My First Lesson On The Battle Of Lexington And Concord

This week I only attended three days for block teaching. Monday was Columbus Day so the school was closed and everyone had the day off. Friday I did not attend because it was fall break for WIU so I decided to go home for the weekend. On Tuesday the students worked on Cornell notes for several headings in their textbook. Then on Wednesday I taught my first lesson on the battles of Lexington and Concord. The students analyzed two primary source documents then as a class we discussed their similarities and differences. The lesson went well despite the fact that two-thirds of the class was missing due to state testing. The fact that majority of the class made me worried for the lesson I prepared for the following day because the two lessons were designed to match up. However, I was pleasantly surprised that Thursday’s lesson went as smoothly as it did. The students stayed on task and were focused so I did not have really any issues with classroom management. Since this week was s hort and I taught two out of the three days I was present my teacher didn’t have much involvement with his class. On Thursday when one student was getting a big rowdy before class due to an argument my mentor pulled him into the hallway to address the situation. I believe my best classroom management skills were displayed during my Wednesday lesson. Due to majority of the class being missing I got the vibe that the students who were present thought of it as a free day. I had one student who decidedShow MoreRelatedWhat Was The Cause Of The American Revolution?1705 Words   |  7 Pagesneeded to be taught a lesson, so we had to get violent. 3: These Americans, so ungrateful and hard headed, we told them that they would be payed back. After we got out of debt from the 7 year war, we were going to give them the profit that that we made. But for some reason, the Americans decided to be difficult, they were difficult, even though they could profit. 1: Speaking of the 7 year war, it seemed reasonable that England would put the Proclamation line into effect. From my understanding, EnglandRead MoreAnalysis Of The Book Into The Wild By Jon Krakauer1686 Words   |  7 Pagesbest. For example, Washington led the Continental Army against the great British Empire, and Chris left his normal and traditional life, to seek a life of adventure and determined to go on a journey across the United States. Washington became the first president of the United States. Washington was also the only one qualified to defend and lead our country during the Revolutionary War. Even though these two examples are different on many levels, both Washington and McCandless are considered to beRead MoreGeorge Washington Essay2499 Words   |  10 PagesGeorge Washington Leadership Paper Abstract George Washington was the first leader of the United States; he was a leader in the military for the French and Indian War, and the American Revolution. While a lot is known about his accomplishments it seems more like destiny and/or fate for his place in history. His upbringing and military battles all are more associated with luck than skill. Discussed in the following is a history and story of an unlikely leader. George Washington WashingtonRead MoreRevisiting, Revising, and Reviving Americas Founding Era6252 Words   |  26 Pages1789, the story has a happy ending and the curtain comes down. This time-honored script renders the road from colonies to nation clear, smooth, and straight, with familiar landmarks along the way, from Bostons Massacre and Tea Party through Lexington and Concord, then on to Bunker Hill and Yorktown before reaching its destination: Philadelphia in 1787, where the Founders invented a government worthy of Americas greatness. Those Founders are equally familiar. Washington and Thomas Jefferson, BenjaminRead MoreOpportunities23827 Words   |  96 PagesFor the exclusive use of D. DE ALEJANDRO 9-801-361 REV: SEPTEMBER 30, 2005 NANCY F. KOEHN Howard Schultz and Starbucks Coffee Company Prologue: International Expansion On August 2, 1996, Starbucks Coffee Company opened its first store outside North America. Like many of its U.S. and Canadian outlets, the new store was located in a busy district of a prominent city—Tokyo. Starbucks managers had devoted much time to selecting the site, designing the store’s layout and fixtures, training

The Moon and Tides Observation Essay - 965 Words

An observation of the Moon was conducted from Friday, November 8, 2013 to Thursday, November 14, 2013. The study of the Moon during this period occurred consistently between the hours of 8 and 9 p.m. EST within the Northern Hemisphere at 37.3346 ° N, 79.5228 ° W (Bedford, V.A.). The Moon was noted to be illuminated on the right side and had a dark shadow on the left side indicating a waxing phase. The light region grew over the surface of the Moon with each subsequent night. The first night’s phase was waxing crescent with over 25 percent of the Moon lit up. The next night, the light had grown to cover more of the Moon as it continued through its waxing crescent phase. On November 10th, the Moon exhibited traits of being at first-quarter or†¦show more content†¦The new moon is the first phase of the lunar cycle. It occurs when the Moon and Sun are lined up on the same side of the Earth so that the moon is not visible from Earth. Next, the waxing crescent moon phas e is displayed whereby the Moon’s surface is less than half lit up. The word waxing means that the light side of the Moon is moving towards the full moon phase. A person viewing the Moon from the Northern Hemisphere will see a waxing moon if any portion of the left side of the Moon is dark and the right side is illuminated. If the Moon is observed on consecutive nights during the waxing phase, they will notice that the light section of the Moon is actually growing during this phase. The next phase is the first quarter moon, which is often referred to as a half-moon because half of the Moon, the right side, is illuminated. The phrase first quarter is not used to describe the shape of the Moon but is used to express that the Moon has completed a quarter of its orbit around the earth. At this point, the Sun and Moon are at a 90-degree angle in relation to the earth. Next in the moon cycle is the waxing gibbous which is characterized by more than half of the Moon being illuminate d and the left portion of the Moon displaying a smaller shadow area. The full moon follows the waxing gibbous phase and is the easiest phase to recognize because the moon is at its fullest illumination in the nightShow MoreRelatedEssay about Ecobeaker1714 Words   |  3 Pageshigh and low tides will a given spot on the coast experience in a day, and why? A given spot on the coast will experience two high and two low tides each day. High tide occurs when the Moon and Earth are facing towards each other and away from each other. Low tide occurs when the Moon is facing the Earth at 90Ëš and 270Ëš. 4.2 – What is spring tide and when does it occur? Spring tide is when the Earth, Moon and Sun are directly aligned. This occurs at new moon and full moon. The gravitationalRead MoreTides1740 Words   |  7 PagesTides and the Moon Name AST/101 Date Teacher Tides and the Moon I was recently tasked with examining the relationship between the Earth’s moon and the Earth’s tides. I took that to mean literally: how are the tide levels of Earth’s bodies of water affected by the Moon? When approaching this question I want to do so with the scientific method in mind. The scientific method refers to a body of techniques for investigating phenomena, acquiring new knowledge, or correcting and integrating previousRead MoreMoons Of The Terrestrial Planets1493 Words   |  6 PagesMoons of the Terrestrial Planets 2.2. Moons of Mars 2.2.1 Introduction Mars orbits at a distance of 1.52 AU from the Sun. Mars has two natural satellites, discovered by Asaph Hall in 1877. The innermost of these, Phobos, is about 22.2 km in diameter (27.0Ãâ€"21.6Ãâ€" 18.8) and orbits the planet with a period far less than Mars s period of rotation 7.7 hr. (only one quarter that of Deimos), causing it to rise in the west and set in the east(Born Duxbury 1975). Thus, it makes more than 3 orbits in aRead MoreNon Gravitational Effects On Jupiter s Satellites1161 Words   |  5 Pagesthe natural satellites orbits were studied recently using observations. This effect creates a quadratic term in orbital longitude and a secular changing of the semi-major axis. Causes may be only hypothetical. It is assumed that the causes of the effects are in the tides in the body of the planet and in the body of satellite (Emelyanov 2015; private communication). Lainey et al. (2009) considered an extensive set of astrometric observations from 1891 to 2007 to study the orbital tidal evolution ofRead MoreBarnacles2521 Words   |  11 Pagesaverage, how many high and low tides will a given spot on the coast experience in a day, and why? Along the coast there will be an average 2 high and 2 low tides per day. The reason behind this is many different forces but one of the most important is the moons gravitational pull because of how close it is to earth. The moons gravitational pull along with the oceans internal elastic forces causes a water ‘bulge’. If you are on the coastline facing the moon, high tide will occur. At the same timeRead MoreIs Jupiters Moon Europa?1430 Words   |  6 PagesIntroduction What if one day our world became too crowded or was at the verge of becoming like Venus, would there be another world we could escape to? Other planets and moons have been traveled to in order to answer this question. One place in particular that has been identified as a possible future home is Jupiter’s moon Europa. With future landing and explorations of Europe we may be able to determine the geophysical processes, ocean composition in order to determine its habitability. What it takesRead More Evolution in the School System Essay1664 Words   |  7 Pagesseen in the data gathered from space. Recent scientific study has concluded that the moon is slowly pulling away from the earth at a very steady rate. If the moon has been pulling away from the earth at a steady rate, it would have been so close to the earth at the dawn of time, that survival of almost anything would have been impossible due to the large tides created by the closeness of the moon. The tides would litera lly erode away the continents (Huse 25). Many such evidence is found all overRead MoreEssay on Oceanography Chapers 9-112676 Words   |  11 Pageson Earths tides is only 46% that of the Moons, even though the Sun is so much more massive than the Moon. although the sun is much larger than the moon and has much more gravitational power, the distance between the earth and the moon is extremely further than the distance between the earth and moon. so much that it greatly dampens the effect of the suns gravity. Why is a lunar day 24 hours and 50 minutes long, while a solar day is 24 hours long? This happens because the moon revolves aroundRead MoreA Cost Of Digging Rabbit Holes For Time Or Money1430 Words   |  6 PagesA Cost of Digging Rabbit Holes for Time or Money Or a Breath from the Dark Side of the Moon A consciousness analysis of the concept elements of time, money and madness within Pink Floyd’s â€Å"Speak to me/Breathe† song as well as lyrics, released in1973, and featured on the album title The Dark Side of The Moon. Arguably, one of the best concept albums as well as a top ten best seller for fifteen years on Billboard’s top album charts is not only a great musical achievement, but a metaphoric masterpieceRead More Galileo Galilei Essay995 Words   |  4 Pagesfrom high places, Galileo became increasingly skeptical. Evidence of Galileo’s brilliance was assured when in 1583, he was attending service in the cathedral and he saw that the flames of the candles osculated back and fourth. It was upon this observation that the pendulum was built. Not having enough money and not having the skills required to stay at the University, they kicked him out. To get by, Galileo began tutoring students. His continuous work with mathematics led Galileo to go to R ome and

