HSA 515 Dealing with Fraud Essay

As the Chief Nursing Officer of the state’s largest Obstetric Health Care Center, this author is responsible for complaints regarding fraudulent behavior in the center. The purpose of this report is to (1) evaluate how the Healthcare Qui tam affects health care organizations, (2) provide four examples of Qui Tam cases that exist in a variety of health care organizations, (3) devise a procedure for admission into a health care facility that upholds the law about the required number of Medicare and Medicaid referrals, (4) recommend a corporate integrity program that will mitigate incidents of fraud and assess how the recommendation will impact issues of reproduction and birth, and (5) Devise a plan to protect patient information that complies with all necessary laws. Qui Tam (from the Latin phrase â€Å"he who sues on behalf of the king†) is a well-known mechanism used by private individual to assist the government in enforcing specific laws (Ruhnka, Gac, & Boerstler, 2000). The False Claims Act of 1863 is one of the most important examples of the Qui Tam mechanism that was enacted during the Civil War to prosecute war profiteers who were caught overcharging the Union Army (Ruhnka, Gac, & Boerstler, 2000). Showalter (2012) states that the whistle-blower (aka relator) files the suit as a kind of â€Å"private attorney general† on behalf of the government in a qui tam case. Evaluate how the Healthcare Qui tam affects health care organizations. Healthcare qui tam affects health care organizations in many ways. The most popular and inconvenient way is financial losses. If an organization is accused of qui tam, a suit is filed and if the company is found guilty of fraud, they stand to incur a financial loss due to having to repay money to the government. Ruhnka, Gac, & Boerstler (2000) state that intentionally fraudulent activities such as billing for services not provided, billing for services or equipment that is not medically appropriate, or violating clearly stated billing rules are unacceptable and should be prosecuted whenever they occur. Qui tam effect on health care organizations has not been a positive one. Cruise (2003) state that qui tam actions has forced organizations to develop a new cadre of operating guidelines and procedures collectively called â€Å"compliance programs† resulting in organizations having to pay $600 – 700 million per year to a consultant industry to advise them on the intricacies of this new era. Health care organizations have adopted Federal Sentencing Guidelines as a part of their compliance programs due to the laws governing Medicare fraud and abuse (Cruise, 2003). Examples of Qui Tam cases that exist in a variety of health care organizations. Healthcare is on the rise in the United States. Medicare and Medicaid is the largest of the government sponsored healthcare plans and provide health care coverage for as many as 95 million Americans, at an estimated cost in 2012 of more than $900 billion (Raspanti, n.d.). Raspanti (n.d.) state that the primary reason for the rise in healthcare cost has been the large degree of fraud committed against these two major government health care programs. Raspanti (n.d.) state the following are examples of qui tam cases, but not limited to: â€Å"Kickbacks: The federal Anti-Kickback Statute prohibits any offer, payment, solicitation or receipt of money, property or remuneration to induce or reward the referral of patients or healthcare services payable by a government health care program, including Medicare or Medicaid. These improper payments can come in many different forms, including, but not limited to: referral fees; finder’s fees; productivity bonuses; discounted leases; discounted equipment rentals; research grants; speaker’s fees; excessive compensation; and free or discounted travel or entertainment. The  offer, payment, solicitation or receipt of any such monies or remuneration can be a violation of the Federal Anti-Kickback statute, 42 U.S.C.  §1328-7b(b), the Federal False Claims Act, as well as various other federal and state laws and regulations. Ghost Patients: The submission of a claim for health care services, treatments, diagnostic tests, medical devices or pharmaceuticals provided to a patient who either does not exist or who never received the service or item billed for in the claim. Up-Coding Services: Billing of government and private insurance programs is done using a complex series of numerical codes that identify the specific procedure or service being performed. These code sets can include: the American Medical Association’s Current Procedural Terminology (â€Å"CPT†) codes; Evaluation and Management (â€Å"E&M†) codes; Healthcare Common Procedure Coding System (â€Å"HCPCS†) codes; and International Classification of Disease (â€Å"ICD-9†) codes. Government health care programs assign a dollar amount it will pay for each procedure code. Up coding occurs when a health care provider submits of a claim for health care services, treatments, diagnostic tests or items that represent a more serious and more expensive procedure than that which actually was performed. Up coding can be a violation of the Federal False Claims Act. Bundling and Unbundling: In many cases, government health care programs have special reimbursement rates for groups of procedures that are typically performed together, such as laboratory tests. One common type of fraud has been to â€Å"unbundle† these procedures or tests and bill each one separately, which results in greater reimbursement than the group reimbursement rate. Attorneys in the national qui tam whistleblower practice of Pietragallo Gordon Alfano Bosick & Raspanti successfully represented the lead relator in one of the largest cases of â€Å"unbundling† in the history of false claims litigation, United States ex rel. Merena v. Smithkline Beecham Clinical Labs, which resulted in a recovery of $328 million for federal taxpayers. False Certification: When physicians, hospitals and other health care providers submit bills to government health care programs they are required to include a number of important certifications, including that the services were medically necessary, were actually performed, and were performed in accordance with all applicable rules and regulations. Additionally, health care companies such as pharmaceutical companies and pharmacy benefits managers that provide products or services to government  health care programs are required to certify that they are satisfying all obligations under their contracts with the government. One common type of fraud has been to falsify these certifications in order to get a health care claim paid or to obtain additional business† (Raspanti, n.d.). Stanton (2001) acknowledges that in a healthcare facility, with Medicare, each false claim is considered an individual billing whether for a specific medical item or service. Penalties can rise quickly with suspension or delay payment of future claims for a facility if it has been accused of submitting false claims (Stanton, 2001). Devise a procedure for admission into a health care facility that upholds the law about the required number of Medicare and Medicaid referrals. In order to avoid health care qui tam, healthcare organizations must stay abreast and compliant with Medicare and Medicaid laws. When a patient enters a facility for illness or an appointment, there are steps to follow. At check-in, the patient gives insurance card and pertinent information to nurse. The nurse enters the information into the system. The patient waits for the doctor to assess the illness to determine the needs of the patient. â€Å"Physician inputs information into the system and system codes the treatment based on Medicare or Medicaid protocols; system confirms and red flags any treatment or medication that is not allowed; patient is discharged and Medicare or Medicaid is billed for services rendered by the hospital, physician, and for medication† (Burnaby, Hass, & O’Reilly, 2011). If for some reason, items billed are questioned or denied, the items are reviewed and resubmitted to Medicare or Medicaid for payment. Recommend a corporate integrity program that will mitigate incidents of fraud and assess how the recommendation will impact issues of reproduction and birth. Corporate Integrity Agreements (CIAs) are considered second chances for healthcare organizations. By using CIAs, the organization avoids exclusion from Medicare, Medicaid, or other Federal healthcare programs by establishing and implementing a compliance program per CIA regulations and guidelines (MetricStream, n.d.). Implementing CIAs is challenging and can cause financial strain; however it can â€Å"protect stakeholders and customers from risk, and build brand value† (MetricStream, n.d.) CIAs are implemented  for healthcare organizations to uphold certain standards and to fulfill the organizations’ missions and goals. CIAs are usually proposed due to allegations of fraud or abuse which are found to be true through audits or self-disclosures; and are drawn up for a period of three to five years and can extend up to eight years (MetricStream, n.d.). Ramsey (2002) suggests that a recommended integrity program should include stipulations such as â€Å"designation of a compliance officer and a compliance committee† – to ensure that the needed changes will be made; â€Å"a required code of conduct, mandated compliance policies and procedures† – stating that the organization is committed to complying with the laws; â€Å"training requirements† – to ensure that staff and physicians are knowledgeable and up-to-date on all requirements and processes required by the organization, the government and vendors; â€Å"review and auditing procedures† – to help reduce errors when reporting claims; and a â€Å"confidential disclosure program where employees internally may report possible violations of the law† . Once a CIA is implemented, to deter employees from committing fraud, a stern disciplinary action process should be enforced and followed. Devise a plan to protect patient information that complies with all necessary laws. Protecting patient information is a responsibility of all healthcare organizations and a plan or process must be in place to do so. In any situation, whether in an office, clinic, or in the field, there are important procedures that can be followed to protect a patient’s information and confidentiality (Centers for Disease Control and Prevention, 2012). As a health care worker, you must â€Å"confirm the patient’s identity at first encounter, never discuss the patient’s case with anyone without the patient’s permission, never leave hard copies of forms or records where unauthorized persons may access them, and use only secure routes to send patient information and always mark confidential† (Center for Disease Control and Prevention, 2012). When in healthcare settings â€Å"conduct patient interviews in private rooms, never discuss cases or use patient’s names in public area, and always obtain patient’s permission before distributing his/her information to a staff member or healthcare worker† (Center for Disease Control and Prevention, 2012). Always keep medical records and  computers used in a locked or secure box to prohibit unauthorized persons access. Creation and implementation of a protection and privacy plan can reduce legal actions under the Health Insurance Portability and Accountability Act. Qui Tam cases impact healthcare organizations in various ways to include high penalties if found guilty, payback of monies received, and a negative image for the organization. Medicare and Medicaid fraud cases are the most common qui tam cases. In order to reduce fraud and abuse cases, healthcare organizations must improve their current admission procedure, their corporate integrity program, and their patient information protection system. Reference: Burnaby, P., Hass, S., & O’Reilly, A. (2011). Generic health care hospital: The road to an integrated risk management system. Issues in Accounting Education, 26(2), 305-319. Center for Disease Control and Prevention. (2012). Measures to protect patient confidentiality. Retrieved from http://www.cdc.gov/tb/education/ssmodules/module7/ss7reading4.htm Cruise, P. L. (2003). Deregulating health care ethics education: A curriculum proposal. Global Virtue Ethics Review, 4(3-4). MetricStream. (n.d.). Corporate integrity agreements. Retrieved from http://www.metricstream.com/solution_briefs/corporate-integrity-agreements.htm Ramsey, R. B. (2002). Corporate integrity agreements: Making the best of a tough situation. Healthcare Financial Management, 56(3), 58-62. Raspanti, M. S. (n.d.). Health care fraud and false claims. Retrieved from http://www.falseclaimsact.com Ruhnka, J. C., Gac, E. J., & Boerstler, H. (2000). Qui tam claims: Threat to voluntary compliance programs in health care o rganizations. Journal of Health Politics, Policy and Law, 25(2), 283-308. Showalter, J. S. (2012). The law of healthcare administration (6th ed.). Chicago: Health Administration Press. Stanton, T. H. (2001). Fraud-and-abuse enforcement in Medicare: Finding middle ground. Health Affairs, 20(4), 28-42.

