Sympathetic Hemingway Essays - Ernest Hemingway,

Sympathetic Hemingway The most striking feature of the short story "Hills Like White Elephants" is the manner in which it is told. It is not typical in the classical sense with an introduction, a development of the story and an end. Instead, we get some time in the life of two people, as if it were just a piece of a film where we have a lot to deduce. This tale does not get everything done for the reader; we only see the surface of what is going on. It leaves an open end because readers can have their own ending and take part in the action when reading. The story told here is that of a woman and a man on their trip to a place where she can have an abortion. Everything in the tale is related to the idea of fertility and barrenness. This main topic can be seen from the title "Hills Like White Elephants," where Hills refer to the shape of the belly of a pregnant woman. White Elephants is an idiom that refers to useless or unwanted things, meaning the fetus they plan on disposing of. Hemingway produces an eff ect of sympathy for the girl through the setting that symbolizes their decision process. The time passing symbolizes the pressure the two people are under, and through their poor communication indicates that this relationship does not and will not work. The first impression the reader gets when reading the text is that the story is set in the middle of a dry, barren place under the sun, with no shade or trees. This reinforces the idea of lack of life, but, in contrast, they are in the warm shadow of the building where life is. This emphasizes the contrast between the pregnancy of the woman, as being fertile and everything around them, including him, in this idea of fertility as he is also apart from the barrenness and sharing the shadow. The "brown and dry" setting sets the tone for the conversation between the couple (Hemingway 281). It allows the reader to understand the feelings of entrapment held by the couple and especially the young girl. The couple is also separated from the rest of the people that are inside the bar by a bamboo beaded curtain. This gives the idea of privacy reinforced by the idea of the warm shadow of the building that protects them from the world that exists inside the bar, they are outside, with nature. Th ere is tension in the air at some moments, but they cannot express it openly. Perhaps they don't want to be heard in case somebody can understand them, or maybe, it is just a problem of communication and of sharing feelings. It could also be a combination of both. No woman should be subjected to making this type of important decision in such a harsh environment. Another thing the reader must take into account is the fact that the train is stopping only for two minutes, a very brief time. This couple is being pressured into making a very important decision in only a short amount of time. According to the narrator, "the express from Barcelona would come in forty minutes," leaving the couple with no time to really go into discussing the important details of their relationship and the decision they are making (Hemingway 282). As the story comes to an end, the woman server informed the couple, "The train comes in five minutes," and a sense of urgency is brought to the conversation (Hemingway 284). This becomes evident by the manner in which the couple is concluding their conversation. The girl does not want to speak about the subject anymore, but the couple has not finished talking things all the way through. In the end she just wants to get this operation over and done with. Ernest Hemingway chose to use the couple's dialogue as the best way to express sympathy for the young girl to the reader. This dialogue is presented as being very natural, but was carefully written, because through it, the reader can deduce the kind of relationship they have. The language here is a very simple one, even informal; this easy language usually expresses

3 Sentences with Flawed Parallel Construction

3 Sentences with Flawed Parallel Construction 3 Sentences with Flawed Parallel Construction 3 Sentences with Flawed Parallel Construction By Mark Nichol In each of the following sentences, an attempt to make a list within a sentence has gone awry. Discussion after each example explains the problem, and one or two revisions suggest solutions. 1. We have specific plans about what we are going to do, how and when. This sentence implies a list consisting of â€Å"what we are going to do, how we are going to do them, and when we are going to do them,† but it elides one word too many: â€Å"We have specific plans about what we are going to do, and how and when.† 2. He holds various roles, from celebrated guest, martial arts envoy, unofficial chargà © d’affaires, and even close confidant. If what appears to be a list of associated nouns or noun phrases is preceded by from, it is not a list, but a range that includes one or more intermediate parameters, so from should be complemented by to, and the sentence must be further revised so that parameters are connected with conjunctions, thereby combining to be clearly associated with either to or from: â€Å"He holds various roles, from celebrated guest to martial arts envoy and unofficial chargà © d’affaires, and even close confidant. Alternatively, revise the sentence slightly to avoid the range construction altogether: â€Å"He holds various roles, including celebrated guest, martial arts envoy, unofficial chargà © d’affaires, and even close confidant.† 3. The company has embarked on the initiative with the objectives of process improvement, increased automation, compliance with internal and public company requirements, and to support future growth. The grammatical structure of the final list item is inconsistent with those preceding it- it alone includes an infinitive phrase (â€Å"to support†)- so revise it to match the others by shifting support from a verb to a noun: â€Å"The company has embarked on the initiative with the objectives of process improvement, increased automation, compliance with internal and public company requirements, and support of future growth.† Alternatively, convert the third item to a final item by inserting a conjunction before it, then make what was the final item a distinct phrase by inserting an of before it to make it parallel with the list (which is preceded by of) and changing the form of the verb: â€Å"The company has embarked on the initiative with the objectives of process improvement, increased automation, and compliance with internal and public company requirements and of supporting future growth.† Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Grammar category, check our popular posts, or choose a related post below:50 Incorrect Pronunciations That You Should AvoidHomonyms, Homophones, Homographs and HeteronymsPunctuation Is Powerful

