Critical Incident

Rich & Parker 2001 defines critical incidents as snapshots of something that happens to a patient, their family or healthcare professional. It may be something positive, or it could be a situation where someone has suffered in some way. Reflecting on critical incidents will allow me to explore and analyse incidents and how it has affects me and what I hope to do with these effects in the course of my training towards becoming a registered practitioner. It also gives me the opportunity of changing my way of thinking or practice, as I learn valuable lessons when I reflect on an incident. This helps me to develop self-awareness and skills in critical thinking and problem solving (Rich & Parker 2001). On the other hand, Johns 2003 defines reflection as â€Å" being mindful of self, either within or after an experience, as if a window through which the practioners can view and focus self within the context of a particular experience, in order to confront, understand and move towards resolving contradiction between one’s vision and actual practice†. I will be using the Beckwith model of reflection which states clearly that reflection is a tool to deal with challenges that will influence the speed and amplitude of one’s development, to explore these effects in other to understand and learn from this incident, with the hope of improving my practice (Beckwith & Beckwith 2007). The incident I will be reflecting upon occurred while attending a clinical placement in the critical care unit at my placement hospital which for the purpose of this essay will be referred to as X Hospital. Critical Care is the multi-professional healthcare specialty that cares for patients with acute, life-threatening illness or injury, (Sheppard & Wright 2005). Critical care can be provided wherever life is threatened. Critical care provided at the scene of an accident or in an ambulance is basic life support. Basic life support is the emergency treatment of any condition where the brain stops receiving adequate oxygen; it could be a cardiac or respiratory arrest, (Kumar). A cardiac arrest is one where there is no pulse and is unlikely the patient will recover with basic life support alone but advanced life support with a defibrillator is required. It is important to carry out basis life support until defibrillator arrives even after careful assessment one discovers it’s a cardiac arrest, as one usually leads to the other, (Kumar). The importance of recognizing, assessing and reacting to cardiorespiratory arrest is very important. Immediate response increases the chances of a successful outcome, (Davey and Ince). Shostek says critical care in a hospital setting is provided by multi-professional teams of highly experienced and professional personnel who use their unique expertise and ability to interpret important therapeutic information, manage highly sophisticated equipment and provide care that leads to the best outcome for the patient. Patients are usually admitted from the emergency room or surgical area where they are first given care and stabilized to CCU, (NHS Careers). The management of the critically ill patient ranges from eye care(Appendix 1), oral care(Appendix 2), infection control, health and safety issues, tissue viability among other vital issues like care bundles for this high risk group of patients who are dependent these care to maintain integrity and dignity according to trust policy. Suction pumps are also vital in the critical care setting as airway hygiene is impaired in critically ill patients as a result of depressed cough reflex and ineffective mucociliary clearance from sedation, high inspired oxygen concentrations, elevated endotracheal tube cuff pressure, and tracheal mucosal inflammation and damage, (X Hospital Policy). Due to this, care of intubated patients includes tracheal suctioning to facilitate the removal of airway secretions (suction therapy) is carried out on all unconscious patient, as it maintains airway patency and prevents pulmonary infection, (X Hospital Policy). A tube or catheter is passed down inside the endotracheal tube and attached to a suction pump, the size of the catheter must be chosen carefully using a simple formula of doubling the size of ET tube minus 2. One should be careful to suction on withdrawal using a suction pressure that is appropriate. Suction depth varies depending on the size of the trachea tube hence suction can be shallow, pre-measured and deep suctioning. Despite the importance of suctioning some complications like hypoxia, cardiac arrhythmias, hypotension, tracheal trauma, laryngospasm and bronchoconstriction are associated with it. Hence tracheal suctioning of intubated patients should be performed on a when needed basis defined by the quantity of secretions obtained, not at prescribed, set intervals, (X Hospital Policy). The incident I will be reflecting on is about a Twenty-Nine-year-old male admitted to the critical care unit with a closed head injury sustained in a motor vehicle accident. His young wife, parents and other family members faced real fears. Most of the family members had never been inside a critical care unit, and found the array of pumps, tubes, machines, monitors and lines, as well as the rush of staff members overwhelming. Just by looking at them and watching their reaction each time they come visiting was enough to tell me how scared and worried they were of their son’s illness and the environment they were in. I started to wonder what was going on in their minds and was drawn to them not only for this reason but because the patient and his family members were the youngest I ever saw in the unit. I was thinking to myself if they have asked questions or done any research about CCU they will most likely be thinking their son’s situation is hopeless. It is important to label and date all the lines as this helps to know what each is used for and how long it has been in situ for. Also care should be taken when moving patients to ensure the stay in place as it can be very uncomfortable and difficult to reinsert a cannula on a patient as most of them are oeadematous. As I was involved in the care of the patient I had to explain to the wife why her husband was connected to a ventilator and it use. A ventilator is an artificial breathing machine that moves oxygen-enriched air in and out of your lungs. If your lungs have failed and you cannot breathe on your own, you will need to be attached to a ventilator (See appendix 3). Being helped to breathe by a ventilator means that you will usually need to be sedated. Ventilators can offer different levels of breathing assistance. If you only need help breathing for a couple of days, it is likely you will have an endotracheal tube from the ventilator to your mouth or nose. The tube will usually be held in place behind your neck as was the case with my patient. However, if you need help with breathing for more than a few days, you may have a short operation called a tracheostomy. This replaces the tube in your mouth with a shorter tube that is placed directly into your trachea. As well as being more comfortable, a tracheostomy makes it easier to keep your lungs clean, and usually requires less sedation. There are two kinds of ventilators, negative pressure and positive pressure. Negative pressure ventilators are not commonly in use today. In