Broken Family Essay

Family is the basic unit of society. This is the most essential component of a country. Governance will only be effective if the citizens are properly oriented with good values and virtues, which is commonly taught by the family. A home is where a family lives. It may be alternated to the word ‘house’ but a house is more appropriately referring to the material structure, whereas ‘home’ refers to the intangible things that bind together the family members. It is the immeasurable love and care that keeps together the mother, father and their children. However, no matter how ideal a family in the terms of their relationship, there are still hardships and misunderstandings that will come along the way. It is just part of any relationship anyway. But, the sad part is when one of the family members gave up and the others have no choice but to accept and let go. Thus, the family starts to be broken. Broken Family is a family with children involved where parents are legally or illegally separated†¦whose parents have decided to go and live their lives separately for several reasons/problems. Too many arguments that might lead to divorce and the parents divide their children. But I believe its mostly cause by drugs or money. Too much money leads to arguments and greediness which causes to forget about love and divorce. Too poor leads to depression and arguments and feels like they have to split up and start over. Drugs messes with someones head and they mostly die or the family leaves that person behind for the cause of the children’s growing. But its not all parents, some teenagers runs away from home, of course, with their own reasoning. Some parent’s children die and it causes them to split. For the cause of the child’s growing, they divorce and find some place else . Or sometimes, its work. Not working too much or a workaholic may lead up for a broken family. Or if someone dies, then of course they’re broken inside the most. Though your answer is very good, I think you miss one detail. Another cause for a broken family, is abuse. Maybe the parents or parent hits the kids, and wife. Or maybe the son hits the parents. I think that is a very big reason in why many family’s are broken. Yes, still there’s one detail also that you may include, when the relatives of each party join to the problem or favors a parties (and sometimes it’s the parents of each party will suggest to them to separate). Or because the husband or wife having an affair. That’s why many FAMILIES break up. maybe one of the reasons of family breake up is the wife is very secretive to his husband for all times, and lack of trust in each parties. And there’s one more if the wife didn’t respect there husband due to high salary compare to a head of the family there will be conflict. And guys lastly Jealousy is one of the big reason why there’s so many BROKEN FAMILY, but its OK if the wife understands the husband feelings and avoid the person that he’ jealous of. But if not we are guys only knows what is the next part of our lives.

