Childhood Essay

Though many are of the view that childhood is the happiest time of a person’s life I do not think we can generalize it is so. Of cause childhood is a very enjoyable phase in a man’s life which is free from many responsibilities and challenges of the adulthood. However I believe there are several conditions that need to be satisfied for a happy childhood. First and foremost, a child should have loving and caring parents who could provide physical, emotional, social and intellectual needs of their child. How many children have such parents today? There are thousands of children raised by foster homes or orphanages. Most of these children have never experienced the love of their mothers or fathers. In fact many a them even do not know who their parents are. These children are often deprived from many privileges and rights of a normal child. We could also see that the numbers of single parents are ever increasing due to various socio economic reasons. It is a known fact that single parents have to struggle hard to raise their children without the help of their partner and in most cases they fail to provide necessary requirements of their children, especially with respect to emotional factors. The security of the child is another important factor that decides whether the childhood is a happy one or not. In my country there was a civil war which spanned for thirty years and fortunately became to an end in the last year. The children who were born during these thirty years of war were raised under its dark shadows. In most families, the fathers had to join the army to fight against the terrorists. Many did not return home leaving endless problems for their families. There were frequent bomb blasts directed on civilians by the terrorists and in many instances children were victims. Also the children in the areas under terrorist control were abducted by the terrorists to strengthen their carders. These children were completely deprived from all their rights as children. They were neither allowed to be with their loved ones nor to attend school. Instead they were given a gun and trained to fire at the enemy. They were taught to hate not to love. How can we say that the childhood is the happiest time for such children?

Grand Theory Written Assignment Essay

A grand theory is a systematic construction for the nature of nursing that has a clear mission and goals for nursing care. There are four categories of schools of thought within the realm of grand theories to include needs theories, interaction theories, outcome theories, and lastly caring/becoming theories. In the following tables I have highlighted a theorist from each school of thought and briefly discussed their educational background, my perception of their definition and philosophy of nursing, and the goal/purpose of their theory. Needs theorist Faye Abdellah Educational Background Faye Abdellah received her nursing education at Fitkin Memorial Hospital School of Nursing, Nepture, N.J. and graduated in 1942. She then went on to study chemistry at Rutgers University prior to receiving her Bachelor of Science, Master of Arts, and Doctor of Education degrees from the Teacher’s College of Columbia University, N.Y. Retrieved from http://fayeabdellah.blogspot.com/p/backgroud-publications.html Philosophy of nursing According to Meleis, her philosophy of nursing includes the use of problem solving approach to deal with 21 distinct problems related to needs of patients. She described a problem as a condition faced by the patient for which a nurse can assist, overtly and covertly. This is done by preventative care (to include hygiene, safety, exercise, rest, sleep, and body mechanics), sustenal care (psychological), remedial care (oxygen, fluid, nutrition, and elimination), and finally restorative care (coping with the illness and life adjustment). Meleis, A.I. (2012), p. 162-164. Definition of nursing â€Å"Nursing is based on an art and science that moulds the attitudes, intellectual competencies, and technical skills of the individual nurse into the desire and ability to help people, sick or well, cope with their health  needs† as stated by Faye Abdellah in her Twenty-one Nursing Problems theory (1960). Goal/purpose of theory To help the individual or patient meet health needs and adjust to their health problems. Meleis, A.I. (2012), p. 164. Interaction theorist Hildegard Peplau Educational Background Hildegard Peplau graduated from the diploma nursing program Pottstown, PA in 1931 and went on to be a staff nurse. Peplau then was recommended to work as a school nurse at Bennington College located in Vermont. While working there she earned her Bachelor’s Degree in Interpersonal Psychology in 1943. From there she went on to earn her Master’s and Doctoral degrees from Teacher’s College of Columbia University. In addition she became certified in psychoanalysis thru the William Alanson White Institution of New York City. Retrieved from http://nursing-theory.org/nursing-theorists/Hildegard-Peplau.php Philosophy of nursing Peplau’s philosophy of nursing focused on harnessing energy psychological disturbances such as anxiety and tension to define understanding with patients and deal with the problem at hand. She felt the goals of nursing included developing patients personalities to make illness an eventful experience. She felt nurses need to develop problem-solving skills via the interpersonal process (educational, therapeutic, and collaborative). Definition of nursing Peplau’s concept and view of nursing is that it is a therapeutic, interpersonal, goal oriented process that is a healing art. It involves recognizing and assisting the patient (individual who is ill or in need of health care) in achieving a common goal. This requires the nurse and patient to build a trusting relationship by way of orientation, identification, exploitation, and resolution (the phases of growing an interpersonal relationship). Meleis, A.I. (2012), p. 165-166. She identified the many roles that nurses must take in order to have a meaningful relationship with  patients and that nurses must understand the relationship to provide good care. Goal/purpose of theory The ultimate goal of Peplau’s theory was to understand the principles of interpersonal relationships between the nurse and patient in order to facilitate problem solving skills. This is to be done by using education and positive interactions. She went on to explain the seven nursing roles (stranger, resource, teacher, counselor, surrogate, and technical expert). These roles can be applied in different situations to provide the best care possible and goal attainment. Retrieved from http://nursing-theory.org/theories-and-models/peplau-theory-of-interpersonal-relations.php Outcomes theorist Callista Roy Educational Background Sister Callista Roy graduated with her first degree; Bachelor of Arts in Nursing from Mount St. Mary’s College in California in 1963. Then in 1966, she went on to obtain her Master’s Degree in Pediatric Nursing from the University of California. In addition she earned a Master’s Degree in Sociology in 1973 and Doctoratal degree in Sociology in 1977. Retrieved from http://nursing-theory.org/nursing-theorists/Sister-Callista-Roy.php Philosophy of nursing From what I can see from Roy’s writing’s she believes that the focus of nursing to her is a focus on clients’ stimuli and the effect it has on them for adaptation. Adaption modes include physiologic, self-concept, role function, and interdependence. Goals of nursing include promoting these changes/adaption in the above mentioned areas by way of manipulating the stimuli (focal, residual, and contextual) by way of positive coping. ). Meleis, A.I. (2012), p. 169-172. Definition of nursing Callista Roy is known to believe that nursing is a system of knowledge based on theory that views the client (sick or potentially sick) as a biopsychosocial being. Clients adapt to changes within their environment and as nurses we provide care through the nursing process to help promote  adaption to state of well-being. In order to do this we must ensure that the client have effective coping mechanisms and responses to avoid disruption in the integrity of the client. Goal/purpose of theory The goal and purpose of Roy’s theory is to promote client adaptation by nursing interventions such as facilitation of adaptive tasks via counseling, effective nurse-client communication, health education, active manipulation, support, and by identifying resources for the client. Roy states that by adapting that the patient is then freed for â€Å"him to respond to other stimuli which may be present† The Roy adaptation model: Comment (as sited by Meleis, A.I. (2012), p. 494. Caring/Human Becoming theorist Rosemarie Parse Educational Background Rosemarie Parse initially was educated at Duquesne University of Pittsburgh. She then went on to get her MSN and Ph.D. from the University of Pittsburgh. Philosophy of nursing The goal of nursing to Parse appears to be co-creating meaning and finding way of being. This is done by not focusing on the illness or problem in itself, but by transforming in new ways deliberately through the human universe process. Nurses are to illuminate meaning, synchronize rhythms and mobilize transcendence by connecting and truly understanding and being present with patients. Decision making is done together with the patient and nurse. Meleis, A.I. (2012), p. 172-174. Definition of nursing Parse’s definition of nursing is that it is a human science and art that uses knowledge to help people. Nurses should not focus on fixing problems, but rather view the patient as a whole living experiences through their environment which help them evolve. She believes that nurses must help guide patients co-create their own health and deal with illness. Goal/purpose of theory The goal or purpose of Parse’s Human Becoming Theory of Nursing is to focus of the quality of life from each separate person’s perspective. It does not focus on bio-medical or bio-psycho-social-spiritual approaches as with most  theories, but instead views the patient as a person and combination of all aspects. Retrieved from http://nursing-theory.org/nursing-theorists/Rosemarie-Rizzo-Parse.php I agree with all of the above listed schools of thought and have incorporated each in my own personal nursing care practice. Abdellah thoughts that nursing is centered on problem solving on the needs of patients in order to assist them in restoring health are near and dear to my heart. Depending on the field you work in this can include a multitude of cares. I personally work mainly in obstetrics and medical aesthetics. In the obstetric realm I provide care to help patients have a happy and healthy delivery of a child whereas in my medical spa my goal is help clients improve their aesthetic appearance, thus helping them feel more attractive and confident. Both have a goal, although widely different. This school of thought mostly is incorporated in my obstetric care as I assist patients to understand and incorporate preventative care, sustenal care, remedial care, and obviously restorative care as becoming a parent is a huge adjustment in life. Peplau brought out the importance of building a therapeutic interpersonal relationship with patients in order to facilitate their skills in coping with the problem at hand. Peplau’s interaction school of thought is also very congruent with my nursing philosophy as I feel it is of upmost importance to build a solid trusting interpersonal relationship with patients/clients no matter what area of nursing one is working in. Without doing so, the patient/client will not believe and trust what we are trying to accomplish with them. The event of birthing a child and learning how to care for them is a very personal process where the nurse-client relationship is of upmost importance. Also in aesthetics the client must feel comfortable with me as a nurse in order to trust me in helping them attain their goals. Roy’s theory is seeding in the outcomes school of thought which is also easy to incorporate into nursing care as adaption is required with all processes of life. As nurses we truly do help our clients adapt to their health  status and can assist them to become able to care for themselves independently. In obstetrics parents must adapt to having and caring for a newborn infant. The mother has been thru months of adaption to being pregnant, and now must instantly step into a new role that is often times scary and confusing! As a nurse I am responsible to ensure that they are prepared and adapting to this change prior to discharge. Lastly the caring/human becoming school of thought is probably the most utilized type of grand theory that I personally use. Parse points out that we should not focus on â€Å"fixing† the problem, but concentrate on the whole of the patient including experiences lived and how this has helped them evolve. Basically we must think of the patients’ quality of life, especially from the patients’ point of view. This can be applied in all fields of nursing as we strive to help patients have the quality of life that they want and deserve. In conclusion I’d like to think that as a nurse I practice from a variety of theories to incorporate the best, quality care possible for patients no matter what the purpose of treatment may be. I try to tailor my approaches taking into account their medical history, environment, and family. Nursing is ever changing and so is the patient population. We must as nurses continue to educate ourselves and evolve with time, never becoming stagnant. References Abdellah, F. G., Beland, I. I., Martin, A., & Matheney, R. V. (1960). Patient-centered approaches in nursing. New York: Macmillan. Meleis, A.I. (2012). Theoretical Nursing Development & Progress, Fifth Edition. Philadelphia, PA: Wolters Kluwer Health | Lippincott Williams & Wilkins. http://fayeabdellah.blogspot.com/p/backgroud-publications.html http://nursing-theory.org/theories-and-models/peplau-theory-of-interpersonal-relations.php http://nursing-theory.org/nursing-theorists/Hildegard-Peplau.php http://nursing-theory.org/nursing-theorists/Rosemarie-Rizzo-Parse.php http://nursing-theory.org/nursing-theorists/Sister-Callista-Roy.php

