Comparison of Indirect Cost Multipliers for Vehicle Manufacturing Essay Example for Free

Comparison of Indirect Cost Multipliers for Vehicle Manufacturing Essay Disclaimer This report was prepared as an account of work sponsored by an agency of the United States Government. Neither the United States Government nor any agency thereof, nor The University of Chicago, nor any of their employees or officers, makes any warranty, express or implied, or assumes any legal liability or responsibility for the accuracy, completeness, or usefulness of any information, apparatus, product, or process disclosed, or represents that its use would not infringe privately owned rights. Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise does not necessarily constitute or imply its endorsement, recommendation, or favoring by the United States Government or any agency thereof. The views and opinions of document authors expressed herein do not necessarily state or reflect those of the United States Government or any agency thereof, Argonne National Laboratory, or The University of Chicago. COMPARISON OF INDIRECT COST MULTIPLIERS FOR VEHICLE MANUFACTURING INTRODUCTION In the process of manufacturing and selling vehicles, a manufacturer incurs certain costs. Among these costs are those incurred directly as a part of manufacturing operations and those incurred indirectly in the processes of manufacturing and selling. The indirect costs may be productionrelated, such as RD and engineering; business-related, such as corporate staff salaries and pensions; or retail-sales-related, such as dealer support and marketing. These indirect costs are recovered by allocating them to each vehicle. Under a stable, high-volume production process, the allocation of these indirect costs can be approximated as multipliers (or factors) applied to the direct cost of manufacturing. A manufacturer usually allocates indirect costs to finished vehicles according to a corporation-specific pricing strategy. Because the volumes of sales and production vary widely by model within a corporation, the internal corporate percent allocation of various accounting categories (such as profit or corporate overhead) can vary widely among individual models. Approaches also vary across corporations. For our purposes, an average value is constructed, by means of a generic representative method, for vehicle models produced at high volume. To accomplish this, staff at Argonne National Laboratory’s (ANL’s) Center for Transportation Research analyzed the conventional vehicle cost structure and developed indirect cost multipliers for passenger vehicles. This memorandum summarizes the results of an effort to compare and put on a common basis the cost multipliers used in ANL’s electric and hybrid electric vehicle cost estimation procedures with those resulting from two other methodologies. One of the two compared methodologies is derived from a 1996 presentation by Dr. Chris Borroni-Bird of Chrysler Corporation, the other is by Energy and Environmental Analysis, Inc. (EEA), as described in a 1995 report by the Office of Technology Assessment (OTA), Congress of the United States. The cost multipliers are used for scaling the component costs to retail prices. ANL METHODOLOGY The ANL methodology described here is based on an analysis concerned with electric vehicle production and operating costs (Cuenca et al. 2000; Vyas et al. 1998). The analysis evaluated the cost structure for conventional vehicle manufacturing and retailing and assigned shares of the manufacturer’s suggested retail price (MSRP) to various cost contributors. Multipliers developed from the ANL methodology are applied to the manufacturing cost of an individual component in order to scale the component cost to the retail price. Several cost contributors are included in the methodology, as summarized in Table 1. Some of the vehicle components for electric and hybrid electric vehicles would be procured from outside suppliers. This assumption is applied to electric drive components, excluding the battery; the vehicle manufacturer would produce the rest. Thus, two cost multipliers, one for the components manufactured internally and the other for outsourced components, are necessary to estimate the price of electric and hybrid electric vehicles. Outside suppliers would incur some of the costs normally borne by the vehicle manufacturer. In the ANL methodology, we assume that the costs of â€Å"Warranty,† â€Å"RD/Engineering,† and â€Å"Depreciation and Amortization† are borne by the Page 1 suppliers of outsourced components. The outside suppliers would include these costs in their prices. The following two cost multipliers are computed by using â€Å"Cost of Manufacture† as the base: Cost multiplier for components manufactured internally = 100/50 = 2. 00. Cost multiplier for outsourced components = 100/(50 + 6. 5 + 5. 5 + 5) = 1. 50. Table 1 Contributors to Manufacturer’s Suggested Retail Price in ANL Methodology Cost Category Cost Contributor Relative to Share of Cost of Vehicle MSRP Manufacturing (%) Vehicle Manufacturing Cost of Manufacture 1. 00 50. 0 Production Overhead Warranty 0. 10 5. 0 RD/Engineering 0. 13 6. 5 Depreciation and Amortization 0. 11 5. 5 Corporate Overhead Corporate Overhead, Retirement and 0. 14 7. 