Lean Six Sigma in Hrm

1 Lean Six Sigma in the Service Industry Alessandro Laureani University of Strathclyde United Kingdom 1. Introduction The business improvement methodology known as Lean Six Sigma is rooted in the manufacturing industry, where it developed over the past few decades, reaching widespread adoption worldwide.However, according to the World Economic Outlook Database, published in April 2011, by the International Monetary Fund (IMF, 2011), the distribution of PPP (Purchase Power Parity) GDP, in 2010, among various industry sectors in the main worldwide economies, reflected a decline in the industrial sector, with the service sector now representing three-quarters of the US economy and more than half of the European economies. PPP GDP 2010 Agriculture Industry Service European Union 5. 7% 30. 7% 63. 6% United States 1. 2% 22. 2% 76. 7% China . 6% 46. 8% 43. 6% India 16. 1% 28. 6% 55. 3% Table 1. PPP GDP Sector Comparison 2010. In light of the increasing importance of the service sector, the objective of this chapter is to discuss whether the business improvement methodology known as Lean Six Sigma is applicable to the service industry as well, and illustrate some case study applications. 2. What is Lean Six Sigma? Lean Six Sigma is a business improvement methodology that aims to maximize shareholders’ value by improving quality, speed, customer satisfaction, and costs.It achieves this by merging tools and principles from both Lean and Six Sigma. It has been widely adopted widely in manufacturing and service industries, and its success in some famous organizations (e. g. GE and Motorola) has created a copycat phenomenon, with many organizations across the world willing to replicate the success. www. intechopen. com 4 Advanced Topics in Applied Operations Management Lean and Six Sigma have followed independent paths since the 1980s, when the terms were first hard-coded and defined.  Control Key and Word – Text and Graphics.The first applications of Lean w ere recorded in the Michigan plants of Ford in 1913, and were then developed to perfection in Japan (within the Toyota Production System), while Six Sigma saw the light in the United States (within the Motorola Research Centre). Lean is a process-improvement methodology, used to deliver products and services better, faster, and at a lower cost. Womack and Jones (1996) defined it as: †¦ a way to specify value, line up value-creating actions in the best sequence, conduct those activities without interruption whenever someone requests them, and perform them more and more effectively.In short, lean thinking is lean because it provides a way to do more and more with less and less—less human effort, less human equipment, less time, and less space—while coming closer and closer to providing customers with exactly what they want. (Womack and Jones, 1996:p. ) Six Sigma is a data-driven process improvement methodology used to achieve stable and predictable process results, reducing process variation and defects. Snee (1999) defined it as: ‘a business strategy that seeks to identify and eliminate causes of errors or defects or failures in business processes by focusing on outputs that are critical to customers’.While both Lean and Six Sigma have been used for many years, they were not integrated until the late 1990s and early 2000s (George, 2002; George, 2003). Today, Lean Six Sigma is recognized as: ‘a business strategy and methodology that increases process performance resulting in enhanced customer satisfaction and improved bottom line results’ (Snee, 2010). Lean Six Sigma uses tools from both toolboxes, in order to get the best from the two methodologies, increasing speed while also increasing accuracy. The benefits of Lean SixSigma in the industrial world (both in manufacturing and services) have been highlighted extensively in the literature and include the following: 1. 2. 3. 4. 5. 6. Ensuring services/products conform to what the customer needs (‘voice of the customer’). Removing non-value adding steps (waste) in critical business processes. Reducing the cost of poor quality. Reducing the incidence of defective products/transactions. Shortening the cycle time. Delivering the correct product/service at the right time in the right place. Antony, 2005a; Antony, 2005b) Examples of real benefits in various sectors are illustrated in Table 2. One of the key aspects differentiating Lean Six Sigma from previous quality initiatives is the organization and structure of the quality implementation functions. In quality initiatives prior to Lean Six Sigma, the management of quality was relegated largely to the production floor and/or, in larger organizations, to some statisticians in the quality department.Instead, Lean Six Sigma introduces a formal organizational infrastructure for different quality implementation roles, borrowing terminology from the world of martial arts to define hierarchy an d career paths (Snee, 2004; Antony, Kumar & Madu, 2005c; Antony, Kumar & Tiwarid, 2005d; Pande, Neuman & Cavanagh, 2000; Harry & Schroeder, 1999; Adams, Gupta & Wilson, 2003). www. intechopen. com Lean Six Sigma in the Service Industry 5 Table 2. Benefits of Six Sigma in Service Organizations (Antony, Kumar & Cho, 2007). 3. Lean Six Sigma and the service industryThe service industry has its own special characteristics, which differentiate it from manufacturing and make it harder to apply Lean Six Sigma tools, which can be summarized in the following main areas (Kotler, 1997; Regan 1963; Zeithmal, Parasur and Berry 1985): Intangibility: Although services can be consumed and perceived, they cannot be measured easily and objectively, like manufacturing products. An objective measurement is a critical aspect of Six Sigma, which requires data-driven decisions to eliminate defects and reduce variation.The lack of objective metrics is usually addressed in service organizations through the use of proxy metrics (e. g. customer survey). Perishability: Services cannot be inventoried, but are instead delivered simultaneously in response to the demand for them. As a consequence, services processes contain far too much ‘work-in-process’ and work can spend more than 90% of its time waiting to be executed (George, 2003). Inseparability: Delivery and consumption of service is simultaneous.This adds complexity to service processes, unknown to manufacturing. Having customers waiting in line or on the phone involves some emotional management, not present in a manufacturing process. Variability: Each service is a unique event dependent on so many changing conditions, which cannot be reproduced exactly. As a result of this, the variability in service processes is much higher than in manufacturing processes, leading to very different customer experiences. www. intechopen. com 6 Advanced Topics in Applied Operations ManagementOwing to these inherent differences, it has b een harder for service organizations, such as financial companies, health-care providers, retail and hospitality organizations, to apply Lean Six Sigma to their own reality. However, there are also great opportunities in the service organizations (George 2003): – – Empirical data has shown the cost of services are inflated by 30–80% of waste. Service functions have little or no history of using data to make decisions. It is often difficult to retrieve data and many key decision-makers may not be as ‘numerically literate’ as some of their manufacturing counterparts.Approximately 30–50% of the cost in a service organization is caused by costs related to slow speed, or carrying out work again to satisfy customer needs. In the last few years, successful applications in service organizations have come to fruition and we will illustrate three possible applications: in a call centre, in human resources, and finally in a healthcare provider. 4. Case study 1: Lean Six Sigma in a call centre (Laureani et al, 2010a) The two major types of call centres are outbound centres and inbound centres. The most common are inbound call centre operations.Almost everyone in their daily life has had to call one of those centres for a variety of reasons. Outbound centres are used more in areas such as marketing, sales and credit collection. In these instances, it is the call centre operators who establish contact with the user. Although there are some differences between outbound and inbound call centres, they each have certain potential benefits and challenges, with regard to the implementation of Lean Six Sigma. Benefits Some of the benefits that Lean Six Sigma can deliver in a call centre are (Jacowski, 2008; Gettys, 2009): . 2. 3. 4. 5. Streamlining the operations of the call centre: Lean strategy helps in eliminating waste and other non-value added activities from the process. Decreasing the number of lost calls: Six Sigma’s root-cau se analysis and hypothesistesting techniques can assist in determining how much time to spend on different type of calls, thus providing a guide to the operators. Better use of resources (both human resources and technology), thus leading to a reduction in the cost of running such centres.Unveiling the ‘hidden factory’: establishing the root causes of why customers call in the first place can help in uncovering trouble further along the process, providing benefits that go further than the call centre itself, improving customer service and support. Reducing employee turnover: call centres are usually characterized by high employee turnover, owing to the highly stressful work environment. A more streamlined operation would assist in reducing operators’ stress, particularly in an inbound centre. ChallengesSpecific challenges of applying Lean Six Sigma in a call centre environment (Piercy & Rich, 2009): www. intechopen. com 7 Lean Six Sigma in the Service Industry 1. 2. 