Determination of Vitamin C Content in Foods

Determination of Vitamin C Content in Foods Zheng Xiao Introduction Vitamin C, also known as L-ascorbic acid, is an essential component of our diets. It is a good antioxidant, a key component that helps to prevent damage to proteins and deoxyribonucleic acids. In the food industry, vitamin C is added to increase the nutritional content of food products and also for preservative purposes. As the human body is unable to synthesise vitamin C, it would have to be consumed as part of our diet. Fresh fruits and vegetables for instance are common sources of vitamin C. Vitamin C is a labile compound and is easily degraded by enzymes and atmospheric oxygen. Its oxidation can be accelerated by excessive heat, light, and heavy metal cations (Pisoschi, Danet, Kalinowski, 2008). During the manufacturing process, some vitamin C would be lost. Thus, in fruit juice products, vitamin C level is commonly used as a gauge for quality. This prompts manufacturers to fortify their products with high levels of vitamin C to ensure that sufficient vitamin C is present in the product throughout the storage process. Due to the wide use of ascorbic acid in both food products and in the pharmaceutical industry, many analytical methods exist for the determination of ascorbic acid, including titrimetric, spectrophotometric and chromatographic methods, each with their advantages and disadvantages. An example of a titrant used is 2,6-dichlorophenolindophenol (DCIP), which will oxidise the ascorbic acid that is present in the sample. While titrimetric methods are simple to use, they are also known to overestimate the amount of ascorbic acid present due to the presence of oxidisable species other than ascorbic acid (Hernà ¡ndez, Lobo, Gonzà ¡lez, 2006). In addition, many interferences often occur with coloured samples (Arya, Mahajan, Jain, 2000). An example would be the masking of colour change at the end point of titration by highly coloured extracts from fruits and vegetables (Eitenmiller, Landen, Ye, 2007). Spectrophotometric methods work by determining the absorbance of vitamin C which is compared against standard concentrations. However, such methods are susceptible to possible interference due to absorbance exhibited by other components that is present in the sample matrix. Lastly, chromatographic methods are commonly used because of their simplicity, short analysis time and sensitivity (de Quirà ³s, Fernà ¡ndez-Arias, Là ³pez-Hernà ¡ndez, 2009). The sample is separated into its components based on their relative affinity with the mobile and stationary phase. Reversed-phase high performance liquid chromatography (RP-HPLC) for instance is a very efficient method that is used in ascorbic acid analysis of fruits, vegetables and beverages. Ascorbic acid is relatively hydrophilic due to the presence of several hydroxyl groups. Thus, it has a higher affinity to the polar mobile phase than the non-polar stationary phase, allowing it to be separated from the other components in a sample. The retention time gives a qualitative analysis of the sample while the area under the peak allows for the quantitative determination of ascorbic acid content present. However, a major disadvantage of this method is its high cost compared to other conventional methods. The objective of this experiment is to determine the ascorbic acid content in commercial guava juice by RP-HPLC. Materials and Methods The product analysed was commercial guava juice. The experimental procedure was as stated in the laboratory manual, with the slight amendments as follows. The filtrate (2mL) from the centrifuged sample was diluted (1 part sample: 4 part acetic acid) with 2% acetic acid. Five sets of standard ascorbic acid solutions were prepared (40ppm, 80ppm, 120ppm, 160ppm and 200ppm for each set) using a stock solution (1000ppm ascorbic acid) and 2% acetic acid for dilution. The standard solutions were filtered using the 0.45 micron cellulose acetate syringe filter, beginning with the lowest concentration. The column used was a Phenomenex Ultrasphere 5u C18 column (1504.6mm) and the wavelength used was 254nm. Results and Discussion A calibration graph was plotted (Figure 1) using average peak area (Table A1 in appendix) for standard solutions versus their respective concentrations. For each standard solution, four duplicates were prepared. This was done to increase the accuracy of the calibration curve. The r2 value obtained (0.9984) was close to the ideal value 1, indicating a good linear correlation between the area under peak of interest and ascorbic acid concentration. This allows good estimates of ascorbic acid content to be made given the area under peak of interest for each sample. Table 1. Ascorbic acid concentration in samples prepared by Groups 10 to 18 Sample calculation for Group 11: Ascorbic acid concentration in diluted sample = = 116ppm Ascorbic acid concentration in original sample = 116ppm 5 = 581ppm = 58.1 mg / 100mL of juice Average ascorbic acid concentration in original sample = =58.0 mg / 100mL of juice The average retention time of the samples prepared by different groups was 2.557min (Table A3 in Appendix), which is highly similar to that of the ascorbic acid standard solutions was 2.559min (Table A2 in Appendix). This verifies that ascorbic acid was the component analysed. The average ascorbic acid concentration