0 Health Selling Distribution, Marketing, Dealer 0. 47 23. 5 Support, and Dealer Discount Sum of Costs 1. 95 97. 5 Profit Profit 0. 05 2. 5 Total Contribution to 2. 00 100. 0 MSRP METHODOLOGY DERIVED FROM BORRONI-BIRD PRESENTATION In his presentation, entitled â€Å"Automotive Fuel Cell Requirements,† at the 1996 Automotive Technology Development Customers’ Coordination Meeting, Borroni-Bird included charts on the â€Å"Typical American Automobile: Price/Cost Breakdown. † The charts provided a graphical breakdown of vehicle price, showing cost contributors and profit. We used the charts to arrive at percentage shares of vehicle price by various contributors. Table 2 shows the resulting allocation. Page 2 Table 2 Price/Cost Breakdown Based on Borroni-Bird Presentation Cost Category Cost Contributor a Vehicle Manufacturing Fixed Cost Selling Sum of Costs Profit MSRP a Material Cost Assembly Labor and Other Manufacturing a Costs Transportation/Warranty Amortization and Depreciation, Engineering RD, Pension and Health Care, Advertising, and Overhead Price Discounts Dealer Markup Automobile Profit. Relative to Cost of Vehicle Manufacturing 0. 87 0. 13 0. 09 0. 44 Share of MSRP (%) 42. 5 6. 5 4. 5 21. 5 0. 10 0. 36 1. 99 0. 06 2. 05 5. 0 17. 5 97. 5 2. 5 100. 0 These two contributors are scaled to sum to 1 in the third column, as in Table 1. In his presentation, Borroni-Bird did not evaluate the treatment of in-house or outsourced components. His methodology does not lend itself to easy computation of cost multipliers comparable with those in the ANL methodology, unless we make a few assumptions. We have assumed that â€Å"Material Cost,† taken together with â€Å"Assembly Labor and Other Manufacturing Costs,† would form the â€Å"Vehicle Manufacturing† base for the in-house components. The costs of â€Å"Transportation/Warranty,† â€Å"Amortization and Depreciation,† and â€Å"Engineering RD† would be borne by the suppliers of outsourced components. However, â€Å"Amortization and Depreciation† and â€Å"Engineering RD† costs were merged with â€Å"Pension and Health Care,† â€Å"Advertising,† and â€Å"Overhead† costs by Borroni-Bird. We assumed that half of the costs under this category would be borne by the suppliers of outsourced components. Our assumptions led to the following cost multipliers: Cost multiplier for components manufactured internally = 100/(42. 5 + 6. 5) = 2. 05. Cost multiplier for outsourced components = 100/(42. 5 + 6. 5 + 4. 5 + 10. 75) = 1. 56. These cost multipliers are very similar to those computed with the ANL methodology. Comparison of ANL and Borroni-Bird Methodologies The information from Tables 1 and 2 is shown in terms of cost categories in Table 3. Both methodologies use vehicle manufacturing cost as the base and add other costs to it. The share of MSRP attributable to â€Å"Vehicle Manufacturing† is 50% in the ANL methodology, compared with 49% in the Borroni-Bird Methodology. Borroni-Bird combined several cost contributors under â€Å"Fixed Cost. † These contributors include (see Table 2) â€Å"Amortization and Depreciation,† â€Å"Engineering RD,† â€Å"Pension and Health Care,† â€Å"Advertising,† and â€Å"Overhead. † Except for the inclusion of â€Å"Advertising,† â€Å"Production Overhead† and â€Å"Corporate Overhead† in the ANL methodology can be combined to form an equivalent category. ANL’s total of 24% by production Page 3 and corporate overheads is slightly lower than the total of 26% by Borroni-Bird. The ANL category of â€Å"Selling,† which includes â€Å"Distribution,† â€Å"Marketing,† â€Å"Dealer Support,† and â€Å"Dealer Discount,† is broader than that of â€Å"Price Discounts† and â€Å"Dealer Markup† specified by BorroniBird, and this category’s contribution is understandably slightly higher in the ANL methodology. The share of MSRP by â€Å"Profit† is the same in both methodologies. The absolute differences, computed as ANL value minus Borroni-Bird value, are 1% for â€Å"Vehicle Manufacturing,† –2% for â€Å"Fixed Cost,† and 1% for â€Å"Selling† cost. Table 3 Comparison of Vehicle Price/Cost Allocation by ANL and Borroni-Bird Methodologies ANL Methodology Cost Contributor or Category Vehicle Manufacturing Production Overhead Corporate Overhead Selling Sum of Costs Profit MSRP EEA METHODOLOGY The methodology of Energy and Environmental Analysis is summarized in the OTA report OTAETI-638, entitled Advanced Automotive Technology: Visions of a Super-Efficient Family Car, published in September 1995. The values of some cost contributors are not listed in the report. Moreover, depreciation, amortization, and tooling expenses are assumed to be case-specific and therefore must be computed for each case. In order to make the EEA and ANL methodologies comparable, some assumptions were necessary. These assumptions are described in the summary below. The EEA cost equations can be simplified as follows: Cost of Manufacture = Division Cost ? [1 + Division Overhead] Manufacturer Cost = [Cost of Manufacture + Assembly Labor + Assembly Overhead] ? [1 + Manufacturing Overhead + Manufacturing Profit] + Engineering Expense + Tooling Expense + Facilities Expense Retail Price Equivalent = Manufacturer Cost ? [1 + Dealer Margin] Borroni-Bird Methodology Share of Cost Contributor or Category Share of MSRP (%) MSRP (%) 50. 0 Vehicle Manufacturing 49. 