Development of Stratford Because of the Olympics Essay

The 2012 Olympics were held in Stratford in the East of London, many of the events took place here. The Olympic park covered an area of 500 acres which features the new built Olympic stadium, the London aquatics centre, the basketball arena, the London velopark and the riverbank arena. Boxing, fencing, judo, table tennis etc. was in the river zone which is located both sides of the River Thames in the Thames gateway area. The central zone which includes venues such as the Wembley stadium (where the finals of football competitions took place) also the Wembley Arena (Badminton) and Wimbledon (Tennis), covered most of central and West London. Stratford was chosen because the London bid team persuaded the 10c that this part of East London was in need of regeneration. Stratford was also chosen because the bid also proved that the area had potential, Javelin trains would take only 7 minutes from London and also the rivers in the area could make the Olympic park look beautiful. Also alongside the old network of river and canals there was plenty of room for new development. This has been one of the most compact Olympic parks – only about 2  ½ square kilometres. Economic: Development will transform rundown rail lands into major shopping and business location. 120 shops and cafes. Environmental: Olympic village will be converted into permanent homes.  The development will attract homes, businesses and visitors because it will look improved and welcoming. Wide variety of open space.  Visionary urban design, architecture and transport projects. The Stratford area will be transformed from a derelict filthy city into a clean, modern city. The regeneration of Stratford will help it be noticed and it will be transformed into a totally new place. The place and people will be noticed in a different and better way. Stratford has been improved in a great way because in the long term massive, new sporting facilities have been built which will attract people as it is a legacy of the games. Also in the long term, old houses have been knocked down and re-built making Stratford look more modern and looked after. Another reason as to why Stratford has been improved is because of more jobs that have been created which will attract more people to the area and make it well known. Another benefit and improvement is that the Olympic park ‘largest Urban Park in Europe for 50 years’ will create a better image for London and East End. Increased participation in sport for young people has been increased making East London and London look like a great healthy place possibly persuading adults to live in London with their children so their children have a healthier and more active life. One of the improvements I have mentioned (old houses being knocked down and new ones being built) has been classed as a social issue because of complaints saying it will change the socio economic structure and the geography of Stratford. Some residents have been offended negatively from the development of Stratford as almost  £9.3 billion has been spent on the games with three quarters of it earmarked for regeneration and they say it is hard to see where the money has gone. This suggests to us that their area has been left and not improved leaving it as it is was and many other areas have been left as they are too. A positive impact on the residents is that their area is going to become well known because of the Olympics and also many more new modern homes and jobs are being created and becoming available. More positive reasons that have affected the residents are that they have reduced untidiness by removing any unnecessary railings, posts, bins and benches. Also they have improved the quality of open spaces and they have planted trees in groups along the road and introduce greenery too make the traffic seem less dominating.

