The Management of Global Trade Distribution Assignment

The Management of Global Trade Distribution - Assignment Example DHL has a considerable market share of around 40% of the Asian market (The Economist, 2012). FedEx accounts for the market share of around of 49%Â  in USA as compared to around 50% by the competitor UPS. FedEx has developed the fleet and service base that has built a strong reputation of the company. For example, GPS tracking, Online Solution (FedEx, 2012a), SenseAware (Business Wire, 2014) are some of the leading services from FedEx. The industry in which FedEx operates is highly competitive and it has low switching cost for buyers and suppliers. Also, the industry is affected by high oil prices. FedEx, with its service to the global market, has focused on building competitive edge with technological innovation and is ranked at the 91st position on the Forbes Most Valuable brands (Forbes, 2013). Competitive information technology orientation has taken the place of absolute advantage for FedEx. Change in the global trade agreements and patterns have a direct impact on the FedEx. FedEx supports FTA for the removal of barriers from Panama, Columbia, and South Korea. Furthermore, FedEx has capitalised the growth in global demand for the Korean products where Korea in all has generated $3.8 billion in the year 2011 (FedEx, 2012b). FedEx has planned to establish logistic hub in Pudong considering the global trade patterns between China to Europe where Shanghai Pudong International Airport is to take the position of hub (FedEx, 2012b). Hence, FedEx is keenly developing the comparative advantage from the changing global trade patterns. Furthermore, the company is also directly impacted by the varying regulations from country to country. For example, FedEx launched SenseAware in different market upon receiving security clearance from the respective countries’ and related organisations (Leung, 2011). Most recently it has expanded to 14 European countries and Canada. Such str ong connectivity with the movement of sensitive products has developed

Hazel Essay Example for Free

Hazel Essay Hazel who worked for Fortune 500 Company for 15 years shows her loyalty and devotion in the company. It is surprising therefore why she was one of the chosen employees to be terminated by the new CEO to downsize the company. It is a question whether Hazel tried to ask the company why she was terminated despite the fact that she has been with the company in the long period of time. It is a need for her to know to fully understand the reasons. It might be even beneficial for her in long run to improve her weaknesses, flaws and mistakes if there are any. The rejection she’s receiving from her application in finding employment must be very hard for her. But her need of survival motivated her to try another line of job. It must be very challenging since she was used to office or paper works perhaps, from the company she previously worked to. Moving lawns, weeding gardens, and trimming shrubbery are all not an easy job. It requires so much energy, effort and perspiration. But Hazel perceived it optimistically believing that it will do her good in the long run. After 15 years being used to be governed and overshadowed by the company’s superiors, rules and policies, Hazel is now taking a different path. She can be more creative in this way in managing her life in terms of time management, communication with her clients, service price and all. Now everything is not routinary. In addition to this she can be more in touch with her clients thus creating opportunities to make friends and learn more. From being an employee, she now has her own business in accordance to her interest and creativity. She can creatively fashion her neighbor’s backyard. Her business will eventually give her opportunities to apply her learning’s from her previous job. It is not bad to make some switch in career at times especially with Hazel’s case after a number of years of building experience and gaining knowledge in one particular field or profession. However switching a career can be wonderful chance to identify some careers that match well with your skill set and personality. Hazel will learn to be flexible in the long run who can both explore blue and white collar jobs.

Impact of Political Stability in India on Economic Growth

Impact of Political Stability in India on Economic Growth Political stability helps in making economic decisions and reducing the risk of imbalance in the economy. In May 2004, elections brought the United Progressive Alliance (UPA) into power. Growth, stability and equity are mutually reinforcing objectives. The quest of the UPA Government is to eliminate poverty by giving every citizen an opportunity to be educated, to learn a skill, and to be gainfully employed. The economic strategy of the UPA is composed of four main elements: maintaining macroeconomic balances; improving the incentives operating upon firms; enhancing physical infrastructure; and a range of initiatives aimed at empowering millions of poor households to participate in the growing prosperity. The major concern remains on commitment towards national interest, reduction of interference of unlawful elements in politics, public accountability and growth oriented policies of the government. Under the leadership of Dr Manmohan Singh the focus of the government is appropriate a nd will not be cause of distress It has positive effect on economic growth but many times due to other factors it may be negative. In India in last 20 years many governments were made. India is a developing country and it grows very fast. Whenever the govt. changes economic effected very much. India is the worlds largest democracy. In India, the prime minister is identified as the head of government of the nation, while the president is said to be the formal head of state and holds substantial reserve powers, placing him or her in approximately the same position as the British monarch. Executive power is enforced by the government. It can be noted that federal legislative power is vested in both the government of India and the two characteristic chambers of the Parliament of India. Also, it can be said that the judiciary is independent of both the executive and the legislature. For most of the years since independence, the federal government has been guided by the Indian National Congress , In India the two largest political parties have been the Indian National Congress and the bhartiya janata party (BJP). Presently the two parties have dominated the Indian politics, however regional parities too exist. From 1950 to 1990, barring two brief periods, the INC enjoyed a parliamentary majority. The INC was out of power between 1977 and 1980, when the Janata Party won the election owing to public discontent with the corruption of the then Prime Minister Indhira Gandhi. In 1989, a janata dal-led National Front coalition in alliance with the Left Front coalition won the elections but managed to stay in power for only two years. As the 1991 elections gave no political party a majority, the INC formed a minority government under Prime Minister P.V.Narsimha Rao and was able to complete its five-year term. The years 1996-1998 were a period of turmoil in the federal go vernment with several short-lived alliances holding sway. The BJP formed a government briefly in 1996, followed by the United Front coalition that excluded both the BJP and the INC. Political uncertainty is an investors nightmare. It does disturb the flow of foreign direct investment plans both into the private sector as well as the government owned public sector units and that surely affects economic growth. However, this argument is good only to a limited extent. Political stability is not necessarily an essential pre-requisite item for good economic growth. In actual practice, it is the other way around as it can be argued, that it is good economic growth, that essentially leads to political stability. Therefore, when the Congress spokespersons talked of political stability without mentioning its correlation with economic growth, their apprehensions of coalition governments appeared misplaced. Further Congress talking political stability was like the devil quoting the scripture. One cannot but remember that it was the Congress that destabilized the governments of 5 Prime Ministers, viz. Mr. Charan Singh, Mr. Chandrasekhar, Mr. H. D. Dev Gowda, Mr. Inder Kumar Gujral and of course Mr. Atal Bihari Vajpayee. Every one, of these governments, was toppled on flimsiest grounds. Indeed, they could have easily lasted their full term, if and only if politics had taken the back seat. Indias Growth Since Independence India has moved from a moderate growth path of the first three decades (1950 to 1980) to a higher growth trajectory since 1980s. Over the last two and a half decades, India has emerged as one of the fastest growing economies of the world, averaging about 6 percent growth rate per annum and ranking of the country in terms of size of the economy, especially in Purchasing Power Parity (PPP) Terms have improved. In the last three years. We have averaged a growth rate of 8 percent. Apart from registering impressive growth rate over the last two and a half decades, Indias growth process has been stable. Studies indicate that the yearly variation in growth in India has been one of the lowest. During the period, we have faced only one crisis in 1991. The crisis was followed by a credible macroeconomic structural and stabilization program encompassing trade, industry, foreign investment, exchange rate, public finance and financial sector. The evidence of stable economic con dition is the successful avoidance of any adverse contagon impact of shocks from the East Asian crisis, the Russian crisis during 1997-98, sanction like situation in post pokhran scenario, and border conflict during May-June 1999. The performance of the Indian economy during the current fiscal year has exceeded expectations. Initial growth projections for the period April 2004 to March 2005 were around 6.8%. Expectation was paired with a percentage point due to low rainfall from July 2004. Global price shocks in oil, steel and coal added to apprehension, particularly about inflation. However, shaking off these fears, the economy has grown by a robust 6.9%. There are two aspects to the emergence of India. First, there are signs of vigorous growth in manufacturing. High growth rates in exports have been extended beyond the now-familiar services story to skill-intensive sectors like automobiles and drugs. Manufacturing growth accelerated every month after May 2004 to reach double-digit levels in September and October. Merchandise export growth in the first 10 months of 2004-05 was 25.6%. For three quarters running, revenue growth in the corporate sector has been above 20% and net profit growth has been around 30%. Second, there is a pronounced pickup in investment. From 2001-02, the investment rate in India, low by East Asian standards, rose by 3.7 percentage points to 26.3% of GDP in 2003-04. ROLE OF POLITICAL PARTIES: The janata dal won elections in 1989, but its government managed to hold on to power for only two years. Between 1996 and 1998, there was a period of political flux with the government being formed first by the right-wing nationalist Bhartiya janata party (BJP) followed by a left-leaning United Front coalition. In 1998, the BJP formed the National Democratic Alliance with smaller regional parties, and became the first non-INC and coalition government to complete a full five-year term. The grenal saw the INC winning the largest number of seats to form a government leading the united progressive alliance and supported by left-parties and those opposed to the BJP. On 22 May 2004, Manmohan Singh was appointed the Prime Minister of India following the victory of the INC the left front in the 2004 lok sabha election. The UPA now rules India without the support of the left front. Previously Atal Bihari vajpeyi had taken office in October 1999 after a general election in which a BJP-led coalition of 13 parties called the national democratic alliance emerged with a majority. Formation of coalition governments reflects the transition in Indian politics away from the national parties toward smaller, more narrowly-based regional parties. Some regional parties, especially in South India, are deeply aligned to the ideologies of the region unlike the national parties and thus the relationship between the central government and the state government in various states has not always been free of rancor. Disparity between the ideologies of the political parties ruling the centre and the state leads to severely skewed allocation of resources between the states. Central and State Governments The central government exercises its broad administrative powers in the name of the President, whose duties are largely ceremonial. The president and vice president are elected indirectly for 5-year terms by a special electoral college. The vice president assumes the office of president in case of the death or resignation of the incumbent president The constitution designates the governance of India under two branches namely the executive branch and real national executive power is centered in the Council of Ministers, led by the prime minister of India. The President appoints the Prime Minister, who is designated by legislators of the political party or coalition commanding a parliamentary majority. The President then appoints subordinate ministers on the advice of the Prime Minister. In reality, the President has no discretion on the question of whom to appoint as Prime Minister except when no political party or coalition of parties gains a majority in the Lok Sabha. Once the Prime Minister has been appointed, the President has no discretion on any other matter whatsoever, including the appointment of ministers. But all Central Government decisions are taken by president. Political stability and Economic Growth: The politicians should realize that in the last decade or so, the scene in the country has undergone a sea change: India is a young country, where the average age is less than 26years. The literacy rate is continuously rising. The Primary Health Care services are improving. Female life expectancy rate and infantile survival rate are improving. There is a growing awareness of the need to let market forces decide on their role in the development of infrastructure projects. The power distribution has shifted from a centralized command structure to one where even the leader at local level has an opportunity to address his local aspirations at the national level. Privatization and Disinvestment Vajpayee had a vision of the 21st century information age. So, he privatized the Internet, reformed the flawed telecom policy, opened radio broadcasting in 40 cities and allowed up-linking facilities to satellite channels. Congress has yet to realize the impact of global market and address issues on taxes, subsidy etc so that the effects of globalization do not come as a jolt to the common man in the street. Mr. Narasimhas government approach on globalization lacked this humane approach. There was progress on other incremental reforms cut the diesel subsidy, de-licensed petroleum products and oil refining, set up a power regulatory authority, threw open transmission to the private sector. Moreover, he surprised us by squashing the irrational swadeshi forces within his own party. Impact in India: There are many affect in Indian economy due to political stability every factor is affected. India opened up the economy in the early nineties following a major crisis that led by a foreign exchange crunch that dragged the economy close to defaulting on loans. The response was a slew of Domestic and external sector policy measures partly prompted by the immediate needs and partly by the demand of the multilateral organisations. The new policy regime radically pushed forward in favour of amore open and market oriented economy. Major measures initiated as a part of the liberalisation and globalisation strategy in the early nineties included scrapping of the industrial licensing regime, reduction in the number of areas reserved for the public sector, amendment of the monopolies and the restrictive trade practices act, start of the privatisation programme, reduction in tariff rates and change over to market determined exchange rates. Over the years there has been a steady liberalisation of the current account transactions, more and more sectors opened up for foreign direct investments and portfolio investments facilitating entry of foreign investors in telecom, roads, ports, airports, insurance and other major sectors. The Indian tariff rates reduced sharply over the decade from a weighted average of 72.5% in 1991-92 to 24.6 in 1996-97.Though tariff rates went up slowly in the late nineties it touched 35.1% in 2001-02. India is committed to reduced tariff rates. Peak tariff rates are to be reduced to be reduced to the minimum with a peak rate of 20%, in another 2 years most non-tariff barriers have been dismantled by march 2002, including almost all quantitative restrictions. The Indian economy is passing through a difficult phase caused by several unfavourable domestic and external developments; Domestic output and Demand conditions were adversely affected by poor performance in agriculture in the past two years. The global economy experienced an overall deceleration and recorded an output growth of 2.4% during the past year growth in real GDP in 2001-02 was 5.4% as per the Economic Survey in 2000-01. The performance in the first quarter of the financial year is5.8% and second quarter is 6.1%. Sectors Industry and services India has one of the worlds fastest growing automobile industries. Shown here is the Tata motors make Nano, the worlds cheapest car. Industry accounts for 28% of the GDP and employ 14% of the total workforce. However, about one-third of the industrial labor force is engaged in simple household manufacturing only. In absolute terms, India is 16th in the world in terms of nominal factory output. Economic reforms brought foreign competition, led to privatization of certain public sector industries, opened up sectors hitherto reserved for the public sector and led to an expansion in the production of fast-moving consumer goods. Post-liberalization, the Indian private sector, which was usually run by oligopolies of old family firms and required political connections to prosper was faced with foreign competition, including the threat of cheaper Chinese imports. It has since handled the change by squeezing costs, revamping management, focusing on designing new products and relying on low labor costs and technology. Textile manufacturing is the second largest source for employment after agriculture and accounts for 26% of manufacturing output. Ludhiana produces 90% of woolens in India and is also known as the Manchester of India. Tripura has gained universal recognition as the leading source of hosiery, knitted garments, casual wear and sportswear. Dharavi slum in Mumbai has gained fame for leather products. Tata Motors Nano attempts to be the worlds cheapest car. India is fifteenth in services output. It provides employment to 23% of work force, and it is growing fast, growth rate 7.5% in 1991-2000 up from 4.5% in 1951-80. It has the largest share in the GDP, accounting for 55% in 2007 up from 15% in 1950. Business services (information technology, information technology enabled services, business process outsourcing) are among the fastest growing sectors contributing to one third of the total output of services in 2000. The growth in the IT sector is attributed to increased specialization, and an availability of a large pool of low cost, but highly skilled, educated and fluent English-speaking workers, on the supply side, matched on the demand side by an increased demand from foreign consumers interested in Indias service exports, or those looking to outsource their operations. The share of Indias IT industry to the countrys GDP increased from 4.8% in 2005-06 to 7% in 2008. In 2009, seven Indian firms were listed among the top 15 technology outsourcing companies in the world. In March 2009, annual revenues from outsourcing operations in India amounted to US$60 billion and this is expected to increase to US$225 billion by 2020. Organized retail such supermarkets accounts for 24% of the market as of 2008. Regulations prevent most foreign investment in retailing. Moreover, over thirty regulations such as signboard licences and anti-hoarding measures may have to be complied before a store can open doors. There are taxes for moving goods to states, from states, and even within states. Tourism in India is relatively undeveloped, but growing at double digits. Some hospitals woo medical tourism. Agriculture Farmers work inside a rice field in Andhra Pradesh. India is the second largest producer of rice in the world after China and Andhra Pradesh is the 2nd largest rice producing state in India with West Bengal being the largest. India ranks second worldwide in farm output. Agriculture and allied sectors like forestry, logging and fishing accounted for 17% of the GDP in 2009, employed 52% of the total workforce and despite a steady decline of its share in the GDP, is still the largest economic sector and plays a significant role in the overall socio-economic development of India. Yields per unit area of all crops have grown since 1950, due to the special emphasis placed on agriculture in the five-year plans and steady improvements in irrigation, technology, application of modern agricultural practices and provision of agricultural credit and subsidies since Green revolution in India. However, international comparisons reveal the average yield in India is generally 30% to 50% of the highest average yield in the world. India is the largest producer in the world of milk, cashew nuts, coconuts, tea, ginger, turmeric and black pepper. It also has the worlds largest cattle population: 193 million. It is the second largest producer of wheat, rice, sugar, cotton, silk, peanuts and inland fish. It is the third largest producer of tobacco. India is the largest fruit producer, accounting for 10% of the world fruit production. It is the leading producer of bananas, sapotas and mangoes. Finance in India Banking in Indiaand Insurance in India The Indian money market is classified into: the organised sector (comprising private, public and foreign owned commercial banks and cooperative banks, together known as scheduled banks); and the unorganised sector (comprising individual or family owned indigenous bankers or money lenders and non-banking financial companies (NBFCs)). The unorganised sector and microcredit are still preferred over traditional banks in rural and sub-urban areas, especially for non-productive purposes, like ceremonies and short duration loans. Mumbai is the financial and commercial capital of India. Shown here is the World Trade Centre of Mumbai Prime Minister Indira Gandhi nationalised 14 banks in 1969, followed by six others in 1980, and made it mandatory for banks to provide 40% of their net credit to priority sectors like agriculture, small-scale industry, retail trade, small businesses, etc. to ensure that the banks fulfill their social and developmental goals. Since then, the number of bank branches has increased from 10,120 in 1969 to 98,910 in 2003 and the population covered by a branch decreased from 63,800 to 15,000 during the same period. The total deposits increased 32.6 times between 1971 to 1991 compared to 7 times 1951 to 1971. Despite an increase of rural branches, from 1,860 or 22% of the total number of branches in 1969 to 32,270 or 48%, only 32,270 out of 5 lakh (500,000) villages are covered by a scheduled bank. The public sector banks hold over 75% of total assets of the banking industry, with the private and foreign banks holding 18.2% and 6.5% respectively. Since liberalisation, the government has approved significant banking reforms. While some of these relate to nationalised banks (like encouraging mergers, reducing government interference and increasing profitability and competitiveness), other reforms have opened up the banking and insurance sectors to private and foreign players. More than half of personal savings are invested in physical assets such as land, houses, cattle, and gold. Indian has the highest saving rate in the world at 36 percent. Natural resources in India Energy policy of India India has the worlds fifth largest wind power industry, with an installed wind power capacity of 9,587 MW. Shown here is a wind farm in Muppandal, Tamil Nadu. Indias total cultivable area is 1,269,219km ² (56.78% of total land area), which is decreasing due to constant pressure from an ever growing population and increased urbanisation. India has a total water surface area of 314,400km ² and receives an average annual rainfall of 1,100mm. Irrigation accounts for 92% of the water utilisation, and comprised 380km ² in 1974, and is expected to rise to 1,050km ² by 2025, with the balance accounted for by industrial and domestic consumers. Indias inland water resources comprising rivers, canals, ponds and lakes and marine resources comprising the east and west coasts of the Indian ocean and other gulfs and bays provide employment to nearly 6 million people in the fisheries sector. In 2008, India had the worlds third largest fishing industry. Indias major mineral resources include coal, iron, manganese, mica, bauxite, titanium, chromite, limestone and thorium. India meets most of its domestic energy demand through its 92 billion tonnes of coal reserves (about 10% of worlds coal reserves). Indias huge thorium reserves- about 25% of worlds reserves- is expected to fuel the countrys ambitious nuclear energy program in the long-run. Indias dwindling uranium reserves stagnated the growth of nuclear energy in the country for many years. However, the Indo-US nuclear deal has paved the way for India to import uranium from other countries. India is also believed to be rich in certain renewable sources of energy with significant future potential such as solar, wind and biofuels (jatropha, sugarcane). CONCLUSION: After complete this term paper I come at this conclusion that politics effects economy very much. If a govt. change than many other factors also changes. Every govt. do work by their own style, they change many things like construction, infrastructure, their employees, contractors and it may affect positive or negative. So it based on situation. Political stability is very important for economic growth. REFERENCES: www.businessline.com www.oppapers.com Wikipedia www.scribd.com