0 17. 0 Fixed Cost 26. 0 7. 0 23. 5 Selling 22. 5 97. 5 Sum of Costs 97. 5 2. 5 Automobile Profit 2. 5 100. 0 MSRP 100. 0 Page 4 The report lists the following values for overhead, profit, and dealer margin: Division Overhead = Supplier Overhead = 0. 20 (We assume that division and supplier overheads are equal; only the supplier overhead is given in the report. ) Manufacturing Overhead = 0. 25 Manufacturing Profit = 0. 20 Dealer Margin = 0. 25 Because the documentation in the OTA report does not provide values for â€Å"Assembly Labor,† â€Å"Assembly Overhead,† â€Å"Engineering Expense,† â€Å"Tooling Expense,† and â€Å"Facilities Expense,† cost multipliers cannot be computed directly from these data. The â€Å"Assembly Labor† and â€Å"Assembly Overhead† share of MSRP is 6. 5% in Borroni-Bird’s presentation. The engineering, tooling, and facilities expenses can be taken as the sum of â€Å"RD/Engineering† and â€Å"Depreciation and Amortization† from the ANL methodology, at 12% of the MSRP. In deriving the division cost and price relationship below, we use the term Retail Price Equivalent (RPE) from the OTA report instead of MSRP. The RPE can be computed as follows: RPE = = = {[Division Cost ? 1. 2 + 0. 065 RPE] ? 1. 45 + 0. 12 RPE} ? 1. 25 Division Cost ? 2. 175 + 0. 268 RPE Division Cost ? 2. 175/(1 – 0. 268) = Division Cost ? 2. 97 Putting ANL and EEA Methodologies on a Common Basis As it was described in the OTA report, the EEA methodology did not provide enough data to compute the cost multipliers. We assumed some cost shares to be the same between the EEA, Borroni-Bird, and ANL methodologies while developing the above relationship between Division Cost and RPE. The EEA methodology is based on the material and labor costs of a division of the vehicle manufacturer, with other costs added on. The ANL methodology evaluates an assembled vehicle, using the vehicle manufacturing cost as the base cost. The ANL methodology also assigns additional costs to the outsourced components, whereas the treatment of such components is not clear in the EEA methodology. We have attempted to develop a common basis for the ANL and EEA methodologies by assigning shares of the final vehicle price, RPE in the EEA methodology, to individual cost categories similar to those listed in Table 1. Table 4 presents such a summary for the EEA methodology. Three cost contributors, â€Å"Division Cost,† â€Å"Division Overhead,† and â€Å"Assembly Labor and Overhead,† are combined under the â€Å"Vehicle Manufacturing† category. Two cost contributors, â€Å"Manufacturing Overhead† and â€Å"Engineering, Tooling, and Facilities Expenses,† combine to form the â€Å"Overhead† category. The â€Å"Dealer Margin† in the EEA methodology represents a factor applied to all manufacturer costs and profit. We assumed that this factor represents all costs of selling the vehicle. Although the profit is computed at the manufacturing level by EEA, we moved the profit to the bottom of the table to be consistent with prior tables. The cost allocation in Table 4 allows us to compute the in-house components cost multiplier as follows: Cost multiplier for in-house components = 100/(33. 7 + 6. 7 + 6. 5) = 2. 14 Page 5 To compute the cost multiplier for an outsourced component, one more assumption is necessary. In the ANL methodology, we assumed that the supplier will bear the costs of â€Å"Warranty,† â€Å"RD Engineering,† and â€Å"Depreciation and Amortization. † However, the EEA methodology does not identify the warranty cost separately. We assumed it to be half of â€Å"Manufacturing Overhead† at 5. 05%. This, with the earlier assumption related to â€Å"Engineering, Tooling, and Facilities Expenses,† led to the following computation: Cost multiplier for outsourced components = 100/(33. 7 + 6. 7 + 6. 5 + 5. 05 + 12) = 1. 56. These multipliers, adapted from our extension of theE EA information on vehicle costs, are very close to those derived from the ANL and Borroni-Bird methodologies. Table 4 Contributors to Retail Price Equivalent in EEA Methodology Cost Category Cost Contributor a Vehicle Manufacturing Overhead Selling Sum of Costs Profit Manufacturing Profit Total Contribution to RPE a Division Cost a Division Overhead Assembly Labor and a Overhead Manufacturing Overhead Engineering, Tooling, and Facilities Expenses Dealer Margin Relative to Cost of Vehicle Manufacturing 0. 72 0. 14 0. 14 0. 22 0. 26 0. 49 1. 97 0. 17 2. 14 Share of RPE (%) 33. 7 6. 7 6. 5 10. 1 12. 0 22. 9 91. 9 8. 1 100. 0 These three cost contributors are scaled to sum to 1 in the third column, as in Table 1. Comparison of ANL and EEA Methodologies The information from Tables 1 and 4 is presented in terms of cost categories in Table 5 for easy comparison. The â€Å"Vehicle Manufacturing† cost share is 46. 9% in the EEA methodology, compared with 50% in the ANL methodology. EEA’s RPE share of 22. 1% by overhead is lower than the ANL value of 24%. The cost of selling is 22. 9% in the EEA methodology, which is close to the ANL value of 23. 5%. The largest difference is in the RPE share by profit, which is 8. 1% in the EEA methodology, more than three times the ANL value of 2. 5%. According to Economic Indicators: The Motor Vehicle’s Role in the U. S. Economy (American Automobile Manufacturers Association 1998), the average net income before taxes for the three domestic manufacturers was 3. 