that could be used to refine or to create new measures.The availability of this clinical information could be used to improve measures of quality. As the science for better quality measures advances, analysts face a number of important research questions. While some critics fence in that existing measures do not capture all clinical information, proponents argue that if there are no systematic prejudicees across hospitals, precise patient-level information may not be needed. Consequently, is the science of quality measurement good enough for aggregate studies of competition and quality? Are they good enough for individual hospital comparisons? How will new measures with better information compare with existing measures?The Evolving Science of Quality Measurement for Hospitals Implications for Studies of Competition and Consolidation PATRICK S. ROMANO The literatur e on hospital quality is young most studies have focused on few conditions and outcomes. Measures of in-hospital mortality and complications are susceptible to bias from unmeasured severity and transfer/discharge practices. We describe the strengths and limitations of various approaches to quality measurement summarize how quality has been operationalized in studies of hospital competition. three mechanisms by which competition may affect hospital quality, and propose measures appropriate for testing each mechanism.To evaluate the effects of competition and consolidation in health care markets on quality of care, it is essential to understand the capabilities and limitations of the tools currently available for measuring quality. The number and scope of these tools have grown considerably over the past two decades. These developments have created new opportunities to understand how competition and consolidation affect quality of care, although critics may still challenge the validit y of any particular quality measure. The fundamental problem is that quality of care has multiple dimensions, and organizations that perform well on one dimension may not perform well on others.It is all too easy to arrive at the wrong conclusion if one focuses on a undivided measure, or even on multiple measures of a single dimension. In this paper, a standard definition of health care quality and an associated typology of quality problems is set. It describes the three general approaches to quality measurement, focusing on their strengths and limitations for studies of the impact of hospital competition and consolidation. Next summarizes how these measures have been applied in previous studies, and how the authors of those studies have dealt with concerns about confounding and endogeneity. It describes a conceptual framework that may be helpful in identifying promising measures for future studies in this area. 1.Definitions of Quality and Quality Problems In this paper, they hav e select a clinical perspective on quality of care. Avedis Donabedian (1980), one of the founders of the modern science of health care quality measurement, defined the quality of medical care as the management that is expected to achieve the best balance of health benefits and risks (taking) into account the patients wishes, expectations, valuations, and means the social distribution of that benefit within the population. The American Medical companionship (1984) defined high-quality care more narrowly as care that consistently gifts to the improvement or criminal maintenance of the quality and/or duration of life. Perhaps the most authoritative definition was published by the be of Medicine (1990), which defined quality of care as the degree to which health services for individuals and populations increase the likeliness of desired health outcomes and are consistent with current professional knowledge. All of these definitions attempt to distinguish between quality and othe r non-price aspects of service, which might be classified as amenities. Amenities include aspects of appearance, comfort, and convenience, such as the number of television channels available to hospital patients, the number of menu choices, and the quality of decoration.In fashioning this line, they acknowledge that the line between amenities and quality may become blurred, especially with important patient-centered measures such as telephone response time, wait time for appointments, clinic hours, prompt complaint resolution and claims payment, and patient satisfaction. Nonetheless, this distinction is useful because it focuses attention on whether provider organizations expend resources in ways that were likely to improve patient outcomes, or in ways that are designed to give the appearance of quality. this paper, also follow the bestow of Medicines (1999) typology of quality problems (Chassin et al. , 1998) as involving inappropriate overuse (i. e. too much care), inappropria te underuse (i. e. , too little care), and misuse. Although this conceptualization may state Paulys (2003) definition of quality as everything about some good or service relevant to consumers well-being that is not measured by quantity, we prefer to place all provider judgments and recommendations regarding appropriate care in the category of quality rather than quantity. 2. Approaches to Quality Measurement Donabedian (2003) has described the three broad approaches to quality measurement as structure, process, and outcomes. This useful schema has been widely adopted by the health services research and quality improvement communities.Structural measures describe the conditions under which care is provided, and encompass material resources such as facilities and equipment, human resources such as the credentials and experience of health care providers, and organizational characteristics such as patient volume and team nursing. Process measures describe the content of health care, an d encompass health care providers activities in the realms of screening, diagnosis, pharmacotherapy, surgery, rehabilitation, patient education, and prevention. Finally, outcome measures describe changes attributable to health care, and encompass mortality, morbidity, functional status and pain, as well as patients health-related knowledge, behaviors, and satisfaction. Although this schema remains conceptually useful, it is sometimes difficult to apply.For example, the shared features of high-reliability organizations (Reason, 2000) include both the structural conditions under which professionals work and how that work is performed. 