Research Proposal on An Investigation on Total Quality Management in University of Zimbabwe

1.0  Title

As initially drafted, the working title of this research will be An Investigation on Total Quality Management in University of Zimbabwe

2.0  Background of the Study

Total Quality Management (TQM) refers to a set of management strategies that aimed at embedding quality awareness in every organisational process and function. The International Organization for Standardization (ISO) defined TQM as a management approach for an organization, centered on quality, based on the participation of all its members and aiming at long-term success through customer satisfaction, and benefits to all members of the organization and to society.

TQM has three paradigms: Total – entirety or wholeness, Quality – excellence or the highest and finest standard and Management – the process of administration. Combined, TQM as an integrative approach aimed at ensuring the consistent meeting and exceeding of customer requirements while emphasizing process management and control as primary means of continuous improvement. TQM is customer-driven, top-down, actions-based and proactive.

Basically, TQM applies in virtually all business sector and industry and the service industry is not an exemption. In particular, as universities and colleges face changes the concept of quality has become an integral component of the educational process. The academia has recently adopted TQM as an operational philosophy albeit the many oppositions. University of Zimbabwe is one specific entity that supports and applies the concept of TQM on their processes.     

3.0  Research Aim and Questions

This research purports to conduct a case study on University of Zimbabwe and how they apply the concept of TQM on their processes, internal and external. How they address the quality of their function in terms of teaching, administration and providing quality education is integrated. In lieu with this, the study will seek to provide answers for the following specific questions:

1)    Do University of Zimbabwe’s access, price and quality of education exceed the expectations of parents and students?

2)    How does TQM apply in teaching at University of Zimbabwe? How does TQM apply in school administration?

3)    How TQM improve the quality of the university? How can the quality of education be improved through TQM?

4)    How TQM contribute to the quality of university administration? How TQM contribute to the quality of university life?

4.0  Research Plan

This research will use a multi-method approach to gather the needed data as it can be used for different purposes and it enables triangulation to take place. Survey strategy will be the first since surveys could gather a large amount of data from a sizeable population in a highly economical way. The researcher will survey both the faculty and the students. The questionnaire will be data gathering instrument used for the survey. The survey would be composed of two parts. The first part will contain information regarding the researcher and the purpose of the study; details about the respondents such as name, age and address. The second part of the questionnaire is the survey proper.

The second method that will be employed is the case study since case study is a strategy for doing research which involves an empirical investigation of a particular contemporary phenomenon within its real life context using multiple sources of evidence. The data collection methods employed may be various such as questionnaires, interviews, observation and documentary analysis.

Descriptive research will be used in the study as well. A descriptive research intends to present facts concerning the nature and status of a situation, as it exists at the time of the study. It is also concerned with relationships and practices that exist, beliefs and process that are on-going, effects that are being felt or trends that are developing. In addition, such approach tries to describe present conditions, events or systems based on the impressions or reactions of the respondents of the research.

As the study involves an interpretative, naturalistic approach to the subject matter, this means that qualitative researchers study things in their natural settings, attempting to make sense of, or interpret phenomena in terms of the meanings that people bring to them. The primary source of data will come from the researcher-made questionnaire and interview questions. The primary data frequently gives the detailed definitions of terms and statistical units used in the study. The secondary sources of data will come from published articles, social science journals, theses and related studies on TQM and University of Zimbabwe.

ATAXIA TELANGIECTASIA

Ataxia Telangiectasia (AT) is an autosomal recessive hereditary progressive neurodegenerative and multisystem disease characterized by cerebellar ataxia, telangiectasias, recurrent sinopulmonary infections, and variable immunologic defects. Its diagnosis is obvious when ataxia and telangiectasia are both present. However, the diagnosis can be made upon the onset of ataxia and before the appearance of telangiectasia if confirmed by laboratory tests. Early diagnosis is important for genetic counseling, appropriate care, and avoidance of unnecessary tests (Lederman, 1998).

 

            Serum IgA is low to absent in 60 to 80% of cases; less common B cell defects include low to absent secretory IgA, increased catabolism of serum IgA, development of anti-IgA, and deficiency of serum IgE. Evidence of impaired T cell function includes periodic lymphopenia, a decreased response to delayed hypersensitivity tests and to in vitro tests of lymphocyte function, and thymus abnormalities (small gland; decreased lymphocytes; absence of Hassall’s corpuscles).

 

            Both neurologic symptoms and evidence of immunodeficiency are variable in onset. Ataxia usually develops at about the time when patients begin to walk but may be delayed until the age of four years. Its progression leads to severe disability. Speech becomes slurred, choreoathetoid movements and opthalmoplegia occur, and muscle weakness usually progresses to muscle atrophy.

 

            Telangiectasias develop between 1 and 6 years of age, most prominently on the bulbar conjunctiva, ears, antecubital and popliteal fossas, and sides of the nose. The recurrent sinopulmonary infections, which result from the immunologic deficits, lead to recurrent pneumonia, bronchiectasis, and chronic obstructive and restrictive lung disease.

 

            Endocrine abnormalities may occur, including gonadal dysgenesis, testicular atrophy, and an unusual form of diabetes mellitus characterized by marked hyperglycemia, resistance to ketosis, absence of glycosuria, and a marked plasma insulin response to glucose or tulbutamide.

 

            The incidence of cancer is increased, most often as lymphosarcoma but also including Hodgkin’s disease, leukemia, gastric adenocarcinoma, cerebellar medulloblastoma, reticulum cell carcinoma, and frontal lobe glioma.

 

            Prognosis is usually poor, with death occurring from chronic sinopulmonary infections or malignancy. However, the progressively and severely handicapped patients may survive into their 30s.

 

            Proper diagnosis of the hereditary disorder AT can be done when only the ataxia or staggering balance problems have appeared but not the telangiecatasia with its characteristic dilation of capillaries on the ears, faces, and eyes. The name of the disorder itself is an impediment to early diagnosis, as it includes both symptoms. A serum alpha-fetoprotein test done on all children who have a lasting ataxia would identify the AT earlier and allow treatment and counseling (Lederman, 1998).

