Why The Evm Is Not Used For A Important Concept On...

I agree with to begin to collect reasons why EVM it is not used accordingly and based on that to build up the examples. My first opinion is that EV is an important concept on measuring the progress of the project, but not well explored as a significant tool and in such context, I think that by knowing why the EVM is not used properly can lead toward how to use it. There are cases that PMs know the concept but it is unusable for different reasons as well as there are many cases in which the concept is not known. So leaving apart the second case, in which the concept is not known because for my opinion this is the simple case, in my mere opinion, the reasons why the EVM is not used correctly or it can not be used can be grouped by: -The project does not have requirements at all. -The requirements change frequently which make absolutely difficult to define correctly the budget and the schedule. -There are wrong estimations of working packages. -The process of change management doesn t work or is ineffective. -The process of calculation Actual Cost is insufficient (reminding here cost collection). -The incorrect progress of the project. I am pretty sure that the reasons I mention above can be enriched to a macro level with many arguments why the phenomena happen. Here below is a couple of examples of my of my reflections why EVM wasn’t used properly: - The scope of Ice on Ice project was the upgrade of the infrastructure of the Call Centre. Lack of understanding theShow MoreRelatedPm Ch. 13 Notes4446 Words   |  18 Pages1. Setting a goal. Project goal setting goes beyond overall scope development to include setting the project baseline plan. The project baseline is predicated on an accurate. Work Breakdown Structure (WBS) process. Remember that WBS establishes all the deliverables and work packages associated with the project, assigns the personnel responsible for them, and creates a visual chart of the project from highest level down through the basic task and subtask levels. The project baseline is createdRead MoreEvaluation Of Routine Immunization Performance Essay8403 Words   |  34 Pagesefforts/plans for synergy between RI and Polio Eradication initiative for needed support for improvement 3) Explore the areas where CDC/NSTOP can contribute to strengthening the routine immunization and polio eradication. Methodology: The reviewer used the following methods to collect data/information for the review: 1) Review of recent reports, plans, publications and assessments on RI/PEI in Pakistan. 2) Meetings with key people responsible of management of RI and PEI at Federal level (NationalRead MoreInterview Question and Answer for Sap Sd10206 Words   |  41 Pages 1. What is total float? 2. What are the difference between free float and total float? 3. What is a constraint? 4. What are the difference between MS Project and Primavera? 5. How to load cost amp; resource in a program? 6. What is WBS? 7. What is a milestone? What are the types of milestone? 8. What are the difference between flag and milestone activity? 9. What is a critical activity? 10. What is resource allocation and leveling? 11. What is a Baseline ProgramRead MoreInformation Technology Project Management Appendix Answers Essay19447 Words   |  78 PagesSolutions to Accompany Information Technology Project Management, Sixth Edition ISBN-10: 0324786921 ISBN-13: 9780324786927 Course Technology MIS Series Companion Web Site: www.cengage.com/mis/schwalbe Kathy Schwalbe, Ph.D., PMP Table of Contents CHAPTER 1 CHAPTER 2 CHAPTER 3 CHAPTER 4 CHAPTER 5 CHAPTER 6 CHAPTER 7 CHAPTER 8 CHAPTER 9 CHAPTER 10 CHAPTER 11 CHAPTER 12 APPENDIX A APPENDIX B APPENDIX C List of solution files available and referenced in this document, in alphabetical order:Read MorePmp Exam Preparation Questions32679 Words   |  131 Pagesanalysis, and quality audits are all Perform Quality assurance tools. Ishikawa diagram illustrates how various factors might be linked to potential problems or effects. As part of the project s quality assurance efforts, your audit team is using these tools in your software development project. Which stage of the project management life cycle are you in? A Planning process group B Executing process group C Monitoring and controlling process group D Closing process group 2 Which one of the

