Read the Italy Defied Starbucks—Until It Didn’t case below and answer the 4 questions:
“We arrive with humility and respect in the country of coffee,” Howard Schultz, the former longtime CEO of Starbucks, told Corriere della Sera, Italy’s leading daily, last week. He was about to inaugurate, in Milan, the first Italian outpost of the global chain that supersized coffee and now vies with McDonald’s and Coca Cola as a symbol of American gastronomic imperialism. Even, of course, if Italy has one of the world’s most developed coffee cultures, which in fact is what inspired Schultz to convince the founders of the small Starbucks coffee company to open its first coffeehouse in 1984.
Italy is a country where the pumpkin is generally found in the ravioli, not the latte, and so the Milan Starbucks isn’t just any Starbucks branch. It’s a huge “Roastery” in the former Milan outpost
of the Poste, the Italian postal service, and is meant as a full “experience,” Starbucks said in a press release that has already been mocked by Eater. (“Eight Ridiculous Things Starbucks Is Saying About Its New Store in Milan.”) The Roastery, the first in Europe after others in Seattle and Shanghai, will offer coffee and food and also illustrate Starbucks’s roasting process.
Okay. But a question leaps to mind: Does Italy need Starbucks? “Che tristezza,” one Italian friend told me when I asked her about it opening in Milan. “How sad.” I called the Tazza d’Oro, one of Rome’s most historic coffee shops—they’re called bars in Italian—and Laura Birrozzi, a manager, offered some thoughts. “We and Starbucks sell something completely different. We have quality Italian espresso,” she said. I asked her if she’d ever been to a Starbucks, and she said she had on one occasion, on a visit to London. “It wasn’t the coffee I’m used to,” was all she’d say.
At the Milan Roastery, an espresso will cost 1.80 euros “sitting or standing,” Corriere della Sera noted, since in Italian coffee shops, the price changes depending on whether you have table service or gulp your drink down at the bar. A cappuccino will cost as much as 4.50 euros. This has already prompted Italy’s consumer association to file a complaint with Italy’s antitrust authority, saying the prices were far above average for Milan. Online, Italians are already complaining that Starbucks could drive up prices elsewhere in Italy. (Still, from the coverage, it seems the Roastery piqued people’s curiosity; the lines were around the block for the musical-gala opening party.)
The announcement last year about the opening did not go over well. The columnist Aldo Cazzullo wrote in Corriere della Sera then that “as an Italian,” he considered the opening of Starbucks in Italy nothing short of “a humiliation.” Though he conceded that the arrival of the chain might make some Italian coffee shops step up their game: Starbucks “represents a philosophy, as well as a sort of office for people who don’t have an office,” he wrote. “Maybe our bars will also become more hospitable.”
But, he ended on a discordant note: “I wonder how many of the 350 jobs announced in Milan will go to young Italians and how many to young immigrants,” Cazzullo wrote. It’s unclear what kind of immigrants he had in mind, or why hiring immigrants would be an issue. What is clear is that in Italy, coffee seems to connect in unexpected ways to national identity. There were polemics last year after Starbucks sponsored a garden of palm trees in Piazza Duomo, to drum up enthusiasm ahead of its opening this year. This prompted Matteo Salvini, then only the leader of the far-right League party and now Italy’s interior minister and deputy prime minister, to decry what he called the “Africanization” of Italy, and to call for the defense of the “Italianness” of coffee. “All that’s missing are the sand and camels, and the illegal immigrants will feel at home,” he said then.
Schultz has been trying to open Starbucks in Italy for decades, and the fact that Italy has such excellent coffee everywhere—even the coffee at the average highway rest stops in Italy is better than much of what’s served in good restaurants elsewhere in the world— was no doubt a major issue. In 1998, Michael Specter wrote in The New Yorker about Schultz’s efforts to open Starbucks and said a branch of the chain would open in Italy “next year.”
So why the delay? For one thing, Italians don’t drink coffee the way Starbucks serves coffee. In Italy, coffee—espresso—is drunk generally standing up, at a coffee bar. Cappuccino or caffè latte is drunk in the morning or sometimes in the late afternoon if you haven’t had a proper lunch, and never after meals, because who can digest milk after a meal? Italians are very attuned to proper digestion.
Also, Italy has a market economy with some protectionist elements. In her interview with Schultz for Corriere, the journalist Daniela Polizzi noted that the context had changed in the past 20 years, from one of adjusting to globalization to one in which trade barriers have become an issue. Starbucks now has 30,000 stores in 77 countries, including 3,400 stores in China, with 45,000 employees, Schultz answered. Italy hasn’t given up quite so much ground, but the chain has now established a beachhead there.
Some saw the arrival of Starbucks as a window into the challenges to the Italian economy. “The lack of Starbucks indicates a double anomaly: On the one hand, the biggest coffee chain in the world wasn’t present in Italy, and on the other, the biggest coffee chain in the world isn’t Italian,” the journalist Luciano Capone wrote in Il Foglio, an intellectual daily, this week, citing the economist Luigi Zingales. It seemed a sign of how Italy’s economy is based on smaller businesses with more modest ambitions. More than 90 percent of Italian companies have fewer than 15 employees.
Then there’s the flip side. “Operating in Italy, in competition with Italian coffee bars, it’s probable that Starbucks will soon learn to make excellent espressos and cappuccinos,” Capone continued. “But will the Italian system manage to learn from Starbucks how to create a global chain? It would be a small step for us, but a great step for mankind: Finally the rest of the world would discover that coffee and pizza aren’t the kind on offer at Starbucks and Pizza Hut.”
So if the wheel is coming full circle, does Olive Garden have any plans to open in Italy? I asked its spokeswoman, Meagan Mills. “We do not have any plans,” she wrote back. “Thanks for thinking of us, though!”
Questions to answer
1- What are the main marketing environment factors affecting Starbucks business in the Italian market? Why are these factors affecting the Italian market?
In: Operations Management
Case Study 9—Social Media Is Gateway to eBook Sales Success: Amazon Kindle eBooks Thomas S. Mueller, Appalachian State University The Amazon Kindle eBook brand is one of the most popular forms of digital publishing in today’s social community. As of early 2016, the direct-to-consumer online retailer was selling 1.06 million eBooks (paid downloads) per day. Consumers spent $5.75 million per day during a recent month, with $1.76 million of those sales directed to author royalties. Though it is somewhat undocumented regarding distribution, authors received an additional $140 million in funds from Kindle Unlimited, Amazon’s subscription reading service.32 The industry as a whole is generating over $2.1 billion in sales annually. It is interesting to note that as established publisher sales decreased, eBooks written by independent authors increased.33 During an assessment in 2016, 56 of Amazon’s 100 top-selling eBooks were self-published titles. Topically, the bestselling independent authors write about paranormal activities, romance, thrillers, urban fiction, suspense, and science fiction. With the ascent of digital titles on Amazon and other sources, industry experts posit that printed versions of books will become a niche market, similar to the effect noted in magazine and newsprint.34 Digital publishing strategist Ben Thompson applies aggregation theory to the process, suggesting that sales portals like Amazon eliminate intermediaries, which allows independent publishers to avoid publishers and go direct to consumers.35 With a substantial faction of the social publishing market operating independently, advertising and promotion become the responsibility of the author. One portion of an author’s time is allocated to writing the novel, while the other half of the time is invested in social commerce, which includes marketing to expand the author’s fan base. The challenge is to differentiate an eBook from millions of competitive titles, then convince readers to download the digital offering onto a Kindle reader or other digital device. Pre-selling is essential to assure return on investment for the self-published author. One viable and affordable option is to build a social media marketing plan. Social media platforms provide opportunities to develop leads, generate a follower list, leverage other prominent users, access large topical groups, and promote content “teasers” that showcase your upcoming eBook.36 Most eBook authors develop a social media plan through content generation. These are most often short, concise articles of 250 to 500 words. Most successful social media plans offer shorter posts, with frequent placement. Social media content is usually housed in a blog, such as Google’s Blogger platform, or the highly customizable WordPress.37 It’s important to claim a URL that is unique and specific to the author and her or his work. A strong URL, along with key search words included in blog post titles, can help the author’s social media content climb in ranking on search engines. Social media portals such as LinkedIn and Google+ offer each user a personal landing page, but much more is available through groups and communities, where individuals share common interests. For example, a fashion community in Google+ hosts 557,000 followers.38 A marketing communication group in LinkedIn has collected 621,000 members.39 And, the LinkedIn Book Marketing group has 28,000 members.40 It is essential to identify a topical group to understand the relevance of posts, how interaction and replies work, and who posts the top viewed submissions. Authors can integrate into these platforms by reading posts, replying to posts, and finally crafting content that resonates with potential readers. Some authors incorporate introductory promotional comments on their upcoming eBook. It is important for authors to remember that blatant selling is not admissible; posted content must provide value and prove interesting to other group members.41 Facebook has been the most influential platform for many eBook authors. It has grown to over 1.4 billion users worldwide, with 70% checking their feed multiple times each day. eBook