9% during 1994-1997. Aside from vehicle sales, this value (3. 9%) includes income from spare parts sales and vehicle financing. Thus, the profit share appears very high in the EEA methodology. The absolute differences – computed as ANL value minus EEA value – are 3. 1% for component/material cost, 1. 9% for overhead, 0. 6% for selling, and –5. 6% for profit. Page 6 Table 5 Comparison of Price Allocation by ANL and EEA Methodologies ANL Methodology Cost Contributor or Category Vehicle Manufacturing Production Overhead Corporate Overhead Selling Sum of Costs Profit MSRP SUMMARY An attempt to put three methodologies for automobile cost allocation on a common basis is presented in this technical memorandum. This comparison was carried out to verify the reasonableness of the cost multipliers used in ANL’s cost models for electric vehicles and hybrid electric vehicles. When put into a common format, by means of certain assumptions, the three approaches yielded the cost multipliers provided in Table 6. Table 6 Summary of Cost Multipliers Computed on a Common Basis Multiplier for In-House Components Outsourced Components ACKNOWLEDGMENT Funding for the analysis presented here was provided by the Planning and Assessment function of the Office of Transportation Technologies of the U. S. Department of Energy, managed by Dr. Philip Patterson. This technical memorandum is produced under U. S. Government contract No. W-31-109-Eng-38. REFERENCES American Automobile Manufacturers Association, 1998, Economic Indicators: The Motor Vehicle’s Role in the U. S. Economy, Detroit, Mich. Borroni-Bird, C. , 1996, â€Å"Automotive Fuel Cell Requirements,† Proceedings of the 1996 Automotive Technology Development Customers’ Coordination Meeting, U. S. Department of Energy, Office of Transportation Technologies, Washington, D. C. ANL 2. 00 1. 50 Borroni-Bird 2. 05 1. 56 EEA 2. 14 1. 56 EEA Methodology Share of Cost Contributor or Category MSRP (%) 50. 0 Vehicle Manufacturing 17. 0 Overhead 7. 0 23. 5 Selling 97. 5 Sum of Costs 2. 5 Profit 100. 0 RPE Share of RPE (%) 46. 9 22. 1 22. 9 91. 9 8. 1 100. 0 Page 7 Cuenca, R. M. , L. L. Gaines, and A. D. Vyas, 2000, Evaluation of Electric Vehicle Production and Operating Costs, Argonne National Laboratory Report ANL/ESD-41, Argonne, Ill. (to be published). Vyas, A. , R. Cuenca, and L. Gaines, 1998, â€Å"An Assessment of Electric Vehicle Life Cycle Costs to Consumers,† Proceedings of the 1998 Total Life Cycle Conference, SAE International Report P339, Warrendale, Penn. , pp. 161-172.

Hamlet’s Madness in Craft Essay example -- Literary Analysis

In Act I, Scene V, after hearing the ghost’s demand for revenge, Hamlet says in advance that he will consciously feign madness while seeking the opportune moment to kill Claudius. Therefore, it is hard to conclude that he coincidentally became insane after making such a vow. Hamlet’s supposed madness becomes his primary way of interacting with the other characters during most of the play, in addition to being a major device that Shakespeare uses to develop his character. Still, the question remains: Is Hamlet really crazy or just pretending? The major conflict which seems obscures the possibility of obtaining clarity on the answer to this question is Hamlet’s inability to find any certain moral truths as he works his way toward revenge. Even in his first encounter with the ghost, Hamlet questions the appearances of things around him and worries whether he can trust his perceptions, doubting the authenticity of his father’s ghost and its tragic claim. Since, he is contemplative to the point of obsession, Hamlet’s decision to feign madness will occasionally lead him perilously close to actual madness. Indeed, one might argue that because of this conflict, it is impossible to say for certain whether or not Hamlet actually does go mad, and, if so, when his feigning becomes reality. Conversely, Hamlet’s sharp and targeted observations lend significant credence to his feigning madness. Most notably, he declares, â€Å"I am but mad north-north-west: when the wind is southerly I know a hawk from a handsaw† (II.ii.361–362). That is to say, he is only â€Å"mad† when he is oriented in a certain way, but that he is lucid the rest of the time. Nevertheless, Hamlet confusion translates into an extremely intense state of mind that is highly suggestiv... ...mlet’s desire to attain Laertes’ pardon clearly represents an important shift in his mental state. Whereas Hamlet was previously self-obsessed and preoccupied with his family, he is now able to think sympathetically about others. He does not go quite so far as to take responsibility for Polonius’s death, but he does seem to be acting with a broader and more humane perspective after the shock of Ophelia’s death. In conclusion, perhaps it is worthwhile to ask this question: if a person in a rational state of mind decides to act as if he is crazy, in order to abuse the people around him regardless of whether he loves those people or hates them, and to give free expression to all of his most antisocial thoughts, when he starts to carry those actions out, will it even be possible to say at what point he stops pretending to be crazy and starts actually being crazy?

