Background:
1. You are the Principal the local Shining Star Elementary School. Your school contains 400 students and is part of a four-school cluster. Your cluster is part of a school district that contains over 100 schools from all levels.
2. You are the emergency manager for this county of over 300,000 people. Your position is to prepare the county for disasters in an area where the worst expected disaster is fire from storms or drought. Wind storms are the next worst expected disaster. Your county is surrounded by counties of equal or larger sizes in a larger city with a population of five million persons. Shining Star Elementary School is in your county.
3. You are the Mayor of a town within the county that contains the Shining Star Elementary School. The city police and fire department work for you.
4. You are the Chairman of the County Supervisors in the county that contains the Shining Star Elementary School. The county sheriff, fire department, health department, and county support offices work for you.
For the four positions you should have: Notified all local Law Enforcement agencies for assistance; established an Incident Command System; and isolated the area.
Scenario:
1. Fires have broken out in twenty-five (25) schools of the district.
2. The City Police and County Sheriff offices are destroyed by explosions.
3. The National Press demands immediate access to the Shining Path Elementary School and whoever is in charge.
4. The group in the Shining Path Elementary School demands all prisoners held in Guantanamo be released within twelve (12) hours or more students and teachers will be killed.
For each of the four positions explain what you would do and expect to happen in the scenario. Consider the following in each of your answers:
1. WHAT ASSETS DO YOU HAVE?
2. WHAT AGENCIES NEED TO BE INVOLVED?
3. WHO DO YOU NEED TO COORDINATE WITH?
4. WHAT ACTIONS CAN YOU TAKE?
5. WHAT NATIONAL AGENCIES SHOULD BE INVOLVED? WHO NOTIFIED THEM? WHAT ARE THEY DOING?
Length: This SLP Assignment should be at least 3 pages not counting the title page and references.
References: At least two references should be included from academic sources listed below(e.g. peer-reviewed journal articles). Required readings are included. Quoted material should not exceed 10% of the total paper (since the focus of these assignments is critical thinking).
Organization: Subheadings should be used to organize your paper according to question.
Required readings:
ATF Home Page, Bureau of Alcohol, Tobacco, Firearms, and Explosives website: Retrieved November 15, 2012, from: http://www.atf.gov/
Brinkerhoff, J.R. (2009). The role of Federal military forces in domestic law enforcement title. US Army Combined Arms Center, Newsletter 10(16), Ch. 11. Retrieved November 16, 2012, from: http://usacac.army.mil/cac2/call/docs/10-16/ch_11.asp
Haddal, C. C. (2010). Border security: The role of the U.S. Border Patrol. Congressional Research Office. Retrieved November 15, 2012, from: http://www.fas.org/sgp/crs/homesec/RL32562.pdf
Vision, mission, core values, and pledge: CDC vision for the 21st Century (2010). Centers for Disease Control and Prevention. Retrieved November 15, 2012, from: http://www.cdc.gov/about/organization/mission.htm
SAMPLE ANSWER
Domestic Terrorism
Scenario One: Fires have broken out in twenty-five (25) schools of the district
The Shining Star Elementary School, being part of a four-school cluster, is relatively well prepared to deal with emergencies that could arise. The same is true for all schools in the district since the standard set in the cluster is the same throughout the district. All schools are equipped with fire fighting equipments including fire extinguishers and hydrants. Additionally, each school has a fire marshal stationed in each school whose primary responsibility it to maintain fire disaster preparedness at all times, assess equipment adequacy and usability state and conduct emergency drills twice every school term. With the reports coming from the respective Fire Marshalls, the disaster preparedness plan is activated immediately. The plan indicates that in the case of a fire, all students after evacuating the premises are to meet at pre designated points for roll-call to determine who is missing.
As the Principal of one of the schools facing a fire disaster, one has to place a call to the local fire department. It will be the responsibility of the local Fire Chief to escalate the incidence after determining its dynamics. It is expected that among the agencies that will respond to this disaster will include, the National Emergency Management Authority (NEMA). Given the multiple locations of the fire disasters, the district fire marshal will take overall responsibility of coordinating all activities and thus becomes the go-to person in case of a need.
As a principal, the immediate action to engage in is to have all students evacuate the premises and assemble at the assembly points for roll call. It is at this point that medical needs will be identified and addressed, while missing students will be known and sort. Given the scale and spread of the fire, NEMA should be involved. Forensic scientists should be involved in order to determine the causes of the fire. The national agencies will be notified and invited by the person in-charge of emergencies in the district (Schmid, 2011).
Scenario Two: The City Police and County Sheriff offices are destroyed by explosions
As the emergency manager of the county, the destruction of the City Police and the County Sherriff office makes this an invasion that affects the core of emergency response in the county. As a result, county resources cannot longer be relied upon to attend to the emerging emergency. Given that the cause of the explosion is not immediately evident; the emergency manager places a call to the State Governor requesting for federal assistance. The Governor will place a call to the President of the Country for federal assistance. This calls set the ground for the deployment of the National Guard – to take care of the enforcement of Law and Order, allocation of Federal resources to assist with the local emergency, deployment of the FBI whose explosives experts should help the cause of the explosive (Haddal, 2010). This revelation will determine the next cause of action. Should it be determined to have been caused by deliberate human action, then criminal investigation will commence immediately. Should the explosion have been caused by natural causes, the reconstruction will commence immediately.
Scenario Three: The National Press demands immediate access to the Shining Star Elementary School and whoever is in charge
The Mayor of a town within the county that contains the Shining Star Elementary School and with command of both the police and fire department, has a responsibility to shield both forces from the prying eyes of the National Press, who can be uncivil in their quest to get the story. This being the case, all information will be shared from one central source – the mayor’s office. Since there are different disaster locations, instructions will be issued to seal-off all the locations and no one apart from authorized personnel should access the sites (Ciment, 2011). Additionally, no emergency worker should talk to the press and all press interactions will be left to the mayor or to whoever the responsibility is designated. As the mayor, a call will be placed to the State Governor for assistance and it is expected that the Governor will in turn place a call to the President seeking Federal aid.
Scenario One: The group in the Shining Path Elementary School demands all prisoners held in Guantanamo be released within twelve (12) hours or more students and teachers will be killed
With the demand coming from the Shining Star Elementary School, it is clear that this is no longer a local problem but has taken on an international dimension. Despite being the Chairman of the County Supervisors with the power to command all the county emergency resources, the situation at Shining Star Elementary School is much bigger and complicated that the local resources are designed to cope with. Given that the situation has clearly degenerated to a terrorism stand-off with demands that border the life or death of the hostages – who include student and teachers, immediately, both the Federal Bureau of Investigation (FBI) and the Central Intelligence Agency (CIA) will be called to the scene and left to determine between the two federal agencies, who will take the lead role (Brinkerhoff, 2009). Additionally, depending on the lead agency, Special Weapons And Tactics (SWAT) teams will be brought into the scene with the clear instruction to prepare for both soft and hard assault of the target and what each plan will entail – both in terms of personnel and possible casualties. Given the epicenter of the action will be at the Shining Elementary School and the publicity generated nationally, after sealing off the school building where the terrorists are, the National Press, will be set up in the playing field with regular briefing being held in pavilion. This should keep the national press and briefing personnel safe while keeping them within the vicinity of the epicenter. Before the federal agencies arrive to take over the situation, the local hostage negotiator will be in-charge off all communication with the captors in an effort to ensure no life is lost while the scene is still under the command of the local agencies.
References
Brinkerhoff, J.R. (2009). The role of Federal military forces in domestic law enforcement title. US Army Combined Arms Center, Newsletter 10(16), Ch. 11 Retrieved November 16, 2012, from: http://usacac.army.mil/cac2/call/docs/10-16/ch_11.asp
Ciment, J (2011). World Terrorism: An Encyclopedia of Political Violence from Ancient Times to the Post 9/11 Era, 2nd Ed, Sharpe Publishers, Armonk, NY.
Haddal, C. C. (2010). Border security: The role of the U.S. Border Patrol. Congressional Research Office. Retrieved November 15, 2012, from http://www.fas.org/sgp/crs/homesec/RL32562.pdf
Schmid, A. P (2011). The Routledge Handbook of Terrorism Research, Routledge Publishing, New York, NY.
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The student is required to cover the required readings and apply the information provided combined with the student’s research to answer the following questions:
1. Explain the advent of Cyber terrorism? What is it? How has it been combated since September 2001? What are the current policies? And, what is being done at a national and international level to combat it?
2. Review McNeal, G. S. (2008) Cyber Embargo: Countering the Internet Jihad. Explain the interface of domestic and international terrorism through the Internet Jihad, its potential impact on domestic security (vis-a-vis the controversy over surveillance within the Patriot Act), and why this is domestic terrorism.
The following items will be assessed in particular:
1. Your ability to apply your understanding past modules into critical thinking concerning Cyber terrorism.
2. Your ability to understand past domestic and international (domestic in their countries) terror groups and relate current capabilities to combat their tactics, vision and goals.
3. In-text references to the modular background readings (APA formatting recommended) and a reference page. Outside background reading sources encouraged and expected.
Length: This Case Assignment should be at least 3 pages not counting the title page and references.
References: At least two references should be included from academic sources (e.g. peer-reviewed journal articles). Required readings are included. Quoted material should not exceed 10% of the total paper (since the focus of these assignments is critical thinking).
Organization: Subheadings should be used to organize your paper according to question
Required readings:
Cyberterrorism: The invisible threat stealth cyber predators in a climate of escalating risk (2010). Foreign Affairs, 89(6), 24A. Retrieved November 15, 2012, from ProQuest.
McNeal, G. S. (2008). Cyber embargo: Countering the internet Jihad. Case Western Reserve Journal of International Law; 2007/2008, 39(3), 789. Retrieved November 15, 2012, from ProQuest
O’Rourke, M. (2010). The real enemy, Risk Management. 57(3), 80. Retrieved November 15, 2012, from ProQuest
Theohary, C. A. and Rollins, J. (2011). Terrorist use of the internet: Information operations in cyberspace. Congressional Research Service. Retrieved November 15, 2012, from: http://www.fas.org/sgp/crs/terror/R41674.pdf
SAMPLE ANSWER
Domestic Terrorism: Cyber terrorism
Cyber terrorism is the act of using computers as weapons or as targets by the politically motivated sub-national or international groups, who end up threatening and causing fear and violence among the people so as to influence them or make the government change its current policies (Arquilla, 2013).
Advent of Cyber terrorism
The public interest in cyber terrorism began in the late 1980’s (Arquilla, 2013). The fear about the millennium bug finely tuned in the year 2000. This is when the potential cyber terrorist attacks also increased. The millennium bug was however not a terrorist attack or a plot against the United States. Instead, it acted as a catalyst to spark the fears of a large-scale devastating cyber attack. On September 11, 2001 there was a high profile terrorist attack in the United States. The states ensuing war on terror led to further media coverage of the possible threats of cyber terrorism in the following years.
How Cyber terrorism has been Combated
Since September 2001, the mainstream media coverage discusses often any possibility of a large attack making good use of the networked computers to damage dangerous infrastructures with the purpose of putting the lives of people in jeopardy or causing distraction on a national scale. Since 2002, security improved following the private sector sharing information with the government regarding the terrorist’s attacks in their private companies. There was an establishment of a Department of Homeland Security (DHS) which attempted to improve the sharing of information (Ferraro, 2014).
Current Policies Regarding Cyber terrorism
Policy makers that face the assessment and targeting of the future cyber threats should address the current and key issues from the multiple perspectives. The policy dimensions of the cyber terrorism include the possibility to discourage other people from resorting to it. Preparedness and prevention is another aspect whereby the sharing of information and establishment of good practices should be of primary importance. This involves the partnerships between the public and the private sectors. At the same time, threats should be detected and responded to via an alert system. This would dramatically increase the timely targeting of attacks. There should also be contigent plans and disaster recoveries in order to mitigate the attacks. Lastly, there should also be a placement of international cooperation and the establishment of active defenses (McCrisken, 2011).
National and International Level to Combat Cyber terrorism
The America’s National Strategy for combating terrorism recognizes that they are at war and that it is their solemn obligation to protect and defend their homeland and the American people. The National Strategy also recognizes that the war on terror is different kind of war since it is both a battle of arms and ideas. They do not only fight the terrorists on the battlefield but also promote freedom and the dignity of the people as an alternative to the terrorists’ wicked vision of oppression and totalitarian rule. Their paradigm to combat terrorism involves the application of all elements of the national power and influence. They do not only employ the military power but also use the diplomatic, intelligence, financial and law enforcement activities for the homeland protection. They also extend their defenses, disrupt the operations of terrorists and deny their enemies what they need in their operation and to survive.
Interface of Domestic and International Terrorism through the Internet Jihad
According to the article, Cyber Embargo, terrorists are occupied in an online jihad. This is characterized by the use of the internet in fundraising, distribution of messages and directives, recruitment and proselytization. It is, however, possible to limit the terrorists’ websites to a particular region, then a modification of current laws can allow the cyber embargo on the jihadists’ websites and their group. Together with the diplomatic cooperation, they are able to curb the impact of the jihadist websites while at the same time increasing the governments’ ability to monitor those websites and shut them down when necessary (McNeal, 2007).