authors create a “landing page” for their profile as an author, or sometimes for a specific title. The challenge is to direct friends from the page to a personal website, and to target specific Facebook users who are profiled as sharing an interest in the eBook topic. Some authors host events or make promotional offers to engage users and increase traffic, which can be measured through social media data management. Mark Dawson initially started writing for a traditional publishing firm. His sales were weak and he transitioned to self-publishing. After learning how to leverage Facebook, Mark invested time and energy and now earns over $450,000 per year.42 Video platforms such as Vimeo and YouTube have been integrated into the social media promotion of eBooks. YouTube, the predominant player, was purchased in 2006 for $1.65 billion by Google. YouTube currently reports that it generates over 1 billion views per month.43 Successful eBook authors have integrated YouTube segments into their social media plans, including interviews or “teasers” that offer special introductory offers at eBook launch time. It’s beneficial to cross-promote YouTube posts across Facebook pages and embedded content in visual sharing sites such as Pinterest and Instagram. Studies indicate that the human brain assimilates images 60,000 times more quickly than text. eBook authors are intentional about visual sharing; Instagram is predominantly 18 to 24 female (56%) and allows space to share images. Pinterest represents a female and male audience, with two thirds between the ages of 18 and 24. One half are located outside the United States. It allows users to aggregate content that appeals to their interests and sensibilities. The author’s challenge is to entice user engagement, create awareness for the latest published eBook, and generate reader feedback, which can channel into digital book reviews. Many authors use the visual advantage to promote their eBook through storytelling in multiple posts.44 A social media platform that serves as the “messenger” for all social media activity is Twitter. Each message is limited to 140 characters, which can in turn be reposted and shared. Twitter now has 320 million monthly users, with over 1 billion monthly visits.45 Savvy eBook authors use Twitter to include “@” user handles to attract other key authors, or hashtags to create topical searches. Twitter can also steer followers to other platforms, where blog or web content has been placed. Some have also leveraged Twitter’s new live video broadcast program Periscope to promote special programs and activities. Some of the most highly successful eBook authors are also prominent podcast hosts. Technology entrepreneur James Altucher has published 11 books, including the Wall Street Journal bestseller Choose Yourself! Altucher’s unique position in the marketplace is that he lost his fortune, earned it back, and then lost it again. He now publishes eBooks such as Reinvent Yourself and promotes his projects on the popular “James Altucher Show” podcast, which is accessible on podbay.fm and iTunes.46 One social media opportunity that is sometimes overlooked is within the Amazon portal itself. An Amazon author page can showcase the author, include a biography, feature a compilation of the author’s Amazon Kindle publications, and link to other social media content such as Twitter or personal blogs. Most anyone can become a digital author, but not everyone can sell books. The holistic author understands how to write, publish, network, create, associate, and entertain. Social media presents the gateway where authors and customers connect in the open and unregulated marketplace.
Historical documentarian Ken Burns created a 1990 television series on the Civil War for the Public Broadcasting Network (PBS). Find Mr. Burns’ Twitter user handle, then write a tweet that would include both user handle and hashtag to link his work with a new eBook on the Civil War.
In: Operations Management
Risk Assessment Homework
In this assignment, you will perform a qualitative risk assessment, using a template that has been provided below.
A listing of threats has been prepopulated for you. These threats have been categorized by type as shown below:
|
Threat Origination Category |
Type Identifier |
|
Threats launched purposefully |
P |
|
Threats created by unintentional human or machine errors |
U |
|
Threats caused by environmental agents or disruptions |
E |
Purposeful threats are launched by threat actors for a variety of reasons and the reasons may never be fully known. Threat actors could be motivated by curiosity, monetary gain, political gain, social activism, revenge or many other driving forces. It is possible that some threats could have more than one threat origination category. Some threat types are more likely to occur than others. The following table takes threat types into consideration to help determine the likelihood that vulnerability could be exploited. The threat table shown in Table 2-2 is designed to offer typical threats to information systems and these threats have been considered for the organization. Not all of these will be relevant to the findings in your risk assessment, however you will need to identify those that are.
|
ID |
Threat Name |
Type ID |
Description |
Typical Impact to Data or System |
||
|---|---|---|---|---|---|---|
|
Confidentiality |
Integrity |
Availability |
||||
| T-1 |
Alteration |
U, P, E |
Alteration of data, files, or records. |
Modification |
||
| T-2 |
Audit Compromise |
P |
An unauthorized user gains access to the audit trail and could cause audit records to be deleted or modified, or prevents future audit records from being recorded, thus masking a security relevant event. Also applies to a purposeful act by an Administrator to mask unauthorized activity. |
Modification or Destruction |
Unavailable Accurate Records |
|
| T-3 |
Bomb |
P |
An intentional explosion. |
Modification or Destruction |
Denial of Service |
|
| T-4 |
Communications Failure |
U, E |
Cut of fiber optic lines, trees falling on telephone lines. |
Denial of Service |
||
| T-5 |
Compromising Emanations |
P |
Eavesdropping can occur via electronic media directed against large scale electronic facilities that do not process classified National Security Information. |
Disclosure |
||
| T-6 |
Cyber Brute Force |
P |
Unauthorized user could gain access to the information systems by random or systematic guessing of passwords, possibly supported by password cracking utilities. |
Disclosure |
Modification or Destruction |
Denial of Service |
| T-7 |
Data Disclosure |
P, U |
An attacker uses techniques that could result in the disclosure of sensitive information by exploiting weaknesses in the design or configuration. Also used in instances where misconfiguration or the lack of a security control can lead to the unintentional disclosure of data. |
Disclosure |
||
| T-8 |
Data Entry Error |
U |
Human inattention, lack of knowledge, and failure to cross-check system activities could contribute to errors becoming integrated and ingrained in automated systems. |
Modification |
||
| T-9 |
Denial of Service |
P |
An adversary uses techniques to attack a single target rendering it unable to respond and could cause denial of service for users of the targeted information systems. |
Denial of Service |
||
| T-10 |
Distributed Denial of Service Attack |
P |
An adversary uses multiple compromised information systems to attack a single target and could cause denial of service for users of the targeted information systems. |
Denial of Service |
||
| T-11 |
Earthquake |
E |
Seismic activity can damage the information system or its facility. Please refer to the following document for earthquake probability maps http://pubs.usgs.gov/of/2008/1128/pdf/OF08-1128_v1.1.pdf . |
Destruction |
Denial of Service |
|
| T-12 |
Electromagnetic Interference |
E, P |
Disruption of electronic and wire transmissions could be caused by high frequency (HF), very high frequency (VHF), and ultra-high frequency (UHF) communications devices (jamming) or sun spots. |
Denial of Service |
||
| T-13 |
Espionage |
P |
The illegal covert act of copying, reproducing, recording, photographing or intercepting to obtain sensitive information . |
Disclosure |
Modification |
|
| T-14 |
Fire |
E, P |
Fire can be caused by arson, electrical problems, lightning, chemical agents, or other unrelated proximity fires. |
Destruction |
Denial of Service |
|
| T-15 |
Floods |
E |
Water damage caused by flood hazards can be caused by proximity to local flood plains. Flood maps and base flood elevation should be considered. |
Destruction |
Denial of Service |
|
| T-16 |
Fraud |
P |
Intentional deception regarding data or information about an information system could compromise the confidentiality, integrity, or availability of an information system. |
Disclosure |
Modification or Destruction |
Unavailable Accurate Records |
| T-17 |
Hardware or Equipment Failure |
E |
Hardware or equipment may fail due to a variety of reasons. |
Denial of Service |
||
| T-18 |
Hardware Tampering |
P |
An unauthorized modification to hardware that alters the proper functioning of equipment in a manner that degrades the security functionality the asset provides. |
Modification |
Denial of Service |
|
| T-19 |
Hurricane |
E |
A category 1, 2, 3, 4, or 5 land falling hurricane could impact the facilities that house the information systems. |
Destruction |
Denial of Service |
|
| T-20 |
Malicious Software |
P |
Software that damages a system such a virus, Trojan, or worm. |
Modification or Destruction |
Denial of Service |
|
| T-21 |
Phishing Attack |
P |
Adversary attempts to acquire sensitive information such as usernames, passwords, or SSNs, by pretending to be communications from a legitimate/trustworthy source. Typical attacks occur via email, instant messaging, or comparable means; commonly directing users to Web sites that appear to be legitimate sites, while actually stealing the entered information. |
Disclosure |
Modification or Destruction |
Denial of Service |
| T-22 |
Power Interruptions |
E |
Power interruptions may be due to any number of reasons such as electrical grid failures, generator failures, uninterruptable power supply failures (e.g. spike, surge, brownout, or blackout). |
Denial of Service |
||
| T-23 |
Procedural Error |
U |
An error in procedures could result in unintended consequences. This is also used where there is a lack of defined procedures that introduces an element of risk. |
Disclosure |
Modification or Destruction |
Denial of Service |
| T-24 |
Procedural Violations |
P |
Violations of standard procedures. |
Disclosure |
Modification or Destruction |
Denial of Service |
| T-25 |
Resource Exhaustion |
U |
An errant (buggy) process may create a situation that exhausts critical resources preventing access to services. |