Role In Health Sector Reform Health And Social Care Essay Free Essays

string(142) " so to safeguard against dearly-won additions in disease out interruptions \( catching diseases \) which would ensue in increasing debt load\." Thailand ‘s economic construction is altering toward more industrialisation and the Gross Domestic Product ( GDP ) increased about 7-9 % yearly from the late 1980s until 1996. The Thai economic system took an unexpected downswing in 1996. The Bank of Thailand forecast the growing rate of Thai economic system would spread out at a rate of 2. We will write a custom essay sample on Role In Health Sector Reform Health And Social Care Essay or any similar topic only for you Order Now 0-3.0 per centum merely, caused by the hapless public presentation of exports and private sector investing. Import growing besides declined during 1996. Decelerating the growing in imports entirely can non better the state ‘s current history shortage significantly. The shortage remains an economic job of major concern.A However, the economic stableness believes to be improved as a consequence of abrasiveness policies or outgo cuts and nest eggs acceleration. The budget shortage will be about 40,000 million tical. Factors Determining Health Health and Health Status are influenced by assorted factors viz. the state of affairss and tendencies of economic, societal, political, administrative, physical environment, substructure development and engineering development. In amount, the economic growing and construction have made alterations in the ingestion form of Thai people. Peoples need more wellness attention and pass more for wellness services, both necessary and unneeded attention. The national wellness outgo has been increasing bit by bit, at a rate faster than the Gross Domestic Product ( GDP ) , from 3.5 % of GDP in 1979 to 6.3 % of GDP in 1991. In the twelvemonth 2000 it ‘s expected to be at a rate of 8.1 % of GDP. With the worst scenario of Thai economic system it is expected to be more than 10 % of GDP in future. The outgo largely covered by the family and the hapless have a higher portion of outgo to income than the rich. The disbursal is for remedy instead than preventative and crude attention. Furthermore, the engineerings for medical services are freely imported with some particular revenue enhancement freedom. This consequences in greater purchase and competition in importing the high cost equipment and imbalanced use of this equipment nationally. The Thai economic construction has changed from agribusiness based industry to more fabrication and service based industries. This caused people to travel to industrially based countries or to migrate from rural to urban countries and society faces many societal jobs including occupational wellness. There is a great economic loss due to route accidents and accidents in the mill because of unequal attending to industrial safety. The job of air, H2O, noise and sight pollution in mill and environment and under standard working conditions is increasing. The increasing rate of utilizing modern engineering and chemicals in agricultural activities, i.e. , pesticides, weedkillers, unreal fertiliser has resulted in people having substances toxic to their wellness. Income disparity between the hapless and the rich, the rural and the urban countries, the agricultural and manufacturing sectors affect the wellness system in footings of unfairness in wellness resource allotment. The free trade system besides has impact on pharmaceutical industry: higher monetary value of drugs because of the patent ordinances. Due to the job of alterations in instruction many people have limited abilities to set to the information received through the assorted media. Some change their wellness behavior to follow more hazard to their wellness. There are besides the jobs of catching diseases, chronic disease, and aged disease among the people. Economic Crisis from mid-1997 The current economic crisis has tremendous impact on the state and this impact will prevail for at least 4-5 old ages. The immediate effects are unemployment, reduced household income and decreased ingestion outgo. These have societal and wellness effects. Economic Crisis and Health Impacts hypertext transfer protocol: //www.econ.chula.ac.th/public/research_center/chealth/im/ChealthCrisis.jpg Some Elementss of Reforms in Health Sector Soft loans from World Bank ( WB ) and Asian Development Bank ( ADB ) were offered to the Government to refill the foreign militias, and to back up indispensable plans. These loans came with certain conditions to continue the safety cyberspace to salvage the vulnerable groups, particularly those unemployed. Under the recent loan from the Asian Development Bank ( ADB ) , there are besides elements of reforms in the wellness sector as conditions of the loan, viz. Redeployment of wellness forces to the rural countries Reform of the referral systems Development of independent infirmaries Policy reform of assorted wellness insurance strategies, i.e. , Civil Service Medical Benefit Scheme ( CSMBS ) , Free Medical Care for the Low Income Household Scheme ( FC/L ) , Free Medical Care for the Aged Scheme ( FC/E ) , Workmen Compensation Scheme ( WCS ) , the Social Security Scheme ( SSS ) and the Voluntary Health Card Scheme ( VHCS ) ( Wibulpolprasert, et Al, 1998 ) . Social Impact and Responses hypertext transfer protocol: //www.econ.chula.ac.th/public/research_center/chealth/im/ChealthImpact.jpg Economic Crisis: Necessity and Opportunity to reevaluate precedences of Health Services Resources What the crisis has already told us: The most carefully laid programs are all of a sudden undermined by unannounced national economic loss We have all of a sudden to do new precedences Health sector versus other sectors Within wellness sector Wages Health services installations Capital investing Disease control / preventative activities Health instruction / media Short term versus long term Local, national, regional New enterprises, i.e. , Health Care Financing, Health Care Investment, etc. Equity, i.e. , the rich and the hapless, between sectors, between parts. Major displacements: Fiscal crisis Private infirmaries, some are running out of money, bankruptcy. Drain of work force from public to private: Private wellness sector interrupted consequences in the possible betterment of manpower state of affairs in public sector conditional upon the handiness of money to pay them. Shift of patronage from private to public wellness sector services, due to fall in income or unemployment of people. Attendant overloading of public wellness sector services. Short versus long term deduction issues: Can equilibrate between public and private wellness sector be legislated based on experience of instability of private sector concern methods exposed by crisis. Debt direction, i.e. , local and foreign investing Investing ordinances Work force policy accommodation Equity consideration Can disease controls / preventative activities are Streamlined, so Protected against cuts in crisis so to safeguard against dearly-won additions in disease out interruptions ( catching diseases ) which would ensue in increasing debt load. You read "Role In Health Sector Reform Health And Social Care Essay" in category "Essay examples" Time toA readdressA affair of comprehensive national wellness insurance embracing all sectors. This might distribute costs equitably. This would likely ask cut downing the benefits of CSMBS, i.e. , co-payment mechanism, keeping the rule of the wellness card strategy and presenting a compulsory wellness insurance strategy overall etc. The urgency of this is highlighted by the rise in unemployment with loss of employee contributed benefits and sudden addition in the figure of eligible individuals for Social public assistance wellness services to the hapless. Health Economicss: Thai Experience This list summarizes on traveling and completed wellness economic sciences research throughout Thailand. National Health System Research, i.e. Social Motions and Economic Transformation: to analyze the historical development of Thai wellness attention system. Private Hospital Survey Cigarettes and Excise Tax: to analyze the impact of a alteration in the rate of coffin nail excise revenue enhancement. Political Economy of Tobacco Products and Optimal Cigarette Taxation Diagnostic Related Group Study Information System for Health Improvement Computer System for Health Care Providers Government Information Network ( GINet ) Rapid Provincial Health Survey Law and Regulation Decentralization and Health Systems Change Public-Private Mix Essential Health Package Thai Burden of Diseases The Economics of Traffic Accidents: to cipher the economic sciences loss and causes of accident. Beginnings of Economic Growth in Thailand Development, Environment and Health in the Eastern Seaboard Area Healthy City Project Health Financing Research Health insurance in assorted strategies, i.e. , Voluntary Health Insurance. Social Security Scheme. Civil Service Medical Benefit Scheme ( CSMBS ) . National Health Account National Drug Account Hospital Costing: assorted degrees Resource Allotment: Confluent Beginnings of Finance and Reforming Payment Mechanisms for Health Servicess Cost, Resource Use and Financing of District Health Services in Thailand Technology Appraisal Quality Improvement Research, i.e. Assessment the Health Welfare ( Low income ) Card Scheme of Thailand Economicss of Social Welfare Project Management Entire Quality Management Study Health Manpower Development Research, i.e. Scientific and Technical Manpower for Economic Growth: to analyze the human resource development impinges upon proficient capacity in many sectors including those which straight and indirectly affect wellness. Future Pattern of Health Manpower Needed at each degree Forecast the Disease Pattern in Thailand Health Behaviour Research, i.e. Economic Evaluation alongside WHO Antenatal Care Trial Cost Effectiveness, Cost / Performance techniques in assorted wellness programmes Quality of Life Study Alcohol Consumption Study Elderly Care Health Situation and Trend Research, i.e. The diseases control plan, i.e. , Economicss of Leprosy Social and Economic Impact of Dengue Hemorrhagic Fever Economic Evaluation of Village Malaria Volunteer Programme Economic Analysis of Malaria Diagnostic Technology Economicss of Screening for Thalassemia Demographic Impact of the HIV/AIDS Epidemic in Thailand Survey of Elderly in Thailand General Agreement on Trade in Services and the Effects on Health System and Services in Thailand Quantitative Approaches to Analysis and Redefinition of Market Roles in Changing Options for Health Servicess Scheme for Research in Health Economicss: Present and Future † in Enabling Mechanisms for Health Summary of Health Economics Research Targets Issues Equity Efficiency Quality Health Insurance Universal Health Insurance Accessibility to Health Care Health Care Behaviour and Utilization Types of Health Care Financing Impact on Utilization and Health Expenditure Essential Package and Outgo Resource Allocation at Various Levels Assess the Standard for Quality of Care Technology Appraisal Technology Diffusion and Distribution Cost-effectiveness for Drug, Medical Equipment and Technology Consumer Protection for Using Health Care/ and Health Servicess Health Manpower Health Manpower Distribution Cost and Number of Health Manpower Quality of Personnel Standard of Providing Care Role of Private and Public Impacts of GATS on Prices and Accessibility Earmarked Taxs Public-Private Mix Optimum usage of Assorted coaction, i.e. , Joint-venture, Contract out Referral System and Network Assess the Standard and its Applications Health impacts of rapid economic alterations in Siam The economic crisis in Thailand in July 1997 had major societal deductions for unemployment, under employment, household income contraction, altering outgo forms, and child forsaking. The crisis increased poorness incidence by 1 million, of whom 54 % were the ultra-poor. This paper explores and explains the short-run wellness impact of the crisis, utilizing bing informations and some particular studies and interviews for 2 old ages during 1998A ±99. The wellness impacts of the crisis are mixed, some being negative and some being positive. Household wellness outgo reduced by 24 % in existent footings ; among the poorer families, institutional attention was replaced by self- medicine. The pre-crisis lifting tendency in outgo on intoxicant and baccy ingestion was reversed. Immunization disbursement and coverage were sustained at a really high degree after the crisis, but studies of additions in diphtheria and whooping cough indicate worsening programme quality. An addition in malaria, despite budget additions, had many causes but was chiefly due to cut down programme effectivity. STD incidence continued the pre-crisis downward tendency. Ratess of HIV hazardous sexual behavior were higher among draftees than other male workers, but in both groups there was lower rubber usage with insouciant spouses. HIV sero-surveillance showed a continuance of the pre-crisis downward tendency among commercial sex workers ( CSW, both whorehouses and non-brothel based ) , pregnant adult females and donated blood ; this tendency was somewhat reversed among male STD patients and more among endovenous drug users. Condom coverage among whorehouses based CSW continued to increase to 97.5 % , despite a 72 % budget cut in free rubber distribution. Poverty and deficiency of insurance coverage are two major determiners of absence of or unequal prenatal attention, and low birth weight. The Low Income Scheme could non adequately cover the hapless but the voluntary Health Card Scheme played a wellness safety net function for maternal and child wellness. Low birth weight and scraggy among school kids were observed during the crisis. The impact of the crisis on wellness was minimal in some sectors but non in the others if the pre-crisis status is efficient and healthy and frailty versa. We demonstrated some cardinal wellness position parametric quantities during the 2-year period after the 1997 crisis but do non hold decisions on the impact of the economic crisis on wellness position, as our observation is excessively short and there is uncertainness on how long the crisis will last. hypertext transfer protocol: //www.business-in-asia.com/medical_tour/images/boi_med1.jpg Siam has good positioned itself to go the medical hub of Asia, with more than four 100 infirmaries offering the most advanced interventions by an internationally trained medical staff. The state boasts the largest infirmary in Southeast Asia and the first of all time to have ISO 9001 enfranchisement, and the first infirmary in Asia to be granted the esteemed Joint Commission International Accreditation ( JCIA ) . In 2005, the figure of foreign patients geting in Thailand, alleged medical tourers, topped one million and reached 1.4 million in 2006. The state has set a mark of 2 million medical tourers by the twelvemonth 2010. With 1000000s of people without wellness insurance in some states, or those merely seeking the best service and attention available, medical touristry continues to be a growing industry for Thailand. The one-year growing rate for the sector has been 14 % , with major surgical processs increasing, every bit good as those seeking standard medical attention. Thai Airways has taken medical touristry one measure farther by boxing medical check-ups as portion of its Royal Orchid Holidays plan. Acknowledging the available market and the state ‘s ability to present medical intervention at international criterions, in 2004 Thailand ‘s authorities adopted a five-year strategic program to develop the state ‘s capacity into the â€Å" Center of Excellent Health of Asia † . This strategic program, advanced by the Ministry of Public Health, focuses on three chief countries of health care: medical services, health care services, which includes watering place, traditional massage and long-stay health care merchandises and services, and 3rd is Thai herbal merchandises. There is a serious committedness on behalf of health care suppliers and the authorities to guarantee that international criterions are met. â€Å" More late, infirmaries in Thailand have opted to besides use for Joint Commission International ( JCI accreditation, which is the international accreditation arm of the U.S. Joint Commission on Accreditation of Healthcare Organizations ( JCAHO ) † , says Mr. Denis Meseroll of Asset Management Systems ( Thailand ) , a company that provides healthcare direction services. hypertext transfer protocol: //www.business-in-asia.com/medical_tour/images/boi_med2.jpg Skyrocketing costs of health care in many western states, along with overladen medical installations in many others, has added great attractive force to Thailand ‘s high quality low cost medical service industry. For illustration, elected surgery in Thailand ‘s best private infirmaries is frequently one tenth the cost of the same process if performed in the United States. With the value of OECD states ‘ wellness attention sector holding been estimated to be every bit high as US $ 3 trillion and the United States at US $ 2 trillion, the potency for Thailand is important. BlueCross BlueShield of South Carolina and Blue Choice of South Carolina, US based health care insurance suppliers, have formed an confederation with one of Bangkok ‘s premier infirmaries to advance medical touristry to its 1.3 million members. In add-on to the cost economy, there is besides the added benefit that intervention and aftercare services are frequently performed in resort like scenes, with a degree of cordial reception non found in other of the universe ‘s medical centres. Doctors are experts in their Fieldss and nurses are registered and good trained. But beyond the medical attractive force, patients are treated to personal service characterized by Thailand ‘s excellence. Patients are non left to linger in infirmary waiting suites for hours, left unattended and uninformed. Some infirmaries will even delegate patients a personal helper who will walk them through the full procedure from the front door, to their assignment with the physician, to the onsite pharmaceutics to make full prescriptions, and to uncluttering all grosss for insurance reimbursement. Patients are kept informed throughout their stay. In fact one of Bangkok ‘s premier infirmary installations boasts a staff of physicians that can talk English, French, Spanish, German, Dutch, Japanese, Cantonese, Mandarin, Hokkien, Hainan, Arabic, Urdu and others, and has 60 translators on its staff. While another has translators in over two twelve linguistic communications, all in order to ease the increasing Numberss of international patients. And many of the state ‘s infirmaries have the most advanced medical equipment, including one which late purchased the MRI 3 Tesla, the first in Asia, which offers better diagnosing without injection of contrast media. While Thailand excels in the medical attention it delivers on a day-to-day footing to patients from over 190 states, the Kingdom is besides deriving acknowledgment as a location for research and for clinical tests of advanced medical specialty and for root cell interventions. Thailand is puting in research and development for tropical diseases, such as dandy fever febrility and malaria, among others ; countries broad unfastened for