System Security Criteria

Trusted Computer System Evaluation Criteria (TCSEC) is applied in classifying and evaluating the computer security in any given system especially where sensitive information is involved. For that reason any organization such as Medical Credential Company has to initially consider a few factors as well as meet security criteria as provided by TCSEC. There exists four divisions (D,C,B, and A) and C,B, and A are further divided into classes but in the context of this study, only classes C-2 (Controlled Access Protection) and B-3 (Security Domains) will be considered.By choosing Class C-2 means that the company opts for Discretionary Security Protection which is under Division C. class C-2 offers defense of the sensitive information/data ‘against and detection of user abuse of authority and direct probing’. Besides, class C-2 also protects the system form activities of non-users and users who may not be using malicious programs. Class C-2 employs security controls for all ob jects in the system which may be personal files and/or specific devices.Subsequently, an individual is supposed to identify and authenticate him/her –self before login into the system and after using a track record of what he/she has done is kept. Therefore Class C-2 puts emphasis on audit trail for evaluation purposes. For that reason, it calls for a selective method to record all events which have occurred and tools to examine the audit record (DoD, 1985). On the other hand, Class B-3 which falls under Mandatory Security Protection, Division B, puts emphasis on security domains in the system.Systems that conform to Class B-3 criteria enforce what Class C-2 criteria entails, discretionary security policies, and its policy. Therefore, Class B-3 is has more has security features compared to class C-2. Reason being substantial confidence is created that the computer system is protected against misuse techniques for instance human error, direct probing, and abuse of authority by users.In particular Class B-3 protects the system from intentional subversions of the computer security methods hence it is widely employed in addressing defense mechanisms against malicious programs. Besides, a computer system that meets security requirements for Class B3 entails security kernel which implements a reference monitor principle which lacks in Class C-2. Both of these classes entail security requirements -classified under policy, accountability, and assurance- aimed at regulating access to information.Security policy, marking, identification, and accountability specify what control measures that needs to be put in place to regulate access to information. Besides, assurance and continuous protection provides guidelines on how a person can obtain credible assurance that overall security is achieved in a trusted system but security requirements in the two classes differ (DoD, 1985; Nibaldi, 1979). Figure 1.Table of security requirements for classes C2 and B3. Legend: â⠂¬Å"x† -no requirement; â€Å"-† class has same requirements as the next lower class; â€Å"R†-class has extra requirement over the lower classes. NB: Adopted from DoD 5200. 28-STD The security requirements outlined in the above table are functionally-oriented and it is in order for the security manager of the company to consider employing security controls first.Considering the security criteria employed by Class B3, as a security manager in the company, it would be better to seek certification for Class B3. References DoD. (1985, December). DoD standard: Trusted Computer System Evaluation Criteria, DoD 5200. 28-STD. Retrieved August 22, 2010 from http://www. dynamoo. com/orange/fulltext. htm Nibaldi, G. H. (1979, November). Specification of A Trusted Computing Base, M79-228, AD-A108- 831 (TCB), MITRE Corp. , Bedford, Mass.

Advantages and Disadvantages of Info Tech Essay

1.more time: I.T has made it possible for businesses to be open 24/7 all over the globe, making purchases from different countries easier and more convenient.it also means that u can have goods delivered right to your doorstep with having to move a single muscle. 2.bridging the cultural gap: I.T has helped bridge the cultural gap by helping people from different cultures to communicate with one another, and allow the exchange of views and ideas.increasing the awareness and reducing prejudice. 3.communication:communication has become cheaper,quicker and more efficient. we can contact anyone in the word simply by sending them and email or using one of the social networks for almost an instantaneous response.the internet has opened up face to face direct communication from different parts of the world by video conferencing. disadvantages 1.unemployment: while I.T may have streamlined the business process it has also created job redundancies, downsizing and outsourcing. this means all the middle class jobs have been gotten rid of causing more people to loose their jobs 2.lack of job security: industry experts believe that the internet has made job security a big issue since technology keeps on changing everyday. this means that one has to be in a constant learning mode if he or she wishes to keep their job secure. 3.privacy: though I.T has made communication cheaper,faster and more convenient, it has also brought along some privacy issues.(eg. email hacking) people are now worried about their once private information  becoming puplic knowledge.