Potential Impact on Domestic Security
Since the internet can be accessed very easily, the number of potential recruits by the terrorists has risen. Websites have provided an instant connection between the terrorists’ recruiters and the most interested sympathizers. Terrorists can then broadcast strong messages to a large audience of viewers. Apart from that, they can use browsers to check language settings and direct viewers to the required site which is customized for language and culture.
Why it is categorized as Domestic Terrorism
Cyber jihad, unlike cyber terrorism, is the information presented on behalf of the terrorist organizations. It can also be used on several activities that support war directly. For example, an expert in cyber terrorism called Joseph Shahda explains that ‘media jihad,’ which is the internet is as important as the battlefield of jihad. Through the internet, terrorist groups set up centers for operation, raise money, spread propaganda and at the same time communicate with ideologies. It provides an inexpensive recruiting tool for the terrorists to win their supporters and members from all over the world.
References
Arquilla, J. (2013). Twenty years of cyberwar. Journal Of Military Ethics, 12(1), 80-87.
Ferraro, M. F. (2014). “Groundbreaking” or broken? an analysis of sec cybersecurity disclosure guidance, its effectiveness, and implications. Albany Law Review, 77(2), 297-347.
McCrisken, T. (2011). Ten years on: Obama’s war on terrorism in rhetoric and practice. International Affairs, 87(4), 781-801.
McNeal, G. S. (2007). Cyber embargo: countering the internet Jihad. (German). Case Western Reserve Journal Of International Law, 39(3), 789-826.
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Cilluffo, Cozzens, and Ranstorp (2010) outline potential problems areas associated with the trend of western nationals going into troubled areas and becoming radicalized. Read this paper and using it with the many sources contained within, answer the following questions:
1. How are terrorist recruiters using target assessment and vulnerability analysis in their selection?
2. What tools do the recruiters use to select targets?
3. Based on the reading, how vulnerable does the U.S and Western Europe remain today to this type of recruitment and utilization? Explain your position.
4. Using the Boyd loop, how would you prepare the steps for counter activities prior to the ACT phase?
Length: This Case Assignment should be at least 3 pages not counting the title page and references.
References: At least two references should be included from academic sources (e.g. peer-reviewed journal articles). Required readings are included. Quoted material should not exceed 10% of the total paper.
Organization: Subheadings should be used to organize your paper according to question.
Cilluffo, F. J., Cozzens, J. B., and Ranstorp, M. (2010). Foreign fighters: Trends, trajectories, and conflict zones. The George Washington University, Homeland Security Policy Institute. Retrieved November 20,
Terrorism is the premeditated use of threat by subnational groups or even individuals to use violence against noncombatants with an aim to obtain social or political objectives trough the intimidation of a large audience. Terrorism can be categorized as transnational or even domestic events, whereby domestic terrorism involves homegrown terrorists, who in most cases are trained at home and even financed there. On the other side transnational terrorism occurs when victims, governments, institutions, perpetrators of more than two countries are involved example the hijacking incidences. Investigations have been conducted to be able to discern the cumulative aggregate patterns of the terrorists over a long period whereby terrorist threats have changed over time (Brandt & Snadler, 2009). Along the perimeters of the government buildings, improved barriers were placed in order to minimize damage from the car and truck bombs thus; bomb sniffing devices were also installed at airports after on-board bombs brought down planes.
According to Brandt and Sandler (2009), terrorists are known to use the target assessment and vulnerability analysis in their selection process to improve their chances of success during their strikes. In addition, Hoffman (2006) supports that most of the latest terrorist attacks have been more successful than the past attacks due to initial target assessment that is designed to eliminate any possible errors. Moreover, the terrorist are likely to strike the most vulnerable groups with more a valuable price. With this regard, attacks on private parties have increased over time since they provide soft targets that favor their vulnerability analysis (Cilluffo, Cozzens, & Ranstorp, 2010). Terrorists are known to choose among their targeted groups to maximize their expected utility or even payoff since the average cost per incidence is constant and not dependent on the number of attacks. A state should not favor one type of target since this will increase the incidences against the target class and terrorists may take advantage of this. Terrorists who pose high political demands to the government, they become more publicly known for their cause of actions. If granted their political demands the terrorists may reduce the number of attacks against their target group and in turn they increase the number of attacks on a relatively cheaper other types of targets.
According to Brandt and Sandler (2009), there are many types of tools used by the terrorists such as bombs, non-aerial hijackings, skyjackings, hostage seizures, barricade and kidnappings which are regarded as the best weapons by the terrorists to their target groups. Nature of victim is a tool that terrorists use to select their targets and it helps them identify whether the attack only involves property or involves people alone. More missions against people rather than property are being completed as planned for all target types owing to relative considerations since their vulnerability is always high. Logistical success is another tool used by terrorists in selecting their target and this is done by securing one or more hostages in a kidnapping or even they may decide to plant a bomb that will later explode (Hoffman, 2006). Target classes, especially military and the officials are now allocated more security as we also anticipate to see a reduction in terrorist attacks on them. There are various media tools used by the terrorists in selecting their targets and these tools include: YouTube, Facebook, blogs, twitter, message boards, audio recording, DVDs and websites (Brandt & Sandler, 2009). These tools are known to provide figures that can bridge and relate to social subgroups in a comfortable medium that is well understood by the targeted audience.
The United States and Western Europe are vulnerable to the terrorist recruitment and utilization due to their deployment of their fighters in the Middle East regions which is the bedrock of terrorists. In addition, the stationing of their troops in Islamic countries has greatly fueled the mobilization of Muslim fundamentalist that are determined to advance the terrorism ideals. The western military involvement while tackling terrorists also continue to award them more sympathy, especially from the Muslim community who feel that they are being targeted with by the west. Moreover, there is a very high presence of social media in the west and the terrorist use such media to source for cheap recruits to advance their ideals (Cilluffo, Cozzens, & Ranstorp, 2009). Therefore, the United States and other western countries are highly vulnerable to terrorist activities.
In order to counter the terrorist activities, the western countries first need to fully understand the operations of the terrorism threats, both at the tactical and strategic level. The law enforcement and the intelligence services should be properly equipped with tools and technologies that can help them deal with the terrorists. Moreover, the western countries should heavily invest in counter-radicalization efforts that are effective enough to destabilize all the radicalization threats (Brandt & Sandler, 2009). Moreover, the west should not overlook the opportunities to infiltrate the jihadist networks and pay a close attention on how such networks utilize homogenous groups of foreign fighters.
References
Brandt, Patrick T., and Todd Sandler. 2009. Hostage taking: Understanding terrorism event dynamics. Journal of Policy Modelling 31 (5):758-778.
Cilluffo, F. J., Cozzens, J. B., and Ranstorp, M. (2010). Foreign fighters: Trends, trajectories, and conflict zones. The George Washington University, Homeland Security Policy Institute. Retrieved November 20, 2012, from: http://www.gwumc.edu/hspi/policy/report_foreignfighters501.pdf
Hoffman, Bruce. 2006. Inside terrorism: Revised and expanded Ed. New York: Columbia University Press.
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Meaningful Use for Nurses:
Implications and Recommendations
Guidelines with Scoring Rubric
Purpose
This assignment is designed to help students
• understand the implications for nurses, nursing, national health policy-making, patient outcomes, and population health associated with the collection and use of Meaningful Use core criteria.
Course Outcomes
Through this assignment, the student will demonstrate the following ability.
(CO 3) Examine the ethical/legal issues arising in NI practice while using, designing, managing, upgrading, and building information systems. (POs 4, 6)
Total Points Possible: 325
Requirements:
Provide an overview of the Meaningful Use program and an analysis of the implications for nurses, nursing, national health policy, patient outcomes, and population health associated with the collection and use of Meaningful Use core criteria. Recommend additional core criteria not presently identified for Meaningful Use collection in Stages 1 or 2 (lists of criteria may be found at cms.gov) that you feel would be beneficial for nurses, nursing, monitoring population health, setting national health policies, and/or improvements in patient outcomes or population health, providing your evidence for your recommendations. If you feel that no additional criteria are necessary, provide your evidence-based rationale for your argument. Conclude with insights gained from this assignment. A minimum of three outside scholarly resources are required—texts may be cited but are NOT included among the minimum of three outside scholarly resources.
PREPARING THE PAPER
1. Required texts may be used as references, but a minimum of three sources must be from outside course readings. No older than 5 years (preferably Scholarly Journals and peer reviewed)
2. All aspects of the paper must be in APA format as expressed in the 6th edition.
3. The paper (excluding the title page and reference page) is 5–7 pages in length.
4. Ideas and information from professional sources must be cited correctly.
5. Grammar, spelling, punctuation, and citations are consistent with formal academic writing.
SAMPLE ANSWER
Meaningful Use for Nurses
The healthcare system has been marred with several human errors that have led to the blame game within the system. Efforts have been made to achieve a culture of safety that protects patients from harm that has been caused by the care givers. Attempts such as patient centered care have been developed to the global goal of safety in health care. As such, exhaustive research of American Recovery and Reinvestment Act (ARRA) 2009 guaranteed that no high-quality health care will be realized without proper documentation of health records of patients (Chesnay & Anderson, 2012). Together with other institution of health care such as Health and Human Services attempts have been put to realize the goal of safety culture in health care is achieved. Therefore, by July 2010, these organizations issued Meaningful Use that is mandated to improve safety, quality, coordination, efficiency as well as engaging families and patients in electronic communication and recording of patients’ status. Therefore, the implementation of Electronic Health Recording (ERH) is one of the core factors of realizing the safety of individuals. A presentation of this paper gives an overview of Meaningful Use through HER and the implication it has on the health care system. The paper also identifies some of the recommendations for its full implementation.
Technology is the core factor that keeps individuals connected irrespective of where they are; hence, its usage in health care system becomes very important. Transferring health records and communication between the medical officers has been done using fax, emails, and phones (Chesnay & Anderson, 2012). However, through technology and serious concern of safety health care, there has been an attempt to use the electronic health records that is believed to be very efficient hence will reduce the occasional errors in health care system. The meaningful use is the set of standard that is developed by the center for Medicare and Medicaid services (CMC) which is mandated on paying providers who have achieved set criteria that are related to the meaningful use of technology to improve safety culture that finally improve patient care. ARRA act of 2009 signed this act into law that included funding the health information technology with $17 billion to physicians who have already adopted the use of EHRs (Chesnay & Anderson, 2012). The issue of funding this program aims at motivating institutions that have already employed the use of EHRs and encourage those who have not used the program.
The use of electronic health recording was aimed at achieving five goals according to health information technology and ARRA. First, it aimed at improving the quality, efficiency and safety of care as well as reducing the preventable disparities. Secondly, to engage both the patients and families in the process of health care. Third, is to facilitate and promote population and public health and improve the outcomes within the institution (Narcisse et. al., 2013). Additionally, it aimed at improving the coordination of medical officers and nurses within the health care. Lastly, this program is to promote the security and privacy of electronic health records since it is more secure than the old methods.
The meaningful use criteria were set to evolve over the next five years in three stages. The first stage is known as the data capture and sharing stage. It involves: capturing health information electronically and in a standardized method; using the information captured to track the key clinical conditions; communicating the found information for coordination processes; initiating clinical quality measures and health information; and using that information to engage the family and the patients in their care. The second stage, which was set to start in 2014, is known as advanced clinical process, which deals with health information exchange and increased need for e- prescribing and incorporation of lab results. The stage also deals with electronic transmission of summaries across several settings and more patient data. The final stage of the program, which is set to begin on 2016, is known as improved outcomes. Its main objective is to improve quality, efficiency, and safety that lead to improved outcomes.
From doctors to patients and everyone in between, the meaningful use will be of importance to change the way individuals’ documents materials. In order to meet the criteria developed by the CMS serious documentation is needed for everybody involved in patient care. The implication of meaningful use includes:
Impact of meaningful use on patient outcome will be very positive. The patients will have access to their health information through enhanced collaboration and engagement with their providers. This will also make the patient receive electronic reminders on follow up care of their health information. At the end, the patients experience the positive changes on how they interact with the system. According to CMS, about 190 million prescriptions have been done by electronic prescribing eRx, and 13 million patients receive reminders through electronic reminders (Halimi & Bassi, 2012).
Meaningful use are focused on helping nurses and doctors to make informed decisions, deliver good care, and create great efficiencies. These tools have prevented duplicative tasting, elimination, drug reactions, and have enhanced provider collaboration. Therefore through the use of the meaningful use the nurses and doctors have performed extremely well with minimal errors. For example in clinical lab results, about 458 million were entered into the system by 111,954 Eps and about 4.3 million transitions of care summaries were seen(Narcisse et. al., 2013). Because many lab results were entered into EHRs, millions of reconciliations were done, and millions of transitions of care sums were created, providers across the countries were also able to access much of the information about their patients, enabling them to give the right care at the correct time.
