Nora in Ibsens A Dolls House Essay Example for Free

Nora in Ibsens A Dolls House Essay Throughout history, the role of gender equality has been viewed with varying degrees of importance by societies. People are quick to identify and label a rebel as the one who goes against all the moral convictions and different normalities of each society. The definition of rebel is listed as someone or something that resists any authority or control. In the context of society, the control which is resisted by the rebel can be no other than the stereotypes of that particular society, a feature which can be directly linked to the oppression of women and their desires and aspirations under standardised conditions and circumstances. Can the rebellious attitudes of women be condemned, ignoring the discontent of these women? Also, should their happiness become repressed, giving way to self-sacrifice and the forfeiting of their desires? It is these issues which Medea and Nora are faced with, and in each case we can see that their decision to go against the stereotypes of the eras are perhaps indicative of the predominance of their own desires and dreams over the notion of self-sacrifice. Thus we can see that both Medea and Nora can be characterised as rebels against the societies they live in. To begin with, Nora has fit into her society quite appropriately. She has married Torvald Helmer, and has three small children. She fulfills her duties as mother and wife with no apparent constraints from happiness. She does indeed thrive on keeping her home as best she can with the limited money she has at her disposal. One example of this is where she has bought Christmas presents for Torvald, all of her children, and even the maids; however she buys nothing for herself. 1 She endures Torvalds condescending stance towards her, and does not retaliate when he criticizes both her and her father by saying that Nora is just like your father always on the look-out for all the money you can get, but the moment you have it, it seems to slip through your fingers 2 The impression we are left with after these first pages is that of Nora being extremely nai ve, and having to be put in her place by Helmer, who does so almost instinctively.

Development of Artificial Sweat Experiment

Development of Artificial Sweat Experiment 3.0 Literature Review : 3.1 Biosensor The terminology for biosensor is usually used for equipment or devices used to monitor the metabolic system or element of biomocules. In addition, the particular term used, is referring to a sensor that uses a biological element, such as enzymes, antibodies, DNA, microorganisms or cell. Besides that, based on the IUPAC,it state that biosensor is an integrated equipment that have the capability to give a good analytical data and information in terms of qualitative and quantitative by using the element of biological recognition that interact with the transducer. Figure 1.1 and 1.2 show the schematic diagram. Gambar Rajah dalam buku 3.1.1 Structural Component of Biodetection The partition in a biosensor that can operate with optimum condition consists of 3 components which are, (a) Bio-recognition elements, where the biomolecules are being placed and integrated which normally known as the immobilization on the surface of sensor, (b) Transducer or Detector devices, where the electrochemical and optical transduction occurs, (c) Processing Signal. Gambar rajah dalam buku 3.1.2 Immobilization Bioreceptor In the development of biosensors, the bioreceptors or biomolecules are important in selectively and add with the sensitivity to certain analytes, to ensure that they need to be situated and connected with a transducer in order to achieve the effectiveness of the biosensor in detecting certain analyte. The immobilization bioreceptor’s techniques involves, Adsorption, Microencapsulation, Entrapment, Covalent Attachment and also Cross-Linking. (gambar rajah dalam buku) 3.1.3 Performance of Biosensor In the development of biosensors, things that should be emphasized is the operated performance of the biosensor in detecting analytes. The biosensor performance covers the aspects of the selectivity, sensitivity, accuracy, solution conditions, the â€Å"responds time† ( tr), the â€Å"delay time† (td) and also the â€Å"lifetimes†. 3.1.4 Application Related to Smart Wearable of Biosensor For Sweat Sensor There are various types of application in sensors that already applicable in the market, such as Smart Bra, Thick-film textile-based amperometic sensors and biosensors, Global Positioning System, Wireless Hands-free Communication, Smart Shirt and the most important sensor, is Smart Sensor that will be discussed in this research. (gambar smart patch) 3.2 Sweat Generally, we know that sweat is excreted by sweat glands while the other term in this review, define the term for human sweat as nonexercise-induced eccrine (thermoregulatory) sweat which is secreted by healthy person and but not focusing on the Apocrine. A person, body region, diet, season, degree of acclimation, activity level ,race ,gender ,and also the sampling techniques can give high possibility affect to the variety in the composition of sweat between an individual. (Buckley and Lewis, 1960; Shirreffs and Maughan, 1997; Patterson et al., 2000, 2002; Hayden et al., 2004; Morgan et al., 2004; Shirreffs and Maughan, 1997; Jacobi et al., 2005; Robinson and Robinson, 1954). 3.2.1 Composition of Sweat : Human sweat is composed of highly variable amounts of primary electrolytes, ionic constituents, organic acids and carbohydrates, amino acids, nitrogenous substances, and vitamins and miscellaneous constituents (Fig. 1). Sweat is 99.0–99.5% water and 0.5–1.0% solids (half inorganic and half organic), with specific gravity of 1.001– 1.008 (Robinson and Robinson, 1954; Rothman, 1954; Spector, 1956; Geigy, 1970, 1981; Altman and Dittmer, 1974; Agache and Candas, 2004). Nevertheless, this research report only focusing in the electrolyte, organic acids and carbohydrates and also pH. 3.2.1.1 Electrolytes In general, concentrations of electrolytes in sweat were highly changeable and can assume to be countless. The major constituents of electrolyte were Na and Cl, and the minority amounts were consists of Ca, K, and PO4 (Robinson and Robinson, 1954; Rothman, 1954).In addition, there was reported in a journal that stated, the concentrations of primary electrolytes in the 45 formulations of artificial SSFL which were generally within ranges for human sweat. Unfortunately, median value were not be equivalentl to human sweat.There was lot of formulations lacked of many of the electrolytes present in human sweat (Fig. 1a). In such a case, some are as minimal as a solution of Na and Cl ions (Chiba et al., 1997; Mawn et al., 2005) while there was also occurred among the 45 formulations of artificial SSFL, 7 lacked Na ,8 lacked Cl, 41 lacked Ca, 38 lacked K, 44 lacked Mg, 34 lacked PO4, and all lacked HCO3 (Table 1). 3.2.1.2 Organic acids and carbohydrates The summary in Fig. 1c was shown the measurement of the concentrations of organic acids and carbohydrates which was reported in human sweat. (Mickelsen and Keys, 1943; Robinson and Robinson, 1954; Rothman, 1954; Kuno, 1956; Spector, 1956; Elze and Oelsner, 1957b; Reed, 1969; Geigy, 1970, 1981; Altman and Dittmer, 1974; Kaiser et al., 1974; Stu ¨ttgen and Schaefer, 1974; Goldsmith, 1999; Guyton and Hall, 2000; Agache and Candas, 2004).However, Lactic acid was plentiful of these constituents and its average constitutes was 0.28% of sweat (Spector, 1956; Altman and Dittmer, 1974). Besides that, by reffering to the published Journal of SSFL, acidity of SSFL was due to the high concentrations of both lactic acid and pyruvic acid (Agache and Candas, 2004). The concentrations of organic acids and carbohydrates in 45 artificial SSFL formulations are also summarized in Fig. 1c. The concentration of lactic acid and glucose in artificial SSFL formulations were generally within ranges outlined for human SSFL. 3.2.1.3 pH The measurement of pH values for whole body are summarized in Table 2 (median = 5.3). Values of whole body sweat in Table 2, are from a very acidic pH 2.1 (Haudrechy et al., 1997) to an alkaline pH 8.2 (Altman and Dittmer, 1974). There was might be a variety of sweat pH during a period of sweating, either it become less acidic or more acidic (Robinson and Robinson, 1954) and by body region (Collins, 1957). In order to analyze the effects of alkaline sweat, an investigation had been done by using the pH greater than 7. (Jordinson, 1941; Collins, 1957; Brown et al., 1982; Emmett et al., 1988, 1994; Wainman et al., 1994; Schimper and Bechtold, 2005.Due to the various in sweat pH, many investigators have studied dissolution of a test article over a range of pH values (Gallay and Tapp, 1941; Collins, 1957; Brown et al., 1982; Hemingway and Molokhia, 1987). 