Starbucks Humana and Ethics Essay Example For Students

Starbucks Humana and Ethics Essay This paper looks at the moral establishments of two organizations working in totally different markets. Starbucks’ is a chain of cafés having some expertise in gourmet espresso lines. Starbucks depends on sound moral principals pervaded through the focal center of its business activities. The aftereffect of a few tests prompts an end that Starbucks works together in a gainful and ethically stable way. Humana Inc. is a huge Health Maintenance Organization (HMO) with activities that place it third among the top players in the field. As opposed to Starbucks’, research exhibits that Humana, and ostensibly just for benefit HMO’s, comes up short on a sound moral establishment. The limits between creating a sound return and giving quality clinical consideration produce irreconcilable circumstances, which for all included lead to awful choices and good dilemas. The ends came to in this paper are the aftereffect of broad examination directed through the Internet, individual meeting, writing audit, and legitimate discoveries. The agreement drawn from this examination is that Starbucks is a brilliant illustration of corporate social obligation and Humana isn't. Starbucks is the United States number one claim to fame espresso retailer and a nearness known far and wide. It has more than 2,600 coffeehouses from Asia, Canada, the United Kingdom and the United States. Starbucks sells espresso as well as: cakes, food and beverages, cups, and espresso making frill. Starbucks offers their beans to cafés, carriers, lodgings, and via mail request. We will compose a custom paper on Starbucks Humana and Ethics explicitly for you for just $16.38 $13.9/page Request now Starbucks statement of purpose is †¦Ã¢â‚¬ to build up Starbucks as the head purveyor of the best espresso on the planet while keeping up our firm standards as we develop. The accompanying six core values will assist us with estimating the suitability of our decisions:† ? Give an incredible workplace and approach each other with deference and poise. ? Hold onto decent variety as a fundamental part in the manner we work together. ? Apply the best expectations of greatness to the buying, broiling, and new conveyance of our espresso. Grow eagerly fulfilled clients constantly. ? Contribute emphatically to our networks and our condition. ? Perceive that benefit is fundamental to our future achievement. This gathering accepts that Starbucks is a moral and displays moral obligation by the activities they take part in to help their central goal. Their numerous philanthropic endeavors are laid out in this paper. Starbucks is dynamic in a few distinctive helpful endeavors. While the helpful gifts of an association can't be demonstrated to make a moral organization, there gives off an impression of being merit in these endeavors. Starbucks gives now is the ideal time, cash, and exertion to advance saving the earth, proficiency, human rights, and AIDS research. With this much helpful gifts, Starbucks gains the presence of a moral and good situation in its industry. Starbucks Environmental Mission gives a structure to dynamic at Starbucks. Starbucks Environmental Mission proclamation expresses that we will satisfy this strategic a guarantee to: (1) comprehension of ecological issues and imparting data to our accomplices, (2) creating imaginative and adaptable answers for realize change, (3) endeavoring to purchase, sell and utilize naturally well disposed items, (4) perceiving that monetary duty is basic to our natural future, (5) ingraining natural obligation as a corporate worth and (6) estimating and checking our advancement for each venture. Starbucks manures its espresso beans, reuses its burlap packs, and works with a counseling firm to explore new reusing plans for its stores. Starbucks activity to build up a naturally amicable cup has not been fruitful. After a two-advertise trial of the cup it has quit attempting to deliver such a cup. The consequences of the test have not been uncovered. Starbucks is dynamic in the undertaking of proficiency. Advancing proficiency has been one of its primary targets. Starbucks has collaborated with various big names to advance education. .u3ca583388f0a4ecea61224b77faffbaf , .u3ca583388f0a4ecea61224b77faffbaf .postImageUrl , .u3ca583388f0a4ecea61224b77faffbaf .focused content territory { min-tallness: 80px; position: relative; } .u3ca583388f0a4ecea61224b77faffbaf , .u3ca583388f0a4ecea61224b77faffbaf:hover , .u3ca583388f0a4ecea61224b77faffbaf:visited , .u3ca583388f0a4ecea61224b77faffbaf:active { border:0!important; } .u3ca583388f0a4ecea61224b77faffbaf .clearfix:after { content: ; show: table; clear: both; } .u3ca583388f0a4ecea61224b77faffbaf { show: square; change: foundation shading 250ms; webkit-progress: foundation shading 250ms; width: 100%; mistiness: 1; change: darkness 250ms; webkit-change: haziness 250ms; foundation shading: #95A5A6; } .u3ca583388f0a4ecea61224b77faffbaf:active , .u3ca583388f0a4ecea61224b77faffbaf:hover { obscurity: 1; progress: murkiness 250ms; webkit-progress: mistiness 250ms; foundation shading: #2C3E50; } .u3ca583388f0a4ecea61224b77faffbaf .focused content region { width: 100%; position: rel ative; } .u3ca583388f0a4ecea61224b77faffbaf .ctaText { fringe base: 0 strong #fff; shading: #2980B9; text dimension: 16px; textual style weight: intense; edge: 0; cushioning: 0; text-improvement: underline; } .u3ca583388f0a4ecea61224b77faffbaf .postTitle { shading: #FFFFFF; text dimension: 16px; textual style weight: 600; edge: 0; cushioning: 0; width: 100%; } .u3ca583388f0a4ecea61224b77faffbaf .ctaButton { foundation shading: #7F8C8D!important; shading: #2980B9; outskirt: none; fringe range: 3px; box-shadow: none; text dimension: 14px; textual style weight: striking; line-stature: 26px; moz-fringe span: 3px; text-adjust: focus; text-adornment: none; text-shadow: none; width: 80px; min-tallness: 80px; foundation: url(https://artscolumbia.org/wp-content/modules/intelly-related-posts/resources/pictures/basic arrow.png)no-rehash; position: supreme; right: 0; top: 0; } .u3ca583388f0a4ecea61224b77faffbaf:hover .ctaButton { foundation shading: #34495E!important; } .u3ca583388f0a4ecea61224 b77faffbaf .focused content { show: table; stature: 80px; cushioning left: 18px; top: 0; } .u3ca583388f0a4ecea61224b77faffbaf-content { show: table-cell; edge: 0; cushioning: 0; cushioning right: 108px; position: relative; vertical-adjust: center; width: 100%; } .u3ca583388f0a4ecea61224b77faffbaf:after { content: ; show: square; clear: both; } READ: Who truly composed shakespeare's work EssayDuring the 1999 baseball season the â€Å"Read. Dream. Develop. Out of the Park †Into the Books† program joined forces Starbucks with Mark McGwire. For each grand slam that McGwire hit Starbucks gave $5000. 00 to help children’s good cause in the network where the game was played. Starbucks ensured at least $250,000 for the season. Starbucks has likewise cooperated with Doonsebury visual artist, Gary Trudeau by selling Doonesbury items at its cafés. All returns go to nearby proficiency programs. The main year of this organization raised over $300,000. Notwithstanding these progressively alluring undertakings, Starbucks has likewise gathered books, gave by its clients, for the All Books for Children book drive. The books will be circulated to nearby association across America. Starbucks has banded together with CARE, a worldwide alleviation association, to advance human rights. Notwithstanding working cafés around the globe Starbucks providers are situated in Latin America, Africa, and Southeast Asia. A few activities that it is associated with are instruction and education programs, provincial network improvement and conservation of national parklands. Starbucks is the principal US horticultural product organization to embrace a corporate proclamation with respect to human rights. The announcement is called Starbucks Coffee Company’s Framework for a Code of Conduct. Starbucks was granted the National Leadership Award by AIDS Action. Helps Action is the national voice on AIDS, speaking to Americans influenced with HIV/AIDS and 2,400 network based associations that serve them. Starbucks got this honor for the endeavors of thousands of Starbucks representatives who have bolstered AIDS causes by gathering pledges and volunteerism and for promoting the Red Ribbon Sampler, an item intended to fund-raise for AIDS specialist co-ops. In 1997 three Starbucks representatives were killed in a Washington D. C. store. Starbucks reacted by making the Starbucks Memorial Fund. All returns from that store are presently given to D. C. noble cause that advance brutality counteraction and casualty help. In June of 1999 $75,000 was given to eight associations. Starbucks calls its representatives accomplices. It offers investment opportunity programs. It urges its workers to be effectively included it the network by giving money related help and item gifts to associations where its representatives give their time. There have been a couple of unsatisfied clients with Starbucks, as is commonly the situation with any huge buyer centered organization. A couple of the displeased clients built up a site, www. starbucked. com, to permit different clients to vent their disappointments. Humana is the third biggest oversaw social insurance organization in the United States. The general size of the association combined with intrinsic irreconcilable situations has driven Humana, among different HMO’s, to get engaged with choices of faulty moral substance. Humana embraces the vision, â€Å"To improve the strength of our individuals, and offer some incentive to our clients, accomplices and investors. † A hidden inquiry is how well would they say they are seeking after their vision? This gathering accepts that Humana is a case of an organization with moral trustworthiness issues. No conversation of one HMO might be finished without taking a gander at the business as a who

Nurse on Thinking Outside the Box Free Essays

Inventive reasoning is required yet In request to do as such, one must increase adequate experience to predict emergency that may chance upon the use of the whimsical. Escaping the crate implies sucking with the difficult longer, and taking a gander at It from different sides, which may not generally be reasonable for a quick paced nurture, even with the opportune time the board attendants are normally multi-testers and are known to achieve one occupation to continue ahead with the other. In the case scholars frequently accept that each issue needs just a single arrangement; in this manner, collapsing more than one potential arrangement is an exercise in futility. We will compose a custom paper test on Medical attendant on Thinking Outside the Box or on the other hand any comparative point just for you Request Now In Nursing Leaders/Supervisors: Nursing pioneers then again, thinking outside about the crate may mean looking for the assessments of others which can help in the innovative reasoning procedure. As a medical attendant pioneer, one can improve out of the crate thinking in the event that one looks for thoughts from those outside of one’s own calling. Asking oneself on how things are being done in different businesses could go far from Just circumventing his/her own specialty. Through this, a pioneer can undoubtedly look for what thoughts can be best applied to a specific circumstance/task/issue and this requires an eagerness to take new individual to everyday work. As medical caretaker pioneers, they have to support their capacity to consider some fresh possibilities and advance this aptitude in others. In Nurses Working in Offices: While medical caretakers who have wandered outside the clinical set-up and have picked the desk area kind of workplace, by doing so just demonstrates that they’re one of the outside of the case scholars. They are the ones who like to challenge their own presumptions all the time, which can be the most troublesome piece of out of the crate thinking. One must recall that Just in light of the fact that something has consistently been one ay, doesn’t imply that it needs to keep on being that way. Out-of-the container thinking expects receptiveness to better approaches for seeing the world and readiness to investigate. It implies thinking about other Innovative choices, from jobs as attendant instructors, official medical caretaker pioneers and policymakers, to nurture business visionaries, retail center medical caretakers, nurture Informatics and researchersâ€to name a fewâ€we have perceived how medical attendants have had the option to parlay their clinical foundations and medicinal services ranges of abilities Into completely new domains, one must not stop on the grounds that even extraordinary inventive individuals can become In-the-case scholars when they quit attempting. The most effective method to refer to Nurse on Thinking Outside the Box, Papers

living the dream UROP edition!