3. Integrating Outcome and Process Measures of Quality Given that quality of care is a complex and multidimensional concept, no single measure of either process or outcome is likely to provide an adequate summary of the effects of competition and consolidation. Hospitals that perform well on risk-adjusted outcomes for one condition often perform poorly f or orthogonal conditions (Rosenthal, 1997 Chassin et al. , 1989), making it useful to consider a spectrum of conditions. Similarly, explicit process measures must be developed and enforced on a condition-specific basis (Ashton et al. , 1994).It may be particularly useful to consider outcome and process measures together, as an integrated approach would offer a more complete assessment of quality and pull in the pathways by which market forces affect patient outcomes. Observed agreement between process and outcome measures at the provider level would support the construct validity of each measure. Disagreement would suggest (1) information bias attributable to misclassification on either measure (2) confounding of outcome measures due to unmeasured severity of illness (3) selection bias due to selective enrollment or dropout of high-risk patients or (4) an incorrect conceptual model, based on an assumed process-outcome linkage that does not actually exist Competition in Medical Se rvices and the Quality of Care Concepts and History MARK V. PAULYConsumers of medical services care about both the price they pay (directly, or indirectly through insurance) for that care and the quality of the care for which they pay. While both an unambiguous measurement of quality and the process by which quality is produced are in many ways unknown, it is surely possible for producers, consumers, and regulators to detect and analyze large (enough) variations in relevant qualitative characteristics. Sometimes, in some places, and with some providers, quality is higher than at other times, places, and providers. To some extent the final level of quality is (from an analysts perspective) going to be random some quality variation is bound to be due to unknown forces and accidents.However, to some extent as well the supplier decisions which affect quality are explicit and rational, and likewise the consumer choices about which provider or which supplier to use depends on perceived qu ality. economically Efficient (Optimal) Quality From an economists perspective, quality in its most general sense just means anything and everything about some good or service relevant to consumers (actual and perceived) well being that is not measured by quantity. Since the definition of quantity is somewhat arbitraryfor hospitalization for example, is it the number of hospital admissions, the number of hospital days, or some amalgam of inpatient services and outpatient services? the definition of quality will depend on how we define quantity. If we define quantity by surgical admissions, then average length of stay would be one dimension of quality, prevalence of wound infections would be another, and patient satisfaction would be a third. There can also be qualities that do not have this orderingfor example, the subterfuge of the walls, the temperature of the room, or even the length of staybut these factors are usually not very important. It is focus on ordered qualities. Howev er, just because people prefer more of some characteristic to less does not necessarily mean (or even usually mean) that the market will or should maximize quality in that dimension.If we think of some unequivocally-ordered characteristic, from an economic viewpoint the best level of quality, given some total quantity, is that level at which the marginal benefit from additional quality (measured in money) just equals the marginal cost of adding to quality. The optimal length of stay is not infinite, the optimal amount of space in a patients room is not enormous, the optimal number of medical errors is not zero (though it could be much lower than at present). Of course, it is possible, indeed, likely, that optimal quality will be different at different quantities (quality and quantity can be substitutes or complements). It is certain that the optimal level of quality, given quantity, will be different for different people, depending on the value they attach to quality.The right qual ity depends on the patient as well as on the illness or procedure, and it depends on the patients preferences (backed up by ability to pay) as well as on the patients physiological state. A more complex question is the optimal variety of quality levels when people have different preferences but it is too costly to produce a different quality level for each person. This definition of optimal quality when applied to medical services certainly includes everything that would be embodied in a clinical definition of quality. However, there are some differences between the economic and what we might call the health services research perspective. One difference is that the economic definition will probably include more features (that consumers happen to care about but clinicians do not).One can think of cases in which consumer preferences about such things as travel time, bedside manner, respect, and uncomfortableness do become important. The other difference is that the economic definitio n will probably require a more careful consideration of marginal cost relative to marginal benefit than would be embodied in the clinical view of ideal quality. 