3.2.2 Physiology of sweat There are two main types of sweat gland, apocrine and eccrine. Apocrine glands are the largest and they produce a viscous sweat containing lipids, cholesterol and steroids [12,13]. Eccrine glands operate almost the whole body and its amount between 2 and 4 million glands in adult skin. Thermoregulation is regulated by the eccrine sweat glands that helps in maintaining a constant body temperature, and hypothalamus become the centre in controlling the physiological sweat with normal rate of secretion ranging from 0.5 to 1mL/min. The characteristics of sweat is a clear hypotonic, and odourless fluid which consists of sodium, chloride, urea, lactate, organic and non-organic compounds [16]. The acidic nature of the excreted sweat is due to transportation and reabsorbing processes, which are relied on the physiological conditions that occur in the duct [17]. For instance, Patterson et al. has proven that the increased blood and sweat pH through the ingestion of sodium bicarbonate is caused by the induction of metabolic alkalosis. However, it is thought and assumed, this is because of the reduced sweat acidification in the reabsorbtive duct of the sweat glands. Furthermore, the relationship of sweat pH to sweat rate [9,15] and even for relationship of pH and sodium (Na+) levels in isolated sweat glands shown that they are directly proportional to each other. It is known that induce active sweating in human beings will give affect to the heat, mental stimuli, muscular exercise and carbon dioxide [20,21] as the sweating is continued to occur as long as the stimulation lasts and subsides quickly after it ends.. 3.2.3 Sweat collection and analysis The characteristics of sweat sampling and the special samples it requires deserve discussion separated from analysis that can be either different or similar to that in other biofluids. Nowadays, the purposes of sweat analysis are used even in optimizing the performance of athletes by studying the effects of dehydration but in the diagnosis of disease, detection of drug abuse, a method for testing deodorants .In addition, there are a lot of availability of different methods for the purposes of sweat collection and testing. However, the original method to test the components of sweat after exercise was revealed by using the whole bodywash down technique. Hence, all fluids lost during the aerobics are being stored for analysis [18].The following method was, sweat collection devices consisted of an occlusive bandage formed by one-to-three layers of filter paper, gauze or towel [5]. However, this kind of patch was time-consuming to apply, uncomfortably large, prone to detachment and yielded a small volume of sweat for analysis. In addition, it was found to alter the steady-state pH of the skin, the types of bacteria that colonize the skin and the transport characteristi cs of the skin, producing skin irritation [6]. To overcome these difficulties, non-occlusive sweat collection devices were developed, consisting of an adhesive layer on a thin transparent film of surgical dressing to which a absorbent pad and the overall being attached to the arm radial region. The transparent film just allow oxygen, water and carbon dioxide to pass through the patch, leaving healthy the underneath skin and prevents from the penetration of the non-volatile substances from the environment [5] .During wearing of the patch, sweat saturates the pad and slowly concentrates it, sweat components are retained, while water evaporates from the patch, thus misleading results of chloride concentration. Hence, its design does not allow to quantatize the concentrations of analytes in sweat, since the whole volume of secreted sweat is unknown. However, there is a commercial devices for sweat sampling are usually linked to subsequent determination of a given analyte by a dedicated instrument into which the sampler is inserted, as is the case with sweat collection for diagnosis of CF [10]. A recent, no validated sampler for a given application that circumvents sweat-volume related problems and fulfills the present trend to microdevices is a microstrip impregnated with a dye pH indicator [11]. A key aspect of sweat sampling is its noninvasive character, crucial in dealing with people such as hemophiliacs, blood sampling of whom is an either difficult or dangerous task. Sweat sampling can avoids risk of infections to patients who need daily analysis, rather than compared with urine, sweat sample preparation is less complex. Therefore, the use of sweat for commonly frequent analysis practices such as drug control in athletesis preferable. In short, sweat as clinical sample is almost free from impurities or interferents and sample preparation is simple and fast step is quite enough. The main limitations of sweat as clinical sample are the difficulty to produce enough sweat for analysis, sample evaporation, lack of appropriate sampling devices, need for a trained staff, and errors in the results owing to the presence of pilocarpine. In dealing with quantitative measurements, the main drawback is normalization of the sampled volume. Later on, the method has been discovered within the framework to produce results with a high coefficient of variation, which has lead to the development of sweat collection patches or capsules [22]. For instance, a disposable sweat collector developed by Brisson et al. that consisted of capsule created inside a flexible adhesive membrane pasted onto the skin [23]. After that, these collected samples are then stored at low temperatures for later analysis in a laboratory. Now, the pH of sweat can only be determined when the subject has already finished exercise and does not give any changes in the results which might occur between the beginning and end of an exercise session. Therefore, it can be validate that a real-time, wearable method of gathering and analysing sweat is preferable and in demand. Generally, this paper explains about the Development of Smart Patch with On-line Sweat Analysis .Besides that, artificial sweat has been chosen as it is an easily accessible fluid sample. The expected applications of this system for the personal health and sports performance and training. 3.2.3.1 Sweat analysis Sweating is naturally increased by nervousness, exercise, stress and nausea, and decreased by cold. Sweat excretion is also affected by other factors, such as ambient temperature, relative humidity, body location, hormonal imbalances, overactive thyroid gland and the sympathetic nervous system, and certain foods and medications A potential, general personal use of sweat is the recently developed smartphone application for in situ colorimetric detection, in prepared microchips, of pH changes in sweat correlated with chloride concentration and sweat rate which, during physical exercise, can indicate to users the proper time for hydratation [11]. 3.2.3 Artificial Sweat : 3.2.3.1 Historical of Artificial Sweat : The term artificial sweat is used throughout this review and encompasses historically used terms such as ‘‘artificial sweat,’’ ‘‘acidic artificial sweat,’’ ‘‘artificial perspiration,’’ ‘‘synthetic perspiration,’’ ‘‘synthetic sweat,’’ ‘‘sweat simulant,’’ and ‘‘simulated sweat.’’. 3.2.3.2 Benefits of a comprehensive artificial sweat Historical formulations of artificial sweat do not appear to have been characterized and often lacked many constituents present in human sweat. However, only four artificial formulations included more than one amino acid. No vitamins were included in any previous formulation of artificial sweat. Among all historical formulations, one of the most chemically comprehensive recipes was developed by Boman et al. (1983) but contains only select electrolytes, ionic constituents, organic acids, and amino acids. The novel formulation presented herein contains the known human sweat constituents at physiologically relevant levels which provides for a more accurate representation of human than previous artificial sweat models. Our novel artificial sweat formulation with composition that matches human is a chemically complex solvent. Preparation of this artificial sweat requires time and costs not associated with simpler formulations containing only the main constituents of sweat. However, caution must be used when excluding constituents. 