Current Issues in Nursing Essay Example

Current Issues in Nursing Essay Example Current Issues in Nursing Essay Current Issues in Nursing Essay Ph. D. and Ann L. Curley, Ph. D. , R. N. The challenges of operating 24/7, focusing on scheduling, training, and staffing. Despite projections that nursing is one of the top ten growth jobs for the next 15 years, our health care system is on the verge of an overwhelming nurse shortage and health care crisis. Adding to the problem is the fact that hospitals and many other health care facilities are extended hours operations that face unique challenges unknown to the 9-5 world. Hazards for nurses discussed in the book: * Health care shows the second highest turnover rate of all â€Å"extended hours† industries * Nursing is one of the ten industries with the highest levels of occupational injury or illness requiring days away from work. * The most prevalent injuries in nursing are musculoskeletal disorders and needlestick injuries. In 89% of needlesticks, the needle was contaminated. * Work related fatigue prompted nearly 20% of nurses to cite â€Å"having an accident while commuting back home† as one of the top three jobs related health and safety risks. * Nurses show high instances of sleep disorders severely affecting productivity. * High failure and short staffing severely affect quality of patient care. ?Problems With Nursing Informatics By: Heidi Cardenas Informatics is the process of advancing in a discipline with a combination of data, information and knowledge. Nursing informatics encompasses the devices, machines, resources, and methods of utilizing information, computers, and nursing science in nursing. Its a recognized specialty for registered nurses, but does present challenges that academics and medical practitioners are working to improve or eliminate. Significance * In 2007, the Healthcare Information and Management Systems Society Nursing Informatics Awareness Task Force estimated that 50 percent of a nurses time is spent on documentation. Because of explosive strides in information technology and the huge body of medical knowledge amassed, controlling medical errors and health care costs are paramount in the health care professions, including nursing. According to RN Journal, handwriting on a piece of paper has been largely replaced by reports from medical devices at the point of care, and nurses have to master electronic documentation. Function * Nursing documentation is complex and situation-dependent. With different technology and medical charting methods in use, consistent education and training on documentation is difficult to achieve, especially electronically. Considerations * There is no single device that generates a comprehensive patient record, stores it and makes it accessible to care providers in different locations. Bar codes on medicines, computerized physician order-entry, automated scheduling systems for nurse administrators, nursing student preparation for IT tools and HIPAA concerns are just a few of the problems in nursing informatics. Potential * Mobile devices, communication technologies, efficient applications, and enhanced workflow and documentation will be the norm going forward and in the future. Ideally, every nurse would learn a universal IT platform for all patient care, but that is an almost unobtainable goal with the rapid advances in research, medicine and information technology. One thing is certainnursing and information technology are integrally intertwined and will remain so in the future. ? Occupational Health and Safety Issues Among Nurses in the Philippines By: A. B. de Castro, PhD, MSN/MPH, RN, Suzanne L. Cabrera, MN, RN, Gilbert C. Gee, PhD, Kaori Fushijiro, PhD and Eularito A. Tagalog, RN, COHN Abstract * Nursing is a hazardous occupation in the United States, but little is known about workplace health and safety issues facing the nursing work force in the Philippines. In this article, work-related problems among a sample of nurses in the Philippines are described. Cross-sectional data were collected through a self-administered survey during the Philippine Nurses Association 2007 convention. Measures included four categories: work-related demographics, occupational injury/illness, reporting behavior, and safety concerns. Approximately 40% of nurses had experienced at least one injury or illness in the past year, and 80% had experienced back pain. Most who had an injury did not report it. The top ranking concerns were stress and overwork. Filipino nurses encounter considerable health and safety concerns that are similar to those encountered by nurses in other countries. Future research should examine the work organization factors that contribute to these concerns and strengthen policies to promote health and safety. ?The National Nursing Crisis: 7 Strategic Solutions By: Jaime Z. Galvez Tan M. D. , M. P. H. Introduction At the rate we are losing monthly our highly skilled nurses to the United States, the United Kingdom, Ireland and the Netherlands, and with the Philippine government, via the Department of Health raising its hands in helplessness, offering no strategic solutions in sight, expect a worsening of the health crisis already plaguing our country. It is not only the nurses the country is losing, our medical doctors are now enrolling in nursing schools offering an abbreviated course for doctors to become nurses. ? Ethical Dilemmas in Nursing By: Jenifer Wilson-Barnett Abstract. Nurses are increasingly realizing that they can offer relevant information and participate in decision-making involving ethical issues. However, inter-professional communications are frequently inadequate, and do not permit exchange of opinions. The consequences are often frustrating and upsetting for nurses whose care is affected by others policies. ? Unemployment * The Professional Regulation Commission estimates the number of jobless Filipino nurses to hit 298,000 this year, to include the 68,000 who took the local licensure exam in December. ? RN Heals Department Order No. 2012-0184 (DO 2012-0184). * The Order speaks of the following interesting points: * RNheals nurses are not ‘employed’ but rather are intended for learning and development. Nurses under the program are not regular employees but pre-service trainees. They are given stipend/allowances not salaries. * RNheals 4 tour of duty will be from January to December 2013. Nurses will be assigned in DOH Hospitals (Hospital Setting) or Rural Health Units (Community Setting). Stipend/allowance for RN Heals 2013 is still 8,000 per month with PhilHealth and GSIS Insurance. * Nurses are to be awarded with Certificate of Completion after satisfactorily completing the RNheals program. * RN Heals 4 Recruitment and selection period will be from October 29, 2012 to November 2012. * Application forms shall be submitted directly to CHDs for community setting and DOH Hospitals for hospital setting. * ONLY NURSES WITH PRC LICENSE are eligible to apply. * Nurses who have previously engaged in RNHeals are not qualified to re-enter the project. * In case of absences, a fixed amount of Php 363. 00 per day shall be deducted. * Stipend shall be given on or before every 10th and 25th day of the month. * Eight training hours per day shall be completed by the nurse.

