Monday, March 16, 2020

Shouldice Hospital Essay Example

Shouldice Hospital Essay Example Shouldice Hospital Essay Shouldice Hospital Essay Q1: How does shouldice compete? In other words why do patients come to shouldice hospital? Two main reasons drive customers into choosing Shouldice over other competitors/hospitals. The first is quality, and the other is cost. talking about quality of the Shouldice â€Å"product† includes both, quality of the operation, and quality of post operation activities and overall services offered by Shouldice. The Shouldice method is a focused, specified operation that deals with Hernias, with a reputation that has been built throughout the years and is still growing; the hospital doesn’t even use advertisement to attract patients, the â€Å"word of mouth† way of advertisement has been doing very well for them so far. The superior quality offered by the Shouldice method, gives the patients a motive to operate at Shouldice for what it gives regarding peace of mind, low risk and low recurrence rates. Away from the in-operation excellence in quality, the services that Shouldice hospital offers are more tempting than other hospitals. Patients do not feel that they are in a hospital; they consider it more like a recovery vacation with an excused absence from work without feeling any guilt in that. How do you count for its performance ? The Shouldice Method * Specializes in external hernias only. * Is a 45 minute procedure for first time repairs, * And a 90 minute procedure for recurrences of hernias previously repaired elsewhere. * Involves separation of muscle layers and six rows of sutures in an overlapping fashion resulting in a reinforced muscular wall. * Typically, only requires use of a sleeping pill, a pain killer, and a local anesthetic allowing for immediate post-op ambulation rapid recovery. The Patient Experience * Appointments are driven by patient referrals. * Patients are encouraged to self-diagnose to avoid a visit. * The experience requires only one or two visits. * A typical length of stay is about 3 days. * All rooms are semiprivate, and patients are grouped with someone of like interest. * Patients nearing discharge help orient new patients arriving. * Surgery occurs on day 2. * Patients walk from the operating table to the post-op room (with some help from surgeons), * For psychological and physiological reasons * And are encouraged to exercise regularly, explore the premises and make new friends. * Patients were so fond of their experience that they sometimes asked if they could stay an extra day. * The most common after-effect in summer is sunburn! The Nurse Experience * Shouldice employs 34 full-time equivalent (FTE) nurses on staff. * The ratio of nurses to patients is 1:15, compared to 1:4 in Canadian acute-care hospitals. * Nurses spend an unusually large amount of time providing counseling services to patients. * Due to low nurse turnover, there is a waiting list of nurses wanting to work at Shouldice. * Competition is constantly short-staffed. The Doctor Experience * 10 full time surgeons, * 8 part-time assistants, * 2 anesthetists on site, * 30-36 operations per day. * Each surgeon performs 3-4 surgeries per day. * Salary is $144k + bonus (15% over competition). * Surgeon’s typically work 7:30 – 4:00 M-F. * On call 1 weekday night in 10, 1 weekend in 10 * Better quality of life than most surgeon schedules * Consequently, turnover is low. The Facility * The facility is designed so patients have to walk in order to do things they need or want to do. * Rooms are not equipped with phone or TV. * Patients must travel to make a phone call, watch TV, socialize, eat, etc. * Small rise stairways make it easier on patients who have just completed surgery. * Carpeting makes it feel warm and comfortable. * Patients and staff eat together in the cafeteria. * Food all fresh ingredients and prepared from scratch. The Administration * No one is fired! Turnover is low. * Staff is non-union. * Pay scale is higher than the competition. * Profit sharing plans are in place for doctors and staff. * Cross-training teamwork are strong. * Managing director stays late one night per week to interact with patients and staff. The Market * 1 million hernia operations in the US in 2000. * Most commonly performed on males. * Shouldice has a backlog of 2400 growing. * Relies entirely on word-of-mouth advertising. * Rates are reasonable. * Annual checkups are provided for alumni free of charge. * Annual reunion of patients draws about 1000. What actions to take to expand the hospitals capacity ? Consider becoming a teaching hospital to provide a new revenue stream and spread the Shouldice technique around the world. Consider performing surgeries on weekends. Provide training for leadership staff, to overcome the concerns about compromised quality control of operations with expansion. Develop resilience skills of all staff and leadership skills for administration. Hire new staff with the understanding of the new operating hours. It is highly recommended to adopt Saturday working option with some minor modifications. The existing procedure needs to be synchronized with the various activities and to be well planned. How would you implement the changes you propose ? * Admission of patients to be made on Sundays with the available administrative staff. * During the peak period of operations, use the 14 hostel rooms available in the third floor for accommodating the patients. * Incentives to doctors, nurses and other staff for the Saturday working days to be paid twice that of normal days. * Successor for Dr. Obney from the existing experienced doctors to be done within six months. * A general meeting is going to be scheduled to discuss the expansion. * Feedback and suggestions would be gathered from the overall staff. * Employees would be allowd to work flexibly.

