A Comparison of The Destructors and Lord of the Flies Essay -- compari

A Comparison of The Destructors and Lord of the Flies      Ã‚  Ã‚  Ã‚   In Graham Greene's "The Destructors," the author presents the Wormsley Common car-park gang, a group of adolescent delinquents who commit petty crimes for fun. William Golding, in his novel Lord of the Flies, presents a slightly younger group of boys who are wrecked on an uninhabited island and develop a primitive society that eventually collapses and gives way to despotic savagery. Although these two cases seem rather different, the boys in both situations show common characteristics. They react to the outside environment of their worlds in similar ways. There are also trends in the development of the dynamic characters in each story. Each account presents a conflict of interests between two dominant characters, a leadership struggle, a predefined goal set by the boys, and a mystified enemy. There are even parallel characters. For example, Blackie in "The Destructors" resembles Ralph in Lord of the Flies. In Graham Greene's "The Destructors," the boys' behaviour, thoughts, and social-development patterns parallel those of the boys in William Golding's Lord of the Flies.    One of the main characters in Lord of the Flies is the "beast." This mythical creation is a product of the boys' collective fear of being plane-wrecked on an uninhabited island. They also have a few unreliable "sightings" to support their suspicions. The beast eventually develops into a totem, a pagan god for Jack's simple religion. The boys fear this beast, because it manifests itself in the boars that roam the island, both a danger and a source of food. The beast of "The Destructors" is not ... ... social class, era, and placement, the Wormsley Common Gang does not seem that different from the boys on the island in Lord of the Flies. They might have different symbolic representations for the various common elements of their cultures, but these elements are the same. Both stories have a beast, a beast's lair, an honest leader, a manipulator figure, an "underdog," and evidence of influence from the outside world. The parallelism between these two works demonstrates the constancy of human nature. Despite changing times, people remain basically the same.    Works Cited Golding, William. Lord of the Flies. London: Faber & Faber, 1954. Greene, Graham. "The Destructors," Story and Structure. Seventh Edition. Edited by Laurence Perrine, assisted by Thomas R. Arp. New York: Harcourt Brace Jovanovich, 1988, 49-61.

Economy and Global Warming Essay

The global warming is viewed as dangerous process not only according to the environmental issues. Now it is often viewed in regards with its impact on the economy. Recently it was claimed that the increase of the rate of global warming led to the higher damage costs. Among the main tasks of the economics of global warming is estimation of the economic costs of global warming, their evaluation and distribution as well as evaluation of the cost of the actions, which are devised for fighting the global warming process. In this process economists rely on the data obtained from the number of sources. The newest findings and current data are discussed at a number of annual conferences and meetings. In April 2007 there was an Intergovernmental Panel on Climate Change (IPCC) conference. Representatives of over 120 nations were present there is order to discuss the ways of mitigation of the global warming process as well as economic and societal costs of these actions. As the result of the conference there was an approval of the IPCC Fourth Assessment Report. The main idea of this report is that benefits of mitigation of global warming are worth all the mitigation costs incorporated in this process (Coleman, 2007). Economic impacts of global warming First of all I’d like to set the discussion and explain why the question of the global warming is so topical for the economists. During the last few decades there were a number of researches focusing on the economic damage of the global warming. As the result of these researches there appeared a number of reports on the aggregate net economic costs of damages caused by the global warming and the climate change. These costs are usually defined in terms of the social cost of carbon (SCC), which can be defined as the estimation of the future expenses of the world economies caused by the global warming from carbon dioxide emissions, which are done in the present. Thus, according to numerous reports SCC in 2005 was estimated as US$ 43 per tonne of carbon (tC) (IPCC Summary for policymakers, 2007) Very valuable idea of the influence of global warming on the economy was provided by Professor Robert O. Mendelsohn of Yale School of Forestry and Environmental Studies in Copenhagen Consensus: A series of studies on the impacts of climate change have systematically shown that the older literature overestimated climate damages by failing to allow for adaptation and for climate benefits. These new studies imply that impacts depend heavily upon initial temperatures (latitude). Countries in the polar region are likely to receive large benefits from warming, countries in the mid-latitudes will at first bene fit and only begin to be harmed if temperatures rise above 2. 5C. Only countries in the tropical and subtropical regions are likely to be harmed immediately by warming and be subject to the magnitudes of impacts first thought likely. Summing these regional impacts across the globe implies that warming benefits and damages will likely offset each other until warming passes 2. 5C and even then it will be far smaller on net than originally thought† (Mendelson, 2007). Valuable findings were presented in the report of Chief Economist and Senior Vice-President of the World Bank Nicholas Stern known as ‘The Stern Review† published in 2006. In this repost Nicolas Stern claims that if no actions are undertaken climate change will produce a very negative influence on economic growth (Peston, 2006). According to Stern’s findings there is a possibility of recession up 20 % of global GDP in case no mitigation of global warming is undertaken. In order to be able to prevent this nations should join their forces for the sake of investing 1 % of global GDP for fighting the negative impact of global warming process (Stern, 2007). Cost estimates According to IPCC TAR (Synthesis Report) annual mitigation costs range from $78 billion to $1141 billion, which constitute from 0. 2 % up to 3. 5 % of present-day world GDP. However, the researchers also realize that some nations of the world are unable to contribute to the mitigation of global warming due to the low level of their economic development. If the burden of mitigation is placed only on more economically-powerful nations, they should donate approximately 0. 3 % – 4. 5 % of their GDP. This percent is high, however, as the researchers state due to the constant economic growth of the world economies, this percentage will decrease with time. One more estimation was done in terms of cost per tonne of carbon emission avoided, which is said to be from $ 18 to $ 80 (House of Lords, 2005). The mitigation costs are every country’s concern. Moreover, according to Lord Peter Levene, chairman of Lloyd’s of London, it is essential that every company should include in its risk analysis the threat of climate change (Business Insurance, 2007). Benefits Numerous researchers tried to estimate the cost of the benefits from the mitigation of global warming. Thus, according to the report of Nordhaus and Boyer based on the Kyoto Protocol the benefits from mitigation for world economies would constitute approximately $ 120 billion. However, this benefit is not accepted by all researchers. McKibbin and Wilcoxen for example state that there cost benefits are too low. They state that in spite of the fact that â€Å"other studies reach similar conclusions, the emissions targets agreed in the Kyoto Protocol are irreconcilable with economic rationality†. In this idea they support the other researcher – Tol, who has the same viewpoint ( McKibbin & Wilcoxen, 2002). On the contrary to the findings of the Kyoto Protocol, the estimates of benefits as stated in Stern Review are much higher and constitute approximately 5 up to 20 % of GDP. The difference is of course very considerable. However, it was stated that benefits depend on the number of factors. Among the most essential of these factors are the discount