A Practitioner’s Guide to Ethical Decision Making

Holly Forester-Miller, Ph. D. Thomas Davis, Ph. D. Copyright  © 1996, American Counseling Association. A free publication of the American Counseling Association promoting ethical counseling practice in service to the public. — Printed and bound copies may be purchased in quantity for a nominal fee from the Online Resource Catalog or by calling the ACA Distribution Center at 800. 422. 2648.ACA grants reproduction rights to libraries, researchers and teachers who wish to copy all or part of the contents of this document for scholarly purposes provided that no fee for the use or possession of such copies is charged to the ultimate consumer of the copies. Proper citation to ACA must be given. Introduction Counselors are often faced with situations which require sound ethical decision making ability. Determining the appropriate course to take when faced with a difficult ethical dilemma can be a challenge.To assist ACA members in meeting this challenge, the ACA Ethics Committee ha s developed A Practitioner's Guide to Ethical Decision Making. The intent of this document is to offer professional counselors a framework for sound ethical decision making. The following will address both guiding principles that are globally valuable in ethical decision making, and a model that professionals can utilize as they address ethical questions in their work. Moral Principles Kitchener (1984) has identified five moral principles that are viewed as the cornerstone of our ethical guidelines.Ethical guidelines can not address all situations that a counselor is forced to confront. Reviewing these ethical principles which are at the foundation of the guidelines often helps to clarify the issues involved in a given situation. The five principles, autonomy, justice, beneficence, nonmaleficence, and fidelity are each absolute truths in and of themselves. By exploring the dilemma in regards to these principles one may come to a better understanding of the conflicting issues. 1. Aut onomy is the principle that addresses the concept of independence.The essence of this principle is allowing an individual the freedom of choice and action. It addresses the responsibility of the counselor to encourage clients, when appropriate, to make their own decisions and to act on their own values. There are two important considerations in encouraging clients to be autonomous. First, helping the client to understand how their decisions and their values may or may not be received within the context of the society in which they live, and how they may impinge on the rights of others.The second consideration is related to the client's ability to make sound and rational decisions. Persons not capable of making competent choices, such as children, and some individuals with mental handicaps, should not be allowed to act on decisions that could harm themselves or others. 2. Nonmaleficence is the concept of not causing harm to others. Often explained as â€Å"above all do no harm†, this principle is considered by some to be the most critical of all the principles, even though theoretically they are all of equal weight (Kitchener, 1984; Rosenbaum, 1982; Stadler, 1986).This principle reflects both the idea of not inflicting intentional harm, and not engaging in actions that risk harming others (Forester-Miller & Rubenstein, 1992). 3. Beneficence reflects the counselor's responsibility to contribute to the welfare of the client. Simply stated it means to do good, to be proactive and also to prevent harm when possible (Forester-Miller & Rubenstein, 1992). 4. Justice does not mean treating all individuals the same.Kitchener (1984) points out that the formal meaning of justice is â€Å"treating equals equally and unequals unequally but in proportion to their relevant differences† (p. 49). If an individual is to be treated differently, the counselor needs to be able to offer a rationale that explains the necessity and appropriateness of treating this indivi dual differently. 5. Fidelity involves the notions of loyalty, faithfulness, and honoring commitments. Clients must be able to trust the counselor and have faith in the therapeutic relationship if growth is to occur.Therefore, the counselor must take care not to threaten the therapeutic relationship nor to leave obligations unfulfilled. When exploring an ethical dilemma, you need to examine the situation and see how each of the above principles may relate to that particular case. At times this alone will clarify the issues enough that the means for resolving the dilemma will become obvious to you. In more complicated cases it is helpful to be able to work through the steps of an ethical decision making model, and to assess which of these moral principles may be in conflict.Ethical Decision Making Model We have incorporated the work of Van Hoose and Paradise (1979), Kitchener (1984), Stadler (1986), Haas and Malouf (1989), Forester-Miller and Rubenstein (1992), and Sileo and Kopala ( 1993) into a practical, sequential, seven step, ethical decision making model. A description and discussion of the steps follows. 1. Identify the Problem. Gather as much information as you can that will illuminate the situation. In doing so, it is important to be as specific and objective as possible. Writing ideas on paper may help you gain clarity.Outline the facts, separating out innuendos, assumptions, hypotheses, or suspicions. There are several questions you can ask yourself: Is it an ethical, legal, professional, or clinical problem? Is it a combination of more than one of these? If a legal question exists, seek legal advice. Other questions that it may be useful to ask yourself are: Is the issue related to me and what I am or am not doing? Is it related to a client and/or the client's significant others and what they are or are not doing? Is it related to the institution or agency and their policies and procedures?If the problem can be resolved by implementing a policy of an institution or agency, you can look to the agency's guidelines. It is good to remember that dilemmas you face are often complex, so a useful guideline is to examine the problem from several perspectives and avoid searching for a simplistic solution. 2. Apply the ACA Code of Ethics. After you have clarified the problem, refer to the Code of Ethics (ACA, 2005) to see if the issue is addressed there. If there is an applicable standard or several standards and they are specific and clear, following the course of action indicated should lead to a resolution of the problem.To be able to apply the ethical standards, it is essential that you have read them carefully and that you understand their implications. If the problem is more complex and a resolution does not seem apparent, then you probably have a true ethical dilemma and need to proceed with further steps in the ethical decision making process. 3. Determine the nature and dimensions of the dilemma. There are several avenues to foll ow in order to ensure that you have examined the problem in all its various dimensions. Consider the moral principles of autonomy, nonmaleficence, beneficence, justice, and fidelity. Decide which principles apply to the specific situation, and determine which principle takes priority for you in this case. In theory, each principle is of equal value, which means that it is your challenge to determine the priorities when two or more of them are in conflict. o Review the relevant professional literature to ensure that you are using the most current professional thinking in reaching a decision. o Consult with experienced professional colleagues and/or supervisors.As they review with you the information you have gathered, they may see other issues that are relevant or provide a perspective you have not considered. They may also be able to identify aspects of the dilemma that you are not viewing objectively. o Consult your state or national professional associations to see if they can pro vide help with the dilemma. 4. Generate potential courses of action. Brainstorm as many possible courses of action as possible. Be creative and consider all options. If possible, enlist the assistance of at least one colleague to help you generate options. . Consider the potential consequences of all options and determine a course of action. Considering the information you have gathered and the priorities you have set, evaluate each option and assess the potential consequences for all the parties involved. Ponder the implications of each course of action for the client, for others who will be effected, and for yourself as a counselor.Eliminate the options that clearly do not give the desired results or cause even more problematic consequences. Review the remaining options to determine which option or ombination of options best fits the situation and addresses the priorities you have identified. 6. Evaluate the selected course of action. Review the selected course of action to see if it presents any new ethical considerations. Stadler (1986) suggests applying three simple tests to the selected course of action to ensure that it is appropriate. In applying the test of justice, assess your own sense of fairness by determining whether you would treat others the same in this situation. For the test of publicity, ask yourself whether you would want your behavior reported in the press.The test of universality asks you to assess whether you could recommend the same course of action to another counselor in the same situation. If the course of action you have selected seems to present new ethical issues, then you'll need to go back to the beginning and reevaluate each step of the process. Perhaps you have chosen the wrong option or you might have identified the problem incorrectly. If you can answer in the affirmative to each of the questions suggested by Stadler (thus passing the tests of justice, publicity, and universality) and you are satisfied that ou have selected an appropriate course of action, then you are ready to move on to implementation. 7. Implement the course of action. Taking the appropriate action in an ethical dilemma is often difficult. The final step involves strengthening your ego to allow you to carry out your plan. After implementing your course of action, it is good practice to follow up on the situation to assess whether your actions had the anticipated effect and consequences. The Ethical Decision Making Model at a Glance 1. 2. 3. 4. 5. 6. 7. Identify the problem. Apply the ACA Code of Ethics.Determine the nature and dimensions of the dilemma. Generate potential courses of action. Consider the potential consequences of all options, choose a course of action. Evaluate the selected course of action. Implement the course of action. It is important to realize that different professionals may implement different courses of action in the same situation. There is rarely one right answer to a complex ethical dilemma. However, if you follow a systematic model, you can be assured that you will be able to give a professional explanation for the course of action you chose.Van Hoose and Paradise (1979) suggest that a counselor â€Å"is probably acting in an ethically responsible way concerning a client if (1) he or she has maintained personal and professional honesty, coupled with (2) the best interests of the client, (3) without malice or personal gain, and (4) can justify his or her actions as the best judgment of what should be done based upon the current state of the profession† (p. 58). Following this model will help to ensure that all four of these conditions have been met.