3. The relentless pace of the activity (often 24/7) makes it more difficult for key staff to find the time to become involved in projects and Lean Six Sigma training. The realization of an appropriate measurement system analysis (MSA) (Wheeler & Lyday, 1990) is difficult because of the inherent subjectivity and interpretation of some call types, failing reproducibility tests of different call centre operators.High employee turnover, that normally characterizes call centres, makes it more difficult for the programme to remain in the organization. Strengths Weaknesses ? ? Root cause analysis can determine major reasons for customers’ calls, helping to unveil problems further along the value stream map of the company Lean Six Sigma deployment requires significant investment in training, that may be difficult from a time perspective in a fastpaced environment such as a call centre Opportunities Threats ? ? ? ? ? Decrease number of lost calls Reduce waiting time for calls in t he queue Improve employee productivity (i. . number of calls dealt with by the hour) ? Lack of metrics Lack of support from process owner Preconceived ideas Table 3. SWOT Analysis for the Use of Lean Six Sigma in a Call Centre. Overall, the opportunities far outweigh the challenges. Call centres nowadays are more than just operations: they are the first, and sometimes a unique, point of contact that a company may have with its customers. Their efficient and effective running, and their timely resolution of customers’ queries, all go a long way to establishing the company’s brand and image. Project selection is a critical component of success.Not all projects may be suitable candidates for the application of Lean Six Sigma, and this needs to be kept in mind in assessing the operation of a call centre. Also, different tools and techniques may be more suited to a specific project, depending on the nature and characteristics of the process it is trying to address. Projects that better lend themselves to Lean Six Sigma share, inter alia, the following characteristics: ? The focus of the project is on a process that is either not in statistical control (unstable) or outside customer specifications (incapable).As already mentioned in the introduction, Six Sigma techniques focus on reducing the variation in a process, making them the ideal tools for tackling an incapable but stable process, whereas Lean tools focus more on the elimination of waste and would be the first port of call for streamlining an unstable process. Priority should be given to unstable processes, using Lean tools to eliminate the waste and simplify the process. Once it has stabilized, more advanced statistical tools from the Six Sigma toolbox, can be used to reduce variation and make the process capable. ww. intechopen. com 8 ? ? ? Advanced Topics in Applied Operations Management The root reason(s) for this has not been identified yet. It is important to start work on the project wit h an open mind and without any prejudice. Data and hard facts should guide the project along its path. Quantitative metrics of the process are available. A lack of measures and failing to realize a complete measurement system analysis (MSA) (Wheeler & Lyday, 1990) can seriously jeopardize any improvement effort. The process owner is supportive and willing to provide data and resources.This is critical for the ongoing success of the project; the process owner’s role is discussed in detail in the Control Phase section. Potential areas of focus for Six Sigma projects in call centres (Gettys, 2009): ? ? ? ? Lost call ratio out of total calls for an inbound call centre; Customer waiting/holding times for an inbound call centre; First-call resolution; Calls back inflating call volumes. Call centres are increasingly important for many businesses and are struggling consistently with the pressure of delivering a better service at a lower cost.Lean Six Sigma can improve the operation o f a call centre through an increase in first-call resolution (that reduces the failure created by failing to answer the query in the first place), a reduction in call centre operator turnover (leveraging on training and experience), and streamlining the underlying processes, eliminating unnecessary operations. Given the large scale of many call-centre operations, even a relatively small improvement in the sigma value of the process can dramatically reduce the defect rate, increase customer satisfaction and deliver financial benefits to the bottom line (Rosenberg, 2005).By focusing on eliminating waste, identifying the real value-adding activities and using the DMAIC tools for problem-solving, it is possible to achieve significant improvements in the cost and customer service provided (Swank, 2003). 5. Case study 2: Lean Six Sigma in HR administration (Laureani & Antony, 2010b) In the late 1980s, when Motorola implemented Six Sigma originally, obtaining astonishing results, the compa ny was then faced with the dilemma of how to reward its employees for these successes (Gupta, 2005).This was the first time Six Sigma and HR practices came into contact, and a more accurate definition of HR practices was needed. If, in the past, the term HR was related only to administrative functions (e. g. payroll, timekeeping, etc. ), the term has increased substantially, in the last few decades, to include the acquisition and application of skills and strategies to maximize the return on investment from an organization’s human capital (Milmore et al, 2007). HR management is the strategic approach to the management of all people that contribute to the achievement of the objectives of the business (Armstrong, 2006).As such it includes, but it is not limited to, personnel administration. In effect it includes all steps where an employee and an organization come into contact, with the potential of adding value to the organization (Ulrich, 1996). www. intechopen. com Lean Six Sigma in the Service Industry 9 As such, and merging terminology from Lean and HR, we define the following seven points as the Human Capital Value Stream Map: 1. 2. 3. 4. 5. 6. 7. Attraction Selection Orientation (or induction) Reward Development Management Separation Fig. 1. Human Capital Value Stream Map.The Human Capital Value Stream Map is a Lean technique that identifies the flow of information or material required in delivering a product or service to a customer (Womack & Jones, 1996). Human capital is the accumulated skills and experience of the human force in an organization (Becker, 1993). The Human Capital Value Stream Map is the flow of human capital required for an organization to deliver its products or service to customers; the objectives of which are briefly described below: ? ? ? ? ? ? ? Attract: to establish a proper employer’s brand that attracts the right calibre of individual.Select: to select the best possible candidate for the job. Orient: to ensure new employees are properly trained and integrated into the organization. Reward: to ensure compensation packages are appropriate and in line with the market. Develop: to distinguish talent and ensure career progression. Manage: to supervise and administer the day-to-day jobs. Separation: to track reasons for voluntary leavers and maintain a constructive relationship. It is possible to apply Lean Six Sigma tools to each step of the Human Capital Value Stream Map, in order to eliminate waste in the HR process Wyper & Harrison, 2000). For each step in the Human Capital Value Stream Map it is necessary to establish proper quantitative metrics that allow objective assessment and control of the process step (Sullivan, 2003). This makes use of the more quantitative statistical tools from the Six Sigma toolbox possible. Establishing HR metrics can be controversial, with different parts of the organization having different objectives (Jamrog & Overholt, 2005), but the answer to these simple ques tions may help to focus on the real value each step can provide. 1. 2. 3.What is the expected deliverable of the step? What are the relevant metrics and key performance indicators of the step? What are the opportunities for defects in the step? www. intechopen. com 10 Advanced Topics in Applied Operations Management For recruitment, for example, the answers to the above questions may be as follows. 1. 2. 3. Hire, in the shortest possible time, new members of staff to fulfil a certain job. The number of days to fill a vacancy (also define the acceptable norm for the organization). Any job remaining vacant for longer than the acceptable norm.Similar thought processes can be performed for other steps: having set metrics for each step of the Human Capital Value Stream Map, an organization is now in the position to apply Six Sigma DMAIC to it. Six Sigma can be used to improve administrative processes, such as HR processes. Implementing the Six Sigma DMAIC breakthrough methodology in HR f ollows the same path as implementing it in any other part of the organization. However, there are some specific key learning points and challenges for the HR area, such as: ? ? ?Difficulty in establishing an appropriate measurement system analysis and metrics; Data collection can be extremely difficult, as the project team is dealing with very sensitive issues; and Difficulty in performing any pilot or design of experiment. Any of these is going to impact on the behaviour of staff, making it difficult to measure its results accurately. As a result, projects may last longer than the standard four to six months and the wider use of tools such as brainstorming and ‘Kaizen’ workshops with domain experts may be necessary (Lee et al, 2008).Examples of potential Six Sigma projects in the HR function are: ? ? ? ? ? ? reduction of employees’ turnover reduction in time and cost to hire a new employee reduction in training costs reduction in cost of managing employeesâ€⠄¢ separation reduction in administrative defects (payroll, benefits, sick pay, etc. ) reduction in queries from the employee population to the HR department. Every area of an organization needs to perform better, faster and more cheaply, to keep the company ahead of the competition, and be able to satisfy ever-increasing customer expectations.HR is no exception: more cost-effective and streamlined HR processes will create value for the organization, instead of just being a support act for management (Gupta, 2005). 6. Case study 3: Lean Six Sigma in health-care delivery Health care is a complex business, having to balance continuously the need for medical care and attention to financial data. It offers pocket of excellence, with outstanding advances in technology and treatment, together with inefficiencies and errors (Taner et al, 2007). Everywhere in the world, the financial pressures on health care have increased steadily in the last decade.While an ageing population and technolog ical investments are often cited as culprits for these financial pressures, unnecessary operational inefficiency is another source www. intechopen. com Lean Six Sigma in the Service Industry 11 of cost increases, largely under the control of health-care professionals (de Koning et al, 2006). Lean Six Sigma projects so far in the health-care literature have focused on direct care delivery, administrative support and financial administration (Antony et al, 2006), with projects executed in the following processes (Taner et al, 2007): ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? increasing capacity in X-ray rooms reducing avoidable emergency admissions improving day case performance improving accuracy of clinical coding improving patient satisfaction in Accident and Emergency (A&E) reducing turn-around time in preparing medical reports reducing bottle necks in emergency departments reducing cycle time in various inpatient and outpatient diagnostic areas reducing number of m edical errors and hence enhancing patient safety reducing patient falls reducing errors from high-risk medication educing medication ordering and administration errors improving active management of personnel costs increasing productivity of health-care personnel increasing accuracy of laboratory results increasing accuracy of billing processes and thereby reducing the number of billing errors improving bed availability across various departments in hospitals reducing number of postoperative wound infections and related problems improving MRI exam scheduling reducing lost