rate, the use of welfare weighting for positive influence on poor nations of the world, a greater emphasis on the negative impact on the natural environment and the application of the newest scientific estimates of this negative influence (Stern, 2007). However, it should be mentioned that the benefits of the mitigation actions are not limited solely to environmental improvement. They have a number of other concealed benefits, which depend on the application of definite technologies. For example, in case the technologies aiming at the reduction of oil use are applied, this will produce great benefits for the country economy due to the lower influence of oil price rises on the economy. This is a very valuable benefit for a number of countries, which are currently importing oil and experience great economic losses from oil price rises (IPCC Summary for Policy Makers, 2007). One more concealed benefit of mitigation actions is connected with the problem of deforestation. Once it is stopped, this will produce considerable benefits due to the increase of biodiversity, tourism promotion, benefits for indigenous people, greater possibilities for research and even in some cases this could save money otherwise spent on protective actions against extreme weather events (Stern, 2007). Optimal strategies for mitigation One of the most essential questions is the relation to the topic of mitigation of the negative impact of global warming on the world economy is the question of the possible strategies, which can be applied in this process. It was estimated that definite financial and technological strategies could be the best for the elimination of the harmful impact of greenhouse gas on the environment. Among these financial and technological strategies I’d like to name the following ones: Trading of carbon emissions Application of the carbon tax Better regulation technologies Application of the hybrid systems of user and permits fees Improvement of energy efficiency Development of nuclear power and renewable energy sectors aiming at decrease of carbon emission (Board on Natural Disasters, 1999). It was stated in numerous researches that these actions, especially is taken in combination, will produce the greatest influence on the mitigation of the global warming and climate change and thus will be beneficial for the world economies. Cost distribution One more question under discussion is the distribution of costs associated with fighting global warming. It is obvious that the costs and benefits cannot be distributed evenly. Mitigation costs are distributed unevenly both between the countries and inside each particular country. This differentiation is greatly due to the existence of the following factors: low-lying countries have a greater risk of floods, so they are more concerned with the issues of the global warming and its mitigation is more beneficial for them; – other countries, which are particularly at risk of the negative impact of global warming are African countries, which is greatly due to the increased drought typical for these areas. Definitely, mitigation of climate change and global warming is extremely beneficial for them, however, they are unable to contribute a lot to the mitigation actions due to the low economical development; poor countries contribute less to mitigation actions but due to the low level of technologies and science they are the main ones who emit greenhouse gasses and pollute the environment (Peston, 2006). Inter-relationships It is obvious that fighting global warming and climate change should be a concern of all countries of the world and they should join their forces and distribute expenses associated with this more or less evenly. Bastianoni claims that there exists great difference in methodologies applied for the defining the responsibility of each country for greenhouse gas emissions. In this respect I’d like to name the following: – the geographical approach, which is based on the IPCC guidelines for GHG inventory; – the consumer responsibility approach, which is grounded on the Ecological Footprint methodology; – the Carbon Emission Added (CEA) approach, which has much in common with the Value Added Tax accounting (Bastianoni, 2004). Due to this differentiation in methodologies we can observe great difference in application of the responsibility of each country for emissions of greenhouse gasses, which has a consequent influence on the design of the policy of mitigation. Reports on Economy and Global Warming In regards with the actions of the world community aimed at the mitigation of the global warming I’d like to name two major reports, defining possible losses from the climate change and benefits of mitigation of global warming as well as regulating economic policies aiming at fighting these processes. The first report under discussion is the Kyoto Protocol. This is an agreement, which was made during the United Nations Framework Convention on Climate Change (UNFCCC). The main idea of the Kyoto Protocol is the actions aimed conducted by the countries, which aim at the reduction of emission of carbon dioxide and other five gases contributing to the global warming, and engagement in trading of emissions (Buonanno, Carraro & Galeotti, 2003). The Kyoto Protocol is genially international. Now it joins over 170 countries, which constitute 60 % of all countries, all over the world in common concern of mitigation global warming and climate change. Till November 2007 only the US, Australia and Kazakhstan did not join this process and did not ratify the act. The Kyoto Protocol is a long-time plan, which is in valid till the end of 2012. However, it doesn’t mean that the actions, started by this treaty will end after 2012. Most likely the Kyoto Protocol policies will be continued through some other treaty (Malakunas, 2007). United Nations Environment Program explained the main essence and policies of the Kyoto Protocol in the press release: The Kyoto Protocol is an agreement under which industrialized countries will reduce their collective emissions of greenhouse gases by 5. 2 % compared to the year 1990 (but note that, compared to the emissions levels that would be expected by 2010 without the Protocol, this limitation represents a 29 % cut). The goal is to lower overall emissions of six greenhouse gases – carbon dioxide, methane, nitrous oxide, sulfur hexafluoride, HFCs, and PFCs – calculated as an average over the five-year period of 2008-12. National limitations range from 8 % reductions for the European Union and some others to 7 % for the US, 6 % for Japan, 0 % for Russia, and permitted increases of 8 % for Australia and 10 % for Iceland (Crichton, 2003). Of course, as any other policy The Kyoto Protocol has its supporters and critics. Support The main idea of the supporters of the Kyoto Protocol is that it is very important for the whole world due to the fact that it is aimed at the establishment of the policies and actions mitigating global warming and fighting climate change. Of course the main supporters of the protocol are the governments of the countries, who signed it with the European Union being the most prominent and active supporter. Among the other actions, which show the compliance to the main ideas of the Kyoto Protocol, is the claim of several Canadian corporations, which also reported their support of the mitigation of global warming and stated that the Kyoto Protocol would be only a first step in this process (Global Warming: What is it? , 2007) Opposition However, the Kyoto Protocol has also raised a wave of opposition. The first group of critics maintains the critical idea towards the existence of the global warming and climate change processes at all. The believe that the Kyoto Protocol was design just for the sake of making the process of money shift to the third world easier and argue that with useless spending of money will slow the economic and technological growth of the powerful countries of the world, who will try to solve the problem which never existed instead of investing money to the development of their economies (Lockwood & Frohlich, 2007). The other critics support the necessity of the actions for mitigation of global warming, however, they either believe that the expenses will outweigh the benefits or consider that goals established by the Kyoto Protocol are unattainable and far too optimistic and won’t change the situation with the global warming and climate change considerably (Houghton, Ding, Griggs, 2001).