Saturday, February 29, 2020

Important Court Cases - 20th century american history Research Paper

Important Court Cases - 20th century american history - Research Paper Example History tells us about the things we should never forget. How civil rights in America were properly respected and enforced by both the courts and the government is something we need to understand fully. It is the cornerstone of America's greatness today and into the future. The legal history of civil rights goes back many decades, but the most important cases appear after the Second World War when increased urbanization was reshaping American demography and social situation (Marable 1984, 14). The first and most significant landmark case was Brown vs. Board of Education. Few can dispute the historical role played by this case which almost certainly is the most famous American court case of the 20th century. This case effectively ended segregation in the United States and proved very controversial at the time (Kluger 1975, 12). The case involved parents in Kansas and elsewhere who wanted to send their children to the schools closest to them, but because of their race were forced to se nd their children to black schools a great distance away. They launched a suit arguing that having separate schools for different races was unconstitutional and a violation of their rights. The Supreme Court agreed with them 9-0. A book by Myrdal showed the court that the state of black schools was inferior (Myrdal 1944). The court realized that schools were separate but not equal. A second case involving similar issues, often referred to as Brown II, led to the Court declaring that the desegregation of American schools should be done soon and quickly (Ogletree 2004, 8). This gave impetus to changes that began to happen across the country. But that was not the end of the consequences of this decision. This was not a court case decided in a vacuum. In its wake, the governor of Arkansas used the national guard to try to block black students from entering white schools (Kluger 1975, 90). He refused to accept the ruling by the Supreme Court of the United States. Instead, he wanted to pl ay to his racist base. President Eisenhower was forced to send in the army to ensure the rule of law. He nationalized the Arkansas guard and saw that the law was enforced. In Alabama, a similar event occurred involving the governor there. These dramatic confrontation set the stage for much of the civil rights movement and the rise of people like Rosa Parks and Martin Luther King Jr. Civil rights leaders saw that the Constitution could protect them even if local sheriffs and lawmakers did everything they could to prevent changes from being made. Inspired by these cases, they pressed their issues by using non-violent protests. Education was just one legal battle fought during the civil war movement. People wanted to have less government control over their personal lives. Who was the government to say who a person could marry in a free country? And yet racist laws in much of the South prevented blacks and whites from marrying. Another significant case in the history of the civil rights movement was Loving vs. Virginia (1967). This was a case involving the marriage between a black woman and a white man, which the state of Virginia held to be illegal under their anti-miscegenation laws. These laws were in place based on a biblical conception of creation and marriage. Many people at the time believed that God had placed the races on

Wednesday, February 12, 2020

Philosophies of the East Essay Example | Topics and Well Written Essays - 1000 words

