Biblical Leadership

The biblical account for leadership varies in manner but similar in substance, as it is given in the Bible's major divisions, the old and new Testament. The biblical leaders prior to Jesus are chosen by God, and the circumstances that these leaders face has God's direct intervention. Jesus and the Old Testament leaders through Martin Buber, both show leadership in a non-conventional manner. Though there are differences, there are also similarities in their approaches to the sense of leadership.Biblical leadership basically does not concern superiority of one over another; this is primarily due to the account that biblical leadership is not defined as the conventional and/or modern account of the position. In the Bible's Old Testament, God does not often choose the physically powerful individual, but the weak ones (Buber, 2002). Take the case of David for instance, David does not have brute force to begin with, yet he is chosen by God to lead the people of Israel against the Philistin ians.There are conversely a few exceptions such as Samson, but still, his physical prowess acquired is through God's divine intervention (Buber, 2002). The Bible appears to conform to an unorthodox concept of leadership; which only goes to show that the law of nature is not always plausible (Buber, 2002(. . Meanwhile, biblical leadership in Christ's account generally calls for humility and simplicity. Christ constitutes that a person should not be called master because there is only one true master, the Lord (Matt 23:10-12, New American Version) (Mark 10:31, New American Version).The context of leadership then does not encompass on the power that withholds people on earth but the power that is of God. Ironically, Christ's account of biblical leadership differs as it poses a challenge since people tend to invest on earthly pleasures such as houses, lands, and other property (Mark 10:29, New American Version). Jesus' leadership by example conforms to the main ideas of humility and sim plicity. One is that he does not make use of his stature as the physical manifestation of God; he shows neither signs of any supremacy nor discrimination of man.He washed his apostles' feet so as to prove that his leadership is more on service and not on being served. Jesus speaks of leadership as not to exercise his own will but to serve in instigating the will of God (Mark 10:33-34, New American Version). In addition, Jesus does not institute any commandment by his own authority, but the authority of God. It is now clear that the concept of Biblical leadership is far different from the conventional definitions of humans.The human principle accords with nature as the strong always rule and the weak, otherwise. The modern take on leadership concerns power, wealth, influence, and in some cases, property, it is in this account that Biblical leadership differs from that of the modern. Current United States president George W. Bush exemplifies the modern approach to leadership; he diffe rs from Christ and Buber's accounts. One is because Bush is addressed as President or Mr.President; he is then called or addressed to as a master in this sense. Second is that the United States is considered the most powerful among nations, thereby giving Bush strength, and conformity to nature’s claims. Last is that Bush exercises his authority and leadership in his own will, and does not put any other will in to consideration but his will alone. This is most blatant in his declaration of war against Iraq and Afghanistan; the United States president did not seek for congress approval,Biblical leadership by perspective differs from that of the secular, from how it is executed in the bible and how it is practiced in the modern standard. In any case, there is no implication of transparent supremacy in the Bible’s context of leadership. Furthermore, the Bible does not account with nature as far as strength in relation to leadership is concerned. The biblical outlook simpl y does not concur with the modern and worldly belief of leaders. References Buber, M. Biemann, A. (Ed. ). (2002). The Martin Buber Reader: Essential Writings. New York: Palgrave Macmillan.

Define Love

When it comes to love in needs a few thing and some of them are passion, intimacy and commitment. However depending the type of love or relationship varies. Passion is a form of an emotion that is how you feel someone, and intimacy is a measurement of how close you are to someone or familiar with them. Finally commitment is the act of being committed or committing yourself, to someone a measurement of loyalty. Now for each of love or relationship these three things are provided in different ways. Such as in a relationship with a friend the loyalty is strong and a form of passion and intimacy happens on a low enough level that most do not become physically engaged with each other. Now a family relationship these three things happen a slightly higher level with an extremely low level of physical of engagement such a hug or a kiss on the chick. Now a mutual relationship between two people unrelated in anyway, may have been friends at one point and time; but the level have increase in a way that there may or may not been some kind of physical engagement , a form of loyalty (commitment), passion and intimacy on a high level. All three of these form of relationship meaning and purpose are very different but the thing they have in common is very much the just in different intervals. It all boiling down to who, what, where, when, and how; But to try define something based emotion and the human mind is to try and define why most water runs south or why the wind blows or how the earth is the only inhabited planet. Each one of these is related because all relationships need these three things to function. To be hones this is all I can write about this, but if I must write more, I strongly believe that love is what really makes the world go round and develop people on a mysterious ways. Explaining how you believe an individual’s attachment style can affect the types of love relationships he or she has. An individual’s attachment style can greatly affect the type of love of relationships he or she has because, the attachment is define on the type of relationship as well the relationship, define one the attachment. This can also cause trouble among a relationship because one person’s level of attachment maybe stronger than the others. Or someone who is attached to someone who is not; this is how in some cases stalking happens or heart break. An attachment affects someone relationship because there is a need for attachment, where there is a need, there is a want as well as a requirement. Basically what I mean is the attachment defines a relationship because the attachment is based on the emotionally as well as the physical that is geared towards the person the attachment is for. An attachment is a bases as well as glue for a relationship defining it in a way for it to grow and be prosperous. And as a relationship grows so does the relationship, thou I still warn of an over attachment, in some instances it can become dangerous. Different level of attachment is how you are attached or feel towards your, sister, your mother, father, mother, daughter, son, friend and neighbors. Its how you are and feel towards each person you meet on your day to day life. as well as the people who come and go in your life. Building attachment and relationship as your grow old. It is the nesseccary good and evil of a relationship because attachments don’t always stay as they sometimes go and fade away. How can you ask someone to define an attachment, because no one really know except from their own experience, to define something from their own experience show the truth of their deferment and so the true color of what is meant in their words. Can it be expanded it a certain amount of words, maybe or maybe not; because people do run out of things to say. What I want to say is this, if you are not attached to the person whom you have a relationship with; no matter what level it is, and then you do not have a relationship. What is that you do have I cannot say, but it is best not spend time on it and is will benefit both if you simply walk away from it. So you have to view attachment from a certain view point and frankly it goes to a point of how the heart feels. An attachment is based on the relationship and affects the relationship because the attachment is based on the relationship, the level of love (sounding a little repeating because of the unessacery word count needed) . the attachment brings some together and some apart. The attachment is the defining moment in some cases when it is discovered. For an example when I discovered the attachment that I had to the women who later becomes my wife, I was overjoyed and pursued the attachment so I could keep the filling of happiness. We have now been married for five years and I couldn’t be even more happier. The attachment started our relationship and has defined it for these last five year and that is my point on how attachment affects relationships. If there where was anything else I could say about this then I would but I have ran out of words.

Fiduciary, regulatory, and contractual Essay Example | Topics and Well Written Essays - 500 words

Fiduciary, regulatory, and contractual - Essay Example For example, an individual entrusting their money to a bank to keep it safely or use it for investment purposes, in this case the bank acts as a fiduciary to the individual. In this type of relationship, an individual, in a vulnerable position, vest his or her confidence justifiably, in good faith and trust in the other person’s advice, assistance or some protection. In this relationship, good conscience needs the action of a fiduciary at any given time for the interest and benefit of the individual who trusts. To indicate that an individual is fiduciary only opens a new chapter and direction for further investigation and inquiry. To whom is the individual fiduciary? What are the obligations that the individual owe as a fiduciary? The norm of the law aims at shaping a conduct that is in existence due to imperfection. It may be used to proscribe conduct or in the calibration of incentives or even in changing individual preferences. Regulation can also be used in rule enforcement and monitoring as established by the legislation either primary or delegated (Griffiths-Baker 67). Regulations focus at creating constraints, limitation or creating a duty. It takes several different forms including self-regulation as exercised by several industries and companies through association of trades, contractual obligations that bind many parties together among others. State mandated regulation attempts outcome production that might not occur, prevent or even produce outcomes in several places to what might probably occur or prevent outcomes in several areas in different timescales that would occur. In this way, regulation is viewed as an artifact of the implementation of statements of policies. Examples of regulations include control of market entries, wages, prices, effects of pollution, approval of developments, employment of some people in various companies, standard of production for some goods.

The rights revolution Essay Example | Topics and Well Written Essays - 500 words

The rights revolution - Essay Example The country has had a lot of trouble incorporating the Quebec and non-Quebec nation into the political framework. As a result of the forced incorporation of such elements as women’s rights, and aboriginal land claims into the 1982’s Charter of Rights and Freedom, Canadian culture has become extremely distinct with respect to people’s rights. Canada is a socially democratic society that places special emphasis on the group rights as reflected both in the Quebec’s Charte de la langue francaise and in the agreements of treaty which acknowledges the rights of aboriginal people upon the land and resources. Canada is one of very few countries which stipulates the terms and conditions regarding the distortion of federation in the decisions of Supreme Court as well as in the federal legislation. Such an overt expression of concerns regarding secession increases its susceptibility to happen. Nevertheless, rules have been defined clearly in order to avoid ambiguitie s and violation by mistake. Besides, clear dictation of the secession laws reduces the chances of breakout of civil war. The recent ruling of the Supreme Court of Canada regarding secession identifies two primary concepts about rights. The first idea says that conflict is frequent while the second idea realizes the purpose of the rights language in the conditions of conflict which is to promote peaceful adjudication. Canada has also influenced the world with her rights talk.

For the third essay, you are going to select an issue that you feel Research Paper

Cyber Insecurity - Research Paper Example In fact, as part of globalization and for that matter technology, communication and commerce have been more enhanced than they used to be before. But as much as we talk of the advantages of globalization, it is also important to have a look at what the repercussions of globalization and for that matter influx of technology have been on the larger population of the world. Cybersecurity is a term that is often used to represent the kind of protection given to personal information and digital documents. In his article â€Å"Winning the fight against cyber crimes†, Lurrent (2012) argues that the need for cybersecurity has increased and become timely mainly because of increases of activities of illegal cyber operations. By this, reference is being made to the numerous acts of cyber attacks that are launched in the field of information systems. In the use of both personal and organized information systems, reports of information thief, virus attacks and other forms of information irregularities have been reported on a daily basis. Some of these are so serious that they easily result in people losing thousands of dollars especially when the bank details of users are tapped by cybercriminals. As much as these acts of cyber insecurity increase, there is the need for advanced countermeasures that can put the minds of end users at rest. In his article â €Å"Countermeasures for cybersecurity†, Deritck (2011) clearly states that unless pragmatic steps are taken to give total protection to users of the internet and other information systems against cyber insecurities of all forms, the interest that people have in using technology in advancing communication and commerce will bring down.  