my trust we have only the positive pressure ventilators. Mode of ventilation should be tailored to the needs of the patient. Understanding these settings is important as they may need to be changed quickly. Once my patient’s next of kin fully understood the treatment he was receiving I could see this young lady’s face soften a bit. I later learnt from my conversations with her that their 5years-old daughter, had been in the back seat with him when the accident occurred. She had not slept properly since the incident, expressing that she was afraid he would â€Å"never come home. † She has continually asked her mother and grand parents, â€Å"When is daddy coming back home? † The 5-year-old girl would not enter the parents’ bedroom at home and insisted that the light remain on and has refused to take her bath as her dad always gave her a bath each evening. From this conversation I concluded that this little girl needed to see, touch, smell and be with her dad to understand what had happened. I believe that she needs to be allowed to grieve and participate in the healing process surrounding her dad’s trauma. However, there were barriers, because our institution’s written policy was to not allow anyone under the age of 12 to visit patients even though the majority of published studies evaluating family member presence in surgery have shown the positive effect it has on family members irrespective of their age, (Kingsnorth et al 2010). Some of these benefits included removing the family’s doubt about the patient’s situation and allowing them to see that everything possible is being done in caring for that patient, reducing their anxiety and fear about what is happening to their loved one, maintaining the family need to be together even at this time. In addition, when and if death occurred, families have reported that their presence gave them a sense of closure and facilitated the grief process, (Kingsnorth et al 2010). With this information I spoke with my mentor and she agreed how awful it must be for her and promised to look into it. Three days after the accident, my mentor came to me and said they have come up with something that will help this young family and asked if I wanted to be involved with it, I said yes. We approached our patient’s family about scheduling an educational conference for the family. We agreed to include aunts, uncles, grandparents a young niece and two nephews. There were fears about how the children will handle the information but the adults were advised that, if the children exhibited fear or discomfort, they can be allowed to leave the conference room. At the conference, I sat with the children at the table and provided them with crayons and paper. Drinks and cookies were available. I was glad the atmosphere was gentle, quiet, comfortable and conducive to learning. We began the session by discussing definitions of grief, mourning, loss and coping. The adults agreed that this was the first trauma in the family and were giving the children explanations such as â€Å"God may take him† and â€Å"Dad may never wake up. †It was now time to listen to the children. They were asked to talk about a time when they had been sick. We went over what each part of the anatomy did and how they worked together. The children were asked to draw picture of what they understand of the discussion, drew pictures of lungs, a heart, a brain and a rib cage. When the patient’s daughter drew her Dad, she placed wires and tubes in his organs. At this stage I could see that the little girl now understands what had happened to her Dad. The adults who previously did not fully understand the injury to their son appreciated the education. The patient’s young wife had her eyes full of tears but I saw relief on her face regardless. As the clinical picture becomes clearer, the little girl asked if she could see her dad. All agreed this might be beneficial. Now we were confronted with the hospital policy prohibiting children in the critical care unit. The sisters spoke among themselves. I was praying silently that they can make an exception here. It is believed that every patient should be treated as an individual and critical care involves the care of family members as well (Kingsnorth et al 2010). I was glad when the sister came back and asked the patient’s wife to take her daughter to the ICU door, while all the staffs were informed of the plan. The decision was to allow the young daughter to see her dad and hospital policy was explained again, they all understood and were evidently glad like I was. The daughter entered the unit with wide eyes and stood at her dad’s bedside, where she was told about every tube and its purpose. The little girl took her dad’s hand and cried, as did the entire staff. Except for the hum of ventilators, the unit was quiet as the little girl held hands with her father, stroked his hair, sang him a song and said goodnight with prayers. I savored this moment as I realized it was an important journey in the little girl’s life. As a student I concluded that surely there can be nothing superior to this type of care giving. Through out the lecture I couldn’t help but think that God forbid if this was me or my family member I would hope for a care team as nice and understanding as these ones looking after my family. I imagined if these were my children I sure would want them to understand what is happening and to be able to confront it if they want to and what better way to do this. Following the visit, we were told how the little girl had become more agreeable at home. She says â€Å"I have to keep things in order until Dad comes home. † Making a difference is what care exemplifies, particularly when the art of humanity in a technologically driven healthcare system is advocated, (NHS Careers). I truly agree with this statement. For me the critical environment was a different setting and honestly I believe there can be no other like it. It is a very emotional setting that requires strong willed people yet competent in their jobs as well as having a heart full of love to care for their patient and family members. This is an experience that will stay with me throughout my career and influence me in a positive way as I can clearly understand that delivering quality care goes beyond what is done for the patient but for family members around as well. In my trust eye care is recognized as a basic nursing care procedure required by critically ill patients to prevent complications such as eye infections or injury. This care involves regular eye assessment on each patient in the ward to ensure that all patients receive individualized evidence based eye care which ranges from no action required to hydration treatment with and sterile water to a more complex treatment prescribed by a doctor. If hydration or cleaned care is taken to wipe from the nasal corner outwards starting with the lower lids using a different wipe or gauze each time. If there is an infection the non-infected eye should be cleaned first. Sometimes a bacteria barrier cream may be applied if the doctors deem it necessary, (X Hospital Trust Policy). Appendix 2- Oral Care Similarly, all critical ill patients who are intubated receive individualized evidence based mouth care. All orally intubated patients will have moisture, integrity and cleanliness of all oral surfaces. Intubated patient are