First Motor Case Free Essays

Global Perspectives on Accounting Education Volume 5, 2008, 17-25 FIRST MOTORS CORPORATION: A CLASSROOM CASE ON IMPAIRMENTS Tim Krumwiede College of Business Bryant University Smithfield, Rhode Island USA Emily Giannini Graduate Student, College of Business Bryant University Smithfield, Rhode Island USA ABSTRACT This case requires a detailed analysis of impairments of both long-lived assets and goodwill for First Motors Corporation, a fictitious automobile company. By integrating multiple issues into this case, students are presented with some of the complexities and interrelationships that are seen in practice. To properly prepare solutions to this case, students must successfully read, interpret, and apply both accounting standards and concept statements. We will write a custom essay sample on First Motor Case or any similar topic only for you Order Now The use of judgment in choosing a discount rate for present value computations is an important component of this case. In fact, an earnings management issue and resulting conflict between First Motors Management and the company’s auditor revolves around the discount rate choice. Additionally, the suggested questions provided with the case require that students address components of the conceptual framework in the context of the impairment standards. This case can be used in upper division financial reporting classes at either the undergraduate or graduate level. Key words: Impairment, goodwill, long-lived assets, discount rate BACKGROUND t is currently 2013 and you are a member of the engagement team assigned to audit First Motors Corporation for the year ending 12/31/2012. First Motors Corporation is a car manufacturing company focused on moving from the production of gasoline-based cars to the production of cars I 17 18 Krumwiede and Giannini based on alternative fuel sources. It was one of the first car companies to successfully produce hybrid-based vehicles in the United States. First Motors has successfully maintained car sales and retained valuable employees while creating modern, efficient cars. By 2008, First Motors was manufacturing two vehicles, both of which are still being manufactured today. One model is a hybrid-powered vehicle that can be customized in style and features for any purchaser around the globe. This model, called the Passaic, is manufactured in Detroit, Michigan, close to the company’s corporate headquarters. First Motors also manufactures a gasoline-powered model, the Mendoza, at its plant in Lorain, Ohio. In 2008, to take advantage of its alternative fuel source expertise, First Motors purchased a large competitor, Macinaw Motors Corporation, which had made significant progress with hydrogen-powered cars. As the United States is moving toward alternative energy sources, hydrogen is increasingly being used as a fuel source to replace gasoline. To achieve such progress, several processes can be used to make hydrogen. According to the National Hydrogen Association (2006), hydrogen can be made from water, biomass, coal, and natural gas. Much of the hydrogen produced today comes from steam reforming natural gas. Alternatively, an electrolyzer can be used to separate water into its components, oxygen and hydrogen. The hydrogen can then be cooled down to form liquid hydrogen which can be stored at hydrogen fuel stations. Macinaw Motors had experimented with several hydrogen technologies but eventually settled on the use of liquid hydrogen in an internal combustion engine as the most effective way to make substantial progress with hydrogen as an alternative fuel. Due to Macinaw Motors’ valuable research and development program, operating efficiencies, and exceptional reputation, part of the purchase price was allocated to goodwill. The amount recorded as goodwill was $1. 3 billion, or the difference between the $5 billion purchase price (fair value) of Macinaw Motors as a whole and the $3. 7 billion fair value of its identifiable net assets. When First Motors purchased Macinaw Motors, the combined company retained the name First Motors Corporation. Although First Motors and Macinaw Motors merged, the former First Motors is operated as the First Motors Division and the former Macinaw Motors is operated as the Macinaw Motors Division. Each division acts as a component of the enterprise that earns revenues and incurs expenses from engaging in its own business activity. Additionally, each division is reviewed by the enterprise’s chief operating decision maker to assess its performance and each division has its own discrete set of financial information. At the time of the purchase, Macinaw Motors had three manufacturing plants, all of which are still operating today. Each plant is used to produce one car model. Plant 1 is located in Irvine, California, where the hydrogen-powered Mankato is produced. Plant 2 is located in Mishawaka, Indiana, where the hydrogen-powered Sheboygan is produced. Plant 3 is located in Braselton, Georgia, where the gasoline-powered Spokane is produced. When Macinaw Motors was purchased in 2008, executives at First Motors believed that consumers were still purchasing gasoline-powered vehicles because their purchase price was still less than that of similarly equipped hybrid-based or hydrogen-based vehicles. Management of First Motors plans to convert Plant 3 to manufacture a hydrogen-based vehicle at some point in the future. However, for the next several years, First Motors wants to capitalize on the market for gasolinepowered vehicles and Plant 3 will continue to be used in the production of gasoline-powered cars. In late 2008, management began retooling Plant 3 of the Macinaw Division to create a new, efficient, and highly desirable gasoline-powered model of the Spokane. To retool Plant 3, the First Motors Corporation: A Classroom Case on Impairments 19 ivision incurred substantial equipment costs including the costs of body assembly jigs, welding equipment, conveyors, robots, and a new platform. Management decided to retool the plant and continue with a new model Spokane under the assumption that there was going to be a significant increase in oil supply from expected oil reserves in the Arctic National Wildlife Refuge of Alaska (ANWR). It was believed that these oil reserves would help keep the price of gasoline down which, in turn, would continue to stimulate demand for gasoline-powered cars. The retooling process was completed during 2009. THE CASE In 2012, First Motors management was surprised to learn that oil reserve estimates were inaccurate for the ANWR. After debate over this controversial drilling location, legislation was finally passed in 2010 that included approval for ANWR oil drilling. Some citizens of Alaska and other states were angered by the new law and protested the approval of oil drilling. Nevertheless, in 2012, drilling proceeded in one small select and authorized area. Results of the initial drilling revealed that the expected oil reserves in that location were not nearly as large as projected. Due to the ANWR finding and turmoil in the Middle East, there was a spike in gasoline prices during 2012 and the sales of the Spokane model did not meet expectations. Closure of Plant 3 was considered; however, for four reasons, management decided to keep Plant 3 open. First, management believed the spike in gasoline prices was not permanent and that other oil reserves would help to moderate future oil prices. Second, significant expenditures had already been made on the plant, and it would not require large amounts of additional capital in the near future. Third, consumers were still purchasing gasoline-powered vehicles because of the continued price differential between these vehicles and vehicles using alternative energy sources. Finally, because of union contracts, any assembly line workers laid off would be paid wages by the Macinaw Division at 75 percent of straight-time pay. Thus, management determined that it was not the appropriate time to convert Plant 3 to a hydrogen-based plant. Impairment Despite these reasons to keep Plant 3 open, its long-lived assets will not generate the net cash flows originally anticipated when the plant was retooled. In fact, as the result of very deep discounting of the Spokane’s retail price during the year, it is possible that the final numbers for 2012 may show negative operating cash flows related to Plant 3. Accordingly, management determined that an impairment test must be performed for the Plant 3 long-lived assets. To determine if the assets are impaired, management compares the future undiscounted cash flows of Plant 3 to the book value of the plant’s long-lived assets. As of 12/31/2012, the net book value of Plant 3’s property, plant, and equipment is $1. 4 billion, before any write-down from impairment is recorded. Additional relevant information is as follows: †¢ †¢ †¢ †¢ The estimated remaining life of the assembly line equipment is 11 years. Yearly anticipated net cash flows for each of the next 11 years is $62,504,377. It is assumed that the land, buildings, and equipment for Plant 3 can be sold for $30 million at the end of this 11-year period. The total estimated undiscounted net cash flows related to Plant 3 over the next 11 years are $717,548,147 (($62,504,377 x 11) + $30,000,000). 20 Krumwiede and Giannini The assembly-line and related equipment are considered the primary assets of Plant 3. In measuring the impairment loss for Plant 3, management considers various valuation methods for this equipment. It is determined that most of the equipment has no alternative use and that a sales value is not readily available. Accordingly, following the guidance of Statement of Financial Accounting Standards (SFAS) No. 157 (FASB, 2006), management determines that the fair value of the Plant 3 long-lived assets is best measured by the present value of its future net cash flows. The company’s management measures the present value of future cash flows using a riskfree discount rate of 3 percent. Because expected net cash flows are not adjusted for inflation, management does not incorporate an inflation factor into the discount rate. Using the 3 percent rate, the present value of the net cash flows is $600 million, resulting in an impairment loss of $800 million (book value of long-lived assets of $1. 4 billion less $600 million fair value as determined by discounted future cash flows). Once the impairment loss is determined, management is not sure how to allocate it and decides to wait for its auditors to assist in the allocation. The property, plant, and equipment of Plant 3 can be divided into four primary categories: land; buildings; robots and related equipment; and all other equipment. In anticipation of the audit, the following information is compiled regarding these Plant 3 assets: TABLE 1 Plant 3: Property, Plant, and Equipment Land Buildings Robots and Related Equipment Other Equipment Total Net Book Value $500,000 20,000,000 140,000,000 1,239,500,000 $1,400,000,000 Fair Value $1,000,000* 20,000,000* Not Available Not Available $21,000,000 Without undue costs, the fair value of the land and buildings are obtained from an outside appraisal. The 2012 Audit In early 2013, you go with your audit team to the First Motors headquarters in Detroit, Michigan for the audit, for the year ending December 31, 2012. Your team gets a quick tour of the factory, and you learn about various changes in the car industry, including the lack of oil reserves in the ANWR. You know that an impairment loss was recorded for the Plant 3 assets, and you are impressed with management’s initiative in measuring, recording, and disclosing the loss. However, you wonder if an impairment loss should have been recorded for the Mendoza, the other gasolinepowered car produced by First Motors. Fortunately, First Motors maintains cash flow and sales information on a plant by plant basis and you quickly learn that during 2012, sales of the Mendoza remained strong because of its compact size and excellent gas mileage. After reviewing the documentation supporting the impairment charge, you note that future cash flows are discounted at a risk-free rate of 3 percent and that this rate does not incorporate an First Motors Corporation: A Classroom Case on Impairments 1 inflation factor because the cash flow estimates were not adjusted for inflation. You vaguely recall from a college class that a discount rate should incorporate a risk premium and although you are relatively new to auditing, you know that 3 percent is a rather low discount rate. You approach management questioning this low discount rate and they become very defensive in explai ning that 3 percent is the rate for all the Plant 3 assets and that no other rate would be appropriate. Upon inquiry about risk being considered in such a rate, management stubbornly states that the 3 percent rate is fine. When asked for justification, management reasons that they reached this conclusion due to the fact that a risk premium could not be adequately measured. Additionally, they refer to Statement of Financial Accounting Concepts No. 7 (FASB 2000), which suggests that in such a situation a risk-free rate can be used. In re-evaluating the net cash flows, and after discussions with management, you agree that the cash flows are in fact the single, most-likely amount in a range of possible estimated amounts or the best estimate for the next 11 years (the expected life of the primary assets of Plant 3). However, you believe risk is not factored into these cash flow estimates. You suggest adding a risk premium to the discount rate, to incorporate fully the risk inherent in the cash flows. After consultation with the firm’s valuation experts, you are told that a risk premium is appropriate. Also, based on their experience in the auto industry and review of First Motors and Plant 3, the valuation experts suggest that an appropriate risk premium is 6 percent. From their advice, you conclude that 9 percent (3 percent risk-free rate + 6 percent risk premium) is a much more reasonable rate to use in discounting the cash flows. You are very proud of your findings and hope to make a good impression on your audit manager, Mr. Bother. Although you had briefly discussed with him the magnitude of the impairment loss and the discount rate used, he left the calculations and details up to you. When you approach him, however, he appears extremely frustrated and explains that First Motors never even complied with the yearly test for goodwill impairment, as specified in SFAS No. 142 (FASB 2001). You suggest that the goodwill impairment test may be unnecessary because an impairment loss for the plant assets has already been recorded by management. Mr. Bother shakes his head at you, grumbles, and tells you in a very stern manner that impairment of long-lived assets and goodwill often go hand in hand. He explains that upon acquisition of Macinaw Motors, $1. 3 billion was recorded as goodwill (the excess of the purchase price over the fair value of the identifiable net assets of Macinaw Motors). Mr. Bother explains to you that the fair value must be re-evaluated and compared to the book value. Furthermore, you heard some members of management grumbling about losing their bonuses if â€Å"these auditors keep coming up with more impairment charges. You realize management has significant bonuses tied to the 2012 target profits, and a large impairment loss will cause them to lose the expected bonuses. A quick review shows that the largest total impairment losses that can be recorded before the target profit will be missed and the management bonuses lost is $1. 75 billion. Your calculation is based on two facts: (a) 2012 unaudited ne t income before impairment charges is $2. 25 billion and (b) the management bonus arrangement states that bonuses will only be paid if 2012 net income exceeds $. 5 billion. You go home that evening and realize that you do not really understand what Mr. Bother said to you about goodwill impairment. For one thing, you do not know if Mr. Bother was referring to the fair value and book value of the entire company or just the Macinaw Division. You print out the firm’s training material on impairments and spend the rest of the evening reading about SFAS No. 142. 22 Krumwiede and Giannini The next day, you attend a meeting with management and Mr. Bother. During the meeting, you are first excited when you hear management indicate that they made an error in the recorded impairment charge for long-lived assets. You think that management finally realizes the necessity of incorporating a risk factor into the discount rate. However, your jubilation is quickly deflated when management indicates that the impairment testing for long-lived assets should have been done at a different level. In particular, management states that impairment testing of long-lived assets should have been for the company as a whole (Plant 1, Plant 2, and Plant 3 of the Macinaw Division, plus the two plants from the First Motors Division) and that the result is the impairment charge should not have been recorded. Management claims this result would hold because the decline in the value of the Plant 3 long-lived assets could be offset by the increase in the value of the longlived assets at the other plants. It is further explained that the individual who made the error is no longer with the company. Mr. Bother explains to management that the issue will be examined more closely. Before any further explanation can be provided, members of management are called away for another meeting. As you leave the meeting you realize that you do not know whether management is correct about combining long-lived assets for all plants of First Motors to perform the impairment test. Furthermore, you wonder if impairment testing is done for both plant assets and goodwill, if it can be a combined test, and if it needs to be done in a specific order. After reviewing your notes and the company records, you also begin to wonder if a mistake was made in the original calculation of the impairment loss related to long-lived assets. In particular, for purposes of the present value calculations, you note that the land and buildings are assumed to be sold at the end of 11 years. However, you recall from discussions with management that manufacturing plants are used for many years and are retooled over and over. Accordingly, it does not seem appropriate to assume the sale of the land and buildings after 11 years. After all, according to the accounting records, the buildings have a remaining useful life of 25 years and the land has an unlimited useful life. A couple of days earlier, the valuation method for any possible goodwill impairment testing was discussed. It was determined that no fair value was readily available for First Motors or its divisions. Additionally, because the stock price of First Motors was so volatile over the past year, the market capitalization was not a good indicator of the fair value of First Motors. You, Mr. Bother, and management came to an agreement that discounted future cash flows was the appropriate valuation technique to use. However, the calculations provided by management incorporated a riskfree discount rate of 3 percent. You took the initiative to do your own calculations based on an 8 percent discount rate, which includes a 5 percent risk premium. The 5 percent risk premium was recommended by the same valuation experts from the firm who recommended a 6 percent risk premium for use in the Plant 3 long-lived asset impairment. Management calculations and your calculations are summarized below in Tables 2 and 3. The information in the first portion of Table 2 represents the total fair value of First Motors and its divisions based on discount rates of 3 percent and 8 percent, respectively. Presented in the second portion of Table 2 is the estimated fair value of identifiable net assets based on discount rates of 3 percent and 8 percent, respectively. Finally, presented in Table 3 is a summary of the book value of identifiable net assets and the book value of net assets before recording any impairment for long-lived assets (the difference represents the book value of goodwill). First Motors Corporation: A Classroom Case on Impairments TABLE 2 Fair Value Information 3% Discount Rate Total Fair Value: First Motors Division Macinaw Division Total (First Motors) Fair Value of Identifiable Net Assets: First Motors Division Macinaw Division Total (First Motors) $2,600,000,000 3,200,000,000* $5,800,000,000 8% Discount Rate $2,045,000,000 2,550,000,000* $4,595,000,000 23 2,500,000,000 2,800,000,000 $5,300,000,000 $2,010,000,000 2,200,000,000 $4,210,000,000 * Please note that the total fair value for the Macinaw Division includes the combined net assets of Plants 1, 2, and 3. TABLE 3 Book Value First Motors Division Macinaw Division Total (First Motors) Identifiable Net Assets $2,000,000,000 3,000,000,000 $5,000,000,000 Goodwill $0 1,300,0 00,000 $1,300,000,000 Net Assets $2,000,000,000 4,300,000,000 $6,300,000,000 QUESTIONS (Assume that currently enacted GAAP is still applicable in the year 2012) Part 1 Please provide detailed explanations in answering each of the following questions. For questions 2a, 3a, 4a and 5, provide a citation to the appropriate accounting standard that supports your discussion. 1. Diagram the organizational structure of First Motors Corporation. 2. a. Under what circumstances is a company required to perform impairment testing for long-lived assets? b. Was impairment testing of long-lived assets required for First Motors? Why or why not? 3. a. At what level is impairment testing done for long-lived assets? b. Are the executives of First Motors correct in suggesting that the impairment of longlived assets at Plant 3 is not needed because the decline in the value of the Plant 3 assets can be offset by the increase in the fair value of long-lived assets at other plants? 4. a. At what level is impairment testing done for goodwill? 24 b. 5. Krumwiede and Giannini For First Motors, at what level should this testing be done (i. e. , should it be done for the company as a whole or just for the Macinaw Division)? If impairment testing of both goodwill and long-lived assets is required, in what order is it done? Part 2 Please provide detailed explanations in answering each of the following questions. Provide citations to the standards for each of the following: questions 6a, 7a, 8a, and 10a. Additionally, it is suggested that you provide citations to SFAC Number 2 (FASB 1980) when answering questions 10b, 11, and 12. 6. a. Prepare a schedule showing the computation of the long-lived asset impairment loss at both the 3 percent discount rate and the 9 percent discount rate. In the information provided in the case, it was assumed that the land and buildings for Plant 3 were sold at the end of 11 years. Be sure to consider and discuss if the land and buildings’ â€Å"assumed sale† after 11 years is appropriate or if the â€Å"assumed sale† should be at the end of the buildings’ useful life. b. Do you think that management is correct in using the 3 percent rate, or are the auditors correct in suggesting the 9 percent rate, or can either interest rate be justified? Provide a detailed answer to this question including a discussion about a risk premium. Be sure to consider the type of cash flow information provided by management. 7. a. Once an impairment of long-lived assets is determined, how is the write-down allocated among multiple assets? Prepare a schedule showing this allocation for Plant 3 (use the impairment loss determined based on the discount rate you chose in question 6b). b. Refer to your answer for part a. After the allocation is completed, will each longlived asset (or asset category) that First Motors wrote down be stated at fair value? Why or why not? c. How will the impairment loss and the corresponding reduction of book value to the long-lived assets affect future depreciation expense to be recorded, (potential) future impairment charges and/or future gains or losses on the sale of the long-lived assets? 8. . Determine the implied goodwill value and the goodwill impairment loss, if any, using both a 3 percent and an 8 percent discount rate. Which rate should be used and why? b. The valuation experts suggested that the risk premium (6 percent) in discounting the free cash flows from Plant 3, for purposes of the long-lived asset impairment, should exceed the risk premium (5 percent) in discounting the cas h flows for the Macinaw Division. Why is this difference in a risk premium justified? 9. a. Will management still receive bonuses if the 3 percent discount rate is used in the calculations? If the 9 percent and 8 percent discount rates are used? b. What is earnings management? c. Discuss the relationship between earnings management and the choice of discount rate to be used in discounting future cash flows for the long-lived asset impairment of Plant 3 and the goodwill impairment of the Macinaw Division. First Motors Corporation: A Classroom Case on Impairments 10. 25 11. 12. Once written down because of impairment, can long-lived asset write-downs or goodwill write-downs be recovered if predictions change (i. e. , the fair value subsequently increases)? Is there such a thing as a write-up for either long-lived assets or goodwill? a. Regarding reliability of financial information, comment on the verifiability and representational faithfulness characteristics of the conceptual framework as they relate to accounting for impairments. Be sure to incorporate First Motors into your discussion. b. Discuss the trade-off between the relevance and reliability of reporting long-lived assets and goodwill at fair value. How does the principle of conservatism apply to this trade-off? Consider the case of First Motors in your discussion. Find a real-world company that has taken an impairment charge (either for goodwill or longlived assets) and discuss how the relevant information was disclosed in the notes to the financial statements and the affect the charge had on net income or net loss of the company. TEACHING NOTES Teaching notes are available from the editor. Send a request from the â€Å"For Contributors† page of the journal website, http://gpae. bryant. edu. REFERENCES Financial Accounting Standards Board. 1980. Qualitative Characteristics of Accounting Information. Concepts Statement No. . (Norwalk, CT: FASB). _______, 2000, Using Cash Flow Information and Present Value in Accounting Measurements, Concepts Statement No. 7. (Norwalk, CT: FASB). _______, 2001. Goodwill and Other Intangible Assets. Statement of Financial Accounting Standards No. 142. (Norwalk, CT: FASB). _______, 2006. Fair Value Measurements. Statement of Financial Accounting Standards No. 157. (Norwalk, CT: FASB). The National Hydrogen Association. Frequently Asked Questions. Retrieved July 12, 2006, from http://www. hydrogenassociation. org/general/faqs. asp. How to cite First Motor Case, Papers