Norman Maclean’s Young Men and Fire Essay -- Young Men

Norman Maclean’s Young Men and Fire â€Å"I now feel brave enough to venture forth and bear earth’s torments and its joys, to grapple with the hurricane.† (Faust, lines 464-66) Have the gates of death been opened unto thee? Or hast thou seen the doors of the shadow of death? Hast thou perceived the breadth of the earth? . . . Declare if thou knowest it all. (Job 38:17,18) Human beings are prideful creatures, and we have good reason to be. We have subdued a planet, changed the course of rivers, watered deserts, written poetry to make angels cry, and wrapped the world in a network of electric impulses and digital displays. We have created and killed not one but many gods. We can make a cloud rain by shooting heavy metal into it, and we can create a lake by pouring concrete in a canyon and damming a river. Most days, it seems that we human beings have everything under control and that if we miss wild nature, well, we can grow it in our gardens. (We can even genetically engineer the plants and animals.) Every so often, however, the universe spins out of our control. Forest fires rage. The earth quakes. Chaos descends like a great modern Zeus hurling thunderbolts and reminding us that nature is not ours to manipulate. In a great universe shaped by raw power and force, human beings are only small, easily crushed, organic structures. We need the remi nder. Chaos and destruction are nature’s great gift to human kind because the realization of our frailty and insignificance leads to enlightenment. We learn something about ourselves, how we are here, where we want to go, and what we have to say about it. Chaos spoke to Darwin in the shaking of the earth: A bad earth quake at once destroys the oldest associati... ...pe of bringing a frightening force of nature under control. Science, too, is a method of telling a story about nature. In the struggle to make sense of the raging universe, we sometimes discover art, an art purged of all pretense by the extreme elements of which it was born. When all is said and done, the disaster that brings us death also brings us an opportunity to find hope and compassion, and a chance to transcend our own blindness and limitations and find peace. Works Cited Darwin, Charles. Voyage of the Beagle. New York: Penguin Books, 1989. Goethe, Johann Wolfgang. Scientific Studies. New York: Suhrkamp, 1988. —. Faust. New York: Anchor Books, Doubleday, 1990. Maclean, Norman. Young Men and Fire. Chicago: U of Chicago P, 1992. Pope, Alexander. â€Å"Essay on Man.† The Norton Anthology of English Literature. 3rd ed. New York: Norton, 1960.

Pak mulls removing import duy on Indian Tea Essay

Free trade takes place when there are no barriers and no intrusions to trade put by the authority(government and trade organisations). Free trade allows goods and services to flow freely freely from one country to another. The opposite to free trade is Protectionism. There are many protectionism that the government of a particular country can impose on trade. Main types of protectionism: * Tariffs * Subsidies * Quotas * Embargoes The governement of Pakistan has imposed a trade barrier on the import of Tea from India. India tea is under a 10 percent import duty. Some possible reasons for the imposition of Import duty on Tea are given below. * To prevent over specialisation * To raise government revenue * To remove balance of payment deficits Given below is a graph that shows the effect of imposing import duty on the import of Tea. Due to the imposition of import duty the prices for Tea rises from ‘P-world’ to ‘P- import duty’ because of which the Supply curve shifts from ‘S-world’ to ‘S- world+ import duty’ . Therefore there is an overall consumer loss. Areas ‘a’,’b’,’c’ and ‘d’ shows the consumer loss. Area ‘a’ shows the producers gain. Area ‘b’ shows green loss. It is said to be a ‘Green Loss’ because there is inefficiency that is creeping in this area as inefficient domestic producers are now producing this area at a higher price. Area ‘c’ shows the government revenue due the import duty. Area ‘d’ shows the net loss. ‘d’ is not being produced or demanded due to the rise in prices, this shows the net loss towards the consumer. Tea is an ‘important drink in every Pakistani house’ and Pakistan is the second largest importer of Tea. Therefore the demand curve for Tea in Pakistan is very inelastic. The smuggled tea is sold at a low cost but due to the Inelastic demand for Tea, The change in the price of tea should have a realively low change in the demand. However, the article states that Pakistan imports 140 million kg and 20 million kg is smuggled. This shows that 12.5 % of tea is smuggled, which is a very high rate. This indirectly shows that Tea inspite of being very inelastic in demand, a change in price will have a big effect on the demand. Area ‘d’ in the above graph is consumer loss in Trade between India and Pakistan. However, this area is being demanded and supplied throught smuggling and illegal trade. Therefore, Area ‘d’ can also be observed as the government loss of revenue. India and Kenya are the two main countrys supplying Pakistan with tea. Due to the drought in Kenya the prices have increased tremendously. This puts Pakistan in a very infavourable situation. ‘S-world’ takes into account the imported supply of Tea from India and Kenya. Due to the import duty the price shifts from ‘P world’ to ‘P- import duty’ and the supply shifts from ‘S- world’ to ‘S- world+ import duty’. Again due to the drougth the price shifts from ‘P- import duty’ to ‘P1’ and the supply shifts from ‘S- world+ import duty’ to ‘S- world 2’. Due to the very high prices people will stop consuming Tea and move to other alternatives like coffee. Also smuggling of Tea will increase tremendously. The net effect will have a tremedous loss of revenue for the government.