 

            Although it is difficult to reconstruct all the factors that lead physicians to a correct diagnosis of AT, we hypothesize that physicians rely on telangiectasia to make this diagnosis and do not consider AT until telngiectasia appear. This may be attributable to the fact that AT is a rare cause of ataxia and/or the physician's unfamiliarity with laboratory methods that may support a diagnosis at an earlier stage of the disease. Furthermore, affected children may not seem to deteriorate in function until the early school years so that the diagnosis of a static condition seems reasonable for a time. Our experience with AT suggests that the name, although a concise and memorable label for the disorder, is also a barrier to early diagnosis (Lederman, 1998).

 

            Laboratory tests that may help support a diagnosis of AT include measurement of serum AFP levels and examination of the karyotype. AFP is a human fetal serum protein found at levels less than 10 ng/mL in children more than the age of 1 year. Rising levels of AFP in young children are distinctly unusual, and characteristic of patients with AT or certain rare tumors. Increased frequency of spontaneous- and x-irradiation-induced chromosomal breaks are also associated with the diagnosis of AT. Recent identification of the gene responsible for AT (ATM) may improve diagnosis and reveal a wider spectrum of the disease. However, the large size of the ATM gene and the finding that most pathogenic mutations are unique make genetic evaluation of the individual patient highly labor intensive and genetic diagnosis more specific than sensitive (Lederman, 1998).

 

            Although the AT is diagnosed based on clinical presentation as is presented in the first few paragraphs, it is sometimes necessary to perform a cytological test to confirm diagnosis. This is done by demonstrating that cells from patients are sensitive to irradiation (IR). This procedure is done by irradiating blood lymphocytes, or skin fibroblast cells from AT patients followed by monitoring frequencies of CAs in metaphase cells relative to frequencies of CAs found in cells from normal, control individuals. In a typical analysis four cells sampled are generated: untreated AT sample, irradiated AT sample, untreated normal sample, and irradiated normal sample.

 

            As the analysis is performed in a way that the person analyzing the samples is not aware of which sample is which, there is no chance for the experiment to be manually manipulated by the researchers in order to come up with the desired results.

 

            The irradiated normal sample showed a total of 12 chromosomal aberrations. The irradiated AT sample on the other hand had a total of 35 chromosomal aberrations. The untreated AT sample had a total of 6 chromosomal aberrations.

 

            The frequency of chromosomal aberrations induced by radiation in each of the samples was found to be similar in the cells irradiated. A similar frequency was recorded also in the cells of genetically or AT defective individuals. However, the incidence of aberrations in specific chromosomes of normal and genetically defective or AT individuals differed and the frequency was found to be higher in the latter group. From the data it is evident that the response of chromosomes of AT patients was significantly different compared to those of healthy individuals.

 

            The radiosensitivity of individual chromosomes and the location of the radiation-induced chromosomal break points are found to be genetically controlled. There exists an intra and interchromosomal variation in the production of radiation-induced chromosomal aberrations.

 

A delay in the diagnosis of AT may compromise care of the patient and other family members. Early diagnosis of AT alerts the physician to possible immunodeficiency and the need to limit exposure to ultraviolet light and diagnostic radiographs. Early diagnosis also allows the opportunity for genetic counseling because parents are at risk for having other children with AT. Timely diagnosis identifies heterozygous parents who may have an increased risk for cancer or complications from cancer therapy.

 

Finally early diagnosis can avoid further costly and unnecessary tests. Many of our patients have had one, if not multiple, neuroimaging studies. In contrast, the cost of determining serum AFP levels is low. On a macroeconomic level, routine determination of AFP for all pediatric patients with chronic ataxia may be cost-effective. AFP measurements are certainly cost-effective in the evaluation of young children with progressive ataxia. In summary, the diagnosis of AT is often delayed, but can be made earlier with readily available and inexpensive laboratory studies. The delay is costly for the patient, family, and society (Lederman, 1998).

 

 

 

 

 

 

REFERENCES

Lederman, H.M. 1998, Consequences of the Delayed Diagnosis of Ataxia-

Telangiectasia, Pediatrics.

Questions and Answers:Greek Drama

Questions and Answers: Greek Drama

 

Pity and Fear

1) We go to see movies and plays to entertain ourselves, to be able to appreciate or criticize art and the work of others, and somehow as our way of escaping the harshness of reality. Art functions for me as a way of expressing myself and exercising my freedom of expression. Yes, plays had a ritualistic function, for it is related to shamanism or animism, where shamans enter into a trance to be able to heal or exorcise spirits (2006).

2) Through tragedy, or the imitation of an action, which has serious implications, catharsis or purgation is being achieved, and this catharsis will be attained through a course of pity and fear (‘2006).

3) When one purges, then it means that he or she is trying to expel emotions from his or her emotional system (2006), and this can be option in relation to watching a tragic drama or play.

4) The play by Arthur Miller entitled “The Death of a Salesman” causes us to face certain ideas in avoiding fear, for the play discusses the reality being encountered as a common person ( 2003). Despite the problems being experienced in the society, one can never regret the existence of hope, which enables us to disregard the feeling of fear. With hope, we can have the edge of fighting fear caused by the harshness of reality.

5) Pity or the ability to sympathize with others, in the context of Aristotle, can be applied in the play Hamlet by Shakespeare with the situation of Hamlet. Hamlet has no choice but to obey the plans of the people around him, so with this, he resorts to suicidal depression and obsessive anger (2006). We can extend our pity to him because we are also subjected to this kind of situation that sometimes, we have to do what others plan for us, even if we do not agree to it.