9-11 Commission Report

The 9/11 commission report was released to give all the information on what occurred on the attacks of September 11. In the commission report it gives information on why the towers were attacked and who was the main suspect. Osama bin laden and Al Qaeda are the ones blamed for the attacks. Since then America isn’t the same anymore. Now we have 24 hour protection from any terrorist risks. Since 9/11, no one has ever been the same. The airports are now really strict on anything that gets on the plane. We have spent a lot of money in our economy on the war on terror. Terrorism has brought a lot of racism and discrimination to Arab people in America. Since people from the Middle East have been pointed out as the main terrorist everyone here thinks that anyone wearing a turban is a terrorist. The way it has affected me is now I see the world different. Now anywhere in the world there can be an attacked on anyone from any ethnic group or religious background. I know that terrorist is a real thing happening in the world and no one can argue that we do not need any protection. The 9/11 commission and the news keep us updated on any terrorist activity. The good thing about having information and security from terrorist is that it keeps us safe and prevents tragedies like the one that happened on September 11th. The bad thing is that I’ve been hearing in the news that a lot of people are not comfortable with the pat down in airports because people feel violated. The screening that they do makes the public feel uncomfortable because their private areas are shown. I necessarily don’t care if they see me naked because I have nothing to hide and I want to get on a plane safe and I hope everyone else has a safe flight. I’m ok with armed air martial’s being on the plane too, you can never be too safe.

Factors that Affect Job Performance Research Paper

Factors that Affect Job Performance - Research Paper Example Factors affecting employee performance include internal factors and can easily be controlled by the management, while the external factors happen outside the organization but affect the organization in one way or another. Exemplary performance by employees is attributed to positive factors that include conducive work environment, effective and efficient skills, proper management team and encouragement among others. In every organization, there exists positive and negative factor, both of which contribute to performance of employees. Positive factors can be maintained within the organization and improved, whereas the management can eradicate negative factors. II. Managerial Standards In an organization, the management team is charged with the responsibility of ensuring proper allocation of resources and tasks to achieve goals and objectives of the organization (Spector, 2008). The managerial team within the organization controls particular sections or departments within the organizati on. As the head of a department or a section, the manager implements short term objectives and strategies to help him or her achieve overall goals of the organization. While executing these functions, they encounter various barriers along the way. The quality of managerial standards is defined by the ability of the management team to overcome these challenges while at the same time ensuring conducive work environment to employees (p. 115). The quality of management influences job performance either positively or negatively depending on various factors. For instance duties assigned to employees on the basis of their skills and knowledge leads to positive results, hence good performance. On the contrary, managers may assign jobs to employees regardless of their academic qualification and too many and high expectations (p. 115). Assigning tasks to employees not in line with their academic qualifications, skills and experience leads to stress leading to poor performance. Too many and hi gh expectations tend to cause panic and stress among employees, hence poor performance. This not only serves as frustration to the management but also demoralizes employees, hence further decline in the performance of the overall organization (p. 116). III. Motivation Motivation depicts measures that the organization can implement to improve employees’ morale in performing their duties. There exists various forms of motivation that when implemented by the management, can help boost and improve job performance. Motivated employees feel part of the organization as their contribution is counted as a significant portion towards the organization’s success. In organization where employees are not given any form of motivation, there are delays in all departments among other fouls resulting to poor job performance. These employees feel excluded and undervalued as there are no incentives given for them to work hard (p. 114). IV. Conducive Environment A favorable work environmen t entails provision of suitable conditions within the organization. The management should work towards provision of acceptable working conditions that allow employees carry out their duties effectively (p. 118). For instance, each job should be allocated to enough time and employees provided with the right king of equipment to help them accomplish various tasks assigned. The management should take correctional measures to provide employees with an environment that is free from

Explain the reasons why left realism emerged Essay

Explain the reasons why left realism emerged - Essay Example Therefore, to fill in the radical vacuum that was prevalent in left-realists thoughts regarding crime, the left-realists had to take a position. This was meant to balance the extreme ideas regarding crime, which were being advanced by the right-realists on the one hand, and the left idealists, on the other hand (Young & Matthews, 1992). Upholding the view that crime was a matter of free will and personal choice as opposed to a behavioural problem, the left-realists emerged to criticize the politics of establishing longer sentences and more prison facilities (Matthews &Â  Young, 1986). Rather than addressing crimes through the concentration of criminals in prisons and rehabilitation centres, left realism advocated for the political class to take the causes of crime seriously. Further, the concept of left realism required that victims of crime must be taken even more seriously, considering that the fear of crime is not irrational, and everyone stands the chance of being a victim of crime (Lea, 2002). In this respect, the left-realists sought to criticize the distorted view that was being advanced by the right-realists and the left idealists. While the right realists cited crime as a function of a sick society full of moral decay and crime that is out of control, the left idealists did not take crime seriously, and thought it was simply a form of exaggerated societal panic (Lea & Young, 1984). The major focus of left realism is the victim, who should be the main concern of criminology. The left-realist also advances the view that it is out of the prevalence of unstructured inequality and perceived social injustices, that crime finds a breeding ground to grow and thrive (Matthews &Â  Young, 1986). Thus, left realism regards the establishment of better and equitable policies as a means of addressing the crime problem. The view of left realism is

Argument about smoking in malls Assignment Example | Topics and Well Written Essays - 750 words

Argument about smoking in malls - Assignment Example The World Health Organization (WHO) estimates that over 47 million people in the United States aged above 18 years smoke, and as a matter of fact, over half of this population will suffer disabilities or die (Berton, 2006). Smoking should be banned in malls, as the consequences suffered from smoking and secondary smoking are far too grave. Effects of secondary smoking to non-smokers in Malls Secondary smoking is a condition in which non-smokers inhale smoke from smokers’ act of smoking in public places. Research shows that over 4000 compounds are contained in second hand smoke from smokers of which 200 are poisonous. This is a dangerous trend as the smokers not only put there health in danger but also jeopardize the health of the individuals in the mall. Should the banning of smoking be implemented in malls, many lives would have been rescued from the impending danger that these secondary smoke pose to the general public that use the mall, including children of all ages that s eek various services from the many amenities that are hosted in a mall (Patrick, 2008). A demerit will however be to the businesses in the malls that sell cigarettes. The banning will probably mean that malls will be a no smoking zone, quickly diminishing the market that would be available for the cigarettes that many business premises carry out in these malls. This will also translate to a lot of losses that the government gets from hefty revenues that governments get from the sale of cigarettes. Probable steps in reducing the population that smokes A large fraction of the population worldwide is known to smoke. It is reported that a third of the entire male population worldwide smokes. A lesser statistic is however documented for female smokers though it is steadily rising. By banning smoking or introducing stringent measures about smoking in malls, a large population is bound to eventually lose the habit. This would be a big step to most countries as the number of diseases that a re related to smoking cases is so alarming. It is also established that smoking kills one out of 10 that die globally. There is no doubt at all that reducing the numbers via such an action would prevent numerous deaths and fatal ailments that smokers usually undergo but won’t just stop due to the addiction suffered (Joelle, 2002). The reduction of smokers will however cause a big blow to the manufacturing industries, the government for its revenue and advertising houses that all make huge profits from activities related to smoking or cigarettes in general. There is also a danger of withdrawal symptoms that will be exhibited by most ex-smokers, a condition that always cause irritability and the reduction of concentration, factors that may really affects ones daily activities. Reduced Influence on underage Children and Teenagers Even though it is recorded that a majority of teenagers get into smoking as a result of peer pressure from fellow peers, a large percentage can be infl uenced into the habit just by public exposure in places like malls and public parks. It becomes worse when they see an influential figure publicly smoking in a mall; something that will make them conclude that the habit is cool. Apart from just the influence, teenagers and children are also prone to health hazards that might be impacted by secondary smoking. Should smoking be banned or limited in malls, many kids are bound to escape forced introduction into

Paradise Essay Example | Topics and Well Written Essays - 750 words

Paradise - Essay Example These days, we use it as a getaway since none of the member of my family is interested in hunting. A night in the cabin is a wonderful and peaceful experience, the sound of night birds and sometimes a cool breeze lulls you to sleep gently so that I not I fall asleep feeling as if the wild is inside with me, but not in a fearful but natural and comforting way. The cabin is made of logs, and it has seen better days, however as I said paradise does not have to be perfect in the sense of the word. In the morning, rays of; sun stream merrily trough the some of the crack in the walls and make incredibly beautiful patterns and with dust particle seemingly dancing in the light which appear to be carrying them like long super thing multicolored florescent bulbs. Then there is the music, in the morning here, birds seem to set up an orchestra, and one wakes up to the most melodious and sweet music imaginable, birds crowd the bird feeder at the back of the house. As they feast, on whatever I had put out for them the previous night, their singing more than makes up for the trouble. At the cabin, there is no telephone or electricity and I have to depend on lanterns and a wooden fire, under other circumstances, I would find this tedious, but here it simply adds novelty to the adventure and makes it more romantic. For breakfast, I normally have fried bacon and coffee the latter, which I cook using an old-fashioned skillet that used to belong to my grandfather. Most of the times when I go to the cabin, I spend the day wandering around in the neighboring woods often snapping pictures and enjoying the idyllic life of woodsman. Apart from my camera the only other gadget, I allow myself is an iPod on which I sometimes listen to my favorite songs as I watch the sunset from one of the hammocks at the back of the cabin. While the cabin holds its own unique thrills, the highlight of any visit is in the long walks I take through the woods, my favorite is a path I transverse the wood for about 4 miles and ends up at a beautiful waterfall. I often set off after breakfast at around 7 am as I slowly make my way downwards, I often stop to admire the flowers as they blossom in their thousands of different colors all, which I take in with new wonder each time I see them. The morning dew glistens and the yellow rays of the new sun reflect on them forming kaleidoscopes that simply astound me. The earth is soft since it is rarely trodden on, on the leaves of the many overhanging trees, as a result of deficient sunlight reaching the soil has a sweet dump smell that reminds me of the smell that results when sudden rain hits parched earth. The soil is mostly dark almost blackish and soft enough to make one feel like they are walking on cotton, but not damp enough to be muddy. The flowers different scents added to this make it a cocktail of the sweetest and freshest smells I very get to experience. I often walk this way for a few hour, and I take many pictures, which often end up adorning my desktop others some posters on my walls back home. The woods thin out as I approach the river and by this time the sun is beginning to be a bit too hot, but this doesn’t bother me in the least since I k now I will soon find respite, from the heat. From afar, the waterfall looks almost like a cutout from a Disney world movie, and one almost expects it to fade away and give way to something