Analysis of the Film The Wizard of Oz (1939) Movie Review

Analysis of the Film The Wizard of Oz (1939) - Movie Review Example With reference to the more obvious part of the subject, the filmmaker appears to enthuse life’s constant fact that by one’s sole endeavor, it would be difficult to attain a sense of fulfillment. In the story, Dorothy meets a Scarecrow, a Tin Man, and a Cowardly Lion on her journey to the Emerald City. Though each of these creatures differs greatly from each other with respect to non-human material characteristics, altogether they possess distinct human traits that complement those of the Kansas girl. Under these circumstances, the four become great friends as they inevitably give one another a hand in overcoming the obstacles encountered. At this stage, the film clearly inculcates to the psyche the significance of friendship that works in good and bad times alike. ‘The Wizard of Oz’ specifically promotes the notion that regardless of the predictive capability of an individual to emerge as a hero or heroine in most cases like Dorothy, there comes a turning p oint when companions are amply necessitated in completing not only the set tasks or mission but also the state of happiness in all sorts of adventures experienced. On the other hand, through in-depth examination, the creation of ‘The Wizard of Oz’ may be found to form an argument that suggests typical culture and ‘populist ideology’. By presenting the rural conditions of an American small town where the tending farm is the chief source of livelihood, the film communicates the value of familial ties and associated hard-work thereof. It seeks to establish agreement to the type of American society during the 1930s when the extended period of industrialization from the Gilded Age brought about several revolutionary ideas which took effect via the outcomes perceived in the drastic change in both the economy and the general community lifestyle. In particular, the ‘yellow brick road’ which symbolizes ‘gold’ and the rainbow’s end bearing a ‘pot of gold’ both represent the principle of prosperity which can only be achieved through enthusiastic attitude toward work while holding ‘family’ essential in the process. It stresses consideration to how the strength of family bond impacts

Child Soldier Issue in Sudan, Uganda and Central African Republic Research Paper

Child Soldier Issue in Sudan, Uganda and Central African Republic - Research Paper Example The need to be able to earn a livelihood and support one's family in terms of earning mere amounts of money for younger siblings or suffering parents made many children become part of the worldwide child soldier community. The reasons that may thus prompt a child to become a child soldier may be the thought to support a poor family, separation from family or child running away due to unfavorable living circumstances, children displaced from their homes, children living in war zones, and children who may have little or no access to education. Orphans and children from refugee camps all over the world become acute targets of being enrolled as child soldiers as well. Owing to all the above mentioned possibilities it may we be assessed that social and economic pressures are the main key behind this grave issue. Children whose families live in warzones may have lost any of their close family member and resultantly may aim to avenge this incident by adopting to becoming a child soldier the mselves. "UN Secretary-General Kofi Annan has condemned child soldiering as a â€Å"damaging and despicable practice† (Child Soldiers, 13) Feelings of uncertainty and insecurity prevail in underdeveloped societies. Families see their and their children's' survival only if they'd be equipped with arms and would be trained to fight for their rights no matter to whatever extent of training it may involve. In addition to all this the providing of free food, clothing and lodging for their children and security are also a very attractive incentives for them. Societal issues are also a major trigger of increasing number child soldier recruitments. For underdeveloped societies where the countries are in a state of unrest it is not uncommon for young children to have lost a single or both parents and to get caught at the hands of the child hunting mafia to get eventually ending up as a militia's recruit. At times the elders purposely brainwash their children and convince them to willi ngly become militants so as to boost their fighting force against their potential enemies. The Concept In certain societal adverse circumstances children may be forced to join armed forces. If they resist they may be threatened to be killed.("Why do Children Become Soldiers?",n.p.). Child soldiers are not part of mainly the official armies of nations but are rather recruited on a regular basis by armed political groups who need fresh blood, conveniently replaceable, potentially harmless and energetic individuals at a very rapid rate. The numbers of recruits are in tens and thousands and their recruitments are both legal and forcible. As a part of their training these poor recruits are subject to all kinds of non-ethical behaviors such as rape, violence, hard labor and other forms of exploitation as well as being trained to use all sorts of weapons under the harshest of survival conditions. ("Child Soldiers" 13) The experiencing of harsh and violent conditions at one's own hands and at such a trivial age of being below eighteen results at the undermining of humanity in the child's conscience. The resultant is that these child soldiers become

Effect of Part Time Work Among Student Essay Example for Free

Effect of Part Time Work Among Student Essay In todays world, just as almost all individuals who are obligated to meet their own needs have to find a well-paid job, a myriad of students also fell obliged to work in order to afford their educational expenses because of their economical conditions. In this regard, there are a lot of positive or negative effects of this case in terms of gaining a sense of responsibility and academic failure. To begin with gaining a sense of responsibility, it is a well-known fact that having a job is a contributory factor in gaining a sense of responsibility. A job enables people to determine their prioritites and show respect to business ethics. Students who have a job could learn numerous useful knowledge on how to organize their time properly. Moreover, they would understand how to combat social and economical problems in their lives. Eventually, should you work and study at the same time,you need to be disciplined and self organized person. On the orher hand, academic failure can be regarded as the negative aspects of having a part time job. Ä °t is quite likely that students who are forced to work and study at the same time may not allocate sufficient amount of time to their studies. Due to this, although individuals in question show great determination to study,they may not pass their exams and they may fail in their studies. All in all, whilst gaining a sense of responsibility is the favorable aspects of having a part time job, academic failure can be regarded as the unfavorable outcomes of this. In this sense, in my opinion, positive aspects outweigh the negative aspects.