Atrial Fibrillation Article Example | Topics and Well Written Essays - 500 words

Atrial Fibrillation - Article Example Possible causes that give rise to AF include comorbidities like hypertension, coronary ischemia, heart failure and obstructive sleep apnoea. The characteristic features of electrical remodelling are alterations in atrial refractoriness, atrial conduction and sinus node function. This happens very quickly and is considered possible to reverse. Loss of contractility results from the contractile remodelling that happens in AF and like electrical remodelling happens very quickly. Reduction in the release of systolic calcium ions is believed to contribute to this change. Myolysis or the loss of sarcomeres is also a likely candidate for this change. The consequences of contractile remodelling are thrombus formation and atrial dilation. Advance of AF may be caused by contractile remodelling through the coexistence of multiple wavelets. Reversing contractility changes takes longer than in the case of reversing electrical remodelling changes possible because of the time involved in the replacement of lost sarcomeres. Persistent AF has been associated with the structural changes within the atria. Many of these changes are consider ed to be irreversible. Evidence from animal studies suggests that these changes occur more slowly than the changes that occur from electrical and contractile remodelling and primarily reflect dedifferentiation. The striking changes seen in animal models are increased cell size, myolysis, and the collection of glycogen around the nucleus of the cell. From the limited data from humans there is indication that degenerative changes may occur (Cohen & Naccarelli, 2008). Management of AF is a three pronged strategy. The first is of the prongs is anticoagulation. Use of anticoagulation is guided by the CHAD scoring system set forth by the American College of Cardiology, American Heart Association, and the European Society of cardiology. When the AF patient has any one of these

Organizational Behavior - General Hospital Case Term Paper

Organizational Behavior - General Hospital Case - Term Paper Example There is a strong link between the individual –organization interface in any institution and since each individual brings about unique personalities and experiences (Griffin & Moorhead, 2010), there is a need to have a harmonized way of operations in organization behavior. This is the typical problem that is being experienced at the General Hospital. Hellringer & Slocum (2011) elaborate that conflict occurs when one group or a party feels that their interests and opinions are being ignored or opposed to by another party. The differences in personalities, experiences, and lack of harmonization of the two in an organization set up as Griffin & Moorhead (2010)argues plays a large part in these conflicts to occur. In the General hospitals, doctors are interested in achieving personal ends through colluding unethically with the employees of pharmaceutical companies that serve the hospital. This makes the doctors leave their duties of attending to the patient as they concentrate on their personalized benefits, and this also becomes a complicated issue in pharmaceutical companies as employees find ways of serving the doctors with the pharmaceutical products for personal ends. Hammer on the other hand as the chief executive officer in the hospital feels that the doctors are not delivering on their services and that the doctors were the major cause of the escalating costs in the hospital. They are the stabling block towards managing the costs. Hammer also believes that the doctors have much allegiance to their professions compared to their duties, and this was affecting the services to patients (Hellringer & Slocum, 2011). Harding supports Hammer and together decides to fire Doctor Boyer, in a move that was believed to aid in saving the hospital from the escalating costs.

Book review Essay Example | Topics and Well Written Essays - 1000 words - 1

Book review - Essay Example Amongst his collection of short stories, Blood and Tears stands out from amongst the rest because of its literary values and the ideas presented within. In the introduction to these stories, Ali (1984) compares Mas to other Malaysian writers and says that, â€Å"The few short stories which he has contributed have greater literary value than the more prolific output of many other writers. For this reason alone Keris has earned a special place and is to be regarded as the leading figure in the new literature (Ali, 1984, Pg. 8)†. If anything at all, Blood and Tears establishes that quality is indeed more important than quantity. While examining the stories, it becomes clear to us that the historical and cultural influences of the Malaysian past figure prominently in the works of Mas. Like many other nations in south Asia, Malaysia has a history of colonization as well as rule by foreigners on local soil and the after affects of colonization remain with the people even after many decades have passed. The struggle between the Japanese and the British over Malaysia during the Second World War gave birth to the country but also create social and cultural dichotomies which still linger as a part of the social structure of the country. Mas was certainly an influential writer and had a close group of fellow writers that sought to bring about changes in Malaysian society by creating awareness through literature. Speaking about these likeminded writers as well as himself as a writer, Mas says that: â€Å"We criticized societal backwardness and those whom we regard as the instruments responsible for the birth of such backwardness. We criticized colonialism and its instruments, that is, the elite class, those whose consciousness have been frozen by the influence of feudalism and myths, and superstition that has been enmeshed with religion (Wikipedia, 2007, Pg. 1)†. Such leanings

The Role of Public Relations in a Modern Liberal Democracy Essay

The Role of Public Relations in a Modern Liberal Democracy - Essay Example Some experts contend that the extent to which media works as a public sphere, representing the civic populace, while remaining free and accessible to all, works as a chief indicator of democracy within a political order. This stems from an old tradition that positions media at a juncture between the governed and the governors. Thus, from this viewpoint democracy appears as a relative concept, where its nature is dependent on the movement of public information. This, in turn, helps to ascertain to what extent the citizens can take steps grounded in informed decisions to make the governors liable for their activities. From the perspective of the orthodox democracy theory, the public sphere is a realm between the two distinctly separate two areas, civil society and the state, which ensures protections for each individual within the society. According to the Liberal theory, the public sphere is equal to the political sphere, and the mass media’s public role is delineated in relati on to the state. The liberal theory theorizes on the virtues of civil society's ascendency over the state (Curran 1991). Along with this, it also views the market as the process optimally suited for addressing all information requirements of society. However, as market-led information to tend to move through privatization, conglomeration and deregulation, after a certain limit it fails to meet the requirements necessary for maintaining democratic ideals of freedom and equal accessibility (Garnham 1986). Major contentions to the liberal press theories have faced challenges from the other democratic theory pertaining to the Marxist viewpoint. From the position of an orthodox Marxist, within capitalist societies, the public sphere tends to disguise the ascendency of media that does not directly confront the liberal nature of the public sphere. Instead of breaking out of the dichotomy that exists between a liberal civil society and the state, Marxism rejected all reforms within the publ ic sphere and considered socialist transformation as the only solution. In this context, to overcome the weak points as seen within the orthodox liberal democracy theory and Marxist theory, Curran suggested amalgamation of the collectivist approach with a general market approach, for democratisation of public sphere by making it more representative and accessible. Analysing mass media as a part of the public sphere from a modern perspective has helped modern liberal democracy theory to transcend the traditional civil society-state polarisation that has dictated all media debate until recently (Dahlgren 1991). Orthodox democratic theory rejected the method in which differences were made between public and private domains, which currently is the chief factor in the definition of public sphere within the realms of liberal democracy theory. The mediation role of mass media and broadcasting currently encompasses almost all areas extending from the home to the workplace (Curran 1991).  

Corporation Taxation Foreign Tax Credit Research Paper

Corporation Taxation Foreign Tax Credit - Research Paper Example However, there are four tests which one requires in order to qualify for the foreign tax credit (Rousslang, 1). It follows that foreign tax credit cannot be more than a company’s tax liability multiplied by a certain percentage thus maximum allowable foreign tax credit. Carrying back of the foreign tax credit is a common practice especially when the credit is more than the maximum limit (About.com, 1). It is usually carried to the future or previous year depending on the situation. Credit for Foreign Income Taxes Irs.gov (1) reveals that income tax systems across the world are known to provide credit for similar income taxes that are usually paid to foreign countries. A limitation of credit is usually subjected to the kind of taxes which are of a similar nature to the taxed being credited. There are a number of rules that govern the eligibility of a tax credit. They include basis and nature of the levy; availability of a tax treaty between the two countries; form of payments; political influence; similarity of credit between the two countries; conditions relating to the levy and property or services that accompany the taxes. A typical example is the United States tax system which allows foreign tax credit on the basis of limitations. These limitations are usually in relation to compulsory levies on gross receipts or net income. The countries that require participating in boycotts are not awarded the credit. This exemption also applies to taxes that are subjected to services and goods according to the relevant taxing authority. In the UK, foreign tax credit is allowed on foreign tax similar to corporation tax; subject to limitations (Irs.gov, 1). This... This essay is the best example of comparison tax system of different countries. The United States tax system which allows foreign tax credit on the basis of limitations. These limitations are usually in relation to compulsory levies on gross receipts or net income. The countries that require participating in boycotts are not awarded the credit. This exemption also applies to taxes that are subjected to services and goods according to the relevant taxing authority. In the UK, foreign tax credit is allowed on foreign tax similar to corporation tax; subject to limitations. This situation is provided for in the respective tax treaties. Canada is known to limit the credit by way of deductions in relation to gas or oil businesses. A common observation has been that most tax systems across the world indicate the specific time when a foreign levy is eligible to receive credit. This has to be in accordance to the agreed requirements of the foreign tax credit. Rousslang further reveals that so me tax systems offer credit simply because the tax can be taxed according to the existing domestic tax system. Other systems offer the credit on the basis of the time when the particular foreign item is being subject to income tax requirements. Some tax systems offer credit on the basis of recognition in their financial statements. The government plays a vital role when it comes to developing tax treaties. It is therefore expected that various countries across the world have different methods of approaching this issue.

Us Womens History Essay Example for Free

Us Womens History Essay The Native American women were trained to work hard in the fields and in the house. They were held responsible for over 75% of food production and the gathering of the fruits in the community. These women were responsible for making clothes for themselves and their families from the skin of rabbit and dear. The Native American women were allowed to dress in long dresses and leggings. The Native American women mostly practice agriculture when civilization of Europeans arrived and because of all their lives depends agriculture their economy grows with their own hard work spiritual role. As the women are the backbone of the community, they are given right to own land and in this they use for farming and inherit it to their descendants. In America native communities in 1600 century, women are given to have much power than European women, this is because Native American women are very hard working and they also have good feelings and near to their husbands, thus they are given equal opportunity to rest of the community. Status of Women in the Southern and Northern colonies In the southern colonies women were legally subordinate to men, politically and nonetheless improved economically in the colonial period. Southern colonies the women were view less than the men, where they took advantage for their right in the society of inheriting the land of their late husbands. The southern colonies focus was on profit while northern colonies focus on religion. The northern colonies are better in status than southern colonies because northern women are married earlier, they had larger families and they live longer than their cousins on the other side of the ocean. Living conditions in the early Northern and southern colonies Living condition in early 1600 in north and south, colonies used Americans as slaves and servants for their plantations, but in late 1600 the African slaves became the primary source of American slaves. Southern plantation used to give huge profit to the northern merchants. Colonies came to America for religion and looking for job as most of them escape war. Although they got a lot of resources, but they started colonizing Americans living condition of Americans was too poor and white colonizes took these advantage and started employing some of the Americans and some of Americans bought as servant with 25- 50 dollars. The servants were given a small grubstake and if she or he was lucky, a few acres of land. Thus, some of the servants were treated fairly. Servants or slaves who are living at southern were treated as slaves without any payment. (Kramarde, Cheris. and Spender, Dale. 107) Work cited Kramarde, Cheris and Spender, Dale. Routledge International Encyclopedia of women. Routledge. (2000).