3.2.3.3 Comparison to human sweat During formulation, we first balanced all ionic constituents and electrolytes except sodium and chloride. Additionally, concentrations of many human sweat constituents vary widely due to factors such as age, diet, season, degree of acclimation, and gender, making it difficult to design an artificial sweat solution that is universally valid. The artificial sweat formulation described in this paper is chemically more comprehensive than any of the 45 previously identified artificial sweat formulations and contains constituents that are nearly all present in concentrations that match median values in human sweat. However, in our review (Stefaniak and Harvey, 2006), we provided estimates of human sweat constituent concentration ranges, pH, and temperature variability that could be used to guide investigations of the relative importance of sweat factors on interactions with materials. In summary, our artificial sweat, represents a novel comprehensive artificial sweat at median constituent concentrations which equivalent to humans. (Stefaniak et al., in press),

Virginia A. Henderson: A Celebrated Nursing Leader

Virginia A. Henderson: A Celebrated Nursing Leader Biography Virginia Avernal Henderson was born in Kansas City Missouri on November 30, 1897. She was the fifth of eight children born to Daniel B and Lucy Minor Henderson (McBride, 1996). She was named after her mothers home state of Virginia and was later educated there at a boys school run by her grandfather (Thomas). Henderson furthered her education at the U. S. Army School of Nursing in Washington D. C. and graduated in 1921. She attended the Teachers College at Columbia University where she earned her Bachelor of Science degree and her Master of Science Degree in 1932 and 1934 respectively. She taught there from 1934 until 1948 and in 1953 went to work at Yale School of Nursing (McBride, 1996). During World War I, Miss Henderson, which she preferred to be called, took a temporary job caring for the wounded. After that she worked as a public health nurse in Washington D. C. and New York City. The experienced she received in the 1920s inspired her to work as a nurse; a career she initially thought she would only stay in for a few years. It was here where she abandoned her aspirations to be an interior designer and focused on nursing as her new career (McBride, 1996). It was her work as an educator and a researcher at the Teachers College of Columbia University and Yale School of Nursing that Henderson is most known for (Thomas, 1996). The naming of the Sigma Theta Tau International University after Henderson made her the most famous nurse of the 20th century. On March 19, 1996, at the age of 96, after having chocolate cake and saying her good-byes to family and friends she quietly passed away (McBride, 1996). Leadership Style Henderson was an elegant lady who was a gracious hostess, had a great sense of humor, and was full of wisdom (McBride, 1996). She taught health professionals that they should work together in a harmonious team towards a common goal for the patients and families they served (Henderson, 2000, p. 96K). Effective nurse leaders are those who engage others to work together effectively in pursuit of a shared goal (Whitehead, Weiss Tappen, 2010, p. 4). She has shown that over and over in her role as a nurse leader. The style of leadership that she has demonstrated is considered democratic. A democratic leadership is characterized by guidance rather than control by the leader (Whitehead, et al., 2010, p. 6). Henderson possessed the leadership trait management of attention; these leaders were able to communicate a sense of goal or direction to attract followers (Whitehead, et al., 2010, p. 5). She claimed that excellence in nursing is dependent upon what each individual brings to it, and that it can be measured by the quality of the individuals personal life, by contribution as a member of a community, and by the professional services he or she offers to society. Excellence, to Henderson, suggests the well-rounded or complete person (Henderson, 2000, p. 96K). She defined the function of a nurse as doing things for patients that were not physically able to or had the required knowledge. She stated that nurses should help the patient either become healthy or die peacefully. She also taught nurses should help their patients become independent and, able to perform relevant activities for themselves as quickly as possible. She stressed the nurses duty is to the patient rather than to the doctor (Thomas, 1996). Henderson taught that no member of the team should make such high demands on another that they could not do their job properly. She also said that no member of the team should be diverted from their duties by non-medical activities such as cleaning, clerking and filing (Henderson, 1964, p. 63). Communication and Crusades Virginia Hendersons greatest achievement was a nineteen year research project which concluded with her publication of the five volume Nursing Research: Survey and Assessment, co-written with Leo Simmons and published in 1964. During this time she gathered, reviewed, catalogued, classified and cross-referenced every known piece of research on nursing published in English (Thomas, 1996). She felt proud to play a part in steering the electronic networking system of information, which was developed to provide nurses with current, jargon-free information wherever they were based. Henderson stated no profession, occupation or industry in this age can evaluate adequately or improve its practice without research. Her strong advocacy for nursing brings forth a challenge to all of us to identify new needs beyond the 14 she enumerated. Hendersons believe that research in nursing is essential for nursing practice in the age of technological advancements (Thomas, 1996). She knew that people are motivated by compassion to help others and she encouraged others to put that first. She stated that the nurse who complements the dependant, sick or well- by supplying him with strength, knowledge, or will he needs for wholeness must be judged excellent (Henderson, 2000, p. 96). Henderson was admired by a lot of her peers as well as other educational theorists. Edward Hallorans recently edited A Virginia Henderson Reader (1995) and stated it is the best source available today for a compilation of Miss Hendersons own thinking. When you glance through that volume, you are struck with the currency of her ideas. She recognized early on the importance of an outcomes orientation, health promotion, continuity of care, patient advocacy, multidisciplinary scholarship, integration of the arts and sciences, and boundary spanning. Her elegant definition of nursing, with its emphasis on complementing the patients capabilities, provides a clear direction for what nursing s hould bea wonderful counter force to the confusion that surrounds a health care system increasingly preoccupied with bottom line rather than enduring values (McBride, 1996). Henderson believed that patients should be taught to understand their medical charts. She believed that if a patient understood their medical records and had access to sources that explained medicine that the patients would not -over-use the medical care system. She stated, If you want to develop a mature and helpful philosophy about maintaining your health, you need to understand the means by which physicians clinical judgments are made and tested (Henderson, 1996, p. 16N). This can be accomplished by communicating with the patients. The more the patients know the more empowerment they will have over their illness; they will want to do more to prevent any further complications, and the chances are greater for medical compliance. Conflict Resolution As a youth, Virginia Hendersons family was quite vocal and they often stayed up late into the night discussing subjects of