Electronic Medical Records

Electronic Medical Records The cost of healthcare is a serious concern for many governments. The health burden seems to be on the rise despite advances in medical technologies. There are newer disease strains, increased virulence of some diseases, issues like drug resistance, and increased people mobility increasing the rate of spread of diseases.Advertising We will write a custom essay sample on Electronic Medical Records specifically for you for only $16.05 $11/page Learn More This is not to say that healthcare has not improved. Rather, it is the recognition that while there is improvement in healthcare standards, the cost is also on the increase. Cost management measure in healthcare includes expanding access to medical insurance such as Medicare and Medicaid. The long-term efficacy of public healthcare systems depends on increasing efficiency to keep the cost of healthcare affordable. IT is proving useful as a means of increasing efficiencies in most industries. IT is already in u se in health facilities. In conventional health facilities, IT finds use in areas such as billing, procurement, pharmaceutical services, and patient registration. However, most conventional IT systems in Health institutions are not integrated. Even where integration exists, usually its aim is to streamline the business process. As such, there was a move to spread the benefits of IT in the management of health information retrieved from patients. This brought about the concept of Electronic Medical Records (EMR). The role of EMR is to make patient information available across the medical value chain to increase the efficiency of medical care. The term Electronic Health Record (EHR) sometimes replaces EMR in literature. Therefore, this paper uses them interchangeably. While EMR refers to the whole system comprising the hardware, software and the medical information in it, the information relating to a specific patient comprises the Personal Health Information (PHI) component of the sy stem. The law protects PHI to deter breaches of patient privacy by parties with access to the information. Structure of the Paper The goal of this paper is to explore the contemporary issues surrounding the implementation of an EMR system. Specifically, the paper examines the stakeholders in the EMR system and their impact on the system. Secondly, the paper looks at the benefits associated with the use of an EMR system.Advertising Looking for essay on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More In addition, the paper examines some of the challenges and controversies EMR systems present. There is a brief look at the legal framework covering the use of EMR systems in America under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. This discussion gives way to a look at the future of EMR. Stakeholders in the EMR System It takes the effort and cooperation of a number of stakeholders to ensure the proper operation of the EMR system. As an IT-based platform, EMR relies on the expertise of IT professionals to operate. This category of stakeholders includes software designers, software vendors, IT administrators, and Hardware suppliers. Their role is to avail and manage the IT infrastructure on which the system operates. There are several classes of stakeholder under each category. For instance, there are commercial software developers and open source developers. The second category of stakeholders is those in the medical fraternity. They include the medical institutions using the EMR system. They also include the medical professionals who feed information into the system, or access the available information in order to provide care for the patients in the system. In addition, there are support professionals such as laboratory technicians, pharmacists, radiographers and others who pr ovide specialized services in the medical institutions. This category of stakeholder represents the primary users of EMR systems and it is responsible for entering data into the EMR system. Patients form a very important category of stakeholders. They are the primary beneficiaries of the systems. They are also the source of information stored in the EMR systems. Apart from the benefits, patients stand to suffer from risks associated with the operations of the EMR such as wrong records leading to erroneous diagnosis, or breach of their privacy based on wrongful use of the information help in the EMR systems. Patients stand to suffer the most, or benefit the most from EMR systems. Their main concern is the privacy of the information they provide. This is the basis of the HIPAA and HITECH laws.Advertising We will write a custom essay sample on Electronic Medical Records specifically for you for only $16.05 $11/page Learn More Other stakeholders include regulat ors such as health agencies, and researchers who use aggregated information from the EMR to improve the services offered. Researchers who take an interest in EMR systems come from the IT industry and those involved in epidemiology and public health. The federal government also forms part of this group of stakeholders considering it creates the rules that all other players live by. Insurance companies also are important stakeholders in the EMR industry because the operation of the industry affects their businesses. These stakeholders have legitimate claims to access data stored in the EMR systems. Justification of EMR Systems The justification for using EMR revolves around the efficiency of these systems and potential uses of electronic records as compared to paper records. Paper records still feature prominently in medical institutions as the means for gathering patient data. The transition to EMR is still underway, with a legal deadline set at 2015. Paper records are very easy and convenient to handle during data entry. However, information storage and retrieval of paper-based systems is very expensive and inefficient. Paper records create serious logistical challenges that compromise the quality of healthcare. The difficulties of information sharing between institutions make paper records almost useless when it comes to determining a patient’s medical history. EMR on the other hand makes storage and retrieval easy, and reduces duplication of effort. From the level of providing national healthcare, EMR promises to help cut the overall cost associated with health records. By using IT based systems, the need for warehouses to hold patient records disappears. Instead, medical institutions can use general IT silos, constructed for the storage and retrieval of digital information. The health facility does not need to build its own data warehouse because of the availability of space in commercial data warehouses at competitive rates. In addition to these, th e availability of information about a patient from multiple points eliminates the need for duplicate tests because each medical caregiver can refer to test results and treatment history indicated in the PHR of a patient. These records are available with the EMR infrastructure. EMR also assists in increasing the efficiency of the entire healthcare value chain. Within the health facilities, the trend is to integrate the EMR system in use with the business systems such as medical supply order processing systems, and billing systems to increase the efficiency of the medical value chain.Advertising Looking for essay on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More Secondly, financiers such as insurance companies, can access better information regarding healthcare. This makes it possible for them to offer competitive premium rates based on the data. This is simply another benefit to the medical care value chain. All the stakeholders experience certain advantages derived from the benefits of EMR. Benefits of EMR Apart from the fundamental justification of EMR, there is a need to explore the specific benefits of the EMR systems in more detail. This section discusses the benefits of the EMR to various stakeholders. Patients Patients are the primary beneficiaries of EMR. Most of the advantages stemming from the use of EMR lead to better care for patients. The first advantage that patients get from EMR is that they have more control over their medical information. By using PHR access portals, a patient can add supplementary information to their health record thereby making a permanent entry to the EMR. This control assures the patient that a physic ian taking care of him or her has access to all the important information. EMR systems trace the source of information in it. This enables physicians and other medical professionals to separate information provided by medical professionals, from that given by the patient. The second benefit patients derive from EMR is that they are at a lower risk of wrong diagnosis. This means that a patient can get accurate treatment of ailments simply because the caregiver has access to the patient’s full medical history. Better care means that the patient can recover faster and resume a productive life quicker. The costs of care also diminish because a patient does not have to spend their health cover on repeat tests after moving from one jurisdiction to another. All healthcare providers with access to the EMR have the same record to work from regarding a specific patient. There is no need to create duplicate files about the same patient. EMR also provides physicians and other healthcare providers with several benefits. First, post-entry data management tasks reduce dramatically for the medical professionals. There is no need to spend time classifying paper records and sending them to warehouses. In addition, the process of retrieving information does not involve lengthy searches in a warehouse. Electronic systems make it very easy to access the records of a specific patient. A healthcare professional can view all the tests undertaken and results posted from the comfort of a consultation room, and without waiting for them to come from a warehouse. They can also determine the best course of medical action to take very fast because there is no need to generate a new medical history. Secondly, healthcare providers also enjoy the benefit of reduced risk of making the wrong diagnosis because of the availability of the medical history of any patient they are treating. It also eases referrals to specialists who can then determine treatment and other medical interventions n ecessary for a given patient based on the physicians entry on the EMR. The specialist can view the full history of a patient’s condition without necessarily consulting with all the medical caregivers who have previously attended to the patient. The overall work rate of a physician working with EMR increases because of the ease with which patient records are available. To healthcare institutions, EMR also posts several benefits. The entire institution stands the chance of increasing its overall efficiency by using EMR. In a healthcare facility, paperwork constitutes a critical component of service provision. A healthcare institution can eliminate a layer of overheads related to managing paper records simply by installing an EMR system. This cuts costs and increases the workflow rate in the entire medical institution. For smaller practices, using EMR can increase patient confidence because of the integration with the overall healthcare system. A patient can enjoy personalized s ervice with the assurance that their medical records will be accessible at any other health facility they will visit in the future. Secondly, fewer medical errors by caregivers mean fewer cases of legal action or loss of practice license. This advantage reduces further the overheads a health facility incurs related to legal suits arising from negligence or medical errors caused by poor information. This also creates the added benefit of increasing patient confidence in the institution. Another benefit health a facility derives from an EMR is that it can do away with warehouses used to store medical records in paper format. These warehouses can be quite large because of the amount of paperwork medical records tend to generate. There is a legal requirement to store paper records for at least seven years after their creation. The warehouses also need staff to maintain them. By eliminating paper records, health facilities no longer need to pay salaries of the staff involved in managing paper records. Regulators derive several