The Associative and Commutative Properties

The Associative and Commutative Properties There are several mathematical properties that are used in statistics and probability; two of these, the commutative and associative properties, are generally associated with the basic arithmetic of integers, rationals, and real numbers, though they also show up in more advanced mathematics. These properties- the commutative and the associative- are very similar and can be easily mixed up. For that reason, it is important to understand the difference between the two. The commutative property concerns the order of certain mathematical operations. For a binary operation- one that involves only two elements- this can be shown by the equation a b b a. The operation is commutative because the order of the elements does not affect the result of the operation. The associative property, on the other hand, concerns the grouping of elements in an operation. This can be shown by the equation (a b) c a (b c). The grouping of the elements, as indicated by the parentheses, does not affect the result of the equation. Note that when the commutative property is used, elements in an equation are rearranged. When the associative property is used, elements are merely regrouped. Commutative Property Simply put, the commutative property states that the factors in an equation can be rearranged freely without affecting the outcome of the equation. The commutative property, therefore, concerns itself with the ordering of operations, including the addition and multiplication of real numbers, integers, and rational numbers. For example, the numbers 2, 3, and 5 can be added together in any order without affecting the final result: 2 3 5 10 3 2 5 10 5 3 2 10 The numbers can likewise be multiplied in any order without affecting the final result: 2 x 3 x 5 30 3 x 2 x 5 30 5 x 3 x 2 30 Subtraction and division, however, are not operations that can be commutative because the order of operations is important. The three numbers above cannot, for example, be subtracted in any order without affecting the final value: 2 - 3 - 5 -6 3 - 5 - 2 -4 5 - 3 - 2 0 As a result, the commutative property can be expressed through the equations a b b a and a x b b x a. No matter the order of the values in these equations, the results will always be the same. Associative Property The associative property states that the grouping of factors in an operation can be changed without affecting the outcome of the equation. This can be expressed through the equation a (b c) (a b) c. No matter which pair of values in the equation is added first, the result will be the same. For example, take the equation 2 3 5. No matter how the values are grouped, the result of the equation will be 10: (2 3) 5 (5) 5 10 2 (3 5) 2 (8) 10 As with the commutative property, examples of operations that are associative include the addition and multiplication of real numbers, integers, and rational numbers. However, unlike the commutative property, the associative property can also apply to matrix multiplication and function composition. Like commutative property equations, associative property equations cannot contain the subtraction of real numbers. Take, for example, the arithmetic problem (6 – 3) – 2 3 – 2 1; if we change the grouping of the parentheses, we have 6 – (3 – 2) 6 – 1 5, which changes the final result of the equation. What Is the Difference? We can tell the difference between the associative and the commutative property by asking the question, â€Å"Are we changing the order of the elements, or are we changing the grouping of the elements?† If the elements are being reordered, then the commutative property applies. If the elements are only being regrouped, then the associative property applies. However, note that the presence of parentheses alone does not necessarily mean that the associative property applies. For instance: (2 3) 4 4 (2 3) This equation is an example of the commutative property of addition of real numbers. If we pay careful attention to the equation, though, we see that only the order of the elements has been changed, not the grouping. For the associative property to apply, we would have to rearrange the grouping of the elements as well: (2 3) 4 (4 2) 3

The Unsavory History of Nutmeg Spice

The Unsavory History of Nutmeg Spice Today, we sprinkle ground nutmeg on our espresso drinks, add it to eggnog, or mix it into pumpkin pie filling. Most people probably dont particularly wonder about its origins, no doubt - it comes from the spice aisle in the supermarket, right? And fewer still stop to consider the tragic and bloody history behind this spice. Over the centuries, however, tens of thousands of people have died in the pursuit of nutmeg. What Is Nutmeg? Nutmeg comes from the seed of the Myristica frangans tree, a tall evergreen species native to the Banda Islands, which are part of Indonesias Moluccas or Spice Islands. The inner kernel of the nutmeg seed can be ground into nutmeg, while the aril (the outer lacy covering) yields another spice, mace. Nutmeg has long been valued not only as a flavoring for food  but also for its medicinal properties. In fact, when taken in large enough doses nutmeg is a hallucinogen, thanks to a psychoactive chemical called myristicin, which is related to mescaline and amphetamine. People have known about the interesting effects of nutmeg for centuries; the 12th-century abbess Hildegard of Bingen wrote about it, for one. Nutmeg on the Indian Ocean Trade Nutmeg was well-known in the countries bordering the Indian Ocean, where it featured in Indian cooking and traditional Asian medicines. Like other spices, nutmeg had the advantage of being light-weight compared with pottery, jewels, or even silk cloth, so trading ships and camel caravans could easily carry a fortune in nutmeg. For the inhabitants of the Banda Islands, where the nutmeg trees grew, the Indian Ocean trade routes ensured a steady business and allowed them a comfortable living. It was the Arab and Indian traders, however, who got very wealthy from selling the spice all around the rim of the Indian Ocean. Nutmeg in Europe's Middle Ages As