truth, beauty, charm or goodness. It was through these discussions, or rather arguments, that she learned how to defend her theories. She learned that her expressed views would be met with an opposing response. In her article, Excellence in Nursing, she is quoted as saying, No persons brought forward as exemplifying charm, beauty, or goodness were unanimously agreed upon by the others. In fact, it was dangerous to set up ones idol for it was sure to be knocked down (Henderson, 2000, p. 96I). Barriers that Henderson and other nurses had to face in the past are legal issues and nursing activities, which made the nursing professions position in healthcare ambiguous and misunderstood. Nurses have long struggled for rightful recognition by physicians and other healthcare members. Issues that arose were, nurses practicing independently, nurses diagnosing and treating patients. The roles of medical providers may be clear-cut in legislative controls, but human needs have always overridden legal barriers (Thomas, 1996). In the Nature of Nursing, Henderson stated that the nurse is and should be legally, an independent practitioner and able to make independent judgments as long as s/he is not diagnosing, prescribing treatment for disease, or making a prognosis, for these are the physicians function (Henderson, 1964). Henderson used her wisdom and charm to defy stereotypes. She had the ability to question the fashionable emphasis on nursing process, reminding us all that problem solving does not belong to any one profession (McBride, 1996). She was also passionate about our ailing health care system. She was glad that nurses were now recognized as providers of primary health care, yet knew that they often were frustrated because within the system, they were often unable to provide the supportive care that they believed was needed. She felt that nurses were unable to make health prevention a priority and that with more and more health agencies coming under corporate management, that it is increasingly difficult to preserve human values in health care. She thought that now, more than ever that the provision of universal health education should be instituted in grade-schools, colleges and beyond. Role Model Henderson is a wonderful role model for todays nurses. She spent her adult life in search for better ways to care for the patient. She defined what is now called the Henderson Theory which organized patient care into fourteen basic needs of the whole person and includes psychological, sociocultural, spiritual, and developmental. Using these principles the nurse and patient can together work to meet these needs and attain client-centered goals (Potter Perry, 2009, p. 50). As a nurse I would incorporate these qualities in how I take care of my patients, whether its being an advocate for them, caring for their well being or sitting and talking with them. Patients are already going through the stress of being sick and they should be able to rely on us as nurses to be empathetic, caring, understanding and helping them gain back their independence. Miss Henderson identified with her patients. She knew this was a difficult task that demanded knowledge, skills, patience, tolerance, sensitivity, and a capacity for sustained effort. She did this with her unwavering character and compassion for other human beings.

Free Henry IV Essays: The Character of Falstaff :: Henry IV Henry V Essays

The Character of Falstaff in Henry IV The character of Falstaff, in Shakespeare’s play Henry IV Part One, serves as an emblem of frivolity and carelessness within a world filled with social and political significance. Falstaff scorns the world of politics and moral decisions in favor of existing from moment to moment. Though he dislikes this "other world", Falstaff realizes he must sometimes come in contact with it. Falstaff’s famous speech in lines 127-139 of Act V shows us how he regards the Prince’s world of honor and duty. Through this speech, Falstaff places himself firmly out of any moral world concerned with justice or honor, instead living for no other reason than life itself. Falstaff’s speech comes after the King and Prince Hal decide to war against the army of Hotspur. Though they wait on word from Worcester, the probability of conflict seems high. Falstaff knows that when the battle comes, he is going to be in the middle of it. Shortly before his speech on the nature of honor, Falstaff shows fear that he might be hurt. In lines 121-2 Falstaff asks Hal to protect him if he should fall during battle. The Prince’s rejection of the request shows his scorn for Falstaff’s desire to passively preserve only his own life. Throughout the last half of the play, as the Prince drifts away from Falstaff, Falstaff’s role in the action of the play as a whole diminishes. The importance placed upon the idea of honor allows Hal to assume his rightful position beside the King, while Falstaff dims into the background. Falstaff’s idea of honor is directly linked to his sense of time itself. In the opening lines of his speech, Falstaff says,"‘Tis not due yet: I would be loath to pay him before his day." (L. 127-8) In this example, God is being related by Falstaff to someone who has set a schedule determining the time and place of everyone’s death. For Falstaff, one’s role in life is not to stray from the path created by that higher Power. The notion of honor, as he later describes in this speech, is a belief through which one can transgress that natural order. He says,"Yea, but how if honor prick me off when I come on?" (L. 130) In order for one to gain honor, one must risk one’s life. This type of gambling is not for Falstaff, as he decides that his own life is more important than,"A word.

The Joy of Corporate Profits :: Corporate Profits Pay For Universities

Whether it's Nation of Islam Minister Louis Farrakhan leading the Million-Man March, anti-WTO protesters or AIDS activists, we're frequently treated to the chant demanding "People Before Profits." Since profit demagoguery is a deceptively appealing tool used by scoundrels everywhere, let's de-mystify the concept of profits. Let's first get its definition out of the way. Profits represent the residual claim earned by entrepreneurs. It's what's left after all other costs - wages, rent, interest - have been paid. The entrepreneur is generally seen as the person who takes risks, innovates and makes decisions. It's important to recognize that profits are a cost of business just as are payments to labor, land and capital. If wages, rent and interest are not paid, labor, land and capital will not be offered; similarly, if profit is not paid, entrepreneurs wouldn't be seen either. Roughly six cents of each dollar companies take in represent after-tax profits. By far, wages are the largest part of that dollar representing about 60 cents. As percentages of 2002 national income, after-tax profits represented about 5 percent and wages about 71 percent. Far more important than simple statistics about the magnitude of profits is the role played by profits, namely that of guiding resources to their highest valued uses, determined not by some tyrant but by ordinary people's wants and desires. Let's discuss just a few examples. When Coca Cola introduced the "new" Coke? Pepsi Cola president Roger Enrico called it "the Edsel of the 80's," representing one of the greatest marketing debacles of the 1980's. Who made Coca Cola Company bring back the old Coke? Was it congress, the courts, the president, or other government officials who claim to have our interests at heart? No way. It was the specter of negative profits (losses) that convinced Coca Cola to bring back the old Coke. Thus, one role of profits is to discover what consumers want and if producers make mistakes, correct them. After the 1992 massive destruction caused by Hurricane Andrew, South Florida stores sold sheets of plywood for twice the price it had sold for prior to the storm. Escalating plywood prices brought charges of price-gouging and prosecutory threats. But look what higher prices and the potential for windfall profits did. Plywood destined to be shipped to the Midwest, West and Northeast suddenly was rerouted to South Florida. Lumber mills increased production. Truckers and other workers worked overtime so as to increase the availability of plywood and other construction materials to Floridians.