Denial of Service |
||
| T-26 |
Sabotage |
P |
Underhand interference with work. |
Modification or Destruction |
Denial of Service |
|
| T-27 |
Scavenging |
P |
Searching through disposal containers (e.g. dumpsters) to acquire unauthorized data. |
Disclosure |
||
| T-28 |
Severe Weather |
E |
Naturally occurring forces of nature could disrupt the operation of an information system by freezing, sleet, hail, heat, lightning, thunderstorms, tornados, or snowfall. |
Destruction |
Denial of Service |
|
| T-29 |
Social Engineering |
P |
An attacker manipulates people into performing actions or divulging confidential information, as well as possible access to computer systems or facilities. |
Disclosure |
||
| T-30 |
Software Tampering |
P |
Unauthorized modification of software (e.g. files, programs, database records) that alters the proper operational functions. |
Modification or Destruction |
||
| T-31 |
Terrorist |
P |
An individual performing a deliberate violent act could use a variety of agents to damage the information system, its facility, and/or its operations. |
Modification or Destruction |
Denial of Service |
|
| T-32 |
Theft |
P |
An adversary could steal elements of the hardware. |
Denial of Service |
||
| T-33 |
Time and State |
P |
An attacker exploits weaknesses in timing or state of functions to perform actions that would otherwise be prevented (e.g. race conditions, manipulation user state). |
Disclosure |
Modification |
Denial of Service |
| T-34 |
Transportation Accidents |
E |
Transportation accidents include train derailments, river barge accidents, trucking accidents, and airlines accidents. Local transportation accidents typically occur when airports, sea ports, railroad tracks, and major trucking routes occur in close proximity to systems facilities. Likelihood of HAZMAT cargo should be determined when considering the probability of local transportation accidents. |
Destruction |
Denial of Service |
|
| T-35 |
Unauthorized Facility Access |
P |
An unauthorized individual accesses a facility which may result in comprises of confidentiality, integrity, or availability. |
Disclosure |
Modification or Destruction |
Denial of Service |
| T-36 |
Unauthorized Systems Access |
P |
An unauthorized user accesses a system or data. |
Disclosure |
Modification or Destruction |
|
Analyze Risk
The risk analysis for each vulnerability consists of assessing threats to determine the likelihood that a vulnerability could be exploited and the potential impact should the vulnerability be exploited. Essentially, risk is proportional to both likelihood of exploitation and possible impact. The following sections provide a brief description of each component used to determine the risk.
Likelihood
This risk analysis process is based on qualitative risk analysis. In qualitative risk analysis the impact of exploiting a threat is measured in relative terms. When a system is easy to exploit, it has a High likelihood that a threat could exploit the vulnerability. Likelihood definitions for the exploitation of vulnerabilities are found in the following table.
|
Likelihood |
Description |
|
Low |
There is little to no chance that a threat could exploit vulnerability and cause loss to the system or its data. |
|
Medium |
There is a Medium chance that a threat could exploit vulnerability and cause loss to the system or its data. |
|
High |
There is a High chance that a threat could exploit vulnerability and cause loss to the system or its data. |
Impact
Impact refers to the magnitude of potential harm that could be caused to the system (or its data) by successful exploitation. Definitions for the impact resulting from the exploitation of a vulnerability are described in the following table. Since exploitation has not yet occurred, these values are perceived values. If the exploitation of vulnerability can cause significant loss to a system (or its data) then the impact of the exploit is considered to be High.
|
Impact |
Description |
|
Low |
If vulnerabilities are exploited by threats, little to no loss to the system, networks, or data would occur. |
|
Medium |
If vulnerabilities are exploited by threats, Medium loss to the system, networks, and data would occur. |
|
High |
If vulnerabilities are exploited by threats, significant loss to the system, networks, and data would occur. |
Risk Level
The risk level for the finding is the intersection of the likelihood value and impact value as depicted the table depicted below. The combination of High likelihood and High impact creates the highest risk exposure. The risk exposure matrix shown in the table below presents the same likelihood and impact severity ratings as those found in NIST SP 800-30 Risk Management Guide for Information Technology Systems.
|
Impact |
|||
|
Likelihood |
High |
Medium |
Low |
|
High |
High |
Medium |
Low |
|
Medium |
Medium |
Medium |
Low |
|
Low |
Low |
Low |
Low |
Risk Assessment Results
This section documents the technical and non-technical security risks to the system. Complete the following risk assessment table, ensuring that you have addressed at least 20 risks. You will be graded on your ability to demonstrate knowledge that the security controls are appropriate to the controlling the risks you have identified, as well as being able to identify appropriate risk levels based on the Impact and Likelihood levels.
The following provides a brief description of the information documented in each column:
Identifier: Provides a unique number used for referencing each vulnerability in the form of R#-Security Control ID.
Threat: Indicates the applicable threat type from the table of threats..
Risk Description: Provides a brief description of the risk.
Business Impact: Provides a brief description of the impact to the organization if the risk is realized.
Recommended Corrective Action: Provides a brief description of the corrective action(s) recommended for mitigating the risks associated with the finding.
Likelihood: Provides the likelihood of a threat exploiting the vulnerability. This is determined by applying the methodology outlined in Section 3 of this document.
Impact: Provides the impact of a threat exploiting the vulnerability. This is determined by applying the methodology outlined in Section 3 of this document.
Risk Level: Provides the risk level (high, Medium, low) for the vulnerability. This is determined by applying the methodology outlined in Section 3 of this document.
|
Identifier |
Threat ID |
Risk Description |
Business Impact |
Recommended Corrective Action |
Likelihood |
Impact |
Risk Level |
|---|---|---|---|---|---|---|---|
|
T-1, T-8, T-23, T-24, T-36 |
Notification is not performed when account changes are made. |
The lack of notification allows unauthorized changes to individuals who elevate permissions and group membership to occur without detection. |
Enable auditing of all activities performed under privileged accounts in GPOs and develop a process to allow these events to be reviewed by an individual who does not have Administrative privileges. |
Low |
Medium |
Low |
|
|
Malicious Code/Social Engineering |
|||||||
|
Application and Network Attacks |
|||||||
|
Physical Security |
|||||||
|
Wireless |
|||||||
|
Email and Web |
|||||||
|
Mobile Devices |
|||||||
In: Operations Management
CASE STUDY 2
The Wedding
Tony and Peggy Sue graduated from a university in Texas last May. She received a degree in elementary education, and he graduated from the culinary school. They both now work in the Dallas area. Peggy Sue is a teacher, and Tony is a chef at a resort hotel restaurant.
It is Christmas Day and Tony asks Peggy Sue to marry him. She excitedly accepts. They set a wedding date of June 30.
Tony is from New York City. He is the only son of “Big Tony" and Carmella. He is known as “Little Tony" to his family. He has three younger sisters, none of whom are yet married. The family owns a restaurant called Big Tony's, and all four children have worked in the restaurant since they were young. They have a large extended family with many relatives, most of whom live in New York City. They also have many friends in the neighborhood.
Peggy Sue is from Cornfield, Nebraska. She is the youngest of four sisters. She and her sisters worked on the family farm when they were young. Her father passed away several years ago. Her mother, Mildred, now lives alone in the family farmhouse and leases the farmland to a neighboring farmer. Peggy Sue's sisters all married local men and all live in Cornfield. All of their weddings were small (about 50 people), simple, and pretty much the same. Mildred has the wed- ding plans down to almost a standard operating procedure–9:00 A.M. ceremony at the small church, followed by a buffet brunch in the church hall, and that is about it. They really could not afford much more elaborate weddings because the income from the farm had been pretty meager. Peggy Sue's sisters did not go to college, and she had to take out loans to pay for her college expenses.
Tony and Peggy Sue decide to call home and announce the good news about their engagement and the forthcoming wedding.
Tony calls home and tells his mom, Carmella, the news. She replies, "That's great, honey! I've been waiting for this day. I can't believe my little baby is getting married. I'm so excited. We're going to have the biggest, best wedding ever. All our friends and family will come to celebrate. We'll probably have 300 people. And, of course, we'll have the reception at our restaurant; the banquet room should be big enough. I'll tell your cousin Vinnie that you want him to be best man. You grew up together, although you haven't seen much of each other since you went off to college in Texas. I'll call Aunt Lucy as soon as we're done talking and tell her that we want her little Maria and Teresa to be flower girls and little Nicky to be ring bearer. And, oh, I almost forgot the most important thing, your sisters, they'll all be bridesmaids. I already know what color their gowns will be-a decp rose; they'll be gorgeous. And sweetie, I didn't ask your papa yet, but I know he'll agree with me-on Monday, I'm going to call my friend Francine, the travel agent, and get two tickets for you for a two-week honeymoon in Italy. You've never been there, and you must go. It will be a gift from your papa and me. And tell Peggy Lee or Peggy Susie or whatever congratulations. We are so happy for both of you. It's your wedding, and I don't want to interfere. I'll just be here to help. You know what I'm saying. So, my little Tony, whatever you want me to do, you just tell me. And one more thing, I'll see Father Frank after Mass on Sun- day and tell him to mark his calendar already for a two o'clock ceremony on June 30. Goodbye, my big boy. I'll tell Papa you called. And I can't wait to start telling everybody to get ready to party on June 30."