living the dream UROP edition! In my New Years reflections post, I mentioned that over the winter break, I applied to a UROP (an undergraduate research opportunity, aka a research assistant job). I didnt say anything more, both because it wasnt relevant to the post as a whole and because I didnt know a lot of the details yet. Now, Im two weeks into the semester and in the thick of being trained, so I feel much more qualified to write about it! Its a  linguistics UROP, which I think is super hecking cool. Right at the end of last semester, in one of my many existential crises, I started to think seriously about pursuing something linguisticky. (Why? Because languages, and words, are just  the coolest shit.) I reworked my schedule to include 24.9000/intro to linguistics. I wasnt really thinking specifically about getting a UROP in linguistics: I mean, research experience would be useful and money is nice but I felt like I had a lot of time left at MIT to do my part for the statistic that 90% of students have had a UROP by the time they graduate. I wasnt rushed. And then a special someone came into my life:  urop.guide!  Its a great little website created by two MIT students that pulls all the advertised UROP postings from the MIT website and puts them into a much more readable format, where you can sort by semester or department and search for keywords. ((Side note: Its actually a pretty awesomely common phenomenon than an MIT student will just make a website or add-on to make life at MIT easier, like Courseroad or Firehose. Just one of the things I love about this place ??)) I got an email in my inbox on maybe December 27th advertising urop.guide, and thought  why not check it out? So I typed linguistics into the search box. The very first one that came up absolutely blew my mind, because the second I read it, I realized it was my  dream UROP! Im serious when I say that basically the moment I read it, there was no question in my mind that I would apply. I started reading the job posting excitedly out loud to my mom and in my head, I was planning how I would update my resume. One cover letter later, I applied, and one Skype interview later, I had a UROP! This semester, I get to work with the Language Acquisition Lab.  The Lab looks at how childrens language develops into adults, and what differences there are in their speech. For example: did you know that children often interpret the sentence the cat only eats fish as only the cat eats fish? In my work with the lab, I go to preschools and the childrens section of the Boston Museum of Science to run experiments with kiddos and tease out the details of differences like these. Armed with a puppet (Mr. Dog, our pig Wilbur, or our money, Mr. Nim Chimpsky) and a PowerPoint presentation, I show the child Im working with scenarios, ask Wilbur to describe them, and turn to the kid to help me out: is Wilbur right when he describes the scenario, or is he being silly? Their opinion, and subsequent explanation, can be very enlightening. If the child is of the right age (4-6, in this case), and their parents have signed a consent form, this info will become a data point in our study. So far, I have been having a wonderful time UROPing! I LOVE children (like. so much. i have serious baby fever and its terrible), and on a university campus I rarely get the opportunity to hang out with them. Plus, I think language is SO COOL. How we learn it is one of the coolest parts, and here I am, helping to figure that out piece by piece!!! Of course, before being allowed to collect real data from real children, I had to go through several hours of training (in addition to the very careful wording necessary to maintain the validity of the experiment, those puppets are dang hard to operate!). It was this past Tuesday that I visited a daycare for the first time. I was super nervous, but it went really well (in part thanks to the persistent positive reinforcement of my UROP supervisor, lol). The kids were so nice, you guys they were such wonderful kids. (All kids are wonderful kids, if you ask me.) In addition to working with children and recording my data, I also get to help a grad student complete the next step in her project: analyzing a corpus (or giant folder of transcripts) of children talking with adults, to see if there is support for her hypothesis about *why* children say one particular thing differently than adults do. To do this, I will learn R! Ive been saying for years that I should really learn R. Well, last Thursday we agreed that I would learn it by this Wednesday. I thought,  well, now I should really  learn R! And that was my Tuesday :D Im still a complete novice, but I can see the shape of my little programs coming together, and I think theyll actually be useful to the lab the first truly useful code Ive written. I am so excited about all of this; I think its amazing that in literally a month, I can go from applying to a job to helping to run experiments with kids, learning a new programming language, and doing real research. As added bonuses ((I want to say boni)): one of my friends (who I first met at CPW!) is also working with the Lab, and I can tell that Im really going to like the other UROP students as well. Plus, I get PAID. Im going to learn so much and have so much fun this semester! (And squirrel away all the money and feel like Smaug on a hoard of gold, only splurging on the occasional Trader Joes chocolate bar) Life is good :D Post Tagged #24.900 Intro to Linguistics #Course 24 - Philosophy Linguistics

Arcadia University Acceptance Rate, SAT/ACT Scores, GPA

Arcadia University is a private university with an acceptance rate of 64%. Located in Glenside, Pennsylvania, Arcadia is 25 miles from Philadelphia. With one of the nations strongest study abroad programs, nearly 95% of Arcadia undergraduates study in one of the schools programs in Australia, China, England, France, Greece, Ireland, Italy, New Zealand, Northern Ireland, Scotland, South Korea, Spain, or Wales. The university has a 13-to-1  student/faculty  ratio  and an average class size of 14. On the athletic front, the Arcadia Knights compete in the NCAA, within the Division III Commonwealth Conference.   Considering applying to Arcadia University? Here are the admissions statistics you should know, including average SAT/ACT scores and GPAs of admitted students. Acceptance Rate During the 2017-18 admissions cycle, Arcadia University had an acceptance rate of 64%. This means that for every 100 students who applied, 64 students were admitted, making Arcadias admissions process competitive. Admissions Statistics (2017-18) Number of Applicants 9,243 Percent Admitted 64% Percent Admitted Who Enrolled (Yield) 8% SAT Scores and Requirements Arcadia University requires that all applicants submit either SAT or ACT scores. During the 2017-18 admissions cycle, 87% of admitted students submitted SAT scores. SAT Range (Admitted Students) Section 25th Percentile 75th Percentile ERW 540 640 Math 510 610 ERW=Evidence-Based Reading and Writing This admissions data tells us that most of Arcadias admitted students fall within the top 35% nationally on the SAT. For the evidence-based reading and writing section, 50% of students admitted to Arcadia scored between 540 and 640, while 25% scored below 540 and 25% scored above 640. On the math section, 50% of admitted students scored between 510 and 610, while 25% scored below 510 and 25% scored above 610. Applicants with a composite SAT score of 1250 or higher will have particularly competitive chances at Arcadia. Requirements Arcadia does not require the SAT writing section or SAT Subject tests. Note that Arcadia participates in the scorechoice program, which means that the admissions office will consider your highest score from each individual section across all SAT test dates. ACT Scores and Requirements Arcadia University requires that all applicants submit either SAT or ACT scores. During the 2017-18 admissions cycle, 19% of admitted students submitted ACT scores. ACT Range (Admitted Students) Section 25th Percentile 75th Percentile English 21 26 Math 19 25 Composite 21 27 This admissions data tells us that most of Arcadias admitted students fall within the top 42% nationally on the ACT. The middle 50% of students admitted to Arcadia received a composite ACT score between 21 and 27, while 25% scored above 27 and 25% scored below 21. Requirements Arcadia does nor require the ACT writing section. Note that Arcadia does not provide information about their superscore policy for the ACT. GPA In 2018, the average high school GPA of Arcadias incoming freshmen class was 3.7. This data suggests that most successful applicants to Arcadia University have primarily A grades. Self-Reported GPA/SAT/ACT Graph Arcadia University Applicants Self-Reported GPA/SAT/ACT Graph. Data courtesy of Cappex. The admissions data in the graph is self-reported by applicants to Arcadia University. GPAs are unweighted. Find out how you compare to accepted students, see the real-time graph, and calculate your chances of getting in  with a free Cappex account. Admissions Chances Arcadia University, which accepts nearly two-thirds of applicants, has a somewhat selective admissions process. If your SAT/ACT scores and GPA fall within the schools average ranges, you have a strong chance of being accepted. However, Arcadia has a holistic admissions process involving other factors beyond your grades and test scores. The admissions office is looking for applicants with strong letters of recommendation as well as those who participate in meaningful extracurricular activities. Applicants can also submit an optional application essay and resume to improve their chances of admission. In the scattergram above, the blue and green dots represent accepted students. You can see that the majority of admitted students had high school grades of B or better, combined SAT scores of about 1000 or higher (ERW M), and ACT composite scores of 20 or better. If You Like Arcadia University, You May Also Like These Schools: Ithaca CollegeNew York UniversityUniversity of DelawareBoston University All admissions data has been sourced from the National Center for Education Statistics and Arcadia University Undergraduate Admissions Office.