For national agency and public health, Stage 1 meaningful use menu objectives have encouraged providers to send several data to public agencies and numerous immunization registries. Stage 2 is believed continue to motivate the transmission of data to public health agencies and registries to inform care policy decisions making, drive perfect practices, and motivate the nation’s public health care. According to CMC Immunization registries received as a minimum of one test data compliance from 69,474 EPs. This information is transferred to the national health agency which can be used to manufacture some vaccines and know the trend of some diseases such as polio. Additionally, Syndromic Surveillance Data Submission also received a minimum of one test data compliance from 12,298 EPs (Halimi & Bassi, 2012). This shows that the system improves the care of patient even in places that they are not present hence their effects is really shaping the health care system from a blame system to a safety culture system.
For nursing, the system will help to make the public and patients believe that the nursing system and the entire health care system have improved by nurturing the safety culture. As such, that lost trust of continuous error will be regained. Thus, the entire health population will have the faith to believe that nursing sector is no longer a home to harm patients rather a place that foster the life of the sick. Halimi and Bassi (2012) note that when the trust is built, the entire population will believe on the nursing system.
One of the recommendations is that there should be a delay of stage two so that stage one is implemented fully. According to American Academy of Family Physicians (AAFP) the members cannot be able to handle the key factors that are needed for complying with stage two of the program by given deadline as at now. The factors include implementation, product services, training, and support. Therefore, it is important for the ARRA to extent the time frame of the initiation of the second stage so that the first stage is implemented fully using the required key components.
To implement this program fully until the final stage, there should be ease of meaningful requirements. Narcisse et al. (2013) say that the requirement of the system is over burdensome. He suggests that the possible way to move the program forward is to ensure that all providers are not left behind; especially, the small ones and the rural ones should participate too. The American hospital association suggested that the providers to meet the stage one by using 2011-certified or the 2014-certified, establishing a reporting period of 90-day in the first year of new stage for all providers, offering flexibility of the implementation for all providers, and extend each stage by at least 3 years since the program is not an easy one to employ.
The associations and ARRA should reconsider the penalties imposed on the physician when they happen to fail to perform their duties of implementing the program. Physicians are already having difficulties meeting the core and noncompulsory meaningful use measures in stage 1. Therefore, they will experience much difficulties in the proceeding phases especially the third phase of this program. According to organized medicine groups associations, the proposal would closely double the number of actions that the practices must meet for eligible patient happenstance to prevent Medicare penalties (Halimi & Bassi, 2012). Any failure even to meet one of the measures by about 1% would make physicians ineligible for enticements and experience the similar financial penalties at the penalty phase as the physicians who had not made any effort to practice EHRs.
Following the discussion herein, the push towards a safety culture in health care system has been the goal for the institution. Following research by various health care organizations, it was found that patient history recording and other documentation are vital factors to ensuring a healthy culture and safety in the health care. Therefore, the center for Medicare and Medicaid services (CMC) proposed use of EHRs to record information of the patients. The main aim of this program is to improve quality, efficiency, and safety that lead to improved outcomes. The program has three stages that were started in the year 2012 and are set to end in the year 2016. This system has impacted the outcome of patient by making the patient part of the care making them engage and contribute about their condition. It has also made the nurses and the providers to have informed decision-making since the system is accurate. Having known that the nurses are performing relatively well, the public have also gained a lot of trust on the nursing institution as a whole. The public and health care agencies have also received the information and the data have been used for immunization. However, there are some recommendations that should be looked at for proper implementation of the program. There should be low penalties on physicians who have not cooperated, the requirements too should be relatively easy, and there should be extension period before the second stage starts.
References
Chesnay, M., & Anderson, B. A. (2012). Caring for the vulnerable: perspectives in nursing theory, practice, and research (3rd ed.). Burlington, MA: Jones & Bartlett Learning.
Halimi, M., & Bassi, S. (2012). What does “meaningful use†mean for perioperative nurses?. OR Nurse, 6(4), 8-11.
Narcisse, M., Kippenbrock, T. A., Odell, E., & Buron, B. (2013). Advanced Practice Nurses’ Meaningful use of electronic health records. Applied Nursing Research, 26(3), 127-132.
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Progress Report/Information Report.
Weighting: 20%
Each member will be allocated a phase of the Marketing Project and will provide a progress report on that particular phase.
The assignment acts as a progress report of the final project to demonstrate understanding of the relevant Phase of the Group Marketing Project and as such detailed feedback will be provided by tutors.
You are required to complete an analysis of the marketing strategy of our Client Partner – Price Waterhouse Coopers, focusing on the particular marketing issue (what does PWC look like in 2-5 years?) related to the organisation. Blue Ocean Strategy (BOS) will be applied to the marketing issue and the framework provided by BOS used to formulate a marketing solution supported by other marketing concepts and analytical tools.
The analysis must demonstrate:
(a) understanding of the predominant marketing systems in the Client Partner industry
(b) the potential to develop ‘blue-ocean’ strategies for the Client Partner
(c) application of the analysis to the Client Partner.
Report Phase 3 – Supply Conditions and Intermediaries, Environment and Observers
Supply Conditions including for example:
• What are the conditions for supplying the product? Number, type, size and location of direct and indirect competitors supplying the product or service (including both domestic based and international import suppliers) i.e. What are the supplier alternatives?
• What is the concentration or lack of concentration of ownership and trends in supply. Use Supplier Power analysis from Porter’s 5 Forces.
• Nature of value creation and delivery system linking producers and consumers for this type of product or service (including channels of distribution, key input suppliers, key complimentors and other relevant intermediaries that impact on the cost of the product)
• Government actors involved and their role
• Environmental Impacts on Supply – contraints and enablers: Including, socio-cultural, economic and material environment, regulations, technology, and relevant infrastructure (transport, communication, finance etc)
• Any marketing models or frameworks applied to the supply conditions you consider appropriate.
• Use appropriate Blue Ocean Strategy theory and models to evaluate the supply conditions. (See Appendix 3 for Model and Chapter Table)
Intermediaries, Environment and Observers
• Nature of Intermediaries (e.g. distributors, transportation, logistics, warehousing, retailers) predominant in the industry and their role.
• Industry Observers Outside the Firm and Service Organisations and their influence/role such as: Industry Studies, Unions, Business Press (BRW), Local Org. Chambers of Commerce, State Governments, Federal Government, Domestic Trade Bodies/Statistics and International Organisations, e.g. OECD; World Bank, etc. Service organisations such as trade associations, investment banks, consultants, advertising agencies, etc
Suppliers and Intermediaries
(Supply Side) Other Marketing Frameworks
– Relevant macro level impacts on industry competition (PESTL)
– Porter’s 5 Forces: Supplier Power
– Porter’s Value Chain
SAMPLE ANSWER
Price Waterhouse Coopers Supply Side Report
In this paper, I propose an analysis of the marketing strategy of Price Waterhouse Coopers (PwC) that focuses on the particular marketing issue – that is, what PwC would like in the next 2 to 5 years – related to the organization. The supply conditions, intermediaries, the environment and observers are analyzed exhaustively. PESTL and Porter’s Supplier Power are described pertaining to PwC’s supply side. The Blue Ocean Strategy (BOS) will be employed to the marketing issue and the framework provided by BOS used in formulating a marketing solution supported by other concepts and analytical tools.
1.0 Supply Conditions and Intermediaries, Environment and Observers
PwC is an international professional services network, and it is currently the second largest professional services network in the world as measured by its revenues of the year 2014. Along with Ernst & Young, KPMG, and Deloitte, PwC is one of the Big 4 auditors worldwide (PwC 2014). With regard to the conditions for supplying the service – auditing, tax, advisory, and consulting services –, the main competitors to PwC include KPMG, Deloitte, and Ernst & Young. Out of four biggest auditors in the world, Deloitte is the largest. In the year 2012, the world revenue of Deloitte was $32.4 billion; PwC had aggregated gross revenues of $32.09 billion; Ernst & Young had combined revenue of $25.83 billion; and in the fourth place was KPMG with worldwide revenue of $23.42 billion (Saito & Takeda 2014, p. 205).
Deloitte, KPMG, and Ernst & Young are each a network of firms, and they are managed and owned independently. They have entered into accords with other member companies in the network to share common quality standards, brand and name. Each of these networks has created an entity for co-coordinating the network’s activities. In most instances, these 3 major competitors to PwC have member firms in countries all over the world. Deloitte, KPMG, and Ernst & Young have separate legal entities in India, Europe, Americas, Africa, the Middle East, as well as the Asia-Pacific region in countries such as Japan and Australia. (Strahler 2013, p. 19). As such, Deloitte, KPMG, and Ernst & Young are the main direct competitors to PwC not only nationally in Australia, but also internationally. Besides these three main competitors, PwC also faces direct competition from many small auditing firms nationally and this impacts on PwC’s financial bottom-line.
Effectual value creation and delivery is marketing that PwC requires considering highly towards achieving the set 2-5 years development policy. For a lengthy period of time there has existed a disconnection between ways in which PwC creates services value along with ways in which the consumers receive the same value. The company needs to bridge the gap between value creations through a number of strategies: firstly, PwC must ensure the attainment of the brand promise at all times, that is, matching the marketing slogans to the firm’s service delivery (Voima & Grönroos, 2011. Secondly, the proposition price, this regards what the consumers have to pay to acquire the service. Thus, PwC should ensure that the service provided is equal if not better than the pay: this is an effectual marketing strategy.
The 4P marketing strategy is an additional aspect that PwC requires to adopt, that is product, promotion, place and price. Certainly, 4P marketing has been able to impact positively when used along with other marketing methods. PwC by recognizing the information asymmetry within the value creation channel will enable it market its services in an efficient manner. Giving the consumer value for their money must remain core to the firm’s marketing policies: this is because consumers are known to be best in comparing notes, ultimately promoting the best services provider between the many (Voima & Grönroos, 2011. Additionally, PwC must move with the evolving marketing strategies work towards adopting and investing heavily internet advertising. Internet advertising should involve ad placement on the trendy business corporate sites to capture and market the services online.
There many fairs organized by companies in Australia and other nations, addressing issues from sustainability to corporate investments. These form some of the mostly important avenues that a company such as PwC has to participate in to sell its services and smartly outdo its competitors.
Increasingly, individuals are looking out for companies that are sustainable in their operations. This includes companies that offer services and who for long have done little in addressing the sustainability subject and practice: PwC as a marketing and promotional strategy needs to participate and lead in promoting a sustainable environment. This can be done through procuring sustainable equipment and materials that are used within the firm as well as participating in community environmental sustainability projects: this presently forms a major marketing strategy (Chimhanzi & Morgan, 2005). Additionally, suppliers have been known to affect the company’s reputation therefore PwC require partnering with ethical suppliers and who are certified as a way to maintain and promote the firm’s reputation. In so doing the supplied material and equipment utilized in offices will be sustainable, durable and dependable to enable efficient service delivery, which will market the company.
Competition in every industry is inevitable. Despite the fact that PwC rates second in terms profitability, it enjoys presence diversity in many nations. In the approaching 2-5 years period the firm should aim penetrating other markets within the globe, bettering the services in the available markets and clients (Chimhanzi & Morgan, 2005. The existence of the company in numerous nations indicates its strength, which requires to be used as a marketing channel to clients within those nations’ economies’ as well as the regional economies.
Government is the major regulator in all the activities concerning every firm. The state has put in place laws requiring companies to deliver quality services to the end consumer. In order for PwC to maintain the good relations with the regulator it requires adopting measures pointed towards self regulation: self regulation to the authority places the firm at highly esteemed position. This is a wonderful position to take geared towards preparations for the approaching expansion period. In addition conforming to the rules and regulations, is a marketing strategy since when the ratings of the best firms that conform to the state’s standards are produced PwC will rank among the highest.
The main environmental impacts on supply consist of regulations, economic, socio-cultural environments. Accounting firms and auditors face market discipline that works towards a decreased likelihood of future accounting scandals. The Auditing and Assurance Standards Board develops guidance and standards for auditors and accountants. The regulations set by the Australian Securities and Investments Commission must be observed which are intended to ensure that Australia’s fiscal markets are transparent and fair, supported by informed and confident consumers and investors (Francis, Michas & Yu 2013, p. 1629).
Technology and especially the mass media have been a great enabler and platform towards attaining marketing aspirations. PwC has wide range of prospective channels that can be used to channel marketing messages from the internet to the mass media. Mass media forms one of the mainly popular avenues of advertising, this is because it reaches numerous individuals inclusive of corporate members. Presenting the firms strategies and achievements on mass media is a great strategy to the catch the eye of the prospective clients (Chimhanzi & Morgan, 2005. The company within its planned expansion and growth plan requires preparing towards conforming to the socio-cultural environments in various parts of nation and the globe as a whole. Some of the firms within the nation originate from diverse nations which observe their cultures even within the company operations. As marketing strategy PwC should market its capability towards observing and respecting cultural components of the firms whilst delivering its services. Taking into account the firm will require to penetrate other global markets, preserving the local cross cultural perspective’s is good marketing strategy which will guarantee continued existence within the said nations.