 

Greek Drama

1 & 2) It has been reported that between 600 and 200 BC, the ancient Athenians created a theatre culture whose form, technique and terminology have lasted two millennia, and created plays that are still considered among the greatest works of world drama ( 2004). The drama or theatre in Ancient Greece developed from religious rites dating back to 1200 BC, wherein Greece was still inhabited by ‘primitive’ tribes. From this, a cult arose that venerated Dionysius, the god of fertility and procreation, and this cult, named the Cult of Dionysius, practices ritual celebrations, which may have included alcoholic intoxication, orgies, human and animal sacrifices, and hysterical rampages by women called maenads (2004). However, its most controversial practice involves uninhibited dancing and emotional displays that created an altered mental state known as ecstasis, which is related to the perception of theatre as a way of releasing powerful emotions through its ritual power (2004).

3) The term ‘orchestra’ means “dancing space” is a circular structure, where the chorus would dance, sing, and interact with other actors who were on the stage, and at its center is a thymele or altar for the worship of Dionysius. On the other hand, the term ‘theatron’ meaning “viewing place” is where the actor sat, and was usually part of hillside overlooking and wrapped around a large portion of the orchestra (‘2006).

4) The theatre attained its greatest height in the 5th century BC, for Pericles promoted and favored it with a series of practical and economic measures, and maintained the tradition according to which theater pieces served the moral and intellectual education of the people (‘2006). This represents the growth of democracy, for in the theater all audiences gather and unite for a single cause. Similarly, its process is the same with the concept of democracy, which aims to unite the people of Greece for a single cause.

5) The term chorus in ancient Greek drama originated from the singing of the dithyramb, or the hymn to the god Dionysius and became a true dramatic chorus when Thespis introduced the actor (2006), and was said to began as a part of a purely religious ceremony, lead off by the leader of a band of revelers, a group of dancers, dancing around an altar (2004). The chorus serves to accompany the actors with sounds, gestures, postures, costumes, and masks, to facilitate flowing actions and stage elements in bringing the play to life. It also serves to narrate, give opinions and keep the rhythm of the play (2006).

6) Since women were not allowed to participate in dramatic productions, male actors had to play their part, and for playing multiple roles, they had to use masks. Masks prevent the audience from identifying the face of any actor with one specific character in the play, and helped eliminate the physical absurdity of men mimicking women. The use of masks also enable the audience to identify the age, sex, and social ranks of the character they portray (2000).  

7) In the play Antigone, Creon is a bad leader because he only uses his judgments in making decisions for his kingdom, and fails to listen to other opinions. He settles for what he believes, even if it is wrong, and because he was unable to undo his wrong deeds, his actions led to disaster and tragedy (2006).

8) Antigone’s character is complex, as she seems to change directions all throughout the play and is unpredictable. Her unpredictability makes her seem very hypocritical because she will say something and then turn on a dime and say the complete opposite. Her character is also heroic about her reasoning for attempting to bury her brother, and also shows her stubbornness (‘2004). Antigone knows that Creon is not strong enough to stand in her way, which shows that she is in total competence of the unlawfulness of her decision, and feels the law does not apply to her by challenging the king ( 2006).   

9) Hamartia, a concept used by Aristotle to describe tragedy, a tragic flaw, or the fall of a noble man caused by some excess or mistake in behavior, not because of a willful violation of the god’s laws (2006).

10) Tragedies were designed to show the right and wrong paths in life, as were not simply plays with bad endings, but viewed as a form of ritual purification, Aristotle’s catharsis, which gives rise to pathos, or instructive suffering. They depict the life voyages of people who guided themselves or were guided by fate on their challenges in relation to society, life’s rules or simply fate (2004).

11) Medea was angered by Jason, for Jason left Medea, with the persuasion of King Creon to marry her daughter Glauce. Jason was said to have married Glauce, which caused Medea to kill her own two children by Jason. Fueled by a need for revenge, she sends Glauce a poisoned dress and crown that burn her to death, then Medea kills her two sons, namely Mermeros and Pheres, knowing it is the best way to hurt Jason (‘2006).

12) The purpose or essence of satire is aggression or criticism, and this is done because some things fall short of some standard, which the critic desires that it should reach. Its corrective purpose is expressed through a critical mode, which mocks or attacks those conditions needing information in the opinion of the satirist (1990). The play Lysistrata addresses the contribution that women could make to society and to policy making, but cannot do so because men are ignoring their views. Moreover, it shows the hurdling of public funds building and withholding sex from their husbands to secure peace and end the Peloponnesian War (‘2006). This shows and addresses the inequality of men and women in the Athenian society during the period.

 

Tragedy

1) The tragedy of Athens challenged its society, as it was able to expose and criticize or make use of satirical plays in order to demand change from the society. One of the forms of these plays include Lysistrata, which addresses the contribution that women could make to society and to policy making, but cannot do so because of their social status (2006). With the use of tragedies, the flaws of society are being criticized and given emphasis to be able to effect change.

2) The contribution of Athenian tragedy to empathy for outsiders is that it was able to give new perspectives to the outsiders regarding the situation of Athens in terms of its politics, society and economics. From these new perspectives, outsiders will be able to criticize and even make some actions to make the citizens of Athens aware of their situation and able to make some changes.

3) Recognition is this context is the acknowledgement of reality, and this occurs when Oedipus’ blind hope meets fate and is destroyed, and until the climactic moment of recognition that precipitates the death of hope, Oedipus wholeheartedly believes that he will succeed. Blind hope submits to fate at the moment of recognition when Oedipus learns that he has been working against himself and that his ambition and faith have become his undoing ( 2005). This happens when Oedipus learned that he is destined to murder his father and sleep with his mother, so he fled Corinth in his blind hope to outsmart fate with his cleverness and foresight. However, he travels unintentionally back to his birthplace in Thebes, where he murders his birth father and marries his birth mother (2005).

4) Reversal in this context is making actions, which contradicts the events that are supposed to happen. In the story of Oedipus Rex, this occurs when Oedipus tries to escape his fate by running away from his adopted parents in Corinth, and using his foresight and intelligence, he will be able to get away from his fate of sleeping with his mother and killing his father.

5) Yes, recognition is present in Death of a Salesman, for recognition or personal discovery is a crucial element of tragedy. In the requiem of the play, Biff had a hint of personal recognition, although Willy, Linda, and Hap never discovered the truth about themselves, and Biff realizes Willy had the wrong dreams. In accommodating the truth about his father, Biff is able to make a decision about his own future based on a realistic view of his potentials (1995).