Defense Budget and Sequestration Assignment Example | Topics and Well Written Essays - 1250 words

Defense Budget and Sequestration - Assignment Example An extra $88.5 billion is required for ongoing military operations, chiefly in Afghanistan( Klein, 2013). The FY 2013 budget requirement is the first budget proposal subsequent to the enactment of the Budget Control Act (BCA) OF 2011. The BCA establishes the budget limits for the unrestricted component of the federal and integrates an enforcement tool, understood as a sequestration, devised to cut spending by design. The BCA as well was responsible for creating the Joint Select Committee on Deficit Reduction, generally referred to as the Super Committee; furthermore, the BCA charged it with establishing an extra $1.2 trillion in deficit minimization over the foreseeable decade. Since the Super Committee failed to arrive any consensus on extra deficit minimization, the constitution requires that the budget limits be reduced to accomplish the $1.2 in the debit diminution through spending cuts. Just of a half of these reductions pertain to the budget explanation for national defense and the other remaining part pertains to non-defense accounts(Klein, 2013). Most estimation suggests that the United States is on the brink of shaky monetary path under the present federal tax and prerogative regimes. The lack of essential reforms many pundits say that the nation’s increasing debt poses a great long-standing threat to the United States national security, and that Pentagon’s budget will finally be sidelined by compulsory social spending plans. Over the past few years, Washington h as debated numerous debit reduction proposals, but a primary legislative bargain has proved obscure. Last month in March 1, sequestration went into effect. For Monetary Year 2013, the reductions total $85 billion, half of which is spent on defense. Where most political pundits surmise that some defense cuts should be part of an exhaustive debit reduction agreement, they show anxiety that the sweeping monetary austerity that began in March

Journal Essay Example | Topics and Well Written Essays - 1500 words - 1

Journal - Essay Example The market In the recent times, the growth in the smartphone market drives the industry for microprocessors. By 2014, it is expected that the total market size for cell phone users alone shall be 1.7 billion primarily driven by the surge in smartphone demand in emerging nations (Fan, Liu, Zhang and Zhao, 2008). As for the market captured by laptops, they completely acquired sales for desktops and face stiff competition from netbooks and tablets who have reported tremendous rise in sales. There are two basic components that hinder entry into the microprocessor industry is prices and innovative technology. Competitors are spending huge sums in new product development, technological upgradation and innovations that can allow patents and hence target market advantage. Companies also need huge economies of scale in order to compete in prices. Off late the substitution in the phone markets has evolved greatly but the substitution of CPU’s is virtually unavailable. The microprocessor industry is extremely competitive in prices. Product differences between major producers like Intel and (Advanced Micro Devices) AMD are virtually absent. Microprocessor industry is a one that entails huge fixed costs but very low marginal costs. This gives each company, the power to undercut the other. Exit costs of the microprocessor industry are also very high owing to huge sunk costs involved. Technology products are characterised by very short product life cycles. Technology changes and industry standards evolve as rapidly as they expire. Innovation here becomes the key to survive. The case of Apple Inc can be cited as a perfect example of innovation that led to market leadership where innovation of the iPhone took away margins and sliced away profits of other cellphone manufacturers who could not keep up. Competitive Business Strategies The desktop market is characterised by slow growth in the recent times. It is presently the largest and one of the most important microproces sor markets with a total of 150 million unit sales globally. The growth figures don’t seem as impressive. Intel, a leading firm in the microprocessor industry, has significant technological and resource advantage in the segment. The low end segment is price sensitive and so companies like Dell and Intel should keep its strategy aligned to prices to maintain itself as a market leader (Fan, Liu, Zhang and Zhao, 2008). In strike contrast to the desktop market, the laptop market needs an entire different strategy. Here front end technologies and processor performance drive sales for a company. In the fig 1 below, it is observed that concentration of exterior design is not as important as data protection. Figure 1: Consumer Need Preference Hierarchy in the Laptop Market (Source: Fan, Liu, Zhang and Zhao, 2008) With a view to capture the laptop market, key industry competitors are targeting the new generation. The trend requires thin and light laptops that do not need batteries and coolers like in CPU’s. Secondly, firms like AMD are increasingly trying to differentiate their laptops by bundling as done in the Centrino platform. The company also seeks to specialise in technologies, like the vPro to enhance security of data, a huge demand fulfilment of the business class. Thirdly, companies like Intel are trying to take on market leadership in the emerging nations via the price advantage. The use of Atom processor has strengthened Intel’

Invention of television Annotated Bibliography Example | Topics and Well Written Essays - 500 words

Invention of television - Annotated Bibliography Example The birth of television is considered as the turning point in the technological inventions. Nowadays, governments of each country are also engaged in the emergence of television. Televisions are also considered as the most reliable source of information because every channel is obliged to follow the rules and regulations and not to spread any rumour or unauthentic information. Viewers possess the right to sue the channel if it violates the norms of the society or spread any unauthentic information. The innovations and ideas coming up from technological advancement lead to the invention of television. Even though, it was not a latent demand of common public, in fact people didn’t even know about television many years after its invention. But as soon as people got acquainted, their demands increased and new varieties, version and models started to come up in the market. The invention of radio is a primary reason which led to the invention of television. Radio is a device which has audio features only. So due to technological advancement, people thought to invent something which has visual aspects as well. This idea led to the invention of television, an appliance having both audio and video features. Despite of having greater benefits, television is always considered as harmful for society. In society, the age group that substantially gets impacted by television is of children. Children waste their precious time in watching television. It is also considered as harmful for their health and eyes specially. Leaving children alone to watch television and providing the remote control facility is another harmful aspect which can hamper children’s habits. According to a research, children who watch more than 4 hours television a day are more likely to get overweight. Television network has held the entire world in a single strand. Due to the fastest broadcasting and

Most important change issues facing health care organizations Essay

Most important change issues facing health care organizations - Essay Example These health care issues must be strategically managed through helping employees establish relationships and systems that can address their social, technical, and financial dimensions. Changing client characteristics affect healthcare provision because these differences have implications on their perceptions of health care, as well as their beliefs, values, practices, and access to health care, that affect their different uses of health care services. Demographics are significant drivers of the size and characteristics of the future health workforce, while demographic trends have deep implications for the future of the health care industry. The U.S. Department of Health and Human Services, together with other health care institutions, presented their 2003 report, Changing Demographics: Implications for Physicians, Nurses, and Other Health Workers. The report provided the following main findings: 1) the aging is increasing in number, which affect their demand for health care services that are specific to their needs and concerns; 2) a high population of aging citizens increases the burden on the health care system because they will be dependent on Medicare and Medi caid programs; 3) increase in population among minorities signifies increase in health care services demand, while their racial, ethnic, cultural, and religious differences can shape their use of health care services; 4) though more and more people are living in urban areas, many citizens still live in rural areas where nurses and physicians are in shortage; and 5) a great number of minority groups are living in poor or low-income communities where there are also shortage of health care staff and services (U.S. Department of Health and Human Services i-iii). In essence, the demographic trends mean that the clients have changing characteristics because of the racially and ethnically diverse patient population, as well as the growth of aging citizens.

Data on Fixed Line vs. Cellular Debate Essay Example for Free

Data on Fixed Line vs. Cellular Debate Essay Most wireline phone companies charge more than what youd pay for most alternatives, and some are taxed more as well. There are some locations where getting new wired phone service is prohibitively expensive or even impossible. Long Distance and extra features like Call Waiting are normally included with alternative phones. More Features: Cellular and broadband phones normally include Long Distance, Voice Mail, Caller ID, Call Forwarding and more, usually at no additional charge. They also have Text Messaging and various forms of data service which are unavailable with a landline. Portability: If you move your home more than average (or if its on wheels), your phone and your number can stay with you. There are no installation charges. Temporary Usage: You can have phone service for the season in a vacation home or cabin, or on an extended stay at a hotel or home of a friend or relative without installing a separate line. Internet Access: Your wireless phone can also be your connection to the Internet, either with an internal browser or tethered to your computer, and available wherever there is cellular coverage. Wireless broadband is also available separate from your cellular account. Wi-Fi for Multiple Devices: You can get a cellular modem that provides a wi-fi signal that can connect to up to 5 separate wi-fi devices. Cons: Reliability: Wired telephone services have come as close to 100% reliable as is practical. Their network has substantial power backup, redundant circuits and years to get it right. Alternatives are improving but their networks can vary significantly. Cell sites and other communications nodes have a limited amount of backup power. In an extended power outage, such as after a hurricane or snowstorm, the service may not work, leaving you with no service. Corded phones work in power failures. Cable phones also have a lower level of reliability. Sound Quality: Some alternative phones dont sound the same or as good as a landline. While your alternative phone may sound fine to you, it may be difficult for others. Also, some broadband phone services just dump their audio into the Internet resulting in widely varying data travel times giving you significant sound delays. Lack of Service: You may be in a location where there are no wireless broadband alternatives or may have poor cellular coverage. This might be rectified by adding a cell site to your home. Broadband Speeds: While there are some fairly fast wireless broadband connections, it may be some time before they will compare to wired or cable connections. Malfunctions: Cell sites can stop working for various reasons. Repairs often need to be made on site and may take time. Broadband services require one or more pieces of equipment at your house which you will need to fix if it fails. Wireline equipment can normally be repaired at the central office. Murphys Law says breakdowns will happen at the worst possible time. You Have No Backup: Unless you have an extra cellular phone, if something happens to your main phone or its associated equipment, or your account, you cant just plug another phone into the wall. Inconvenience: Some alternative services only offer a single jack for one phone. If you want service throughout the house you either must go wi-fi or cellular. Otherwise, plan on using the phone near your computer or router. With a cell phone you need to keep it close to you if your home is large or on multiple floors. (The Unwired Home) There are companies that offer the best of both worlds of fixed line and cellular communications. These are just some of the included services offered by the number 1 provider; 1. Price If you plan to use Skype just for calling other Skype users, then it’s free you can even have a small online meeting. Skype also lets you video conference with another person using the free plan. The only drawback is that you cant have a larger video conference on the free plan, as you can only hold a video call with one user at a time. There are no monthly fees to pay, unless you’ve chosen a monthly plan. You can also save on your phone bill by inviting other people who you need to call often to join Skype too. If you prefer to call on a landline or cell phone, you have the option to choose a pay-as-you-go plan, which charges a small amount for these kinds of calls if you call international numbers often, using Skype could work out cheaper than using your office phone. 2. Ease of Use Skype is very easy to install, set-up and begin using. It has a really user-friendly interface that anyone, regardless of their level of tech knowledge, can learn to use. Adding new contacts, sending instant messages and placing calls are all done with the click of a button. It’s also very easy to know if Skype was set up correctly, as the tool has a test call number where users can check if their audio and microphone are working properly. This is great, as there is no guessing whether Skype was installed correctly or not. 3. It is where you are With a number of Skype versions available, you can use it anywhere, from virtually any device. Whether you’re on your office computer, laptop, tablet computer, or smartphone, you can have Skype with you and make free or cheap phone calls from anywhere in the world. This is especially handy if you need to be out and about often for your job, as you can still hold your regular calls from wherever you are via Skype, as long as you’re connected to the Internet. There’s no need to postpone calls just because you’re away from your desk. This is a huge benefit for small businesses as there usually isnt a large number of staff available to take or make important calls at all times. 4. Reliability In the early VoIP days, call quality was bad and calls got dropped often. This kind of technology wasn’t an option for businesses as not only it was very annoying to have calls drop all the time, but it was unprofessional to choose such bad quality services. However, VoIP has improved greatly since then and Skype is very reliable. As long as your Internet connection is stable, you can expect your call won’t get dropped. Furthermore, if the Internet connection is bad for any of the parties, Skype will inform users of that, so they know that the call might get dropped. Skype also encourages users to rate their calls when they’re done, and Skype is continuously improving the reliability of the service. 5. Call quality As a small business, it’s important to choose inexpensive services that are of high quality this is where Skype really delivers. Calls both to other Skype users and landlines are crystal clear, so long as the caller has a good headset with a high quality microphone. Calls to landlines and cell phones get connected quickly, and don’t usually suffer from problems such as echoing or words getting cut off. For the most part, it’s as if users are talking to someone just next to them. And whats better than that for establishing strong and long-lasting business relationships? (Warren)