2. Quality Options with Inefficient Suppliers A Diagrammatic Analysis Although the precedent seems fairly basic, there are some aspects of the normative notion of optimal quality that may be controversial in both health policy and health services research, and some aspects of the positive aspects of market supply that are both confusing and contentious. A key issue for much of the literature is that of the innovation of tradeoffs.The previous discussion implicitly assumed that higher quality costs morethat cost (which rightfully just represents an index of the sacrifice of all other goods consumers value) and quality trade off. Yet many observers of medical care markets in the United States have the strong opinion that cost and quality dont usually trade offthat higher quality implies lower cost or that it is at least an open question (Leatherman et al. ,2003). Improving the Service Quality of Distance Education( Rui-Ting Huang,USA / Taiwan) states that the success of a maintain knowledge program is dependent on the quality of supporting services. This research relates to services, gaps in service, business models, continuous quality improvement, and maintaining a competitive edge.Distance Learning has become an important learning option for education systems (Yilmaz, 2005) and training solutions in the Human Resource Development (HRD) area (Felix, 2006). The growth of the distance learning industry has been high-velocity than expected (Huynh, Umesh & Valacich, 2003). Most importantly, in terms of organizational training, an investigation from the Fortune-500 companies indicates that over 80% of companies use distance learning or plan to do so (Hammond, 2001). Through distance learning, organizations have a more commodious, practical and cost-effective way to train the employees (Hammond, 2001 W hitney, 2006 David, 2006). Due to the growth and competition in the distance learning market (Huynh, Umesh & Valacich, 2003), DL research includes the study f consumer aspects such as consumer services and satisfaction (Shaik, 2005 Granitz & Greene, 2003 Huynh, Umesh & Valacich, 2003). Feedback from learner give the instructor important data to determine how well the instructional program satisfies individual learner needs (Steyn & Schulze, 2003 Long, Tricker, Rangecroft, Gilroy, 1999). This in turn offers service providers in the market place important information to streamline the business process to improve the quality of distance learning services (Granitz & Greene, 2003 Steyn & Schulze, 2003). Quality services and support will help the service providers, institutions and organizations in DL get a competitive advantage in the marketplace (Shaik, 2005).As the distance learning industry has become mature in the educational marketplace (Huynh, Umesh & Valacich, 2003), it is provi ding learners with convenient and flexible learning alternatives (Alexander, 1999 Tarr, 1998). It is also giving organizations alternative cost-effective and timely training solution to in effect and efficiently implement the human resource development plans (Hammond, 2001 Whitney, 2006 David, 2006). ). The focus on consumer service may offer the service providers new insights (Moisio & Smeds, 2004) to help them streamline the business process, improve the quality of future service in distance learning (Granitz & Greene, 2003 Steyn & Schulze, 2003) and gain long-term competitive advantages (Shaik, 2005). Mary Nugent ( 2002, vice president and general manager of Subscription Services for BMC Software Inc. a leading provider of endeavor management)said that an increasing number of companies are relying on service providers to manage their mission-critical applications, service providers are realizing that they need an improved method for consistently delivering reliable and highly av ailable service at a competitive cost. Measuring the performance and availability of Web and enterprise applications is inherently difficult. Without accurate and timely measurements it is all but impossible to measure customer satisfaction and Quality of Service (QoS). Due to the cost of developing and implementing such a solution, service providers are finding they need to partner with others in the marketplace to ensure service level agreements (SLAs) are being met and the end-user experience is optimized. A quality end-user experience is what service provider clients require service providers must deliver in order to survive.Online shoppers are not tied by brand loyalty since they can get what they need at many different sites. Companies that want to achieve customer loyalty must deliver value through the customer experience. By outsourcing to service providers for this expertise, companies are entrusting their business and reputation on the solutions they offer. This makes it d oubly important that service providers choose solutions that deliver on their SLAs. Principles Of Quality Customer Service 1. Quality Service Standards -Publish a debate that outlines the nature and quality of service which customers can expect, and display it prominently at the point of service delivery. 2. compare/Diversity -Ensure the rights to equal treatment established by equality legislation, and accommodate diversity, so as to contribute to equality for the groups covered by the equality legislation (under the grounds of gender, marital status, family status, sexual orientation, religious belief, age, disability, race and membership of the Traveller Community). Identify and work to eliminate barriers to access to services for people experiencing poverty and social exclusion, and for those facing geographic barriers to services. 3. Physical Access -Provide clean, accessible public offices that ensure privacy, comply with occupational and safety standards and, as part of this , facilitate access for people with disabilities and others with specific needs. 4. Information -Take a proactive approach in providing information that is clear, timely and accurate, is available at all points of jobber, and meets the requirements of people with specific needs.Ensure that the authority offered by Information Technology is fully availed of and that the information available on public service websites follows the guidelines on web publication. Continue the drive for simplification of rules, regulations, forms, information leaflets and procedures. 5. Timeliness and Courtesy -Deliver quality services with courtesy, esthesia and the minimum delay, fostering a climate of mutual respect between provider and customer. Give contact names in all communications to ensure ease of ongoing transactions. 6. Complaints -Maintain a well-publicised, accessible, transparent and bare(a)-to-use system of dealing with complaints about the quality of service provided. 7.Appeals -Simi larly, maintain a formalised, well-publicised, accessible, transparent and simple-to-use system of appeal/ canvass for customers who are dissatisfied with decisions in relation to services. 8. Consultation and Evaluation -Provide a structured approach to meaning(prenominal) consultation with, and participation by, the customer in relation to the development, delivery and review of services. Ensure meaningful paygrade of service delivery. 