mentioned above, by the Middle Ages, wealthy people in Europe knew about nutmeg  and coveted it for its medicinal properties. Nutmeg was considered a hot food according to the theory of humors, taken from ancient Greek medicine, which still guided European physicians at the time. It could balance cold foods like fish and vegetables. Europeans believed that nutmeg had the power to ward off viruses like the common cold; they even thought that it could prevent the bubonic plague. As a result, the spice was worth more than its weight in gold. As much as they treasured nutmeg, however, people in Europe had no clear idea of where it came from. It entered Europe through the port of Venice, carried there by Arab traders who portaged it from the Indian Ocean across the Arabian Peninsula and into the Mediterranean world... but the ultimate source remained a mystery. Portugal Seizes the Spice Islands In 1511, a Portuguese force under Afonso de Albuquerque seized the Molucca Islands. By early the next year, the Portuguese had extracted the knowledge from the locals that the Banda Islands were the source of nutmeg and mace, and three Portuguese ships sought out these fabled Spice Islands. The Portuguese did not have the manpower to physically control the islands, but they were able to break the Arab monopoly on the spice trade. The Portuguese ships filled their holds with nutmeg, mace, and cloves, all purchased for a reasonable price from the local growers. Over the next century, Portugal tried to build a fort on the main Bandanaira Island  but was driven off by the Bandanese. Finally, the Portuguese simply bought their spices from middlemen in Malacca. Dutch Control of Nutmeg Trade The Dutch soon followed the Portuguese to Indonesia, but they proved unwilling to simply join the queue of spice shippers. Traders from the Netherlands provoked the Bandanese by demanding spices in return for useless and unwanted goods, like thick woolen clothing and damask cloth, which was completely unsuitable for tropical climes. Traditionally, Arab, Indian, and Portuguese traders had offered much more practical items: silver, medicines, Chinese porcelain, copper, and steel. Relations between the Dutch and Bandanese started out sour  and quickly went down-hill. In 1609, the Dutch coerced some Bandanese rulers into signing the Eternal Treaty, granting the Dutch East Indies Company a monopoly on spice trade in the Bandas. The Dutch then strengthened their Bandanaira fortress, Fort Nassau. This was the last straw for the Bandanese, who ambushed and killed the Dutch admiral for the East Indies and about forty of his officers. The Dutch also faced a threat from another European power - the British. In 1615, the Dutch invaded Englands only foothold in the Spice Islands, the tiny, nutmeg-producing islands of Run and Ai, about 10 kilometers from the Bandas. The British forces had to retreat from Ai to the even smaller island of Run. Britain counter-attacked the same day, though, killing 200 Dutch soldiers. A year later, the Dutch attacked again  and besieged the British on Ai. When the British defenders ran out of ammunition, the Dutch overran their position and slaughtered them all. The Bandas Massacre In 1621, the Dutch East India Company decided to solidify its hold on the Banda Islands proper. A Dutch force of unknown size landed on Bandaneira, fanned out, and reported numerous violations of the coercive Eternal Treaty signed in 1609. Using these alleged violations as a pretext, the Dutch had forty of the local leaders beheaded. They then went on to perpetrate genocide against the Bandanese. Most historians believe that the population of the Bandas was around 15,000 before 1621. The Dutch brutally massacred all but about 1,000 of them; the survivors were forced to work as slaves in the nutmeg groves. Dutch plantation-owners took control of the spice orchards  and grew wealthy selling their products in Europe at 300 times the production cost. Needing more labor, the Dutch also enslaved and brought in people from Java and other Indonesian islands. Britain and Manhattan At the time of the Second Anglo-Dutch War (1665-67), however, the Dutch monopoly on nutmeg production was not quite complete. The British still had control of little Run Island, on the fringe of the Bandas. In 1667, the Dutch and British came to an agreement, called the Treaty of Breda. Under its terms, the Netherlands relinquished the far-off and generally useless island of Manhattan, also known as New Amsterdam, in return for the British handing over Run. Nutmeg, Nutmeg Everywhere The Dutch settled down to enjoying their nutmeg monopoly for about a century and a half. However, during the Napoleonic Wars (1803-15), Holland became a part of Napoleons empire  and was thus an enemy of England. This gave the British an excellent excuse to invade the Dutch East Indies once again  and try to pry open the Dutch stranglehold on the spice trade. On August 9, 1810, a British armada attacked the Dutch fort on Bandaneira. After just a few hours of fierce fighting, the Dutch surrendered Fort Nassau, and then the rest of the Bandas. The First Treaty of Paris, which ended this phase of the Napoleonic Wars, restored the Spice Islands to Dutch control in 1814. It could not restore the nutmeg monopoly, however - that particular cat was out of the bag. During their occupation of the East Indies, the British took nutmeg seedlings from the Bandas and planted them in various other tropical places under British colonial control. Nutmeg plantations sprang up in Singapore, Ceylon (now called Sri Lanka), Bencoolen (southwest Sumatra), and Penang (now in Malaysia). From there, they spread to Zanzibar, East Africa and the Caribbean islands of Grenada. With the nutmeg monopoly broken, the price of this once-precious commodity began to plummet. Soon middle-class Asians and Europeans could afford to sprinkle the spice on their holiday baked goods and add it to their curries. The bloody era of the Spice Wars came to an end, and nutmeg took its place as an ordinary occupant of the spice-rack in typical homes... an occupant, though, with an unusually dark and bloody history.