Is Unbridled Freedom A Myth Or Reality Education Essay

Is Unbridled Freedom A Myth Or Reality Education Essay Freedom has been an object of study and discussion since antiquity. The definition, extent and implications of the idea of human freedom have been discussed in disciplines ranging from the arts, humanities and even the sciences. Freedom has been variously defined by many people. These definitions can be broadly classified into 2 categories for simplicity.  [1]   External Freedoms These include Legal and human rights that are conferred on human beings from the outside. These are circumstantial in nature. Their absence, misuse or withdrawal can be clearly seen and is usually protested against. These include freedom of speech and expression, freedom of religion, Freedom from want, Freedom from fear, freedom of association, freedom of thought, etc. Internal Freedoms These are more Metaphysical in nature. Internal freedoms concern our inner mechanisms, thought- processes and the freedom to self-determination. These are less obviously visible, more complex and have far reaching consequences for our powers of decision making, judging accountability and responsibility. It is these internal freedoms that are the subject of interest for students of psychology and for those interested in understanding human behavior. The most contentious issue has been whether human beings can be free at all. Is Unbridled Human freedom a myth? Are we always constrained by internal and external forces that shape our ideas and beliefs or does each individual have some autonomy to make his/her own decisions? Generally speaking, the disparate views on this issue fall into three main categories  [2]   The Deterministic View The Libertarian View The Compatibilist Approach The first two approaches agree that both freedom and natural causality cannot exist simultaneously. However, they derive two opposite conclusions from this incompatibility. The deterministic approach asserts that there is no possibility of freedom. Thought, action, events are already decided and human choices are severely constrained by events beyond our control. The idea of freedom is hence an illusion. The libertarian approach says the exact opposite. Inspired by modern, rationalist school of thought, it concludes that human beings have unlimited choices and are absolutely free to pick and choose, to think and to act, keeping in mind physical limitations. . These choices may be influenced by certain factors, but these decisions have the power to change the direction of natural events. The third approach is therefore called the compatibilist position. Some actions are free, while others are reflexive. Freedom and free will is understood as a part of the workings of the human brain. A person is responsible for an action when this action results from a conscious intention. To be responsible for an action is not to be ultimately responsible for it, in the sense of also being responsible for all the events in the causal chains that led to the existence of the conscious intention that determined the action. In this project, we will be taking the third position. We will attempt to show, by taking some examples relevant to our lives, that unbridled freedom is indeed a myth. Further, we propose that unbridled freedom is not an ideal to be cherished either. There are certain limits to the freedom that one person can enjoy, without trespassing on the freedoms of others or spreading chaos and disturbance in society. It is desirable to have some restrictions that enable us to live in society and differentiate us from animals. The first restriction that human beings face in the exercise of unlimited freedom is the constraints put upon us by society. Human beings are social animals that have agreed to give up certain rights and freedoms in order to gain the benefits of living in society. This has been explained by various social theorists under the idea of the Social Contract.  [1]   Living within society, human beings are influenced by three types of factors.  [2]   The genetic factors The way they are activated Interaction between inner potential and outer surroundings The first factor talks of our inheritance from society and parents. Both in terms of genetic material passed down to the next generation, as well as the collective social conscience, which is a determinate system of ideas and beliefs which creates social likeness among all members of society  [1]  . The second factor consists of inner characteristics inherited from our parents as they are expressed in us. Some are recessive, some are dominant, but both types play a role in determining who we are. The third factor brings in the importance of the interaction with society from birth, that moulds and shapes our personality in millions of imperceptible ways. The third factor is considered to be the most relevant and potent since its influence begins the moment we are born and serves to shape and mould the ideas generated through the first and second factors. Society is always present, both inside and outside us. It guides our behaviours, determines the range of our choices and influences our decision making process. Most of the time, we are unaware of this situation. Many times, we do not mind this intrusion. because most of the time we ourselves desire just that which society expects of us. We want to obey the rules. We want the parts that society has assigned to us  [2]   This is evident in the way that advertisements  [3]  , for example shape our choices. Individuals are often attracted to products that they may not otherwise buy, need or use, purely on the basis of the way it is presented on the television, in the print media etc. The advertising and marketing industries try to appeal to this tendency- to seek the opinion of others, to do what everyone else is doing, to conform to social norms and standards- to their own advantage. Another example of purely external factors influencing personal decisions is seen in the concept of opinion and exit polls. The Indian government has banned the airing of exit polls on television, until all phases of voting is over, due to the fear that expected results in one region may hamper the influence the voting patterns in other regions. Similarly, opinion polls can often become opinion-generating mechanisms. Another factor that has been very effective in influencing thoughts, actions and behaviour has been religion. All over the world, various religions have encouraged people to think within preset frameworks. There are however, two sides to this coin. The unifying potential of religion has been well researched by thinkers such as Emile Durkheim who has claimed that- A religion is a unified system of beliefs and practices relative to sacred things, i.e., things set apart and forbiddenbeliefs and practices which unite in one single  moral community  all those who adhere to them.  [1]   This positive view of religion is countered by Karl Marx who refers to religion as opium for the masses i.e. something that distracts them from alienation and hardship in this life, by promising leisure and comfort in the next, thereby serving the interests of the bourgeoisie. As an intrinsic part of the society we live in, religion- whether we accept it or not- is an important factor that influences the early development of our personalities. Its morals, values and teachings are instilled in us, and even if later in life we choose to turn away, these collective values remain with us. Another crucial institution that shapes us is the education system. The issue of freedom within the classroom and its importance in the learning process has been the subject matter of many debates. It is evident that unbridled freedom in a classroom, especially when the students are young or immature will only lead to chaos and confusion. The focus will be diffused since the authority of the teacher- who enforces discipline and concentration in the class will be lost. Also, the students, who are unaware of future benefits of studying certain difficult or complex subjects, will tend to avoid them altogether. As we have all experienced ourselves, unbridled freedom in the form of no attendance constraints usually leads to high levels of absenteeism. However, it is also important to consider what would be the case in a class with absolutely no freedom at all. Where the teacher is the absolute dictator and students have no rights, and only one duty- to listen to the authoritarian teacher. Such a scenario cannot be beneficial to the overall growth of the students. Their creativity will be stifled. Not allowed to ask questions or think independently, their curious and questioning natures will be subsumed under the weight of conformity, mediocrity and obedience. Education then divorces itself from understanding and development of the personality. It reduces to merely rote learning and superficial information gathering. This will have consequences for their future where they will be unable to take any independent decisions, never having faced that prospect earlier. As earlier, the most beneficial approach lies in the middle of these two extremes. Children must be given freedom within the classroom and within the education system. But how much authority should the teacher retain and how much he/she should leave the children to make their own decisions is a difficult question to answer. A number of theories have been put forward by various authors in this regard. Pioneers in child developmental theory- Jean Piaget (1896-1980), and Russian psychologist Lev Vygotsky (1896-1934), have powerfully influenced beliefs about interacting with children, how to set up learning environments, and expectations for childrens development.  [1]   There are some similarities and differences between Piagets and Vygotskys theories and these differences influence how teachers struggle and negotiate the location of their control and the childrens freedom in child-centred classrooms. The key difference between Piagets cognitive- constructivist theory and Vygotskys social constructivist theory lies in the role each theory assigns to the individual child and the social context of play in a Childs development. Although both approaches support the idea that individuals construct knowledge, Piaget and Vygotsky viewed nature (individual) and nurture (social context) as taking different roles in this process  [2]  . From the Piagetian perspective, individuals construct a personal reality based on previous knowledge and new experiences. Knowing is therefore, an interaction between the environment and the individual. For Vygotsky, learning is an interactive and constructive activity, and both society and individuals play essential roles in learning.  [3]   Both approaches emphasize the importance of social adaptation and social interaction in childrens learning, the difference comes in determining the direction of influence, that is, whether knowledge is constructed as a result of social interaction and then internalized (the Vygotskian view), or whether knowledge is constructed by the individual as a result of experience and then refined through testing in social situations (the Piagetian view) Moreover, both approaches locate learning within a social context, but each attributes different functions to that context. For Piaget, the importance of the social context is that it provides children with a means of testing the knowledge they had constructed. For Vygotsky, the social context is both the source and the cultural repository of the learning. The classrooms guided by Piagets theory give children the greatest degree of freedom. Teachers set up a rich environment for children to explore by themselves. Teachers are observers. On the other hand the classroom applying Vygotskys theory seeks to find a balance between teacher-directed and child-initiated activities. Teachers assist children and give them challenges in order that children may attain the top level within their zone of proximal development. Two other writers who have provided valuable insights about the tension between childrens autonomy and the teachers authority in classroom teaching are John Dewey (1859- 1952) and Maria Montessori (1870-1952). Both, Deweys Experience and Education (1998) and Montessoris Absorbent Mind (1995) discuss many points about the relationship between childrens freedom and teachers roles in education. Although their ideas about education are widely considered to be child-centred, they hold divergent views about childrens freedom and the role of the teacher. In Deweys Progressive Theory, democracy is the aim of schooling. The curriculum is child-centred and is rooted in the ideas of continuity and interaction in a social context. Learning is experiencing. Teachers and children decide together what experience is meaningful to each individual students current learning needs and later development. Moreover, the experience is always a transaction taking place between the individual and the environment.  [1]   Therefore, as children develop within a school that functions like a democratic society, they learn and develop the ability to function well in the larger democratic society. Dewey (1998) believed that childrens freedom should be constructed, that it is not simply a product of their free will. He made a distinction between freedom based entirely on free will (doing whatever one wants to do) and freedom of intelligence, which is constructed from purposes that are intrinsically worthwhile, through observation and exercise of judgment in real-life situations.  [2]   Further, he believed that, Guidance given by the teacher to the exercise of the pupils intelligence is an aid to freedom, not a restriction upon it  [3]   Therefore, teachers should act as the representative and agent of the interests of the group as a whole, and should be responsible for each Childs on-going growth with the community. Moreover, Dewey indicated that the ideal aim of education is the creation of self-control. The mere removal of restriction or external control is no guarantee that children have self-control.  [1]   Maria Montessori believed that children and their proper education is the key to building a new world. Education must develop the potential abilities of children, who (she believed) are endowed with unknown powers. The role of education is therefore, to offer an orderly environment and materials which children can explore, by themselves, in order to promote their development. Montessoris educational philosophy is centred on the interaction between objects and the individual. The teacher acts as an observer to find a childs inner spirit and offers an orderly environment in which children can develop and grow. Montessori believed that the child has the power to teach herself. Children can adapt and have the ability to develop freely, which can become directly visible if their minds are not oppressed by adults who may limit the childs inner work and weigh down his spirit  [2]   She indicated that child herself must become the centre of education and should be guided by her inward mind. Therefore, the teachers task is not to talk, but to prepare and arrange a series of motives that inspire children to develop without any need of direct instruction However, Montessori did not ask teachers to completely abdicate authority. She believed that authority does not come from the adults dignity, but from the help that parents or teachers are able to give to their children. Therefore, authority consists of teachers aim to help children construct their work, without posing a threat to the childrens minds or reconstructing the childrens work.  [3]   Although Montessori suggested that teachers should refrain from either interfering with children as they are absorbed in their work or preventing childrens free expansion, she still believed that teachers should interrupt children if the children persistently annoy the others, because it means the childrens spirits or disciplines of development would unfold negatively. Therefore, the teachers should interrupt to break this negative development and guide children toward the right track These theories lead to 2 types of classrooms, with varying degrees of teacher control and childrens freedom. It would be generally expected that these ruminations on students freedom would lead to a low teacher control and high student freedom scenario. However, this is not the case. Low Teachers control, High Students Freedom Some people may assume that the progressive way of teaching should be located in this quadrant because they believe high teacher control (the application of teacher authority) may oppress children and cause unjust power relationships between teachers and children. However, it has been seen that is impossible to help children attain educational goals without the teachers guidance. Those who advocate this view must critically examine the following questions: Does teacher control have to be contradictory to childrens freedom? Does teacher control automatically oppress childrens freedom? Does teacher control prohibit childrens learning initiatives?  [1]   High Teachers control, High Students Freedom Reflected by both Piagets and Vygotskys theories. A teacher may respect and value childrens unfolding development, but he/she must also set up the expectations and goals for learning and give some guidance to children. In this kind of interaction, teacher control and Childrens freedom are not thought of as opposite to one to another; they coexist and both are highly valued in the whole process of teaching  [2]   This process of education, that gives great degree of freedom to the student, yet locates a certain degree of guidance and control with the teacher has implications for the professional domain as well. When these students grow up and enter organizations, the degree of freedom they are used to exercising and the decision-making skills that have been instilled in them through the process acquire great significance. The degree of freedom that an organization gives to its employees is also an important factor. The interaction between freedom given to employees within an organization and the degree of freedom the employees are accustomed to function under is very complex and gives rise to different types of behaviours. For example, those who are brought up through a process that involves high degree of control by parents, teachers etc. may, on finding a low control environment within the organization, be unable to function and take independent decisions, or they may end up mis-using those freedoms. Freedom within an organization has many meanings, and always involves the complex dynamics between individual freedom and the importance of meeting organizational/ professional targets. Some of these include: Freedom to have flexible work hours to accommodate family and lifestyle, while still meeting organizational goals. Freedom to come to leadership with new ideas and opposing viewpoints, while learning to trust people and letting go of absolute control. Freedom to do things differently by leveraging personal strengths to achieve goals, while still maintaining a professional, formal attitude. Freedom to leverage social media to communicate professionally and to help build brand awareness for your organization, while not devoting too much time to personal issues. Freedom to celebrate great accomplishments and milestones, while at the same time, having the freedom to say (without judgment,), I dont know or I cant handle any more or I made a mistake. Freedom to be compensated fairly, equitably, and even sometimes generously There is no debate that these, and many more such freedoms within the workplace will unleash creativity, encourage an environment of innovation, lead to relaxed and more productive employees, increase employee retention, make jobs more interesting and inspire employees to perform better. But, like in the case of implementing freedom within the education system, here too, there needs to be a delicate balance between employee freedom and organizational support and guidance. To make this possible, one of the major factors is the top leadership and their management style. Many people contend that this is exactly what makes companies like Google India, MakeMyTrip,Intel Technology,  Marriott Hotels, NetApp India the top 5 places to work in (in India). Freedom can be planned. It is the result of a designing triad consisting of the planning agents assumptions, the planning systems conditions and the opportunities and/or barriers which enhance or hinder the exercise of freedom.  [1]   Depending upon the amount of freedom and flexibility that organizations give to employees, and the qualities and skills they expect in their employees, they can be classified under 3 broad categories  [2]  : The industrial organization The Industrial Economy required the mass scaling of production and distribution. It met the requirements for the design of systems for scale, and was successful in plugging workers in to execute their specialized tasks. This type of organization is based on physical capital. Intellect, obedience and diligence are important employee characteristics. Employees have little or no decision-making freedom. The information Organization The information organization Information is used to uncover patterns, reduce the costs of production and consumption and find new solutions to vexing issues. Workers employ their intellect to solve problems relating to data. This type of organization is based on similar employee characteristics as the industrial, but gives a greater degree of freedom to its employees. The creative/learning organization  [2]   The creative organization is based on ideas and values qualities like initiative, creativity and passion. These qualities are intrinsic to employees, and when given freedom, bloom to provide a competitive advantage to the company. These assets are not physical in nature like commodities; hence the organization needs to work on retaining its highly skilled employees. Gary Hamel has given some great examples of companies that are innovating in terms of management to encourage these traits in their employees. W.L. Gore is one such example. It has made the list of Best Places to work for the past 25 years. The Great Place to Work organization noted these four aspects of W.L. Gores culture: People experience tremendous freedom at Gore: the freedom to talk with whomever they need or want to, the freedom to make comments and provide input, the freedom to bring who they are to work, and the freedom to make commitments.  [3]   To conclude, this paper tries to argue that there is no such thing as unbridled freedom. Human beings are essentially social animals and they are born within society. Society shapes and moulds human behaviour, which may also be influenced by certain intrinsic genetic predispositions of individuals. However, Institutions like Religion, Education, the state, family, friends, etc. have a huge role to play in the way we develop into adults. These may be conducive to the development of a balanced personality. However, they may sometimes be oppressive and may deter us from reaching our full potential in terms of faculties like creativity, innovation, lateral thinking etc. Further, unbridled freedom, even if it existed, is undesirable since it disconnects us from the social nature of our lives. Unbridled freedom can be destructive, chaotic and may in fact hamper the optimum developmental process, as was explained in the discussion on freedom within education earlier. The situation with high teacher control and high student freedom was found to be the best approach to bringing freedom within the classroom. Finally, the degree of freedom we are used to exercising and functioning under has a significant impact in the professional scenario- both for the employee as well as the organization. Employees must learn to handle freedom with responsibility and accountability while organizations must work on loosening bureaucratic hierarchical controls and give more freedom to make decisions to their employees.