especially vulnerable to complications if inadequate oral care is practiced. Also there are many factors that pose as barriers to carrying out effective oral care such as: difficulty to access oral cavity, changes in mucosa and normal bacteria flora of the mouth, immunocompromise and medication, presence of endotracheal tubes, oral suctioning and therapeutic dehydration. Based on the above, assessment is carried out daily using the Eilers assessment guide. Whatever the outcome of this assessment oral care on all critically ill patients on a daily basis involves using a soft tooth brush and toothpaste every 12hours in a circular stroke away from the gums, cleaning the tongue and inside of the cheeks. A through rinse using a syringe and gentle suction to remove secretions thereby minimizing trauma to soft tissues in the mouth. Foam sticks and sterile water can be used in cases of extreme dryness as it’s is effective for moistening oral cavity. Soft paraffin can also be used to prevent lips from cracking. Dentures are usually removed and cared for till when patient needs it, (X Hospital Trust Policy). Appendix 3 – Understanding ventilators settings Tidal volume This is the lung volume representing the normal volume of air displaced between normal inspiration and expiration with no extra effort. Typical values are around 500ml or 7ml/kg. To avoid adverse effects of barotrauma and volutrauma it is recommended to use lower tidal volumes. An initial TV of 5-8 mL/kg of ideal body weight is generally indicated. The goal is to adjust the TV so that plateau pressures are less than 35 cm H2 O. Continuous mandatory ventilation (CMV) Breaths are delivered at preset intervals, regardless of patient effort. This mode is used most often in the paralyzed patient because it can increase the work of breathing if respiratory effort is present. CMV has given way to assist-control (A/C) mode. Many ventilators do not have a true CMV mode and offer A/C instead. Assist-control ventilation The ventilator delivers preset breaths in coordination with the respiratory effort of the patient. With each inspiratory effort, the ventilator delivers a full assisted tidal volume. Spontaneous breathing is not allowed. This mode is better tolerated than CMV in patients with intact respiratory effort. Intermittent mandatory ventilation With intermittent mandatory ventilation (IMV), breaths are delivered at a preset interval, and spontaneous breathing is allowed between ventilator-administered breaths. Spontaneous breathing occurs against the resistance of the airway tubing and ventilator valves, which may be formidable. This mode has given way to synchronous intermittent mandatory ventilation (SIMV). Synchronous intermittent mandatory ventilation The ventilator delivers preset breaths in coordination with the respiratory effort of the patient. Spontaneous breathing is allowed between breaths. These modes are beneficial for patients who require high minute ventilation. Full support reduces oxygen consumption and CO2 production of the respiratory muscles. A potential drawback of A/C ventilation in the patient with obstructive airway disease is worsening of air trapping and breath stacking. Pressure support ventilation For the spontaneously breathing patient, pressure support ventilation (PSV) has been advocated to limit barotrauma and to decrease the work of breathing. Pressure support differs from A/C and IMV in that a level of support pressure is set (not TV) to assist every spontaneous effort. Airway pressure support is maintained until the patient's inspiratory flow falls below a certain cutoff. PSV is frequently the mode of choice in patients whose respiratory failure is not severe and who have an adequate respiratory drive. It can result in improved patient comfort, reduced cardiovascular effects, reduced risk of barotrauma, and improved distribution of gas. CPAP is an acronym for â€Å"continuous positive airway pressure†, a variation of the PAP system. Respiratory rate A respiratory rate (RR) of 8-12 breaths per minute is recommended for patients not requiring hyperventilation for the treatment of toxic or metabolic acidosis, or intracranial injury. High rates allow less time for exhalation, increase mean airway pressure, and cause air trapping in patients with obstructive airway disease. The initial rate may be as low as 5-6 breaths per minute in asthmatic patients when using a permissive hypercapnia technique. Positive end-expiratory pressure Positive end-expiratory pressure (PEEP) is a term used in mechanical ventilation to denote an airway pressure that is kept above atmospheric pressure at the end of the expiratory cycle. The equivalent in a spontaneously breathing patient is CPAP. One obvious beneficial effect of PEEP is to shift lung water from the alveoli to the perivascular interstitial space. It does not decrease the total amount of extravascular lung water. This is of clear benefit in cases of cardiogenic as well as noncardiogenic pulmonary edema. An additional benefit of PEEP in cases of CHF is to decrease venous return to the right side of the heart by increasing intrathoracic pressure. References Amitai, A. and Kulkarni, R. Medscape (2010), Ventilator Management. Available at: http://emedicine. medscape. com/article/810126-overview,assessed on 13/03/11 Beckwith, M. A. R. ; Beckwith, P. T. (2008) â€Å"Reflection or Critical Thinking? : A pedagogical revolution in North American health care education†. Refereed Program of the E-Leader Conference at Krakow, Poland, Chinese American Scholars Association, New York, New York, USA June 2008, Courey, A. J. and Hyzy, R. C. Up to date 19. 1(2010) Over view of mechanical ventilation. Availableat: http://www. uptodate. com/contents/search? earch=ventilators&source=USER_INPUT&searchOffset=assessed on 13/03/2011 Hatfield A, Tronson M, (2009), The Complete Recovery Book, 4th edn. New York: Oxford University Press. Chapter 2, Page 29. Johns, C. (2004) Becoming a Reflective Practitioner, 2nd edn. UK: Blackwell Publishing Ltd. Kingsnorth, J. , O’Connell,K. , Guzzetta, C. E. , Edens, J. C Atabaki, S. Mecherikunnel, A. and Brown, K. (2010) Journal of Emergency Nursing: Family Presence During Trauma Activations and Medical Resuscitations in a Paediatric Emergency Department: An Evidence-Based Practice Project,36/2,pp115 NHS Careers (2009) Operating Department Practice. Available at: http://www. nhscareers. nhs. uk/details/Default. aspx? Id=255 (assessed 11/03/2011) Pirret, M. (2002) Utilizing TISS to differentiate between intensive care and high-dependency patients and to identify nursing skills requirements. Intensive and Critical Care Nursing. 18(1) pp. 19-26. Rich, A. and Parker, D. L. (1995) Reflection and critical incident analysis: Ethical and moral implications of their use within nursing and midwifery education, Journal of Advanced Nursing 22(6): 1050-1057 Sheppard, M & Wright, M (2005) Principles and practice of High Dependency Nursing. nd ed. Philadelphia. Bailliere, Tindall Elsevier. The Intensive Care Society (2010) An Introduction to intensive care medicine for junior doctors [Online] Available from: http:/ /www. ics. ac. uk/education/2010_trainee_handbook: Accessed 19 January 2011. Unknown Author (2006) Eye care for critically ill patients, X Hospital Policy. Unknown Author (2006) Mouth care for intubated patients, X Hospital Policy.