Impact of Telephone Technology on Society Research Paper

Impact of Telephone Technology on Society - Research Paper Example Specifically, the upsurge in 3G connections, sustained by the production of the current data-enabled devices which permit mobile internet connectivity, caused a huge growth in mobile data use. Currently, an examination of the economic influence of this technological transformation has been restricted by data availability. However, Van (2012) used VNI Index data of Cisco for 14 nations to investigate this concern and he found a strong relationship existed between economic growth and mobile data usage per 3G connection. Van also asserts that doubling the use of mobile data causes the GDP per capita to increase by 0.5 percentage points. Although the effects of telephone have fully been realized in developed markets, telephone technology continues to offer strongly assist developing markets. Issa, Isaias & Kommers (2013) who measured the influence of ‘simple’ telephone penetration on Total Factor Productivity of a nation – a parameter of economic productivity which al ways reflects the technological dynamism of an economy – found out that an increase of 10% in telephone penetration upsurges Total Factor Productivity by 4.2% in long run. Telephone technologies add considerably to GDP growth. It is projected that the technology will occasion a 1.8% GDP growth in UK and 24.9% GDP growth in Egypt across 2010-2020. Again, Issa, Isaias & Kommers (2013) claim that the impact will be great in developing nations. They claim that the impact of increasing phone subscriptions, across 10 nations.

NOGO Railroad Case Analysys Form Essay Example | Topics and Well Written Essays - 1750 words

NOGO Railroad Case Analysys Form - Essay Example Dave is wary of Allen’s intentions and is torn between making the required changes and not making those changes. However, the situation is not new to NOGO Railways as it has struggled with the same issues (highlighted later) since its inception. It is only that Dave has now been promoted to such a position where he must address the problems encountered. 2. Problem NOGO Railways faces a myriad of problems which can best be separated as surface-level problems and deeper or micro problems. At the macro level, the company faces an outdated and ill designed system of organizational policies and practices, thereby reflecting a poor HR system. This is the backbone of all other problems such as high debt and resistance to change. Owing to faulty (and biased) recruitment practices, productivity has been low and unnecessary positions have been created for the sake of compensating family and relatives. One such example is that of Fireman’s position whose only task was to take char ge of the engine in the event of assistance required by the engineer (Brown). The major problems facing Dave (and the company) are that employee expenses have been on a rise and that there was friction amongst NOGO’s employees with respect to change management. Next, it is important to analyze the micro level issues that NOGO is faced with. One of these is featherbedding which is defined as the practice of restricting output of work so as to create more jobs and reduce the chances of unemployment. Another problem pertained to the absence of a formal, structured recruitment process that objectively selected candidates with the right ‘fit’ for the job. These faulty hiring procedures gave way to favoritism. This meant that employees whom Dave worked with were related to each other in some way as spouses, children, brothers or cousins. This practice tends to create a disconnected workforce with ties based on their relations and not work. 3. Causes The presence of a u nionized workforce meant that the union acted as a resistance to any changes implemented by the management. This was clearly causing resistance to change which was one of the macro-level problems confronting NOGO. The union terms were guaranteeing complacency and minimizing worker efficiency owing to a contract that workers would get pay for 40 hours of work even if there was no availability of such work (Brown). These contract terms (as settled by the unions) meant that NOGO was covering the living expenses of their away-from-home, overtime employees as well as duplication of tasks such that clerks would have no task to carry out in the presence of telegraph operators. Furthermore, the union as well as improperly crafted contracts provided workers unnecessary cushion of refusing to do a task just because it wasn’t part of their job description. This was directly contributing to the high employee expenses which, again, was one of the major problems facing NOGO. Furthermore, t he lack of HR planning and strategy was at the backbone of a host of problems encountered by the company. For one thing, the lack of HR planning led to overstaffing leading to greater number of employees being hired than was necessary. This bred â€Å"featherbedding†. The employee contract was not designed appropriately with conditions such as prohibition of women clerks to work directly with train and radio communication personnel reducing the

Gotham City the residents reported that the street prostitution Assignment

Gotham City the residents reported that the street prostitution Discussion - Assignment Example the offender, suppression of any opportunity that the offender may have and hardening the situation making it difficult for the offender to do crime(Ikerd, 2010). The scenario provide us with an opportunity to probe some questions; why are the people of Gotham city not bothered with prostitution in the area? Why do the residences indulge in prostitution? What are the factors that make prostitution easy? After answering the questions, clear and well planned method can be employed in curbing the act. Some specific methods like; using informants, sweep of the area, saturation patrol, profile interview, operation indent and installing visible cameras can help in curbing the act. These are secondary methods, and the primary method is the best. It involves gathering intelligence unto why the community members indulge in the practice, then that the primary drive is handled. The local business people should be kept in mind while handling this matter, because some may argue that prostitution is what is making them have customers, and perhaps that is the reason people of Gotham are not concerned with prostitution. In conclusion there must be professional analysis to help in managing crime without infringing with anyone’s