Succubus Heat CHAPTER 18

When it was over, I rested my cheek against his chest while still staying mostly on my side. His heart beat heavy beneath my hands, and the smell of his skin and sweat nearly overpowered me. I lay there, perfectly still, scarcely daring to breathe. I was afraid that if I moved too much, I'd break this spell, this dream that I'd somehow stumbled into. Slowly, carefully, Seth ran his fingers through my hair, idly twining the strands into loops. He let his hand drop and shifted slightly, just enough to press a kiss to my forehead. I exhaled and snuggled closer, realizing that I really wasn't going to wake from this dream. At least, that's what I thought until his cell phone rang. The ring was â€Å"Where the Streets Have No Name† by U2, not a particularly hard or jarring song but one that made me flinch anyway. For a moment, we each held our breath, both of us frozen. I wanted the phone to disappear off the face of the earth, to get smote the way I kept fearing some demon would smite me. I needed it to go away because if it kept ringing, it meant none of this was real. That we were going to have to face reality. But it was already too late. The spell was broken. The phone was reality. â€Å"You should answer that,† I said. He hesitated for the space of two heartbeats, sighed, and then slowly disentangled himself from me, still careful of my back. Sitting on the side of the bed, he reached down and pulled the cell phone from his jeans pocket. I shifted over, staying propped up on one elbow, admiring the shape of his body, even as a strange, bittersweet feeling began spilling through my heart. I knew, without knowing how I knew, that it was Maddie. â€Å"Hey. Yeah†¦I got caught up with†¦um†¦Ã¢â‚¬  Seth paused, and I sensed something monumental about to take place. â€Å"I got an idea for this latest chapter.† I closed my eyes. In all the time I'd known him, I'd never heard Seth outright lie. â€Å"Right. Yeah. Okay. Um, if I leave now, I can probably make it in†¦oh, twenty minutes. Mmm-hmm. You want me to pick you up, or†¦? Okay. See you there.† He disconnected and continued sitting with his back to me, clasping the phone in his hands. Although he sat up straight, he had the air of someone hunched over, weary with defeat. â€Å"You have to go?† I asked. He looked back at me, anguish on his face. â€Å"Georgina†¦Ã¢â‚¬  I managed a weak smile. â€Å"It's okay. I wasn't tricked here. I understand the situation.† â€Å"I know, but I want you to realize that it wasn't†¦that I didn't†¦Ã¢â‚¬  He didn't need to finish. One of the things I'd always loved about Seth was his open, honest nature. Occasionally he'd been able to hide his feelings from me, but more often than not, they shone through on his features. This was one of those times. With a single look, I saw what was in his heart, that he hadn't had sex with me because I was easy or available. He'd done it because of how he felt about me, because he loved-still loved-me. It made all of this that much worse. â€Å"I know,† I said softly. After one more kiss to my forehead, he put on his clothes. I watched each move hungrily, uncertain if I'd ever see anything like it again. When he was dressed and ready to go, he sat beside me on the bed, playing with my hair again. Again, those golden brown eyes spilled over with emotion. He was overcome and confused. I was too, but for his sake, I tried to appear strong and articulate. â€Å"It's okay,† I said. â€Å"It was great. Amazing†¦but I understand that we shouldn't have and that we can't ever†¦Ã¢â‚¬  So much for articulation. â€Å"Yeah,† he agreed. â€Å"It was just this once. And it was perfect.† â€Å"Just this once,† he repeated. I couldn't read his voice, but something told me he wasn't entirely happy about that. Neither was I, but honestly, what could we do? We'd succumbed to passion, and now he had to go back to his girlfriend. End of story. He tipped my head back, and our lips met in a soft, warm kiss. It was brief, only a few moments, but I felt that same, soul-deep connection that had consumed me during sex. He stood up and studied me for a few moments more, as though he might not ever see me again. I felt a little silly lying there naked, but his expression told me he thought I was beautiful. He left after that, and I stayed in bed, drunk on my own feelings. Aubrey joined me, curling up against my leg. â€Å"Was that how it was supposed to be, Aubrey?† I couldn't decide. Certainly the sex had been everything I'd ever imagined with Seth. But this afterglow? It was a bit lacking. Nothing about the situation was normal. I had no prior experience to fall back on. After almost a half hour of staring at nothing and reaching no conclusions, I got out of bed. I was still reeling from what had happened, and my body burned with what Seth and I had done. I usually liked to shower after sex, but not today. I could smell Seth on me, his sweat and even a faint trace of the leather-and-apple cologne he used sometimes. I couldn't stand to wash him off yet, so I put the old cotton robe back on. Ratty or not, its fabric was soft against my bruised skin. As I was about to leave my room, I noticed the photo of the medallion on the floor. I picked it up, intending to set it on my nightstand, and froze. There was writing on it. Inked with a black Sharpie, neat handwriting read: Smoky quartz indicates earth or a oneness with the earth . The symbols on the medallion were circled, with lines drawn out from each one, leading to brief notes: this indicates an affinity for water, a harmonious, blending state; this is similar to the water one, except it's for the earth; this is a masking symbol, meant to shield the object it protects and keep the seal strong; this one's strange, indicates blankness or whiteness-maybe white sand or stones?; this is the symbol for tears-combined with the water sign, probably indicates salt water . I reread the notes three times. Where had they come from? When had this happened? I retraced my steps, trying to figure out when I'd abandoned the picture. There'd been no writing when I showed it to Dante. The most likely time would have been while I was out for food. Someone could have also theoretically broken into my home and done it while I was with Carter in the living room, but sneaking past the angel seemed pretty out there. Unless†¦was it possible Carter had helped me after all? He kept saying he couldn't; he'd even directly denied involvement with my assorted rescues. But the timing here was awfully coincidental. I kept staring at the symbols, at the notes, and the pictures of the seal. Whoever had written this was irrelevant for now. If their notes were correct, then I needed to use them to find Jerome. Carter had said the seal served two purposes. One was to infuse the vessel with power. The other was to serve as a â€Å"lock† that could open the vessel and release Jerome. The parts of the seal itself were with the demon and the summoner, but the symbols should give some clues to the vessel's location. Supposedly, these symbols would have been used in hiding Jerome, infusing the vessel with a type of energy specific to the location that would help blend and mask Jerome's presence. An affinity with the earth, as well as markings for water-salt water, specifically. A lot of places that were infused with power tended to be wild, natural places, though some had become centers of civilization and activity. Pike Place Market in downtown Seattle, for example, was one such ancient place of power that had been completely built upon by humanity. But these†¦what did they indicate? Some place near salt water, apparently. The vessel was probably close enough to the water that the symbols would resonate and camouflage its location. And the earth location? Buried in the dirt maybe? Was Jerome buried on some beach near the ocean? Jerome's kidnappers wouldn't want to keep him too far away from them, but nonetheless, the Pacific flanked the entire western half of Washington. That was a lot of beach, and I knew there were a lot of places of power along there. I didn't know of any white sand beaches anywhere in the area; only further investigation could say for sure. Groaning, I lay back on my bed, still holding the picture. The notes had only narrowed down the locations, but that was still a lot of area to cover. Yet what could I do? I had to find the vessel, sooner rather than later, or else Seattle was going to have a new archdemon. Studying the photo further, I willed it to give me some more info. Nothing. Just the medallion, the mystery notes, and Mary's cataloging info at the top which told me little- I frowned, rereading her header. It was brief, just the materials, name, and date the medallion had been created and then picked up. But the date it had been finished†¦the date stuck in my head. Why? It was from a week ago. Something about that date was important, but I couldn't figure out why. It felt likes years had passed in this last week, but I nonetheless counted backward, reassessing my recent activities. There. The seal had been made the day after I'd first gone to Vancouver†¦the day the vampire turf war had gone down. Would the seal's creation have triggered anyone's immortal radar? I didn't know, but if it had, Jerome, Grace, and Mei would have all been busy sorting out the ensuing vampire mess. Misdirection. From there, other things began to arrange themselves in my head. I thought back to the Army of Darkness, wondering what events their activities might line up against. The event in Queen Elizabeth Park matched the date the seal had been picked up. And the Army's impromptu visit to Seattle†¦? That had preceded Jerome's summoning, though no one would have wanted to direct attention to that, would they? The answer was here. I just couldn't quite make the pieces fit yet. The Army had staged their show. Jerome, Grace, and Mei had given it their full attention. Jerome had been summoned. Where had this game's other players been? I left the bed and its aching, alluring memories. Finding my cell phone, I dialed Kristin's number. â€Å"Hi, Georgina,† she said, pleasant but busy like always. â€Å"Hey,† I said. â€Å"How's it going?