Gauging The Patient Satisfaction Level Health And Social Care Essay

Fast alterations in the environment have put important force per unit areas on infirmaries to add patient satisfaction in their strategic stance and quest for market portion and long-run viability. Historically, the constitutions of quality criterions in wellness attention scenes were delegated to the medical professionals. Not surprisingly, quality was defined by clinicians in footings of proficient bringing of attention. The recent literature ( in the developed states ) , nevertheless, emphasizes the importance of the patient ‘s position. Hospital decision makers, insurance companies, community groups, and research workers have all need to acknowledge the value of the penetrations that patients can supply in order to custom-make their services harmonizing to the need/desire of the patients. It has been observed that there has been no such work done in the wellness sector of Pakistan. In order to accomplish client satisfaction, there is a strong demand to place some important factors that are responsible for fluctuation in client satisfaction degree and prove their significance in Pakistani environment.Scope/Justification:Estimating patient ‘s satisfaction degree through assorted factors is a widely ignored country in the wellness attention sector in Pakistan. Besides few private infirmaries no other public and private infirmaries are being focused on client centeredness. Unfortunately no important researches are taken topographic point in this country bespeaking deficiency of involvement. As internationally important research work had been done in this respect reflecting importance of patient ‘s satisfaction in order to run successful wellness attention organisation. As competition among the private infirmaries in urban countries of the Pakistan is on the rise hence there is demand of important research work to place the tools and factors responsible for fluctuation in client satisfaction degree in wellness attention industry in Pakistan. Su ch research work will supply an penetration to the infirmaries that how they can stay competitory. To get down with this research in which three major private infirmaries in Karachi will be evaluated on the footing of the feedback of the users of their service on different factors of satisfaction degree.Restriction:Due to fiscal and clip constrains it will non be possible to carry on the state broad research and hence the range of research will be confined to the Karachi metropolis merely.Boundary line:Karachi is a mega metropolis holding legion authorities and private infirmaries. Since this research will be conducted to prove the significance of five factor theoretical account on satisfaction degree of patients who attended private infirmary therefore all authorities infirmaries are excluded and merely private infirmaries are included in the research. In this respect three major private infirmaries including The Aga Khan University Hospital, Liaquat national Hospital and Ziauddin Hospital are selected.Methodology:This research will be qualitative in nature. Interviews will be conducted with a little but representative sample of selected infirmary users. Questionnaire will be developed in a mode which will let respondents to supply their feedback related to the factors selected and eventually their overall satisfaction with infirmary services. In following measure multiple arrested development will be applied after coding the information collected through questionnaire to look into the degree of significance of each factor on patient satisfaction degree. Patient satisfaction degree will be considered as dependent variable and factors including communicating with patients, competency of the staff, their behaviour, quality of the installations, and perceived costs will be used as an independent variable.Aim:The aim of this research is to prove the significance of five factor theoretical account including communicating with patients, competency of the physicians , attitude & amp ; behaviour of staff, quality of the installations, and perceived costs on fluctuation in client satisfaction degree.Research Question:Q. How significantly the factors including communicating with patients, competency of the physicians, attitude & amp ; behaviour of staff, quality of the installations, and perceived costs lending upon fluctuation in client satisfaction degree in private wellness attention scenes in Karachi?Introduction:Customer relationship direction is the most of import facet which these yearss every organisation has to work on to stay competitory. Hospitals has to concentrate on client centeredness in doing their policies and strategic plans.. In add-on to that fast alterations in the environment have put important force per unit areas on infirmaries to add patient satisfaction in their strategic stance and quest for market portion and long-run viability. This research survey proposes and trials five factors that explain considerable fluctuation in client satisfaction with infirmaries. These factors include communicating with patients, competency of the staff, their behaviour, quality of the installations, and perceived costs. The purpose of this instance survey is to place the most relevant factors that are responsible for fluctuation in client satisfaction degree. The result of this survey would supply an organisation an penetration to be more focussed on keeping or bettering these factors in order to increase satisfaction degree of the clients. The appraisal of service quality poses some interesting challenges that have engaged faculty members and practicians in the developed states for rather some clip now. Two major concerns continue to breed healthy argument on this issue: Who will measure quality and on what standards? Historically, the constitution of quality criterions was delegated to the medical profession. Not surprisingly, quality was defined by clinicians in footings of proficient bringing of attention. The recent literature ( in the developed states ) , nevertheless, emphasizes the importance of the patient ‘s position. Hospital decision makers, insurance companies, community groups, and research workers have all begun to acknowledge the value of the penetrations that patients can supply. Harmonizing to O'Connor, S.J. , Shewchuk, R.M. and Carney, L.W. , 1994. The great spread. Journal of Health Care Marketing 14 2, pp. 32-39.O'Connor, Shewchuk and Carney ( 1994 ) , â€Å" It ‘s the patient ‘s position that progressively is being viewed as a meaningful index of wellness services quality and may, in fact, represent the most of import position. † ( p. 32 ) .But some still feel that patients can non truly be considered good Judgess of quality, disregarding their positio ns as excessively subjective. Petersen ( 1988 ) challenges this position by proposing that it is non of import whether the patient is right or incorrect, what is of import is how the patient felt even though the health professional ‘s perceptual experience of world may be rather different. Remedy is a cardinal wellness service outlook. Specifically, patient satisfaction is defined as an rating of distinguishable health care dimensions. It may be considered as one of the coveted results of attention and so patient satisfaction information should be indispensable to quality appraisals for planing and pull offing health care. Patient satisfaction enhances hospital image, which in bend translates into increased service usage and market portion. Satisfied clients are likely to exhibit favourable behavioural purposes, which are good to the health care supplier ‘s long-run success. Customers tend to show purposes in positive ways such as praising and preferring the company over others, increasing their purchase volumes or paying a premium.Literature Reappraisal:Health attention industry is one of the fastest turning industries these yearss. Fast growing of this sector has been brought in dramatic alterations in the environment and hence wellness attention decision maker s have to happen out the ways to stay competitory. These force per unit areas include increasing options for clients for exchanging and better informed clients. Many infirmaries with the aid of researches have realized that client satisfaction is the nucleus component of scheme and the critical factor for long term sustainability and sustainable competitory advantage. 1.Donabedian A. ( 1988 ) , suggests in â€Å" Quality appraisal and confidence: integrity of intent, diverseness of agencies † , Inquiry, Vol. 25 pp.173-92. that â€Å" patient satisfaction may be considered to be one of the coveted results of attention information about patient satisfaction should be as indispensable to appraisals of quality as to the design and direction of wellness attention systems † . 2.Vaida and Osmo ( 2002 ) investigate in â€Å" Why are people dissatisfied with medical attention services in Lithuania? † chief beginnings of dissatisfaction with medical services among the population in Lithuania. They analyse written responses to an open-ended inquiry as a portion of a questionnaire study. Results revealed 12 classs of dissatisfaction that were related to three degrees: defects in the wellness attention system ( systemic degree ) , lacks in proviso and quality of services ( institutional degree ) and lacks in doctors ‘ attitudes, accomplishments and work ( single degree ) .3.Mario lino Raposo, Helena Maria Alves and Paulo Alexandre Duarte ( 2008 ) investigate in â€Å" Dimensions of service quality and satisfaction in health care: a patient ‘s satisfaction index † about importance of factors influence satisfaction are really of import for health care directors as it influences healthcare consequences and health care. Partial Least Square s way mold ( PLS ) was the technique chosen. The consequences show that patients ‘ satisfaction is 60.887 in a graduated table from 1 to 100, uncovering merely a medium degree of satisfaction. It is besides possible to reason that the most of import positive effects on satisfaction are the 1s linked to the patient/doctor relationship, the quality of installations and the interaction with administrative staff, by this order.4.J Hughes ( 1991 ) in his reappraisal â€Å" Satisfaction with Medical Care: A Review of the Field ( 1991 ) stated that Peoples dislike out-of-pocket costs, co-payments and deductibles, peculiarly if they have to pay at the site of attention ( Dolinsky and Caputo, 1990 ) . When they have inquiries, they like to hold person available to explicate processs to them until they understand. In factor analysis, satisfaction with insurance supplier tends to be a really independent dimension from satisfaction with suppliers, lending small to overall satisfaction ( Singh, 1990 ) . Satisfaction with ambulatory attention has mostly to make with satisfaction with one ‘s doctor, while satisfaction with the inmate experience has more to make with the quality of the staff ( Hall and Dornan, 1988 ) . With the doctor, satisfaction interruptions down into two facets, ( a ) satisfaction with sensed proficient competency and ( B ) satisfaction with interpersonal accomplishments. In measuring nurses and other staff, nevertheless, patients place much more accent of the interpersonal facets than on perceptual experiences of proficient competency. undermentioned tabular arraies are based on a sample of 1600 outpatients and 700 inmates of the University of Chicago, drawn from those who passed through the infirmary in January 1991. Harmonizing to the Picker Commonwealth sample of 1990, the University of Chicago has one of the highest rates of patient satisfaction in the state, so the findings are capable to the cautiousnesss about little discrepancy note d above. These two theoretical accounts of inmate and outpatient satisfaction are implicative of the variables that are by and large found to foretell overall satisfaction and the determination to return. The inquiries below were found to be the most prognostic of four or five times as many inquiries in the studies. 