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Environmental Groups Essay Example for Free

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Use Of Automatic Storage And Retrieval System Information Technology Essay

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Today, with the advent of information and communication technologies, the scenario for warehouse management and materials handling in India is changing fast with introduction to IT enabled systems such as MRP, inventory management, logistics control and automated Storage and Retrieval System. The importance of warehouse management, materials handling, storage and the need for the automation in the warehousing invokes the need for an ASRS. ASRS An automated storage and retrieval system (ASRS) is a high-rise system which consists of computer-controlled methods for automatically placing and retrieving loads from specific storage locations. Thus, reduces human intervention and avoids human error. ASRS are used in applications where there is a very high volume of loads being moved into and out of storage storage density is important because of space constraints no value adding content is present in this process accuracy is critical because of potential expensive damages to the load ASRS basically involves the use of high-rise racks with a storage machine operating within the aisle, is serves both sides of the aisle. Loads are stored in the racks and retrieved either automatically or in a semi-automated fashion. The loads could either be unit loads that are palletized, or, in some cases, involve drawers and totes that are used to store smaller parts. The heights of ASRS systems can vary, depending on the application. The highest systems are 100 feet high. Improved material control is one of the most important functions of an ASRS. Using an ASRS to automatically store and retrieve product provides the means for controlling the movement of material, and eliminates the possibility of human error. Another important benefit of an ASRS system is the immediate reporting of moves completed, which provides a critical link in the chain of information systems that control inventory. Components of an ASRS: A basic ASRS system is comprises of one or more aisles which have a robotic crane to retrieve from and store product in the racks on either side of the aisle. The use of a robotic crane allows racks to be built several stories high over almost any length, providing more storage density than almost any other storage solution. The cranes also bring the materials to the operator which virtually eliminates wait, walk and cycle times. ASRS systems can also handle a variety of materials, from small bins of parts up to entire pallets of materials, with fast cycle times and high precision. An ASRS consists of the following: Rack Structure The racks can either accommodate palletized unit loads or totes/bins or drawers, depending on the size and characteristics of the part. Other types of racks are cantilever racks, flow racks, and any other specially designed storage structure. The rack openings are typically standardized, as the cost of non-standard, or customized, openings can be significantly higher than those for the standard openings. The pallets do not leave the warehouse to customers, including manufacturing. The reason for this is the rough use received by pallets in loading/unloading and in transportation. Damaged pallets with nails or slivers sticking out can cause serious problems in the operation of an ASRS. Also, the rack structure can be either free standing, or the building can be rack supported. Storage/Retrieval Machine The storage retrieval machine operates within a storage aisle. Its function is to store and retrieve loads. It is designed for applications requiring high lifts, fast speeds, control features and accurate positioning, not available in other types of material handling equipment. Typically, it consists of a structural frame of either a single or multiple mast construction. The lower portion of the frame has wheels which normally run on a single floor rail or two rails. The frame is guided by support from the storage structure at the top of the structural frame. The structural frame of the storage retrieval machine is used to guide the carriage for accurate locating of the load as it is raised and lowered. The carriage carries the mechanism to carry, store and retrieve the load. The storage and retrieval mechanism can either be a shuttle device or a pushpull arrangement with a pin to engage/disengage the load. The storage and retrieval mechanism also must be able to transfer loads to and from conveyors, shuttle cars and Pick and Deposit stations. The storage retrieval machine is typically captive in a single aisle, with one storage retrieval machine per aisle. There are cases, however, where the storage retrieval machine can operate in more than one aisle. In this case, a transfer car is required at the end of the aisle to transfer the storage retrieval machine from one aisle to another. The choice of one versus the other configuration depends on the cost and the throughput requirements. Typically, storage retrieval machines service both sides of the aisle and can operate in very narrow aisle configurations, where the aisle is only marginally wider than the load. The storage retrieval machines can have a person on board, or can be completely unmanned. The person-on-board systems permit less than a full unit load to be picked from a storage location. P D Stations (Transfer Stations): Pick and Deposit station is a location at which a load is entering or leaving storage is supported in a manner suitable for handling by the S/R machine. These may be a simple as a fork truck setdown station, a shuttle car, a conveyor section or an Automatic Guided Vehicle System (AGVS). Normally, every AS/RS has at least one pick-up station and one delivery station. P D stations are usually located at the end of the storage aisles. Sometimes the P D stations are integrated with an in-plant or warehouse transportation system. Features of ASRS: Following are the main safety features of AS/RS. AS/RS systems are typically automated man less system, they almost eliminates human interaction with moving equipment and increases the occupational health safety levels in warehouses. All operational commands are given electronically from host system and thru pre-programmed path logic, eliminating all major risks associated with material equipment damage. Catching devices over speed governors are provided for hoisting movement to arrest over speed/acceleration of equipment, ensuring absolute trouble free operation. Limit switches safety bumpers are provided at end of aisle to detect avoid over-travel of equipments. Physical dimensions of load/pallet are checked in all three directions while entering of pallet on forks over dimensional loads are rejected from the system, ensuring only suitable sized objects gets handled by AS/RS. Motion of load handling device (LHD) are locked during vertical horizontal travel of equipment. Unlike fork trucks/battery stackers, AS/RS do not have telescopic mast. AS/RS mast is supported by bottom top rail, restricting sway of mast during travel of equipment. Benefits of ASRS: Provides make-to-order capability in addition to make-to-inventory production Real-time inventory control and instantaneous reporting functionality Bringing material to the operator cutting cycle time by eliminating wait, walk, and search time. Reduces work-in-progress inventory. Better inventory accuracy and better responsiveness to need result in reduction or elimination of safety stock in the overall inventory model. This has the net effect of inventory reduction. Dramatically increases operator productivity. The Part to Picker model of order fulfilment is 3 to 5 times more productive that having the picker travel to the part to complete the fulfilment. Provides real-time inventory control with instant reports. With near 100% accuracy and real time information about the inventory on hand, achievable commitments can be made to your customer as opposed to best efforts promises. Improves product quality and productivity. Real time information, faster response to a need, physical protection, and traceability of material access all contribute to a better process where time can be spent on improving the quality of the process instead of on expediting material to a point of use. GLOBAL SCNERIO: An automated storage and retrieval system (ASRS or AS/RS) consists of a variety of computer-controlled methods for automatically placing and retrieving loads from specific storage locations. Automated Storage and Retrieval Systems (AS/RS) are typically used in applications where: there is a very high volume of loads being moved into and out of storage; storage density is important because of space constraints; no value adding content is present in this process; accuracy is critical because of potential expensive damages to the load. AS/RS Systems are devices designed for automated