Machiavelli2 Essay Example For Students

Machiavelli2 Essay The Prince, written by Machiavelli, was a guide for all the rulers of his time who wanted to become major powers and to find all the solutions to their political problems. In his book, Machiavelli mentions a great amount of key points that guide rulers to the road of success. One of the key aspects that Machiavelli talks about is fate and how it effects the decisions of a ruler. The following paragraphs will discuss how human affairs are governed by fate, and how fate can be contested. During Machiavellis time, it was commonly thought that events were ruled by fate and by God only. Not only that, but men could do nothing to stop or protect themselves from those events. Machiavelli did believe in fate, but he did not believe in the fact the fate controlled all events that occurred to mankind. If that were so then princes would rule by chance. This is proven when Machiavelli states I am not unaware that many have held and hold the opinion that the events are controlled by fortunecause of this, they would conclude that there is no point in sweating over things, but that one should submit to the rulings of chance. (Machiavelli, pg.79) Machiavelli argued that fate controlled one half a persons life but the other half was governed by the people themselves. Machiavelli strongly suggests that princes are fortunate when fate and time are in harmony with their procedures, but things fall apart when things begin to change and the princes do not attempt to adapt to the changes. Machiavelli uses Pope Julius II who was always impulsive with his commands and succeeded in obtaining what no other pope obtained. The reason for this is because times and decisions were constantly changing and he adapted those changes to his procedures. Machiavelli quotes Pope Julius II was impetuous in everything; and he found the time and circumstances so favorable to his way of proceeding that he always met with success. (Machiavelli. Pg 81. ) Machiavelli Concludes that fortune is like a women, and to keep her suppressed it is necessary to beat her and fight with her. This is revealed when Machiavelli declares that it is better to be impetuous than circumspect; because fortune is a women and if she is to be submissive it is necessary to beat and coerce her. (Machiavelli. Pg. 82) Machiavelli has some very convincing points when it comes to fate and how it could be opposed. I agree with the fact that not all things are caused because of fate or fortune and that people can change the things if they put their minds to it. However, I disagree when Machiavelli states that its better to be impetuous than it is to think calmly about the situation. I strongly believe that if decisions are to be made, they should be made with extreme caution and not in a hasty manner. Especially if a ruler is dealing with politics and issues that would affect a country.Furthermore, I find a major flaw in Machiavellis comparison with fate and women. Think of the relationship between a man and a woman as a princes relationship with himself and the thrown. If a man treats a woman with love, care, and is not rash with his decisions then they could end up having a long lasting relationship. However, if a man decides to do something with out calmly thinking about the consequences, like having an affair, then he can loose the relationship. Bibliography:

Islamic extremists believe that the only governmen Essays - Islam

Islamic extremists believe that the only government should be the one controlled by their god, and the only laws in place should be those that are laid out in the Qur'an and the Hadith. Because of this, they believe that democracy, liberalism, human rights, personal freedom, international law, and international instructions are illegal, and go against god. Western society happens to go against these beliefs in just about as many ways as possible, causing Islamic extremists to target western societies. This is especially true for the United States, who is recognized by jihadis as the center of liberalism and democracy, things that islamic extremists don't want to spread. Islamic extremists, because of their warped world view believe that it is their duty to rid the earth of democracy or it will destroy true Islam. Their thoughts are filled with violence, and they are taught that the conflict between the United States and Islam is part of a universal struggle between good and evil, truth and falsehood, belief and infidelity that has been going on since the beginning of time. They do not believe that their problems with the western world can be resolved with peace, but believe violence to be the only true solution. Extremists are even taught that if they die fighting for the end of democracy they will be guaranteed a spot in a "paradise of unimaginable delights". Overall, Islamic extremists are taught to hate anything and everything that goes against their religious doctrine, the Qur'an and the Hadith. They think it is the only system of law or government there should be in the world. Western society goes against these traditions in almost every way possible, supporting women's rights, accepting homosexuality, and using secular democracy. This causes them to hate us deeply, as they are taught from birth that western people and society is the infidel, and must be killed to prevent the destruction of true Islam.

Free Essays on Global Citizenship

â€Å"A woman down in the valley began to scream. It was a wild and terrible sound †¦ Silence followed for as long as it takes to fill lungs with air †¦ before the woman’s breath broke, other voices joined in† (Gourevitch, 1998: 33). In Rwanda, there is a certain responsibility one has to their neighbors. When someone is in danger, they begin to whoop. This is the â€Å"conventional distress signal.† When you hear it, you have a responsibility to whoop also, find whoever is in danger, and help save them from it. â€Å"If you ignored this crying, you would have questions to answer† (34). Under common law in the United States, any person who went to help an individual who was in danger could be sued for any negligence or carelessness committed during the rescue attempt. A very common example is a person moving someone from a severe car wreck that may lead to an explosion. During the move, the victim becomes paralyzed. The victim then could sue his rescuer for paralyzing him, though his life may have been saved by this hasty move. Situations like this discouraged people from helping their neighbors in a time a trouble. Now in many states, Good Samaritan Legislation has been passed to safe guard the rescuer who is only trying to help. Under such statutes, even if the rescue attempt is â€Å"less than perfect, the helping person cannot be sued for additional injuries which he or she might cause† (Pennsylvania Emergency Health Services Council, 2002). The passing of this legislation, along with Rwandan tradition, shows that as human beings we have an ethical obligation to those who we know are in danger. So, should we be responsible to help only those cries of help that we can hear? We live in a shrinking world where the affairs of one country easily effect many others. In this shrinking world, we are also more interconnected through mass media, the Internet, and travel. That being established, it is possible to hea... Free Essays on Global Citizenship Free Essays on Global Citizenship â€Å"A woman down in the valley began to scream. It was a wild and terrible sound †¦ Silence followed for as long as it takes to fill lungs with air †¦ before the woman’s breath broke, other voices joined in† (Gourevitch, 1998: 33). In Rwanda, there is a certain responsibility one has to their neighbors. When someone is in danger, they begin to whoop. This is the â€Å"conventional distress signal.† When you hear it, you have a responsibility to whoop also, find whoever is in danger, and help save them from it. â€Å"If you ignored this crying, you would have questions to answer† (34). Under common law in the United States, any person who went to help an individual who was in danger could be sued for any negligence or carelessness committed during the rescue attempt. A very common example is a person moving someone from a severe car wreck that may lead to an explosion. During the move, the victim becomes paralyzed. The victim then could sue his rescuer for paralyzing him, though his life may have been saved by this hasty move. Situations like this discouraged people from helping their neighbors in a time a trouble. Now in many states, Good Samaritan Legislation has been passed to safe guard the rescuer who is only trying to help. Under such statutes, even if the rescue attempt is â€Å"less than perfect, the helping person cannot be sued for additional injuries which he or she might cause† (Pennsylvania Emergency Health Services Council, 2002). The passing of this legislation, along with Rwandan tradition, shows that as human beings we have an ethical obligation to those who we know are in danger. So, should we be responsible to help only those cries of help that we can hear? We live in a shrinking world where the affairs of one country easily effect many others. In this shrinking world, we are also more interconnected through mass media, the Internet, and travel. That being established, it is possible to hea...