5.Ford, Robert C. ; Bach, Susan A. ; Fottler, Myron D. investigate in â€Å" Methods of Measuring Patient Satisfaction in Health Care Organizations, Health Care Management Review: Spring 1997 – Volume 22 – Issue 2 – pp 74-89 the advantages, disadvantages, and jobs associated with nine different methods of mensurating patient satisfaction with service quality. The rightness of each of these techniques under different organisational conditions is besides discussed. The article concludes with guidelines for measuring of patient satisfaction and execution of managerial follow-up including both qualitative and quantitative attacks. They vary in cost, truth, and the grade to which they inconvenience the patient. Choosing the best method or combination of methods should stand for an ideal balance between the organisation ‘s strategic ends and the cost of accomplishing these ends. Finding this balance depends upon the information the organisation is seeking, how t he ensuing information will be used, the fiscal resources available, the expertness available for roll uping the information, and the grade of statistical cogency and dependability required.6.Alessandra Mazzei, IULM, Vincenzo Russo, IULM, Alberto Crescentini, Alta Scuola Pedagogica di Locarno, investigates in â€Å" Patient satisfaction and communicating as competitory levers in dental medicine † the most relevant quality factors and communicating activities that are suited as competitory levers in dental medicine. This research is based on interviews with senior tooth doctors, focal point groups with patients and a study of dental medicine patients. They conclude that the repute of the tooth doctor, perceived service quality and patient satisfaction are progressively relevant in the current Italian medical services market. Indeed, to pull patients requires improved quality and communicating activities. Following theoretical accounts were suggested by the researches to be con sidered in order to set up effectual communicating7.M.A.A. Hasin, , Roongrat Seeluangsawat, M.A. Shareef, investigate in â€Å" Statistical steps of client satisfaction for wellness attention quality confidence: a instance study the elements of client satisfaction, by roll uping information through study, utilizing both written questionnaire and interview, and so statistically finding correlativity between factors and elements of dissatisfaction. The survey is performed at the Muang Petch Thonburi Private Hospital, located in Petchaburi state of Thailand. They conclude that though the infirmary has a good degree of overall service, there are many countries that need attending to further better the service. Continuous betterment of TQM is therefore really helpful to increase fight in infirmaries and many other wellness attention organisations. The followers are some factors which are found necessary at this specific infirmary, though the survey believes that they are necessary in an y other wellness attention organisation: Change attitude of employees about the nonconformist service, it does non intend lack in the section ; instead it means that things should better to run into client satisfaction. Training at all degrees ( non merely for physicians and nurses, but besides for others ) within the infirmary is required to better service quality. To increase the efficiency of inter-department cooperation and interrupt the departmental barrier, the operation consequences should be emphasized on an organization-wide footing alternatively of a department-wide footing. In add-on, use of job work outing meetings for operational struggles should be increased. Absence of policy is a job. ISO9000 QMS may assist in this respect. It may be mentioned that this infirmary decided to implement ISO9002 for this intent. This would intend internal audit besides. 8.The survey concluded and recommended solutions sing the sentiments of lone external clients. The survey suggests that for a better declaration in the field of TQM in any sort of organisation, employee behaviour and attitudes should be taken into history. Customer satisfaction represents a profitable competitory scheme variable because surveies have shown that the populace is inclined to pay more for attention from quality establishments which are better disposed to fulfill clients ‘ demands ( Boscarino, 1992 ; Hays, 1987 ) . Its value as a competitory tool besides derives from the fact that infirmaries with better images have been able to interpret these into increased use and market portion ( Boscarino, 1992 ; Gregory, 1986 ) . Delivering client satisfaction is besides imperative because today ‘s users of wellness attention services in urban countries are better educated and more cognizant than in the yesteryear. These users carefully study and monitor the options available to them ; they are, hence, more discerning users, cognizing precisely what they need. These alterations are being driven by the copiousness of information that is available to them from public and private beginnings. 9.Syed Saad Andaleeb ( 1998 ) tested in â€Å" Determinants of client satisfaction with infirmaries: a managerial theoretical account † five-factor theoretical account that explains considerable fluctuation in client satisfaction with infirmary. These factors include communicating with patients, competency of the staff, their behavior, quality of the installations, and perceived costs. A chance sample was selected and a multiple arrested development theoretical account used to prove the hypotheses. The consequences indicate that all five variables were important in the theoretical account and explained 62 per cent of the fluctuation in the dependant variable. Hospitals should device schemes to concentrate on these variables if competitory advantage is to be gained through presenting client satisfaction. 10.Syed Saad Andaleeb ( 2001 ) , investigates in â€Å" Service quality perceptual experiences and patient satisfaction: a survey of infirmaries in a underdeveloped state † quality factors that are of import to patients. He besides examines their links to patient satisfaction in the context of Bangladesh. A field study was conducted. Evaluations were obtained from patients on several dimensions of sensed service quality including reactivity, confidence, communicating, subject, and gratuity. Using factor analysis and multiple arrested development, important associations were found between the five dimensions and patient satisfaction. Deductions and future research issues are discussed. He concluded that all five dimensions of service quality were important in explicating patient satisfaction. The waies of the relationships were as hypothesized. Discipline, as an extension of the â€Å" tangibles † dimension, had the greatest impact on client satisfaction as indicated by the standardised I? values. While this determination is contrary to theoretical accounts in developed states, the developing state context, the by and large province of undiscipline in the service environment, and the hapless direction and disposal of service bringing seem to warrant this consequence. Assurance had the 2nd greatest impact on patient satisfaction. In an environment where the professional demeanour and public presentation of the hospital staff, particularly physicians, have frequently come under terrible unfavorable judgment, it is non surprising that patients were more satisfied when they felt more assured of their wellness results. There is besides grounds that for services with acceptance belongingss, confidence dramas an of import function in patient satisfaction ( Zeithaml, V.A. and Bitner, M.J. , 2000. Services selling, McGraw-Hill, New York.Zeithaml & A ; Bitner, 2000 ) . This determination is, therefore, corroborated, particularly in the fact that the writers besides suggest the similarity of demands between patients in developed and developing states. The impact of reactivity and communicating on patient satisfaction was besides important. While the magnitude of their effects was relatively lower than the effects of subject and confidence, this does non connote that reactivity and communicating are unimportant or should be ignored in infirmaries ‘ pursuit to better service quality. This lone suggests that greater additions in patient satisfaction can be realized by go toing to train and assurance in the infirmary environment. Baksheesh, while besides important, had the least impact on patient satisfaction. Although this determination may look surprising, a small contemplation suggests that it makes sense. Baksheesh does rarefy client satisfaction ; nevertheless, as a necessary immorality it possibly has merely nuisance value. The low impact of gratuity besides seems to back up the chief thesis of this paper – that quality ( via confidence and subject ) is more of import than cost and entree as reflected in gratuity. In other words, gratuity is marginally of import to patients for whom a disciplined scene, confidence of rapid recovery, and a antiphonal and communicative staff are of greater importance. If a little monetary value demands to be paid in the signifier of gratuity, its impact on patient satisfaction is important but fringy. 11.Jiunn-I Shieh, , Hsin-Hung Wub and Kuan-Kai Huang investigate in â€Å" A DEMATEL method in placing cardinal success factors of infirmary service quality † The critical factors to pull off a infirmary successfully, the of import ends are to pull and so retain as many patients as possible by run intoing possible demands of assorted sorts of the patients. This survey foremost conducted the study based on SERVQUAL theoretical account to place seven major standards from patients ‘ or their households ‘ point of views at Show Chwan Memorial Hospital in Changhua City, Taiwan. When the cardinal standards were found, the 2nd study developed for using decision-making test and rating research lab ( DEMATEL ) method was issued to the infirmary direction by measuring the importance of standards and building the causal dealingss among the standards. They concluded that The consequences show that trusted medical staff with professional competency of wellness attention is the most of import standard and reciprocally affects service forces with good communicating accomplishments, service forces with immediate problem-solving abilities, elaborate description of the patient ‘s status by the medical physician, and medical staff with professional abilities. Th erefore, preparations on communicating accomplishments and problem-solving abilities would ensue in positive interaction for patients to swear medical staff. When the sure medical staff provides professional competency of wellness attention to patients, satisfaction would be increased. 12.Sohail S.M. examines in â€Å" Service quality in Hospitals: More Favorable than you might believe † the quality of services provided by private infirmaries in Malaysia. Empirical research is used to find patients outlooks and perceptual experiences of the quality of service, and a comprehensive graduated table adapted from SERVQUAL is through empirical observation evaluated for its utility in the Malayan infirmary environment. Consequences based on proving the average testing between outlooks and perceptual experience indicate that patients perceived value of the services exceed outlooks and perceptual experience for the variable measured. These variables including tangibleness, dependability, confidence and empathy. 13.Pamela and J. Gregory attempted in â€Å" Verbal Communication Skills and Patient Satisfaction, A survey of physician patient interviews † to quantify specific behavior in the physcian ‘s initial interviewing manner with patients. The interviews were tape recorded and later on evaluated with the usage of the computerized Language Analysis System. It was found that three variables are significantly affection verbal communicating between patients and their doctors. The variables are usage of silence or reaction clip latency between talkers in an interviews, whether there was linguistic communication reciprocality as determined through the mutual usage of word lists and 3rd is the brooding usage of breaks within an interview. 