Philosophies of the East - Essay Example Hinduism as a philosophic creed has had no known founder, and there are no standard set of doctrines other than those in the Vedas and the Upanishads, universally accepted by all followers, and this may seem a disadvantage when compared to Confucianism and Buddhism. But when seen closely, it appears that Hinduism grapples with concepts of a different philosophical significance than Confucianism, because Hinduism deals with the nature of creation itself, whereas the other deals with the Way, a Way of worldly human life on the material plane alone. Buddhism, of course had a founding father in Gautam Buddha, many of whose given precepts are strikingly similar to that of Hinduism. Hinduism accepts that absolute reality is One, the Brahman, the various gods, demi-gods and the entire creation is Its expression. The human soul Atman is a part of It but is separated from It by a veil of ego and ignorance in the samsara, the world. The more the ego and ignorance, the more the reincarnations, in each of which the soul goes through various kinds of physical and mental suffering due to his or her Karma, or action and desires. Good karma brings the soul closer to Nirvana, or salvation from the cycle of rebirths, and bad karma and material desires drag it back down into the cycle.It is good human action and lack of material desires that can achieve salvation. On the other hand, human suffering can be understood in terms of bad past Karma, or human actions in a previous life. The Atman works out its Karma in an atmosphere of Lila or Maya, the history of the world and humans, which is in fact an illusion. Human life, then, is the journey of the Atman wherein humans try to control both the mind and the senses and become Brahman-oriented in the hope of experiencing total fulfillment in oneness with God or Brahman. Hindu philosophy allows for various ways to achieve Nirvana and over the ages various philosophers from Nagarjuna, Ramanuja, Sankara and the modern day Aurobindo Ghosh have offered their own interpretations. Buddhism is quite similar in its approach. Buddha's concern with the cause of human suffering led him to determine the Eightfold Path of human thought, speech, action, contemplation and mindfulness which is the way human beings can be free of all desires and suffering and attain Nirvana. Moreover, upadana or "clinging to existence" should be relinquished because existence in this world is illusory, and it is important to achieve a silence of body, mind and word. But unlike Hinduism, Buddhism does not believe in a divine creator or in divine salvation; the problem of suffering is one that humans must cope with themselves. Confucianism, on the other hand, is not concerned with the other world or rebirths at all. Direct human action is the only way human beings can better themselves according to Confucius. Human beings can gain wisdom through experience and study, following a set of principles which dictate positive action, helping others, and gaining their respect in a non-coercive fashion. Confucius held that it is possible to become a superior man through constant practice of the principles he set out, and his philosophy had much to do with political codes and family life as well. Confucius did not feel that human life and existence is governed by a fixed and eternal transcendental principle that stands outside and above events and determines them: human

Saturday, February 1, 2020

Work Based Practice Project Essay Example | Topics and Well Written Essays - 3000 words

Work Based Practice Project - Essay Example vascular dementia, medical conditions such as pick’s disease substance induced dementia must be first ruled out in order to com to this diagnosis. The accurate assessment of DAT is done through extensive testing Psycho – motor testing and neuroimaging as well as standard lab work to mention but a few deficits are found in the following areas. This study is based largely on experience gained through the ongoing with Care Company who wish to develop a training capability in Dementia care. This research will be involved working intensively in an Elderly Mentally Infirm registered residential home. The purpose of this research is to outline ways in which training can be use to help staff develop into reflective practitioners. This study concerns a case study examination of Care Company from which permission has been obtained. It is hoped that this research will contribute to the company’s development and implementation of health sector goals and objectives. Studies done have indicated the major signs of dementia are forgetfulness. A condition called mild cognitive impairment is observed first. This is the stage that describes the situation where one develops normal forgetfulness that is due to old age and the commencement of dementia. People that find themselves as victims of this MCI generally experience problems that are related with memory and thinking capacity. This however does not interfere with their daily undertaking. Several studies have been done to develop the major causes and symptoms that are associated with dementia. According to Biernacki (2007) the major cause attributed to Dementia is the damaged brain cells. Damage to the brain cells causes breakdown of communication making it impossible to translate the different undertakings of the body for instance thinking and behaviour. This can be explained by the through looking at the composition of the brain. From the studies done, the brain is made up of several distinct regions. Each region