benefits from EMR. For the purposes of this paper, regulators refer to state and federal authorities active in the health sector. One area where regulators find benefits from the EMR is in the matter of epidemiology. Through the data provided from the EMR, agencies involved in the protection of public health can detect the spread of diseases and other health conditions. This enables them to develop responses that inform the quality of healthcare in their jurisdiction. Similarly, the federal government is in a position to make better healthcare choices based on the data collected through the EMR. Reduction in healthcare costs makes it possible for the federal government to improve the quality and range of services offered to the public based on the benefits derived from EMR systems. In total, EMR leads to a reduced health burden because of efficient care and lower cost of care. This advantage increases the overall productivity of the workforce , and frees resources for use in other areas of the economy. Researchers are very critical in healthcare delivery. Within healthcare, there are several categories of researchers tackling various components of healthcare research. Researchers involved in healthcare issues do not only include medical researchers. There are other categories such as IT researchers and workflow research specialists. The most significant benefit researchers derive from EMR is that it makes available high quality data. Researchers with access to EMR can use very clear data in standard formats to pursue their research needs. Unlike in the past when they had to collect data from various repositories, EMR is one large data pool where researchers can collect data quickly and in highly usable formats. The integrity of the data is also very high. Researchers also enjoy the ease and speed of access to the data. They no longer need to deal with multiple authorities in order to access data. Since it is possible to aggregate electronic data, manipulating it is also very easy, which increases the range and quality of information researchers derive from EMR. It was almost impossible to remove identifying details in paper records to make it easy to use in research. However, with EMR, it is possible to get the information relating to medical histories and treatment regimes without including the personally identifiable patient information. This also reduces the anxiety patients previously felt when researchers perused their data. The final categories of stakeholders who benefit from EMR are other providers of healthcare support services such as insurance agencies and software vendors. Insurance companies are very important partners in healthcare financing. These companies use the data from EMR to calculate premiums. EMR reduces the cost of healthcare by reducing duplicate costs such as repeated medical tests when previous records are not available. In addition, EMR eliminates the time and effort pr eviously used to collect, store and retrieve medical records. This translates to reduced cost of medical insurance and increased quality of the services offered. Other stakeholders who provide support for healthcare also glean many benefits from EMR. For instance, software vendors and hardware providers in the health sector are in business because of the need to install and maintain EMR systems in health facilities. Secondly, better records make it possible for pharmaceutical companies to determine the efficacy of drugs they provide. This is important when carrying out research regarding drug resistance, and when examining potential side effects of recently introduced drugs. These records provide all round benefits for anyone who needs information to provide better services in the healthcare setting. Controversy Surrounding EMR While there are glowing benefits of using an EMR, a number of practical problems accompany the use of EMR. Physicians suffer the brunt of these problems beca use they are the primary data entry professionals in the EMR systems. The first category of problems they encounter relate to usability. Secondly, there are concerns about the overall effectiveness of EMR systems in cost savings for medical institutions. Thirdly, data security is of great concern to patients and finally, there are a number of hardware and software challenges dogging the use of EMR systems. Usability EMR systems have several documented usability problems. These problems come from the fact that there is no general standard when it comes to EMR design. Different software development firms adopt different system design standards for their systems. This results in a situation where there are numerous interfaces for EMR software developed by different companies. The difference in interface layout design is reducing the efficiency of physicians. Physicians have to learn to use different EMR systems in the different facilities where they work. For instance, a physician base d in one medical facility uses the EMR system in that facility to enter patient data. However, when that physician goes to another medical facility either as a consultant or as a supporting physician, chances are that the second facility uses a different EMR system. This makes it necessary for this physician to learn how to use several EMR systems in order to be effective in each health facility that they visit. It is normal for physicians to use several EMR systems depending on the number of healthcare facilities that they work in. This situation is reducing the quality of user experience with EMR systems from the physician’s point of view. In addition to reducing the quality of their experience, it obviously takes a lot of learning to become proficient in the use of several distinct EMR systems. Learning to use different EMR systems is making it very difficult for physicians to operate the systems as efficiently as expected. The systems tend to be complicated with different layout design, menu arrangement, naming protocols, and different data entry procedures. Another well-documented problem is system access. Physicians are suffering from â€Å"password fatigue†. In each facility a physician visits, he needs a password to access the EMR system there. In addition, each time a physician moves from the consultation room to the examination room, he must log out from the previous location and login in the new location. As if this is not enough, many facilities require physicians to change their passwords on a regular basis. Worse still, the passwords settings of some EMR systems require a combination of letters in both upper and lower case, and numbers. This makes access very difficult for physicians. Cost Savings In theory, IT increases operational efficiency, which should result in decreased overheads. Many sectors report gains in efficiency due to the adoption of IT based systems. In fact, even health facilities have seen savings and gains in eff iciency because of the adoption of IT in the procurement of medical supplies and billing. However, IT also comes with costs, which may wipe out any gain in efficiency. There is a lively debate relating to the potential of EMR to cut down healthcare costs. In large facilities, it seems that IT brings in large gains because of the historical operational inefficiencies associated with large medical facilities. Large institutions benefit from the economies of scale, which IT harnesses. However, for smaller practices, the use of EMR systems creates an additional layer of overheads. The cost of installation and maintenance of EMR for small practices can wipe out the benefits it promises. In fact, some researchers have shown that adoption of EMR by small practices can result in increased overheads . It does not always bring about a reduction in operating costs. While EMR systems bring about cost savings that accrued from management of paper records such as warehousing costs, the EMR system s also come with an additional layer of costs. There are hardware and software costs, and the cost associated with maintaining IT staff in the organization. Therefore, it is not always true for every organization that introduces EMR will see savings in their overall costs. On another front, IT systems work at their optimum once there is widespread adoption and use of the systems. The barriers physicians face while using EMR systems is reducing the overall benefits of the systems. For instance, the time it takes to enter data into the EMR is longer than the time it takes for a physician to create a paper record. The experience of a patient getting attention from a physician who is not fluent in the use of EMR systems may be worse than their experience when using the physician uses paper. Security Concerns With the expansion of interconnection of IT based communication platforms in the last two decades, information security has taken center stage as the most significant threat to IT. Individuals and corporations alike need constant assurance that their information will be safe in the long term. With EMR systems, a very large network of people can access the information stored in the system. Any physician with access to the EMR can access data relating to any patient. In addition, there are IT specialists, regulators, and insurance service providers with access to these systems. The numbers of potential people who can access the health records of an individual makes patients feel unsafe to have their PHR stored in EMR systems. That said, there is another layer of threat from cyber criminals. The motive of cyber criminals may by terrorism, criminal intent, or mischief. Whatever the case, patients are wary of the potential outcome of unauthorized access to their health records. Privacy is also a matter of concern for many patients. Different people have different views on privacy, with some regarding privacy as something very important. Other people may not attach a lot of weight to the privacy of the information they provide as long as no one uses it to harm them. EMR complicates the arrangements that previously existed, which assured patients of confidentiality of their personal information under client-doctor privilege. EMR allows anyone with access to the system to access this information. To increase information security, database management technology is advancing. Information silos are taking on data encryption to deter unauthorized access. Such a measure works well for unauthorized users, but it does not prevent leaks from those with authorization to access the EMR. Other data protection measures include the use of passwords, and tracking the users who access data in the EMR. Tracking users do not work in situations where unauthorized persons use the accounts of authorized persons to access patient information in the EMR. Password based systems lack authentication capabilities. Therefore, it is possible to gain access to a physicianâ €™s account in the EMR after obtaining the physician’s password through phising. This demonstrates that there are still serious concerns relating to privacy and information security plaguing the use of EMR systems. Software and Hardware Issues EMR software comes in various forms. The most common form of EMR software is commercial software where the medical facility buys EMR software from a vendor under a license allowing for institution-wide use. Commercial software comes with technical support and at times, the software development company provides training for staff and other EMR users to improve uptake. EMR software is useful only if the users are competent in its operations. Depending on their needs, medical institutions can choose from several commercial EMR software options. Each institution chooses the software that it feels meets its needs in the best way. Apart from commercial software, open source software is also available for facilities that cannot afford comm ercial software, or are not ready or willing to pay for commercial software. Open source software depends on volunteer software developers who keep improving the quality of the software. Usually, a central committee moderates the development of the software and releases improvements over time. Open source software can be a great place to start from because of the lower upfront obligations. That said, open source software frequently lacks dedicated support. The most common type of support available for open source software is through user forums. Through these online forums, users share experiences