Mr. Chiu Saboteur by Ha Jin

Mr. Chiu Saboteur by Ha Jin Introduction Ha Jin is a Chinese novelist currently living in the US and the author of the book Saboteur. Saboteur is about a young man, Mr. Chiu (34 years old) living under the times when China is under Cultural Revolution. Due to unfair reasons, he is taken in as a prisoner while on his honeymoon. To secure his freedom, the bureau chief forces him to sign a fake statement. He signs the document reluctantly mainly because he is suffering from acute hepatitis and needs urgent medical attention.Advertising We will write a custom essay sample on Mr. Chiu: Saboteur by Ha Jin specifically for you for only $16.05 $11/page Learn More The Imprisonment of Mr.Chiu Mr.Chiu is newly married and out for his honeymoon. One day while having lunch at a restaurant with his wife, a police officer accidentally splashes tea on them. Instead of being apologetic, he acts rudely and discourteously accusing Mr.Chiu of undermining him and therefore, Mr. Chiu is under arrest. Unfort unately, Mr. Chiu arrest is due to false allegations. When he reaches the police station, none of the police officers including their chief officer listens to him; instead, they lock him up in a cell exposing a society full of injustices and oppression. This parallels the contemporary world, full of injustices and mistreatments perpetrated especially by the police force and the judicial systems that are full of corruption and impunity. Ironically, the people who are supposed to protect citizens violate the very rights they should be protecting. While in police cell, a false evidence report is prepared accusing Mr. Chiu of being a nuisance to the public and lack of respect to police officers. The chief officer orders Mr. Chiu to admit his misdeeds and sign a confession. However, when Mr. Chiu realizes his arrest is due to his affiliation to the communist party, he declines their order. Unfortunately, whilst in the cell, Mr. Chiu suffers hepatitis, which devolves his health for he can not access health services. Unluckily it is during the weekend hence no medical attention to the inmates but he hopes the University will come to his rescue. On Monday morning, the university sends Fenji to secure the release of Mr. Chiu. Unfortunately, his rescuer is cuffed to a tree killing his hopes. In addition, one of the police officers heartlessly tortures Fenji as Mr. Chiu watches. The police officers are a symbolic nature of those in power and authority in the present society (Esherick, Pickowicz, and Walder 7). There is lack of humanity, respect, freedom of speech and expression as experienced by Fenji and Mr. Chiu. Likewise, the current leaders especially those in power are oppressive and sometimes they care less about human rights. On the other hand, there are poor health and welfare policies for citizens or those in correction centers.Advertising Looking for essay on literature languages? Let's see if we can help you! Get your first paper with 15% OFF L earn More Finally, Chiu surrenders to the demands of bureau chief securing his freedom and that of Fenji. However, he is full of revenge to destroy the police force. Although he knows he is suffering from hepatitis, a contagious disease, he eats in different cafeterias and touches food allover to spread hepatitis. He succeeds in his revenge mission for the disease infects around 800 people and kills six of them. This is an irony because as a university lecturer, Mr. Chiu spreads hepatitis yet he knew it is contagious, therefore infecting innocent people. Currently In the society, there are people who are out to destroy innocent souls either knowingly or unknowingly just like Mr. Chiu. Conclusion Mr.Chiu finds himself in prison unfairly courtesy of a disrespectful police officer. The chief officer backs up his junior officer and even goes ahead to harass Fenji who had come to secure his release. In summary, at last, Chiu acquires his freedom but his human rights are violated because he is suffers hepatitis. The story draws parallels in the contemporary society. Mr.Chiu represents people experiencing inhuman acts by security personnel in charge of their safety. On the other hand, the bureau chief is a symbol of corrupt officers and leaders in the contemporary society. Esherick, Joseph, Pickowicz, Paul, and Walder, Andrew. The Chinese Cultural  Revolution as History. Stanford: Stanford UP, 2006. Jin, Ha. Saboteur: The Story and Its Writer. Ed. Ann Charters. Boston: Bedford/St. Martin’s, 2007.

How to Get to Know Your College Professors

How to Get to Know Your College Professors You may be totally intimidated by your professors, or you may be eager to meet them but not know what to do first. Its important to remember, however, that most professors are professors because they like teaching and interacting with college students. Knowing how to get to know your college professors might just end up being one of the most rewarding skills you learn during your time in school. Go to Class  Every  Day Many students underestimate the importance of this. True, in a lecture hall of 500 students, your professor may not notice if youre not there. But if you are, your face will become familiar if you can make yourself noticed a bit. Turn In Your Assignments on Time You dont want your professor to notice you because youre always asking for extensions and turning things in late. True, he or she will get to know you, but probably not in the way you want. Ask Questions and Engage in Class Discussion This can be an easy way to have your professor get to know your voice, face, and name. Of course, only ask questions if you have a legitimate question (versus asking one just for the sake of asking) and contribute if you have something to say. Chances are, however, that you have plenty to add to a class and can use that to your advantage. Go to Your Professors Office Hours Stop in to ask for help with your homework, ask for advice on your research paper, ask your professors opinion about some of the research he is doing, or on the book theyre talked about writing. You can even stop in to invite him or her to your poetry slam next week! While you may at first think theres nothing to talk to a professor about, there are, in fact, lots of things you can discuss with your professors. And having a one-on-one conversation is perhaps the best way to start to build a connection! See Your Professor Speak Go to an event where your professor is speaking or to a meeting for a club or organization your professor advises. Your professor is most likely involved in things on campus other than just your class. Go hear him or her lecture and stay afterward to ask a question or thank them for the speech. Ask to Sit In on Another of Your Professors Classes If youre trying to get to know your professor- for a research opportunity, for advice, or just because he or she seems really engaging- you most likely are interested in similar things. If they teach other classes that you might want to take, ask your professor if you can sit in on one of them this semester. It will indicate your interest in the field; additionally, it will lead to a conversation about why youre interested in the class, what your academic goals are while youre at school, and what interested you in the topic in the first place.