ACT On My Own

Should I Hire A Tutor Or Study For The SAT/ACT On My Own SAT / ACT Prep Online Guides and Tips Your number two pencils are sharpened; you have functioning erasers at the ready and tissues for when you can’t stop the tears. That’s right. You’re gearing up to study for the SAT/ACT. Except†¦how do you actually go about studying for the SAT/ACT? Do you need a tutor, or can you just do it on your own? We cover this topic pretty thoroughly in our free booklets on comparing methods of test prep for the SAT and ACT, so this article will just give you a brief rundown of when it’s worth it to hire a tutor. feature image credit: Lady Mary Fairfax with her Tutor, 1647 by Lisby, used under CC BY 2.0/Cropped from original. In general, if you want to succeed on the SAT or ACT, you must have all of the following five components. 1. Motivation and Accountability Finding the motivation to study for the SAT/ACT can be...problematic. I mean, your score doesn’t directly impact your high school education (unless your school uses it for something), and test prep isn’t as interesting as Youtube. If you aren’t motivated, you won’t make progress in your test prep. A vague reason that you just give lip service to, like â€Å"I know I probably need to study so I can get a good enough score get into the school I want,† won’t do you any good. You need reasons to study that will actually motivate you. Because it’s the strength of the motivation that matters, not the loftiness of the reason, â€Å"I want to beat my older sibling’s score on the SAT† is just as valid a motivator for test prep as â€Å"I want to do well on the SAT so I’m guaranteed a scholarship to a state school.† Accountability may play a role in your motivation, if you find that you are most motivated to succeed if you have people counting on you who you don’t want to disappoint. Maybe you’ll care if a friend or a sibling shames you for not doing work like you said you would (not that I speak from experience), or if your parents are disappointed in you for failing to improve your test scores (as long as this is also something YOU care about). Bottom line: you need to find a source (or multiple sources) of motivation that work(s) for YOU. IF you have problems finding the motivation to study on your own, without anyone holding you accountable for studying, THEN a tutor may be helpful for you. 2. Strong Study Plan Students who succeed on the SAT/ACT go into prep with a structured study plan. When you’re just studying on your own, it can be hard to stay organized in your studying. The first step to forming a high-level study plan is to know where you currently stand and where you want to be on test day. Take a timed practice test under realistic conditions to get a sense of how you are scoring now. Next, what is your target score? We have two articles about this, one for the SAT and one for the ACT, but to summarize: List the schools you want to apply to Search online to find their average SAT/ACT scores Take the average of all the averages to get your target test score. Once you know your current score and your target test score, you will have a better idea of what it's going to take to get there. A structured study plan will be able to answer all of the following questions. When am I taking the SAT/ACT? How long do I have to prepare before test day? How many hours will I study each week? What material do I need to cover? What resources will I use? Should I use books or a complete prep program? When do I take practice tests? How will I know how to adjust my plan according to my progress? I'm going to use a fictional student named Aaron to answer these questions. Aaron recently took a practice SAT and scored a 1000 and has six months to reach his target score of 1250. He and his tutor have assessed his weak areas and discovered that Aaron has serious content weaknesses across all of SAT Math and some smaller issues with the Critical Reading and Writing sections. Aaron's study plan looks something like this: Months 1-3: 1 hour every other week with tutor, 3 hours a week otherwise focusing on weaknesses in SAT Math. Practice tests every three weeks. Months 4-5: 1 hour every other week with tutor, 6-7 hours a week outside of tutoring sessions drilling weaknesses in Math, Critical Reading, and Writing and reviewing missed questions, using books and materials hand-selected by the tutor; practice tests every other week. Month 6: 1 hour every other week with tutor, 9-10 hours a week outside of tutoring sessions working on remaining weaknesses that the tutor has identified by drilling with actual practice questions, practicing reading comprehension by finding interesting articles in the New York Times and analyzing them; practice tests every week, increasing in frequency as the test draws nigh. Because Aaron sticks to his study plan, he bumps his Math score from 400 to 630 and his overall SAT score from 1000 to 1260, meeting his target goal. If he had not had this study plan, even if he had gotten focused help on the Math section a month before the test, it's unlikely that he would have been able to improve as much as he did, both in Math and across the board. So IF you have problems structuring your study time, THEN a tutor may be helpful for you. 3. Excellent StudyResources Being motivated with a plan won’t do you any good if you don’t have good resources for your test prep. It is extremely important to use actual SAT/ACT practice tests when you study, not other test prep company’s materials, since only the questions that will test you in the same way the real test does are...questions from an official test. Luckily, there are a bunch of free practice tests available online for the SAT and the ACT. What if there’s a topic you just don’t understand? Let’s make up an example and say I never really understood probability in class, but somehow managed to fake my way through it. Suddenly, I’m faced with the SAT or ACT, which questions you on probability in really weird ways. To address this, I could try going through back through notes or borrowing old textbooks, prep material from other people. But what if I don’t have any good notes or materials to begin with? Not only this, textbooks and class notes aren't the best way to prep for the tests since they're so different. What if I’m not good at teaching material to myself? My best bet would be to find a tutor who has a good reputation for teaching SAT Math, and get focused instruction on improving my knowledge of probability. IFyou don't know what the best resources available to target your weaknesses are, THEN you would definitely benefit from time with the right tutor. 4. Effective Way To Learn From Your Mistakes One of the mistakes many people have when they study for the SAT/ACT is failing to thoroughly review the questions they miss. A thorough review involves more than a halfhearted â€Å"Oh, I see. I got this wrong because I was careless.† In order for going over your errors to actually help you, you need to dig deep into why exactly you missed the question. Where were you careless? Did you make the mistake because you were rushing? If so, why were you low on time? What are concrete ways you can avoid making this mistake in the future? If you’re thinking that you’d love to read an entire article about the best way to review your mistakes, then you are in luck. IF you have trouble going over your mistakes and figuring out what in particular you did wrong (and concrete ways to avoid it in the future), THEN hiring a high quality tutor will be helpful. Bourgai Sadia by sebastien Delcoigne, used under CC BY-SA 2.0/Cropped from original. Don’t speed past your mistakes. 5. Ability To Measure Progress In order to successfully prepare for the SAT/ACT, you need a way to measure your progress as you study, and be able to adapt your study plan accordingly. This is the area I have the most trouble in – it’s tempting to keep doing the same things over and over, but after a certain point those things may no longer be helping you boost your score. So how do you measure progress? When beginning your test prep, you should take a timed, full-length practice test and score it; alternatively, if you've already taken the test once recently, you can use that as your starting point. As you proceed through your test prep, continue to take timed practice tests at regular intervals, spaced according to how much time you have to study. For instance, if you're preparing for the SAT over the course of two months, start out by taking a practice test at the end of each week of prep for the first month. Why is taking timed practice tests so important to your test prep? It's the only way, short of taking the actual SAT or ACT, to see how you're doing under realistic conditions. If you don’t know if you’re doing better than before on the test, it's impossible to know if your studying is effective...or if you're just wasting your time. By periodically checking your score on practice tests, you'll be able to see if you are improving, and if you need to be improving more quickly to meet your goals (or if you're doing just fine). Let's extend the example of a student who takes four practice tests in the first month of her studying. He started out with an ACT composite score of 24, and his goal is to improve to a 30; however, after a month of studying a couple of hours a week, his practice test composite is holding steady at 26. If this student wants to meet his goal, he's going to need to adapt his studying method. In this case, a tutor would be helpful because she would be able to identify the ways in which the student should adapt his studying method to reach his target score, whether this is by increasing the amount of time he studies or changing the specifics of how he reviews questions he's messed up on. IF you’re not really sure how to measure your progress, or how you can adapt your test prep as you improve, THEN you might find a tutor helpful. No Sweat, I’ve Got This Without A Tutor If you are confident that you take care of the following on your own: Motivation and Accountability: You have a reason or multiple reasons to study that are actually important to you. Strong Study Plan: You know your target score and the amount of time you have to study and are able to use that to plan out your test prep in a schedule that you can stick to. Good Resources: You have the right material to study, or you have the ability to aquire it. Effective Ways to Learn From Your Mistakes: You are expert at picking apart your mistakes, seeing exactly where you went wrong, and finding solutions to avoid these mistakes in the future. Ability to Measure Progress: You know what your starting point is and that you need to take timed practice tests along the way as yardsticks against which to asses your progress. ...then absolutely go for it - you don't need a tutor to do well, or even get a perfect score, on the SAT or ACT. As I can personally attest, working smart and working hard will get you most places when it comes to test prep. Storytime: When I was a senior in college, I was under the impression that I might want to go to grad school for psychology, and so I knew I had to take the GRE Psychology Subject Test. I didn't have the funds or time for a tutor, and there wasn't really a test prep course out there that I knew of. Instead, I studied with a friend for about an hour a day, every day, for the six weeks leading up to the test. We both scored exceptionally well, and my friend is in the process of earning her doctorate in psychology. So I don't want to suggest that you MUST have a tutor to do well on the SAT/ACT. But if you feel like you need help on one of the above key components, you should consider it. Uh Oh†¦I’m Not So Sure I Can Do This On My Own If you’re worried about even one of those 5 areas, however, you might want to consider getting yourself some assistance to maximize your score. The more areas you struggle with, the more a high quality tutor will help. On the other hand, if you’re not entirely sure that you want to go with a tutor, a test prep program, like PrepScholar’s automated drilling platform, is a good compromise. You get motivation, a pesonalized study plan that focuses on your weaknesses, materials, and a way to measure progress, but pay less and miss out on the one-on-one attention. What’s Next? Wait, what is it that tutors actually do during SAT/ACT tutoring, anyway? I’ve got the answer for you! Sounds good so far, but should I be doing online tutoring? Find out here. How do you find the right tutor for you? Reading this article is a good start (although since I wrote it, I might be a little bit biased). Want to get serious about improving your SAT/ACT score? Our tutoring service is designed to be the most effective in the nation. We hire the best tutors from across the country. This is then paired with our exclusiveonline drillingprogramthat gives your tutor complete insight into your progress to design the most effective sessions. Think about what improving 160 points on your SAT, or 4 points on your ACT, can do for you. Learn more about tutoring now:

extraterrestrials essays

extraterrestrials essays Domestic Violence Against Men In the United States, many women cry out about domestic violence in their homes, but are the men always to blame? The idea that men would claim domestic violence against their spouse is practically unheard of. To men it may be a sign of weakness or just flat out embarrassing. The statistics show that in 100 cases of domestic violence, 40% is inflicted by the woman. In a year about 400,000 women are abused, and by doing the math, about 300,000 to 350,000 men are abused by their spouse each year. Men are abused almost as equally as men because, statistics back it up, men are not as outspoken as women are, and women are more emotional causing them to be more violent. From the Detroit News the statistics show that men were: 32% of the aggravated assault victims 10% of miscellaneous other offenses in crimes As stated before, it was said that 40% of men out of 100 cases were the victim of domestic violence, however, in 1998 the Department of Justice report on National Violence showed that only 36% of men were the victims of domestic violence. The numbers are still pretty close. In Murray Strauss and Richard Gelles Conflict Tactics Scales, their research showed that women are more likely to: assault with an object other than a knife or gun The current myth is that women are assaulted by men 90-95% of the time. The actual facts were that 1.5 million women and 835,000 men are the victims of domestic violence each year. The percentage of men abused for that fact is about 38-50%, which was according to major studies from Canada, the United States, and Great Britain. Another myth is that 20-35% of womens emergency room visits are there because of domestic viol ...

Fidel Castros Rise To Power essays

Fidel Castro's Rise To Power essays Cubas government is currently a totalitarian state since the revolution on January 1st in 1959. The head of state is currently Fidel Castro, also the Chief of State, as well as the Head of Government, First Secretary of the Cuban Communist Party, and Commander in Chief of the armed forces. Fidel Alejandro Castro Ruz was born August 13th in 1926 to Angel Castro, a Spanish farmer living fairly well in Biran, Orient province. Growing up Angel Castro had big plans for his son unknowing that his son had even bigger plans. As a young boy Fidel was often teased because of his rough manners and because of this was sent to a Jesuit school in Santiago de Cuba. He had also attended the Colegio Dolores, once graduated he was accepted into Havana University where he became interested in politics. With this strong interest in politics, Fidel felt he had to take some action in order to guarantee himself in Cubas political world. In 1947 he joined a group, whom were planning to overthrow of the Dominican Republics dictator. Although the mission failed, Fidel became more and more of an activist. Frequently he spoke out against the repression in Cuba, against the communism and dictatorships. Following graduation Fidel established a law partnership with two other attorneys from his university; however he spent most of his time representing the less fortunate and trying to reform a society that was against him. Fidel began what some call his campaign to head of state when he petitioned the Emergency Court of Havana nothing that Batista had undermined and violated the 1940 Constitution. When no one seemed to listen to Fidel joined with Abel Santamaria Cuadrado to form an organization of students for an armed rebellion. When the time came the group stormed one of the military garrisons of Santiago, sadly their attack had been unsuccessful due to the group being left without information on the layout of the inside compound. Those ...