Analysis Of Ray Bradbury s Fahrenheit 451 - 1090 Words

Ray Bradbury’s theme in Fahrenheit 451 is that a hero is one who makes a change for the better in society. In my rewritten version, my theme is that one who fails to change society is never a hero. Before my essay begins, Montag is running from the police/government. His occupation as a fireman is to incinerate books and he fails to do so by saving a couple of books before anyone sees them. As he reads the books, he learns about the tragic endings which used to be real. He wonders why the government had been hiding this from the citizens. Afterward, he starts taking action about these truths and is revealed to the government. The chase is broadcasted on television and viewers are urged to open their doors to look for Montag. â€Å"At the count†¦show more content†¦Montag never thought that what he saw would happen. The sharp bone had uprooted from the skin of his back. He wanted to scream in pain, but his mouth wouldn’t move. He wondered why he was stuck in this horrible mess of blood and terror? He wanted to be alone, unfound, untouched. As he lay there, paralyzed by the hands which held him, he saw out of the corner of his eye a machine crawling out of the woods. The shining silver creature approached Montag and the crowd of people who surrounded him. As soon as he saw the sharp glint of silver, he knew it was the Hound. The metallic monster slid across the asphalt and the hands quickly went away from Montag. He scrambled to his feet to flee from it, but the Hound was already chasing him down. As each step passed, the distance between Montag and the Hound decreased. Suddenly, the Hound leapt through the air and pushed Montag to the ground. He rolled across the gravel and tried to stand before his pursuer. But before Montag could even try to push himself up, the agonizing blade of the Hound’s needle sunk into Montag’s chest. Terrifying shrieks filled the air as dark blood trickled down his body. He lay on the road, worn down, the blood staining his clothes, creating a stream down the road. He thought of his life, why he hadn’t realized what horrible acts he had committed. He thought why he had to be a fireman. He thought why was there no good in this world. He lay there waiting for his final seconds to quickly pass. â€Å"Farewell,Show MoreRelatedAnalysis Of Ray Bradbury s Fahrenheit 4511743 Words   |  7 PagesIn Fahrenheit 451, by Ray Bradbury, the protagonist, Guy Montag, suddenly realizes his overwhelming discontent with life when he meets Clarisse McClean, a seventeen year old girl who introduces him to beauty of the world and the notion of questioning ones surroundings. This novel, having been released shortly after the Second Read Scare, a time when fear of communism lead to the baseless accusation of political figures by Senator McCarthy, was received with mixed reviews. However, today more so thanRead MoreAnalysis Of Ray Bradbury s Fahrenheit 451 Essay2089 Words   |  9 PagesThe analysis of Ray Bradbury s dystopian novel, Fahrenheit 451, shows that literature as books, education and alike is abused and criminalized in the hero’s reality, who is Guy Montag. The novel’s setting is when new things seem to have totally replaced literature, fire fighters set flames instead of putting them out, the ownership of books is deserving of the law and to restrict the standard is to court demise. The oppression of literature through innovation and technology can be analyzed throughRead MoreAnalysis Of Ray Bradbury s Fahrenheit 4511722 Words   |  7 Pagesthem†. Morrison’s claim can be interpreted as meaning that heroes, whoever they may be, are people who have the courage to revolt against injustices that are viewed by most as fixed or unchangeable parts of their societies. In Ray Bradbury’s acclaimed 1953 novel Fahrenheit 451, the protagonist Guy Montag certainly qualifies as a hero as he rebels against the dystopian society he lives in, which has completely eschewed critical thinking and reading books. Montag begins to realize that this society isRead MoreAnalysis Of Ray Bradbury s Fahrenheit 4511633 Words   |  7 PagesBradbury’s Fahrenheit 451: Dissecting the Hero’s Journey to Dystopic World Each person has a perception of the world. People are capable of judging the place they live in, human beings often find it either satisfactory or not. Creative writers have displayed similar, albeit different worlds in their works. They are similar in the way they portray societies with varied amounts of good and evil which may be reflective of how we view our own. On the other hand, they can also be different, as creativeRead MoreAnalysis Of Ray Bradbury s Fahrenheit 4511193 Words   |  5 Pagestrue today? In Ray Bradbury’s Fahrenheit 451, ideas such as dystopian society, the dulling of emotions, personal freedom, and government censorship are utilized to illustrate how technology, the advancement of society, and government control has blindfolded the population from the creativity, knowledge, and truth of the past. Bradbury employs each of these ideas frequently throughout the novel to further enhance the deeper meaning behind his masterpiece. When one looks at Fahrenheit 451 like a workRead MoreAnalysis Of Ray Bradbury s Fahrenheit 4511241 Words   |  5 Pagesof the people who do not do anything about it† (Albert Einstein). In Ray Bradbury’s novel Fahrenheit 451, the novel explores censorships role as a hindrance on individuality, and the severe toll it takes on society’s self-awareness. Academia has widely argued the reason behind Bradbury’s dystopian themed work of art. Most interpretations of the novel suggest the work resembles anti-censorship propaganda. On the other hand, Bradbury himself stated: â€Å"I wasn’t worried about censorship-I was worried aboutRead MoreAnalysis Of Ray Bradbury s Fahrenheit 451 1486 Words   |  6 Pagesthe story. The novel Fahrenheit 451 concludes with a corrupt censored society in which hundreds of oppressed individuals are killed by an atomic bomb leaving Guy Montag and a few others to rebuild humanity. Many will propose that the ending was not app ropriate because there were too many questions left unanswered. For example, â€Å"What happened to Professor Faber?† or â€Å"How will a couple of homeless men survive post from a nuclear war?† The conclusion of Ray Bradbury’s Fahrenheit 451 leaves the readerRead MoreAnalysis Of Ray Bradbury s Fahrenheit 451 Essay1311 Words   |  6 PagesAuthored by Ray Bradbury in 1953, Fahrenheit 451, a descriptively written science fiction, presents its readers with his bitterly satirical view of the foreboding future and the consequences that may come with it. The novel depicts a dystopian society in which freedom of expression and thought is limited and books are outlawed. Written after WWII, when book burning and the blacklisting or censorship of films was a common threat. Technological advances were beginning to spread and therefore, influencingRead MoreAnalysis Of Ray Bradbury s Fahrenheit 451 1815 Words   |  8 PagesRay Bradbury was a well-known author who happe ned to write several novels, books, and short stories. He was very famous and I have never read anything that he wrote, until I read this book. I wasn’t sure what to expect because I had no idea what it was about and what kind of story it told. Fahrenheit 451 told a breathtaking adventure, was relatable, and it was almost as if I was submerged in this dystopian society, who was forced to live without imagination, books and a sense of wonder. Mr. BradburyRead MoreAnalysis Of Ray Bradbury s Fahrenheit 4512341 Words   |  10 Pagesrecognizable and typical patterns of behavior with certain probable outcomes†. While in Ray Bradbury’s Fahrenheit 451, water is used to represent death and rebirth, showing that our experiences can change us, and we can be re-birthed as a totally new person, while in Homer’s Odyssey, water is used to show that life is full of vast trials and adventures to overcome. The archetype of fire is also used in both novels. In Fahrenheit 451, it is used to show that even through destruction can emerge good; while in

Women Empowerment Free Essays

Empowerment has multiple, interrelated and interdependent dimensions- economic, social, cultural and political. It can be understood in relation to resources, perceptions, Relationship and power. But what does women empowerment mean? Women empowerment generally has five components : firstly, women’s sense of self worth; secondly, their right to have the power of control their own lives, both within and outside home; and lastly, their ability to influence the direction of social change to create a just social and economic order nationally, internationally and universally. We will write a custom essay sample on Women Empowerment or any similar topic only for you Order Now Educational attainment and economic participation are the key constituents in ensuring the empowerment of women. Other than educational and economic empowerment, changes in women’s mobility and social interaction and changes in intra-household decision-making are necessary. We should not forget that history in a witness to the women who have in the past demonstrated unique leadership capabilities. Razia Sultana, Rani of Jhansi, Sarojini Naidu and Indira Gandhi are motivation examples of women empowerment. I would like to peep into the past when the stature of women as destroyed. They were in this way; they deprived women of their due place. Most men view themselves as being the superior life-form in society. They justify this belief by saying that they are stronger and more capable; thus, making those more qualified for the more important roles in society. Treated as chattel in the early Roman society. In France, they were termed as half-soul creatures responsible for the destruction of society. The Chinese considered them as devil’s soul. Japanese men preferred to live unmarried lives But the truth is that women have advanced in all the areas. In India, the empowerment process has already begun. We are now witnessing a steady improvement in the enrollment of women in schools, colleges and even in profession institutes. Their health is better as compared to earlier decades. In this decade, women are entering into the job market in increasing numbers. They are showing their skills even in non-traditional sectors like police, defense, administration, media and research fields. But a lot of work has to be done as there is a category of women (who consider themselves highly educated) that proudly accepts that they don’t have digital literacy even though they own a computer, they cannot even operate bank accounts or make travel arrangements for family or handle hospital admissions even during emergencies. Even for a simple task like social visits or shopping generally they need the company of their husbands. Dependent women are not empowered women. If modern women think that they are empowered, it’s a myth for them . If women choose to be ignorant then all the efforts taken by the Government and women activists will go in vain. Even in twenty-fifth century, they will remain backward and will be paying a heavy price for their dependence, so, it is a wake-up call for women to awake from their deep slumber and understand the true meaning of their empowerment. In the end I would like to conclude with the following words, â€Å"Women as the motherhood of the nation should be strong, aware and alert†. Thank you The end How to cite Women Empowerment, Papers Women empowerment Free Essays Blob Writing Firstly, women can start a personal blob. It should cover a topic which Is directly related to their skills set. Once they acquire a decent number of readers and followers, they could begin to offer them their services related to their skills and charge a fee for It. We will write a custom essay sample on Women empowerment or any similar topic only for you Order Now Another option In blobbing as one of the top 10 home based businesses involves writing for another individual or company and earning a service fee in return. 2. Providing Professional Advice Women can offer paid advice related to their profession. This is one of the top 10 home based businesses because they do not need to worry about setting up their own online platform for this service. There are many websites which offer professional advice to Its customers by appointing a team of experts from various lines of work. They often have predetermined rates and commissions for their registered experts while others also keep them negotiable. 3. Book Publishing Publishing may sound Like the most Investment-demanding option out of the other top 10 home based businesses. This does not hold true for online book publishing or content marketing. Some websites offer free registration to use their online publishing services while others charge a nominal amount. In the end, women can enjoy writing books on their favorite topics and set the prices themselves. Online book publishing is part of the top 10 home based businesses because it enables women to publish books only in the demanded quantity. 4. Designing Shoes Many fashion-savvy females have a creative sense which is often specific to items like hoes. The Ideas may come to them naturally but they may be unable to take up shoe-designing as a full-fledged career option. However, women should utilize different software to develop unique designs and sell them to small-sized shoe businesses along with the ownership right to the designs. It would be a mutually beneficial relationship. 5. Conducting Online Research More and more companies are relying on the internet as an effective tool for conducting marketing research. Some of the benefits they find in this option Include access to geographically dispersed respondents, less time required, etc. This has given birth to the need for employing individuals to conduct the research. Women with an inquisitive nature often prefer this choice out of the different top 10 home based businesses. 6. Image Consultancy This line of work Involves assisting people who wish to achieve their goal of Improving their overall Image. This Is known to be a women-centric choice among the top 10 home based businesses. This field pertains to providing consultancy In different areas, such as grooming, styling, dressing, etc. Audio Typing investment of a computer and internet connection. In most cases, these facilities are already present which makes it a zero-investment alternative. Women can offer the services as a typist to reproduce provided audio files into a written format. Although typing speed would be a helpful skill, beginners could always commit to a deadline according to their skills and improve with time. 8. Affiliate Marketing For Affiliate Marketing as one of the top 10 home based busine sses, women need to have their own website. It would allow them to associate with other businesses to pay them a commission when visitors to their websites are linked to purchase the company’s products. 9. Online Teaching Teaching makes it to the list of top 10 home based businesses because the internet has made it possible to use it as a way to make money online at home. Women can provide interactive sessions to students for their daily homework while offer topic- wise teaching through video tutorials. 10. Writing Guides Writing guides are one of the top 10 home based businesses suitable for women cause they often have a wide knowledge base on different topics. How to cite Women empowerment, Papers Women Empowerment Free Essays WOMEN EMPOWERMENT† Since the olden times, women have been treated as second rate citizens of all across the globe. The situation is almost the same everywhere-irrespective of the developed country or the developing country-caste, community, colour or creed a position which is comparable in many ways, with that of racial minorities. Women have been relegated to secondary position despite the fact that they numerically constitute about half the world population today. We will write a custom essay sample on Women Empowerment or any similar topic only for you Order Now In the very beginning of civilization, women enjoyed a respectable position in society-at par with men but later men became dominant over women  This situation had caused immense loss to their self-dignity as human beings and also their independent entities, associated with men, apart from other matter, in context with intellectual and professional capability. The need for women’s empowerment arises from the subordinate position they have been accorded for a long time. The empowerment has been felt as a tool to bring about changes in their socio-economic condition. It has been felt on the part of nation as well as individual that no society can progress till women, a major constituent of society, lag behind. Empowerment of women needs to begin with her participation in different spheres of life. Education is a great determinant in this regard. To achieve empowerment women have to be educated to be aware of their rights and privileges in a modern society. It is education which can bring about awareness in them related to their social status, injustice and differentiation meted out to them. Besides, economic independence is a major factor which can contribute in empowering women. The uneducated women are quite unaware of their rights and privileges and are therefore subject to exploitation at the hands of government machinery, as well by family members. Therefore, our efforts should be directed towards the all- around development of each and every section of Indian women, not confining the benefit to a particular section of women in society, by giving them their due share. It is a must to protect their chastity, modesty and dignity and ensure their dignified position in society. Without removing social stigma, enduring progress and development could not be achieved. For this, the governmental and non-governmental organisations including media should come forward and play an active role in creating awareness in society. The task is not too difficult to achieve. The honesty and sincerity on the part of those involved is a must. If the lots of women change, definitely it will have a positive impact on society. Hence, the women’s empowerment is the need of the hour. How to cite Women Empowerment, Papers Women Empowerment Free Essays Women’s Empowerment Introduction Women have generally been looked upon with contempt for centuries with various strictures inflicted upon them reducing their status to the mercy of men. They have been confined to hearth and home. But now the perspective of the society has changed and a general thinking to work for the emancipation and empowerment of women is being developed so that they could also contribute in the enhancement and welfare of the society. We will write a custom essay sample on Women Empowerment or any similar topic only for you Order Now Their Emancipation But their emancipation is not without challenges. Breaking the age old barriers, storming into a predominantly male bastion are something they have to fight for. Even as they are becoming aware about their rights and demands, the violence and crime against women is on the increase. History is the witness that the women had enjoyed a privileged position in ancient India. It is definitely a matter of pride that there existed a culture and them a respectful Living in the social life. However, the woman lost their status with the coming up of Brahminical traditions and with the advent of Islam, they were further pushed into the background. They were left secluded, devitalized and sheltered and these practices slowly turned into customs which have now become traditions. It was in the medieval period that the social evils like female infanticide, child marriage, purdah. Jauhar. Sati and slavery emerged. Such evils and ill- practices were imposed upon them in the name of customs. They were reduced to the mere household obligations and with this the Indian society plunged into abysmal darkness. The Britishers introduced a few measures to raise the status of women in the society and they initiated the legislation to ban the Sati and to limit the child marriage. With women’s participation in the struggle for India’s independence, there ushered a new age and a recognizable future for them in India. Putting aside the veil they came in the forefront of the national movement for India’s liberalization. A new chapter was added into the history of women’s empowerment with India gaining independence. The norm of their less, unimportant of secondary role to that of men was withdrawn. When the new constitution was formed, the constitution makers took into account the Women’s plight and asserted by introducing various measures in the constitution to hold their rightful place in the society. They were given freedom to participate in the social, political, economic and cultural life of the nation. Feminism Movement During 1960s and 1970s the movement by the women to seek equality with men gained ground all over the world. With this movement called feminism, the educated women in particular and poor rural women in general realized the need to break the old shackles to breathe in the open space. Still the experience shows that man’s tyrannical hegemony is overwhelmingly strong and deep rooted to allow for any change in the short run. In India a crime is committed against a woman every seven minutes. Every 26 minutes a molestation take place and every 54 minute somewhere a woman is raped. The burning of brides for dowry continues unabated in the various parts of the country. The condition of rural women is still more deplorable. The various women’s movements are led and organised by white collared middle class women and social workers from upper and upper middle class non-working women who are unaware about the ground realities existing in the rural structure of Indian society and are not concerned to the rural women’s miserable conditions. Women’s organization have lobbied heavily for the introduction of Women Reservation Bill for 33 per cent reservation in Lok Sabha and in state assembly seats. In the Panchayats and municipalities the reservation has already been provided. They have said that the reservations would give them political platform to work for the rest of women for their emancipation. The government has also taken various measures like committee on statues of women in 1974, followed by National Plan of Action for women and the National Perspective Plan for women in 1988. However despite of these measures, the challenges before the women for their emancipation has remained still an uphill task and their conditions still remained the same. What is required is the seriousness of the various government agencies to work for the women’s empowerment by spreading awareness through various educative programmes. Conclusion However, in spite of the constitutional and legal guarantees aiming to eradicate the inequality and discrimination in any form, the plight of women still remained far from improved. Even today the evils like child marriage, eves teasing, sexual assaults, wife beating, female infanticide and gender discrimination are widely prevalent in the society. However, still the realization is taking roots in the various structures of the society and the women themselves try to raise their voice against the discrimination and violence by the male dominated society. How to cite Women Empowerment, Papers Women empowerment Free Essays â€Å"Why I Believe in Women Empowerment† Ages ago, women only had limited opportunities in life. Usual connotation of a woman is the one who does household chores. But nowadays, it may mean offensive to women because their abilities and capabilities to do other things are under estimated. We will write a custom essay sample on Women empowerment or any similar topic only for you Order Now The current generation of women is considered empowered. When we say empower, this means that there is an authority given to somebody, thus, that authority will make the person more confident and assertive. I believe in women empowerment because I think as a woman, I should be treated equally with man. Also, being a scholar with wisdom, I speak the truth without doubt or hesitation giving me a sense of empowerment. Because of this, I have greater choices and chances to explore, learn and expose myself in all walks of life which will be beneficial not only to me but also to others. I want to portray an ideal member of the society. Because of having respect and self confidence, I can do things possible and excel with my outmost dedication to work. Women can perform task that a man can do but outshining them is not our goal instead, living harmoniously with them is our desire. Also, women empowerment is not destruction to man’s self-esteem and ego. We work not to prove that we can do better than a man but to complement what a man can do. Being one of the empowered women, I clearly understood my worth. That’s why I was able to look at the world as a place where I can freely express who I am and what I believe, making me surrounded with people who honor, love, and respect me as I honor, love, and respect myself. Therefore, women empowerment should be realized by every girl to achieve a successful and fulfilled life. How to cite Women empowerment, Papers