14.Lekidou Ilia, Trivellas Panagiltis and Ipsilandis Pandelis investigate in â€Å" Patients Satisfaction and quality of attention An empirical survey in a Grecian Central Hospital † about the relationship of patients admittance, adjustment facets, external environment and the attention provided by physicians nurses and support helpers with service quality reflected on the patients, satisfaction. Their survey was patients centered and identifies the quality factor tha are of import to patients. They besides examine their links to patient satisfaction in the context of Greece. They conducted field study based on a sample of 164 patients of a cardinal public infirmary. The method used was multiple arrested developments. Consequences revealed important associations which shed visible radiation on the determiners of patients satisfaction particularly visiting hours, physicians consistence, the sort of insurance, yearss of hospitalization, the types of clinic and hygiene ‘s o bservation have a positive relationship with patients satisfaction. In add-on to that factors of dissatisfaction including if quiet is non observed, if its hard to turn up physicians, if jobs occur with parking, and admittance procedure, deficiency of communicating with nurses, physicians, impoliteness, orderly improper behavior and wellness detoriation after patients hospitalization were identified. 15.Sara N Bleich a, Emre A-zaltin B & A ; Christopher JL Murray investigates in â€Å" How does satisfaction with the health-care system relate to patient experience? † the factors underlying people ‘s grade of satisfaction with the health-care system and the extent to which the latter reflects their experience of attention. Datas from the faculty on wellness system reactivity in the World Health Survey for 2003 provided a alone chance to better understand the determiners of people ‘s satisfaction with the health-care system, besides their experience as patients, in 21 states of the European Union ( EU ) . Throughout the paper, research workers use WHO ‘s term â€Å" reactivity † to mention to satisfaction with the wellness system from the position of patient experience. They include in the analysis all 21 EU states for which informations were available in the World Health Survey for 2003. The study was conducted by face-to-face interviews in all states except Luxembourg, where it was conducted by telephone. Survey respondents were chosen through stratified, multistage bunch trying and interviewed in the national linguistic communication. Sample size varied by state. The cardinal consequences of the 7th and concluding OLS arrested development theoretical account, which was used to research the possible determiners of satisfaction with the health-care system showed positive consequence on client satisfaction degree. These factors including liberty, pick, communicating, confidentiality, self-respect, prompt attending and quality of basic comfortss. It is notable that all the covariates combined explained merely 17.5 % of the ascertained fluctuation in satisfaction with the health-care system, a determination that resembles that of a recent survey on the determiners of satisfaction in developing states. We do non believe that this consequence is due to high random measuring mistake. We attribute it, alternatively, to a ample spread in our apprehension of the factors finding people ‘s satisfaction with the health-care system. 16.Dr Sona Bedi, ** Dr Sanjay Arya, *** Prof RK Sarma ( 2004 ) proved in Patient Expectation Survey – A Relevant Selling Tool for Hospitals † . that a relevant tool for infirmary decision makers today is a patient outlook study, which reveals what patients really desire from infirmaries. They conducted patients expectation study among patients sing the Outpatient section of two authorities infirmaries in India. Entire 230 patients were surveyed. Consequences revealed that patient outlook study can be considered as a pro-active selling activity designed to hold a better opportunity at accomplishing patient satisfaction. It is seen that if any infirmary fulfils outlooks of patients, patients are more likely to remain with that peculiar service supplier for a longer clip. Patients in both infirmaries consider good physician with the ‘ability to bring around ‘ as the most of import property of medical attention in a infirmary. Different attributes which affair mo st to patients are about same, but comparative importance of these is a map of background ( socio-economic position ) and what is available in the infirmary. But the most of import thing is the physician, who should be non merely be competent i.e able to handle, but besides have good communicating accomplishments and is empathic. Good environment is needed to make a right feeling on the patient, and absence of the same can hold a negative impact. Marketing strategy- without technically or clinically competent physicians, a high degree of patient satisfaction is hard to accomplish. Physical installations and sanitation rate high in patient outlooks implicitly. 17.Shahbaz Shabbir1* , Hans Ruediger Kaufmann2 and Mudassar Shehzad3 ( 2010 ) investigated in â€Å" Service quality, word of oral cavity and trust: Drivers to accomplish patient satisfaction † the elements of the services provided in Pakistani infirmaries ( Public and Private ) and their part to patient satisfaction sing trust on the service suppliers. They conducted study of patient in public and private infirmaries in Islamabad. The informations were analyzed through a correspondence analysis which was applied to the consequences. of the 245 distributed questionnaires. Correlation and arrested development analysis were used to happen out the impact of Service quality, Word of oral cavity and Trust on patients satisfaction. Consequences revealed that Pakistani patients perceived public infirmaries to be superior in the quality of their service proviso, which is non, aligned with the bulk of recent survey findings. These consequences are recognized because Islamabad ‘s infirmaries are offering improved service so that they accomplish the demand of their patient. The information was gathered from infirmaries situated in Islamabad merely, therefore future research workers suggested that research could widen to other metropoliss in Pakistan to prove their generalizability as Islamabad is the capital metropolis and they are offering improved service so that they accomplish the demand of their patient. Besides consequences indicated that service quality is positively and significantly correlated with patients satisfaction in wellness attention industry. Trust and word of oral cavity is positive but non significantly correlated with patients satisfaction in wellness attention industry. 18.Aditi Naidu ( 2009 ) tried in â€Å" Factors impacting patient satisfaction and health care quality â€Å" to construct a comprehensive conceptual theoretical account to understand and step variables impacting patient satisfaction-based health care quality. A sum of 24 articles from international diaries were consistently reviewed for factors finding patient satisfaction and health care quality. The survey showed that outlooks were non equal for all three wellness service suppliers. For walk-in-clinic frequenters, the most of import influence on outlooks was staff friendliness and cost. For private physician patients, they were friendliness and clip spent with the client, intervention accounts and competency. Customers said exigency suites were the least attractive. The most of import influence were physician friendliness, competency, sum of clip spent with the client and the sum of information provided. Both private doctor and exigency room frequenters placed walk-in suites as the referent for their outlooks. Staff friendliness, cost and the sum of clip the physician spent with them were found to be the three most of import considerations/discriminators. With low outlooks, exigency suites generated higher than expected satisfaction degrees. The lone group where what was received was precisely as what was expected was walk-in frequenters. In the instance of private doctors, the public presentation fell abruptly of outlooks, therefore bring forthing dissatisfaction. Finally it was concluded that patient satisfaction is a multi-dimensional health care concept affected by many variables. Healthcare quality affects patient satisfaction, which in bend influences positive patient behaviors such as trueness. Patient satisfaction and health care service quality, though hard to mensurate, can be operationalized utilizing a multi-disciplinary attack that combines patient inputs every bit good as adept judgement. Restriction of this research is that it was a conceptual theoretical account that needs to be Confirmed through empirical observation. 19.Arpita Bhattacharya* , Prema Menon** , Vipin Koushal*** , K.L.N. Rao**** ( 2003 ) investigated in â€Å" Study of Patient Satisfaction in a Third Referral Hospital † the perceptual experience of patient attenders sing the services provided to in-patients by the Department of Pediatric Surgery at this Institute. PGIMER is a prime institute in India, which trains medical instructors, provides patient attention as a third referral centre and behaviors high quality medical research in India. The perceptual experiences and outlooks of attenders sing proficient quality, general satisfaction, communicating, interpersonal facets, handiness, convenience etc. The information was collected from two hundred 50s two inmates through an interview with the parents or a close relation at the clip of discharge of the patient.The collected information was analyzed as a whole and a comparative analysis besides done by spliting the patients into subcategories on the footing of admittance positi on ( ward vs. NSICU ) , position of unwellness every bit good as affordability and literacy of parents. Frequency distributions were obtained to look into the frequence of the self-asserting and negative responses. Chi-Square trial was applied to cipher the significance of differences between the sentiments of patient attenders belonging to different sub classs except admittance position. Consequences revealed that 61 per centum were paying patients. Fifty-nine per centum of the attenders were literate. Overall degree of satisfaction with physicians ranged from 89.3 % to 99.6 % . Very high degrees of satisfaction were expressed on proficient quality of physicians ‘ work and their accessibility. However 10.7 % felt that physicians had n't to the full explained the disease and the intervention. The per centum of satisfied attenders sing proficient facets of nursing attention was supra 90 % . Literate attenders were more satisfied sing accessibility of nurses to their personal jobs compared to illiterate/semiliterate attenders ( P & lt ; 0.01 ) . However, the latter were more satisfied than the literate attenders with the advice given at the clip of discharge ( P & lt ; 0.05 ) . The degree of satisfaction with behaviour and attitude of nurses towards the attenders was hapless. 24.2 % attenders thought that some of the nurses were ill-mannered whereas 21.4 % felt they were apathetic. In the NSICU, satisfaction degrees with attitude and manner of speaking of nurses was higher with paying, literate attenders. Moderate degree of satisfaction mark was noted sing quality of work of ward servants/sweepers. High rate of dissatisfaction was found sing their helpfulness. Many of the attenders ( 23 % ) did n't interact with them. Chronic and literate attenders were more satisfied with their quality of work, helpfulness, and communicating. 