MRI films improving turn-around time for pharmacy orders improving nurse or pharmacy technician recruitment mproving operating theatre throughput increasing surgical capacity reducing length of stay in A&E reducing A&E diversions improving revenue cycle reducing inventory levels improving patient registration accuracy improving employee retention The focus has been on the improvement of clinical processes to identi fy and eliminate waste from the patient pathways, to enable staff to examine their own workplace, and to increase quality, safety and efficiency in processes (e. g. Fillingham, 2007; Silvester et al, 2004; Radnor and Boaden, 2008).The barriers specific to the deployment of Lean Six Sigma in health care, in addition to the ones commonly present in other industries, are: ? Measurement: it is often difficult to identify processes, which can be measured in terms of defects (Lanham and Maxson-Cooper, 2003). www. intechopen. com 12 ? Advanced Topics in Applied Operations Management Psychology of the workforce: in the health-care industry it is particularly important to not use jargonistic business language, as this has a high chance of being rejected or accepted with cynicism by medical professionalsThe application of Lean Six Sigma in health care is still in its early stages. Therefore early successes in simple projects will pave the way for tackling more complicated initiatives in the f uture, initiating a positive circle of improvement, bringing clinical change on a broad scale. Appropriately implemented, Lean Six Sigma can produce benefits in terms of better operational efficiency, cost-effectiveness and higher process quality (Taner et al, 2007), as the case studies presented in this paper illustrate.The spiralling costs of health care means that unless health-care processes become more efficient, a decreasing proportion of citizens in industrialized societies will be able to afford high-quality health care (de Koning et al, 2006). Continuous process improvement is needed to ensure health-care processes are efficient, cost-effective and of high quality. The five case study applications we have examined in this paper provide examples of how Lean Six Sigma can help to improve health-care processes.The adoption of similar programs in other hospitals across the health-care sector will help the delivery of high quality health care to an increasing population. 7. Conc lusion Lean Six Sigma is now accepted widely as a business strategy to improve business profitability and achieve service excellence, and its use in service organizations is growing quickly. However, there are a number of barriers to the implementation of Lean Six Sigma in services, such as the innate characteristics of services, as well as the manufacturing origins of Lean Six Sigma that have conditioned service managers to consider them as physical products only.On the other hand, as shown in the case studies, there are a number of advantages for the use of Lean Six Sigma in services (Eisenhower, 1999). Overall, the applications so far have showed the benefits (such as lowering operational costs, improving processes quality, increasing efficiency) to outweigh the costs associated with its implementation. 8. References Adams, C. , Gupta, P. & Wilson, C. (2003) Six Sigma deployment. Burlington, MA, Butterworth-Heinemann. Antony, J. (2005a) Assessing the status of six sigma in the UK service organizations. Proceedings of the Second National Conference on Six Sigma, Wroclaw, pp. -12. Antony, J. (2005b) Six Sigma for service processes. Business Process Management Journal, 12(2), 234-248. Antony, J. , Antony, F. & Taner, T. (2006), The secret of success. Public Service Review: Trade and Industry, 10, 12-14. Antony, J. , Kumar, M. & Cho, B. R. (2007) Six Sigma in services organizations: benefits, challenges and difficulties, common myths, empirical observations success factors. International Journal of Quality Reliability Management, 24(3), 294–311. www. intechopen. com Lean Six Sigma in the Service Industry 13 Antony, J. , Kumar, M. & Madu, C. N. 2005) Six Sigma in small and medium sized UK manufacturing enterprises: some empirical observations. International Journal of Quality & Reliability Management, 22(8), 860-874. Antony, J. , Kumar, M. & Tiwari, M. K. (2005) An application of Six Sigma methodology to reduce the engine overheating problem in an automot ive company. IMechE – Part B, 219(B8), 633-646. Armstrong, M. (2006) A handbook of human resource management practice. London, Kogan Page. Becker, G. S. (1993) Human capital: a theoretical and empirical analysis, with special reference to education. Chicago, University of Chicago Press. e Koning, H. , Verver, J. P. S. , Van den Heuvel, J. , Bisgaard, S. & Does, R. J. M. M. (2006) Lean Six Sigma in health care. Journal for Healthcare Quality, 28(2), 4-11. Eisenhower, E. C. (1999) The implementation challenges of Six Sigma in service business, International Journal of Applied Quality Management, 2(1), 1-24 Fillingham, D. (2007) ‘Can lean save lives? Leadership in Health Services, 20(4), 231-41. George, M. L. (2003) Lean Six Sigma for service: how to use Lean speed and Six Sigma quality to improve services and transactions. New York, McGraw-Hill. George, M. L. 2002) Lean Six Sigma: combining Six Sigma quality with Lean speed. New York, McGraw-Hill. Gettys, R. (2009) Using Lean Six Sigma to improve Call Centre operations. [Online]Available from: http://finance. isixsigma. com/library/content/c070418a. asp [Accessed 22nd January 2009]. Gupta, P. (2005) Six Sigma in HR, Quality Digest, QCI International. Harry, M. and Schroeder, R. (1999) Six Sigma: The breakthrough management strategy International Monetary Fund (IMF), (2011) World Economic Outlook Database. [Online] Available from: http://www. imf. org/external/pubs/ft/weo/2011/01/weodata/index. aspx. Accessed 7th August 2011] Jacowski, T. (2008) Maximizing call centre resource utilization with Six Sigma. [Online] Available from: http://ezinearticles. com/? Maximizing-Call-Centre-ResourceUtilization-With-Six-Sigma&id=1014905. [Accessed 22nd January 2009]. Jamrog, J. J. & Overholt, M. H. (2005) The future of HR metrics, Strategic HR Review, 5 (1) 3-3. Kotler, P. (1997) Analysis, planning ,implementation and control, 9th ed. Prentice-Hall. Lanham, B. & Maxson-Cooper, P. (2003) Is Six Sigma the answer fo r nursing to reduce medical errors? , Nursing Economics, 21(1), 39-41. Laureani, A. & Antony, J. 2010) Reducing employees’ turnover in transactional services: a Lean Six Sigma case study, International Journal of Productivity and Performance Management, 59(7), 688-700 Laureani, A. , Antony, J. & Douglas, A. (2010) Lean Six Sigma in a call centre: a case study, International Journal of Productivity and Performance Management, 59(8), 757-768 Lee, Y. , Chen, L. & Chen, S. (2008) Application of Six Sigma methodology in human resources to reduce employee turnover rate: a case company of the TFT-LCD industry in Taiwan. International Journal of Operations and Quantitative Management, 14 (2), 117-128.Milmore, M. et al, (2007) Strategic human resource management: contemporary issues. Prentice Hall/Financial Times. www. intechopen. com 14 Advanced Topics in Applied Operations Management Pande, P. , Neuman, R. & Cavanagh, R. (2000) The Six Sigma way: how GE, Motorola and other top compa nies are honing their performance. New York, McGraw-Hill. Piercy, N. & Rich, N. (2009) Lean transformation in the pure service environment: the case of the call centre. International Journal of Operations & Production Management, 29 (1), 54-76. Radnor, Z. & Boaden, R. (2008) Editorial: does Lean enhance public services? Public Money and Management, 28(1), 3-6. Regan, W. J. (1963) The Service Revolution, Journal of Marketing, 47, 57-62 Rosenberg, A. (2005) Six Sigma: the myth, the mystery, the magic: can Six Sigma really make an impact in your call centre? [Online] Available from http://www. callcentremagazine. com/shared/article/showArticle. jhtml? articleId= 59301130 [Accessed 22nd January 2009]. Silvester, K. , Lendon, R. , Bevan, H. , Steyn, R. & Walley, P. (2004) Reducing waiting times in the NHS: is lack of capacity the problem? Clinician in Management, 12(3), 105-11. Snee, R. D. 2010) Lean Six Sigma: getting better all the time, International Journal of Lean Six Sigma, 1(1), 9 –29. Snee, R. D. (2004) Six Sigma: the evolution of 100 years of business improvement methodology. International Journal of Six Sigma and Competitive Advantage, 1(1), 4–20. Snee, R. D. (1999) Why should statisticians pay attention to Six Sigma? Quality Progress, 32(9), 100–103. Sullivan, J. (2003) HR metrics the world class way, Kennedy Information. Swank, C. (2003) The Lean service machine. Harvard Business Review, October, 123-129. Taner, M. T. , Sezen, B. & Antony, J. 2007) An overview of Six Sigma applications in the health-care industry. International Journal of Health Care Quality Assurance, 20(4), 329-340 Ulrich, D. (1996) Human resource champions. The next agenda for adding value and delivering results. Boston, Harvard Business School Press. Wheeler, D. J. & Lyday, R. W. (1990) Evaluating the measurement process. 2nd ed. SPC Press. Womack, J. P. & Jones, D. T. (1996) Lean thinking. New York, Simon & Schuster. Wyper, B. & Harrison, A. (2000) Deployment of Six Sigma methodology in human resource function: a case study. Total Quality Management, 11, (4/5/6), 720-727. Zeithaml, V.A. , Parasuraman, A. & Berry, L. L. (1985), Problems and strategies in services marketing, Journal of Marketing, 49 (Spring), 33-46. www. intechopen. com Advanced Topics in Applied Operations Management Edited by Mr. Yair Holtzman ISBN 978-953-51-0345-5 Hard cover, 200 pages Publisher InTech Published online 16, March, 2012 Published in print edition March, 2012 The chapters in Advanced Topics in Applied Operations Management creatively demonstrate a valuable connection among operations strategy, operations management, operations research, and various departments, systems, and practices throughout an organization.The authors show how mathematical tools and process improvements can be applied effectively in unique measures to other functions. The book provides examples that illustrate the challenges confronting firms competing in today's demanding environment b ridging the gap between theory and practice by analyzing real situations. How to reference In order to correctly reference this scholarly work, feel free to copy and paste the following: Alessandro Laureani (2012). Lean Six Sigma in the Service Industry, Advanced Topics in Applied Operations Management, Mr.Yair Holtzman (Ed. ), ISBN: 978-953-51-0345-5, InTech, Available from: http://www. intechopen. com/books/advanced-topics-in-applied-operations-managem ent/lean-six-sigma-in-theservice-industry InTech Europe University Campus STeP Ri Slavka Krautzeka 83/A 51000 Rijeka, Croatia Phone: +385 (51) 770 447 Fax: +385 (51) 686 166 www. intechopen. com InTech China Unit 405, Office Block, Hotel Equatorial Shanghai No. 65, Yan An Road (West), Shanghai, 200040, China Phone: +86-21-62489820 Fax: +86-21-62489821