Reflection On Foundations Of Teaching †MyAssignmenthelp.com

Question: Discuss about the Reflection On Foundations Of Teaching. Answer: The references to the annotated bibliography has helped me to learn about the factors regarding communication skill that affects the practice of teaching. The journals helped me in gaining a better insight into the factors that help in growth and development of the students. The factor that affects the growth and development of students the most is the communication skill of the teacher. I am a pre-service teacher myself, thus these annotated bibliographies helped me a lot to understand the importance of effective communication between the teacher and the students. This journal helped me to understand the fact that the effective communication between the teacher and the student is necessary in order to motivate the students to participate in various activities and communicate in the various programmes that are organised. The journal presents a study of a total number 245 students from over four different universities situated in Romania. These students were assigned various activities on communication. The journal presents a study of the recorded and observed responses of both the teachers and the students regarding the communication activities assigned to the concerned students. The journal in discussion provides the readers with an extensive explanation of the significance of the skill of communication in the job of a teacher. The journal deals with the practical as well as the conceptual approaches towards the understanding of the ways in which the communication skills of a teacher may affect the development and the growth of a student. The journal in discussion helped me to understand the methods that must be utilized to tackle the challenges that the students as well as the teachers face. According to the journal, the students must be presented with new inspirations to arouse their curiosity on the subject. The teachers should provide their students with success in the early stages of the activity so as to boost the development of confidence of the student. The students should bear a positive outlook towards the activity that they are assigned. It is considered to be the duty of the teacher to cater to the needs of the students in an individual manner. A teacher is known to be a person who helps the student to gather knowledge and skills. A teacher has to fulfil a number of various responsibilities towards the students. The primary responsibility of the teacher is to impart education to the students. A teacher should help in providing the students with motivation in order to develop their urge and ability to learn. A teacher is expected to take decisions based on the correctness. The decisions taken by the teacher should be well-informed decisions (Zeichner Liston, 2013). The concept of education is based on the theory of exchanging of information (Erozkan, 2013). The power to communicate with the student will help me in my future days as a teacher. One of my main roles as a teacher would be understanding the problems of my students (Danielson, 2013). The only way to establish an understanding between the student and the teacher is to establish an effective communication between them. I have observed several times that there is a hesitation on the part of the student to approach the teacher. This may be the result of the fact that the student lacks enough confidence in the subject or due to the fact that the student is scared of approaching the teacher with the issue of his problems. This occurs mainly due to the communication lack between the teacher and the student (Owens, 2016). A student should never be hesitant to approach the teacher on any issues that he is facing regarding education or any significant phase of his life. The assurance of the fact that the teacher is available for any kind of help that the student might need helps in the formation of a bond between the teacher and the student. This bond helps the teacher to understand the psyche of the students better and thus help him to solve the issues that the student comes up to him with. I have observed in my class that every student is different from the other therefore the methods of reaching out to each student must be different as well. I have observed that it is relatively easier to approach the students who are outgoing in nature rather than those who are shy and introverts by nature. The teacher should therefore adopt different methods to reach out to each student (Danielson, 2012). References Danielson, C. (2012). Observing classroom practice.Educational Leadership,70(3), 32-37. Danielson, C. (2013).The framework for teaching: Evaluation instrument. Princeton, NJ: Danielson Group. Duta, N., Panisoara, G., Panisoara, I.-O. (2015). The effective communication in teaching. Diagnostic study regarding the academic learning motivation to students. Procedia-Social and Behavioral Sciences, 186, 1007-1012. Erozkan, A. (2013). The Effect of Communication Skills and Interpersonal Problem Solving Skills on Social Self-Efficacy.Educational Sciences: Theory and Practice,13(2), 739-745. Owens Jr, R. E. (2016). Language Development: An Introduction| Edition: 9.Instructor. Zeichner, K. M., Liston, D. P. (2013).Reflective teaching: An introduction. Routledge.

Sudeep Annem Essays (364 words) - Christianity, Literature

Sudeep Annem Mrs. Burch AP English Literature 11 September 2017 Visual Essay Statement I examined the impact of the dark theme of death which reflected the atmosphere of the medieval times. In an era rampant with disease and misfortune, many works of poetry reflected the gloomy atmosphere surrounding their poets. The poems that asserted the dominance of death in medieval literature were Death be Not Proud written by John Donne, Hell before Purgatory located in the Worcester Manuscript, and Pearl by an unknown official writer. These three poems provided varying point of views of the impactful writers in medieval times. The first poem describes one attitude that many adapted towards death during this time. Since death was occurring so frequently those like John Donne sought to justify death and discuss its weakness. He states that death has no power over humans as they can live eternally after they pass away. Also, since the body remains after death Donne argues that the only thing that truly perishes is death itself. The second poem has a more gruesome outlook on the effects of death. It talks about how the fires of purgatory are inescapable regardless of how many merits are accumulated over the course of a lifetime. The final poem discusses how death is a dreamlike state, but it is sacred. No mortals may trespass on the celestial affairs of the afterlife. A man goes looking for his pearl and angers the heavens resulting in divine punishment. All of the aspects of death led to the selection of visuals I ma de in my collage. The choice of a scythe represented the power that death held over humans in medieval times and within the scythe was an array of unique medieval paintings and pieces of art which expressed the fleetingness and inevitability of death. In addition, I incorporated images that suggested the impact of religion and the current state of world affairs (namely the Black Plague) had on the interpretation of death in medieval art and literature. The theme of death defined the culture of Medieval times and the many representations and beliefs surrounding death located in literature helped show the modern people the harsh life that awaited those in that time.

Free Essays on Views On Western Civilization

Discussion #4 In Condorcet’s Progress Of The Human Mind the enlightenment view of history is expressed as a series of long open-ended questions that sort of map out what mankind has to do in order to develop, improve and be peaceful. In the first paragraph Condorcet quotes â€Å"Will not every nation one day arrive at the state of civilization attained by those people who are most enlightened, most free, most exempt from prejudices, as the French, for instance, and the Anglo-Americans?† I think what he means here is that in order for a nation or the world to become a better place people need to put aside all their differences and just except the fact that everyone is human and that we’re all the same. In Condorcet’s view man’s greatest crime and fault is war. On page 300 Condorcet is being quoted saying â€Å"The people being more enlightened, and having resumed the right of disposing for themselves of their blood and their treasure, will learn by degrees to regard war as the most dreadful of all calamities, the most terrible of all crimes†¦Ã¢â‚¬  In Condorcet’s view man should use technology to improve upon man’s capabilities and skills and improve himself rather than to destroy himself, â€Å"†¦, that instruments, machines, looms, will add every day to the capabilities and skill of man-will augment at once the excellence and precision of his works, while the will diminish the time and labour necessary for executing them.† The final stage of human development is for the enlightened people to be able to pass on enlightenment to their children. In the 1851 Economist progress has been â€Å"rapid† since the late half of the 18th and the first half of the 19th century. Where roads in 1650 were â€Å"almost as bad everywhere, except near the metropolis: the streets nearly as ill-lighted and not much more and ill-arranged.† In the middle of the 18th century the streets are described as being lit up in a â€Å"blaze of ligh... Free Essays on Views On Western Civilization Free Essays on Views On Western Civilization Discussion #4 In Condorcet’s Progress Of The Human Mind the enlightenment view of history is expressed as a series of long open-ended questions that sort of map out what mankind has to do in order to develop, improve and be peaceful. In the first paragraph Condorcet quotes â€Å"Will not every nation one day arrive at the state of civilization attained by those people who are most enlightened, most free, most exempt from prejudices, as the French, for instance, and the Anglo-Americans?† I think what he means here is that in order for a nation or the world to become a better place people need to put aside all their differences and just except the fact that everyone is human and that we’re all the same. In Condorcet’s view man’s greatest crime and fault is war. On page 300 Condorcet is being quoted saying â€Å"The people being more enlightened, and having resumed the right of disposing for themselves of their blood and their treasure, will learn by degrees to regard war as the most dreadful of all calamities, the most terrible of all crimes†¦Ã¢â‚¬  In Condorcet’s view man should use technology to improve upon man’s capabilities and skills and improve himself rather than to destroy himself, â€Å"†¦, that instruments, machines, looms, will add every day to the capabilities and skill of man-will augment at once the excellence and precision of his works, while the will diminish the time and labour necessary for executing them.† The final stage of human development is for the enlightened people to be able to pass on enlightenment to their children. In the 1851 Economist progress has been â€Å"rapid† since the late half of the 18th and the first half of the 19th century. Where roads in 1650 were â€Å"almost as bad everywhere, except near the metropolis: the streets nearly as ill-lighted and not much more and ill-arranged.† In the middle of the 18th century the streets are described as being lit up in a â€Å"blaze of ligh...