Gratitude as a Ritual Expressing Thanks on Thanksgiving

Gratitude as a Ritual Expressing Thanks on Thanksgiving What do you think of when you think of â€Å"rituals†? For me, the word conjures up Shabbat dinners, Passover seders, and lighting the Hannukah menorah. Growing up in a Jewish household, we observed these rituals at the proper time on the calendar, and I always found they were an opportunity to take a step back from the other routines of life and reflect on the theme of the holiday. With Thanksgiving coming, many of us are preparing for a popular ritual: A big dinner, likely comprised of turkey (or Tofurkey), cranberry sauce and pumpkin pie, amongst other goodies. In the air is a general sense that the theme is gratitude. But do you actually take time to express your gratitude on Thanksgiving, or do you just stuff yourself silly? And do you find yourself uplifted during this season, or like so many, do sadness and anxiety creep in? Expressing Thanks on Thanksgiving In my family, we usually go around the Thanksgiving table at some point and each say something we’re grateful for. I like this ritual. Expressing gratitude is scientifically proven through positive psychology research to increase happiness. It gives us a sense of our own goodness (it’s sure more self-affirming than complaining!) as well as a recognition of the good things around us. I have noticed that there’s often a level of discomfort in expressing gratitude publicly, even amongst family. But everyone still does it and I always feel more connected with the family after we express our gratitude. People often give thanks for food and health, for something that has happened in the past, or for being safe given specific world events. This year, the sense of gratitude will be very real given that I will be with my sister’s in-laws who have family in Puerto Rico. It occurs to me that there is also a deeper level we can reach: a direct personal expression. I’m inspired this year to bring a deeper aspect of gratitude to our Thanksgiving ritual. A New Gratitude Ritual? There’s a video series on the Science of Happiness that came out in 2013 and that for some reason I just saw for the first time last week. The experiment in the video was based, I believe, on research by Martis E.P. Seligman, who found that people who wrote and delivered letters of gratitude exhibited a huge increase in happiness compared to a control group. In the video, individuals were asked to write a letter to a person who influenced them and then to read it to that person. Before and after the exercise, their happiness was tested. Overall, there was a strong trend toward more happiness after the individuals read their letters to their recipients. This has me thinking, what if we take time this Thanksgiving to appreciate someone in the room who has made a difference in our lives, in addition to the standard things we’re grateful for? To me, that will make for an even more memorable Thanksgiving and will likely start out my holiday season- and the holidays of anyone who participates- with a higher happiness quotient. What’s in Your Gratitude Basket? What are you grateful for this holiday season? Who will be at your Thanksgiving table to whom you want to offer gratitude for the way they’ve influenced your life? Are you willing to go the extra step to express your feelings to them? And if you won’t be with someone who fits that category, would you be willing to write a letter and read it to the recipient? Let’s get the gratitude ball rolling, and bring it into all aspects of our lives. Into our home, our relationships, and our workplaces. The science shows we’ll all have more well-being, motivation, and overall success. In that spirit, thank you for reading my blog week after week, letting me know I make a difference, and inspiring me to bring my thoughts and creativity to life. You give me a weekly boost in my own gratitude and happiness. Thank you and enjoy your Thanksgiving ritual! Did you enjoy this article? Sign up for my Life and Leadership e-list for more inspiring articles like this one.

Great Gatsby Research Paper Example | Topics and Well Written Essays - 1000 words

Great Gatsby - Research Paper Example The American dream of earning money for a decent life was violated by Gatsby as he used his money casually to throw extravagant parties to impress Daisy. He refused to come out of his past and believed that Daisy has always loved only him and not her husband. This novel depicts the violation of American dream in the 1920s through the character of Gatsby. He grew up in poverty and reached a life of opulence with a huge house, car and servants. With his self acquired wealth and social status he could develop in himself a completely different personality from his unprivileged past. The wealthy Americans of 1920s are signified by Gatsby who flaunts his money extravagantly as was depicted by his lavish parties. In the beginning of his life, Gatsby could represent American dream because like any other American he took nurtured the dream of earning money. Later in life, he differs from the other newly rich Americans in a way that he earned his money in dishonorable ways. The main idea of Am erican dream is to earn money through hard work and Gatsby failed to do so. In order to earn the love of Daisy, he obtained big house, car and other material possessions. American dream is an idea of pursuing happiness and this was violated by Gatsby as he pursued mere wealth. Gatsby depicts a character who used to harbor mythicised dreams of achievement and success that can be gained with money. He had the endless desire of going back to the past by craving for Daisy whom he almost married in the past. America’s multiple identities are shown in the character Gatsby. American culture believes in recreating by setting alongside any doubts about the... This novel depicts the violation of American dream in the 1920s through the character of Gatsby. He grew up in poverty and reached a life of opulence with a huge house, car and servants. With his self-acquired wealth and social status, he could develop in himself a completely different personality from his unprivileged past. The wealthy Americans of the 1920s are signified by Gatsby who flaunts his money extravagantly as was depicted by his lavish parties. In the beginning of his life, Gatsby could represent American dream because like any other American he took nurtured the dream of earning money. Later in life, he differs from the other newly rich Americans in a way that he earned his money in dishonorable ways. The main idea of the American dream is to earn money through hard work and Gatsby failed to do so. In order to earn the love of Daisy, he obtained big house, car, and other material possessions. The American dream is an idea of pursuing happiness and this was violated by Ga tsby as he pursued mere wealth. Gatsby depicts a character who used to harbor mythicised dreams of achievement and success that can be gained with money. He had the endless desire of going back to the past by craving for Daisy whom he almost married in the past. America’s multiple identities are shown in the character Gatsby. American culture believes in recreating by setting alongside any doubts about the reality of such a concept.

Chp 24 dis Essay Example | Topics and Well Written Essays - 250 words

Chp 24 dis - Essay Example or and the promisee), the amount of consideration (money) to be paid, terms of payment (include date of payment or how the payment is to be made) and in case of interest, then it is also indicated in the note. The above are the conditions and instructions present in a promissory note and after it is signed, it is considered legally binding (Miller and Jentz, 394). In the above mentioned case, even though the defendants were acting only as agents of the real promisor who is Sunshine Sales Corp., the promissory note that they signed did not indicate that and hence they are the once considered to be the promisor in this situation. The defendants indicate that a bank officer promised to type the name but they have no witnesses or evidence of such a conversation and hence it cannot hold water in a court of law. They are therefore liable on the notes and all the evidence from the promissory notes states that. If only they had indicated the name of Sunshine Sales Corp. or they had waited until the name was indicated by the bank officer, then they would not be liable as they are

MidTerm Study Guide Essay Example for Free

MidTerm Study Guide Essay The Midterm Exam is open book, open notes. The maximum time you can spend in the exam is 3 hours. If you have not clicked the Submit For Grade button by then, you will be automatically exited from the exam. In the Midterm Exam environment, the Windows clipboard is disabled, so you will not be able to copy exam questions or answers to or from other applications. 2. You should click the Save Answers button in the exam frequently. This helps prevent connection timeouts that might occur with certain Internet Service Providers, and also minimizes lost answers in the event of connection problems. If your Internet connection does break, when you reconnect, you will normally be able to get back into your Midterm Exam without any trouble. Remember, though, that the exam timer continues to run while students are disconnected, so students should try to re-login as quickly as possible. The Help Desk cannot grant any student additional time on the exam. 3. See the Syllabus Due Dates for Assignments Exams for due date information. 4. Reminders You will only be able to enter your online Midterm Exam one time. Click the Save Answers button often. If you lose your Internet connection during your Midterm Exam, logon again and try to access it. If you are unable to enter the Midterm Exam, first contact the Help Desk and then your instructor. You will always be able to see the time remaining in the Midterm Exam at the top right of the page. 5. Assessments with Multiple Pages Make sure you click the Save Answers button before advancing to the next page (we also suggest clicking on Save Answers while you are working). Complete all of the pages before submitting your Midterm Exam for instructor review. Do NOT use your browsers Back and Forward buttons during the Midterm Exam. Please use the provided links for navigation. 6. Submitting Your Midterm Exam When you are finished with the Midterm Exam, click on the Submit for Grade button. Please note: Once you click the Submit for Grade button, you will NOT be able to edit or change any of your answers. 7. Exam Questions There are 10 randomly selected multiple choice questions each worth 5 points for a total of 50 points. The Midterm Exam covers TCOs 1-4, 8, 11, and 12 and Weeks 1–5. The Midterm Exam contains two pages, which can be completed in any order. You may go back and forth between the pages. The Midterm Exam questions are pooled. This means that not everyone will have the same questions. Even if you do have some of the same questions, they may not be in the same order. These questions are distributed amongst the TCOs. The entire exam is worth 200 points. On the essay questions, your answers should be succinct, should fully address each part of the question, and should demonstrate your knowledge and understanding in a concise but complete answer. Most essay questions require answers that are a couple of paragraphs (not a couple of sentences) that directly speak to each part of the question. Some students opt to work on the essay questions first, due to their higher point value and the length of time needed to adequately address each question, but this is entirely your choice. Remember to always use proper citation when quoting other sources. This means that ANY borrowed material (even a short phrase) should be placed in quotation marks with the source (URL, author/date/page #) immediately following the end of the passage (the end quote). Changing a few words in a passage does NOT constitute putting it in your own words and proper citation is still required. Borrowed material should NOT dominate a student’s work, but should only be used sparingly to support your own thoughts, ideas, and examples. Heavy usage of borrowed material (even if properly cited) can jeopardize the points for that question. Uncited material can jeopardize a passing grade on the exam. As a part of our commitment to academic integrity, your work may be submitted to turnitin. An online plagiarism checking service. Please be VERY mindful of proper citation. 8. Some of the key study areas are below. Although these are key areas, remember that the exam is comprehensive for all of the assigned course content and that this study guide may not be all inclusive. TCO 1 Definitions of Technology and Science, the Three Technological Revolutions, Technological Systems, Week 1 Lecture, Week 1 Readings TCO 2 – Technology and Historical Change, the Industrial Revolution, Technologies in Different Cultural Contexts, Week 2 Lecture, Week 2 Readings TCO 3 – Technology and the Arts, Digital Technologies, Collaborative Technologies, Week 4 Lecture, Week 4 Reading TCO 4 – The Cultural Impact of Technologies (Computers, Cell Phones), Technologies as Artifacts and Ideas, the Social Shaping of Technology, Week 3 Lecture, Week 3 Readings TCO 8 The Industrial Revolution and the Steam Engine, Determinism and Its Critics, Week 2 Lecture, Week 2 Readings TCO 11 – Research Methods, Research Sources, Week 1 Tutorial TCO 12 Potential Impact of Emerging Technologies (GMOs, nanotechnology, robotics), Week 3 Lecture, Week 3 Readings 9. The readings from the first four weeks are emphasized in this exam. Please make sure that these are read and that you participate in the discussion of these readings. Areas that were discussed in the threads will be prime targets. 10. Assignments will also be prime targets for revi siting. 11. Reviewing the TCOs, which I have listed below for your convenience, will also be a great preparation for the Midterm Exam. 1 Given one or more examples of major technology development projects based on scientific theory, such as controlled heavier-than-air flight or the Manhattan Project or cloning, develop a definition of technology that includes a clarification of its relationship to science. 2 Given a historical turning point, such as the fall of the Roman Empire, the Crusades, the Protestant Reformation, the growth of cities, or the collapse of the Soviet Union, establish the role of technology in triggering the event and shaping its outcomes. Given an account of a stylistic trend in an art such as painting, music, literature, theater, or film, determine what technologies were involved and how they affected the evolution of the respective art. 4 Given examples of the widespread adoption of a technology that changes the culture of a society (e. g. , cars, computers, cell phones, etc. ), analyze the technology and the patterns of its adoption to identify the sources of the technologys influence. 8 Given a consequential technological invention, such as the printing press, the telephone, the automobile, the microchip, or the Internet, assess the cultural, economic, or social changes brought about by the invention. Given a process for defining and limiting a topic, participate in a research project as a member of a student team that investigates, formulates, and presents its analysis of (a) an issue associated with a technology, (b) the characteristics of the technologys development, (c) its present and likely future impact, and (d) the ethical or moral issues arising from the development or implementation of that technology. 12 Given an emerging technology, evaluate its future prospects by identifying the cultural and social factors that may prevent or promote its successful application. Finally, if you have any questions for me, please post them to our Q ; A Forum or e-mail me. Good luck on the exam!