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Introduction to the Electronic Medical Record (EMR) Introduction to the Electronic Medical Record (EMR) Gary L Williams Western Governors University Introduction to the Electronic Medical Record (EMR) The new millennium has produced many changes in the world as we know it. Our national security which seemed to be impermeable has revealed its vulnerability to being breached. Remember September 11, 2001 when the hi-jacking of planes lead to the destruction of the Twin Towers in New York City, and severe damage the Pentagon in Washington DC.Now our Healthcare System has now moved into the information highway. How you may ask, through the introduction of the EMR. So will the EMR be safe and secure? Let us investigate. So just what is the EMR? There are many formal definitions but the one that stands out and will be used today is from the Healthcare Information and Management Systems Society (HIMSS). It states: The Electronic Health Record (EHR) is a longitudinal electronic record of pati ent health information generated by one or more encounters in any care delivery setting.Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports. The EHR automates and streamlines the clinician's workflow. The EHR has the ability to generate a complete record of a clinical patient encounter – as well as supporting other care-related activities directly or indirectly via interface – including evidence-based decision support, quality management, and outcomes reporting. (HIMSS) Within this definition there is a multitude of system components.Think of it like the multiple Introduction to the Electronic Medical Record (EMR) dividers that were found in the paper medical record. For instance, you may see headers like, medication record, order entry, nursing assessments, the plan of care, education, radiology, cardiology, etc. Under the medication tab la ys the eMAR, medication history, and reconciliation. Each band with the click of the mouse will open a new file within this record. The design is formatted to follow a systematic flow with check boxes, drop down lists, or free text space to document the patient findings, activities, and assessments.The EMR will have many benefits for the entire healthcare team and the patient. By development and design with the assistance of key personnel, the EMR should flow and make documentation easier. By having a standardized flow and options to document the standards of care, documenting should become easier and provide more consistency. Take for example a urine description. You may see for color description amber, yellow, red, clear, or tea. Then cloudy, turbid, clots, or mucous followed by malodorous, sweet, or pungent. This will provide a means of potential measurement for Evidence-Based Medicine (EBM).How many patients with UTI receiving Bactrim DS have amber mucous pungent urine on a GU u nit? Can you see the pattern? The EMR will assist in critical thinking as well. Your physical assessment for instance may be by body system or a complete head to toe assessment. These screens will assist the nurse in reminders of required documentation. The nurse may receive a task list for a certain procedure or required documentation of a high risk factor, such as fall precautions, to alert the bedside nurse or technician that the document is due or past due.Introduction to the Electronic Medical Record (EMR) The EMR will provide real time data and reports from various disciplines within the healthcare facility. For instance, a Vancomycin trough was ordered at 0700 and its 0900 and the IV medication is due. By selecting the laboratory tab your result will be there in front of you before the dose is administered. The same can be expected of radiology imagining results, EKG, stress test reports, a bedside capillary glucose test done by the technician. No more searching through multi ple computer systems or piles of lab results to find the data you need.The information is there and readily available. Healthcare providers have the penmanship of a deranged mad scientist. How often do you have multiple nurses trying to determine what Dr. Hyde just wrote? What if you guess wrong? Now you place that call to Dr. Hyde for clarification when you have a multitude of things to be doing. With Computerized Provider Order Entry (CPOE), no longer will guessing what was written be an issue. Standard order sets will be available with the opportunity to be individualized or modified from a pre-determined list of ommon orders for routine admission or for specific disease processes like the Acute Myocardial Infarction. Included may be diet, activity, vital signs, IV fluids, labs, EKG, PCXR, or consults. As touched upon earlier with the urine sample report, there is a myriad of potential data that can be extrapolated to form reports for research and to assist with the EBM. What is the average number of days for patients on the ventilator for June, 2011? How many patients in the rehabilitation unit have pressure ulcers? Maybe a nurse says to the unit manager that it seems like a large number of the patients on the unit have C- Difficile?A report can be run to show Introduction to the Electronic Medical Record (EMR) trends of the patients with this condition. Maybe it’s a hand washing issue or cross contamination from multi-use bathroom facilities. There are many opportunities that would at best have been difficult to track from the old paper medical record. Identity theft is rampant in this world of technology. How will the EMR be secured? How can the nurse access the EMR? Today home computers are almost essential. The same virus and malware that affect your home computer can infect the EMR if security is lacking.The Information Technology team will provide the overall security for the system by continuous upgrades to software like antivirus and firewal l protection. Each team member will be issued a unique log-in and password to access the EMR. This must be kept strictly confidential for the nurse’s protection. This secure log-in is like a finger print of the assigned user. When the EMR is accessed, there is a time stamp of what records were accessed, for what length of time, and by whom. A secure trail of entry into the EMR can be traced. What is the Personal Health Record (PHR) and how does it differ from the EMR?The PHR is essentially the same document that you would produce in the Physician’s Office. The PHR can be completed online either through a Physician’s Office or through an outside resource. Things that would be included in the PHR might be your name, address, telephone number, date of birth, and possibly the social security number. This record could also contain your Physicians name and phone number, the list of your current medications and dosages, a list of current and Introduction to the Electro nic Medical Record (EMR) past medical conditions, and passed surgical history.This type of a record is usually maintained by the patient themselves. The PHR will differ from the Electronic Medical Record in that the Electronic Medical Record is property of the Health Care facility and not the consumer. The personal health record becomes more vulnerable to breaches in security since it is maintained by the consumer. For example, I might give my sign on and password to my family or friend to input data for me. This obviously breaches ones security. This allows access to these individuals to alter ones personal health record at will.The website that maintains the personal health record may not be as secure as that of the Health Care facility. The Electronic Medical record is usually maintained by the healthcare facility, outpatient clinic, or Physician’s Office. These healthcare facilities must maintain high security to protect the information within that medical record. In 1996 , Congress passed a law entitled The Health Insurance Portability & Accountability Act (HIPAA). This law was designed: -To improve portability and continuity of health insurance coverage in the group and individual markets. To combat waste, fraud, and abuse in health insurance and health care delivery. -To reduce costs and the administrative burdens of health care by improving efficiency and effectiveness of the health care system by standardizing the interchange of Introduction to the Electronic Medical Record (EMR) electronic data for