Demonstrate an understanding of financial statement analysis Essay

Demonstrate an understanding of financial statement analysis - Essay Example For instance, if a financial statement analysis is conducted and the results indicate profitability of the company then the shareholders are assured of a company’s prospective growth hence safety of investments. In the contrary, they may decide to sell their shares where financial statement analyses indicate a downfall in profitability. This group’s interest concerns the company’s wealth situation. Their major interest is security of the money they invested in the company and the ability of the company to refund both the accrued interest as well as principle amount within the designated repayment time. The creditors are interested in financial statement analysis for purposes of establishing the short-term liquidity status of a firm. Their main interest is to ascertain a firm’s capability to repay the amount they owe on time. â€Å"They do financial statement analysis from which they are informed on whether there is need to extend the lends and ask for advanced interest charges† (Sinha & Sinha, 2009). It is for this purpose that the information gathered from the financial statements is important. The management is charged with the responsibility of ensuring a smooth running of an organisation. They are responsible in formulation of future policies and plans as well as undertaking immediate decisions. It is for this reason that they should analyse financial statements in order to measure the effectiveness of the policies and the decisions they make in the day-to-day running of a firm. â€Å"In addition, the management’s interest is to ascertain both the short-term and long-tern creditworthiness of the company, productivity, liquidity and return on investment status of the business† (Shim, & Siegel, 2007). It is the duty of every government to ensure that firms conform to tax regulations. Therefore, the government examines financial statements with an aim of determining tax submission. In addition, the government

Communication Essay Example | Topics and Well Written Essays - 500 words - 5

Communication - Essay Example r, our on field work has showed that there exists a significant communication gap between the two sections of hospital personnel rising from inconsistent micromanagement practices and a general absence of information in the lower levels of hierarchy. There existed a general perception that the NHCGL is not a career enhancing option for senior and junior members alike. The concern over stagnation in the career graph can adversely affect the motivation level of the personnel and their subsequent work efficiency. The senior management was found not to take an active interest in the development of junior members and are alleged to be more concerned with their own affairs. In matters pertaining to the administrative policy making, there exists no mechanism for the administration to review the feedback of ‘those administered’. Another recurring concern is that of redeployment of military personnel which should ideally consider various personnel parameters such as time on contract, time on board, previous deployments and moreover ensuring that only qualified candidates are called for deployment. A majority of the staff is ill informed about the general redeployment process. These micro managerial flaws exist despite the presence of various training, development and administrative grievance redressal programs within the organization. The Command Career Counselor (CCC) ensures that the Commanding Officer is informed on all matters concerning retention. There is an Education and Training Department which requires the naval staff to undergo an annual training program which covers various topics pertinent to the staff members. The entire training session beginning at the period of initiation of a new member is tracked by a Command Check In/ Check Out program. In addition there are numerous orientation programs emphasizing a multidisciplinary approach to training and services. But none of these addresses the concerns of those members who are well initiated into the