farther investing. With the exponential growing of Thailand into going a medical hub in the part, considerable chances in related Fieldss are being created. The medical device sector, for one, will go on to see healthy growing to run into the demands of health care installations for new and upgraded medical machinery and devices. Thailand ‘s health care industry is genuinely turning in springs and bounds. HEALTH CARE SYSTEMS IN THAILAND The bulk of wellness attention services in Thailand is delivered by the populace sector, which includes 1,002 infirmaries and 9,765 wellness Stationss. Universal wellness attention is provided through three plans: the civil service public assistance system for civil retainers and their households, Social Security for private employees, and the Universal Coverage strategy theoretically available to all other Thai subjects. Some private infirmaries are participants in these plans, though most are financed by patient self-payment and private insurance. Harmonizing to the World Bank, under Thailand ‘s wellness strategies, 99.5 % of the population has wellness protection coverage. The Ministry of Public Health ( MOPH ) oversees national wellness policy and besides operates most authorities wellness installations. The National Health Security Office ( NHSO ) allocates funding through the Universal Coverage plan. Other health-related authorities bureaus include the Health System Research Institute ( HSRI ) , Thai Health Promotion Foundation ( â€Å" Thai Health † ) , National Health Commission Office ( NHCO ) , and the Emergency Medical Institute of Thailand ( EMIT ) . Although there have been national policies for decentalisation, there has been opposition in implementing such alterations and the MOPH still straight controls most facets of wellness attention. Thailand introduced cosmopolitan coverage reforms in 2001, going one of merely a smattering of lower-middle income states to make so. Means-tested wellness attention for low income families was replaced by a new and more comprehensive insurance strategy, originally known as the 30 tical undertaking, in line with the little co-payment charged for intervention. Peoples fall ining the strategy receive a gold card which allows them to entree services in their wellness territory, and, if necessary, be referred for specializer intervention elsewhere. The majority of finance comes from public grosss, with support allocated to Contracting Units for Primary Care yearly on a population footing. Harmonizing to the WHO, 65 % of Thailand ‘s wellness attention outgo in 2004 came from the authorities, while 35 % was from private beginnings. Thailand achieved cosmopolitan coverage with comparatively low degrees of disbursement on wellness but it faces important challenges: rise costs, inequali ties, and duplicate of resources. Although the reforms have received a good trade of unfavorable judgment, they have proved popular with poorer Thais, particularly in rural countries, and survived the alteration of authorities after the 2006 military putsch. Then Public Health Minister, Mongkol Na Songkhla, abolished the 30 tical co-payment and made the UC strategy free. It is non yet clear whether the strategy will be modified farther under the alliance authorities that came to power in January 2008. Public Health Issues Although infective diseases, most notably HIV/AIDS and TB, remain serious public wellness issues, non-communicable diseases and hurts have besides become of import causes of morbidity and mortality. Major infective diseases in Thailand besides include bacterial diarrhoea, hepatitis, dandy fever febrility, malaria, Nipponese phrenitis, hydrophobias, and swamp fever. Human immunodeficiency virus/acquired immune lack syndrome ( HIV/AIDS ) is a serious job in Thailand. The United Nations Programme on HIV/AIDS ( UNAIDS ) reported in November 2004 that the Thai authorities had launched a well-funded, politically supported, and matter-of-fact response to the epidemic. As a consequence, national grownup HIV prevalence has decreased to an estimated 1.5 per centum of all individuals aged 15 to 49 old ages ( or about 1.8 per centum of the entire population ) . It was besides reported that 58,000 grownups and kids had died from AIDS since the first instance was reported in 1984. The authorities has begun to better its support to individuals with HIV/AIDS and has provided financess to HIV/AIDS support groups. Public plans have begun to change insecure behaviour, but favoritism against those septic continues. The authorities has funded an antiretroviral drug plan and, as of September 2006, more than 80,000 HIV/AIDS patients had received such drugs. Food Safety Food safety panics, like the remainder of developing Asia, are non uncommon to Thailand. Furthermore besides the of all time common microbic taint of street side nutrient left out in the hot Sun and dust-covered roads, every bit good as shop nutrient, taint by banned or toxic pesticides and forge nutrient merchandises is besides common. 3-MCPD, a genotoxic and carcinogenic substance, was found in utmost sums ( 100s to 1000s of times bounds ) in an Asia-wide ( ex Japan and Korea ) acid-hydrolyzed soy sauce dirt in 2001, including exports to Western states, cyanuramide in Thai nutrient merchandises along with 2008 Chinese milk dirt, and July 2012 consumer action groups demanding 4 unlisted toxic pesticides found on common veggies ( which are banned in developed states ) be banned. Chemical companies are bespeaking to add them to the Thai Dangerous Substances Act so they can go on to be used, including on exported Mangifera indicas to developed states which have banned their usage. Medical and Healthcare Services Currently Provided in Thailand: Medical Servicess Medical Examination ( Chulalongkorn Hospital ) Outpatient Department Nursing Department Dentistry Extended Service Clinics Social Security Services ( Chulalongkorn Hospital/Somdej Na Sriracha Hospital ) On-line Consultancy Anonymous Clinic Nurses at Home Project Medical Certificate Services ( Chulalongkorn Hospital/Somdej Na Sriracha Hospital ) Rabiess Clinic Immunological Clinic New Tract Medicine Services Immunological Clinic and Tourist Consultancy Biological Merchandises Chula Excimer Laser Center Ostomy Clinic Community Medicine/Community Health Wednesday Club Anti-AIDS Campaign in Slum Communities Elderly Care Project, Klong Toey Slum Community Educational Servicess Nursing College Other Health related Servicess First Aid Training Knowledge for Life Project Home Nursing Training Health Education for the Disadvantaged, Including inmates, no educated kids Rabiess Hot Line Health Restorative Service at Home Consultancy for HIV AIDS infected and household Catastrophe Relief Services Consumable and Life Pack Aids Mobile Medical Unit of measurements First Aid Unit, Medical Supplies and Vehicles Service Coverage ( Map ) â€Å" Princess Pa Project † voluntary Project, the Thai Red Cross Society Blood Servicess Blood Bags manufactured by the National Blood Service Center Eye Bank Eye Bank procedure Cornea in Optisol Cornea in Glycerine Eye Whites Amniotic membrane Fair and Equal-Opportunity Eye Allotment Organ Donation Heart, Lung, Liver Allocation Kidney Allocation Child Aids Biological Family Tracking Family Finding Child Follow-Through Adoption Process Chalerm Phrakiat Child Development Center ( For Thai Red Cross Personnel ) Human-centered Relief Consumable AIDSs and life battalions Mobile Medical Unit of measurements First Aid Units Specialized Medicine Unit of measurements Other Services Dissemination of Red Cross Principles and Human-centered Laws in young persons Chalerm Prakiat 72 Pansa Iodine Nutrition Project Community Service Activities Strong industry growing mentality several cardinal supportive factors We believe Thailand ‘s health care sector has bright chances in visible radiation of the undermentioned supporting factors: Low health care incursion. An ageing population and a lifting decease rate from complex unwellnesss. A limited supply menace due to high entry barriers. Thailand ‘s competitory market place in medical touristry. The first three factors guarantee quickly lifting demand for health care from local people in Thailand. However, we see greater demand chances from provincial countries than from the Bangkok Metropolitan Region ( BMR ) due to the turning urbanization tendency and lower incursion. Local Government Policies and Major Measures to Promote The Thai authorities began strategic programs since 2004 to advance Thailand as a premier medical touristry finish. Since so, the state has enjoyed a big figure of visitants in this class. The Department of Export Promotion and the Department of Health Service Support reported a rapid growing of 16.48 % during 2001-2009 for wellness services bringing to aliens: Year No. of Foreign Patients Estimate Income ( Million Baht ) 2007 1,373,807 106,640 2008 1,380,000 107,419 2009 1,390,000 108,197 Thailand is now widely acclaimed among the international community as the medical hub in Asia, with important advantages including the handiness of modern equipment and fortes, easy entryway, competitory monetary values, and great cordial reception from service operators and forces. These, when coupled with the well-established fact that Thailand is a brilliant tourer finish with calm beaches and mountains, fascinating humanistic disciplines and civilization, nutrient, amusement, and shopping, make Thailand a great medical touristry finish. The policies and schemes to advance Thailand as a medical hub of Asia 1 ) . Most healthcare service suppliers peculiarly infirmaries participate in travel marketplaces, travel carnivals, trade carnival, exhibitions, seminars, conferences. 2 ) . Using advertizements in travel magazines in states with the back uping from the authorities. With the cooperation from the Ministry of Public Health, Tourism Authority of Thailand ( TAT ) , Ministry of Foreign Affairs, and Department of Export Promotion ( DEP ) organized these activities for advancing health care services to international markets. 3 ) . Other enlightening stuffs are provided such as booklets, brochures, video-cds, paper bags and jersey with Sons were besides used to make consciousness of the available health care services 4 ) . Some healthcare service suppliers build up cooperation with the local institutes, universities, medical schools in other states to set up coaction in instruction, exchange of cognition and preparation every bit good as to advance their option health care services. 5 ) . Advertising about medical and nonmedical services in both local and international media are used by healthcare service suppliers. The advertizement has to be based on Thai Torahs and ordinances about how to publicize health care services. Media such as magazines, newspaper ( both in Thai and English ) , telecasting etc. are used to aim local people and exiles who work in Thailand. FUTURE TRENDS Harmonizing to the KASIKORN RESEARCH CENTER, ASEAN wellness service liberalisation will heighten the chances for Thai medical attention concern investing into ASEAN states. This is because of ASEAN cancellation of all pre-conditions to wellness service markets and enlargement of ASEAN investors ‘ shareholdings of up to 70 per centum beginning in 2010. Positive factors that would back up Thai entry into ASEAN medical concern would include the possible in the first-class direction of Thai infirmaries that have attracted the highest figure of foreign patients in ASEAN. Furthermore, the impact of ASEAN trade and investing liberalisation and the development of transit logistics into the Indochina part will assist ease travel within the part via land transit ; hence, offering greater chances to Thai private sector infirmaries to spread out into other metropoliss in Thailand and back up a turning figure of foreign patients wishing to utilize medical attention services in Thailand. However, the enlargement of Thai medical attention services may confront some challenges in forces deficits within ASEAN, an investing finish – including. It is expected that the effectivity of liberalisation in the motions of medical forces within ASEAN in 2015 will be rather limited and may confront challenges caused by competition with and that besides aim to spread out such investings within ASEAN and would wish to go hubs for medical attention within this part, every bit good. Meanwhile, the enlargement of Thai private infirmaries into other ASEAN states may worsen forces shortages domestically and impact our ability to go a major Asian medical service hub pulling foreign patients to. It is expected that the job of competition in pulling medical forces between service suppliers domestically, authorities and private sector, will go on to escalate, peculiarly if there is an unequal authorities budget for medical Personnel development. Thailand Health Profile study Health is related to legion factors. Indispensably, analysis of state of affairs and tendency of the Thai wellness system requires comprehensive consideration on alterations in both single and environmental contexts that influence wellness, e.g. economic system, instruction, human ecology, household characteristic and migration, genetic sciences, value and belief, civilization, political relations and authorities, environment, substructure and engineering, every bit good as wellness services system itself. This inspires the thought of making the Thailand Health Profile study, a study that offers information on Thailand ‘s wellness system integrally connected with its determiners. Siam can be proud to hold achieved most of the eight UN Millennium Development Goals ( MDGs ) , in peculiar the three health-related ends. In 1970, Thailand had an infant mortality rate of 68 per 1,000 unrecorded births, while today it is estimated at 13 per 1,000 unrecorded births. Harmonizing to a 2008 survey published in the medical diary Lancet, Thailand enjoyed the highest one-year rate of decrease in child mortality among 30 low- and middle-income states between 1990 and 2006. The maternal mortality ratio has besides shown a similar decreasing tendency. In add-on, Thailand has been successful at controling new HIV infection rates by 83 per cent since 1991, thanks to the backbreaking attempts made by authoritiess and NGOs. Such impressive wellness results did non happen in isolation from its socio-economic development context. From 1969 to 2009, its gross national income ( GNI ) grew from US $ 210 to $ 3,760 in current figures, or 17 times over 40 old ages. During the 1970s and 1980s, Thailand invested to a great extent in main roads that connect the stray and destitute Northeast and North to Bangkok ; electrification throughout the state ; every bit good as enlargement of school registration for both male childs and misss. As a consequence, the positive spillover effects besides benefited the public wellness sector. As economic growing accelerated in the mid-1980s and 1990s, the state continued to finance substructure undertakings which brought greater connectivity, wider entree to electricity and safe imbibing H2O and clean sanitation, primary and secondary schools, and primary wellness Centres in rural countries across the state. Four decennaries ago when Thailand was still a low-income state, it invested early in wellness attention substructure that has reached the most distant rural communities. Alternatively of concentrating resources to urban third infirmary development, public wellness leaders placed more funding to rural countries from 1982 onwards, which has encouraged greater and low-cost entree to healthcare at the most local degrees. Such investings have paid off. In a survey carried out by the London School of Hygiene and Tropical Medicine and released in Bangkok last month, Thailand featured as one of the states to accomplish â€Å" good wellness at low cost † . Harmonizing to the World Health Organization ( WHO ) , its entire wellness outgos ( THE ) is estimated at 4.1 per cent of its GDP or $ 328 per capita, which is comparatively low for the wellness outcomes achieved. The extended web of primary health care installations implemented through territory wellness systems supplemented by some of the first-class research outfits doubtless played a important function in bettering wellness results particularly for the rural population. In add-on, Thailand has been successful in preparation nurses and physicians for its wellness system, innovatively administering human resources to rural countries by prosecuting new medical alumnuss to function for three old ages in a rural infirmary, and supplying extra pecuniary inducements. In add-on, wellness voluntaries recruited from local communities besides play of import support, bar and sensing functions, and thereby heightening community engagement. Thailand ‘s wellness accomplishments are non limited to impressive indexs, but extend to achieving cosmopolitan wellness coverage ( UHC ) .Globally, the figure of states that have attained UHC is comparatively little, and comprises largely of OECD states. Within Asian, Brunei, Malaysia, Singapore and Thailand have achieved UHC, with the Philippines, Vietnam, and Indonesia nearing full coverage as they embark on reforms. Yet, harmonizing to the International Labour Organization ( ILO ) , merely 5 to 10 per cent of people are covered in sub-Saharan Africa and South Asia, while in middle-income states, coverage rates vary between 20 to 60 per cent. Annually across the universe, about 150 million people suffer fiscal calamity and 100 million are pushed below the poorness line due to regressive payment systems for health care and absence of UHC. In 2002 when Thailand was still a lower-middle income state with a GDP/capita of $ 1,900, the state achieved UHC. This did non go on overnight but bit by bit since the 1970s through the creative activity of three wellness insurance strategies: the Civil Servant Medical Benefit Scheme ( CSMBS ) , Social Security Scheme ( SSS ) Subsequently the Universal Coverage ( UC ) Scheme – once referred to as the â€Å" Bt30 † Scheme. Achieving a coverage rate of 99 per cent of the population is more than merely run intoing a national aim ; it represents a beginning of inspiration to other low- and middle-income states. As a affair of fact, functionaries from assorted wellness ministries and NGOs from Asia and Africa frequently request a visit to Thailand ‘s public wellness establishments such as the National Health Security Office, International Health and Policy Programme, Health Systems Research Institute and the Ministry of Public Health to â€Å" analyze how Thailand did it † . As of now, 99 per cent of the Thai population is covered through a comprehensive health care bundle that ranges from wellness bar and primary attention, to hospitalization due to traffic accidents to renal replacing therapy and entree to ART intervention for HIV. It has been shown that the UC Scheme has contributed significantly to cut downing cases of ruinous health care outgos, particularly in destitute countries of the state. Based on the recent rating of the 10 old ages of the Scheme, the figure of destitute families dropped from 3.4 per cent in 1996 to 0.8-1.3 per cent between 2006 and 2009, therefore lending to poverty decrease, edifice greater fiscal stableness to vulnerable families and improved long-run support security. In add-on, it helps Thailand to achieve the rule of the right to wellness for