Statistical Significance and Homemade Shampoo

A Study on Gugo and Okra as Homemade Shampoo A Research Done by: Francine Faye A. Jumaquio Majaline Faye A. Tolentino Romer T. Nepumoceno Talavera National High School Talavera Nueva Ecija A Study on Gugo and Okra as a Homemade Shampoo Claudine M. Lajara I-Rosal Introduction This study was conducted to determine the effectiveness of a homemade shampoo out of the native Gugo, scientific name Entada phaseuoliodes and Okra, scientific name Abelomoschus Esculentus L. in making different type of hair stronger. Four phases were done: Phase 1, the control treatment; Phase 2, homemade shampoo compared to control treatment; Phase 3, homemade shampoo compared to varied concentration of gugo and okra; and Phase 4, where the acceptability of the homemade shampoo was determine in terms of smoothness, softness, and manageability. Statement of the Problem: Specifically, the researchers aimed to answer the following questions: 1. Can gugo and okra be used as raw material in making shampoo? 2. How effective are gugo and okra on the tensile strength of the hair? 3. Which treatment is more effective – treatments with greater concentration of okra han gugo or more gugo than okra? Procedure A. Preparation of Materials About 10,000 hair strands were gathered from four respondents having different types of hair, (normal, and dry, ethnic, curly). In each type of hair, 2020 strands were used: 240 strands for water, okra, 10 percent gugo, and 100 percent gugo; 240 strands for seven brands of shampoo; 12 0 strands for gugo and okra; and 600 strands for 10 treatments with varied concentration of okra and gugo. Five hundred grams of gugo bark were boiled in 70 ml of water for 30 minutes, and strained to extract the juice. The decoction was placed in a clean bottle. To prepare okra decoction, 200 grams of okra fruits were boiled in 200 ml tap water for10 minutes. The cooked okra was masked for extraction and decoction was strained for the preparation of solution. The homemade shampoo was prepared from 50 ml gugo decoction and 50 ml okra decoction. A 58ml coconut oil was added to the mixture and placed in an earthen pot. It was heated for 5 minutes and placed in a clean bottle. The homemade shampoo was then prepared into two setups: setup A and setup B. The treatment involves four type of hair (normal, dry, ethnic, curly). Setup A Treatment |Gugo (ml) |Okra (ml) | |1 |50 |50 | |2 |40 |60 | |3 |30 |70 | |4 |20 |80 | |5 |10 |90 | Setup B Treatment |Gugo (ml) |Okra (ml) | |1 |50 |50 | |2 |60 |40 | |3 |70 |30 | |4 |80 |20 | |5 |90 |10 | B. Soaking Process and Determination of the Hair Strength In phase 1, four treatments were prepared: †¢ Treatment 1: water, †¢ Treatment 2: Okra , †¢ Treatment 3: 10 percent gugo, †¢ Treatment 4: 100 percent gugo. These are the control treatments. Six bowls were prepared and labeled as 5, 10, 15, 20, 25, 30 minute, respectively. Sixty strands of normal hair were used and divided into 10 strands. The hair strands were simultaneously soaked in the respective bowls with 100 ml tap water and were removed when the time allotted for each bowl had elapsed. Then they were rinsed separately. They were placed in clean sheets of paper labeled according to the length of time they were soaked, (such as T1- water: 5 minutes; T2 – water: 10 minutes; and so on). The bowl used from the first treatment was washed thoroughly and were used again for the other treatments. The process was repeated for treatments 2, 3, 4. To determine the strength of the hair strands, a spring scale was used and five trials were done. From the 10 strands of normal hair, 5 strands from Treatment were tested. The hair strands were tied up to the spring scale at one end. A 15 cm length of the hair strands were maintained between the spring scale and the weight. The weight was pull until the hair snaps. The amount of force in Newton (I Newton = 100 grams) registered on the spring scale prior to the breaking of the hair was recorded and the average result from the five trial was computed. The process was repeated for treatments 2, 3, 4. Also the same process was done for ethnic, dry, and curly hair. In the second phase, 480 strands from four hair types were used. Out 480 strands, 120 strands of the hair were prepared for trial 1 and trial 2, using the homemade shampoo (gugo and okra). The same procedure ion phase 1 was done for these treatments. In the third phase, 2,400 strands of hair were prepared from the four types of hair. Out of 2,400 strands, 1,200 strands were used in setup A and another 1,200 in set up B. Each set up has 5 treatments and 60 hair strands were divided into ten, and each 10 were soaked separately in six bowls labeled 5, 10, 15, 22, 25, and 3 minutes, respectively. The same procedure from the previous phases was done to determine the hair strength. In the 4th phase, 20 female respondents, who had normal and dry hair were asked to apply Treatment 1 in setup A: 10 percent gugo + 90 percent okra. Most of their hairs were equal in length. The respondents treated their hair one by one. They wet their hair first and 20ml of this treatment was applied to the entire crown and was massaged on the scalp. After 1 min. , the hair was rinsed thoroughly with tap water. A clean towel was used to dry and comb their hair slowly. After 1 hour, the effect on the hair was observed using 1 to 4 scales. The following scales were used: |A. Softness |B. Smoothness |C. Manageability | |1 – slightly soft |1 – slightly smooth |1 – slightly manageable | |2 – fairly soft |2 – fairly smooth |2 – fairly manageable | |3 – soft |3 – smooth |3 – manageable | |4 – very soft |4 – very smooth |4 – very manageable | After having applied and observed the effects of treatment 1; treatments with 90% gugo + 10 % okra were used by the same respondents with the same procedure as of Set up A. Results, Discussion and Conclusion Phase 1: Significant comparison on the hair strength among the control treatments: There was no significant difference on the hair strength, considering the different types of hair. However, the longer the longer the time each type of hair was soaked, the greater the hair strength. Among the four treatments in this phase, the hair strength when soaked in 10 %gugo, were the strongest while water was the weakest. Phase 2: Significant comparison between homemade shampoo and control treatment: Normal hair was significantly strongest compared to curly, dry and ethnic. Among the control treatment, hair strength was the strongest when soaked in treatment three: 10% gugo. Treatment 1: water was registered the weakest. It was also observed that as the soaking time increased, the hair strength also increased. Phase 3: Significant comparison among homemade shampoo, control treatment, Setup A and Setup B: Normal hair was significantly stronger, curly hair was the weakest, while dry and ethnic hair were almost comparable to each other. 10% gugo registered the strongest hair strength, followed by okra, then okra and gugo. Together, these three treatments were significantly different from all other treatment. The longer the soaking time, the stronger the hair strength. Phase 4: Acceptability of treatments. For normal hair, the two treatments showed no significant differences in terms of smoothness, softness and manageability. The 90% gugo+ 10%okra treatment was fairly manageable and the 10% gugo + 90% okra treatment was manageable. For dry hair, the two treatments showed no significant difference in terms of smoothness, softness. But there was a significant difference of manageability at 0. 5 probability level. Recommendations Based on the findings, the researcher recommends the following: 1. Use okra as raw material for making shampoo; 2. Further study of the properties of the homemade shampoo to establish the effect on hair; 3. Follow-up research must be conducted on the acceptability for other types of hair; 4. This research would provide information to those who are interested in the production of this product. Bibliography Jumaquio, Francine Faye A. , et. al. , â€Å"A Feasibility Study of Gugo and Okra as Homemade Shampoo†.