62.5 % of NSICU attenders answered that the figure of lavatories were equal. However in the ward, 85 % were dissatisfied on this facet. Harmonizing to 62.7 % attenders, the infirmary provided best installations for intervention. None of the respondents categorized intervention installations as bad but 37.3 % thought that it could be better. More than 94.5 % of the attenders besides responded positively to the general cleanliness and nutrient. Most of the attenders were satisfied sing OPD services provided.This survey provided an penetration to hospital disposal, staff, physicians and research workers who want to better the quality of service and patient satisfaction degrees. It appears that such little and good manageable forte centres may be an reply to the widespread unsatisfactory conditions predominating in general in public sector infirmaries in India.20.Al Johara A. Al-Hussyeena, ( 2010 ) investigated in â€Å" Factors impacting use of dental wellness services and satisfaction among adolescent females in Riyadh City † factors impacting use of dental wellness services among intermediate female school pupi ls in Riyadh in add-on to measuring their satisfaction with the alveolar consonant attention received during the last dental visit. The survey protocol was approved by moralss commission at the College of Dentistry Research Center, King Saud University and Ministry of Education, Saudi Arabia. Eight intermediate public and four private schools were selected indiscriminately from the four different administrative zones [ North, South, E and west ] in Riyadh City. The figure of selected pupils for each zone was based on the figure of schools and figure of the pupils enrolled in them. Datas for this survey was obtained through the usage of a self-administered Arabic questionnaire. Entire 531 pupils were included in this survey. Statistical Package for Social Science ( SPSS ver. 13 ) was utilized to cipher descriptive statistics and statistical trials. T-test was used.Results revealed that pupils who visited the tooth doctor for everyday intervention were more concerned about the quality of dental attention compared to those who made their visits due to trouble. Regular attenders visit the tooth doctor more often ; accordingly, they are more experient and demand high quality of dental attention. While those who visit merely in instance of hurting are pleased by holding the hurting relieved, these findings. Findingss of this survey besides indicated that stripling ‘s pick an use of dental service can be improved if dental clinics were located closer to their places and if they provided high quality of dental attention with sensible fees. High quality of dental attention, modern equipped alveolar consonant clinic which recommended by a comparative or a friend and have friendly staff, in add-on to acquiri ng convenient assignments were found to increase pupils ‘satisfaction significantly.21.B.Krishan Reddy, G.V.R.K. Acharyulu ( 2002 ) investigated in â€Å" Customer Relationship Management ( CRM ) in Health Care Sector – A Case Study on Master Health Check † some of the CRM constructs and elements – formulate CRM scheme to take proactive steps towards customer-centric concern in a corporate infirmary to better client satisfaction by constructing up better client relationships taking to increase in grosss. This survey focuses on the maestro Health Check bundles, profile of clients, their behavior and eventually finding the relationship factors to plan CRM scheme. An explorative research is undertaken to concentrate on making a client Relationship Management scheme for the Master Health Check in the infirmary. The research is chiefly based on secondary informations, and supplemented with primary informations. Secondary Data included MHC feedback signifiers, M HC patient records, repetition patient records and OP accession registry. Primary Data gathered through questionnaire, interviews and observations. Consequences revealed that maximal figure of people opted Master Health look into up due to comprehensive trials included in the bundle and besides its economical cost. Male clients availed more MHC bundle as compared to female clients due to miss of consciousness among females. It was further revealed that overall satisfaction has besides been increased by 12 % and dissatisfaction was increased by 1 % as compared to the twelvemonth 2000. Satisfaction with physicians and courtiousness of the staff has besides indicated positive consequence on client satisfaction.22.Fei Lung Lau investigated in â€Å" Can communicating accomplishments workshops for exigency section physicians improve patient satisfaction? That go toing of the communicating accomplishments workshops by the exigency section physicians improves patient satisfaction and redu ces the figure of ailments on physicians ‘ attitude. Patient satisfaction studies in four representative EDs conducted before and after the workshops, were collected and the satisfaction rates of physicians ‘ attitude, account and advice were later compared. Consequences revealed that after the series of workshops, there was a 42 % decrease ( from 26 to 15 instances ) in the figure of ailments against physicians ‘ attitude. This occurred despite the increased attending from 724 000 to 898 000 in the eight infirmaries. This survey supports writer ‘s belief that communicating accomplishments workshops can better the physicians ‘ communicating accomplishment with a corresponding addition in patients ‘ satisfaction and lessening in patients ‘ ailments towards ED physicians. 23.Kathryn Frazer Winsted ( 2000 ) examined in â€Å" Patient satisfaction with medical brushs – a cross-cultural position † about behaviours of physicians that influence patient rating of medical brushs in USA and Japan. Method used for analysis is that a list of behaviours relevant to patient rating of a medical brush is developed. Performance of these behaviours in specific medical minutess is so examined and the relationship between public presentation of each behaviour and brush satisfaction is analyzed. Behaviors are grouped, utilizing factor analysis from consumer studies. Consequences revealed that that many of the behaviours and constructs are of import to consumers in measuring service brushs are really similar across civilizations. These constructs are congenialness, communicating, civility concern and courtesy. 24.John e. Ware, Jr. PH.D. and Mary K. Snyder, PH.D. ( 1975 ) investigated in † Dimensions of Patient Attitudes Regarding Doctors and Medical Care Services † about patient attitudes sing features of physicians and medical attention. Four major dimensions of patient attitudes were identified and described, including attitudes toward physician behavior ( humanity and quality ) and such enabling constituents as handiness of services, continuity/convenience of attention and entree mechanisms ( cost, payment mechanisms, and easiness of exigency attention ) . Questionnaire were used to roll up informations with the patients. Factor analysis was applied to measure the findings of the information. Reliability and proof cheques were besides applied. Consequences revealed that these dimensions, which accounted for about 72 per cent of the dependable discrepancy in index tonss, include attitudes toward: a ) doctor behavior, B ) handiness of attention, degree Celsius ) continuity/con venience of attention, and vitamin D ) entree mechanisms such as fiscal considerations and entree to exigency attention, steps of patient attitudes toward the quality of attention received from physicians ( thoroughness, preventative steps, information giving, and the similar ) have fundamentally the same factor content as steps of physician humanity ( consideration and support ) suggests that consumers of medical attention services may hold one general attitude toward their physicians. Second dimension of measuring identified in the current survey involves attitudes toward constituents of wellness services including fiscal barriers, exigency attention services, handiness of wellness services resources as infirmaries, specializers, household physicians, and general medical installations which enable one to have attention. 25.Penelope Angelopoulou, Peter Kangis, George Babis, ( 1998 ) investigated in â€Å" Private and public medical specialty: a comparing of quality perceptual experiences † , that how do doctors and patients perceive the quality of medical services offered and besides is such perceptual experience is the same in the private and public sector? Method used to roll up the day of the month was through study conducted in Greece. Results revealed that patients in the populace sector property greater importance to resources of a medical and proficient nature and do non look peculiarly concerned about the contextual or environmental characteristics of a infirmary. Private patients are anticipating a more holistic attack to their intervention and anticipate some attending to be directed to their emotional demands. 26.Mosad Zineldin, ( 2006 ) investigated in â€Å" The quality of wellness attention and patient satisfaction: An explorative probe of the 5Qs theoretical account at some Egyptian and Jordanian medical clinics † , the major factors impacting patients ‘ perceptual experience of cumulative satisfaction to turn to the inquiry whether patients in Egypt and Jordan evaluate quality of wellness attention likewise or otherwise. Research questionnaire was used for study subsequently on through empirical observation analyzed for consequences. Results revealed that patients ‘ satisfaction with different service quality dimensions is correlated with their willingness to urge the infirmary to others. A remedy to better the quality for health-care services can be an application of entire relationship direction and the 5Qs theoretical account including Quality of object, Quality of procedures, Quality of substructure, Quality of interaction and Quality of atmosphere together with client orientation scheme. Practical deductions – The consequence can be used by the infirmaries to reengineer and redesign 27.Amira Elleuch, ( 2008 ) in â€Å" Patient satisfaction in Japan † , extended bing cognition about wellness attention quality and patient satisfaction by researching Nipponese context holding a different wellness attention system and a different civilization from the USA and Europe.A structural equation theoretical account is used to research links between quality perceptual experience and patient satisfaction every bit good as between patient satisfaction and knowing behaviour trusting on 159 Nipponese outpatient answers. Consequences revealed that procedure quality attributes including service velocity, quality of interaction with staff and the scene ‘s visual aspect were found to be patient satisfaction ancestor when measuring wellness attention service 28.Shou-Hsia Cheng, PhD Yu-Jung Wei, MS Hong-Jen Chang, MD, MPH, MS ( 2006 ) investigated in â€Å" Quality Competition Among Hospitals: The Effectss of Perceived Quality and Perceived Expensiveness on Health Care Consumers † that what quality and cost factors influence whether patients perceive wellness attention services as expensive and will urge a infirmary to other patients. The writers analyzed informations from a national study of patients in Taiwan in 2002 through questionnaires. Logistic arrested development theoretical accounts applied on the informations. Consequences revealed that a patient ‘s perceptual experience of expensiveness was determined at the same time with the sensed quality and the out-of pocket monetary value of attention, a patient ‘s perceptual experience of hospital quality appeared to be the most of import determiner for urging a infirmary, and while the out-of-pocket monetary value did non impact a patient ‘s recommendation, the sensed expensiveness of the services did. The sensed value instead than the monetary value itself is the kernel of quality competition in Taiwan ‘s wellness attention market. 29.Dilaver Tengilimoglu, Adnan Kisa and Sophia F. Dziegielewski ( 1999 ) investigated in â€Å" Consumer Opinions with Ancillary Hospital Services: Improving Service Delivery in Turkish Hospitals † through interviews about direct measuring of consumer-satisfaction and use of this information to better service bringing. The SPSS computing machine bundle plan analyzed all informations. One-way analysis of discrepancy ( ANOVA ) was used to find any statistically important differences in degree of consumer sentiment on accessory services between the seven infirmaries. Further, cross-tabulations were depicted between satisfaction degree and several of the independent variables. The t trial was utilized to mensurate the differences between male and female consumer penchants. Two critical countries were examined: accessory staff and consumer dealingss and overall feelings of the comfort of the installation. Relationships and per centums within and among these variables are reported. Consequences revealed that consumers were instead giving importance to direct intervention they focused on interactions with the infirmary ‘s staff and other services provided by the installation ( e.g. comfort, cleanliness, parking, etc. ) .