6) The tragic flaw of Willy is in failing to question whether his dream is valid, for he believes and puts emphasis on the fact that being well liked will bring him to perfect success. This is not a dangerous dream; however, Willy adheres to this idea as if it is a lifesaver, refusing to give it up (2006).

7) It has been reported that Willy does not come to a full self-realization, and thus does not meet the definition of the tragic hero, for he is not of the noble stature, which is traditionally prerequisite of tragic heroes (2006). In essence, this play is not a pure tragedy in the classical sense, and Willy could be described as an anti-hero, for he lacks the nobility and high-mindedness expected of the traditionally distinguished tragic hero (2006).

8) Yes, catharsis is present in the play, such as the enactment of Willy’s suffering, fall, and partial enlightenment, which provokes a mixed response, and this mixed response is that anger and delight, indignation and sympathy, pity and fear, which is being described by Aristotle as catharsis (2003). Moreover, the tragic feeling is being evoked when we are in presence of a character who is ready to lay down his life, if needed, to secure one thing, which is his sense of personal dignity (2003).

 

Immigration Enforcement Act (H.R. 4437)

HUMAN RIGHTS ACT

The Border Protection, Anti-Terrorism and Illegal Immigration Act of 2005 was approved by the House of Representatives of the United States on December 16, 2005 (:2005). This Act is also called HR 4437 and also known as “Sensenbrenner.” This bill has been the reason behind the U.S. immigrant rights protest. The past years have been remarkable changes in how the United States governs immigrant admissions and rights. Initially, American policymakers focused their attention in these years on a problem that seemed to highlight the extent to which national borders had become porous and inadequately regulated: illegal immigration (:2005). By the close of the millennium, however, the entire structure of U.S. immigration and of refugee and immigrant policies had been recast by significant federal legislation, independent executive actions, and judicial rulings. Sweeping policy changes of this period were achieved in both good and bad economic times, always during divided government, and despite the fact that congressional and White House officials dreaded the issue because of the contentious and unpredictable politics it routinely inspired. The House of Representatives cleared that they understood that something which speaks to so many basic concerns such as jobs, health, crime, racial fairness, civil liberties, trade, foreign relations.

Illegal immigration has always been an issue in the U.S. and statistically, brought hundreds of thousands of additional newcomers to U.S. soil. Moreover, the major policy changes adopted by national political actors in 2005 were not only less restrictive than originally expected, but they dramatically increased immigration opportunities (:2006). To be sure, national immigration law and administration in this period were unkind to particular foreigners, including persons infected with the AIDS virus and asylum-seekers fleeing Haiti, El Salvador, Guatemala, and other noncommunist countries. This was not a new open-door era indeed, there never was such a time in our national development. But in historical comparison to earlier policy regimes, the immigration controls established from 1980 to 1990 were decidedly expansive for alien admissions and rights. U.S. efforts to govern international migration in this period capture this trend well (2006).

There is a military collaboration with the border patrol in the U.S.-Mexico for the implementation of HR 4437 (:2005). The military's geographic focus extends beyond the border and it now works with a plethora of police bodies throughout the U.S. on immigration enforcement. Such ongoing military involvement in domestic police matters is unique in post-Reconstruction U.S. history. The more militaristic elements of that collaboration and support, however, have focused primarily on the border (2006). Such support gave rise to the tragic killing in 1997 of a U.S. citizen by a Marine during a border-area ground surveillance mission conducted for the Border Patrol. Since then, military collaboration has decreased and has changed at the level of formal policy.

The human rights repercussions of the involvement of the military police is based on the theoretical guiding principles since the significance of the human rights is a nation-state issue.

 

The issues and conflicts of human rights is that extra-governmental and have traditionally been used to work against the repressive capacity of states (2006). The government is responsible for human rights violation and that bureaucracy that tends to undermine the human rights of the “truly disadvantaged” through a process of “social triage” that sacrifices the general well-being and dignity, and repression of immigrants in the U.S. HR 4437 has sacrificed the human rights of these subordinated groups and it is just right to say that both the military and the government is responsible for the human rights abuse connected to the border enforcement, such as the killing of a Mexican-American teenager in Redord, Texas .

 

In this case of oppression, military behavior was sated with gross confusions by soldiers and their unwarranted growth of the use of force. The unsuitable corresponding of military troops in opposition to nonmilitary threats show the danger leap up in border enforcement, because they are trained to respond with deadly force to perceived threats, regardless of the objective situation

 

 

 

 

 

 

Stakeholders' Concern

        To most of the stakeholders, the equity purchase of BII raised concerns over its pricing which is more than 4.6 times its book value, above Maybank’s 2.3, and expensive even when compared with Chinese banks that trade between 3.3 and 5.4 book value,  this allowing controlling shareholder, Singapore State owned, Temasek, to make a capital gain of RM 2.6 billion after holding it for nine years, for a 55.7% control of BII. Maybank had agreed to buy to buy 42% stake in BII from Temasek and almost 14% from Kookmin Bank. On the same note, analyst commented that Maybank was also priced more than it should have for the stake in Pakistan’s MCB where it was reported that the price for Pakistan’s MCB was 5.2 times premium over net tangible assets for 20% stakes in MCB. According to a note written by Deutsche Bank, Deutsche Bank believed that the acquisition price is expensive when compared to regional and domestic banking sectors (The Edge Financial Daily, 2008).

Thesis Statements on concentration in soccer and how will i apply

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Thesis Statements on concentation

CTA vs Conventional Angiograpy

            This paper discusses about the differences between Computed Tomography Angiography and Conventional Angiography in terms of quality and reliability.  The two are compared and contrasted based on their characteristics. At the end of the paper, Computed Tomography is recommended to diagnose many diseases and it shows many advantages over the conventional angiography.