Agriculture and Tractor

The tractor industry reported a strong 28. 3% growth in sales volumes during 2009-10, thereby ending the phase of cyclical correction that had pulled down tractor sales during the preceding two years (200709). Significantly, the revival of 2009-10 happened despite the droughtlike conditions in many States during the kharif1 season dampening sentiments.The key factor enabling the demand growth of 2009-10 was strong rural liquidity, which in turn was sustained by several factors, including: higher minimum support price (MSP) for crops; greater ability of farmers to make cash purchases (including the usage of Kisan Credit Card which are increasingly being used to part-finance tractor purchases); enhanced employment opportunities (with rural employment schemes being implemented by the Government of India); an improved credit environment; and continuance of replacement demand.These factors apart, non-agricultural use of tractors (for haulage in construction and infrastructure projects) co ntinued to increase, benefiting tractor demand. Also, with infrastructure projects and rural employment schemes increasing employment opportunities, availability of labour for agricultural activities continued to decline, persuading even farmers with medium-sized land holdings to either rent or purchase tractors. On a regional basis, the performance of the eastern, northern and western parts of the country was robust during 2009-10 in terms of tractor demand, while that of the southern region was moderate.A strong growth in tractor volumes, albeit on a low base, was witnessed in the eastern States, including Bihar, Orissa and Jharkhand, which had a good paddy crop. Tractor volumes in the northern and western regions also reported strong growth during 2009-10, especially in the second half (H2) of the year, benefiting from a low base (H2, 2008-09) and a satisfactory kharif crop in some States. The southern region reported moderate performance in terms of tractor demand (growth of 11. 9% in 2009-10), being impacted largely by the de-growth in Andhra Pradesh (AP)—a key southern market—where rainfall was irregular in 2009-10.However, in Karnataka and Tamil Nadu, higher MSPs for rice along with some revival of interest of public sector banks (PSBs) in tractor financing led to strong tractor sales volumes. Historically, tractor demand has been fairly volatile, being influenced by cyclical trends, availability of finance, and crop patterns (monsoon). After four years of strong growth during 2003-07, the fiscal years 200708 and 2008-09 both reported a marginal decline in tractor sales volumes, largely reflecting cyclical corrections.In addition to the cyclical dips, during H2, 2008-09, the industry also had to cope with the 1 Kharif season in India is during the south-west monsoon (June-October) ICRA Rating Feature Tractor Industry: An ICRA Perspective liquidity crunch, which pushed up interest rates, even as financiers resorted to more stringent lending norms in the face of rising non-performing assets (NPAs). However, the situation improved during 200910 as credit availability improved on the strength of greater liquidity in the banking system.While tractor financing has traditionally been done by PSBs, of late, private banks and non-banking finance companies (NBFCs), despite their higher interest rates vis-a-vis the PSBs, have been able to increase their penetration of this market on the strength of faster loan processing and use of more liberal credit norms. Overall, with tractor demand being closely linked to agricultural output, growth in farm mechanisation and farmers’ remuneration, the long-term demand drivers for the industry remain robust.The currently low levels of tractor penetration in India, strong Governmental focus on availability of finance for agriculture mechanization tools and on rural development, increase in the use of tractors for nonagricultural purposes, and the growing emphasis on tractor exports au gur well for the industry. Background Chart 1: Annual Trends in Tractor Sales Volumes Chart 2: Monthly Trends in Tractor Sales Volumes Source: Industry, ICRA’s estimates Source: Industry, ICRA’s estimates The tractor industry reported a compounded annual growth rate (CAGR) of over 20% in volume terms during the period 2003-07.The long up-cycle in demand was supported by several factors, including excise duty exemptions on tractors (2004-05), thrust on rural development, improved availability of finances for tractor purchase, and low interest rates. The growth also came on a low base, with the preceding three fiscal years (2000-03) having witnessed a prolonged phase of volume correction. The cyclical correction during 2000-03 had been aggravated by the build-up of channel inventory with the major players having pushed aggressively for larger sales.In contrast to this phase of cyclical slowdown, the one that happened during 2007-09 was less severe, with volumes declining by around 3%, despite the intermittent tightening of the liquidity situation during H2, 2008-09. The demand slowdown during H2, 2008-09 also impacted the profitability of the original equipment manufacturers (OEMs), that is, the tractor manufacturers, because of the high price inventory they were carrying. However, the situation improved on the cost structure front in H1 2009-10 with the softening of commodity prices preparing the ground for the industry to earn higher profitability margins.The pickup in volumes also lowered the overhead expenses for the tractor manufacturers, boosting their profitability. While the OEMs did not lower the listed sales price of tractors, the benefit of lower steel prices was passed on to the end customers via discounts. This is an accepted practice in the industry; given that once prices are lowered it is difficult to raise them subsequently. However, during H2 2009-10, the tractor majors increased the prices with the reversal of commodity prices an d the discounts have also come down. ICRA Rating Services Page 2 ICRA Rating FeatureChart 3: Trends in Profitability Margins of Select Players Tractor Industry: An ICRA Perspective Source: Company releases, ICRA’s estimates; refers to Profit before Interest and Tax (PBIT) and volume in the tractor segment Capacity utilisation in the tractor industry had hit a low during 2002-03, following large capacity additions and a volume slump. After that, capacity utilisation improved steadily, but remained moderate at around 50% during 2008-09. In 2009-10, the tractor volume growth has helped the OEMs improve their capacity utilizations; however, there is still excess capacity in the industry.Thus, over the medium term, most tractor manufacturers would not need to make any significant capital investments in building capacities. As discussed, the domestic tractor industry has to cope with demand volatility on account of cyclical trends and the strong linkages it has with agricultural pr oduction and monsoon rains. Many of the industry players have thus diversified into related products, including generator engines and cranes, besides focusing more on exports, to gain some insulation against the volatility in domestic tractor demand.As for tractor exports, while a major part of that currently goes to USA, the OEMs are now exploring various other markets across Europe, Asia and Africa for future exports. Industry Trends by Region The biggest markets for the tractor industry include States like Uttar Pradesh (UP), Andhra Pradesh (AP), Madhya Pradesh (MP), Rajasthan, and Maharashtra, which together accounted for around 50% of the total tractor sales in India during 2009-10. The tractor industry witnessed a strong y-o-y growth of 28. 3% during 2009-10, with most of the States reporting positive growth during the year.Chart 4: Trend in Tractor Sales across regions Chart 5: Trend in Tractor sales across States Source: Industry, ICRA’s estimates Source: Industry, IC RA’s estimates The northern region remains the largest tractor market in India with sales of around 1,67,000 units as of 2009-10. This region reported a growth rate of 35. 7% in volume sales in 2009-10 over the previous fiscal, with the key contributors including UP, Punjab, Haryana and Rajasthan. The northern region benefited from higher MSPs (for crops), limited availability of labour (forcing higher mechanisation), and increasing non-agricultural use of tractors.Additionally, increased infrastructure development activities (especially highways) led to appreciation in land values and use of tractors for non-agricultural purposes. In some cases, farmers also received compensation for the Government’s acquisition of select land patches (adjoining highways), which increased the availability of cash with them. Feedback from industry players ICRA Rating Services Page 3 ICRA Rating Feature Tractor Industry: An ICRA Perspective suggests cash purchases (including purchases u sing Kisan Credit Card) in some northern States increased to 35-40% of the total tractor volumes in 2009-10 from 10-15% in the past.Tractor volumes in UP grew by 42. 7% during 2009-10, with H2, 2009-10 reporting particularly strong growth (around 51% y-o-y) mainly on the back of high sugarcane prices for the kharif crop and improved irrigation facilities. In the case of Punjab, tractor volumes remained strong for the fifth straight year in 2009-10 (y-o-y growth of 42%). In Rajasthan however, growth in tractor volumes was relatively subdued in 2009-10 (around 24% y-o-y) as compared with the figure for the northern region as a whole.Tractor sales in Rajasthan were especially low in H2, 2009-10 versus H1, 2009-10, due to lower kharif output on account of deficient rains and inadequate financing availability. In the eastern region, tractor volumes continued to report strong growth in 2009-10, albeit on a small base, and went up by 53. 8% over 2008-09, being driven mainly by the higher M SPs announced for paddy. Within the region however, many financiers remained reluctant to finance tractor purchases in some States like Bihar. Nevertheless, in Bihar, tractor volumes grew 66% over 2008-09 to around 29,000 units in 2009-10, thereby accounting for over 50% of the totalsales in the eastern region. The Bihar market, where tractor penetration had been low historically, has shown sustained growth over the last few years and become one of the important markets for the tractor industry. Overall, in the eastern region, growth in tractor volumes is expected to moderate, going forward, as the benefit of a low base get diluted gradually. The western region reported sales of around 92,000 tractor units during 2009-10—a growth rate of 35. 7% over the previous fiscal—benefiting particularly from the strong performance that Maharashtra, Gujarat and MP posted during H2, 2009-10 (55% y-o-y growth over H2, 2008-09).The factors contributing to the strong growth in the reg ion during H2, 2009-10 included a benign base effect, higher crop prices (of sugarcane and cotton in Maharashtra, and of cereals and soyabean in MP), and greater availability of retail finance. The performance of the southern region in terms of tractor sales was relatively modest during 2009-10, with the growth rate being around 11. 9% over the previous fiscal. While most States in the region reported healthy growth, AP, which is the largest tractor market in the south, de-grew by 10. 4% in 200910.The AP market has been undergoing a volume correction since 2007-08, with the preceding four to five years having witnessed a large and sustained volume growth; this factor apart, the de-growth of 2009-10 was also aided by irregular monsoons. The other big market in the southern region, Karnataka, reported growth of 74% in tractor volumes in 2009-10 mainly on the strength of higher MSPs for rice; however, volume growth is expected to moderate in 2010-11 because of the base effect. In Tamil Nadu, tractor sales were flat during H1, 2009-10, but the performance improved in H2, 2009-10 mainly because of improved retail financing by the PSBs.Industry Trends by Tractor Horse Power (HP) The Indian tractor market has traditionally been a medium HP market, with 31-40 HP tractors accounting for around 47% of the total industry volumes. In 2008-09, the 31-40 HP category had reported sales of 157,602 tractor units, which was about the same as the previous year’s figure but lower than the 2006-07 statistic by 7%. In 2009-10 however, this category reported a strong revival, with the volume growing by 22%2 over 2008-09; the revival was led by UP, Karnataka and Madhya Pradesh. The other major segment in theIndian tractor market is the 41-50 HP range, which accounts for around 23% of the total industry volumes. This segment grew by around 10% during 2009-10, thereby underperforming the growth in overall tractor volumes (around 19%) that year. The main reason for this underperf ormance was the low growth that the southern region, the biggest market for this segment, reported in 2009-10. 2 The HP wise y-o-y growth rates are based on 9M 2009-10 tractor volumes. Page 4 ICRA Rating Services ICRA Rating Feature Tractor Industry: An ICRA PerspectiveThe >51 HP segment of the Indian tractor market also underperformed the industry growth rate in 200910 mainly because of the de-growth in the exports which is a key demand area for these high HP tractors. Some Long-Term Demand Drivers for the Industry Low penetration of tractors in Indian agriculture: Indian agriculture is characterised by low farm mechanisation, fragmented land holdings, and high dependence on monsoon rains (in the absence of adequate irrigation facilities). Tractor penetration in India is low at around 13 tractors per 1,000 hectares as against the global average of 19 and the US average of 29.While this does indicate the relative backwardness of Indian agriculture, it also points to the significant scope that exists for raising tractor penetration, which bodes well for tractor demand over the long term. Government support for the agricultural sector: Although agriculture contributes just around 20% to India’s GDP, it provides employment to a large rural population, which is why the sector remains a strong focus area for the Government. The tractor industry benefits significantly from the Governmental focus on agriculture, with measures such as nil excise duty ontractors (even the excise duty on tractor parts has been lowered from 16% to 8%) and inclusion of tractor financing under priority sector lending (by PSBs) serving as long-term demand drivers. Financing of tractor purchase is of great significance for the industry, it being a key demand facilitator. Export of tractors: Indian tractor manufacturers have been increasingly targeting the international markets over the last few years. The industry exported a total of around 37,900 tractors during 2009-10, with the USA , Africa, South America, and some Asian countries being the top destinations.The industry leader, Mahindra and Mahindra (M&M), has acquired Yancheng Tractors, the fourth largest tractor manufacturer in China (in terms of FY2008 volumes), to improve its presence in the country. In the developed markets, Indian tractors have a relatively marginal presence, with sales being largely restricted to the hobby farming segment. Outlook Tractor sales are expected to remain healthy in fiscal 2010-11, given the good rabi crop this time around, the continuing firmness in the prices of agricultural products, and the healthy monsoons anticipated during the coming kharif season.Moreover, improving farm mechanisation levels (with labour availability in rural areas declining), increasing non-agricultural use of tractors, higher credit disbursements for agriculture, and sharper Governmental focus on the farm sector (larger budgetary allocations) are also expected to encourage tractor sales. The indust ry’s profitability is however expected to remain moderate in the medium term, considering the high competitive intensity and low capacity utilisation levels, although larger players could benefit from scale economics.As for margins, while they have seen an improvement in 2009-10, they would remain vulnerable to adverse changes in commodity prices. While some States in the northern region have achieved high levels of tractor penetration and farm mechanisation, on an all-India basis, the penetration remains low, which along with the current shortage of farm labour and consequently rising labour costs, may be expected to lead to greater mechanisation and use of tractors.The long-term prospects for the Indian tractor industry hinge on agricultural growth and Government support in areas such as financing availability, tax exemptions, and fiscal stimulus for rural development. Overall, ICRA expects the long-term growth rate for the Indian tractor industry to trend around the histor ical average of 6-8%, supported by increasing tractor penetration. ICRA Rating Services Page 5 ICRA Rating Feature Tractor Industry: An ICRA Perspective Annexure I: Structure of the Indian Tractor IndustryThe Indian tractor industry has around 13 national players and a few regional players. The industry is dominated by Mahindra and Mahindra (M&M) with a market share of around 41. 1%, followed by Tractors and Farm Equipments TAFE, which holds around 22% of the market. The other major players include Escorts (12. 1%), L&T-John Deere (7. 8%), and International Tractors Limited (8. 9%). During the last few years, the industry has seen some consolidation with M&M acquiring Punjab Tractors (PTL) and TAFE acquiring Eicher Tractors.Most of the tractors sold in India are in the 21-50 HP range, with the 31-40 HP category alone accounting for around 50% of this. The long-term prospects of the Indian tractor industry are highly dependent on Government policies for the agriculture sector. Histor ically, most tractor sales are done on credit even as over the last few years financial institutions, facing an increase in their non-performing assets (NPAs), have resorted to some tightening of credit norms. Also, during 2009-10, there has been a sharp increase in cash purchases, reflecting the rise in disposable incomes in the rural markets.Most of the tractor financing done by banks comes under priority sector lending, a directed-lending mechanism of the Government of India. In terms of volume, India is one of the largest tractor markets in the world, besides China and the USA. The prospects of the domestic industry are highly linked to monsoon rains, which remain a key factor in determining agricultural production. Better irrigated States like Punjab and Haryana have a high tractor density (over 100 per 1,000 hectares), while States like Rajasthan, Gujarat, Himachal, Tamil Nadu, Maharashtra, Andhra, MP and WestBengal have low levels of tractor penetration—a pointer to th e substantial growth potential that the latter set offers. On an all-India basis, tractor penetration remains low at around 13 per 1,000 hectares. Besides being used in farming, tractors find application in activities such as harvesting and irrigation, land reclamation, drawing water and powering agricultural implements. In addition, lately, the tractors are also being used for non-agricultural purposes including haulage in construction and infrastructure projects which has expanded the tractor market.The Indian tractor market, thus, is expected to grow in future and remain one of the biggest tractor markets in the world. Chart 6: Trend in State wise market share Source: Industry, ICRA’s estimates Annexure 2: Region-wise Market Shares of Various Players The market shares of the top four players in the Indian tractor industry did not change much during 200910 in comparison with 2008-09. M&M remained the market leader with around 41. 1% market share, followed by TAFE with a mar ket share of around 22%, Escorts with around 12. 1%, and International Tractors (ITL) with around 8. 9%.ICRA Rating Services Page 6 ICRA Rating Feature Tractor Industry: An ICRA Perspective Chart 7: Movement in Regional Market Shares of Select Players 2009-10 vs. 2008-09 (bps) Source: Industry, ICRA’s estimates M&M remains particularly strong in the southern region (50. 4% market share during 2009-10). However, L&T John Deere (LT-JD) was able to increase its market share in the region by around 250 bps in 2009-10, mainly at the expense of M&M (market share down by 140 bps) and Escorts (down by 140 bps).In the western region too, LT-JD performed well in 2009-10, increasing its market share by 190 bps, even as TAFE lost market share by around 90 bps there. In the northern region, where M&M has been traditionally weak, the company increased its market share by 140 bps during 2009-10, even as ITL and Escorts lost market shares by around 90 bps and 60 bps respectively, there. In t he eastern region, M&M was able to raise its market share by around 140 bps in 2009-10 at the expense of Escorts and TAFE.ICRA Rating Services Page 7 ICRA Rating Feature Tractor Industry: An ICRA Perspective ICRA Limited An Associate of Moody's Investors Service CORPORATE OFFICE Building No. 8, 2nd Floor, Tower A; DLF Cyber City, Phase II; Gurgaon 122 002 Tel: +91 124 4545300; Fax: +91 124 4545350 Email: [email  protected] com, Website: www. icra. in REGISTERED OFFICE 1105, Kailash Building, 11th Floor; 26 Kasturba Gandhi Marg; New Delhi 110001 Tel: +91 11 23357940-50; Fax: +91 11 23357014Branches: Mumbai: Tel. : + (91 22) 24331046/53/62/74/86/87, Fax: + (91 22) 2433 1390 Chennai: Tel + (91 44) 2434 0043/9659/8080, 2433 0724/ 3293/3294, Fax + (91 44) 2434 3663 Kolkata: Tel + (91 33) 2287 8839 /2287 6617/ 2283 1411/ 2280 0008, Fax + (91 33) 2287 0728 Bangalore: Tel + (91 80) 2559 7401/4049 Fax + (91 80) 559 4065 Ahmedabad: Tel + (91 79) 2658 4924/5049/2008, Fax + (91 79) 2658 4924 Hyderabad: Tel +(91 40) 2373 5061/7251, Fax + (91 40) 2373 5152 Pune: Tel + (91 20) 2552 0194/95/96, Fax + (91 20) 553 9231  © Copyright, 2010 ICRA Limited. All Rights Reserved. Contents may be used freely with due acknowledgement to ICRA.All information contained herein has been obtained by ICRA from sources believed by it to be accurate and reliable. Although reasonable care has been taken to ensure that the information herein is true, such information is provided ‘as is' without any warranty of any kind, and ICRA in particular, makes no representation or warranty, express or implied, as to the accuracy, timeliness or completeness of any such information. All information contained herein must be construed solely as statements of opinion, and ICRA shall not be liable for any losses incurred by users from any use of this publication or its contents.