Peggy Sue also calls her mom to tell her the news about the upcoming wed- ding. Mildred responds, “That's wonderful, dear. I'm glad you're finally getting married. You waited so long with going off to college and everything. I'il start getting everything ready. I know how to do this in my sleep by now. Tīl mention it to Reverend Johnson after Sunday service. I'll tell your sisters to expect to be bridesmaids again in keeping with the family tradition. I guess Holley will be the matron of honor; it's her turn. By the way, she's expecting her third child probably right around the same time as your wedding, but I don't think that will matter. Well, I guess pretty soon you'll be having babies of your own, like all your sisters. I'm glad you are finally settling down. You should really be thinking about moving back home, now that you are done with college. I saw Emma Miller, your second-grade teacher, at grocery store the other day. She told me she is retiring. I told her you would be excited to hear that and probably want to apply for her job."
"She said she didn't think they would have too many people applying so you would have a good chance. You could move in with me. The house is so big and lonely. There is plenty of room, and I can help you watch your babies. And your boyfriend, Tony—isn't he a cook or something? I'm sure he could probably get a job at the diner in town. Oh dear, I'm so happy. I've been praying that you would come back ever since you left. I'll tell all your sisters the news when they all come over for family dinner tonight. It won't be long before we're all together again. Goodbye, my dear, and you be careful in that big city."
Tony and Peggy Sue start discussing their wedding. They decide they want a big wedding—with their families and friends, including a lot of their college friends. They want an outdoor ceremony and outdoor reception, including plenty of food, music, and dancing into the night. They are not sure how much it will cost, though, and realize Peggy Sue's mother cannot afford to pay for the wedding, so they will have to pay for it themselves. Both Tony and Peggy Sue have college loans to pay back, but they hope that the money gifts they get from the wedding guests will be enough to pay for the wedding expenses and maybe have some left over for a honeymoon.
It is now New Year's Day, and Tony and Peggy Sue decide to sit down and start laying out the detailed plan of all the things they need to do to get ready for their wedding
CASE QUESTIONS
1. Develop an estimated duration for each activity.
2. Using a project start time of 0 (or January 1) and a required project completion time of 180 days (or June 30), calculate the ES, EF, LS, and LF times and TS for each activity. If your calculations result in a project schedule with negative TS, revise the project scope, activity estimated durations, and/or sequence or dependent relationships among activities to arrive at an acceptable baseline schedule for completing the project within 180 days (or by June 30). Describe the revisions you made.
3. Determine the critical path, and identify the activities that make up the critical path.
4. Produce a bar chart (Gantt chart) based on the ES and EF times from the schedule in item 2.
In: Operations Management
Utilize either of the following theories: Gestalt, Behavior, or CBT
What theory or theories will be most appropriate for this client? What are the main concepts regarding the theories? How can the client’s problem be understood utilizing the theories? Ex: “The client reports difficulty in x, y, and z problems. According to the psychoanalytic theory, the client may be exhibiting these symptoms due to her early childhood experiences….” Expand from there to thoroughly examine the problem through the theory lens. Describe what the suggested theory (or theories) says about the possible cause or origin of the primary problem(s) discussed. If you choose to explore multiple theories, limit it to 2 so the study remains consistent and clear in its direction.
A brief description of data from the intake form is provided here:
Age: 39
Sex: Female
Race: Caucasian
Marital Status: Married
Socioeconomic Status: Middle class
Appearance: Dresses meticulously, is overweight, fidgets constantly with her clothes,
avoids eye contact, and speaks rapidly.
Living Situation: Recently graduated from college as an elementary-education major,
Lives with husband (John, 45) and her children (Rob, 19; Jennifer, 18; Susan, 17; and
Adam, 16).
Presenting Problem
Client reports general dissatisfaction. She says her life is rather uneventful and predictable, and she feels some panic over reaching the age of 39, wondering where the years have gone. For 2 years she has been troubled with a range of psychosomatic complaints, including sleep disturbances, anxiety, dizziness, heart palpitations, and headaches. At times she has to push herself to leave the house. Client complains that she cries easily over trivial matters, often feels depressed, and has a weight problem.
History of Presenting Problem
Client’s major career was as a housewife and mother until her children became adolescents. She then entered college part time and obtained a bachelor’s degree. She has recently begun work toward a credential in elementary education. Through her contacts with others at the university, she became aware of how she has limited herself; how she has fostered her family’s dependence on her own life. As a part of the course, she participated in self-awareness groups, had a few individual counseling sessions, and wrote several papers dealing with the turning points in her own life. One of the requirements was to write an extensive autobiography based on an application of the principles of the counseling course to her own personal development. This course and her experiences with fellow students in it acted as a catalyst in getting her to take an honest look at her life. Ruth is not clear at this point who she is, apart from being mother, wife, and student. She realizes that she does not have a good sense of what she wants for herself and that she typically lived up to what others in her life wanted for her. Ruth has decided to seek individual counseling to explore her concerns in several areas:
Psychosocial History
Client was the oldest of four children. Her father is a fundamentalist minister, and her mother, a housewife. She describes her father as distant, authoritarian, and rigid; her relationship with him was one of unquestioning, fearful adherence to his rules and standards. She remembers her mother as being critical, and she thought that she could never do enough to please her. At other times her mother was supportive. The family demonstrated little affection. In many ways Ruth took on the role of caring for her younger brother and sisters, largely in the hope of winning the approval of her parents. When she attempted to have any kind of fun, Ruth encountered her father’s disapproval and outright scorn. To a large extent this pattern of taking care of others has extended throughout her life.
One critical incident took place when Ruth was 6 years old. She reported: “my father caught me ‘playing doctor’ with an 8-year-old boy. He lectured me and refused to speak to me for weeks. I felt extremely guilty and ashamed.” It appears that Ruth carried feelings of guilt into her adolescence and that she repressed her own emerging sexuality.
In her social relationships Ruth had difficulty making and keeping friends. She felt socially isolated from her peers because they viewed her as “weird.” Although she wanted the approval of others, she was not willing to compromise her morals for fear of consequence.
She was not allowed to date until she completed high school. At the age of 19 she married the first person that she dated. She used her mother as a role model by becoming a homemaker.
In: Psychology
1. What are employer' rights regarding employee lifestyle choices?
2. What are the employee' rights regarding lifestyle choices?
Based in this article
Finding employment is becoming increasingly dificult for smokers. Twenty-nine U.S. states have passed legislation prohibiting employers from refusing to hire job ause they smoke, but 21 states have no such restrictions. Many ealth care organizations, such as the Cleveland Clinic and Baylor Health Care System, and some large non-health care employers, including Scotts Miracle-Gro, Union Pacific Railroad, and Alaska Airlines, now have a policy of not hiring smokers-a practice opposed by 65 percent of Americans, according to a 2012 poll by Harris International. agree with those polled, believing that categorically refusing to hire smokers is unethical: it results in a failure to care for people, places an additional burden on already- disadvantaged populations, and preempts interventions that more bec efféectively promote smoking cessation. One justification for not employing smokers, used primar- ly by health care organizations, is symbolic. When the World Health Organization introduced a nonsmoker-only" hiring policy in 2008, it cited its commitment to tobacco control and the importance of '"denormalizing" tobacco use. Health organizations with similar policies have argued that their mployees must serve as role models for patients and that only care nonsmokers can do so.