            Diseases in blood vessels including those of the brain and the heart can be diagnosed through angiography. Angiography is used to diagnose pathology of blood vessels such as blockage caused by plaque build up ( 2006). Traditionally, X-ray or the conventional angiography was used but due to the development of technology, Magnetic Resonance, ultrasound, and Computed Tomography slowly replaced x-ray angiography.

            Basically, angiography is a radiographic technique where a radio-opaque contrast material is injected into a blood vessel for the purpose of identifying anatomy on x-ray. This technique is used to image arteries in the brain, heart, kidneys, gastrointestinal tract, aorta, neck or carotids, chest, limbs and pulmonary circuits ( 2006). This technique is carried out in a laboratory by a trained cardiologist or radiologist and technicians. The doctor will first need to insert an intravenous, IV, line into one of the blood vessels of the patient’s arm, chest, neck or groin (2004). Then, a catheter is inserted through the IV and into the patient’s blood vessels using x-ray machine that produces real-time pictures. When the catheter is already placed into the blood vessel of interest, contrasts material is injected and pictures are taken. It usually takes time for the doctors to get the catheter into the right spot ( 2004). There are different types of angiography depending on the type of test such as cerebral angiography for the head, extremity angiography for arm or leg, renal angiography for the kidneys and pulmonary angiography for the lungs.

            Conventional angiography or cardiac catheterization is the diagnostic of standard for determining the presence, location, and severity of coronary artery disease ( 2006). Conventional angiography has long been used in the medical field for its high effectiveness. However, this technique is invasive, labor intensive due to its procedure, costly and has a significant risk of complications. This technique involves passing a catheter onto the right or left side of the heart. It is also used to determine pressure and blood flow in the heart’s chambers, collect blood samples from the heart and examine the arteries of the heart with an x-ray technique called fluoroscopy. Fluoroscopy provides real-time visualization of the x-ray images on a screen and provides a permanent record of the procedure ( 2004).

            Conventional angiography carries risks depending on organ undergoing a test. These risks may include bleeding and pain at IV site; a risk that the soft plastic catheters could damage the blood vessels; the risks the blood clot could form on the catheters and later block blood vessels in the body; and the risks that the contrast material could damage the kidneys especially in diabetes patients (2004) aside from some discomfort and it mandates routine follow-up care.

            On the other hand, there are other angiography techniques that are more advantageous than the conventional type. One of these is the Computed Tomography Angiography, CTA. CTA is replacing conventional angiography because this test is less invasive and easier to perform than conventional angiography while obtaining results just as accurate as the results obtained from conventional angiography. CTA is a three-dimensional technique that provides information about the imaged vessels and adjacent structures (Tins et al, 2001). It enables the display of vascular structures aided by injections of contrast medium. The multislice scanner enables the system to display the entire vascular system including small vascular exits, branches, embolisms or dissection membranes ( 2006). This is one of the advantages of CTA, with this type of imaging the physician can easily conduct and decide for surgical planning using the image produce through a CTA.

CTA requires only venous vascular access and is an outpatient examination with lesser risks than conventional angiography. At minimum, CTA requires a thin section helical CT acquisition coupled with a power injection of intravenous iodinated contrast medium. A multidetector-row CT or MDCT, that is capable of detecting and reliably diagnosing pathology in the adjacent structures and end organs of the vessel is commonly used and preferred for CTA (CIGNA, 2005). For cardiac and some aortic CTA, an electrocardiograph-gated acquisition should be performed that allows retrospective reconstruction of the scan volume at multiple phases through the cardiac cycle (   2005).

The advantages of Computed Tomography angiography over conventional angiography were studied by the American Heart Association ( 2004) and found out that the advantages and use of CTA varies depending on the type of disease being evaluated. For occlusive disease of the extracranial carotid arteries, CTA has higher degree of accuracy compared with conventional angiography. For thoracic aorta, one major advantage of CTA is the ability to accurately evaluate the surrounding structures within the thorax for pathology that may provide alternative explanations for the patient’s symptoms (CIGNA, 2005) necessary for the treatment. For abdominal aorta diseases, CTA has high accuracy in measuring vessel lengths, diameters and angles. With peripheral arterial disease, CTA can produce image not visualized by conventional angiography aside from the greater longitudinal coverage of multidetector-row CT ( 2005).

Generally, CTA has many advantages over the conventional angiography. These advantages include visualization of the anatomy from multiple angles and in multiple planes; improved visualization of soft tissues and other adjacent anatomic structures; less invasiveness and fewer complications. However, it is still a standard for coronary artery diseases to use the conventional angiography or the Cardiac Catheterization because there is still no sufficient evidence to support the use of CTA with suspected coronary artery disease. CTA also involves radiation exposure and the potential for ionated contrast related reaction (2005) as well as temporal and spatial resolution. Recommendation of the use of either CTA or the conventional angiography depends on the type of the disease to be imaged. However, for its accuracy and advantages over the conventional one, CTA is recommended due to above mentioned characteristics, quality and reliability and due to it less invasiveness than conventional angiography.

Critical Thinking Case Study Essay Instructions

 

Case Study Assignment

Assignment Overview

Prepare a report for the CEO of AcuScan about the situation described in the GEN 480 Critical Thinking Case Study.  Your report should include the following two parts:

1.     Part One:  Respond to the specific questions on the worksheet that follows (100 points possible).

2.     Part Two:  Write an executive summary for the CEO of AcuScan. (100 points possible).

PART ONE:

Use the case materials to complete this assignment.

Analysis

1.     Describe all assumptions seen in any of documents provided in the case study.

For full credit, provide AT MINIMUM:   four to six assumptions held by Kelly; six to nine assumptions held by Pat; two to three assumptions held by Cliff; two to three assumptions held by Chris.

a.     Kelly

b.    Pat

c.     Cliff

d.    Chris

2.     Explain the arguments made by each of these people.

Explanations should comprise two to six sentences for each of the following:

a.     Cliff O’Connor

b.    Pat Lambert

c.     Kelly Thomas

d.    Chris Martinas

3.     Evaluate each argument listed above as sound or unsound and why. Indicate whether they are emotional or logical in nature.