Mulligan Vs Maitland Talar Glide Health And Social Care Essay

Mulligan Vs Maitland Talar Glide Health And Social Care Essay Does Mulligans anterior-to-posterior talar glide is effective in improving dorsiflexion in subjects with acute ankle inversion sprain than Maitlands anterior-to-posterior talar glide mobilization. Design: Experimental, Comparative, Randomized Controlled Trail-single blinded study. Participants: 90 samples with acute ankle inversion sprain diagnosed by radiologist through X-Ray imaging will be collected with convenience sampling. Intervention: Based on inclusion and exclusion criteria subjects randomly allocated to 3 groups of intervention- Group I Mulligans anterior-to-posterior talar glide along with RICE, Group II Maitlands anterior-to-posterior talar glide along with RICE, Group III RICE (control group) for 2 weeks. Outcome Measures: Pre and Post session, measurement of dorsiflexion range of motion will be taken with Modified Lidcombe templates. Duration: The expected duration of study is considered 8months for ethical clearance, data collection and analysis, editing and publis hing. Budget: An estimation of Rs 30,000 is made including the investigation, instruments, materials and refreshments. BACKGROUND Ankle is a complex joint which is categorized as a hinge joint. It is one of the important component for ambulation in humans. Ankle sprains are one of the commonest injuries in athletics. It accounts for 20% of all sports injuries (Bergfeld J; 2004).In India, incidence rate of ankle sprain accounts for 0.31% of the population and the chances of re-injury is seen as high as 78-80% despite the continued research in this field (Statistics for ankle sprain; 2003). The pathomechanics for ankle inversion injury is inversion and plantar flexion of the ankle joint. There is loss of dorsiflexion and inversion range of motion which is attributed to pain and swelling (Denegar CR et al; 2002), (Collins et al; 2004).According to Denegar C et al (2002) the loss of dorsiflexion range of motion is due to restriction of posterior talar glide. This suggests that in an acute ankle inversion sprain the loss of dorsiflexion range of motion could be due to mechanical dysfunction in talocrural joint. The conventional treatment for acute ankle sprain is RICE (rest, ice, compression, elevation).The main aim of conventional treatment (RICE) is primarily to reduce pain and inflammation (Starkey JA; 1976), (Slatyer MA et al; 1997). The conventional treatment (RICE) with early movement is found to be more effective for reducing pain, swelling and improving mobility (Dettori et al; 1994). Because of the ineffectiveness of conventional treatment for treating the positional dysfunction caused due to acute ankle inversion injury the joint becomes more susceptible to injury (Hertel J et al, 1999). Manual Therapy focuses on reduction of pain and correction of the postural and movement dysfunction due to ankle sprain. According to Maitland grades of mobilization grade I and II mobilization is used in acute condition and grade II mobilization is seem effective in reducing pain and improving dorsiflexion range of movement in acute musculoskeletal conditions. Maitland grades of mobilization improves the ankle dorsiflexion in acute ankle inversion sprain (Green et al; 2001) and reduces pain by modulation of nervous tissue (Vincenzino B et al; 1998). According to Maitland GD (1986), passive joint mobilization improves the range of movement by gentle oscillatory movement of the articular surfaces that creates movement of the mobile segments by a means other than the muscles .According to Collins et al (2004), Mulligans mobilization with movement technique is effective in reducing pain and improves dorsiflexion of ankle joint. A single case study done by O Brien, B.Vincenzino (1998) sh owed that Mulligan Mobilization with movement technique on acute ankle sprain improved the range of movement (dorsiflexion and inversion), functional outcome and reduced the pain. According to pilot study conducted by John-Mark Chesney, Erin Morris, Mulligans mobilization with movement technique and taping had significant effect on temporal and spatial parameters of gait. Immediate decrease in pain and an early return to function are claimed to be result of Mulligans mobilization with movement Mulligan 1995; Vincenzino Wright 1995; Hetherington 1996). However, the lack of adequate evidence in literature for the effectiveness of Mulligans anterior-to-posterior talar glide with movement technique in acute ankle inversion sprain failed to prove its clinical and statistical significance in research methods. The above literature also shows lack of studies done to compare the effects of Maitland and Mulligan mobilization technique in treatment of acute ankle inversion sprain. Hence, the aim of the study is to find the immediate effect of Mulligans anterior-to-posterior talar mobilization with movement technique in acute ankle inversion sprain with RICE and compare the results with that of Maitland anterior-to-posterior talar glide mobilization with RICE for treatment of acute ankle inversion sprain. REVIEW OF LITERATURE Ankle joint is a complex joint due to its articular, ligamentous and tendinous anatomy. The anterior talofibular ligament restricts anterior translation and internal rotation of talus inside the mortise. The coupled motion during plantar flexion happens as internal rotation and anterior translation of talus aided by deltoid ligament. The calcaneofibular ligament restricts inversion of the talocrural and subtalar joint. The posterior talofibular ligament restricts inversion and internal rotation after calcaneofibular ligament and anterior talofibular ligament undergo injury. According to Konradsen and Voight (2002) an inversion torque was produced on loading a cadaveric leg, when the unloaded foot was positioned in 30 degree inversion, full plantar flexion and 10 degree internal tibial rotation. The collision with 20 degree inverted foot in swing phase follow through forced the foot into full limit of inversion, plantar flexion and internal tibial rotation. According to Denegar CR et al (2002) in normal biomechanics the instantaneous axis of rotation of talocrural joint translates posteriorly during dorsiflexion, but in anterior malaligned talus or with restricted posterior talar glide the axis of rotation is shifted anteriorly leading to joint dysfunction. According to Baumhauer JF et al (1995) previous history of sprain, limited range of motion and reduced dorsiflexor and plantar flexor strength ratio, elevated eversion to inversion ratio have been attributed to predisposing to inversion injury. According to Eren OT et al (2003) high malleolar index (posteriorly positioned fibula) is attributed to predisposing factor to sprain. Average malleolar index was +11.5 degree in subjects with ankle sprain and +5.85 degree in normal controls. Green T in 2001 used a Modified Lidcombe Template to measure the pain free dorsiflexion range of motion occurring in talocrural joint. The template consisted of 2 boards joined by an adjustable hinge. One board served as a footplate and other was placed under the subjects calf. The adjustable hinge served as the axis of rotation of template in vertical plane and the board placed under the subjects calf allowed for adjustment in horizontal plane. The measurement was standardized by measuring both force applied and the angle of dorsiflexion at which the subject first experienced the pain (Matyas T, Bach T; 1985). The force applied was standardized throughout the trail by spring balance and the direction of force was standardized by spirit level attached to the spring. The device showed high intrarater and interrater reliability of which 29% were in exact agreement and 84.5% were within 2 degrees, ICC=0.94. The conventional management of ankle sprain is RICE in acute stage of injury. The functional treatment procedures with early initiation of weight bearing as tolerated, early mobilization, proprioceptive training, balance training has been advocated to provide early functional rehabilitation to subjects. According to Bahr R (2004) and Bruce Beynnon B, (2004) the management of sprain concentrates on static and dynamic stability, gaining normal ankle range of motion, optimal strength of peroneal, dorsiflexors, plantar flexors, and invertor muscles of ankle and retraining ankle strategy. According to Kerkhoffs et al (2002) functional treatment is superior to immobilization and surgical intervention in areas of pain on activity, quality of performance on return to sport/work, objectives instability on x-ray views and patient satisfaction. Manual therapy in ankle inversion sprain Maitlands Mobilization Green et al (2001) conducted a randomized controlled trial of passive accessory joint mobilization on acute ankle inversion sprain. The study included 38 subjects with acute ankle inversion sprain( Elizabeth L et al (2008) conducted a study in which 10 subjects were taken with immobilized ankle for at least 14 days and presented with at least 5 degree of dorsiflexion deficit compared to contralateral ankle. A crossover design was employed and subjects received Maitlands grade 3 mobilization in one group and control intervention (no treatment) in other group. Results showed that joint mobilization led to a reduction in pain and improvements in pain-free dorsiflexion. Mulligan mobilization with movement technique Collins et al (2004) conducted a double-blinded randomized controlled trial with a crossover design approach. In this study 14 subjects with grade 2 ankle sprain were taken. The dorsiflexion in weight-bearing and thermal pain threshold were calculated. All the subjects undergo 3 treatment conditions-Mulligans mobilization with movement technique for dorsiflexion, placebo group and control group (no treatment).Results showed that the talar anterior-to-posterior glide improved the recovery rate in treatment with Mulligans mobilization with movement technique. The study conducted by Collins N was done on subjects with sub acute ankle sprain. T OBrien, B.Vincenzino (1998) conducted a single case study to investigate the effects of Mulligans with movement technique mobilization for acute lateral ankle sprain. The technique used in this study was posterior glide to distal fibular while patient actively inverted the ankle. In the study 2 subjects with acute ankle sprain were used to control for natural resolution of ankle sprain. Subject I underwent ABAC protocol while subject II BABAC protocol where A was no treatment phase B was treatment phase and C was post treatment return to sport phase. The outcome measures Modified Kaikkonen test functional outcome, VAS for pain and range of dorsiflexion and inversion were measured pre and post of each intervention session. Results showed rapid improvement of range of motion (inversion and dorsiflexion) and immediate decrease in pain. Hence from the above studies we can infer that anterior-to-posterior talar glide technique in both Maitland and Mulligan mobilization is effective in treating ankle inversion sprain than the RICE protocol alone. The above studies also infer that Maitlands grades of mobilization is significantly effective in improving dorsiflexion range in acute ankle sprain. However, Mulligans mobilization had shown effective results in treating ankle sprain in subacute condition. The study done by T OBrien, B.Vincenzino (1998) shows the effectiveness of Mulligans mobilization with movement technique in improving dorsiflexion range of motion in acute ankle sprain but the study design leads to limitation of generalization of its findings. However, it does provide the knowledge to conduct a random clinical trail in utility of Mulligans mobilization with movement technique in the treatment of acute ankle inversion sprain and to compare the results with Maitlands grades of mobilization to find the best e ffective treatment method for improving the recovery rate in acute ankle inversion sprain. IDENTIFICATION OF RESEARCH PROPOSAL QUESTION Does Mulligans anterior-to-posterior talar glide is effective in improving dorsiflexion in subjects with acute ankle inversion sprain than Maitlands anterior-to-posterior talar glide mobilization. ALTERNATE HYPOTHESIS Mulligans anterior-to-posterior talar glide is effective than Maitlands grades of mobilization in improving dorsiflexion range of motion in subjects with acute ankle inversion sprain. NULL HYPOTHESIS Mulligans anterior-to-posterior talar glide is not effective than Maitlands grades of mobilization in improving dorsiflexion range of motion in subjects with acute ankle inversion sprain. METHODOLOGY Design An Experimental, Comparative, Randomized Controlled Trail design. The study will be single blinded to avoid any possible bias. The subjects will be allocated to 3 group of interventions-Mulligans anterior-to-posterior talar glide with movement technique with RICE, Maitlands anterior-to-posterior talar glide mobilization with RICE, and third group RICE alone .Outcome measure will measure the degree of dorsiflexion pre and post to each session which will be measured by the assessor blinded to the allocation of subjects to the groups. Subjects The study will be conducted by recruiting 90 samples through convenience sampling by giving advertisements and notices to orthopaedic and physiotherapy department in MS Ramaiah Memorial hospital and the hospitals nearby its surrounding areas. The subjects recruited will be diagnosed for acute ankle inversion sprain and referred by radiologist through X-Ray imaging. To maintain the homogeneity of the groups all the subjects will be recruited based on Inclusion and exclusion criteria. Inclusion criteria-All subjects of age group 20-30years of age, History of ankle inversion injury with pain over lateral aspect of ankle ( ETHICAL APPROVAL The ethical approval will be taken from Ethical Board of MS Ramaiah Memorial Hospital along with the permission of other hospitals near by its surroundings. Subjects will be given a copy of informed consent with the details of the study and the confidentiality of patients personnel information and data obtained after the study will be maintained. Subjects can withdraw from study at any given point of time. VENUE/LOCATION OF THE STUDY The study will be conducted in MS Ramaiah Memorial Hospital Physiotherapy Department, Bangalore. A RANDOMIZED CONTROLLED TRAIL STUDY An experimental randomized controlled trail -single blinded study will be conducted on 90 subjects with acute ankle inversion sprain. The technique of the interventions will be finalized during the study and side-effects or any error in the intervention will be noted and rectified. RESEARCH METHOD AND EXPERIMENTAL INTERVENTION 90 samples will be recruited by convenience sampling. The samples will be assessed for acute ankle inversion sprain by X-Ray imaging done by the radiologist in radiology department of MS Ramaiah Memorial Hospital. The subjects will be randomly assigned to 3 groups by chit method. Each group will be assigned 30 subjects. The researcher who will conduct the study is a qualified physiotherapist who specializes in manual therapy. After the allocation of the group the experimental group I will receive Mulligans anterior to posterior talar glide along with active dorsiflexion of ankle which will be followed by RICE application. The mobilization will be performed in weight bearing in which the therapist applies a postero-anterior force to distal leg through a treatment belt while stabilizing the foot and talus (Mulligan; 1999).The experimental group II will receive Maitlands anterior-to-posterior talar glide (Grade II) followed by RICE application. The mobilization will be performed with subject lying supine and the ankle will be positioned over the edge of plinth with proximal hand of therapist stabilizing the distal tibia and fibula while the distal hand will mobilize the talus with posteriorly directed oscillation(Maitland;1977).Group III will receive RICE treatm ent for maximum of 2 weeks. Subjects in experimental group I and II will be treated every second day for maximum of 2 weeks. Therefore 6 sessions of treatment over 14 days will be done. Three sets of 10 repetitions will be applied with 1 minute between sets (Exelby, 1996) in both mobilization technique. Pain experienced during treatment will result in immediate cessation of technique and exclusion of the subject from study. OUTCOME MEASURES Dorsiflexion range of motion will be measured by Modified Lidcombe template. The template enabled standardized measurement of dorsiflexion range of movement. The axis of rotation of ankle was aligned with adjustable axis of rotation of template. The spring balance attached to the footplate measure the force applied in the standardized direction. A hydrogoniometer placed on the footplate measures the range of dorsiflexion in degrees. The template have a high intrarater and interrater reliability of which 29% were in exact agreement and 84.5% were within 2 degrees, ICC=0.94. Hydrogoniometer have high intraclass coefficients (0.84-0.99) which revealed high agreement between the raters (Lex D.De jong et al; 2007) RESULTS AND DATA ANALYSIS The dorsiflexion range of movement measured will be in degrees which represent a parametric data. The data collected pre and post of each 6 session in group I and group II will be analyzed by related t test (i.e. within the group) and unrelated t test will be done to compare between the group I and group II for dependent variable. One way ANOVA will be used for analysis of data from all the 3 groups along with Scheffe test to find the most effective group for treatment of acute ankle inversion sprain. The level of significance will be set at 0.5; the probability will be calculated based on the t value with degree of freedom table. The confidence interval will be kept to 95%. ANNEXURE PROJECT TIMELINE The overall estimated time required for the completion of the study is 8months i.e. 1 month for ethical clearance, 4 months for the randomized controlled trail, data collection and data analysis, 1 month for writing up and presenting results and 2 months for publishing results. Tasks 1 2 3 4 5 6 7 8 Ethical clearance + Randomized controlled trail amend data collection tools + Data collection + + + Data analysis + + Writing up presenting results + Publishing results + + BUDGET The overall estimation of the budget is Rs30, 000 which includes X-RAY imaging Rs20, 000 (90 subjects) Modified Lidcombe Template and hydrogoniometer Rs5000 Stationary Rs1000 Transportation and refreshments Rs4000 INFORMED CONSENT Introduction This is an informed consent given to a subject who wishes to participate in research study. Please red the informed consent carefully or you can ask anyone of your relative who you trust can read this informed consent for you in your language by translating it. Please feel free to ask any questions you have about this informed consent or research study in your mind. Please sign the consent form only after you have no doubts about the research study or consent form. Do not sign the consent form under any kind of pressure. Title of Research Project Immediate effects of Mulligans anterior-to-posterior talar glide with movement technique versus Maitlands anterior-to-posterior talar glide for pain free dorsiflexion in acute ankle inversion sprain. Investigator SUMIT KIMOTHI M. Sc in Clinical Physiotherapy. Purpose Of Study Acute ankle sprain has high percentage re-injury. Mulligans mobilization with movement technique helps in improving dorsiflexion range of motion by correction of positional dysfunction of joint. This study is to find the effect of Mulligans mobilization with movement technique and compare it with effects of Maitlands grades of mobilization in treatment of acute ankle inversion sprain. Description of Study After being diagnosed with acute ankle inversion sprain you will be sent to the physiotherapy department in physiotherapy department. The researcher will explain you about the treatment technique and the study and an informed consent will be given to you based on your decision your participation will be decided. If you wish to participate a treatment technique selected for the respective group in which you will allocated will be performed on you and the assessment will be taken before and after the treatment session. The duration of treatment is 2 weeks and if there is any changes, you will be informed prior. Possible Risks or Complication The treatment technique itself has no side-effects or complication and it will be performed by a qualified physiotherapist in Manual Therapy. Treatment Alternative If the therapy is not effective to you, you will be provided with an alternative treatment with free of cost. Financial Implications All the expenses regarding the research work including the investigation, transportation, food expenses and treatment will be free of cost. Potential Benefits The study may be beneficial to society and individuals of similar condition. You can benefit by improving you condition with help of this treatment. Participation Participation in this research study is voluntary. If the participant wants to withdraw he/she can withdraw at any given point of time. CONSENT FORM I have read the foregoing information, or it has been read to me. I have had the opportunity to ask questions about it and any questions that I have asked have been answered to my satisfaction. I consent voluntarily to participate as a participant in this research and understand that I have the right to withdraw from the research at any time without in any way affecting my medical care. Name of the participant _____________________ Signature of participant _____________________ Date: _____________________ Day/month/year ___________________ If illiterate A literate witness must sign (if possible, this person should be selected by the participant and should have no connection to the research team). I have witnessed the accurate reading of the consent form to the potential participant, and the individual has had the opportunity to ask questions. I confirm that the individual has given consent freely. Name of witness ___________________ AND Thumb print of participant Signature of witness ___________________ Date: ______________ Day/month/year ______________ I have accurately read or witnessed the accurate reading of the consent form to the potential participant, and the individual has had the opportunity to ask questions. I confirm that the individual has given consent freely. Print Name of Researcher _________________ Signature of Researcher ___________________ Date __________ Day/month/year ____________ A copy of this Informed Consent Form has been provided to participant ____________ (initialed by the researcher/assistant) For more information contact: Sumit Kimothi M. Sc in clinical physiotherapy, MS Ramaiah Memorial Hospital, Bangalore. 9916261101 ASSESSMENT CHART Name : Age : Sex : Site of Disorder : Mode of Treatment : Measurement : Parameters Before Treatment After Treatment Dorsiflexion range of motion Signature of Clinician : Signature of Chief Physiotherapist :