storage and retrieval of parts and items in manufacturing, distribution, retail, wholesale and institutions. They focus on bringing goods to the man rather than manual walking and searching. Space savings, increased productivity/reduced labour, increased accuracy and reduced inventory levels are some of the primary benefits. Ideal for lean manufacturing, sustainability, six sigma, Kahnban, JIT and other value added methodologies and processes. Material Handling Institute of America (MHIA), the non-profit trade association for the material handling world, and its members have broken AS/RS into two primary segments. Fixed Aisle and Carousels/Vertical Lift Modules (VLMs). Both sets of technologies provide automated storage and retrieval for parts and items, but use different technologies. Each technology has its unique set of benefits and disadvantages (like everything in the world). Fixed Aisle systems are characteristically larger systems where as Carousels Vertical Lift Modules are used individually or grouped, but in small to medium sized applications. Fixed Aisle AS/RS is categorized into three main types: single masted, double masted, and man-aboard. Most are supported on a track and ceiling guided at the top by guide rails or channels to ensure accurate vertical alignment, although some are suspended from the ceiling. The shuttles that make up the system travel between fixed storage shelves to deposit or retrieve a requested load (ranging from a single book in a library system to a several ton pallet of goods in a warehouse system). As well as moving along the ground, the shuttles are able to telescope up to the necessary height to reach the load, and can store or retrieve loads that are several positions deep in the shelving. To provide a method for accomplishing throughput to and from the AS/RS and the supporting transportation system, stations are provided to precisely position inbound and outbound loads for pickup and delivery by the crane. In addition, there are three types of AS/RS devices called Vertical Lift Modules (VLMs), Horizontal Carousels and Vertical Carousels. These systems are used either as standalone units or in integrated workstations called pods. These units usually are integrated with various types of pick to light systems and use either a microprocessor controller for basic usage or inventory management software. These systems are ideal for increasing space utilization up to 85%, productivity levels by 2/3, accuracy to 99.9%+ levels and throughput up to 750 lines per hour/per operator. Man-aboard AS/RS: A man-aboard AS/RS offers significant floor space savings. This is due to the fact that the storage system heights are no longer limited by the reach height of the order picker. Shelves or storage cabinets can be stacked as high as floor loading, weight capacity, throughput requirements, and/or ceiling heights will permit. Man-aboard automated storage and retrieval systems are far and away the most expensive picker-to-stock equipment alternative. Aisle-captive storage/retrieval machines reaching heights up to 40 feet cost around $125,000. Hence, there must be enough storage density and/or productivity improvement over cart and tote picking to justify the investment. Also, because vertical travel is slow compared to horizontal travel, typical picking rates in man-aboard operations range between 40 and 250 lines per person-hour. The range is large because there is a wide variety of operating schemes for man-aboard systems. Man-aboard systems are typically appropriate for slow-moving items where space is fairly expensive. Vertical Lift Module The VLM is a computer controlled automated vertical lift module, storage and retrieval system. Functionally, stock within the VLM remains stationary on front and rear tray locations. On request a movable extractor unit travels vertically between the two columns of trays and pulls the requested tray from its location and brings it to an access point. The operator then picks or replenishes stock and the tray is returned to its home. VLM system offers variable tray sizes and loads, which could be applied in different industries, logistic, as well as office settings. The VLM systems could be customized to fully utilize the height of the facility, even through multiple floors. With the capability of multiple access openings on different floors, the VLM system is able to provide an innovative storage and retrieval solution. The rapid movement of the extractor as well as the integrated inventory management software can dramatically increase the efficiency of the picking process. Unlike large AS/RS systems, which require a complete overhaul of the warehouse or production line, the Vertical Lift Module are modularized, which can be easily integrated into the existing system, or to be rolled out in gradually over different phases. This is the first model of the same. Horizontal Carousels: A horizontal carousel is a series of bins which rotate on an oval track. Every bin has shelves which are adjustable to .75 and can be configured for a myriad of standard and special applications. An operator simply inputs a bin number, part number or cell location and the carousel will rotate via the shortest path. Multiple horizontal carousels integrated with pick to light technology and inventory management software (a pod of carousels) are used for order fulfilment. A wave of orders are sent to the pod. A group of orders are selected to create a batch. The operator simply follows the lights and pick round robin from the carousels and place items in a batch station behind them. Each carousel pre-positions and rotates when picked, so it is awaiting for the operator who picks round robin till the batch is complete. When the batch is complete, a new batch is inducted and the process repeated until the wave is complete. Horizontal carousels can save up to 75% of floor space, increase productivity by 2/3, accuracy levels to 99.9%+ levels and throughput up to 750 lines per hour/operator. Horizontal carousel systems generally outperform robotic systems which are very vogue right now for a fraction of the cost. Horizontal carousels are the most cost effective AS/RS system available. Unit-load AS/RS are used in distribution centres Unit-load AS/RS are used in distribution centres for storing pallet loads of goods, replenishing of mini-loads or for direct picking. In manufacturing plants they store raw materials, finished goods, work in process and spare parts for equipment. With companies being forced to do more with fewer resources and fewer employees, the benefits of a unit-load automated storage and retrieval system are 100 percent order control, visibility and traceability within your facility, says Todd Jedelsky, account executive with Murata Machinery. The system keeps account of whats going in and out, so users are not correcting mistakes as frequently. As the economic downturn forces more companies to practice lean handling techniques, the latest developments in these technologies are yielding more efficient picking and enhanced returns on investment. Here is a look at the latest trends. Mini-load AS/RS systems have incrementally crept up in heights and speeds in recent years. Now reaching as high as 78 feet, with travel speeds as fast as 23 feet per second, suppliers have been developing independent mini-load handlers and drive systems that compensate for mast movement with motor-driven anti-pendulum and belt-driven omega drives. Well-entrenched in food and beverage handling, mini-load AS/RS is growing in popularity for smaller retailers, adds Bill Ostermeyer, vice president of sales at viastore systems. The technology allows you to do a better job at sequencing and fine tuning the cubing and loading of trailers for efficient delivery and unloading at the retail stores. This is because of the ability to control the release out of the system in a very logical manner. Unit Load, Mini-Load, or Layer-Load AS/RS Improve Sales Profitability with these storage solutions Which type of load do you need to store and retrieve? à ¢Ã¢â€š ¬Ã‚ ¢ Unit Load pallets, paper rolls, bakery trays, etc. à ¢Ã¢â€š ¬Ã‚ ¢ Layer-Load layers of different products à ¢Ã¢â€š ¬Ã‚ ¢ Mini-Load container based small parts à ¢Ã¢â€š ¬Ã‚ ¢ Self Storage Containers à ¢Ã¢â€š ¬Ã‚ ¢ Car Parking Systems Virtual pallet movement Faster speeds and smoother motion are visible improvements. A more important advancement is the software that manages the systems. Software capability has defined the technology since its inception: the automation arm of defense contractor Litton Industries created the dominant supplier decades ago. The successor organization is HK Systems Inc., and software development remains a focus. Full pallet movement will remain the distribution mode of breweries and other large-scale bottlers for the foreseeable future, but distributors and other food segments need systems that can retrieve cases from a variety of locations and assemble them for shipment. Rainbow pallets can be built automatically, but