Scientific Knowledge Not Like Other Forms Of Knowledge

Scientific Knowledge Not Like Other Forms Of Knowledge The argument that science possesses some inherent features not possessed by other disciplines, thus making scientific knowledge distinct from other forms of knowledge has long been debated by philosophers of science. Instinctively, when questioned, the layman may propose that what distinguishes scientific knowledge from other disciplines are the fundamental principles of scientific experimentation, hypothesis testing and theory construction and that the aim of science is ultimately to understand, explain and consequently predict the world in which we inhabit. However, can scientific knowledge really be distinguished from other forms of knowledge on the basis of these features alone? The nature of philosophy of science is to determine what constitutes a science, therefore what common feature all the disciplines purporting to fall under the umbrella of science share that makes them a distinctive form of knowledge. The purpose of this paper is to examine scientific knowledge and compare it with other forms of knowledge in terms of the methodologies they employ, and the rational behind the knowledge. As Okasha (2002) articulated, it is implausible to argue that scientific knowledge is distinct from other forms of knowledge purely on the basis that the aim of science is to comprehend and explain worldly phenomena since this aim is surely shared by all disciplines. Intuitively, one might argue that scientific knowledge can be demarcated from other disciplines by the methodology utilised by scientists to progress scientific explanation, which predominantly resides in the implementation of empirical investigation, theory construction and hypothesis testing. However, as Haack (2003) highlighted, controlled experiments, for example, often thought of as distinctive of the sciences, are not utilised by all scientists, nor are they only utilised by scientists. Whilst astronomers and evolutionary theorists rely on observational methods rather than empirical testing, it is arguable that people such as mechanics and plumbers do utilise methods more akin to the standard scientific means. In f act, as Haack (2003) asserted, what distinguishes science from other disciplines is not that science relies on a distinct methodology, but rather that scientists have merely extended and refined the resources utilised by ordinary people in everyday empirical inquiry, of which we all partake in. In concurrence, Sokal (2008) emphasised that the use of the term science should therefore not be limited to the natural sciences but should include investigations aimed at acquiring accurate knowledge of factual matters relating to any aspect of the world by using rational empirical methods analogous to those routinely employed in the natural sciences. This supports the notion proposed by Huxley that the man of science simply uses with scrupulous exactness the method of which we all habitually and at every minute use carelessly. All empirical inquirers, whether they be molecular biologists, sociologists, historians or detectives, make informed conjectures about the possible explanation of the phenomena that concerns them, examine how well these conjectures stand up to evidence they already have and any further evidence they can obtain and then use their judgement to determine whether to continue to support their original conjecture, modify or reject it. Hence, scientific knowledge cannot be distinguished from other forms of knowledge on the basis of the methodology that it employs since science is not in possession of a special method of inquiry unavailable to historians or detectives or indeed the layman. The methods of certain scientific endeavours may be more refined and exact than for other forms of investigations, however, as Sokal (2008) emphasised, methods of inquiry must be adapted to the subject matter at hand. The underlying principles of scientific inquiry as opposed to other rational inquiry that relies on empirical methods are ultimately the same. What then can distinguish scientific knowledge from alternative types of knowledge? Popper (1972) made a strong case for the notion that whilst some empirical testing conducted in science or indeed in other forms of rational inquiry is genuinely empirical, some disciplines purporting to fall under the umbrella of science rely on methods that are arguably non-empirical or even irrational and pseudo-empirical and that whilst they utilise methods which appeal to observation and experimentation, nevertheless they do not meet the scientific standards. Popper (1972) highlighted cases of supposed pseudo-scientific theories, such as Freuds psychoanalysis theory and Alders individual psychology theory as providing evidence for this stance, arguing that they had more in common with myths than with science whilst seemingly possessing strong explanatory powers. He argued that the fact that any behaviour observed could be explained by these theories, although used to bolster credibility for the t heories, was in fact their biggest weakness since no conceivable behaviour could contradict them and therefore the theories were non-testable and ultimately non-falsifiable. He argued that it is easy to obtain confirmations for any theory if we seek confirmations and that confirming evidence should not count except when it is the result of a genuine test of the theory which means that it can be presented as a serious but unsuccessful attempt to falsify the theory. Popper emphasised that whilst the procedure of making a theory such as Freuds psychoanalysis theory compatible with any possible course of events is always possible, and the theory can be rescued from refutation, the price is that its scientific status is significantly reduced. Significantly, however, Popper was not saying that non-falsifiable theories and therefore knowledge based on non-falsifiable claims do not have significance or their place. Rather, that many of the non-testable theories such as the psychoanalytical or individual psychology approaches to human understanding are analogous with myths, and historically nearly all scientific theories have been borne out of myths therefore a myth may contain important anticipations of science theories. Thus, if a theory is found to be non-scientific or metaphysical as it cannot be falsified it cannot be labelled as insignificant in terms of its value to knowledge but it cannot claim to be supported by empirical evidence in a scientific sense. Therefore, religion, whilst not falsifiable since it is not possible to prove whether God exists, is still a valuable discipline. One caveat to Poppers (1972) criterion of demarcation however, expressed by Okasha (2002) is that whilst Popper criticised, for example, Marxists for explaining away data that appeared to conflict with their theories, rather than accepting that the theories had been refuted, it would seem that this procedure may be routinely used in the field of science. For example, Adams and Leverrier in 1846, determined the existence and location of the planet Neptune by utilising Newtons theory of gravity despite the fact that it had made an incorrect prediction about the orbit of Uranus and had therefore been falsified. Rather than concluding that Newtons theory was completely inaccurate, they continued to advocate the theory and attempted to explain away the conflicting observations regarding Uranus by postulating a new planet, thus demonstrating that even falsified theories can lead to important scientific discoveries. Hence, whilst Poppers argument is initially strong it is somewhat flawed. I t is still essential for scientific knowledge to be based on evidence that has been stringently tested against a clearly defined set of principles, which arguably makes scientific knowledge distinct from other knowledge such as theological knowledge that is not based on such stringent evidence, however scientific knowledge and other forms of knowledge cannot be distinguished purely on the bases of whether the theories they originate from are falsifiable or not since some scientific theories when falsified are