Strategic Analysis Research Paper Example | Topics and Well Written Essays - 3500 words

Strategic Analysis - Research Paper Example There are risks and advantages, however, to Google’s broad multinational presence related to the external business environment. Google’s target markets are broad due to the complexity of the business model that sustains multiple products and service catering to professional and household consumers. Google operates G-Mail, a webmail service with massive storage capabilities and accessibility to access G-Mail from virtually any mobile device (Google, 2012). Additionally, Google acquired YouTube, the social media service promoting user-generated video content, a service with 800 million different users domestically and internationally. Other products including cloud computing attract professionals in multiple industries while Adwords is targeted to consumers and business professionals alike. Google maintains mass market appeal in operating environments sustaining differing cultural preferences because the products and services the company provides are relevant to sustain the Web-based and software-based needs of diverse markets. However, to assess how customer markets impact business strategy development and operational direction, certain target markets can be deconstructed to better determine their impact on Google’s strategic direction. Google, for YouTube, had to develop its own segmentation strategy rather than following established marketing models. This is due to the fact that YouTube maintains 800 million users daily, making it nearly impossible to establish a singular, homogenous segmentation and targeting model. This segmentation strategy is based on behavior, taking into consideration important factors regarding the tangible purpose of patronage at YouTube, including for entertainment purposes, for education, for music appreciation, or for simply watching television (MSMR, 2010). Having such a massive, geographically-dispersed set of consumers with varying needs creates a

Metaphysics Essay Example | Topics and Well Written Essays - 500 words

Metaphysics - Essay Example Although, eventually Plato's philosophical ideas could have laid the groundwork to influence the formulation of the idea of metaphysics (Walsh 1963, 34), the attempt to explain the ultimate causes and underlying nature of things, matter. The vast array of philosophers and philosophies conceptualizing the ultimate causes and underlying nature of things, familiarly known as metaphysics would most likely believe that the theory was grounded on the basic principles of Socrates rather than on his subsequent followers who had been his students. Obviously, this could be taken along the logic of passing on body of knowledge regarding metaphysics concepts by educators to students. One good way to view Socrates theory on the nature of matter is to see what were the principles developed by his successor along the ultimate causes and underlying nature of things, metaphysics. For example, according to Walsh (1963, 20), Plato expressed the idea that 'wisdom and understanding could come only if men would abandon belief for knowledge'. Obviously, this practice would engage an aggressive separation with what went before as a way of life (Walsh, 1963, 20). It also includes doing away with past behaviors. As well, it meant doing away with traditional views. Additionally, this would call for a battery of restraint.

The Son Also Rises Essay Example | Topics and Well Written Essays - 500 words

The Son Also Rises - Essay Example Paris, which had been his home previously, is no longer suitable for him. The city’s pace and vibrancy is something he cannot keep up with. The city also reminded him of his lover Brett, to whom he no longer can make love due to his physical impotency. Hence, he decides to go to the more laid back and picturesque town of Burguete. The slower pace of life here and the cordial nature of the town’s inhabitants enable him to start the process of recuperation. More importantly, this place enables Barnes to impose order on his life and make an independent living. He is able to live life on his own terms and also maintain dignity. But the story of Jake Barnes’ confrontation with his physical and emotional marring does not end there, for his discontent with the sedate and lonely existence in Burguete forces him to continue his search for inner peace. This peace proves elusive and not until the end of the story does Jake Barnes able to somehow reconcile with his reality. It is only when he moves to San Sebastian, does Barnes achieve some sort of stability and harmony, albeit with an element of resignation too. Hence, Jake Barnes typifies the Hemingway Hero in The Sun Also Rises. The other important character in the novel is that of the popular Bull fighter Pedro Romero, whom Jake admires very much. In fact, Jake takes comfort and pride from the successes of Romero. Hemingway is implying that Jake Barnes compensates for his inadequacies through the accomplishments of Pedro Romero. The qualities that define Jake Barnes also differ sharply from the attributes of a typical Hemingway Code Hero. As opposed to a Hemingway Hero, the Code Hero, though dealt harshly by the circumstances of life, does not submit himself to its constraints. To the contrary, he refuses to be defeated by life and remains tough and optimistic. Romero is also shown to display humility and dedication to his craft of Bull

Health Education Case Study Example | Topics and Well Written Essays - 1250 words

Health Education - Case Study Example This paper approves that not consume a large amount of unhealthy foods but there are always exceptions. One has a rather active life and does not participate in formal exercise; however, do try not to remain stationary. Most of the people that we associate with are very much the same. One believe that it is about balance, as simple as that: it is not just about strict exercise routines and calorie counting charts, it is about moderation. There is such a thing as too much of a good thing; diet, exercise, and good health cannot be the only focus in one’s life. I do not think I know anyone that personifies heath, whose characteristics or behaviors This essay makes a conclusion that being healthier than you are today is hardly a bad thing. The goal of good health. Wanting to improve and lengthen the quality of the life that you have is important and is relevant. Most of us could, probably, afford to eat a little healthier and be active a bit more often. Exercise has its place. As stated before, it is about balance and moderation. It is the only way to meet all the accepted requirements of good health. It must be reflected in all aspects of your being, internally, externally, emotionally, mentally, and socially. This will not just make you healthier, but a more well-rounded person within your own life. The World Health Organization coined the definition that, â€Å"health is a state of complete being and not merely the absence of disease or infirmity.† Meaning that not being sick and free of disease does not necessarily guarantee the presence of good health. This definition encompasses all the aspects of what it means to be healthy, it is more than physical. Given that definition it becomes much easier to approach the analysis of the three women presented in the case study provided. The three women are completely different in how they perceive being healthy. Peggy is a constant exerciser. She talks about little else and has few friends. Kathy, also, regularly exercises, as well as, being an athlete. However, she talks little about it and makes friends more easily than Peggy. Lastly, is Mary, who makes no real extra effort, aside from daily walks, to be healthier. At first glance it would be easy to identify Kathy, the athletic, but likeable, girl as the healthiest, Peggy as an avid exerciser would fall in the middle, and this leaves Mary as the least healthy. Based solely on the inclusion of exercise as a representation of health then the former might be a fair assessment. However, that is not necessarily accurate. I have decided to put these women in a different order. The most healthy could easily be Mary, with Kathy in the middle, and, lastly, Peggy as the least healthy. It may be surprising to see these women in this order, but there is science that can support it. Exercise alone is not an indicator of health on its own, in fact, there is such a thing as too much exercise. There is even the potential to become addicted to exercise. They will become all consumed with the need to exercise. The act of exercising could become compulsory; completely out of their control.(Costin) They will abandon opportunities for social interactions, with friends and family, to participate in more exercise activities. This is the potential issue with Peggy, given the d escription in the case study. Her â€Å"one-track-minded† fixation is negatively impacting her life on a social level, potentially on a mental level; this is not necessarily a healthy state of mind. If the definition of total health includes ones mental state and social levels, and Peggy is clearly lacking in those two areas; then it would be impossible for her to be the healthiest. Without knowing more about her personal life and her attitudes on a regular basis concerning her exercise it would be difficult to know her actual state of health and make an accurate judgment. Kathy, who seems to be more sociable and likeable, has no real indications of obsessions with the athletic part of her life. However, athletes often stress their bodies too much when they train, without realizing or intending to. They, also, do not, always, allow their bodies a proper rest time in between training sessions. That said, it would be possible for her not be as