the cost is out of line with the labor savings. Proof of concept has been done on mixed-SKU automation, he adds, though commercialization is years away. But the batch picking and wave planning capabilities of todays systems already are far superior to traditional sortation systems, and whats changing the game is the sophistication of the software. Refrigerated storage with deep racks is becoming more common in food applications, and rising energy costs will accelerate the trend. Overview of Warehouse ASRS in India: In India, a warehouse has been generally perceived to be a place to store things, out of sight, and out of mind, certainly not an image of high tech or sophistication. In fact, most plant modernization efforts have typically ignored or bypassed the warehousing segment completely. Since quality warehouses are few, warehouses charge a premium for providing value-added services. Describing the Indian scenario Till the 90s, most of the warehouses were nothing but a tin shed with four walls. All the goods were mostly stored on the floor and handled by manual labour. Automation was practically unheard of except in some MNCs who were present then. With the entry of many new MNCs as well as global Third Party Logistics(3PL) service providers in late 90s and early 2000, the warehouse infrastructure started improving. Storage and Material Handling Equipments (MHE) started getting much needed attention. Today we have many players, both domestic (TCI, Indo Arya, Safexpress, M J Logistic) and foreign (Toll, Arshiya, etc.) who are investing millions of rupees to construct world class warehouses/logistics centres and equip them, with the latest storage and handling equipments as well as IT systems. MJ Logistic, a leading 3PL solutions provider, began operations of its state-of-the-art four-million tonne capacity cold storage warehouse and distribution facility with new customer acquisitions in the frozen food vegetables segment at its Palwal facility in Haryana near Delhi. According to CrISIL research estimates, the market size of the warehousing industry as on 2009-10 stood at Rs 250-300 billion, with size of the industrial and agricultural warehousing segment, excluding temperature controlled warehousing, in the range of Rs 220-260 billion and Rs 30-40 billion, respectively. Warehousing industry has grown at 8-10 per cent per annum. Industrial warehousing and agricultural warehousing have grown at the rate of 9-11 percent and 3.5- 4.5 per cent per annum, respectively. Several factors such as growth in external trade, growth across major industry segments such as automobile, pharmaceutical, fast moving consumer goods (FMCG) and the emergence of organised retail have favourably impacted growth of the warehousing industry. Despite this growth, the general perception is that warehouses are places to simply store things, while big companies have their own warehousing facilities, smaller ones depend on the services provided by private operators, mostly in the unorganized sector. Warehousing automation: Warehouse automation in India is at its infancy. Right now, only big players are in a position to implement automation. Most small and medium enterprises are yet to adopt it. Typically, the small players do not have long-term plans, and, therefore, look for quick results from their investments. Warehouse automation requires considerable investment and the benefits are only realised after a while. This has dissuaded the small players from investing in warehouse technologies. High end technologies such as radio Frequency Identification (rFID), Barcodes and other advance tracking system are must for any warehousing company to sustain in the market today, Emphasizing that the warehouses should have adequate mechanical, technical and auxiliary systems to facilitate speedy functioning, Minda says, Loading unloading, material handling, ciphering, transferring and tracking would be the key operational attributes of warehouse.WMS (Warehouse Management System) are there with visibility and key warehousing analytics. Major Companies using ASRS in India: Genix Automation Pvt.Ltd, Pune was founded in 2006 and is providing Automation solutions in India. It has been servicing Automotive OEMs for their facility Automation. The company has in a very short time bagged numerous projects from almost all major car manufacturers. 1. GENIX Automation has supplied total solutions to Fiat India 2. GENIX has supplied engine storage system (ASRS) to TATA motors 3. GENIX has supplied system to NISSAN motors. 4. GENIX has supplied system to Ford motors. 5. GENIX has supplied system to Volks wagon motors. M J Logistic Services Ltd: Clients Acenorca S.C.L Bharti-Walmart Colgate Palmolive Coca Cola (India) Pvt. Ltd. Danisco India Pvt. Ltd Darshan Foods Pvt. Ltd. Family Health International (FHI) Hindustan Coca-Cola Beverages Pvt. Ltd. ITC Limited Kirloskar Brothers Limited Kwality Dairy India Ltd. Mico Bosch Philips Electronics Ltd. RFCL Limited Republic Of Chicken Tata Motors Limited SCOPE IN INDIA GENIX INDIA SCOPE à ¢Ã¢â€š ¬Ã‚ ¢ Manufacturing Installation of Underguarding à ¢Ã¢â€š ¬Ã‚ ¢ Installation of Overhead Conveyor. Project : Ford Chennai , Bumper Line à ¢Ã¢â€š ¬Ã‚ ¢ Manufacturing Installation of Complete PBS Structure 220Tonnes à ¢Ã¢â€š ¬Ã‚ ¢ Manufacturing Installation of Line Side Utility Structures . Project : Ford Chennai , PBS ( Painted Body Storage ) à ¢Ã¢â€š ¬Ã‚ ¢ Manufacturing Installation of Transfer Mezzanine 40 Tonnes . à ¢Ã¢â€š ¬Ã‚ ¢ Mfg Installation of Dropà ¢Ã¢â€š ¬Ã‚ lift Safety Fence Project : Ford Chennai , Trim 1 to Trim Over head Transfer Managing the Risks of AS/RS: There are a few simple rules to investing in warehouse automation: Buy only the highest quality equipment. Dont think that the best deal will provide the lowest cost to your firm. The down-time associated with problems from lower quality equipment is too expensive and will quickly erode the initial cost savings. Think long-term: Every successful business has a vision that requires small, steady steps to reach goals that are realistic and profitable. Because an AS/RS has a 20+ year life, dont expect a 12-month payback. Introduce operating personnel early: Include operating personnel early in the process and make them a part of the project team before the system goes on-line. Think proactively: Preventive maintenance is far less expensive than reactive repair. Talk to the experts who design and maintain the equipment and take necessary action. Dont buy from companies that cannot demonstrate: Their successful expertise in environments similar to your project requirements. These rules sound basic and simple. All too often, however, one or more are not applied, which results in unrealistic expectations and frustration. At Westfalia, we avoid this by sticking to the fundamentals, staying within our core competencies, and making sure that we can fully identify with the customers problem domain. CASE: High Performance Picking System Eliminates Replenishment Labor Features/Benefits Provided: à ¢Ã¢â€š ¬Ã‚ ¢ Dynamic Slotting of SKUs à ¢Ã¢â€š ¬Ã‚ ¢ Automatic Replenishment à ¢Ã¢â€š ¬Ã‚ ¢ Pick to Light Interface à ¢Ã¢â€š ¬Ã‚ ¢ Replenishment Labour Eliminated The warehouse and conveyor systems of a European cutlery supplier were technically outdated. Some of the spare parts were no longer available. Moreover, the profile of the orders received had changed over the years. The average size of shipments had decreased while the number of shipments had increased. At the same time, the packaging variety increased due to the companys growing international orientation. The company decided to respond to these new market challenges by restructuring the intra-logistic processes in its warehouse and distribution center. The selected supplier was to design and build a completely redesigned central warehouse and distribution center using the existing building structure. This presented the challenge of performing the modernization work without interrupting the day-to-day operations. A High Performance Picking System (HPPS), an intelligent combination of mechanics and software, met the project requirements. Through the use of the HPPS, customer orders and replenishment of stock are performed quickly, efficiently, and ergonomically. There are several distinct advantages of the HPPS. The pick faces of the pick-to-light system are automatically replenished with the required containers, and the storage and retrieval (S/R) machines automatically remove containers and cartons when they are empty or when dynamic slotting of slow moving SKUs is required and beneficial. The containers are placed directly in a sloping rack position that allows for a comfortable and highly ergonomic access to the containers during picking, thereby reducing pick cycle times. The HPPS incorporates an S/R machine designed with a carriage that tilts the load handling device (LHD) to correspond with the slope of the pick channels. is a proud member of AS/RS, a Product Section of the Material Handling Industry of America