Thursday, January 23, 2020

Abortion :: essays research papers

ABORTION – THE ISSUE Abortion is the termination of a pregnancy. Legal abortions can be performed up until the sixteenth week of pregnancy, after sixteen weeks most doctors or clinics will not perform the procedure unless keeping the baby presents a medical risk to the mother. Even in these situations abortions are very risky after sixteen weeks. The moral question has always been whether or not it should be a woman’s decision to get an abortion. The other side of that question is whether the government should have control over a woman’s body and forbid her to get an abortion. Both the pro-life and the pro-choice supporters on this issue are adamant about their ideas and their beliefs. Pro-life activists carry a strong argument, and continue to push their beliefs. They feel so strongly about these beliefs that violence has broken out in some known instances. Pro-choice activists, on the other hand, also carry very strong points. They believe that the child inside them is their property and its life doesn't be until birth. The Church is against abortion seeing it as the killing of a human life. Pope John Paul â€Å"condemned abortion as a crime†¦urging Roman Catholics to fight what he called an abominable crime and the shame of humanity.† (The Age 6-10-97) and on a trip to Brazil stated â€Å"May the abominable crime of abortion, shame of humanity, not condemn the unborn to the most unjust execution – that of the most innocent human beings.† Mother Teresa another widely recognised religious figure was whole heartedly against Abortion seeing it as â€Å"murder† of the innocent. The Catholic Church believes that abortion should be undertaken only in extreme circumstances such as when the mother is in risk of dying. The media on the other hand seem to relay both sides of the issue. The electronic media seem to go by public support that abortion is a woman’s right and that the baby is only a foetus with no feeling. The print media follow the same structure as an opinion article in the Age by Pamela Bone reads â€Å"The law should reflect society’s needs, and at this point in time, that need includes safe and legal abortion.† (12/2/98) on making abortion illegal across the states. The media seems to voice what the statistics show that the 80 000 abortions in a year will still happen even if abortion is made illegal.