all. In a state with high income inequality as measured by the Gini Coefficient, entree to low-cost health care is a span that helps extenuate many of the socio-economic unfairnesss that still plague this state. Thailand has demonstrated that UHC may non be an unachievable dream to be experienced by merely the rich states. Low-income states such as Ghana and Rwanda have already made much advancement towards UHC, and states such as India and Bangladesh are working towards developing effectual UHC systems. The biggest individual determiner in this is political committedness. In a round-table conference in Bangkok in November, 2011, UN Secretary-General Ban Ki-moon declared that no states rich or little would hold â€Å" adequate † resources to transport out UHC reform but the challenge for every state is how shortly they can travel into it. This was echoed at the recent Prince Mahidol Award Conference with the subject of UHC. Attended by participants from 68 states, none said that UHC is impossible to accomplish in their contexts. With the right policies – societal, economic and political, it is possible for a low- or middle-income state to ship on the route towards UHC. Although Thailand has achieved cosmopolitan coverage, large challenges remain. These include: how to include foreign migratory workers into the health care system how to unify the three strategies to cut down unfairnesss in benefit bundles how to guarantee sufficient and highly-trained human resources in wellness to run into current deficits how to pull off Thailand ‘s passage into a â€Å" Grey † society in the following decennaries what are the germinating fiscal mechanisms that can be used to better function the population? UHC after all is non an end point in itself, but a journey that moves us closer to better wellness for all. Mushtaque Chowdhury and Natalie Phaholyothin are based at the Rockefeller Foundation ‘s Asia Regional Office in Bangkok. The article reflects the positions of the writers, which do non needfully represent those of the Rockefeller Foundation. Healthcare in Thailand Introduction One of the most popular Asiatic states for resettlement is Thailand. The state has a rich historical and cultural background. However, there are some concerns that exiles should be cognizant of, and one of these is the issue of health care. The health care system Most of the physicians in Thailand are specializers ; that is why it may be difficult to happen a dependable all-around general practician to handle you for minor medical jobs. As an exile, you will hold to travel to a general infirmary, where you will most probably be examined by a physician who is a specializer in one field or another. Since it may be common to hold a figure of smaller medical conditions, it may be hard for a medical specializer to cover with these. The best manner, particularly if you are non rather certain of your job ( s ) , is merely to seek an internist as your first port of call. However, it should be noted that there are still some major infirmaries in Thailand that have household physicians or medical practicians. Most physicians in Thailand do non hold one specific topographic point of work. Thai sawboness and doctors have different working agendas at different infirmaries thatA can beA spread over the whole of Bangkok. Because of this, physicians are likely to travel from one infirmary to another to make their unit of ammunitions. Additionally, these physicians may besides hold private clinics. In visible radiation of this, they tend to work really long hours. It is non hard to conceive of the jobs that this could do. For illustration, if you merely had surgery and a job arises, there is the possibility that your sawbones might be executing another surgery in a different infirmary, or he may be at his private clinic. This may ensue in your physician seeking to work out the state of affairs over the phone. Obstacles in medical exigencies Emergency conveyance installations in Thailand are non yet to the full developed. Large infirmaries in Thailand have mobile intensive attention units where you can be hold immediate intervention in exigency state of affairss. However, you will seldom see an ambulance rushing the streets of Bangkok. Although traffic accidents are attended to, voluntary organisations are usually the 1s to supply deliverance units. Passers-by will besides help in exigencies. For traffic accidents, you can ever seek aid from the Police Hospital at the Ratchaprasong Intersection ( if you are in the country ) . In footings of exigency conveyance, the chief obstruction in medical exigencies is the traffic in Bangkok. Unwanted holds are ineluctable, unless you are in close propinquity to a infirmary. By and large talking, autos do non automatically give manner to reacting ambulances. Therefore, if you have a medical status that may necessitate immediate attending, where possible, remain in a topographic point which is near to a suited infirmary. Having a wellness service that is able to handle controlled and stable conditions is one thing, but being capable of covering with exigency processs is another. Unfortunately, Thailand needs some major betterments in this respect. Money is of import When you are in Thailand, it is of import to hold your medical insurance paperss with you ; either that or another signifier of payment. In the instance of a infirmary admittance, you will be required to pay up forepart for the interventions. It appears thatA moneyA plays an even larger portion than normal when discoursing the health care system of Thailand. In most European states, jobs like these are usually avoided because the patients have compulsory medical insurance and infirmaries can be confident about acquiring paid. It is recommended that you avail of private wellness insurance when sing Thailand as a topographic point to see or populate. Making Business in Thailand India has many chances for making concern with Thailand. Priority countries are: aˆ? Advanced Engineering aˆ? Agribusiness aˆ? Education and preparation aˆ? Environment aˆ? Food and Beverage aˆ? Railway aˆ? Power aˆ? Motor vehicle and motor vehicle parts aˆ? Healthcare and Pharmaceutical, Medical Hub is targeted for Thailand aˆ? Petro aˆ? Renewable Energy aˆ? Tourism, athleticss and leisure equipment Healthcare Sector in Thailand Thailand had a population of 69.51 million at the terminal of 2011.Life anticipation is 71 old ages for work forces and 77 old ages for adult females has increased. With a population growing rate of around 0.4 % , Thailand is confronting an aging society. Proportion of the population over age 60 in 2020 is expected to make 17.51 % . Market Overview The entire health care market in 2012 is expected to make U.S. $ 13.13bn, while the pharmaceutical and medical devices market forecast market for U.S. $ 4.1bn U.S. $ 9.36bn. However, some medical equipment produced for domestic ingestion in Thailand, the state imported from abroad, 70 % of medical devices. Due to increasing demand from international and local patients, Thailand ‘s first medical substructure in developed states and at a fraction of the cost of similar processs provides the highest possible quality of attention. Thailand is ready to take a serious involvement in this dynamic market ; this is an exciting concern chance for companies. Key chances Thailand in cardinal and emerging chances for Indian companies in the health care include: Medical equipment and instruments Specialist intervention engineering Aging Population Standard Certification Accident Emergency E-Health Geting into the market Medical equipment and instruments The most popular finishs for medical touristry in Thailand, more than 1,000 public infirmaries and 400 private infirmaries with international criterions are powered on. Turning medical touristry market with a 10-20 % one-year growing in the sector has played an of import function. Both foreign and domestic patients Thai wellness installations continue to spread out due to the increasing demand for wellness intervention. We are besides seeing a new tendency of amalgamations between private infirmaries. Therefore, both private and public infirmaries for medical machinery and equipment, including a turning demand continues to upgrade their installations. Purchase of major medical equipment in public infirmaries, accounting for 60 % of the consumers live. Specialist intervention engineering Demand for particular intervention in Thailand, non merely because of the figure of foreign patients in Thailand but besides increased health-conscious consumers. Aging Population Harmonizing to the analysis of a decease certification, major and increasing cause of decease among Thai citizens of non-communicable diseases, accidents, and HIV / AID. The impact of an aging population opens up many chances. Due to the increasing aging population, we besides take attention of the aged by both the populace and private sector to see an increasing figure of advanced characteristics. The Thai authorities is cognizant of the aging society and provides support for the aged life. The National Science and Technology Development Projects Agency ( NSTDA ) besides on new engineering in these countries are done by collaborating with international organisations. Standard Certification An indispensable tool for pulling foreign patients is an internationally recognized commissioned infirmary. Consequently, the Joint Commission International ( JCI ) to better its services to international criterions scheme has gained big private infirmary. However, some private infirmaries to seek other options which allow more flexibleness in the execution procedure of the want. Accident Emergency Emergency Response therapy has progressively become a precedence in Thailand, as the state ‘s natural catastrophes and political agitation in recent old ages experienced a figure. National Institute of Emergency Medical Services Emergency Medical System is to develop international criterions in this country and has played a major function in natural catastrophes. More preparation and guidance every bit good as experts in the country, include the demand for devices that generate chances. E-Health Thailand is one of a turning figure of smart phones and tablet computing machines have followed the planetary tendency. Some e – wellness undertakings, wellness informations aggregation, wellness position monitoring, etc. In the past few old ages has been the usage of the hand-held device. Commercially available from Q1 2013 due to 3G service, local infirmaries, which will let them to function in distant vitamin E – are cognizant of the wellness benefits. National Health Information System, tele-medicine, for smart places and independent life, the Thai Government Smart Health ‘s National Electronics and Computer Technology Center, with focal point on 3 countries ( NECTEC ) has supported the undertaking launched by. Thailand Health Care Industry Local Government Policies and Major Measures to Promote The Thai authorities began strategic programs since 2004 to advance Thailand as a premier medical touristry finish. Since so, the state has enjoyed a big figure of visitants in this class. The Department of Export Promotion and the Department of Health Service Support reported a rapid growing of 16.48 % during 2001-2009 for wellness services bringing to aliens: Year No. of Foreign Patients Estimate Income ( Million Baht ) 2007 1,373,807 106,640 2008 1,380,000 107,419 2009 1,390,000 108,197 Beginning: The Royal Thai Embassy, Washington Thailand is now widely acclaimed among the international community as the medical hub in Asia, with important advantages including the handiness of modern equipment and fortes, easy entryway, competitory monetary values, and great cordial reception from service operators and forces. These, when coupled with the well-established fact that Thailand is a brilliant tourer finish with calm beaches and mountains, fascinating humanistic disciplines and civilization, nutrient, amusement, and shopping, make Thailand a great medical touristry finish. The policies and schemes to advance Thailand as a medical hub of Asia 1 ) . Most healthcare service suppliers peculiarly infirmaries participate in travel marketplaces, travel carnivals, trade carnival, exhibitions, seminars, conferences. 2 ) . Using advertizements in travel magazines in states with the back uping from the authorities. With the cooperation from the Ministry of Public Health, Tourism Authority of Thailand ( TAT ) , Ministry of Foreign Affairs, and Department of Export Promotion ( DEP ) organized these activities for advancing health care services to international markets. 3 ) . Other enlightening stuffs are provided such as booklets, brochures, video-cds, paper bags and jersey with Sons were besides used to make consciousness of the available health care services 4 ) . Some healthcare service suppliers build up cooperation with the local institutes, universities, medical schools in other states to set up coaction in instruction, exchange of cognition and preparation every bit good as to advance their option health care services. 5 ) . Advertising about medical and nonmedical services in both local and international media are used by healthcare service suppliers. The advertizement has to be based on Thai Torahs and ordinances about how to publicize health care services. Media such as magazines, newspaper ( both in Thai and English ) , telecasting etc. are used to aim local people and exiles who work in Thailand. History of Development Modern medical system in Thailand day of the months back over 100 old ages, during the reigns of King Rama III and King Rama IV when American and British missionaries introduced modern medical specialty in Thailand. However, the promotion of modern medical specialty truly took a immense measure during reign of King Rama V and began to lift steadily from so on. King Rama V initiated the thought to establish Siriraj Hospital to suit people ‘s demands for health care. He founded the Royal Medical School that would subsequently put the foundation of modern medical schools. These enterprises led to constitutions of other infirmaries in Bangkok and big metropoliss. His Royal Highness Prince Mahidol of Songkhla was one of the drive forces that have given Thai modern medical specialty its topographic point among that of developed states. HRH Princess Mahidol of Songkhla received certification in Public Health and subsequently graduated M.D. semen laude from Harvard University, USA. He became the innovator in the Thai modern medical specialty and has been regarded as the â€Å" Father of Thailand ‘s Modern Medicine. † Even though he passed off at the early age of 38 due to deteriorating wellness, he has greatly contributed in modern medical specialty of Thailand. His Majesty King Bhumibol has granted permission to set up the Prince Mahidol Award as a planetary award in award of His Royal Highness Prince Mahidol of Songkhla. The Award is granted to persons or organisations around the universe with outstanding work for humanity in the Fieldss of medical specialty and public wellness. During 1950s, many Thai medical physicians graduated or completed their preparation abroad, in the United States in peculiar. In 1970s and 1980s, a big figure of Thai physicians continued their surveies and preparations in the United States. A big figure of medical physicians moved from public infirmaries to work in private infirmaries. At the same clip, many Thai physicians practising or holding medical licences abroad moved back to Thailand to and other states. During this clip, private infirmaries with international accreditation emerged in work in private infirmaries. One of the major drive forces behind the promotion of Thai modern medical specialty is the constitution of the â€Å" Thai Red Cross Society. † During the economic roar of the 1990s in Thailand, as the economic status improved and personal income degree increased, public demand for good quality wellness attention besides increased consequently. Leading private infirmaries expanded their capacity to suit such demand. Harmonizing to the Ministry of Public Health of Thailand, the entire figure of infirmaries increased from 422 in 1991 to 491 in 1997, and the figure of beds more than doubled, from 14,927 to 38,275 during the same period. However, when the 1997 fiscal crisis hit, the domestic market was significantly affected. Personal wellness outgos were curtailed as economic status declined. Private infirmaries had to do up for the loss of their domestic patients by switching their focal point outside of Thailand and ask foring patients from abroad. Because of the local currency devaluation, every bit good as the low labour and other factor costs, the entire monetary value of the medical intervention in Thailand was less than half that in the United States, even after adding in the costs of travel and adjustments. In the face of worsening gross, Bumrungrad Hospital in Bangkok brought in a new direction squad from outside the state to pull off its plan for international patients and to take the infirmary out of its fiscal troubles. Under this new direction, Bumrungrad became the first internationally commissioned infirmary in Southeast Asia in 2002 and pioneered the medical touristry concern. Its 50,000 international patients in 1997 had gone up to 350,000 in 2005. In this sense, the success of medical touristry in Thailand was a typical factor-driven phenomenon, where people traveled to obtain medical services with the lowest cost. 3. Industry Introduction ( SWOT Analysis and Development Status ) Thailand is one of the best finishs in Asia for health-conscious tourers. The state has been one of the modern-day innovators of Medical Tourism in Asia, with more than a million foreign patients yearly coming to over 956 public and 309 private infirmaries, 7 of which are JCI commissioned ( as of 2010 ) , and 17 of which are in the grapevine. The international patients will hold entree to the rich pool of over 19,000 medical physicians and 100,000 nurses, many of which have undergone preparations in the United States, UK, Germany, Australia, Japan, and other states. It is besides noteworthy that Thailand has been the leader in holistic intervention attacks, including health care, illness bar, interventions, rehabilitative and renewing attention. These attacks have gained greater attending in the western states. Thailand has convenient entree, beautiful tourer finishs, and superior services. Soon, Thailand is able to offer most comprehensive scope of medical interventions to the universe due to many Thai-Physicians have been studied and forte trained as specializer from abroad since 1960.These Physicians moved back to work in Thai private Hospitals and Clinics. So, they are able to freely offer their expertness and specializers to Thai every bit good as alien patients. The most three popular services in medical touristry consist of: Cosmetic and Fictile Surgery such as Breast Augmentation ( Augmentation Mammoplasty ) , Breast Lift ( Mastopexy ) , Nose Surgery ( Rhinoplasty ) , and Liposuction ( Lipoplasty ) Dentistry such as Dental Bonding, Dental Bridges, Dental Crowns, Dental Filling, Dental Implants, and Teeth Whitening Renaissance mans ramping from Blood Vessel System, Bones, Joint and Tendons, Breast, Cardiology, Diagnostics, and General Surgery How to cite Role In Health Sector Reform Health And Social Care Essay, Essay examples

