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Case Study

Case Study:

Southwestern University: F The recent success of Southwestern University’s football program is causing SWU’s president, Joel Wisner, more problems than he faced during the team’s losing era in the early 1990s. For one thing, increasing game-day attendance is squeezing the town of Stephenville, Texas and the campus. Complaints are arising over parking, seating, concession prices, and even a shortage of programs at some games. Dr. Wisner, once again, turns to his stadium manager, Hank Maddux. This time, he needs a guaranteed revenue stream to help fuel the stadium expansion. One source of income could easily be the high-profit game programs. Selling for $6 each, programs are a tricky business. Under substantial pressure from Wisner, Maddux knows he has to ensure that costs are held to a minimum and contribution to the new expansion maximized. As a result, Maddux wants the programs for each game to be purchased economically. His inquiries have yielded two options. A local Stephenville printer, Sam Taylor of Quality Printing, has offered the following discount schedule for the programs and game inserts: Programs Weekly Game Detail Inserts 10,000 to 30,000 $2.00 each 10,000 to 30,000 $1.00 30,000 to 60,000 $1.90 each 30,000 to 60,000 $0.95 60,000 to 250,000 $1.80 each 60,000 to 250,000 $0.90 250,000 and up $1.50 each 250,000 and up $0.85 As a second option, however, First Printing, owned by Michael Shader, an S.W.U. alumnus in Ft. Worth, will do the job for 10% less as a favor to help the athletic department. This option will mean sending a truck to Ft. Worth to pick up each order. Maddux estimates that the cost of each trip to Ft. Worth will be $250. Maddux’s other major problem is he is never sure what the demand for programs will be. Sales vary from opponent to opponent and how well the team is doing that year. However, he does know that running out is a very bad idea. This football team is not only expected to make money for SWU, but it is also entertainment. This means programs for all who want them. With the new facility, attendance could be 60,000 for each of the five home games. And two of every three people buy a program. In addition to the programs, Maddux must purchase the inserts for each game. The inserts have information about the opposing team, photos of the expected starters, and recent game statistics. The purchasing issue is the same for inserts, except inserts will be purchased separately for each game and are a total loss after the game. The carrying cost, because inserts are to be delivered just as they are needed, should be nominal; he estimates 5%. The other costs and the same discount schedule apply, but the inserts only cost half as much because they are much smaller. First Printing will give the same 10% discount on the inserts. Givens: Annual demand is 300,000 (60,000 per game times 5 games) Set-up cost for programs is $1,000.00 Holding cost is 40%

DISCUSSION QUESTIONS 1. With whom should Maddux place the order for the programs, and how many should he order each time? 2. With whom should Maddux place the order for the inserts, and how many should he order each time? 3. What is Maddux’s total cost for programs with inserts for the season? 4. What other program management opportunities might Maddux pursue?

Solution:

1. With whom should Maddux place the order for the programs and how many should he order each time?

Answer:

D = 60000 * 5 * 2/3= 200000

H = 0.5 * unit price

S quality printing = 100

S first printing = 100 + .9*(200) = 280

For quality printing

Q = √2DS / IP

Q1 = √2(200000)(100) / 0.5*5 = 4000

Q 2 = √2(200000)(100) / 0.5*1.80 = 6667

Q3 = √2(200000)(100) / 0.5*1.70 = 6860

Q4 = √2(200000)(100) / 0.5*1.60 = 7071

Q4 = √2(200000)(100) / 0.5*1.40 = 7559

Q1 = 6928

Q2 = 11547

Q3 = 30000

Q4 = 60000

Q5 = 250000

Annual Product cost = Demand * unit price

Annual order cost = Demand* setup cost/order quantity

Annual holding cost = Order quantity * holding cost / 2

Number Unit Price Order quantity Annual Product cost Annual order cost Annual holding cost Total