Wednesday, January 15, 2020

Margaret Atwood; Cat’s Eye Analysis- Refraction and Self Essay

â€Å"Our commonsense explanations of the world and ourselves are problematised by Atwood through her novel. Nothing is quite as it seems, when we look at anything (in a mirror, in the past, at others) it is refracted as if through water.† Discuss the ideas and issues in the novel in relation to this statement, paying particular attention to the techniques and narrative elements used to show this. Our commonsense explanations of the world are based on the absolutes in our lives. Ways of seeing have been socially constructed embedded with values and attitudes that influence our behaviour and view of the world and ourselves. Reality cannot be captured and is interpreted differently by every individual as if refracted through water. Cat’s Eye is a work of influential English by author Margaret Atwood. The novel’s central area of exploration is of different versions of reality, and the accuracy and truthfulness of our own visions of how we see the world and ourselves. These visions are problematised by Atwood, as she uses various techniques that allow her to discretely proffer her idea of ‘nothing is quite as it seems’ to position the audience. This results in our own endorsement of these beliefs, and leads us to question our own lives as just a version of reality, with a sense of disillusionment. Our world and our own lives are challenged by Atwood’s novel, as in questioning the idea of no absolutes and constants in our lives, we also begin to question the other constants in our society such as religion being just another version of reality and not an absolute. This distresses many people and problematises our lives. Measurable, knowable, constant, and absolute qualities of life provide security in our beliefs and understanding of the world and our place within it. Absolutes help us make sense of the world, and provide a connection to the world and our own inner selves generating a sense of belonging. Atwood challenges the concept of absolutes, fixed/knowable identities, and common truths through various techniques. She uses narrative elements to proffer her ideas, such as autobiographical writing to encourage us to question the one and only version of reality that is being told (through Elaine and her life). Imagery/symbolism and intertextuality are recurring techniques, for example her repetitive use reflective surfaces such a glass, water and mirrors are all symbols used to question reflection, and how we see  ourselves; is what we see what we get? These techniques are used in order to provoke self-doubt and insecurity, to unsettle and complicate the way we see ourselves and our world, through the provocative questions that it asks of us. Cat’s eye challenges the naturalized and socially constructed views and encourages the reader to question the dominant views of the world and themselves. Refraction is the distortment of light, as it travels, it’s broken-up as it changes and moves through different mediums. Atwood uses refraction as a symbol representing the key belief that our vision of life and ourselves is refracted, broken up, distorted, and that as a result our perceptions aren’t always accurate. Atwood uses Elaine’s second encounter at the bridge to imply that our views, especially on other people are refracted, and not necessarily as they seem to be. Cordelia is seen to effect Elaine the most significantly, and it is not until the end of the book, when Elaine is finally coming back to herself (the bridge) that Elaine realises that Cordelia was not what she seemed to be. â€Å"There is the same shame, the sick feeling in my body, the same knowledge of my own wrongness, awkwardness, weakness; the same wish to be loved; the same loneliness; the same fear. But these are not my own emotions anymore. They are Cordelia’s; as they always were.†It is only at the end of Elaine’s life when she realizes that her emotions that traumatized her childhood (and adult life) were in fact Cordelia’s, who in order to escape them and cope transferred them to Elaine. Elaine feels stronger with this knowledge and finally releases Cordelia, as the Virgin Mary once released her â€Å"Its ok, you can go home now.† Elaine’s mourning is over and she is free of Cordelia, she can see clearly now- â€Å"The snow in my eyes withdraws like smoke† and is starting to make sense of her past. Atwood also uses Elaine’s misconception of Cordelia to exemplify how our ‘refracted’ view of others substantially affects our view of ourselves and the world; our experience of the present is coloured by our past events. Elaine realises that all these years, she still did not ‘know’ Cordelia, supporting Atwood’s dispute of the notion that there can really be a ‘fixed’ and ‘knowable’ identity. Atwood employs this metaphor in order to position the reader to be receptive to the idea  that our views on others, the world, and ourselves are not absolute but equivocal. In Cat’s Eye the first person limited narration is unreliable in the sense that Elaine cannot ‘see’ enough – either because of her own maturation and desires and the forces conditioning them, or of the consequences of her choices. The novel questions whether ‘lives’, ‘stories’ or autobiographical narratives can ever be accurate. A novel that presents a straightforward linear narrative that moves through events sequentially and constructs a complete set of ideas about life that seem unproblematic. It accepts that our experience of life, our thoughts and feeling, motivations, movement through time – our very representation in a literary text, can be captured accurately. It implies order, coherence, unity and stability; a rational basis for our actions and thoughts thus presenting a conservative worldview. The structure of Cat’s Eye serves as a critique of this unproblematic view of the world. The novel constantly shifts between past and present and her narration as a young Elaine and an old Elaine. This shifting represents Elaine’s life, as she feels it is barley comprehensible. Because the story is written in first person, its only presents one version of reality- Elaine’s version. This leads us to question Elaine’s version and its accuracy. Atwood’s purpose behind this is to bring to light the complexity of character in Elaine, and highlight her struggle in coming to terms with her own identity. This challenge on the common qualities of autobiographical narratives even leads the reader to question Cat’s Eye as just another version of reality that is presented to us in life. Atwood questions the belief that the individual is knowable and that appearance corresponds with fixed reality; she critiques the notion that reality can be ‘captured’. This is shown through her questioning of autobiographical writing, and is perpetuated through the use of Elaine’s paintings at her gallery Sub-versions. Cordelia subjected Elaine to subtle, psychological bullying as a child, and destroyed her self-confidence, which lasts well into her adult life. Her art is a way of expressing these bottled-up emotions and a means of dealing with her trauma; her art presents a different version of reality of her life, one that she is unable to  confront in her everyday life. â€Å"I can no longer control these paintings, or tell them what to mean. Whatever energy they have came out of me. I’m what’s left over.†Through her art she exerts a power that she did have in her childhood, taking revenge on Mrs. Smeath and confronting other issues such as her bullying in the painting Cat’s Eye, where Elaine appropriates the idea of the pier glass reflecting figures outside the frames of the main picture. This glass hangs behind a self-portrait that shows only half of Elaine’s head and incorporates signs of aging. In her childhood the three girls watch her from behind yet the young Elaine in the picture is turned around, facing her tormentors. The painting symbolises the claiming and relinquishing of control. The child, Elaine looks back at the three girls, the adult Elaine looks back at the outside viewer. The back of the head is crucial: a mirror that shows only the ruined half of your face. Elaine’s art reflects the psychological state she is in and has faced in her childhood. This is symbolic of Elaine looking back on her life and seeing her childhood in a different light-‘Nothing is what it really seems.’ The gallery is appropriately named, contributing to Atwood’s hypothesis; Life is a series of different and conflicting versions of reality, identity and reality are not fixed and the concept of ‘exact truth’ can never be captured. Atwood’s novel Cat’s Eye shapes the reality by which we view the world and ourselves. Our lives operate around security (especially of ourselves) and we generate and understanding and connect ourselves to the world through various versions of reality that we reinforce to become believed ‘absolutes’ upon which we base our lives Without the ‘fixed reality’ we create for ourselves and the absolutes that structure our lives, our sense of purpose, and meaning diminishes. Distress is brought upon us through Cat’s Eye because Atwood critiques our quest for identity as she suggests that we will never ‘know ourselves’ and will never have a fixed identity. It is therefore the reader’s choice on weather to comprehend the notions Atwood is proffering. Atwood uses varied techniques and narrative elements such as imagery, symbolism, and the narrative point of view to allude her beliefs. Through the particular employment of these techniques Atwood strengthens her case to the reader and positions them to support her indited criticisms of a knowable identity, and a fixed reality and truth. Cats Eye challenges the  measurable, and the way we qualify things as knowable and existing and a truth. Bibliography: Atwood, Margaret, Cat’s Eye, Penguin, Montreal 1968