Case study Report Essay Example | Topics and Well Written Essays - 2000 words

Case study Report - Essay Example This globalization develops a significant test to service providers like PwC: the manner in which to arrive at the needed degree of international co-ordination of the efforts of 160,000 individuals globally without reducing the firm’s receptiveness locally in 150 countries where PwC operates. Human resource management as well as management development specifically play a vital role. This issue is significantly compounded since PwC is a firm where most of the workforce has the capability to advance to management positions, even though only a limited number have the aim, prospect or chance to actually get there. Many junior staff members could have joined the management development or trainee program of another large organization but at PwC, managers as well as those who wish to become managers are a majority when all the staff is considered. Conversely, PwC has global management positions that are supposed to be filled. Internationalization has always been an intricate tactical problem and continues to be so for PwC and on the contrary, the huge dimension of local markets demands for progressive watchfulness and suppleness locally. On the contrary, the continued existence of the firm is dependent on its capability to arrive at global synergy in dealing with big global customers. A lot of literature has been written to date concerning the internationalization of HRM and many models created to address the dissimilarities and resemblance in several forms of global human resource management. These models are founded on the boundaries to which one or more national cultures are involved with the global HRM (Perlmutter, 1969) while the boundaries to which either one international HRM policy is sought or many local centers are employed (Adler and Ghadar, 1990). Party to the internationalization procedures of the heritage of Coopers & Lybrand, all these models proved insufficient to act as a principle for arriving at the needed

Mountaintop Removal Coal Mining Essay Example | Topics and Well Written Essays - 2000 words

Mountaintop Removal Coal Mining - Essay Example The first process of this heavily mechanized mining method is clearing of any vegetation in the site, and then powerful explosives are deployed turning the immediate surface weak thus making it easy for powerful machines to dig through it. Big trucks are continuously being filled with earth debris which is constantly taken away from the site. Then a powerful machine known as the dragline digs through the rocks to expose the coal deposits. Finally, giant machines scoop the coal and deposit the load on waiting trucks for transportation (Perks 2). This mining method is actively taking place in the Central Appalachia region spanning across four states that include, Tennessee, Virginia, West Virginia and Kentucky in Central America (Perks 2). A continuous increase in electricity demand and a reduction in the once easily accessed coal has led to the ever increasing coal mines in the Central Appalachian mountain tops. This has resulted to the destruction of mountaintops in the hundreds thus loosing the beauty they once possessed since the land is left bare with little or no vegetation. Many environmental organizations’ have called to the immediate halt of this mining method since they argue it poses eminent danger to the environment and to the wellbeing of the surrounding communities. The environmental implications brought about by this economic activity cannot be understated. The damage that has been caused by the mountaintop removal coal mining method on the water bodies, the wildlife and the forest cover around the Central Appalachian mountaintops has led to a disrupted ecosystem (Perks 2). From the cleared forest cover to the disposal of waste and debris into the neighboring valleys, the environmental degradation of the Central Appalachian region has been on a steady rise.... This valley fills become large expanses of barren land, which because of their toxic nature it becomes impossible to develop. Mining companies do not embark on reforestation exercises as required by law and instead plant non native grass to replace the forest of hardwoods that was once present (Perks 4). The remaining waterways that are not entirely blocked by the mine valley fills run the risk of being heavily polluted. The toxic nature of these valley fills makes the water streams that run from them carry toxic chemicals and trace metals that are not only harmful to the aquatic life, but also to the surrounding wildlife and human population (Perks 3). EPA estimates that over 60% of the streams located in the Central Appalachian region are compromised by the hazardous amount of toxic chemicals and heavy metals. A study done by the EPA has found levels of magnesium, calcium, manganese, dissolved solids and water hardness have increased significantly, thus greatly compromising the qua lity of the water to any life form around the area (Perks 3). Apart from the solid waste that create valley fills, the liquid waste that is created by water that is used to wash the coal for impurities so that it can be ready for the market. The liquid waste is a mixture of carcinogenic chemicals, small particles of coal that contain mercury and arsenic which are considered harmful heavy metals and all other chemical compounds found in coal (Chhotray 5). Liquid waste from the mining process is put in storage in an enormous, risky impoundment that is usually located near a water body. Backwater spills that frequently occur from these

THE STOCK MARKET GAME Assignment Example | Topics and Well Written Essays - 750 words

THE STOCK MARKET GAME - Assignment Example With the steady growth of the American economy (Hafer and Scott 07), Kraft foods will continue its rise to be one of the greatest food companies the world has known. I have owned this stock several times before and it’s tried and tested record gives me no reason to leave it since it is an industry leader. Its competitors are either short of ideas or just a level below it since they don’t have a complete package that can pose a serious challenge to Kraft foods. Currently there seems to be nothing hindering the success of the company from the inside. The company has survived the high competition from the many upcoming companies in the past decade and remained on top of the industry just as it joined years back. Unilever is a globally recognized company with over 400 brands under its belt (â€Å"Introduction to Unilever†1). All the 400 brands focus on the good health of the company’s customers and their well being as well. With such a wide range of products, Unilever touches the lives of people in several different ways. Their products range from nutritious foods to generous ice creams, soaps, and household products. They produce brands that lead the markets like Omo, Knorr, Axe, Lipton and Dove. They also produce locally trusted names like blue band, Suave and Pureit. Unilever’s products are consumed worldwide in over 190 countries. Its products are consumed by two billion people every single day. In the recent year, they recorded a growth in sales of 6.5%. Emerging markets contributed to almost 55% of their business. The company has a stable expansion plan as shown with its rapid growth and acquisitions like Alberto Culver which was their biggest in a decade increased their turnover by more than 1% in the past year. Unilever is a market leader and because of the high standards that it maintains in the market,

The Taguchi Methods for Quality Improvement