9. Choice -Provide choice, where feasible, in service delivery including payment methods, location of contact points, opening hours and delivery times. Use available and emerging technologies to ensure maximum access and choice, and quality of delivery. 10.Internal Customer -Ensure staff are recognised as internal customers and that they are properly supported and consulted with regard to service delivery issues. cognitive operation measurement In Health care, the patients satisfaction has been widely used as a critical dependent variable to eval uate success of the service provider. The patient is one of the important stakeholders in the health care arena (Yeung, 2001 Yang & Cornelious, 2004). And it is reasonable that the patients perception will be considered as a crucial index to evaluate the quality of service(Steyn & Schulze, 2003). In the business area, consumer satisfaction often denotes whether the service provider met the consumers need (Steyn, & Schulze, 2003).Anderson, Fornell and Lehman (1994) propose there are at least two viewpoints in the definition of consumer satisfaction. The first viewpoint is a transaction-specific perspective, which refers to the consumers post-purchase idea or judgment of the products or service based on expectations at the specific buying time or location. The second viewpoint is cumulative satisfaction, which refers to consumers overall appraisal of purchasing and consuming experience toward the products or service. Therefore, we may regard patients satisfaction as the patients ove rall post-use evaluation toward the health care service. Performance measurement is a fundamental building block of TQM and a total quality organisation.Historically, organisations have unendingly measured performance in some way through the financial performance, be this success by profit or failure through liquidation. However, they do not map process performance and improvements seen by the customer. In a successful total quality organisation, performance will be measured by the improvements seen by the customer as well as by the results delivered to other stakeholders, such as the shareholders. A simple performance measurement framework includes more than just measuring, but also defining and instinct metrics, collecting and analysing data, then prioritising and taking improvement actions.It is important to know where the strengths and weaknesses of the organisation lie, and measurement plays a key role in quality and productivity improvement activities. The main reasons it is needed are to ensure customer requirements have been met, to be able to set sensible objectives and comply with them, to provide standards for establishing comparisons, to provide visibility and a scoreboard for people to monitor their own performance level, to highlight quality problems and determine areas for priority attention,to provide feedback for operate the improvement effort Quality-related activities that will incur costs may be split into prevention costs, appraisal costs and failure costs.Prevention costs are associated with the design, implementation and maintenance of the TQM system. They are planned and incurred ahead actual operation, and could include Product or service requirements setting specifications for incoming materials, processes, finished Products/servicesQuality planning creation of plans for quality, reliability, operational, production, inspection Quality assurance creation and maintenance of the quality system education development, preparation and maintenance of programmes. Appraisal costs are associated with the suppliers and customers evaluation of purchased materials, processes, products and services to ensure they conform to specifications.They could include Verification checking of incoming material, process set-up, products against agreed specifications Quality audits check that the quality system is functioning correctly Vendor rating assessment and approval of suppliers, for products and services. Failure costs can be split into those resulting from internal and external failure. Internal failure costs occur when the results of work fail to reach designed quality standards and are detected before they are transferred to the customer. They could include Waste doing unnecessary work or retention stocks as a result of errors, poor organisation or communication Scrap defective product or material that cannot be repaired, used or sold Rework or rectification the castigation of defective material or errors Fail ure analysis activity required to establish the causes of internal product or service failure.External failure costs occur when the products or services fail to reach design quality standards, but are not detected until after transfer to the customer. They could include Repairs and servicing of returned products or those in the field Warranty claims failed product that are replaced or services re-performed under a guarantee Complaints all work and costs associated with handling and servicing customers complaints Returns handling and investigation of rejected or recalled products, including transport costs Effective quality improvements should result in a future stream of benefits, such as Reduced failure costs Lower appraisal costs Increased market share Increased customer base More productive workforce Service Quality Management (SQM)Service quality can be defined as the collective effect of service performances which determine the degree of satisfaction of a user of the service. In other words, quality is the customers perception of a delivered service. Service-quality management, refers to the monitoring and maintenance of end-to-end services for specific customers or classes of customers. As larger varieties of services are offered to customers, the impact of network performance on the quality of service will be more complex. It is vital that service engineers identify network-performance issues that impact customer service. They also must quantify revenue incapacitated due to service degradation.The service-mapping tool comes in next. Performance data is mapped onto service-quality data. Take a customer using Multimedia Messaging Services, or MMS. If a video download is interrupted many times during a session, the customer will lose interest. The operators revenue will be lost with it. To lift this situation, key quality indicators (KQIs) like availability can monitor the QoS offered to customers. From a customers point of view, the availabili ty KQI measures how successfully he or she can access and use the MMS service. With the service mapping tool, its possible to combine KQIs from multiple key performance indicators (KPIs) across different service resources.KPIs measure a specific aspect of the performance of either a service resource or a group of service resources of the same type. A KPI is restricted to a specific resource type and derived from network measurements. By following this top-down approach, the service-mapping tool provides several benefits. It helps operators manage end-to-end quality of service from a customers perspective. It also allows them to reuse key performance indicators and key quality indicators across services and products. Lastly, it helps operators reading down to the service elements that are responsible for quality degradations. Service quality also demands a simple and easy-to-use user interface.With this interface, Network Operations Center (NOC) staff and service managers can monito r service-quality objectives against thresholds. These thresholds may be internal targets for the network operator. Or they could be derived from Service Level Agreement (SLA) definitions. When the service quality travel below the contracted levels, managers could then initiate corrective actions. They could focus on the service degradations that affect the greatest number of customers. A set of standard reports for different user communities should also be available. For new services, marketing and sales may be interested in reports on service usage and service uptake. subject area regulators may also request historical service quality against given service objectives. CHAPTER 3METHODOLOGY Cooper and Emory (1995) defined research as a systematic inquiry aimed at providing information to solve problem. This chapter will present a detailed idea about how the research will be conducted. In this chapter research methodology, the sample selection methods, data collection methods & dat a extraction from the Questionnaire and data analysis will be studied and explained. At the end of this chapter validity and reliability issues will be discussed to follow the quality standards of the research. Research strategy will be a general plan of how researcher will go about answering the research questions that has been set by researcher.It will contain clear objectives, derived from research questions mark the sources from which researcher intend to collect data and consider the constraints that researcher will inevitably have such as access to data, time, location and money, ethical issues. (Thornhill et. al. , 2003) Based on three conditions 1) form of research question 2) requires control over behavioral events and 3) focus on contemporary events Yin (1994) identified five research strategies in social science. These are experiments, surveys, archival analysis, histories and case studies Most important condition for selecting research strategy is to identify the type of research question being asked. Who, What, Where, how and Why are the categorization scheme for the types of research questions. ii possibilities need to investigate by asking the what question.First, some types of what questions are justifiable for conducting an exploratory study and the intent is to develop pertinent hypotheses and propositions for further inquiry. Any of the five research strategies can be used in that situation- exploratory survey, exploratory experiment, or an exploratory case study. The second type of what question is actually form a how many or how much line of inquiry and the outcomes from a particular situation. The survey or archival analysis is more favorable than other strategies. If the researcher needs to know the how question, the better strategy will be doing history or a case study. (Yin 1994) Research PurposeResearch can be classified in terms of their purpose. Accordingly, they are most often classified as exploratory, descriptive or explanat ory (Saunders, Lewis & Thornhill 2003). Exploratory research is useful when the research questions are vague or when there is little theory available to guide predictions. At times, researcher may find it impossible to form a basic statement of the research problem. Exploratory research is used to develop a better understanding (Hair, Babin, Money & Samouel 2003). Exploratory studies are a valuable means of finding out what is happening, to seek new insight, to ask questions and to assess phenomena in a new light.It is particularly useful if researcher wish to clarify the understanding of a problem. There are three principle ways of conducting exploratory research a search of the literature, talking to experts in the subject, conducting focus group interviews (Saunders, Lewis & Thornhill 2003). Descriptive research describes some situation. in the main things are described by providing measures of an event or activity. Descriptive research designs are usually structured and specif ically designed to measure the characteristics described in a research question. Hypotheses, derived from the theory, usually serve to guide the process and provide a list of what needs to be measured (Hair, Babin, Money & Samouel 2003).The object of descriptive research is to portray an accurate profile of persons, events of situations. It is necessary to have a clear picture of the phenomena on which researcher wish to collect data prior to the collection of the data (Saunders, Lewis & Thornhill 2003). Explanatory Research establishes causal relationships between variables. The emphasis here is on studying a situation or a problem on order to explain the relationship between variables (Saunders, Lewis & Thornhill 2003). Explanatory studies are designed to test whether one event causes another (Hair, Babin, Money & Samouel 2003). The purpose of the research is mainly descriptive and explanatory.It is descriptive because descriptive data has been collected through detailed interview s and it is also explanatory since we will explain the relationship between the service quality variables and customer satisfaction and how these dimensions affect customer satisfaction. It is somewhat exploratory nature since Data exhibition Method Data was collected by primary as well as by secondary winding data c