in the guava juice product determined experimentally was 58.0mg/100mL of juice. This was approximately 3.9 times higher than the amount indicated on the packaging (15mg/100mL). As mentioned earlier, As the expiration date is approached, ascorbic acid would be lost to different extents depending on the storage conditions (Kabasakalis, Siopidou, Moshatou, 2000). Manufacturers are known to add ascorbic acid to their products to improve their nutritional value and also to account for the ascorbic acid lost during the manufacturing and storage process (Ottaway, 2008). Since the experiment was conducted before the expiration date of the product (March 14, 2014), a higher ascorbic acid content would be expected. The original ascorbic acid concentration for group 14 was excluded from the calculation as it was almost double of other results and thus likely to be an outlier. A possible reason might be an error in dilution during the preparation of the sample. The other results were found to be precise with a low standard deviation (1.4) and a low coefficient of variation (2.5%). Conclusion The ascorbic acid content of commercial guava juice determined using RP-HPLC was 58.0mg/100mL of juice. References Arya, S. P., Mahajan, M., Jain, P. (2000). Non-spectrophotometric methods for the determination of Vitamin C. Analytica Chimica Acta, 417(1), 1-14. doi: http://dx.doi.org/10.1016/S0003-2670(00)00909-0 de Quirà ³s, A. R.-B., Fernà ¡ndez-Arias, M., Là ³pez-Hernà ¡ndez, J. (2009). A screening method for the determination of ascorbic acid in fruit juices and soft drinks. Food Chemistry, 116(2), 509-512. doi: http://dx.doi.org/10.1016/j.foodchem.2009.03.013 Eitenmiller, R. R., Landen, W. O., Ye, L. (2007). Vitamin Analysis for the Health and Food Sciences, Second Edition: Taylor Francis. Hernà ¡ndez, Y., Lobo, M. G., Gonzà ¡lez, M. (2006). Determination of vitamin C in tropical fruits: A comparative evaluation of methods. Food Chemistry, 96(4), 654-664. doi: http://dx.doi.org/10.1016/j.foodchem.2005.04.012 Kabasakalis, V., Siopidou, D., Moshatou, E. (2000). Ascorbic acid content of commercial fruit juices and its rate of loss upon storage. Food Chemistry, 70(3), 325-328. doi: http://dx.doi.org/10.1016/S0308-8146(00)00093-5 Ottaway, P. B. (2008). Food Fortification and Supplementation: Technological, Safety and Regulatory Aspects: Elsevier Science. Pisoschi, A. M., Danet, A. F., Kalinowski, S. (2008). Ascorbic Acid Determination in Commercial Fruit Juice Samples by Cyclic Voltammetry. Journal of Automated Methods and Management in Chemistry, 2008. doi: 10.1155/2008/937651 Appendix Table A1. Area under peak of interest for standard solutions Average area under peak for 40ppm = = 2197282 Table A2. Retention Times for standard solutions Table A3. Retention Times for samples prepared by Groups 10 to 18

Spirituality and John Coltrane Essay -- Essays Papers

Spirituality and John Coltrane After being fired from Miles Davis's band in 1957 for his chronic use of heroin, John Coltrane was hurt tremendously. He decided it was time he quit using heroin. He took a month off from music while he went "cold turkey." During this month in the early spring of 1957, Coltrane had a momentous religious experience (Nisenson, 40). Coltrane asked God to give him "the means and privilege to make others happy through music" (Coltrane, 1995, 2). As time went on, Coltrane felt that he was leading a life that was "contradictory to the pledge and away from the esteemed path" that he had made to God (Coltrane, 1995, 2). Starting with A Love Supreme (recorded in December, 1964), Coltrane stuck to his pledge. In doing so, Coltrane would seek for the "truth" in sounds, Einstein, the Kabbalah and Sufism. Coltrane's version of God was not limited to denominational name, and this broad palette of spirituality helped guide him through his life and his music until his death on July 16 , 1967. A Little Background John William Coltrane was born September 23, 1926 in Hamlet, North Carolina. He was the grandson of a Reverend, Walter Blair. Blair was the pastor of St. Stephen's African Methodist Episcopal Zion Church. John's father, John Robert Coltrane, loved to play the violin and the ukulele (Nisenson, 4). John Coltrane received some of his musical training from the Zion Church his grandfather was the pastor of. First, the young Coltrane played clarinet, and eventually moved to saxophone, which was the instrument he was associated with from that time on. During his earliest days of playing music, the church had an impact on him. But in 1943, he moved to Philade... ...ystery of Humanity: Tranquility and Survival. New York: University Press of America, 1986. Coltrane, John. Live in Japan. Impulse, GRD-4-102, 1991. Coltrane, John. A Love Supreme. Impulse, GRD-155, 1995. Coltrane, John. The Major Works of John Coltrane. Impulse, GRD-2-113, 1992. Coltrane, John. Meditations. Impulse, IMPD-199, 1996. Davis, Miles with Quincy Troupe. Miles: The Autobiography. New York: Touchstone, 1990. Einstein, Albert. Relativity: The Special and General Theory. Trans. Robert W. Lawson. New York: Crown, 1931. Halevi, Z'ev ben Shimon. Kabbalah: Tradition of Hidden Knowledge. London: Thames and Hudson, 1979. Nisenson, Eric. Ascension: John Coltrane and His Quest. New York: St. Martin's, 1993. Thomas, J. C. Chasin' the Trane: The music and mystique of John Coltrane. London: Elm Tree, 1976.