Differences of Skills in Work and Skills in Social Settings

Differences of Skills in Work and Skills in Social Settings WHAT IS THE DIFFERENCE BETWEEN SKILL IN THE PERSON, SKILL IN THE JOB AND SKILL IN THE SOCIAL SETTING AND WHY IS THIS IMPORTANT. A quarter century ago skill was generally referred to as manual dexterity (tool usage or control) and to some understanding of underpinning bodies of theory and knowledge associated with the exercise of particular trades or occupations. Hence, there has been growing priority of softer social skills and personal attributes such as manner, deportment, appearance, dress sense, accent, ability to get on with people and self confidence (Payne, 1999; Grugulis et al, 2004). As one employee reports one recruit attitude (Calligham and Thompson, 2002:240). These attributes and attitudes are being referred to as skills (Payne, 1999 cited in Stephen Bach, 2007). One of the most difficult to describe and hard to define concept is skill (Warhurst, Grugulis and Keep, 2004), in a survey carried out by (Francis and Penn, 1994), they concluded that different occupational groups will categorize skill in different ways, which suggests that a persons conception of skill is largely based on his or her own experiences of employment. Therefore, this essay aims at defining the approaches of skills and also what these approaches are and why it is fundamental in analyzing skill. WHAT IS SKILL? Skill is defined as the expertise, ability or competence to undertake specific activities often acquired through formal instruction or work experience (Brown et al, 2001). The dictionary definition of skill reveals the complexity of the concept. At the core of all definitions is the idea of competence or proficiency-the ability to do something well. The word encompasses both mental and physical proficiency meaning skill implies understanding or knowledge, it also implies physical dexterity. In distinguishing between skill as mundane accomplishment and skill as virtuosity will help give theoretical insights into the mechanisms that underlie skilled activities, failure to distinguish between the two senses of the word can lead to conceptual confusion (Attewell, 1990). Attewells research indicates four distinct sociological notions of skill which yields different images of skill. Positivist Ethno-methodological Weberian Marxist Positivism This refers to those who treat skill as an attribute amenable to qualitative measurement and believe that this attribute has an objective character independent of the observer. With this assumption, at the outset positivists are faced with two issues: First, should skill be treated as a measureable attribute of persons or jobs/tasks (Spenner, 1983)? Second, should apparently diverse or qualitatively different skills be rendered commensurate and hence measurable? Is there a yardstick that underlies varied skills? (Attewell, 1990). Ethno-methodological This is completely at odds with the positivists assumptions about complexity, routine, and conscious analysis, it offers a view of human activity and hence, skills.ÂÂ   The core of this perspective is the idea that all human activity, even the most mundane, is quite complex. Things such as walking, crossing the road and carrying on a conversation that everyone does, are amazing accomplishments requiring a complex coordination of perception, movement, and decision, a myriad of choices, and a multitude of skills (Garfinkel, 1969). The Weberian School This school tries to understand the conditions under which occupations are socially demarked as skilled and the processes by which some jobs come to command higher standing than others. This school points that tasks complexity becomes important as it creates uncertainty as to whether and how the task can be accomplished. This then becomes the core around which practitioners build claims to skill, even when their knowledge and techniques are modest (Attewell, 1990). The Marxist School This school enters skill from three areas which are: in the labor theory of value, in debates concerning the labor aristocracy, and in the theory of alienation and technological change. However it would be misleading to suggest that classical Marxist has a well articulated theory of skill as such. Marx and Engels writings provide theoretical hints and some neo-Marxists have built upon these. Hence, many contemporary Marxists treat skill as a common sense category which does not require explication, while other neo-Marxists treatments of skill frequently shade into either positivist or social constructionist thinking (Attewell, 1990). APRROACHES TO THE ANALYSIS OF SKILL There are three approaches to the analysis of skill as shown in (Table 1). Skill in the person Skill in the job Skill in the setting Focus Principal Area of Concern Typical Method of Analysis Typically Adopted by: Person Individual attributes acquired through: Education Qualification Training Experience Questionnaire surveys Aptitude test / Experiments Economists Psychologists Job Task requirements Complexity Discretion Job analysis Job evaluation Occupational Psychologists Management theorists Industrial / Employment Relations theorists Setting Social relations Case studies of industries and occupations Ethnographic studies of workplaces Social historians Sociologist Table 1: Skill approaches (Source: Noon M. Blyton P., 2002) Skill in the person In this aspect, the skill centers on the quality possessed by the individual through knowledge, dexterity, judgment, linguistic ability which is accumulated as a result of education, training and experience (Noon and Bylton, 2002). Skill that focuses on the person often attempts to identify individual attributes and qualities and seek to measure these by the use of aptitude test under experimental conditions. Psychologists agree with this approach and view it as an independent variable (Vallas, 1990). Hence, questionnaires might be distributed to assess the individuals education, training and experience which could serve as a proxy for skill- a method mostly used by economists (Cockburn, 1983). Some commentators have argued that there is a need to broaden the definition of skill in the person by labeling certain personal characteristics as skills. Warhurst, Grugulis and Keep (2004) points that attitudes, character traits and predispositions are being described by employers as skills required and they lacking in the labor market. Lafer (2004) argues that a skill is a quality learned or developed by individuals that will secure them a living, however, many of the new skills such as punctuality, appearance, manner e.t.c. are not skills because alone, they cannot secure an individual a living wage although they might be prerequisite for getting a job in the first place and are also required in order to remain in employment. Lafer points that the consequence of broadening the definition of skill means the concept of skill in the person becomes increasingly meaningless. Skill in the person is very essential in the labor market, as Becker (1964) argues that in a market economy, an individuals human capital will determine his or her value as an employee. An individual can choose to increase their human capital through taking advantage of educational opportunities and training or they can as well choose to ignore these opportunities and as such lower their relative value in the labor market. This approach is typified of human capital theorist, they point that the responsibility for success in work lies with the individual and they raise the notion of meritocratic society, where individual effort is rewarded (Noon and Blyton, 2002). Skill in the job In this case, the focus is on assessing the skill required by the job rather than the skill possessed by the individual doing the job. Sociologist agrees with this approach and view skill as a dependent variable (Vallas, 1990). Attention is placed on the complexity of the tasks required to perform a job and the extent of discretion in the job which is of keen interest to individual/employment relation theorist. According to Noon and Blyton, (2002), the more complex the task required by the job, the more skilled the job is. There is however, need to measure the extent of complexity so as to arrive at a skill level. Hence, different jobs could be reflected in systems of status and remuneration which takes the form of job evaluation schemes. Discretion is of great importance in a job. Discretion involves choosing between alternatives required by an activity. The greater the number of decisions required by an activity, the greater the skill level. The more the employee is able to exercise his/her judgment, then the more skilled a task may be said to be. Therefore, examining the amount of rules employees are obliged to follow will serve as an assessment of the skill level: the more rules, the less scope for discretion and the lower their skill will be judged to be. Discretion is the key element of job skill. It grants workers the space to develop their expertise and to exercise judgment and features heavily in academic attempts to theorize skill (Grugulis, 2007). Feature of Skilled Work Identified as Important Most Likely to be Identified as Important by: Apprenticeship Older, male, manual workers (particularly those processing apprenticeship qualifications) Training Younger, female, public-sector service employees (particularly those processing higher level qualifications) Qualifications Women (particularly in retail distribution). Younger respondents people with lower level qualification High Abilities Men People with higher level qualification Experience No specific group Table 2: Based on Francis and Pen (1994). The survey comprised of nine hundred and eighty seven adults aged between 20 and 60, and was undertaken in Rochdale, U.K. in 1986. (Source: Noon M. And Blyton P., 2002) Education, apprenticeship, training and qualification all focus on developing and maintaining individual skill. Cockburn (1983) and Littler (1982) have argued that skill is also an aspect of jobs and work can be designed to make use of demand, develop and deploy skills just as it can also minimize the need for skill (Grugulis, 2007). When individual possess skill in the job it may enhance organizational benefits. It ensures consistency of product; work is been completed quickly and satisfactory. Workers with appropriate skill will know about the product they are producing and make decisions on how they might best work or judge the quality of their labor. It is important to note that as individuals gain knowledge of the organization they work in their level of skill increases by seeing the way their system operates, experience problems been solved successfully and learn which of their colleagues to approach with certain requests. Felstead et als (2000) analysis of survey data reveals that even when respondents have held the same job for five years there is still an increasing demand for skills suggesting that workers gain in skills and experience over time. In addition, skill in the individual and skill in the job are closely linked. Hence, skill is important to an employer because an employer cannot employ an individual that does not have the skill required in the job. Skill in the setting The definition of skill in the social setting is Cockburns 1983 third element. Individual status or group may protect skill, in same way as skill itself confers status. This means to an extent, skill, status and control are necessarily linked; expertise may require control over work and this brings with it higher status. Those aspects of social life that do not relate with skill but confer to status, impacts on the way skill is been perceived (Grugulis, 2007). Skills are socially and politically negotiated and it reflects the power and influence of diverse interest groups. As Sadler (1970:23) has observed, skill is to a considerable extent determined by social factors present in the work situation and in the occupational culture at large [and therefore includes] the evaluations placed on particular kinds of activity and on particular classes of individual and the actions of organized pressure groups directed at safeguarding the earnings and job security of particular trades and professions (Noon and Blyton, 2002). This then means skill in the social setting is important as it create room for protectionism; certain groups want to protect their skills in order to form a particular status. Social setting can be viewed from the notion of social closure which is one fundamental concept of sociology as defined by Weber (1947) and elaborated by Parkin (1979) and Kreckel (1980). Social Closure or Skilled Status The total process of occupational social closure is composed of three interacting sub-processes (see Fig.1). An ideological process: in this case individuals recognise a shared set of values, beliefs and reinforce these symbolically. A political process, whereby group members act collectively, combines their resources in pursuit of common goals. A material process, whereby members of the group seek to appropriate the tools and technology to the work process and control or influence the work organisation. CONCLUSION As a result of the different theoretical perspective of skill, there has been little consensus about the way skill should be assessed and, indeed different perspective tend to base their argument upon different concepts of skill (Attwell, 1990; Spenner, 1990; Vallas, 1990; Gallie, 1991). This has made the issue very controversial. However, the different meaning of skill centers on the three approaches above- skill in the person, skill in the job and skill in social setting. Hence, there are still unanswered questions about skill. What is the generally acceptable definition of skill? as work is changing continually, hence, demanding different abilities. Are people becoming deskilled or up skilled? REFERENCES Attwell, P. (1990). What is Skill?ÂÂ   Work and Occupations. Vol. 17, No. 4, pp 422-443. Brown, P; Green, A.ÂÂ   and Lauder, H. (2001). High Skills. Oxford University Press. Keep, E. (2005). Skills, training and the quest for the Holy Grail of influence and status in Bach, S. (ed) Managing Human Resources: Personnel Management in Transition 4th edition Oxford: Blackwell. Grugulis, I. (2007). Skills, Training and Human Resource Development. New York: Palgrave Macmillan. Noon, M. and Blyton, P. (2002). The Realities of Work. New York: Palgrave Macmillan. Vallas, S.P. (1990). The concept of skill: a critical review Work and Occupations Vol 17, No. 4, pp 379-398. Warhurst, C., Grugulis, I. And Keep, E. (2004). The Skills that Matter. New York: Palgrave Macmillan.