Oral Feeding Readiness Preterm Infants Health And Social Care Essay

What is meant by â€Å" unwritten eating preparedness in preterm babies? † This peculiar construct is frequently elusive, contextual, subjective and really complex when used with the preterm population of babies. It has besides been a subject of involvement for many old ages within the scene of the neonatal intensive attention unit ( NICU ) . The ability of a preterm baby to entirely unwritten provender is non merely a mark of competent unwritten eating accomplishments but is a necessary criterion for discharge preparedness from the NICU ( McGrath & A ; Braescu, 2004 ) . For nurses in the NICU the ability to orally feed a preterm baby is a many-sided undertaking necessitating successful attainment of a battalion of accomplishments: the proficiently to measure preterm baby eating accomplishments, clinical proficiency at preterm baby eating and proficiency in finding unwritten eating preparedness. On the other manus, the ability to orally feed is a complex undertaking for the preterm baby in the NICU every bit good. Questions often arise in the clinical sphere related to unwritten feeding preparedness of the preterm baby including those of physiologic adulthood, motor and province stableness, and the baby ‘s capableness of interactions with the environment and health professionals. All of these factors contribute to the underlying conceptual inquiry: should oral eatings be attempted? In embarking to reply this inquiry, a figure of instruments have been developed over the old ages to mensurate unwritten feeding preparedness of preterm babies in the NICU scene. Most of these instruments refer to the conceptual facet of unwritten feeding preparedness without specific usage of any theory as a footing for formal instrumentality. However, each of these tools was designed to help in supplying a clearer apprehension of the indispensable elements of unwritten feeding preparedness in the preterm baby as they apply to daily eating patterns. By integrating unwritten eating preparedness into NICU nursing pattern, intercessions that are grounds based can back up day-to-day nursing intercessions and will finally ensue in results that support infant good being and preparedness for discharge to place. Description of Instruments The unwritten eating preparedness tools being described were identified by seeking the PubMed, Ovid Medline and CINHAL databases for articles written in English and published between 1980 and 2011. The keywords used for the hunt were unwritten eating, preparedness, preterm, preterm eating measuring, feeding assessment tool and feeding instrument. The footings were used separately and in combinations. Electronic hunts produced three eating tools for preterm newborns related to bottle eating as the primary method of unwritten eating: the Early Feeding Skills Assessment ( EFS ) ( Thoyre, Shaker & A ; Pridham, 2005 ) , the Neonatal Oral-Motor Assessment Scale ( NOMAS ) ( Braun & A ; Palmer, 1986 ) , and the Oral Feeding Skills in Preterm Infants ( OFS ) ( Lau & A ; Smith, 2011 ) .The Early Feeding Skills Assessment for Preterm InfantsTheoretical Underpinnings The Early Feeding Skills Assessment ( EFS ) for preterm babies is a checklist for profiling a preterm baby ‘s developmental phase sing specific feeding accomplishments. It has been described as an â€Å" evidence-referenced tool † ( Sheppard & A ; Fletcher, 2007, p. 206 ) for detecting unwritten eatings by chest or bottle. Items on the checklist refer to theoretical facets of unwritten feeding preparedness: unwritten eating preparedness, ability to stay occupied in feeding, ability to organize swallowing and external respiration, ability to form unwritten motor operation, ability to keep physiologic stableness and unwritten eating recovery ( Sheppard & A ; Fletcher, 2007 ) . There is no published information sing a connexion between a peculiar theory and the beginning or design of the EFS. Instrument Data Collection The EFS is a thirty-six point experimental measuring tool that can be used from the â€Å" induction of unwritten feeding through ripening of unwritten eating accomplishment † ( Thoyre et al. , 2005, p. 8 ) . It is divided into three subdivisions: unwritten eating preparedness, unwritten eating accomplishment, and unwritten eating recovery. The EFS is scored based on observation of an full eating with each point holding scaled picks of yes-no, never-occasionally-often, or all-most-some-none. The first subdivision is the unwritten eating preparedness subdivision. This subdivision consists of five points and assesses whether the baby has province and motor control to back up orally feeding. If all replies to the five points are yes, the baby is fed orally. If the replies are non all yes, intercessions to fix for unwritten eating can be recommended and accordingly provided. The following subdivision is the unwritten eating accomplishment subdivision. This subdivision assesses four countries felt to be critical for successful eating: the ability to stay occupied during feeding ( three points ) , the ability to form oral-motor operation ( seven points ) , the ability to organize suck-swallow-breathing ( six points ) , and the ability to keep physiologic stableness ( 11 points ) . The unwritten eating recovery subdivision is three points that are completed five proceedingss after the eating session has ended and evaluates the impact of the eating on the baby ‘s province, motor and physiologic control. The EFS besides provides an country at the terminal of the signifier for feeding forms ( e.g. , type mammilla, length and volume of feeding ) and caregiver feeding