What were the origins of African-American slavery Essay

What were the origins of African-American slavery - Essay Example However, these were not actually the first slave. This is because slave trade had long started before the 16th century i.e. during the Triangular trade or transatlantic trade, which involved the Americans, Europeans and the Africans. In the transatlantic trade, slave traders delivered slaves captured in war from Africa to work in the South America in exchange for sugar and tobacco. After the first batch of slaves in 1641, the colony of Massachusetts made slavery legal and then Virginia followed suit in the year 1660. Slavery intensified in the 17th and 18th century being enforced further in 1787 when U.S constitution was drafted to prohibit congress from meddling with slave trade before 1808 (Berlin, 2003). After the American Revolution War 1775-83, Americans began associating enslavement and oppression of Africans to the manner in which they were manhandled by the British. The slaves had no right to vacation, wages, owning property and marriage. This led to call for slavery ban, acknowledgement of slaves as three-fifth of a person for taxation purposes and recognition of slave as person held under service. Mostly in 1800’s slavery in North America was viewed as oppression amongst many, however, people of South America did not conquer with this opinion. This is because they relied heavily on slave labor and abolition of slavery would amount to loss of much of their wealth (Franklin, 2000). Despite the above progress, South faced Economic crisis in late 18th century as a result continued slavery in contrast to the North America. This was in the European industrialization period and there was high demand for cotton, South America cash crop. Moreover, the invention of the mechanical cotton gin in 1793 required more manpower. Consequently, the south continued slave trade to counter the huge labor demand and to meet their export demands. However, between

Training and development 6 Essay Example | Topics and Well Written Essays - 250 words

Training and development 6 - Essay Example With this in mind, this trend will affect my personal career development as I would have to take several measures to promote my own career development. Some of these steps would include, I would need to develop several sources of income to supplement my main income. I would also need to attend career improvement and development conferences, seminars, workshops and symposiums to ensure that I am always abreast with the current developments in my chosen career and hence always remain ahead of most competitors. In an attempt to be able to be favorably placed in the event that new opportunities happen to arise, I would need to ensure that I diversify the range and breath of my experience by ensuring that I always engage in new projects when given the chance to do so (Kakabadse et al 50). As the protean career trend continues to develop, job security is fast becoming a thing of the past and I would need to ensure that I extensively network with other professionals in an attempt to ensure that I am always kept in the loop on the events taking place in my industry. Networking will also potentially provide new employment

Personal paper on SoHo, NYC. First-person Essay

Personal paper on SoHo, NYC. First-person - Essay Example . Geographically, Soho is a neighborhood located in Lower Manhattan, New York City. It is a zoned neighborhood bounded by Houston Street and Lafayette Street, with the Centre Street on the East and Canal Street on the South. As a place, one can immediately observe that there is more to the city than its geographical location evident with the characters of its more than 250 iron cast buildings. Indeed there is more that meets the eye because what made Soho special are not only its buildings but its inhabitants and its history. Dreams and perfection were created in that community, a dwelling place were great artworks were conceived and worked during the stillness of its night and the brightness of its day. Soho’s nature to become the nest and breeding place of so many artists can be said to be a happy accident or perhaps even by Divine Providence. In the early part of Sohos history, the place was virtually empty where its historic buildings became unattractive to factories or any form of business. At some point, it was thought of as a miserable place, without place to work, all space and no money from industry where abandoned buildings litter the community. For a time, there may be no money coming in during in Soho but its historic buildings and its lofts that has large unobstructed space where light can get in freely, has a special charm to artists. It could provide them the space to work and for their art to flourish. Its bane of being absent of industry and factories actually became an advantage and an asset because it afforded artists rent cheap to do their creative works. Just imagine a place, or a community where all of its residents are dreamers or purveyors of beauty whose heads are always on the cloud even if their feet touches ground. Many may have been gone but you can still feel that artistic aura, to explore and to open up, and pour ourselves in creative ways that only God understand.

Forum Article Example | Topics and Well Written Essays - 250 words - 1

Forum - Article Example lude  how to  house  them, provision of quality health care services to the refugees, and protecting the refugees from the  county  they are running away from and the dangers that they are facing.   The issue of helping the refugees has complicated by the fact that the hosting countries have got their own policies which they have to  twist  so as to cater for the refugees.  The countries have to stoop quite low and be able to cater for the refugees as a way of promoting the human rights. They have to  sponsor  the refugees and ensure that the refugee camps  are well equipped  and that the refugees are able to get food supplies, the hosting government should ensure that they are remarkably able to receive quality health care services to the refugees and also provide the refugees with adequate security (Hollenbach 78). For all governments to be able to keep the refugees in their countries, they  need  to  put  their policies in a way that will ensure better  accommodation  to the refugees and ensure that their human rights  are taken  care of in a good way (Hollenbach

Intellectual and Property Law Essay Example | Topics and Well Written Essays - 2500 words