Electronic Health Record Benefits

Electronic Health Record Benefits The electronic health record is a mean of organizing patients data making use in the field of information technology. Its purpose is to fulfill the various needs for information not only of patients and healthcare providers but also of other beneficiaries. The implementation of electronic health record system in health care organization is very complex and involves many parameters. Introduction Electronic health record is currently used by 12% of the physicians and 11% of the hospitals nationwide. Industry and government have promoted Electronic health record as a means of controlling costs and improving patients care. The electronic health record has become one of president obama main agenda and the investment necessary to ensure that within the coming years, all of Americas medical records are computerized. Today with the advance of globalization the electronic health record is still highly unlikely to advance in the next five years, governmental, technical and industry advances are adopting, which will drive the electronic health record in the hands of medical providers. The electronic health record (E.H.R) is a digital record of patient health information generated by one or more encounters in any care delivery setting. It contains information of the patient includes demographics, problems, medications, vital signs, past medical history, laboratory data and radiology re port . The electronic health record also promises the removal of many barriers in the medical field such as saving lives, money, and time, but unfortunately the fulfillment of this promise in the real world application has remained with a big question mark due to many factors cost of implementation, privacy and security. The following graph is the result of survey experts at nearly 3000 group practice nationwide. The table below lists barriers to Electronic health record adoption. well known factors such as security and cost are cited as key factors, but other factors which is usability is not mentioned frequent is another barrier to the electronic health record adoption. Usability is a primary concern Usability issues are also a factor why electronic health record implementation fails. In a survey paper primary care physicians were asked the reasons why they did not use the electronic health record system. From the research finding 35% of the physicians listed specific electronic health record usability issues, the most common were: Problems with the screen navigation, and the lack of functioning and the concern that the data will be lost. Anecdotal support for usability and Electronic health record failure comes from Cedars- Sinai medical centre of Los Angeles. They developed a $ 34 million computerized physician order entry system, but only included the input of a few physicians before launching it hospital wide in 2002 without thorough training Physicians who previously used to take notes by hand now required going through nearly a dozen screens and responding through numerous alerts for even common orders. Traditional doctors around 400 of them demanded its removal within three months of its launch. Poor usability can also endanger patients health. The electronic health record should be modernized helping the clinician workflow. In the year 1991, the institute of medicine released a report supporting the idea of implementing the Electronic health record within the coming years. In 2010, researchers believe only a small portion of health providers both public and private implementing the system. The implementation o f electronic health record provides answers to many barriers in the medical world. Background An electronic health record is a digital or electronic record of the patient health information gathered over the history of the patients interaction with the health care system. An electronic health record stores all information concerning the patient health statues. Information varies and includes the following age/sex, medications, and vital signs, past medical history, laboratory data and radiology report. The concept of a medical report goes back to the fifth century B.C developed by the Greek physician Hippocrates, also known as the Hippocratic Oath. Hippocrates described two main goals behind his findings 1- a medical record should accurately reflect the course of disease 2- a medical record should indicate the problem cause of the disease. In the present days, the electronic health record first began to appear in the 1960s. Reported that at least 73 hospitals began to use the electronic health record system. In 1991, the institute of medicine released a landmark report recomm ending the electronic health record be implemented in health system within 10 years. Almost 20 years later, according to the latest researchers only a small portion of health providers have implemented electronic health record. A Meta analysis of diffusion rates of the electronic health record in the United States shows that an uptake has slowed in recent years. The study concludes Electronic health record is the future. President Obama administration has the electronic health record as one of its primarily agenda the investment necessary to ensure that within the next five years, all of Americas medical records are computerized. While still with the advance of globalization the electronic health record is highly unlikely within the next five years, governmental, technical and industry advances are adopting, which will drive the electronic health record in the hands of medical providers. The electronic health record also promises the removal of many barriers in the medical field suc h as saving lives, money, and time. The question is still debatable whether the whole world will move towards the implementation of the Electronic health record. The electronic health record is one of the most important electronic patient data collection of our time and with the expanding population of the world it has become a necessity to implement the system in all public and private hospitals. The G.C.C region Literature review The opinions concerning the positive effects an E.H.R can have on patients health and whether all the healthcares in the world should step in and implement the system. The collection of personal health data is described to have many formats when speaking of systems that manage it. Reduction of the storage necessary to keep paper charts is also a noted as a reason to leverage an E.H.R freeing up of space better used for revenue generation. Paper charts have their own risk associated with them in terms of getting lost, productivity impacts to maintain and retrieve paper records and the resulting negative patient care (Carpenter 2002). An electronic health record system is the collection of data that is central to the patient (Rishel, Handler Edwards, 2005). These opinions agree the importance of the E.H.R and implementation of the system. An E.H.R system exists to facilitate the storage, revival and continuity of the record itself (Gans, Kralewski, Hammons Does, 2005). These opinions also strongly agree with the improvisation of the Medical record with the advances with science and technology. reversing the scenario, an E.H.R system can collect and aggregate information from other sources such as laboratory, X-ray and unstructured data like faxes or handwritten notes ( Wojcik, 2006) the scholar Wojcik agrees strongly with the use of E.H.R talking about the positive of the E.H.R reduces the storage of handwritten notes and stacks and piles of paper. The near term presents providers with realizing the digitization of the boxes of paper that is generated by patient encounters. These paper databases represent the clinical data that is ultimately needed to take EMR systems to the next level. The near term presents providers with realizing the digitization of the boxes of paper that is generated by patient encounters. These paper databases represent the clinical data that is ultimately needed to take EMR systems to the next level. Clinical data is the baseline in whic h all healthcare processes subscribe including decision support, health outcome analysis, billing and claims processing and health maintenance. Correlation and access to this data is what EMR systems seek to facilitate (Handler Hieb, 2007). Electronic health record systems, once materially implemented across the healthcare spectrum, will itself become the framework in which more overarching goals can be accomplished, such as the centralization of a persons health history. With Clinical data as a basis, further utilization of EMR systems can occur. EMR systems, once materially implemented across the healthcare spectrum, will itself become the framework in which more overarching goals can be accomplished, such as the centralization of a persons health history (Gartner. Currently, about 25 percent of U.S physicians are using systems that facilitate electronic health records (Murdock, 2007). E.H.R has become a primary concern in the medical world and the according to past literature re view in this generation we find that it some of the scholars are concerned with the paper works as they say that the E.H.R will help save doctors a lot of time and makes the process more efficient. Some scholars say that paper based system is very negative as it leads to losing important patient data which might confuse the doctor in prescribing proper medication to the patient. There are differences of opinion but according to most scholars the E.H.R is a vital tool in solving many of the issues that both public and private hospitals face around the world Questionnaire Results The questionnaire focuses on the importance of the E.H.R system and its implementation in the United States of America at a nation wide level. With growing medical demands around the world Hypothesis one results Our research finding indicate that the U.S government is encouraging the country medical networks to start using the E.H.R Hypothesis two results Our research finding according to 430 surveyors say that 55.1 % of their medical practices use the Electronic health record system Hypothesis three results Our research finding shows that majority of the surveyors have a positive outlook that majority of the medical practices will start using the E.H.R between the next 1 to 2 years Hypothesis four results Our research finding shows that 41.8% of the surveyors believe that their medical providers will qualify for the Medicare and Medicaid programs Hypothesis five results Our research finding again shows a positive outlook of the near future as 65% of the surveyors say that their practices will qualify for the Medicare and Medicaid programs by the end of 2011 Hypothesis six results Our research finding again shows that the U.S government financial incentive can upgrade the performance of E.H.R surveyors helped us with the conclusion that government financial backing to the Medicaid and Medicare programs can improve the medical performance in the near future Hypothesis seven results Our research finding states the importance of the U.S government testing the E.H.R program before purchasing them according to the surveyors 71% agreed the importance of testing the systems before implementing them nationwide Hypothesis eight results Our research finding concluded that most of the clinicians hire 1-5 physicians which is low according to the demands of medical needs of our current era Case Study Questions and answers regarding on implementing the electronic health record (Case Study). The case study focuses on the systematic reviews and the effects of electronic health record system can have in the medical sector if implemented at nationwide level. In the G.C.C the electronic health record is still new and according to our case study taken from the united states we want to find whether implementing the electronic health record system will add value to the medical sector or not. Will electronic health record improve patients health outcome? In a review evidence results in two study cases came up with the following result In 2004 a systematic review conducted 3 study cases that reported patients outcomes, no benefit was the conclusion In 2008 an analytical survey of several U.S patients found very few data or no association between the use of electronic health records and the improvement of patients outcomes In the end of the study there was no evidence linking between electronic health record with better patient outcomes Will electronic health record improve the quality of care? Evidence proves that the following result might occur on the electronic health record if implemented in practice In 2004 a review of 26 studies analyzed several outcomes related to the quality of patient physician encounters and with the research it discovered a sharp incline in provision of preventing care In 2006 a review on health information technologies and their impact on quality, efficiency and cost findings were: Increased adherence to guidelines based care, advanced surveillance and monitoring and a decline in medication errors In 2007 a study of data from some community health centers over the course of one year concluded that while electronic health record related costs had not been recovered, the quality of care improved In 2008 a review on the advantages and costs of electronic patient Concluded that concerning the influence of EPRs on the quality of care The studies did not clearly identify a clear answer to the questions of Benefit In 2009 a review of 7 countries experience implementing health information systems concluded that they had a neutral experience where neither benefit nor harm between the system implementation and quality of care The conclusion of the study indicates that the electronic health record has a positive effect on the quality of care; however some of the reviews still find it neutral so the opinions of the doctors and physicians are still conflicting. Will the Electronic health record be cost effective? In 2003 cost benefit analysis on the electronic health record in primary care settings concludes that electronic health record can result in positive return on investment In 2007 review on informatics system designed to improve care of chronic disease found that both cost effectiveness and adherence were significantly improved In 2008 report on the United States budget office summarized evidence supporting the practice of health information technologies describes the benefits on cost saving as limited In 2010 assessment on the quality of care resulting from hospital computerization concludes that currently implemented hospital computing might improve process measures of quality but not administrative or overall costs The research cite modest cost benefit associated with electronic health record, however based on results for small trails or projections based on modeling: empirical evidence supporting the cost effectiveness on electronic health record remains limited or conflicting Will the electronic health service save time and improve the efficiency of health services delivery? In 2006 a review of quality measures on the use of electronic health records indicated that the lack of implementing health services has been demonstrated, but the author notes that the outcome is limited to a wider health service provider A systematic review in the year 2008 analyzed six studies that addressed electronic health record with respect