specified administrative and financial transactions. -To ensure protecting the privacy of Americans’ personal health records by protecting the security and confidentiality of health care information. (James) The security and confidentiality are paramount. Fines are levied as a result of a breech to the HPPA law.There must be alerts to vulnerabilities, safeguards to help protect the EMR and the Information Technology team must be able to identi fy possible threats. Using an EMR (electronic medical record) has no absolute right and wrongs in either computer equipment or software for HIPAA compliance. Usually there are four areas to examine: -Physical Security – can your computers with patient data be stolen? -User Security – can anybody log on to the patient database? -System Security – what happens on a hard drive crash? -Network Security – can unauthorized persons outside your facility access patient data? Milne, 2006) Security is never easy to maintain; it requires continuous safeguarding. As a team we are all responsible to assist in the security of the EMR. Always log on and off when you are no longer Introduction to the Electronic Medical Record (EMR) using the bedside computer. Always check before charting that it is indeed you that is longed into the system and that only one patient record at a time is open for use. The EMR can be a valuable tool for Quality Improvement (QI). Through the design phase, a number of measurable data can be built into the EMR for report generation.If the team wanted to look at the number of times vital signs were not documented as dictated per Policy & Procedure. This data can be built into the system and reports run daily, weekly, or monthly. The same thing can be built to monitor for overdue or omitted medications. This can be further expanded to identify which team member is involved and to check for trends. Data may also be collected to support EBM. For example, tracking the effectiveness of two different antibiotic treatment regimens of a selected disease process may be used to support a change in the disease treatment (e. . antibiotic A showed improvement in five days where as antibiotic B showed improvement in ten days. ) Here again the possibilities seem endless. Think of the time savings for all the key people that would be required to look through endless paper medical records for this type of data collection in the paper medic al record. So how does the EMR come to fruition? It takes a large team of various specialties and specialists to develop the EMR. It starts with the Healthcare system researching and then purchasing the best system to fit the company’s needs and requirements.Once purchased, the owner of the software will deploy a team of specialists that will assist the Healthcare systems team to design and develop the contents and flow of the EMR. The team includes senior management which will assist in the purchase and be the governing authority of the proposed Introduction to the Electronic Medical Record (EMR) work flow before implementation. There are many subdivided teams. Nursing will have Subject Material Experts (SME) that will be the voice to assist in the flow, wordage, and design of the nursing components of the EMR. The SME’s will be from every department of nursing.From this group will be the Super User. The Super User will act as the cheerleader for the project developme nt and will be the main source for assisting with the Go Live of the EMR. The Information Technology (IT) will be a multi-tiered group ranging from System Support Analyst or the front line of communication, the Computer Programmers and System Analyst or the builders and troubleshooters, to the Project Managers or the supervisors of the IT team. Nursing will also have the Clinical Informatics Application Analyst who will be the voice between nursing and the technical side of issues, concerns, and development.The End User which is the front lines of nursing and everyone that will be using the system for documentation. And last but not least will be the Educators that will teach the system to the entire team. This is a rather large of individuals working as the voice of the EMR development and implementation. In conclusion, change will be rough at times but change is necessary for progression. Be positive and listen to the teams and the tips that are offered. Assist each other as suppo rt with the continued learning and development of the EMR. The Technology age is here and we should all reap the benefits of this endeavor.Remember how Florence Nightingale was the frontier to nursing as we know it. Well each of you deserves a pat on the back as you are the pioneers that have lead nursing into the technology phase of the Electronic Medical Record. You too are a part of nursing history. References HIMSS. (n. d. ) EHR Electronic Health Record. Retrieved from http://www. himss. org/asp/topics_ehr. asp James, R. (n. d. ) What is HIPPA? Retrieved from http://www. dhmh. state. md. us/hipaa/whatishipaa. html Milne, M. (2006, March 6). HIPAA in a â€Å"Nutshell† – Guidelines for EMR and Paper Medical Records Compliance.Retrieved from http://ezinearticles. com/? HIPAA-in-a-Nutshell—Guidelines-for-EMR-and-Paper- Medical-Records-Compliance&id=156737 Ten open ended questions. 1. When the EMR is first implemented on your unit, how can you assure the patient that you are competent in your profession? You will explain that you are a seasoned nurse and an expert in the nursing field. Today our facility is introducing the new EMR which will benefit you in the future. This will take a little more time for me to learn and I do not want you to feel like you are being ignored. I may have to ask you a lot of questions as I go through each section.Please feel free to ask me any questions or concerns that you may have. Our goal is your comfort and safety though the high quality of care. 2. On the day of Go-Live, how can your unit best assist you in providing support as you learn this new technology? My unit manager should over staff initially as we learn the new system. I can foresee the nurse being so buried in the computer that the delivery of care might be too slow initially. Having the extra staff will decrease the patient load and allow extra hands to assist with the delivery of care. 3. As you learn the new system there will be some anticip ated frustration.How can you divert this frustration so that your patient doesn’t sense that something is wrong? We will need to have the Super-User and Analyst available to assist us as problems or concerns occur. It is imperative that the bed side nurse remain positive an up beat as we learn. I suggest maybe huddles through out the day away from the bed side to discuss our concerns. We don’t want the patient to feel uncomfortable. 4. Your patient asks you why it is important to have the computer charting. Briefly tell me what you might say and why? The EMR is being implemented throughout the area as well as world wide.As you record develops, we will only need to verify some of your past medical history, allergies, medications, etc. These types of data will flow from one visit to another making you care easier as the data is readily available. No more waiting for old charts to arrive and thumbing through page after page of data to look for pertinent information. 5. Ho w do you perceive future benefits of an interoperable EMR? It will be possible in the future as the EMR progresses, that your hospital record, physician office record, out patient records, and pharmacy to communicate with each other.By doing so, some potential errors may be thwarted. For instance, maybe you are not able to recall all of your home medications and your consulting physician decides you need a new blood pressure medication. If the records could speak to each other then this physician would be able to see that you were already prescribed an antihypertensive medication or the pharmacy might catch the possible error. 6. Futuristically, let’s say you take a dream vacation to a foreign country. While on your visit you become ill and collapse unconsciously.How can the interoperable EMR potentially be a benefit in this case? If the system develops into a world wide communication link, then with limited data perhaps the hospital in the foreign country would be able to ac cess and utilize my EMR to provide answers in how to deliver the best possible care for me. So if I went in with a suspected ruptured appendix, by accessing my EMR surgical history it would be noted that I have had an appendectomy ten years prior so the focus could be directed at another possible cause. 