† â€Å"Crazy.† I could imagine the grimace on her face. â€Å"Cedric's stressed to hell-no pun intended-with all these demons in the area. At least that†¦that succubus is distracting him.† â€Å"Tawny?† â€Å"Whatever her name is. Cedric's actually out with her right now.† Bitterness and the tiniest hint of jealousy came through in Kristin's voice. I remembered her perpetual devotion to him-and the look on her face when he'd asked Tawny out. I felt for her but had too many romantic hijinks of my own to deal with. â€Å"Huh.† I didn't really know what else to say. â€Å"Look, I have a question for you. Do you know, did Cedric come to see Jerome the day the Army was down here?† â€Å"Yeah. Cedric came down after you left the message. I thought you knew.† â€Å"No†¦I only heard about it after the fact, and then, the whole summoning kind of took precedence.† â€Å"Why do you want to know?† I hesitated. I liked Kristin, but she was clearly loyal to Cedric. I didn't think it'd be wise to share my theories with her, like that the Army being in Seattle had provided a convenient reason for Jerome and Cedric to be together when Jerome got summoned. It occurred to me that I might very well owe Hugh an apology for my adamant denial of Cedric's involvement. Something else also occurred to me. â€Å"Um, it's a long story,† I said hastily. â€Å"Do you know if he's been hanging out with Nanette a lot?† â€Å"Why?† Her tone was quickly turning suspicious. She didn't like me interrogating her about her boss. â€Å"Well†¦I told him the other day that I thought Nanette might be involved with Jerome's disappearance. He didn't think so, but he told her†¦and she got really pissed off. She, um†¦. well, let's just say she got physical, and I have the scars to prove it.† My immortal friends had pointed out that Nanette's attack made her look guilty. If Cedric had done enough goading to make her angry when he told her, it could have very well sent her to me in a rage-and successfully shifted attention from him. Fuck. I didn't want another suspect in all of this. I didn't want it to be Cedric. Nanette had hitherto been a convenient explanation. Kristin was silent for several seconds. â€Å"I didn't know that,† she said quietly. â€Å"Are you okay?† â€Å"Mostly. Mei healed the worst of it, but I'm still a little sore.† â€Å"I can't imagine†¦Cedric would never have told her if he thought that was going to happen. He likes you. He wouldn't condone that. He couldn't have known. I'm sorry.† She was sincerely contrite, hurt at the thought that her boss-even if he was a demon and a servant of evil-could have been involved with something that had turned out so terrible. â€Å"It's okay,† I said. â€Å"I've gotta run, but thanks for the info. Things are kind of crazy here too, as you can imagine.† We said our good-byes and disconnected. I flipped the cell phone around in my hand, feeling overwhelmed. Nanette wasn't off the table yet, but Cedric was right alongside her now as a culprit-maybe more so. If I had enough evidence, I could possibly take it to Grace and Mei†¦but I didn't have that yet. Besides, knowing who the culprit was wouldn't solve the immediate issue: finding Jerome. I glanced back at the photo, resting on my nightstand. Sore back or no, it looked like I had to do a little beachcombing. I nearly knocked Dante over when he came home that night. â€Å"Succubus,† he said, letting me wrap my arms around him. He was careful only to rest his hands on my hips. â€Å"Happy to see you too.† My eagerness was twofold. I was excited to see him because I wanted to pick his brain about the medallion and places of power. But also†¦well, while hanging around today, I'd had a lot of time to think about Seth and what had happened between us. The memory of his body still made mine burn, and I grew breathless recalling that amazing connection and sense of rightness between us. And yet†¦whatever rightness had been between us, it had still been wrong. He was with Maddie-my friend. I'd been upset when she and Seth had first slept together. I was no different. In fact, I'd knowingly done it, which made it worse. Now there was Dante to consider. Dante, who despite that dark, scowling nature really did love me and wanted to win my regard as more than just someone I had sex with. This was where my future lay, not with Seth. I kissed Dante on the lips, lingering several seconds. â€Å"I missed you.† His smile turned wry. â€Å"Don't look at me like that, or I'm going to have a hard time remembering that you're injured and that I should keep my hands off you.† Those words triggered a pang of guilt. My injuries certainly hadn't been enough to keep Seth off me. I could have told Dante that I was better, that it didn't matter, yet for whatever reason†¦I didn't. We broke apart, and I found the medallion picture for him. He stared incredulously as I showed him the phantom notes and explained my story. â€Å"What, you have no idea how they got there or who did it?† â€Å"Nope, but at this point, I'm not going to question it.† He shook his head, face still shocked. â€Å"Well. I wish I'd known this before I left. Would have been a lot easier to just wait and have invisible helpers come leave clues.† I recalled how he'd gone out to see what he could find about the medallion. â€Å"What'd you turn up?† He gestured at the picture. â€Å"Same thing.† I rested my hand over his. â€Å"Sorry. I really appreciate your help. And if your research found the same thing, it means I can probably trust this.† â€Å"Maybe,† he said, still not sounding happy about the wasted time. â€Å"What are you going to do? Something crazy?† â€Å"Look for saltwater beaches, I guess.† Dante let out a low whistle. â€Å"There are a lot of those around here. Not to mention you have no way of identifying this vessel anyway.† â€Å"I know. But I've got to start somewhere. Can you help me make a list?† We got an atlas of the Pacific Northwest area from my car and laid it flat on the kitchen table. Scrutinizing every detail, we each marked as many places as we knew. Dante knew a lot more than me, which didn't particularly surprise me. I'd once noted to Erik Lancaster that those who study religion tend to know more about it than those who practice it. Sometimes, I felt the same way about immortal affairs. We found twelve in all that were easy day trips-and many more beyond that. â€Å"Looks like you've got your work cut out for you,† Dante mused. â€Å"When are you going to look? Too dark now.† I stared at the map with dismay. â€Å"Tomorrow, I guess. Can you go with me?† A psychic like him might able to sense something, as Carter had pointed out. He grimaced. â€Å"Not tomorrow. I've actually got a few appointments people have scheduled. Crazy, huh? I probably can go the next day or the day after, if you can wait. I'd feel better if you didn't go alone.† I was glad for his business but sad at the delay. â€Å"I don't think I can wait. Don't worry, though. I'll find somebody.† â€Å"On the bright side,† he said, trying to cheer me. â€Å"I'll have money tomorrow. We can go out somewhere nice.† I mustered a smile. â€Å"Yeah, that'll be-oh, shit. I can't.† â€Å"What's going on?† â€Å"Fuck. I promised the people at the store I'd teach salsa after work.† â€Å"Cancel,† he said dismissively. My dance lessons didn't hold much importance, as far as he was concerned. â€Å"Tell them you're sick.† That wouldn't entirely be a lie†¦and yet, I hated to go back on my word. Furthermore, I could still see Maddie's radiant face, so excited and happy when I'd agreed. How could I deny her that after what I'd done to her today? â€Å"No†¦I've got to do it. Let's go eat out now. My treat.† He drove us over to Belltown for some of Seattle's best seafood. Wine and conversation flowed, and I discovered I was healing by leaps and bounds. When we got back to my place later and went to bed, Dante snuggled up to me and kissed my neck. â€Å"Looks like you're on the mend,† he noted, moving his lips up to my earlobe. â€Å"We could do it†¦I could be careful†¦Ã¢â‚¬  All around us were the sheets and blankets where Seth and I had made love earlier. The thought nearly smothered me. God. I really should have washed the bedding. I swallowed and shifted position so that I didn't meet Dante's eyes. â€Å"Maybe†¦but I'd rather wait, so we can not be careful.† I hoped there was enough of a seductive growl in my voice to make it believable. Dante sighed, fortunately unwilling to push me. â€Å"Fair enough.† He rolled over and left me to sleep, but it was a long time in coming.