Evaluations should comprise two to six sentences for each of the following:

a.     Cliff O’Connor

b.    Pat Lambert

c.     Kelly Thomas

d.    Chris Martinas

4.     Describe specific fallacious arguments, and identify the people who hold them.

For full credit, provide AT MINIMUM four to six fallacious arguments.

Conclusions

1.     Describe all problems in this situation.

Describe a minimum of two to three problems that characterize the situation.  Single sentence format is acceptable.

2.     For each problem listed above, describe the data, arguments, and reasoning that contribute to the problem.

Describe issues of data, arguments, and reasoning-related to each problem within two to six sentences.

3.     What is the underlying problem that is the base cause of the conflict within AcuScan?

Present the underlying problem in one to four sentences.

4.     What alternative solutions would you propose for this situation?

Present a MIMINUM of two potential solutions in the format of two to four sentences each.

5.     State the relative strengths and weaknesses of each alternative solution.

Describe at least one strength and one weakness for each alternative solution.

6.     Which solution will you recommend to the CEO and why?

In two to six sentences, fully articulate the exact solution you would propose and the reason(s) for that choice.

PART TWO:

Executive Summary

Write an executive summary of the case for the CEO of AcuScan.  The executive summary should give readers the essential contents of the master document(s) in approximately two pages.  It should preview the main points of your document, enabling readers to build a mental framework for organizing and understanding the detailed information you are presenting, and helping them determine the key results and recommendations reported in your document.  Be sure to include the following:

1.     Purpose and scope of document

2.     Summary of the situation

3.     Key points relating to the situation

4.     Conclusions

5.     Recommendations and actions  to be taken, and why

6.     Other supportive information:

a.     The executive summary should be 700 to 1,050 words in length.

 

 

 

 

 

 

 

 

Thesis Abstract, Table of Contents and List of Tables on The Practice of Public Relations in Lebanon

THE PRACTICE OF PUBLIC RELATIONS IN LEBANON

 

 

ABSTRACT

This study described and analyzed the perceptions and practices of public relations in Lebanon. It focused specifically on media relations and was based on Grunig’s (1984) theoretical framework of four models of public relations: press agentry, public information, two-way asymmetrical, and two-way symmetrical.   A review of the literature was conducted that revealed a debate about whether public relations can be practiced the same way all over the world or if certain localized practices should be considered for each nation. 

The research design was a triangulated method.  Data were collected using a written survey questionnaire and telephone interviews with Lebanese public relations practitioners.  The results showed that all four of the Grunig models were practiced in Lebanon, with the two-way symmetrical model the most popular.  Evidence collected from this research supported the hypothesis of this study that public relations can be globalized despite cultural differences. 
 

TABLE OF CONTENTS

 TOC \o "1-3" \h \z \u LIST OF TABLES. PAGEREF _Toc16066654 \h iv

LIST OF FIGURES. PAGEREF _Toc16066655 \h v

CHAPTER ONE: INTRODUCTION TO THE STUDY.. PAGEREF _Toc16066656 \h 1

Introduction. PAGEREF _Toc16066657 \h 1

The Problem.. PAGEREF _Toc16066658 \h 2

Background of the Problem.. PAGEREF _Toc16066659 \h 3

Lebanon: General Overview.. PAGEREF _Toc16066660 \h 4

Communication Styles and Cultural Differences. PAGEREF _Toc16066661 \h 6

Research Questions. PAGEREF _Toc16066662 \h 9

Scope of the Study. PAGEREF _Toc16066663 \h 10

Definition of Terms. PAGEREF _Toc16066664 \h 10

Organization of the Remainder of the Study. PAGEREF _Toc16066665 \h 10

CHAPTER TWO: LITERATURE REVIEW... PAGEREF _Toc16066666 \h 11

Introduction. PAGEREF _Toc16066667 \h 11

Theoretical Perspective. PAGEREF _Toc16066668 \h 11

Globalization versus Localization. PAGEREF _Toc16066669 \h 13

Advocates for Globalization. PAGEREF _Toc16066670 \h 13

Advocates for Localization. PAGEREF _Toc16066671 \h 17

Conclusion. PAGEREF _Toc16066672 \h 21

CHAPTER THREE: METHODOLOGY.. PAGEREF _Toc16066673 \h 22

Introduction. PAGEREF _Toc16066674 \h 22

Research Approach. PAGEREF _Toc16066675 \h 22

Sample Population. PAGEREF _Toc16066676 \h 23

Instrumentation. 24

Survey. PAGEREF _Toc16066678 \h Error! Bookmark not defined.24

Qualitative. PAGEREF _Toc16066679 \h 26

Qualitative Data Analysis. PAGEREF _Toc16066680 \h 28

Summary. PAGEREF _Toc16066681 \h 30

CHAPTER FOUR: RESULTS OF THE STUDY.. PAGEREF _Toc16066682 \h 31

Introduction. PAGEREF _Toc16066683 \h 31

Quantitative Results. PAGEREF _Toc16066684 \h 31

Qualitative Results. PAGEREF _Toc16066685 \h 38

Answers to Research Questions. PAGEREF _Toc16066686 \h 39

Chapter Summary. PAGEREF _Toc16066687 \h 40

CHAPTER V: CONCLUSION.. 4 PAGEREF _Toc16066688 \h 1

Introduction. 4 PAGEREF _Toc16066689 \h 1

Public Relations Principles. 4 PAGEREF _Toc16066690 \h 1

Summary. 4 PAGEREF _Toc16066691 \h 2

Limitations. 4 PAGEREF _Toc16066692 \h 3

Suggestions for Further Research. 4 PAGEREF _Toc16066693 \h 4

REFERENCES. 4 PAGEREF _Toc16066694 \h 5

APPENDIX A: MODEL STATEMENT FREQUENCY CHARTS. 51

APPENDIX B: QUESTIONNAIRE COVER LETTER.. 59

APPENDIX C: QUESTIONNAIRE.. 60

LIST OF TABLES

 