Growth Of The Medical Tourism Industry Tourism Essay

Growth Of The Medical Tourism Industry Tourism Essay CHAPTER 2 LITERATURE REVIEW In the previous chapter a brief introduction to the meaning of medical tourism and the medical tourism industry has been given to develop a basic understanding of the subject for this dissertation. This chapter deals with the review of the literature for developing a conceptual and theoretical background for further research and identifying the research areas required. Literature review is an essential part of any research as it not only helps the researcher understand the research areas required, but also develops a conceptual background of the study for the reader. In survey and experimental research, the review of literature serves as a variety of background functions, which helps in the preparation of the collection of the actual data (SINGH, 2007, pp-61). The literature review in this dissertation has been designed in a systematic and a conclusive way for the reader to understand the subject clearly. The literature review has been divided into three main parts which are:- (Part A) Introduction:-This part deals with the literature required for understanding the concept of medical tourism as an industry and the medical tourism industry in India. (Part B) Medical Tourism in India: Strategic Implications and Growth:-This part consists of literature required to study the strategic implications and factors influencing growth of the medical tourism industry in India. This part is related to the second and third objective of this dissertation and also helps in developing a research area required for the fourth and fifth objective. (Part C) Conclusion:-After understanding the concept of the strategic implications and growth of the medical tourism industry the main conceptual framework can now be made and the main research areas can now be identified. The reason for this literature review is not just to review the related literature but to identify the concepts that will be used in the research. The importance of a literature review cannot be matched by an understanding as to how a review of literature can be done but how it can be used in the research (HART, 1998, pp-1).This chapter will help in finding the questions that needs to be answered in the research. PART A Medical Tourism: Background (A.1)Defining Medical Tourism Since ancient times, travellers have left their homeland in search of the best health care possible. Historical records show that early civilizations, such as the Romans (about 4 to 400 BC) were drawn toward the healing properties of bath or spring waters (KHAN, 2010).Although Medical tourism seems to be an entirely new concept which is now being acknowledged as an industry itself it has existed from the 18th century. Some of the earliest forms of tourism were directly aimed at increased health and well being for example, the numerous spas that remain in many parts of Europe and elsewhere, which in some cases represented the effective start of local tourism, when taking the waters became common by the 18th century (CONNEL, 2005).By the 19th century spas were found in the most remote colonies such as the French Pacific Territory of New Caledonia while the emergence of hill stations throughout the tropics further emphasized curative properties of tourism (SMYTH,2005 cited in WOODSIDE,2 007).History proves that medical tourism has existed for a long time. According to John Connell (Cited in WOODMAN,2007) recently travellers have travelled in search of yoga and meditation as the search for cure took on more spiritual and holistic perspectives. Today people not only travel long distances for spas and relaxation but for complicated medical procedures in search for affordable and quality medical care. Globalisation, it is said, lifts nations out of their isolated existence and makes them part of one knowledge society. Today, outsourcing of activities like labora ­tory investigations, medical transcriptions, software de ­velopment, and telemedicine to countries like India, China, Korea, Japan, has become easier with business process outsourcing(QUADEER and REDDY,2010) . The globalization of healthcare services has given rise to a new phenomenon called Medical Tourism. It is also called Healthcare Globalization, Health Vacation, Wellness Tourism, Medical Outsourcing, or Generation Next Health Holidays. The term Medical Tourism can be defined as travel outside ones home country in search of healthcare that is either less expensive or more accessible (KHAN, 2010).Carrera and Bridges (Cited in LUNT and CARERRA, 2010) identify health tourism as the organised travel outside ones local environment for the maintenance, enhancement or restoration of an individuals well-being in mind and body. Definitions and the seeking to know meaning of terms and words can put things right elementarily between people and their words (JACKSON, JACKSON and HARMON, 197, pp-235). Although there are many definitions of the term Medical Tourism the definition must serve the general purpose of understanding the meaning of the term Medical tourism. The term Medical tourism can be divided into two words Medical and Tourism as shown in the figure below (JAGYASI, 2008). MEDICAL TOURISM MEDICAL TOURISM The word Medical means treatment of illness, disorder or injuries. The activities of persons travelling to and stay in a place outside their usual environment for leisure, business and other purposes. + Figure 1: Defining Medical Tourism Source: JAGYASI, P.2008.Defining Medical Tourism ~ another approach. Medical Tourism Magazine .July 15 th According to Dr Prem Jagyasi (JAGYASI, 2008) understanding of the words medical and tourism individually will not be sufficient to define the term Medical Tourism. Considering the definitions of the words, medical tourism can be defined as a set of activities in which a person travels often long distance or across the border, to avail medical services with direct or indirect engagement in leisure, business or other purposes. Today medical tourism has become a huge industry itself.According to a report by Mckinsey and company and the confideration of Indian industry(2005) the medical tourism industry is expected to become a hundered million dollar industry by the year 2012.The figure below represents the projected growth in the earning in revenues of the worldwide medical tourism industry. Figure 2 Some of the internationally know hospitals for medical tourism such as Bumrungrad in Thailand and Apollo in India, report revenue growth of about 20 percent to 25 percent