Velocity Cellular Revenue Case

Case 09-1: Velocity Cellular Page 1 D I S C U SS I O N M A T E R I A L S O b j e c t i v es o f t h e C a se This case gives students the opportunity to use accounting and auditing literature and professional judgment to research complex accounting issues effectively and efficiently. Specifically, students will be able to: Understand the application of the guidance in ASC 605-25, as amended by ASU 2009-13, to complex multiple-deliverable arrangements. Understand the application of the guidance in SAB Topic 13.A p p l i c a b l e P r of essi on a l P r onou n c e m e n ts ASC 605-25, Revenue Re cogni t ion : Mul t ipl e- E l ement A r r angements (ASC 605-25) (formerly EITF Issue No. 00-21, Revenue Arrangements With Multiple Deliverables (Issue 00-21)), as amended by ASU 2009-13, Revenue Re cogni t ion (Topi c 605) : Mul t ipl e- D e l ive r abl e Revenue A r r angements (ASU 2009-13) (formerly EITF Issue No. 08(Issue 08-1)) SEC Staff Accounting Bulletin Topic 13, Revenue Recognition (SAB Topic 13) P rof essor N ot e : This case study requires students to recognize an arrangement comprising multiple deliverables.The case study essentially focuses on determining whether the activation card represents a separate arrangement deliverable and, if so, whether this deliverable represents a separate unit of accounting. In other types of arrangements, a company may provide additional deliverables, such as hardware (cellular phone), minutes, and additional services (e. g. , Web browsing, mail). Each multipledeliverable arrangement should be analyzed to determine the number of deliverables and units of accounting before determining the appropriate revenue recognition model.Given the multitude of possible combinations of alternatives, this case study focuses on the activation card to simplify the analysis that is required in analyzing a multiple-deliverable arrangement. D isc uss ion Refer to current, relevant accounting guidance to determine and support the appropriate met hod for recognizing revenue for the Power Starterpack. To determine the appropriate revenue recognition model, students must first determine whether the Power Starterpack comprises multiple deliverables or is a single deliverable.The prepaid voucher will probably be readily identifiable as a deliverable and a separate unit of accounting because it is sold separately, but the activation card will probably not be. Accordingly, the discussion that follows focuses on the need to determine whether the a c t i v a t ion c a r d is a separate unit of accounting. Copyright 2009 Deloitte Development LLC All Rights Reserved. Case 09-1: Velocity Cellular Page 2 A c co u n t i n g A l t e r n a t i v es A l t e r n a t i ve 1 The a c t iva t ion c a rd is not a sepa r a t e de l ive r abl e and not a sepa r a t e uni t of a c count ing in a c cordanc e wi th AS C 605-25.Proponents of A l t e rna t ive 1 believe that subscribers do not ascribe value to the activation card separately from the pre paid voucher because they chose to purchase the Power Starterpack that includes both the prepaid minutes and the activation card. A l t e rna t i ve 1 proponents contend that subscribers have the option to purchase the activation card on a standalone basis but elected to purchase the Power Starterpack. Regarding review of the arrangement to determine separate deliverables, ASC 605-2525-4 states: A vendor shall evaluate all deliverables in an arrangement to determine whether they represent separate units of accounting.That evaluation shall be performed at the inception of the arrangement and as each item in the arrangement is delivered. Although there is no authoritative guidance defining proponents of A l t e rna t ive 1 believe that the perspective of the customer should be considered. The SEC staff has the deliverables. However, no clear consensus or group view delineates the criteria that should be used to determine separate elements or deliverables in a service arrangement. A l t e rna t ive 1 proponents believe that the a ccess to the network and, therefore, payment for the activation card should be viewed as an activation fee. Although the additional functionalities (the Bluetooth-enabled technology, international calling capabilities, and additional memory capacity) significantly enhance the existing cellular phones of subscribers, these existing subscribers believe that they are paying for a service and the extra charge for the activation card represents an activation fee that must be incurred in obtaining the prepaid minutes.Proponents of A l t e rna t ive 1 further believe that the activation card is of no value without activation card . A l t e r n a t i ve 1 proponents therefore conclude that the activation card is not a separate deliverable and, accordingly, it cannot be a separate unit of accounting. To determine the appropriate revenue recognition model, the reviewer must combine the activation card with the prepaid phone service voucher. A l t e r n a t i ve 2 The a c t iva t ion c a rd is a sepa r a t e de l ive r abl e and a sepa r a t e uni t of a c count ing in a c cordanc e wi th AS C 605-25.Proponents of A l t e rna t ive 2 believe that subscribers clearly ascribe value to the activation card separately from the prepaid voucher because subscribers are willing to replace their existing activation cards with new activation cards. Subscribers are willing to replace their existing activation cards because the additional functionalities of the new activation cards provide subscribers the ability to use new features on their existing cellular phones.Accordingly, the activation card should first be considered a separate deliverable. Copyright 2009 Deloitte Development LLC All Rights Reserved. Case 09-1: Velocity Cellular Page 3 Regarding review of the arrangement to determine separate deliverables, ASC 605-2525-4 states: A vendor shall evaluate all deliverables in an arrangement to determine whether they represent separate units of accounting. That evaluation shall be performed at the inception of the arrangement and as each item in the arrangement is delivered.Although there is no authoritative guidance defining a deliverable, proponents of A l t e rna t ive 2 believe that the perspective of the customer should be considered, as described in A l t e rna t ive 1 above. No clear consensus or group view delineates the criteria that should be used to determine separate deliverables in a service arrangement. Other considerations that may be useful when determining whether an item is a deliverable in a contractual arrangement include (1) the fair value of the item, (2) whether the item is essential to the functionality of other products or services included in the arrangement, (3) eceiving a full or partial refund, and (4) whether failure to deliver the item causes a vendor to incur a significant contractual penalty. In the current fact pattern, the subscribers who obtain new activation cards also obtain additional functionalities. The additional functionalities (the Bluetooth-enabled technology, international calling capabilities, and additional memory capacity) significantly enhance the subscribers existing cellular phones.These existing subscribers do not believe that they are paying for a service or paying an additional activation fee; rather, they ascribe a value to the additional functionalities of the new activation card. Since Velocity Cellular Services (Velocity ) subscribers believe that they are paying for additional hardware that provides additional functionalities, the activation card should be viewed as a separate deliverable.Proponents of A l t e rna t ive 2 acknowledge the view that the a purpose is to provide access to the network; therefore, payment for the activation card could be viewed as an activation fee. However, although the activation card does provide for network access and could be viewed as an in-substance activation fee, A l t e rna t i ve 2 proponents believe that the predominant feature of the activation card is to provide additional functionalities for subscribers existing cellular phones.If this were not the case, subscribers would not purchase new activation cards on a standalone basis because the subscribers already have access to the network via their existing activation cards. After determining that the activation card represents a separate customer deliverable, proponents of A l t e rna t ive 2 also believe that this deliverable, which would be provided to the customer before any future activation services or airtime rights, should be considered a separate unit of accounting in a multiple-element arrangement if the appropriate criteria in ASC 605-25 are met.ASC 605-25 describes the appropriate model for separation of arrangement deliverables and allocation