still utilised to progress knowledge. Therefore, in terms of science and religion, it is possible to distinguish between the two in terms of the methods of study and how knowledge is acquired, i.e. knowledge derived from empirical testing as opposed to personal beliefs, however it is not possible to distinguish between these two knowledge bases on the fact that scientific knowledge can be falsified whereas religious beliefs cannot since not all scientific knowledge can be. The process of reasoning on which scientific knowledge is based can also be compared with the reasoning behind other forms of knowledge. As Okaska (2002) articulated, scientific knowledge is largely based upon the process of inductive reasoning whereby scientists move from premisses about objects they have examined to conclusions about objects they have not examined. An example of this would be found in the study of Downs Syndrome, in which geneticists have established that sufferers have 47 chromosomes instead of the normal 46. In order to determine this, a large number of sufferers have been examined and in each case the additional chromosome has been found. Therefore, it has been concluded that having this additional chromosome causes Downs Syndrome. However, this is an inductive inference as not all Downs Syndrome sufferers have been tested for the chromosome and therefore the geneticists have moved from the premises about the sufferers they have examined to conclusions about suf ferers they have not examined. It is possible that another explanation could be equally plausible. Scientists heavily rely on inductive reasoning wherever they move from limited data to a more general conclusion. It is arguable that other forms of knowledge as well as scientific forms of knowledge are largely based on inductive reasoning. In fact, we use inductive reasoning in everyday life and our common sense is built on inductive reasoning as highlighted by Haack (2003). However, there are forms of knowledge which do not rely on inductive reasoning, namely religion and theology. According to Haack (2003), unlike religion, science is not primarily a body of belief, but rather a federation of kinds of inquiry. Scientific inquiry relies on experience and reasoning and the sciences have developed many ways to extend the senses and enhance our powers of reasoning but they require no additional kinds of evidential resource beyond these, which are also the resources on which everyday empirical inquiry depends. Religion, on the other hand, is not primarily a kind of inquiry but a body of belief based on personal commitment. Unlike religion, theology is a form of inquiry. Unlike scientific inquiry however theology welcomes and indeed seeks supernatural explanations, explanations in terms of Gods making things so. Furthermore theology usually calls on evidential resources beyond sensory experience and reasoning and most importantly on religious experience and the authority of revealed texts. As Sokal (2008) highlighted, unlike scientific reasoning that is based on facts, theological reasoning stems from the notion that the holy scriptures provide the answers to life and when asked how it can be known that this evidence is accurate, the answer given is because the holy scriptures say it is. Thus theology is subject to circular reasoning and so unlike scientific inquiry; according to Haack (2003) theological inquiry is discontinuous with everyday empirical inquiry both in the kinds of explanations in which is traffics and in the kinds of evidential resource or method on which it calls. However, debate looms large over the nature of inductive reasoning, and whether in fact it is merely a form of circular reasoning itself. Hume (1739) argued that induction cannot be rationally justified at all since it invokes the uniformity of nature which is the assumption that unexamined objects will be similar to examined objects. According to this we cannot assume that past experiences will be a reliable guide to the future and to argue that induction is trustworthy because it has worked up until now is to reason in an inductive manner. The uniformity of nature cannot be tested empirically either since this would require inductive reasoning. Hume emphasised that our inductive inferences rest on an assumption about the world for which we have no good grounds and therefore postulated that our confidence in induction is just blind faith. Therefore, arguably if this were the case then science is like religion and theology after all in that it is based on reasoning that can never be proved. However, there are many caveats to Humes theory. As Strawson emphasised, induction is so fundamental to how we think and reason that it is no the sort of thing that should and could be justified as induction is one of the standards we use to decide whether claims about the world are justified. Furthermore, the notion of probability would suggest that there is weight in our inductive reasoning, and therefore since scientific knowledge is founded on objective empirical evidence, it is arguable that the reasoning behind science is more trustworthy that that of religion which is subjective in nature. In conclusion, intuitively scientific knowledge is a distinctive form of knowledge; however, under closer examination it is evident that similarities do exist. The reasoning behind predominantly all scientific knowledge, like the majority of other disciplines and our everyday inquiry, is inductive in nature, which raises the question as to whether any scientific knowledge can ever be proven. Furthermore, whilst science depends on the scientific method of experimentation, theory construction and hypothesis testing, as Haack (2003) emphasised, these methods are by no means exclusive to science. Rather, scientific inquiry should be seen as continuous with everyday inquiry, although somewhat more refined and other disciplines should be equally able to utilise the scientific method. Whilst methodology may differ between disciplines, the underlying concept that the inquiry must be rational for the knowledge obtained to be credible is inherent in most disciplines akin with science. As Chalm ers (1999) argued, there is a false assumption that there is a universal scientific method to which all forms of knowledge should conform however as Feyerabend (1975) argued, defenders of science typically judge it to be superior to other forms of knowledge without adequately investigating these other forms. He postulated that there can never be a decisive argument in favour or science over other forms of knowledge that are incommensurable with it and that if scientific knowledge is to be compared with other forms of knowledge then it will be necessary to investigate the nature, aims and methods of science and those other forms of knowledge by utilising methods such as by studying historical texts, records, original papers, letters, private conversations and so on, rather than simply by utilising scientific methods. In concurrence with Haack (2003) and Sokal (2008), Chalmers (1999) also emphasised that other forms of knowledge should not conform to the rules of logic stipulated by s cience and therefore pseudo-science and disciplines such as Marxism should not be rejected as implausible on the grounds that they do not conform to the preconceived notion of the scientific method. CONCLUSION: In conclusion, intuitively scientific knowledge is a distinctive form of knowledge; however, under closer examination similarities exist. The reasoning behind predominantly all scientific knowledge, like the majority of other disciplines and our everyday inquiry, is inductive in nature. Furthermore, whilst science depends on experimentation, theory construction and hypothesis testing, as Haack (2003) emphasised, these methods are by no means exclusive to science. Scientific inquiry is seemingly continuous with everyday inquiry, although somewhat more refined. Whilst methodology may differ between disciplines and some theories may be more testable than others, the underlying concept that the inquiry must be rational for the knowledge obtained to be credible is inherent in most disciplines akin with science.