annually (ROTH, 2006). McKinsey Company (2005) estimates that Indian medical tourism will grow to $2.3 billion by 2012.In 2005 approximately 250,000 medical tourists sought care in Singapore, and 500,000 travelled to India for medical care(HUTCHINSON,2005).According to these reports the medical tourism industry is expected to grow at a large scale. A commonality in all these reports concludes that the three main destinations where growth of this industry is expected to be the highest are India, Thailand and Singapore which are countries in Asia. Therefore before the medical tourism industry in India can be seen it is important to identify the key factors influencing growth of the medical tourism industry in Asia and the different destinations gaining popularity in this industry who will eventually are the competito rs. (A.2) Medical Tourism in Asia Table 1: Popular medical tourism destinations around the world. Source:-NATAN, M and SEFER, E.2009.Medical Tourism: A New role of Nursing? .OJIN: The online journal of Issues in Nursing. July 22 .Vol 14 There are many countries that are now competing in the medical tourism industry all around the world. The table given below indicates the major destinations for medical tourism in the world. As it can be seen Asia has a lot of countries that have established themselves as medical tourism destinations. According to an update in a report given by Deloitte (2008) the number of medical tourists visiting Asia will grow at a rate of 20% annually and will create an industry worth US$4 billion by the year 2012.India is estimated to account for half of the medical tourism industry, countries like Singapore, Malaysia and Thailand are already promoting their medical tourism industries. Asia The Americas Europe Africa Oceania China Argentina Belgium South Africa Australia India Bolivia Germany Israel Jordan Brazil Columbia Hungary Lithuania Malaysia Philippines Singapore Thailand Cost Rica Jamaica Mexico United States Poland Asian Governments are now supporting medical tourism through organizing awards and promotional events such as Asian Spa and Wellness tourism in 2006 and the establishment of dedication promotional boards (HENDERSON,2004 cited in COCHRANE,2008) The four main countries identified as medical tourism destinations in Asia are Thailand, Malaysia, Singapore and India. In 2002 Thailand became home to the Asias first JCI-Accredited hospital which was Bumrungrand in Bangkok and presently has six other hospitals which have been given this accreditation (WOODMAN, 2009). In Thailand according to the Kasikorn Research Centre, about 1.28 million foreigners visited hospitals in 2005 generating revenues of about thirty three million Thai baht (DELOITTE, 2008).Another important destination for medical tourism is India a country that has pioneered the outsourcing industry is now quickly gaining popularity as a medical tourism destination. Before the medical tourism industry in India can be looked at it is important to understand the factors that promote Asia itself as a caterer to the medical tourism industry. As seen below a SWOT analysis on the medical tourism industry is given which analysis the strengths, weaknesses, opportunities and threats of Asia itself. Organizations use the SWOT analysis as the first step in developing their marketing plan as it is relatively an easy process and helps in describing the major considerations to be taken in designing an appropriate strategy(BRIGGS,2001,p-47). This SWOT analysis plays a significant part of this research as it outlines the significant strategic implications of the Medical tourism in Asia. SWOT ANALYSIS OF THE MEDICAL TOURISM INDUSTRY IN ASIA STRENGTHS à ¢Ã… ¾Ã‚  More mature medical tourism markets, facilities, and practices. à ¢Ã… ¾Ã‚  Government sponsored tax breaks and open environment for foreign private investments in healthcare infrastructure. à ¢Ã… ¾Ã‚   A relative surplus in the labour pool due to large populations and strong emphasis in education in some countries. à ¢Ã… ¾Ã‚  A history of using complementary and alternative e.g., yoga, Ayurveda, herbs, TCM/TKM. à ¢Ã… ¾Ã‚   In close proximity to Middle Eastern medical tourists. à ¢Ã… ¾Ã‚  Asia also has a booming tourism market with many scenic locations and various types of geography (beaches to mountains) to choose from. à ¢Ã… ¾Ã‚  Asians are known for their culture of hospitality and service. à ¢Ã… ¾Ã‚  Services and procedures such as: wellness/CAM, eye-care, musculoskeletal care, cardiac care, transplants, haemodialysis, and general/plastic surgery. Source:-VEQUIST, VALDEZ and MORRISON, 2009 WEAKNESSES à ¢Ã… ¾Ã‚  The length of travel for many European and North American tourists. à ¢Ã… ¾Ã‚  Some fears of travelling to Asia because of a reputation of social unrest, corruption and violence. à ¢Ã… ¾Ã‚  The lack of European and North American language (e.g., English, German, French, etc.) ability. à ¢Ã… ¾Ã‚  The culture in Asia is arguably very different from occidental cultures. à ¢Ã… ¾Ã‚  Difficulty in seeking legal remedy in the event of malpractice. à ¢Ã… ¾Ã‚  Large disparity in the healthcare systems for the poor and rich/medical tourists. à ¢Ã… ¾Ã‚  Several Asian countries are trying to serve too wide a swath of the market to maintain a sustainable industry. Source:-VEQUIST, VALDEZ and MORRISON, 2009 As it can be seen above the strengths and weaknesses of the medical tourism industry in Asia have been identified. These factors play an important role in identifying the strengths and weaknesses of the medical tourism industry in India as the Indian medical tourism industry is a part of the Asian medical tourism industry. These factors also develop a contrast between the positive and negative features of the medical tourism industry in Asia. As it can be seen above Asia also has a booming tourism market and is known for hospitality and service. The health care facilities in Asia are well developed. Asia also has a history of using complementary and alternative medicines which will support in developing wellness tourism .Although there are many positives of this industry in Asia, it also has some negatives such as a weak legal system in the case of malpractice. People also have the fear of the unknown as there is a change in the social climate. These factors relate to the Indian medi cal tourism industry in many ways but some of them may not apply such as the language barrier as India has a large English speaking population and the legal system which is developing rapidly. After a comparative study of the strengths and weaknesses