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Issue14 - Essay Example The major theme of this method was to simply identify the top performers of the company, along with employee’s slight developmental needs and the dismissal of underperformers. GE remained successful with the execution of this method; later several companies adopted forced ranking performance, because it gave them the positive outcomes. Two issues were brought into attention regarding this method, in association with Alex Blyth & Gail Johnson. Alex Blyth supported this appraisal method in accordance with ‘cull or cure’. Operating the culling system over the bottom employees, will elaborate morale among the rest of the employees. Culling must be done properly to gain the positive results. Gail Johnson profoundly disagreed with forced ranking performance method. He stated that, it is such a method which will give birth to negative environment within the company employees, in reflection to several perspectives (discrimination & highly competitive environment). Today, approximately 20% of the fortune companies are still adopting the method of forced ranking performance, out of which some gain benefit, some remains at average and some face the possible chances of enduring the case of unfair appraisal system. Jack Welch’s policy of ‘rank and yank’ got popularity among huge organizations with effective results. Giving financial rewards to the top 20% & training the middle 70%, have been satisfactory enough; but straight firing the 10% of the bottom, blasted as the red light agenda among the organizations. Critics argued it to be as undermining the team work within the company. In general, the main motive of the employees should be working as a group for the company’s benefits, but the action of firing would enforce the engagement of employees in wasteful playing game situations to get the reward. According to the survey of Sanford professors, ‘Jeffery Pfeffer & Robert Sutton†, forced ranking performance encouraged