Reflective Essay on Acutely ill Patient Mrs Smith

Reflective Essay on Acutely ill Patient Mrs Smith This essay will be a reflective essay focussing on a critical incident that took place whilst being at practice placement earlier in the year. A critical incident is defined as a learning technique that breaks an event down into its main components for the purpose of reflective analysis (Hoystonard, and Simpson, 2004) The essay will give a critical analysis of an event with an acutely ill adult and will use Gibbs model of reflection (1988) to do so. For the purpose of this essay, the patient will be referred to as Mrs Smith. The reflective model I have chosen to use is Gibbs model of reflection (1988). Gibbs model of reflection incorporates the following: description what happened?, feelings what were you feeling?, evaluation what was good or bad about the experience?, analysis what sense can be made of the situation?, conclusion what else could you have done?, and an action plan if the situation arises again what would you do?. The model will be applied to the essay to facilitate critical thought, relating theory to practice where the model allows. This incident occurred in the middle of my 10 week placement on the ward. My reason for using this critical incident is because of the impact that it had on me. I did not expect to see my mentor in a situation which she did not appear to be able to cope with, principally through lack of communication. Mrs Smith is a 46 year old lady suffering from acute myeloid leukaemia (AML). In order to provide treatment for this disease, it was decided that a Hickman line would be the most appropriate type of access for the patient, so this procedure was performed in theatre under sterile conditions. Mrs Smith was well enough to go home just a few hours after the procedure but started to feel unwell the following morning. She was experiencing extreme pain at the wound site so returned to hospital. When Mrs Smith returned to the ward it was clear this event was serious as her neck and chest were very red and inflamed looking and she was showing all the signs and symptoms of a severe infection, i.e. temperature of 38+C, heart rate greater than 90 beats per minute, respiratory rate greater than 20 breaths per minute and white blood cell count greater than 12,000. These combined symptoms are known as the Systemic Inflammatory Response Syndrome. This, in conjunction with a confirmed infection is kn own as Sepsis. My mentor and I immediately began the process of managing the infection, keeping Mrs Smith stable and preventing further deterioration in her condition. Although we managed to prevent Mrs Smith from progressing to septic shock, I felt the management of the situation could have been handled better by my mentor, enabling me to provide better care. This is the issue which I would like to reflect on. My thoughts and feelings towards this event were initially fear ,as I had not dealt with such a seriously ill patient before and I was worried that my mentor would expect more from me than I was capable of giving. I felt under pressure as things had to be done quickly and I did not want my mentor to think I was not capable in a critical situation. I also did not want the patient to feel that I was not able, and that she was not in safe hands. Durbin (2004) has said that critically ill patients may experience many unpleasant and frightening events, so the use of reassuring mannerisms and honest communication improves patient comfort. My mentor started to become flustered and was not staying calm which was what was needed in this situation. I felt that procedures were being rushed and not done as well as they could have been owing to the pressure of the situation. My mentor was trying to do everything herself and not communicating with either myself, the patient or other staff members, causing uncertainty and confusion. Houston (2009) states that keeping calm under pressure will enable you to make good decisions, have a better judgement, and be able to deal with patients and their families better. I was trying to think and plan ahead for Mrs Smiths care but knew I was not achieving this because of the lack of communication from my mentor. I wanted to ask my mentor to calm down as it was not helping the situation, and I imagined that it was making the patient feel worse and more anxious seeing this lack of control from the nursing staff who were supposed to be helping her. Mrs Smith just needed to be reassured and kept calm during this initial crucial hour, but I could see that we had not achieved this and she looked very worried. McCabe (2003) states that patient-centred communication is vital to encourage and support both nurse and patient in a critical situation and Radcliffe (2006) is a firm advocate of improving communication with patients . As blood cultures and urine samples were taken and the administering of antibiotics began, the patient eventually stabilised and vital signs began to improve which was a great relief as we both now felt more in control of the situation. It was not until then that my mentor began to deliver better care and I started to plan ahead for what would be needed next. Gillie and Thorman (2008) state that having a positive attitude will let you be more in control of a critical situation, and that being positive shows you have the strength to stand up to a negative situation. I did not go into this event with a positive attitude as I had never experienced this before and initially just felt panicked and under pressure. However, in future I will always have a positive attitude when going into a new and difficult situation as it will have a greater effect and better outcome for all involved. Mrs Smith was now being managed for sepsis and my mentor had removed the source of infection which was proven to be the Hickman line, and inserted a urinary catheter to monitor Mrs Smiths urinary output as she had not passed urine at all that day. She was given IV fluids to maintain her circulating volume and I continued to monitor her vital signs and assess Mrs Smiths mental state. The antibiotic therapy should have been started earlier, but owing to my mentor not contacting the doctor quickly enough, this delayed the patient being stabilised quicker. If my mentor had remained calmer then she would have been more focussed on what was a priority. Prioritising what has to be done first, is an essential skill nurses need in order to provide a good level of nursing care, Castledine (2002). I felt this was a negative aspect of my experience as I knew myself that we had not prioritised and that antibiotic therapy should be started shortly after diagnosis of sepsis to prevent further deter ioration. However, positive aspects of the experience were that I learned that I was calm under pressure and was able to reassure the patient when I did not think I could. Another positive aspect was that my mentor and I managed to control the sepsis before the patient went into septic shock. She was however, already showing signs of severe sepsis as her kidney function had altered. On looking back and analysing the situation, it was a worthwhile exercise as it was a good learning curve for me on how not to act in a critical situation. I did not want to be like my mentor who was flustered and panicking and therefore not thinking properly, as I saw how it affected the situation. Because of this critical incident occurring, I learnt valuable skills that I will use in other situations, should they arise. Skills such as, staying calm and not panicking, communicating with the patient to reassure them they will be ok and communicating with relatives as they need to know what is going on as well. Acting quickly under pressure, but not too quickly which may cause mistakes to happen. Also, very importantly, to ask for help when required. If this situation was to happen again, I feel I am more prepared and would not have the initial feeling of worry and fear, as I know what to expect and am capable of carrying out what may be asked of me. On making sense of the situation, I realise I am more confident now not only in this situation but other tasks that are asked of me in the practice placement. This incident began as what should have been a straightforward case of managing sepsis, but soon turned into a worrying case of possible severe sepsis and losing control of this situation all down to panic, lack of forward planning and lack of communication. Robson and Daniels (2008) discuss how the Sepsis Six Bundle could have been used in this situation, as it has been introduced in 2007 for cases exactly like this, reducing mortality rates by 25%. Six simple steps to be followed within the first hour and severe sepsis will be avoided. Mitchell et al (2004) looks at the changes made to the patients care if sepsis is managed well and how one of the roles of the nurse in this situation must be to keep the patient reassured as much as possible. Reassurance would have kept Mrs Smith from becoming more panicked and would have made the event slightly easier for myself and my mentor. Once the initial hour had passed and the management of the sepsis was under control, Mrs Smith became more stable and was relieved to have her pain under control. After a few days on a course of antibiotics, Mrs Smiths infection soon cleared. On reflection, I now know what was good and bad about this event and what to take from it. If a situation like this were to occur again, the first thing to apply would be a positive attitude leading to a more controlled and calmer management of a critical incident. Being more in control of the situation makes forward planning easier to do and better nursing care can be achieved. The patient would benefit greatly and a lot more quickly than a rushed, uncontrolled environment. Fewer mistakes would occur and simple tasks would not be missed as the nurse involved would be more focussed. Proper communication is a huge factor in how any incident turns out. Anderson (2009) states that breakdown in communication can cause negative outcomes, and warns about poor communication, especially with patients and their families. Lack of communication can lead to lack of trust and mean that any future communications could well be disregarded. Egan (2007) states that the face and body are very communicative and in this situation the patient was picking up my mentors uncertainty and panic eve n through her non-verbal communication, making her worried and ill at ease. McCabe and Timmons (2006) stress how important communication is in establishing rapport with the patient, again building up trust. Coulehan et al (2001) also note how communication, using empathy helps to establish a relationship with both patient and relatives. In a future situation I would ensure proper communication with all involved especially the patient, to put them at ease and reassure them that the staff knows what they are doing. Now that I have had this experience and learnt from it, I have gained a lot more confidence in how to better manage a patient in a similar situation, not just a critical incident. Being more confident lets the patient know that you are in control and can put their mind at ease, Penzien and Rains (2007). I would know not to show fear, as there was not anything to fear and the last thing the patient needed was to feel worried she was not in safe hands.