and potential fixes to glitches in the software. The third type of EMR software is available under the arrangement called Software as a Service (SaaS). This version refers to a system where the software development company retains all rights to the software and does not sell the software as a product to users. Rather they give users a license to use the software for a period. The software remains in the provider’s server and the users access the software on demand. The advantage of SaaS is that the developers can keep adding to the functionality of the service without the need to send copies of updates to the users. This makes SaaS a very reliable way of providing services. Difficulties associated with the use of SaaS include data management and transition to new platforms. Data storage is easier for the institution because the software development company invests in storage hence client health facilities do not need their own data silos. It also protects the medical institutions from local threats such as the crushing of servers, destruction of data silos, and local sabotage. The software development companies can afford to implement higher-level security protocols for the data in their silos. However, the issue of access is still very thorny. Storing patient data in a third-party information warehouse exposes the data to information security threats. It is a lso very difficult to move data to a new data warehouse if the storage facility is not under the control of the health institution. Other software related issues affecting the operation of EMR is data entry capabilities. The latest technologies supporting data query are still insufficient for Natural Language Processing (NLP). NLP refers to the capacity of software to aggregate data related to the same subject but expressed in different phrases. The most developed technologies in this regard utilize keyword search algorithms. Keyword based systems cannot decode contextual meanings when aggregating data. Different physicians use different expressions to refer to the similar conditions. In addition, the medical vocabulary used for similar medical conditions tend to be diverse. The main limitation that this brings about is that it makes data aggregation very difficult. It limits the usability of the data collected in the EMR. One of the ways of overcoming this challenge is by using ele ctronic data collection forms with standardized vocabulary. This option is useful for medical services such as laboratory tests, and for diagnosis. However, the conclusions from these processes cannot fit on a form-based system. A minor issue with huge consequence that also fits in this category of problems is the use of different spellings to refer to the same conditions. The spelling problems arise because of the differences in regional spelling standards, or simply wrong spelling of medical terms based on subjective mistakes. This also complicates the usefulness of EMR systems. Legal Framework for EMR The two main laws surrounding the use of an EMR is the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. These laws define the legally accepted use of medical information and address the rights and liabilities of various stakeholders. In particular, these laws look at the parties involved in conveying health Information and seek to deter the misuse of health information. HIPAA sought to establish limits surrounding the transmission of â€Å"individually identifiable health information†. HIPAA served to reduce the risk of unauthorized information sharing by determining parties with a legal right to access medical records and the penalties for disclosing medical information. Parties with access to personalized medical information include healthcare providers, healthcare funders, and regulatory agencies. Information meant for wider audiences such as researchers, by law, cannot include individually identifiable information. The law requires the removal of all information such as names of patients and the identity of their employers before transmission. Some reviewers of the implementation of these laws felt that medical practitioners were more cautious about sharing information than these laws required . The explanation for this phenomenon is that there is an increase in the number of cases against medical practitioners. The professionals in the field feel that it is better to be stricter than required instead of dealing with a case in court. The Future of EMR It is difficult to imagine a future without EMR systems. While EMR is responsible for a new set of issues, its benefits, and potential, make EMR a necessary part of the future of medical services. The implementation of EMR led to the realization of other potential benefits that a medical facility could derive from it. These benefits outline the future of EMR. The first element is that there will be increasing pressure from healthcare institutions to have EMR systems that improve a physician’s workflow. This is indeed the first advantage that EMR promised in addition to availing the information needed to treat a patient on-demand. A physician’s workflow is a very important business element in the provision of health services. Reducing the work processes a physician undertakes to deliver healthcare, or improving the turnaround, makes physicians more efficient. In terms of resource commitment, a physician who concentrates on the highest value work makes more money for the healthcare facility than the one who handles other mundane tasks that reduce the effective high value time the physician spends waiting for the completion of processes. Future EMR will strive towards improving physician workflow. The essential element of the workflow is the need to have faster, yet safer means of accessing data from different points in the healthcare value chain. There are movements towards e-medicine where a physician is able to treat a patient using virtual contact. In the conceptualization of these systems, an experienced surgeon can supervise a surgery remotely, while specialists can render views on MRI scans and other tests from remote locations. The ability to do this without incurring travel costs will improve physician workflow leading to incr eased profitability for healthcare institutions. Secondly, EMR systems will tend towards greater integration with other electronic systems to improve efficiency. This will take place at various levels. One of the major problems bedeviling EMR is information security. The use of complex passwords is cumbersome especially if there is need to log in at different locations within the same facility. The simplicity of a password based security system explains its current widespread use, not just in EMR, but also across the entire IT industry. The problem with passwords is that there are no means of authenticating a login if a user gives a correct password, even if they are not the ones authorized to use that password. Already, there are many options available for better authentication based on biometrics. The options here include fingerprint scanning, iris scanning, facial recognition, speech pattern recognition, and hand dimension recognition (CITE). These technologies require an additio nal investment in IT infrastructure. In addition, they can only provide security if they are available at all possible access points. It is possible to implement such systems within a closed facility, but it would be very difficult to support remote login. However, with improving technologies, the standardization of security systems will make it possible for EMR systems to implement these security measures. For instance, most of the latest laptops come with a camera as a standard feature. This hardware can form the basis of a face recognition based security option for EHR. There will be an increase in the standardization of EMR systems based on consumer needs. As software developers understand user needs better, they will be a convergence of systems to make it easier for physicians to interact with different EMR systems. In part, this will reduce the current problems physicians face when they move from one facility another with different EMR systems. It is also likely that there wil l be an increasing degree of compatibility between EMR systems to reduce the problems associated with the use of different EMR systems. In the last few years, mobile web is proving to be a serious competitor to traditional computer-based access to the internet. With the advent of smart phones, EMR systems will find their way to mobile devices . Physicians will have the option of accessing EMR systems using applications on their mobile devices. EMR for mobile devices will require different software platforms from those used for computer based access. Its benefits will include round-the-clock access. Physicians will be able to attend to emergencies faster because they will not need to have access to a computer to attend to a patient remotely. Their phones will be sufficient for this role. One of the benefits some healthcare facilities are enjoying from EMR is integration with billing systems and even drug supply. This kind of integration will increase. In the near future, EMR will hav e full integration with e-commerce systems such that after treatment, a patient will be able to pay for services automatically. EMR systems will also include communication integration options reminding a patient of their annual checkups and upcoming appointments either by email or via short messaging to their phones. Patients with electronic health devices such as pace setters, electric wheelchairs, hearing aids, blood sugar monitors among others, will have real time data relating to their health status fed into the EMR automatically. Such devices, in conjunction with mobile communication devices can collect and relay data directly to the EMR. Such systems can then alert a patient to see a physician, and in cases of managed care, the caregivers would have alerts sent to them to check on their patients. These technological possibilities point to multiple futures in the use of EMR. Some of these ideas are already past the research stage, and are simply awaiting commercialization. They will improve the functionality of EMR and will improve the quality of healthcare. Akhtar, Saeed. Epidemiologic Measures of Association. Karachi: Division of Epidemiology and Biostatistics, Aga Khan University, 2008. Print. Bauer, M and R Nay. Factors Associated with Constructive Nursing Staff-Family Relationships in Care of Older Adults in the Institutional Setting. A Systematic Review. International Journal of Evidence-Based Healthcare (2008): 23-45. Print. Dube, Line, Carmen Berner and Vital Roy. Taking on the Challenge of IT Management in a Global Business Context: The Alcan Case Part A. International Journal of Case Studies in Management 7.2 (2009): 1-13. Print. Engelbrecht, Rolf. Connecting Medical Informatics and Bio-informatics: Proceedings of MIE2005 : The 14th International Congress of the European Federation for Medical Informatics. Amsterdam: IOS Press, 2005. Print Guerra, Antony. EMR Problems Hurt Doctor Efficiency, AMA Says. 1 July 2011. Information Week. Web. Hersh, William R. The Electronic Medical Record: Promises and Problems. Journal of the American Society on Information Science (1995): 772-776. Print. HHS. Health Information Privacy. 2012. US Department of Health and Human Services. Web. Hoadley, Jack. Cost Containment Strategies for Prescription Drugs: Assessing the Evidence in Literature. March 2005. AMCP.ORG. Web. Jacobs, Philip, John Rapoport and Egon Jonsson. Cost Containment and Efficiency in National Health Systems: A Global Comparison. Weinheim: Wiley Verlag, 2009. Print. Jeffrey, Mark and Joseph F Norton. MCDM, Inc. (A) IT Strategy Sychronization. Kellog School of Management (2006): 1-9. Print. Miller, Eula and Lucy Webb. Active Listening and Attending: Communication Skills and the Healthcare Environement. Webb, Lucy. Nursing: Communication Skills for Practice. Oxford: Oxford University Press, 2011. 52-72. Print. Niles, Nancy J. Basics of the U.S. Healthcare System. Sadbury, MA: Jones Bartlett Learning, 2010. Print. Smelcer, Jo hn B, Hal Miller-Jacobs and Lyle Kantrovich. Usability of Electronic Medical Records. Journal of Usability Studies (2009): 70-84. Print. Ulmer, Cheryl. Future Directions for the National Healthcare Quality and Disparities Reports. Washington DC: National Academies Press, 2010. Print.