Blue Ocean Strategy (BOS) theory
This theory postulates that there are unexploited markets as well as the opportunity for higher growth without having to eat away at the competitors’ profits. Competition is not relevant according to the Blue Ocean Strategy, since the rules of the game are yet to be laid down. With supply being more than the demand in many industries, to compete for contracting markets would not be adequate in sustaining high performance (Kim & Mauborgne, 2005). With the use of BOS, PwC can be able to succeed not by fighting with the competitors in the marketplace, but through the creation of blue oceans of uncontested market space. Such strategic moves would lead to a leap in value for Price Waterhouse Coopers, its staffs, and clients, whilst unlocking new demand and rendering the competitors irrelevant.
Blue Ocean Strategy eliminates the customary corporate fights regarding particular clients. For an advanced company like PwC, marketing should be more responsible and innovative, BOS extends this provision. The back and forth wars results in wastage of resources which could be used effectively in exploiting the untapped areas or industries. Further, in order to ensure a national presence and extend a considerable impact PwC can exploit the lower end firms and offer attractive and competitive services. The lower end firms are a sector that has been disregarded by numerous multinational auditing firms such as the PwC’s competitors making a valuable strategy for consideration. The BOS theory can aid the firm in identifying areas of opportunities in the developing markets especially in Africa and Asia. PwC’s can use this as growth strategy towards penetrating these markets to offer the ever increasing demand for audit services (Kim & Mauborgne, 2005). It is true that particularly African market has been underutilized and PwC could take this advantage and make its way to the inadequately serviced nations.
2.0 Intermediaries, Environment and Observers
Nature of Intermediaries
The role of the intermediaries in marketing strategies and maintaining marketing strategies is enormous. The employees of the firm are the distributors of the PwC’s services: distributors play an important role in marketing the service in question. The staffs are able to market the firm through portrayal of ethical and responsible auditing practices. For PwC to ensure the staffs are good marketers they require to be equipped through necessary training to instill the required conduct as well as enlightening them with issues regarding ethical auditing regulations. Logistics would involve delivering the service to the client in most satisfying and timely manner. Despite the fact that these are services, the delivery channel needs to show vigilance and efficiency. The service must be delivered at the agreed upon period and price. This is a good marketing strategy which will retain the current clients and induce the prospective ones.
Industry Observers Outside the firm
There are several organizations that have a considerable influence to the auditing industry in Australia. The Australian Securities & Investments Commission (ASIC) administers the requirements of the Corporations Act as it pertains to auditor independence as well as audit quality. ASIC’s audit oversight activities assist with maintaining and raising the standard of conduct in the profession of auditing. It is of note that whilst these activities have both a compliance and educational focus, enforcement action could be taken when considerable non-compliance is identified (Australian Securities & Investments Commission 2014).
The other industry observers are the Australian and Assurance Standards Board and Australian Auditing Standards, which set the requirements and offer application on other explanatory material regarding: (i) the form as well as content of the auditor’s report. (ii) The responsibilities and duties of an auditor when engaged to carry out an audit of a fiscal report, or complete set of fiscal statements, or any other historical fiscal information (Auditing and Assurance Standards Board 2014). Another industry observer is the Australian Accounting Standards Board (AASB), a statutory, independent agency with the responsibility of creating standards and guidance for auditors as well as providers of other assurance services. The Australian Financial Security Authority (AFSA) administers and regulates the proceeds of crime, personal insolvency system, and trustee services. The Financial Reporting Council (FRC) provides board oversight of the process for establishing standards of accounting in Australia (Australian Government 2014).
PESTL
A scan of an organization’s external macro-environment may be described in terms of Legal, Political, Economic, Technological, Environmental, and Social factors (Porter 1998).
Political: at present, there is political stability in Australia and in a lot of other countries in which PwC operates in, and this is favorable to PwC and other auditors.
Economic factors: the economic growth in Australia was 2.8% in 2013 and the rate of inflation is 3% (World Bank 2014). This is favorable to PwC and other auditors since it illustrates that there is a growing market and opportunity of the services offered by PwC.
Social factors: in terms of demographics, Australia has a population of about 23.13 million, with 89 percent living in suburbs, cities and other urban areas as of the year 2014. The rate of population growth is currently 1.4 percent, and the education level in the Australia is very high (World Bank 2014).
Technological factors: technology has a substantial influence and impact on auditing. The incessant evolution of software and hardware provides auditors with the capacity to do more complex calculations with greater accuracy, speed, ease and mobility. Now, auditors can speedily collect data, produce reports, and explicitly communicate the results (Montgomery 2010, p. 50). Some of the new technology available to auditors includes IDEA from CaseWare IDEA Inc., and ACL from ACL Services Ltd, which are software programs for data mining and data extraction.
Legal factors: these include consumer protection, rules on monopolies and mergers, international trade regulations and restriction, as well as national employment laws in Australia and in other nations around the world wherein PwC operates in. In Australia, PwC must pay its workers no less than the stipulated minimum wage of $16.87 per hour or $640.90 per week as mandated by the Fair Work Commission (Montgomery 2010, p. 42). Auditors must also comply with the regulations established by the government and government bodies such as the Australian Securities and Investments Commission, and the Australian Accounting Standards on auditing quality, standards, and integrity.
Porter’s 5 Forces: Supplier Power – Low
In Porter’s 5 Forces, the supplier power is understood as the pressure that suppliers can exert on business organizations by raising the prices (Gurau 2007, p. 380). At present, the bargaining power of suppliers is not a significant force in such a fragmented industry. Essentially, universities are suppliers considering that nearly all employees in this market come out of business schools. The auditing firms can obtain workers from the many universities and business schools across Australia, and therefore this makes the supplier power to remain low.
Cooperative strategies
The three top competitors of PwC have established cooperation with customers and suppliers in Australia and in many other nations the world over. Ernst & Young, KPMG and Deloitte all work with various universities and business schools, which supply the firm with employees.
Environmental factors affecting competitive and cooperative strategies
The key environmental factors that affect competitive as well as cooperative strategies include state and national governments and regulations considering that policies established by the government can enhance or impede competition strategies and cooperation strategies. All the competitors in this industry must observe the ASIC, and AASB standards, rules and regulations. The companies in this industry take into account the Blue Ocean Strategy and understand that there are unexploited markets as well as the opportunity for higher growth without having to eat into the profits of other players in the industry. KPMG, Deloitte, Ernst & Young have been able to succeed not by fighting with each other and other auditors in the marketplace, but through the creation of blue oceans of uncontested market space (Kim & Mauborgne 2005).
5.0 Conclusion
In conclusion, regarding the conditions for supplying the service – auditing, tax, advisory, and consulting services –, the main competitors to PwC include KPMG, Deloitte, and Ernst & Young. Each of these networks has created an entity for co-coordinating the network’s activities both in the Australia and in more than 150 nations globally hence they are PwC’s competitors both nationally and globally. The main industry observers are Australian Accounting Standards Board, Australian Prudential Regulation Authority, and Australian Securities and Investments Commission. The competitors have partnered with suppliers and clients including universities and business schools across Australia. By using Blue Ocean Strategy, PwC can be able to succeed not by fighting with the competitors in the marketplace, but through the creation of blue oceans of uncontested market space.
Australian Securities & Investments Commission 2014. Financial Reports & Audit: For Auditors. Available at http://asic.gov.au/auditors (Accessed October 14, 2014).
Chimhanzi, J., & Morgan, R. E. 2005, Explanations from the marketing/human resources dyad for marketing strategy implementation effectiveness in service firms. Journal of Business Research. doi:10.1016/j.jbusres.2003.11.003
Francis, J, Michas, P, & Yu, M 2013, ‘Office Size of Big 4 Auditors and Client Restatements’, Contemporary Accounting Research, 30, 4, pp. 1626-1661, Business Source Complete, EBSCOhost, viewed 12 October 2014.
Gurǎu, C 2007, ‘Porter’s generic strategies: a re-interpretation from a relationship marketing perspective’, Marketing Review, 7, 4, pp. 369-383, Business Source Complete, EBSCOhost, viewed 12 October 2014.
Kim, W, & Mauborgne, R 2005, Blue Ocean Strategy : How To Create Uncontested Market Space And Make The Competition Irrelevant, Boston, Mass: Harvard Business School Press, Discovery eBooks, EBSCOhost, viewed 12 October 2014.
Montgomery, A 2010, ‘Price Waterhouse Coopers shrinks to PwC’, Design Week Online, 2010, Business Insights: Essentials, EBSCOhost, viewed 12 October 2014.
Murray, AI 2008, ‘A Contingency View of Porter’s “Generic Strategies”‘, Academy Of Management Review, 13, 3, pp. 390-400, Business Source Complete, EBSCOhost, viewed 12 October 2014.
Porter, M 1998, Competitive Strategy. New York: Free Press.
Robson, GS., & Roseman, GH 2009, Is Government Regulation of Auditors Redundant? Boca Raton, FL: Penguin Publishers.
Saito, Y, & Takeda, F 2014, ‘Global Audit Firm Networks and Their Reputation Risk’, Journal Of Accounting, Auditing & Finance, 29, 3, pp. 203-237, Business Source Complete, EBSCOhost, viewed 12 October 2014.
Strahler, SR 2013, The Big Four’s New Math, Crain’s Chicago Business, 36, 40, p. 0019, Regional Business News, EBSCOhost, viewed 12 October 2014.
the Case Study title is ‘Call centres in the financial services sector—just putting you on hold…’.
After reviewing your assigned reading and the information presented in the case study, answer the following questions:
1. Identify and assess the key HRM issues at UniCall.
2. Recommend and justify HRM interventions that would improve business performance.
SAMPLE ANSWER
UniCall
Key HRM Issues at UniCall
Human resource professionals are often involved in making key personnel decisions/resolutions in organizations of all sizes. These individuals are in charge of implementing ongoing trainings of workers in different areas within companies. Since human resource professional are always in the management of employees with various qualifications and from various backgrounds, they often face several issues that need their attention (Marie, 2012). In relation to this, UniCall happens to be faced with several HRM issues. These issues are related to personnel and training issues.
One of the personnel-related issues that often present significant problems to HR professionals is the need to identify and recruit qualified and competent workers. Some of the organization’s employees seem to be incompetent, thereby highlighting the fact the firm’s HR has not been active in the identification and recruitment or appropriate workers (Ferndale, Paauwe & Boselie, 2010). For instance, consumers have been noted to present complaints concerning the aspect of rudeness on the part of the company’s staff. This rudeness is linked to issue of inflexibility of the firm’s staff when handling complex account-related matters. In addition, the aspect of incompetency on the part of the firm’s employees is evidenced by all of them giving similar responses to consumers when called upon. As such, it is clear that UNiCall’s HR department lack suitable mechanisms of identifying and hiring competent workers who can address consumers’ problems in various ways. Moreover, UniCall’s HR department also faces the problem of
UniCall’s HR department also faces training-related issues. Prior to the opening of UniCall, UniBank focused on the provision of financial and personal banking services to small businesses and individual consumers. UniBank decided to venture into the telephone banking sector following the increasing commercial success of organizations that operate in the field of direct line banking. As a result, UniBank opened UniCall, and redeployed some its works to the new business, UniCall. Employees that were redeployed in UniCall lacked skills that were required to handle issues in this business, thereby subjecting the firm to its current problems. For instance, some of the company’s staff members face problems using the computer system. These employees cannot manage to retrieve accurate information concerning simple enquiries. Besides, they cannot retrieve accurate information concerning the durations taken by interrogations. Moreover, these workers face problems handling the firm’s monitoring systems, which measure the duration and number of various types of call. As such, the inquiries that are related to direct debit arrangements and standing orders take an extra of 50% of the time required for them to be completed. In addition, some of the redeployed workers are not satisfied with their job as they argue that it is too impersonal.
It is also clear that the management of UniCall’s HR department is facing issues handling their employees in that they seem to embrace the transactional form of leadership. This form of leadership seems to emphasize on intense supervision and directive measures as seen in the case of UniCall. As result, most employees in this organization are not empowered to execute even simple operation on their own as they have to receive directives from the call center. Moreover, the aspect of constant surveillance has led to resentment on the part of employees, which in turn has made them develop informal ways of executing their duties (Anca-Ioana, 2013). Moreover, the firm’s management has not established appropriate systems that can be employed in motivating employees and recognizing workers’ skills. This deficiency has led to discontentment on the part of younger employees who are inclined towards seeking employment in other firms in the industry. In addition, these employees argue that the firm’s pay structure does not take their skills into consideration, thereby subjecting the company’s HR to compensation issues.
HRM Interventions for Improvement of Business Performance
Addressing HRM issues is significant in ensuring that businesses lay robust foundations for organizational growth. UniCall’s HR department should focus on suitable ways of addressing the personnel, training, compensation challenges that it is facing.
The Company’s HR department should engage in active search of sources of potential employees. This undertaking will help the HR department end the problem of incompetency on the part of its employees. Some of the sources of potential workers are employee referrals, recruiters, networks and associations, headhunters, and temporary agencies (Armstrong, 2009). Moreover, the company’s HR department should involve in an active running of advertisements on job websites and newspapers in order to attract competent workers. The firm’s HR should also focus on developing a suitable action plan, which is aimed at attracting competent workers.