schemes ( e.g. , chin support, cheek support ) . The method of hiting is non available in any of the published articles depicting the tool, nevertheless a preparation class for usage of the EFS is offered nationally by the instrument developers. Dependability and Validity Thoyre et Al. ( 2005 ) study that content cogency of the EFS â€Å" has been established with adept neonatal nurses and unwritten eating research workers † ( p. 8 ) and that â€Å" intra- and interrater dependability have been found to be stable and acceptable † ( p. 8 ) . The instrument ‘s developers besides report that prognostic, coincident and concept cogency are presently being tested. To day of the month, no informations sing any of these facets of the EFS has been published. Related Surveies Although this instrument has been available for usage since 2005, no surveies using or measuring the unity of this instrument were located in an electronic hunt of PubMed, Ovid Medline and CINHAL databases.Neonatal Oral Motor Assessment ScaleTheoretical Underpinnings The NOMAS was designed to place and quantify neonatal non-nutritive and alimentary oral-motor sucking forms by professionals that are specifically trained to utilize this instrument as a method of quantifying an baby ‘s oral-motor accomplishments. The theoretical underpinnings are those related to infant sucking accomplishments: most feeding troubles in preterm babies are caused by immature or unequal suck-swallow-breathe coordination and direct appraisal of suction and sup can be described by agencies of assorted non-invasive, experimental steps of physiologic parametric quantities. These theoretical underpinnings are the footing for the undermentioned three premises sing instrument result measurings of the NOMAS: ( 1 ) normal suction forms are displayed by babies who display coordinated suction, sup and breathe mechanisms during alimentary and non-nutritive suction, ( 2 ) a disorganised suction form may be displayed in the presence of an baby ‘s inability to organize su ction, sup and breathe mechanisms, and ( 3 ) a dysfunctional suction form may be displayed by baby ‘s exhibiting unnatural jaw and lingua motions, as is the instance with babies diagnosed with neurologic upsets ( Costa & A ; Schans, 2007 ) . Instrument Data Collection The current NOMAS instrument consists of a 28 point checklist placing features of jaw motion and features of lingua motion which organizes a newborn ‘s oral-motor forms during alimentary sucking into one of three classs: normal, disorganized or dysfunctional. The baby ‘s suction accomplishment is assessed by a trained NOMAS perceiver for two proceedingss during non-nutritive sucking anterior to feeding and during the first five proceedingss of regular eating. The trained NOMAS perceiver does non touch the baby, but simply observes the figure of sucking motions during one sucking explosion and the continuance of intermissions between turns of sucking. Jaw and lingua motions are besides analyzed as a constituent of the checklist. Observed oral-motor forms are marked on the listed behaviours and babies are classified into normal, disorganized or dysfunctional harmonizing to the behaviours that are marked. The hiting method has been revised several times since it was foremost reported by Braun & A ; Palmer in 1985 and badness evaluations for the disorganised and dysfunctional classs were included in the revised version, nevertheless, no numerical marking method is used to day of the month ( Howe, Lin, Fu, Su & A ; Hsieh, 2008 ) . Dependability and Validity In several dependability surveies, inter-rater dependability utilizing Cronbach ‘s i was found to be 0.93-0.97 ( Case-Smith et al. , 1988 & A ; Palmer et al. , 1993 ) . Test-retest dependability was determined by Case-Smith ( 1988 ) to be 0.67 – 0.82 when used in a survey of 26 babies with feeding jobs. Construct and prognostic cogency has been supported by multiple surveies for all classs of the NOMAS ( Braun & A ; Palmer, 1985 ; Case-Smith et al. , 1989 ; Howe et al. , 2007, & A ; Palmer & A ; Heyman, 1999 ) . Related Surveies There are several documented surveies that utilize the NOMAS instrument. The three that will be described here are current surveies that have been published within the past five old ages and are relevant to the usage of NOMAS with the preterm population of babies. In the 2007 survey by Howe, Sheu, Hinojosa, Lin & A ; Holzman, the NOMAS was used to mensurate unwritten motor accomplishments in order to find factors related to bottle-feeding public presentation in preterm babies. A sum of 116 preterm babies were included in the survey and research workers found that babies who need more unwritten support during eatings and those who have disorganized oral-motor accomplishments tend to take lower volumes of eatings orally. In contrast, babies with more feeding experiences are able to take higher unwritten volumes. These findings are of import in the designation of feeding experience and feeding techniques as being built-in constituents of a preterm baby ‘s unwritten eating public presentation. In Howe, Sheu, Hsieh & A ; Hseih ‘s 2007 survey sing the psychometric features of the NOMAS in healthy preterm babies, the writers examined the dependability, cogency and reactivity of the NOMAS in healthy preterm babies as the intents of the survey. The survey consisted of 147 medically stable preterm babies. Feeding public presentations were assessed and documented by an occupational healer trained in the disposal of the NOMAS. The writers concluded that the NOMAS demonstrated acceptable degrees of cogency and reactivity in preterm babies from 32 to 35 hebdomads