7.Your patient states to you that she hates the computer and that it is the devils advocate. She is tearful and appears anxious. How might you handle this as you are in the middle of documenting in the EMR? You should stop what you are doing and maybe sit beside the patient and gently hold her hand and ask what seems to be troubling her? She might say she feels the nurses spend more time touching the computer and no time touching her, as you just did, and that we come across as cold and not caring. We need to realize that patient interaction is still paramount to the overall delivery of care.Take time to interact with the patient. Then step back and document; perhaps explaining what you are documenting and why it is important to her care. 8. What do you anticipate will be your plan of action when the computer system is down? What will be your back up plan? If the computer is down for a set amount of time, as determined by the hospitals administration, then the paper chart will be utilized. If the downtime is for an extended period of time, then this data would be scanned into the EMR as soon as possible after the computer system is back on line.If the duration was short, say an hour or so, then this data should be manually documented back into the EMR with the assessment time documented. 9. How do you anticipate computer physician order entry being a benefit? For one legibility! No more trying to decode what you think may have been written. It will be clear and concise. Also the physician may be able to look at documentation form somewhere other than the patients unit and decide orders need to be given. He can simply do computer order entry and a task will appe ar for new orders.If the order is anything other than routine, a call should be placed to alert the nurse of the priority. 10. What do see as a benefit to Quality Improvement by the institution of the EMR on a unit basis? We will be able to track data at a faster and higher accuracy a opposed to thumbing through paper record after record searching for data collection. The data collected can be as concise as to a particular nurse or a specific health issue. The data collected helps to support EBM change.

Role Of The Emperor In Meiji Japan Essays - Meiji Restoration

Role Of The Emperor In Meiji Japan Essays - Meiji Restoration Role of The Emperor in Meiji Japan Japan is a society whose culture is steeped in the traditions and symbols of the past: Mt. Fuji, the tea ceremony, and the sacred objects of nature revered in Shintoism. Two of the most important traditions and symbols in Japan; the Emperor and Confucianism have endured through Shogunates, restorations of imperial rule, and up to present day. The leaders of the Meiji Restoration used these traditions to gain control over Japan and further their goals of modernization. The Meiji leaders used the symbolism of the Emperor to add legitimacy to their government, by claiming that they were ruling under the "Imperial Will." They also used Confucianism to maintain order and force the Japanese people to passively accept their rule. Japanese rulers historically have used the symbolism of the Imperial Institution to justify their rule. The symbolism of the Japanese Emperor is very powerful and is wrapped up in a mix of religion (Shintoism) and myths. According to Shintoism the current Emperor is the direct descendent of the Sun Goddess who formed the islands of Japan out of the Ocean in ancient times.Footnote1 According to these myths the Japanese Emperor unlike a King is a living descendent of the Gods and even today he is thought of as the High Priest of Shinto. Despite the powerful myths surrounding Japan's imperial institution the Emperor has enjoyed only figure head status from 1176 on. At some points during this time the Emperor was reduced to selling calligraphy on the streets of Kyoto to support the imperial household, but usually the Emperor received money based on the kindness of the Shogunate.Footnote2 But despite this obvious power imbalance even the Tokugawa Shogun was at least symbolically below the Emperor in status and he claimed to rule so he could carry out the Imperial rule.Footnote3 Within this historical context the Meiji leaders realized that they needed to harness the concept of the Imperial Will in order to govern effectively. In the years leading up to 1868 members of the Satsuma and Choshu clans were part of the imperialist opposition. This opposition claimed that the only way that Japan could survive the encroachment of the foreigners was to rally around the Emperor.Footnote4 The Imperialists, claimed that the Tokugawa Shogunate had lost its imperial mandate to carry out the Imperial Will because it had capitulated to Western powers by allowing them to open up Japan to trade. During this time the ideas of the imperialists gained increasing support among Japanese citizens and intellectuals who taught at newly established schools and wrote revisionist history books that claimed that historically the Emperor had been the ruler of Japan.Footnote5 The fact that the Tokugawa's policy of opening up Japan to the western world ran counter to the beliefs of the Emperor and was unpopular with the public made the Tokugawa vulnerable to attack from the imperialists. The imperialists pressed their attack both militarily and from within the Court of Kyoto. The great military regime of Edo which until recently had been all powerful was floundering not because of military weakness, or because the machinery of government had broken but instead because the Japanese public and the Shoguns supporters felt they had lost the Imperial Will.Footnote6 The end of the Tokugawa regime shows the power of the symbolism and myths surrounding the imperial institution. The head of the Tokugawa clan died in 1867 and was replaced by the son of a lord who was a champion of Japanese historical studies and who agreed with the imperialists claims about restoring the Emperor. Footnote7 So in 1868 the new shogun handed over all his power to the Emperor in Kyoto. Shortly after handing over power to the Emperor, the Emperor Komeo died and was replaced by his son who became the Meiji Emperor.Footnote8 Because the Meiji Emperor was only 15 all the power of the new restored Emperor fell not in his hands but instead in the hands of his close advisors. These advisers such as Prince Saionji, Prince Konroe, and members of the Satsuma and Choshu clans who had been members of the imperialist movement eventually wound up involving into the Meiji Bureaucracy and Genro of the Meiji Era.Footnote9 Once in control

Enterprise Architecture as Strategy Essays

Enterprise Architecture as Strategy Essays Enterprise Architecture as Strategy Paper Enterprise Architecture as Strategy Paper Enterprise architecture is important because organizations need to adapt increasingly fast to increased competition, changing customer requirements, and business goals. Since MEG international was showing signs of reduction in sales and threatening market position by foreign competition were perfect examples that MEG was not adapting to reapply canalling environments I Nils need Tort Patton NAS Incidence over ten entire business processes; change in one business process may influence other business process. To keep enterprise architecture coherent, change should be managed accordingly in all architectures, and the relations between different architecture just be clear so it is vital for MEG to implement enterprise architecture as a strategy to be able to gain competitive advantage. Main difficulty in adopting enterprise architecture as strategy is to match business architectural alignment and IT alignment because of the differences in architectural modeling methods. Business analysts build complex business process models; similarly IT architects can design complex applications. These two groups of people may be best at what they do but they lack common language to understand each others design. Mona Lisa although being Information Systems consultant didnt have he leadership capacity or vision on how she is going to approach the issue of aligning these two processes, or