UniCall’s HR should implement reward-based programmes, which should be directed to employees and managers. Reward-based trainings have been noted to be suitable motivators to employees. These training should focus on equipping workers with adequate technological skills that are required to handle the company’s computer systems and other technology-based activities. Furthermore, the HR should also conduct a separate training on its supervisors and managers on aspects of good leadership, which is vital in creating suitable leader-employee relationships (Shaw, Park & Kem, 2013). This undertaking is significant in ensuring that employees and managers/supervisor communicate in a suitable way. As a result, employees can manage to present issues affecting them to the management, which in turn can end issues such as informal execution of operations on the part of workers with the aim of pleasing the management.
The company’s HR should also ensure that its managers are trained on the aspect of reward-based management, which will ensure that they implement a performance appraisal system in the firm (Shaw, Park & Kem, 2013). As a result, this undertaking will help identify the skills of all workers. Lastly, the company’s HR department should review its payment structure to provide for benefits and allowance for certain talents.
Reference List
Anca-Ioana, M., 2013. “New Approaches of the Concepts of Human Resources, Human Resource Management and Strategic Human Resource Management,” Annals of the University of Oradea Economic Science, 22(1), pp. 1520-1525.
Ferndale, E., Paauwe, J & Boselie, P. 2010. “An Exploratory Study of Governance in the Intra-Firm Human Resources Supply Chain,” Human Resource Management, 49(5), pp. 849-868.
Shaw, D., Park, T & Kem, E. 2013. “A Resource-Based Perspective on Human Capital Losses, HRM Investments and Organizational Performance,” Strategic Management Journal, 34(5), pp. 572-589.
Marie, H. 2012. “Strategic Human Resource Management in Context: A Historical and Global Perspective,” Academy of Management.
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The influence that customers have on business activity
The influence that customers have on business activity has increased in recent years. What HRM implications does this have for workers and managers?
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The influence that customers have on business activity has increased in recent years. What HRM implications does this have for workers and managers?
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The influence that customers have on business activity
HRM is the devolution of many aspects of the management of people of different specialization and directing their specialty directly to the line of management within the organization. HRM consist of offering; equal job opportunities and compliance, carrying out job analysis, recruiting, selecting, motivating and retention of the employees, carrying out human resource planning, performance evaluation and compensation, training and development, labor relationship, safety, health and wellness. Always the effective HRM focuses on the activities of the business rather than the record keeping, and written procedures of the business through the use of the rules and policies that are outlined to help in the running of the organization and offers solutions to the realized problem. This paper will look at the implication that the customers’ activities have caused to the HRM.
Customers demand for the compensation due to fail or accident caused by the goods or services offered by the organization (Halbesleben & Stoutner, 2013). . Different countries have different policies that are outlined on the compensation and this has led to the daily adjustment of the HRM objectives and goals which has led to the problem towards achieving the goals of the organization. The HRM must always outline the policies in line with the goals of the organization and these compensation challenges may destabilize the organization especially where the goods are exported to different countries.
Most customers have realized the importance of the analyzing the company’s ethical practices, the environmental issues of the organization, the level and quality of the products offered and this has greatly affected the demand for the goods and services. HRM must therefore analyses these environmental issues and formulate the ways to develop good environment within the organization, recruit workers with new skills to maintain the good image of the business and produce of high quality to meet the customer’s need (Kalpina, Sania, & Javed, 2013). This will change the system of the HRM operation and HRM will have to have frequent check on the competence of the employees and recruit where appropriate.
Customers have increased their involvement in the business approach i.e. establishing a balanced stakeholder orientation. Customers have different approach towards obtaining the goods they want; other may have a self-centered approach where they purchase goods without involving in any communication with the stakeholder employees (Ullah, & Yasmin, 2014). Others may carry out operations like boycotting purchase and even spreading the worst information to other buyers. HRM therefore must change their operation and carry out daily training of the employees and even evaluate them on daily basis.
Customer base line orientation of the company is a result of the relationships that takes place during work related interactions (Croitor, 2012). The initial approach of the customers towards the company has changed the environment and most of the organization is opting for the potential customers. Due to this the initial relation with the customer tends to bring more customers and HRM must ensure quality production and daily training of the working personnel on how to make customers have good ethical relationship with the organization to enable the organization to maintain its customers and bring in more to the organization or business (Feng, T., Wang, D, Prajogo, 2014).
HRM should therefore study frequently the behavior and changes of the customer needs and change their policies and operation as per the change realized. HRM should realize that they are responsible for the management and contagious transformation, shaping processes and cultures that together improve the quality and the capacity of the organization.
Bibliography
Croitor, L. 2012. Consumer Utility Theory to Business Management. USV Annals of Economics & Public Administration, Vol. 12 Issue 1, p138-143.
Feng, T., Wang, D, Prajogo, D. 2014. Incorporating human resource management initiatives into customer services: Empirical evidence from Chinese manufacturing firms. Industrial Marketing Management, Vol. 43 Issue 1, p126-135.
Halbesleben, J & Stoutner, O. (2013). Developing Customers as Partial Employees: Predictors and Outcomes of Customer Performance in a Services Context. Human Resource Development Quarterly. Vol. 24 Issue 3, p313-335.
Kalpina, K., Sania, U., & Javed, H. 2013. HR Management Practices and Customer Satisfaction: The Mediating Effect of Effective Supply Chain Management Practices. Global Business & Management Research. Vol. 5 Issue 2/3, p137-160.
1-300 Abstract
2-introduction need to be paraphrased
3-methods need to be change the style of writing to scientific English in a style how methods of experiment is written
4- discussion you should write 2500 with 30 reference to support the interpretation of the graph
5-conclusion should be 200
6- references should be in Vancouver style
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DECLARATION
This final project report does not contain any material which has been accepted for the award of any other degree or diploma and to the best of my knowledge and belief,contains no material written or published previously by another person, except where due reference is made in the text
Signed:
Date: 19 October 2014
Table of Contents
List of figures……………………………………………………………………..……………………4
List of Tables…………………………………………………………………………………………..5
List of Abbreviations…………………………………………………………………………………..6
ELISA is undoubtedly one of the extensively utilized biochemical techniques hence considered a routine procedure in most clinical laboratories. A combination of ELISA with other throughput technologies has significantly revolutionized the way laboratory procedures are conducted particularly those involved in purification of assays or analytes. Through development and validation of a competitive ELISA assay to measure levels of serum cortisol making comparison of the results obtained from ELISA with those obtained from the LCMS/MS, it is possible to conduct an evaluation of the highly reproducible, most reliable, highly accurate and sensitive method for the quantification of cortisol between the methods that are considered. Moreover, considering that there was need in this laboratory project to extract cortisol, then it can be highly justified that the laboratory project would definitely begin with the development of the technique to extract the cortisol which began by choosing the solvent to be used for the extraction of cortisol whereby ethyl acetate, hexane, and MTBE were considered and eventually the extracts were run on LCMS/MS. The project validated the techniques by evaluating the accuracy, sensitivity, linearity and imprecision for the ELISA. However, the linearity plot results indicated that that there was consistency between the linearity plot results with those of the calibration curve where the cortisol’s concentration in the upper limit was 750nmol/L. Thus, this implies that in spite of the ELISA’s performance been not very good for the considered analyte, a significant correlation was in existence upon comparing between the two methods.
Enzyme-Linked Immunosorbent Assay (ELISA) is undoubtedly one of the most used biochemical techniques hence considered a routine procedure in most research and clinical laboratories1. This is mainly because ELISA is a detection method that exploits the ability of antibodies to bind specifically and very tightly to a particular compound such as the antigens. The detection of the antibodies is done through a secondary antibody that is linked to a quantification or visualization strategy2. As a result ELISA has a wide usage in the diagnosis diseases and screening for the presence of some drugs in the body3. LC-MS/MS Chromatography is a method of separating components in a mixture based on the differences in partitioning behavior between a stationary phase and a flowing mobile phase2. Moreover, ELISA is usually combined with other biochemical analysis techniques which include liquid chromatography tandem mass spectrometry (LC–MS/MS), has led to major breakthroughs in quantitative bioanalysis in biomedical sciences mainly because of the inherent sensitivity, specificity, and speed4. According to Lequin5 due to the above mentioned characteristics which are inherent in LC-MS/MS, the technique has received general acceptance as the preferred technique for the quantification of small molecule metabolites, drugs, as well as other xenobiotic biomolecules in biological matrices. Techniques that are liquid chromatography tandem mass spectrometry (LC-MS/MS) based have gained wide usage nowadays in the analysis of steroid serum. For instance, in the detection of serum aldosterone liquid chromatography–mass spectrometry (LC–MS) method is usually regarded an upper method1. However, LC–MS/MS technique should be used as a reference method because it mainly offers numerous advantages compared to GC-MS5.The aim of the experiment was to develop a competitive ELSA for serum cortisol to be acceptable standard essay and to validate Elisa assay by comparing with LC-MS/MS reference method.
CHAPTER 2: MATERIALS AND METHODS
2.1 Materials and Reagents
For sample extraction, Methanol and Ethyl acetate and Monoclonal cortisol antibody (5.4mg/mL) was used for labeling antigen.Tween20, Bovine serum albumin( BSA), Cortisol-1,2-d2 internal standard and Lumigen PS-atto (substrate)were used in this competitive ELISA assay and the rest of the materials used and their manufactures are provided in the appendix. For the purpose of diluting pure cortisol with 1000nmol/L Sercon was used. Cortisol Quality Controls samples were used with 3 different levels for testing the experiment reliability and acceptability. Cortisol sample was used by RCPA QAP general chemistry program and Endocrine program. The main equipment used in this experiment are Fume hood, Eppendorf centrifuge, vortex equipment for sample preparation.
Table 1: showing the all materials used and their manufacturers.
Materials
(manufacturer name, city, state)
1
Bovine serum albumin
Sigma-Aldrich, 3050 Spruee St ST. Luis, M063103 USA
2
Cortisol-1,2-d2 internal standard
CIDIN IsotopcpInc, 88 Leacock St Pointe-Claire, Quebec Canada
The main buffer used in this experiments were phosphate buffer saline (PBS), washing, coating and blocking buffer. Coating buffer was crucial for efficient immobilization. The pH was adjusted to be 9.6 as wrong pH can affect the assay. The reagents used in Coating buffer were made of 1M Na2CO3 the amount taken was 3.03g, 1M of NaHCO3the amount taken was 6.0 and 1mL of distill water. To make a 10 times concentrated phosphate buffer saline (PBS)buffer. The reagents used in 10X PBS buffer were Na2HPO3.12H2O (1.16g), KH2PO4 (0.1g), NaCl (4.0g), KCl (0.1g), distill water (500 mL) and the pH was adjusted to be 7.4.For removing the component that are not bound, washing buffer was used. The reagents used in washing buffer were 0.05% (v/v) of Tween 20 in PBS. Blocking buffer used as a blocker of non-specific protein-surface binding. The reagents used in blocking buffer 1% BSA (Bovine serum albumin) solution phosphate buffered saline (PBS), blocking and washing buffer. All these buffers were prepared to perform ELISA assay. The details of the buffer and their reagent are show in the table above.
2.3 Liquid extraction Protocol for ELISA
About 100 µL of unknown or control samples were put in labeled microfuge tubes followed by subsequent addition of about 100 µL of methanol and pulse vortexted for 2 minutes. After that about 100 µL of distilled water were added to the tube and vortexted for 2 minutes; this was followed by subsequent addition of about 800µL of Ethyl acetate and pulse vortexted for 5 minutes. The tubes were then centrifuged for 5minutes at 8000 rpm. This was followed by the transfer of about 500µL of the supernatant from each tube to new glass tubes and dried in 37C.
2.4 Sample Extraction Protocol for ELISA
About 100 L of the samples were added to each tube then 100 µL of methanol were added. The tubes were vortexing for 2 minutes and about 100 µL of distill water were then vortex for 2 minutes followed by addition of about 800µL of ethyl acetate then vortex for 5mins. All the tubes were then centrifuged at 8000 R.P.M for 5 minutes and about 500 µL of supernatant were transferred into clean tubes. The sample was dried at 37oC. Finally, the sample was reconstituted with 500 µL of PBS or ceracon.
2.5ProtocolLiquid Liquid extraction for LCMSMS
About 100 µL of unknown or control samples were taken in labeled microfuge tubes. The same amount of cortisol-1.2- d2 internal standard plus methanol solution was added and the tubes were pulse vortexted for 60 seconds. About 100 µL of distilled water were added to the tubes and vortexted again for 60 seconds followed by addition of about 500µL of ethyl acetate to the tubes and vortexted for 5 minutes. The tubes were then placed in the centrifuge and spanned at 1000 rpm for 5 minutes. About 200 µL of the supernatant was then transferred from each tube to new glass tubes and dried down with Nitrogen. The tubes were then reconstituted with 250 µL of 70 % methanol and were then vortexted for 20 seconds.