A second, more general, argument is that employees must take personal responsibility for actions that impose financial or other burdens on employers or fellow employees. Accord- ingly, smokers should be responsible for the consequences of their smoking, such as higher costs for health insurance claims, higher rates of absenteeism, and lower productivity. These costs amount to an estimated additional $4,000 annually for each smoking employee. Yet it seems paradoxical for health care organizations that exist to care for the sick to refuse to employ smokers. Many patients are treated for illnesses to which their behavior has contributed, including chronic obstructive pulmonary disease, heart failure, diabetes, and infections spread through unpro- tected sex or other voluntary activities. It is callous-and contradictory-for health care institutions devoted to caring for patients regardless of the causes of their illness to refuse to employ smokers. Just as they should treat people regardless of their degrée of responsibility for their own ill health, they should not discriminate against qualified job candidates on the basis of health-related behavior. The broader claim that it is fair to exclude smokers because they are responsible for raising health care costs is too simplis- tic. It ignores the fact that smoking is addictive and therefore not completely voluntary. Among adult daily smokers, 88 per- cent began smoking by the time they were 18,1 before society would consider them fully responsible for their actions. Much of this early smoking is subtly and not so subtly encouraged by cigarette companies. As many as 69 percent of smokers want to quit, but the addictive properties of tobacco make that exceed- ingly difficult: only 3 to 5 percent of unaided cessation attempts succeed.3 It is therefore wrong to treat smoking as something fully under an individual's control
In addition, all other diseases-and many healthful behaviors-also result in additional health care costs. Peo- ple with cancer burden their fellow workers through higher health care costs and absenteeism. People who engage in risky sports may have accidents or experience trauma rou tinely and burden coworkers with additional costs. Having babies increases premiums for fellow employees who have Many of these costs result from seemingly innocent, everyday lifestyle choices; some choices, such as those regarding diet and exercise, may affect cancer incidence as well as rates of diabetes and heart disease We as a society have rejected the notion that individuals should be fully responsible for their own health care costs. In instituting health insurance, we acknowledge the fragility of health and the costliness of restoring it, and we minimize cata- strophic consequences. The United States has chosen to pool risk predominantly through employers rather than the govern ment. Consequently, U.S. law requires firms with more than 50 employees to provide risk-pooled insurance. Finally, although less than one fifth of Americans currently smoke, rates of tobacco use vary markedly among sociodemo- graphic groups, with higher rates in poorer and less-educated populations. Some 42 percent of American Indian or Alaska Native adults smoke, but only 8 percent of Asian women do. Among adults with less than a high school education, 32 per cent are smokers; among college graduates, smoking rates are just over 13 percent. More than 36 percent of Americans living low the federal poverty line are smokers, as compared with 22.5 percent of those with incomes above that level. Crucially, policies against hiring smokers result in a "double whammy" r many unemployed people, among whom smoking rates are nearly 45 percent (as compared with 28 percent among Ameri- cans with full-time employment).4 These policies therefore roportionately and unfairly affect groups that are already burdened by high unemployment rates, poor job prospects, and job insecurity what should employers do? We believe that offering sup- port for healthful behaviors is the best approach. Central in this regard is assisting employees by providing evidence-based smoking-cessation programs, removing cost barriers, facilitat- ing access, and providing necessary psychological counseling nd other support. For example, many employers, such as Wal- greens, provide free nicotine-replacement therapy and smoking sation counseling to employees
Recent research also indicates that financial incentives can effectively promote smoking cessation. For example, a ran- domized, controlled trial involving employees of General Elec- tric showed that a combination of incentives amounting to $750 led to cessation rates three times those achieved through information- only approaches (14.7% vs. 5.0 %)
But General Electric's experience also reflects the politi. cal challenges of instituting policies regarding smokers. When the company decided to provide the program to all employees. nonsmokers objected to losing out on what would effectively be lower insurance premiums for their smoker colleagues. In response, the company replaced the $750 reduction with a $62;5 surcharge for smokers. Just like policies of not hiring smokers, penalties imposed on smokers raise serious ethical and policy concerns. The Department of Labor is considering whether to permit employ- ers to penalize smokers with a surcharge of up to 50 percent of the cost of their health insurance coverage (typically than $2,000 per employee per year). Yet even rewards for quit- ting are hard to sell to nonsmokers, who might also object to free smoking-cessation programs they through their insurance premiums. Underlying such opposition a distorted notion of personal responsibility and deserved- ness, according to which refraining from smoking results from willpower and active choice alone. Although some employees may be nonsmokers through such efforts, most should have the to recognize that "there but for the grace of God go they
Given nonsmokers resistance, it would be helpful if employers providing smoking cessation support engaged in early out reach emphasizing that helping smokers to quit adheres to the principle of risk pooling underlying health insurance. Success- ful cessation programs could lead to higher productivity and lower insurance contributions for nonsmokers, thereby benefit- diven nonsmokers' resistance, it would be helpful if employ. ing all employees. The goal of reducing smoking rates is important. Although smoking rates among U.S. adults have decreased from 42 percent in 1965 to 19 percent today,5 more remains to be done, particu- larly for low-income and unemployed populations. Promoting public health is a shared responsibility, and employers have a social obligation to contribute to the public health mission out- lined by the Institute of Medicine: "fulfill ing] society's interest in assuring conditions in which people can be healthy. By cherry- picking "low-risk" employees and denying employment to smokers, employers neglect this obligation, risk hurting vulnerable groups, and behave unethically. The same goes for imposing high penalties on smokers under the guise of providing wellness incentives. We believe that employers should consider more construc- tive approaches than punishing smokers. In hiring decisions, they should focus on whether candidates meet the job require- ments; then they should provide genuine support to employ ees who wish to quit smoking. And health care organizations in particular should show compassion for their workers. This roach may even be a win-win economic solution, sinc employees who feel supported will probably be more produc ap tive than will those who live in fear of penalties.
In: Economics
ROLE-PLAY EXERCISE On Command Corporation PROCESS You have been assigned a role in the On Command Corporation case. Please read the general information (Introduction) about the case. Read and understand your role. Your teammates have different roles. Due the situation, you need to work with your team to produce an employee meeting, you have 15 minutes to present the statement and conduct the meeting – see the link attached with information about an employee meeting (you need to create a statements, be prepare for questions, and defend your organization). Key Issues Sexual harassment Employee retaliation Appropriateness of product This role-play was developed by Mark Arvizu, Ira Baeringer, Mark Hess, Kelley Hoven, Bill Speights, and Jennifer Sawayda for and under the direction of O.C. and Linda Ferrell. © 2015 On Command Corporation Background (Everyone reads.) On Command Corporation (OCC) is a world-leading provider of interactive in-room entertainment, information, and business services to the lodging industry. The company annually serves more than 250 million guests through 950,000 rooms in approximately 3,450 hotel properties. OCC provides on-demand and, in some cases, scheduled in-room television viewing of major motion pictures and independent non-rated motion pictures for mature audiences, for which guests pay on a pay-per-view basis. Depending on the type of platform installed and the size of the hotel, guests can choose up to 50 different movies with an on-demand system, or eight to 12 movies with a scheduled system. In addition to pay-per-view movies, OCC offers other services such as short subjects (such as yoga and sporting packages), Internet services, music, game services, and other hotel and guest services. OCC obtains the non-exclusive rights to show recently released motion pictures from major motion picture studios during the time period after the initial theatrical release and before home video or cable distribution. The company also contracts with a variety of other vendors and distributors of in-room entertainment for the other products it sells to hotels and guests. OCC negotiates contracts with major hotel chains and individual hotels that involve agreement on the type and extent of movies and services that are offered. Programming choices are key for OCC to differentiate itself from competitors. As guests order movies, they are shown in their rooms and then appear on their bill at check-out. Depending on the contract with the hotel, it may receive some of the profits from the movie ordered. The PS4 games are the least profitable, while adult films are by far the most profitable. Although not disclosed directly, most of the company’s revenues are from adult movies. In fact, some analysts estimate that up to 80 percent of the revenues OCC generates are from its adult movie business. A new management team has come to On Command and is evaluating the company’s strategy and business plan. Although the company has been around for 10 years with 2014 revenues of $262 million, it still has yet to become profitable. Three recent events have re-kindled discussion about the true nature of the company’s products, as well as potential ethical issues. The first situation arose when several female employees complained to their superiors about feeling uncomfortable in the presence of a certain male colleague, Ted Jones, because of what they say are “lewd” remarks about women. Ted Jones is the senior adult film editor whose job it is to edit adult films to reduce graphic sexual content. When approached about his actions, Ted defended himself by denying the allegations. Due to lack of concrete proof, Ted was given a warning and the women who filed the complaint were told just to avoid Ted whenever possible. However, more complaints have surfaced, and the human resources department has decided to conduct an investigation. The second issue arose from a complaint filed by another female employee, Donna Wilson, working as an administrative assistant. She threated to file suit against the company because of the way she was treated. She was personally offended by the content of the adult movies. Although she had signed a document that clearly stated the nature of the videos available for viewing in her office upon her hire, she protested and said that the adult portion of the OCC product line should not be viewable in any of the corporate offices because it was sexually offensive, degraded women, and promoted sexual harassment in the workplace. She also insisted that the true extent of the sexual content was not explained to her when she signed the agreement. After hearing her complaint, her supervisor informed her of the release she had signed and also told her she had the clear choice not to work there. Since that time, Donna alleges, she claims she overheard her supervisor telling other workers to shun her at work because she was a troublemaker who refused to be a team player. She has also been cut out of meetings and claims the supervisor is constantly cutting her down in front of her colleagues. Finally, it has recently come to management’s attention that there has been a drop in revenue due to the deliberate refusal of many hotels to offer the adult film products as they would conflict with their quality, “family-friendly” image. The increase is this type of product censorship has led to a drop in revenue for OCC. At a recent meeting at Liberty Media (OCC’s parent company), several questions were raised about the ethical nature of OCC’s primary revenue source. Questions such as these were presented during the discussion regarding what to do with struggling OCC. A big question is whether it was masquerading as an entertainment company with many different product offerings to mask the fact that it is really in the adult movie business. Management is not sure whether it would be wise to disclose where most of its revenue comes from. Also, is the nature of how the company handles the editing of adult films internally encouraging sexual harassment and retaliation of female employees? The management team decided to develop a business strategy they could use going forward. AND I AM Pam Stone – General Counsel You joined OCC at the same time Chris Smith did. You both came from another subsidiary of Liberty Media, the parent company of OCC and several other entertainment type companies. Your specialty is more in the contract and merger and acquisition area. However, you have been dealing with a tremendous amount of employment-related issues. The human resources department has been significantly cut, meaning that you must often work in close proximity with Don Randall, the human resource manager. Chris has made you aware that all of the offices contain televisions, and employees have the same access as hotel guests. This includes the adult films. You have recently begun to research charges brought up by Ms. Wilson. You feel that adult movies should not be watched in the workplace unless they are being edited or viewed for possible selection. You learn that many employees frequently watch adult content in their offices, although most claim they do so during their break time. OCC has about 300 employees in the field who work directly with hotels to install the product as well as perform updates to products. Unfortunately, the system OCC currently uses does not allow for updates to be done electronically. The field service employees see the adult films during the updating process. OCC also manufactures its own “box” that allows the pay per systems to operate. As part of the testing process, the manufacturing employees must test each line of products by watching to make sure they work properly regular cable, short subjects, games, and adult films. The human resource manager Don Randall has provided you with waivers and disclaimers that all employees sign upon hire indicating that they may be exposed to adult film content during their employment. However, Ms. Wilson’s claims have gone beyond simply being offended. Now she is claiming that her supervisor has begun retaliating against her because she complained. This could certainly be grounds for a lawsuit if not handled properly. Don Randall has also asked you for assistance in handling some potential sexual harassment allegations he has heard. Since you came to OCC, you have been responsible for collecting and providing due diligence to an outside law firm to review for a possible merger and/or sale. You were intimately involved in the contract to secure an additional $60 million investment from Liberty Media. You have also been involved in many of the discussions with Chris Smith and executive VP and CFO Bill Moore as to what the company strategy needs to be.