to consultation time, one study found the decrease in consultation time and the other found no difference A 2008 report from the United States congressional budget office summarized evidence supporting the adoption of health information technologies described the evidence around efficiency as conflicting In 2009 a review examined the impact on regional health information system and figured that, studies were of variable scope and quality improves the medical data access, timely information, and medical data exchange and improvement in communication and coordination within a region between health care professionals While there are some evidence supporting an association between the electronic health record and efficiency, there is also evidence which does not support this conclusion Will electronic health record improve physicians and patients satisfaction? In 2004 a review found that results were mixed with both the patients and physicians expressing enthusiasm for electronic health record and on the other hand expressing significant concerns about the impact of their use on a variety of outcomes A 2009 review of seven united based studies examined patient satisfaction with the electronic health record and figured that: one out of seven studies reported a positive effect on patient satisfaction, five out of seven studies reported a neutral effect and one out of seven studies reported a negative effect Evidence on patients and physician satisfaction is scarce An interview with Dr Michael Shuskho on the electronic health record As a professional in your field how do you find the electronic health record system? Michael: the E.H.R is an advanced system which is very useful for doctors especially in the current Era. It provides better patient care, and makes a permanent record that is legible that other doctors can review the system and also actually streamlines patient care Will the electronic health record improve efficiency and reduce time Michael: yes, the electronic health record is a valuable system to most of the doctors because it replaces the piles of paper and with a few click on your computer screen the doctor can view all the patients past medical record and send all the information to the other doctor within minutes Is the electronic health record system better than the manual paper based system? Michael: yes, the E.H.R is clearer and safer than the manual system provided that it is used carefully. Exg: a doctor can view patients X-Ray, picture of his electro cardio graph in a much clearer and digitalized form while in the paper based system the pages might wear or get old and by the time the picture of the X-Ray gets more aged, it makes it hard for the doctor to identify the exact diagnosis Is it cheaper to implement an electronic health record? Michael: The electronic health record system is expensive and the start up cost of the Medicaid and Medicare programs is high but in the long term it will eventually become cheaper for the clinics and hospitals to use them What are the barriers that prevents the electronic health record system by being in practice at a larger scale Michael: some doctors who arent familiar with updated technology and use practical manuals prefer not to implement the E.H.R in their clinics. Another barrier to the electronic health record is the upfront cost which is expensive and the some doctors find it hard adapting to the system Dr. Michael one last question before we conclude our interview. In your personal opinion will the E.H.R be mandatory by 2015 in the U.S Michael: I assume the probability that the electronic health record system might be mandatory in the U.S and the government might take actions in seeing that all the practices and clinics use the system The implementation of the E.H.R IN Kuwait and Bahrain Based on our research we have found that the electronic health record still needs to adapt at a global scale and the system is new to the G.C.C countries compared to the western countries such as United States, United Kingdom. Kuwait started using the E.H.R in 2005 in private and public clinics replacing the paper based system. According to the hypothesis questions and results in the U.S case studies it shows clearly that the E.H.R is on the way of improving and use the E.H.R rather than the traditional filing system. Bahrain is also taking a step further in implementing the system and the public and private clinics and with the help of the MGA methodology and the case study we have come with proposed solutions and the benefits that the kingdom of Bahrain and other G.C.C countries will achieve through the E.H.R December 2010 The health ministry in Bahrain will launch its national e-files project early 2011. It will cost the ministry between BD 25 Million to BD 30 million. Files of patients at salmaniya Medical complex and health centers will be converted into e-files. The first phase will cost BD 1.5 million and include all SMC and health care patients. Private hospitals and clinics can also be part of the system by paying a fee The health minister stated that many countries were struggling to meet the challenges of providing adequate health care for citizens. Changing demographics increased patients expectations, a global shortage of health professionals and rising costs associated with innovative technologies and new drugs means that healthcare is consuming an increasingly large proportion of gross domestic product and is becoming a priority for most governments. The minister also discussed Bahrain healthcare agenda through some strategic objectives which includes health promotion and prevention by strengthening primary healthcare services, the provision of quality health services by maintaining international accreditation of facilities and enhancing access to all health care services (Gulf Daily News- [emailprotected]) Plan for online health service Patients in Bahrain may soon be able to manage their healthcare online. Patients know best (PKB) enables people to communicate securely with doctors and nurses, access their medical records and send and receive health data. The medical group was founded two years ago by Bahraini Dr Mohammed Al Ubaydli in the United Kingdom. He has more than 15 years of experience in the medical software and trained as a physician at the Cambridge University. The expert worked as a staff scientist at the national institutes of health and was a management consultant to US hospitals at the Advisory board company and is the author of six books. PKB is the first company to integrate into Britains NHS secures connecting for patients to work online with clinicians. The group was voted as the best social innovation start up at tech crunch europas European start up awards 2010. At least two hospitals in Bahrain as well as others in the UAE and Malta have shown interest in signing up to the initiative. In the U.K, PKB affiliates includes great Ormond St hospital, Thalidomide Trust, Cure Parkinson and Two NHS hospitals will also sign up soon Access Dr Al Ubaydli said hospitals and medical centers that have affiliated with the PKB give their patients an online ability to securely access their medical documents, history and test results, have online consultations with their doctors and receive prescriptions. Once you give the medical record to the patient they can give them to their GP, relatives, social workers and so on he told the GDN. The patient can start an online consultation with any doctor they have added, it works a bit like the face book. They can also reach their doctor at any time say, for example, their child is taking medication but develops a fever at 3am and they can go online and ask the doctor how to adjust their medication. The system asks automated questions that your doctor would ask so that when the doctor sees this in the morning it saves them a lot of time and they can quickly respond with advice. ( Gulf Daily News 8 Dec 2010) The articles concludes the following results The kingdom of Bahrain is taking new measures in implementing the E.H.R in the G.C.C and mena region Many of today healthcares can be solved through networking Globalize E.H.R System Networking communication is an intermediary between practicing doctors implementing the E.H.R in their private clinics or public clinics. The information process is much faster through communication networks which reduces time, saves lives and improves efficiency Exg: Steve Dr Akram Favorite doctor has a patient and needs emergency solution to a problem through a communication network can achieve his goal browsing the Globalize E.H.R network finding solutions through other Doctors specialized in that field. An E.H.R system that works like a face book Doctors can log on their account and log on the system with other health professionals and discuss emergency situations and provide solutions The problems can be solved through fast communication and accurate knowledge the tacit knowledge key challenges to health practitioners implementing the E.H.R in the GCC countries Cost of implementation is not offset by the efficiencies in the E.H.R Technical support needs to be modified due to the advancement in IT Stress on staff and the practice in general was significant A 2007 review article recommended strong physician leadership and a staged approach to successful implementation In 2010 an article challenged conventional assumptions that the physicians were to blame for low uptake of electronic health record. Electronic medical records vary greatly in capability, quality, and cost. Doctors will become enthusiastic users if the electronic medical records are helpful in the care of their patients There are significant challenges associated with implementing E.H.R in the Mena or G.C.C countries Benefits of networking for the G.C.C Region Improves patient care through greater access to information Reduces test result times Decrease paper work for clinicians Integrate communication Helps ensure that patient medical data and stats are there when patients need to find his/ her test results Compliance with privacy regulations Proposed solutions for the electronic health record A 2008 synthesis of 3 qualitative studies identifies essential components of successful electronic health record implementation A project champion Realistic expectation of the challenges of implementing an electronic health record Addressing existing staff attitude towards IT Provide adequate training to staff A systematic review of 7 countries experience implementing health information system in primary care identified the following factors Quality of the graphical user interface and feature functionality Quality of implementation project management Users previous experience with information technology systems The Electronic health record today application The adoption of the electronic health record is difficult to overcome due to the lack of the return on investment. Scholars and writers on the subject noted that health care decision makers find it difficult to demonstrate return on investment to undertake a comprehensive electronic health record system within their organization. The health care costs continue to increase and the fact that the initial investment on equipment can be quite expensive. Another fact that complicates the adoption of the electronic health record is that the data is heavily structured, being recorded in the allotted space. Training is an important issue and this is required by a large amount of population. One should keep in mind that the population has different levels of computer literacy (Upham 2004). These contributors of the electronic health services contributed to a slow increase in the adoption of such systems in many hospitals. In a survey question regarding the E.H.R and the implementation of the m ethod out of 436 who have responded to the question, 35.6% said that they have already implemented the electronic health services. The percentage is expected to grow in the coming years of application. The G.C.C is taking all the necessary step in implementing the system with an enhanced knowledge in the field and the governments should test all the Medicare and Medicaid programs before implementing the system The Evolution of the Electronic Health Record The electronic health record is an open field of debate amongst the doctors, physicians, clinicians and scholars. In the electronic implementation of such records, we may also expect to find populations of patients, integrated access to biomedical literature and interactive environment for offering clinical guidelines or consultative advice. Throughout ages the world is becoming more globalized and in the age of science and technology the computer is being the number one tool. The (local area network) is connected to the full internet, with an integrated access to a wide variety of information sources that are geographically distributed well beyond local institutions. The electronic health record system is expanding worldwide and some of the future implementation An enhanced internet: an internet with much higher bandwidth and reliability, increased response time and financial models that makes the application cost effective and practical is required. Major research effort is underway to address some of these concerns, including the federal next generation Internet activity in the United States exploratory effort that continue to push the state of art in internet technology, and all significant implication for the future of health care delivery in general for computer- based health record in particular Better Education and health care training for health care providers: there is a difference between computer literacy (familiarity with computers and the routine users in society) and the knowledge of the role that computing and communication technology can and should play in our health care system. More medical information training programs and the expansion of existing programs are needed. Junior faculty in health science schools who may wish to seek additional training in this area should be supported Changes in the management and organization of health care institution: health care provide some of the most complex organizational structures in society, and it is simplistic to assume the off shelf products will be smoothly introduced into a new institution without major analysis. Discussion The project mainly discusses on electronic health record system that the implementation of the idea goes back to Hippocrates who laid the foundation in the 5th century and by the following years doctors, physicians, pharmacists and clinicians tried to improvise the idea of the health record system on paper but in the 1960s the standards of the paper based changed to the electronic health record systems and hospitals welcomed the new system which was more efficient and reduces paperwork and time. The electronic health record according to numerous researches and articles emphasized that the system should be introduced worldwide. the G.C.C region is expanding in both size and capacity since the countries like Bahrain, Kuwait, Qatar, Uae opened door to foreign investment in their respected countries. Our research focuses on the implementation of the E.H.R in the U.S and the results of the case study gave us a better understanding on whether to implement the system in the G.C.C countries. The results were positive and the need of the system is becoming compulsory in our world today. Kuwait have already