of the Asian medical tourism industry a comparison of the opportunities and threats is discussed in the SWOT analysis. The next two factors of the SWOT analysis are the opportunities and threats which draw a comparative study on the external capabilities of the Asian medical tourism industry. Source:-VEQUIST, VALDEZ and MORRISON, 2009 OPPORTUNITIES à ¢Ã… ¾Ã‚  Large populations in the region offer many advantages (e.g., more regional medical tourism, lower cost of labour, more healthcare professionals, etc.). à ¢Ã… ¾Ã‚   Increasing strength and diversity of Asian economies and many fast-growing areas. à ¢Ã… ¾Ã‚   Many strong governmental initiatives supporting medical tourism. à ¢Ã… ¾Ã‚  Shrinking cost of fuel (i.e. gas prices) which makes airfare lower and encourages medical tourism. à ¢Ã… ¾Ã‚  The wealth in the Middle Eastern could lead to more tourists travelling to the Asian region. à ¢Ã… ¾Ã‚  The Asian expertise in off-shoring of various industries to add to their chances to capitalize on this market. à ¢Ã… ¾Ã‚  The emphasis on education and healthcare in many countries in Asia. à ¢Ã… ¾Ã‚   Strong private investments will build the infrastructure of the region. THREATS à ¢Ã… ¾Ã‚   Disease (particularly pandemics), social unrest, terrorism, overcrowding, dirty environments in some areas of Asia are perceived negatively and hurt marketing efforts. à ¢Ã… ¾Ã‚  Competition from Latin America, Eastern Europe, and the Middle East for North American, European, and Middle Eastern medical tourists. à ¢Ã… ¾Ã‚  Due to the economy, many consumers simply do not have large enough cash reserve to pay for services or airfare. à ¢Ã… ¾Ã‚  Limited numbers of insurance carriers that have comprehensive relationships with medical providers in Asia. à ¢Ã… ¾Ã‚  Fast growth of medical tourism in other regions and countries outside of Asia. Source:-VEQUIST, VALDEZ and MORRISON, 2009 As seen above the opportunities of the Asian medical tourism industry is huge and a major advantage is the increasing strength of the economies which fuels the development of stronger governments and health care infrastructure. Asia also expertises in off-shoring servicing as seen in the case of India which is also considered the off-shoring capital of the world. Although there are many opportunities there are threats to the Asian medical tourism industry as there is an increasing competition from Latin America and certain countries in Europe. Asia is also perceived as a continent of social unrest, terrorism and unhealthy environment which impacts negatively on the marketing strategy. In the above SWOT analysis the strength, weaknesses, opportunities and threats of the Asian medical tourism industry can be highlighted. These factors explore the internal and external capabilities of Asia itself in this industry which brings out a contrast between the positive and negative features of this industry in Asia. These factors adversely affect the medical tourism industry in India. (A.3) Medical Tourism in India. The Indian governments commitment to providing compre ­hensive healthcare to the citizens, irrespective of their paying capacity, as part of its welfare policies was given up after 30 years of independence when the Sixth Plan opened up medical care to the voluntary and private sectors (QUADEER and REDDY, 2010).The involvement of the private sectors in the health care industry in India helped in the emergence of a corporate health sector in the 1990s.After opening up to the corporate sector in healthcare policies the government emphasised on healthcare to the poor and their involvement in it which was seen in the eighth and ninth year plans given by the government of India in 1992 and 1997 respectively. The acceptance of the new economic policy, of the health sector reforms by 1992 increased cutbacks in public sector investments in health as well as the commoditisation of health services (RAMA and NUNDY, 2008).The cutback in public sector investments led to the breakdown of the publ ic healthcare institutions with more collaboration from the private healthcare sector. When the healthcare services became dominated by the private sector, a new phenomenon of healthcare services becoming a form of market expansion and financial gains rather that welfare could be observed. This gave rise to the medical tourism industry in India. The government policy of merging medical expenditure and tourism was announced by Finance Minister Jaswant Singh in his 2003 annual budget speech when he described India as a global health desti ­nation. He identified the potential of complex health care services that are offered at relatively cheaper rates and yet earned profits. In this report he also mentioned the possibilities in investing in large chains of medical institutions and creating medi-cities. After this report heavy investment in improving medical institutions continued and today India has become of the fastest growing medical tourism destinations. This country is usually viewed as one of the most important global leader in the medical tourism industry, and it advertises itself as offering everything from alternative ayurvedic therapy to coronary bypasses and cosmetic surgery (CONNELL, 2006).Some hospital executives in India use the phrase value medical travel to promote India as a high-quality, low-cost destination for international health care travellers (TURNER, 2007).The medical tourism industry has grown at a large scale with companies like WellPoint Blue Cross Blue Shield to handle their pilot program of offering medical tourism for Americans travelling to India (KHAN,2010).India has made its mark in the medical tourism industry in the world by providing world class medical care at cheap and affordable prices. In a nutshell it has been predicted that the Indian medical tourism industry will rise rapidly and will continue to grow at a fast pace. There are many growth drivers involved in the evolution of this industry in India; some of them include cost factors, government policies and quality health care. After a brief understanding of the emergence of the medical tourism industry in India it is important to understand the factors involved in the growth process. The next part deals with an in-depth review of literature on the growth drivers and strategic implications of the medical tourism industry in India. PART B Medical Tourism in India: Growth and Strategic implications (B.1)Medical tourism in India: Growth Professor Michael Porter from the Harvard University is one of the well know strategic writers and describes the industry