Economics- Assessment

Assessment (Demand and supply) Answer the following 1. Distinguish between a shift of the demand curve for a product and a movement along the product’s demand curve (10 marks) 2. With reference to two different determinants of demand, explain why the demand curve for bicycles might increase. Use a diagram to support your answer (10 marks) 3. Distinguish between a shift of the supply curve for a product and a movement along the product’s supply curve (10 marks) 4.With reference to two different determinants of supply, explain why the supply of coffee beans might decrease. Use a diagram to support your answer (10 marks) Assessment advice * Answers tend to resemble each other structurally. * Each should start with a written explanation in which the key economics terms are defined. * This would usually be followed by a diagram to illustrate the theory, followed by a further explanation in which the diagram is explained in the context of the specific question. * Be sure to u se arrows to show directions of change in the diagrams and refer to any changes in the variables.Assessment criteria (Each question carries 10 marks) Level Marks 0 The work does not reach a standard described by the descriptors below. 0 1 There is little understanding of the specific demands of the question. Relevant economic terms are not defined. There is very little knowledge of relevant economic theory. There are significant errors. 1–3 2 There is some understanding of the specific demands of the question. Some relevant economic terms are defined. There is some knowledge of relevant economic theory. There are some errors. –6 3 There is understanding of the specific demands of the question. Relevant economic terms are defined. Relevant economic theory is explained and applied. Where appropriate, diagrams are included and applied. Where appropriate, examples are used. There are few errors. 7–8 4 There is clear understanding of the specific demands of the quest ion. Relevant economic terms are clearly defined. Relevant economic theory is clearly explained and applied. Where appropriate, diagrams are included and applied effectively. Where appropriate, examples are used effectively. There are no significant errors. 9–10