The Crisis of the American Teen Essay -- Teenager Youth

The Crisis of the American Teen Premature adulthood is imposed upon teenagers in today’s society. It affects them in two different but closely related ways. One is in which a teenagers needs to find a sense of self and needs protection on trying to do so. The other is the stress that is being forced upon them. Teenagers need to be given time , support and guidance to form from child to adult, but that must come from the parents. Many parents either feel powerless to give a child what they need in life because the child can get it else where: they may do whatever it is that they want behind a parent’s back. They could also be insecure about themselves and that they did not receive the guidance themselves when they needed in growing up. Teenagers need protection against the dangers that they may face so that they can be prepared for the future. Teenagers now are highly stressed. There are more things for teenagers to stress about then there was years ago. Since teenagers are given so much freedom which doesn’t give them much time to focus on their future. Freedom also makes it hard for a teenager to adapt to new situations because they are already conformed to do what they want rather then for what is best in that situation. In relation to the two different ways in which premature adulthood is forced upon today’s teenagers is that it can be hard for a teenager to form a sense of identity because they are faced with many challenges in life. Since they are given so...

Collegiate Gladiator in the Gauntlet of Education :: Personal Narrative Papers

Collegiate Gladiator in the Gauntlet of Education I felt the presence of early morning dew against my skin as I marched through a grass field on a brisk October day. My classmates exuded enthusiasm; this excursion was reason to escape the confines of our bleak high school. There was abundant conversation with the occasional youthful act of animation, like sprinting downfield or throwing a rock. The world seems just a bit different when a student is taken from a classroom setting into a non-academic one. Opportunity and freedom appear to be ever so present. Perhaps, that was reason for our class being outside during my regularly scheduled English period. In all honesty I was quite skeptical. I have never been a morning person and can be a silent cynic when it comes to group events. I staggered behind the group, hands in pocket, submerged in totally unrelated thought. My teacher led the way stammering uphill and clenching his worn black book, almost appearing as if he was Moses carrying the Ten Commandments up Mount Sinai. After trekking through the endless barren of soccer and lacrosse fields, we came upon the overgrown pathway that led into the woods. Many of us were familiar to this area, coaches often made their teams run through these wild trails. Others seemed puzzled. Stepping into the wild that day we crossed the threshold on many levels: not just escaping into nature but escaping from ordinary thinking. For me, the change in location would also mark a change in philosophy. Some distance I have covered. The start of my journey seems like a lifetime ago. Blinded by innocence and burdened with little responsibility, being eight years old had its perks. Sure I had to attend school, but what exactly was school at that echelon? A day spent singing songs, playing dodge ball, paper macheing cardboard figurines, with the occasional napping and recess break. Almost like summer camp. To my surprise, second grade was far from what I imagined. My year revolved daily lessons on reading and writing... in hopes of achieving basic literacy. With the occasional dip into the kiddy pool of arithmetic, second grade was a year of hard work. I was lucky to have an incredible teacher like Mrs. Perdiz. She pushed me so hard, so hard that at times I disliked her. Music, math, and art took a definite backseat to reading.