The Taguchi Methods for Quality Improvement INTRODUCTION: Taguchi methods are statistical methods developed by Genichi Taguchi to improve the quality of manufactured goods, and more recently also applied to, engineering, biotechnology, marketing and advertising. Professional statisticians have welcomed the goals and improvements brought about by Taguchi methods, particularly by Taguchis development of designs for studying variation, but have criticized the inefficiency of some of Taguchis proposals. Taguchis work includes three principal contributions to statistics: A specific loss function see Taguchi loss function; The philosophy of off-line quality control; and Innovations in the design of experiments. Loss functions Loss functions in statistical theory Traditionally, statistical methods have relied on mean-unbiased estimators of treatment effects: Under the conditions of the Gauss-Markov theorem, least squares estimators have minimum variance among all mean-unbiased estimators. The emphasis on comparisons of means also draws (limiting) comfort from the law of large numbers, according to which the sample means converge to the true mean. Fishers textbook on the design of experiments emphasized comparisons of treatment means. Gauss proved that the sample-mean minimizes the expected squared-error loss-function (while Laplace proved that a median-unbiased estimator minimizes the absolute-error loss function). In statistical theory, the central role of the loss function was renewed by the statistical decision theory of Abraham Wald. However, loss functions were avoided by Ronald A. Fisher.[6] Taguchis use of loss functions Taguchi knew statistical theory mainly from the followers of Ronald A. Fisher, who also avoided loss functions. Reacting to Fishers methods in the design of experiments, Taguchi interpreted Fishers methods as being adapted for seeking to improve the mean outcome of a process. Indeed, Fishers work had been largely motivated by programmes to compare agricultural yields under different treatments and blocks, and such experiments were done as part of a long-term programme to improve harvests. However, Taguchi realised that in much industrial production, there is a need to produce an outcome on target, for example, to machine a hole to a specified diameter, or to manufacture a cell to produce a given voltage. He also realised, as had Walter A. Shewhart and others before him, that excessive variation lay at the root of poor manufactured quality and that reacting to individual items inside and outside specification was counterproductive. He therefore argued that quality engineering should start with an understanding of quality costs in various situations. In much conventional industrial engineering, the quality costs are simply represented by the number of items outside specification multiplied by the cost of rework or scrap. However, Taguchi insisted that manufacturers broaden their horizons to consider cost to society. Though the short-term costs may simply be those of non-conformance, any item manufactured away from nominal would result in some loss to the customer or the wider community through early wear-out; difficulties in interfacing with other parts, themselves probably wide of nominal; or the need to build in safety margins. These losses are externalities and are usually ignored by manufacturers, which are more interested in their private costs than social costs. Such externalities prevent markets from operating efficiently, according to analyses of public economics. Taguchi argued that such losses would in evitably find their way back to the originating corporation (in an effect similar to the tragedy of the commons), and that by working to minimise them, manufacturers would enhance brand reputation, win markets and generate profits. Such losses are, of course, very small when an item is near to negligible. Donald J. Wheeler characterised the region within specification limits as where we deny that losses exist. As we diverge from nominal, losses grow until the point where losses are too great to deny and the specification limit is drawn. All these losses are, as W. Edwards Deming would describe them, unknown and unknowable, but Taguchi wanted to find a useful way of representing them statistically. Taguchi specified three situations: Larger the better (for example, agricultural yield); Smaller the better (for example, carbon dioxide emissions); and On-target, minimum-variation (for example, a mating part in an assembly). The first two cases are represented by simple monotonic loss functions. In the third case, Taguchi adopted a squared-error loss function for several reasons: It is the first symmetric term in the Taylor series expansion of real analytic loss-functions. Total loss is measured by the variance. As variance is additive (for uncorrelated random variables), the total loss is an additive measurement of cost (for uncorrelated random variables). The squared-error loss function is widely used in statistics, following Gausss use of the squared-error loss function in justifying the method of least squares. Reception of Taguchis ideas by statisticians Though many of Taguchis concerns and conclusions are welcomed by statisticians and economists, some ideas have been especially criticized. For example, Taguchis recommendation that industrial experiments maximise some signal-to-noise ratio (representing the magnitude of the mean of a process compared to its variation) has been criticized widely. Off-line quality control Taguchis rule for manufacturing Taguchi realized that the best opportunity to eliminate variation is during the design of a product and its manufacturing process. Consequently, he developed a strategy for quality engineering that can be used in both contexts. The process has three stages: System design Parameter design Tolerance design System design This is design at the conceptual level, involving creativity and innovation. Parameter design Once the concept is established, the nominal values of the various dimensions and design parameters need to be set, the detail design phase of conventional engineering. Taguchis radical insight was that the exact choice of values required is under-specified by the performance requirements of the system. In many circumstances, this allows the parameters to be chosen so as to minimise the effects on performance arising from variation in manufacture, environment and cumulative damage. This is sometimes called robustification. Tolerance design With a successfully completed parameter design, and an understanding of the effect that the various parameters have on performance, resources can be focused on reducing and controlling variation in the critical few dimensions (see Pareto principle). Design of experiments Taguchi developed his experimental theories independently. Taguchi read works following R. A. Fisher only in 1954. Taguchis framework for design of experiments is idiosyncratic and often flawed, but contains much that is of enormous value. He made a number of innovations. Outer arrays Taguchis designs aimed to allow greater understanding of variation than did many of the traditional designs from the analysis of variance (following Fisher). Taguchi contended that conventional sampling is inadequate here as there is no way of obtaining a random sample of future conditions.