The English Legal System assignment Essay Example | Topics and Well Written Essays - 1750 words

The English Legal System assignment - Essay Example The construction process is, therefore, a cohesive process that begins with the survey of the land and the determination of the effective terrestrial features thus influencing the development of property that sustains the investment for all the parties involved. The land surveyor may face legal responsibility for negligence on their jobs in the survey and design of the house depending on the complaints and conflicts that arise thereafter. Such complaints may arise from either the property owner or the eventual client who either buys or rents the property. The complaints may include any boundary feuds that arise thereafter or the nature of the structure that arises from the design. Surveyors inform the architect on the nature of the land and its ability to support particular designs and populations. A surveyor should determine if a land is swampy and therefore advise the architect on the design of the structure and the possible reclamation methods capable of making the land usable for the purposes of constructing a residential property. Legal cases would arise in case a building sinks later since such portrays evident lack of effective land survey. In a bid to ascertain the security of the citizen, the government of Britain asserts more importance on the practice and, consequently, evaluates every surveyor. The government certifies the survey schools and the courses taught in such facilities. Additionally, it certifies every surveyor thus permitting their practice. This way, it becomes possible to track any fraudulent surveyors who cause the loss of either property or lives. The property owner always contracts a surveyor who may be a real estate agent. The agent then...England, unlike most of the European countries, has a unique constitution; the country’s constitution arises from several acts of parliament, legal documents, and judicial decisions. In determining the negligence as discussed above, the court uses such acts of parliament, torts, and past pr ecedence . The courts employ relative yet effective applications of the statutes. In doing this, the courts must ensure that they protect the interests of all the parties involved by instituting fairness to all. The courts consider precedents as set by the courts in past similar cases. By doing this, the courts avoid instances of unfairness as either party in such cases may compare past cases to their current case and identify inconsistencies. In the case of unique cases, the courts analyse the statutes and state laws thus maintaining fairness in the determination and in the setting precedents for future cases. In retrospect, land surveyors may face negligence cases depending on the manner in which they offer their services to the public. The English legal system provides an elaborate process of falsifying a contractor and determining negligence in their cases. The courts thus use the existing legislations to ensure effective compensation for the losses incurred by the parties conce rned.

Greed Field Ventures Limited Essay Example | Topics and Well Written Essays - 2250 words

Greed Field Ventures Limited - Essay Example Allison Madison has been in agricultural production since 1980s. He inherited a vast land at different locations. All together he inherited about 1150 acres. Only about half of the total farm land was cultivated at the initial stage. Farming was highly seasonal. Hence there the capital base was small. The turnover was about $89,500.00. Only the farm lands close to villages were cultivated. Labour was provided by villagers and seasonal migrants. There were no built structures except small round-shaped mud warehouses scattered in the village settlements. The crops produced were crops produced in the neighbouring village settlements. They were all cereals: maize, millet and guinea corn. Although production was above subsistence level, farm produce were largely sold in the village market. Thus prices were highly variable and unpredictable. There was no proper record of the inputs and outputs in the production process. Except for the processing of maize stalks into fence, there was no val ue added to the production process. By late 1990s Allison has settled down. The acreage inherited was fully utilized. The types of crops produced have increased. Ground nuts, soya beans and rice were produced. Manual labour was complimented by tractors. Two tractors were hired. The size and type of crops produced were not for village market. Two warehouses were consequently built, where farm produce were stored and sold when prices are favourable. A truck with capacity of conveying 3 tonnes was bought purposely for transporting produce to distant markets and buyers. Allison was assisted in the management of the farms by his son, with a degree in business administration, and his nephew with a diploma in agricultural economics.

Critical Thinking & Application Paper - Case Study Essay

Critical Thinking & Application Paper - Case Study - Essay Example Is it ethical to do the wrong thing if it will please the majority and ensure harmony? Does dismissing Darrell through a criterion that is ethically and professionally unacceptable, constitute an ethical decision if the committee members are doing the wrong in order to please the mass of student whose interests they are supposed to primarily serve? Is it ethical to sacrifice Darrell as some committee members opt to do for the sake of harmony within the school and to ensure that the previous situation whereby the lecturer was unpopular with the students was not witnessed again? Is it ethical to dispense the laid down hiring procedures and criteria of dismissal as some members opt to? Is it ethical to make a moral choice if it is likely to bring conflict in future? The main reason why the issue of hiring or failing to hire Darrell raises the case’ main ethical issue is because the article revolves around Darrell’s plight due to his physical appearance and how fair each de cision made either to hire him or otherwise will be to him and to the students. This is because such a choice will most probably be guided by his looks and not his professional qualifications and capabilities as the ideal case should be. II. Research. (find at least three articles) Only complete articles should be chosen, not just abstracts of articles Article citation- Richards, J. &Lucas, J. R. (1985) Discrimination, Proceedings of the Aristotelian society. Supplementary volume 86, p.53-82 The case study is about unfair or discriminatory treatment on account of a condition that is not as a result of one’s personal choice. The article explores in depth the ills brought about by discrimination on various grounds. The article further looks into the issue of inevitable discrimination like when one is psychologically coerced to choose between a close relative and another qualified candidate in job recruitment or a person whom they share ideals like religious affiliation and anot her who they differ in the same. Blood being thicker than water, the decision maker is compelled to give the job to his relative. The author observes that even the society would expect him to act as such. In this case therefore, the other candidate is disqualified not on the basis of merit, for the fact that he is not related to the person in- charge of the recruitment. The article relates to the case study in that it provides an insight in discrimination in the recruitment process. Article citation- Agerstrom, J. & Rooth, D. (2011). The role of stereotypes in Real Hiring Discrimination. Journal of Applied Psychology ,volume 96, p.790-805 This article is a study that looks into the discrimination that obese people in the hiring process. It further evaluates measures they take to counter such discrimination such as photo manipulation. The article further considers previous studies into discrimination and concludes that body weight is in fact a big source of prejudice against job- see kers. The article gives statistical facts on people disqualified for jobs in many fields for being obese. It relates directly with our case study as the case study gives one example where a person’s obesity is used as an index to judge whether he is qualified for the job or not. Article citation- Park, L. & Harwin, M. (2010) Visible versus non-visible rejection: Consequences of appearance-based rejection sensitivity.

Knowledge Management in Healthcare Essay Example | Topics and Well Written Essays - 1750 words

Knowledge Management in Healthcare - Essay Example This paper would expound on the need for and how Knowledge Management is adopted in healthcare, what problems does it address, what are the considerations to maximize its total benefits, what factors may hinder it from being an effective tool in effecting development in the field of healthcare and what are the importance of transferring the explicit knowledge.. "Healthcare organizations are facing many challenges in the 21st Century due to changes taking place in global healthcare systems. Spiraling costs, financial constraints, increased emphasis on accountability and transparency, changes in education, growing complexities of biomedical research, new partnerships in healthcare and great advances in IT suggest that a predominant paradigm shift is occurring. This shift is necessitating a focus on interaction, collaboration and increased sharing of information and knowledge which is in turn leading healthcare organizations to embrace the techniques of Knowledge Management in order to create and sustain optimal healthcare." (Sharma et al., 2005) Indeed healthcare plays by the rules of the economy and the society too, it lends itself vulnerable to the limitations of the body administering it. As acquiring information does not come without a cost, readily available yet reliable information are sought for, thus the role of Knowledge Management to regulate and pass on information. (Tandon, Angrish, Anand, 2006) Knowledge Management, though having relative definitions sums up the process of creating, controlling, channeling and transferring knowledge assets to address competitive advantage and optimal performance. (Morgan, Doyle, Albers, 2005) In healthcare, most especially in nursing care, knowledge continuity is posed as an organizational challenge. In the US, there is a high turnover rate among hospital staff-already amounting to 20% (Morgan et al., 2005). This dynamics breaks the links of transferring knowledge from old to new employees leading to poor acquisition or transfer of valuable knowledge assets. In basic terms, knowledge is shared through a "traditional scholastic medical education" through "textbook based" learning, and acquiring lessons through experience and mentorship. Although this, in the beginning, could let the workers harness best business practices, it could also mean lack of diversification in knowledge unless branching out to different hospital units is initiated. "There are a number of organizational benefits to KCM [Knowledge Continuity Management] such as decreasing job turnover costs, increasing organizational effectiveness, improving training for new employees, facilitation of organizational learning, speeding the maximal productivity of new employees, and improving the decision making and decreasing the process errors of new employees." (Morgan et al., 2

Nature of British Colonialism Essay Example | Topics and Well Written Essays - 1250 words

Nature of British Colonialism - Essay Example So the course of the different British colonies is diverse.1 Generally, the overall quality of colonial administration improved at the beginning of the nineteenth century, when the Colonial Office prospered under effective leadership who created distinct departments, recruited and hired experts in colonial management, and worked with true humanitarian intentions to create policy that recognized the human worth of the colonists. According to historian Harold J. Schultz, the leaders of the Office, "under the influence of the humanitarian and Evangelical movement, produced a colonial policy favoring missionary expansion and racial equality."2 At the end of the nineteenth century, a wave of imperialist expansion swept over European nations. Fostered by nationalism, militarism, and the Industrial Revolution, Britain and its neighbors determined the best chance for real expansion was overseas. They began what is often termed a "scramble" for colonies, which may have been just as messy a process as the word implies. Britain began to feel threatened by the other nations' expansion. It worried about its sources of raw materials, its markets, and its ability to conduct free trade.3 This fear affected its attitudes about colonies and its policies. In Canada, colonial policy was influenced by friction between groups such as French and English, and Catholic and Protestant. In the north, early colonists were angered by the influx of new settlers and worried that local government might come under their control. In the south, the elected Assembly feuded with the upper house, which was seen as the governor's cronies. There was actually a rebellion in 1837, which showed the British government how serious the Canada situation was. Britain sent Lord Durham to Canada to assess the situation and make recommendations.4 Lord Durham's assessment concluded there were "two basic problems in Canada: 'two races warring in the bosom of a single nation,' and representative government without political responsibility for its actions."5 He created a plan to unite Upper and Lower Canada to reduce racial differences, and offered ideas to reform the government to make it more honest and effective. His recommendation was to allow governors to select their ministers from members with a majority in the Assembly.6 In this way, the legislature would have a power check on the executive branch. Durham's plan was quite fair and reasonable. It showed that creating responsible government for at least some colonies was Britain's goal. It suggested that the "colony-mother country" relationship would be one of voluntary association, and not coercion. Britain had been paying attention in the years after the American Revolution, and now had a different view of that relationship.7 India All colonial policy is influenced by economics, but that seems to be especially the case with India. After the Seven Years' War, the East India Company grew in power "from a trading post to a private imperial empire."8 The company abused its power in India, governing without accountability. Corrupt officials made huge fortunes collecting taxes and pocketing them. Corruption became widespread enough to draw the interest of the House of Commons. Lord North reduced the company's power but still left it with control. Over

Engine performance and Efficiensy Coursework Example | Topics and Well Written Essays - 1250 words

Engine performance and Efficiensy - Coursework Example Momentum drag is the negative thrust (force) opposing the jet thrust or motion through air, it is also referred to as the ram drag. It is a product of the incoming air (flow rate) and the velocity via which it is fed to the jet engine. It is normally denoted as Ti or To. Mathematically, it is the difference between the gross and net thrust (Momentum drag = Gross thrust – Net thrust) (Farokhi 290). It is computed as (Gunston 187): Momentum drag is the opposition the aircraft experiences as it surges through the air. to the engine, it may be referred to as the ‘friction’ experienced by the engine as it propels the aircraft forwards. Net thrust is the resultant aerodynamic force that causes propulsion of an aircraft in air, which is represented by the summation nozzle thrust and momentum of motion. It is a result of the propulsion system, engine, overcoming momentum drag. It is thus the difference between the gross thrust and the momentum drag on the engine of an aircraft (Net thrust = Gross thrust – Maximum drag) (El-Sayed 125). It is usually denoted by T and is calculated as follows: The aircraft thrust is influenced by the airflow into the engine. A change in the rate of airflow triggers a resultant thrust alteration. In the case of net thrust, the increase in the aircrafts speed results to an increase for air fed into the engine, resulting to a higher output (Cumpsty 193). With static thrust, the environmental factors tend to determine the ability of the craft to engage in motion. With static thrust, the air speed is kept constant and is not affected by the crafts motion thus differing from the net thrust. b) Calculate the net thrust of a turbo jet flying at 150 M/S with an air mass flow of 50 Kg/S and a jet stream velocity of 300 M/S with a chocked nozzle. The residual gas pressure in the jet stream is 45 KPa gauge, the nozzle area is 0.2M2. It is evident from the derived