lifecycle model as the grandfather of concepts for predicting the industry evolution (LYNCH, 1997).According to this model an industry goes through four major stages which are introduction ,growth, maturity and decline. The figure shown below is the diagrammatic representation of the industry lifecycle with the four steps. Figure 2: Industry Lifecycle Stages Source:-LYNCH, 1997, p 126 This concept helps in describing any industry as it goes through the stages as a result the strategy of the industry changes as the stage changes. It also can help in formulating the correct strategy required at a particular stage in the industry lifecycle in an entrepreneur perspective. This concept is very well relevant to the medical tourism industry as it helps in identifying the stage that the industry is in. Identifying these key aspects at an early stage will lead to formulating the right strategy for the success of a business entering this industry. It is important for companies to understand the use of the industry lifecycle for businesses to compete in the industry effectively and successfully (BAUM and MCGAHAN, 2004). In 2007, an estimated 750,000 Americans travelled abroad for medical care and an estimated growth to a staggering six million was expected by the end of 2010(BALIGA, 2006).According to a study carried out by Deloitte in 2008 there will be a large amount of significant growth in the medical tourism industry. In this study the numbers of medical tourist from the United States of America going to foreign countries for treatments will increase. This report also indicates that the medical tourism industry may reach the maturity by 2016 where the growth will start decreasing. This report basically proves that this industry is growing and can therefore be place in the growth sector of the industry lifecycle. The growth sector of the industry lifecycle represents that the market is expanding and customers have become more informed about the products. In this stage there will be more competitors that will enter the industry market (CARPENTER and SANDERS, 2009).The figure given below is the es timated growth given in the Deloitte report (2008) of the medical tourists going to foreign countries for medical treatment. Figure 3: Annual growth and patient volume growth in major countries in the medical tourism industry Source: Deloitte report (2008) GROWTH INTRODUCTION TIME Figure 4: Predicted Growth of the medical tourism industry in India The figure represents a huge rise in the patient volume growth in major countries over the next few years which indicated the amount of growth and demand in the medical tourism industry. These statistics affect the medical tourism industry in India in terms of growth planning and understanding that growth potential of this industry in India. After witnessing the immense growth of the medical tourism industry in the world, India felt the need for this industry and entered into this market in late 2002. Indias efforts to promote medical tourism took off in late 2002, when the Confederation of Indian Industry (CII) produced a report in collaboration with McKinsey Company which outlined the immense growth potential of this sector in India (KURIACHAN and BASANTH, 2008).In this report they made future predictions of this industry in India considering the economic and political factors. There were many strategic points hig hlighted in this report which concluded that the forecasted growth of the medical tourism industry in India will be from US $ 18.7 billion in 2001 to around US $ 45 billion by 2012 which is equivalent to 8.5% of GDP. The figure below represents the predicted growth according to the Confederation of Indian Industry (CII) and McKinsey Company. Year US $Billion [Type a quote from the document or the summary of an interesting point. You can position the text box anywhere in the document. Use the Text Box Tools tab to change the formatting of the pull quote text box.] Source: Confederation of Indian Industry (CII) and McKinsey Company (cited in KURIACHAN and BASANTH, 2008) As it can be seen above the medical tourism industry in India is expected to grow to a 45 billion dollar industry by the year 2012 which is a 26.3% rise from the year 2001. The worldwide market for medical tourism is estimated in 2004 was estimated to be US $ 40 billion with India market share 1%.In 2012 the world medical tourism industry will be US $ 100 billion with India market share being 3% (KURIACHAN and BASANTH, 2008).These figures represent that the Indian medical tourism industry will grow at a fast pace .At a strategic level it is important to understand the factors which will affect the growth of this industry in India. (B.3Factors influencing growth of medical tourism industry in India The previous section showed the predicted growth of the medical tourism industry in India and the SWOT analysis of Asia that affect this industry in India. To analyze the medical tourism industry in India on a strategic level the competitive advantage of India must be analyzed. In reference to this context of global competition was given by Michael Porter in his book The competitive advantage of nations. He conducted a study of ten nations to develop an analytical framework at a strategic level, which tries to explain why a nation succeeds in particular industries but not in others (PORTER.1990).Porter suggests that the national home base of an organisation plays a very important role in creating an advantage on an international scale (JOHNSON, SCHOLES and WHITTINGTON, 2005).The study on this model can clearly help in distinguishing the factors that may influence the growth of the medical tourism industry in India. The model basically describes the four main attributes that individua lly and as a system constitute the diamond of national advantage .These attributes are:- Factor Conditions:-The nations position in factors of production, such as skilled labour or infrastructure necessary to compete in a given industry. Demand Conditions:-The nature of home market demand for the industrys product or service. Related and Supporting Industries:-The presence or absence in the nation of supplier industries and other related industries that are internationally competitive. Firm Strategy, Structure and Rivalry:-The conditions in the nation governing how companies are created organized and managed as well as the nature of domestic rivalry. Source:-PORTER, 2008 Chance and the government are two factors that influence these four determinants, but are not determinants themselves (OZ, 2002). FIRM