As Good As It Gets?: An Examination Of The Mechanism And Mode Of Treatm

As Good As It Gets?: An Examination Of The Mechanism And Mode Of Treatment Of Obsessive-Compulsive Disorder Obsessive-compulsive disorder, often referred to as simply OCD, is a mental illness in which an individual experiences endless cycles of repeated thoughts and rituals, known as obsessions and compulsions, which she feels she cannot control (1). Although many people possess habits and routines that help them organize their every day schedules, people with OCD form patterns of behavior that are extremely time-consuming and interfere with their daily lives. Once believed to be a rare and incurable disease which people kept hidden for fear of embarrassment (2), OCD is now recognized as being far more common than previously believed, affecting both men and women, and people of all races and socio-economic backgrounds equally (3). In fact, recent studies have shown that about 2.5% of the population have this disorder at some point in their lives (2), with between 3 to 5 million Americans affected with the disorder each year (3). Though OCD is a chronic illness that can take over a person's life if left untreated (1), a strict regiment involving proper medication and effective treatment can vastly improve the OCD sufferer's condition. Obsessive-compulsive disorder is composed of two major constituents evident in its very name - obsessions and compulsions. Obsessions are recurring thoughts or impulses that seem to invade one's mind despite attempts to ignore or suppress them (4). Though these thoughts range from the tedious and seemingly innocuous sort, to the shameful and morbid kind, all are generally viewed as senseless and are accompanied by anxiety to some degree (4). Some common examples of obsessions include: fe... ...tion remains an option. Regardless of whether an OCD patient is treated in or out of a hospital, treatment is vital in improving his condition, for if left untreated, the disorder will continue indefinitely (3). With the wide range of treatment options available to OCD sufferers and the extensive studies being conducted in lieu of the disorder, the promise of a future with less worries and anxiety appears to be well within reach. WWW Sources 1) Obsessive-Compulsive Disorder , on the National Institute of Mental Health website http://www.nimh.nih.gov/anxiety/ocdfacts.cfm 2) Obsessive-Compulsive Disorder: What Is It and How To Treat It http://familydoctor.org/133.xml 3) Most Frequently Asked Questions About OCD http://www.ocdhelp.org/faq.html 4) Obsessive-Compulsive Disorder , on the Encyclopaedia Britannica website http://www.britannica.com/

Clothing and Body Language in Literary Works and Art Essay -- Poe Baud

Clothing and Body Language in Literary Works and Art   Ã‚  Ã‚  Ã‚  Ã‚  Throughout life, clothing and body language are often utilized as sources of emotional expression. These emotions can also be portrayed in literaray works and artisitic displays, such as those of Poe, Baudelaire, Manet, and Warhol. In Poe's â€Å"Man of the Crowd,† there are several descriptions of different types of people based on their appearances, but one particular man is focused on by the narrator due to his unique appearance. Baudelaire's â€Å"The Painter of Modern Life† emphasizes the emotional expressions of beauty and fashion expressed in art. Manet is an artist who paints scenes to his liking. All of his works were done in his studio and set up the way that he wanted them. He holds a particular focus on men and women and the relationship between them. The positions and clothing that the men and women are set up in hold strong emotional implications about their feelings towards one another and the emotions involved in the social setting.   Ã‚  Ã‚  Ã‚  Ã‚  The opening of â€Å"The Man of the Crowd,† describes the emotions involved in untold secrets and the deepest of crimes; there are internal conflicts, struggles, anxieties, and agonous results due to the horror of the unsolvable crimes. The possibility of these crimes is introduced through the man of the crowd through his unseemingly unidentifiable expression The narrator describes his thoughts of this man as: There arose confusedly and paradoxically within my mind, the ideas of vast mental power, of caution, of penuriousness, of avarice, of coolness, of malice, of blood-thirtstiness, of triumph, of merriment, of excessive terror, of intense - of supreme despair. I felt singularly aroused, startled, fascinated. â€Å"How wild a history,† I said to myself, â€Å"is written within that bosom!† Although the narrator had never spoken to this man of the crowd, he was compelled to follow him based on his expression that had never been viewed by the narrator. He continued to follow the man of the crowd, noticing his patterns of following people by the mass and his shambled cloting and he concluded that he â€Å"[was] the type and genious of deep crime. He refuses to be alone.†   Ã‚  Ã‚  Ã‚  Ã‚  Prior to viewing the man of the crowd, the narrator observed several different types of people, all of which were able to be â€Å"read† through their outward appearances... ...p is not meant to be applied naturally and should be used as a method of exhibition of their beauty. Although Baudelaire does not describe the actions of women in the section of makeup, he clearly praises women who wear makeup because of their holy nature and uncriticalness.   Ã‚  Ã‚  Ã‚  Ã‚  Monet is able to express several emotions through his paintings, particularly through the arrangement and the depiction of the subjects in his work. In In The Conservatory, Manet focuses on the relationship between the man and the woman. The woman is properly dressed with buttons vertically lined up through her dress, thus constricting her presense. She has a fixed gaze and is not looking at the man. Although she is sitting comfortably, the woman has a rigid appearance. The man is leaning over towards her and is dressed like a dandy. The expressions on their faces and the way the man is leaning over the woman and looking at her appears as though he is pleading for forgiveness or attention. The rims of her eyes are red adding the possibility of her crying and an emphasis is placed upon their hands, which both contain wedding rings, suggesting that they are a married couple with problems.

“Mugged” By: Jim Crocket : Reader Response Essay

In the essay â€Å"Mugged† by Jim Crockett he talks about his relationship with his coffee mug. This essay is about building relationships and how almost everyone has something they cling to. In the beginning he makes it sound like he was mugged by some people and lost all his money, but that wasn’t the case, he lost something more valuable to him, his coffee mug. Jim thinks he has an addiction to coffee itself, but in reality its with the coffee mug. People never see him without his coffee mug, and Jim always knows where its at, wether its on the table, or in his hand. I believe that even though Jim Crockett is attached to his coffee mug, everyone has some sort of attachment to something. I believe Jim Crockett has a somewhat unhealthy attachment to his coffee mug. By reading his essay the reader can infer several things. He seems to be somewhat desperate to control the details of his life. It would seem that Jim Crockett does not currently have any type of meaningful relationship with a significant other or his piers. The way he speaks of his mug â€Å"its shape, curvaceous, tapered, slim-waisted, and a bit heavier on top†seems to suggest that the coffee mug serves as a surrogate for female companionship. Jim Crockett’s denial of his attachment to his coffee mug and his justification of his actions as addiction to caffeine seem to be a defense mechanism. While a seemingly superficial object to most people the coffee represents a constant presence in Jim Crockett’s life. The reader can also assume that Jim Crockett is also environmentally conscious. He speaks of â€Å"organically, shade-grown coffee† and the â€Å"paper cup and insulating sleeve, both little bits of tree stay in the store.