Case Report of Six Sigma at Academic Medical Hospital Essay

Six Sigma is a business management strategy designed to meet customer needs and process capability. Six Sigma seeks to improve the quality of process outputs by identifying and removing the causes of defects and minimizing variability in manufacturing and business processes. It uses a systematic project-oriented fashion through define, measure, analyze, improve, and control (DMAIC) cycle, including statistical tools, and creates a special infrastructure of people within the organization (like â€Å"Black Belts†, â€Å"Green Belts†, etc.) who are experts in these methods. Each Six Sigma project carried out within an organization follows a defined sequence of steps and has quantified financial targets (cost reduction, profit increase, etc). Overview: Project name: Six Sigma at Academic Medical Hospital (AMH) Problem: Patients with potentially life-threating injuries and illnesses are waiting for over an hour for treatment in Emergency Department at AMH! Although long wait times seemed to be readily excuses by many physicians due to complexity of managing emergency room and processes and clinical staff, it is still unacceptable for the patients. Targets: help Emergency Department (ED) at Academic Medical Hospital (AMH) to reduce the wait time Method: instituting Six Sigma at AMH and establishing a Six Sigma Foundations Teams, which undertake an application practicum on an assigned AMH project with, cooperate trainers acting as coaches. Six Sigma Foundation TEAM: Champion: Dr. Elbridge (establishes business targets and creates an environment within the organization to promote the Six Sigma methodology and tools) Sponsor: Dr. Terry Hamilton (key communicator and approves final recommendation) Owner: Nancy Jenkins (implementation and accountable for sustaining long-term gains) Black Belts: Jane McCrea (project leaders who are experts in Six Sigma methodology and statistical tool applications) Green Belts: Dr. James Wilson (trained by six Sigma methodology from hospital) The Foundations Team: (a group of local experts who participate in the project) &4 people (Nancy Jenkins, Patient Care Manager; Georgia Williams, ED registration Manager; Bill Barber, senior Clinician; and Steve Small, Senior Clinician and Quality Improvement Coordinator) Seven Process Steps and Activities for patients at the Emergency Department: Triage: The Nurse complete a preliminary assessment of the patient’s condition and ranks his criticality accordingly; Register: The Nurse obtain demographic and insurance information; Lobby: The Patient wait for the nurse call your name; Tx Room& Nurse: The patient do testing and get the results; MD: The patient wait for doctors. Questions: Q1.Describe how Six Sigma Methodology (DMAIC) is implemented in the â€Å"ED Wait Time Project.† As stated, Six Sigma is based on a 5 phase, step-by-step process that was used in the â€Å"ED Wait Time Project.† In the Define phase the team identified expected benefits of the project including expedited medical care delivery, improved patient satisfaction, reduced patient complaints, increased patient capacity and improved operational efficiency. Moving on to the Measure phase, the team determined the baseline measures and the target performance of the original process as well as defined the input/output variables. They collected 2 groups of data sets as well as administered a patient satisfaction survey, which produced the maximum wait times for pa tients. During the Analyze phase the team then analyzed the baseline study and found that two processes mainly influenced the wait time; the waiting room time and the time spent waiting on the MD. As the ED Wait Time Foundations team moved on to the Improve phase it was decided that they would improve: Patient flow, Care Team Communication and Streamlined Order Entry and Results Retrieval Process. By changing procedure by which the Priority Level II patients were moved, it resulted in less or no waiting room time and allowed patients to proceed to the examination room. Modifying ED zone assignments within the patient- care team and using new communication boards would reduce patient complaints and improve satisfaction. This change will also help with new central clerks that will help entering patients and decrease the amount of time that physicians and nurses are occupied. Lastly, in the Control phase the team ensures that the new standard operation procedures for moving patients through the ED are maintained. They compared the performance of the Emergency Department before and after in order to note their progress and set guidelines to preserve their advancement. Q2.Access the pilot results from the process changes. What should the team say to the Project Sponsor, Dr. Hamilton, and to the Project Champion, Dr. Elbridge about the results? According to the results, the pilot Lobby Wait Time mean value came in under the acceptable target of 15 minutes, and the MD Wait Time measure was improving(pilot mean was 8.9 minutes against a study 1 baseline of 16.1 minutes and a study 2 baseline of 11.2 minutes). Although pilot MD Wait Time didn’t reach the target set at 8.0 minutes, it was apparently improved. Pilot Lobby Times were better than established 15 minute target, the defect rate dropped, and the 95% confidence interval test on the study 1 median and study 2 median vs. pilot median validated statistical significance of the improvement in wait times. Results of MD Wait Times were stat istically significant in one of two Mood’s Median tests (study 1 vs. pilot). Positive trending was demonstrated in the comparison of study 2 to the pilot which showed that the MD Wait Time became shorter and the detect rate decreased. The outcome looked promising. However, the Hawthorne effect came into play, particularly in the study 2 data collection activities. Due to unreliable automated data-gathering procedures in the ED’s information systems and the need to use intra-departmental manual data surveyors, the presence of bias was recognized. The team needed to decide whether to redo some aspects of their work in the Improve phase. The data was not convincing enough, and the result of improvement in MD Wait Time was not very apparent. Q3.What are the obstacles to AMH adopting Six Sigma? The equation [Q*A=E] is the cornerstone of successful Six Sigma improvement implementation. It infers that the quality of process solutions multiplied by the Acceptance level of stakeholders is equal to the effectiveness of those results. In this case, the primary obstacle is the acceptance level of the hospital. NO matter which solutions result from the analysis, the potential for success will be limited without the acceptance of the people affected and involved. Getting people to embrace six Sigma reforms in ED was going to be an uphill battle. There are 3 reasons: 1) Physicians are not hospital employees, but independent contractors of a sort from the Medical school. It is almost a disincentive to participate since their incentives lie with research, education, and patient care specialty. 2) Dr. Hamilton who is the sponsor of the project was hesitant to get involved in anything that he was unfamiliar with or which would add to his already full plate. Also, Nancy Jenkins, who is the project owner, implementing significant process and behavior change were not among her strengths. 3) Last, it was noted that the Hawthorne effect came into play. The Hawthorne effect refers to a phenomenon in which participants alter their behavior as a result of being part of an experiment or study. It is hard for the team to get reliable automated date-gathering procedures. Q4.Consider whether or not the team should recommend a change in the Project Sponsor even at this late phase of the project. The project sponsor is supposed to be the reque stor of the project and is committed to its solutions. He/She should also be responsible to identify project goals, objectives and scope; remove barriers and aligns resources; serve as a key communicator of project progress and status and approves final recommendations. However, in this case, Dr. Terry Hamilton, the project Sponsor, had a lot of work in his own domain to focus on (busy vice-chair of the Medical School’s Emergency Medicine Department, active in several other department initiatives and responsibilities) and he was also an involved father and husband. As a result, he was so reluctant and kind of indifferent to this project. We would like to recommend the project team to change the Sponsor. Who’s elective? Dr. George Calhoun, the Emergency Medicine Department Chair, had remained at arm’s length throughout the team’s work. As the chair, Dr. Calhoun was in a position of influence over faculty and long-term changes that could result from the ED Wait Time Project. And we also learned that Dr. Calhoun’s interests and incentives were linked to achieving national emergency medicine program recognition and publications. So Dr. Calhoun is the appropriate candidate for the Project Sponsor. Q5.Based on what you k now of the project’s results, limitations, and key stakeholders, what would you recommend as the next step for McCrea in her role as the Black Belts of the ED Wait Time Project? According to the results and the analysis, there are many improvements we can do. There are four aspects of improvements: Eliminating interference factors They should reduce the Hawthorne effect recording the Wait Time without being observed by the staff. They should think of new methods to record the MD Wait Time more accurately because there were some bias and errors in the measurement. Perhaps we can use video camera to observe staff’s actions to make sure they comply with the rules of Six Sigma and to record the MD Wait Time. 2.Increasing the Acceptance level The equation, Q x A = E, is the cornerstone of successful Six Sigma improvement implementation. No matter which solutions result from the analysis, the potential for success will be limited without the Acceptance of the people affected and involved. I think increasing the Acceptance level is the most important mission for the next step. The tools and techniques are referred to as â€Å"The Change Acceleration Process,† or CAP. Several CAP techniques were used throughout the ED Wait Time project, including Process Mapping, Elevator Speech, Extensive and Creative Communication Plans and The Stakeholder/Resistance Analysis. 3.Quality Improvement Considering that the Pilot MD Wait Time apparently didn’t decrease, I suggest the team should look for some other methods for improvement. The current methods seemed not very effective. Changing some key members As the article mentioned, the project Sponsor, Dr. Hamilton, was not very active. He was very busy and was not interested in Six Sigma project. The project Owner, Nancy Jenkins, was not good at implementing significant process and behavior change. It’s less likely that the implementations will be sustained after the Six Sigma experts leave. Perhaps the two members mentioned above should be replaced by more competent people. As mentioned above, Dr. Calhoun may be the right person for the Sponsor. I also think that Dr. Elbridge should be more positive in this project.