Pigs are emotional and sensitive Research Paper - 1

Pigs are emotional and sensitive - Research Paper Example Regardless of how intelligent and emotional pigs are, humans still raise them as livestock and treat them in less than humane ways. This paradox lies in contradiction with a number of assumptions we hold about the world we share with our fellow creatures (Fudge). In spite of a popular concept of a pig as a filthy, mechanical being, scientists know pigs are capable of complex emotions and thoughts. The domestic pig belongs to the genus Sus, as classified by Carl Linnaeus in 1758. There are approximately 2 billion domestic pigs on the planet; they are remarkably social and intelligent animals. One of the first animals to be domesticated, domestic pigs can be made to perform any number of tricks and tasks. They are commonly raised for meat (or pork) as livestock and for leather. Inconsistent with popular perceptions of pigs, it is actually the case that the pig’s sensory life is filled with a mass of information, requiring the animal to interpret and filter it quickly in order to deal with the world. Quite acute, the pig’s sensory inputs include highly adept senses of sound, sight, touch, olfaction, and taste. Despite having a relatively poor sense of sound, pigs use verbal communications in a quite advanced way. Auditory signals and vocalizations convey complex sets of information between pigs, such as the sender’s identity (Held, Cooper and Mendl 48). For example, piglets recognize the grunts of their own mother. Like their sense of sound, pigs do not have a particularly strong sense of vision. Poor visual acuity and color discrimination in pigs suggest vision is only a secondary sense as the pig seeks out food. The domestic pig’s sense of touch is far more acute than either its sense of sound or sight. Pain, by definition, functions to bring attention to specific areas of tissue damage to protect an area of damage. There is a difference between short- and long-term pains; the