Minimizing Cost of Volatile Inhalational Anesthetics

Minimizing Cost of Volatile Inhalational Anesthetics P The population that will be examined are male and female patients with a physical status (PS) of I-II requiring general anesthesia for surgery, ages 20-40. I The intervention being introduced is utilizing Sevoflurane (UltaneÂÂ ®) as the inhaled anesthetic for surgeries requiring general anesthesia lasting less than one hour. C The comparison group will be those utilizing Desflurane (SupraneÂÂ ®) as the inhaled anesthetic for surgeries requiring general anesthesia lasting less than one hour. O The use of Sevoflurane for surgery cases requiring general anesthesia for less than one hour will save money for the anesthesia department rather than using Desflurane. PICO Question: Will the use of Sevoflurane rather than Desflurane in surgeries requiring general anesthesia lasting less than one hour save money for the anesthesia department? Abstract Inhalation anesthetics are used millions of times every single day in surgeries requiring general anesthesia all over the world. Cost containment is anesthesia is no longer an option, it is an absolute necessity. Anesthetic drugs account for up to 6 percent of total hospital pharmacy costs and inhalation agents comprise over twenty percent of that as a whole. One of the areas most amenable to cost reduction in the anesthesia department budget is the use and choice of inhalational anesthetic. A quantitative quasi-experimental controlled trial was developed to determine if money could be saved in the anesthesia department by utilizing Sevoflurane as the inhalational anesthetic for surgeries requiring general anesthesia less than one hour rather than Desflurane. The study chose males and females, ages twenty to forty, requiring general anesthesia at a mid-sized, urban, teaching hospital in South-Western Pennsylvania. Prices of anesthetic agents were gathered from the same facility and c alculated to determine the total cost savings that would ensue with the use of the interventional inhalation agent rather than that used by the control group. The use of Sevoflurane for two-thirds of the cases which Desflurane was used saved the institution over twenty thousand dollars. Key Words: Inhalational Anesthetics, Pharmacoeconomics, Desflurane, Sevoflurane, Anesthesia Introduction Research Problem: The cost of health services and technologies continue to increase exponentially while resources are finite. Developing effective strategies to minimize costs without compromising patient safety and quality of care are the most difficult challenges medical professionals experience.13 Inhalational anesthetics comprise twenty percent of the drug expenses in anesthesia departments. The cost of inhalational anesthetics depend on their potency, which is their minimum alveolar concentration (MAC), the minimum amount of inhalational anesthetic needed in the lungs to facilitate the absence of movement to noxious stimuli, the fresh gas flows (FGF) used to deliver the anesthetic gas, the amount of anesthetic vapor released by each milliliter of liquid, and the price of the inhalational anesthetics themselves.2,16 Inhalational anesthetics are used when general anesthesia is needed for surgery and patients do not have diseases or conditions which would preclude them from being able to utilize them (e.g. those who have malignant hyperthermia). The anesthesia provider decides which inhalational anesthetic is best for a given patient, based on their history and needs for the surgery. The problem exists when providers just use whichever anesthetic is most easily accessible at that time without minding any consideration as to the cost of the particular gas and the level of FGF they are using, which is purely a waste of money as the patient will lose heat and humidity, waste high levels of inhaled anesthetic, and demise cost containment for the anesthesia department. Statement of Purpose The purpose of this research study is to determine whether the implementation of Sevoflurane as the choice inhalation anesthetic for surgery requiring general anesthesia for procedures lasting less than one hour rather than using Desflurane will provide cost containment for the anesthesia department. Objectives/Aims The objective of this study is to provide an avenue of cost containment for the anesthesia department of a mid-sized, urban, teaching hospital and overall savings for the medical health system. This will allot more money in the department budget to be spent on technological advances, and equipment used to better develop opportunities for patient safety, the ultimate goal of all medical professionals. Review of Literature: Many studies explore different methods of cost containment in the anesthesia department. Almost all of the studies exclusively develop the notion of cost savings related to the fresh gas flows used to deliver inhalation anesthetics. Cost containment requires primarily a decrease in FGFs, but it may also be influenced by a rational use of the available halogenated agents.3 With the advances in technology and the ultra-modern anesthesia machines available, anesthesia providers should feel safe in using minimal FGFs to deliver anesthesia that would not harm their patients in any way.3 Anesthetists can directly influence healthcare costs through the patterns in which they practice, which includes reducing the FGFs chosen during inhalational anesthesia, which will directly affect the amount of inhaled anesthetic delivered to the patient and ultimately the costs which are attributable to inhaled anesthetics.10,15 Depending on breathing systems used, which are mostly semi-open today, up to ninety percent of the anesthetic gases delivered escapes into the atmosphere completely unused. By using low-flow anesthesia, most of the patients air they exhale is recycled and then returned to the patients lungs after the carbon dioxide from the exhaled air has been absorbed.15 There are also advantages of using low-flow anesthesia such as conserving the patients heat and humidity, making it less of a need to warm the patient externally, which will cut down costs on heating blankets and the like, as well as maximized the rebreathing of the exhaled anesthetic, which will cut down on the amount of gas vented into the environment,6 but there are cautions that anesthesia providers must take when using low FGFs, as titration in inhalation anesthetic is not as easily predicted. Product labeling for Sevoflurane does include a warning that patient exposure should not exceed two hours using FGF rates greater than one and less than two liters per minute.7 Also, it is not recommended at all to maintain FGFs less than one when using Sevoflurane as the patients inhalational anesthetic of choice. These recommendations are to minimize the risk of exposure of the patient to compound A which in laboratory animals, has been shown to be linked to nephrotoxicity. There are no minimum flow rate designations that exist for Desflurane.7,8 Isoflurane is less expensive than Sevoflurane and Desflurane at equal dose and the same FGFs.7 When comparing Sevoflurane with Desflurane as they are being used for surgeries lasting less than two hours, there was a ninety percent decrement time for Sevoflurane which approached the short duration of anesthesia matching that of Desflurane. However, when the duration of anesthesia increased over two hours, Sevofluranes ninety percent decrement time approached that of Isoflurane.7 The cost of inhaled anesthetic agent can be estimated by using an equation that provides the cost of anesthetic per MAC hour: Cost per MAC hour ($) = [(Conc.)(FGF rate)(Duration)(MW)(Cost per mL)] / [(2412)(D)]6 The cost of one milliliter of Isoflurane is twenty-three cents, Sevoflurane is forty-one cents, and Desflurane is eighty-three cents. Regardless of the fast onset and emergence Desflurane offers, the cost of administering Desflurane is greater than the cost of Sevoflurane at any FGF rate.10,11 The cost of inhaled anesthetic agent can be estimated by calculating the cost per MAC hour, which is the administration of inhaled anesthetic agent at 1 MAC for a one hour time interval. The cost can be calculated using the concentration percent on the anesthetic dial of gas delivered, the FGF rate chosen, the duration of the anesthetic (sixty minutes in this case), the molecular weight of the anesthetic agent (MW in grams), cost per mL of liquid agent (in dollars), a factor accounting for the molar volume of a gas at twenty-one degrees Celsius (a constant of two thousand four-hundred twelve), and the density of the agent (D in grams/mL). Cost per MAC hour ($) = [(Conc.)(FGF rate)(Duration)(MW)(Cost per mL)] / [(2412)(D)]6 The cost per MAC hour can be seen in Table 2. Desflurane is associated with a shorter recovery as is Sevoflurane, but the differences between the two in terms of patient discharge cannot be consistently shown in research studies.13 Gupta evaluated n=246 patients for recovery time after undergoing surgeries less than two hours with either Sevoflurane or Desflurane. Patients given Desflurane were able to open their eyes sixty seconds before those who received Sevoflurane, P When comparing Sevoflurane and Isoflurane for patients who are undergoing surgery for more than two hours, Gupta evaluated n=634 patients. The patients who underwent Sevoflurane were able to open their eyes sooner, P Savings of more than one hundred thousand dollars resulted from the change of using Desflurane to using Sevoflurane in the operating rooms at Montefiore Medical Center in the Bronx, New York. Traynor noted that three bottles of Desflurane are needed to maintain a level of anesthesia equal to that of one bottle of Sevoflurane, making this agent much less expensive for the hospital to utilize, with no difference in patient discharge times. Reviews of Literature indicated that patients who received Desflurane could be extubated in the operating room about two minutes sooner than the patients who received Sevoflurane; an advantage seen meaningless in the large scale of the operating room sequences.9,15 Methodology The research design chosen was a quasi-experimental study. It involved the use of an experimental group and a control group. It is important to mention that the control group was compiled from hospital anesthesia records. The study did not involve randomization as a medical facilitys computer database cannot throughput this information. Permission from a mid-sized, Southwestern Pennsylvania teaching hospital was granted and all information gathered from the facility involved no patient identifiers, including gender or age. The hospitals Institutional Review Board (IRB) was provided all details of the research study and deemed the research experiment to be exempt and permission was granted to start the study without any changes in the studys design. General anesthesia data spreadsheets were gathered from the hospital exemplifying a patient anesthesia case total for the month of July, 2012. From this information, it was determined there were a total of n0=1,459 general anesthesia cases and after careful analysis, it was found that n1=500 cases lasted less than one hour and n2=959 cases lasted equal to or more than one hour in length from the beginning of anesthesia delivery to the end of the surgical procedure, as seen in Chart 1 in Appendix A. The Southwestern Pennsylvania hospital was asked to provide their costs for Desflurane, Sevoflurane, and Isoflurane inhalation anesthetics. These prices can be seen in Table 1 of Appendix A. Utilizing the equation to calculate the amount of inhaled anesthetic used during a general surgical case in a sixty minute time duration, MAC hour costs could be calculated as seen in Table 3. The pharmacy was also asked to provide how many bottles of inhalational anesthetic are bought and used annually in their operating rooms. These results are seen in Chart 2 and calculated annual costs of the anesthetics are shown in Chart 3 in Appendix C The experimental group for the research procedure involved men and women, ages twenty to forty, with PS scores of I and II, who were undergoing general