The Confederate Soldier and the Union Soldier essays

The Confederate Soldier and the Union Soldier essays Confederate soldiers were very proud men. When given a promotion it was like being insulted. They thought it would be better and more patriotic to be at a lower ranking. It became obvious that the country didnt just want braun but brains as well in a soldier. When a soldier was at a camp their day would begin taking roll call. After that they would go to breakfast where they would fry whatever saltpork or fatback they had, they would also have a sort of pancake batter type thing. The confederate soldier was supposed to get eleven dollars per month. However somtimes a private would go four to six months without pay. If a soldier was in training camp the day would be continuous drilling. Soldiers would als spend there time writing and reading letters and listening to music. And if their not working at all at night he would sleep as much as possible. Life as a Union soldier basically was hard and rough. There day started out with roll call. After that was breakfest, Then all the sick were called then t was cleaning up the company street. Then they had guard mounting. The Sergeant then called for picket duty and drill. Lunch came after that. They had free period then more drilling. During their free time a lot of soldiers spent their time reading. They would also gamble. There were also a lot of different groups of personalities in the camp. The most annoying of these was known as a beat. Which was known as a lazy person. The lives of the Confederate and the Union soldier were different in many ways, but one thing stands clear, they were both very proud of who they were and what they were fighting for. ...

Free Essays on Elizabeth Carey

Lady Elizabeth Tanfield Cary, Viscountess Falkland Elizabeth (Tanfield) Cary is an important literary figure worthy of study in the 21st century because she was a rebel with a cause for women’s rights, especially within marriage; because she became a rebel with a religious cause; and finally, because she was the first Englishwoman to write and publish a drama, The Tragedy of Mariam (1613). Elizabeth (Tanfield) Cary was born in 1585, was the only child of Judge Sir Lawrence Tanfield (Weller), and was provided a strict but extensive education (Krontiris). Cary’s life was characterized by her constant struggle between the pressures of conformity and submission and an inner imperative to resist and challenge authority. Societal expectations of women at this time were that women were to be nominally educated, if at all. Women were to be quiet and meek, to be subservient to men in all regards, to be used as an asset when arranging marriages. Women were to be a beautiful ornament on the arm of their husband in society, to bear and raise his children, and were expected to have no thoughts or opinions on matters of politics or religion. Women had no power to choose their own futures, and were at the mercy of their parents in regards to education, and the choice of a spouse. Although Cary was raised within this environment, she dared to step outside the bounds of so ! cietal and gender expectations and undertook much of her own education, learning 5 languages, translating classical texts and writing verse (Weller). She married Sir Henry Cary in 1602. Subsequent to her marriage, her husband, a successful courtier was appointed Privy Councillor (1618), Viscount Falkland in the Scottish peerage (1620), and Lord Deputy of Ireland (1622). She bore him eleven children between 1609 and 1624; and continued to expand her education by reading continually in history, poetry, moral philosophy, and the Church Fathers (Beilin). ... Free Essays on Elizabeth Carey Free Essays on Elizabeth Carey Lady Elizabeth Tanfield Cary, Viscountess Falkland Elizabeth (Tanfield) Cary is an important literary figure worthy of study in the 21st century because she was a rebel with a cause for women’s rights, especially within marriage; because she became a rebel with a religious cause; and finally, because she was the first Englishwoman to write and publish a drama, The Tragedy of Mariam (1613). Elizabeth (Tanfield) Cary was born in 1585, was the only child of Judge Sir Lawrence Tanfield (Weller), and was provided a strict but extensive education (Krontiris). Cary’s life was characterized by her constant struggle between the pressures of conformity and submission and an inner imperative to resist and challenge authority. Societal expectations of women at this time were that women were to be nominally educated, if at all. Women were to be quiet and meek, to be subservient to men in all regards, to be used as an asset when arranging marriages. Women were to be a beautiful ornament on the arm of their husband in society, to bear and raise his children, and were expected to have no thoughts or opinions on matters of politics or religion. Women had no power to choose their own futures, and were at the mercy of their parents in regards to education, and the choice of a spouse. Although Cary was raised within this environment, she dared to step outside the bounds of so ! cietal and gender expectations and undertook much of her own education, learning 5 languages, translating classical texts and writing verse (Weller). She married Sir Henry Cary in 1602. Subsequent to her marriage, her husband, a successful courtier was appointed Privy Councillor (1618), Viscount Falkland in the Scottish peerage (1620), and Lord Deputy of Ireland (1622). She bore him eleven children between 1609 and 1624; and continued to expand her education by reading continually in history, poetry, moral philosophy, and the Church Fathers (Beilin). ...