[7] In Fishers design of experiments and analysis of variance, experiments aim to reduce the influence of nuisance factors to allow comparisons of the mean treatment-effects. Variation becomes even more central in Taguchis thinking. Taguchi proposed extending each experiment with an outer array (possibly an orthogonal array); the outer array should simulate the random environment in which the product would function. This is an example of judgmental sampling. Many quality specialists have been using outer arrays. Later innovations in outer arrays resulted in compounded noise. This involves combining a few noise factors to create two levels in the outer array: First, noise factors that drive output lower, and second, noise factors that drive output higher. Compounded noise simulates the extremes of noise variation but uses fewer experimental runs than would previous Taguchi designs. Management of interactions Interactions, as treated by Taguchi Many of the orthogonal arrays that Taguchi has advocated are saturated arrays, allowing no scope for estimation of interactions. This is a continuing topic of controversy. However, this is only true for control factors or factors in the inner array. By combining an inner array of control factors with an outer array of noise factors, Taguchis approach provides full information on control-by-noise interactions, it is claimed. Taguchi argues that such interactions have the greatest importance in achieving a design that is robust to noise factor variation. The Taguchi approach provides more complete interaction information than typical fractional factorial designs, its adherents claim. * Followers of Taguchi argue that the designs offer rapid results and that interactions can be eliminated by proper choice of quality characteristics. That notwithstanding, a confirmation experiment offers protection against any residual interactions. If the quality characteristic represents the energy transformation of the system, then the likelihood of control factor-by-control factor interactions is greatly reduced, since energy is additive. Inefficencies of Taguchis designs * Interactions are part of the real world. In Taguchis arrays, interactions are confounded and difficult to resolve. Statisticians in response surface methodology (RSM) advocate the sequential assembly of designs: In the RSM approach, a screening design is followed by a follow-up design that resolves only the confounded interactions that are judged to merit resolution. A second follow-up design may be added, time and resources allowing, to explore possible high-order univariate effects of the remaining variables, as high-order univariate effects are less likely in variables already eliminated for having no linear effect. With the economy of screening designs and the flexibility of follow-up designs, sequential designs have great statistical efficiency. The sequential designs of response surface methodology require far fewer experimental runs than would a sequence of Taguchis designs.[ TAGUCHI METHODS There has been a great deal of controversy about Genichi Taguchis methodology since it was first introduced in the United States. This controversy has lessened considerably in recent years due to modifications and extensions of his methodology. The main controversy, however, is still about Taguchis statistical methods, not about his philosophical concepts concerning quality or robust design. Furthermore, it is generally accepted that Taguchis philosophy has promoted, on a worldwide scale, the design of experiments for quality improvement upstream, or at the product and process design stage. Taguchis philosophy and methods support, and are consistent with, the Japanese quality control approach that asserts that higher quality generally results in lower cost. This is in contrast to the widely prevailing view in the United States that asserts that quality improvement is associated with higher cost. Furthermore, Taguchis philosophy and methods support the Japanese approach to move quality improvement upstream. Taguchis methods help design engineers build quality into products and processes. As George Box, Soren Bisgaard, and Conrad Fung observed: Today the ultimate goal of quality improvement is to design quality into every product and process and to follow up at every stage from design to final manufacture and sale. An important element is the extensive and innovative use of statistically designed experiments. TAGUCHIS DEFINITION OF QUALITY The old traditional definition of quality states quality is conformance to specifications. This definition was expanded by Joseph M. Juran (1904-) in 1974 and then by the American Society for Quality Control (ASQC) in 1983. Juran observed that quality is fitness for use. The ASQC defined quality as the totality of features and characteristics of a product or service that bear on its ability to satisfy given needs. Taguchi presented another definition of quality. His definition stressed the losses associated with a product. Taguchi stated that quality is the loss a product causes to society after being shipped, other than losses caused by its intrinsic functions. Taguchi asserted that losses in his definition should be restricted to two categories: (1) loss caused by variability of function, and (2) loss caused by harmful side effects. Taguchi is saying that a product or service has good quality if it performs its intended functions without variability, and causes little loss through harmful side effects, including the cost of using it. It must be kept in mind here that society includes both the manufacturer and the customer. Loss associated with function variability includes, for example, energy and time (problem fixing), and money (replacement cost of parts). Losses associated with harmful side effects could be market shares for the manufacturer and/or the physical effects, such as of the drug thalidomide, for the consumer. Consequently, a company should provide products and services such that possible losses to society are minimized, or, the purpose of quality improvement is to discover innovative ways of designing products and processes that will save society more than they cost in the long run. The concept of reliability is appropriate here. The next section will clearly show that Taguchis loss function yields an operational definition of the term loss to society in his definition of quality. TAGUCHIS LOSS FUNCTION We have seen that Taguchis quality philosophy strongly emphasizes losses or costs. W. H. Moore asserted that this is an enlightened approach that embodies three important premises: for every product quality characteristic there is a target value which results in the smallest loss; deviations from target value always results in increased loss to society; [and] loss should be measured in monetary units (dollars, pesos, francs, etc.). Figure I depicts Taguchis typically loss function. The figure also contrasts Taguchis function with the traditional view that states there are no losses if specifications are met. Taguchis Loss Function It can be seen that small deviations from the target value result in small losses. These losses, however, increase in a nonlinear fashion as deviations from the target value increase. The function shown above is a simple quadratic equation that compares the measured value of a unit of output Y to the target T.: Essentially, this equation states that the loss is proportional to the square of the deviation of the measured value, Y, from the target value, T. This implies that any deviation from the target (based on customers desires and needs) will diminish customer satisfaction. This is in contrast to the traditional definition of quality that states that quality is conformance to specifications. It should be recognized that the constant k can be determined if the value of L(Y) associated with some Y value are both known. Of course, under many circumstances a quadratic function is only an approximation. Since Taguchis loss function is presented in monetary terms, it provides a common language for all the departments or components within a company. Finally, the loss function can be used to define performance measures of a quality characteristic of a product or service. This property of Taguchis loss function will be taken up in the next section. But to anticipate the discussion of this property, Taguchis quadratic function can be converted to: This can be accomplished by assuming Y has some probability distribution with mean, a and variance o.2 This second mathematical expression states that average or expected loss is due either to process variation or to being off target (called bias), or both. TAGUCHI, ROBUST DESIGN, AND THEÂ  DESIGN OF EXPERIMENTS Taguchi asserted that the development of his methods of experimental design started in Japan about 1948. These methods were then refined over the next several decades. They were introduced in the United States around 1980. Although, Taguchis approach was built on traditional concepts of design of experiments (DOE), such as factorial and fractional factorial designs and orthogonal arrays, he created and promoted some new DOE techniques such as signal-to-noise ratios, robust designs, and parameter and tolerance designs. Some