case presentations what can be my answer for this case if I am the general counsel
it could be 1 or 2 slide it does not matter thank in advance
In: Economics
"Thanksgiving weekend. Tanya Martinez is looking forward to a
busy holiday weekend entertaining her extended family. Tanya, 29,
is a busy stay-at-home mom. She has a degree in Business
Administration and recently worked in marketing for a major
insurance company in the city. Married nearly 8 years ago, Tanya
and her husband Alex, 29, have two children. Tanya quit working
several years ago to raise their two children, 4-year-old Randy and
2-year-old Samantha. The Martinezes, a multiracial couple, lived in
a large city in the Northwest, where Alex works as a skilled
construction carpenter on high-rise commercial building
projects.
Tanya, Alex, and the kids celebrated the holiday with Tanya’s mom
Deidra, a city engineer; dad Michael, a college professor; her
brother, a computer engineer; and her sister-in-law, a nurse
practitioner. On Friday, Tanya felt some nausea and intestinal
discomfort, which she assumed was due to the Thanksgiving
festivities. While Tanya was typically active and athletic, she had
to skip her usual long-distance run. By Saturday, her condition had
quickly worsened. She was weak, vomiting with periodic abdominal
pain, and using cold compresses for a high fever.
With Tanya running a 103o fever Sunday, Alex stayed home with Randy
and Samantha, while her parents Deidra and Michael took her to
Urgent Care at a nearby full-service medical center. There she was
quickly sent to the Emergency Department of the 400+ bed, Level 2
Trauma Center. Various lab tests and a CT scan showed an elevated
white blood cell count, but no conclusive findings regarding her
non-specific intestinal discomfort. So, after rounds of antibiotics
and fluids for dehydration, Tanya was sent home without any
prescriptions or further instructions.
Tanya’s condition did not improve by Tuesday, and she was still
experiencing a high fever plus nausea, bloating, and abdominal
pain. The family brought Tanya back to Urgent Care, where she was
sent to the Emergency Department again, and then referred to the
main hospital for observation care. Observation care is a hospital
outpatient category (even though patients stay overnight). It is
controversial because it blurs the lines between outpatient and
inpatient care, which often increases the patient’s financial
liability (due to larger co-pays). It can also compromise clinical
care delivery due to poorer coordination of care during observation
stays (Hagland, 2018; Society of Hospital Medicine, 2017).
In the observation care ward, Tanya was seen by several
hospitalists who each interacted with her for different purposes
and with different questions. They conducted a variety of
additional blood draws and lab tests to assess intestinal illnesses
such as Crohn’s disease, inflammatory bowel conditions, or possible
intestinal blockage. While observation care is intended to take 24
hours, or 48 hours maximum, in practice it sometimes exceeds 48
hours (Society of Hospital Medicine, 2017). Tanya ended up in
observation care for 5 days.
Observation ward rooms are shared, and during Tanya’s stay, three
different female roommates entered observation care and were
admitted to inpatient care shortly thereafter. Tanya’s first
roommate did not permit Tanya’s husband Alex to stay overnight with
Tanya, so her mother stayed with her each night. Alex, their
children, and family were frequent visitors during the 5
days.
One evening when both parents Deidra and Michael were visiting
Tanya, they noted two uniformed city police officers in the
corridor talking to the in-charge nurse. The pair of officers soon
entered Tanya’s room unannounced saying “We have to check your
belongings,” without offering any explanation. Tanya and her
parents complied but were unclear about what was happening. When
one officer asked, “Does she have a history of drug abuse?” Deidra
exploded, saying “What are you doing here? Leave right now!” The
officer explained “We’ve had calls and a report there have been a
lot of visitors and possible illegal drug activities here.” Next,
the in-charge nurse burst into the room stating, “It’s a mistake,
it’s not this room, it’s another room!” The officers were quickly
redirected to search the nearby room occupied by a well-tattooed
white male.
Frustrated by days with no clear diagnosis or treatment plan and
angered by the allegation his daughter was using drugs, Michael
demanded “I want to see the nursing supervisor now or we are
leaving this hospital and will sue you!” When the RN supervisor
arrived, Michael confronted him “Why did you call the cops on my
daughter?” The supervisor wanted to check on what happened and
scheduled a meeting for the next day after tempers had
cooled.
During a tense meeting with the RN supervisor the next day, her
parents sought to transfer Tanya to a different hospital and leave
“Against Medical Advice” (AMA). Informed that insurance might not
cover an AMA transfer, and that another hospital might not accept
an AMA, they “felt like hostages, with no options.” Unwilling to
take the risk, the parents compromised that the hospital could
transfer Tanya to the medical floor on in-patient status with a
private room.
Michael and Deidra also confronted the floor nurses, asking “Why
did you send the police to Tanya’s room?” The nurses explained that
“somebody had called the cops,” leaving the nurses to guess which
patient it might be. A junior nurse admitted she had pointed the
police towards Tanya’s room. Even Tanya’s observation ward
roommate, who was present when the police arrived, said their
treatment from the nurses and officers was inappropriate. The
hospital’s security chief apologized and said he “would look into”
the incident with the police.
Tanya spent another week as an inpatient on the medical floor. At
the time of transfer to inpatient status, she was generally stable,
though very weak, and showed few signs of improvement. She was
still nauseous, with abdominal distention and cramping, and little
bowel activity. The family hoped Tanya’s attentive new physician,
Dr. Johnson, would finally get a clear diagnosis and treatment
plan. Dr. Johnson arranged for endoscopy and requested other
consults, though staff resisted performing a second CT scan (after
two previous ones in the ED), saying “she should get better.”
Finally, 4 days later, before going off rotation, Dr. Johnson’s
written medical report called for a surgical consultation,
stipulating that if the hospital could not provide answers and
appropriate treatment the patient would need to be transferred to
University Hospitals for additional evaluation and care.
At last the third CT scan clearly showed an intestinal ileus—a
potentially dangerous stoppage of the normal intestinal
contractions that move food through the intestines. While an ileus
is commonly a complication of abdominal surgery, Tanya had no
history of surgery or medical conditions that lead to an ileus, and
prior to her sudden hospitalization had been very healthy and fit.
After surgeons drained accumulated fluids and matter from her lower
abdomen, they put her on antibiotics, and released her from
hospital the next day—after 2 weeks in the hospital. Tanya
gradually recovered at home, though it took several months to
regain her strength and eventually return to her active
lifestyle.