New Cases Of Tb Health And Social Care Essay

Over 8 million of new instances of TB are discovered and about 1.5 million deceases resulted from TB yearly, TB has declared figure one infective slayer. [ 1 ] [ 2 ] Generally, TB ( TB ) is defined as a catching infective disease cause by Mycobacterium TB. A individual can infected when he or she inhales a proceedingss sum of septic phlegm of air. Terbium is non catching by direct contact with apparels or agitating custodies with person who has Terbium. Terbium is spread through the external respiration of the septic air during close contact. There is besides another type of untypical TB, transmitted when imbibing unpasteurised milk. Related bacteriums, Mycobacterium bovis which are found in unpasteurised milk are responsible to do this signifier of TB [ 23 ] . The symptoms of TB are non obvious until the disease is rather advanced. The early symptoms of TB are usually confused with other common symptoms of a febrility, including weariness, loss of appetency, a productive cough, febr ility, weight loss and dark workout suits. The infection of the TB is more frequently than non spotted in the upper portion or lobe of the lungs. It normally takes months ( incubation ) from the get downing point of initial lung infection for symptoms to be noticeable. The worsen infection in the lungs can besides ensue in symptoms like chest hurting, coughing continuously, coughing out phlegm of stuff from the lungs and blood and trouble in take a breathing ( panting for breath ) . Incidence1 Prevalence 2 Mortality WHO part no. In 1000s % of planetary sum rate per 100 000 pop3 no. In 1000s rate per 100 000 dad no. In 1000s rate per 100 000 dad Africa 2 828 30 % 351 3 809 473 385 48 The Americas 282 3 % 31 221 24 29 3 Eastern Mediterranean 675 7 % 115 929 159 115 20 Europe 425 5 % 48 322 36 55 6 South-East Asia 3 213 34 % 183 3 805 216 477 27 Western Pacific 1 946 21 % 109 2 007 112 261 15 Global sum 9 369 100 % 139 11 093 164 1 322 20 1Incidence is the figure of new instances originating during a defined period. 2Prevalence is the figure of instances ( new and antecedently happening ) that exists at a given point in clip. 3Pop indicates population. Diagram 1: Estimated TB incidence, prevalence and mortality, 2008 hypertext transfer protocol: //www.who.int/mediacentre/factsheets/fs104/en/ Diagram 1 indicates the estimated TB incidence and rate of decease in 2008. South-East Asia and South-East Asia have the highest figure of incidence, prevalence and morality rate of TB. These are low income states. Terbium is a poorness related disease which will be discussed subsequently in this study. ( 436 words )SolutionCocktail of drugs hypertext transfer protocol: //physicianjobster.com/wp-content/uploads/2010/01/latent-tuberculosis-guidelines-and-diagram.pngTB is categorized into two chief group based on the pharmacologic intervention for several phase, latent infection and active disease. About 90 % of patients who infected with primary TB will hold no farther clinical manifestation and will mend without the realisation of the disease. Merely approximately 5 % of the patients will travel on to develop the disease into a more progressive and active disease including disseminated TB ( TB bacteria infected parts of the organic structure other than lungs ) . Latent infection occurs when the pneumonic macrophages are able to incorporate the bacteriums but non extinguish them. C: UsersdantesDesktop blatent-tuberculosis-guidelines-and-diagram.png Chemoprophylaxis During the phase of latent infection of TB, although the symptoms of the disease are non manifested but latent infection can develop into the active phase. Therefore, chemoprophylaxis can be initiated to pull off the status. Chemoprophylaxis is the prescription of certain medicines in the purpose of forestalling an infection. Normally, two drugs are involved in this regimen. Isoniazid which is a common drug will be prescribed to patients with latent infection. Generally, 300mg daily of Isoniazid ( INH ) will be given for 9 months in grownups. If there are any intuition of opposition of bacteriums strain to INH or intolerance of patients to INH ( allergic reaction ) , INH can be replaced with Rifampin ( RIF ) . Normal medicine of RIF of 600mg for 4 months is a suited permutation [ 22 ] . Drugs intervention therapy ( 698words ) While for the phase of active disease of TB, the standard regimen Isoniazid, Rifampin, Pyrazinamide ( PZA ) and ethambutol ( EMB ) for 2 months followed by INH and RIF for 4 months is administered [ 7 ] [ 9 ] [ 22 ] . The consequence of the phlegm cultivation TB of patients is used to find the susceptibleness of the bacteriums to the drugs. It in bends decides which drugs to be used in the intervention. The tabular array 2 below is a guideline for the prescription of the intervention. Diagram 2: Prescription for intervention of TB hypertext transfer protocol: //www.cdc.gov/mmwr/preview/mmwrhtml/rr5211a1.htm ( 753 words ) If the bacterium become drug immune, multi-drug resistant TB ( MDR ) , other drugs are to be given. For illustration, Ethionamide, Streptomycin, Cycloserine and the list goes on. Drug opposition should be suspected in the undermentioned state of affairss: Patients who have received anterior therapy for Terbium Patients from geographic country with high prevalence of opposition ( Mexico and Southeast Asia ) HIV patients Patients known to be exposed to MDR-TB instances Patients who still have acid-fast bacilli-positive phlegm vilifications after 2 months of therapy Patients who still have positive civilization for TB after 2 to 4 months of therapy Particular intervention should be given to a certain population depending on their status for case, HIV patients, pregnant adult female, kids, extrapulmonary TB. In population of pregnant adult female, the drugs used are non to present a hazard to the foetus every bit good as to the female parent. RIF is non given because it is related to limb decrease and cardinal nervous system lesions in foetus. Ethionamide may be associated with premature bringing, congenitial malformations and Down ‘s syndrome. The drugs prescribed must be monitored carefully to forestall any long term side effects to the patients [ 7 ] [ 22 ] . The tabular array in diagram 3 show the chief two groups of drugs used to handle TB, first line and 2nd line drugs. If the first line drugs fail to handle TB as the TB bacteriums strain becomes immune, 2nd line drugs are used. ( 992 words ) Diagram 3: The first and 2nd line drugs for TB ( hypertext transfer protocol: //www.cdc.gov/mmwr/preview/mmwrhtml/rr5211a1.htm ) ( 1005 words ) Effectiveness Diagram 4: Treatment result and clip from start of intervention to transition of sputum civilization among 39 patients ( http: //www.biomedcentral.com/1471-2334/8/6/table/T2 ) C: UsersdantesPicturesTB.jpg All of the patients ab initio received day-to-day therapy that comprised INH, RIF, EMB, and PZA. Treatment was successfully completed in 36 patients ( 92 % ) , and 35 ( 90 % ) were cured. This indicates a high success rate of intervention utilizing the drugs above. ( 1067 words ) Direct observation of Therapy To maximize the completion of intervention class, direct observed therapy ( DOT ) is introduced. This method will advance attachment to the intervention. Medical officers should supervise DOT. This method ensures the intervention class of the patient is completed. hypertext transfer protocol: //www.cdc.gov/mmwr/preview/mmwrhtml/rr5211a1.htmhttp: //www.health-res.com/EX/08-01-20/r211a1b14.gif hypertext transfer protocol: //www.health-res.com/EX/08-01-20/r211a1b14.gif ( 1122words ) Diagram 5: the intervention success of TB ( % ) under DOTs in Albania, Ecuador and HaitiEffectiveness Diagram 6: the intervention success of TB ( % ) under non- DOTs in Albania, Ecuador and Haiti hypertext transfer protocol: //apps.who.int/globalatlas/includeFiles/generalIncludeFiles/toolOptions.asp? displayType=chart ( 1146 words )The DOTS programme in China, the largest DOTS programme in the universe, prevents about 30 000 deceases a twelvemonth. Over 90 % of patients treated are cured.( hypertext transfer protocol: //www.who.int/inf-new/tuber2.htm ) Diagram 7: Terbium instances human death rates ( % ) with or without DOTS in 2009 in China ( http: //www.who.int/inf-new/tuber2.htm ) Based from grounds from diagrams 5, 6 and 7, it is shown that the TB intervention success rate addition with the execution of DOTS. In diagrams 5 and 6, the informations in Ecuador shows that the intervention success rate under DOTs is much higher than those under non-DOTs by about 75 % . In diagram 7, the human death rate from TB is decrease by about 15 % if DOT is implemented. In my sentiment, DOT is effectual because most patients did non follow the physician ‘s recommendations and they tend to bury to take medicines regularly.DOT provides a manner to guarantee that all the patients are following their medicines. ( 1296words )DeductionsEconomic deduction One economic issue that I have encountered while carry oning this research is that the under-developed states have the highest rates of TB. And they do non hold fiscal support to derive entree to the antibiotic intervention. â€Å" Tuberculosis ( TB ) – a preventable disease linked to poverty – was declared an exigency in Africa in 2005. Each twelvemonth it claims the lives of half a million Africans, many immature and in their most productive old ages. In the past 15 old ages, overall rates have doubled in Africa and tripled in high HIV countries. Africa has the highest per capital incidence of TB in the universe ( 28 % ) , with most of the worst affected states located in sub-Saharan Africa. †( African Medical and Research Foundation, 2005 )The province of exigency is a consequence of immense fiscal load of the low-income states as the interventions are time-consuming and dearly-won. Furthermore, overcrowded country in Africa means easier transmittal of disease from individual to individual. These grounds result in more incidence of TB in Africa per twelvemonth. In my sentiment, the authorities demand to be financially stable in order to supply citizens with efficient and broad ent ree to intervention. Government should besides form runs to increase the consciousness towards the figure one infective disease slayer TB. ( 1505words ) Social deduction Many TB patients will halt taking the medicine after several hebdomads as their symptoms are relieved. First of wholly, the drugs for TB are dearly-won. Second, they feel healthy after twosomes of month of drug intervention. If the patients did non finish the antibiotic class, possible result is some bacteriums will last and go immune to the drug and infectiousness of the patient doing continued transmittal to the community. These bacteriums will go on to multiply and can non be killed by the old drug, multi-drug-resistant TB. Therefore, other more expensive drugs must be used for intervention. [ 6 ]â€Å" Poverty increases the hazard of TB ; TB impoverishes the victims. More than 90 % of TB instances and decease occurs in low and middle-income states. †( TB Advocacy, A Practical Guide 1999, WHO Global Tuberculosis Programme, STOP TB Annual Report 2001 )The intervention of TB requires a great trade of fiscal support. The cost of the drugs and the installations merely can non b e afforded by low income states. Therefore, low income states like South Africa has the most instances of TB incidence and deceases. Besides that, if a patient can non afford the medicine possible result is more people will be infected as TB is contagious. ( 1707words )Benefits and hazardsOne of the most conspicuous benefits from antibiotics intervention for TB is that it can bring around and liberate the patients from TB. Antibiotics can kill and suppress the growing of TB bacteriums in the organic structure provided the bacteriums are non drug-resistant. Equally long as the patients complete the intervention class, there is a large possibility that he or she will retrieve from the disease. Isoniazid administered to latent infection of TB patients besides prevents the patterned advance of the active disease. The intervention besides aims to halt the infection from distributing to other people [ 8 ] . However, there are a certain side effects of the drugs. Normally, the side effects of the drugs are non common but they can be serious. Patients are recommended to confer with their doctor for any possible side effects and how to cover with them. By and large, the side effects of the interventions includes liver issue ( icterus, abdominal hurting, sickness, and emesis, weariness, fever, dark piss, roseola and itchiness ) , flu-like symptoms ( febrility and icinesss, sickness, purging and musculus hurting ) , flu stain, diarrhoea and the effects may change depend on the drugs administered in the intervention. One of the most common used drugs, Isoniazid can hold side effects of dysarthria, crossness, ictuss, dysphoria, and inability to concentrate, fever, roseola and hepatitis. [ 9 ] [ 10 ] [ 11 ] [ 12 ] ( 1923 words ) Alternate solution Vaccine Bacillus Calmette-Guerin is given during childhood as a vaccinum against TB. It is prepared from attenuated Mycobacterium bovis. The definition of vaccinum is substances that can trip and fix human immune response to specific bacteriums in the hereafter such as dead or attenuated bacteriums. A tuberculin trial must be conducted before the individual is to be vaccinated. Merely non-reactors are given inoculation because they lack immunisation against TB.â€Å" We estimated that the 100A ·5 million BCG inoculations given to babies in 2002 will hold prevented 29aˆ?729 instances of TB meningitis ( 5th-95th centiles, 24aˆ?063-36aˆ?192 ) in kids during their first 5 old ages of life, or one instance for every 3435 inoculations ( 2771-4177 ) , and 11aˆ?486 instances of miliary TB ( 7304-16aˆ?280 ) , or one instance for every 9314 inoculations ( 6172-13aˆ?729 ) . At US $ 2-3 per dosage, BCG inoculation costs US $ 206 ( 150-272 ) per twelvemonth of healthy life gain ed. †( B. Trunz ; P. Fine ; C. Dye. The Lancet, Volume 367, Issue 9517, Pages 1173-1180, 14 April 2006 )The monetary value of BCG is cheap [ 21 ] . Therefore, it can cost-effectively cut down the figure of TB compared to the cost of intervention. The effectivity of BCG is besides proven when it was foremost introduced into England in 1953. [ 13 ] When it was foremost introduced in 1950s, the inoculation programme has efficaciously reduced the incidence of TB by 77 % [ 18 ] [ 21 ] . ( 2145 words ) Diagnosis Tuberculin trial or Mantoux trial The Oklahoman the disease is discovered, the Oklahoman the disease is treated, the larger the opportunity the disease can be cured and managed so that it will non distribute to others unwittingly. This is due to early sensing of disease can forestall more organic structure parts from being infected and the country of infection can be reduced. The most common method used in diagnosing of TB infection is the tuberculin trial or Mantoux trial. It uses purified protein derivative and inject 5 units of it into the tegument of a patients. [ 14 ] [ 15 ] If a raised bump of more than 5mm appears at the site after 48 hours, the trial may be positive. The trial can hold false positive or false negative consequence. hypertext transfer protocol: //en.wikipedia.org/wiki/Mantoux_test ( 2274words ) Chest X ray If the tuberculin trial shows positive consequence, collateral clinical intuition of TB can be carried out via x-ray and microbiologic scrutiny of phlegm. X-ray image of a TB patient will demo abnormalcy in mid and upper lungs Fieldss and lymph nodes might be enlarged. X-ray trial can merely propose there is TB infection but do non corroborate it. Normal chest x-ray ( hypertext transfer protocol: //www.medicine.cu.edu.eg ) Chest X ray of a XDR-TB patient ( hypertext transfer protocol: //www.eurosurveillance.org/images/dynamic/EE/V13N30/TB_Ireland_Figure1.jpg ) Sputum trial ( 2428 words ) hypertext transfer protocol: //nursinglink.monster.com/nfs/nursinglink/attachment_images/0000/2432/SputumTest_crop380w.jpg? 1212559672 Besides that, day-to-day phlegm aggregation over 3 back-to-back yearss is recommended. Sputum proving for acid-fast B is the lone trial that confirms a TB diagnosing. Sputum or other bodily secernments such as from your tummy or lung fluid can be cultured for growing of mycobacteria to corroborate the diagnosing. It may take one to three hebdomads to observe growing in a civilization, but eight to 12 hebdomads to be certain of the diagnosing.Evaluation of beginningBeginning 1 I evaluated the beginning hypertext transfer protocol: //www.cdc.gov/mmwr/preview/mmwrhtml/rr5211a1.htm where the guideline on the intervention of the TB was published. It proved to be accurate because it matched with many other beginnings in term of information. For illustration, in the book of pharmacotherapy enchiridion used by druggist as a beginning of mention ( Barbara G. Wells ; Joseph T. Dipiro ; Terry L. Schwinghammer ; Cecily V. Dipiro ( 2009 ) 7th edition Pharmacotherapy Handbook. United States of America: McGraw-Hill Companies, Inc. ) , it is found that the guideline for intervention and the doses is the same. Furthermore, the information from this web site is dependable and accurate as it was published by Centre for Diseases Control and Prevention, United States of America. It is a United State federal bureau under the Department of Health and Human Services. It works to protect public wellness and supply information sing how to forestall and bring around diseases for the safety intents. It is non-profit based. Beginning 2 Besides that, I evaluated the beginning from a journal article [ Pereira S.M. ; Dantas O.M. ; Ximenes R. ; Barreto ML. ( 2007 ) BCG vaccinum against TB: its protective consequence and inoculation policies ] . The information about BCG vaccinum in this article is proven to be dependable and accurate because it matched with the beginning from hypertext transfer protocol: //www.patient.co.uk/health/BCG-Immunisation.htm. Both of the beginning stated that BCG inoculation is non 100 % guaranteed protection but its high effectivity of about 80 % enable many TB instances to be prevented. ( 2664 words )