Stock Market Assignment Part II--Retirement Plan Requirements Research Paper

Stock Market Assignment Part II--Retirement Plan Requirements - Research Paper Example I will live off 25 years depends on my retirement account. Average age of living of my past family members is 85 years and for this reason I have estimated this time duration of living for my life. Now, I am 25 years old and I have started earning from this year only. I want to cover the basic cost of living of my total family so that the children do not need to concentrate on savings. So, with this post retirement regular annual income I will cover the annual cost of my family. After retirement my cost of living will be minim um in terms of the essentials and regular expenses like the EMI of house loan and car loan will not be needed at that time. Apart from these regular expenses education will also be not needed at that time because children will become established and will be the earning family members when I will be retire from my job. So, I am expecting to get an annual post retirement withdrawal amount of at least 25% of the last annual income. I need this amount to be increased every year because of possibility of the increase of the inflation rate. This will result to increase in cost of living. So as the pre retirement income increases every year, the post retirement annual withdrawal amount will need to be increased. For getting 25% of the last annual of income after the 60 years of my age I need to save 20% of my total annual income. Rate of saving need I will increase at rate of increase in the annual income and for th8is purpose I am also cons idering the average inflation rate and the average percentage increase based on the past five years growth rate. I do not want a fixed amount after my retirement and for this reason I want a regular income from my savings and also this income from needs to be increasing in order each year so that I can withdraw increasing amount each year after my retirement. For this amount of withdrawal I have to save 20% of savings each year with increase rate of savings of 1.5% due to the

IT for Investor Relation Assignment Example | Topics and Well Written Essays - 1000 words

IT for Investor Relation - Assignment Example Evidently, one of the benefits of advertisement to Gap Inc is the creation of brand awareness and exposure by capturing the minds of the target audience. Consequently, it creates familiarity with the target audience and inculcates a sense of consumer trust. Improvement in product sales is another benefit from advertising that Gap stands to achieve. In this regard, the business will make profits through a reduction in unit cost per product. The achievement of competitive edge is a further advantage that Gap Inc will achieve over its competitors through forefront awareness and being ahead of its competition. The type of advertisement for consideration by Gap Inc. is one that is simple, informative and straight to the point without overloaded visuals and statements that distort the consumer. In this regard, the key costs to be considered in terms of advertising include research and design team costs, printing costs for designed posters, cost of graphic designs for the visuals displayed in the website or over the posters and flyers. The importance of annual reports is that it is a tool applied by investors in the evaluation of the current physical, financial standing, objectives and report on any new developments of a company in general. Moreover, the annual reports serve as mode of written and formal communication. In light of Gap Inc.’s vision of continuous international growth and geographic footprint, annual reports are necessary requirement. In this regard, there are two technology requirements for the effectiveness of the annual reports. Foremost, are the visual templates or format to be adapted in generation of the annual reports. Second, is the select choice of database such as Excel to be used in production of the financial statements. The benefits and advantages that Gap Inc stands to gain in using the annual reports includes informing its customers and the public on

Unfair dismissal law in the UK Essay Example | Topics and Well Written Essays - 1250 words

Unfair dismissal law in the UK - Essay Example It is the somewhat a term that workers would like their contracts to have, but cannot claim, since it is a buyer’s market for labour, and workers tend to view the exploration for work as a contest with other potential human resources. This essay provides insights on the unfair dismissal law in the United Kingdom. Similarly, it would be inept, for a prospective worker to make inquiries at an interview when seeking employment about the degree of misbehaviour the company can tolerate before the worker is discharged. The inequity of bargaining command is an attribute of the majority of jobs contract. There exists a body that deals with grievances that arise between employers and the employees called the Employment Tribunal (ET).Latreille, Latreille and Knight (2005, pg. 325) affirms that the ET is an autonomous judicial organisation founded to determine disagreements between a company and workers regarding employment civil liberties. The ET hears allegations concerning employment issues such as unfair dismissal, unfairness, wages and redundancy costs. A number of rationalisations for the law are usually presented to intercede the unfair dismissal law in the management’s capacity to manage its dealings such as rectifying the inequity in bargaining command between the company and workers; shielding possessions right that workers boast, or should boast, in their occupations, defending the decorum and independence of the workers. The paramount clarification is perhaps provided by Hugh Collins when he asserts that the aim of unfair dismissal law is inclined at presenting some level of security to the decorum and independence of workers in the perspective of the job contracts and probable release (Collins, Ewing and McColgan, 2012, pg. 48). The fortification of these values is not indefinite; whereby in various instances the fiscal effectiveness and administrative prudence get priority,

AR 364 HISTORY OF ART(print based) Research Paper

AR 364 HISTORY OF ART(print based) - Research Paper Example Every man is an artist. Every individual has a way to voice out what is going on inside of him and loose it out in ways that would make an impact to whoever perceives. Art as an expression reflects what is happening in a certain society and culture. If art is a work output, then it must come from inside of the artist. The freedom of every individual lets him explore the vastness of his creativity exploding into varied concepts of supreme work of art and achievements. Historically, art has evolved through time and culture. Since the evolution of human history, art is already present. Early artworks were seen on the caves and rocks. They were aesthetically basic, devoid of colors, no definite forms and lacking in medium. Regardless of their simplicity, they are renowned important due to the message and content that they carry. What they have done is considered supreme and historically significant. Their art is their way of expression of what they perceive in their nature. Due to their simple cave wall caricatures and sketches, man’s civilization was traced. The message of an artwork reveals the environment at certain point in the history. There is a dynamic relationship of the artist with the environment, whether internal or external. With all his intellect, emotions, and religious beliefs, he freely cast out what he infers from his system. There are various factors that affect the artist’s works such as geographical, historical, religion, politics, and other day to day happenings can make artists resolved into expressions painted in canvasses to portray soundless words. This symbiotic human cycle produces a total artwork that is directed into shaping the world creating history and directing the course of the future. Art has been evident since the early period of Paleolithic, Mesolithic and Neolithic period in 30,000 BC to 2,000 BC. Man has expressed what they perceived from nature through