† Jim Crockett shows a very divided personality. While somewhat concerned what his peers seem to think of his supposed coffee addiction he is almost oblivious to stopping traffic to pick up his coffee mug that he left on his bumper. It would also seem that Jim Crockett is somewhat apposed to a big business and corporations based on his jobs as a spanish instructor, some writer, farmer, and carpenter all decidedly, independent professions as well as his mentioning of the â€Å"earth/human pillaging multinational cartel.† While Jim Crockett seems to have a rather unhealthy fixation to his coffee mug we all have attachments to some inanimate object. I can relate to his attachment because as a child I received a blanket, it still gives me a sense of security and well being. It would seem that there is a fine line between

Surgical Site Infections

Surgical Site Infections Elizabeth Griffor HCA 375 Continuous Quality Monitoring & Accreditation Instructor: Annajane Schnapp October 27, 2012 I chose to do my paper on the hospital-acquired condition of surgical site infections. In this paper I will discuss what a surgical site infection is, why it is considered preventable, the legal implications related to the patient, the role disclosure plays, accreditation expectations, and analyze the cost of continuous quality monitoring as it relates to quality.Surgical site infections account for 40 % of all hospital-acquired infections ( HAIs) and are unnecessary and largely preventable. Use of antibiotics is fundamental in preventing surgical site infection and includes three core elements: 1. appropriate selection, 2. timing of the first dose, 3. and discontinuation postoperatively. It used to be the standard practice to â€Å"shave and prep† a patient prior to surgery, but a study done in 1992 revealed that surgical site infectio ns were 50% lower in surgery patients whose hair was removed with clippers rather than a razor.One of the most common complaints from surgery patients is being cold in the holding area, operating room, and the post anesthesia care unit ( PACU) . This is uncomfortable and can increase risk of complications; such as surgical site infections. Glucose control is also important as a method for decreasing surgical site infections ( Frances, 2005). Guidelines for preventing surgical site infection are at the preoperative stage, intraoperative stage, and postoperative stage. They are as follows: 1. Preoperative stage: Patient preparation- Identify and treat all infections before surgery; postpone surgery if possible until infection is resolved. * Do not remove hair by the incision site unless it interferes with the operation; use electric clippers immediately before surgery if hair must be removed. * Have patients bathe or shower with an antiseptic the day of the surgery or the night before . * Thoroughly wash and clean at and around the incision site to remove gross contamination. * Keep hospital stays as short as possible to limit the patient’s exposure to nosocomial infections.Antimicrobial prophylaxis- * Work with the physician, pharmacist, and administer a prophylactic antibiotic only if it is indicated; antibiotic chosen should be effective against common pathogens that cause surgical site infections. * I. V. administration of the antibiotic should be timed so it is concentrated when the incision is made. * Do not use Vancomycin for antimicrobial prophylaxis routinely. Surgical team preparation- * Keep fingernails short, no artificial nails; bacteria and fungi can colonize on your hands if you wear artificial nails. Surgical team members who have signs or symptoms of an infectious illness need to promptly report this to their manager and occupational health service personnel. * Surgical team members that have draining skin lesions should be relieved from d uty until infection has been ruled out, they have had therapy, or the infection is gone. * It is also suggested that no hand or arm jewelry be worn, as well as nail polish. 2. Intraoperative stage: Ventilation- * Maintain ventilation in the operating room and maintain a minimum of 15 air changes per hour. Keep the operating door closed as much as possible. * Limit the number of staff entering the operating room. Surfaces and equipment- * Clean surfaces or equipment with hospital disinfectant if they are soiled with blood or body fluids before the next operation. * Do not perform special cleaning or closing of operating room after contaminated or dirty operations. * Sterilize all surgical equipment according to guidelines. * Assemble sterile equipment and solutions just before using them. Surgical attire- * Before entering the operating room, a surgical mask and hood that covers he hair on the face or head must be worn. * Sterile surgical gloves must be worn, putting them on after a sterile gown. * Shoe covers are not necessary for preventing surgical site infections. Vascular access- * Adhere to the rules of asepsis when placing intravascular devices and administering I. V. drugs. 3. Postoperative stage: Incision care- * Use a sterile dressing for 24-48 hours on an incision after surgery. * Wash your hands before and after any contact with the surgical site, even when changing the dressing. Use a sterile technique when changing dressings. * Teach the patient and family about incision care, signs or symptoms of surgical site infection, and when to report any symptoms (Adams, 2001). Following these guidelines can effectively reduce or prevent surgical site infections. Although nothing is 100% full proof, surgical site infections can be reduced and prevented in most situations. If an infection is not present at the time of admission and becomes evident after 48 hours of hospitalization; it is considered to be hospital acquired.Following the above mentioned guidel ines indicates quality health care practices. By using these techniques, surgical site infections will be prevented and reduced resulting in quality care; benefiting both the patient and the hospital. A legal implication related to a patient developing a surgical site infection, results in more cost to the hospital, less profit, and leaves them open to possible lawsuits. Hospital acquired infections affect 1. 7 million hospitalizations, cost $ 8. 1 billion to treat, and lead to 2. 3 million total days of hospitalization.Infections are the fourth most expense in hospitals, costing $ 252,600 per hospital on average, and each afflicted patient requires $ 24,500 more in care on average as a result. Examples of lawsuits filed due to hospital infections are as follows: July 2008, couple awarded $ 2. 58 million after the patient contracted a deadly type of staph infection ( MRSA), resulting in the loss of a kidney, and an amputated leg and foot. November 2008, jury awarded $ 13. 