Tuesday, January 7, 2020

Magnetic Resonance Imaging Great Helps Medicine Essay

Subject: Magnetic Resonance Imaging *INTRODUCTION Magnetic Resonance Imaging (MRI) has been around since the 1930s. An MRI machine has a great purpose in the medical field. It is a radiology technique that uses magnetism, radio waves, and a computer to produce images of body structures, such as a patient’s head, chest, blood vessels, bones and joints, and much more. MRI machines help doctors figure out what is wrong with their patients bodies. It allows doctors to take a closer look at a certain location and see things that other machines cannot see. By using this machine, it helps doctors figure out the problem faster and allows them to try and find a treatment or a cure. METHODS OF RESEARCH I selected this research topic because†¦show more content†¦Every time a surgeon goes in for an operation they tend not to say anything to their patients so that they do not worry. Honestly, what patient would want to know that their doctor is going in blind, while carrying a knife? The doctors can only see what is in front of them, but not around the next bend. The surgeons hope that the structures look like what they have seen, but they really do not know. According to Josh Fishchman a journalist from U.S News, â€Å"new developments are making surgical procedures safe, more accurate and more successful. Due to real time MRI and computed tomography, doctors and surgeons are able to pinpoint certain cancerous areas and operate with a clearer view† (Josh Fishchman). Predict Risk of Heart Attack Advantages Heart Disease is the number one cause of death for both men and women in the United States. Every 33 seconds someone in the United States dies from a heart attack. Just this year more than 920,000 Americans will have a heart attack and probably more than half of them will occur without prior symptoms or warning signs. According to an article from USA Today Magazine, â€Å"Research study conducted by Christopher Maroules and colleagues; MRI imaging of aortic atherosclerosis can predict risk of heart attacks.† Cost Disadvantage MRIs are extremely expensive because of the prices for equipment. WithShow MoreRelatedTechnology And Its Impact On The Medical Field1562 Words   |  7 PagesIn the world we live in today technology is always advancing; having many great effects in our personal lives and in the medical field, one of which being the technical advances on magnetic resonance imaging (MRI). 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