Sirius XM Financial Analysis free essay sample

In the previous project assigned to me, I completed a SWOT analysis of Sirius XM Radio where it was noted that the Sirius XM is firmly at the top of its industry. For the purposes of this project, I went through the financial statements of Sirius XM as well as computed several key financial ratios to indicate Sirius XM’s profitability, growth, performance, and efficiency amongst other things. I then compared these ratios to the industry averages as well as with Sirius XM’s top competitors. After completing this close analysis, I found that although Sirius XM is enjoying incredible growth and a strong place in the market, there are still several flags that an investor should still note. The very first fact that I noticed about Sirius XM’s radios financial statements was its incredibly large revenue. When compared to its competitors, there is essentially no competition, with Sirius XM posting revenues of over $3 billion for each of the past two years. The closest competitor to Sirius in the radio broadcasting market in terms of revenue was Cumulus Media, which had posted revenues just over $1 billion in 2012 and $550 million in 2011. Sirius XM has also shown consistent growth of its revenue since the merger in 2008. Over the past 3 years Sirius XM has seen its revenue grow by 14%, 7%, and 13%, which can is a significant amount due to the fact that Sirius XM’s revenues are in the billions. In addition to the growth in revenue, Sirius XM has seen a consistent growth in net income over the years as well. One issue with these facts that I quickly noticed upon analyzing the financials of Sirius XM is that Sirius XM relies heavily on subscribers to post its revenue. The subscription revenue accounts for over 85% of Sirius XM’s total revenues. As stated in the previous analysis of Sirius XM, it relies heavily on the auto industry for its subscribers, with new cars or leases usually coming with a pre-paid membership to Sirius XM radio. Sirius must give a share of its subscription revenue to certain auto manufacturers, which they book as an expense instead of deducting it from its revenues. This share accounts for roughly 18-20% of its subscription revenues and about 15-16% of its total revenues. Another issue that stuck out to me was the high costs that Sirius XM incurred. Sirius XM has a low retention rate when it comes to subscribers so its sales and  marketing costs (over $200M) , as well as its subscriber acquisitions costs (over $400M) are extremely high due to the fact that it is constantly marketing for new subscribers. This greatly affects the net income of the company. This flaw was not reflected in the 2012 income statement because Sirius XM received a tax benefit of almost $3 billion as a result of previous years of operating losses. This tax benefit greatly skewed some of the financial ratios of Sirius XM because it was a one-time tax benefit that will not happen again, and net income will surely decrease in 2013. Despite these facts, Sirius XM is still a profitable company that shows no signs of being in financial danger. When compared to competitors such as Cumulus Media, and Dial Global Inc., Sirius XM boasts a higher operating (26%) and gross margin percentage (64%), with both percentages consistently growing as well. This shows that although Sirius is posting huge revenues with high costs, it is still able to maintain consistent growth, especially when compared to its competitors. It should however be noted that if one were to take into account the revenue share that Sirius XM records as an expense, the gross margin percentage would decrease by about 6%. Another ratio that I calculated that I found to be equally important was Sirius XM’s debt to equity ratio, which has been significantly dropping. It went from 15.85 in 2010 to 0.61 in 2012, which means that Sirius XM is no longer heavily relying on debt to finance its activities. This is a clear indicator that Sirius XM will have a higher return on assets, which has also been steadily improving over the years, than its competitors. Sirius XM also proves that it can, for the most part, meet its short-term obligations by boasting a current ratio of 0.79. Sirius XM’s current ratio is relatively low because of its strong operating cash flow (over 800M). Just like the debt to equity ratio, this low current ratio can also mean a higher return on assets for Sirius XM. It should however be noted that, when I calculated the quick ratio, I took into account the quick ratio with accounts receivable (0.78) and without accounts receivable (0.32). One glaring issue that I found in the notes to the financial statements of Sirius XM radio is the fact that Liberty Media owns over 50% of Sirius XM radio. Because of this fact, Liberty Media owned all of Sirius XM’s Series B Preferred Stock. In September of 2012, Liberty Media converted over 6 million of these shares into over a billion shares of common stock, which no doubt affected Sirius  XM’s earnings per share as well as price to earnings ratio. It should also be noted that in January 2013, Liberty Media converted the rest of its Series B Preferred Stock into common stock as well, which will further affect earnings per share. Overall, Sirius XM is a profitable company, but I am unsure of how much longer Sirius XM will be able to sustain such profitability simply because of its reliance on the auto industry and new customers. Sirius XM’s low retention rate shows that there is no loyalty among its customers, which to me means that on any given day it can suffer serious losses.