Jean Rhys's Wide Sargasso Sea influence by Charlotte Bronte's Jane Essay

Jean Rhys's Wide Sargasso Sea influence by Charlotte Bronte's Jane Eyre - Essay Example The Caribbean fashioned Rhys's sensibility and she remained nostalgic for the emotional vigor of its black people. But the conflict between its beauty and its cruel history became internalized within her own self destructive personality. In the 1960's Rhys gained international recognition with the publication of her most admired novel, Wide Sargasso Sea. The novel had its origins early in life. As a young girl when Rhys read Charlotte Bront's Jane Eyre, she began to imagine the Caribbean upbringing of the character Rochester's infamous Creole wife, Bertha Mason. The result is one of literature's most famous prequels, an aesthetic experiment in modernist techniques and a powerful example of feminist rewriting Wide Sargasso Sea gives voice to a peripheral character and transforms her tragic demise into a kind of victorious heroine. But this is un-typical of the feminist writers of the by-gone era where literature writing and reading by women was quite to the contrary where heroines were depicted in a more positive light. Feminist writing has had a long development. Nineteenth-century English women writers sought and created the sense of literary community by reading one another's books (Shattock p.8). They studied clo sely books written by their own gender and developed a sense of comfortable familiarity with the women who wrote them. There were very intelligent women reading other intelligent women who were also perceptive critics of each other's work and conveyed their views sometimes in personal correspondence and other times in published reviews. Those reading the books felt they knew the authors. There was a sense of community with women readers of fiction and the emergence of female heroines as role models. Even so, there was a certain fascination in searching for the women behind the books since very few people knew them personally and the professional writers did not live in the public domain. They were not university members and did not visit social clubs and societies, gave no lectures, their association with politics were minimal, travel opportunities were limited and their personal lives were the subject of gossip mainly derived from the work they produced. In the nineteenth century a lthough their contribution to journalism was increasing, they conducted the work from home. The twentieth century female writer was much more emancipated, free to characterize her heroines in any way she chose. They portrayal of male characters had no restrictions. Rhys does not hesitate to depict her protagonist and her husband in extreme ways. Returning to the theme of dominance and dependence, ruling and being ruled, Rhys narrates the relationship between a self-assured European man and a powerless woman. The character of Antoinette Bertha Cosway, a West Indian, provides a vehicle for Rhys to examine the conflicting cultures. Her black playmate called her a "white nigger" during her childhood. She marries Edward Rochester a domineering Englishman and follows him to his native country. In the same way Bertha in Charlotte Bront's Jane Eyre ends up confined in the attic of a her husband's country house Antoinette too finds herself in similar circumstances. Many reviewers have examined the "feminine" and "masculine" aspects of Jane Eyre. The novel has been found to evoke 'charm' and 'power' (Boumelha p.2). Some consider its strengths

Battle Royal( Ralph Ellison) Essay Example | Topics and Well Written Essays - 250 words

Battle Royal( Ralph Ellison) - Essay Example In the beginning of the chapter, the African American Narrator is praised by the white folks for his speech in satirical terms. But the black man will not relent. He wishes to protect his essential dignity, notwithstanding the fact that the white people are out to ridicule him on all counts. The black narrator is firm about his decision. Instead of avoiding the white men, he wishes to actively associate with them, to prove his worth. But racial segregation continues. Social harmony between the people of black and white races is still a distant dream. Blacks undergo horrific experiences and Ellison has availed the option to make the story full of imagery and satire than come out with statements and statistics. Strange situations are created for the humiliation of the black youngsters. This happens in an all-white men’s club, where a black protagonist of the story, considered to be a brilliant orator, is invited for a speech on cultural issues. A clever plan is hatched to humiliate him and other black youngsters. He is supposed to give a talk on humility but what is the use of talk on such a topic to people devoid of humanity? In the next situation, describing a fight scene in the ring Ellison states, "It was complete anarchy. Everybody fought everybody else. No group fought together for long" (942). This is the broad indicator as for the tactics used by the white people to keep the blacks suppressed, divided and fight amongst