5 million to a woman’s family after she died of an infection aused by flesh-eating bacteria; contracted during cancer treatment. And November 2008, a woman reached a confidential settlement of $ 16 million when a hospital failed to detect a flesh-eating bacteria, before and after she gave birth, resulting in the loss of three limbs and several organs ( Gaffey, 2010). According to the AMA’s code of ethics, it is a requirement that a physician should at all times deal honestly and openly with patients concerning medical errors. Several doctors cite the risk of litigation as grounds for caution when discussing medical errors.Practicing defensive medicine such as ordering more tests or consults has become the norm to avoid malpractice suits. 94% of physicians say they would inform a patient if a mistake was made that caused an injury. Concern regarding legal liability which might result from telling the truth should not affect a physician’s honesty with a patient according to the AMA’s Code of Medical Ethics, however some skeptics maintain that it is easier to brag about virtue, than actually follow it ( Rice,2002).For the most part physicians agree that honesty is the best policy. Many doctors in a survey confessed to errors such as; prescribing the wrong medications, wrong dosage, misinterpreting x-rays, misinterpreting lab reports, etc†¦ One physician stated that being upfront about his mistakes, talking to the family, and apologizing probably avoided a lawsuit. Most doctors agree that it is better to be upfront about a mistake for several reasons, they are: 1. That it always comes out eventually, 2. Dishonesty causes more damage and loses the public’s trust, 3.Honesty decreases the chance of being sued, as well as it is the right thing to do, and 4. They want their patients or family to hear it from them first ( Rice, 2002). Communicating with the patient or family, educating them on the procedure and signs or symptoms to look for can prevent surgical site infections. Being open and honest with the patient and their family when an error occurs can possibly help to avoid a lawsuit. Honesty is always the best policy when providing quality health care.In October 2008, CMS announced that it would no longer pay for hospital-acquired conditions. It is their view that if a hospital has a good standard of practice and multidisciplinary care guidelines that these events should not happen and can easily be prevented. This is not to penalize health care, but to improve the safety of patient care and improve the quality of care by establishing standards of care and protocols. The Joint Commission has also implemented similar reporting and nonpayment initiatives to improve safety and improve the quality of care ( Lisa, 2009).The Joint Commissions new national patient safety goal to prevent surgical site infections includes a requirement to look for surgical site infections for up to 30 days after a procedure. The Center for Disease Control ( CDC) estimates that between 12% and 84% of surgical site infections are found after patients are discharged from the hospital. Joint Commission surveyors will be looking to see if the following protocols are being followed: * Hospital educates health care workers involved in surgical procedures about healthcare –associated infections, surgical site infections, and the importance of prevention. Before all surgical procedures, the hospital educates patients/family about surgical site infection prevention. * Hospital implements policies and practices aimed at reducing surgical site infections. * Hospital conducts periodic risk assessments for surgical site infections. * Measurement strategies follow evidence-based guidelines and surgical site infections are measured for the first 30 days after surgery. * Hospital supplies surgical site infection rate data and prevention outcome to leaders, practitioners, nursing staff, and other clinicians. Antimicrobial ag ents for prophylaxis used for a particular procedure or disease are administered according to standards and guidelines. * Administer I. V. antimicrobial prophylaxis within one hour before incision. * Discontinue the prophylactic antimicrobial agent within 24 hours after surgery. * When hair removal is necessary, use clippers or depilatories ( Hospital Infection Control, 2008). Localized improvement occurs when a team is developed to look at a specific problem; such as the rate of surgical site infections. Organizational learning occurs when this process is ocumented and results in the development of policies that are implemented; such as a protocol for preventing surgical site infections. Process reengineering occurs when a major investment blends internal and external resources to make changes; such as being accredited by the Joint Commission and following their guidelines for prevention of surgical site infections. Evidence-based medicine involves the selection of the best clinica l practices; implementing surgical site infection control guidelines or protocol to reduce cost and increase profit (Sollecito & Johnson, 2013).The most effective strategies for improving health care quality are: clinician-directed audit and feedback, clinical decision support systems, specialty outreach programmes, continuing professional education based on interactive small-group case discussions, and patient-mediated clinician reminders. Pay-for-performance strategies directed to clinician groups and organizational process redesign are modestly effective ( Scott, 2009). In my opinion using the organizational learning strategy would generate the best outcome and cost the least to implement.Having a team put together to gather data on surgical site infections and implementing a protocol or guidelines to follow to prevent these events would result in less cost and increased profit. In conclusion, surgical site infections are for the most part preventable. Following protocols or guid elines can greatly reduce surgical site infections. Educating staff, patients, and their families, can have a big impact on preventing surgical site infections and implementing these strategies reduces cost and increases profit. References: Adams, A. 2001). Preventing surgical site infection ( SSI): Guidelines at a glance. Nursing Management, 32 (8), 46-46. Retrieved from http://search. proquest. com/docview/231438710? accountid= 32521. Frances, A. G. ( 2005). Best-practice protocol is: Preventing surgical site infection. Nursing Management, 36 (11), 20-26. Retrieved from http://search. proquest. com/docview/ 231393974? accountid=32521. Gaffey, A. D. RN, MSN, CPHRM, FASHRM. ( 2010). Legal Implications of Healthcare- Acquired Infections. Retrieved from http://www. ahe. rg/ahe/conference/2010/content /092910/a. Lisa, M. S. ( 2009). Compliance with CMS â€Å" never events† billing requirements. Journal of Health Care Compliance, 11 (5), 33-36. Retrieved from http://search. proqu est. com/ docview/227916352? accountid=32521. Rice, B. (2002). Medical errors: Is honesty ever optional? Medical Economics, 79 ( 19), 63-72. Retrieved from http://search. proquest. com/docview/227734141? accountid=32521. Scott, I. (2009). What are the most effective strategies for improving quality and safety of healthcare?Internal Medicine Journal, 39 (6), 389-400. Doi:http://dx. doi. org/ 10. 1111/j. 1445-5994. 2008. 01798. x. Sollecito, W. A. & Johnson, J. K. (2013). Continuous quality improvement in health Care (4th ed). Sudbury, MA: Jones and Bartlett Publishers. ISBN: 9780763781545. The joint commission update for infection control: SSI goal: Look for infections a month after procedure. (2008). Hospital Infection Control, Retrieved from http://search. Proquest. com/docview/758852362? accountid=32521.