2.6 ELISA protocol
About 100 µL of monoclonal antibody were added to each well on the plate and the plate was then covered with parafilm and incubated at 37oC for 2 hours. The plate was blocked with blocking buffer incubated at 37 Cº for 1 hour. After that, the plate was washed 3 times with 200uL of PBST and rinsed 1 time with 200 µL of 1X PBS. Around 100 µL of extracted sample, control and standards were added to assigned wells then incubated for 15 minutes at 37Cº. About 100 µL of Cortisol-3-CMO( HRP) conjugate (1:10,000 dilution factor) followed by incubation for 1 hour at 37 Cº. The plate was washed with 200 µL of PBST 3 times followed and then rinsed once with 200 µL of 1X PBS. Lastly, 100 µL of lumigen which considered as substrate was added then followed by immediate detection of the signal39.
2.7 Method development of competitive ELISA assay
Three RCPA QAP samples low, medium and high samples along with Seracon as a blank were run on ELISA as per the protocol to obtain a response curve.
For the low sample the range was 80-08 (234 nmol/L), QC1: 40661 (127 nmol/L), Range = 107-147, QC2: 40662 (427 nmol/L), Range = 359-495, QC3: 40663 (937 nmol/L), Range = 787-1087
2.7.1Pipette Calibration (Accuracy):
The 4 pipettes that were used throughout the project were calibrated. The pipettes used were the 100 – 1000 µL and 20 – 200 µL. The percentage error was calculated following this equation –
%Error = [(Average Weight – 1.000g)/1.000g] x100.
2.7.2 pH of Buffers:
The pH of all buffers and consistency was checked (visual check). For example, Coating Buffer (pH=9.6), Washing Buffer (pH=7)and PBS (1X Buffer) (pH=7.4)
2.8 Methods Validation:
Method validation was done to ensure that the methods done in this experiment is fit for purpose after approving the effectiveness of the standard curve for the ELISA assay. The validation was performed by evaluating imprecision, linearity, sensitivity and finally the method was compared to LCMSMS. The QC materials used were from RCPA QAP.
2.8.1 Calibration Curve
Seven standards were prepared as described for calibration curve as shown in Table 1. Then all standards were extracted (Liquid-Liquid extraction with MTBE) and run on ELISA. The calibration curve was plotted using the Readerfit program.
Table 2. Seven Standards, their concentration and the final cortisol concentration
Standards
Concentration
Total Volume (μl)
Diluent Volume (µL)
Cortisol (µL)
1
0
100
1000
0
2
150
100
850
150
3
300
100
700
300
4
450
100
550
450
5
600
100
400
600
6
800
100
200
800
7
1000
100
0
1000
2.8.2 Linearity (Reportable range)
Using 2 pools one with low and the other with high concentration, five mixtures were add as shown in Table 2. These mixtures were run on ELISA in 4 replicates. The concentrations of the mixtures were obtained from the Readerfit program and this was used as the assayed concentration to plot the linearity plot using the Linchecker program.
Table 3. Preparation of the five mixtures for linearity
Mixture
Pool
Low pool (µL)
High pool (µL)
Total Volume (µL)
1
100% low
0% high
100
0
100
2
75% low
25% high
75
25
100
3
50% low
50% high
50
50
100
4
25% low
75% high
25
75
100
5
0% low
100% high
0
100
100
2.8.3 Imprecision (Within run)
Following the protocol, extraction was performed for both low and high samples and run on ELISA in 10 replicates. The mean, standard deviation and CV% were calculated.
2.8.4 Between run imprecision
The between run imprecision was calculated by evaluating the three Biorad QC samples run throughout the project. The Levey Jennings chart was plotted to determine the acceptability of the run.
2.8.5 Sigma chart
The coefficient of variation (CV%) and bias% obtained for the low and high concentration samples were used for the sigma chart to evaluate the performance of the ELISA. The formula of the bias metrics is as below:
2.8.5 Functional Sensitivity ( Limit of Blank, limit of detection, limit of quantitation)
The Seracon (cortisol free matched serum) was run in 10 wells (10 repeats). The mean and standard deviation were calculated and used in the following equation to calculate the Limit of Blank (LoB)
LOB = mean blank + 1.645(SD blank).
The low QC sample was used in 10 repeats and the following equation was used to calculate the Limit of Detection (LoD)
LOD = LOB + 1.645(SD low concentration sample).
A curve was plotted with the LOB and LOQ and the CV%, the concentration at which the CV=20% was used as the Limit of quantitation ( LOQ).
2.9.6 Method comparison with LCMSMS
The developed ELISA was compared to the LCMS/MS by running the RCPA QAP samples and the concentrations were obtained from the Readerfit and was compared to the concentrations of the LCMSMS using Passing Bablok and Bland Altman difference plot. The Method validator program was used to plot these plots. The purpose of this was to identify constant and proportional error.
CHAPTER 3:RESULTS
3.1 Selection of extraction solvent
Hexane, MTBE and ethyl acetate were run in LCMS and ethyl acetate was selected as the best solvent selected as it showed sharp peak and had high sensitivity. The chromatograms of the three solvents are shown in Figure 1.
MTBE
Hexane
Ethyl acetates
Fig. 1 The results of LLE extractions with different solvents. Hexan then ethyl acetate and MTBE. The x axis represents the time in minutes while the y axis represents the counts
3.2 Calibration curve
Calibration curves were obtained using the standard cortisol calibrators (34- 988 nmol/L) and were fitted using a nonlinear four- parameter logistic calibration plot using the Readerfit program.. The maximum asymptotic value was 505534.04 and the minimum asymptotic value was 505292.06. The value of inflection point was 7852.3 and the slope was -0.44. The QC1 and QC3 were in the reference range but QC3 was out of the range as shown in Table , which indicated that this experiment was not so successful. Further improvement was required.
Fig. 2 calibration curve showing the concentration of standard versus the absorbance plotted by readerfit software.
Table 4.The QC concentration from the calibration curve comparing them to the reference range for their assigned lot number.
The mean value obtained from graph
QC information
The reference range
QC1
128.50
QC1: 40661 (127 nmol/L)
Range = 107-147
QC2
359
QC2: 40662 (427 nmol/L),
Range = 359-495
QC3
405.87
QC3: 40663 (937 nmol/L)
Range = 787-1087
The QC1 and QC3 were in the reference range but QC3 was out of the range, which indicated that this experiment was not so successful. Further improvement was required.
3.2Impression: within run
Within run imprecision was determined by calculating the CV% for the low and high concentration samples. The CV % for the low and high samples was 15.4% and 65.8 % respectively. Table 5summarises the statistical data for the two samples
Table 5: Mean, SD and CV% for the low and high concentration samples
High values
Low values
Mean
611.5
Mean
655.9
SD
397.9
SD
100.9
CV %
65.8
CV %
15.4
3.5 Between run
The between run imprecision was assessed by analyzing the 3 QCs run across 5 weeks. This was done by plotting the Levey Jennings chart as shown in Figure 4 and analyzing in accordance with the Westgard rules. Only few values were acceptable for all the QCs. Most of the QC values were rejected as it was outside the +/- 2SD and +/- 3SD limits. This might be due to the random error and it can be corrected by repeating the assay or repeating the controls. With the level 1 QC, 3 runs was accepted as they fell within the 2SD ( yellow line). While in level 2 QC only two run were accepted as they fell within acceptable limit and not exceeding the 2SD or 3 SD. With the level 3 QC, only two runs were accepted and the rest of run were rejected.
Levey Jennings chart
Fig. 3 Levey Jennings plot: The green line is the mean, the yellow line represents the 2SD and the red line represents 3SD.
3.3 Sensitivity Test:
LOB = mean blank + 1.645 (SD blank).
= 117.3+(1.645*8.7389)
=131.7
LOD = LOB + 1.645(SD low concentration sample).
= 131.7 + (1.645* 100.9)
= 297.7
3.7 Precision profile:
The precision profile was assessed by evaluating the LOB, LOD and LOQ and the data is shown in Table and Figure
Table 6 :Concentration of LOB, LOD, high and low values and their CV%
Fig. 4 This graph represent the precision profile. The x axis represents the concentration of the target value while the y axis represents the CV%. From this graph LOQ was determined.
In this graph the low and high values were utilized. It was clearly shown the high value was 65.8% and it didn’t meet the imprecision and bias requirement however the low value did meet the bias and imprecision value as the CV% was 15.4% therefore, the assay isn’t fit for purpose. LoQ value that was determined from the graph was-132.1which is very low and not reliable value for LoQ as LoQ value must be close LOD or slightly higher8.
Removing the high value:
Fig.5 This graph represent the precision profile. The x axis represents the concentration of the target value while the y axis represents the CV%.
In this graph the low values only were utilized and high have been removed. LoQ was determined in this graph and it was 144.2 which is higher than LoD value. However, this graph is not acceptable so it didn’t include the low and high values together to check they meet the bias and imprecision requirement to conclude that assay fit for purpose or not.
3.4 Linearity
The linearity was evaluated by plotting the assigned and assayed concentrations and was found that the ELISA was linear with the upper limit of reportable range as 511 nmol/L with a best fit polynomial of y= 312.5 +0.6002x with an intercept of 0.6 and a slope of 312.5 nmol/L. The linearity plot is shown in Figure 3.
Table 7: Assigned and assayed concentration for the linearity plot
Fig.6Linearity plot. The x axis represents the assigned concentration ( the values obtained from RCPA QAP website) and the y axis represents the assayed concentration ( the values of
3.5 Method Comparison
ELISA was compared to the LCMSMS using Passing Bablok and difference plot. The comparison is shown in Figures7 and 8. The correlation coefficient was 0.804 with 1.56 slope of 1.56 and an intercept of -51. The difference plot showed a mean difference of 225nmol/L with a 95% confidence interval of 73.1 to 376.
Fig. 7This graph represent the Passing Bablok. The x axis represents the reference methods while the y axis represents field methods.
Difference plot showed the mean bias of 225 and 73.1 to 376 of 95% confidence interval.
Fig. 8 This graph represent the difference plot. The x axis represents the mean while the y axis represents difference.(The black line depicts the bias and the dashed lines show the 95% limits of agreement)
3.6 Sigma Metrics chart
Sigma chart was used to analyse the perfromance of ELISA using the bias and CV% for the low and high concnetration samples as shown in Table . The chart as shown in Figure 7 demonstrated that both the samples were unacceptable.
Table 8 : table shows the values used to draw the sigma Metrics Chart
This table shows the values used to draw the sigma Metrics Chart
CV %
Bias
low level
15.4
-0.66
High level
65.8
349
Fig. 9 This graph represent the sigma Metrics Chart. The x axis represents the CV % while the y axis represents the bias. Both values are not acceptable as they fall outside the acceptable range.
CHAPTER 4: DISCUSSION
Since the aim of the laboratory experiment was towards developing and validating a competitive ELISA assay for the measurement of the concentration levels of cortisol in serum and also making comparisons between the results obtained from the competitive ELISA with those obtained from the mass spectrometry TANDOM from the RCPA, it is evidently clear that by critically evaluating the two methods determination of the method which is the highly sensitive, highly reproducible, most reliable, as well as accurate and precise for quantitating cortisol concentration levels in the serum can be carried out.. This is mainly because cortisol serum concentration levels’ measurement require to be done with specificity that is extremely high even when the concentrations are significantly low for the monitoring of the steroid hormone levels in both research and clinical laboratories to make sure there is accuracy in diagnosis for appropriate treatment and follow-up.12. Thus, considering that the experiment needed cortisol to be extracted first it is very justifiable that the initial part of the experiment was to develop a technique that is ELISA based for cortisol extraction which started by the selection the solvents for extracting the cortisol where three of them were considered such as ethyl acetate, hexane, and MTBE and then the extracts were run on LC-MS/MS23.. However, amongst the considered cortisol extraction solvents ethyl acetate was eventually chosen as the extraction solvent that was most preferred mainly because it exists in a non-liquid matrix as well as due to the fact that it also exists an organic solvent and cortisol which was the target extract exists as an organic soluble steroid which means that in order for cortisol’s extraction phase which should be organic to be achieved ethyl acetate would only be the most preferred solvent for extraction. Moreover, extraction of cortisol using ethyl acetate is also advantageous due to the fact that it can be easily removed completely from the extract or cortisol when there is utilization of centrifugal vacuum devices24.
In order to succinctly determine the concentration of cortisol at any measurement ranging between the minimum and maximum concentration, a calibration curve was plotted using readerfit software utilizing the five parametric logistic calibration plots. Two blanks and seven standards and 3 samples of QCs were used to plot the curve. The calibration curve showed a working range of between 250nmol/Land about 750nmol/L. The results of the calibration curve implies that the ELISA method is capable of measuring cortisol within a range of the least concentration to highest concentration, that is, from the lowest concentration of 250 nmol/L to the highest concentration of 750 nmol/L.(5-12) Therefore, the plotted calibration curve can be very essential for the determination of the unknown concentrations of the sample solution in an experiment, since the sample solution is plotted against the observable variable on basis of their concentration and absorbance or the calibration standards of several prepared solutions. After plotting the calibration curve, unknown solution concentrations (which in this case are assumed to mean cortisol concentrations) can be determined upon placing the sample solution on the calibration curve mainly on the basis of its absorbance or on the basis of other observable variable.16 In this experiment, a calibration curve was vital for the determination of concentrations of cortisol at varied ranges of absorbance on the basis of other observable variable. (7-10, 17-20) The calibration curve is clearly showing high response values in low concentration. But, as the concentration increased the response values dropped. It is difficult to distinguish the concentration beyond 500nmol/L.