Swot Analysis of Walmart Essay Example For Students

Swot Analysis of Walmart Essay Wal-Mart Company Strategy This section will examine Wal-Marts company strategy in several sections. Three elements of successful strategy formulation and a fourth element, which exemplifies the implementation process of company strategy, will be looked at. Followed by this, an analysis of key factors contributing to this strategy will be detailed. These include looking at Wal-Marts competitive strategy, the CEOs leadership, and company strategy strengths and weakness assessment. The material used to analyze Wal-Mart strategy consists of the companys annual reports, its Fact Sheets and other information found on the company Internet site. Other information is obtained from outside sources such as Fortune Magazine, and from outside groups who are critical of the corporation. The focus of this analysis will be placed on identifying the resources of the firm, its weaknesses and strengths in terms of its competitive environment. The sections examined will highlight the leadership style of Wal-Mart CEO H. Lee Scott, who inherited the corporate legacy of Wal-Mart founder Sam Walton. Other elements such as the culture, the corporate organization and values of the company come to play. 1. We will write a custom essay on Swot Analysis of Walmart specifically for you for only $16.38 $13.9/page Order now Strategic Goals This section looks at three successful elements of strategy formulation and a fourth element, where the strategy is implemented successfully. These are as follows: Dominate the Retail Market wherever Wal-Mart has a presence. Growth by expansion in the US and Internationally. Create widespread name recognition and customer satisfaction with the Wal-Mart brand, and associate the retailer with the reputation of offering the best prices. Branching out into new sectors of retailing such as pharmacies, automotive repair, and grocery sales. a. Dominate the Retail Market Everywhere A key strategy of Wal-Mart is to dominate the retail market. Company founder Sam Walton put in place a retail philosophy the company still follows. Wal-Mart is primarily a discount retailer because they sell their products at the lowest possible prices. By selling at the lowest price. Walton outlines that the essence of successful discount retailing to cut the price on an item as much as possible, lowering the markup, and earn profit on the increased volume of sales. (Wal-Mart pricing philosophy document, www. walmart.com). Another subset of this strategy is the competitiveness of every unit. Each store is encouraged to ferociously compete against all other stores in its customer base until the Wal-Mart store gains dominance over its local competitors (Quinn, 2, 115). Wal-Mart is currently ranked as the worlds number one retailer and the number one company in the world in terms of sales (over $200 billion) on the Fortune 500 list (www.walmart. com) (www.fortune.com) The key strategy is to dominate a market. Using its size and volume buying power, the company effectively implements its strategy. b. Growth by expansion in the US and Internationally. A strategic goal of Wal-Mart is to expand. It has done so successfully. Looking at the facts and figures clearly shows the corporations dominance and power. Currently the corporation employs over 1.3 million employees, one million in the US alone. The company owns over 4000 stores worldwide. Over 1,200 units (stores) are in operation internationally. Domestically, Wal-Mart is the largest US retailer, employing around 1 million people. It has over 3,000 stores and outlets, and 77 distribution centers. The company serves more than 100 million customers weekly in all 50 states, Puerto Rico, and several nations around the world. (www.walmart. com, Fact Sheet Wal-Mart at a Glance, 2002). Internationally, the retailer operates in Mexico, Canada, Argentina, Brazil, China, Korea, Germany, and the United Kingdom. Its expansion strategy internationally has been aggressive and powerful. The latest expansion strategy is for the company to gain entry into a nation by corporate takeover of a national retailer. Once the company is bought, Wal-Mart converts the stores into Wal-Mart stores. Three countries, all with no previous Wal-Mart stores, became part of the corporations international presence when domestic retail chains were overtaken. .ud8312be085df4e16334959c2f552f8e8 , .ud8312be085df4e16334959c2f552f8e8 .postImageUrl , .ud8312be085df4e16334959c2f552f8e8 .centered-text-area { min-height: 80px; position: relative; } .ud8312be085df4e16334959c2f552f8e8 , .ud8312be085df4e16334959c2f552f8e8:hover , .ud8312be085df4e16334959c2f552f8e8:visited , .ud8312be085df4e16334959c2f552f8e8:active { border:0!important; } .ud8312be085df4e16334959c2f552f8e8 .clearfix:after { content: ""; display: table; clear: both; } .ud8312be085df4e16334959c2f552f8e8 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .ud8312be085df4e16334959c2f552f8e8:active , .ud8312be085df4e16334959c2f552f8e8:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .ud8312be085df4e16334959c2f552f8e8 .centered-text-area { width: 100%; position: relative ; } .ud8312be085df4e16334959c2f552f8e8 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .ud8312be085df4e16334959c2f552f8e8 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .ud8312be085df4e16334959c2f552f8e8 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .ud8312be085df4e16334959c2f552f8e8:hover .ctaButton { background-color: #34495E!important; } .ud8312be085df4e16334959c2f552f8e8 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .ud8312be085df4e16334959c2f552f8e8 .ud8312be085df4e16334959c2f552f8e8-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .ud8312be085df4e16334959c2f552f8e8:after { content: ""; display: block; clear: both; } READ: Upstarts Assault Essay In 1994, Wal-Mart bought 122 Woolco stores in Canada; today there are 196 units in Canada. In 1998 Wal-Mart bought the Wertkauf store with 21 units, now there are 94 Wal-Marts in Germany. In 1999, Wal-Mart acquired the ASDA chain with 229 units in the UK. Today, the UK has 252 Wal-Mart stores. (www.walmart. com, Fact Sheet on International Operations, .

What Is Zema Dosage, Effects, and Safety

What Is Zema Dosage, Effects, and Safety SAT / ACT Prep Online Guides and Tips Have you recently started using a Zema-pak or been told that you’ll be prescribed it to treat a specific illness or symptom? If so, you’ve come to the right place. In this article, I’ll explain what Zema is, what it treats, how to take it, and what you need to know to safely use the drug. Feature image source: NIH.gov What’s Zema Used For? A Zema-pak tablet is an oral corticosteroid hormone that’s used to treat a number of different conditions. Zema’s generic name is dexamethasone. Dexamethasone is used to treat a variety of different conditions, including allergic reactions, arthritis, adrenal gland disorders, bowel disorders, skin conditions and certain cancers. Dexamethasone can also be used to treat symptoms caused by illnesses like Lyme disease. Corticosteroid hormones like dexamethasone are used to decrease your body’s natural defensive response. For instance, someone with ulcerative colitis may take dexamethasone to decrease inflammation in their large intestine. Zema-Pak Dosage and Administration Zema-paks come in three separate doses: the 6-day pack, the 10-day pack, and the 13-day pack. The 6-day pack contains 21 tablets, the 10-day pack contains 35 tablets, and the 13-day pack contains 51 tablets. Each tablet is a Zema-pack is a 1.5mg dexamethasone pill. Corticosteroids like dexamethasone can cause dependency and can be dangerous if you stop taking them without warning. Each Zema-pak is designed to slowly and carefully help you stop using the drug. You should take each of the pills in the Zema-pak by mouth as directed by your doctor. To avoid upsetting your stomach, take the pill with food or milk. You should also drink at least one full glass of water when taking the medicine. Make sure you take your pill at the same time each day, for the entire length of the prescription. If, for instance, you’re on a 10-day Zema-pak and start to feel better around day six, you should still take the rest of the pills until you finish the pack. Stopping the medication suddenly can lead to serious side effects or the return of symptoms that you were initially trying to ease. Zema Drug Name and Manufacturer While there are both brand name and generic versions of dexamethasone, Zema-paks in particular are only available in the 6, 10, or 13 day packs. Zema Side Effects Corticosteroids can have serious long and short-term side effects. If you’re experiencing any side effects from your Zema-pak that cause you distress or discomfort, you should seek help from a medical professional. If you’re taking dexamethasone for a long period of time, you should visit your doctor regularly to monitor you for long-term, unwanted side effects. Minor Side Effects The following side effects are minor and do not require immediate medical care. However, if you experience any of these side effects and they worsen, are bothersome, or if you have any questions about them, you should speak with your doctor. Aggression Agitation Headache Irritability Nausea Noisy breathing Shortness of breath Sweatiness Weight gain Major Side Effects The following side effects are more severe and require medical attention from your doctor. Anxiety Darkening of skin Decrease in height Depression Facial hair growth in females Increased risk of serious infection Menstrual irregularities Nervousness Skin rash Trouble thinking, speaking, or walking Long-term use of corticosteroids like a Zema drug pack can lead to serious personality changes, such as increased aggression and irritability. While these side effects may seem minor at first, they can increase and become more out-of-control as time goes on. Corticosteroids can also put you at greater risk of developing serious infections. If you have any signs of infections, such as prolonged fever or sore throat, make sure you inform your doctor. Precautions for Taking Zema Before starting a new drug, it’s important to keep your doctor informed about your medical history so he or she can plan for any potentially dangerous side effects. In particular, make sure you inform your doctor about allergies, infections, kidney or liver disease, mental or mood conditions, high blood pressure, heart problems, brittle bones, and history of blood clots. Interactions to Avoid While Taking Zema Do not get any new immunizations, vaccinations, or skin tests while taking dexamethasone, as you may be at increased risk for infection. You should also avoid people who’ve recently gotten the oral polio vaccine or have inhaled the flu vaccine. Dexamethasone can make it difficult for people with diabetes to control their blood sugar levels. You may need to adjust your medicine or diabetes treatment plan while taking a Zema-pak.= If you have a history of ulcers, you should avoid drinking alcohol while on dexamethasone, as it may increase your risk of intestinal bleeding. There are many drugs that may interact with dexamethasone. You should check with your doctor or pharmacist before taking any new medication to ensure that it interacts properly. Here are some medications that may interact with Zema-paks: Birth control pills Certain cancer drugs (dasatinib, lapatinib) Estrogen hormone replacements HIV inhibitors Antifungals Seizure medications like Phenytoin You should always inform your doctor or pharmacist that you’re taking a Zema-pak if you need to start another medication. Recap: What Is Zema? Zema is a corticosteroid that’s used to treat a variety of conditions from skin rashes to Lyme disease. Zema-paks are brand name and come in three standard doses: 6-day, 10-day, and 13-day. Your doctor will work with you to determine the dosage that’s right to meet your needs. As with any drug, Zema has potential side effects, ranging from minor, such as headache, to major, such as depression. If you’re experiencing any side effects that cause you discomfort or seem particularly dangerous, you should contact your doctor.

Development a brain controlled prosthetic hand Research Paper

Development a brain controlled prosthetic hand - Research Paper Example The recorded brain signals are then used to control a physical or virtual device that carries out a task according to the user's intent. The first step we took when designing the prosthetic hand was to decide on the best control mechanism for finger movement. The goal for our design was to minimize the number of actuators necessary to control the movement of the finger and simplify the equations needed to describe the motion of the finger. The first proposal, which was the tension controlled model, consisted of the three joints of the finger, with a cable attached to a fixed point on each link of the finger which was run back through the finger to an actuator mechanism at the hand or behind the wrist. For this model, each joint would have a compliant mechanism which forced the resting state of the links to be in the bent position. The second approach for this design has the complaint mechanisms such that the resting state for the links is in the straightened positions. A second design proposal included the use of pneumatic systems to drive the bending or unbending of the fingers. In this proposal small tubes could be used to fill with either air or liquid to actuate the finger. The noise would create the same discomfort for the user as non life-like prosthetics. The third proposal for the finger design wa... In this proposal small tubes could be used to fill with either air or liquid to actuate the finger. The noise would create the same discomfort for the user as non life-like prosthetics. The third proposal for the finger design was a pulley system to control each joint independently. Pulley's would be placed at each joint in the finger, and would be independently controlled by its own wire. Therefore, when the actuator is active, the fingers will bend and hold their positions. When the actuator becomes inactive, the compliant mechanism would return the fingers to their straightened positions. In the designs described above, a pulley at each joint in the finger would have a cable wrapped around it just enough for it to actuate the exact number of degrees of rotation required at that joint. It may be possible to use flexinol in place of the motors, but testing would need to be completed to confirm that overheating does not occur and that temperatures of the prosthesis do not rise above the melting point of the prosthetic skin covering. One aspect of this design that we later incorporated into our final design was the knuckle joint. This piece had to be designed so that it could provide space for the pulley to rotate as well as allow the finger to rotate side to side. This piece also had to allow for the actuating cables to pass through it on its path to the motors. The third, and final, approach to the design of the finger uses a four bar mechanism to control the movement of the finger, and compliant mechanisms to move the finger back to its resting state at the straight position. In this design, the four bar linkage is placed between the two upper joints on the finger. From our preliminary research, we had determined the

Medical Information Confidentiality Research Paper

Medical Information Confidentiality - Research Paper Example The questionnaires were distributed in five primary care clinics. The receptionists in these clinics were requested to issue questionnaires to all the patents who visited the clinics. The survey was intended to run for three weeks and it was aimed at collecting 100 questionnaires (Whiddett et al. 532). Patients were requested to answer all the questions and put them in a collective box in the respective clinics. Alternatively, they could return them using pre-paid envelopes. The research team did not monitor the issuance of the questionnaires or make attempts to identify repeat respondents and non respondents (Whiddett et al. 532). This was the major limitation facing the exercise however; it did not impact on the findings as the sample size was adequate. The survey was representative enough as the clinics were chosen to represent a wide range of demographics. The questionnaire covered three key areas. These are basic demographics, attitudes towards sharing different kinds of informa tion and patients’ knowledge towards information sharing practices. Secondly, secondary data was used to complement the findings that were obtained from the survey. The information will be collected from a peer reviewed sources, credible internet sources and medical journals that have conducted similar studies. A comprehensive study of past case studies reveals that medical confidentiality in the health sector is at a risk of getting eroded due to the use of the current technology. The respondents are wary about sharing their personal information to various parties and the study reveals that most of them are not aware of the increasing information sharing practice in the medical field (Levenson 20). Data Collection Instrument: Questionnaire Tick the appropriate answer 1. My age is: 18 to 30 years 30 to 60 years Above 60 years 2. I am Male Female 3. My ethnicity or race? (Tick one) White Americans Black Americans Asian Americans Hispanic and Latino Americans Other 4. How much information do you have concerning those who can access your medical records? Nothing Something A lot 5. Are you aware of the NHI number? Nothing Something A lot 6. I am comfortable with confidential health information being shared between the following groups. Health administrators Yes Maybe, if consulted first No Don’t know Health professionals Yes Maybe, if consulted first No Don’t know Researchers Yes Maybe, if consulted first No Don’t know Other bodies (Insurers) Yes Maybe, if consulted first No Don’t know 7. I am comfortable with confidential health information being shared to the following groups as long as it does not contain my personal information. Health administrators Yes Maybe, if consulted first No Don’t know Health professionals Yes Maybe, if consulted first No Don’t know Researchers Yes Maybe, if consulted first No Don’t know Other bodies (Insurers) Yes Maybe, if consulted first No Don’t know Question Specificat ions The first question is important since it helps to establish the link between the age of the respondents and their level of awareness concerning confidentiality of medical information. In addition to, it helps to establish the age bracket that attends the clinics often. The second question concerning gender helps to determine the relationship between gender and attitudes towards medical information confidentiality. The third question is aimed at finding out the level of awareness about medical confidentiality (Whiddett et al. 534). It also gives information on varying attitudes across ethnic groups. In a nutshell, the first three questions are interested in determining the primary demographics which