Xox Supply Chain

Answer the following questions in relation to Xbox case: Lee, Hau; Hoyt David W. and Holloway, Chuck, â€Å"Evolution of the Xbox Supply Chain† * Who are the various stakeholders for Xbox that formed the Microsoft ecosystem while developing the supply chain business strategy for Xbox? * What were the challenges faced by Xbox when it first launched Xbox? * How did this compare to the launch of Xbox 360? * Did they consider any changes in the supply chain? Essay: Xbox StakeholdersMicrosoft’s Xbox project was started by a group of gamers in 1999 so that they can also develop a gaming console which threatened the performance of the home PC market. The Xbox project consisted of both internal and external stakeholders who had either a direct or indirect â€Å"stake† in the project. These stakeholders include the Microsoft employees (i. e. , Xbox project team, Microsoft executives), shareholders, suppliers (e. g. , Intel, Nvidia), contract manufacturers (i. e. , Flextro nics, Wistron Corp, Celestica), game developers, designers (i. , Astro Studios), distributors, broadband providers, retailers and customers. The stakeholders of the Xbox project can be visualized in terms of their position in Microsoft’s extended supply chain, shown in Figure 1. 0 below. Figure 1. 0 Microsoft’s Xbox supply chain Challenges with Original Xbox Microsoft encountered many challenges when launching the original Xbox in 2001. To better understand the challenges in the original Xbox, we can adopt the SOSTAC (Situation analysis, Objective Setting, Strategy, Tactics, Actions and Control) approach.Situation Analysis. Microsoft did not have a presence in the gaming console market and was up against strong competitors which already had established markets such as Sony (Playstation) and Nintendo (GameCube). This competitive landscape put them in a position wherein they needed to develop a product that offered features that were comparable to existing products in th e marketplace which was perfectly priced to establish themselves in the market. Moreover, Microsoft recognized that it was critical to launch in time for the 2001 holiday eason to allow them to have a presence in the marketplace before they became up against the â€Å"next-generation product†. Thus, Microsoft’s early challenges came at a price of high production ramp up costs, where they needed to produce 100,000 consoles in a week in order to launch the new Xbox in time for the Christmas. Objective. The short-term objectives of developing the original Xbox was primarily aimed at entering the gaming console market, learning from the experience and paving way for the next generation of products. Strategy. Microsoft adapted a push supply chain strategy using an extended supply chain.They developed their products based on existing game consoles with added features, most of which were built to compete against Sony PS2. In addition to a having features similar to other gami ng consoles available in the market, the Xbox had other features such as allowing Xbox to play DVDs, and a built-in modem which in 2002 was used to launch Xbox live. Tactics. Microsoft lacked the competency in building hardware –neither did it have exposure to designing and manufacturing hardware that can be used as a game console nor did it have any experience with the game console market.Hence, Microsoft decided to form strategic partnerships with preferred contract manufacturers who can deliver the products for them because they did not have the time to deal with unproven vendors and risky designs. Actions. Microsoft also took into account the location of manufacturing facilities in their selection of contract manufacturers to allow to take into account the logistics of to shipping products quickly to the US and European markets and decided to find plants in Mexico and Hungary.Logistics is the time-related positioning or resource, or the strategic management of the total s upply chain. The supply chain is a sequence of events intended to satisfy a customer: It can include procurement, manufacture, distribution, and waste disposal, together with associated transport, storage and information technology(Chaffey, 2002). Microsoft’s Xbox had over one thousand (1000) components and forty-five (45) of which were critical components that was only available from a single supplier. The Xbox also required several parts with high technical performance requirements (e. . , processing speed, graphics resolution, memory requirement and internet access). The high dependence on Microsoft’s suppliers made it necessary to integrate the information exchange with its key suppliers. Thus, Microsoft decided to require co-investments from its suppliers and electronics manufacturing services (EMS) to improve the coordination among the various groups. This suggests that Microsoft recognized the need for using technology to improve the flow of information and adap ted some form of technology to manage the relationship with various intermediaries.Control. While the case did not provide enough data to see how Microsoft measured the outcome, it can be inferred from the changes they made to the launch Xbox 360 that they did some reviews internally so that they can make the necessary changes. Unfortunately, Microsoft had very little time to learn to how to manage the supply networks — â€Å"[t]he coordination of all supply activities of an organization from its suppliers and partners to its customers†(Chaffey, 2002, p. 335).While they adopted a push approach to supply chain management, which is typically suggests that the production processes are aimed at cost and efficiency, Microsoft was up against significant challenges that made it difficult to be cost effective. In the end, Microsoft’s investment in the Xbox is higher than the expected sale price of the product — i. e. , the costs for producing the Xbox hardware we re estimated to be at $450, when retail price for the Xbox was only at $299. 00. Profitability was therefore dependent on driving the costs down for the Xbox console and sales from selling games.Differences between Original Xbox and Xbox 360 and Supply Chain Changes Situation. When Microsoft launched Xbox 360, gaming had already become a big part of the home entertainment and broadband access was substantially higher. Microsoft also had a better understanding of what games were needed in each country because they had already established a presence in the market. Objective. Microsoft’s decisions on developing the Xbox 360 was no longer based on their desire to get into selling hardware and simply offering a gaming console, but more on their goal of increasing software sales.So, Microsoft developed the new system in such a way that can be a central part of home entertainment thereby incorporating other features such as internet access. Strategy. In launching Xbox 360, Microsoft planned a global launch, which no other company had done before, so that Xbox 360 can be made available in all major markets before Sony would have a chance to launch PS3. Implementing a global strategy posed two large risks for Microsoft. To mitigate this risk, Microsoft also implemented some risk management techniques. Risk management is intended to identify potential risks in a range of situations and then take actions to minimize risk† (Chaffey, 2002, p. 599). It involves several stages which include the identification of risks, possible solutions, implementing