Phaedra Essay -- essays research papers

Theseus was the son either of Poseidon or Aegeus the king of Athens. His mother was Aethra. The childless Aegeus consulted the Delphic Oracle and was told not to untie his wine skin until he returned home. He did not understand what the oracle meant and so visited his friend King Pittheus of Troezen. Realizing that Aegeus was going to beget a powerful son immediately after the celebration feast for his safe return to Athens, Pittheus made his guest drunk and put him to bed with his daughter Aethra, and so Theseus was conceived. Before he left for home, Aegeus took the pregnant Aethra to a great boulder underneath which he placed his sword and sandals. He told her that, should she have a son, she must wait until he was strong enough to raise the boulder before she sent him to his father's court. After Aegeus' departure the wily Pittheus said his daughter's lover was really Poseidon. When Theseus came of age, Aethra explained that he was heir to the Athenian throne and he retrieved the sword and sandals. On his journey to Athens he slew several desperate bandits, a fearsome son of Hephaistos, and a dreadful sow, the daughter of the monster Typhon. At Eleusis, then a kingdom separate from Athens, Theseus was forced to accept the challenge of a wrestling match with its king, Cercyon. The aggressive ruler died as a result of the contest, so Theseus became king of Eleusis, which he later added to the Athenian kingdom. On his arrival in Athens, Theseus learned that his father A...

ozone layer :: essays papers

ozone layer Summary of Learning of the Ozone Experience On the 16th of September 1987, negotiators meeting in Montreal finalized a landmark in international environmental diplomacy: the Montreal Protocol on Substances That Deplete the Ozone Layer. The Successful Conclusion of the negotiations in Montreal was widely hailed at the time as a historic even. As the protocol was the most ambitious attempt ever to combat environmental degradation on a global scale. In the 10 years since that meeting in Montreal, the accord has set in motion myriad actions by national governments, international organizations, scientists, private enterprises, and individual consumers. The results are clear: by 1995, global production of the most significant ozone-depleting substance (ODS) the chlorine, containing chlorofluorocarbon (CFCs) was down 76 percent from its peak in 1988. But three is a substantial lag between the time when emissions begin to decline and the point at which the ozone layer begins to recover, as it takes years for CFCs and other ozone-depleting compounds to reach the stratosphere, and some last for centuries once there. Yet it is clear that the Montreal Protocol ushered in a new era of environmental diplomacy. Although in some ways the ozone story is an inspiration, in other respects it is a cautionary tale. Since it’s beginning, the ozone experience has been characterized by a path breaking partnership between scientist and international policymakers. When CFCs were invented in the late twenties, they were viewed as wonder chemicals nontoxic, nonflammable, non-corrosive, and stable. The seeds of the Montreal Protocol were sown in 1974, when chemist Mario Molina and Sherwood Rowland at the University of California at Irvine published a landmark article in Nature. It hypothesized that the stability CFCs, while an asset for industrial applications, might prove deadly for the ozone layer. Yet the scientific process was initially slow to yield clear answers. Indeed, models in the early eighties suggested that CFCs would cause less severe ozone depletion than Molina and Rowland had initially hypothesized. Fortunately, the scientific collaboration initiated years earlier began to bear fruit. Two months after the Vienna agreement was reached, a scientific bombshell provided a much-needed jolt to protocol negotiations just then getting under way. The findings took the world by surprise: no such precipitous decline had been predicted by any atmosphere models. Ten years after the historic Montreal signing ceremony, the response to the protocol around the world has been substantial indeed.