Record Retrieval System Essay

Chapter 1 The Problem and Its Scope Introduction Technology plays an important role in retrieving patient records in the lives of every patient, an office staff and a medical hospital because of the big boom of technology across the globe it enhanced the services of health institutions. Big, small hospitals or even clinics use the advantage of technology that gave ease to every transaction made especially on important document stored and released for patients. Every record is important just like birth certificates that every parent will retrieve from a hospital for future use of their children, a medical record or laboratory results needed by doctors for medical purposes. For the past decades, medical hospitals all over the world are using a paper system in the retrieval of patient’s records. Patient Record Retrieval is the process of getting the patient records back from a repository or a place where records are stored. Such as, an outpatient record is stored in the deck of folders, envelopes mostly sorted by family names, and there are hundreds or thousands in one of the corner of the office. Patients come and will retrieve records if needed anytime and does not have the assurance that a record will be able to retrieve in a short period of time. Medical centers in the country, it maybe prestigious or not, has also encountered the same problems as other countries encountered, scattered records are everywhere and occupied the whole space of the office, adds manpower for processing transaction and waste of office supplies and most especially retrieval services are slow. Government hospitals have many patients most especially poor people from rural areas and retrieving patient records in the hospital is the common problem. Negros Oriental Provincial Hospital is a government health agency intended for the poor and one of its services is to retrieve records of patients. One problem that clients lost their patience is because of turtle-like services of the agency in retrieving records. Factors that the hospital has a slow service in retrieving patient records and it is because records are very hard to locate that consumes couple of minutes in retrieving for a specific record being requested. In addition to the problems of Negros Oriental Provincial Records Department is that the paper  system consumes the office space, waste of paper materials and additional personnel for locating records. Thus, with all problems encountered by Negros Oriental Provincial Hospital Records Department in retrieving records, the researchers came up a solution to have a new computerized patient records retrieval system. Review of Related Literature, Studies and Systems Review of Related Literature Patients record a collection of documents that provides an account of each episode in which a patient visited or sought treatment and received care or a referral for care from a health care facility. The record is confidential and is usually held by the facility, and the information in it is released only to the patient or with the patient’s written permission. A problem-oriented medical record also contains a master problem list. The patient record is often a collection of papers held in a folder, but it may be computerized. Retrieval of medical record has been a significant means of communication between the Provider, Payer and Legal community. For decades it has been an extremely manual driven, paper driven process and time consuming process. With the advent of technology, issue of regulatory guidelines of PHI security and confidentiality such as Privacy Rules or HIPAA, Medical Record Retrieval and Release of Information is an industry which has undergone and is going through a lot of transformation. Earlier being done by the organizations themselves, this service is now being outsourced to specialists with the end goal to reduce retrieval time by process automation, reduce paper usage, and abide by the stringent HIPAA and Privacy rules. Retrieving medical records isn’t overly difficult, but it is a process with specific requirements. For example, medical records aren’t always stored at a physician’s office. First, the medical provider needs to be contacted and asked about where the medical records request forms should be sent. Once the correct mailing address has been obtained, the record request forms as well as a HIPAA authorization form and a check for copy charges needs to be sent. In a perfect world, the provider would receive the request and fill it right away. However, it’s not unusual for a request to sit in a pile on some clerk’s desk making follow-up calls an absolute necessity. Lehnart et al. defines a patient record management system as a system that stores demographic, and medical information from ancillary services such as registration, lab, radiology, pathology, pharmacy, consultation and transcription.They state that a record management system is not simply automated updates of paper based charts, but rather a dynamic system used to help health care workers make better informed dragonesses. According to Gaillour et al. a record management system is only effective at achieving the goals of increasing quality of care and lowering costs if the organization re†designs it’s current workflow and practices. Hence a very user† friendly system needs to be created to mitigate the risk of user dissatisfaction towards the new system. Fromberg et al. claim the clinical benefits to such a system includes easier, more rapid access to patient data charts; Improved clinical decision making and disease management; More educated patients about their own ailments; An increase in time to spend consulting with patients; An increased perception of patient care and theoretically a better working environment. All these benefits overall translate to better patient care. More benefits include a more efficient workflow, as duplicate tasks would not be performed as the need to re gather information would be eliminated as all data pertaining to the patient is readily available at all times. Time taken to execute administration functions, such as capturing patient demographics, drop dramatically. According to Dassenko and Slowinski, an average of up to 15 minutes was saved per patient on the patients first visit and further 20 minutes on each subsequent visit as a result of implementing a computer based patient record. Fischer and Bloude (1999) states findings that the retrieval of paper records was time consuming and finding the required information amongst many documents for certain patients could be a lengthy process. Wellen et al (1998) emphasized the advantage of EPR because it enables information be Time is saved by EPR in not requiring the whole patient file to be used to find to available quickly about specific requirements perhaps just one piece information. Coiera (2003) EPR added that information instantaneously drugs though many documents. with EPR instead of requiring a search such as allergies to particular could be obtained information strategy states that in the EPR system the patient records should be secure, accurate, and legible. They can be easily accessed by authorized staff and in addition to use for individual patients can be incorporated in research. Data can also be available for the improvement of quality. Bush (2002)recommended introducing and using an appropriate EPR system since it helps to reduce costs and ongoing expenses in providing multiple users access to faster. Distance is information, data protection and backups. An EPR backup system is more economical than the manual system since it saves space, time to locate and access information and maintenance costs. Abdellhak et al (1996) and Young (2000) state that physical control of a file are not always available, EPR data can be accessed at any provides adequate security. However, sometimes as many as 30% of which is not possible with paper records. Englebardt and Nelson (2002) and Reynolds (2003) agree that an increasing number of paper records approved workstation are authorized difficult more Robert(2002) one the information for the right reason. Especially Friedman (2005) considered security for confidentiality must be ensured this is and relevant with EPR systems even if it makes authorized access access patient record especially in emergency cases. Kirshna and authorized person. Where as a paper based system is available to only one person at a time to point out that an EPR system can  be used simultaneously by more than Amatayku (2004) drew attention to access policy which needs not only a ban sharing passwords but also a reminder of the possible legal consequences. Schmitz (1979 p.74) described an early EPR system at a time when â€Å"there is as yet no such thing as a fully electronic medical record†. The benefits were then seen to be â€Å"timeliness, accuracy, completeness and availability† resulting from†having physicians interact directly with an electronic management information system† (Schmitz 1979, p.75). He seems to have been one of the pioneers in anticipating the potential of EPR, and the benefits from professional input. Kovner (1990), who considered the use of electronic records for patient history and current treatments. The availability of computer systems from 1990 onwards further helped to prove the arguments raised by the two authors above. This availability changed medical record keeping to electronic methods, which were beneficial in many ways. methods of recording have reduced the size of records despite the fact that they contain very much more information. By using computers, doctors can easily access information from more than one source. The organization of records for ease of access is essential for efficiency and the importance of the service is recognized by supervisors in charge. Good organization and management requires good leadership to ensure efficiency and co-operation and a constant improvement performance. In addition to the above observations, Meijden et al (2000) measured the attitudes towards electronic patient record among physicians and nurses. The researchers noted that the experienced physicians and nurses were move positive, whereas the inexperienced ones found EPR to be more time consuming for data entry and retrieval, and they were concerned about their familiarity with computers and the need for training. This study implies that one has to be experienced in making the optimum use of EPR systems. Furthermore, an EPR system proves to have more effect on improving quality of patient care. Bickford (1995)noted the in as a restriction potential that EPR systems have for improving patient health costs, adding satisfaction for providers, researchers and administrators. Dick and Steen (1991) argued that patient records should include more information than just treatment details for as proposed by earlier researchers such as Kovner (1990), example, guiding problem solving, decision analysis, reminders, and risk assessment ,an do the relevant details(Dick & Steen1991,p.37). The system could prompt staff about additional considerations not available in paper records. The system would be accessible at all times. Similarly, a report by the Institute of Medicine (IOM 1997) helped to argue further that an electronic patient record is to be as the one that is specifically designed to support users through of complete and accurate data, practitioner reminders and alerts, clinical understood availability decision support systems, links to bodies of medical knowledge and other aids. Novak(2005) considered EPRs as time saving which can be life saving, transfers to cost other physicians history, effective whilst maintaining confidentiality and, making easy and immediate. However A personal EPR can contain a total medical complicated. EPR systems have to a greater extent improved patients records and facilitated  the selection of the most appropriate treatment. Amongst these advantages, Burton et al with the patient’s input can be created when records are retrieved much Lane & Hayward (1999) investigated the value of electronic patient records make adequate and legible records has been reduced to take only a few minutes per patient, when physicians’ time is tightly scheduled. However, Soper (2000) observed that more time to see a patient, together commented that the time taken to. Furthermore, the above author noted that accessibility of record sat a made possible. Electronic records are more legible and can resolve the problem of misplaced documents and the opportunity to show parents the records of their children if required. For  GPs and found them to be considerable, but there were doubts about the system on a larger. Furthermore, (Atkinson 1997; British Medical Association 2002). The training of users on EPR scale in hospital use. Mansoor (2002) Training the users in manipulating EPR systems has proved to be easier them to familiarize themselves with other aspects of computer supports the observation in that physicians use systems motivates applications. Computers for administrative purposes as well as EPR systems, and are keen to acquire computer skills and knowledge to enhance their clinical practice. They learn how to access computer based information and to how to make the best use of such resources. Svenningsen (2003) found the advantages of EPR included no loss of records, ease of access for all medical staff, some reduction in professionals. The same was the case for Smith, (2003) who considered good medication errors, better documentation, and more co-ordination between leadership and supportive staff were essential for a planning, strong successful EPR system. Benefits include accurate medication lists, legible notes and physician. Having experienced EPR he would never revert to paper records. Seems to summarize the general point of view of those who have experienced prescriptions. This the change from manual to electronic systems. Amatayakul (2005) emphasized the value of EPRs providing reminders to alert hospital staff to particular problems which may arise, and improve decision making, in addition to reducing errors. At the same time much information is still being handwritten in many hospitals and the electronic records do not necessarily include information which would assist decision making. Also it was helpful to have systems which work similarly in different places e.g. surgeries, clinics and hospitals. The benefits of EPR as outlined by Ginneken (2002, p. 115) included Flexibility in content and use, integration and adaptability to change. Once consensus is reached on terminology, architecture, and legislation, the EPR  will become as established as the Hippocratic Oath record has been for centuries†.It seems from the literature that benefits have been obvious in all the countries that have adopted the system, and even those who originally had difficulties in making the changes now express no regrets, because they have experienced the great advantage of electronic systems. There was a reported reluctance to change which needs to be overcome by a good training programme, and some people under-estimate their capabilities to cope with different systems ( Loomis & Ries 2002). As Huston (2004) noted, to such a change would require an agreed standard procedure and provision for the transition period. Faber(2003)draws attention to the fact that several authors new and implement argue that the implementation of EPR can fail if the assumed nature of the medical work being considered does not match the real aspects of that work. Related Studies and System According to the study of abdullah, f. Epr system in hamad medical corporation   Qatar that it greatly resolved the dissatisfaction with the existing manual patient  Record system expressed both doctors and nurses referred to many defects of the  Present manual system which caused irritation and potential exposure to reducing  Patient safety. Such obstacles can affect the improvement of patient care and delay Important treatment. From the findings the major problem of the traditional paper  Based record system