Disseminating Evidence Assignment Example | Topics and Well Written Essays - 500 words

Disseminating Evidence - Assignment Example The strategies that will be used to disseminate this evidence include reports, workshops, emails, newsletters, workshops, websites, conferences, and press release (Gerrish, & Lacey, 2006). Each of the methods of disseminating evidence is suitable to a certain group of stakeholders. For example, conferences, websites, and press releases are the best strategies of informing the community about the results of the project (Holland, & Rees, 2010). This is because these methods are affordable to the members of the society. The youth and those who are conversant with the internet will get information from the website of the organization while those who have televisions and radios will watch the press release statement on these media. The project managers will also organize workshops that will aim at informing the community about the results of the plan. These workshops will encourage the members of the society to take corrective measures to protect themselves against the obesity stigma (Krisberg, 2014). The internal staff members of the company who include the nurses, clinicians, and managers will be informed about the evidence of the project using emails, workshops, newsletters, and reports. The reports will be used mainly to inform the managers and other key stakeholders who are involved in the management of the organization. The reports will consist of the objectives of the plan, the strategies used, and the results obtained (Burns, & Grove, 2009). This will enable these leaders to take corrective measures in ensuring that their staff members and the community surrounding the company get the right information about how they may protect themselves from gaining overweight. The nurses and other staff members who help in providing services in the organization, on the other hand, will be informed about the results of the project through

Porter forces five Essay Example | Topics and Well Written Essays - 250 words

Porter forces five - Essay Example However, several forces shape the competition within the business industry. Porter identifies five distinct forces that affect the competition involving industries. These involve the bargaining power of suppliers, bargaining power of buyers and the threat of new entrants in to the market (Hill and Jones, 2010). In addition, the threat of substitute products as well as the rivalry between the existing competitors also forms the key factors that shape the industry. It is significant to note that new entrants may bring several changes in the market. These entrants may come up with good products that favorably compete the already existing ones. This follows that such entries always follow an up to date research. The entry of such new industries can pose major challenges to the already existing industries offering the same products (Hill and Jones, 2010). As such, the entry can lead to fluctuation in prices of goods thereby minimizing the profits made by the other industries. Such new entrants may also command a large customer base following their improved products sold at low prices, thus posing greater risks to the other rival industries. The rivalry amongst the existing competitors can also shape the business industry in many ways. Such rivalries may lead to price fluctuations (Ahlstrom and Bruton, 2010). This makes the consumers purchase goods at very low prices at the expense of the industry. In this case, the industry generally makes losses since they are forced to lower their prices to suit the current state of the market. Again, if such rivals compete on price, it presents a good opportunity for entry of new entrepreneurs in to the market, thereby flooding the market with well-researched goods (Henry, 2011). This leads to reduction in profits to such industries. The bargaining power of buyers also affects the industries in several perspectives. When the bargaining power of the buyers is very high, it means several goods will be bought at a

Best Buys Problems Essay Example for Free

Best Buys Problems Essay 1. After Anderson took over Best Buy in 2002, he pursued four pivotal strategic initiatives, what prompted him to do so – his rationale? After Brad Anderson became the CEO of Best Buy in 2002 his team of executives came up with and emphasized four main central strategic initiatives, which are customer-centricity, promoting an efficient enterprise, win with providing the best service, and win in entertainment. As we all know, customer-centricity being by far the most important initiative. One major reason that prompted Brad Anderson and Best Buy to come up with these strategic initiatives was the main threat of imitation by competitors for example the emergence of Wal-Mart, Target as mass merchandisers/wholesalers and other forms of retail such as Amazon (online retailers). In the past, most of Best Buy’s competition focused on customers whose main concern is pricing, without providing anything extra such as advice, support and services. However as the competition began to emulate or imitate Best Buy’s strategy/business model by delving into the higher-end consumer domain (electronics) which is of course Best Buy’s bread n’ butter, Brad Anderson and his team of executives had to come up with a new way to do business by focusing on customer-centricity instead of just focusing on the product (or the selling of it) itself. For example Wal-Mart is poaching or headhunting talented Best Buy salespeople or their rising stars by offering them better benefits which will in turn cause a high turnover rate of Best Buy staff and hinder their sales force and development program. Another reason, which is also vital and in turn prompted change in Best Buy’s strategic initiative is the key concept that the environment or the world we live in as well as the people/customer will continually change. One who understands this concept will ultimately grasp the fact that people’s needs are constantly evolving and changing over time. For example as mentioned briefly above whereas in the past clients tended to be more function and price-conscious, in the modern world of today customers will tend to value service and support and put more of an emphasis on those elements rather than just the pricing itself so instead of trying to just sell the product/service, a company must in essence place more emphasis on the customers themselves, thus creating a customer-centric worldview by centering on individual needs instead of the â€Å"one style fits all† approach and by redefining its value proposition in a coherent way which aligns with the central strategic initiative of customer-centricity. 2. What are the key elements of Anderson’s most important strategic initiative – customer centricity? One of Best Buy’s core goals is to create a customer-centric culture by developing a better understanding of customer’s needs or requirements and by providing them with attention, care, excellent service and knowledge. Therefore one crucial element in Anderson’s customer centricity strategic initiative is the introduction of customer segmentation. He firmly believed that Best Buy would do well if it could concentrate on the most profitable segments and deter the unprofitable segments altogether. Because of this Anderson aimed to build customer loyalty with the profitable segments and in doing so, the company’s existing assets can then be leveraged. Therefore 5 different customer segments were introduced and implemented; Barry, Buzz, Ray, Jill and BB4B (for businesses) each led by a segment leader whose primary purpose was to deeply understand his/her segment’s buying behavior, attitudes and tendencies, armed with insight into consumer needs. By focu sing on customer segmentation, Best Buy can come up with or improve its system and products catered to the specific needs of each group thereby also enhancing differentiation to meet long-term trends or needs. Another key element in Best Buy’s customer centricity model is the concept of Best Practice Sharing and instead of just focusing on the selling of the product, staff (sales) must also focus on offering customers solutions. For example instead of just offering to sell a single product, the informed staff can offer to sell the â€Å"whole deal† such as video conferencing, digital signage, and technology lifecycle management packaged altogether for a business client. Because of this I believe that HR has a very important role to play in providing development/training programs for the employee as well as identifying and recruiting â€Å"star† employees, providing them with the benefits so that their services can be retained on a long-term basis. A central element in Best Buy’s customer centricity initiative is a change in its labor force or model. Because of this new specialized positions were added into the Best Buy labor force. So instead of solely having skilled salespeople, Best Buy also employs Geek Squad agents (technology experts valuable to small businesses and well equipped to deal with the BB4B Best Buy for Business segment), home-theater/technological product installers, and even personal shopping assistants. This focuses on extensive training regarding the different customer segments, addresses the need to recognize the different necessities of many types of customers and also finally to identify customers most likely to buy which product from a particular segment/domain (scope). In addition to the change in labor force or model, leveraging prior acquisitions is also an important element in Best Buy’s customer centric ideology. By leveraging the two, Best Buy can pool its resources and put its custo mers first and in turn offer them more options as well as solutions. Customer relationships can also be leveraged to create customer loyalty fostering long-term relationships with the client. For the sake of brevity I would like to briefly mention the last important element in Best Buy’s customer centric ideology/strategy, which is the empowering element. This calls for empowering sales staff to make wholesome, informed merchandizing decisions. With a proper training and development programs, employees can use their knowledge about customer behavior, form hypotheses and test it out in a real world setting to see what works. After they can discuss about the results and if something yields favorable results (promoting and meeting a variety of needs with more choices for customers), new ideas can be implemented to promote and attain the perfect customer experience and customer satisfaction. By empowering its employees new and worthy ideas can be attained. The ever-comprehensive Best-Buy reporting system and its â€Å"chalk-talks† are also vital in obtaining important information (customer centric vs. non-centric stores) and trends as well as teaching its employ ees good business practices. 3. How would you recommend Brad Anderson for further actions? I believe that Best Buy’s problem lies in its function of a flawed business model, which in turn led to a function of poor execution. The poor model being where the merchant organization, segment/domain leaders, and GMs were forced to coexist and work wholly together as a business group. Before the customer centricity initiative kicked in, the merchant organization was in charge of everything such as buying, pricing, marketing/merchandizing, etc. The new model however forced merchants to work together with segment leaders. This in turn forced the merchants to switch out of their comfort zone and take a more holistic view of the business, focusing more on customer needs. The company’s growth path now expected merchants to put the customer first and foremost and grow the business by offering more than just the product itself, it must also identify customer trends. While the merchant organization was used to controlling everything, now they have to listen to and work with the segment leaders who have all the insight regarding customers, where they tended to focus on the opportunity solely from the consumer’s point of view. Ron Boire (VP GM) himself believed that their loss in the third-quarter results was because there was no camaraderie between the three business units (GMs, Merchants, and Segment leaders). Coexistence between the business units is difficult, therefore contributing to a flawed model. For positive further action, one thing Anderson could do is eliminate the risk of fragmentation altogether. Fragmentation can lead to a â€Å"focus on everything† strategy, which in turn can harm the business by trying to do too much, and wasting away valuable resources. It should concentrate and have at all times 3-5, but never more than 5 customer segments, which will create confusion and loss of focus. Best Buy should ultimately focus its assets on its â€Å"angel† group or most profitable customer niche. For example it can separate its most successful segment that being BB4B (Best Buy for Business) and establish an individual unit. This is because that segment in itself can be a separate yet focused unit because it will inevitably also encompass various segments in the business as well, cross-cutting. Another element that Best Buy can focus on is (I know that this has been said and done over and over again) having a proper staff development program in place, which of course, focuses on customer centricity. I’m sure this element is and has been addressed before however I would like to emphasize the importance of having a proper system to measure the results of the program itself. Training can be done repeated again however what is most important is that there is a system that directly measures the results of effects of staff development initiative. Another way to go would be to cut costs and heavily promote online sales. Best Buy has been slow in capturing the online market share. It also has to improve its image as it suffers from price comparison issues. Best Buy should ultimately focus on these factors, which it is of course currently doing in its â€Å"Renew Blue† strategy: * Reinvigorate the customer experience. Best Buys plans include offering customers unique benefits and exclusive membership programs, and continuing to develop a leading edge, multi-channel shopping experience through a highly relevant and effective system. * Attract and grow transformational leaders who will inevitably energize employees to deliver extraordinary results.