 

Practice of the Two-way Symmetrical Model

Average Score             ……………………………………………………………………32

 

Practice of the Two-way Asymmetrical Model

Average Score             ……………………………………………………………………33

 

Practice of the Public Information Model

Average Score             ……………………………………………………………………34

 

Practice of the Press Agentry Model

Average Score             ……………………………………………………………………35

 

Ranking of the Top Five Survey Statements

Average Score             ……………………………………………………………………37

 

 

 

 

 

 

 

 
 

 

Occupational Therapy

 

INTRODUCTION

Just living is an occupation people everywhere participate in daily activities that are the occupations of life. Growing, playing, learning, exercising, caring for the family and working make lives full and enjoyable but when unexpected things happen to change that level of participation, what can be done? Occupational therapy is there to restore the joys of living without pain or suffering. Occupational therapists are increasingly taking on supervisory roles due to rising health care costs that are beginning to encourage occupational therapy assistants and aides to take more hands-on responsibility, the cost of therapy should be more manageable for those needing service. Occupational therapy provides the bridge that allows the health client to cross the gap between decreased ability and living a full life and represents the best of applied science in health care practice and its needed assessment tools. The goal of occupational therapy (OT) assessment tools as well as services is to provide educationally related services that will assist in benefiting from therapy which is designed to enhance the development of skills necessary for academic learning and vocational training within the child's current and future educational settings. Several highly trained professionals work closely with teachers, parents and other service providers to enable students with exceptional needs to realize their potential both in and outside of the classroom.

 

 

DISCUSSIONS

The paper will critically evaluate a certain occupational therapy assessment tool - the Canadian Occupational Performance Measure (COPM) being used to facilitate useful process such as children affected by autism as it can involve this intervention program and goals related to the domains of communication, behavior and social interaction. The COPM was found to be a useful tool for enabling parents to identify goals for their children, when used and understood from a strong client and family-centered philosophical perspective. Pre- and post-intervention parent ratings of goal performance and satisfaction are presented to demonstrate the use of the COPM as an outcome measure. Implications for practitioners in early childhood and special education settings and areas for further research are also discussed ( 1998). Fundamental to a family-centered approach is the importance of matching early intervention support with the unique characteristics of each child and family (1990). As stated by  (1994), 'the greatest impact on child, parent, and family functioning is most likely to occur when interventions are based upon the needs, aspirations, and desires a family considers important' .

 

 

 

 

The Canadian Occupational Performance Measure (COPM) (1998) is used to identify priorities for therapy and to document the client's self-rating of occupational performance and satisfaction. It is embedded in an understanding of client- and family-centered practice (2002;  1995) and the Canadian Model of Occupational Performance, which highlights the importance of the transaction between the client, occupation, and the environment (1990). (1998) and  (1993) reported good utility of the COPM across a wide range of occupational performance dysfunctions such as orthopaedics, pain, traumatic brain injury). The scoring of the COPM has been found to be responsive to changes in perceived occupational performance over time (1999; 1994; 1999). When used as an outcome measure, pre- and post-performance and satisfaction ratings and change scores can be determined. A change score of two to three points is considered indicative of clinically significant change (1998). To date, there has been some use of the COPM with children (aged over seven years) (2001; 2001). However, limited use with families has been reported in the literature. A modified version of the COPM (2003) was used with parents to facilitate the identification of priorities and goals for intervention.

 

 

 

Certain study aimed to:

Ø      Consider the utility of the Modified COPM (M-COPM) in assisting parents to identify and prioritize their goals

Ø      Demonstrate the utility of the M-COPM as a self-report outcome measure, pre- and post-intervention.

Modified Canadian Occupational Performance Measure (M-COPM)

Two modifications were made to the COPM to create the M-COPM. First, when working with children, it was important to reframe occupations as the things children need to do, want co do and are expected to do in their daily lives. For young children with compromised language and communication abilities, parents are in the best position to identify their child's occupational performance issues, prioritize these and in collaboration with professionals, identify realistic intervention goals. The modified version of the Canadian Occupational Performance Measure (M-COPM) (2003) which can be obtained from the corresponding author--was administered during the first visit following the two-day workshop. This visit was scheduled, where possible, at a time convenient to both parents. In the majority of cases, both parents were involved in the administration of the M-COPM. The second, post-intervention, administration occurred within two weeks of the completion of the home visits.

 

 

Administration of the M-COPM:

Ø      Parents were asked to identify occupations that were difficult for their son/daughter in regard to self-care, play and relaxation

Ø      Parents then rated the difficulties using a 10-point scale to identify priorities for intervention

Ø      Parents then rated current performance and satisfaction of their son/daughter on three to five of the priority areas using a 10-point scale and rated performance and satisfaction post-intervention.

In addition to describing their goals, the M-COPM enabled parents to prioritize these goals, using the rating scale format for importance. Second, the M-COPM was clinically useful, enabling facilitators to help parents reflect upon their children's occupations and consider the difficulties they experience. The modifications that enabled this reflection appear to have been successful in assisting this process. Specifically, the structure of the M-COPM interview helped parents consider communication, behavior, play, self-care, routines and transitions, as well as family socialization. Important prerequisites in utilizing the M-COPM include the establishment of rapport with parents and ensuring that the interviewer embodies the underpinning philosophies of family-centered practice and have developed excellent listening skills.

 

 

Professionals need to be sensitive to language use and ensure that other practices involved in goal setting are parent friendly such as keeping goal-setting meetings small in size by minimizing the number of professionals’ present and holding meetings at convenient times and in a family-friendly location (1994;2001). The M-COPM provides a clear yet flexible structure for both parental goal identification and prioritization. Measurement tools that provide information regarding how the child performs in the educational setting have become the focus of attention in recent years in support of the client-centered approach to measuring performance (2001). Developmental and diagnostic assessments may be beneficial in providing more in-depth information for a particular deficit area, but these assessments do not provide information about performance in context. Recommendations regarding interpretation of test results from the Developmental Test of Visual Perception-Second Edition (1993) indicate that diagnosis regarding a child's visual perceptual skills cannot be made by test data alone. Thus, these test authors, along with others (1998), have stressed the need to validate findings with objective measures of the student's performance of daily life activities (1998) and provides information about the barriers that may be interfering with the child’s performance in the educational setting. The unique tool affords the therapist working with adolescents in a school-based practice the opportunity to receive first-hand information from the adolescent regarding performance issues in daily life.