Spread of Islam in the Post Classical Period Essay Example for Free

Spread of Islam in the Post Classical Period Essay The Sassanid Empire served as the revival of the Persian Empire from 244-651 C.E., Persian traditions had endured during this time period and kinships as well as Zoroastrian religion were part of their everyday life. Bedouin or nomadic societies inhabited the Arabian Peninsula as well, with a culture based on goat and camel herding. However, life styles and interactions changed with the introduction of Islam in the Post Classical period. In the 7th century Islam began a series of conquest and conversions, making their potential to become the first truly global civilization unstoppable. Once the Muslim raids began in India in 711 C.E. Islam’s influence changed the Hindu way of life and cultural unity between these and other civilizations began. The introduction of Islam to the Middle East and India from 622-1450 C.E. brought cultural, political, and economic continuities and changes to these societies. Cultural and economic continuities included architecture and the growth of a strong trading system; however, there were changes in political systems from kinships and Persian influence to religious based kingdoms and rulers. Cultural unity became one of the leading characteristics of the Empire. Architecture was one of the ideas that spread throughout the continents as well. Not only did it reach India and Africa, but the European continent as well. The mosque is a place of worship for those who follow the Islam faith. The first mosque to be built was the Quba Mosque in Medina, which was built when Muhammad arrived from the hijra back in 630 C.E. After the construction of the first mosque the idea of a place for worship spread. The first mosques had dome shaped roofs and minarets to call people for prayer. As these ideas spread they became continuous in different societies as they adopted the same architectural techniques. As Islam spread, and architecture spread with it the idea of the mosque, a place for worship, and full devotion to Allah remained throughout its history. India adapted many of the Islam-Persian ideas for construction such as domes and minarets. The idea of the mosque is prolonged until this day. However, within this continuity changes arose. India and the Middle East were located in nearly the same region and shared a common climate. Their architectural ideas didn’t differ to extremes. What did affect their differences was their idea of beauty and the materials available to them at that time. Both civilizations developed nearly isolated from each other until the first raids in 711 C.E. and the formal establishment of a political Islamic power in India on 1206 C.E. By that time each of them had developed their own concept of beauty, which they introduced to architectural designs. For a long period of time Hindus had used wood as their primary material in construction, and had learned to modify it and use it to their taste. When this material became scarce they started using brick or stone like the Arabs. Both civilizations used the same materials, but Hindus managed stone differently since they brought many of the ide as and techniques they used with wood to this material. Nevertheless, a mosque can be clearly recognized in most societies, and although cultures introduced their concept of beauty into it, the idea of a place of worship to Allah was and still is continuous. Trade, no matter where and when, has always been an economic continuity throughout history. Dar al- Islam referred to the freedom to practice the religion in different places. As the religion spread, Dar al- Islam became more prominent among societies. Religious beliefs arrived at different civilizations and were soon adopted by them. Trade had been seen before in civilizations, however with Islamic conquests it flourished. In Bedouin society tribes and towns traded with each other on a small scale. With the introduction of Islam landmasses were linked by important trade routes like: the Silk Road, the Trans- Saharan trade, the Indian Ocean, and the Mediterranean Sea. The Middle East was in the middle of this trading business and so it benefited from this constant interaction. For the Post Classical part of its history, the Middle East controlled much of India’s trade with other civilizations. As trade flourished, new demands for materials took place. Although trade was sustained throughout history and it became a continuity in every society, during this time period some of the ways it was used and some of the demands for materials changed. In the Indian Ocean trade grew bigger each time, and demands for silk, porcelain, spices, gems, cotton, horses, and even slaves increased. Changes in the demand for goods reflected in the prosperity of the civilizations. Now, people mainly traded luxurious, and beautiful objects, which they couldn’t find where they lived but were not really essential for their survival. The materials they traded may have changed, but trade flourished during these years making many economies dependent to its growth. Many changes were seen once the Muslims adjusted the Persian society to a religious based empire. Politically, many traditions and cultural influences from the Persians changed during the early development of Islam. The Middle East was a mix between nomads, Kingdoms, and empires ending with the Sassanid Empire in 651 C.E., Past societies used kinships to choose their rulers, unlike Islamic ones who used religious leaders as successors of Muhammad. The same happened with India, which was a Hindu society ruled by the caste-system. The religion did influence the civilization politically if we take the caste system into account, but aside from that no Hindu beliefs and traditions were used in the government. Islam changed this idea completely. The religion believed in a government fully merged with Islamic beliefs. The Zakat, for example, was a tax for charity obligatory for the new faith, the places under Islamic control most be involved in paying this tax. Islam caused unity as well, warriors and leaders were given a common cause and strength to glorify their new religion, and so this encouraged them to spread to other regions. Jihads, which were holy wars, took place, all because of the words of Allah in the Qur’an. Everything being done was influence by the word of Allah. Sharia, which is the moral codes and laws of Islam, became the fundamental set of laws to follow. This set of moral codes and laws are derived from the Qur’an, showing its strong influence in politics from the reign of Muhammad to today. India was influenced by all these changes as well, which in a way mixed with Hinduism. The idea that men and women both could reach heaven promoted equality, and it was something that the Hindus adopted from the religion. However, the Arabs also adopted some of the Hindus ideas like the veil and harem, which still placed women as inferiors and submissive. Historically, Arab culture did not show this type of behavior towards women. In fact, Muhammad’s first wife Khadija was actually of great importance in Islamic religion, often referred to as â€Å"mother of Islam† and being the first real adherent of Islam. Khadija was given great value and respect among with other women who became adherents afterward. After this huge change however, Islamic politics became continuity throughout the whole Post Classical Period and even to present day. An Islamic based government was soon incorporated into their culture and became normal from there on. With the introduction of religion to the government a significant change was made from Persian culture to Islamic beliefs, after the fall of the Sassanid Empire, however once this change was made it became perpetual to the society. The Post Classical period, raging from 622-1450 C.E., was a period of change and continuous growth. Islam became the first global society in history, extending its territory and providing similar cultural aspects like architecture and economic aspects like trading to different societies. Political changes were prominent in this era, and they changed the way civilizations under Islamic power functioned, from kinships and clan leaders to religious based empires. Islam had a rapid growth and with the growth of Dar Al-Islam, the religion was able to spread to different continents and change past traditions, but at the same time integrate with local traditions and create a lasting influence in various societies.

Essay on The Value of Dreams in Hawthornes Young Goodman Brown

Young Goodman Brown: The Value of Dreams Young Goodman Brown The Birthmark Nathaniel Hawthorne's stories "Young Goodman Brown" and "The Birthmark" both make use of dreams to affect the story and reveal the central characters. With each story, the dreams presented are extremely beneficial to the development of the story as they give the reader a new view of the plot itself, or the characters within. At the same time, however, it becomes difficult to determine how much of the dream has been affected by the character, and how much is pure fantasy. This is true with Young Goodman Brown, who cannot determine whether the events in his life actually occurred, or if they simply were created in his troubled mind while he slept. In "The Birthmark," Aylmer too is haunted by his night-time musings as he dreams of mutilating his wife in order to rid her of a small birthmark. This small detail later turns out to foreshadow the conclusion of the story, while giving readers further insight into his diabolical nature. Dreams thusly play an important developmental role in the explica... ...he beauty of his bride, which is, at least, unsettling, until his dream of butchering Georgianna is revealed. Troubled, too is Young Goodman Brown, who can not determine whether or not the incredible visions of the previous night were real. As a precaution, he avoids contact with the dream-related peole and lives the remainder of his life alone, but surrounded by those who were once his friends, associates, and family. As evidenced by these two short stories, we can see the important role that dreams can play in the effective telling of a tale.