of arrangement consideration. However, ASC 605-25 does not describe appropriate separation, attribution, and recognition models for deliverables that are within the sco pe of other relevant accounting literature. Copyright 2009 Deloitte Development LLC All Rights Reserved. Case 09-1: Velocity Cellular Page 4Thus, the first step in determining whether the activation card deliverable should be separated and accounted for on a standalone basis would be to establish whether the deliverable is subject to accounting literature outside the scope of ASC 605-25 and, if so, whether this guidance provides a model for separation, allocation of arrangement consideration, and recognition. Proponents of A l t e rna t ive 2 believe that the deliverables under this arrangement (the activation card and the prepaid voucher) are subject to the accounting guidance in SAB Topic 13 (e. g. , revenue recognition guidance outside the scope of ASC 605-25).ASC 605-25-15-3 and 15-3A, as amended by ASU 2009-13, state: A multiple-deliverable arrangement may be within the scope of another Codification Topic. Those Topics include all of the following: a. For leases, see Topic 840. b. For franchisors, see Topic 952. c. For property, plant, and equipment, see Topic 360; specifically, Subtopic 360-20. d. For guarantees, see Topic 460. e . F o r r e v e n u e r e cogn i t ion , se e T op i c 605 ; sp e c i f i c a l l y , Su b top i cs 605-20 a n d 605-35. f. For software, see Topic 985; specifically, Subtopic 985-605. g. For entertainment films, see Topic 926; specifically, Subtopic 926-605.T hose T op i cs m a y p r ov i d e gu i d a n c e w i t h r esp e c t t o w h e t h e r a n d how to a l l oc a t e co ns i d e r a t i o n o f a m u l t i p l e- d e l i v e r a b l e a r r a n ge m e n t . W h e t h e r d e l i v e r a b l es a r e w i t h i n t h e scop e of t hose ot h e r T op i cs is d e t e r m i n e d b y t h e scop e p r ov isions of t hose T op i cs, w i t hou t r ega r d t o t h e o r d e r of d e l i v e r y of t h a t i t e m i n t h e a r r a nge m e n t . The following describes the three categories into which the other Codification Topics fa ll and the application f this Subtopic or the other Topics in determining separate units of accounting and allocating arrangement consideration: a. Other Topics address both separation and allocation. If another Topic provides guidance regarding the determination of separate units of accounting and how to allocate arrangement consideration to those separate units of accounting, the arrangement or the deliverables in the arrangement that is within the scope of that Topic shall be accounted for in accordance with the relevant provisions of that Topic rather than the guidance in this Subtopic. b. Other Topics address separation, but not allocation.If another Topic provides guidance requiring separation of deliverables within the scope of that Topic from deliverables not within the scope of that Topic, but does not specify how Copyright 2009 Deloitte Development LLC All Rights Reserved. Case 09-1: Velocity Cellular Page 5 to allocate arrangement consideration to each separate unit of ac counting, such allocation shall be based on the relative selling price of the deliverables within the scope of that Topic and the deliverables not within the scope of that Topic. For example, leased assets are required to be accounted for separately under the guidance in Subtopics 840-20 and 840-30.See paragraph 605-2555-3. (For purposes of the allocation between deliverables within the scope of another Topic and deliverables not within the scope of that other Topic, the selling price shall be determined using the guidance as discussed in paragraphs 605-25-30-6A through 30-6B. ) Subsequent identification of separate units of accounting and allocation of arrangement consideration to the deliverables not subject to that other Topic would be governed by the provisions of this Subtopic. c. O t h e r T o p i c s a d d r e s s n e i t h e r s e p a r a t i o n n o r a l l o c a t i o n .I f a n o t h e r T o p i c p r o v i d es n o g u i d a n c e r eg a r d i n g t h e se p a r a t i on o f t h e d e l i v e r a b l es w i t h i n t h e scop e of t h a t T op i c f r om t hose d e l i v e r a b l es t h a t a r e not o r t h e a l l oc a t i o n of a r r a n ge m e n t c o n s i d e r a t i o n t o d e l i v e r a b l e s w i t h i n t h e sco p e of t h a t T op i c a n d to t hose t h a t a r e not , t h e n t h e gu i d a n c e i n t h is Su b top i c sh a l l b e fol low e d fo r p u r poses of s u c h se p a r a t ion a n d a l l oc a t ion . For example, Subtopic 605-35 provides separation and allocation guidance [segmentation provisions] for deliverables within its scope. However, that Subtopic does not provide separation and allocation guidance for deliverables within its scope and deliverables not within its scope. ) In such circumstances, it is possible that a deliverable subject to the guidance of another Topic does not meet the criteria in paragraph 605-25-25-5 to be considered a separate unit of accounting.In that event, the arrangement consideration allocable to such deliverable shall be combined with the amount allocable to the other applicable undelivered items within the arrangement. The appropriate recognition of revenue then shall be determined for those combined deliverables as a single unit of accounting. [Emphasis added] Proponents of A l t e rna t ive 2 note that SAB Topic 13 does not provide guidance on separating elements in an arrangement into units of accounting; instead, it refers to ASC 605-25.SAB Topic 13 is focused solely on recognition of revenue for specific revenue deliverables. Accordingly, proponents of A l t e rna t ive 2 believe that a determination of whether the activation card deliverable in this arrangement represents a separate unit of accounting should be made solely in accordance with ASC 605-25-25-5, which states, in part: In an arrangement with multiple deliverables, the delivered item or items shall be considered a separate unit of accounting if both of the following criteria are met: a.The del ivered item or items have value to the customer on a standalone basis. The item or items have value on a standalone basis if they are sold separately by any vendor or the customer could resell the delivered item(s) on a standalone basi s ability to resell the delivered Copyright 2009 Deloitte Development LLC All Rights Reserved. Case 09-1: Velocity Cellular Page 6 item(s), [the Task Force observed that] this criterion does not require the existence of an observable market for the deliverable(s).Under ACS 605-25-25-5(a), the activation card, or the delivered item in Velocity multiple-element arrangements, the same activation card model that is sold to existing customers (with the same additional functionalities) in the Power Starterpack is also sold by Velocity and other wireless retailers on a standalone basis. The second condition that must be met for Velocity to consider the activation card a separate unit of accounting relates to whether a general right of return exists. ACS 6052 5-25-5(c) states: c.If the arrangement includes a general right of return relative to the delivered item, delivery or performance of the undelivered item or items is considered probable and substantially in the control of the vendor. Since there is no general right of return, the second condition is not applicable. Therefore, proponents of A l t e rna t i ve 2 believe that since both relevant conditions in ASC 605-25-25-5 are met, the activation card has standalone value and should be accounted for as a separate unit of accounting.A l t e r n a t i ve 3 The a c t iva t ion c a rd is a sepa r a t e de l ive r abl e but not a sepa r a t e uni t of a c count ing in a c cordanc e wi th AS C 605-25. In a manner consistent with that of proponents of A l t e rna t i ve 2, proponents of A l t e rna t ive 3 perform a similar analysis and believe that the activation card should be considered a separate deliverable.However, A l t e rna t ive 3 proponents question whether the criterion in ASC 6 05-25-25-5(a) is met because, as stated in the accounting memo, Standalone transactions for new activation cards are i n f r e q u e n t Proponents of A l t e rna t i ve 3 believe that if the standalone transactions are infrequent, there may not be enough evidence to conclude that the activation cards have standalone value per the requirement of ASC 605-25-25-5(a).Without additional information, proponents of A l t e rna t ive 3 believe it is not possible to conclude that the activation card is a separate unit of accounting, citing the requirements of ASC 605-25-25-6: A delivered item or items that do not qualify as a separate unit of accounting within the arrangement shall