Graduation Speech -- Graduation Speech, Commencement Address

After four years, we are finally gathered on the steps of what we thought we'd never come to. We are graduating, finally shedding the familiar and embarking on a world of "what's-next?" Despite that, though, today is perhaps most importantly a day to remember our past. In the entire childhood of memories that each of us has accumulated, beginning roughly when we were still young enough to believe braces are cool, some of the most vivid and influential are from this campus. The high school years are mainly those in which a person leaves off building their lives around what they have been shown, and begins to select the path they will take for themselves. It is fair to say that these last four years have seen immense changes in each and every one of us. And today is also a day to...

Legal Compliance in the Distribution of Software Applications

Software piracy is a rising problem not only in the United States, but around the world. In 1993 worldwide software piracy cost 12. 5 billion dollars to the software industry, with a loss of 2. 2 billion dollars in the United States alone. Estimates show that over 40 percent of U. S. software company revenues are generated overseas, yet nearly 85 percent of the software industry's piracy losses occurred outside of the United States borders. The Software Publishers Association indicated that approximately 35 percent of the business software in the United States were obtained illegally, which 30 percent of the piracy occurs in corporate settings. In a corporate setting or business, every computer must have its own set of original software and the appropriate number of manuals. It is illegal for a corporation or business to purchase a single set of original software and than load that software onto more than one computer, or lend, copy or distribute software for any reason without the prior written consent of the software manufacturer. Many software managers are concerned with the legal compliance, along with asset management and costs at their organizations. Many firms involve their legal departments and human resources in regards to software distribution and licensing. In 1974, Congress created the Natural Commission on New Technological Uses (CONTU) to investigate whether the evolving computer technology field outpaced the existing copyright laws and also to determine the extent of copyright protection for computer programs. CONTU concluded that while copyright protection should extend beyond the literal source code of a computer program, evolving case law should determine the extent of protection. The commission also felt that copyright was the best alternative among existing intellectual property protective mechanisms, and CONTU rejected trade secret and patents as viable protective mechanisms. The CONTU report resulted in the 1980 Computer Software Act, and the report acts as informal legislative history to aid the courts in interpreting the Act. In 1980 The Copyright Act was amended to explicitly include computer programs. Title 17 to the United States Code states that it is illegal to make or to distribute copies of copyrighted material without authorization, except for the users right to make a single backup copy for archival purposes. Any written material (including computer programs) fixed in a tangible form is considered copyrighted without any additional action on the part of the author. Therefore, it is not necessary that a copy of the software program be deposited with the Copyright Office in Washington, D. C. for the program to be protected as copyrighted. With that in mind then a copyright is a property right only. In order to prevent anyone from selling your software programs, you must ask a federal court to stop that person by an injunction and to give you damages for the injury they have done to you by selling the program.

Contingencies to Airasia’s Marketing Strategy Essay

Suggest three contingencies AirAsia should consider and rationalize your choice. What are the main modifications to the current marketing strategy should AirAsia undertake to respond to these contingencies. There are number of threats that AirAsia faces thus it should have well-prepared contingency plans in case certain situations occur. The following part focuses on analyzing three main contingencies that AirAsia should take into consideration as well as the modifications to the current marketing strategy that it would have to make to respond in case certain events occur. What if price war happens†¦Ã‚  To compete with the rivals, each airline introduced its own strategy. Famous full service carriers like Singapore Airlines and Thai Airways have set up low cost subsidiaries. Malaysia Airlines launched competitive promotion scheme while independent low-cost airlines like Valuair focused on improving customer services through offering additional benefits to customers. Obviously, the harsh competitiveness in the region strengthens the probability that price war might happen. Price war happens when almost all airline companies simultaneously start to reduce their prices and the region’s aviation industry as a whole fails to deliver profit. Price war might have a serious impact on AirAsia if it, together with other airlines in the region, starts to reduce its prices to compete. Customers now will have various choices and would be able to switch to the airlines that offer them the best price as well as best service. If price war does happen, AirAsia should make the following modification to its current strategy: Increase customer satisfaction by improving on-flight service quality as discussed in depth in the third paragraph of question one. What if customers decide to switch to other airlines†¦ Air Asia now has to face up with increasing competition not only from low cost subsidiaries of full service carries but also from the emergence of independent low cost airlines. With the increasing emergence of new airlines which provide customers with not only low fares but also â€Å"a level of service far beyond that expected†, the probability that customers switch to other airlines is very high. Recently, AirAsia has been receiving many complaints from passengers who are unsatisfied with the service quality. Focusing intensively on keeping costs low, AirAsia neglected the satisfaction and convenience of its customers. Thus, the company should consider the possibility that customers might switch to other airlines. In this case the following modifications to the strategy should be made: AirAsia should offer incentives for the customers to stay with the company by introducing frequent flyer bonus miles. To motivate customers’, AirAsia can also offer membership cards which would provide them not only with additional miles but also with regular customers’ discount on specific flights to specific destinations or at special period of time. What if AirAsia is unsuccessful in entering new markets such as China and India†¦ AirAsia is now looking for expanding routes to other countries in the region and China and India are a huge potential. However, these markets have completely different economies and therefore there is a probability that the market will not support a new airline. Also, for example, when going to China – a huge market, AirAsia needs to be ready to face tough competition. Besides good reputation in the market, well-established airlines in China such as China Airline, Cathay Pacific, etc. are offering very high quality service to customer. In addition to that in the meantime, AirAsia has to compete with many tough competitors in its local market. Thus, there is possibility that AirAsia might not take the lead when entering new markets and might not be able to reach its targets in new markets. Therefore, AirAsia should take into account the possibility of low demand and be ready to make modifications to its strategy in order to respond: The Olympic Games 2008 would be a great opportunity for AirAsia to strengthen its image in customers’ mind. To take this advantage, AirAsia should organize some activities to promote the company. Other big companies will certainly promote itself through taking part in such activities as Olympic Sponsorship, On-Air advertisement, etc. AirAsia should choose a different tactic. Instead, it can create association between AirAsia and the Olympic through programs spread via mass media such as: design logo for AirAsia used during the Olympic time or organize a lottery program the prizes of which would be Olympic tickets or flying tickets inside China. AirAsia can also use other promotion programs like offering round trip tickets flying to cities where the Games would take place at the price of 1 reminbi (Chinese currency) for the first 10 customers buying tickets at a random period of time during 6 months before the Olympics. This should help build up the demand for AirAisa’ services among the customers and enhance its position in customers’ mind. To conclude, it is important for AirAsia to be aware of all contingencies that may happen during its operations and to be ready to apply modifications to the strategy to protect itself from any possible issues that might occur. These contingencies may not come to reality but it is essential to have contingency plans and to be able to make necessary modifications to the strategy in case of the price war, or lost of the customers, or difficulties entering the new markets in order to adapt to these changes and continue to operate successfully.

TO WHAT EXTENT DID THE NAZIS S essays

TO WHAT EXTENT DID THE NAZIS S essays QUESTION @ TO WHAT EXTENT DID THE NAZIS SUCCEED IN BRINGING ABOUT A SOCIAL REVOLUTION BETWEEN 1933 AND 1939? On the 30th January 1933 President Hindenburg offered Adolf Hitler, the leader of the National Socialist Party, the position, Chancellor of Germany. From this day forward, the future of Germany was to radically change. The question, whether the Nazis succeeded in bringing about a social revolution poses many different questions. Such as the impact of the Third Reich on the youth, attitudes to women, and also how the Nazis economic policies affected different classes. However, to assess whether a revolution came about, you need to see what came before the years 1933 to 1939. A comparison with the Weimar republic needs to be made to measure the extent of the change. The years of the Weimar Republic saw the setting up of a democratic government with all Germans given equal rights including the right to vote. During the later years of Weimar, the Dawes plan did much to restore confidence in the German economy and investment came in from the USA especially. This meant that new houses, roads and public facilities could be built. Wages rose in real terms every year from 1924-30 and working hours were shortened. Women were given more equality and some were elected to the Reichstag. Germans saw the Weimar Republic bringing about many radical changes but in the case of Nazi ideologies, a return to past traditional values was demanded. Hitler disliked the industrial society and loved the idea of a return to a more rural way of life. However he realised that without industry and mass production, rearmament would not be possible, as this was one of his main aims he had accept it. One historian, Ralf Dahrendorf claimed that the revolution that took place between the years of 1933 and 1939 was one of modernity and that National Socialism had completed the social revolution which had been held up by Weimar Germany. Centra...

René Laennec and the Invention of the Stethoscope

Renà © Laennec and the Invention of the Stethoscope The stethoscope is an implement for listening to the internal sounds of the body. It is widely used by doctors and veterinarians to gather data from their patients, in particular, breathing and heart rate. The stethoscope may be acoustic or electronic, and some modern stethoscopes record sounds, as well.   The Stethoscope: An Instrument Born of Embarrassment The stethoscope was invented in 1816 by the French physician Renà © Thà ©ophile Hyacinthe Laà «nnec (1781-1826) at the Necker-Enfants Malades Hospital in Paris. The doctor was treating a female patient and was embarrassed to use the traditional method of Immediate Auscultation, which involved the doctor pressing his ear to the patients chest. (Laà «nnec recounts that the method was rendered  inadmissible by the age and sex of the patient.) Instead, he rolled up a sheet of paper into a tube, which allowed him to hear his patients heartbeat. Laà «nnecs embarrassment gave rise to one of the most important and ubiquitous medical instruments. The first stethoscope was a wooden tube similar to the ear horn hearing aids of the time. Between 1816 and 1840, the various practitioners and inventors replaced the rigid tube with a flexible one, but documentation of this phase of the device’s evolution is spotty. We do know that the next leap forward in stethoscope technology took place in 1851 when an Irish doctor named Arthur Leared invented a binaural (two-ear) version of the stethoscope. This was refined the next year by George Cammann and put into mass production.   Other improvements to the stethoscope came in 1926, when Dr. Howard Sprague of Harvard Medical School and M.B. Rappaport, an electrical engineer, developed a double-headed chest piece. One side of the chest piece, a flat plastic diaphragm, rendered higher-frequency sounds when pressed to the patient’s skin, while the other side, a cup-like bell, allowed sounds of a lower frequency to be discerned.