Interest Rate SWAPS Literature review Example | Topics and Well Written Essays - 2000 words

Interest Rate SWAPS - Literature review Example According to Pelsser (2000) the market related to derivative securities has been stated to be perceived similar to an insurance market in relation to the considered financial risks. The rapid rate of globalisation in terms of the capital markets has resulted in a significant rise in the level of volatility related to interest rate across the globe. Numerous companies displayed a preference in favour of purchasing insurance in opposition to the rising improbability and instability with regard to the market linked to interest rate. Owing to this particular rationale, the market related to interest rate derivatives witnessed a sharp rise and development during the past two decades (Crotty & North Carolina State University, 2006). It was stated by Whaley (2006) that interest rate derivatives are referred to those kind of derivatives which are supposed to make available the pay-offs that are ascertained by the way of alterations that takes place in the interest rates. The similar derivati ve products that were made use of with the intention to handle and deal with the risks related to foreign exchange were found to posses the competence of managing the risks related to interest rates as well (Kohn, 1990). The popular form of derivative product that was found to be used in this context was the interest rate swaps. ... The advantage of tailoring or modifying the risks associated with interest rates in accordance with the requirements of a particular risk manager was attributed to be the major cause behind its popularity. Interest rate swaps have been recognised to be the most extensively applied form of interest rate derivative (Grant & Marshall, 1997; Bodnar & et. al., 1995; Moffet & Karlsen, 1994). Interest rate swap has been stated to be quite an effectual instrument. It is competent of being structured at quite a decreased degree of cost and is also supposed to be less pricey in comparison to a fresh loan with a fixed rate (Schaeffer & Ludwig, 1993). According to Coyle (2001), the concept of interest rate swap is referred to the swap over of payment of interests based on a theoretical amount with regard to the principal. In such instances, one particular party is believed to disburse a preset interest rate with regard to the principal amount for the duration in relation to the swap. Similarly, the other involved party continues disbursing a floating interest rate which is attuned or rather periodically altered. The notion of interest rate has been explained as the sum of money or funds that is assured to be paid by a particular borrower to the concerned lender. The usage or the execution of an interest rate is learnt to be dependent on the degree of relative credit risk as it is believed that the more the expected degree of credit risk, the rate of interest that is assured by the specific borrower also soars and gets increased in relation to it. The interest rate swap is considered to be quite popular and has been stated to be amongst the chief

Summary Essay Example | Topics and Well Written Essays - 500 words - 115

Summary - Essay Example Hansberry believed deeply that when humanity had peace within itself, it would enable them reach their full potential and lead to achievement of justice. Peace would lead to achievement of social justice which would mean an end to negative things that have been dominating the society such as corruption, poverty, wars and even maltreatment of particular type of group of people (Lieberman 230). Her approach which indicated she was a black radicalism follower portrayed her passion for her course of peace which she even attempted to use media and theatre to pass across her peace preaching and have to do more before one could even be considered a hero. Her peace activism had roots in politics and art from the way back in the time when she was growing up and hence her work cannot simply be reduced to just activism because she also explored the politics development and philosophy and incorporated them in her peace attempts and activities. She was brought up in a world full of war and atomic bombs to destroy mankind in the heart of World War II and it is therefore understandable why she would support communism and try to broker it as a view of the world that people should indeed follow if they wanted to live in peace during the post-World War II era. Communism in the South was linked to issues or race such as racial pride, black leadership and the anticipation of the black movement. Her idea of peace and social justice was not only supported by communists but non-communists as well who were tired of the cold war and structural violence and just wanted to coexist in peace. Hansberry used her voice and writing skills to openly address the issue of structural violence reminding people that violence, the crimes committed by youth and their youthful delinquency tendencies as well as discrimination and a lack of opportunity all culminated to fueling war and causing more problems for mankind. She attempted to borrow a few courageous acts to