Cartoon Violence, Has it gone too Far Essay -- essays papers

Cartoon Violence, Has it gone too Far Aggression. Killing. Revenge. Sound like the latest Scream movie or Keanu Reeves thriller? You may be surprised to hear that this describes the average Saturday morning cartoon. One of the most surprising facts is that the level of violence during Saturday morning cartoons is higher than the level of violence during prime time. There are 3 to 5 violent acts per hour in prime time, versus 20 to 25 acts per hour on Saturday morning (Gerbner,1). Violence on television in general is damaging to society. But the specific targeting of the younger population through the use of cartoons to show violence is destructive and in no way helping to profit the upcoming generation. Violence in cartoons is harmful to children in many ways. Desensitizing children, increasing aggressiveness, and increasing their fear of becoming victims in real life, are all accredited to violence on television. â€Å"Myriad studies show that television violence affect children by desensitizing children to the horror of violence, teaching them to accept violence as a solution to problems, teaching them to imitate the violence they see on the television and leading them to identify with characters seen on television (and thus imitate the characters they identify with) (Parenthood Web).† The amount of violence in television programming is obviously directly related to the amount of violence witnessed by children. The more of a role that television plays in the daily activities the more of a role violence will influence that child. In 1985 alone, 85% of all television programming contained violence, with 92.1% of cartoons aired containing violence. These cartoons generally contain one violent act every three minutes ... ... and go straight to fighting. Children are becoming more desensitized, more aggressive and more afraid with the huge influx of violence on the glowing television set in all of our homes. Clearly, the children watching television all over the world are learning to embrace violence, often the wrong solution to any problem. Violence in television should not be banned, however, the frequency of the violence in television shows, especially cartoons aimed at kids, should be cut down significantly. Bibliography: Work Cited 1. Chen, Walter. http://interact.uoregon.edu/MediaLit/FA/MLArticleFolder/kalin.html, 2000. 2. Gerbner, George. http://www.4children.org/news/1- 97vtch.htm, 1999. 3. Liebert and Sprafkin. Violence in the Media. New York: Basic Books, 1990. pages 115-120. 4. The Parenthood Web. http://www.4children.org/news/1-97vtch.htm, 2001.

Civil Disobedience: Henry David Thoreau and Rev. Dr. Martin Luther King Jr

â€Å"Disobedience to be civil has to be open and nonviolent. † – Mahatma Gandhi Throughout history philosophers have played a key role in our society. Both Henry David Thoreau and Dr. Martin Luther King Jr. brought forth their own ways of civil disobedience, in their belief that it was imperative to disobey unjust laws. Their thoughts manifested from ideas, to theories, and eventually lead to our society today. Civil disobedience in a pragmatic way is the act of a non-violent movement in order to enforce the change of certain laws to ensure equality for all. Dr. King explained in his quote â€Å"One who breaks an unjust law must do so openly, lovingly, willingly to accept the punishment† (220). Nevertheless, on opposite ends of the spectrum, Thoreau implied an aggressive stance motivated by his own personal hate for the government but yet King used religion, supported by his charismatic ways of being gentle and apologetic. While King and Thoreau both believed in the use of civil disobedience to create change, they went about using civil disobedience in staggeringly different fashion. As stated by Dr. King in his letter from Birmingham Jail, â€Å"Injustice anywhere is a threat to justice everywhere† (214). Regarding this issue, King believed that all American communities are connected and that injustice in one community will affect other communities. Perhaps, one could deem injustice as a disease such as cancer that forms in one area then quickly spreading and eventually discombobulating the entire social infrastructure. Dr . King reshaped America’s social issues through a non-violent approach in distinction to boycotting buses in Montgomery to marching through Selma, King responded to unjust laws with civil disobedience and direct action. Dr. King’s stance on prejudice laws came from morality. Primarily using morality as a backbone in his argument, we would agree that it is wrong to foster laws that affect a certain race or group of people. Moreover, our laws are a reflection of our morals and it sets forth what we know is right and what we know is wrong. Early philosophers often struggled and faced opposition with either the government or social groups. Opposition faced consequences such as confinement, torture, or worse, death, whereas the idea of brutal punishment inflicted fear on the next individual. In his â€Å"Letter from Birmingham†, King compared his calling to Birmingham to the Apostle Paul in the Bible, â€Å"[and how he] carried the gospel of the lord to the far corners of the Greco-Roman world† (214). King expressed a legitimate concern over the anxiety to break laws; elaborating the fact that there are two laws; just laws and unjust laws. King stated, â€Å"In no sense do I advocate evading or defying the law† (220). Rather more, King agreed that just laws should be followed; however unjust laws are to be met with civil disobedience. What makes a law unjust one might ask? From the terms of St. Thomas Aquinas, King explained that â€Å"any law that degrades human personality is unjust†. (219) Segregation gives the segregator a false sense of superiority and distorts the soul and damages the personality. Back in Dr. King’s time, a series of laws were passed that were the ethos of â€Å"separate but equal†. King rallied in oppositi on of these laws as still prejudice and unjust, in fact these laws were against morals. Under this doctrine, services, facilities and public accommodations were allowed to be separated by race, on the condition that the quality of each group's public facilities was to remain equal. Signage using the phrases â€Å"No Negros allowed† and â€Å"whites only† distorted our views on race relations. However, King believed this in fact is not equality and it is against our morals. As a result of Henry David Thoreau using civil disobedience and direct action, Dr. King was motivated by his techniques which lead to a series of events that would lead to the Civil Rights Movement. â€Å"All men recognize the right of revolution; that is, the right to refuse allegiance to, and to resist the government when its tyranny or its inefficiency are great and unendurable† (180). As Thoreau explained in his excerpt from â€Å"Civil Disobedience†, Thoreau used the revolution of ’75 as an example of bad government. Thoreau elucidated how the government taxed certain foreign commodities that were brought to its ports. He then began to correlate bad government to a machine and stated how all machines have their friction, however, when friction takes over a machine, â€Å"and oppression and robbery are organized, I say let us not have such a machine any longer† (180). Thoreau elaborated on this idea that the government is a machine and when evil takes over, let us no longer have such a government. He believed not that a government should exist â€Å"but at once a better government† (178), Thoreau argued that power should not be left to the majority, but the â€Å"conscience†, in fact he questioned the reader rhetorically asking â€Å"Must the citizen ever for a moment, or in the least degree, resign his conscience to the legislator? †(178) Thoreau feels that the â€Å"conscience† plays a personal role. Thoreau questions democracy, and thereupon he advises us to question why we should capitulate to the government if we do not agree with a law? Why would we possess brains and have a conscience of our own if we are not allowed to think for ourselves and do what we want? Thoreau feels we ought to be real for ourselves, not the government. Furthermore, he articulated the idea that should we surrender our thoughts, or conscience to the government, or should we pursue a justifiable explanation of the dilemmas that surround us? What is right as opposed to what is wrong is what leads to civil disobedience. Thoreau believed that the idea of paying taxes to support the Mexican-American was an unjust cause, whereas; King strongly disagreed with laws that were prejudice. In Thoreau’s reading from his article â€Å"Civil Disobedience†, he argues â€Å"that government is best which governs not at all† (177), which ultimately leads the people to discipline themselves. On the other side King explained how â€Å"nonviolent direct action seeks to create such a crisis and foster such a tension that a [community that has refused, is forced] to confront the issue† (216). By cause of King being after Thoreau’s era, King used Thoreau’s â€Å"Civil Disobedience† and direct action to spark a change in society. While both Thoreau and King argued with morality in mind, they both believed injustice exist. Thoreau thinks of injustice as friction or tension that can wear the machine down. King believes that injustice just exists and tension must be created with direct action to negotiate with the machine. I accredit Dr. King in presenting the best argument due to the audience he reached out to which of course was the populace and his motives that captivated his courageous and selfless acts. Furthermore, Dr. King was concerned about injustice towards people based on their race, religion, or sex; whereas Thoreau was motivated by his personal hatred for the government. Regardless of how either King or Thoreau used civil disobedience, their contributions led to an admiration for their works and casted a light on unjust laws.