Advantages and disadvantages of studying abroad Essay

Almost every student around the world wishes to pursue his or her education. However, every issue has its pros and cons. In order to making a better decision, one has to explore different aspects of a plan. Studying abroad lets you experience things you have never faced them before. It gives you the opportunity to communicate with different people who have different religions and speak different languages. This will improve your social skills. In addition, when you graduate from a university in a foreign country, It will make you more prestigious. In work life and in your personal life, It will bring more respect for you. To them, you are a person who experiences a different world with different inhabitants. Needless to say, this prestige will help you to find jobs with more salaries. On the other hand, when you leave your hometown and migrate to another country to continue your study, some obstacles may show up. For one thing, you must be away from your family and your intimate friends for a while. No doubt, your relationship will fade away if you don’t try to keep in touch with them. Moreover, you are exposed to an environment where everybody else acts and behaves different from what you have learned before. They also expect you to express yourself using their culture. Furthermore, your costs most likely are higher and your income is less than in your country. Because you are a foreigner to these new people, you barely find an appropriate job with a high salary at first. All in all, going abroad in order to continue the education has some advantages and disadvantages. After a thorough consideration of merits and demerits of it, I decide to put all my vigor and pursue my education abroad.

Debut Albums and Young Man

A Talking Frog An older gentleman was playing a round of golf. Suddenly his ball sliced and landed in a shallow pond. As he was attempting to retrieve the ball he discovered a frog who, to his great surprise, started to speak! â€Å"Kiss me, and I will change into a beautiful princess, and I will be yours for a week. † He picked up the frog and placed it in his pocket. As he continued to play golf, the frog repeated its message. â€Å"Kiss me, and I will change into a beautiful princess, and I will be yours for a whole month! The man continued to play his golf game and once again the frog spoke out. Kiss me,and I will change into a beautiful princess, and I will be yours for a whole year! † Finally, the old man turned to the frog and exclaimed, â€Å"At my age, I'd rather have a talking frog! † The Last Ticket During a busy holiday weekend, a woman who was eight months pregnant went to the railway station to return home to her husband. At the reservation counter, when her turn came, there was only one ticket left.Taking pity on a very old lady behind her in line, she offered her berth to the old lady and sent a telegram to her husband which arrived with a small error: â€Å"Shall be coming tomorrow, heavy rush in the train, ave birth to an old lady. † A Business Loan A businessman walked into a bank in San Francisco and asked for the loan officer. He told the officer that he is going to Europe on business for two weeks and needed to borrow $5,000. The bank officer explained that the bank needed some kind of security for such a loan. So the businessman handed over the keys to a Rolls Royce parked on the street in front of the bank.Everything checked out, and the bank agreed to accept the car as collateral for the loan. A bank employee drove the Rolls into the bank's underground garage and parked it there. Two weeks later, the businessman returned, repaid the $5,000 with interest, which came to $15. 41. The loan officer said, â€Å"We are very happy to have had your business, and this transaction has worked out very nicely, but we are a little puzzled. While you were away, we checked you out and found that you are a multimillionaire. What puzzles us is why would you bother to borrow $5,000? The businessman replied, â€Å"Where else in San Francisco can I park my car for two weeks for only 15 bucks? † A Big Decision A six-year-old boy walked up to his father one day and announced, ‘Daddy, I'd like to get married. His father replied hesitantly, ‘Sure, son, do you have anyone special in mind? ‘ ‘Yes,' answered the boy. ‘l want to marry Grandma. ‘ ‘Now, wait a minute,' said his father. ‘You dont think I'd let you get married with my mother, do you? ‘ Why not? ‘ the boy asked. ‘You married mine. ‘ 100 Penguins A truck driver was driving 100 penguins to the New York Zoo when his truck broke down on the freeway.The driver got out of the cab and was looking at the engine when a second truck driver stopped in front of him and asked if he needed any help. The penguins' driver explained that ne was taking the penguins to the zoo and asked f the other man would take the penguins there. He agreed. Some hours later, the second truck driver drove past the first one, who was still waiting on the freeway for help to come. The penguins, however, were still on the truck! â€Å"l thought I asked you to take those penguins to the zoo,† shouted the first driver. The second replied, â€Å"l did, but I had some money left, so we're going to the cinema now. Supermarket Encounter A young man was walking through a supermarket to pick up a few things when he noticed an old lady following him around. Thinking nothing of it, he ignored her and continued on. Finally, he went to the checkout line, but she got in front of him. â€Å"Pardon me,† she said, â€Å"I'm sorry if my staring at you has made you feel uncomfortable. It's Just that you look Just like my son who Just died recently. † â€Å"I'm very sorry,† replied the young man, â€Å"Is there anything I can do for you? † â€Å"Yes,† she said. â€Å"As I'm leaving, can you say ‘Goodbye mother'? It would make me feel much better. â€Å"Sure,† answered the young man. As the old woman was leaving, he called out, â€Å"Goodbye mother! † As he stepped up to the checkout counter, he saw that his total was $127. 50. â€Å"How can that be? † he asked, â€Å"l only purchased a few things! â€Å"Your mother said that you would pay for her,† said the clerk. Do you deserve to enter heaven? A man died and went to heaven. An angel met him at the Gates of Heaven and said, ‘Before you meet with God, I thought I should tell you – we've examined your whole life, and you really didn't do anything particularly good or bad. We're not sure whether we can admit you into heaven or not.Can you tell us anything exceptional you did that can help us make a decision? ‘ The newly arrived soul thought for a moment and replied, ‘Yeah, once I was driving along and came upon a woman who was being harassed by a group of goons. So I pulled over, got out my tire iron, and went up to the leader of the gang. He was a big, muscular, hairy guy with tattoos all over his body and a ring pierced through his nose. Well, I tore the nose ring out of his nose, and told him that he and his gang had better stop bothering the woman or they would have to deal with me! ‘ ‘I'm impressed,' The angel responded, When did this happen? The man replied, ‘About two minutes ago'. Return my horse! A cowboy rode into town and stopped at a saloon for a drink. Unfortunately, the locals always had a habit of picking on strangers. When he finished his drink, he ound his horse had been stolen. He went back into the bar, handily flipped his gun into the air, caught it above his head without ev en looking and fired a shot into the ceiling. â€Å"Which one of you sidewinders stole my horse?!?!? † he yelled with surprising forcefulness. No one answered. â€Å"Alright, I'm gonna have another beer, and if my horse ain't back outside by the time I finish, I'm gonna do what I did in Texas!