be combined with the other applicable undelivered item(s) within the arrangement.The allocation of arrangement consideration and the recognition of revenue then shall be determined for those combined deliverables as a single unit of accounting. Sol u t i on A l t e rna t ive 1 was rejected because the facts estab lish stronger support that the activation card is a deliverable on a standalone basis. In this fact pattern, the additional functionalities of the new activation card are the predominant reasons for subscribers to Copyright 2009 Deloitte Development LLCAll Rights Reserved. Case 09-1: Velocity Cellular Page 7 purchase the prepaid phone service plan because existing customers are willing to replace their old activation cards to add additional functionalities to their existing cellular phones. If the additional functionalities were not available in the new activation cards, existing customers would have continued to use their old activation cards, which already allowed them access to the network.This is further evidenced by the fact that vendors outside of Velocity also sell the same model activation card on a standalone basis. -making process, the price the customer is willing to pay for the Power Starterpack with the additional functionalities of the new activation card indicates str ongly that the activation card is valuable to the customer without the prepaid voucher (which can be purchased separately for $50) and represents a deliverable in the arrangement.An analysis of the activation card under ASC 605-25 indicates that both criteria in ASC 605-25-25-5 are met and, therefore, the activation card is considered a separate unit of accounting. A l t e rna t ive 2 was determined to be the preferred alternative. T h e a c t i v a t ion c a r d is a se p a r a t e d e l i v e r a b l e a n d a se p a r a t e u n i t o f a c co u n t i n g. A l t e rna t ive 3 represents a legitimate question that should be evaluated in more detail according to specific facts and circumstances.Generally, in situations in which a vendor sells an element, even infrequently, the criterion in ASC 605-25-25-5(a) will be met because the element is sold separately. A ddendum J u n e 2010 In September 2009, the EITF reached a consensus on Issue 08-1, which has been codified in ASC 605-25 a nd amended by ASU 2009-13. ASU 2009-13 requires the use of the relative selling price method to allocate arrangement consideration to the separate units of account and eliminates the use of the residual method.When applying the relative selling price method, an entity should determine the selling price for each deliverable using vendor-specific objective evidence (VSOE) of selling price, if it exists; otherwise, thirdparty evidence of selling price is to be used. If neither VSOE nor third-party evidence of selling price exists for a deliverable, the vendor should use its best estimate of the selling price for that deliverable when applying the relative selling price method.This revenue accounting model differs significantly from the previous model in Issue 00-21: the previous Issue 00-21 requirements for determining whether a deliverable in a multipleelement arrangement represented a standalone unit of accounting were based not only on the standalone value and general right of retur n requirements retained in Issue 08-1, but also on whether objective and reliable evidence of the fair value of any undelivered items was present.The model presented in Issue 08-1 is thought to be less punitive to the revenue recognition process because it eliminated the requirement to have evidence of fair value of undelivered items on a standalone basis. The case and solution have been updated to reflect the adoption of ASU 2009-13. On June 24, 2010, the FASB issued an exposure draft (ED) on a proposed ASU, Revenue Re cogni t ion : Revenue F rom C ont r a c ts Wi th C ustome rs, which was the result of a joint project between the FASB and IASB (the boards ) to clarify the principles for recognizing revenue and to develop a common revenue standard for U.S. GAAP and Copyright 2009 Deloitte Development LLC All Rights Reserved. Case 09-1: Velocity Cellular Page 8 IFRSs. The core principle in the proposed ASU would require an entity to recognize revenue to depict the completion of its separate performance obligations pertaining to the transfer of goods or services to customers in an amount that reflects the consideration that it receives, or expects to receive, in exchange for those goods or services. The proposed ASU includes a model for entities to apply the core principle and includes guidance that pecifies the accounting for some arrangement costs. The boards received nearly 1,000 comment letters in response to the ED and began their redeliberations of the proposals in January 2011, considering the feedback received on the ED. They have reached decisions on various aspects of the model and will continue developing the model with the goal of issuing a final standard in 2011. Certain significant provisions pertaining to the accounting model for multiple-element arrangements that have been contemplated in the redeliberation process are as follows:I de n t i f y i n g Sep a r a t e P e r f o r m a n c e O b l i g a t i o n s The boards have noted that in some cas es, an entity promises to provide a bundle of goods or services that the entity should account for as a single performance obligation because the risks to the entity of providing the goods or services are inseparable. That would be the case if the goods or services are highly interrelated and providing them requires the entity to provide a significant service of integrating the goods or services into the combined item(s) for which the customer has contracted.That service typically results in significant modification of the goods in the contract. In all other cases, the boards decided an entity should account for a promised good or service as a separate performance obligation only if both of the following conditions are met: a. The good or service is distinct. A good or service is distinct if either: 1. The entity regularly sells the good or service separately, or 2. The customer can use the good or service either on its own or together with resources that are readily available to th e customer.Readily available resources include goods or services that are sold separately (whether by the entity or another entity), or resources that the customer has obtained from previous transactions or events. b. The pattern of transfer of the good or service is different from the pattern of transfer of other promised goods or services in the contract. This recognition model is similar to the model in Issue 08-1. However, there are some slight differences in comparison to ASC 605-25-5, discussed above.A l l oc a t i o n o f t h e T r a n s a c t i o n P r i c e to t h e Se p a r a t e P e r f o r m a n c e O b l i g a t i o n s The boards have preliminarily determined: Copyright 2009 Deloitte Development LLC All Rights Reserved. Case 09-1: Velocity Cellular Page 9 An entity should allocate to each separate performance obligation the amount of consideration the entity expects to receive in exchange for satisfying that performance obligation.To apply that principle, an entity sho uld allocate the transaction price (or change in the transaction price) on a relative standalone selling price basis. If the standalone selling price of a good or service is highly variable, the most appropriate technique to estimate a standalone selling price may be a residual technique. Using a residual technique, an entity would determine a standalone selling price by reference to the total transaction price less the standalone selling prices of other goods or services in the contract.An entity should allocate a portion of (or a change in) the transaction price entirely to one (or more) performance obligation if both of the following conditions are met: a. The contingent payment terms of the contract relate specifically to the from satisfying that separate performance obligation; and b. The amount allocated (including the change in the transaction price) to that particular performance obligation is reasonable relative to all of the performance obligations and payment terms (inclu ding other potential contingent payments) in the contract.The model presented above for the allocation of consideration to a multiple-element revenue arrangement is relatively consistent with the model provided in ASC 605-25. However, there are some slight differences noted, primarily in that the ED would allow for use of a residual method of consideration allocation, whereas this method is explicitly prohibited in ASC 605-25 (this provision was removed in Issue 08-1). Copyright 2009 Deloitte Development LLC All Rights Reserved.