what framework to use for the enterprise architecture and what IT strategy to choose to move forward towards the change process. Some of the well known examples of enterprise architecture frameworks that can help to build the strategies around enterprise architecture in MEG are: Coachmans framework for enterprise architecture (Coachman, 1987) (Figure 1): This framework is a logical structure for classifying the different perspectives involved in enterprise architecture in a two dimensional matrix that are significant to TTS stakeholders. The matrix consists of levels or player perspective (scope or planner, business model or business owner, system model or designer, technology or builder, detailed representations or subcontractor and Functioning Enterprise) and six columns or aspects (data, function, network, people, time, motivation). From the Business owner perspective data represents information about customers, products, suppliers and relationships between these entities (Session, 2007). On the other hand data from the perspective of technical person implementing the database is rows and columns in tables which are linked together by Joins (Session, 007). If we move left to right on the grid we see different system descriptions from one player view whereas if we move from top to bottom it changes the different player perspective of viewing the system descriptions. Both perspectives are therefore critical for understanding the systems architecture that Coachman tries to address in his architecture. There are some criticisms about this framework that it itself doesnt define the methodology of the framework and is a complex process and can be applicable for large organizations only. This framework mainly acts as a template where goals, ales, processes, materials, roles, locations and events that organizations require must be filled in. Session (2007) argues that the Coachman Framework is actually taxonomy for organizing architectural artifacts (I. E. Design documents, specifications, models) Tanat takes Into account Don won ten retract targets (e. G. Dustless owner, builder) and what particular issue (e. G. , data, functionality) is being addressed. The Open Group Architecture Framework (known as TOGA) (Figure 2): This framework mainly has four components such as: business architecture, application architecture, data architecture and technical architecture. Business architecture explains how business processes are aligned to meet the organizational goals. Application architecture describes how the applications are designed and explains the relationship between industry wide applications. Similarly Data architecture explains how the enterprise data are stored and accessed and finally technical architecture is responsible for explaining the interactions between software and hardware infrastructure. It mainly relies on already existing, proven technologies and products and tries to give a well-tested overall starting model which can be further extended. Although TOGA describes itself as framework, Session (2007) categorized TOGA as architectural process rather than an architectural framework. Session (2007) further extends Coachman explains how to categories the artifacts and TOGA gives the process to create them. So for an organization like MEG international Togas Architecture Development Method (ADAM) (Figure 3) provides a strategic process for moving from generic to specific enterprise architecture. Therefore taxonomy like Coachman and an architectural process like TOGA seem very much appropriate for MEG to adapt Enterprise Architecture as strategy. . 2 Re-engineering Re-engineering could also be interpreted as reverse engineering or radical redesign of a business process which disregards all the traditions and assumptions of the past business processes or procedures and develops new one aiming to leap forward in performance and this seems essential for MEG International. Reengineering process involves in identifying the characteristics of an already engineered product or services and the processes involved in developing those, then redesigning all the processes from the scratch to improve current productivity or customer satisfaction. Hammer Champs (1993) describe business re-engineering as the fundamental rethinking and radical redesign of an entire business system to achieve dramatic improvements in critical measures of performance. Reengineering is most often called business process reengineering which is aimed to accomplish tremendous changes within an organization and underpins all the possible outcomes to maintain a true competitive advantage among the competitors. Reengineering focuses on identifying and abandoning outdated rules and assumptions and creating new rules, work methods and workflow to achieve organizational goals aiming to increase productivity, product quality and customer satisfaction drastically. Harshly company need to lamben tly ten problems Ana want can De ten solutions to TAX them. If that cannot be fixed by some other means or change process then a basic re engineering model must be developed, then companys core processes should be redesigned and final stage is to adopt the new design. Re-engineering is not a simple task to accomplish, it requires fundamental rethink and radical redesign of business processes. For effectiveness it requires structured and analytic approach to generate aromatic improvements in cost reduction, quality improvements, customer satisfaction, speed etc. Pick] Reengineering (Hammers Champs, 2003, p. 2) Companies that are in deep competitive differences with their competitors, companies who have managers who can see problems arising like MEG and start on re-engineer the business before all their competitive advantage are wiped off. Hammer and Champs (1993)gs rhetorical question of reengineering is that If I were re-creating this company today, given what I know and the current level of technology, what would it look liker. Focus on fundamentals, radical redesign element, the potential for dramatic results and business process orientation must be addressed while answering the question. Fundamentals like what the organization does, why it is done that way, what are the tactical aspects, should be addressed while designing re-engineered process what should be. Superficial changes and quantum leap in performance is the must while re-engineering not only marginal enhancements and improvements. These changes should address current business process, plus implement improved and simplified processes that improve value to he customer. . Critical risks to re-engineer organization and successful change implementation Re-engineering the organization processes or business process reengineering (BPR) can produce drastic change and improvement in the organizational processes if implemented successfully. However if it is not implemented correctly it will not work as advertised and fail to meet the high expectations. Re cent surveys show that about 70% BPR fail and some organizations that have put massive effort in BPR are only able to gain marginal benefits (Davenport, 1993). These figures indicate that re- engineering has high risk but also organizations are ready to take the risk because the output when executed efficiently can be astounding. Some of the risk that could derail BPR process can be no support from senior managers, focusing on automating current processes before reengineering process is identified, making technology alone dependent on change process and not identifying the limitation of the current Information technology infrastructure. Other directly impacting difficulties that BPR can face involves employee resistance to change, not addressing employee concerns, Alsatian AT strategy goals, lack AT learning overslept Ana commitment. Including all these risks main critical factor is that organization must be truly committed to change in the re-engineering process with full support of senior level management. At Meg international even though Latino thought that everyone would be excited by the prospects of organizational change, only few expressed any enthusiasm for understanding general management. Most of the divisional heads were not clear on what re-engineering process is and were misinterpreting the concept in their own words which created an anxiety among most of the employees which