1 5.00 4000 1000000 5000 5000 5000

2 1.80 10000 360000 2000 4500 366500

3 1.70 30000 340000 666.67 12750 353416.67

4 1.60 60000 320000 333.33 24000 344333.33

5 1.40 250000 280000 80 875000 367580

Order quantity of 60000 will minimize total cost to 344333.33

For first printing, Q = √2(200000)(280) / 0.5*5 = 6693

Total cost = Setup cost + holding cost + product cost

= 200000/6693 * 280 + 6693 / 2 * (0.5*5.00) + 6693*5

= 50198.20

So the order for the programs should be placed at quality printing as ordering quantity of 60000 each time

2. With whom should Maddux place the order for the inserts and how many should he order each time?

D = 60000

H = 0.5 * unit price

S quality printing = .5*100 = 50

S first printing = 0.5(100 + .9(200)) = 140

For quality printing

Q = √2DS / IP

Q1 = √2(60000)(50) / 0.5*2.5 = 12649

Q 2 = √2(60000)(50) / 0.5*.90 = 21082

Q3 = √2(60000)(500) / 0.5*.85 = 21693

Q4 = √2(60000)(50) / 0.5*.80 = 22361

Q4 = √2(60000)(50) / 0.5*.70 = 23905

Q1 = 6928

Q2 = 11547

Q3 = 30000

Q4 = 60000

Q5 = 250000

Annual Product cost = Demand * unit price

Annual order cost = Demand* setup cost/order quantity

Annual holding cost = Order quantity * holding cost / 2

Number Unit Price Order quantity Annual Product cost Annual order cost Annual holding cost Total

1 2.50 6928 150000 433.03 433 150866.03

2 0.90 11547 54000 259.81 259.81 54519.62

3 0.85 30000 51000 100 637.50 51737.50

4 0.80 60000 48000 50.00 1200.00 49250

5 0.70 250000 42000 12.00 4357 46387

Order quantity of 250000 will minimize total cost to 46387

For first printing, Q = √2(60000)(140) / 0.5*2.50 = 11593

Total cost = Setup cost + holding cost + product cost

= 60000/11593 * 140 + 11593 / 2 * (.05*2.50) + (11593 * 2.50)

= 30431.64

3.What is Maddux’s total cost for programs with inserts for the season?

The total cost for the program for the inserts for this season will be about $ 374764.97

4. What other program management opportunities might Maddux pursue?

Answer:

Maddux focuses on purchasing the game economically with a strong focus on quality printing, there are different program that maddux can pursue different programs, 10000 to 30000, 30000 to 60000, withna strong focus on first printing, Maddux. Muddux has high carrying cost because he lacks a good place to store the programs. He can’t put them in the office, or store them down in the maintenance department, where they may get dirty and damaged. So, the compnay needs to focus on reducing the carrying cost so as to have profits. Maddux needs to focus on inserts as well for the programs, so as to increase its revenue and sales.

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Case study

Case “A”

Irene Upton was a 29-year-old special education teacher who sought a psychiatric education teacher who sought a psychiatric consultation because “I’m tired of always being sad and alone.”

The patient reported chronic, severe depression that had not responded to multiple trials of antidepressants and mood stabilizer augmentation. She reported greater benefit from psychotherapies based on cognitive behavioral therapy and dialectical behavior therapy. Electroconvulsive therapy had been suggested, but she refused. She was hospitalized twice for suicidal ideation and sever self-cutting that required stitches.

Ms. Upton reported that previous therapists focused on the likelihood of trauma, but she casually dismissed the possibility that she had ever been abused. It was her younger sister how reported “weird sexual touching” by their father when Ms. Upton was 13. They had never been a police investigation, but her father apologized to the patient and her sister as part of a resultant church intervention and an inpatient treatment for alcoholism and “sex addiction.” She denied any feelings about these events and said, “He took care of the problem. I have no reason to be mad at him.”

Ms. Upton reported little memory for her life between about ages 7 and 13 years. Her siblings would joke with her about her inability to recall family holidays, school events, and vacation trips. She explained her amnesia by saying, “Maybe nothing important happened, and that’s why I don’t remember.”