Learning Organization Research Paper Example | Topics and Well Written Essays - 500 words

Learning Organization - Research Paper Example Thereby it decided to bring about a change in its working structure so as to make the production processes more efficient and to improve the weak points that were reducing its optimal functionality. The initial step the company took was to make an analysis of the black and white film department. It made them aware of the practices that were infringing upon the efficiency of the process along with working processes that could be improved to boast productivity. Moreover the evaluation report highlighted the processes which had become outdated over the period of time and required replacement. After finding out these issues, Kodak formulated a team by the name of Team Zebra, whose function was to make these issues their objectives and devise solutions for them. The prime purpose of the team was to cut down the inefficiencies of work practices and eliminate obsolete processes. As mentioned previously, learning organizations give companies an insight into the external environment and this is what the Zebra Team intended to do. It studied the environment the company was operating in, making an assessment of the technologies available. From the results, the Team was able to chalk out a plan for introducing best practices which would shorten the production lifecycle, prevent delays in delivering orders and improve the service provided to the customers (Barker & Camarata, 1998). The plan was essentially focused on a process known as the flow. Each employee of the organization was no longer employed in a conventional department; rather they worked as part of the flow and were called Zebras. They had meetings, in which they were apprised of the finances of the company. Such a measure allowed for the development of a sense of belonging in them (Dennis, Detering, Santos, Leonard & Norman, n.d.). Moreover, they were divided into different groups

Business Strategy in Corporate Giftware industry (PEST Analysis) Essay

Business Strategy in Corporate Giftware industry (PEST Analysis) - Essay Example Corporate giftware is an industry, which caters to almost all the industries across the board, in varying degrees. Sponsoring sports and other events, organizing hospitality events also form part of the corporate gift industry. The profitability of any industry, in general, depends upon five environmental factors enlisted by Porter as: ï‚ § Buyers'/Consumers' power: This is the power of industry’s buyers to secure discounts or negotiate added value to products. The consumer profile of Corporate gifts presents a two-dimensional picture. Personalized Corporate gifts are procured by different companies like Intel, Microsoft, Tesco, Asda, Starbucks, Pepsi, Virgin Airways etc. from the companies which are in the business of personalizing the promotional merchandise. This merchandise is then given away to the corporate clients, general customers, students, sales agents, company executives etc or on occasions like employee appreciation, retirement or special recognition etc. Therefore the actual buying power lies in the hands of companies which get such merchandise prepared with their logos/ messages. But to a certain extent, the ‘power’ is also exercised by the stakeholders, who are the end point receivers of such gifts. The power depends on buyer concentration, information and switching costs. The desires and tastes of stakeholder also keep on changing with times and they expect their companies to give away items which are in tune with the times.

Decisions in Paradise, Part II Essay Example | Topics and Well Written Essays - 750 words - 1

Decisions in Paradise, Part II - Essay Example The company has gained the trust and confidence of the company’s current and future customers that they are paying their money’s worth of coffee and other Starbucks products. In terms of service, the company has proven itself to implement world class restaurant service in more than 30 countries around the world. Implementing the going green policy complies with global environmental laws, including the Island’s anti-pollution laws (Ferrell, 2010). Weaknesses. Within the Kava Island market segment, the Starbucks entity’s coffee and other restaurant products are normally higher than the prices of Starbucks’ competitors’ selling prices. The company is only focusing a majority of its marketing management activities on coffee sales. The company relies on coffee sales to bring the company out of a possible bankruptcy situation. The current economic depression enveloping the United States and United Kingdom triggered a drop in the demand for Starbuck s coffee. With many employees retrenched by the bankrupt United States and United Kingdom companies, the increased unemployment rate precipitated to many of Starbucks’ current and future customers losing their jobs. With the lost of their jobs, the current and future customers’ purchasing power declined. ... The company can also save on salaries in countries where the legally allowed salaries are lower than the salaries of Starbucks employees in the United States and United Kingdom. Another opportunity is to hire 16 years old and above employees as part time workers for short periods of time. Hiring the teenagers will help the parents pay for their students’ school and personal needs (Ferrell, 2010). Threats. There are several competitors cropping up in the same coffee restaurant market segment, including Kava Island. The Island’s coffee competitors include the lower priced coffee-serving restaurants in the newly established Kava Island branch. The cultural diversity of the new countries hinders the implementation of the United States-based culture imbued in the company’s unique global marketing strategies (Ferrell, 2010). Analysis of specific steps of the chosen decision-making technique Starbucks implements specific steps in the implementation of the companyâ€℠¢s decision-making techniques. The steps include advertising the many benefits of sipping the reasonably priced cup of the uniquely Starbucks coffee aroma (strengths). For example, the Starbucks coffee ambience creates togetherness among the company’s group clients. Likewise, the advertisements effectively show the busy business line and staff employees can easily ponder the day’s decision making plans while taking their Starbucks lunch (Nutt, 2010). Additionally, buying the local coffee products of Kava Island farmers, instead of importing the coffee plant raw materials from the US reduce raw materials transportation expenses. Consequently, the company can lower the selling prices and still generate more than enough profits (Nutt, 2010). Furthermore, the company hires the local residents to work

Discuss How Fashion And Photography Inform Each Other Essay

Discuss How Fashion And Photography Inform Each Other - Essay Example This paper approves that the intricate relationship between photography and fashion, as evidenced in the existence of numerous fashion/photography collaborations in the history of the world of fashion, points out to the symbiotic relationship between these two fields of practice. Whereas the fashion photographers cannot exist without the designers who produce the subject of their work, the designers, on the other hand, cannot function effectively without the help of the fashion photographers who present their creative designs to the rest of the world in print. In view of the successful working relationship between the designer Issey Miyake and photographer Irving Penn’s, which went beyond commercial necessity to mutual creative respect that benefits both practitioners, it is evident that fashion and photography can, and indeed do inform one another. This paper makes a conclusion that the distinct field of fashion photography has risen out of the love relationship between fashi on and photography that has developed over the years, which has been motivated by both commercial benefits and the creative potential for practitioners in the two fields. Fashion and fashion photography collaborations allow the practitioners in both fields to indulge their creative capacity beyond imagination, thereby giving rise to fashion images that endear, challenge, and even engage individuals at various levels, making the genre of fashion photography unique and powerful.

A vacation trip from your childhood Essay Example | Topics and Well Written Essays - 250 words

A vacation trip from your childhood - Essay Example In retrospect, the entire air trip itself was not very interesting. However, the ability to fly high above the earth and imagine what was down below and what we were flying over captivated my imagination. Once in London, I was surrounded by foreign sights and sounds; sights and sounds that would now seem as if they were second nature to me. Perhaps the most interesting aspect of the entire trip was with regards to the cuisine. Used to my native cuisine and the way in which my mother and loved ones cooked, the rather bland food of Europe came as something of a surprise to me. As such a young traveler, my palate was not used to these strange dishes and I would oftentimes reject them out of the hopes that my frustration would somehow magically create more interesting dishes for me to eat. All in all, the trip was both formative and enlightening. It was formative due to the fact that it infected me with a desire to see new places and travel for the remainder of my life. Further, it was e nlightening due to the fact that I came to see how other people interact with each other whereas I had only been familiar of the way that my own people acted and interacted with one

Americas Equality is our Shared Reality Essay Example | Topics and Well Written Essays - 1000 words

Americas Equality is our Shared Reality - Essay Example Without these equalities, there could be no freedom. Fuchs clarifies the unique relationship we have with freedom and equality when he testifies, "Liberty was grounded in what they called the equality of every person under God, a belief asserted in the Declaration of Independence". Equality is not a myth; it is an idea and concept that our law, culture, and freedom is rooted in. It is a reality that we continue to struggle to attain and vigilantly guard to preserve as much today as we did in 1776. Jefferson's immortal words, "all men are created equal", were meant to be an ideal to aspire to, and that ideal is as real today as it was then. They were not stated as an accurate reflection of the current state of affairs in 1776. Jefferson did not imply that there was absolute equality and that all men would forever be treated fairly. He was keenly aware of the injustices facing the infant Nation as well as he understood the long road that lie ahead towards true liberty. Jefferson, a slaveholder all his life, was against the institution of slavery and looked forward to the day of its abolishment. As if looking into the future with crystal clear vision, Jefferson understood the grave issues at stake for America and the looming threat of violence and destruction if the people failed to accept his words. Writing of the necessity of a movement toward eventual emancipation, he writes in his Autobiography, in the year 1820, It was found that the public mind would not yet bear the proposition, nor will it bear it even at this day. Yet the day is not distant when it must bear and adopt it, or worse will follow. Nothing is more certainly written in the book of fate than that these people are to be free []. The reality of Jefferson's notion of equality is further evidenced by the slow, yet steady, progress America has made towards these concepts. When drastically altering our culture, laws, and society, change must necessarily proceed at a deliberate pace. While for many change has not come quick enough, we can view America's commitment to Jefferson's words and the reality of the idea by comparing 1776 to today. When the Declaration of Independence was written, there was an entrenched system of slavery that affected a single race. Women were not allowed to own property and only a minority of the population were allowed to vote. The issue of the displaced Native Americans still loomed in the future. Sixty years after the revolution for equality, women were granted the right to own property. Every generation since then has seen more equality affecting more people than their parents had witnessed. The next generation saw these immortal words reaffirmed at Gettysburg, P.A., when Lincoln proclaimed that America was, "[] conceived in liberty and dedicated to the proposition that all men are created equal". Equality was no myth to Lincoln as he tackled the difficult task of freeing the slaves and playing out the prediction that Jefferson had made forty years earlier. Ensuing years would be graced with the monumental Fourteenth Amendment, which once again framed Jefferson's words as it reads, "[] nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal

Invention Synopsis Essay Example | Topics and Well Written Essays - 500 words

Invention Synopsis - Essay Example Many alternative fuel sources like electricity, LPG, CNG etc. have been discovered and develop but the problem doesn’t seem to go away. Something needs to be done about it. During the mid and late 1970’s, Elsbett of Germany began works on a new type of fuel for automobiles, Vegetable oil. The concept of SVO (Straight Vegetable Oil) was born. It is the concept that diesel engines can also run on vegetable oil (Addison, n.d). This oil can be unused or recycled. Recycled vegetable oil must be clean, free of any water or particles. Vegetable oil serves as a substitute for diesel fuel which is the prime fuel source for heavy transport such as trucks and busses. These make up a large percentage of commercial and private transport. Converting these vehicles to run on an alternative source could save millions of dollars on oil purchases. Apart from commercial vehicles, a significant percentage of private vehicles are also diesel powered. If converted to SVO, this could further improve the situation. Furthermore, there are conversion kits and services available for gas/petrol powered cars. People, who do not own diesel powered cars, would definitely want to convert seeing the sharp drop in fuel prices. SVO fuel is cheaper than diesel and much cheaper than petrol. So, what’s the catch? Until now, the vehicles that have used vegetable oil fuel have done it privately or individually. Companies do provide conversion services and filtering and recycling of used vegetable oil on a small scale, but nothing is being done on a scale comparable to other primary fuel sources. Maybe this is the reason why it’s not getting popular. My idea is to provide this service on a bigger scale. A company that has a contract with local restaurants and food outlets to purchase this used oil at low prices, filter and recycle it and provide it to the general public. With the growing fuel prices today, a proper outlet for a cheaper fuel source would be a welcoming

Understanding Science through History Essay Example for Free

Understanding Science through History Essay The inquisitive of science and its blend in history is important in understanding the book â€Å"E=mc2: A biography of the World’s Most Famous Equation† written by David Bodanis. It is seen that in order to understand the empirical evidences of a technical concept, it is important to go back to the history of the concept and put this in the context of the events. Thus, it is seen that history plays an important part in understanding science. The book traces the historical events, the same as a biography would do, in order to understand the said formula. It proceeds from the time where this formula is created by Albert Einstein and proceeds to the important events in history which are related to the said formula. In gaining understanding, the author also mentions events such as the Second World War and mentions women such as Cecille Payne and Lise Meitner. Moreover, the author makes use of ordinary examples in order to relate to the birth of the formula. The author slowly made his way into defining the E, M, C, and 2 components of the formula through these examples. The connection of the present and the past is immediately established by the author as he mentions that â€Å"the world of 1905 seems distant to us now, but there were many similarities to life today† (Bodanis 4). It is with much realization that the author wishes to make a connection between what is present in today’s society with that of the past. Moreover, there is the establishment of the foundations of the present to be rested on the past. This is further emphasized by the author where he recognizes the importance of the past to the present. In the words of the author, â€Å"the year 1905 was also when Einstein wrote a series of papers that changed our view of the universe forever† (Bodanis 4). In bringing about this particular information, the author shows that there is always something in the past that led to what is in today. This is especially true for science where there are constant developments that are made in order to enhance the theories and the field of research. This book is definitely a must-read for those who are interested in understanding and gaining further knowledge of the formula. Despite the complexity of the concept, it becomes easier to read because of the relationship to more familiar concepts. Thus, the familiarity makes understanding a better experience in reading the life of a formula. Work Cited Bodanis, David. E=mc2: A Biography of the World’s Most Famous Equation. New York, NY: The Berkley Publishing Group.

Penang Mutiara Essay Example for Free

Penang Mutiara Essay Speed Speed means do thing fast. Speed means fast response to requirements of external customers or new conditions, speedy decision making and speedy movement of materials and information inside the operation. It’s benefit are: †¢ Speed reduces inventories reducing i inventories mean increasing the utilization of rooms and restaurant, that fast cleaning and preparing the available rooms and dinner tables for external customers adds revenue for organization, and improving the efficient of working. †¢ Speed adds flexibility fast response adds the capability for operations to the flexibility dealing with urgent things. †¢ Speed adds dependability fast delivering for the latest information among other department of operations, such as the newest customer entrance information, available room information, adds the dependability for each internal operation’s coordination and communication. Dependability Dependability means do things on time. Dependability means well management and coordination with each operation ensuring other process. are reliable, such as delivering right material or information on time, correct foreseeing and planning the facilities, reorder and workforce. It leads to more effective operation. It effectively arranging the facilities, information, material, workforce, money and time to ensure all of them can be available at any time, saves the time to wait or to look for the other substitutes. Dependability arrangement reduces the chance of repeating input resources or some resources leaving unused increasing the cost of maintain or store fee, or labor cost. Flexibility Flexibility means change what you do. It means according different requirements or things to fast handle with, making change or decisions , flexibility arranging and coordinating operations’ work. †¢ Flexibility saves resources can prevent unnecessarily repeating planning, spending, and using resources such as time, money, workforce, to follow the traditional ways to do things done. †¢ Flexibility increase speed of response being able to give fast service for customers depends on the operation being flexible. Flexible operations speedily transfer extra skilled staff and equipment to the urgent conditions and emergencies will provide the service with other customer’s needs. Quality Quality means ‘doing things right’. For Mutiara, quality means consistently producing impeccable services, using top-class and durable materials to create the right impression and environment, and anticipating and preventing all potential problems in advance. It is benefit to make life easier inside the operation. †¢ Good quality leads to stable and efficient processes that less mistake, easy for coordination for matching the standard of processes, dependable and advance equipments and tools to use adds dependability for internal customer. †¢ It reduces cost for Mutiara due to it is fewer the chance to make mistakes. Redoing or correcting mistakes, or to reducing confusion or irritation for each people; second, it also reduces the labor cost. Dispelling some serious troubles or problem always needs more staff or more time to do it, thus, it results in the labor cost added, such as part-time salary, overtime compensation. The more minimizing mistakes, the more minimize the excess labor costs to pay for doing excess works; third, less mistake and using top-class and durable materials also result in saving expenditures such as maintaining fee, cost of materials resulted by mistakes, transporting fees, and other excess expenditures. ALTERNATIVE COURSES OF ACTION †¢ Expand its business in other areas to acquire more market shares against other high-class and strong competitors in the whole Asia region, or even in the world. †¢ Through concession and alliance with other business such as tour companies, ocean safari theme park, movie companies, golf or car club, complete set of hotel industry which is gathering tour, amusement, business and relaxation together. †¢ Upgrade technology such as wireless internet, website, including introduction of hotel services, traffic map, resource and promotion information, booking on line and e-payments †¢ Develop marketing strategies to widen up market share, such as offering difference holiday traveling packages, discounts and loyalty cards. †¢ Continues improvement internally by developing Total Quality Management (TQM), Kaizen, and 5S system and ISO standards. †¢ Monitor customer’s feedback by developing centralized customer relation office which conducts satisfaction survey. †¢ Offer continual training for staff to improve the standard quality of services, English and Foreign language speaking, handling these new automatic system and internet using. †¢ Adding the advertisement through TV, internet, high-income reader journal or fashion magazines and newspaper. CONCLUSION AND RECOMMENDATION To conclude, even though Penang Mutiara managed to maintain its competitiveness with their current strategy, however it is not sufficient to remain competitiveness due to volatile market demand. Moreover, with the emergence of the global tourism, hospitality industry and globalization with competition from all over the hotel industry, the need to augment existing and new strategies need to be address speedily. In order to compete for business and to keep abreast with stiff competition in the hotel industry. The hotel’s management should strengthen their marketing and operation strategies as a tool in increasing market share, prioritizing in developing website and upgrade the hotel facilities. Performance measurement by monitoring feedback and implement quality management. Also adopt proactive approach to enhance and maintain consistency in quality and level of services by conducting staff retrain and upgrading of skills. Reviewing new service standards, conduct regular focus group studies to predict future customer requirements, minimize and eliminate high employee turnover by taking good care of staff welfare, and exercise job rotation of staff to promote innovation and creativity in the job.