Furthermore, a consideration of the Levey Jennings chart was a clear indication that all the QCs did not effectively function its intended role due to the fact that the values for high and medium QC were undeniably within the limits which could be regarded as acceptable even though a consideration of the values for the low QC the Levey Jennings chart showed that they were undeniably not within the limits. 38, 39.
This clearly indicate that there was a considerably improved techniques for developing the assay, and the results that were obtained which could not be found to be within the present limits and/or ranges could have been attributed to a number of reasons which include some errors which are inherent in the process of experimentation particularly procedures such as those involved in the extraction of the cortisol, contamination of the extraction solvent and/or the extract as well as errors in pipetting. (11, 25, 27) Furthermore, the observed variations which may be considered to relatively considerable when compare to the expected limits and/or ranges may have also been as a result of the errors that may have likely occurred in course of the process through which the analyte and/or extract is labeled or transferred as well as errors that are inherent in the calibration deviations that are integral within the equipment and/or devices used for the measurements carried out during the laboratory experiment. Thus, this implies that the standard procedures that are previously laid down should be stringently adhered to during the laboratory experiment for the purpose of making sure that the obtained results are reliable, valid and can be reproduced.31
During the laboratory project there was also consideration of technique validation by evaluating the accuracy, sensitivity, linearity and imprecision for the ELISA technique in order to make sure it could be appropriately and effectively used for precise measurement of cortisol concentration levels28. In order to achieve this, the necessary protocols were stringently adhered to because it was regarded extremely crucial due to the fact that making conclusions and decisions concerning the validity and/or reliability of a certain procedure used to carry out scientific laboratory experiments13. For instance, according to Lequin5 clinical significant decisions could only be made regarding the analyte, whereby the degree of change that is detected is considered to the same as the total error that is allowable (TEa). 1 This implies that bias or accuracy indicates of disagreement between any two or multiple analytical methods and/or procedures used in the experiment which are under comparison. However, the systemic error that is detected for a particular method is recorded in terms of positive or negative bias. This implies that description of the recorded variations between the two or more methods being compared can be done using a coefficient of variation due to the fact that it usually provides a good idea with regards to the method and/or performance as well as the assay. 18 According to Lumsden18 a good method’s and/or technique’s performance is in most cases or always denoted by a CV (coefficient of variation) of below 5%; whereas whenever the CV (coefficient of variation) is equal or higher than 10%, this implies that the developed method’s and/or technique’s performance is not satisfactory. In addition, Yeh, Glock and Ryu13 reiterated that the upper limit of CV (coefficient of variation) for cortisol should be + 25% if the developed method’s and/or technique’s performance is good. However, the CV (coefficient of variation) for the results of the developed ELISA technique indicated that a CV (coefficient of variation) of 32% was obtained with a bias of 19 % for the higher sample and CV (coefficient of variation) of 24% and a bias of 20.7% for the lower sample. This is a clear indication that developed ELISA technique or method performance was not good or satisfactory for the analyte. Thus, in order for this analyte to be analyzed further, Sigma Chart or medical decision chart was used mainly because the achievement of the Six Sigma is undoubtedly the world class measure of the gold standard for the definition of quality. This means that performing an assay at the 3-sigma level, this is considered to be the minimum quality level acceptable; while when a method or an assay is below the 3-sigma level, adoption of a new better method needs to be implemented due to the fact that the quality of the test/analysis can’t be assured even upon repetition of the QC runs. 17 Thus, considering figure 9 in the results chapter it can be clearly seen that for this particular project the developed ELISA method or technique could not be accepted for both the levels based on the Sigma chart mainly because the sigma levels were considerably low.
In addition, the results obtained from the laboratory project were also utilized in the plotting of the linearity which with regards to observed results it can be clearly seen that the linearity of the ELISA extended up to 750 nmol/L meaning that 750 nmol/L was the upper limit for detecting cortisol. Therefore, the linearity plot results are clearly indicative of the fact that there was consistency between the results obtained from the calibration curve which also indicated that the upper limit at which concentration levels of cortisol could be detected was 750nmol/L. Thus, irrespective of the fact that the developed ELISA technique or method performance was not satisfactorily good for the detection of the analyte considered in this laboratory experiment/project which is cortisol, a clear evidence of considerably high level of correlation between the two measures for the analyte such as the linearity curve as well as the calibration curve is observable.30-32
Furthermore, the descriptions of the analyte’s lowest concentration was done in terms measures such as the sensitivity, functional/ analytical sensitivity, Limit of Blank (LoB), Limit of Detection (LoD) as well as Limit of limit of quantitation (LoQ) and there measurement cab achieved through an assay or through the method/techniques used. For example, LoB is indicative of the fact that 95% of the measurement values that are observed upon consideration of a Gaussian distribution, whereas LoD provides a method for the estimation of bias and imprecision when the analyte’s levels are at very low concentrations which implies that it is the lowest analyte’s concentration that can be distinguished from the LoB concentration levels which implies that when compare to LoB it should always be greater than LoB.11 However, when the obtained Gaussian distribution was considered, 95% of the analyte’s values were above the LoB while 5% of the analyte’s values were below LoB. Furthermore, a consideration of the LoQ means that it is lowest concentration level at which the measurement of the analyte can be done, but not detected at a point where the goals for bias and imprecision are met. Additionally, functional sensitivity was also considered which is a measure of an assay’s precision of measurement at low concentration levels of the analyte and in this project the functional sensitivity resulted in a CV (coefficient of variation) of 20%. Sometimes, the values for LoD can be equivalent to the values of LoQ but it can’t be higher. For example, if measurements the imprecision or bias of LoD are done within the TEa or total error that is allowable, LoQ can be equivalent to LoD.21 This means that when the results obtained in this project for LoB, LoD and LoQ are considered considerable insights can be gained concerning the biasness and imprecision of the method and/or analyte based on TEa or the total allowable error. Therefore, on the basis of the results obtained in this experiment, the LoQ is not equivalent to LoD, implying that the imprecision and bias doesn’t meet the total allowable error requirements. (9-12). The Sensitivity result was 131.7 using this equation LOB = mean blank + 1.645 (SD blank); whereas at the same the result for LOD was 297.7 using this equation LOD = LOB + 1.645(SD for a sample with low concentration of the cortisol).In figure 4showed the low and high values were utilized. It was clearly shown the high value was 65.8% and it didn’t meet the imprecision and bias requirement however the low value did meet the bias and imprecision value as the CV% was 15.4% therefore, the assay isn’t fit for purpose. LoQ value that was determined from the graph was -132.1which is very low and not reliable value for LoQ as LoQ value must be close LOD or slightly higher8. While in figure 5 showed the low values only were utilized and high have been removed. LoQ was determined in this graph and it was 144.2 which is higher than LoD value. However, this graph is not acceptable so it didn’t include the low and high values together to check they meet the bias and imprecision requirement to conclude that assay fit for purpose or not. The reason why the results was like this is because we used the concentration of target values instead of measured values instead of. LoQ was the lower limit of reportable range. The upper limit of this range we can get it from linearity.
The final part of the experiment was to make comparisons between the results obtained from the developed ELISA with the results which were obtained from the RCPA QAP by analyzing using the difference plot as well as the Passing Bablok. The results of Passing Bablok in figure 7 showed a regression with 1.56 slope and -51 intercept and the correlation coefficient was 0.804. While Difference plot in figure showed the mean bias of 225 nmol/L and 73.1 to 376 of 95% confidence interval, which meant that there was relatively low level of agreement between the RCPA from QAP and the developed ELISA technique or method which showed a mean difference of 225 nmol/L. (5, 22, 32)
CHAPTER 6: CONCLUSION:
A satisfactory ELISA was developed, validated and compared to the LCMS/MS. There are many factors that should be considered when developing an assay such as the pH of the buffer, incubation time and temperature, extraction procedure, pipetting etc. Further studies should be performed to completely evaluate the performance of the ELISA by taking into account of these factors. Therefore, in clinical and research laboratories, this type of procedures are usually carried out on routine basis for the purpose of making sure comparisons between various methods or techniques used in the biomedical laboratories is done. Moreover, these procedure have also been extensively used as a protocol for the validation of a newly developed technique or method of analyte measurement in order to make sure that the obtained results are always reliable, valid and reproducible. Thus, as new methods continue to be developed on day to day basis in the biomedical field for utilization in the clinical and research laboratories, validation of these techniques must always be prioritized despite been throughput. Finally, routine comparison of various methods and/or techniques used in the same laboratory for measurement of a similar analyte should be encouraged in order to regularly determine which of them is producing more reliable, valid and reducible results.
Acknowledgement
I would like to express my gratitude to Dr. Ronda Greaves and Dr. Sonia La Vita for their supervising this experiment.
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Remember that is a continues paper and I have listed reference number for my previous paper under this topic to help understand this paper. This is my policy change paper and the writer must refer back to other papers base on the references provided to be able to understand how to respond to this paper. Hear below are detail instructions on how to go about this paper and its critical that the writer follow strictly the instructions. Take note that no reference can be before 2010 , they most all be from 2010 and above as the affordable care act was pass in 2010. Also remember that they are 2 SECTIONS A and B, and both sections must have separate reference list 4 in each section , listed at the end of that section.
SECTION A (1 pages)
Remember to include a minimum of 4 references at the end of each section.
To complete this paper correctly, the writer must look take a look at 111521,111489, 111623 and 111582 (section B), 111623, and 111542. To be exact any of my past papers regarding policy change proposal as I had mentioned at the beginning that this paper will be a continues assignment.
Explain the three cost-effective recommendations for the policy change proposal below which you plan to implement in your proposed policy change. Be sure the recommendations include a way to reach a global market.
Hear below are some guidelines from the Prof on how to respond to this section and also an example to follow.
Fellow students,
This week we are developing commendations that you will use in your Unit 9 policy change proposal to implement your policy change. Remember you are trying to develop relationships to understand & support your proposed change and will help to convince others to do the same. And we are using an expository style writing 🙂
For example:
Engaging in public health social media campaign to educate the public about the use of and need for APNs in health care, focusing on filling the disparity gaps
Utilize lobbying groups and professional organizations to educate the public that employing nurse practitioners improves xxxxxx
Apply the amendment change utilizing the Incremental Change option, because this will allow for not only time for stake holders to buy into the proposed change but it will also provide for evaluation of any positive or negative changes that can be reevaluated and redesigned along the way to complete implementation of the proposed change.
CW
Take note that you have to write in an expository style and Remember that the propose amendment is
The public policy problem is that section 2713 requires organizations to provide their workers with birth control as part of their insurance coverage. The public policy question is: should the federal government mandate that organizations can choose whether or not to provide contraceptive services to employees as part of their insurance coverage? The public policy resolution is an amendment to section 2713(a) (4) of PL 111-148 that would say: organizations – both for-profit and non-profit organizations – have the option of either offering their employees birth control as part of their insurance coverage or not to offer contraceptive services (Cauchi, 2014).
SECTION B (1 pages minimum).
Remember to also include 4 reference at the end of this section.
Since the implementation of a policy change proposal requires that it be communicated to a large number of stakeholders, do you think that there are drawbacks or advantages to the use of social media for this purpose?
The Staff of the Washington Post. (2010). Landmark: The inside story of America’s new health care law and what it mean for all of us. New Your, NY: Public Affair.
Policy Change in the Provision of Contraceptive Services
SECTION A
The public policy (section 2713) has a problem since it requires all organizations to provide their employees with birth control measures as part of their insurance coverage. Due to this challenge, the public resolved to amend section 2713(a) (4) of PL 111-148 in order to allow nongovernmental organizations to have an option of either providing their employees with birth control as part of their insurance coverage or not to offer contraceptive (Cauchi, 2014). This article will basically address ways in which this public policy change could be implemented since policy change implementation requires that it be communicated to a large number of stakeholders.
One of the ways of implementing this public policy change is by carrying out campaigns in the public especially through the social media. Public social media campaigns are very necessary since they educate the public and the organization on the pros and cons of providing birth control as part of insurance coverage. This would therefore allow the public to debate comprehensively on the issue and eventually make informed. Therefore, policy implementation has to address organizational, professional and social affairs around which that policy has to be implemented. The recommendations for the implementation process of the policy change therefore have to be cost-effective (Holly, Salmond & Saimbert, 2012).
According to Shi & Singh (2012), adoption of this policy would mean employing practitioners that are more public. In order to ensure that the public appreciates the need and urgency of this move, lobbying groups and professional organizations would be mobilised to educate the public on the need to have these reforms
Afifi et al., (2013) states that, since the organizations are the ones mandated to adopt this policy change, the amendment change would be applied through use of the incremental change option. This option will allow the organizations and any other stakeholder’s time to digest the reforms by weighing the advantages and disadvantages of the reforms
References
Afifi, A. A., Rice, T. H., Andersen, R. M., Rosenstock, L., & Kominski, G. F. (2013). Changing the u.s. health care system: Key issues in health services policy and management. San Francisco, Calif: Jossey-Bass.