Deidra and Michael filed a complaint on Tanya’s behalf shortly
after she was released from hospital. They identified the following
substandard practices:
■ Abusive encounter: Patient was accused by
uniformed police of using drugs without reasonable cause. This
incident also raised the question of whether Tanya and her husband
came under suspicion because Alex is of Latino/Native American
descent.
■ Negligence that compromised quality of care:
Patient was assigned to observation care for 5 days without clear
diagnosis and treatment; patient was admitted on in-patient basis
for 5 days and staff resisted taking further action to refine the
diagnosis and treat appropriately. The resulting delayed
confirmation of an ileus further weakened Tanya and prolonged her
time to full recovery months later.
■ Observation Notice Requirement: Patient was
assigned to and maintained on observation status without sufficient
diagnostic efforts, and without explanation of its clinical and
financial implications.
The hospital completed its internal review without interviewing Tanya, her family members, or her roommate. While acknowledging the grievance, the hospital’s report concluded Tanya’s care was appropriate."
"Discussion Questions
1. How do you suppose each of the actors in this case interpreted
the situation? What did they believe they were seeing and how would
they explain it?
2.What automatic thinking, cognitive biases, and stereotypes may be
affecting how each of the actors sees this situation? Include as
many as you can think of.
3.Because assumptions tend to be wrong, they must be tested. Of the
assumptions and attributions you have generated, which ones could
the actors check or verify?
4.Describe a patient’s likely mental schema for a quiet evening on
a hospital ward. How might the appearance of uniformed police on
the ward affect patients? The staff? The staff’s judgments and
actions?
5.What stereotypes or biases might hospital staff hold about a
potential drug user?
6.If you were on the hospital’s risk management committee with
responsibility for preventing misunderstandings that could lead to
a complaint or lawsuit, what concerns and what further questions do
you have regarding each charge? What would you recommend the
hospital do differently?
7.Based on the information in the case, how do you assess the
family’s three complaints?"
In: Nursing
Hello, A summary of the article below
I need a summary of the article below please. Thank you
As Coronavirus Surveillance Escalates, Personal Privacy Plummets
Tracking entire populations to combat the pandemic now could open the doors to more invasive forms of government snooping later.
In January, South Korea began posting detailed location histories about people who tested positive for the coronavirus, leading to public blaming and shaming.Credit...Woohae Cho for The New York Times
By Natasha Singer and Choe Sang-Hun
In South Korea, government agencies are harnessing surveillance-camera footage, smartphone location data and credit card purchase records to help trace the recent movements of coronavirus patients and establish virus transmission chains.
In Lombardy, Italy, the authorities are analyzing location data transmitted by citizens’ mobile phones to determine how many people are obeying a government lockdown order and the typical distances they move every day. About 40 percent are moving around “too much,” an official recently said.
In Israel, the country’s internal security agency is poised to start using a cache of mobile phone location data — originally intended for counterterrorism operations — to try to pinpoint citizens who may have been exposed to the virus.
As countries around the world race to contain the pandemic, many are deploying digital surveillance tools as a means to exert social control, even turning security agency technologies on their own civilians. Health and law enforcement authorities are understandably eager to employ every tool at their disposal to try to hinder the virus — even as the surveillance efforts threaten to alter the precarious balance between public safety and personal privacy on a global scale.
Yet ratcheting up surveillance to combat the pandemic now could permanently open the doors to more invasive forms of snooping later. It is a lesson Americans learned after the terrorist attacks of Sept. 11, 2001, civil liberties experts say.
Nearly two decades later, law enforcement agencies have access to higher-powered surveillance systems, like fine-grained location tracking and facial recognition — technologies that may be repurposed to further political agendas like anti-immigration policies. Civil liberties experts warn that the public has little recourse to challenge these digital exercises of state power.
“We could so easily end up in a situation where we empower local, state or federal government to take measures in response to this pandemic that fundamentally change the scope of American civil rights,” said Albert Fox Cahn, the executive director of the Surveillance Technology Oversight Project, a nonprofit organization in Manhattan.
As an example, he pointed to a law enacted by New York State this month that gives Gov. Andrew M. Cuomo unlimited authority to rule by executive order during state crises like pandemics and hurricanes. The law allows him to issue emergency response directives that could overrule any local regulations.
In Lombardy, the Italian authorities are using cellphone location data to determine what percentage of people are obeying a lockdown order.Credit...Alessandro Grassani for The New York Times
Increased surveillance and health data disclosures have also drastically eroded people’s ability to keep their health status private.
This month, Australia’s health minister publicly chastised a doctor whom she accused of treating patients while experiencing symptoms of the virus — essentially outing him by naming the small clinic in Victoria where he worked with a handful of other physicians.
The health provider, who tested positive for the coronavirus, responded with a Facebook post saying the minister had incorrectly characterized his actions for political gain and demanded an apology.
“That could extend to anyone, to suddenly have the status of your health blasted out to thousands or potentially millions of people,” said Chris Gilliard, an independent privacy scholar based in the Detroit area. “It’s a very strange thing to do because, in the alleged interest of public health, you are actually endangering people.”
But in emergencies like pandemics, privacy must be weighed against other considerations, like saving lives, said Mila Romanoff, data and governance lead for United Nations Global Pulse, a U.N. program that has studied using data to improve emergency responses to epidemics like Ebola and dengue fever.
“We need to have a framework that would allow companies and public authorities to cooperate, to enable proper response for the public good,” Ms. Romanoff said. To reduce the risk that coronavirus surveillance efforts might violate people’s privacy, she said, governments and companies should limit the collection and use of data to only what is needed. “The challenge is,” she added, “how much data is enough?”
New software in China decides whether people should be quarantined or permitted to enter public places like subways. Green means a person is at liberty to go out.Credit...Raymond Zhong
The fast pace of the pandemic, however, is prompting governments to put in place a patchwork of digital surveillance measures in the name of their own interests, with little international coordination on how appropriate or effective they are.
In hundreds of cities in China, the government is requiring citizens to use software on their phones that automatically classifies each person with a color code — red, yellow or green — indicating contagion risk. The software determines which people should be quarantined or permitted to enter public places like subways. But officials have not explained how the system makes such decisions, and citizens have felt powerless to challenge it.
In Singapore, the Ministry of Health has posted information online about each coronavirus patient, often in stunning detail, including relationships to other patients. The idea is to warn individuals who may have crossed paths with them, as well as alert the public to potentially infected locations. “Case 219 is a 30-year-old male,” says one entry on the Health Ministry’s site, who worked at the “Sengkang Fire Station (50 Buangkok Drive),” is “in an isolation room at Sengkang General Hospital” and “is a family member of Case 236.”
In Singapore, the Ministry of Health has posted information online about each coronavirus patient, often in stunning detail.Credit...Adam Dean for The New York Times
On Friday, Singapore also introduced a smartphone app for citizens to help the authorities locate people who may have been exposed to the virus. The app, called TraceTogether, uses Bluetooth signals to detect mobile phones that are nearby. If an app user later tests positive for the virus, the health authorities may examine the data logs from the app to find people who crossed their paths. A government official said the app preserved privacy by not revealing users’ identities to one another.
In Mexico, after public health officials notified Uber about a passenger infected with the virus, the company suspended the accounts of two drivers who had given him rides, along with more than 200 passengers who had ridden with those drivers.
In the United States, the White House recently spoke with Google, Facebook and other tech companies about potentially using aggregated location data captured from Americans’ mobile phones for public health surveillance of the virus. Several members of Congress subsequently wrote a letter urging President Trump and Vice President Mike Pence to protect any virus-related data that companies collected from Americans.
The digital dictates may enable governments to exert more social control and enforce social distancing during the pandemic. They also raise questions about when surveillance may go too far.
In January, South Korean authorities began posting detailed location histories on each person who tested positive for the coronavirus. The site has included a wealth of information — such as details about when people left for work, whether they wore masks in the subway, the name of the stations where they changed trains, the massage parlors and karaoke bars they frequented and the names of the clinics where they were tested for the virus.
In South Korea’s highly wired society, however, internet mobs exploited patient data disclosed by the government site to identify people by name and hound them.
Internet mobs used patient data disclosed by the South Korean government to identify people by name and hound them.Credit...Jean Chung for The New York Times
As other countries increase surveillance, South Korea had an unusual reaction. Concerned that privacy invasions might discourage citizens from getting tested for the virus, health officials announced this month that they would refine their data-sharing guidelines to minimize patient risk.
“We will balance the value of protecting individual human rights and privacy and the value of upholding public interest in preventing mass infections,” said Jung Eun-kyeong, the director of South Korea’s Centers for Disease Control and Prevention.
That is a tricky balance that some United States officials may need to consider.
In New York this month, Mayor Bill de Blasio posted details on Twitter about a lawyer in Westchester County who was the second person in the state to test positive for the virus — including the name of the man’s seven-person law firm and the names of the schools attended by two of his children. A few hours later, The New York Post identified the lawyer by name and was soon referring to him as “patient zero” in the coronavirus outbreak in New Rochelle.