Equipment for Cosmetic Dermatology Clinic

Equipment for Cosmetic Dermatology Clinic A cosmetic dermatology clinic differs from the traditional dermatology clinic in terms of the requirement of a wide range of equipment to perform various aesthetic procedures. In the past, the only instrument associated with dermatology practice was a magnifying glass. It then progressed to equipment’s such as Woods lamp, electrocautery, radiofrequency, cryotherapy and phototherapy units. Beyond these tools, the cosmetic dermatologists’ armamentarium includes various basic and specialized equipment’s to carry out a multitude of dermatological treatments and cosmetology procedures. (Box 1) In addition to the treatment equipment, photo documentation devices are also essential. These devices record the results and changes for analysis and prognosis of the treatments and can actually document the percentile UV damage, wrinkle score etc. The cosmetic clients (internet savvy) are aware of the equipment usage in various procedures and check for clinics offering faciliti es with the latest equipment and low downtime. The cosmetic dermatologist not only needs to be updated about the latest equipment’s but should also be aware of its management and maintenance needs. Poor maintenance leads to financial losses for the physician and compromises on efficacy and safety issues for the patient. This chapter gives a brief outline of equipment management and maintenance aspects which would enable the physician to provide safe, effective treatments and sustain the financial aspects of his/ her practice optimally. Box 1: Basic and Specialized equipment in a cosmetic clinic Basic Equipment Microdermabrader Radiofrequency and cautery Cryotherapy Mesotherapy Jet Peel or hydrafacial Microcurrent Electroporation Dermatoscope and photography equipment ( detailed in chapter 5) Phototherapy Units Specialised Equipment- LASERS and Light Systems Intense Pulse Light LASER Hair Reduction- Long Pulse Alexandrite, Long Pulsed ND YAG, Diode Pigmentation- Q Switched ND YAG Fractional and Ablative LASERS Hair Restoration- Low Level Lasers and lights Skin Tightening- LASERS and Radiofrequency, Micro needling Radiofrequency Vitiligo and Psoriasis- Excimer lamp and LASER Body contouring- Radiofrequency, cryolipolysis, ultrasound cavitation, low level laser therapy,etc. BASIC REQUIREMENTS FOR EQUIPMENT MANAGEMENT The basic requirement from any machine/ equipment is its longevity and optimal usage. This can be achieved by effective equipment management procedures [1] (Box 2) Box 2: Effective equipment management procedures Equipment Purchase Installation requirements (storage and space electrical supply, air-conditioner) Standard Operating Protocols Training of the staff Quality control checks (cleaning, safety devices, consumables, regular inspections) Maintenance and servicing (Daily, Preventive, Annual ) Equipment/ Accessories modification Equipment Purchase: The following checklist should be kept in mind during purchase of the equipment. This helps to trouble shoot maintenance issues effectively. Always buy from a certified company or a certified official dealer Check with the dealer for skilled technicians for installation and troubleshooting Sign the maintenance contract with the company (No machine is zero maintenance) Establish the warranty period (details and time lines) Note of the date of manufacture and the numerical code unique to each equipment. Installation Requirements Space and storage Requirements of the equipment and accessories should be taken into account prior to installation. Electrical connections and stabilizers: This has been detailed in Chapter 60. Special sockets and high voltage breakers, stabilizers and UPS (uninterrupted power supply) should be provided. Air conditioner: Most of the LASER machines generate heat and require certain temperatures to be maintained while in operation. An air conditioned environment is preferred as it remains closed, relatively dust free and is useful for machine longevity. Smoke evacuators Fragments of skin, hair and aerosols can damage LASER lenses or light based equipment due to physical interference with transmission. Smoke evacuation systems may be used to reduce the plume debris and limit the harmful effects on the staff, patients/clients and the laser equipment. Standard Operating protocols (SOPs) SOPs regarding usage of the machine are provided by the manufacturer. Indications and Specifications are provided in the operator manual and should be adhered to. Based on the patient requirement, if modifications are made in the SOPs, these should be documented and informed to all the staff. Training of staff (machine operators or staff responsible for maintenance) All the staff members in the cosmetic dermatology set up should be trained to follow the SOPs, understand the need and importance of equipment maintenance for the smooth functioning of the clinic. Quality control checks (cleaning, safety devices, consumables) In addition to the daily cleaning; regular weekly or fortnightly check of each machine, safety devices and consumables should be done. This helps to prevent emergency maintenance issues and financial losses. Maintenance and servicing (Daily, Preventive, Annual) A record should be maintained of all planned and unplanned maintenance and services, including any problems or modifications. The service contract records, contact details of service personnel should be documented well. Equipment/ Accessory modification Any modification to the equipment or accessories; or change in its operational usage may have safety implications associated with it. Hence, whenever any modification is done, appropriate documentation is mandatory. Standard accessories should be used. STANDARDISED AND EFFECTIVE EQUIPMENT MANAGEMENT A standardised form, including all the aspects detailed above for equipment management should be kept with individual machines. A soft/ hard copy of this format for all machines should be catalogued and serve as a ready reckoner to the concerned staff. A basic outline of the form has been provided in Box 3. The salient aspects for effective equipment management have been included in Box 4. Box 3: Standard form for individual machines Name of the machine Indications Standard specifications (usually provided by manufacturer) Storage specifications: Equipment/ Accessories Space: Table mounted/ Floor mounted Electricity: Earthing/ UPS requirement AC requirement Consumables Safety devices- Goggles, cooling devices, smoke evacuators Cleaning Techniques Maintenance- Daily, Preventive, Annual or comprehensive maintenance services ( AMC/ CMC) Special tips do’s and don’t’s Installation date Operator Training: Names/ Dates Contact details for Maintenance services: Phone/ Mail id/ Website address/ Personnel Warranty details: Equipment/ Accessories, along with datelines Services Contract: AMC/ CMC, Renewal along with Dates Service done: Dates/ Done by whom/ Supervisory staff Box 4: General Tips for effective equipment management Keep a standardised form with individual machines. Train the staff to handle the equipment carefully Understand the Operators manual Take care of all the parts of machine. Hand pieces are the most important part. Place them in a protective box or on the machine as instructed Keep a check list of the consumables Keep all the machines covered and in a dust free environment Contact technical personnel for preventive machine maintenance at regular intervals Check for contraindication in case of all clients BASIC EQUIPMENT MAINTENANCE The general principles of basic equipment maintenance (as per the standardised form) has been outlined in Table 1. Modifications can be done based on individual machines and clinic requirements. Table 1: Basic Equipment Management Equipment Crystal Diamond- USG, Cleanser, head Salt – cartridges Microcurrent Diamond Pro Lift Radiofrequency /Cautery Mesomate/Dr Injector Injector MesoGun-Manual-Automatic Jet M Machine Indications Exfoliation gently removes the outermost dead skin cell layer for the epidermis. Reduces pigmentation and tanning Improves Acne scars Reduces fine lines and wrinkles Reduces pore size and age spots Facial lift Muscle lift Body Contouring Iontophoresis-Product penetration Disencrustation- Deep cleansing Dermatoses papulosa nigra (DPNs) Warts Skin tags Moles Seborrheic Keratosis Granuloma pyogenicum Xanthelesma Rhinophyma Dull skin Irregular texture Uneven skin tone Hair loss Cellulite Lymphatic drainage Exfoliation Infusion Standard operating protocols Available Available Available Available Available Storage Temperature:20 -600 C Humidity Space Table mounted Table mounted Table mounted Table mounted Dr. .Injector has its own Trolley Table mounted or specially designed trolley Electric/ UPS/ AC Earthing + UPS/ AC- Earthing + UPS/ AC- Earthing + UPS/ AC- Earthing + UPS/ AC- Consumables Hand piece depending on the type of machine Nozzles of two different sizes small for face and neck and big for the body parts Aluminium oxide crystals Two long metal probes, one small probe with sponge for earthing , two sets of coloured wires, one metal roller, sticky pads and big pads. Hand piece Wire loop electrode and pointed electrode Disposable as well as reusable tips are available Kinked wires may need replacement Safety devices Foot pedal Air tubing Triple nozzle handpiece Safety goggles (during peel infusion ) Vitamins Cleaning The jar has to be cleared of all the crystals after every service and cleaned. Hand piece needs to be cleansed with alcohol swab before use. Tissue residue should be removed from the active electrode (Rf power ON) with a sterile moist gauze (water only) No scalpel scissors or any sharp objects should be used as it may lead to tissue adherence Disinfection All commercially available disinfectants may be used to disinfect the electrodes. Electrodes should be immersed in fresh cidex solution .then they must be washed and under tap water , dried and Placed in the supplied box Sterilisation All non- disposable hand pieces, cables, plugs and electrodes are autoclavable to 2500 F or 1210C. Steam cleaning of electrodes must be done just before use. Sterilize the guard with alcohol swab prior to the service Regular cleaning of hand piece Maintenance Jar needs to be replaced every fortnight for smooth functioning of the machine Spare hand pieces should always be available Replace filter and nozzle after every 15 bottles Daily Maintenance: Clean hand piece with alcohol swabs or SPCL cleaning Solution. Straighten the tubes. AMC Preventive maintenance should be done at an interval of 1-2 months Preventive machine maintenance at an interval of 1-2 months. The electrodes should be dipped in dilute H2O2 solution so that debris gets cleared, before washing AMC Preventive machine maintenance should be at an interval of 6 months. Daily Maintenance Clean the gun exterior with spirit. Do not allow spirit to enter the interiors. Charge the Gun daily AMC Preventive machine maintenance should be at an interval of 6 months. AMC Preventive machine maintenance should be at an interval of 6 months. Special Tips: Do’s and Don’ts Do’s- follow the instructions mentioned in the user manual Don’ts – do not place anything on the machine Don’ts- Coloured wires should always be tied up and placed on the machine when not in use Do’s- The only way the radiosurgery can create tissue damage is if the heat is allowed to accumulate in the tissue to the point where it can lead to excessive dehydration and hence tissue destruction. Preventing accumulation of such heat is the basic objective of radiosurgery technique and hence one should practice 10 seconds ON and 30 seconds OFF. Don’ts – Do not Use any inflammable anesthetics or cleaning agents. Use the injector and needle that meets the international and domestic standards. SPECIALISED EQUIPMENT MAINTENANCE Specialised equipment’s such as Lasers, lights, radiofrequency based machines are now an integral part of cosmetic clinics. Most of these equipment are expensive and have specific maintenance issues. In addition, the optical radiation emitted by lasers, IPLs and LEDs has potentially hazardous effects on patients, clients and equipment users. There can be direct damage to eyes or skin. A potential risk of fires or explosions from lasers igniting gases or fabrics and the problem of smoke inhalation exist. Engineering (in- built safety measures provided within the laser machine), procedural (policies and practices followed at the cosmetic clinic) and administrative (review by health department) control measures are needed to prevent exposure to potential laser hazards. [2] Effective equipment management procedures as outlined in Box 2 should be followed for each of the specialised equipment in the clinic. The most important aspect of maintenance is simple prevention. This can be achieved through the following measures: Routine inspection, of the laser system and the surroundings (Daily/ weekly checks) Periodic inspection and maintenance of optical components and critical subassemblies (Preventive and annual maintenance checks) Documentation and Record keeping Few examples for daily/ weekly/ preventive checks for laser equipment are outlined in Box 5 [1] Box 5: Examples for daily/ weekly/ preventive checks for laser equipment Examples for daily checks: Check whether the laser output terminates on release of foot/ hand switch Check the device’s alignment of the aiming beam with the therapeutic beam Check device’s filters/ tips for scratches or dirt. Check all system alarms and lights are operating appropriately Assess all device accessories including cables and connectors are clean and functioning. Examples for weekly checks: Inspect protective eye wear for lens scratches or general damage Check all protective blinds, windows and doors, are dust free and functioning appropriately Check that electrical system connections/ UPS, warning lights are functioning correctly Examples of annual/ preventive checks: Electrical safety Device calibration checks Output measurements Beam alignment Shutter operation Accuracy of timer Filters The general tips for effective and safe laser equipment management are outlined in Box 6. The general principles of specialised equipment maintenance (as per the standardised form) has been outlined in Table 2. Modifications can be done based on individual machines and clinic requirements. Box 6: General tips for effective and safe laser equipment management Laser Room (details in chapter 60) Restrict entry to the room when the system is in use; put laser warning sign Do not include any light reflecting objects such as mirror, Provide rubber mat flooring ( prevents damage and losses in case of accidental fall of hand pieces, goggles, etc) Services/ Maintenance checklist Maintain a logbook of regular maintenance check and calibration Maintain detailed information about service centre/ personnel Check for engineers training certificate. Calibration must be checked by authorized personnel with calibrated power meter. Always check for calibration certificate when under AMC/ Maintenance Deionized (DI) water is needed for cooling in some machines. Check levels 1-3 monthly and change Check fire safety measures Check for Electromagnetic immunity and declaration compliance. Check for recommended separation distances between portable and mobile RF communications equipment and laser Equipment Use Check the power supply/ UPS before the machine is switched on. If the machines need to be moved to a different room, do it carefully and avoid jerky movements Always place the tips or hand pieces in the designated box so as to avoid any accidental fall or damage to the same Optical lenses, fibre optic cord, some hand pieces contain lasing medium are expensive, hence handle all equipment parts with care Never leave the system in ready mode unattended Practice use of hand switch as much as possible Most laser screens have a touch screen. Be sure not to point on the screen while firing the laser shot ( Can inadvertently happen with the foot pedal) In event of any emergency use the emergency shut –off knob Use colourless gels for lasers Use Skin markers and colours for demarcating areas. Skin markers should be preferably white or appropriate colour depending on the laser absorption spectrum or else they can act as chromophores and cause burns Cleanse and dry the area to be lased thoroughly Inspect the laser tip always before treating the patient. Do not use if damaged. Make sure the correct eye wear is used (Different protective eyewear is indicated for different wavelengths) Do not treat eyebrows eyelashes or other areas surrounding the eye orbit with Nd: YAG or Er: YAG lasers. The light emitted by these can cause serious eye damage or blindness. Use corneal shields especially in cases of direct touch lasers being used in the orbital area. Gas based and pulse dye lasers (Example- Excimer, Pulse dye lasers) Switch ON everyday Cleaning of hand piece with alcohol swabs. Gas bottles used as consumables are very expensive Mirrors needs to be cleaned by engineers every 3 months. Calibration of voltages is very important. Dye needs to be replaced after 50000 shots Body shaping and contouring machines: All hand pieces need to be cleaned daily Better to use specific oils or gels, otherwise ultra-sonography gel can be used; may be glycerine based. The emitted sounds should be perfect Phototherapy units Check lamp power every month and calibrate if needed Clean fans every quarterly Table 2: General principles of specialised equipment maintenance ( separate doc- horizontal chart) CONCLUSION Equipment management and maintenance is an integral part of the cosmetic practice set- up. Specialised equipment such as lasers and radiofrequency based devices are expensive and have specific maintenance issues. In addition to the financial implications for the practice, the safety and efficacy of the treatments provided by the physician are chiefly dependent on well managed equipment. SUMMARY A cosmetic dermatology clinic differs from the traditional dermatology clinic in terms of the requirement of a wide range of equipment to perform various aesthetic procedures. It is a good practice to employ equipment management and maintenance measures. The effective equipment management procedures include checklists and processes for purchase, installation, developing standard operating protocols, staff training, quality control checks, maintenance and servicing (daily, preventive, annual ) and modifications in equipment/ accessories. Good equipment management and maintenance practices have healthy financial implications for the practice. It assures optimal usage and longevity of the machine life, along with safe and effective treatments for the patients/ clients.