Knowledge Management in Healthcare Essay Example | Topics and Well Written Essays - 1750 words

Knowledge Management in Healthcare - Essay Example This paper would expound on the need for and how Knowledge Management is adopted in healthcare, what problems does it address, what are the considerations to maximize its total benefits, what factors may hinder it from being an effective tool in effecting development in the field of healthcare and what are the importance of transferring the explicit knowledge.. "Healthcare organizations are facing many challenges in the 21st Century due to changes taking place in global healthcare systems. Spiraling costs, financial constraints, increased emphasis on accountability and transparency, changes in education, growing complexities of biomedical research, new partnerships in healthcare and great advances in IT suggest that a predominant paradigm shift is occurring. This shift is necessitating a focus on interaction, collaboration and increased sharing of information and knowledge which is in turn leading healthcare organizations to embrace the techniques of Knowledge Management in order to create and sustain optimal healthcare." (Sharma et al., 2005) Indeed healthcare plays by the rules of the economy and the society too, it lends itself vulnerable to the limitations of the body administering it. As acquiring information does not come without a cost, readily available yet reliable information are sought for, thus the role of Knowledge Management to regulate and pass on information. (Tandon, Angrish, Anand, 2006) Knowledge Management, though having relative definitions sums up the process of creating, controlling, channeling and transferring knowledge assets to address competitive advantage and optimal performance. (Morgan, Doyle, Albers, 2005) In healthcare, most especially in nursing care, knowledge continuity is posed as an organizational challenge. In the US, there is a high turnover rate among hospital staff-already amounting to 20% (Morgan et al., 2005). This dynamics breaks the links of transferring knowledge from old to new employees leading to poor acquisition or transfer of valuable knowledge assets. In basic terms, knowledge is shared through a "traditional scholastic medical education" through "textbook based" learning, and acquiring lessons through experience and mentorship. Although this, in the beginning, could let the workers harness best business practices, it could also mean lack of diversification in knowledge unless branching out to different hospital units is initiated. "There are a number of organizational benefits to KCM [Knowledge Continuity Management] such as decreasing job turnover costs, increasing organizational effectiveness, improving training for new employees, facilitation of organizational learning, speeding the maximal productivity of new employees, and improving the decision making and decreasing the process errors of new employees." (Morgan et al., 2

Engine performance and Efficiensy Coursework Example | Topics and Well Written Essays - 1250 words

Engine performance and Efficiensy - Coursework Example Momentum drag is the negative thrust (force) opposing the jet thrust or motion through air, it is also referred to as the ram drag. It is a product of the incoming air (flow rate) and the velocity via which it is fed to the jet engine. It is normally denoted as Ti or To. Mathematically, it is the difference between the gross and net thrust (Momentum drag = Gross thrust – Net thrust) (Farokhi 290). It is computed as (Gunston 187): Momentum drag is the opposition the aircraft experiences as it surges through the air. to the engine, it may be referred to as the ‘friction’ experienced by the engine as it propels the aircraft forwards. Net thrust is the resultant aerodynamic force that causes propulsion of an aircraft in air, which is represented by the summation nozzle thrust and momentum of motion. It is a result of the propulsion system, engine, overcoming momentum drag. It is thus the difference between the gross thrust and the momentum drag on the engine of an aircraft (Net thrust = Gross thrust – Maximum drag) (El-Sayed 125). It is usually denoted by T and is calculated as follows: The aircraft thrust is influenced by the airflow into the engine. A change in the rate of airflow triggers a resultant thrust alteration. In the case of net thrust, the increase in the aircrafts speed results to an increase for air fed into the engine, resulting to a higher output (Cumpsty 193). With static thrust, the environmental factors tend to determine the ability of the craft to engage in motion. With static thrust, the air speed is kept constant and is not affected by the crafts motion thus differing from the net thrust. b) Calculate the net thrust of a turbo jet flying at 150 M/S with an air mass flow of 50 Kg/S and a jet stream velocity of 300 M/S with a chocked nozzle. The residual gas pressure in the jet stream is 45 KPa gauge, the nozzle area is 0.2M2. It is evident from the derived

Charles law Essay Example for Free

Charles law Essay Aim: To investigate how the charge on a capacitor is related to the p. d. applied across it by charging the capacitor at a constant rate. Apparatus: o Capacitor (electrolytic type) 500 ? F o Microammeter 100 ? A o Clip component holder o Stop-watch o CRO o Connecting leads Theory: From definition, the capacitor C of a capacitor is found from C = Q/V Where Q is the charge stored on the capacitor and V is the potential difference across it. == Q = CV ==. If a capacitor is charged up at a constant rate, i. e., where I is a constant. Then is also constant. Hence the potential difference across the capacitor increases linearly with time. Procedure 1. The circuit was connected as shown in the figure below. The CRO was set to d. c. and the sensitivity to 1 V/cm. 2. The time base was set to any high value so that a steady horizontal trace is displayed. The trace was shifted to the bottom of the screen. 3. The capacitor was shorted out by connecting a lead across it and adjust the 100 k ? potentiometer for a suitable current, say 80 ? A. 4. Shorting lead was removed and the capacitor will charge up. Note what happens to the microammeter reading and the CRO trace. 5. The procedure was repeated but this time start the stop-watch and continuously adjust the potentiometer to keep the current constant as the capacitor charges up. 6. The times was measured for the CRO trace to move up by 1 cm, 2 cm, 3 cm, etc. These are the times for the p. d. across the capacitor to reach 1V, 2V, 3V, etc. 7. The results was tabulated. Results and discussion. 8 Describe what happens to the microammeter reading and the CRO trace as the capacitor is being charged up. The microammeter reading increase momentarily, then it decrease to zero in a few second. After the capacitor had been completely charged,the CRO trace is a horizontal line, which continuously move up. 9 Tabulate the times for the p. d. across the capacitor to reach 1 V, 2 V, 3 V, etc. as below: P. d. across capacitor Plot a graph of p. d. across the capacitor against time. How is the p. d. related to the time? p. d. is directly proportional to time. 11 Deduce a relationship between the charge on the capacitor and the p. d. across it. From the graph it is found that p. d. is directly proportional to time. Since Q=CV = V=Q/C Therefore if V across the capacitor is directly proportional to t, Q is directly proportional to time as current was constant. Conclusion We can find out that the p. d. across the capacitor is directly proportional to the time needed. Given that the charging current is constant. Sharing. The experiment is much easier than the last one , but we encountered some obstacles in connecting wires , as usual , we messed up positive and negative terminals and couldnt conduct it smoothly. At last, we had to call for help. Suggestion and there may be some personal error , for example counting the time taken for the capacitor be charged to extent value was rather inaccurate. Perhaps, we could conduct the experiment several times and compute out the average value. Reference list http://en. wikipedia. org/wiki/Capacitor http://www. elecsound. cn/Ceramic-Capacitor. htm.

Consequences of Using an Existing Company Name

Consequences of Using an Existing Company Name In relation to Roy wanting to name his company ‘Mini-Mahogany Ltd.’, the Minister for Enterprise, Trade and Employment could refuse to allow the registration of the afore mentioned business as it could be misleading to the consumers. There is already a company registered in Dublin called ‘Mega-Mahogany Ltd.’ This minor difference between the names of the two companies could lead some people to become confused as both companies deal in timber products. One such case that this infringement can be seen is the case of: Jacob Fruitfield vs United Biscuits (2007) Jacob Fruitfield was previously in the Irish market selling Fig Rolls and Cream Crackers when the defendants, United Biscuits (U.K.) Limited, tried to enter the market selling their version of both products. Jacobs sought an injunction to stop United Biscuits selling the biscuits using the same name and they were successful. To have the injunction passed, the judge tried a test. He asked for these three statements to be proved either true or false; The existence of a reputation or goodwill in the claimant’s product including, where appropriate, in a brand name or get-up. The risk of confusion between what is alleged to be the offending product and the claimant’s product. Whether damage to the claimants goodwill by virtue of any such confusion has been established. (Simon McAleese Passing Off) Having then found that United Biscuits were indeed failing on these three tests, Clarke J granted the injunction for to prevent the sale of United Biscuits’ Fig Rolls on the Irish market as they were too similar to the Jacobs Fig Rolls. Wrappers of both Jacobs and United Biscuits Fig Rolls and Cream Crackers Difference between Memorandum and Articles of Association Roy would also need to know that he would need to have a Memorandum and Articles drawn up for his company. Memorandum of Association and Articles of Association are separately very important documents and together they serve as the constitution of a company. A Memorandum is a document which outlines the rules and regulations of the proposed company and its dealings with the outside world. The Memorandum has the following features included; The name, address and the office of the company that has been registered. The way the share capital of the company has been structured The aims and the objectives of the company being set up. The Articles of Association is a document that contains the rules of the company which are used by all employees of the company. This is an internal document and is filed with the Registrar of Companies on Parnell Square, Dublin 1. Some of the major features of the Articles include; The structure of the company The rights of the employees and the voting pattern if needed Conduct of Directors meetings Conduct of Shareholders Difference in the structures of Shares The main differences that Roy would need to understand between the two documents would be the following: The Memorandum is also called the Charter of an organisation. This document is a helpful document for future investors as it gives them an insight into how their money will be used by the company. The Articles, however, is the document that allows the structure of the company and the breakdown of the power in the company. The Articles contain all the laws by which the company will adhere to and also the rules that the employees must follow. (Difference Between Memorandum of Association and Articles of Association, 2011) Statutory Duties imposed on Directors of Irish Companies When a Director is appointed to a company, they are given a list of duties which they must follow for the wellbeing of the organisation. Some of these duties are common law duties; they are also called ‘Fiduciary Duties’. Other duties fall under the heading of ‘Statutory Duties’. These duties include the following points; Duty to maintain proper books of the company accounts. Duty to prepare the annual accounts of the company. Duty to file the necessary documentation with the Companies Registration Office. Duty of disclosure on personal information. Duty to call general meetings within the company. Duty to have an annual audit carried out in the company. Duty to write reports for the members of the company. (Pearse Trust Blog, 2014) Companies can only make loans to the directors of the company for a small number of circumstances and once the loan is fully disclosed in the company’s accounts. As mentioned in Section 31 of the Companies Act 1990, if the company has given a loan to a director and not followed all the necessary protocols, the director who granted the loan or who received the loan may be held liable for the cost of the loan. The same director could also be liable if the company goes into liquidation. For the director to avoid this punishment, they must follow all steps in that have been outlined in the Companies Act (see appendix). (McNulty, 2014) Directors must also disclose any interests they have in the company or in any company associated with the company they work for. Every company must keep a registry of these interests. The keeping of this registry is to avoid any situation where any person may claim that the company was fully aware of the director’s interest. Any such failing could result in criminal sanctions and/or the interested shares being void for that director. Fixed Charge and Floating Charge Roy also needs to know about the different types of charges he would face if he needs to take out a loan from the company in the future. Fixed and floating charges are used by companies to secure borrowing. This type of borrowing is typically arranged under the terms of a debenture. Any charge on a company’s assets must be recorded at the Companies Registry Office. A fixed charge is a mortgage that is secured on a piece of property owned by the company. These pieces of property could include land or buildings, machinery, shares, copyrights, patents, etc. Whereas floating charges are much easier for a company to handle as they can be taken without any specific asset being registered to the company. This means that any stock that the company holds or vehicles used by the company can be charged to obtain the loan. The speciality of the floating charges means that the company can go about normal business, buy and sell its stock, change machinery or vehicles without needing prior p ermission from the person or organisation they are paying mortgage to. As most borrowing is done through banks, it is these banks that then set the type of charge being applied to the company. Most of the time the bank will apply fixed charges on any asset which the company owns that already has fixed charges on. All other charges are then floating charges. Most banks want more than just this type of guarantee and will often ask the directors of the company for personal guarantees. (Fixed Floating Charges) Personal Guarantee A personal guarantee is a pledge in which an individual agrees to be responsible for the financial obligations of a debtor or a borrower to a lender in the event that the debtor or borrower fails to pay an amount owing under the loan agreement. A personal guarantee signifies that the lender can lay claim to the guarantor’s assets in case the borrower defaults. It is the equivalent of a signed blank cheque without a date. The guarantee can only be cancelled by the lender, not the borrower. In the event of the guarantor’s death, normally the lender will not void the personal guarantee but will seek for a new guarantor to fill in the deceased place and continue the guarantee. (McManus, 2011) Bank of Scotland (Ireland) vs Jim Mansfield In the case of Bank of Scotland vs Jim Mansfield, Bank of Scotland (B.o.S.) granted Jim Mansfield a loan to further his empire at CityWest. Mansfield gave a personal guarantee that the loan would be repaid in full. When Mansfield refused to pay back the money to NAMA, they sought an injunction in the Commercial Court where they successfully won and the court forced Mr. Mansfield to repay the â‚ ¬204m. Mr. Mansfield passed away before he could pay back the loan which now leaves his family liable to repay the fortune. Works Cited Companies Act 1990. (n.d.). Retrieved December 01, 2014, from www.irishststutebook.ie: http://www.irishstatutebook.ie/1990/en/act/pub/0033/sec0031.html Difference Between Memorandum of Association and Articles of Association. (2011, May 10). Retrieved November 30, 2014, from www.differencebetween.com: http://www.differencebetween.com/difference-between-memorandum-of-association-and-vs-articles-of-association/ Fixed Floating Charges. (n.d.). Retrieved November 30, 2014, from www.companylawclub.co.uk: http://www.companylawclub.co.uk/topics/fixed_and_floating_charges.shtml McManus, F. (2011, February). The Dangers of Personal Guarantees. Retrieved November 30, 2014, from www.morganmcmanus.com: http://www.google.ie/url?sa=trct=jq=esrc=ssource=webcd=3ved=0CDAQFjACurl=http://www.morganmcmanus.com/pdfs/The_Dangers_of_Personal_Guarantees.pdfei=j4N8VPWwOImU7AanwIGIBgusg=AFQjCNFYmFIsOKFPbT4a9yHjkycnbuCtdgbvm=bv.80642063,d.ZGU McNulty, T. (2014). Class Notes. Company Law. Dunlin. Pearse Trust Blog. (2014). Retrieved November 30, 2014, from www.pearse-trust.ie: http://www.pearse-trust.ie/blog/bid/99334/Duties-Powers-Of-Directors-Of-Private-Companies-In-Ireland Simon McAleese Passing Off. (n.d.). Retrieved November 30, 2014, from www.simonmcaleese.com: http://www.simonmcaleese.com/asp/printf.asp?RecordId=310 Appendices Case of Jacob Fruitfield Food Group Ltd v United Biscuits (UK) Ltd United Biscuits, more commonly known as McVities, sought to introduce fig roll biscuits and cream crackers into the Irish market. The packaging of both products was strikingly similar to comparable products already available on the Irish market by Jacobs. Jacobs successfully obtained an injunction in the High Court preventing the distribution of the McVitie fig rolls in packaging which was confusingly similar to that of Jacobs. What is the test to be met in determining whether packaging is so strikingly similar that it is in fact passing off? Clarke J set down a three part test to be applied in assessing whether or not there is an action for passing off: The existence of a reputation or goodwill in the claimant’s product including, where appropriate, in a brand name or get-up; The risk of confusion between what is alleged to be the offending product and the claimants product; and Whether damage to the claimants goodwill by virtue of any such confusion has been established. Clarke J specifically considered that the similarity between the two products should be judged, to a significant extent, as a matter of first impression. He stated: Firstly I should have regard to the circumstances in which the products are likely to be purchased, the sort of customers who are likely to purchase them, and the amount of attention which, at least the less careful of those purchasers, are likely to apply to their considerations. The competing get ups should be judged as a matter of first impression but also by reference to the type of features which, in all the circumstances of the case, are likely to attract the attention of a purchaser in those circumstances. Having considered the colour combinations, style of lettering and the suggested serving photograph of each of the packaging, he considered thatthe fig roll packaging was extremely similar, but that the packaging on the cream crackers was distinguishable. In deciding whether or not the balance of convenience lay with granting the injunction against the distribution of the McVities fig rolls, the court stated that it was never a presumption that the balance of convenience would lie with granting the injunction and that damages may sometimes be an adequate remedy. Nevertheless, Clarke J held that the balance of convenience in this case did lie with granting the injunction preventing the distribution of the McVitie fig rolls in packaging which was confusingly similar to that of Jacobs. (Simon McAleese Passing Off) Companies Act 1990 (Companies Act 1990) 1 | Page