appears to be misfiling of records causing difficulties in obtaining   Information quickly in emergencies. Thus the newly EPR system benefited the   Hamad medical in terms of the accuracy,legibility, confidentiality and time saving  in the patient records. Another study from Droma, Fahad et al. in automation of the patient record management sytem in St Francis Hospital Nsambya that Patient record management systems in hospital today necessitate a competent administration when handling patients, generating reports from cashier, patient details which serves as a key factor for the flow of business transactions in St Francis Hospital Nsambya. Unfortunately the current Record management system leads to misplacement of drug details, payment details, and late release of reports and insecurity to records. This research project is aimed at computerizing all the records about patients, staff and drug suppliers. In order to achieve this goal, a thorough System Study and investigation was carried out and data was collected and analyzed about the current system using document and data flow diagrams. The concept of report production has been computerized hence, no more delay in report generation to the hospital manager. Errors made on hand held calculators are dealt out completely The method used to develop the system include iterative waterfall model approach, dataflow, logical and entity relationship diagram were used to design the system and finally the language used were MySql, php, HTML, CSS and JavaScript. Atkinson (1997), whilst seeing the benefits of EPR systems, also that they could change clinical practice, and that there could be problems of controlling access to them. His research also reported anxieties that were expressed regarding the possibility of computer failure. The argument shows that the electronic record system has a â€Å"back up† scheme for computer failure patient which automatically prevents information from being lost. In addition, even if the benefits of EPR are recognized,found that the time taken to learn procedures was an obstacle to their use. A software engineering consultant, Sam Simple was hired to design a Computerized Patient Record system for a hospital. Each patient’s record in the database consists of a patient’s name, address, age, phone number, next of kin, name of parents, phone number, birth date and place, social security number, occupation, marital status, religion, military service, treatment history, family background, lifestyle information such as drug history and sexual  preferences, diagnostic and testing information, and insurance information. At the initial meeting held to discuss the project requirements, a hospital representative indicated to Simple that the hospital had conducted research on CPR systems prior to hiring him. Based on the report produced from the hospital’s research, it considered that user authentication to verify users’ ID and password at login was sufficient for their system, as far as the system security was concerned. However, Simple learned from a study that 85 percent of the passwords on a typical computer system were guessable. According to Dr. Marie Sy, CHITS, an electronic medical record (EMR) specifically designed for the community health centers in the Philippines, was developed through a collaborative and participative process involving health workers and the Information and Communication Technology (ICT) community, using the primary health care approach and guided by the open source philosophy. â€Å"The development of CHITS that the paper record retrieval time was decreased from 2.41 minutes to less than 5 seconds,† has resulted in increased efficiency of health workers, allowing them to spend more time for patient care, improved data quality; streamlin ed records management; and data-guided decision-making, both operationally and strategically,† Dr. Sy added. The development of EPR in most countries has been rapid in recent years with some differences to meet local requirements. Beaumont (1999) noted the advantage of electronic records in the UK, including simultaneous access from multiple locations, legibility, ease of exchange of data, and confidentiality. He compares the advantages with those of paper records which are: easily transported; easy to read; require no training and are never â€Å"out of order†. According to Beaumont’s personal experience, electronic records are an improvement on medical handwriting which is often illegible. In addition, he noted a need for training in the details of categories which the manual records should contain, just as computers may be â€Å"down†, so misfiled patient records can be equally frustrating. Frolick, (n. d. ) noted that electronic patient records in USA are of great benefit to patients, because they are not subject to loss, illegibility or inaccuracy, and assist in guiding patients’ daily treatment. In addition, the records would be readily available for research and accessible directly on the users’ screen. Furthermore, Madison(1997) reported Dr. Paul King’s opinion that the ability to create, and retrieve  charts quickly was of importance and time saving. The choice of the best EPR in USA for a particular department as important and there should be a wide range of availability of a system for selection. By the immediate accessibility of the right technical information lives could be saved, and this is the most important consideration of all. In addition to aspects such as time saving and quality of care, Kowalsky (2002)observed that, to make the system comprehensive and cost effective was a large task and integrating existing systems was difficult. Much as the EPR systems are suggested to provide the best solutions to improve patient record keeping, several authors have observed a number of challenges to them. For example, Fields & Duncker (2003) mentioned that although EPR systems are planned to be universal in UK by 2008, there were doubts about this. The complexity of the task and the need to complete it rapidly caused concern after previous NHS computerisation problems. There was anxiety and the need to convince staff of the benefits of the system. Bishop (2003) referred to availability, as being able to use the information or the source desired i. e., hardware, software or networks. The same issues were discussed by Singh et al. (2004) who noted that primary care in USA is complex and includes safety problems, with no two providers being alike. EPR imposed on any health system can have unpredictable effects, reducing or increasing safety. To some extent EPR could distract a GP from properly recording observations, but, if used correctly, would greatly assist in providing immediate and accurate information. In practice it is essential that all staff are familiar with EPR systems, if these are to be used effectively, and all aware of hazards and how to avoid them. Similarly, Pizziferri et al (2005) considered one factor which inh ibits the use of EPR in USA was the concern that it may take more time than paper records. A study of 20 physicians’ use of time at primary health centres was recorded, before and after the introduction of EPR, and a decrease in time was noted. This was also the case with dictating notes, reading, and writing; however searching for data was much faster than before. The researchers concluded that EPR took less time than manual records but that there was a need to identify EPR users who had difficulty with the system. Mikkelsen & Aasly (2005) of the neurology department at St Olave’s Hospital, Norway analysed electronic patient records and how the system affected performance, e. g. the ability to access information. Records for a neurological department were of variable accuracy because of lack of precise definitions, and were a potential threat to the safety of the system. Strict procedures are required to ensure accuracy and sufficient relevant information. The Steiermà ¤rkischeKrankenanstaltenGes.m.b.H. (KAGes), the governing body of the Styrian hospitals. Out of a new MIS, termed OpenMedocs, has been conducted. This system shall simplify the management, the access to and the exchange of health-related patient information. It is a centrally managed system at the headquarter of KAGes in Graz. The core of OpenMedocs is an electronic patient record (EPR) system. All documents concerning patients are stored in this system. Thus, it is possible to receive documents from a patient which have been generated in different hospitals ’at the push of a button’. Since almost all medical information of the hospitals concerning patients is managed in the ERP system, it is possible to avoid various disadvantages of ’traditional documentation’, like multiple medical attendance or local constraints of usage of retrieval possibilities, and user-oriented presentation of data should help, among other things, to speed up and to improve the quality of the medical decision-making process of physicians. Since the roll-out of OpenMedocs, the amount of these patient-related documents increased continuously. Thus, the efï ¬ cient storage and the timely retrieval of documents in the EPR system have gained considerable importance. The Problem Statement of the Problem This present study tries to analyze, design, develop, test and implement a Record Retrieval System for Negros Oriental Provincial Hospital. This study attempts to answer the following questions. 1. What is the current retrieval system used by Negros Oriental Provincial Hospital Records Department in retrieving records? 2. What are the problems encountered by retrieval section employees in the retrieval of patient’s records in NOPH Records Department? 3. What are the requirements needed for the development of the Computerized Retrieval System for Negros Oriental Records Department Retrieval Section? 4. How secure and manageable is the Computerized Retrieval System for NOPH Records Section? 5. How beneficial is the Computerized Retrieval System for  Negros Oriental Provincial Hospital Records Department Retrieval Section. Hypothesis H0: There is an existing problem with the current retrieval system of Negros Oriental Provincial Hospital Records Department. H1: Negros Oriental Hospital Records Department is in need of a new system that will help them improve their service. Technical Background Design Concept Input Data Captured Process Working with records Output Showing results by print outs Storage of the patient records Figure 1 It shows the input, process and output of the patient record retrieval system that in input in order to retrieved such records they need a personal information and the records they want to be retrieved in a system. In Process it is where the records has been process in order they could release the record and in output it is where the records have been already retrieved and ready to release to the authorized person. Design Method Figure 2 Agile Approach The methodology that use in developing the system is agile the researcher use  agile since it promotes adaptive planning, evolutionary development and delivery; time boxed iterative approach and encourages rapid and flexible response to change. A conceptual framework promotes foreseen interactions throughout the development cycle. There are five phases in this methodology the requirements, design, implementation, test and deployment. In requirements phase in which the requirements for the software are gathered and analyzed. This is equivalent to researching and brainstorming what the product requires. Examples can include general features, architecture discussions, workflow discussions and general product discovery. Design phase this is which will have all the requirements defined for the product. Implementation phase during the development, needed to test the code as well as get feedback from the customer on progress. Feedback from the customer can include mockups, front-end designs, and usability. Testing phase bugs and defects are always a constant in the software development process. It is important that there are good quality assurance standards to eliminate general issues. Deployment the software application is finally deployed and live. Once this occurs, a support plan needs to be in place for maintenance and general support on potential future issues. Significance of the Study Negros Oriental Provincial Hospital Record Department.The study will serve as a new instrument for the technological advancement that greatly benefits for Negros Oriental Provincial Hospital. This computerized system is intended to lessen the manpower which will lead to a faster and more accurate record retrieval process which will lead to profitability of the Negros Oriental Provincial Hospital. Employees. The job of the employees will become more accurate and efficient through the use of the proposed system. This leads to less error which saves time and energy on the side of the workers. Employees can also focus on other tasks assigned that will make them more productive. Patients. The service of Negros Oriental Provincial Hospital to the patient will become more convenient. Less time will be consumed during the retrieval process. This will also lessen time for patients to wait for their records to be release. The study is also expected to increase the satisfaction of the patients to the services of the Negros Oriental Provincial Hospital. Researchers This study is a great achievement for the researchers because it  will improve their skills in technical writing. The experiences while doing the research build up their characters and teach them values like creativity, working hard, team building and responsibility and time management. It also builds friendship and camaraderie among the co-researchers. It also gives them an overview of the IT industry and trains them to prepare to the competitive professional field. Questionnaire Directions: Please put a checkmark on the selected choice. Name (Optional):____________________________________ Age:______ Gender:____________ Department:______________________ I. The current system that NOPH are using in retrieving records: 1. What is the present system used by Negros Oriental Provincial Hospital Records Department Retrieval Section? __ Manual Retrieval __ ComputerizedRetrieval If manual, what are the tools or things used in retrieving records or how a single record is retrieved according to its arrangement? _By folders _By logbooks _By envelopes _By family names _By cabinets _By disease/injury Others (Specify):______________________ If computerized, what are the applications used? _ Microsoft Excel _Microsoft Word _Microsoft Access _Others(Specify):_____________________________ II. The problems encountered by employees in retrieving records: 2. What are the problems encountered by Negros Oriental Provincial Hospital Records Department in retrieving records? _Unarranged Documents _Difficulty in finding records _Lost Documents _ Mountainous Stocked Files _Crowded area Others(Specify):______________________________ III. Particular documents that Negros Oriental Hospital retrieve. 3. What are the common documents that hospital clients retrieved mostly? _Birth certificates _Death certificates _Laboratory results Others(Specify):___________________________________ References: Related Literature http://medical-dictionary.thefreedictionary.com/patient+record http://www.wipro.com/industries/healthcare-segments/medical-records-retrieval.aspx http://www.sunbeltreporting.com/sunbelt-blog/bid/45059/Benefits-of-Outsourcing Medical-Records-Retrieval) Fischer, J. S. & Blonde, L., 1999. Impact of an electronic medical record on diabetes practice workflow. Clinical Diabetes, 17(2), 10-12. Wellen, D. et al., 1998. The electronic medical oncology record: misconceptions, barriers, and benefits. Cancer Management, 3 (5), 6-8. Coiera, E., 2003. Guide to health informatics. 2†³d ed. London: Arnold. Bush, J., 2002. Looking for a good electronic medical records system? Family Practice Management, 9(1), 50-51. Lenhart, J. G., Honess, K., Covington, D., and Johnson, K. 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