anesthesia for surgery cases lasting less than one hour. These patients were administered Sevoflurane as their inhalational anesthetic during surgery at a FGF rate of 2 liters per minute (LPM). To be sure all patients were given the same standard induction regimen, all drug doses were based on current body weight calculations. Propofol, a sedative hypnotic was given at 2 milligrams per kilogram (mg/kg). Fentanyl, an opioid analgesic was given at 5 micrograms per kilogram (mcg/kg). Midazolam, a benzodiazepine sedative was given at a standard dose of 2mg/kg. Lidocaine, a class 2 anti-arrhythmic agent was given at 1.5 mg/kg. All patients participating in the study were given their induction medications at these doses provided. In the preoperative area, all patients were given the right to participate or not participate in the research experiment as they were provided a letter of informed consent, which described completely that they would be treated no differently than any other patient and they were voluntarily consenting to participate in a research study as an individual, and in no way obligated to participate if they were unwilling to do so. Those who were not involved in the experimentation are those patients who were unwilling to consent to participate in the experiment as an individual. Those with malignant hyperthermia were excluded from the study as they could not receive volatile inhalational anesthetics. Patients who required additional narcotic for pain during surgery were excused from participation. Those with chronic kidney disease or kidney failure were also not involved in the experiment as Sevoflurane, the experimental variable could lead to kidney complications. Participants who only were given inhalational anesthetic for painful stimulation during intravenous sedation were also excluded from participation in this study. It was important to determine which inhalational anesthetic was favored most by anesthesia providers at the Southwestern Pennsylvania hospital between Sevoflurane and Desflurane for general anesthesia cases lasting less than one hour. Surveys were sent out to all members of the anesthesia team as titled Survey 1 in Appendix D. Ethics/Professionalism Ethical considerations were regarded during the completion of the study from start to finish. All information gathered from a Southwestern Pennsylvania hospital was kept in confidence and destroyed at the finish of the study by professional paper shredding services. Participant names, ages, race, nationality, and medical histories were not gathered from the hospital and were blinded from the investigator, owing to complete confidence of all those who participated during a twelve month interval. Results Results are pending until the quasi-experimental research study is completed. Discussion Volatile inhalational anesthetics account for twenty percent of pharmacy costs in the anesthesia department.10,16 By using a pharmacoeconomic model, it can be seen that careful choice of anesthetic for patients can represent a large cost containment for the anesthesia department in the hospital, without compromising patient care. All patients need to be considered a new case and may not fit into the pharmacoeconomic model because of family histories (e.g. malignant hyperthermia). However, when possible, using Sevoflurane for the choice inhalation anesthetic for general surgery cases rather than Desflurane for those lasting less than one hour can result in large cost savings for the anesthesia department. Over twenty thousand dollars could be saved if the Southwestern Pennsylvania hospital would utilize Sevoflurane over Desflurane for two-thirds of their total surgeries requiring general anesthesia for less than one hour. It is important to mention that as a professional anesthesia student, FGF commonly observed with Sevoflurane are 2 LPM and FGF with Desflurane commonly observed are 2 LPM. The nephrogenicity associated with Sevoflurane is not commonly observed when this amount of FGFs are used.7 With the use of 1 LPM FGF when using Desflurane, as there is no minimum FGF required to avoid physiological aberrance, 17,19 there is also a great cost savings maintained for the anesthesia department. Limitations There are limitations in any study when research is conducted and from this study, results are limited to a single institution and this limits its external validity as a result. Randomization was not included in this research study as a convenience sample population was used at one hospital location. The study was not extremely descriptive as patients with higher PS scores were not studied in this particular research project. This study is also missing research on older age groups, as participants age twenty to forty were included only. As all of these limitations can be seen in the experimental study, the results from this research study cannot be imposed on larger populations and therefore generalizability is poor. Future research can make these findings representable and provide for better generalization. Future Recommendations for Research In future research, randomization should be used when developing research as this will strengthen the results. Larger sample populations should be used in defined, smaller age variances to be able to impose the results on a specific group of patients. Defined surgeries should be used in sample populations to show stronger significance when looking at varied surgical procedures their results. With the inclusion of the above criteria, the research study would be experimental rather than quasi-experimental, and results could be superimposed onto given populations with much stronger data observance. Dissemination This research project will appear in the May, 2013 edition of Anesthesia and Analgesia in its entirety with all results included. There will also be one hour lectures provided on these research findings at the University of Pittsburgh at Greensburg, Robert Morris University, and St. Vincent College, times and final adjusted locations are to be announced via bulletins, which be hung in the cafeterias of each of these locations. Conclusion Inhalational anesthetics represent a significant cost for pharmaceutical costs in the anesthesia department. It is important for professional anesthesia providers to deliver cost-effective, safe anesthesia care to patients in surgery. When analyzing surgical procedures requiring general anesthesia for less than one hour, the use of Sevoflurane rather than Desflurane as the choice inhalation anesthetic in surgery can provide the anesthesia department an avenue of cost savings without compromising patient care. When Desflurane must be used for patients who cannot be administered Sevoflurane, it is important to keep in mind there is no recommendation for FGF rates, and cost savings can also be preserved by utilizing low FGFs when using Desflurane. References Weinberg L, Story D, Nam J, McNicol L. (2010). Pharmacoeconomics of volatile inhalational anaesthetic agents: an 11-year retrospective analysis. Anaesthesia and Intensive Care, 38(5), 849-854. Lockwood GC White DC (2001). Measuring the costs of inhaled anesthetics. British Journal of Anesthesia, 87(4), 559-563. Odin I, Feiss P. (2005). Low flow and economics of inhalational anaesthesia. Best Practice Research Clinical Anaesthesiology, 19(3), 399-413. Strum EM, Szenohradszki J, Kaufman W, Anthone GJ, Manz IL, Lumb PD (2004). Emergence and Recovery Characteristics of Desflurane Versus Sevoflurane in Morbidly Obese Adult Surgical Patients: A Prospective, Randomized Study. Anesthesia and Analgesia, 99, 1848-1853. Boldt J, Suttner S. (2000). Low-Flow Anesthesia: Does it have Potential Pharmacoeconomic Consequences? Pharmacoeconomics, 17(6), 585-590. Golembiewski J. (2010). Economic Considerations In the Use of Inhaled Anesthetic Agents. American Journal of Health-System Pharmacy, 67(4), 9-12. Meyer T. (2010). Managing inhaled anesthesia: Challenges from a health-system pharmacists perspective. American Journal of Health-System Pharmacy, 67(4), 4-8. Boldt J, Juan N, Kumle B, Heck M, Mund K. (1998). Economic Considerations of the Use of New Anesthetics: A comparison of Propofol, Sevoflurane, Desflurane, and Isoflurane. Anesthesia and Analgesia, 86, 504-509. Agoliati A, Dexter F, Lok J, et al. (2010). Meta-Analysis of Average and Variability of Time to Extubation Comparing Isoflurane with Desflurane or Isoflurane with Sevoflurane. Anesthesia and Analgesia, 110(5), 1433-1439. Dolk A, Cannerfelt R, Anderson RE, Jakobsson JP. (2002). Inhalation anesthesia is cost-effective for ambulatory surgery: a clinical comparison with propofol during elective knee arthroscopy. European Journal of Anesthesiology, 19(2), 88-92. Chernin EL (2004). Pharmacoeconomics of inhaled anesthetic agents: Considerations for the pharmacist. American Journal of Health-System Pharmacy, 61(4), 18-22. Beaussier M, Deriaz H, Abdelahim Z. (1998). Comparative effects of desflurane and isoflurane on recovery after long lasting anaesthesia. Canadian Journal of Anaesthesia, 45(5), 429-434. White PF. (2010). Facilitating Recovery from Anesthesia: Assessing the Costs and Benefits of Anesthetic Drugs. Anesthesia and Analgesia, 110(2), 273-275. Gupta A, Stierer T, Zuckerman R, Sakima N, Parker S, Fleisher LA (2004). Comparison of Recovery Profile After Ambulatory Anesthesia with Propofol, Isoflurane, Sevoflurane and Desflurane: A Systematic Review. Anesthesia and Analgesia, 98, 632-641. Traynor K. (2009). Inhaled anesthetics present cost-saving opportunity. American Journal of Health-System Pharmacy, 66(7), 606-607. Kapur P. (1994). Pharmacy Acquisition Costs: Responsible Choices Versus Overutilization of Costly Pharmaceuticals. Anesthesia and Analgesia, 78, 617-618. Dexter F, Bayman EO, Epstein RH (2010). Statistical Modeling of Average and Variability of Time to Extubation for Meta-Analysis Comparing Desflurane to Sevoflurane. Anesthesia and Analgesia, 110(2), 570-580. Southwestern Pennsylvania Hospital. (2012). Annual Anesthesia Data Tracking Information. Accessed 08/30/2012 with Permission from Corporate Department. Southwestern Pennsylvania Hospital. (2012). Pharmacy Records. Accessed 08/30/2012 with Permission from Corporate Department. Appendix A Table 1: Cost of Inhalational Anesthetic per a Southwestern Pennsylvania Hospital Pharmacy Records Inhalational Anesthetic Cost Per Bottle ($) Total Volume in Bottle (mL) Cost per mL of Liquid ($) Sevoflurane (Ultane) 100.82 250 0.40 Isoflurane (Forane) 9.73 100 0.09 Desflurane (Suprane) 136.37 240 0.56 Reference 19. Table 3: Calculated MAC Hour Inhalation Anesthetic Cost at a Southwestern Pennsylvania Hospital FGF Rate (L/Min) Isoflurane ($) Desflurane ($) Sevoflurane ($) 1 0.31 9.68 2.71 2 0.62 19.36 5.43 3 0.93 29.04 8.14 All estimated costs are based on duration of 60 minutes and the formula proposed by Golembiewski. Isoflurane calculations are based on concentration of 1.15%, MW of 184g, cost per mL=$0.09 and D of 1.49 g/mL Desflurane calculations are based on concentration of 6%, MW of 168g, cost per mL=$0.56, and D of 1.45g/mL Sevoflurane calculations are based on concentration of 2.0%, MW of 201g, cost per mL=$0.40, and D of 1.51g/mL Appendix B Chart 1: Total Anesthesia Cases in July, 2012: Time Intervals from a Southwestern Pennsylvania Hospital Reference 18. Table 2: Estimated Cost per MAC Hour ($) of Inhaled Anesthetic Gases: Based on FGF Rates FGF Rate (L/Min) Isoflurane ($) Desflurane ($) Sevoflurane ($) 1 0.5 12.9 6.0 2 1.0 25.9 12.1 3 1.5 38.8 18.1 All estimated costs are based on duration of 60 minutes and the formula proposed by Golembiewski. Isoflurane calculations are based on concentration of 1.15%, MW of 184g, cost per mL=$0.15 and D of 1.49 g/mL Desflurane calculations are based on concentration of 6%, MW of 168g, cost per mL=$0.96, and D of 1.45g/mL Sevoflurane calculations are based on concentration of 2.0%, MW of 201g, cost per mL=$0.90, and D of 1.51g/mL Reference 7. Appendix C Chart 2: Number of Bottles of Inhalational Anesthetic Used Annually at a Southwestern Pennsylvania Hospital Reference 19. Chart 3: Annual Expenditure on Inhalational Anesthetics at a Southwestern Pennsylvania Hospital