Long and Short Term Causes of WWI :: World War I History

Long and Short Term Causes of WWI There were several long-term events that led to the outbreak of World War One. The most prominent factors include: nationalism, militarism, imperialism, the Balkan and Morocco crises, and the alliance system. Ironically, these things were either started in response to, or upheld because of, one of the other factors. The alliance system was one of the last factors to emerge before the war. Consequentially, the contributions of this system to the beginning of the Great War have to be considered. Although the alliance system was a main cause of the First World War, it arose because of several other factors, and did not cause the war single handedly. Nationalism, the love and support of one's country, has always existed. In this era, however, it was to take part in the creation of one of the most famous wars in history. Since so much pride was devoted to countries, it made the possibilities of peace between past rivals less probable. It also meant that most nations, especially the great powers, would rather fight a war than back down from a rival's diplomatic provocation. In effect, nationalism was also a contributing factor to the alliance system. No country feels comfortable being in a war alone, and with the growing militaries in almost every country, allies provided much comfort. The supreme present of militarism, "a policy of aggressive military preparedness" , in this period of time gave all countries great reason to feel the heavy weight of an oncoming war. Great Britain's naval policy (to always be twice as big as the next two largest navies put together), along with the predominate feeling of war provided countries with a strong reason to try and create an incredibly strong military force. This led to an arms race, which made the impending war seem inevitable. The military planning in some countries also caused an increased fear of war. Since military machines were being developed, each country was appointing a general staff of experts. The greatest problem with this was that there was a fear that "some chief of staff, in order to maintain the schedule on his 'timetable', might force an order of mobilization and thus precipitate war." These two factors also led, in part, to the alliance system. If two or more countries are allied with each other then the y have a better chance of defeating their common enemy if war is declared.

Computer Crimes :: essays research papers

Computer Crime Computer crime is a very broad term. It could mean anything from a total invasion by a hacker into the federal government or just the simple fact of one person letting another borrow a copy of his favorite flying game. Computers are defined in the dictionary as a machine that computes (WBD vol. 23). But to most people it is a machine that's helps us do a task easier. As we move into the 21th century though one thing is for sure, the computer will help crime become more prevalent. Hackers are probably one of the more common threats out there. These are the people who use modems and telephone lines to enter your computer. A teenager sits across the table yelling, "I want this and this and this†¦.". This is not a kid talking to his parents; it is a hacker talking to the business he just hacked into. Whenever you think about it, the idea of a teenager being able to make a big software firm grovel like that is pretty amazing. This is a site often seen though. When a company is hacked into it often hires its predators as protectors (Glass 11). If companies do not come forward to claim that they have been infiltrated how are these hackers supposed to be prosecuted. This is a serious issue being faced today by the federal government. In an article by Stephen Glass he quotes a radio advertisement by the Nevada law-enforcement officials. They were so desperate the advertisement ran "Would you hire a shoplifter to watch the cash register? Please don' t deal with hackers." The state took the airwaves after a boy had broken into a department stores computer system and made it credit $500 a day to his Visa card. The boy had racked up $32,000 before being caught. But, the store did not prosecute. Instead they let the boy keep his money, all in exchange for showing them how to improve their security (Glass 11). Also cases have been reported of government agencies being hacked into. If the government is worried about a hackers' invasion with their security system what is the American people to do. Hackers and computer criminals also use computer viruses to either do some odd job or just reek havoc. "Virus" is the one computer-security buzzword that has made its way into the mainstream. Most people do not know exactly what one is, but that it's bad.

Solutions to E- waste problem Essay -- Recycling Electronics

In the last decades, technology became more sophisticated in creating modern devices. Consequently, in our disposable age most apparatus turn into aged ones in a couple of years or even months. This is one of the reasons why electronic devices become waste. E-waste is discarded, surplus, obsolete, or broken electronic devices or apparatuses. Most environment protection organizations maintain that e-waste induces health and pollution problems. The primary reason for this view is that almost all of the electric devices contain hazardous substances which are toxic and are not biodegradable. There are mercury, lead, and chromium in parts like circuit boards, batteries, and color cathode tubes. These toxic components can easily enter the environment since they settle on the landfills. Hence, in order to protect our future life, we must determine the suitable solutions. The first solution to E-waste problem is to reduce the environmental impact with the help of recycling companies. The primary goal of these companies is to recycle dead electronics. Nowadays, recycling is a widely used solution as it can stop the pollution of environment. As well as environment pollution, greenhouse gas emissions could decrease. Materials which existed after recycling process can be reused in industry. â€Å"A company sometimes produces a byproduct that is useful to another company, and sells or gives it away. Such byproducts are sometimes advertised in order to find buyers† (Hill 2004, 285). By recycling people can minimize the use of raw materials. For instance, plastic, glass, steel and some precious metals such as gold, silver, platinum and palladium can be recycled and reused in industry(Electronics: A new opportunity for waste prevention, reuse, and... ... buy equipment that was made by using recycled materials. To solve the problem of e-waste pollution is not a simple one. It is also necessary, that is why resolution takes a big amount of time for thinking. Reference List: Electronics: A new opportunity for waste prevention, reuse, and recycling. 2001. Environmental protection agency. http://epa.gov (accessed November 8, 2010). Electronics reuse and recycling. 2000. Environmental protection agency. http://epa.gov (accessed November 8, 2010). Hill, M. K. 2004. Understanding environmental pollution: A Primer. 2nd ed. New York: Cambridge University Press. Krikke, J. 2008. Recycling e-waste: The sky is the limit. IT Professional 10(1): 50- 55. McCarthy, M. 2010. The bid question: How big is the problem of electronic waste, and can it be tackled. The Independent, February 24.