 

Thus, examinations of the student's performance in context, such as assessment techniques, yield valuable information in the evaluation process when the OT is required to provide input regarding the need for assistive technology. Using the information from relevant assessment tools facilitates the development of outcome measures that enable children to be active participants in the school day. It is believed that occupational therapists are taking on supervisory roles. Due to rising health care costs, to encourage occupational therapy assistants and aides to take more hands-on responsibility under the guidance of a therapist, the cost of therapy should be more manageable for those needing service. The emergence of more opportunities where occupational therapy is needed guarantees the future of the profession and creates a better job process. The focus is to assist the person in achieving maximum independence through individualized adaptation to health care challenges and that practitioners in the field must have these strengths: high level critical thinking, the ability to creatively adopt tools, make observation of daily life skills and the ability to recognize the unique needs of work therapy as it provides the bridge that allows the health client to cross the gap between decreased ability and living a full life and represents the best of applied science in health care.

 

 

 

Implications

Parent-identified goals in the domains of communication, behavior, play and social interaction frequently pervade all environmental contexts in which the child with ASD functions. Knowledge of these goals can assist early childhood educators in both special education and inclusive settings to discuss with parents how they envisage these goals being supported with specific interventions ( 1998), This enables a consistent approach across home, early childhood and community settings. Awareness of the parents' goals for a child in a child care setting can also assist early childhood professionals to make the most of their time in this environment, which is frequently highly sought after and valued by parents (1994) and offering frequent requesting opportunities. The involvement of family and professionals in all of the contexts in which the child engages is recognised as one of the key components of effective programs for young children with autism ( 1997).

 

 

 

 

 

The COPM is a useful method for identifying parents' priorities in both inclusive and special educational settings. It also provides a structure for discussing parents' expectations of what they wish their child to achieve in inclusive settings. This can assist educators to clarify expectations of how they will support the child in various settings to achieve priority goals, as well as to determine realistic expectations of each educational setting. The COPM could also be used for such discussions in transdisciplinary team settings, where one team member as primary case manager may undertake the COPM with parents to assist with goal identification, and report back to the team who can then identify the necessary. It would seem that the tool provides a useful means for identifying and prioritizing goals in home-based programs, early special education and regular early childhood settings. In addition, it provides a means of documenting outcome of intervention by way of addressing parental perception of change, in both the child's performance in relation to specific goals as well as their satisfaction with that performance as used within a framework of family centered practice, the COPM appears to have potential in assisting parents to identify and prioritize early intervention goals for their children with Autism Disorders.

              A patient may express more than one desired outcome of treatment. In such cases, we contend it is important for the therapist to have the patient rank which outcomes are most important. The Canadian Occupational Performance Measure (COPM) was designed for use by occupational therapists, but it can be useful for physical therapists to help patients to identify and rank goals of intervention. The COPM provides a standardized format for assisting patients to identify goals that are most important to them in the areas of self-care, productivity (work, household management, play/school), and leisure. Following intervention, the tool is again used to rate patients' perceived change in their performance and change in satisfaction with performance. Assessment that describes studies designed to investigate the reliability of data obtained with the Physiotherapy Evidence Database (PEDro) scale developed to rate the quality of RCTs evaluating physical therapist interventions randomly selected from the PEDro database generated a set of individual and consensus ratings of individual and consensus ratings repeated the process.

 

 

 

 

 

In such a situation, both sides of the base rate problem debate would agree that the estimates of reliability provided by the kappa statistic are misleading. In both studies, we randomly selected a sample of trials from the population of trials on the PEDro database. Not surprisingly, the base rates in the 2 samples were very similar to the base rate for the population was justified and did not produce misleading inferences about reliability of ratings for items on the PEDro scale. An understanding of the error associated with the PEDro scale can be used to guide the conduct of a systematic review that uses a minimum PEDro score as an inclusion criterion. In our studies, we noted that repeated PEDro consensus scores were within one point on 85% of occasions and within 2 points on 99% of occasions. We believe it is sensible to conduct a sensitivity analysis to see how the conclusions of a systematic review are affected by varying the PEDro cutoff. For example, in Maher's review of workplace interventions to prevent low back pain, reducing the PEDro cutoff from the original strict PEDro cutoff of 6 to a less strict cutoff of 5 (or even 4) did not change the conclusion that there was strong evidence that braces are ineffective in preventing low back pain. Readers should have more confidence in the conclusion of a review that is unaffected by changing the quality cutoff.

 

 

 

CONCLUSION

The precision of the PEDro scale also should be considered by users of the PEDro database. None of the scale items had perfect reliability for the consensus ratings displayed on the PEDro database; users need to understand that the PEDro scores contain some error. Readers who use the total score to distinguish between low- and high-quality RCTs need to recall that the standard error of the measurement for total scores is 0.70 units and consider the standard error of the measurement, a difference of 1 unit in the PEDro scores provides confidence that truly had different PEDro scores (1998;1996; 2004). M-COPM was clinically useful, enabling facilitators to help parents reflect upon their children's occupations and consider the difficulties they experience. The modifications that enabled this reflection appear to have been successful in assisting this process. Specifically, the structure of the M-COPM interview helped parents consider communication, behavior, play, self-care, routines and transitions, as well as family socialization. Important prerequisites in utilizing the M-COPM include the establishment of rapport with parents prior to the underpinning philosophies of family-centered practice and have developed listening skills and expertise in perspective, aiming all the time to understand the parents' perspectives (1994;2001). The M-COPM provides a clear yet flexible structure for both parental goal identification and prioritization.