Prostate Cancer in African American Men Essay Example for Free

Prostate Cancer in African American Men Essay Prostate Cancer is the gland below a mans bladder that produces fluid for semen. Prostate cancer is common among older men. Prostate cancer is a silent killer, and because it grows slowly, many men have no idea its there It is rare in men younger than forty. Risk factors for developing prostate cancer include being over sixty five years of age, family history, being African American, and some genetic changes. There is an estimated of 241,740 new cases and 28,170 deaths from prostate cancer in the United States in 2012 (National Cancer Institute, 2011). Prostate cancer is the second most common cancer among men, behind skin cancer, and the second leading cause of cancer deaths among men especially in African American men. one out of six men will be diagnosed with prostate cancer during their lifetime. For example, if youre at home having a cookout with 11 of your friends, its likely that two of you at some point in your lives will be diagnosed with prostate cancer. and If youre an African-American man, those odds increase to nearly one in five. Prostate cancer affects African American men twice as often as Caucasian men; the mortality rate among African American is also twice as high. African American men have the highest rate of prostate cancer of any ethic group in the world. In the African American community men are at high risk due to low socioeconomic status, and not getting cancer screening because of no health insurance. With the increased amount of men being diagnosed each year it is shocking that many men still avoid visiting the doctor because it makes them uncomfortable and they are afraid of what the results will be even when some clinics give free prostate cancer screening. While prostate cancer screening test can have abnormal results even when cancer is not present, it is important for men to have prostate screening done.prostate cancer is usually detected through screening, and there are two methods for early detection. The prostate-specific antigen test (PSA) is used, but there are many factors that can inf luence the outcome of the PSA test. Medications such as antihistamines, physical exertion or recent ejaculation can raise a PSA level. Another test for early detection of prostate cancer has been the digital rectal exam (DRE). Although, DRE is a better method for early detection, it is also a hindrance among men, particularly African-American men, to screening and early detection According to American Cancer Society (ACS) and American Urological Association (AUA), the PSA and DRE should be offered annually for all men beginning at age 50. However, they also recommend that African-American men with a family history of prostate cancer should begin testing by age 45. Early intervention is the key to a 5 year survival rate. Prognosis of prostate cancer diagnosed at an early stage is noted as being optimistic. Despite these credible statistics, free prostate cancer screening and early detection remains a problem area for many health care practitioners when it comes to the African American population (Plowden 2009) Madeline Leininger’s Sunrise Model has been used in many studies over the past twenty years. Between 1999 and 2008, over 200 citations of articles were noted using Leininger Theory (McEwen, 2011). She postulated that nurses should attempt to increase knowledge related to the care of people who value their cultural heritage and way of life (McEwen, 2011). The Leininger Sunrise Model of cultural diversity is used to obtain compliance with prostate cancer screening among African-American men; the goal has been to build a relationship of cooperation between clients and health care workers. Educating the men as well as examining their fears and anxieties is useful in removing barriers of resistance and gaining trust, thus empowering the client (McEwen, 2011). The Health Belief Model (HBM) â€Å"postulates a person’s perception of disease threat and benefits of taking action will predetermine taking action† (Rivers, 2009). The HBM is used to determine the African American male understanding of prostate cancer and to identify factors that would motivate that populatio n to seek screening and treatment of prostate cancer. The HBM has been used to design intervention to educate as well as facilitate access to screening and treatment (Rivers, 2009). Leininger’s Theory of cultural care diversity is a middle range theory that is based upon the major concepts of culture, culture care and understanding the differences as well as the similarities to transcultural human care. Her other major concepts of transcultural care are, caring, and ethic views, the system of health care, the professional system of care and culturally congruent nursing care. (McEwen, 2011) The strength of Leininger Theory lies in the fact that it is a holistic theory seeking to cover both the diversity and universality of nursing care concepts. Caring aspects within and between cultures must include the acknowledgement of the similarities and differences. The theory has been widely used within the credibility and confirm ability of data gained from research (McGee, 1994). Because the Leininger Theory places emphasis on cultural s ensitivity and cultural congruence, it can be said that cultural knowledge will improve care. However, because the approach fails to take into account a political and structural inequality of minorities and focuses on differences and deficits, it can be construed that the culture itself is the problem. The possibility of reinforcing stereotypes and increasing the gap between provider and patient may actually make the care aspect less than culturally safe (Orià ¡, 2005). Leininger Theory can be used in a wide range of modalities when considering the problem of prostate screening. When examining the focus of this clinical problem i.e., how to get increased participation from a high risk group to prostate cancer screening, Plowden reached several conclusions that are applicable to today’s practice for advance nurse practitioners. For example, African-American men were more likely to seek screening and participate in the treatment process if 1.) There was a perceived susceptibility to prostate cancer and that threat was perceived as severe in life threatening or disabling . 2.) There were perceived benefits to the screening such as early detection and accurate diagnosis. 3.) There were no perceived barriers. 4.) Sufficient triggers need to exist to motivate behavior (Plowden, 2009). When applying these findings to advanced nurse practitioners’ practices, it can be said that men in the high risk groups must first be educated on the risks of prostate cancer. They need to understand the implications involved with failure to be screened. Early detection and accurate diagnosis are very important to the 5 year survival post diagnosis. Screening is essential to the quality of life for a person diagnosed with prostate cancer. For example, lifestyle changes would have to be made after a radical prostectomy versus a chemo radiation treatment of a localized slow growing tumor. When health care professionals can successfully manage to remove or go around barriers, whether real or perceived, the goal of seeking medical intervention is improved. Health care professionals can attempt to established sufficient triggers so that the behavior can be motivated to attain compliance to screening. The advanced nurse practitioner’s challenge will be to first establish trust and reputation as a caregiver who cares and is approachable; educate the population of the high risk group to the benefits of early detection versus late discovery; provide easy access to screening and the follow up phase of the intervention; and maintain confidentiality. Peer group discussions with professionals have shown to aid in getting better compliance (Plowden, 2009). The African-American males’ decision making process when considering prostate cancer screening is influenced greatly by cultural mores and beliefs. These cultural beliefs often lead to a lower rate of compliance to free screening versus all other races i.e. Caucasians, etc. Leisiniger’s cultural diversity theory can be used to effectively educate and increase compliance by teaching practitioners ways to overcome these cultural barriers. By following the concepts of care, caring, and understanding feelings of self, as well as the feelings of others, it is possible to overcome cultural barriers. Works Cited Cherath, Lata, et al. Prostate Cancer. The Gale Encyclopedia of Medicine. Ed. Laurie J. Fundukian. 4th ed. Vol. 5. Detroit: Gale, 2011. 3578-3584. Gale Virtual Reference Library. Web. 7 Dec. 2012. LATEST RESEARCH: Faster Prostate Cancer Growth In Black Men?. Prostate Disorders (2011): 31. Health Source Consumer Edition. Web. 7 Dec. 2012 Prostate Cancer. National Cancer Institute. SEER Cancer Statistics Review, 1975-2009 (Vintage 2009 Populations), National Cancer Institute. Bethesda, MD, n.d. Web. 7 Dec. 2012. .

Organizations Essay Example for Free

Organizations Essay An organization can be defined as a group of persons or individuals that unite to perform a common task. Each individual within an organization usually has a relatively well-defined job description, so that the group is â€Å"organized† in a way that will ensure that all tasks necessary for the completion of the goal will be covered. Organizational behavior involves applying the behavioral theory of how persons act within groups to the practice of working within organizations. It is the practical application of research done in such disciplines as psychology. The approach taken in organizational behavior is known as â€Å"systems† through which relationships are probed and defined according to the level of organization and the types of individuals that make them up. The human side of organization is directly related to organizational behavior, as it acknowledges the factors such as personality and behavior that may cause different types of managerial strategies to be employed. The personality of the manager may cause him or her to display a certain type of leadership style, while the personalities of employees may make it necessary for the manager to display a different style. Because an organization is made up of humans, it is practically impossible to separate it from the behaviors that are common to humans. Work is an important part of human life. Because people spend so much energy preparing and educating themselves for the jobs they perform, work tends to define the individual. Also, a large portion of any person’s day is spent doing the work from which they derive monetary and other resources. Therefore, work is more than just a means of earning money. It is also a method of channeling one’s creativity and can be the area in which one offers a unique gift to mankind. I, for example, take inventory for a copier company and I enjoy it because it allows the staff of the company to remain organized. My job is also necessary as it allows the managers and owners to have tangible evidence of the company’s health by gauging the speed at which the stock leaves the shelves and goes into the hands of consumers. Finally, it is a fulfilling job because I am able to make sure that customers are satisfied when all the goods they need are there on the shelves. Reference http://www.nwlink.com/~donclark/leader/leadob.html