Middle Cerebral Artery Aneurysm Identification

Middle Cerebral Artery Aneurysm Identification Middle cerebral artery is a very common site for aneurysm formation. MCA aneurysms represent 18-40 of all intracranial aneurysms. MCAAS are commonly divided into three groups: proximal (M1As), bifurcation (MbifAs), or distal (MdistAs) aneurysms. Each group presents with distinct anatomic features that have an impact on their management. Assigning MCAAs into a particular group can sometimes be difficult since the length and caliber of the M1 segment often varies and there may be two or more major branching sites along its course. This has led to fallacies in sub-grouping of MCAAs with resultant high variability in the reported frequencies of the different subgroups: M1As (2 61%) and MbifAs (39 90%), of all MCAAs [2, 3, 5-8]. Preoperative identification of MCA aneurysm origin either at the main MCA bifurcation (Mbif) or at another branching point has a great implication on surgical planning as different groups of MCAAs pose different challenges to the neurosurgeon requiring different surgical strategies. In this report, we present our technique for accurate identification of the MCA main bifurcation from other branching points along MCA as a key for a more accurate classification of MCA aneurysms. Furthermore we suggest an extension to the classic MCA classification. Also, we present the distribution of 1309 MCA aneurysms as a part of the largest CTA anatomic study, so far, for MCA aneurysms. Our aim is to help recognize the branching pattern of MCA with special emphasis on the exact characterization of MCA main bifurcation. Patients and methods Patients and radiological data: Data were retrieved from a prospectively collected database that sequentially encompassed all patients with intracranial aneurysms admitted to the Department of Neurosurgery at Helsinki University Central Hospital (catchment area, 1.8 million people). We identified 1124 consecutive patients with MCA aneurysms diagnosed between 2000 and 2009. We excluded 115 patients from the study due to lack of adequate CTA (98 cases) or having non-saccular MCAAs (17 cases). The remaining 1009 patients with a total of 1309 saccular MCA aneurysms had adequate cerebral CTAs. The routine use of CTA (GE Lightspeed QX/i; GE Medical Systems, Milwaukee, WI) started in the year 2000 and has been the primary imaging modality for cerebral aneurysms at our institution ever since. CTA is rapid, safe, readily available and can provide 3D reconstruction of vessels and bony structures. Each patient`s radiological images were stored in the hospitals central digital archiving system (PACS; AGFA, IMPAX, version 4.5), launched in 1998, from which all of the relevant diagnostic images were recalled. Nomenclature: For each patient, pretreatment CTA images were evaluated and measured on screen (AGFA, IMPAX DS 3000). The MCA aneurysms were identified in each patient and classified according to the location of aneurysm neck in relation to the main MCA bifurcation (fig.6). MCA aneurysms were grouped into three groups: M1As, aneurysms on the main trunk (M1) of the MCA, between the bifurcation of internal carotid artery (ICA) and the main MCA bifurcation; MbifAs, aneurysms at the main MCA bifurcation; MdistAs, aneurysms distal to main MCA bifurcation on M2, M3 or M4 segments. Then M1As were sub-grouped into 2 groups: M1-ECBAs, aneurysms arising at the origin of early cortical branches; M1-LSAAs, aneurysms arising at the origin of Lenticulostriate arteries. The M1-ECBAs comprised aneurysms arising at the origin of early frontal branches (M1-EFBAs) and aneurysms arising at the origin of early temporal branches (M1-ETBAs). CTA for precise recognition of MCA main bifurcation For localization of Mbif, we simply examine the MCA branches in sagittal views of CTA at the insular level and detect the insular trunks from direction and course then follow these trunks till their essential meeting at the Mbif. This pilot examination must be correlated with examination of axial and coronal views for accurate confirmation. In some cases with difficult branching and looping patterns, 3D reconstruction is necessary. CTA for accurate classification of aneurysms along MCA: (figures 2-6) We examine the direction and course of the branches originating at the neck of the aneurysm in sagittal views to know whether these branches are cortical or insular. Correlation with axial and coronal views and sometimes 3D reconstructions is necessary. Then we check the relation of this branching point to the MCA main bifurcation (the primary meeting point of insular trunks) for correct sorting of the aneurysm. Results: Demographics: The mean age at diagnosis in our patient population was 54 years (range 13-89 y). The number of women 690 (68%) doubled that of men 319 (32%). Aneurysms were more common on the Rt. MCA 732 aneurysms (56%) than on the lt. MCA 577 aneurysms (44%). In 466 (46%) Patients, there were one or more additional aneurysms totaling 1761 aneurysms. Classification of MCA aneurysms: Table 1 shows the distribution of 1309 aneurysms along MCA. The number of aneurysms arising at the MCA main bifurcation (MbifAs) 829 (63%) doubled the total number of all aneurysms arising along M1 segment (M1As) 406 (31%). The distal MCA aneurysms (MdistAs) were the least frequent group only 74 (6%). Around three quarters (77%) of ruptured MCA aneurysms and 57% of unruptured MCA aneurysms were located at the MCA bifurcation. Types of M1As: Aneurysms arising along the main trunk of MCA (M1As) were grouped into 2 groups according the nature of the branches taking off at the base of the aneurysms. Among the 406 M1As, 242 (60%) aneurysms arose at the origin of early cortical branches from M1 segment (M1-ECBAs) while the remaining 164 (40%) M1As were not associated with early cortical branches but LSAs (M1-LSAAs). The aneurysms at the origin of early cortical branches (M1-ECBAs) comprised 178 aneurysms at the origin early frontal branches (M1-EFBAs) and 64 aneurysms at the origin of early temporal branches (M1-ETBAs). Discussion: The high variability in the reported frequencies of different groups of MCA aneurysms (M1As, 2-61%; MbifAs, 39-90%)[2, 3, 5-8] could be attributed to falsies in classification of these aneurysms and / or obtaining such incidences from small statistically unreliable series. In a trial to resolve this issue in a large statistically reliable non-selected group of MCAAs, We performed a retrospective anatomical study of CTAs for consecutive 1009 patients with 1309 saccular MCAAs aneurysms. We tried to find and follow the objective characteristics of branching points along MCA to be more precise when classifying MCA aneurysms. In our previous MCA publications [1-4, 9]we have followed the classic classification of MCA aneurysms. Recognizing the importance and the deceptive appearance of the early cortical branches, we have added an extension to the traditional classification by subdividing M1 aneurysms into M1-ECBAs and M1-LSAAs. This proofed helpful to keep attention to this previously und erestimated group of aneurysms arising at the origin of early cortical branches (M1-ECBAs). Preoperative identification of MCA aneurysm origin either at the main bifurcation or at another branching point has an implication on surgical planning especially for ruptured MCAAs as different type of MCAAs poses different challenges to the neurosurgeon requiring different surgical strategy[1-3]. Also when selecting the recipient vessel for bypass surgery if indicated to compensate for an inevitable vascular compromise during securing the aneurysm. MCA is classically subdivided into 4 segments: the sphenoidal (M1) segment extending from ICA bifurcation to the main MCA bifurcation where insular trunks (M2) begins and course over the insula till the peri-insular sulci where the opercualar (M3) segments start and course till the lateral surface of the brain in the sylvian fissure then continue as parasylvian (M4) segments whose distal extensions are sometimes called the terminal (M5) segments [10-13]. Although Yasargil used the main MCA bifurcation as the demarcation point between M1 and M2 segments, Rhoton used the MCA genu at the limen insulae as the demarcation point between M1 and M2 segments, hence he had prebifuration M1 and post bifurcation M1[8, 14]. Aneurysms along MCA are classically divided into three groups: proximal (M1As), bifurcation (MbifAs), or distal (MdistAs) aneurysms. It is evident that the identification of the MCA main bifurcation is the key for accurate classification and grouping of these aneurysms. Although MCA anatomy has been widely described in standard anatomy, neuroradiology, and neurosurgery textbooks[8, 15-17], it is still not uncommon to mistaken the identification of the main MCA bifurcation from other branching points along the main trunk of MCA particularly those associated with a large-caliber cortical branch. This misconception led to wide range of the reported length of MCA main trunk (0 -30 mm) and large differences in the reported relative frequency of M1As (2 61%) and MbifAs (39 90%) between authers[2, 3, 5-8]. Accurate identification of the MCA main bifurcation: Crompton named the cortical branches arising from M1 segment proximal to MCA bifurcation as early branches. Yasargil and colleagues defined the origin of the large cortical branches arising proximal to the most lateral LSAs as (false early bifurcation) and declared that aneurysms arising at this region of M1 could be mistakenly diagnosed as MCA bifurcation aneurysms. They stressed the importance of the LSAs in defining the site of the main bifurcation as the main bifurcation is usually located distal to the origin of LSAs [8, 12, 13]. These early cortical branches are found in nearly 85 to 90% of hemispheres [14]. In the anatomical study for the early branches of MCA, Rhoton and colleagues found that the early branches arising on the proximal half of the main trunk of MCA resembled postbifurcation trunks of M1 in some aspects with possibility of being misinterpreted as postbifurcation trunks of the M1 leading to false localization of the main bifurcation. They could identify LSAs on M1 segment distal to the origin of these early branches. MCA main bifurcation was identified proximal to the genu in 82%, at the level of genu in 8%, and distal to the genu in 10% of hemispheres [14]. It is obvious that the exact identification of MCA main bifurcation is the key for correct sorting of aneurysms along the MCA. It is popular to subjectively accept a branching point close to MCA genu giving rise to the largest branches as the MCA main bifurcation. It is also not uncommon to feel more internal confidence when such a branching point holds an aneurysm to consider it as MCA main bifurcation. This might be correct in the majority of cases but unfortunately it would be misleading in some cases. The idea for identification of the main MCA bifurcation (Mbif) accurately is to find a constant criterion for Mbif which can be used as a hallmark for identification of Mbif from other branching points along the MCA with high certainity. Keeping into mind that Mbif might share some characteristics (like size of out-coming branches, location in relation to MCA genu and relation to LSAs) with other branching points along MCA preclude accepting any of these characteristics as a hallmark for Mbif. The fact that all insular trunks (M2s) authentically originate from one point that is the MCA main bifurcation, means that the primary meeting point of all insular trunks (M2s) can be considered as a hallmark for Mbif. So, simply by identifying the insular trunks and following them proximally till their original meeting into one point, the Mbif can be localized accurately and with certainty. Insular (M2) trunks cannot be identified by being the largest branches as early cortical branches are sometimes of the same caliber or even larger than the actual M2 trunks. M2 trunks run along the insula from the limen insula for a variable distance taking the superior and posterior directions. So by observing the direction and course of each of the branches originating from the MCA trunk in sagittal, coronal and axial CTA views, it will be easy to identify the insular trunks and to follow them proximally till their authentic meeting at the Mbif. In fewer words, considering that the main MCA bifurcation is not always distal to the origin of LSAs or always proximal or at the genu, but it always gives insular trunks (M2s) means that identification of the primary starting point of these insular trunks will guide to the main MCA bifurcation. These insular trunks should be recognized by their course over the insula for variable distance not by their size as some early cortical branches might be of similar or even larger size. Among all the aneurysms arising along MCA, those aneurysms arising from M1 segment at the origin of early cortical branches (ECB) are more likely to be misdiagnosed as a bifurcation aneurysm especially when the cortical branch is large and arises close to the MCA genu. The fact that early temporal branch becomes smaller as it arises closer to genu[14]means that it would not be common to misinterpret an aneurysm arising at the origin of an early temporal branch as a bifurcation aneurysm even if it is close to genu. There is no relation between the size of EFB and its distance from the genu. In angiograms, such large frontal branches look very similar to post bifurcation M2 trunks. This shows clearly how some aneurysms arising at the origin of large early frontal branches (EFB) could be, if enough attention was not paid, misclassified as MCA bifurcation aneurysm especially when close to the MCA genu. Ulm et al.[7] unexpectedly found, in their anatomical retrospective study of MCAAs with special emphasis on those aneurysms arising from M1 at the origin of early cortical branches, that M1As arising at the neck of EFB were more common than MbifAs and they claimed that many of EFB aneurysms were misclassified as early MbifAs reasoning why MbifAs were reported in previous pubilcations to be the most common location for MCAAs. This was contrary to our and general experience of Mbif being the most common location for MCAAs [1-5, 13, 18]. During this study, it was easy to sort some aneurysms along MCA, such as a small aneurysm at the origin of LSAs close to ICA bifurcation or a small aneurysm along M4 segment, precisely from the first look. Unfortunately, the biggest percentage of MCA aneurysms arose close to the MCA genu at some branching points which included early cortical branches, MCA main bifurcation and early furcation of M2 branches. This necessitated a lot of work to discriminate between these branches for precise sorting of MCA aneurysms. Moreover, some morphological characteristics of the aneurysms, such as large aneurysm size and complex projections, added to the difficulty for proper distinguishing of these branches. The task was more difficult for ruptured MCA aneurysms especially when associated with large ICH distorting the anatomy. On the other hand the availability of the 3D reconstructions, which made it possible to examine the aneurysms and MCA branches from different angles, together with the clas sic CTA views paved the way to accomplish our goal for sorting MCA aneurysms accurately with high degree of certainty. The present work shows, in harmony with our previous publications (table 3), that MCA bifurcation is the most common location for aneurysms along the MCA. The number of MbifAs 829 (63%) doubled the total number of all M1As 406 (31%) including those aneurysms arising at the origin of LSAs and those at the origin of ECBs. MCA bifurcation aneurysms comprised 77% of ruptured MCA aneurysms and 57% of unruptured MCA aneurysms. Among the 406 M1As, 178 (44%) aneurysms arose at the origin of early frontal branches (M1-EFBAs). The diameter of the associated early frontal branch was à ¢Ã¢â‚¬ °Ã‚ ¥ half the diameter of M1 in 106 (60%) cases. We assume that such aneurysms, without careful examination, might be misclassified as MbifAs especially when the associated large EFB is close to the genu of MCA. Early temporal branches were associated with 64 (16%) aneurysms (M1-ETBAs). The remaining 164 (40%) M1As were not associated with early cortical branches but with LSAs (M1-LSAAs). (Table 2) At the end of this study we realized that many M1 aneurysms arising at the origin of large early cortical branches especially EFB could be sometimes misclassified as MbifAs, but Mbif is still the most common location for aneurysms along MCA. We agree with Ulm et al [7] for the possibility to mistaken EFB aneurysms as bifurcation aneurysms if much care was not paid, but we assume that their surprising results of EFB being the most common location for MCAAs came from the small number of the cases included in their study. (Table 4) Conclusion: Careful objective analysis of MCA branching pattern from preoperative CTA is very important to understand patient-specific vascular anatomy which aids the surgeon to successfully exclude MCAAs from the circulation while preserving the surrounding vasculature. Although many M1 aneurysms arising at the origin of large early cortical branches especially EFB could have been misclassified as MbifAs in previous reports, Mbif is still the most common location for aneurysms along MCA. Figures legends: Fig. 1: Identification of MCA main bifurcation CTA images (A: sagittal, B: coronal C: axial D: 3D reconstruction) demonstrating an early cortical branch aneurysm (white arrow) arising at the origin of an early frontal branch (green arrow) proximal to the main MCA bifurcation (yellow arrow) which gives frontal (red arrow) and temporal (blue arrow) M2 trunks. The MCA main bifurcation (yellow arrow) is located at the genu. The accompanying diagrams (E, F G) display how to accurately identify the main MCA bifurcation from other branching points along MCA just by following the insular branches back towards their primary meeting at one point that is the MCA main bifurcation. We are used to start the check in sagittal views then to confirm by rechecking the axial and coronal CTA views. 3D reconstructions are sometimes needed. Fig. 2 CTA images (A: axial, B: coronal, C: sagittal the corresponding 3D reconstruction views (D, E F respectively) demonstrating an early cortical branch aneurysm (white arrows) arising at the origin of a large early frontal cortical branch (green arrow) just proximal to the right MCA genu. Such an aneurysm can be subjectively misclassified as an MCA bifurcation aneurysm especially in coronal views, but in sagittal and axial views, the frontal branch (green arrow) is seen running anteriorly and superiorly away from the insula. Also, the right MCA bifurcation (yellow arrow) is clearly seen distal to the genu giving frontal (red arrow) and temporal (blue arrow) insular trunks. Fig. 3 CTA images (A: axial, B: coronal, C: sagittal D: 3D reconstruction) demonstrating an aneurysm (white arrow) arising at the main MCA bifurcation (yellow arrow) which gives frontal (red arrow) and temporal (blue arrow) M2 trunks. Notice the frontal cortical branch (green arrow) arising from the frontal M2 trunk (red arrow). The MCA main bifurcation (yellow arrow) is located proximal to genu. Fig. 4 CTA images (A: axial, B: coronal C: sagittal) demonstrating an early cortical branch aneurysm (white arrow) arising at the origin of an early frontal branch (green arrow) proximal to the main MCA bifurcation (yellow arrow) which gives frontal (red arrow) and temporal (blue arrow) M2 trunks. The MCA main bifurcation (yellow arrow) is located proximal to genu. Fig. 5 CTA images (A: axial, B: coronal, C: sagittal D: 3D reconstruction) demonstrating an early cortical branch aneurysm (white arrow) arising at the origin of an early temporal branch (green arrow) proximal to the main MCA bifurcation (yellow arrow) which gives frontal (red arrow) and temporal (blue arrow) M2 trunks. The MCA main bifurcation (yellow arrow) is located at genu. Fig. 6 CTA images (A: axial, B: coronal C: sagittal) demonstrating a distal MCA aneurysm (white arrow) arising at the takeoff of a frontal cortical branch (green arrow) from the left frontal M2 trunk (red arrow) distal to the main MCA bifurcation (yellow arrow) which gives frontal (red arrow) and temporal (blue arrow) M2 trunks. The MCA main bifurcation (yellow arrow) is located proximal to genu.