History of the periodic table Essay

Alexandre Beguyer de Chancourtois (1820-1886) In 1863, a 44 year old French geologist, he created a list of the elements arranged by increasing atomic weight. The list was wrapped around a cylinder so that several sets of similar elements lined up, creating the first geometric representation of the periodic law. In 1862 was the first person to make use of atomic weights to reveal periodicity (i.e. when the elements were arranged according to their atomic weights, similar elements seemed to occur at regular intervals.) He drew the elements as a continuous spiral around a cylinder divided into 16 parts. The atomic weight of oxygen was taken as 16 and used as the standard against which all others were compared. Chancourtois noticed that certain of the triads appeared below one another in his spiral. In particular the tetrad oxygen, sulfur, selenium and tellurium fell together, and he called his device the â€Å"telluric helix†. The atomic weights of these elements are 16,32,79 and 128, respectively, and quite fortuitously they are multiples or near multiples, of 16. Other parts of the screw were less successful. Thus boron and aluminium come together all right but are then followed by nickel, arsenic, lanthanum and palladium. Chancourtois had discovered periodicity, but had got the frequency wrong. If a periodic table is regarded as an ordering of the chemical elements demonstrating the periodicity of chemical and physical properties, credit for the first periodic table (published in 1862) probably should be given to a French geologist, A.E.Beguyer de Chancourtois. De Chancourtois transcribed a list of the elements positioned on a cylinder in terms of increasing atomic weight. When the cylinder was constructed so that 16 mass units could be written on the cylinder per turn, closely related elements were lined up vertically. This led de Chancourtois to propose that â€Å"the properties of the elements are the properties of numbers.† De Chancourtois was first to recognize that elemental properties reoccur every seven elements, and using this chart, he was able to predict the the stoichiometry of several metallic oxides. Unfortunately, his chart included some ions and compounds in  addition to elements.

Health Literacy and its Impact on Patients Essay

Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Low health literacy has a negative impact on a patients health status and use of the health care system. Patients with low health literacy levels cannot make decisions regarding their health care or follow instructions on medications and health maintenance behaviors. This can affect health care in a variety of ways. It is the health care provider’s responsibility to ensure that patients with low health literacy levels are identified and measures are taken to ensure those patients understand their options and instructions. To educate these patients, health care providers need to develop resources that are easily understood and interview skills that can ensure patient comprehension. Research has shown that patients with a low health literacy level may be more likely to have problems following verbal or written medical advice and medication instructions or understanding health-related materials. This review discusses the commonness of health literacy and its impact on patients and the health care system, and provides recommendations for creating supplemental literature at the appropriate level. The use of these tools and improved physician interview skills will establish a better physician/patient relationship and continue to encourage patient participation in the health care process. By providing the patients with the basic knowledge to understand and adhere to the instructions given to them and the confidence to communicate any questions or concerns, the hospital is promoting a better patient/physician relationship. There was a study conducted in 2003 by the National Assessment on Adult Literacy that was released in 2006 that included a Health Literacy component that evaluated patient’s health literacy in three main categories: clinical, preventative, and navigation of the health care system. These three categories were designed to reflect things that patients would see or be asked to do in their daily lives. There were examples such as following medication instructions, scheduling health screening tests and finding one’s way to the appropriate location for a medical appointment within a health care facility. The results of this study indicated that 36-38 of adults in the United States had a basic or below health literacy level or were not literate in English and could not participate in the assessment. Another 55% of U. S. adults reported having a mid-range level of health literacy which showed room for improvement. Patients who have low health literacy levels often are not able to comprehend and follow the instructions on a medication bottle or determine the dosage information on over-the-counter medications. The inability to understand the information requested on a health care form can prevent an individual from having adequate health care coverage or having access to care when it is needed. If a patient does not have the ability to identify when treatment is needed for a medical condition, make the appointment and navigate through the health care system to be treated, their health can suffer. By not seeking medical attention at the beginning of an illness or not accessing the appropriate point of entry in a health care clinic, the patient is reducing the chance of having a positive health outcome. People with lower health literacy may wait to seek medical attention rather than utilizing preventative health services. These patients often have higher rates of admission and use services that are designed for more critical patient care. When faced with a disease or health care condition, patients are often turning to a variety of places for health information such as the internet, magazines, or books. Adults with basic or below basic health literacy levels did not turn to such resources. Physicians are with a patient such a short amount of time at each visit, yet they have so much they need to provide to the patient. At a visit to the physician several new concepts are being introduced to the adult such as discontinuing a the use of a current prescription, modification of the prescribed dose, or introducing a new medicine. It is of great importance to verify that the patient understands what is being said to them. Asking the patient to demonstrate what they just heard is more effective in gauging whether a patient understands the information. There can be additional time spend with patients, or supplemental materials can be provided to patients who have difficulty processing this critical information. Other factors that can have a negative impact on a person’s comprehension of health-related materials include limited English language skills, chronic health conditions, hearing problems, or vision problems. In order for patients to be able to most effectively use these health education materials, they should be written at lower reading levels using simple words and pictures to emphasize points. Low health literacy is a problem that continues grow in patients in the health care system, contributing to a lack of use of services, often leading to negative health outcomes. Hospitals should focus attention on their forms and the health education materials they are distributing to the patients to ensure that there materials are appropriate for all levels of health literacy. Having forms that are more easily understood may increase a patient’s ability to access and utilize appropriate hospital services. Also by giving patients more appropriate health education materials will encourage them to become more actively involved in their care by providing them with the confidence to make decisions about their treatment. As the individual relationship is built between patient and care team, the trust will follow to ask questions about information that is not clear and seek assistance when it is first needed instead of when it is a critical situation. DeMarco, Joanna. ( 2011, Spring). The Importance of Patient Education Throughout the Cotinuum of Health Care. 295-301. Journal of Consumer Health. Retrieved April 4, 2012 from EBSCOhost.