Impact of the Internet on Developing Countries

Impact of the Internet on Developing Countries Abstract The Internet has completely changed the information management scene in developed countries. It has improved the communication systems and has developed user-friendly environments for information sharing and exchange. The benefits of the Internet in developed countries have inspired the developing countries to develop the Internet and use it to their benefit. The Internet is now changing the information practices in various sectors in developing countries. The impact of the Internet has caused developing countries to modify traditional methods of conducting information business by setting up new sources of information and new methods of communication on a global basis. The Internet has helped the developing countries to take advantage of access to global sources of information in order to improve their economic markets. In this paper we will discuss the evolution of the Internet along with the atmosphere, which initiated the growth of the Internet in developing countries. We will touch upon the constraints involved in promoting Internet growth, the models used to enhance Internet growth, the areas benefited by the Internet and the future of Internet in developing countries. We have focused our discussion on the impact of the Internet on the two most populous developing countries, India and China. Introduction In todays world where globalization is inevitable if you want to succeed, the Internet is your only respite. The Internet has revolutionized information technology and made information access across boundaries very easy. It has spread in all spheres of life and you cannot think of life without the Internet. Come to think of it, how did the Internet evolve and how did it become such an essential part of our lives? The Internet has created competition by bringing many international and indigenous information technology vendors on to the same platform and has raised the standards of quality of services. Even though the Internet has its advantages, the developing countries are facing a lot of issues in using it to achieve maximum benefits. Some concerns are related to the infrastructure costs, language and cultural barriers, political barriers and economic costs. If the issues related to the growth of the Internet can be tackled, there would be phenomenal growth in the economy of the developing countries due to the benefits of the Internet. Statement of Purpose The three major aspects involved in the overall development of a country are economic, political and social. As it is evident from the success of the Internet in developed countries, and will be clear from the examples stated in the paper, we can see that the Internet plays a very important role in all these aspects. It is evident from the extent of usage of the Internet in our daily lives that it has and will continue to change the way we live. How it has changed, and how it will continue to change our lives, is the reason for discussion on the topic of à ¢Ã¢â€š ¬Ã…“Impact of the Internet in Developing Countriesà ¢Ã¢â€š ¬Ã‚ . We are discussing the impact of the Internet specifically on developing countries because the awareness and number of users of the Internet is still growing. As compared to the number of users of the Internet, the effect of the benefits of the Internet has been phenomenal. Evolution of the Internet The idea of the Internet originated about 25 years ago at the US Defense Department Advanced research Projects Agency (ARPA), to keep track of data through computer hardware and software. The Internet is now a complex web of networks connected with high-speed links cutting across countries. There are no set boundaries for the Internet in cyberspace. Recent statistics show 50,000 networks in more than 100 countries with more than 50 million users (MIDS press release). It is estimated that the rate of growth in Internet use is around 20 per cent a month. Currently the Internet is not proprietary and is available to anyone with computer access connected to the external world. Since the USA launched the information superhighway in 1994, the Internet has come to play an ever-increasing role in the vast information market in many countries. Malaysias Prime Minister, Mahathir Mohammed, once said: à ¢Ã¢â€š ¬Ã…“It can be no accident that there is today no wealthy developed country that is information poor, and no information rich country that is poor and underdevelopedà ¢Ã¢â€š ¬Ã‚  This statement emphasizes the importance of the Internet for developing countries. From an international perspective access to and use of the Internet is unbalanced; there are obvious gaps between developed and developing countries in terms of the numbers of nets, hosts and users. Information Environment in Developing Countries China and India have the highest population among the developing countries. With the vast population, the market for the Internet in these countries is huge. Both India and China are information-rich countries with a long tradition of learning and applying their knowledge. Both countries have had phenomenal growth economically and are utilizing information technology and information management for the same. The reduction in the price of personal computers and the multimedia influx only accelerated the growth in Internet usage. For countries with vast information centers, the Internet proves to be the most valuable resource. Chinese general information systems are divided into six categories: (1) Information centers affiliated with the National Scientific and Technical Commission (2) Information centers belonging to central government ministries (3) Information centers of a provincial nature (4) Information centers of a specialized nature affiliated to regional governments (5) Information centers affiliated with state enterprises, universities and other research institutions (6) Information centers of non-governmental, regional, professional and similar bodies In India, at the national level the main sources of information include: (1) Various line ministries; (2) The Central Statistical Organization (CSO) (3) The National Sample Survey Organization (4) The Registrar-General of India (RGI) (5) The National Information Center (NIC) (6) The Center for Monitoring Indian Economy (CMIE) (7) The Federation of India Chamber of Commerce and Industries (FICCI) (8) Tata Energy Research Institution (9) The Center for Science and Environment Given such huge information centers in both countries, the public need for the Internet and its potential are vast. Areas of concern in Developing Countries Three major areas of concern about the Internet in developing countries are: (1) National information policy (2) Regulatory framework and information infrastructure (3) Proper education and training National information policy Awareness of various information sources in developing countries is limited to oral form. Awareness in print is negligible. The national information policies in developing countries concentrate on trade, international relations, national security and technology, but they barely concentrate on electronic access of information through the Internet to achieve maximum benefits. For rapid economic growth, official documents of developing countries should include high priority plans to implement electronic information delivery systems. National policy documents, like five-year plans, should contain policy statements and should be implemented on time. Sufficient funding should be available during planning and implementation phases of electronic information access models. Regulatory framework and information infrastructure Developing countries have a regulatory framework in place, which makes protection of investment, intellectual property and individual privacy compulsory in the information market. Developing countries have legal frameworks in place, which deals with private sector involvement, skilled human resources, standards and implementation. Regulatory frameworks for information do not exist. Even though information technology and telecommunications have made a way into all the markets in a developed country, in developing countries, information technology is still seen only as a means to support information management systems, finance and accounting facilities and data processing. As compared to the population numbers, the per capita penetration of computers in both India and China in the area of small office/home office (SOHO) is very insignificant. Telecommunications has also not yet picked up in India and China. If the information infrastructure were to cover the wide Indian and Chinese markets, and if technology was used for global access to information through the Internet, there would be a phenomenal economic growth in these countries. Both the countries need to urgently address the awareness of the Internet and its importance for policy makers at the political level. Proper education and training As in developed countries, workforces in developing countries are also adopting knowledge-based methodologies rather than labor intensive ones. Surveys have shown that Internet use is associated with higher education in developed countries. The same applies to developing countries. Literacy rates in developing countries needs to be improved to a great extent. The governments, central, state and local and learning institutions and civic associations should take responsibility and should work together to raise the literacy levels in developing countries. Information professionals should be trained on priority. Trained information professionals can make better use of the Internet and will be more efficient in acquiring, organizing and propagating information. Developing countries are often concerned about preserving language and culture heritage and supporting political systems. They are weary of foreign economic formats. Thus, proper trainings and seminars for information professionals is a must. These trained professionals can help educate the masses and can take advantage of the benefits of the Internet. This would help in sharing of knowledge through cyberspace and would help in increasing the value of the global information sector. The Internet will support development in the following ways: * Assess the information capacity of the country and determine the needs of users, organize and synthesize information and provide access to internal and external information * Disseminate information to meet the public needs and private sectors and the daily information needs of the general public The governments role in utilizing the Internet is very critical. It influences the appropriate use of the Internet for social and economic change in the shift from labor-intensive production to knowledge based information industries. Also, it reveals the market to a strong private information sector by defining public and private sector relationships. In order to destroy monopolies and encourage competition among international and indigenous vendors, it redefines telecommunication policies. Internet Growth in India Internet service in India started in 1994 with government being the monopoly provider. Service was costly and unreliable and by 1996 there were only 4,000 subscribers nationwide. In 1998, the ISP market was deregulated. By 2000, there were 225 ISPs (India Infoline 2001) and prices had dropped 60%. PC prices also dropped significantly owing to lowering of import duties. The subscriber base then grew rapidly, reaching 1.8 million in January 2001. E-mail and chat are the most popular applications (Natarajan 1999). E-commerce is yet to find wide acceptance but is expected to touch $2.3 billion by 2002 (Pai 2000a). PC penetration in urban middle class households has increased in recent times (Dataquest 2000; Pai 2000b), and has led to an increase in the Internet subscribers. The popularity of the Internet has also had a feedback effect on PC sales (Dataquest 2000). The demand for bandwidth outstrips supply thirty-fold (Desai 2001). As of December 2000, there were only 28 million telephone lines equal to a tele-density of 3.5/100 persons. Alternatives to analog modems, such as ISDN lines or cable modems, are limited. Regulations have also stifled Internet growth. The ban on Internet telephony and the requirement to obtain security clearance before setting up an international gateway are two examples. In short, Internet diffusion in India started very recently and is characterized by high telephone charges, limited customer acceptance of E-commerce applications, limited telecommunications infrastructure, and restrictive regulations. These characteristics are prevalent in many other developing countries as well. The VSNL, is still by far the dominant player in the ISP market, and maintains the backbones that most private firms will have to use to provide access to consumers. There is currently one Level 1 gateway owned by VNSL, as well as a Level 2, through which most private companies will have to connect. 