A New Way to Educate Children Essay -- Papers

A New Way to Educate Children Rousseau lobbies against an educational system that tries to teach children concepts and facts before such time, as they would make use of them. He believes that a child should not neglect those studies, which meet his present needs, in order to learn that which he may acquire in later years. He claims that experience and emotion are our real teachers, thereby reinforcing the theory that a child should not be educated in matters which are not pertinent to their current station in life. He contends that a child should â€Å"remain in complete ignorance of those ideas which are beyond his grasp† (p686). In essence, Rousseau argues that the healthy spontaneous impulses of children were being repressed by the adult demands for emotional restraint, intellectual precision and social conformity as abdicated by the social and educational practices of his time. Rousseau constructs a theory of education, starting with the influence of the child's natural environment, which should prevail over the influence of society and social institutions. Rousseau advocates allowing children to grow and develop naturally, in direct opposition to the prevailing methods of teaching. Children should be encouraged to develop their faculties through experience. This forms the basis for his fundamental principle of education. Rousseau argues that to be of use to a child, a concept must be relevant to his age. Rousseau promotes involving the student in hands-on learning experiences, as opposed to the more traditional methods of instruction. Children pay little heed to verbal explanation, nor do they remember them in his opinion. He stresses the importance of discovery as a learning tool. Ideas that seem difficult at the ... ...nlightenment was that nothing was accepted on faith or face value and he expected no less from his students, he would demonstrate his teachings and not expect them to accept just a verbal description. Rousseau stressed that feeling and sentiment were two very important factors in the motivation of humankind. He emphasizes the need to live and develop in conformity with Nature. The child must be raised in a rural rather than an urban environment, so that he may develop in continuity with nature rather than in opposition to it. A child’s character will mature in harmony with nature if that child’s natural curiosity is allowed to develop unhindered by the corruption of society. All of Rousseau’s educational theories had roots in the enlightenment of the 18th century. Bibliography: A History of Western Civilization, McKay J.P. et al, Houghton, 1999

The Oil Spill is Affecting Animals, but What About the Government? Essa

Since the dawn of the industrial revolution, mankind has increasingly become reliant on fossil fuels such as oil for energy. Oil fuels our car, warms our homes, generates our electricity, and creates a myriad of goods including everything that contains plastic. In our global economy, oil must be transported great distances to reach markets throughout the world. With seemingly increasing frequency, these journeys sometimes end in accidents that result in oil being spilled into the ocean. The most devastating oil spill, The Deepwater Horizon oil spill, occurred on April twentieth of this year. Deepwater Horizon is an oilrig located in the Gulf of Mexico and it is owned by B.P. Everything seemed to be running efficiently on the rig until April twentieth, when methane gas leaked through the rig. The gas was under high pressure and as a result exploded turning the rig into a raging inferno that eventually caused the rig to plummet to the bottom of the ocean floor (Dickinson). The explosion caused a massive amount of oil to gush the Gulf of Mexico. Although there is no exact statistic on the amount of oil that rushed out of the well where Deepwater Horizon stood each day before, â€Å"the median figure for Crone’s independent calculations [of the oil gush] is 55,000 barrels a day† (Dickinson). Approximately three months after the explosion, the well was finally capped, which stopped the flow of oil into the Gulf of Mexico. To put this spill into perspective, if the calculations by Crone on the spill were correct, this means that eighteen times the total amount of oil spilled in the Exxon Valdez incident was spilled total in the Deepwater Horizon catastrophe. This is an astronomical amount of oil moving through the Gulf of Mexico. Even... ... an even larger scale than the Deepwater Horizon rig. If past mistakes are not learned from, they are going to be repeated in the future. The federal government needs to reenact the ban on deepwater drilling until engineers are able to assess all components of deepwater drilling rigs. This is the only certain way to prevent another disaster like that of the Deepwater Horizon crisis. Even though this ban may cause gas prices to rise, it is a necessary sacrifice in order to keep the environment safe. Work Cited Baker, Peter. "White House Is Lifting Ban on Deepwater Drilling." New York Times. N.p., 12 Oct. 2010. Web. 10 Nov. 2010. Dickinson, Tim. "The Spill, The Scandal and the President." The Rolling Stones. N.p., 24 June 2010. Web. 10 Nov. 2010. Kaufman, Leslie. "Concerns Up and Down the Food Chain." New York Times. N.p., 12 Oct. 2010. Web. 14 Nov. 2010.

Sense of Belonging in Our Society :: Personal Narrative Essays

Sense of Belonging in Our Society Fashion is one of those things that people can claim they don't care about. They can defend again and again that it doesn't matter what one wears, it's the person who wears it. But in all likelihood they will continue to be judged, as we all are, for the clothes on our body, the shoes on our feet and the hairstyle we are sporting. In one journal entry I wrote, I brought to light that the popular group is something that every one of us, for some reason feels as though we need to be a part of. This is from my own experience and things I have observed throughout my four-year career in high school. I think it was perhaps worse in junior high, however. When you are in seventh and eighth grade you are not sure of who you are and are desperately searching around for something to belong to, to be a part of. Why is this, why are we a society that are most often drawn to the most popular, "cool" and "beautiful" that high school has to offer? Why is acceptance the most important thing to us, is belonging really as important as losing your own sense of self? Who you hang out with, who your closest friends are as an adolescent without a doubt help to shape who you are. And it's funny that you seem to end up being friends with the ones who are the same type of people as you. Same fashion sense, taste in music or cars and movies. When searching for an identity in high school, it is hard not to just attempt to pick up the one that seems the most socially acceptable. I know that my personal experiences include these conforming characteristics. Still as a freshman in college I am constantly looking at the fashion of my peers, wondering to myself "do they think I fit in"? This was especially true the first few weeks of college when I wasn't sure who my good friends were going to be; I made sure that I dressed as well as I could everyday, in all the new clothes I had bought specifically for college.

Moral Absolutes Essay

Why are Christian ethics and theology inseparable? What did Francis Schaeffer mean when he said that not all things are the same to God? Christian ethics is inseparable from theology because it is grounded in the character of God. Francis Schaeffer said that not all things are the same to God and means that God exists and has a character, but not all things are the same to him. Some things conform to His character, and some are opposed to his character. 2. What did Schaeffer conclude about a society without moral absolutes? Do we see this in society? Schaeffer concludes that if a society has no moral absolutes then there is no final appeal to judge between individuals and groups whose moral judgments conflict. There will be no standards and only conflicting opinions. 3. On what authority do Christians base their belief in moral absolutes? How specific is this authority? Christians base their beliefs in moral absolutes through the Bible. Of course, you cannot solve all moral decisions by referring to the Bible but there sufficient guidelines provided to give us a sense of what is morally right. These guidelines are the Decalogue also known as the Ten Commandments and tat is how specific the authority is. 4. Ethically speaking, what are Christians called to do? Christians are called to love the Lord with all their heart, all their soul, and with all their strength and with their entire mind and love your neighbor as yourself. 5. What did Dietrich Bonhoeffer mean by the question, â€Å"Where are the responsible people? He meant Christians, who are willing to treat God’s moral order with the same respect they show His physical order; who love God with their whole body, soul, spirit, mind and strength; who treat others as they desire to be treated. Ethics 3. 2 6. Why do Muslims view Muhammad as morally exemplary even though the Hadith does not paint a flattering portrait of his life? Muslims are conditioned to look at the whole picture through the eyes of faith. Certain things that the Prophet did do not conform to ordinary ideas of morality and may be considered sensual and cruel, but believers look at the whole thing differently. To them morality derives from the Prophet’s actions; the moral is whatever he did. Morality does not determine the Prophet’s actions, but his actions determines morality. 7. How do Christianity and Islam differ in relation to their beliefs about ethical absolutes? Christianity and Islam differ because Christianity is based on the Bible and Islam is based on the Qur’an and the Bible grounds morality in God’s essential character; the Qur’an teaches that God cannot be ultimately known. 8. In what two ways is the term jihad used? First: the battle against temptation and sin for the sake of self-control and the development of virtue; Second: the battle against any and all who oppose Islam. 9. What motivates Muslims to behave ethically? They are motivated by several fronts like: to develop personal virtue and spirituality, to better the state of others, to strengthen relationships, and to anticipate the coming judgment. 10. Which motivation is strongest? The anticipation of final judgment. Ethics 3. 3 11. What is the ultimate ethical question for a Secular Humanist? What questions did Morris B. Storer outline in his book Humanist Ethics? The ultimate ethical question for a Secular Humanist is Can morality be achieved without the foundation of absolute religious beliefs? Who makes the rules, God or men? Morris B. Storer outlined: Is personal advantage the measure of right and wrong or the advantage of all affected? Is there truth in ethics? Are right and wrong expressions of heart or head? Do people have free wills? Do you measure morality by results or by principles? Do people have duties as well as rights? 12. Why are there such diverse views and conflicts regarding humanistic ethics? There are diverse views and conflicts because there is a lack of consensus about the foundation of ethics and that is problematic for the whole concept of Humanistic ethics. 13. Who proposed the â€Å"no-truth thesis† and what does it state? Kai Nelson and it states that no question of the truth or falsity of moral values can sensibly arise. 14. How do most humanists attempt to dodge the â€Å"no-truth thesis†? How does Corliss Lamont address this issue? They attempt to doge it by claiming that they use reason to determine right and wrong in the context of ethical relativism. Lamont addresses the issue with optimism stating that as long as we pursue activities that are healthy, socially useful and in accordance with reason, pleasure and happiness will accompany us and the supreme good will the eventual result. 15. What did Arthur E. Gravatt, Joseph Fletcher, Herbert W. Schneider, and Paul Kurtz have to say about Ethics? Dr. Arthur E. Gravatt: Moral behavior may differ from situation to situation. Behavior might be moral for one person and not another or moral at one time and not another. Joseph Fletcher: Rights and wrongs are determined by objective facts or circumstances, that is, by the situations in which moral agents have to decide for the most beneficial course open to choice. Herbert W. Schneider: Morality is â€Å"an experimental art† and is the â€Å"basic art of living well together. † Moral right and wrong must therefore be conceived in terms of moral standards generated in a particular society. Paul Kurtz: Moral principles should be treated as hypotheses, tested by their practical worth and judged by what they cause to happen. Ethics 3. 4 16. How did Karl Marx and Friedrich Engels view the issue of morality? Marx and Engels denied that moral ideals, moral considerations, are central in human life and social evolution. Rather, it is biological and social evolution that determines their definition of morality. What is right and wrong is determined by what is best for evolution. 17. What is the Marxist-Leninist morality of the future? How will it be determined? Their morality of the future is when the proletariat finally destroys the bourgeoisie. The new classless society will determine the new morality, just as this evolution toward a classless society is dictating today’s morality. 18. What is the Marxist-Leninist view of â€Å"old morality?They view old morality as products of the bourgeoisie invented and used by the propertied class to oppress the propertyless proletariat. 19. What is the Marxist code of ethics according to the book Scientific Communism? â€Å"Devotion to the cause of the working class, collectivism, mutual aid, comradely solidarity, hatred toward the bourgeois ie and toward traitors to the common cause, internationalism, and stoicism in struggle are traits which not only define the content of proletarian ethics, but also characterize the moral image of the typical representatives of the working class. 20. What means have Marxists historically believed would bring about a society without class distinction? What have been the results of such an ethical system? They believe that revolution is the most efficient means for creating a society without class distinctions. This system is responsible for 83 million deaths between 1917 and 1964. But from a Marxist-Leninist point of view, it is worth the price if people die to abolish social classes and private property.