The Jonestown Massacre :: Papers

The Jonestown Massacre The Jonestown massacre was a horrible tragedy, which took the lives of over 900 innocent people and could possibly be the most corrupt and horrific experiment the American government has ever done. To get to know about the massacre, you have to know a little about the man behind it all, Reverend Jim Jones. Jim Jones was the son of a Klansman and considered himself to be a reincarnation of both Jesus and Lenin. (Lenin was a Russian revolutionist who helped bring about socialism in Russia.) They say he was paranoid of the American government, but later, it was found that he worked for it. He was a well-known person in San Francisco because he was the leader of the People's Temple and also because of the fact that he was the Chairman of the Housing Department and he and his church won many humanitarian awards. He was called "Father" by members of the People's Temple. The People's Temple was the so-called "church" that Jones established. People joined the People's Temple for different reasons; a political statement, structure, discipline, or a way to escape from violence, alcohol and drugs. Whatever the reason they joined for, when they got in something kept them there. Jim Jones was a mastermind at brainwashing, and that's just what he did to all of his followers. He had many tactics; he was an excellent speaker and was amazingly convincing, he staged fake healings, and used narcotics on his followers, so they would believe almost anything. As he was doing all this brainwashing he was stealing money from the people, raping the young women and girls of his church, and on top of it all, murdering those who seemed a threat to his church or attempted to leave. Eventually, The People's Temple was being investigated by the police, so Jim Jones moved it to the jungle of Guyana, he called this place Jonestown. Jonestown was his idea of the perfect community. It was based on the ideals of socialism and communism, and everyone worked

Cause and Effect of the Water Wheel :: essays research papers

A water wheel changes the energy of falling water into mechanical energy that can be used for machines. The water is directed into the wheel through a tube. The wheel is placed on an axle, which is connected by gearing with the machine it is to operate. There are two types of water wheels, vertical and horizontal. The vertical wheels has an overshot and a undershot. The overshot water wheel has buckets around its edge. Water is delivered to the top of the wheel. The weight of the water falling into the buckets makes the wheel turn. An overshot water wheel has a very good chance of working with a 80 percent efficiency rate. That means, it may turn as much as 80 percent of the energy of the water into mechanical energy. Though, its use is limited to making small amounts of power. The undershot water wheel is built so the water hits the blades at the bottom of the wheel. The power of the wheel depends on the speed of the water hits the blades. The undershot wheel has such a low efficien cy that it is rarely used. Most modern water wheels are horizontal. A horizontal wheel rotates on a vertical shaft. It is driven by the force of the water hitting the blades on one side of the wheel. Horizontal wheels are very efficient if made correctly.   Ã‚  Ã‚  Ã‚  Ã‚  For my experiment I made an vertical undershot waterwheel. For the base of the waterwheel I cut off 8 centimeters of the bottom of a milk jug. Then out of the top of the jug I cut four triangles, four squares and four circles out for the fins of the waterwheel. After that I thumb tacked the 4 triangles to a cork. Put a hole at the end of each side of the cork and glued a skewer in each side for an axis. Then I cut a hole at each side of the base and put the skewers with the cork suspended in the middle. Then I put a 2 inch x 2 inch piece of clay shaped as circles on each side of the skewer. That’s how I got my waterwheel.   Ã‚  Ã‚  Ã‚  Ã‚  In my experiment I didn’t use electricity instead I measured the rate at which a water wheel lifts a weight. Doing this determined the speed at which the water wheel spins. For a weight I used a penny that was taped to a string which was wrapped around the clay. Cause and Effect of the Water Wheel :: essays research papers A water wheel changes the energy of falling water into mechanical energy that can be used for machines. The water is directed into the wheel through a tube. The wheel is placed on an axle, which is connected by gearing with the machine it is to operate. There are two types of water wheels, vertical and horizontal. The vertical wheels has an overshot and a undershot. The overshot water wheel has buckets around its edge. Water is delivered to the top of the wheel. The weight of the water falling into the buckets makes the wheel turn. An overshot water wheel has a very good chance of working with a 80 percent efficiency rate. That means, it may turn as much as 80 percent of the energy of the water into mechanical energy. Though, its use is limited to making small amounts of power. The undershot water wheel is built so the water hits the blades at the bottom of the wheel. The power of the wheel depends on the speed of the water hits the blades. The undershot wheel has such a low efficien cy that it is rarely used. Most modern water wheels are horizontal. A horizontal wheel rotates on a vertical shaft. It is driven by the force of the water hitting the blades on one side of the wheel. Horizontal wheels are very efficient if made correctly.   Ã‚  Ã‚  Ã‚  Ã‚  For my experiment I made an vertical undershot waterwheel. For the base of the waterwheel I cut off 8 centimeters of the bottom of a milk jug. Then out of the top of the jug I cut four triangles, four squares and four circles out for the fins of the waterwheel. After that I thumb tacked the 4 triangles to a cork. Put a hole at the end of each side of the cork and glued a skewer in each side for an axis. Then I cut a hole at each side of the base and put the skewers with the cork suspended in the middle. Then I put a 2 inch x 2 inch piece of clay shaped as circles on each side of the skewer. That’s how I got my waterwheel.   Ã‚  Ã‚  Ã‚  Ã‚  In my experiment I didn’t use electricity instead I measured the rate at which a water wheel lifts a weight. Doing this determined the speed at which the water wheel spins. For a weight I used a penny that was taped to a string which was wrapped around the clay.

From 1600 †1763

From 1600 – 1763, several European nations vied for control of the North American continent. Why did England win the struggle? Support your answer with details of each nation's successes and failures. From the early 1600’s to the mid 1700’s, several European nations vied to control North America. Spain, Great Britain, and France were all powerhouses trying to colonize the free world and create a massive empire. Out of the three, England won the struggle because of failures made by the Spanish and French in the years before the American Revolution.The Spanish were the most powerful nation before the colonizing of the West Indies began. They had the Spanish Armada who was known for never losing a single battle. They also had all the riches in the world from all of their explorations. Unfortunately, during the early 1600’s, the Spanish began to experience fatigue from overextension with their army. The Spanish had to take care of problems in their Dutch terri tories causing them to leave the West Indian Islands and Jamaica open for grabs.Great Britain would eventually claim it and they began to work with sugar, the rich man’s crop. One difference between the British and Spanish motives for colonizing was that the Spanish based part of their time converting people to Catholic. The British were not concerned with religion, but more concerned with expanding their empire and making a profit. So by now, the British had colonized most of the Atlantic coast from Maryland down to Georgia. Another nation that wanted to have control over North America was the French.The French owned land from Quebec all the way down to the end of the Mississippi River in New Orleans. They basically controlled â€Å"middle† America. The French were in the business of trapping and fur trade. A very profitable business, but not a very sustainable one on its own. The French never really had a chance to control the New World because they were not as power ful as the Spanish or the British. France lost their hopes of having control in North America when they lost the French and Indian War with Great Britain.Great Britain’s victory over the French caused them to give up most of the land that they claimed and now half of the United States was in control of the British. England won the struggle for control of North America because when they saw a chance to pick up more land from another country, they would grab it. They had the army power to go to war with France and the Spanish had too much on their plate which weakened them. The English controlled the east coast of North America and had many profitable industries such as tobacco, sugar, and indigo. England won based on their power and strategy.