Operations Management - Discussion Paper Essay Example | Topics and Well Written Essays - 750 words

Operations Management - Discussion Paper - Essay Example The question of survival of the fittest has made the business organizations to increasingly take resort to the above strategy (Lawler and Worley, 2006, p.154-155). The paper endeavors to further divulge on the issue of gaining a new workforce at the cost of the existing people in a much detailed fashion. Maintenance of Stable Workforce within Organizations in Respect of Changing Markets The fact of changing market conditions impose challenges over the business organizations in regards to maintaining a stable workforce. It is found that to overcome the stress of external changes in the technological and competitive business sphere business organizations have shifted their endeavor to work for the development of the existing people to recruiting readymade skillful and productive workers from outside. Though it is held that retiring workers increases the turnover cost of the concerns yet it helps the concerns to strategize the development process of staffs to meet market demands. In ord er to compete with the technological and business development of its competitors the business concerns need to take in effective manpower that can be trained quite faster to help the organization counter market challenges. The policy of taking in new recruits and retiring the existing people in regards to market changes and opportunities is referred to as ‘travel light’ and was employed by Kodak when film technology shifted from chemical to digital. Chemical engineers were replaced by digital photography engineers (Lawler and Worley, 2006, p.154-156). Workforce Stability in Organizations based on Financial Position of the Concern It is observed that taking resort to the above discussed ‘travel light’ human resources policy endangers the business organization in regards to increasing the cost of human resources of the concern. The organization needs to both render immediate financial benefits to the retiring employees and also to invest quite enough to recru it and train the new workforce. Further the new workers need to be properly streamlined into the business process which requires enough time leading loss of productivity and thereby rise in business costs. Administrative costs also get highly tuned to such both in relation to rendering advertisements for recruiting and also in terms of generation of insurance, uniform and other costs for the new individuals. Again the new employees on failing to use the machineries in the right manner lead to increase in the cost of erosion of such. The time required for the new employees to be trained properly requires existing employees to perform the overtime work for which they are required to be rightly paid. This increases the cost of operations for the firm (Indicator Protocols Set: EC, 2006, p.7). Organizational Productivity in terms of Skills and Competition and Workforce Stability Organizations round the world in order to better compete with their competitors are found to take resort of ne wer and productive workforce based on new skill sets. However such practice of the business conc

Communication Issues Paper (Individual) Research

Communication Issues (Individual) - Research Paper Example The community ought to support music, whereby since FBi is independent and has passionate volunteer, the people need to listen to the music the radio station plays. This is because, as Somerville (2011) states a community can be a way of organising the societal relationships, having a desirable quality of mutual regard and sociability. The role of the community involves summons to undertake in joint, mutual action. This implies that the community, which is the target group, should play a considerable role in ensuring that the music played by the station, which mainly is local, receives audience so as to promote the talents of local artists. The music also ensures that the social relationships are strong and binding as seen in the research work of Howley (2010). For these issues regarding to music, the stakeholders include, the volunteers who work for the radio station and the whole community who are the listeners. The radio station requires support from the community to pay for radio . For the radio station to stay on air, the station needs financial supporters. To make this real, the community should be able to make pledges to support the station by contributing a small amount at the end of every month. According to Somerville (2011), commonality is the requisite imperative that helps in the foundation of the community, which has a common project or goal. Since it is the aspiration of the community to get a radio station which is non-profit, then it is also their obligation to finance it to ensure its smooth operation. The non-profit organization requires support from the community to remain independence. According to Parada & Homan (2011), the radio station plays unique music, which is new and local. Other stations do not have this music genre. Since the radio station is a community sponsored unlike other radio stations which are commercial, the ratings or the profits do not dictate the music the radio station plays. The station plays music since they like it, and it is the urge of the station for people to like the music. Music, which is independent and local, helps understand the community well. According to Secomb (2007), there is a need to consider the community perspectives brought about by the music played so as to understand the community. The music also describes the community subsystems, the peripherals of the community, the functioning of the community and community characteristics which are basic. To be able to support the non-profit organization and the local music, the people around the community should make a regular contribution so as to keep new music on the air waves. To elaborate more on the community engagement issue that the radio station needs, the station requires more volunteers. The radio station will ensure that the volunteers have their rights to be treated as co-workers, have all the details regarding to the organization, receive orientation regarding to new developments. There station is also to provide advanc e notice of changes which affect the work of the volunteer and also provide guidance and direction. According to Albert, Flournoy and Lebrasseur (2009) to seek change and stability within a community, it is vital for the people in the community to live collectively, play, worship and work together. Since the station is an initiative by the

Reaction paper for international studies lectures Essay

Reaction paper for international studies lectures - Essay Example The relationship between the economy and globalization is only based on positive impacts and change. While defining globalization, Norberg (2003) points out that globalization is a way in which nations can share the same platform of trade with minimized legal and corporate requirements. He regards this definition as the main reason behind the development of many nations from underdeveloped countries to developed and developing countries. Apart from economic growth, globalization has led to many other positive changes in the modern society. Norberg (2003) cites gender equality, improved education and a more efficient way of fighting global crimes such as terrorism as other significant changes impacted by globalization. In his arguments and theories, Held & McGraw (2007) argue that globalization creates a united globe that greatly depends on each other for excellence. Norberg (2003) creates well formulated defensive arguments in support of globalization. In his arguments, he acknowledges the most important positive changes globalization has impacted in the global front (Norberg, 2003). He cites significant reduction of poverty and hunger across the globe as one major importance of globalization (Norberg, 2003). With globalization, poverty and hunger are effectively addressed as global bodies and nations have steeped up the efforts to eradicate the two problems. Additionally, Norberg (2003) argues that globalization has increased the level and spread of democracy. Across the globe people have the freedom of speech and decision making regardless of the cultural or social affiliations. Kalder (2000) also points out that the increased gender equality can be attributed to the rising levels of globalization. Kalder (2003) also depicts globalization with positive perception. The most important argument in her literary piece is that globalization is the answer to wars experienced across the globe. She points out that