STRATEGY, STRUCTURE AND RIVALRY RELATED AND SUPPORTING INDUSTRIES DEMAND CONDITIONS FACTOR CONDITIONS CHANCE GOVERNMENT Figure 4: Michael Porters Diamond Framework: Competitive Advantage of Nations Source: PORTER (1998, p. 127) (B.4)Strategic implications Figure 4: Strategic implications of the Medical tourism Industry As described by LYNCH (1997) there are many strategic implications for the industry lifecycle .These can be modified in terms of the medical tourism industry as shown in the following figure. These Strategic implications will also help in the clear understanding of the drivers responsible for the growth of this industry. MEDICAL TOURISM INDUSTRY Customer strategy Research and Development strategy Company Strategy Competitor strategy Source:-Modified from LYNCH (1997, p 127) The first strategic implication is customer strategy which is one of most important implications as it tends to understand the customer strategy for selecting the product and the factors which are involved in it. This is also a significant factor that a business in this industry should try and evaluate on a continuous basis to complete efficiently and effectively with the growth of the medical tourism industry in the industry life cycle. By understanding customer strategy a clear view on the factors affecting the growth of the medical tourism industry can be identified. Joseph Woodman (2008) in this book Patient beyond Borders: Everybodys Guide to Affordable, World-class Medical Travel gives a guide to consumers interested in going abroad for medical treatments. In this book a step by step guide is also given and the factors influencing consumers to choose medical tourism have also been identified. According to this book there may be many reasons why medical tourists travel to attain medical care but there are seven main reasons as shown in the figure below. It is important to explore the customer strategy as it tends to understand why medical tourists choose certain particular locations as their medical tourism destination. The figure given below represents the customer strategy and the main factors influencing it. Figure 5: Customer strategy for the Medical Tourism Industry Cost saving Better quality care Customer Strategy Shorter waiting periods Other Treatments Inpatient friendly Excluded treatments Speciality treatments Source:-WOODMAN (2008, pp 51-63) Cost Saving As health care costs in developed countries like the United States of America and United Kingdom escalate individuals, small businesses, and state governments are all attempting to control health-related expenditures. Outsourcing health care to countries where surgical procedures and other forms of treatment are available at substantially lower prices is attracting interest from individuals and businesses (TURNER, 2007). With the continuing health care cost increases in developed countries, it is likely that patients, insurers and employers, particularly in countries where employers share the costs of private health insurance, will continue seeking low cost treatment abroad (FORGIONE and SMITH, 2007). There many ways in which service costs are kept low for example most provider countries, malpractice litigation costs are much lower than in most highly developed countries, which has helped to reduce the cost of medical care(HADI,2009,p.11). Table 1: Major Medical Tourism Destinations: Cost Comparison Medical procedures USA India Thailand Singapore Costa Rica Mexico Korea Heart Bypass $80,000 To $130,000 $6,651 to $9,300 $11,000 $16,500 $24,000 $22,000 $34,150 Heart Valve Replacement $160,000 $9,000 to $9,000 $10,000 $12,500 $15,000 $18,000 $29,500 Angioplasty $57,000 $4,998 to 7,500 $13,000 $11,200 $9,000 $18,000 $19,600 Hip Replacement $43,000 $5,800 to 7,100 $12,000 $9,200 $12,000 $14,000 $11,400 Hysterectomy $20,000

Use of Imagination in Dr. Jekyll and Mr. Hyde, Study in Scarlet and Sig

  Ã‚   While reading Robert Louis Stevenson's The Strange Case of Dr. Jekyll and Mr. Hyde and Arthur Conan Doyle's A Study in Scarlet and Sign of the Four, I found myself impatiently competing against Mr. Utterson and Sherlock Holmes to find out the solutions to the crimes.   Stevenson and Doyle cleverly use the imagination of their protagonists to display through fictional literature the concern late Victorians felt about the rise of a new science.   The characters of Utterson and Holmes resemble each other in their roles as objective observers who use imagination to create a picture in the reader's mind about the narrative.  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In Dr. Jekyll and Mr. Hyde Utterson is a prominent London lawyer retained to oversee Dr. Jekyll's personal affairs.   Utterson is characterized as an upright and honest man who is genuinely interested in his client's well being.   Through his acquaintance with Enfield, a man about London, Utterson learns more about Dr. Jekyll's friend, the mysterious Mr. Hyde.   For the reader's benefit, Utterson exhibits his imagination by opening a window to the discrete aspects of Dr. Jekyll's life.   It is important for readers to envision the discrete aspects of Jekyll's character including his good and evil nature that he continually experiments with through scientific study.   This display of imagination allows the narrative to smoothly unfold and quantify Stevenson's attempt to reveal late Victorian concerns through fiction.        Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In the same way, Sign of the Four's character of Holmes uses imagination through his role as an optimistic, amateur detective.   Holmes is portrayed as being driven by his imagination, which compels him to shoot cocaine in order to alleviate the feeling of boredom... ... at Pondicherry Lodge and while Utterson's concern with character of Jekyll discloses an aspect of the new science that probes the duality of good versus evil.      Works Cited and Consulted: Doyle, Arthur Conan.   A Study in Scarlet in The Complete Sherlock Holmes.   New York: Doubleday and Company, Inc., 1930.   22-75. Chesney, Kellow. The Victorian Underworld. New York: Schocken Books, 1970. Macdonald, Ross. "The Writer as Detective Hero." Detective Fiction: A Collection of Critical Essays. Ed. Robin W. Winks. Englewood Cliffs, London: Prentice-Hall, 1980. Stevenson, Robert Louis. The Strange Case of Dr. Jekyll and Mr. Hyde. First Vintage Classics Edition. New York: Vintage Books, 1991. Veeder, William. Dr. Jekyll and Mr. Hyde after One Hundred Years. Eds. William Veeder and Gordon Hirsch. Chicago: University of Chicago Press, 1988.