Atlantic Conveyor Belt System Essay Example | Topics and Well Written Essays - 500 words

Atlantic Conveyor Belt System - Essay Example In detailed, ocean waters circulate around the world in patterns due to factors including the differences in solar energy received by the equator and the poles, topography of the ocean floor and coastal land masses, changes in seawater density, rotation of Earth around its axis, and atmospheric winds. The pattern of the Atlantic conveyor belt is the northward flow of warm surface waters from the Caribbean along the Atlantic coast of the United States, known as the Gulf Stream. As the warm waters reach the North Atlantic, it becomes denser due to the lowering of temperature, and becomes more saline from the evaporation of surface water and formation of ice. Denser water sinks forming a cold bottom current in the Atlantic. The current then circulates to the south towards Antarctica and turn eastward. By passing across the equator, the water becomes warm, rises to the surface and veers westward towards the Atlantic Ocean (Bloom 2011). Moreover, the Scientists of the National Aeronotics Space Administration once suspected that the speed of the Atlantic conveyor belt has slowed down. However, using recent measurements of the Atlantic Meridional Overturning Circulation show no significant slowing of overturning over the past 15 years NASA/Jet Propulsion Laboratory, 2010). On the contrary, it was found out that water circulation had sped up about 20 percent from 1993 to 2009 (NASA/Jet Propulsion Laboratory 2010). The circulation of the Atlantic Ocean is very important in the climate system. The warm currents contribute to the higher average temperatures of about 5Â °C in the East Coast of the United States, Europe, and Scandinavia compared to other land masses along the same latitude (Bloom 2011). In general, warm currents transport energy from the tropics to the sub polar North Atlantic. It also influences weather and climate patterns. Cold currents facilitate the transfer of carbon from