Survival of the fittest essays

Survival of the fittest essays Justification of African Americans continued use of unorthodox medicine The science of medicine and the practice of medicine after slavery have been an evolving and dynamic series of events. After slavery ended, the majority of African Americans held fast to their methods of healing such as therapeutic herbal remedies, conjuring and other unorthodox procedures, for several reasons, despite improvements and advances in medical technology. Doctoring as practiced by slaves on slaves was much more acceptable to them than modern white medicine. It was quite clear that this clinging to the familiar, was in part due to the innate and profound distrust of the medical care rendered by whites, their faith in the African healers and conjurers, affordability and conditions of the very few black hospitals, racism as well as the all important fact that in some states, medical treatment was denied to blacks by white hospitals and doctors. While therapies appeared to become significantly important to maintaining good health and crossing social divides, African American s often struggled against racial, gendered, and class based constructions of who was fit to claim the privileges of medical authority. The majority of supporting evidence is narratives from books such as Remembering Jim Crow by Chafe and Working Cures by Sharla Fett and African American Midwifery in the South by Gertrude Fraser which clearly indicate the reasons why black people resorted to their herbal remedies and treatments after slavery as opposed to white medicine. Documents from the United States Public Health Service and doctors reports from medical journals will further support the mistreatment of black people during and after slavery. The U.S. Public Health Services study from 1932 to 1972 of untreated syphilis in African American Alabama men remains the most concrete symbol of scientific ...

Gender of Animals in Spanish

Gender of Animals in Spanish If you think that masculine nouns in Spanish are always used with referring to males and feminine nouns when referring to females, your assumption would be wrong - especially when talking about animals. Like most nouns, the names for nearly all animals are either masculine or feminine. For example, the word for giraffe, jirafa is feminine, and it can be used when referring to any giraffe, whether male or female. Similarly, rinoceronte is masculine, and it can be used to refer to rhinoceroses of either sex. The same is done with people. El humano (human) is masculine even when referring to a woman or girl, and la persona (person) is feminine even when referring to a man or boy. Animals With Sex-Differentiated Names Some animals have different names for each sex. For example, a perro is a male dog, and a perra is a female dog or bitch. The names dont have to be so similar: a cow is una vaca, while a bull is un toro, even though they refer to the same species of animal. As in these examples, it is common, although not universal, for animals with sex-differentiated names in Spanish to have differentiated names in English as well. Some other animals with different names for the sexes are: el lagarto (male lizard), la lagarta (female lizard)el elefante (male elephant), la elefanta (female elephant)el caballo (stallion), la yegua (mare)el carnero (ram), la oveja (sheep)el gallo (rooster), la gallina (hen)el macho (billy goat), la cabra (nanny goat) Generally, the masculine form can be thought of as the default name for the type of species. Thus if you dont know whether a cat is male or female, its fine to refer to it as un gato. But a cat known to be female can be referred to as una gata. Groups of Animals In the case of animals whose names vary with the sex, if you have a group of animals, some female and some male, they should be referred to by the masculine plural: thus los gatos or los perros. But if the name of the animal is invariably feminine, the feminine must still be used: las jirafas (even for a group of males) or las araà ±as (spiders). In a very few cases where each sex has a different name - they include vaca, cabra, and oveja - the feminine form can be pluralized to represent a group. (The same can be true in English, as cattle might informally be referred to as cows even if bulls are part of the mix.) Macho/Hembra If you need to indicate the sex of an animal with a undifferentiated name, you can add the word macho for male or hembra for female: la jirafa hembra, the female giraffela jirafa macho, the male giraffeel dinosaurio macho, the male dinosaurel dinosaurio hembra, the female dinosaur Note that macho and hembra, however, are traditionally considered to be either nouns or invariable adjectives. Thus they do not vary in form with gender or number: las jirafas hembra, the female giraffeslas jirafas macho, the male giraffes Although treating macho and hembra as invariable adjectives is the grammatically safe thing to do, in real life speakers often make them plural. You should stick to the traditional form in formal writing, however. Personal Names When referring to animals with personal names (such as pets), you should use adjectives whose gender matches the given name of the animal when using that name as the subject of a sentence: Pablo, la jirafa ms alta del zoo, est enfermo. (Pablo, the zoos tallest giraffe, is sick.)Su hmster negro se llama Elena. Elena es muy guapa. (His black hamster is named Elena. Elena is very pretty. Note the change in grammar depending on whether the category name or given name is the grammatical subject.) Key Takeaways The category or species names for most animals are either masculine or feminine, and the gender for the animal name is used whether a specific animal in male or female.Some animals have separate names for each sex, such as a cow being una vaca and a bull being un toro.When the subject of a sentence is the personal name of an animal, such a pet, the accompanying adjectives should match the animals sex rather than that of its species name.

Questions for Thought Assignment Example | Topics and Well Written Essays - 500 words - 2

Questions for Thought - Assignment Example On the other hand, the waterfall method is a sequential design process. Completion of one stage usually leads to the next stage that has different goals. Agile methods allow an individual to make frequent changes to the management process and test the various stages of the project (Nayab 1). Change management is a vital process for IT professionals in many organizations. Every organization undergoes different forms of change. As the world of technology and business is changing it is paramount for organizations particularly the IT departments to conform to these changes. Change management is whereby the organization applies structured processes and tools for leading people during the change to achieve a particular outcome. Organization change management offers a framework upon which organizations can manage the changes in organization structure, new business processes, and cultural changes facing the company. Change management is beneficial particularly when the change requires all employees or people in the organization to learn new behaviors and skills. Organizations should set expectations, use tools to improve communication and reduce misinformation among employees to ensure they adapt to the change. Managing change is paramount for organizations that seek in the cor porate world (Fernandez and Rainey 168). There is a growing contention on whether organizations should develop their software packages of not. Several advantages are cited to support the development of personal software packages. However, before developing build in software packages, the company should assess the benefits of the software in relation to canned software packages. The â€Å"build versus buy† discussion is an important issue facing companies today. If building seems cheaper, it may be the best option rather than buying. Other benefits of building software packages include the ability to

Race and Your Community Essay Example | Topics and Well Written Essays - 1500 words

Race and Your Community - Essay Example I could see and identify everything around me and it seemed everything was just a copy of yesterday’s, which was a copy of the day before yesterday, and so on. And I guess would be same tomorrow, and the day after tomorrow. People are the same, rushing towards the same definite directions as yesterday. They live by the minute and worry much of what happens the next hour. It is the same with the big cities in the country I came from, but much different from the town I was born and grew up. People in my hometown live by the day instead of by the minute and anxious of what might happen the next year instead of the next hour. Time is pretty slow and lenghty. The last turn towards my apartment building detached me from the bumper to bumper drive. I park just few meters away from the building door. People I have just passed by gave me, as usual, a how-in-the-world-he-is-driving such make of car. My car is not a luxury one, not even that expensive. But what make them give me that look as if I carnapped it is because I am driving a car of their country’s make and that their look seems telling me that I should be driving my own country’s make instead. Why? Don’t they race use Toyota, Hyundai, BMW, or Mercedes? Cars not their own country’s make? They are nice enough not calling 911 for a suspected carnapped car being driven by a member of the visible minority like me. Though not so many people give me such look; there are just a bunch of them. I heave my other bag to my shoulder from the passenger’s fron seat and go off the car. The same disrespectful schoolchildren that have just got out from their school service shout something at me again. I am not sure if they deliberately using an incomprehensible accent for me not to understand what they are yelling at me almost every day. Their school service dump them in front of the same apartment