Courage can be applied and used in almost every aspect of life Essay

Definitions are meant to help us understand different concepts all around us. A definition allows us to communicate something that needed to be said. According to the Oxford English Dictionary, the definition of the word definition is â€Å"the action of defining, or stating exactly what a thing is, or what a word means† in a sense where it will help us understand its meaning. Definitions provide insight to the meaning of something. At times we may feel like we know a word but cannot clearly come up with a way to define it and that is when definitions come into play providing clarity for a word. They help us understand everything around us, from peoples ideas to their feelings, to all sorts of concepts of ideology and life. Without definitions we would not know what anything would be, mean, act for, and so on. Definitions are an essential part of life that helps us cope with many things by helping us understand a broader perspective of objects and ideas. As a freshman in English class, one of our assignments was to read â€Å"Solitude and Leadership† by William Deresiewicz which is an extended definition of the words solitude and leadership. William Deresiewicz used different methods to define the two words including quotes, examples, characteristics, and reference to Heart of Darkness by Joseph Conrad, which in my case was one of the hardest novels I had to read. One of the definitions Deresiewicz gives us is â€Å"solitude means being alone, and leadership necessitates the presence of others†, both words contradicting themselves. Deresiewicz uses a series of characteristics to define the words, which included words such as courage, independence, thinking, creativity, honor, concentration, honesty, introspection, friendship, and morality among others. Courage was one characteristic that stood out to me. Courage can be interpreted in many ways. According to the Oxford English Dictionary one way, courage is defined as â€Å"the heart as a seat of feeling, thought, etc.; spirit, mind, disposition, nature.† Another definition that was provided was that courage is â€Å"applied to a persons spirit† and yet another definition was â€Å"spirit, liveliness, lustiness, vigor, vital force or energy.† All three definitions contained the word â€Å"spirit† in them, and I believe that ones spirit is really important in relation to courage because it is what keeps  us going. I can say that courage drives our spirit because without courage we would not do the many things that we have done and will do. For example, we would not talk to someone we really like without having the courage to go up to him or her right? According to the essay by Deresiewics, there is two types of courage one being â€Å"physical† which he says we â€Å"all possess in abundance† and â€Å"moral courage†, which is the courage that allows us to â€Å"stand up† for what we â€Å"believe† (175). Courage drives us to the many things we do in everyday life whether it is something simple like having â€Å"the courage to argues† our â€Å"ideas† or something adventurous like skydiving (175). To myself, courage contains some of the same characteristics, but I can out it into different words. Courage is a quality of mind or spirit that leads one to make certain decisions. Defining courage this way makes much more sense to me. Courage is very important because without it we probably would not be in certain situations we are in. For example, without courage I would not be three hundred ninety four miles away from home all on my own living with someone who was once a complete stranger to me. I believe that that took tons of courage from me. Without courage many of us would not be away home our homes starting our college careers, which will prepare us for our future careers. Courage is a drive one must have to keep our spirit going. As a freshman in college, I have set goals that I hope to achieve by the end of the year. I believe that courage can help achieve many goals. For example, one of my goals is to leave here with the courage to take up more rigorous classes next year. Taking up more challenging courses is definitely going to require courage because college can already be difficult for some and taking up more can be a harder task. Another goal I wish to accomplish is to learn from all that will be done this year and apply it to the future. This goal can also take a bit of courage because learning from mistakes and applying the experience onto the future can be difficult. Courage is a really important characteristic to contain. No matter what age or situation, courage is extremely important, just having the mentality of wanting to do something and being able to do it says a lot about a person’s character. After reading the â€Å"Solitude and Leadership† I suddenly realize that there  are many things that take part in building character. Courage goes a very long way. It helps us decide on certain ideas, gestures, etc. Being able to take the essay and go onto defining a word in my own terms, like in the essay, took courage because many people can judge my ideology but having that courage the author spoke about and arguing for my own idea took courage. Courage can be applied and used in almost every aspect of life. Sometimes all you need in life is a bit of courage to get you through a certain situation in life because â€Å"at such moments, all you really have is yourself† (182). Works Cited â€Å"definition, n.†. OED Online. 2012. Oxford University Press. 29 October 2012 . â€Å"courage, n.†. OED Online. 2012. Oxford University Press. 29 October 2012 . Deresiewicz, William. â€Å"Solitude and Leadership.† The Best American Nonrequired Reading 2011. Ed. Dave Eggers. New York: Houghton, 20122. 169-182. Print.