resulted in loss of number of good technical staff. These were clear signs that most of the divisional heads were not ready to help in the re-engineering process that was very bad sign for Mona Lisa to start with. Since the BPR is a high risk process and involves high level of tasks to achieve, it can never be one man Job; it stresses the use of team throughout the process. Lisa however didnt show any initiative in having a team; as a result her rigorous efforts were wasted and ultimately lead to her resignation. If I was in her position then my first priority of this project loud be to create team of experts from different parts of organization to understand the business processes and technical infrastructure, and hire few members in the team from outside who have better understanding of re-engineering process who will be responsible for explaining the management team what re-engineering actually is and what we are planning to achieve. It is unlikely that an organization can ignore the existing infrastructure and implement a process from scratch. It is more realistic to acknowledge the resources available and any real constraints and develop fundamental understanding of their implications on the process redesign (Davenport, 1993). After the process is redesigned, available Information Technology should be used to facilitate the implementation of new process that rules out the possibility of technology to be the limited factor. While process re-engineering is not a technology endeavourer, IT is recognized as having a critical role to play in re- engineering efforts, primarily as an enabler of new operational and management processes (Davenport and Short 1990; Hammer and Champs 1993; Davenport 1993). However, IT in itself cannot be held responsible for the ultimate success or allure of the business strategy. When skillfully applied, IT can provide support for the intermediate processes that taken together comprise the execution of an organizations strategy. Since organizations culture is an important aspect and cannot be ignored in the change process, the framework that I will be using during re-engineering process is Muckinesss seven S diagram (Figure 4) because it encapsulates the key components of an organization and has Shared Values (or Culture) at its centre. 2. 1 Systems:- These are the processes, methods, procedures, rules, techniques, technology, manuals, etc. Hat ensures that work is undertaken efficiently and accurately. These are the essential part of an organization to guide the management and staff. Therefore key to BPR process is to understand current systems and redesign them, often as Davenport (1993) highlights, new processes are enabled by new technology wanly ultimately engages employees to learn new techniques. 2. 2 Structures:- After the key processes are redefined, the next step would be to restructure the organization to match along these processes. The new form of organizational structure that aims to break the traditional types of structure, particularly eructation and divisional structures is required. Hammer Champs (2003) recommend a move to much flatter structures organized around the processes, whereas Davenport (1993) recommends a multidimensional matrix structure, with process responsibility as a key dimension (p 160). To achieve this, Johansson et al (1993) states: the new organization must accommodate a balance between functional expertise and process involvement and goes on to say it is essential to remove functional barriers (IPPP). 2. Staff:- As per Henley (1991) Staff is the quality and quantity of people employed and anger has the role of motivation, reward systems, the structure of Jobs and team work (pap). Davenport (1993) expresses gain-sharing (Pl 10), lateral promotion, upgrade from role title to process title (Pl 1 1), and interesting and challenging through work role rotation, he believes encourages employees to redesign the processes to eliminate their own Job. In contrast to Davenports expression BPR to some extent will be involved in down-sizing and right-siz ing the workforce. 2. Skills:- Henley (1991) defines skills as The competences the organization needs in its people in order to perform difficult tasks to a high standard (pap). The BPR redefines the roles that should enhance and provide space for skills development where Hammer Champs (1993) add New World of Work where Jobs change from simple tasks to multi-dimensional work. This means Job preparation changes from training to education, from rule following to exercising Judgment and managers change from supervisors to coaches and executives change from scorekeepers to leaders(p 169). . 5 Strategy:- The main task in BPR is to discover the organizations strategy and of what rives competitive advantage in a particular industry; the industrys value chain and the basis for competition, and how a particular company seeks to gain competitive edge Monsoon et al 1993, pap). BPR decisions and strategic decisions involving new processes new structure and new staff mindset is extremely diffic ult to achieve but managers should be trained to articulate their Process vision driven by Business Strategy Davenport (1993, Pl 27). By style Henley (1991) means the philosophy, values and shared beliefs adopted by managers in their use of power (pap). BPR should be able to change the way hinge are done in the organization and behavioral changes. Process innovation involves massive change, not only in process flows and the culture surrounding them, but also in organizational power and controls (Davenport, 1993, Pl 3). 2. 7 Shared Values:- Andrews Stick (1994) state that in successful reengineering business operations, individual belief systems become aligned with the stated beliefs of the organization (Pl 15). Reengineering will definitely have a big impact on the cultural aspect of an organization under new processes, structure, staff role, management tragedy and style but re-engineering demands that employees deeply believe they work for their customers, not for their bosses(Hammer Champs, 1993, pap). BPR should establish new process teams linked by common values where employees must believe in self empowerment, self management and rewards based on skills must be used. Following this structure would provide me path to develop perfect strategy that would enable me to lead my team to successful re-engineering process at MEG international that would significantly improve the performance of the business processes. 3. Justification for Change in an Organization Change is inevitable in an organization, the organizations unable to keep up with the change; cannot match up with the fast changing market and their survival will be in question. There are many things, events, or situations that occur in an organization or its external environment that affect the way a business operates, either that can be positive or negative. To cope with these occurrences, situations or events; every organization has to fundamentally alter the way they do business. Thus we can say the statement Change is an ever-present feature of organizational life, both at an operational and strategic level. Therefore, there should be no doubt regarding the importance to any organization of its ability to identify where it needs to be in the future, and how to manage the changes required getting there. Consequently, organizational change cannot be separated from organizational strategy, or vice versa is very true. There are mainly four reasons that organizations need to changes that can be market changes, increased competition, external forces, and internal forces. 3. 1 Market changes The international demand for quality products, low prices, better service and increased level of client satisfaction are the key for the organizations change the way they do business in current global economy. To match these ever changing needs companies are Trace to Tort collaborative arrangements, cooperative ventures Ana even alliances. Social and political pressures have always been there for the organizations. Employee values, needs, priorities and their motivations are always influenced by the political and social events. To match up with their needs its essential for managers to adjust their management styles and arrange comfortable environment for employees. . 