Enterprise Resource Planning Systems For Smes

Enterprise Resource Planning Systems For Smes Several researches have revealed that Enterprise Resource Planning (ERP) systems bring greater benefits to organisations, small or large. These reports asserted that successful implementation of the right ERP solution will empower the financial success of the organisation while its failure can spell doom and gloom. SMEs in contrast to their larger counterpart have peculiar challenges that further make the choice of ERP solution difficult. These challenges have defined the expectations and requirements of SMEs from ERP solutions. Various ERP software are available in the market for their use, with the software leader being SAP, but it is essential for an SME to select the appropriate software solution that appropriately address their needs putting in consideration their peculiar predicament. This is easily achieved through an adequate software selection and evaluation process. This research looks into past works on ERP implementations for SMEs to come up with ERP requirements for SMEs ; available software (and hardware) solutions available to them and a detailed software evaluation and selection process in line with industry best practice which they can use. It also addresses current ERP market and market trends. Methodology This paper is largely based on review of previous academic documents in form of journals, conference documents and books. These were reviewed extensively in line with the topic of discussion. Another helpful source of information used in the report is the internet. Through the internet, we were able to get more current information and data to support previous academic works. While we have done extensive research on this topic, it should be noted that the academic documents used in this research represent just a subset of the numerous documents that have been written concerning this topic. They are by no means a perfect representation of all the possible views. Table of Contents 1 Abstract 1 Methodology 1 Table of Contents 2 Introduction 3 Enterprise Resource Planning (ERP) Systems 4 Small and Medium Size Enterprises (SMEs) 4 ERP Market and Market Trend 6 ERP Requirements for SMEs 9 Analysis of ERP Solution (Software and hardware) 11 SAP 11 Oracle ERP Software 14 International Financial Services (IFS) 15 SAGE Accpac 15 Microsoft Dynamics 16 Open Source Software (OSS) 16 ERP Evaluation and Selection process 17 Stage 1 Plan Requirement 18 Stage 2 Request for Proposals (RFP) 19 Stage 3 Solution Evaluation 19 Stage 4 Contract Negotiation 19 Stage 5 Selection and Agreement 20 Introduction Enterprise resource planning (ERP) systems, according to Joseph et al 2003, is now being promoted as a desirable and critical link for enhancing integration between all functional areas within an enterprise and between the enterprise and its upstream downstream trading partners. Despite all benefits potentially offered by ERP systems (Banker, 1998; Hicks, 1995; Minahan, 1998) however, the issue of organisational changes needed by ERP implementation as well as predicting return on investment assumes particular importance within small and medium-sized enterprises (SMEs) because of their peculiar challenges. In SMEs, the implementation and the evaluation of the potential benefits is still a difficult task. (Ravarini, 2000). (Chan, 1999), asserted that many SMEs either lack enough resources or are not enthusiastic about committing a huge fraction of their resources to ERP implementation due to long implementation period and high fees associated with ERP, (Chau, 1995). These amongst other factors have resulted in slow ERP adoption by SME (Tagliavini et al, 2002). Nowadays, some SMEs are not only seeking ways of integrating their various island-of-information within the organisation, but have also moved to extend the whole scope beyond their organisation to include their suppliers, trading partners and customers (Charlesworth et al., 2002). Therefore, implementation of a right and cost effective ERP solution is essential. This however must be preceded by an accurate ERP software evaluation and selection process. This paper explores ERP for SMEs and is formatted as follows; Introduction, Methodology, Background on ERP, ERP Market and Trends, ERP and SMEs, ERP requirement for SMEs, Different Software (and Hardware) Solutions Analysis a Detailed Software Evaluation and Selection Process, Discussion, Conclusion and Future Research work. Enterprise Resource Planning (ERP) Systems ERP systems can be defined as the most predominant computing systems for business in a lot of organisations, both in the public and private sectors (Gable, 1998) The ERP software can be customised to support critical existing processes which organisations follow (Stefanou, CJ., 2001) Included in an ERP system are: Storage, orders, assets, vendor contacts, purchasing, financials and human resources (Dahlen C. and Elfsson J., 1999) (OLeary, 2000) stated that An ERP system integrates the majority of business processes and allows access to the data in real time. However, (Gardiner et al., 2002) also stated that an ERP system improves the performance level of a supply chain by helping to reduce cycle times. Other benefits which enterprises enjoy by implementing an ERP system include: better customer satisfaction, reduced quality cost, increased flexibility, improved resource utility, improved decision-making capability, improved information accuracy and improved vendor performance (Siriginidi, 2000). The flip-side to this is that, most ERP software tend to be complicated, large and expensive (Mabert et al., 2001). The implementation of an ERP system is time consuming and puts pressure on an organisations information technology (IT) department or outside professionals (Khaled Al-Fawaz et al., 2008) Putting ERP in place requires new procedures, employee training, and both managerial and technical support. (Shang and Seddon, 2002) Small and Medium Size Enterprises (SMEs) SMEs, in most countries are businesses that employ fewer than 250 people. For some other countries, SMEs are those which employ fewer than 500 people. Countries like these include: USA, Italy and Australia. 99.9% of the businesses in Albania come under SMEs. (Nito E., 2005) ERP customers are usually split into three market divisions by annual income. These include: large, midà ¢Ã¢â€š ¬Ã‚ market and small. The borderline of these divisions tend to be different, depending on which ERP vendor is using them. For small enterprises, Sage, SAP, Microsoft, Infor and to a slight extent Lawson, compete with a number of smaller vendors for ERP systems. Figure 1: Source: bla bla bla As shown in the diagram above, only SAP and Sage have set ERP products designed for the small enterprise market. The other vendors compete in this division with products that they also use for the midà ¢Ã¢â€š ¬Ã‚ market. The top six vendors compete in the mid-market. A lot of these products are industry specific e.g. pharmaceutical distribution, projectà ¢Ã¢â€š ¬Ã‚ oriented services, process manufacturing, etc. Successful competition has been attained by the leading ERP vendors adding sector specific focus to their products. This has been approached by: Industryà ¢Ã¢â€š ¬Ã‚ specific preà ¢Ã¢â€š ¬Ã‚ configured templates using a standard ERP product being developed by the ERP vendor (e.g. Oracles Business Accelerators or SAPs Best Practice Templates). ERP Market and Market Trend Trend, as defined by (Kotler, 1997) is: A direction or sequence of events that have some momentum and durability. Over the last decade, the ERP market has grown very quickly. The three main reasons for this growth are: globalisation, year 2000, and the need for better information integration. (Dahlen C. and Elfsson J., 1999) As at 1998, Merrill Lynch estimated that 40% of companies with revenues over $1billion had already implemented base ERP systems in the USA (Caldwell Stein, 1998) and had started implementing additional applications, a market that was estimated at $8billion by 2002. An American-based research firm, AMR Research, also predicted the enterprise applications market could hit $78billion by 2004 compared to $27million in 1999 (Stefanou, CJ., 2001). However, according to Gartner group, a high percentage (88%) of the ERP market is concentrated in the western countries. SAP, the German flagship company, holds a global market share of 32%, while Oracle has a global market share of 14.5%. Both vendors have the lion share of the Global ERP market. However, this is not the case in the Chinese market where SAP and Oracle hold a combined market share of 24.4% and the domestic companies holding a combined market share of 51.6%. (Huigang Liang et al., 2004) Total ERP market revenue grew to over $28B in 2006. This was driven by a combination of strong customer demand and leading vendors expanding their product portfolios through acquisition. (Jacobson S., 2007) As at 2000, the AMR Research, Inc. predicted that the ERP market would grow at a compound annual growth rate of 37% over the following five years. Currently, SAP and Oracle have dominated the market. Their competition, however, lies in the SMEs market With rivals like: Sage group, Microsoft, Epicor and Lawson (Jacobson S. et al 2007) Below is an ERP application revenue estimate for 2006 2011 This was estimated as at 2007 by the AMR, Research GroupFigure 2: (Jacobson, S. et al 2007 The ERP Market sizing Report, 2006-2011, AMR Research., ERP 2007 Market sizing series). In recent times, the ERP Vendor Outlook has changed a lot. Six vendors are responsible for almost two thirds of global ERP sales. Oracle and SAP control 50% of the World market by income. At the start of the last decade, Infor and Microsoft did not have a market presence. Below is a pie chart showing Global ERP Revenue by Vendor (2008) Figure 3: Source: BSM, ERP. May 2010 ERP Requirements for SMEs According to Huin 2004, SMEs have an enormous difference in needs, operating requirements, logistics fulfilment and financial capabilities compared to their large counterparts. First among these requirements is a cost effective ERP solution. Costs associated with ERP solution include not only the software, but also to items such as training, hardware and consulting (Willis et al 2001). Besides, most ERP software available in the market, according to Bounanno G. et al 2005, are just too expensive for SMEs. Chan R. 1999, supported that many small-medium enterprises either do not have sufficient resources or are not willing to commit a huge fraction of their resources due to long implementation times and high fees associated with ERP implementation. This emphasises the fact that cost is a major factor for SMEs when attempting to undergo a capital intensive venture like ERP implementation. A research of 50 Italian SMEs carried out by Federici 2009 suggested that small and medium enterprises mostly chose systems provided by small national software houses obviously for cost reasons. Contrast to larger establishments, SMEs have limited experiences, human resources and skills that are necessary for some kind of ERP implementations according to Adam and ODoherty 2003 cited in Winkelmann and Klose 2008. It is a well known fact that most SMEs have a scaled down number of employees who handles more than one function. This position is further supported by Huin 2004, which confirmed that most SMEs experience a high turnover rate compared to large companies. That work further stated that high turnover rate adversely impacts how SMEs manage their labour resource-a key resource input in any ERP project. This is in line with the research work of Winkelmann A et al 2008 which emphasised that a dedicated IT department addressing the selection and implementation of an ERP system dont actually exist in most SMEs. As such most SMEs have requirements for ERP solutions (software and hardware) that leverage on their lean human resources, especially in the IT department and provide a user friendly platform not riddled with so many complications. Achanga et al 2006 confirmed in his work that most SMEs do not have a good management structure on which innovations such as ERP thrives. It is customary to have the Managing Director or the CEO involved in daily administration of the companies in addition to making strategic decisions. They further explained that most SMEs were established by owner managers who may not have the tactful management know-how. As such, strategic progress is usually hampered by lack of good leadership traits which bring about informal working processes. This was supported by (Mintzberg H. et al 2003 p.217). Processes here according to Beretta 2004 is the medium that coverts activities efficiently and effectively in order to generate value for a specific customer. It is important to note that these processes are what ERP serves to integrate. As such ERP solution for SMEs must be simple and flexible to accommodate these peculiarities of most SMEs. Such flexibility involves things like allowing only specific modules or even sub-modules to be implemented. The type and focus of the SMEs should begat the requirement for consideration in the choice of ERP solution. Most SMEs have very specific operations and as such have very specific processes. These processes differ according to the specialisation of the company. Example is the case of a construction company in Taiwan that wanted to implement ERP but could not get software fit because of its unique operations (Yang J et al, 2007). Another example: Made-To-Stock (MTS) manufacturing companies have different ERP requirements from Made-To-Oder (MTO) companies (Deep A. et al 2007). The implication is that MTO and MTS have different production processes and thus will need a system that aligns with their peculiar requirement. We can therefore conclude according to Deep A. et al, 2007 that issues relating to the specificity of an organisation will need to be determined before proceeding to make a choice on the ERP solution for implementation. Analysis of ERP Solution (Software and hardware) ERP software belongs to a suit of software called Enterprise system software. According to Shanks G. et al 2003, it is; a set of packaged application software modules, with an integrated architecture, that can be used by organizations as their primary engine for integrating data, processes, and information technology, in real time, across internal and external value chains impound deep knowledge of business practices that vendors have accumulated from implementations in a wide range of client organizations, that can exert considerable influence on the design of processes within new client organizations is a generic semi-finished product with tables and parameters that client organizations and their implementation partners must configure, customize and integrate with other computer-based information systems to meet their business needs. Thus, ERP software are sold to organisations on the platform that its a way for them to implement best practices in an organisation (Wagner and Newell 2004), but there is a vast gap between this theory, the actual implementation and use of the software. The idea behind the software use is that a blend of best practice within a particular industry is built into the design so that this can be used by a similar company irrespective of where it is to automate its working process. According to Holland and Light 1999, most organizations now opt for off the shelf software instead of developing one in-house for its function. While there are over one hundred ERP software available, we will be reviewing a list of some well known ERP solutions available to an SME below; SAP A company that started in Germany, the application has captured the integrated market of most large and medium market throughout the world (Martin and Cheung 2000). With high functionality and a great deal of integration, the solution covers requirements such as financial accounting and control, sales and distribution, materials management, production planning and human resource management. Bancroft et al 1998 revealed that SAP design consists of the following layers of software; The SAP graphical user interface (GUI) representing the presentation layer; The SAP application layer; and The SAP database layer SAP supports critical business functions and processes and can actually be tailored to meet the business needs of any enterprise (SAP Global, 2010). It delivers the following solutions SAP ERP Financials: helps addressing changing financial reporting standards, improve cash flows and manage risks SAP ERP Human Capital Management: helps in automating key processes like End-user service delivery, workforce analytics, talent management, workforce process management and workforce deployment SAP ERP Operations: helps with process like procurement and logistics execution, product development and manufacturing and sales and services SAP Corporate Services: covers real estate management, Enterprise asset management, project and portfolio management, travel management, environment and safety management, quality management and global trade services SAP Global claimed that the product helps in increasing oversight of business operations and providing adequate information for strategic business decisions. It also claimed high flexibility and innovation and that modules can be implemented as needed and upgraded as the need arises. The SAP for SMEs has been implemented by over 80000 SMEs. Figure 4 below shows the SAP Solution roadmap showing the multiple level of blueprint of processes supported by SAP. SAPs benefits were echoed by the research work of Mandal and Gunasekaran 2003. This was implemented at PMB Water Corporation. They discovered greater benefit of implementing SAP. However, Al-Mashari and Zairi 2000 confirmed that SAP is a very complex solution that is too prone to failure. This position is supported by the research work of Martin I. et al, 2000 in an organization in Australia where he discovered that the training was complex, expensive and enormous. It is also not a user friendly application. For a small and medium sized company this enormous complexity and capital investment among other things is not one that can be readily and easily accommodated as previously stated in the requirements section. Figure 4 SAP Solution Roadmap (available at http://www. sap.com/businessmaps However, it should also be noted that quite a number of medium establishments have been able to implement SAP successfully and are reaping the benefits (Martin I. et al 2000). Oracle ERP Software The Oracle ERP software is part of the Oracle e-Business suite. It consists of the following modules (Oracle 2010); Channel Revenue Management: enables information driven channel management. Includes modules like Accounts receivable deductions settlement, channel rebates and point-of-sale, partner management, price protection and supplier ship and debit Financial Management: covers things like Asset lifecycle management, cash and treasury management, credit-to-cash, financial control and reporting, financial analytics, governance, risk and compliance, lease and finance management, procure-to-pay and travel and expense management Human Capital Management: includes Global Core HCM , Workforce Management, Workforce Service delivery, Integrated talent management, and HR analytics Project Portfolio Management: Involves things like project analytics, project billing, project contracts, project collaboration, project costing, project management, project portfolio analysis, project resource management and time and labour. According to Oracle, Oracle E-Business suite is the most adaptable global business platform and the most customer-focused application strategy. This opinion seems to be supported by Panorama Consulting group 2010, that the software has the highest level of predictability of all ERP software that was studied, and that the average initial cost to implement is 25% less than that of SAP. It also claimed that Oracles total cost of ownership is nearly 50% less than that of SAP. The fact remains though that its usage does not as yet compare to that of SAP. This is true considering the fact that there has not been much academic research into the use of the software as an ERP solution. International Financial Services (IFS) IFS is a single, integrated product supporting the management of 4 core processes (IFSWorld 2010); Service and Asset, Manufacturing, Project, Supply chain. It can be added to other suites of software e.g. Financials, Human Resources, Sales and services, Engineering, Project, Manufacturing and Distribution. According to IFSWorld 2010, its easy to use software that provides an attractive, intuitive and efficient user experience. It is also quite flexible, allowing an organisation to choose the required module and upgrade at a future date if so desired. The benefits of IFS was supported by the work of Lahikainen T. et al 2000 comparatively saying that ERP software like SAP is rather clumsy and large, and because of this cannot easily be reworked to suit a business process. Rather, the business will have to readjust its process for the software. SAGE Accpac This product offers middle sized organisation an adjustable enterprise resource for finance, SRM and operations (Sage, 2010). It supports global aspirations for mid-market and upper-mid-market companies with its robust financial management capabilities and flexible open architecture. Modules of the software include; Financials: General Ledger, G/L Consolidations, Reporting, Multi-Currency, Intercompany Transactions, Transaction Analysis and Optional Field Creator Purchasing: Purchase Orders, Accounts Payable, Electronic Funds Transfer (ETF), Direct payables, Document Management, Fixed Asset Management, Check and Form printing Sales and Receivables: Order Entry, Accounts Receivable, EFT Direct Receivables, Electronic Data Interchange (EDI), National Accounts Management, Unit Sales Analysis, Return Material Authorization (RMA) Customer Management: Contact Management, Sales Force Automation, Marketing Automation, Customer Service Automation Inventory/Warehouse Management: Inventory Control, Lot Tracking, Serialized Inventory, Warehouse Management, Manufacturing Management Project Management: Project and Job Costing, Service and Maintenance management, Payroll: In-house Payroll, Electronic Funds Transfer (EFT), Direct Payroll, Sage Accpac HRMS System Administration: System Manager, Alerts and Alerts Manager Sage manages the processes that are common to all businesses, such as finance, HR, or CRM; the vertical modules give customers a greater ability to match technology to specific industry needs (Sage, 2010). Microsoft Dynamics According to Microsoft 2010, Microsoft Dynamics offer solution that can help fastrack performance, measure financial effectiveness and enhance decision making. It helps drive businesses by providing a backbone of an elastic system. It is easy to implement and adapt. Apart from on-premise installation, the solution can also be deployed to work with cloud computing, a solution some organisations are already considering. The capabilities delivered by this solution includes Financial management, Supply chain management, business intelligence, performance management, Collaboration, Project Management, Human resource management, IT management and Software-plus-Services. Open Source Software (OSS) There are also a number of open source ERP software that seems to be of an increasing interest at the moment according to the research work of Johansson and Sudzina 2008. The list includes Compiere, OpenBravo, Opentaps, Facturalux, TinyERP. It may be that most SMEs will find OSS ERP implementations able to cater for their needs since according to Raymond 2005, SMEs are highly flexible and adaptable to change. Implementation may also work out cheaper as costs associated with licensing fees are usually not incurred (Johansson and Sudzina, 2008). It should however be noted that support for implementations for OSS ERP software is quite hard, as there can be several versions of a given software and finding an expert can be daunting. ERP Evaluation and Selection process A successful ERP project requires selecting an ERP solution, implementing the solution, managing changes and examining the practicality of the system (Wei and Wang, 2004). Wrong ERP solution choice would either cause implementation to fail or weaken the system to a greater impact on the enterprise (Hicks,1995; Wilson,1994). Most enterprises often jump into looking at ERP functions and features rather than examining the strategy and business processes. According to Donovan, 2001, it is important for management to know the current strategy, processes and supporting systems compared to what they could be with the new systems. For most enterprises, the decision to implement ERP functionalities will require buying a software package from one of the more popular vendors on ERP market. But the selection process is not a straightforward task, hence thorough understanding of what ERP packages are to offer, differences in each of them and what might be at stake in selecting one package over the other should be well examined or evaluated, (Sammon and Adam, 2000). Evaluating and selecting an ERP system, even though can be a very complex process (Donovan 2001). It should be a fact-based process that will bring an enterprise to the point where comfortable well-informed decisions can be made. Figure 5 below shows an online poll conducted by ESI International survey of 2,000 business professionals in 2005. This clearly indicated that most software projects, ERP inclusive, failed due to lack of adequate requirements definition. Fig. 5: Source: ESI International survey of 2,000 business professionals, (2005). In addition to the above figure 5, Donovan pointed out that typical ERP project implementation can also fail because of a wrong choice of ERP solution. Therefore, Management Agility Inc in 2005 revealed that it is imperative to adopt a thorough evaluation and evaluation process before adopting any ERP solution in SMEs. Their report detailed eight steps necessary for a careful and reasonable level of successful ERP implementation in SMEs. This is represented in Figure 6. We have further categorised this into the following five stages for our discussion; Planning, RFP, Solution Evaluation, Negotiation, Selection Agreement These five stages are explained below based on the research carried out by Management Agility Inc in 2005. Stage 1 Plan Requirement Define business along with areas of business that require technical approach. Develop a specific business case with business value for a solution. Ensure that the project sponsor is willing to articulate the business case for change, identify vendors and get familiar with the available solutions. Get general view of investment needed, considering software, hardware, other related infrastructure and ongoing support. Evaluate the organisation readiness for the investment and decide whether to continue or not. Define priorities under must-have and nice-to-have accordingly. Stage 2 Request for Proposals (RFP) Shortlist interesting vendors based on the outcome of market survey for solutions and then for demonstration. Collects facts in line with the business need from product demonstrations for the development of unbiased RFP for vendors. Set-up a neutral body to develop RFP, using facts gathered from products demonstration aligned to the business requirements. Distribute out RFP to selected vendors. Generate basic expectations from ideal proposal in line with the business need for onward selection of the ideal software vendor. Stage 3 Solution Evaluation Identify and prioritise remaining gaps between software capabilities as demonstrated and business requirements. Identify how the gaps will be bridged in terms of configuration, process change or a combination of all these. If the gaps cannot be bridge, then discontinue the evaluation exercise immediately, otherwise consider reengineering of those affected business processes and continue with the evaluation. Stage 4 Contract Negotiation Negotiate with each vendor; establish software, hardware and other infrastructure agreement requirements, which include version, components, maintenance and support. Also negotiate participation in user groups, license costs, maintenance fees and many others. Establish service provider agreement which also include deliverables, timelines, resources, costs, payment schedules and other legal requirements. Stage 5 Selection and Agreement Upon successful negotiation with the right vendor; Review all legal terms on privacy protection, operation guidance and data manipulation etc. Approve agreements with the selected vendors. Agree on implementation plan. Fig. 6: Detailed flowchart for ERP Software, Hardware Evaluation and Selection Processes Management Agility Inc, 2005 ERP Software Hardware (Solution) Evaluation and Selection Steps Yes No Stage 4 Stage 3 Stage 2 Stage 1 Define Requirements Shop Round for Product Clarify Requirements Evaluation Vendor Inquiry Interact with Vendors Negotiate Agreement Action Agreement Define business case/need and spell-out required values. Be specific. Ensure the business sponsor is willing to push through business case for change. Look round the market for what product is available. Identify vendors that operates and their general approaches to technologies the take. Discuss with others in the same industry as you are etc. Clarify your requirements and be sure of what you are looking for in line with you business case. Refine requirements if possible and be specific too. Find out what product is looking promising in line with the business need and from which vendor. Identify which vendor and their products and invite interesting ones for demo etc. Request for proposal (RFP). Invite each shortlisted vendor over for a chat and find out more about the product. List out expectations based heavily on business requirements. At this point evaluate this approach. Can you afford to change your current process? Can you afford the change the new product will bring and many more? Initiate Negotiation for the selected product with the selected vendor. Agree on who does what, when are they to be done. Negotiate deliverables, timelines, co