Pharmacy is a health profession

Pharmacy is a health profession Chapter 1 The word is derived from the Greek word pharmakon meaning drug or medicine and has been used since the 15th and 17th centuries 1. Pharmacy is a health profession that combines the health sciences with the chemical sciences. It ensures the safe and effective use of pharmaceutical drugs. Pharmacy practice includes modern services that are related to health care: clinical services, providing drug information and reviewing medications for safety and efficacy purposes 1. 1.1.1 The various disciplines of Pharmacy Pharmacy can be divided into three major disciplines: a) Pharmaceutics b) Medicinal Chemistry and Pharmacognosy c) Pharmacy Practice Pharmacology is often considered to be a fourth discipline but is not specific to pharmacy, even though it is essential. The boundaries between the different disciplines and other sciences like biochemistry are not clear cut. Hence, research work from the various disciplines is often done concurrently 2. 1 The Hormone Shop LLC. The History of Pharmaceutical Compunding. [home page on the Internet]. 2010 [cited 2010 Oct 10]. Available from: http://www.thehormoneshop.com/historyofcompoundingpharmacy.htm 2 Dayanada Sagar College of Pharmacy, Bangalore, India. History of Pharmacy. [home page on the Internet]. 2008 [cited 2010 Oct 10]. Available from: http://www.dscpharmacy.org/pharmacy.php 1.1.2 The Pharmacist and Community Pharmacy Pharmacists are skilled and highly-trained health care professionals who ensure optimal health outcomes for their patients. In the community pharmacy, the pharmacist has various roles and these include amongst others (Azzopardi, 2010): a) the procurement of medications that are suitable for human consumption b) ensuring the appropriate conditions for the storage of medicines c) ensuring the appropriate and safe disposal of expired medicines d) dispensing of medications that are either on a prescription, or pharmacist-recommended or asked for directly by the patient e) point-of-care testing f) offering general medical advice without the need of a prior appointment. The practice of community pharmacy varies between countries. Nevertheless, the basic functions and responsibilities are the same. A community pharmacist builds a special relationship with the clients, especially the regular ones. Hence, communication skills are of major importance. The pharmacist finds him / herself comforting and hearing out the patient when necessary, and is expected to be understanding and also a good listener. 1.2 History of Pharmacy The first pharmacies, apothecaries as they were formerly known, were founded in the Middle Ages in Baghdad. The first one was founded in the year 754 AD by Muslim pharmacists during the Islamic Golden Age 2. During the 11th century, community pharmacies were established in southern France and southern Italy. In 1240, Emperor Frederick II issued a decree the medical profession was to be separated from the pharmacy profession. Pharmacy practice was to be supervised so that drugs of a suitable quality would be prepared and produced (Azzopardi, 2010). The history of pharmacy can be classified into three stages: a) compounding and dispensing b) clinical pharmacy c) pharmaceutical care. Originally, the pharmacists had to prepare and dispense medicines so they had to excel at compounding. The community pharmacist was therefore highly esteemed because the preparation of medicines was greatly valued in society. In fact, at that time, the pharmacists and other professionals such as lawyers, medical doctors and parish priests were the leaders in the community. As time passed, newly discovered drugs became more dangerous and potent so they started being prepared by manufacturing companies. The pharmacists role was only to dispense these drugs (Al-Shaqha, Zairi, 2001). 2 Dayanada Sagar College of Pharmacy, Bangalore, India. History of Pharmacy. [home page on the Internet]. 2008 [cited 2010 Oct 10]. Available from: http://www.dscpharmacy.org/pharmacy.php Pharmacists moved to clinical practice about 25 years ago. The original concept of clinical pharmacy services was based on the fact that pharmacists ought to use their professional knowledge to ensure the appropriate and safe use of drugs in patients. As a result, several pharmacists nowadays work in hospitals, nursing homes and some ambulatory clinics. Problems remained within the drug-use-system despite the advances made in clinical pharmacy and documenting and recognising these problems has led to the concept of pharmaceutical care becoming the new basis for pharmacy practice (Al-Shaqha, Zairi, 2001). 1.2.1 History of pharmacy in Malta 1.2.1.1 History of pharmacy in Malta from the late 15th century until the arrival of the Knights of the Order of St. John of Jerusalem in 1530 Before 1500, the pharmacists in Malta were almost all Sicilian. In the early 15th century, pharmacists were employed either by the Universita or by the Hospital of Santo Spirito. Mastru Salvatore Passa is the first documented pharmacist in Malta who practised in Mdina and the Hospital of Santo Spirito in Rabat from 1450 to 1475. The medicines prescribed in those days were mainly herbal. During this period, Passa often travelled to Sicily due to his work, presumably to import medicinal herbs as many herbs did not form part of the local flora (Borg, 1998). 1.2.1.2 Pharmacy under the Knights of the Order of St. John of Jerusalem The Knights of the Order of St. John of Jerusalem arrived in Malta on the 26th October, 1530 and they applied their knowledge of pharmacy to the practice in Malta. A Holy Infirmary in Birgu was built and the Greek pharmacist, Giacomo Gualterio, who had accompanied the Order to Malta was the apothecary (Borg, 1998). Grand Master Nicholas Cottoner established the School of Anatomy and Surgery at the Holy Infirmary in 1676. It is very probable that a Pharmacy course was established in the school (Borg, 1998). Under the Knights, the practice of pharmacy in Malta changed gradually, but continuously, occurring in a similar way to that in Europe. However, extemporaneous preparations remained the same from the times of Mastru Salvatore Passa because the enlargement of the pharmaceutical industry still had to occur (Borg, 1998). 1.2.1.3 Pharmacy under the French and British colonies The French arrived in Malta in 1798. There were no more than 32 pharmacies under their dominion, each one having an average clientele of 3,000 patients. No changes were made to the laws governing the practice of pharmacy under the French. Hence, the daily activities of the pharmacists were identical to those of under the Knights. The laws established by the Knights of the Order of St. John remained in force until 1900. In their stay in Malta, which lasted for about one hundred years, the British left their mark on the pharmacy profession. The use of the English language, the names of pharmacies pertaining to Britain or England and the consulting room in the pharmacy are all such examples (Borg, 1998). 1.2.1.4 Pharmacy in the 20th century The Medical and Kindred Professions Ordinance of the Laws of Malta, governs pharmacy laws. This was enacted in 1900 as the laws governing the profession at that time had become outdated and needed restructuring. A legislation that allowed pharmacists to dispense certain medicaments without a prescription was enacted in October 1955 and on the 12th October 1955, a list of these substances was published in the Malta Government Gazette (Borg, 1998). The Malta Chamber of Pharmacists was founded in 1900 in order to protect the common interests of the pharmacists and also to maintain the professions dignity. Hence, the professions standards were raised by enabling the profession to keep abreast of the changes that were occurring internationally (Borg, 1998). In April 1961, an Extraordinary General Meeting was held by the Chamber to discuss the issue of forming a Trade Union that would represent pharmacists; all 33 pharmacists present agreed that this was necessary. One of the Unions objectives, among others, was to improve the conditions under which the profession was exercised and to promote the interests of pharmacists. The Pharmacy Board was set up in 1968 and this was the greatest achievement of the Chamber and Union. The Union worked very closely with the Chamber and in 1979 they formed one association, i.e. the Chamber of Pharmacists Trade Union. This association worked very hard and it affected the current state of the profession and also the legislation governing the practice of pharmacy (Borg, 1998). In 1984, after several meetings with the Chamber, it was finally decided that new pharmacies ought to be owned by pharmacists and that before granting new permits, the population ratio has to be taken into consideration (Borg, 1998). Patients could get their free medications from the Central Hospital Dispensary and Government Dispensaries throughout the first fifty years of the 20th century. The latter could be found in most villages around Malta. In 1954, the Central Hospital at Floriana was turned into the Headquarters of The Malta Police Force as by the late 1940s, St. Lukes Hospital became Maltas General Hospital. Hence, the Out-Patient Dispensary of St. Lukes Hospital became the Central Government Dispensary (Borg, 1998). Pharmamed, the first local pharmaceutical enterprise, was founded in 1974. This gave rise to several job opportunities in the industrial field, besides enhancing Maltas image abroad. In 1995, as a result of strong and consistent negotiations and representations by the Maltese Chamber of Pharmacists, there was the appointment of the first director of the Government Pharmaceutical Services (GPS). This was part of the reform of the GPS and the career progression of pharmacists in Government service. It was concluded in 1998 in agreement with the Ministry of Health on the full implementation of the GPS reform. 1.2.1.5 Pharmacy in the 21st century In June 2007, Mater Dei Hospital replaced St. Lukes Hospital as the national hospital of Malta. The last of the personnel migrated to Mater Dei by November of that year. Hence, the main Government Dispensary was moved to Mater Dei as well 3. In 2008, the much awaited and debated Scheme of the Pharmacy of Your Choice (POYC) was introduced. This Scheme enables the people to have an easier and more comfortable access to the medicaments that are given for free by the Government. 3 Mater Dei Hospital Malta. [homepage on the Internet]. 2009 [cited 2010 Oct 23]. Available from: http://malta.cc/health-care/mater-dei-hospital-malta/ Thus the service that was previously provided for by the village Health Centre Dispensaries was transferred to the community pharmacies. The patients chose the pharmacy of their choice. The initial stages of the POYC Scheme do not envisage any changes in the reimbursement system. Therefore, patients who are entitled to take free medication will continue to do so; there is no co-payment (Grima IC). Until January 2011, the POYC Scheme had spread to 96 Maltese community pharmacies and to 17 community pharmacies in Gozo. Following the introduction of the Scheme, the village Health Centre Dispensaries where the Scheme was initiated, were closed down after sufficient time had elapsed. Over the past few years, the number of local pharmaceutical manufacturing companies has dramatically increased. So has the number of locally licensed pharmaceutical wholesalers who import medications from EU countries. There are more pharmaceutical products registered with the local Medicines Authority. This has had a positive impact on both the private and public pharmaceutical sectors due to the availability of more different therapeutic classes of medicines and more medicines that fall within the same therapeutic class (Grima IC). Recently, the number of generic medicinals in the private sector has also increased considerably. Nowadays, a pharmacist can substitute a branded prescribed medicinal with a generic product that is cheaper for the patient (Bugeja, 2007). Accession into the European Union in May 2004 had a great impact on the medicines in Malta, especially with regards to their availability. Some medicines that were previously available were not registered due to the high registration costs. Hence, EU accession improved the quality of medicines. On the other hand, it had a negative impact on their availability and affordability (Bugeja, 2008). The prices of medicines in Malta increased considerably after EU accession in 2004. In fact, according to studies carried out, the Maltese are paying about 40% more than the average price for medicinal products in the European Union 4. In July 2010, the Parliamentary Secretary, Chris Said, announced reductions in prices of 62 medicines. Some of these reductions were to be implemented immediately whereas with others, when stocks were sold out. Many medicines in Malta are overpriced when compared to other EU countries, so this was a step in the right direction 5,6. 1.3 Pharmaceutical Care In 1990, Hepler and Strand looked at the responsibilities of the pharmacist and at pharmacy services in a new way. They applied the term pharmaceutical care and over the years pharmacists have endeavoured to develop pharmaceutical care practices (Foppe, Schulz 2006). According to Hepler and Strand (1990): 4 Maltastar. The price of medicines in Malta under European Commission scrutiny. [homepage on the Internet]. 2010 [cited 2010 Oct 27]. Available from: http://www.maltastar.com/pages/rl/ms10dart.asp?a=11804 5 Xuereb M. Makers cut prices of 62 medicines. Times of Malta [serial on the Internet]. 2010 [cited 2010 Oct 27]. Available from: http://www.timesofmalta.com/articles/view/20100703/local/makers-cut-prices-of-62-medicines 6 Vella Matthew. Medicine importers agree to cuts in prices of up to 67%. MaltaToday [serial on the Internet]. 2010 [cited 2010 Oct 27]. Available from: http://www.maltatoday.com.mt/news/medicines/medicine-importers-agree-to-cuts-in-prices-of-up-to-6 Pharmaceutical care is the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patients quality of life. These outcomes are (1) cure of a disease, (2) elimination or reduction of a patients symptomatology, (3) arresting or slowing of a disease process, or (4) preventing a disease or symptomatology. In their definition of pharmaceutical care, Hepler and Strand looked at the patients quality of life (Strand et al, 1991). Pharmaceutical care involves a pharmacist cooperating with the patient and members of other health care professions 7. This interprofessional relationship allows the implementation, design and monitoring of a therapeutic plan that will have specific therapeutic outcomes for the patient to benefit from (Ford, Jones, 1995). Pharmacists are the last health care professionals to come in contact with the patients. They thus have a major role in educating them regarding drug use. For this reason, pharmacists must be adequately trained and have excellent communication skills in order to provide this service in an effective manner (Alkhawajah, 1992). Pharmaceutical care can therefore be seen as the component of pharmacy practice that has to be performed by a competent pharmacist who must be committed, honest, accountable and loyal to the patient (Strand et al, 1991). 