Intellectual and Property Law - Essay Example In USA, the Uniform Trade Secrets Act (UTSA) was enacted some twenty-five years back. (Dreyfuss et al 2011:113). Now, trade secrets can be justified as a guise not of customary property but of intellectual property. The incentive by way of IP protection to trade secrets is justifiable, mainly to offer a boost for new inventions. Offering legal protection for those new inventions not only promotes their creation, but also facilitates an inventor to cash his inventions by selling his new ideas to others. Through patent law, trade secrecy can be safeguarded as it is not only quicker but also cheaper to obtain patent over such business secrets as it extends safeguard to various varieties of business and manufacturing process information. Sometimes, court considers trade secret law as a common law tort instead of perusing the same under IP rights. Protection of trade secrets through IP promote pre-emption of â€Å" unjust enrichment â€Å" philosophies and other common law remedies that courts are enticed to offer the private parties legal control over information that is available in the public domain. In case of commercial scenarios, the cases of the breach of confidence most recurrently happen. It is to be noted that there exists a difference between a trade secret and just commercial â€Å"know-how.† It has been observed that mere know-how is not safeguarded under the law and to be safeguarded, it should be in the guise of a trade secret. Majority of the commercial know-how is no doubt having great value and hence, it is essential to keep it away from public dissemination. For instance, a chemical formula for a specific ingredient (for instance coca-cola) should be preserved under lock and key, which is known as the trade secret. Trade secret connotes information, including but not restricted to a pattern, formula, method, compilation, technique, programme or information or process embodied or contained in a product mechanism or devise which: may or is may be employed in a business or trade; b) is not normally recognised in that business or trade; c) has some economic value from not being generally be disclosed; d) Is adequate initiatives have been taken to maintain the secrecy under the scenario. (Sumpter 2006:100). Illustration of confidential information: Plans and Designs as held in Saltman v Campbell Swizzle sticks embellished with a cruise ship name where they are being widely used as held in Ackroyds (London ) Ltd v Islington Plastics Ltd1 A manufacturing process for establishing a confectionary as held in AB Consolidated v Europe Strength Food. Exhaustive information about assets, supplies, budgets, strategic planning and clients stored in computer files as held in Ravensdown Corp Ltd v Groves 2 Concepts and ideas gathered during negotiations in commercial opportunities as held in Pacifica Shipping Co Ltd v Andersen3 Disclosures made about the patented invention during the course of business negotiations as held in Seager v Copydex. Details stored about the requirements of clients and list of customers as held in Target Recruitment Services Ltd v Lewin4 Details of general information about the company which contains details about the products dealt with , chemical formulae , prices to be quoted in the tenders , budget forecasts and market information as held in AM Satterthwaite & Co Ltd v Gay 5 The genetic components of plant budwood that was stolen as held in Franklin v Giddins. If a new plant variety for which litigation is made is kept as secret or

Murder Trial and Murder Case Study Example | Topics and Well Written Essays - 1750 words

Murder Trial and Murder - Case Study Example The Circumstantial evidence that could be deduced was that of Massachusetts State Police chemist Deanna Dygan who in her testimony in the superior court held up the floral underpants of the Rachel stated that blood samples and sperm cells were found in the crotch area. However seminal fluid could not be tested positive. Further, the shirt of Rachel which was covered with blood was found to have sperm cells and three holes out of which two had tested positive to lead which is present due to a gunshot. Finally, it was found that the death of the infant had been caused due to a contact shot. The circumstantial evidence which had been put forward by Dylan was said to be inconclusive and thus was of not much help. The objectivity of the investigation was put into question by the lawyer of Elliot Weinstein who put in the relevant evidence that is if prior to or during the investigation Dylan had put in Entwistle’s name in the suspect box on crime scene sheet. Dylan stated in the affirmative on which Elliot stated that this had affected the investigation procedure. Further, he argued that the bullet wound had not been found at the crime scene and had been found during the autopsy, a vital element not noticed during the investigation of the crime scene. Finally when Weinstein asked if the bullet trajectory had been carried out which was answered in the negative by Dylan. The relevant evidence which had been established in the specific case led to the establishment of the fact that Dylan had been led to believe that Neil Entwistle the possible suspect was the culprit. and so a biased opinion had been possibly established by the chemist. The direct evidence that was provided was that by Drugan, the senior chemist in the state police crime lab's arson and explosives unit who stated that the residue of gun primer was found only on the hands of Rachel. He went on to say that quite a few items of the BMW had been tested at the airport and it was deduced that neither the steering wheel, keys and a shirt had all been found to be negative when the tests for the gun primer had been carried out. Further eleven knives had been tested for the knife block but all came negative. The direct evidence that had been provided for by Drugan was in itself a bit inconclusive which led to a stronger case being established for the possible suspect. Further the items that had been tested had strengthened the case of the husband of Rachel. The testimonial evidence was provided by Trooper Stephen Walsh who is a member of the fire arms identification unit. He provided that he had tested a bullet which had been removed from the body of the victim Rachel's chest and had further removed two fragments of bullets.

Ontology in Anselm, Descartes and Kant Essay Example for Free

Ontology in Anselm, Descartes and Kant Essay Ontology is a purported proof that God exists. The ontology provided by St. Anselm in the eleventh century set the standard in Western thought, and on which all subsequent ontology attempted to measure itself. Before the renaissance and the age of reason it was generally agreed that only a fool would deny the existence of God. Accordingly the ontology of St. Anselm employs the attitude of a fool – meaning some one without any of the higher concepts of philosophy – as the crux of the argument. The argument commences with a definition of God: â€Å"Now we believe that [the Lord] is something than which nothing greater can be thought† (81). The association made is to perfection, for only in perfection can we conceive nothing beyond. In traditional attempts at ontology the strategy was to find God amongst the splendor of his creation. Anselm, however, eschewed the evidence of experience and tried to affect a proof from pure thought. It is placed in the head of a simpleton, and in this way is made to appear as stemming from the innate mind, and not clouded by the errors of perceptual understanding. Anselm’s fool wants to cling to the idea that â€Å"God is not!† But such atheism does not strangle the thought processes inside the head. It necessarily searches for perfection, that being the natural inclination of man, which is to seek happiness, comfort, order, and so on. Can the fool imagine perfection, asks Anselm. The answer is that he cannot. For whatever ideal it fixes on, the mind surges past it for something even better. However, this relentless ascendancy within the mind presages the existence of perfection therein, for otherwise the mind chases after nothing. Now, since we have already identified perfection with God, the mind imagines God, and indeed strives towards it. Existence in the mind will not suffice as ontology. Therefore, as the next step in the argument, Anselm attempts to measure the idea with reality. We must next consider whether that which has been imagined as perfect has a corresponding reality beyond the mind. If it does not then we have a contradiction. For being in the mind alone we are then able to imagine something even greater than it. That which was imagined as perfect now turns out have something that is more perfect than it. Anselm is sure that he has found a contradiction here. So he proceeds to conclude:   â€Å"Therefore, there is no doubt that something than which a greater cannot be thought exists both in the understanding and in reality† (82). Descartes, though largely accepting this ontology, doesn’t accept the contradiction derived in the final step. He argues that reality has not been introduced at all, but only an idea if reality. In the final analysis the entire ontology is taking place in the head. It is an imagined God that Anselm proves, says, Descartes, not a real one. His correction, therefore, was to consider the phenomenal world after all. In this manner he laid out what has famously come to be known as â€Å"Cartesian doubt†. The world of sensory experience, when examined philosophically, naturally induces doubt, for all perspectives are subjective. It is impossible to construe an objective form subjective sensory experience. But instead of holding back doubt Descartes allows it full reign. He starts to explore what else can be doubted. Soon it is found that not only material reality, but also all the perceptions and ideas of the mind must also be doubted, for they all stem from the same faculty of understanding. But his doubting reach must come to and end eventually, when he comes to consider consciousness itself. Descartes discovers that he is unable to doubt the â€Å"I†, for it is the â€Å"I† itself that is doubting, i.e. thinking. Thus his famous conclusion, â€Å"Cogito, ergo sum† – I think, therefore I am (68). From the proof of self-existence to the proof of God is a simple step. A self that is subject to doubt is imperfect, and therefore implies the existence of Creator who is perfect. Kant, in turn, comes to dismiss both these attempts at ontology on the simple premise that existence is not a predicate. In other words, it is meaningless to say simply â€Å"God is.† Our concepts of understanding allow us to apply reason in the form of sentences that contain both subject and predicate. So that we can say that ‘God is good’, or that ‘God is merciful’. But simply ‘God is’ is not meaningful, and human understanding does not allow such speculation. In effect, Kant is saying that ontology is not possible. This is in concord with the rest of Kant’s philosophy, which emphasizes that we are not able to pronounce on the noumenal world, i.e. on â€Å"things in themselves†. He describes three categories of noumena – the soul, the material world, and God, the last being the source of the first two. Therefore God is definitely part of Kant’s philosophical scheme, only that he remains beyond human understanding, and we cannot even pronounce on God is the simplest form – ‘God is.† Just as we cannot know anything about the soul, or the material world, as things in themselves, but only come to know the consequences of them. Our understanding is limited to the phenomenal world, where practical reason applies. Kant also speculates on the existence of a transcendental â€Å"pure reason†, that which overcomes the anomalies of practical reason. Pure reason is identified as an end in itself, and is thus identified with perfection. He stipulates it as a moral imperative that we pursue â€Å"pure reason† as the highest goal. Yet he refuses to identify this perfection with God, and differs with Anselm on this point. He also differs with Descartes’ ‘cogito, ego sum’, and complains that logic is being applied to derive existence, the rationale being that the part cannot be used to explain the whole. The least objectionable ontology, in my opinion, is that of St. Anselm’s. To make this point I will show that the refutations put forward by Descartes and Kant are not appropriate. Descartes’ complaint was that the proof given by Anselm is wholly ideal, without reference to the phenomenal world to give it substance. But Anselm does indeed refer to the phenomenal world, when he introduces the postulate that the ideal of perfection has no corresponding existence in the real world. In fact on this postulate the entire argument hinges, for it is used to derive the contradiction, from whence the ontology ensues. â€Å"Cartesian doubt† a merely a long-winded way of coming to the same conclusion. Kant’s complaint, on the other hand, is not really an argument at all, but rather a boast that he has not has to use the words â€Å"God exists† anywhere in his philosophy. For to pick on the grammar of â€Å"God exists† on the justification that the noumenal world is unknowable is taking matters too strictly. Even accepting Kant’s theory, it is not right that we desist from pronouncing the existence of God. He may not have done so explicitly, but Kant does indeed pronounce of the existence of God in the implicit sense. As a moral precept to action he gives us the categorical imperative: â€Å"I am never to act otherwise than so that I could also will that my maxim should become a universal law† (13). The universal law is pertaining to the moral law, which is described as an end itself, and therefore is no different from the idea of perfection. An imperative is only categorical when it works universally, without contingency. To paraphrase Kant, the rationale of human existence is to pursue the moral life in order to attain to perfection, in other words, God. Other than the fastidious insistence of grammar, Kant does not really object to Anselm’s ontology. With both Descartes’ and Kant’s objections discredited, Anselm’s ontology must stand as the best, being the simplest and most intuitive. Works Cited Anselm. Basic Writings. Translated by Thomas Williams. Boston: Hackett Publishing, 2007. Descartes, Rene. Meditations on First Philosophy: With Selections from the Objections and Replies. Translated by John Cottingham. Cambridge: Cambridge University Press, 1996. Kant, Immanuel. Fundamental Principles of the Metaphysic of Morals. Whitefish, MT: Kessinger Publishing, 2004.