experts in the field have shown that some of these techniques, especially signal-to-noise ratios, are not optimal under certain conditions. Nonetheless, Taguchis ideas concerning robust design and the design of experiments will now be discussed. DOE is a body of statistical techniques for the effective and efficient collection of data for a number of purposes. Two significant ones are the investigation of research hypotheses and the accurate determination of the relative effects of the many different factors that influence the quality of a product or process. DOE can be employed in both the product design phase and production phase. A crucial component of quality is a products ability to perform its tasks under a variety of conditions. Furthermore, the operating environmental conditions are usually beyond the control of the product designers, and, therefore robust designs are essential. Robust designs are based on the use of DOE techniques for finding product parameter settings (e.g., temperature settings or drill speeds), which enable products to be resilient to changes and variations in working environments. It is generally recognized that Taguchi deserves much of the credit for introducing the statistical study of robust design. We have seen how Taguchis loss function sets variation reduction as a primary goal for quality improvement. Taguchis DOE techniques employ the loss function concept to investigate both product parameters and key environmental factors. His DOE techniques are part of his philosophy of achieving economical quality design. To achieve economical product quality design, Taguchi proposed three phases: system design, parameter design, and tolerance design. In the first phase, system design, design engineers use their practical experience, along with scientific and engineering principles, to create a viably functional design. To elaborate, system design uses current technology, processes, materials, and engineering methods to define and construct a new system. The system can be a new product or process, or an improved modification of an existing product or process. The parameter design phase determines the optimal settings for the product or process parameters. These parameters have been identified during the system design phase. DOE methods are applied here to determine the optimal parameter settings. Taguchi constructed a limited number of experimental designs, from which U.S. engineers have found it easy to select and apply in their manufacturing environments. The goal of the parameter design is to design a robust product or process, which, as a result of minimizing performance variation, minimizes manufacturing and product lifetime costs. Robust design means that the performance of the product or process is insensitive to noise factors such as variation in environmental conditions, machine wear, or product to-product variation due to raw material differences. Taguchis DOE parameter design techniques are used to determine which controllable factors and which noise factors are the significant variables. The aim is to set the controllable factors at those levels that will result in a product or process being robust with respect to the noise factors. In our previous discussion of Taguchis loss function, two equations were discussed. It was observed that the second equation could be used to establish quality performance measures that permit the optimization of a given products quality characteristic. In improving quality, both the average response of a quality and its variation are important. The second equation suggests that it may be advantageous to combine both the average response and variation into a single measure. And Taguchi did this with his signal-to-noise ratios (S/N). Consequently, Taguchis approach is to select design parameter levels that will maximize the appropriate S/N ratio. These S/N ratios can be used to get closer to a given target value (such as tensile strength or baked tile dimensions), or to reduce variation in the products quality characteristic(s). For example, one S/N ratio corresponds to what Taguchi called nominal is best. Such a ratio is selected when a specific target value, such as tensile strength, is the design goal. For the nominal is best case, Taguchi recommended finding an adjustment factor (some parameter setting) that will eliminate the bias discussed in the second equation. Sometimes a factor can be found that will control the average response without affecting the variance. If this is the case, our second equation tells us that the expected loss becomes: Consequently, the aim now is to reduce the variation. Therefore, Taguchis S/N ratio is: where S 2 is the samples standard deviation. In this formula, by minimizing S 2 , 10 log 10 S 2 , is maximized. Recall that all of Taguchis S/N ratios are to be maximized. Finally, a few brief comments concerning the tolerance design phase. This phase establishes tolerances, or specification limits, for either the product or process parameters that have been identified as critical during the second phase, the parameter design phase. The goal here is to establish tolerances wide enough to reduce manufacturing costs, while at the same time assuring that the product or process characteristics are within certain bounds. EXAMPLES AND CONCLUSIONS As Thomas P. Ryan has stated, Taguchi at the very least, has focused our attention on new objectives in achieving quality improvement. The statistical tools for accomplishing these objectives will likely continue to be developed. Quality management gurus, such as W. Edwards Deming (1900-1993) and Kaoru Ishikawa (1915-), have stressed the importance of continuous quality improvement by concentrating on processes upstream. This is a fundamental break with the traditional practice of relying on inspection downstream. Taguchi emphasized the importance of DOE in improving the quality of the engineering design of products and processes. As previously mentioned, however, his methods are frequently statistically inefficient and cumbersome. Nonetheless, Taguchis design of experiments have been widely applied and theoretically refined and extended. Two application cases and one refinement example will now be discussed. K. N. Anand, in an article in Quality Engineering, discussed a welding problem. Welding was performed to repair cracks and blown holes on the cast-iron housing of an assembled electrical machine. Customers wanted a defect-free quality weld, however the welding process had resulted in a fairly high percentage of welding defects. Management and welders identified five variables and two interactions that were considered the key factors in improving quality. A Taguchi orthogonal design was performed resulting in the identification of two highly significant interactions and a defect-free welding process. The second application, presented by M. W. Sonius and B. W. Tew in a Quality Engineering article, involved reducing stress components in the connection between a composite component and a metallic end fitting for a composite structure. Bonding, pinning, or riveting the fitting in place traditionally made the connections. Nine significant variables that could affect the performance of the entrapped fiber connections were identified and a Taguchi experimental design was performed. The experiment identified two of the nine factors and their respective optimal settings. Therefore, stress levels were significantly reduced. The theoretical refinement example involves Taguchi robust designs. We have seen where such a design can result in products and processes that are insensitive to noise factors. Using Taguchis quadratic loss function, however, may provide a poor approximation of true loss and suboptimal product or process quality. John F. Kros and Christina M. Mastrangelo established relationships between nonquadratic loss functions and Taguchis signal-to-noise ratios. Applying these relationships in an experimental design can change the recommended selection of the respective settings of the key parameters and result in smaller losses.