She reported a “good” relationship with both parents. Her father remained “controlling” toward her mother and still had “anger issues,” but had been abstinent from alcohol for 16 years. On closer questioning, Ms. Upton reported that her self-injurious and suicidal behavior primarily occurred after visits to see her family or when her parents surprised her by visiting.

Ms. Upton described being “socially withdrawn” until high school, at which point she became academically successful and a member of numerous teams and clubs. She did well in college. She excelled at her job and was regarded as a gifted teacher of children with autism. She described several friendships of many years. She reported difficulty with intimacy with men, experiencing intense fear and disgust at any attempted sexual advances. Whenever she did get at all involved with a man, she felt intense shame and a sense of her own “badness,” although she felt worthless at other times as well. She tended to sleep poorly and often felt tired.

She denied use of alcohol or drugs and described intense nausea and stomach pain at even the smell of alcohol.

On mental status examination, the patient was well groomed and cooperative. Her responses were coherent, and goal directed, but often devoid of emotional content. She appeared herself as “numb.” She denied hallucinations, confusion, and a current intention to kill herself. Thoughts of suicide were, however, “always around.”

More specific questions led Ms. Upton to deny that she had ongoing amnesia for daily life, particularly denying ever being told of behavior she could not recall, unexplained possessions, subjective time loss, fugue episodes, or inexplicable fluctuations in skills, habits, an/or knowledge. She denies a sense of subjective self-division, hallucinations, inner voices, or passive influence symptoms. She denied flashbacks or intrusive memories but reported recurrent nightmares or being chased by “a dangerous man” from whom she could not escape. She reported difficulty concentrating, although she was “hyper focused” at work. She reported an intense startle reaction. She repeated counting and singing in her mind, repeated checking to ensure that doors were locked, and compulsive arranging to “prevent harm from befalling me.”

  1. What are the most likely diagnoses for this patient?
  2. What subjective and objective information leads you to these diagnoses?
  3. What is in your differential diagnoses?
  4. Is there anything else you would like to know in order to solidify your choice of diagnoses?

Case “B”

Peggy Isaac was a 41-year-old administrative assistant who was referred for an outpatient evaluation by her PCP with the chief complaint of “I’m always on edge.” She lived alone and never married or had children. She has no past psychiatric history of inpatient or outpatient treatment.

Ms. Isaac lived with her longtime boyfriend until 8 months earlier, at which time he abruptly ended the relationship to date a younger woman. Soon thereafter, Ms. Isaac began to agonize about routine tasks and the possibility of making mistakes at work. She felt uncharacteristically tense and fatigued. She had difficulty focusing. She also started to worry excessively about money and, to economize, she moved into a less expensive apartment in a less desirable neighborhood. She repeatedly sought reassurance from her office mates and her mother. No one seemed able to help, and she worried about being “too much of a burden.”

During the 3 months prior to the evaluation, Ms. Isaac began to avoid going out at night, fearing that something bad would happen and she would be unable to summon help. More recently, she avoided going out in the daytime as well. She also felt “expose and vulnerable” walking to the grocery store three blocks away, so she avoided shopping. After describing that she figured out how to get her food delivered, she added, “It’s ridiculous. I honestly feel something terrible is going to happen in one of the aisles and no one will help me, so I won’t even go in.” When in her apartment, she could often relax and enjoy a good book or movie.

Ms. Isaac said she had “always been a little nervous.” Through much of kindergarten, she cried inconsolably when her mother tried to drop her off. She reported seeing a counselor at age 10, during her parents’ divorce, because “my mother thought I was too clingy.” She added that she never liked being alone, having had boyfriends constantly (occasionally overlapping) since age 16. She explained, “I hated being single, and I was always pretty, so I was never single for very long.” Nevertheless, until the recent breakup, she said she had always thought of herself as “fine.” She had been successful at work, jogged daily, maintained a solid network of friends, and had “no real complaints.”

On initial interview, Ms. Isaac said she had been sad for a few weeks after her boyfriend left, but denied ever having felt worthless, guilty, hopeless, anhedonic, or suicidal. She said her weight was unchanged and her sleep was fine. She denies psychomotor changes. She did describe significant anxiety, with a Beck Anxiety Inventory score of 28, indicating severe anxiety.