Analyses on Different Recruitment and Selection Approaches

Analyses on different recruitment and selection approaches and case study Abstract This report introduces several methods recruitment and selection approaches in HRM and discussed their advantages and disadvantages, as well as cultural differences. While external recruitment is applied widely, internal recruitment is better used in large scaled companies. Personal reference can be applied in emergency situation regardless of its drawbacks. 1. 0. Introduction The importance of recruitment and selection cannot be overstated. The recruitment and selection policies and practices can be perceived as integral.Recruitment and selection not only seek to attract and select applicants for a certain position to achieve the certain objective or strategic goals, but may also have significant influence on the whole composition of the workforce (Beer et al. 1984). There is no perfect recruitment and selection method for every situation. In this report, approaches of recruitment and selection are in troduced and discussed. Recruitment in HRM is defined as â€Å"the different activities of attracting applicants to an organization, and the selection of people to fill vacancies. † (Bloisi, 2007: p. 07) and selection is defined as â€Å"the process ‘by which managers and others use specific instruments to choose from a pool of applicants’† (Bratton and Gold, 2003: p. 221). 2. 0. Analyses on different recruitment and selection approaches In this section, approaches of recruitment and selection are both discussed. Section 2. 1 mainly highlights internal recruitment approaches and cultural differences through the process. Section 2. 2 focuses on some traditional selection approaches and personal reference, illustrating their application, pros and cons. 2. 1. Recruitment approachesRecruitment in HRM includes two important parts: job analysis and person specification. The ultimate target is to combine these two parts, thus selecting the right person for the ri ght position. To accomplish this goal, two basic methods are introduced: internal recruitment and external recruitment. They both have their own pros and cons, and should be carefully applied to different situation. To better analyse the problem, this section only focuses on the methods of internal recruitment approaches. In addition, since the cultural influences on recruitment should never be underestimated especially, arguments are also made in this section.Looking for the right person for a vacancy within company can not only reduce advertisement fees on media, but also provide a good way for current staff to further considering about and acting on their careers in the company, improving their passion for career. The relationship between internal and external recruitment can be viewed in two perspectives: substitute and complementary (Matias-Reche et al. 2006). Today’s large number of staff that are considered as good candidates in internal promotion and reassignment are contingent workers who are initially hired for multiple results.According to studies and research, relationship between the proportion of contingent workers and the level of internalisation of employment practices within company is complementary and positive (Abraham 1990; Gramm and Schnell 2001; Ko, 2003). For these contingent workers, they already had some basic knowledge both for their current job and the company, thus making the further investment and especially trainings fewer, compared with those on a new employee. This advantage is more evident in large scaled companies, since there would be much more rules and standards for operation to learn in big companies (Matias-Reche et al. 006). However, for small companies, the save on further training may not seem evident and the promotion of these contingent workers has possibility of triggering dissatisfaction among current workers, who have managed to enter the company through formal recruitment process. It also reduces the possi bility of outside recruitment, narrowing down the range of choice of HRM. For large scale companies especially international conglomerates, cultural difference should also be taken into accounts in recruiting.Realistic job preview, which has been regarded as one of classical techniques used in recruitment in Western, turned out to be a moderately important one in Taiwan (Hsu and Leat 2000). This fact may result from that in late 1990s, realistic job preview was still new for Taiwanese, and companies were not willing to expose too much and too explicitly about themselves especially those negative information. 2. 2. Selection approaches Traditional selection process include application forms, shortlist, interviewing and etc.These fundamental methods can help HR managers get to know the applicant in a short time. As information is clear, there is no need to consider cultural differences in these processes. However, to cater HR managers’ expectancy, the content in application for m or the answers in interview can be exaggerated by applicants, which can hardly be distinguished immediately. A survey in 1985 showed that over 85% applicants in the USA have ever tried to â€Å"polish† at least one critical item on their CVs (Li 2006). In this way, background investigation can be used to diminish such situation.However, as background investigation can cost a lot manpower and material resources, it’s only preferred in final selection (Li 2006). Interview is one of the most frequent selections in practice. Through observation and communication, HR managers can evaluate the applicant both rationally and emotionally. While questions about applicants can be answered immediately, applicants can get to know the company by asking back, which provide a multi-way communication. However, a well-structured interview requires well preparation and due to limited interviewees at one time, the whole interview can last for a long time.Also, biased opinions may be mad e by interviewers who are inclined to be attracted by certain personal traits, which don’t have much relation to the job requirement. Personal reference is also an efficient way especially when the vacancy is an emergency. The applicant recommended by current staff is usually more acknowledged with the whole situation, job description and proper expectation to the company than an applicant who just â€Å"hears of† the company, which can decrease the length of adaptive phase, being more suitable for emergency.Also, being responsible for the company, the referrer is always cautious and considerate when s/he recommends. However, it also has disadvantages. The authenticity of applicant is not as high as those selected through applicants’ pool, increasing the possibility that the ability of applicant is exaggerated by referrer as a result of personal relationship. Furthermore, the position of referrer is also play an important part in the selection, and even in futur e work, especially when the referrer is in comparatively high position. Problems can appear as the manager of the applicant (future subordinate) has o consider more on punishment or critique for the referrer’s sake. Last, not all positions are suitable to this method. When it comes to managerial and professional recruitment, companies usually prefer to use external recruitment such as advertisement in the media and direct applications more frequently (Hsu and Leat 2000) since the skills and professions can easily be distinguished in those selection process. Culture differences still exist in selection especially in Eastern cultures, where guanxi (a personalized networks of influence) relationship can influence the choice especially for entry-level positions (Fan, 2002). . 0. Reward strategies on real-life job advert 3. 1. Case description In the case, the company is looking for an ideal junior executiv. S/he has to work 37. 5 per week, in which 4 days in PR and 1 day Marketin g, which means that s/he has to be both capable of these two fields. His/her job is to support the Head of PR to increase public awareness and understanding of the organisation as well as assist the Marketing Manager in developing marketing materials and literature . The salary is ? 18,000 per year and base in London. No specific potential career development is mentioned. . 2. Reward strategies For new comers, the most important reward may not have to be material one since most of them are young. Good opportunity and promising future both in promotion in the company and in this working field seem more attractive. Thus, professional work trainings and expected promotion are good rewards. Besides, since this job first requires the staff to do both works in PR and Marketing, the company can offer the free choice of either of these two fields to the staff as a reward after working for a certain period of time.This would not only be beneficial to the staff, but also better for the compan y to develop talent. Also, emergencies and accidents often happen in PR field especially in important events. Rewards can be offered to the staff when the accidents are solved perfectly and more importantly, if s/he finds a perfect way to prevent the accidents from happening again. This evaluation of performance is also in accordance to LeBoeuf (1984)’s ten ways to motivate staffs. The company wish the staff to be able to work during evenings and weekends when it is necessary.As a reward, extra vacations and bonus can be offered according to staff’s performance and the scale of the project. Also, as the staff is supposed to be working overtime, a supplement life insurance and annual physical exam can be provided, as research shows that they are also top choices in rewards and perks (www. hrmguide. com). 4. 0. Conclusion The methods for recruitment and selection should be considered in different situations. Specifically, cultural differences should be taken into conside ration. For entry-level jobs, the material reward is not most important.Leaving more space for the staff to grow and showing respect to his/her choice is also a way of reward. References Abraham, K. G. 1990. , Restructuring the employment relationship: the growth of market-mediated work arrangements, in Abraham, K. G. and McKersie, R. B. (Eds), New Developments in the Labour Market: Toward a New Institutional Paradigm , MIT Press, Cambridge, MA, p 85-120. Beer, M. et al. , 1984. Managing Human Assets, New York: Free Press. Fan, Y. 2002. Guanxi’s consequences: Personal gains at social cost. Journal of Business Ethics, 38 ,p. 371–380 Gramm, C.L. and Schnell, J. F. 2001, The use of flexible staffing arrangements in core production jobs, Industrial and Labour Relations Review 4 (2), p 245-258. Hsu & Leat, M. 2000. A Study of HRM and Recruitment and Selection Policies and Practices in Taiwan. Int. J. of Human Resource Management 11(2) p. 413-435 Ko, J. R. (2003, Contingent and internal employment systems: substitutes or complements?. Journal of Labour Research, 24 (3), p 473-490. Li, D. , 2006. The Recruitment and Selection Methods in HR. Science and Technology Literature Press LeBoeuf, M. , 1984.How to Motivate People. Sidgwick & Jackson Ltd Matias-Reche, F. , & MarFuentes-Fuentes, M. , 2002. The Internal Labour Market and The Employment of Temporary Help Workers in Spain. Personnel Review, 35 (4) p. 378 – 396 Appendix (including job advert) The Sick Children's Trust – PR ; Marketing Junior Executive http://www. graduate-jobs. com/job/the_sick_childrens_trust_pr_and_marketing_ju nior_executive_50615 Salary: ?18,000 Location: London Date posted: 2 November 2012 Job start date: 7-Jan-2013 ————————————————-Application close date: ————————————†”———- 17-Nov-2012 The Sick Children's Trust – PR & Marketing Junior Executive (Four days PR and one day marketing) Hours:  37. 5 per week/FT (Four days PR and one day marketing) Reports to:  Head of PR Job purpose †¢ To support the Head of PR in the development and implementation of a successful media relations programme to increase public awareness and understanding of the organisation †¢ To assist the Marketing Manager in developing marketing materials and literatureResponsibilities †¢ †¢ Assist Head of PR in securing maximum publicity of community events, SCT events, corporate support †¢ Ensure that high quality news releases and statements on the organisation’s activities are researched, produced and disseminated to appropriate media contacts to generate maximum coverage   †¢ Develop and maintain relationships with targeted media contacts †¢ Assist the Head of PR on publicity of national campaigns and fundraising appeals when necessary †¢ Assist on the night of events by assisting Head of PR in o-ordinating press activity and ensure photo-calls are organised where appropriate †¢ When needed assist the Head of PR in rolling out the social media campaign and updating SCT website †¢ Assist Head of PR in celebrity liaison role. †¢ Assist the Marketing Manager on the design and production of marketing materials and literature such as the Direct Mail, Annual Report, Newsletter and charity promotional literature and merchandise. General †¢ Represent the organisation at agreed events organised by the organisation and others e. g. aunches on behalf of the organisation †¢ Build an understanding, as far as possible, of the work, requirements and priorities of the other department teams Administration †¢ Take responsibility for own administration, including filing and handling a range of telephone enquiries †¢ Ensure that The SCT’s internal data base is kept up to date and add media and celebrity contacts according to the database policy †¢ Ensure media/photo consent forms are completed and filed Duties may vary from time to time with development of the post.The post holder will be required to carry out such duties as receiving general telephone enquiries and dealing with general office administration as befits a small office environment. Experience †¢ Degree educated, preferably in relevant subject such as English, Media or Communication Studies (E) †¢ Experience of managing own workload effectively, planning and organising a number of projects at one time to set timescales (E) †¢ Experience of working effectively without close supervision, dealing with problems as they arise (E) †¢ Experience of working in the voluntary sector (D)Abilities ; Skills †¢ Able to produce correspondence and written work using good compositional skills and to produce accurate work to a high standard at all times (E ) †¢ Good oral communication skills (E) †¢ Able to prioritise workload and manage own time effectively to meet deadlines (E) †¢ Can communicate clearly and assertively with a wide range of people at all levels (E) †¢ Ability to generate and identify hard news angles and react where possible (D) †¢ Ability to think creatively (D) Ability to develop and maintain sensitivity, respect and understanding of people linked with the organisation (E) †¢ Uses initiative to perform tasks well and demonstrate pro-active thinking(E) †¢ Work as part of a Team (E) Knowledge †¢ Kowledge of Microsoft Office software in particular, Word, PowerPoint, Excel and Outlook, In-design, PR Max and Photoshop (E) †¢ Good working knowledge of how the media works, including social media (E) †¢ Good working knowledge of marketing (E)Education/Training †¢ Educated to A Level standard at least including English (E) †¢ A journalistic qualification would be a n advantage (D) Other Requirements †¢ Able to work evenings and weekends when necessary (D) †¢ Commitment to work within the principles of the equal opportunities policy (E) †¢ Results orientate approach to working (E) †¢ Represent The SCT according to the values of the organisation (E)