Holly, C., Salmond, S. W., & Saimbert, M. K. (2012). Comprehensive systematic review for advanced nursing practice. New York: Springer Pub.
Shi, L., & Singh, D. A. (2012). Delivering health care in America: A systems approach. Sudbury, Mass: Jones & Bartlett Learning.
Shoniregun, C. A., Dube, K., & Mtenzi, F. (2010). Electronic healthcare information security. New York: Springer.
SECTION B
Since the implementation of a policy change proposal requires that it
be communicated to a large number of stakeholders, there are so many challenges and opportunities by this change in technology. First and foremost, privacy is a key factor in any health care system. Therefore, inappropriate sharing of information, and limits pertaining professionals has to be adhered to. How much that should be disclosed in relation to provision of contraceptives as a health care insurance cover is a factor that requires limits. According to Grol, Wensing, Eccles & Davis (2013), social media is still very young hence privacy is a feature that would be incorporated as this technology advances.
Marks (2012) states that the privacy of the patients, Health Insurance Portability and Accountability Act (HIPAA) regulations, and patient-professional boundaries has to be the guiding principles on what should be channeled through the social media. This is not an assurance at the moment for anyone using the social media for any form of campaign.
The social media also posses the challenge of evaluating the applications hence very few organizations are adopting them. However, more reports establish that the application is very easy to adopt only that it needs more labor in terms of human availability. Therefore in order to adopt this process more effectively, there need to be development of guidelines on how to use this social media by the organizations (Blas, Kurup & Światowa 2010).
However, according to Buse, Mays & Walt (2012), the social media is very effective since it reaches many people hence can be able to address a specific group of people especially those who use the social applications although some form of controlled analysis of social media is very necessary before establishing whether the approach is very effective . This would enable the campaign for implementation of the public policy change to reach a huge population of people.
References
Top of FormBottom of Form
Blas, E., Kurup, A. S., & Światowa Organizacja Zdrowia. (2010). Equity, social determinants and public health programmes. Geneva: World Health Organization.
Buse, K., Mays, N., & Walt, G. (2012). Making health policy. Maidenhead: McGraw Hill/Open University Press.
Holly, C., Salmond, S. W., & Saimbert, M. K. (2012). Comprehensive systematic review for advanced nursing practice. New York: Springer Pub.
In Grol, R., In Wensing, M., In Eccles, M., & In Davis, D. (2013). Improving patient care: The implementation of change in health care. Chichester, West Sussex: Wiley-Blackwell/BMJ Books.
Kawachi, I., Takao, S., & Subramanian, S. V. (2013). Global perspectives on social capital and health. New York, NY: Springer
Marks, R. (2012). Health literacy and school-based health education
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Perception vs long term memory;why a witness’ account may differ from reality
Order Instructions:
Explain why a witness’s account of events may differ from what really happened.
– Assume that the witness is fit and healthy and will provide and honest account according to their recollection.
– Research should focus on PERCEPTION and LONG TERM MEMORY.
Writing style as Harvard.
SAMPLE ANSWER
An incident is reported of a woman that accused Donald Thompson of raping her. A rapist attacked her while she was watching Donald Thompson on a live telecast. The woman confused the rapist’s face with the one she had seen on TV and identified Donald Thompson as the perpetrator. Before the authorities realized that she had confused the face of the rapist with that of Thompson on TV, Thompson had been arrested. The police had dismissed the alibi that the rape occurred when he was on TV and together with the audience and other discussants (Braddeley, 2004). It is a story of how accounts of mentally fit and healthy witnesses with honest intentions may starkly differ from what really happened. It is an intriguing phenomenon whose explanation lies in the mental processes of perception and long term memory.
Perception
The eyes just like other sensory organs have limitations that can cause erroneous identification of objects. For example, a story is told of two men that were in the woods talking and thinking about bears. They then spotted a large object that was moving and making some noise. Their conversation had conditioned them to think that it was a bear and so they aimed their barrels and shot at what was later revealed to be a tent harboring a couple that was making love. They killed the woman and during trial, the jurors found it difficult to understand their perceptual problems because they could not imagine how a yellow tent seemed like a growling bear. Prior conditioning altered their perception and the perpetrator received a negligent homicide judgment (Loftus & Ketcham, 1991).
People do not see what they sense, rather they see what they think they sense. In this light, a witness perceives not the raw data of the event, rather, an interpretation of the raw data. There is an unconscious information processing process that interprets and discards the raw data or information (Norretranders, 1999). It presents an interpretation of the event. It is the reason why different witnesses of a similar event perceive it differently because their interpretation is subject to their unique information processing process based on their world view. The perception process only encodes the information that one thinks is expected. A witness also perceives events selectively based on prior life experiences. This conditioning may cause witnesses in good faith to fill gaps in perception depending on what is expected or wanted to perceive. Their perception leads them to give accounts that differ from what really happened.
Perception occurs through the senses and the perceived sensations are processed. For instance, research shows that most people would perceive a smaller light in the dark as being further away than the larger light even when in reality they are on the same distance from the eyes (Moses, 2001). All the information that a witness presents is first and foremost perceived. It is because nothing sticks in the mind unless it is perceived. Processing the perceived sensations thus heavily depends on how one makes inferences. Engaging in inferential reasoning covers the gaps in actual perception. Witnesses may thus infer things they do not know from other things that they do know. It leads them to give an account that differs from what really happened. For instance, a witness may infer that the person they see carrying a stolen wallet is the one that robbed them (Moses, 2001).
Witnesses can only remember what they perceive and can perceive only what they attend to. Perception is influenced by a combination of stimulus that one already knows, expects or wants. Perception of events is a momentary and personal occurrence and once complete, the witness relies on memory. Perception can be flawed because the brain is filled with one’s interpretation rather than the actual sensory information. A witness may thus have an altered perception that distorts memory based on inherent expectations at the acquisition stage of memory. A witness may interpret visual sensory information based on their inherent expectations, pre-existing knowledge or wants and thus an account that starkly differs from what really happened (Loftus & Ketcham, 1991).
Stressful situations also interfere with detailed perception. It is because heightened stress levels narrows the scope of perception and elevates emotions. Physiologically, stress affects the hippocampus, impairing the formation of memories. In this event, stress makes an impression on the person making perception unreliable. The impact of a life threatening situation such as rape thus makes a witnesses’ perception unreliable. It makes the retrieval process unreliable as well and it may be the reason their account may differ from what really happened (Moses, 2001).
Memory
For the most part, matters involving eyewitness’s memory rely on the accuracy of long term memory rather than sensory and short term memory. Sensory memory stores information that lasts for the split second of an event because sensory organs only store information for less than a second in its unprocessed form. Individuals preserve information from their sensory systems in its sensory form. Short term memory allows one to store acquired memory for some seconds to minutes (Weiten, 2005). Short term memory stores limited items and when rehearsed and elaborated, it is registered and can be moved to the long term memory. Long term memory retains information that can last a lifetime. Witnesses recount an event by retrieving information from the long-term memory (Hagsand, 2014).
Long term memory is divided into implicit and explicit memory. Implicit memory stores information that one does not unconsciously know like peddling a bike or a neonate’s lurch on a mother’s breast. Explicit memory stores information that one can verbalize consciously. Witnesses draw on their both their semantic and autobiographical aspects of their explicit memory. Semantic memory contains facts such as people’s names and it is more about what one knows than recalling. Autobiographical memory contains a recollection of events and episodes. When one draws on the autobiographical memory, they recall the exact details of uttered words, and the elements in the environment (Green, 2013).
One of the reasons why a witness’ account may differ from what really happened is a faulty memory acquisition process. It is whereby one may not have perceived some information in the acquisition phase. When someone fails to effectively perceive information it affects their capacity to develop a comprehensive account of what really happened. It is also likely that the retention process was interfered with or even that information may be inaccessible during the retrieval process (Loftus, 1979).
Witnesses retrieve bits and pieces of their memories as a puzzle. Memory is thus a reconstruction of past events rather than a recording. A witness often has insufficient information in the memory and h as to invoke pieces of information from other sources during the reconstruction process. They draw from pre-existing schemas that are the stereotyped models of events and objects (Green, 2013). A witness’ account is thus susceptible to being altered because a lawyer’s questioning may alter the testament when fragments of the memory is unknowingly combined with information provided during questioning (Arkwotitz & Lilienfeld, January).
It is also likely that a witness may confuse the sources of information. For instance one may present imagined memories of imagined events rather than of an actual event. Memory source confusion may also incorporate information that is subsequently gained from other witnesses or read in newspapers, information from ones’ general knowledge. The witness may thus pool memory separate occurrences or mistake imaginative events for real ones. The witness may thus give information that differs from what really happened owing to the poor ability to determine the source of information (Green, 2013).
It is also evident that a witness may give an account that differs from the real occurrence because the retrieved information is subjected to subjective interpretation. Every witness interprets events based on personal beliefs, experiences and needs and world view. It is the reason different eyewitnesses observing the same event have different interpretations and different memories. They store their unique perception or interpretation of events in their memory. More reason a witness’ account differs from what really happened is because memory changes with time. In recalling an event over and over, a witness drops details from earlier versions and adds new details to later versions. They may also incorporate information learnt after the event combining two memories into one (Green, 2013).
Forgetting is also responsible for why a witness’ account may differ what really happened. When a memory remains inactive for months or days, the physiological bases of memory tend to change. The memory trace in the brain or the engram gradually decays. Disuse decreases the amount of information that can be recalled and items of information in memory become less accessible with increased time. The loss of information occurs rapidly at first and is then followed by a leveling off. Research shows that basic level information decays less rapidly than more fine detailed information. A study indicated that eye witnesses’ reports provided after 40 days are less detailed than those provided immediately after the event (Read & Connolly, 2006).
Retrieving an item from a memory also increases the likelihood that it is recalled again. In a forensic context, once witnesses make an immediate recall attempt, it preserves their subsequent recall performance making memory loss unlikely. It is because retrieval strengthens the associations between them and increases their representation in memory (Read & Connolly, 2006).
A witness may also give an account that differs from what really happened due to retrieval enhanced suggestibility. Witnesses may fall into repeated retrieval when providing testimony to police investigators, lawyers, friends and family members and it negatively influences their ability to resist subsequently misleading information (Chan & LaPaglia, 2011). Providing a witness with misleading information produces higher confidence for the incorrect information than for the correct information. It may occur because initial retrieval may inadvertently draw attention to particular aspects of the event that was witnessed. Attention increases when new information regarding those particular items is presented and in the subsequent retrievals, the misinformation – new information is integrated into the memory becoming more memorable. Repeated retrieval can only lead to accurate recall when the questions are asked in an open ended and neutral way. However, when one receives misleading information, it increases suggestibility (Chan & LaPaglia, 2011). Engaging witnesses in frequent retrieval with misleading information may thus influence their tendency to provide information that differs from what really happened.
Conclusion
Indeed memories can be altered during retelling because people rarely retell memories in a neutral way. A witness’ testimony has a pivotal influence on the determination of guilt or innocence about the defendant. Mentally fit and healthy witnesses with good faith can provide an account that differs from what really happened due to a flawed perception and negative influences on their long-term memory. Perception occurs through the senses and witnesses can only remember what they perceive and can perceive only what they attend to. Their perception is again influenced by ones environmental conditions and internal conditioning. Environmental conditions at the time of the event also significantly influence the witness’ capacity to for quality perception. Elevated emotions interfere with the hippocampus ability to register the entirety of the event. It means that a witness’s perception can alter their account based on personal interpretation and stress levels. A witness’ account may also differ due to impaired memory acquisition, external influences during memory reconstruction, confusion of sources of memory, forgetfulness, subjective interpretation, delays in retrieval and misinformation during repeated retrieval. These factors are pertinent in assessing the reliability of witnesses’ testimony particularly because memory is continuously altered and reconstructed.
Braddeley, A. (2004). Your Memory: A User’s Guide . Richmond Hill, Canada: Firefly Books.
Chan, J. C., & LaPaglia, J. A. (2011). The Dark side of Testing Memory: Repeated Retrieval can Enhance Eyewitness Suggestibility. Journal of Experimental Psychology, 8(29), 1-15.
Hagsand, A. (2014). Alcohol-Intoxicated Eyewitnesses’ Memory. Gothenburg, Sweden: University of Gothenburg.
Loftus, E. F. (1979). Eyewitness Testimony. Massachusetts: Harvard University Press.
Loftus, E., & Ketcham, K. (1991). Witness for the Defense: The Accused, the Eyewitness, and the Expert who Puts Memory on Trial. New York : St. Martins Press.
Norretranders, T. (1999). The User Illusion: Cutting Consciousness Down To Size. New York: Penguin Books.
Read, J. D., & Connolly, D. A. (2006). The Effects of Delay on Long Term Memory for Witnessed Events. In M. P. Toglia, D. Ross, J. Read, & R. C. Lindsay, Handbook of Eyewitness Psychology: Volume 1: Memory for Events (pp. 117-155). Mahway NJ: Lawrence Erlbaum Associates Inc.
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