Accounting Data in Productivity Measurement and Strategic Decision-Making

Table of content: Page number Executive Summary—————————————————- 2 Introduction —————————————————– 3 What is Cost Accounting? ——————————————- 5 Importance of data collection —————————————- 6 Accounting data for productivity measurement —————– 7 Accounting data for decision making ——————————- 9 Identifying profitable segment’s using accounting————— 11 Managerial Accounting changes———â⠂¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€œ 13 Conclusion —————————————————————- 14 Reference —————————————————————- 15 Executive summary:The report titled ‘Accounting Data in Productivity Measurement and Strategic Decision-Making’ provides an analysis and evaluation of how accounting data is used by companies to promote their profitability and to improve their productivity. Most of the data and information has been collected from online journals. The journals collected were written by renowned professors and researchers from established universities. The journals dealt with not only the importance of data collection for promoting profitable segmen ts but also on the recent change in accounting practices around the world with primary focus on developing countries.Results of the report suggest that data mining is an essential activity for firms who are committed to advance their productivity. The findings also suggest that such information allows for firms to obey their budgets. The report finds that more and more firms have recognized the importance of data collection for their organization and are finding new ways to promote efficient accounting practices. The report also investigates certain limitations of the journals used. The journals are often much generalized rather than using information about a certain organization.Moreover the data provided in the journals ranges over long periods of time through many different firms in many nations. Thus the findings may not be applicable for all firms. Introduction What is managerial accounting? Managerial accounting  is concerned with the provisions and use of  accounting info rmation to managers within organizations, to provide them with the basis to make informed business decisions that will allow them to be better equipped in their management and control functions. In contrast to  financial accountancy  information, management accounting information is: * primarily forward-looking, instead of historical model based with a degree of abstraction to support decision making generically, instead of case based * designed and intended for use by managers within the organization, instead of being intended for use by shareholders, creditors, and public regulators * usually confidential and used by management, instead of publicly reported * Computed by reference to the needs of managers, often using  management information systems, instead of by reference to general financial accounting standards.According to the  Institute of Management Accountants  (IMA)-Management accounting is a profession that involves partnering in management decision making, dev ising planning and performance management systems, and providing expertise in financial reporting and control to assist management in the formulation and implementation of an organization's strategy.Managerial accounting as practice extends to the following three areas: * Strategic management—advancing the role of the management accountant as a strategic partner in the organization. * Performance management—developing the practice of business decision-making and managing the performance of the organization. * Risk management—contributing to frameworks and practices for identifying, measuring, managing and reporting risks to the achievement of the objectives of the organization.The Institute of Certified Managerial Accountants (ICMA), states  Ã¢â‚¬Å"A managerial accountant applies his or her professional knowledge and skill in the preparation and presentation of financial and other decision oriented information in such a way as to assist management in the formu lation of policies and in the planning and control of the operation of the undertaking†. Managerial accountants therefore are seen as the value-creators amongst the accountants.They are much more interested in forward looking and taking decisions that will affect the future of the organization, than in the historical recording and compliance aspects of the profession. Managerial accounting knowledge and experience can therefore be obtained from varied fields and functions within an organization, such as information management, treasury, efficiency auditing, marketing, valuation, pricing, logistics, etc. (Managerial Accounting,2011, para:1-2) Importance of Managerial accounting for firms in generalManagerial accountants record financial information for their companies that is used by the organization’s management team to aid in the decision-making process. Managerial accountants develop budgets, perform asset and cost management, and create important reports used by the management team. Managers depend greatly on the information provided by managerial accountants to develop effective business strategies. Small business owners make most of the decisions within their company.The information presented by managerial accountants affects the owner’s ability to make sound business decisions. The two primary functions of managerial accounting in a firm are planning and controlling. Both of these help managers accomplish decision making. Managerial accountants have a dual reporting relationship. As a strategic partner and provider of decision based financial and operational information, managerial accountants are responsible for managing the business team and at the same time having to report relationships and responsibilities to the corporation's finance organization.The activities managerial accountants provide inclusive of forecasting and planning, performing variance analysis, reviewing and monitoring costs inherent in the business are ones that have dual accountability to both finance and the business team. Examples of tasks where accountability may be more meaningful to the business management team vs. the corporate finance department are the development of new product costing,  operations research, business driver metrics, sales management score carding, and client profitability analysis.Conversely, the preparation of certain financial reports, reconciliations of the financial data to source systems, risk and regulatory reporting will be more useful to the corporate finance team as they are charged with aggregating certain financial information from all segments of the corporation. In corporations that derive much of their profits from the information economy, such as banks, publishing houses, telecommunications companies and defense contractors, IT costs are a significant source of uncontrollable spending, which in size is often the greatest corporate cost after total compensation costs and property related costs.A fu nction of management accounting in such organizations is to work closely with the IT department to provide  IT cost transparency. Managerial accountants help drive the success of the business while strict financial accounting is more of a compliance and historical endeavor. The goal of managerial accounting in a firm is to provide information for internal decision making, primarily for planning and control purposes. The types of decisions made by managers rely substantially on accounting information.Because financial accounting information does not provide enough detail for internal decisions, it must be broken into more detail of the individual products or services provided by a company. Not only do managers need to know the cost of a product or service, they need the costs broken into smaller components so they are able to perform what-if analyses and forecasts for the future. Some types of decisions that managers often make include pricing products, dropping a product or produc t line, buying new equipment to replace old, evaluating the performance of managers or divisions of a company, or making rather than buying a part or product.What is Cost Accounting? Cost accounting  is a process of collecting, analyzing, summarizing and evaluating various alternative courses of action (Wikipedia, March 23, 2013, Revised Standard Version). It helps to find out the detailed information to the manager to control operation based on cost efficiency and capability. Managers made decisions for their own firm. So they need to manage the cost regarding productivity and strategic decision making. Cost accounting helps managers to control and manage resources.Strategic decisions based on cost reduction and rising costs are based on cost accounting. Basically the information is designed for managers as they take all the decisions for the organization. Important strategic decision making are made depending on the costs that the company can manage to pay for. Thus cost account ing is an important tool for the managers for productivity management and strategic decision making. Importance of data mining: Data mining is primarily used today by companies with a strong consumer focus.The application of data mining is ever-increasing in today’s business as in enables business to pull out hidden information from huge amount of data for better understanding of the consumers (Chopoorian et al. , 2001). The information is analyzed based on different perspective and summarize into useful data that can be used to increase revenue or cut costs. Although data mining is a relatively new term, but large companies are using it to find co-relation among huge amount of data in large database. The importance’s of data mining for modern business are given below: Data mining is used in restoration of hidden data which helps to extract the valuable information and construct practical analysis for decision making. * Data mining gives financial institutions informat ion about loan and credit reporting (â€Å"Zentut†, â€Å"n. d. †). * It also helps banks detect fraudulent credit card transactions to protect credit card’s owner (â€Å"Zentut†, â€Å"n. d. †). * It is being used ever more for understanding and forecasting consumer buying actions, buying tendency, customer profile and industry analysis (â€Å"Articlebase†, July 18, 2009). Data mining can be used as decision making tools in market research, industry research and competitor analysis which made it more beneficiary for the business industry. * It can manipulate large database swiftly and effectively accomplishes entire data analysis process. * Data mining helps government agency by excavating and scrutinizing records of financial transaction to build molds that can identify money laundering or criminal activities (â€Å"Wordpress†, December 5, 2006). * It can be used in every sector like science, business and others and it is cost effec tive.Limitation: Data mining has uncountable benefits and importance in today’s modern business but it has some limitations. Most of them are based on technological advancement, which is considered as the foremost advantage of data mining. Additional limitations are discussed below: * Security concern: One of the major limitations of data mining is the security issue. Most of the businesses accumulate their customers’ social security number, payroll etc. Hackers can easily go across their accounts and steal such sensitive data of the customers (â€Å"Zentut†, â€Å"n. . †). Thus customers do not feel safe to share information through data mining. To avoid the unwanted security concern, companies ought to take several crucial precautions so that the customers can trust them with no trouble. * Privacy concern: The misuse of internet has threatened the privacy concern among its users. People are afraid to share any of their personal information as it can be collected and used in unethical ways. Customers’ do not prefer to buy goods online in apprehension of getting any information revealed (â€Å"IT Law WIKI†, â€Å"n. . †). As business has to collect many of the information, they must take care about the privacy policy so that the information cannot easily disclose. * Inaccurate information: Unethical businesses or people might use information that is given in data mining for some other purposes or can inequity against some other people. Moreover the information or the assessment published in data mining is not absolutely accurate if the data has been entered wrong. Thus people cannot reliance completely on data mining. Possible benefits:Data mining is useful for modern business today as particular user will be looking for a pattern not for complete data in the database, it is better to read wanted data than unwanted data. There are some other benefits. They are: * Data mining technique is required pattern will be drawn from database with in short time * Data mining software is easy to use and does not require complicated statistical acquaintance and data preprocessing (Chen and Sakaguchi, 2000) * Data mining tools are programmed in such ways, it automatically present data analysis with visual charts and table to assist understandingImportance of Accounting Data in Productivity Measurement: According to Kaydos (1991), â€Å"Productivity and subsequently performance measurement has become more important and has been regarded as a prerequisite for continuous improvement† (as cited in Phusavat & Photaranon, 2006). Accounting data is important for measuring productivity to provide a systematic and comprehensive explanation of changes in profitability. Productivity measurement is one of the criterions for performance analysis of a firm.According to Sink (1985), â€Å"Productivity is simply the relationship between the outputs (goods and services) generated from a system and the inputs pro vided to create those outputs† (as cited in Phusavat & Photaranon, 2006). It is very important that accounting data collected should be correct and reliable otherwise productivity measurement would be inaccurate which will lead to incorrect forecast of cost and profitability data. Both technical and managerial aspects should be recognized in order to ensure successful and sustainable productivity measurement.For this purpose, strong database management is essential in order to ensure timely provision of accounting data for productivity measurement. It is essential to timely collect production-related data and report performance information by the database management to ensure better performance-analysis. According to Harper (1984), â€Å"It is vital for an organization to become continuously more productive in order to sustain its growth† (as cited in Phusavat & Photaranon, 2006). The productivity measurement based on accounting data divides production inputs into five categories such as capital, labour, energy, materials, and services.Productivity also includes unit cost, price, factor proportion, cost proportion, product mix, and input allocation (Phusavat & Photaranon, 2006). Accounting data consisting of integration between productivity, financial performance (i. e. profitability) at the operational level, and features such as opportunity gain/loss is used for productivity and performance measurement. Management report on opportunity gain/loss is useful for future monitoring and evaluation. Accounting data such as concepts of the opportunity gain/loss and the dynamic/static ratios in both single and partial formats are essential for performance measurement.Accounting information such as value-added labor productivity and ROA are also included in measurement technique. More comprehensive analysis of entity by measurements requires more accounting data to be aggregated (Phusavat & Photaranon, 2006). Importance of Accounting in Strategic Decision making: Accounting is essential in managing business performance and the accountants helps to improve decision making by offering strategic and practical advice, by managing risk, and by supporting key decisions at all stages of the decision making process for enhanced productivity and profitability measurements.An accountant can help significantly in the areas of budgeting, investigating, interpreting and communicating results for use by both internal and external decision makers. For example, at the problem recognition stage, they may be the first to detect an opportunity or approaching threat. At the ideas stage, they can help to provide creative solutions (â€Å"Improving strategic decision making†, n. d. ). Profitability is consequence of adopting a market orientation and plays important role in decision making (as cited in Inglis & Clift, 2008).Market orientations is composed of three behavioral components, such as customer orientation, competitor orientation and inter functional coordination, and two decision criteria, long-term focus and profitability (Narver and Slater, 1990). Customer orientation component of a market orientation and profitability acts as decision criterion (Inglis and Clift, 2008). There is an identified requirement for accounting information about the costs involved in providing a range of customer product-attributes which help businesses to choose most profitable market segment.According to Gray and Hooley (2002), within the market-orientation, customer value, customer product-attribute needs and accounting information are interrelated conceptually from a managerial and economic perspective (Gray and Hooley, 2002). McNaughton et al. (2002) stated that accounting function develops a sense of those attributes of greatest value to customers and in this way they may provide link between customers, value and profitability (as cited in Inglis and Clift, 2008). According to Inglis and Clift (2008), creating value for customer thr ough product attributes requires accounting information very much for decision making.Function cost analysis and interrelated techniques of value analysis are integral to target costing (TC) which seeks to reduce the life-cycle costs of products while ensuring all customer requirements are met (Shillito and De Marle, 1992; Kato, 1993). According to Inglis and Clift (2008), the accounting function may interact with customers in managing payment procedures and terms for a richer understanding of how to differentiate its business in the market place and assist in creating value for the customer (Inglis and Clift, 2008).Importance of using ABC Method to avoid the problems faced by firms providing financial services According to Hussain and Gunasekaran (2001), activity based costing (ABC) has become highly essential to overcome shortcomings faced by traditional accounting method, in terms of validity, accuracy, completeness, consistency, understanding and relevance. It helps management t o make internal decisions and formulate plans to provide new services, improve existing services and measure performances in order to achieve overall competitive strategies and advantages of organizations.The approach further provides a more factual basis for decisions by identifying truly profitable and truly unprofitable products, eliminating unnecessary costs, identifying and distinguishing between true value-add activities and non-value add activities, and pricing products so as to achieve acceptable margins. It is a powerful tool in achieving competitive advantages and in providing operational and discretionary project cost data (Hussain and Gunasekaran, 2001).Activity based costing in service costs in bank demonstrated by Hussain and Kock (1994) showed unit time is a more complex calculation involving work measurement processes (as cited in Hussain and Gunasekaran, 2001). Once information obtained the bank can calculate the profitability of various segments, retain highly prof itable segments and transform unprofitable segments into profitable ones through actions on pricing, product features, operating improvements and technology introduction (as cited in Hussain and Gunasekaran, 2001).West and West (1997) demonstrated the need of activity-based costing implementation in services . . . for financial survival without which managers cannot make effective decisions involving long-term captivated contract profitability (as cited in Hussain and Gunasekaran, 2001). Harr (1990) reports activity-based accounting approach for budgeting and financial performance reduces the costs without losing either the timeliness or the quality of its services.In spite of the advantages, however, ABC costing does not solve all the problems involved in decision making as management might overlook basic analysis needed for customer adaptation, flexibility and economies of scope (Hussain and Gunasekaran, 2001). It is important to constantly focus upon customers' total perceived se rvice quality and to maintain relationships to profitable customers. ABCM can then be accepted as a real tool for management to make strategic decision, formulate plan and operate control (Hussain and Gunasekaran, 2001)Using Target costing to identify profitable segments and maintaining productivity: In the journal ‘Target Costing’ (1995) the authors have stated that ‘product innovation is one of the keys to a company’s survival and competitiveness’ (p. 1). Thus Management accounting and cost accounting play an important role as they help in the creation of new products which attracts customers while maintaining low costs and ensuring profitability. As the effects of globalisation becomes more apparent companies are forced to reconsider their accounting practices, more specifically there management accounting practices.This is where target costing comes in. Target costing has been defined in the book Managerial Accounting (2012) ‘the process of determining the maximum allowable cost for a new product and then developing a prototype that can be profitably made for that maximum target cost figure’ (p. 763). In other words a desired profit margin is deducted from the selling price and a new target cost is determined for the new product. Implementing Target Costing: The different departments of the firm run a cost analysis to develop a target cost for the new product.If the manufacturing cost for the new product is equal or below the target cost then the product can be introduced in the market. Finally the target cost is deducted from the selling price. Thus target costing not only helps find a profitable segment in the market but also makes sure that product is being produce in its most productive capacity. The target profit process has been summarised in Figure 1 (see appendix). The journal further states that the companies that benefit the most from Target costing (p. 6) are: 1. Firms involved in assembly production style. 2.Firms involved in product diversification thus need target costing to determine a profitable market segment. 3. Firms whose product life cycle is relatively short (less than 3 years). 4. Firms wanting to reducing costs during the planning, design and development stages of a product’s life cycle. Managerial Accounting Changes: Research shows that Managerial Accounting has under gone changes in the last decade. According to the journal ‘Managerial Accounting Change in South Africa’ (Waweru, Jan 2004) this is especially true for developing nations. The case study considers four retail firms in South Africa.This helped them to find out the exact changes in Management Accounting Practices and the reasoning behind such changes. The journal reports that the main reason for such transformations can mainly be attributed to three main reasons. They are: 1. Increased Globalisation-This has made sure there is increased competition between the countries of the world . Thus necessitating for changes to take place in the managerial accounting world. 2. Huge variations in Information Technology-Technological advancements in the last decade has revolutionized the way world does business.The introduction of supercomputers has made sure that decision making process is faster and also made information more freely available. 3. Recent economic recession-The recession which has gripped the world since 2007 has made businesses reassess their managerial practices. Thus the journal has found that in order to deal with such challenges the businesses have evolved and so has their accounting practice. In developed nations more and more firms are now involved in Target Costing, Activity Based Costing (ABC), Product Life-cycle costing and finally Quality Costing.It should again be mentioned that these changes has only been noticed in developing nations and not so much in developed nations around the world. However the paper cautions regarding such changes by st ating that no one accounting system is universally appropriate for all firms. But rather that it varies from company to company. Thus the factors a firm should consider are (Waweru, 2004): 1. Size and type of the firm 2. Foreign competition 3. Economic restrictions 4. Technological advancements 5. Political and Social ConsiderationsHence we can conclude from this journal that Management practices evolves slowly in developing countries where it is greatly aided by government reforms/deregulations and globalisations and technological improvements. Conclusion: Thus we can say that accounting data has a strong effect on productivity and strategic decision making for firms. Since the data’s collected, both time series and cross sectional data, provides an insight into what has increased output for firms over the years and all the possible actions firms can make to engage in efficient production. Data’s are also used to make important decision.Time series accounting data giv es a good understanding of the profitable segments of the firms and the different sectors the firm can further expand into. Hence we can conclude by saying that accounting data are extremely vital for management accounting practices. Reference: 1. So,S and Smith,M. (2003). Managerial Auditing Journal. The impact of presentation format and individual differences on the communication of information for management decision making. 18 (1), p1-3. 2. Farag,M and Elias,R. (2012). Public Accounting Firms' mix of service revenue and average productivity. Evidence using revenue per person. 7 (8), p1-5. 3. Phusavat,K and Photaranon,W. (2006). Productivity/Performance measurement. Case application at the government pharmacuetical organisation. 106 (9), p1-16. 4. Waweru,N and Hoque,Z. (2004). Management Accounting Change in South Africa. Case studies from retail services. 17 (5), p1-30. 5. Inglis,R and Clift,R. (2008). 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