postmenstrual age ( PMA ) but hapless cogency for babies 36 hebdomads PMA in the normal and disorganised classs. The writers suggested farther proof research in response to the findings of this survey. In Bingham, Ashikaga & A ; Abbasi ‘s survey ( 2010 ) using the NOMAS, 51 preterm babies were evaluated for correlativity of non-nutritive sucking accomplishments with subsequent feeding public presentation. The NOMAS marking was performed by NOMAS-certified healers and NICU nurses within 72 hours of successful induction of unwritten eatings. Findingss were implicative that NOMAS hiting at the induction of unwritten eatings was non significantly associated with the accomplishment of feeding milepost results being measured in the survey including clip from induction of unwritten eatings to clip of sole unwritten eatings.Oral Feeding Skills in Preterm BabiesTheoretical Underpinnings The developers of the OFS tool identify two basic theoretical underpinnings of unwritten eating that health professionals are faced with when turn toing the determination of unwritten feeding preparedness: the ability of the baby to finish the eating safely and the appropriate rate of promotion to sole unwritten eating. They propose that the OFS tool offers an nonsubjective index of an baby ‘s ability to orally feed by combing proficiency of unwritten feeding with minimum weariness and rate of milk transportation as a contemplation of feeding accomplishment ( Lau & A ; Smith, 2011, p. 64 ) . They do non depict a peculiar theory in connexion to the beginning or design of the OFS tool. Instrument Data Collection Data aggregation for the OFS is comparatively simple and no specialised preparation is needed. Caregivers document the prescribed volume of a eating in millilitres, the volume of feeding taken orally at 5 proceedingss into the eating, the full unwritten volume that is taken and the clip in proceedingss that it takes an baby to orally feed in that peculiar eating session. Proficiency ( PRO ) is calculated as the per centum entire volume taken in the first 5 proceedingss divided by the entire prescribed volume. The rate of milk transportation ( RT ) is calculated as the volume in millilitres ( milliliter ) that is taken orally divided by the figure of proceedingss to take this volume. PRO is so used to index existent eating ability when weariness is minimum ( within the first five proceedingss of unwritten eating ) and RT is used as an index of endurance ( being affected by weariness ) . The OFS tool is divided into four degrees runing from degree one to level four. Level one is low pr oficiency and low endurance, degree two is low proficiency and high endurance, degree three is high proficiency and low endurance and degree four is high proficiency and high endurance. A PRO greater than 30 per centum is defined as high proficiency while a PRO less than 30 per centum is defined as low proficiency. An RT greater than one and a half milliliter per minute is defined as a high endurance while an RT less than one and a half milliliter per minute is defined as low endurance. Potential intercessions are recommended for unwritten eating therapy at each accomplishment degree with the end of heightening existent eating accomplishment. Dependability and Validity To day of the month, no information sing dependability or cogency of the OFS has been published. The 2011 survey by the developers did show that OFS degrees had a important positive correlativity with an baby ‘s feeding public presentation and gestational age strata ( p & lt ; 0.001 ) and had a important opposite association with yearss from the start of unwritten eatings until independent unwritten eatings ( P & lt ; 0.002 ) ( Lau & A ; Smith, 2007, p. 68 ) . Related Surveies This instrument was ab initio described in 1997, nevertheless, the prospective survey published by the developers in January 2011 was designed for the intent of utilizing the EFS as an nonsubjective tool for the appraisal of a preterm baby ‘s unwritten eating accomplishments. No other surveies using or measuring the unity of this instrument beyond the initial development were located in an electronic hunt of PubMed, Ovid Medline, and CINHAL databases. DecisionRelevance to Future StudiesEach of the instruments antecedently described has advantages and disadvantages as an instrument for measuring unwritten eating preparedness. Both the EFS and the NOMAS necessitate specialised preparation in order to be able to utilize them as a valid instrument of unwritten eating ability, whereas the OFS is a simple tool that is designed for usage by any caretaker of preterm babies having unwritten eatings. Neither the EFS nor the OFS has been used in any published clinical survey nor do they hold published dependability or cogency grounds. The NOMAS, on the other manus, has been examined more thoroughly and has multiple internal consistence, dependability and cogency surveies to back up its usage. Another concern of all three instruments is that they differ in both the designation of measureable factors that contribute to readiness for unwritten eatings and in factors lending to success at unwritten eatings, doing comparings between these instrum ents hard. One common happening when measuring each of these tools, nevertheless, is the fact that unwritten eating preparedness is a complex construct affecting a battalion of factors for consideration. Instruments to help with the measuring of this construct demand to be consistent with their theoretical underpinnings and construct analyses in order to be able to supply consistent, valid and dependable results that can be farther utilized for future research and