2 Increased competition In past where there were technology was not advance enough and there was less global competition with slower moving business environment where change occurred incrementally and infrequently. But now challenges organizations face is different, globalization has created both opportunities and challenges forcing firms to make drastic changes not only to compete but to survive in the market. Globalization is basically driven by technological advances, international economic integration and domestic market maturation (cotter 1996). Even companies operating in small entries can feel the impact of global competition. 3. 3 External forces External driving forces are those kinds of situations or events that occur outside of the company and they are beyond the control of an organization. External forces can be expressed under these sub-classifications: Demographic Characteristics: The change in population and their density come under this classification that can trigger organizational changes. This mainly includes changes in age, gender, race, and increase in diversity. Technological developments: In current business environment technology plays vital role in any organization. The Internet has revolutionized the way in which information is exchanged, communication facilitated and commerce conducted. Technology is rapidly changing and effective management demands more knowledge in these areas in order for companies to manage their resources and develop, maintain or keep their competitive edge. It is essential for organizations to adapt technology to improve productivity and market competitiveness. Since technology is fastest changing entity, any business missing to follow the technological changes might loose their competitiveness or wiped off completely from the market. . 4 Internal Forces Internal driving forces are those kinds of situations or events that occur inside the company and they controlled if there is proper initiative taken. Internal forces can be expressed near tense sun Human resource factors: -classification: People change more frequently and they bring in their changed perceptions in the organizations. Their perceptions about the work and work environment, their expectations from their managers and colleagues, flexibility and balance between work and their life etc could act as important factor for organizational change. To increase employee motivation, and improve their commitment and dedication towards work, their stresses, sources of conflict, work overload, and ambiguity need to be identified and eliminated. Managerial behavior/decisions: Excessive interpersonal conflict is often a clear sign that change is needed. Due to the important role of the manager in introducing and managing change in the organization, skills training and capacity building programmer for both manager and employee might be necessary. It is suggested that a better strategic approach to change is where organizations and heir people continually monitor, sense and respond to external and internal environment in small steps as an ongoing process (Burners, 2004). Early model of change was developed by Lenin (cited in Burners 2004, p. 985) consisting of three- stage process. First stage is unfreezing which is mainly aimed at overcoming or dismantling the existing mind set that are resisting change. Secondly the change implementation which can be of lot of confusions where old ways are challenged and new ideas have not been fully stable. Final stage he called is refreezing stabilizing hang within organizational culture, norms, policies and practices in order to ensure the new behavior is sustained in individuals.

Analyzing the Literary Features of “The Lottery” Essay Example for Free

Analyzing the Literary Features of â€Å"The Lottery† Essay In the story of Shirley Jackson’s â€Å"The Lottery†, many literary devices are used to convey messages, give clues and give the reader a better understanding on the story overall. Within the story, literary devices such as allegory, symbolism, and satire are used, which are for the moral that Jackson is trying to send to readers. Other devices used are foreshadowing, imagery and irony. Jackson uses imagery to give a good visualization of the setting. Foreshadowing helps give a clue as to what to happen next in the story, and Jackson uses irony for surprise effect to shock the reader in the end of the story. At the beginning of â€Å"The Lottery†, it opens with â€Å"The morning of June 27th was clear and sunny, with the fresh warmth of a full-summer day; the flowers were blossoming profusely and the grass was richly green. † This description Jackson gave is a clear example of imagery as she uses phrases such as: â€Å"richly green† â€Å"blossoming profusely† and â€Å"fresh warmth†. After reading this, the reader gets a sense of pleasantness in the story. Furthermore, Jackson writes â€Å"The lottery was conducted–as were the square dances, the teen club, and the Halloween program–by Mr. Summers†. This excerpt meant the lottery is traditional, and is followed by other fun activities such as square dances, the teen club and the Halloween program. From knowing the ending, this is an example of irony because the lottery is thought to be a fun opportune activity, but in the end it is found that the winner receives the prize of death. On forward, the lottery is introduced with the arrival of Mr. Summers and his black box he brings for the drawing. In the story, Jackson states â€Å"The black box grew shabbier each year: by now it was no longer completely black but splintered badly along one side to show the original wood color, and in some places faded or stained†. The literary devices of symbolism and foreshadow are used here because the box color â€Å"black† is a symbol of death. With the box being in bad shape being faded and splintered badly, this adds to the symbol of death as fading means disappearing and wood splintering is signs of the wood’s breakdown. The names of these characters are also a form of symbolism and foreshadowing. Two characters, Mr. Graves and Mrs. Delacroix have names with deeper meaning. In the name â€Å"Graves†, grave means death as well, and within â€Å"Delacroix†, Croix is the French word for cross, which in the story of the bible, Jesus was sacrificed upon a cross and both are a form of Jackson’s symbolism to give a message. These objects of symbolism give off the literary device of foreshadow as the symbol of death means something bad may happen later within the story. Analyzing the Literary Features of â€Å"The Lottery†. (2016, Sep 13).

How Does Common Core Work for Children who are Deaf and Hard of Assignment

How Does Common Core Work for Children who are Deaf and Hard of Hearing - Assignment Example Before the Common Core Standards came in place, each state had its own standards. The standards varied considerably in the areas of focus and content hence leading to different learning outcomes. As such, there was a need to formulate a common national standard for learning by which states could make tailored changes that meet their priority. Individuals without hearing loss acquire 80% of their information through accidental means. However, the figures for those who are deaf and hard of hearing is lower due to the fact that hearing loss interrupts the path of information from the teacher to the student. Consequently, there is the need for specialized training for teachers of students who are deaf or are hard of hearing so as to address the needs of these students. It states that transitions from school to the real world environment are a real challenge for students who are deaf and hard of hearing. Therefore, Gunderson claims that the Common Core State Standards have been expanded to incorporate eight fields which are, audiology, family education, functional skills for success in education, communication, technology, self-determination and advocacy, and career education. According to Gunderson, the Common Core State Standards should empower the students and help them in understanding their current predicaments through audiology. This is one method of early intervention and will help them to understand themselves at an early age. Family education is a crucial component of the Common Core Standards. The families of deaf and hard hearing children may be faced with numerous challenges such as acceptance, educational services, language to use and mode of communication.