the solutions that target high-impact risks and monitoring them for the future. First, was related to the fact that the Xbox required complementary products for it to be enjoyed and their biggest concern was whether there would be sufficient game titles available at the same time. Thus, Microsoft lined up game developers who could develop new games.For this task, Microsoft had a better appreciation of game types ne eded in each country based on the original Xbox experience, nonetheless ensuring that the games were ready had various timing issues. The unavailability of games in a particular country would mean a decrease of sales of consoles and would have a significant impact on the profitability of Microsoft. Second, Microsoft faced the risk of success where the supply of gaming consoles would not be sufficient to keep up with demand. Foreseeable, this can manifest itself in different ways but both negatively impacting their ability to acquire new customers.This suggests that Microsoft recognized the implication of complementary products to allow them to take advantage of the network effects. For Microsoft, the worse case scenario is for Microsoft to miss customer expectations and put them at risk for losing their customers. Another scenario is if their demand calculations were off and end up with an over/under supply of gaming consoles in one area. Tactics. As soon as the original Xbox was la unched, Microsoft started working on the next generation of Xbox and required the new model to have high definition capability, high storage capacity and access to the internet.Unlike the earlier launch of the Xbox, where Microsoft delivered a superior product whose features that came at the expense of cost, Microsoft included cost considerations as part of their new strategy. This time, Microsoft also wanted to take advantage of the timing, pricing and exploiting the relationships with complementary product. Actions. Microsoft made three changes in its supply chain management to drive down costs: (1) change the location of its manufacturing facilities; (2) increase the number of EMS suppliers; and (3) chip contracting.First, when launching the original Xbox, Microsoft decided to select manufacturing facilities that were geographically near the customers in order to quickly deliver the products to facilitate fast product introduction. However, in launching Xbox 360, Microsoft decide d to take advantage of a less expensive option by switching the facility location from Mexico and Hungary to China. While this meant an increased risk in fulfilling orders in time for a global launch, the firm was able to leverage lower labor rates from a place where the infrastructure was already available for electronic manufacturing.Second, by permitting multiple EMS suppliers, Microsoft was able to ensure that they had enough manufacturers who would be able to fulfill the orders. This also provided the ability to negotiate as compared with being dependent on a single supplier at Xbox launch. This helped Microsoft manage the supplier vender lock-in that they had originally and arrest the possible increase in switching costs such as search costs, specialized suppliers, contractual commitment (Shapiro & Varian, 1998).Third, Microsoft decided that it was best to take ownership of the design of the chip (which was previously owned and designed by Nvidia and Intel) and source its parts from the supply chain. This disintermediation strategy in their supply chain made it possible for Microsoft to be in a better position to control costs over the product’s lifetime. Moreover, this strategy is consistent with what is usually referred to as an outside-in outsourcing activity so that they can build up skills internally and manage this area.Microsoft was also able to compress the design cycle by engaging in concurrent design development activities which included a closer link between and manufacturing, continuous testing and iterative redesign. This was a change from Microsoft’s original Xbox strategy which had significant system and supplier level lock-in effects for Microsoft because Nvidia and Intel owned and designed the chips. While the dual sourcing strategy minimized the risks of lock-in at the supplier level, they were still locked-in at the system level where Microsoft had to contend with any enhancements or changes in the design of the chips .Microsoft also used HDTV technologies that was available in the market, while Sony (being a hardware company) decided to bet on Blu-Ray to allow it to establish it as the new DVD standard for high-definition. In hindsight, Microsoft’s decision provided them a one-year head start in third generation consoles because Sony’s Blu-Ray decision caused a significant delay in Sony’s PS3 launch. By betting on Blu-Ray, Sony was betting on standards change to increase their competitive advantage. Control.As discussed previously, the case did not provide enough data to see how Microsoft measured control. Japanese Automakers’ Supply Chain Structures The disintermediation strategy that Microsoft took gives some insight to classic â€Å"make or buy† arguments that companies make in determining where to source their supplies. In contrast to Microsoft’s decision to do things themselves, â€Å"Japanese automakers apparently assume that quality, delivery, in ventories, and related costs can be better governed by the purchasing department in a buy situation, than by making it yourself. † (Deming, 1982, p. 7). However, for them to control the quality they require invariably have demanding expectations from their suppliers. The expectations include: (1) exceptional quality requirements; (2) reliable just-in-time deliver; (3) exact quantities – no over- or under-runs; and (4) continuously improving productivity resulting in long-term cost reductions (Deming, 1982, p. 48). In return for the high investments on the part of their suppliers, they have production contracts that are usually long-term (as long as six years), and may include requirements for product design and testing.For the Japanese automakers, they have â€Å"arms around relationship† where they embrace the lock-in effects with their suppliers instead of â€Å"arms-length transactions† which rely on the spot-market. The Japanese auto manufacturers are more likely to engage in vertical disintegration and outsourcing of processes to a network of suppliers. For example, in the case of Honda, they engage in strategic alliances with first tier suppliers whom they are said to have a strong â€Å"close relationship through shared history† (Choi & Hong, 2002, p. 78). They are said to have approximately 400 â€Å"core† suppliers and a number of indirect suppliers which all contribute to the production of 400,000 units of Accord models each year (Choi & Hong, 2002). Another example is Acura, where the structure of their network is very complex with 76 entities in the supply network (i. e. , 1 first-tier, 20, second-tier, 28 third-tier, 17 fourth-tier, 9 fifth-tier, and 1 six-tier) to produce their Acura CL/TL center console alone (Choi & Hong, 2002).Another example is Toyota, a company that is recognized worldwide for adopting lean management principles in its supply chain. Toyota has various stakeholders that con tribute to the success of the supply chain namely: Domestic Suppliers; Overseas suppliers; Parts Centers; Toyota Plants; Distributors; Kyohans; Dealers; Repair Shops; Parts Jobbers; Customers. SOSTAC Analysis of Toyota To better appreciate how supply chain strategies differ, we can also adopt the SOSTAC model to explain Toyota’s strategy. Situation Analysis. Toyota is an established car manufacturer that has been in existence since 1937.Toyota offers a full range of models – from mini-vehicles to trucks. Toyota believes that their long-term success is based on loyal customers. Toyota manages using the Toyota Way, which is underpinned by two pillars, continuous improvement and respect for people. Toyota believes that the Toyota Way should be used in interactions because they believe that their success is not created by individual efforts but rather as a team. Objective. Toyota’s supply chain objective is to establish strong links to its customers, dealers and cha nnels. Strategy.Toyota created an efficient network so that it can deliver excellent service to its customers. Their close interrelationship between various parts of the chain suggests that they engage in a pull strategy and their supply chain can be viewed in terms of Figure 2. 