Patients Rights Essay

The legal interests of persons who submit to medical treatment. For many years, common medical practice meant that physicians made decisions for their patients. This paternalistic view has gradually been supplanted by one promoting patient autonomy, whereby patients and doctors share the decision-making responsibility. Consequently doctor-patient relationships are very different now than they were just a few decades ago. However, conflicts still abound as the medical community and those it serves struggle to define their respective roles. Consent Consent, particularly informed consent, is the cornerstone of patients’ rights. Consent is based on the inviolability of one’s person. It means that doctors do not have the right to touch or treat a patient without that patient’s approval because the patient is the one who must live with the consequences and deal with any dis-comfort caused by treatment. A doctor can be held liable for committing a Battery if the doctor touches the patient without first obtaining the patient’s consent. The shift in doctor-patient relationships seems inevitable in hindsight. In one early consent case, a doctor told a woman he would only be repairing some cervical and rectal tears; instead he performed a hysterectomy. In another case, a patient permitted her doctors to examine her under anesthesia but insisted that they not operate; the doctors removed a fibroid tumor during the procedure. In yet another case, a doctor assured a man that a proposed operation was simple and essentially without risk; the patient’s left hand was paralyzed as a result of the surgery. Consent must be voluntary, competent, and informed. Voluntary means that, when the patient gives consent, he or she is free from extreme duress and is not intoxicated or under the influence of medication and that the doctor has not coerced the patient into giving consent. The law presumes that an adult is competent, but competency may be an issue in numerous instances. Competence is typically only challenged when a patient disagrees with a doctor’s recommended treatment or refuses treatment altogether. If an individual understands the information presented regarding treatment, she or he is competent to consent to or refuse treatment. Consent can be given verbally, in writing, or by one’s actions. For example, a person has consented to a vaccination if she stands in line with others who are receiving vaccinations, observes the procedure, and then presents her arm to a healthcare provider. Consent is inferred in cases of emergency or unanticipated circumstances. For example, if unforeseen serious or life-threatening circumstances develop during surgery for which consent has been given, consent is inferred to allow doctors to take immediate further action to prevent serious injury or death. Consent is also inferred when an adult or child is found unconscious, or when an emergency otherwise necessitates immediate treatment to prevent serious harm or death. Consent is not valid if the patient does not understand its meaning or if a patient has been misled. Children typically may not give consent; instead a parent or guardian must consent to medical treatment. Competency issues may arise with mentally ill individuals or those who have diminished mental capacity due to retardation or other problems. However, the fact that someone suffers from a mental illness or diminished mental capacity does not mean that the individual is incomp etent. Depending on the type and severity of the disability, the patient may still have the ability to understand a proposed course of treatment. For example, in recent years most jurisdictions have recognized the right of hospitalized mental patients to refuse medication under certain circumstances. Numerous courts have ruled that a mental patient may have the right to refuse antipsychotic drugs, which can produce disturbing side effects. If a patient is incompetent, technically only a legally appointed guardian can make treatment decisions. Commonly, however, physicians defer to family members on an informal basis, thereby avoiding a lengthy and expensive competency hearing. Consent by a family member demonstrates that the doctor consulted someone who knows the patient well and is likely to be concerned about the patient’s well-being. This will probably be sufficient to dissuade a patient from suing for failure to obtain consent should the patient recover. Legal, moral, and ethical questions arise in competency cases involving medical procedures not primarily for the patient’s benefit. These cases typically arise in the context of organ donation from one sibling to another. Many of these cases are approved in the lower courts; the decisions frequently turn on an e xamination of the relationship between the donor and recipient. If the donor and recipient have a relationship that the donor is aware of, actively participates in, and benefits from, courts generally conclude that the benefits of continuing the relationship outweigh the risks and discomforts  of the procedure. For example, one court granted permission for a kidney transplant from a developmentally disabled patient into his brother because the developmentally disabled boy was very dependent on the brother. In another case, a court approved a seven-year-old girl’s donation of a kidney to her identical twin sister after experts and family testified to the close bond between the two. Conversely, a mother successfully fought to prevent testing of her three-and-a-half-year-old twins for a possible bone marrow transplant for a half brother because the children had only met the boy twice and were unaware that he was their brother. Married or emancipated minors, including those in the Armed Services, are capable of giving their own consent. Emancipated means that the minor is self-supporting and lives independently of parents and parental control. In addition, under a theory known as the mature minor doctrine, certain minors may consent to treatment without first obtaining parental consent. If the minor is capable of understanding the nature, extent, and consequences of medical treatment, he or she may consent to medical care. Such situations typically involve older minors and treatments for the benefit of the minor (i.e., not organ transplant donors or blood donors) and usually involve relatively low-risk procedures. In recent years, however, some minors have sought the right to make life- or-death decisions. In 1989, a state court first recognized that a minor could make such a grave decision. A 17-year-old leukemia patient refused life-saving blood transfusions based on a deeply held, family-shared religious conviction. A psychologist testified that the girl had the maturity of a 22-year-old. Ironically, the young woman won her right to refuse treatment but was alive and healthy when the case was finally decided. She had been transfused before the slow judicial process needed to decide such a difficult question led to a ruling in her favor. Some state statutes specifically provide that minors may give consent in certain highly charged situations, such as cases of venereal disease, pregnancy, and drug or alcohol abuse. A minor may also overrule parental consent in certain situations. In one case, a mother gave consent for an Abortion for her 16-year-old unemancipated daughter, but the girl disagreed. A court upheld the daughter’s right to withhold consent. Courts often reach divergent outcomes when deciding whether to interfere with a parent’s refusal to consent to a non-life-threatening procedure. One court refused to override a  father’s denial of consent for surgery to repair his son’s harelip and cleft palate. But a different court permitted an operation on a boy suffering from a severe facial deformity even though his mother objected on religious grounds to the accompanying blood transfusion. In another case, a child was ordered to undergo medical treatments after the parents unsuccessfully treated the child’s severe burns with herbal remedies. Courts rarely hesitate to step in where a child’s life is in danger. To deny a child a beneficial, life-sustaining treatment constitutes child neglect, and states have a duty to protect children from neglect. One case involved a mother who testified that she did not believe that her child was HIV positive, despite medical evidence to the contrary. The co urt ordered treatment, including AZT, for the child. Many other cases involve parents who want to treat a serious illness with nontraditional methods or whose religious beliefs forbid blood transfusions. Cases involving religious beliefs raise difficult questions under the First Amendment’s Free Excise of Religion Clause, Common Law, statutory rights of a parent in raising a child, and the state’s traditional interest in protecting those unable to protect themselves. When a child’s life is in danger and parental consent is withheld, a hospital seeks a court-appointed guardian for the child. The guardian, often a hospital administrator, then consents to the treatment on behalf of the child. In an emergency case, a judge may make a decision over the telephone. In some cases, doctors may choose to act without judicial permission if time constraints do not allow enough time to reach a judge by telephone. In 1982, a six-day-old infant with Down’s syndrome died after a court approved a parental decision to withhold life-saving surgery. The child had a condition that made eating impossible. The baby was medicated but given no nourishment. The public furor over the Baby Doe case eventually helped spur the department of health and human services to create regulations delineating when treatment may be withheld from a disabled infant. Treatment may be withheld if an infant is chronically and irreversibly comatose, if such treatment would merel y prolong dying or would otherwise be futile in terms of survival of the infant, or if such treatment would be virtually futile in terms of survival and the treatment would be inhumane under these circumstances. Although courts overrule parental refusal to allow treatment in many instances, far less common are cases where a court overrides an otherwise competent adult’s denial of consent. The cases where courts have compelled treatment of an adult usually fall into two categories: when the patient was so physically weak that the court ruled that the patient could not reflect and make a choice to consent or refuse; or when the patient had minor children, even though the patient was fully competent to refuse consent. The possible civil or criminal liability of a hospital might also factor into a decision. A court typically will not order a terminally ill patient to undergo treatments to prolong life. Informed Consent Simply consenting to treatment is not enough. A patient must give informed consent. In essence, informed consent means that before a doctor can treat or touch a patient, the patient must be given some basic information about what the doctor proposes to do. Informed consent has been called the most important legal doctrine in patients’ rights. State laws and court decisions vary regarding informed consent, but the trend is clearly toward more disclosure rather than less. Informed consent is required not only in life-or-death situations but also in clinic and outpatient settings as well. A healthcare provider must first present information regarding risks, alternatives, and success rates. The information must be presented in language the patient can understand and typically should include the following: * A description of the recommended treatment or procedure; * A description of the risks and benefits—particularly exploring the risk of serious bodily disability or death; * A description of alternative treatments and the risks and benefits of alternatives; * The probable results if no treatment is undertaken; * The probability of success and a definition of what the doctor means by success; * Length and challenges of recuperation; and  * Any other information generally provided to patients in this situation by other qualified physicians. Only material risks must be disclosed. A material risk is one that might cause a reasonable patient to decide not to undergo a recommended treatment. The magnitude of the risk also factors into the definition of a material risk. For example, one would expect that a one in 10,000 risk of death would always be disclosed, but not a one in 10,000 risk of a two-hour headache. Plastic surgery and vasectomies illustrate two  areas where the probability of success and the meaning of success should be explicitly delineated. For example, a man successfully sued his doctor after the doctor assured him that a vasectomy would be 100 percent effective as Birth Control; the man’s wife later became pregnant. Because the only purpose for having the procedure wa s complete sterilization, a careful explanation of probability of success was essential. Occasionally, informed consent is not required. In an emergency situation where immediate treatment is needed to preserve a patient’s health or life, a physician may be justified in failing to provide full and complete information to a patient. Moreover, where the risks are minor and well known to the average person, such as in drawing blood, a physician may dispense with full disclosure. In addition, some patients explicitly ask not to be informed of specific risks. In this situation, a doctor must only ascertain that the patient understands that there are unspecified risks of death and serious bodily disabilities; the doctor might ask the patient to sign a waiver of informed consent. Finally, informed consent may be bypassed in rare cases in which a physician has objective evidence that informing a patient would render the patient unable to make a rational decision. Under these circumstances, a physician must disclose the information to another person designated by the patie nt. Informed consent is rarely legally required to be in writing, but this does provide evidence that consent was in fact obtained. The more specific the consent, the less likely it will be construed against a doctor or a hospital in court. Conversely, blanket consent forms cover almost everything a doctor or hospital might do to a patient without mentioning anything specific and are easily construed against a doctor or hospital. However, blanket forms are frequently used upon admission to a hospital to provide proof of consent to noninvasive routine hospital procedures such as taking blood pressure. A consent form may not contain a clause waiving a patient’s right to sue, unless state law provides for binding Arbitration upon mutual agreement. Moreover, consent can be predicated upon a certain surgeon doing a surgery. It can also be withdrawn at any time, subject to practical limitations. Right to Treatment In an emergency situation, a patient has a right to treatment, regardless of ability to pay. If a situation is likely to cause death, serious injury, or  disability if not attended to promptly, it is an emergency. Cardiac arrest, heavy bleeding, profound shock, severe head injuries, and acute psychotic states are some examples of emergencies. Less obvious situations can also be emergencies: broken bones, fever, and cuts requiring stitches may also require immediate treatment. Both public and private hospitals have a duty to administer medical care to a person experiencing an emergency. If a hospital has emergency facilities, it is legally required to provide appropriate treatment to a person experiencing an emergency. If the hospital is unable to provide emergency services, it must provide a referral for appropriate treatment. Hospitals cannot refuse to treat prospective patients on the basis of race, religion, or national origin, or refuse to treat someone with HIV or AIDS. In 1986, Congress passed the Emergency Medical Treatment and Active Labor Act (EMTALA) (42 U.S.C.A.  § 1395dd), which established criteria for emergency services and criteria for safe transfer of patients between hospitals. This statute was designed to prevent â€Å"patient dumping,† that is, transferring undesirable patients to another facility. The law applies to all hospitals receiving federal funds, such as Medicare (almost all do). The law requires hospitals to provide a screening exam to determine if an emergency condition exists, provide stabilizing treatment to any emergency patient or to any woman in active labor before transfer, and continue treatment until a patient can be discharged or transferred without harm. It also delineates strict guidelines for the transfer of a patient who cannot be stabilized. A hospital that negligently or knowingly and willfully violates any of these provisions can be terminated or suspended from Medicare. The physician, the hospital, or both can also be penalized up to $50,000 for each knowing violation of the law. One of the first cases brought under EMTALA involved a doctor who transferred a woman in active labor to a hospital 170 miles away. The woman delivered a healthy baby during the trip, but the doctor was fined $20,000 for the improper transfer of the woman. In addition to federal laws such as EMTALA, states may also impose by regulation or statute a duty on hospitals to administer emergency care. There is no universal right to be admitted to a hospital in a nonemergency situation. In nonemergency cases, admission rights depend largely on the specific hospital, but basing admission on ability to pay is severely limited by statutes, regulations, and judi cial decisions. For  example, most hospitals obtained financial assistance from the federal government for construction; these hospitals are required to provide a reasonable volume of services to persons unable to pay. The amount of services to be provided is set by regulation, and the obligation continues for 20 years after construction is completed. Patients must be advised of the hospital’s obligation under the law, or the hospital may be foreclosed from suing to collect on the bill. In addition, many states prohibit hospitals from denying admission based solely on inability to pay; some courts have made similar rulings against public hospitals based on hospital charters and public policy reasons. Hospitals are also prohibited from requiring a deposit from a Medicare or Medicaid patient. Once a patient has been duly admitted to a hospital, she or he has a right to leave at any time, or the hospital could be liable for False Imprisonment. This is so even if the patient has not paid the bill or if the patient wants to leave against all medical advice. In rare cases, such as contagious disease cases, public health authorities may have state statutory or regulatory authority to quarantine a patient. In addition, state laws governing involuntary commitment of the mentally ill may be used to prevent a person of unsound mind from leaving the hospital if a qualified psychiatrist determines that the person is a danger to himself or herself or to the lives of others. A doc tor familiar with a patient’s condition determines when a patient is ready for discharge and signs a written order to that effect. If the patient disagrees with a decision to discharge, she or he has the right to demand a consultation with a different physician before the order is carried out. The decision to discharge must be based solely on the patient’s medical condition and not on nonpayment of medical bills. In the mid-1990s, concern over maternity patients being discharged just a few hours after giving birth prompted legislation at both the state and federal levels. In September 1996, President bill clinton signed a law ensuring a 48-hour hospital stay for a woman who gives birth vaginally and a 96-hour stay for a woman who has a caesarean section, unless the patient and the doctor agree to an earlier discharge. A number of state legislatures have passed similar laws as well. With the rise of Managed Care and Health Maintenance Organizations (HMOs), patients faced new issues involving the right to treatment. HMOs may deny authorization for expensive or experimental treatments, or for treatments  p rovided outside the network of approved physicians. HMOs contend that they must control costs and make decisions that benefit the largest number of members. In response, state legislatures have enacted HMO regulations that seek to give patients a process for appealing the denial of benefits. The HMOs have opposed these measures and have vigorously defended their denial of benefits in court. In Moran v. Rush Prudential HMO, Inc., 536 U.S. 355, 122 S.Ct. 2151, 153 L.Ed.2d 375 (2002), the Supreme Court in a 5–4 decision upheld an Illinois law that required HMOs to provide independent review of disputes between the primary care physician and the HMO. The law mandated that the HMO must pay for services deemed medically necessary by the independent reviewer. Most importantly, the court ruled that the federal Employee Retirement Income Security Act (ERISA) did not preempt the Illinois law. ERISA is an extremely complex and technical set of provisions that seek to protect employee benefit programs. The decision was significant because it empowered other states to enact similar laws that give patients more rights in obtaining treatment Med ical Experimentation Medical progress and medical experimentation have always gone hand in hand, but patients’ rights have sometimes been ignored in the process. Sometimes patients are completely unaware of the experimentation. Experimentation has also taken place in settings in which individuals may have extreme difficulty asserting their rights, such as in prisons, mental institutions, the military, and residences for the mentally disabled. Legitimate experimentation requires informed consent that may be withdrawn at any time. Some of the more notorious and shameful instances of human experimentation in the United States in the twentieth century include a 1963 study in which terminally ill hospital patients were injected with live cancer cells to test their immune response; the Tuskegee Syphilis Study, begun before World War II and continuing for 40 years, in which effective treatment was withheld from poor black males suffering from syphilis so that medical personnel could study the natural cou rse of the disease; and a study where developmentally disabled children were deliberately infected with hepatitis to test potential vaccines. Failure to obtain informed consent can arise even when consent has ostensibly been obtained. The California Supreme Court ruled in 1990 that a physician must disclose preexisting research and  potential economic interests that may affect the doctor’s medical judgment (Moore v. Regents of the University of California, 51 Cal. 3d 120, 793 P. 2d 479). The case involved excision of a patient’s cells pursuant to surgery and other procedures to which the patient had consented. The surgery itself was not experimental; the experimentation took place after the surgery and other procedures. The cells were used in medical research that proved lucrative to the doctor and medical center. Patients in teaching hospitals are frequently asked to participate in research. Participants do not surrender legal rights simply by agreeing to cooperate and validly obtained consent cannot protect a researcher from Negligence. In hospitals, human experimentation is typically monitored by an institutional review board (IRB). Federal regulation requires IRBs in all hospitals receiving fed eral funding. These boards review proposed research before patients are asked to participate and approve written consent forms. IRBs are meant to ensure that risks are minimized, the risks are reasonable in relation to anticipated benefits, the selection of subjects is equitable, and informed consent is obtained and properly documented. Federal regulations denominate specific items that must be covered when obtaining informed consent in experimental cases. IRB approval never obligates a patient to participate in research. Advance Medical Directives Every state has enacted advance medical directive legislation, but the laws vary widely. Advance medical directives are documents that are made at a time when a person has full decision-making capabilities and are used to direct medical care in the future when this capacity is lost. Many statutes are narrowly drawn and specify that they apply only to illnesses when death is imminent rather than illnesses requiring long-term life support, such as in end-stage lung, heart, or kidney failure; multiple sclerosis; paraplegia; and persistent vegetative state. Patients sometimes use living wills to direct future medical care. Most commonly, living wills specify steps a patient does not want taken in cases of life-threatening or debilitating illness, but they may also be used to specify that a patient wants aggressive resuscitation measures used. Studies have shown that living wills often are not honored, despite the fact that federal law requires all hospitals, nursing homes, and other Medi care and Medicaid providers to ask  patients on admission whether they have executed an advance directive. Some of the reasons living wills are not honored are medical personnel’s fear of liability, the patient’s failure to communicate his or her wishes, or misunderstanding or mismanagement by hospital personnel. Another way individuals attempt to direct medical care is through a durable Power of Attorney. A durable power of attorney, or proxy decision maker, is a written document wherein a person (the principal) designates another person to perform certain acts or make certain decisions on the principal’s behalf. It is called durable because the power continues to be effective even after the principal becomes incompetent or it may only take effect after the principal becomes incompetent. As with a Living Will, such a document has little power to compel a doctor to follow a patient’s desires, but in the very least it serves as valuable evidence of a person’s wishes if the matter is brought into court. A durable power of attorney may be used by itself or in conjunction with a living will. When advance medical directives function as intended and are honored by physicians, they free family members from making extremely difficult decisions. They may also protect physicians. Standard medical care typically requires that a doctor provide maximum care. In essence, a livin g will can change the standard of care upon which a physician will be judged and may protect a physician from legal or professional repercussions for withholding or withdrawing care. Right to Die A number of cases have addressed the right to refuse life-sustaining medical treatment. Broadly speaking, under certain circumstances a person may have a right to refuse life-sustaining medical treatment or to have life-sustaining treatment withdrawn. On the one side in these cases is the patient’s interest in autonomy, privacy, and bodily integrity. This side must be balanced against the state’s traditional interests in the preservation of life, prevention of suicide, protection of dependents, and the protection of the integrity of the medical profession. In in re quinlan, 355 A.2d 647 (1976), the New Jersey Supreme Court permitted withdrawal of life-support measures for a woman in a persistent vegetative state, although her condition was stable and her life expectancy stretched years into the future. Many of the emotional issues the country struggles with in the early 2000s were either a direct result of or were influenced by this case,  including living wills and o ther advance medical directives, the right to refuse unwanted treatment, and physician-assisted suicide. The first U.S. Supreme Court decision addressing the difficult question regarding the removal of life support was Cruzan v. Director, Missouri Department of Health, 497 U.S. 261, 110 S. Ct. 2841, 111 L. Ed. 2d 224 (1990). Cruzan involved a young woman rendered permanently comatose after a car accident. Her parents petitioned to have her feeding tube removed. The Supreme Court ruled that the evidence needed to be clear and convincing that the young woman had explicitly authorized the termination of treatment prior to becoming incompetent. The Court ruled that the evidence had not been clear and convincing, but upon remand to the state court the family presented new testimony that was deemed clear and convincing. The young woman died 12 days after her feeding tube was removed. The Supreme Court decided two right-todie cases in 1997, Quill v. Vacco, 521 U.S. 793, 117 S.Ct. 2293, 138 L.Ed.2d 834 (1997), and Washington v. Glucksberg, 521 U.S. 702, 117 S.Ct. 2258, 138 L.Ed.2d 772 (1997). I n Glucksberg, the appellate courts in New York and Washington had struck down laws banning physician-assisted suicide as violations of Equal Protection and due process, respectively. The Supreme Court reversed both decisions, finding no constitutional right to assisted suicide, thus upholding states’ power to ban the practice. Though both cases were considered together, Glucksberg was the key right-to-die decision. Dr. Harold Glucksberg and three other physicians sought a Declaratory Judgment that the state of Washington’s law prohibiting assisted suicide was unconstitutional as applied to terminally ill, mentally competent adults. The Supreme Court voted unanimously to sustain the Washington law, though five of the nine justices filed concurring opinions in Quill and Glucksberg. Chief Justice william rehnquist, writing for the Court, based much of his analysis on historical and legal traditions. The fact that most western democracies make it a crime to assist a suicide was backed up by over 700 years of Anglo-American common-law tradition that has punished or disapproved of suicide or assisting suicide. This â€Å"deeply rooted†opposition to assisted suicides had been reaffirmed by the Washington legislature in 1975 when the current prohibition had been enacted and again in 1979 when it pass ed a Natural Death Act. This law declared that the refusal or withdrawal of treatment did not constitute suicide, but it explicitly stated that the act did not authorize Euthanasia. The doctors had argued that the law violated the Substantive Due Process component of the Fourteenth Amendment. Unlike procedural due process which focuses on whether the right steps have been taken in a legal matter, substantive due process looks to fundamental rights that are implicit in the amendment. For the Court to recognize a fundamental liberty, the liberty must be deeply rooted in U.S. history and it must be carefully described. The Court rejected this argument because U.S. history has not recognized a â€Å"right to die† and therefore it is not a fundamental right. Employing the Rational Basis Test of constitutional review, the Court concluded that the law was â€Å"rationally related to legitimate government interests† and thus passed constitutional muster. Privacy and Confidentiality Confidentiality between a doctor and patient means that a doctor has the express or implied duty not to disclose information received from the patient to anyone not directly involved with the patient’s care. Confidentiality is important so that healthcare providers have knowledge of all facts, regardless of how personal or embarrassing, that might have a bearing on a patient’s health. Patients must feel that it is safe to communicate such information freely. Although this theory drives doctor-patient confidentiality, the reality is that many people have routine and legitimate access to a patient’s records. A hospital patient might have several doctors, nurses, and support personnel on every shift, and a patient might also see a therapist, nutritionist, or pharmacologist, to name a few. The law requires some confidential information to be reported to authorities. For example, birth and death certificates must be filed; Child Abuse cases must be reported; and infectious, contagious, or communicable diseases must be reported. In addition, confidential information may also be disclosed pursuant to a judicial proceeding or to notify a person to whom a patient may pose a danger. In spite of the numerous exceptions to the contrary, patients legitimately demand and expect confidentiality in many areas of their treatment. Generally speaking, patients must be asked to consent before being photographed or having others unrelated to the case (including medical students) observe a medical procedure; they have the right to refuse to see anyone not connected to a hospital; they have the  right to have a person of the patient’s own sex present during a physical examination conducted by a member of the opposite sex; they have the right to refuse to see persons connected with the hospital who are not directly involved in the patient’s care and treatment (including social workers and chaplains); and they have the right to be protected from having details of their condition made public. A patient owns the information contained in medical records, but the owner of the paper on which they are written is usually considered the actual owner of the records. The patient’s legal interest in the records generally means that the patient has a right to see the records and is entitled to a complete copy of them. The patient’s rights are subject to reasonable limitations such as requiring inspection and copying to be done on the doctor’s premises during working hours. Federal Patients’ Bill of Rights Dissatisfaction with an expanding corporate healthcare industry dominated by profit margins has spawned numerous reform ideas. One idea that has gained a foothold is a patients’ federal Bill of Rights. In 1997, President Bill Clinton appointed an Advisory Commission on Consumer Protection and Quality in the Health Care Industry. The commission was directed to propose a â€Å"consumer bill of rights.† The 34-member commission developed a bill of rights that identified eight key areas: information disclosure, choice of providers and plans, access to emergency service, participation in treatment decisions, respect and nondiscrimination, confidentiality of health information, complaints and appeals, and consumer responsibilities. The proposed rights include: the right to receive accurate, easily understood information in order to make informed health care decisions; the right to a choice of healthcare providers that is sufficient to ensure access to appropriate high-quality health care; the right to access emergency healthcare services; the right and responsibility to fully participate in all decisions related to their health care; the right to considerate, respectful care from all members of the healthcare system at all times and under all circumstances; the right to communicate with healthcare providers in confidence and to have the confidentiality of their individually identifiable healthcare information protected; the right to a fair and efficient process for resolving differences with their health plans,  healthcare providers, and the institutions that serve them; and the responsibility of consumers to do their part in protecting their health. This bill of rights has been debated in Congress and there are bipartisan areas of agreement, but, as of 2003, no final action has taken on enacting a set of rights into federal law.