In a response posted on Facebook, Adina Lewis Garbuz, a lawyer who is the wife of the man, Lawrence Garbuz, pleaded with the public to focus instead on the personal efforts the family had made to isolate themselves and notify people who came into contact with them.
“We would have preferred this all remain private,” Ms. Garbuz wrote in the Facebook post, “but since it is no longer, I wanted to at least share some truths and allay people’s fears.”
In: Nursing
Case Study : "Global Warming"
Case study 1.1: Global Warming Part I: What to do about global
warming Yet hot-headed attempts to link specific weather A UN
treaty now under discussion looks promising - disasters to the
greenhouse effect are scientific bunk. as long as it remains
flexible The correct approach is coolly to assess the science of
How should reasonable people react to the hype and climate
modelling is still in its infancy, and for most of climate change
before taking action. Unfortunately, controversy over global
warming? Judging by recent the past decade it has raised as many
questions as it headlines, you might think we are already doomed.
has answered. Now, however, the picture is getting Newspapers have
been quick to link extreme clearer. There will never be consensus,
but the weather events, ranging from floods in Britain and balance
of the evidence suggests that global warming Mozambique to
hurricanes in Central America, directly to global warming. Greens
say that worse will is indeed happening that much of it has
recently been man-made; and that there is a risk of potentially
ensue if governments do not act. Many politicians disastrous
consequences. Even the normally stolid have duly jumped on the
bandwagon, citing recent disasters as a reason for speeding up
action on the insurance industry is getting excited. Insurers
reckon that weather disasters have cost roughly $400 billion Kyoto
treaty on climate change that commits rich countries to cut
emissions of greenhouse gases. This over the past decade and that
the damage is likely week saw the start of a summit in The Hague to
only to increase. The time has come to accept that global warming
is a credible enough threat to require discuss all this. a
public-policy response.
But what exactly? At first blush, the Kyoto treaty expertise. The
result is all too likely to be bad policy, at seems to offer a good
way forward. It is a global potentially heavy cost to the world
economy. treaty: it would be foolish to deal with this most In our
Economics focus of February 15th this year, global of problems in
any other way. It sets a long we drew attention to and posted on
our website) term framework that requires frequent updating and
telling criticisms of the IPCC's work made by two revision, rather
like the post-war process of trade independent commentators, lan
Castles, a former liberalisation. That is sensible because climate
head of Australia's Bureau of Statistics, and David change will be
at least a 100-year problem, and so Henderson, formerly the chief
economist of the will require a treaty with institutions and
mechanisms Organisation for Economic Co-operation and that endure.
The big question over Kyoto remains its Development (OECD) and now
visiting professor at cost. How much insurance is worth buying now
Westminster Business School. Their criticisms of the against an
uncertain, but possibly devastating, future IPCC were wide-ranging,
but focused on the panel's threat? And the answer lies in a
clear-headed forecasts of greenhouse gas emissions. The method
assessment of benefits and costs. The case for doing employed, the
critics argued, had given an upward something has increased during
the three years since bias to the projections. Kyoto was signed.
Yet it also remains true that all The IPCC's procedure relied,
first, on measuring answers will be easier if economic growth is
gaps between incomes in poor countries and meanwhile sustained:
stopping the world while the incomes in rich countries, and,
second, on supposing problem is dealt with is not a sensible
option, given that those gaps would be substantially narrowed, or
that resources to deal with it would then become entirely closed,
by the end of this century. Contrary to steadily scarcer. standard
practice, the IPCC measured the initial gaps That points to two
general conclusions about how using market-based exchange rates
rather than rates to implement Kyoto. The simplest is that
countries adjusted for differences in purchasing power. This should
search out "no regrets" measures that are error makes the initial
income gaps seem far larger beneficial in their own right as well
as reducing than they really are, so the subsequent catching-up is
emissions - such as scrapping coal subsidies, correspondingly
faster. The developing country liberalising energy markets and
cutting farm support. growth rates yielded by this method are
historically The second is that implementation should use
implausible, to put it mildly. The emissions forecasts
market-friendly measures that minimise the costs based on those
implausibly high growth rates are
The second is that implementation should use implausible, to put it
mildly. The emissions forecasts market-friendly measures that
minimise the costs based on those implausibly high growth rates are
and risks of slowing economic growth. accordingly unsound. The
Castles-Henderson critique was subsequently Part II: Hot potato
revisited published in the journal Energy and Environment A
lack-of-progress report on the Intergovernmental (volume 14, number
2-3). A response by 15 authors Panel on Climate Change associated
with the IPCC purporting to defend the You might think that a
policy issue which puts at stake panel's projections was published
in the same issue. hundreds of billions of dollars' worth of global
output "deplorable misinformation and neglecting what the It
accused the two critics of bias, bad faith, peddling would arouse
at least the casual interest of the world's economics and finance
ministries. You would the case Mr Castles and Mr Henderson had laid
out- 15 regard as proper procedure. Alas, it fails to answer be
wrong. Global warming and the actions namely, that the IPCC's
low-case scenarios are contemplated to mitigate it could well
involve costs patently not low-case scenarios, and that the panel
of that order. Assessing the possible scale of future
greenhouse-gas emissions, and hence of man-made of possibilities.
If anything, as the two critics argue in has therefore failed to
give a true account of the range global warming, involves economic
forecasts and economic calculations. Those forecasts and an article
in the subsequent issue of Energy and calculations will in turn
provide the basis for policy on Environment, the reply of the 15
authors gives new the issue. Yet governments have been content to
grounds for concern. This week the IPCC is preparing to embark on
its next global warming "assessment leave these questions to a body
- the review" - and if the tone of its reply to the critics is any
Intergovernmental Panel on Climate Change guide, it is intent on
business as usual. (IPCC) - which appears to lack the
necessary
It is true, as the IPCC says in its defence, that the panel
presents a range of scenarios. But, as we pointed out before, even
the scenarios that give the lowest cumulative emissions assume that
incomes in the developing countries will increase at a much faster
rate over the course of the century than they have ever done
before. Disaggregated projections published by the IPCC say that
even in the lowest- emission scenarios - growth in poor countries
will be so fast that by the end of the century Americans will be
poorer on average than South Africans, Algerians, Argentines,
Libyans, Turks and North Koreans. Mr Castles and Mr Henderson can
hardly be alone in finding that odd. of submissions. When the peers
in question are drawn from a restricted professional domain -
whereas the issues under consideration make demands upon a wide
range of professional skills - peer review is not a way to assure
the highest standards of work by exposing research to scepticism.
It is just the opposite: a kind of intellectual restrictive
practice, which allows flawed or downright shoddy work to acquire a
standing it does not deserve. Part of the remedy proposed by Mr
Castles and Mr Henderson in their new article is to get officials
from finance and economics ministries into the long-range
emissions-forecasting business. The Australian Treasury is now
starting to take an active interest in IPCC-related issues, and a
letter to the British Treasury drawing attention to
Castles-Henderson (evidently it failed to notice unassisted) has
just received a positive, if long delayed, response. More must be
done, and soon. Work on a question of this sort would sit well with
Mr Henderson's former employer, the OECD. The organisation's
economic policy committee - a panel of top economic officials from
national ministries - will next week install Gregory Mankiw, head
of America's Council of Economic Advisers, as its new chairman. If
Mr Mankiw is asking himself what new work that body ought to take
on under his leadership, he need look no further than the dangerous
economic incompetence of the IPCC. TUNNEL VISION The fact that the
IPCC mobilised as many as 15 authors to supply its response is
interesting. The panel's watchword is strength in numbers (lacking
though it may be in strength at numbers). The exercise criticised
by Mr Castles and Mr Henderson involved 53 authors, plus 89 expert
reviewers and many others besides. Can so many experts get it
wrong? The experts themselves may doubt it, but the answer is yes.
The problem is that this horde of authorities is drawn from a
narrow professional milieu. Economic and statistical expertise is
not among their strengths. Making matters worse, the panel's
approach lays great emphasis on peer review
• This case study illustrates the variety of issues with which
managerial economics is concerned. The following questions
arise:
Q1. Is there a problem to be addressed?
Q2. Is there a solution or solutions to the problem, in terms of strategies or course of action that can be taken?
Q3. What objective or objectives can be defined for these strategies?
Q4. What constraints exist in terms of operating any strategies?
Q5. How can we identify strategies as solutions to the problem?
Q6. How can we evaluate these strategies in terms of costs and benefits, particularly when these involve life and health?
Q7. What is the best way of measuring the relevant variables?
Q8. What assumptions should be made in our analysis?
Q9. How do we deal with the problem of risk and uncertainty
regarding the future and the effects of strategies in the
future?
Q10. How can we approach the problems of conflicts of interest between different countries and between different consumers and producers?
Q11. What criteria can we use for selecting strategies from among different possible course of action?
Q12. How do political biases and agendas affect decision-making processes in practice?
In: Economics