Hydrotherapy for Post-Cerebrovascular Accident (CVA) Patient

Hydrotherapy for Post-Cerebrovascular Accident (CVA) Patient Hydrotherapy, in its broadest term, is the use of any one of the varying forms of water (i.e. liquid, ice or steam) to facilitate either a specific treatment, or to aid with overall health promotion (Mooventhan Nivethitha, 2014). One systematic review (Geytenbeek, 2002) looked at some of the available literature regarding the effectiveness of various hydrotherapy treatments. The review found that the majority of the research available was focused primarily on musculoskeletal conditions and concluded there was little research that was pertinent to the use of hydrotherapy in the specific treatment of neurological pathologies. However, since this systematic review was published there have been numerous pieces of research that do have a primary focus on the benefits of liquid-based hydrotherapy interventions for the treatment of neurological disorders. This literature review will aim to evaluate the current available evidence, with a specific focus being on the effectiveness of those hy drotherapeutic interventions that have the purpose of improving balance, quality of life and gait re-education in post-cerebrovascular accident (CVA) patients. The term CVA would be more commonly recognised as a Stroke and it can be medically defined as an interruption of the blood supply to a specific area of the brain (WHO, 2017). The region of cerebral tissue that has been affected by this interruption will largely dictate both the severity of the CVA and the symptoms that are then suffered by the patient. Water-based interventions have been used for hundreds of years for both pain relief and to treat numerous pathologies. It was Vincent Priessnitz however, who is credited as the founder of modern hydrotherapy after opening the first hydropathy clinic in Grà ¤fenberg, Czech Republic in 1826 (Metcalfe, 1898). Since then a greater understanding of the effects of hydrotherapy has been developed, in particular the numerous physiological changes that can occur during submersion in water. For example, submersion up to the sternal notch is now known to cause an increase in cardiac output and stroke volume, which can then further increase along side a rise in the water temperature (Grady, 2013). With this in mind the search strategy for this literature review was to include the terms cerebrovascular accident, CVA and stroke, and then also hydrotherapy, aquatic therapy and water based therapy with a date limitation set to only include research published since 2008. The search was conducted using the databases AMED, CINAHL, Medline and Medline with full text and returned 51 results when searching for linked full text only. There were several duplicate journals in the results and those remaining included various different types of research from across the hierarchy of evidence, ranging from case studies to randomised control trials. Seven journals were selected from the search results as the only publications that specifically focused on hydrotherapy interventions for the treatment of post-CVA patients (see Appendix A) and this literature review will therefore seek to critically evaluate these and summarise any common findings. In order to successfully validate a hypothesis it is important that the research clearly identifies which hydrotherapeutic intervention is being tested and also the control intervention that is being used for comparison. Three of the seven journals that were selected (Noh et al., 2008; Tripp Krakow, 2014; Park et al., 2016) used Halliwick Therapy as their primary intervention and then land-based physiotherapeutic programmes as the control group. The Halliwick concept was initially designed to help teach disabled children how to swim and is a ten-point programme that has a heavy focus on mental adjustment and body control within the water (Gresswell, 2015). This initial concept has then been further developed into Halliwick Aquatic Therapy, which has a holistic approach to neurorehabilitation that uses the support provided by the water to increase confidence in the patient and therefore also increase their participation in the exercise programme. The exercises themselves are designed to improve postural control and reduce muscle stiffness, with the overall aim to facilitate motor re-learning that can then be translated to on-land functional tasks (Weber-Nowakowska et al., 2011). This specificity of Halliwick Therapy, with regards to functional rehabilitation for neurological disorders, makes it ideally suited as a therapeutic intervention in such cases, however, only one of the papers listed above (Tripp Krakow, 2014) applied a specific functional outcome measure to their results. Another hydrotherapy technique that was used in one of the reviewed papers (Cappadocia et al., 2016) is known as the Bad Ragaz Ring Method. This utilises ring shaped floating devices that are typically placed around the patients neck, pelvis and peripheral joints, such as elbows and knees. The therapist is then able to fix their own position and use the peripheral limbs as levers to facilitate the patients trunk muscles and to encourage increased range of movement in the peripheral joints (Dutton, 2012). Unlike Halliwick Therapy this method does not have a focus on the transference of any benefits gained into more functional tasks. Instead it uses proprioceptive neuromuscular facilitation (PNF) techniques to enhance the patients active and passive range of movement and this can then hopefully be transferred into a more functional neuromuscular pattern of movement.