0 below. Figure 2. 0 Toyota’s supply chain Tactics. Toyota developed its own Toyota Production System where they introduced various manufacturing techniques such as Just-In-Time, Kaizen (continuous improvement). Toyota makes strategic alliance with its partners and puts an emphasis on long-term relationships.Toyota’s manufacturing processes is also developed so that each plant serves a local market and at least another market across the world. While this tactic can be seen as a logistical decision, it is also driven by various risk considerations. It is driven by a financial consideration so that it can hedge exchange-rate risks and shift production when exchange rates increase (Chopra & So dhi, 2004, p. 345). It is also driven by capacity considerations so that idle capacity is mitigated by ensuring that more than one market are supported by the plants to deal with demand fluctuations(Chopra & Sodhi, 2004).Action. Toyota ensures that both the upstream and downstream supply chains are highly efficient networks. For its upstream supply chain, Toyota not only engages in activities that ensure that information flows across its suppliers, but also engages in various activities geared toward promoting a shared network identity among its suppliers. More specifically, Toyota created network-level processes to ensure that they share a social community, network norms and knowledge (Dyer & Nobeoka, 2000, p. 352).To implement this, Toyota has established various supplier associations (kyohokai) since 1943 so that they can have â€Å"(1) information exchange between member companies and Toyota, (2) mutual development and training among member companies, and (3) socializin g events†(Dyer & Nobeoka, 2000). † For its downstream supply chain, Toyota is dependent on its dealers to distribute new and used vehicles, as well as servicing for its profitability. Toyota manages its dealers with three principles: (1) Independence of dealers as outside investors; (2) Winning jointly; (3) Encouraging competition among channels.This approach encourages their dealers to make independent decisions and be proactive in making improvements. Toyota help the dealers make decisions toward investing in areas necessary to improve so that they can be both successful. Toyota embraced lean manufacturing techniques to keep costs down. Not only do they apply these principles in their manufacturing of cars, but they also apply this in other areas of their supply chain. For example, they use kyohans to allow their dealers to maintain a low level of parts supply.The use of an intermediary to have a central control of parts allows the network some flexibility so that parts do not sit idly at dealers at the same time allow Toyota to move the parts to dealers that need them. Kyohans can order supplies of stocks once a day, and supplies them to the dealers 3-4 times a day. In case the stock is unavailable, kyohans can put in an emergency stock request which can be fulfilled by a domestic distributor within half a day to a day or an international distributor in under 5 days. Toyota also promotes continuous improvement through a concept they refer to as kaizen.This process allows them to improve their operations through innovation, organizational learning and standardization of processes. For example, a mandatory bi-annual inspections of cars for registration at the service facilities usually takes 2-3 hours. The length of time it took was largely dependent on skills and experiences of the service technician in charge of the inspection. After applying kaizen principles, Toyota was able to streamline and standardize the inspection process so that insp ections would only take 45 minutes. Control.Toyota conducts performance measurements at predetermined timeframes. For instance they do annual reviews wherein they apply some ranking and rating mechanism to evaluate their dealers. The dealers are measured in terms of sales volume of new and used cars, after-service sales service, customer satisfaction, number of showrooms, number of service centers, number of staff, and profitability. Discussion There are various approaches to managing the supply chain of a firm. The decision to adopt one over another is highly depended on the long-term strategic goals of the corporation.From the Microsoft’s Xbox case, we can see that sometimes firm make costly decisions in the process of launching a product to gain foothold in the market place. It is then ultimately up to the firm to learn form the process and as an organization learn from the experience and make the necessary changes. Microsoft adopted two distinct approaches in managing the ir supply chain based on their short- and long-term objectives. In the launching Xbox, they were highly dependent on the expertise of their suppliers so that they can launch the Xbox in time for the 2001 holiday sales.This enabled the firm to learn from their experience so that they can come up with a new strategy to launch the next generation gaming console. Microsoft’s disintermediation strategy appears to minimize lock-in effects with suppliers so that they can take advantage of spot-markets and ultimately lower their costs. Interestingly, in the case of Toyota, they took a very different approach from Microsoft even when their objective was also to minimize production costs. Instead of relying on spot-markets, they embraced lock-in and invested in long-term relationships with its suppliers.This approach allowed them to make continuous improvements across multiple suppliers by sharing knowledge and information among the upstream and downstream processes. The increased info rmation flows across the network was made possible by the use of various e-supply and e-demand applications. From the Toyota case, it can also be seen that a highly integrated supply chain that shares information, expertise across the firm can take advantage of minimized costs and profitability.It can also be gleaned from this case the importance of trust and respect because the members of the supply chain has access to critical information that can be detrimental to the other partners if opportunistic behavior arises. Chaffey, D. (2002). E-business and E-commerce Management: Strategy, Implementation and Practice. Essex: Pearson Education Limited. Choi, T. Y. , & Hong, Y. (2002). 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