Lincoln Hospital Case Study Essay

Introduction This case describes a crisis situation that unfolds at the Lincoln Hospital, a 400-bed for-profit facility. At the root of the crisis is a dysfunctional relationship between the newly elected chief of surgery, Don, and the Operating Room (OR) director of 13-years, Mary. As a result of their discord, multiple exacerbated issues are occurring throughout the hospital. These issues are impacting the ability of the hospital to successfully perform the planned surgeries without incurring significant issues. The hospital has lost forty percent of the experienced OR nursing staff during the previous eight months, lessor experienced OR nurses are inefficiently replacing the more experienced nurses, physicians are threatening to conduct their surgeries in different hospitals, physicians are arriving late for scheduled surgeries, the staff is divided, and the necessary equipment is either not available or not the correct size resulting in delays and impacts to performing the surgeries. The president of the hospital is facing a daunting dilemma in trying to figure out how to bring this discord to closure and remedy the perturbating effects of this hostile relationship. He believes the discord is responsible for  the other systematic issues seen throughout the hospital. He considers firing Mary but quickly realizes she is an invaluable asset that he cannot afford to let go. At the same time, he realizes he needs to be accommodating to the surgeons or they will take their patients to another hospital. The competitive market adds complexity to the situation since the hospital is facing escalating costs, changes in regulations, and strict accreditation standards. The president realizes the surgeons are loyal to the new chief of surgery and that he cannot afford to alienate or oppose the newly elected chief of surgery for fear of losing the surgeons to his competition. The president conducts his own initial investigation by speaking with both nurses and doctors. He tells Mary and Don that they must resolve their conflict by meeting with each other until they resolve their issues; the meetings would begin immediately. To ensure Mary and Don follow through with his mandate, the president selects an impartial observer, the new executive vice president and chief operating office, Terry, to mediate the meetings. Both Mary and Don also ask their respective vice presidents to sit in on the meetings to ensure fairness in the process. Neither Mary nor Don wants to participate in these meetings and as such, the results of the meeting are less than fruitful. The initial meeting results in a hostile free-for-all. The president of Lincoln Hospital ultimately contracts with an Organizational Development (OD) consultant to remedy the situation. The OD consultant meets with Mary and Don separately to obtain answers to the following three questions: 1) What does he or she do well? 2) What do I think I do that bugs him or her? 3) What does he or she do that bugs me? Mary and Don were able to see the positive characteristics about the other person through the process of answering the questions. Neither Mary nor Don had openly attributed their respect and admiration for the skills of the other person. Prior to participating in this exercise, their answers revealed the existence of ongoing and escalating frustrations concerning their inability to effectuate good interpersonal skills. As Mary and Don continue to participate in these meetings, they become better equipped to address their confrontational issues. They are better positioned and able  to follow through with identifying specific problems, altering their reactions and their behaviors to effectuate co-existence in a productive way. Contracting and Diagnosis Stages The case did not elaborate much on the contracting stage between the president and the OD consultant. The case stated the president was in communication with the OD consultant. The president described a high level overview of the problem and subsequently hired the OD consultant with the expectation that the consultant would champion resolution of the dysfunction between Mary and Don. The OD consultant did not have the opportunity to talk with either Mary or Don prior to establishing a contract with the president. There was no agreement regarding the time to resolve the issues, or the acceptable solutions versus unacceptable solutions, other than the solution must include ongoing employment for both Mary and Don. The output of the contracting process is make a good decision about how to carry out the effort, define the resources needed to accomplish the tasks and document the assumptions, risks, and constraints. The contract ensures all parties are in agreement regarding the necessary commitments, support, and resources. Suggestions for establishing an effective contract would include carefully approaching the contracting process by laying out a model of how the OD process should flow. The contracting process should include all parties, which would be inclusive of Mary and Don. This ensures they all have an input into establishing expectations for the process in terms of the desired outcomes, establish ground rules that all parties could abide by, and agree upon the time and resources that would be devoted to completing the goals within the given constraints. In addition, the OD consultant should state what his expectations are regarding the process. All parties involved need to be clear about their commitment of time and resources to the effort. In addition, Mary, Don, and the OD consultant should agree upon how they will work together. Some conversations may require confidential conversations or information. This type of information should be part of the contract. The diagnosing process began largely from the description given to the OD consultant by the president and not as a collaborative effort among all affected stakeholders. As stated earlier,  Mary and Don, as well as other affected members of the organization, were not engaged in the early meetings. The OD consultant may have a skewed view of the problem since he did not diagnose the problem but rather received the information second hand. His ability to identify the issues to focus on, how to collect data to measure the progress of a proposed implementation, and how to obtain agreement upon the process for assigning action steps is largely from the president’s view. Suggestions for implementing a better diagnosing process would include engaging all affected parties, in a collaborative fashion, to understand all the issues, analyze them, and draw conclusions for action planning and intervention. They should be involved in actively developing appropriate interventions and implementations. An assessment, of the current state of the organization, will identify ways to enhance the organization’s existing functioning. A diagnostic model will point out what areas to examine and what questions to ask in assessing how they are operating. The diagnostic model should include inputs, design components, and outputs. Third-Party or Other Types of Intervention The third-party intervention is an appropriate intervention. It successfully generated positive results and reduced the friction between the two parties. However an element of tension still exists between Mary and Don. The consultant was able to get Mary and Don see past their differences and work together to resolve the issues in a productive way. This allows Mary and Don to see a side of each other they did not know existed, which allows the tensions to subside between the two. This also allows the organization to benefit since Mary and Don appear to be the catalyst for subsequent symptoms appearing throughout the organization. Since much of the information, for diagnosing the situation, came from Mary, Don, and the other people affected by the discord, the diagnosis stage is utilizing accurate data to implement resolutions to the problems. This data is the basis of the intervention and as such it allows Mary and Don to make commitments regarding resolution of their issues. Mary and Don also have a new tool they can use in future meetings and interactions. Other possible interventions may include utilization of process consultations and  team building events. Process consultations focus on the interpersonal relations and the social dynamics between groups. The team building intervention assists groups in working to evaluate their processes as well as establishing solutions to resolve problems. Third-Party Effectivity and Next Steps The third-party intervention is an effective intervention even though not all of the problems were completely resolved; perturbating effects still exist and fuel the discord between Mary and Don. Other issues are still present that need to be resolved throughout the organization. This intervention allows both parties, Mary and Don, to take ownership for the issues that resulted and changes the way they relate and interact with each other. It allows Mary and Don the ability to collaborate in the solutions and accept mutual responsibility for their part in the situation. In addition, they are now able to focus on solutions versus their problems. Although there continues to be some conflict between Mary and Don, they are trying to work through their issues in a productive way. Process consultation should occur to ensure they are still making the needed progress. This method would allow flexibility regarding time commitments for all involved. In addition, repetitive practice in exercising these newly learned behaviors will result in institutionalized behaviors. References Cummings, T. & Worley, C., (2009). Organization development & change. In (Eds.), Mason, OH: South-Western Cengage Learning.