  1. What is the most likely diagnosis for this patient?
  2. What subjective and objective information leads you to this diagnosis?
  3. What is in your differential diagnoses?
  4. Is there anything else you would like to know in order to solidify your choice of diagnosis?

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CASE STUDY

Answer each item at the cellular level using information using molecular biology content (neurotransmitters, hormones, etc.), and include anatomical areas affected and/or pathways. See the syllabus regarding 7th ed. APA use. Title page not required. Citations and a reference page required. Each written response must be numbered. 

 

Case

 

A 32-year-old female with a history of rheumatoid arthritis (RA) and RA associated paresthesia to hands and feet has a primary complaint of being depressed. She is currently a graduate student in an academic program and works part time at the university library. She reports finding it harder to keep course information in her head and has to reread a lot. Sometimes she feels so tired it’s hard to complete her school work. She mentions feeling stressed all the time. She gets more depressed and stressed when co-workers at her job and peers in her classes act like she is a slacker when she gets RA exacerbations. 

  1. Based on the reported manifestations, explain how chronic stress impacts the hippocampi.
  2. Explain why individuals with chronic pain develop depression.
  3. Explain how RA leads to neuropathic pain.
  4. Explain how systemic inflammation from her RA exacerbations increases her depressive symptoms?
  5. In speaking with her, you find out that she really does not go out with her friends or family. She has no desire to go out and when she does, she feels no pleasure or fun. She feels like she ruins everyone’s fun. Explain what may be occurring in the brain to manifest her lack of wanting to spend time with family/friends and to participate in social activities. 

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Case Study

Unit VI Case Study

The Scenario:

You are back at your plant the Monday after the Dangerous When Wet leaking tanker incident happened, and you are

telling your fellow HazMat Team Coordinator how you handled the situation. Before he has a chance to offer his opinion, a

call comes in over your radio that a forklift has punctured a 55 gallon drum at the door between the oxidizer storage area

and the production department. There is a spill, and no one is injured; however, the production employee does not know

what was spilled. You make an immediate page to all emergency response team members in the area, and then you head

out the door to the scene with your fellow HazMat Team Coordinator (the production department chief engineer). While en

route to the scene, you call the plant manager and apprise her of what you know and that you will report back as soon as

you have more information.

The incident command center can either be the production office or the conference room near the plant manager’s office.

In this case, your first choice is the production office.

The storage area building has multiple storage bays for oxidizers, flammables, acids, and bases. When you arrive near

the scene, you find the punctured drum on its side against a pallet of three other drums and a very small fuming cloud of

vapor developing from the area, but you cannot tell its exact point of origin. It turns out that the drums are just inside the

storage area building. You can see that the drums on the pallet have flammable labels. The fourth flammable drum has

been knocked off the pallet and is also lying on its side next to the punctured drum. The punctured drum has not been

identified at this point – it is a strong oxidizer, strong acid, or strong base raw material.

Questions:

1. How do you proceed?

2. What information are you after, how do you gather it, and what instructions do you provide for your team?

3. What hazardous situations are you and your team facing? If you need to, you can differentiate these situations

depending on the punctured drum being a strong oxidizer, strong acid, or strong base. Develop a brief priority list

and a brief action list for what you should do.

4. What, if any, restraints should you exercise?

5. What advice would you give to any other individuals coming upon the scene?

BOS 3640, Interactions of Hazardous Materials 4

6. Do you call for an evacuation of any, or all, of the plant itself? There are approximately 180 employees currently

on site during this first shift – located in different areas around the plant (i.e., administrative offices, shipping and

receiving, raw material bulk chemical storage, finished product bulk chemical storage, production operations,

packaging operations, labs, and production/engineering offices).

 

respond in the form of an essay, which should consist of several

paragraphs and appropriate priority or task lists. Responses should be supported fully and completely. A well-thought-out

response can be accomplished in 300-500 words (one or two pages, double spaced). Any published material used to

support a response should be cited per the APA style guidelines.

 

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