1.4 The Health Care System in Malta Maltas health care system is divided into the public / national health care system and the private health care system in which pharmaceutical services are provided for by 211 pharmacies that are distributed around Malta and Gozo. The public / national health system is based on a model that is founded on the principles of Equity, Solidarity and Justice. 7 American Pharmacists Association. Principles of practice for pharmaceutical care. [homepage on the Internet]. 2005 [cited 2010 Oct 12]. Available from: https://www.caremark.com/portal/assset/Principles_of_Practice_for_Pharmaceutical_Care.pdf 1.4.1 The Public Health Care System The Maltese Government consists of different Ministries, one of these being the Ministry of Health, Elderly and Community Care. This deals with the healthcare needs of the people and ensures that adequate services are provided for 8. The main goals of the Government for the public health services include 9: The concern of the patient, which is a constant issue The provision of health care and its management The value for money The sustainability of public health care. The Maltese Medicines Authority controls and ensures the quality, safety and efficacy of the pharmaceuticals that are available locally. It also authorizes the medicines that are to be placed on the local market. The Government Health Procurement Services (GHPS) is responsible for the purchasing, storage and distribution of all the pharmaceuticals that are required by the Government Health Services (GHS) in Malta. This entity operates with the funds that are allocated annually by the Government. Procurement of pharmaceuticals is done via tendering procedures that are regulated by the Public Service (Procurement) and Public Contracts regulations. 8 Government of Malta. The health care system in Malta. [homepage on the Internet]. No date [cited 2010 Oct 25]. Available from: The Government of Malta, Web site: http://www.sahha.gov.mt/pages.aspx?page=156 9 Integrated health information system phase 2. [homepage on the Internet]. 2010 [cited 2010 Oct 24]. Available from: The Government of Malta, The Malta Information Technology Agency Web site: https://www.mita.gov.mt/TenderFile.aspx?tfid=727 1.4.1.1 Primary Health Care The Government delivers primary health care via the Health Centres that are distributed around various villages in Malta and Gozo. These centres were set up in 1980 in order to provide free health care services 9. Besides providing the free services of general practitioners, these centres also provide a vast range of other services, including: Specialist clinics eg: gynaecological clinics and diabetes clinics Laboratory diagnostic facilities Radiology. Many people choose to have the services of private general practitioners and / or specialists who work in the primary health care sector. In the private scenario, their services are against payment. 1.4.1.2 Secondary and Tertiary Health Care These are provided for by public and private hospitals, found in different locations in Malta. The main public hospital is Mater Dei Hospital and it provides a wide range of services, including transplant surgery, open heart surgery, emergency care and diagnostic services. Sir Paul Boffa Hospital, another public hospital, has an oncology and dermatology unit. Mount Carmel Hospital is the islands public psychiatric hospital. There are a number of private hospitals in Malta, amongst which is Saint James Capua Hospital. 9 Integrated health information system phase 2. [homepage on the Internet]. 2010 [cited 2010 Oct 24]. Available from: The Government of Malta, The Malta Information Technology Agency Web site: https://www.mita.gov.mt/TenderFile.aspx?tfid=727 1.5 Free health services provided by the government The Government provides free health services; free at the point of delivery, as these are directly funded from general taxation. In Malta, the boundary between the private and public sectors can be seen from two different aspects: medical and pharmaceutical (Wismayer, 2010). 1.5.1 The Medical Aspect The healthcare is available to ALL Maltese citizens, irrespective of the social and financial background of the patient. Anybody can turn up at a Health Centre or public hospital and be given the necessary treatment. Hence, up to a certain extent there is a holistic attitude as no distinction is made between citizens and whoever requires a healthcare service is provided with what is needed (Wismayer, 2010). The seams start to show up when the services available in the public health system are not accessible. That sector of society who can afford to pay, will therefore have to seek the services from the private sector. A case in point is the long waiting lists for certain required procedures at Mater Dei Hospital. 1.5.2 The Pharmaceutical Aspect One of the major tools to achieve good healthcare is to provide good pharmaceutical care. From this aspect, there is a clearer distinction between the private and public sectors. The Government offers free medications to a number of people who fall under different categories: The Schedule II Patients (Pink Card Holders) These cards are issued from the Department of Social Security. They are accompanied by a pink form which bears the name of the pink card holder. The total household income is assessed and the entitlement is based on this. Each household has one pink form that lists all members. However, every member of the household has his / her pink card. The pink form and pink card entitle their holders to free medication that is listed on the Government Formulary. Diabetics also have a pink card issued in their name. There are several faults in the administration of this system, as there does not seem to be a distinction between the strata of society, as is the case with some affluent people who are also in possession of a pink card. Also, no distinction is made between hospital in-patients and out-patients; there is only one formulary for all. 10. The Schedule V Patients (Yellow Card Holders) If a person suffers from a medical condition that is listed under the fifth schedule of the Social Security Act, then he / she can benefit from this free service, irrespective of the financial position. Examples of these conditions include: Respiratory conditions Cardiovascular diseases Malignant diseases Schizophrenia Liver diseases CNS diseases 10. 10 Ministry for Health, the Elderly and Community Care. Free medicinals. [homepage on the Internet]. No date [cited 2010 Oct 12]. Available from: The Government of Malta, Web site: http://www.sahha.gov.mt/pages.aspx?page=8 When a patient is diagnosed with such a condition, he / she is referred to a Consultant by the General Practitioner. The Consultant applies for a Schedule V Card for the patient listing the required medications. Subsequently, the patient is issued with the Card from the Almoner Section at St. Lukes Hospital. People who possess a yellow card are only entitled to take the medications that are listed on the card for free. The list must be amended if the treatment is changed. The Government Hospital In-Patients Any patient resident in the Government Hospitals is entitled to free medication. To date, there is only one Government formulary for all public hospitals. It would make more sense if each hospital had its own formulary due to the specialisation of the hospitals that varies accordingly. These formularies ought to be put together by the doctors who work at the hospitals and by the pharmacists who know what medications are available and which are best suited for the patients. Other people entitled to free medicines include amongst others: Members of certain religious orders Inmates of charitable institutions Refuse collection employees Prisoners People who are injured on duty Members of the Police Forces below the grade of Sub Inspector AFM personnel 11. 11 Ministry for Health, the Elderly and Community Care. Free medicinals. [homepage on the Internet]. No date [cited 2010 Oct 12]. Available from: The Government of Malta, Web site: http://www.sahha.gov.mt/pages.aspx?page=172 1.6 The Pharmacy of Your Choice Scheme The Pharmacy of your choice Scheme (POYC) falls under the umbrella of the Health Division in Malta. The latter is under the portfolio of the Ministry of Health, the Elderly and Community Care. POYC is under the direct responsibility of the Permanent Secretary of Health. The Scheme started in 2008 after several years of discussions and debates. It enables the people to have an easier and more comfortable access to the medicaments that they are entitled to take for free from the Government. The Scheme started in 2008 with an estimate budget of à ¢Ã¢â‚¬Å¡Ã‚ ¬460,000 and the actual expenditure for that year amounted to à ¢Ã¢â‚¬Å¡Ã‚ ¬366,000. In 2009, the estimate budget was of à ¢Ã¢â‚¬Å¡Ã‚ ¬400,000 and that for 2010 was of à ¢Ã¢â‚¬Å¡Ã‚ ¬1.5 million. The 2011 budget allocated à ¢Ã¢â‚¬Å¡Ã‚ ¬1 million to the Scheme apart from the additional à ¢Ã¢â‚¬Å¡Ã‚ ¬400,000 which had to be injected to strengthen the electronic system. The POYC pilot study started in December 2007 in two pharmacies in the Ghargur area. About 550 patients were registered in these pharmacies. Mgarr was next (one community pharmacy having approximately 600 patients), followed by Mellieha (three pharmacies having approximately 1500 pateints) in January 2008 and Naxxar in February 2008 ( Sant Fournier, 2008). Most community pharmacies enrolled in the POYC when the Scheme was introduced in their villages. For example, in the Mosta area, which includes Naxxar, St. Pauls Bay, Xemxija, Gharghur, Mgarr, Mellieha and Mosta, only one out of the 24 community pharmacies did not join in the Scheme due to lack of space (Zahra, 2007). With the introduction of the POYC Scheme, the village Health Centre Dispensaries were closed down after sufficient time had elapsed to allow for a seamless transition. 1.6.1 Advantages associated with the POYC Scheme The main scope of the POYC Scheme was to reduce the long queues at the Health Centre Government Dispensaries. Also, patients are monitored better by the community pharmacists who ensure that the medicines are taken in the correct way as more patient advice is given on a one-to-one basis when compared to the previous system (Zahra, 2007). Pharmacy practice in the community has always focussed on the establishment of an excellent patient-pharmacist relationship (Sant Fournier, 2007). This advice is lacking in the public sector as the patients are given the medicines they require with haste, due to the large number of people waiting to collect their medications. Dosage regimen advice is usually the only advice given. Many people used to turn to their community pharmacists anyway to seek advice and to solve any queries they may have had. With this Scheme, there is also a decrease in wastage because patients are not given the medicines if these are not required, despite the fact that they are entitled to them. Sant Fournier, the President of the Malta Chamber of Pharmacists, claimed that most patients have become more educated and as a result acknowledge the fact that medicines are not to be taken as a for granted privilege but must be used rationally (Borg, Bonello, 2009). The patients find it easier to confide in their habitual pharmacist rather than talk to someone who they do not know. 1.6.2 Problems associated with The POYC Scheme According to Mario Debono, the then General Retailers Trade Union (GRTU) Pharmacy and Health Division President, this system has been a success even though it would improve if more money is allocated by the Government and if it receives more attention (Borg, Bonello, 2009). As with any other recently introduced systems, there are flaws. Nevertheless, several efforts are being made to sort them out. The main problem that is associated with the POYC Scheme is the large number of medicines that are out of stock. This is causing unnecessary stress on the pharmacists and patients. The latter have to go to a Government Health Centre Dispensary that is still open or to Mater Dei Out-Patients Pharmacy to get the medications that are not available from the Scheme. However, this out of stock problem is not the fault of the POYC Department but it has got to do with the purchasing system of the Government. In October 2009, Debono stated that a possible reason why such a large number of medicines is out of stock is that some suppliers have not been paid for their services. Shortages of certain medicines abroad could also lead to decreased stock levels (Borg, Bonello, 2009). The Government did not organise any educational campaigns for the general public regarding the implementation of the POYC Scheme, even though it was advised to do so (Sant Fournier, 2009). Hence, pharmacists were faced with several problems, including sometimes, heated arguments with their patients. It was recommended to have the campaign based on the one used for the introduction of the Euro in Malta, the Malta Euro Changeover Campaign. In October 2009. Reginald Fava, the then President of the Malta Chamber of Commerce, Enterprise and Industry, made new proposals to upgrade the POYC system which were estimated to cut at least a third of present consumption and abuse. He described the current POYC system as being obscene because according to him medicines were being collected even when they were not required by the patients. Fava suggested that patients ought to pay for the medicines they require and will be reimbursed by the Government at a later stage. With this proposed system, the patients would also have the option to go for more advanced or more expensive medications as compared to their entitlement, and will only have to pay the difference in price. Hence, with this proposal, the POYC Scheme would be allowing superior medicines to be taken for free. It would also make the Scheme more sustainable as it would reduce the out of stock problem, be more cost-effective for the Government, reduce wastage and abuse. Th e Government would thus be saving on costs and would be in a better position to widen the National Formulary with more recent and advanced medications (Borg, 2009). At the moment, this is not possible due to financial constraints. The POYC Scheme affected the daily running of the community pharmacies. Due to the increased work load, some pharmacy owners had to employ further staff. The owners had to purchase a computer and a printer for labels to be issued with every dispensed prescription. They also had to apply for internet service at the pharmacy. Also, some pharmacies had to make the necessary arrangements to increase shelving space to accommodate the weekly delivery of medicines from the POYC Department. Some pharmacies even needed to install another air-conditioning unit. Admittedly, the Government subsidized these expenses to a maximum capital expenditure of à ¢Ã¢â‚¬Å¡Ã‚ ¬6,990 (Lm 3,000). After the Memorandum of Understanding was signed, negotiations were held and the amount was capped at à ¢Ã¢â‚¬Å¡Ã‚ ¬9,000. According to an article on the The Malta Business Weekly that was published in November 2009, only the pharmacists who own the pharmacy are happy with this new system. The employed pharmacists have had their work load doubled, if not trebled. Hence, they do not give their patients the service that they used to give before the implementation of the Scheme (Attard, 2009). 1.6.3 The Memorandum of Understanding The very first document on the POYC Scheme was submitted to the Government by the Malta Chamber of Pharmacis