farther construct elucidation. Well-designed surveies are needed to measure the cogency and dependability of both the EFS and the OFS as instruments of mensurating unwritten eating ability. Research workers should besides see utilizing one of these instruments in future surveies to prove the feasibleness and effectivity of intercessions that are designed to back up unwritten eating preparedness. Awareness and understanding of indispensable elements of the construct of unwritten feeding preparedness in preterm babies is necessary and w ill supply for farther elucidation of unwritten eating preparedness. It will besides take to greater consistence in the proviso of evidence-based nursing attention during feeding times for preterm babies hospitalized in the NICU.Greatest LearningThis activity was much more complex and involved than I originally thought it would be. I was cognizant of the fact that there were several instruments to mensurate unwritten eating preparedness in preterm babies, but was non cognizant of the changing theoretical underpinnings and by differences between these instruments in really mensurating unwritten eating preparedness and differences in general construct elucidation. I was besides non cognizant of the preparation involved for the usage of some of these instruments, either. The necessary preparation is non merely an added disbursal, but it adds to the trouble in being able to implement their usage in a big NICU scene such as the one I presently work in. We have a staff of 127 staff nurses who routinely orally feed babes as a constituent of clinical nursing attention. It would be really hard, every bit good as dearly-won, to develop every nurse in a sensible sum of clip without even sing turnover rates and the demand to develop new staff every bit good. A simpler instrument such as the OFS would be of greater benefit to nursing staff given current staffing tendencies and nurse to patient ratios at feeding times. I besides now realize that in order for an instrument to be able to sufficiently mensurate a construct, the construct must hold been sufficiently analyzed and the instrument must be valid and dependable as a measuring of the construct at manus every bit good as being simplistic to utilize. If this does non go on, consequences have a much higher chance of being erroneous and so the construct that is being measured merely becomes more ill-defined.

Informative Speech Outline on Addiction to Prescription Drugs

Informative Speech – Topical Orientation General purpose: Addiction to prescription drugs Specific purpose: To inform my audience about the growing problem of prescription drug abuse, some common drugs that cause abuse, and their effects and some common treatments. Pattern: People living in today’s society must be aware about the dangers that prescription Drugs can cause them, as well as the people around them. Introduction: * Attention : Is it possible that you or someone you love is addicted to prescription drugs? * An estimated 48 million people according to the National Institute on Drug Abuse, have used prescription drugs for nonmedical reasons in their lifetime. According to†¦show more content†¦e. .anti depressants as well as anti anxiety they can cause sexual disfunction weight gain fatigue. with the use of these drugs it’s a chance you can be physically uncoordinated for the first few days until you build your tolerance. f. .stimulants can cause enhanced brain activity increase and llertness in energy elevated blood pressure increase heart rate increase respiration and sleep deprivation†¦. Ultimately these three drugs possess the same long term affect when abused; high potential for physical dependence and addiction. 3. Ways for physiciaisn patients and pharamasists to all play a role in identidying and preventing prescription drug abuse. g. . physicians- ask about any and all drug abuse; screening for prescription drug use can be incorporated into routine medical visits. Take note of of rapid increases in the amount of medication needed. f. patients follow directions and be aware of potential interactions with other drugs. Don’t just change your dose without discussing with your doctor first. Never use another persons prescription. Transition: .. B. . Why is prescription drug addiction on the rise? 1. Why is prescription drug addiction on the rise a. Doctors don’t exactly know how many people are addicted to pain medication, but one of the reasons so many people are is the availability. b. Vastly more peopleShow MoreRelatedDeveloping Management Skills404131 Words   |  1617 Pagesmanagement textbook, it is important that you understand its distinctive learner-focused features especially the five-step learning model: Skill Assessment, Skill Learning, Skill Analysis, Skill Practice, and Skill Application. You’ll also find informative research on how much managers’ actions impact individual and organizational performance, and the characteristics of effective managers. †¢ Thoughtfully complete the Skill Assessment surveys in each chapter. These diagnostic tools are designed toRead MoreExploring Corporate Strategy - Case164366 Words   |  658 Pagesfuturistic, electronic music of the gay clubs of Chicago and New York. The new style had been picked up by British DJs in Ibiza, who combined it with the drug Ecstasy to create a new ‘blissed-out’ sound. Dance music arrived in the UK during 1988, the so-called ‘Second Summer of Loveâ⠂¬â„¢, strongly associated with recreational drugs. By the early 1990s, drug-dealing in its most ugly sense had become part of the dance culture. Palumbo recalled: When I came into this business, with my bonuses and my nice City