1995/96 1996/97 1997/98 1998/99 1999/2000 2000/2001 2001/2002 States Popn CAGR (81-91) Estd Popn CAGR of Lines Actual Lines à ¢Ã¢â€š ¬Ã‹Å"000 Lines/100 Estd Lines Lines/100 Estd Lines Lines/100 Estd Lines Lines/100 Estd Lines Lines/100 Estd Lines Lines/100 Estd Lines AP 2.19 696.98 20.44 797 1.35 959 1.59 1155 1.87 1391 2.20 1675 2.60 2017 2.58 2044 Assam 1.20 227.37 21.59 107 0.56 130 0.68 158 0.81 192 0.98 233 1.17 283 1.16 284 Bihar 2.14 903.30 19.97 280 0.36 335 0.43 401 0.50 481 0.59 577 0.69 692 0.68 694 Gujarat 1.94 428.65 16.52 916 2.44 1067 2.79 1243 3.19 1448 3.64 1687 4.16 1965 4.18 2012 Haryana 2.45 174.52 21.31 295 2.00 357 2.36 433 2.80 525 3.31 636 3.91 771 3.90 786 Himachal 1.91 53.60 28.27 110 2.58 141 3.23 180 4.06 230 5.10 295 6.42 378 6.45 387 JK 2.57 82.29 13.61 53 0.71 60 0.79 68 0.87 77 0.96 87 1.05 98 1.02 98 Karnataka 1.93 466.52 20.32 784 1.98 943 2.34 1134 2.76 1364 3.26 1641 3.85 1974 3.85 2013 Kerala 1.35 307.74 22.24 681 2.67 832 3.22 1017 3.88 1243 4.68 1519 5.64 1856 5.71 1905 MP 2.41 700.25 22.47 623 1.06 762 1.27 933 1.52 1142 1.82 1398 2.17 1712 2.14 1730 Maharashtra 2.32 831.86 18.70 2425 3.38 2878 3.92 3416 4.55 4054 5.28 4812 6.12 5711 6.19 5904 Orissa 1.85 327.44 19.68 166 0.59 198 0.69 236 0.82 282 0.96 337 1.12 403 1.11 405 Punjab 1.91 210.22 25.23 571 3.34 715 4.1 895 5.03 1120 6.18 1402 7.60 1755 7.70 1813 Rajasthan 2.53 468.70 28.14 494 1.32 633 1.65 811 2.06 1039 2.57 1331 3.21 1705 3.17 1727 TN 1.44 570.17 22.01 1014 2.14 1237 2.57 1509 3.09 1841 3.72 2246 4.47 2740 4.50 2798 UP 2.30 1464.71 25.53 810 0.68 1016 0.83 1275 1.02 1600 1.25 2008 1.54 2520 1.51 2537 WB 2.23 714.44 15.56 610 0.96 704 1.09 813 1.23 939 1.39 1085 1.57 1253 1.55 1265 à ¢Ã¢â€š ¬Ã‹Å"The above table represents an extrapolation based on the s available at the end of the 1995-96 fiscal year. The s show that the penetration of phone lines is in fact growing faster than the population. In addition, the s represent only the penetration of public services, whereas the latest telecom policy calls for added investment in the private sector. Nevertheless, it is clear that the current trends in growth will not result in the planned telephony penetration into India (7% by 2005 and 15% by 2010). In addition, in many cases the s are skewed towards the urban regions within the states, and mask a poorly developed rural sector. Thus, the general indication at this juncture is that there is a clear need for dedicated infrastructure developed throughout india. The Impact of the internet in developing countries http://cse.stanford.edu/classes/cs201/projects-00-01/third-world/india-overview.html Modeling Internet Growth To get a thorough understanding of the technicalities of Internet diffusion in developing countries, we will discuss a model, which combines contagion effects and their interaction with external factors. There are a variety of methodologies available in the market to represent dynamic processes. We will be discussing the SD (Sterman 2000) model. Some of the reasons for choosing this model are listed below: * The feedback loop, which is the main structural element in an SD model, makes the model well suited for capturing the interaction among different drivers of diffusion over time * The SD model not only represents quantifiable variables, but also soft variables, which help in understanding because the diffusion context has both social as well as technical aspects * System behavior in SD models results from interaction among its feedback loops When you build an SD model, you start with the development of a causal loop graph that consists of a collection of causal links. Each of these causal links has a certain polarity. A positive (negative) link is associated with a reinforcing (balancing) relation. A positive (negative) change in the cause in this scenario leads to a positive (negative) change in the effect. Small lines intersecting causal links represent the delays in an effect. A causal loop is the result of a closed sequence of causal links and the loop polarity can be easily understood from the individual link polarities. The causal loop graph results in a mathematical model in which relationships are illustrated by means of time varying difference equations. A what-if analysis is conducted by simulating the mathematical model under different parametric and structural alternatives. The given above depicts the causal loop diagram for our diffusion model. The first of validation is the verification of each of the structural components involved. We will be discussing the foundation for the core component, followed by the selected components that capture external factors that are typical of developing countries. At the heart of the diagram lies the contagion based Internet Adoption, which helps PC owners become Internet subscribers. Innovation Coefficient and Imitation Coefficient drive Contagion in the same manner as in Bass 1969. The causal loop structure consisting of the above five variables would result in the familiar S-shaped diffusion curve, if it did not have any other structural components. The basic contagion mechanism is augmented by external factors typical of developing countries. In the above , this is accomplished by driving the contagion parameters by external factors like PC price, tele-density and the level of competition allowed by regulation. Model validation Replicating observed behavior Replicating the observed behavior is the second stage involved in validating an SD model. The given above was transformed into the corresponding difference equations and was then implemented using the iThink package. The s given below provide a comparison of the simulated and observed behavior of subscriber base and growth rates respectively, using quarterly data for India from 1996 to January 2001 (Dutta. A, Roy. R, 2001) (Dutta. A, Roy. R, 2001) Conclusions from this model The validated model offers a synthetic environment that helps us in analyzing the effect of different external factors. Loop dominance analysis (LDA) was used in SD parlance in order to analyze the external factors. A dominant loop is one, which is mainly responsible for model behavior over a particular time interval. The relevance of LDA is that it helps in identifying which loops need to be strengthened and/or weakened, through policy actions, so that we can achieve maximum desirable behavior. Two conclusions analyzed from our model, using LDA, are listed below: * Low infrastructure facility, high hourly usage costs and low geographic dispersion are dominant in the diffusion process. Regulatory policies would help in weakening these variables and therefore would dominate the future diffusion processes. * Besides the industrial countries, security concerns have not spread intensely in developing countries. One explanation for this could be that e-commerce has not yet got a hold in developing countries. Political barriers hindering the growth of the Internet The political atmosphere in India is to blame for the slow growth of both, the Internet access and the telecom infrastructure. In spite of the liberalization of Indian economy in 1991, the telecommunication sector remained in tight control of the government. This resulted in a number of problems for both, private firms as well as consumers. Even though the government has increased its interest in promoting the growth of the Internet throughout India, there is still a need for the review and/or removal of regulations still in place if we want the telecom industry to flourish. The government should rethink its current policies on telecommunications, take into account the global changes brought the about by the advent of new technology, and work to create a market environment that is favorable for investment by both local and international IT firms. Impact of the Internet on various sectors in developing countries The Internet has considerable potential in various sectors in developing countries: à ¢Ã¢â€š ¬Ã‚ ¢ Education à ¢Ã¢â€š ¬Ã‚ ¢ Banking and Finance à ¢Ã¢â€š ¬Ã‚ ¢ Business à ¢Ã¢â€š ¬Ã‚ ¢ Government à ¢Ã¢â€š ¬Ã‚ ¢ Telecommunications à ¢Ã¢â€š ¬Ã‚ ¢ Travel and Tourism We will discuss the impact of Internet on some sectors in detail. a) Impact on Education The world of education is undergoing some major changes, the most important of which is the use of the Internet in teaching and learning. Before the advent of the Internet the main sources of information for students were the teachers and the books available in the libraries. Now, thanks to the Internet, teachers are just one of the sources of information. Global access to information has widened their horizons to gain maximum knowledge. In this à ¢Ã¢â€š ¬Ã…“Information ageà ¢Ã¢â€š ¬Ã‚ , the Internet has helped involve students in active learning. They are more interested in hands-on learning, which presents them with practical, real-life experience. Studies have revealed that this style of learning results in better retention and understanding of topics. Also, learning is now not confined to the walls of the institutions. The easy and quick access to infinite resources of information has encouraged out of the box thinking. Besides these benefits, the Internet has helped in personal development of students. Social interaction over the Internet has helped students who are shy to interact and improve their communication skills. With the advent of the Internet, the concept of online exams has also evolved. It has become easier to appear for exams like GRE, GMAT, TOEFL, technical certification like SCJP etc. These exams are now conducted online, which has helped people in developing countries to enhance their knowledge. It has reduced the overheads and hassles involved in personally going to exam centers. One of the best examples would be CISCO human network which has promoted education in remote areas of almost all developing countries like India, Africa etc. by using the Internet for teaching through virtual classrooms which use video conferencing. b) Impact on Banking and Finance Around the clock banking is one of the biggest advantages of Internet use in banking. With the help of the Internet, we have remote access to the banks, which helps in transfer of money overseas with concepts like RTGS from RBI, India. It has reduced daily visits to the banks because we can get regular updates about our bank details online. Expenditure on administration services, paper, stationery etc. has been reduced which has helped in increasing the profit margins of banks besides being environment friendly. Internet has eliminated the tedious paperwork involved in banks, and has provided easy and fast access, making life much easier for bankers as well as customers. The concept of digital signatures has also picked up and it will only enhance the benefits of Internet banking. Tedious and monotonous process of dealing with brokers has been eliminated with the help of Online Trading. Demat accounts have eliminated the concept of physical shares. c) Impact on Business The Internet has provided a global source of information, which helps in developing new strategies and methodologies to enhance businesses. Even for the smallest of traders, constant updates of the prices of commodities are available online. Some companies use the Internet to build direct associations with their customers. Others are using the Internet to bring together buyers and sellers in the new tremendously efficient marketplaces. The Internet has taken the concept of e-Commerce to e-Business. The growth of the Internet has promoted inter-company trade of goods over the Internet. The best examples would be of online websites like e-Bay and other companies promoting online gifting systems. Airline industries have also benefited a lot from the Internet. Tickets can be booked online at any time of the day. d) Impact on Advertising The companies attract customers by building brand awareness and by providing market information over the Internet. This can be seen in the recent IPO (Initial Public Offerings) releases like those of Reliance Petronet. In e-business, the profits are generated not only by speeding up and automating the companys own internal processes but also by recognizing its ability to spread the efficiency benefits to the business systems of its suppliers and customers. The capability to team up with others may be just as much of a competitive advantage as the ability to deploy the technology. e) Impact on e-Governance With the growth of the Internet, people have realized that the use of information and communication technology to provide and improve the government services can be highly beneficial. Using the Internet for e-Governance is a convenient and cost effective method to provide people access to current information. Internet can promote greater citizen participation in the nations capital. It will encourage people all over the country to interact with politicians to make their voices heard so that the political situation can improve and the countries can progress. E-Governance would make the political system more efficient, provide improved services, better accessibility of public services and would make the processes more transparent and accountable. Nowadays, online counseling for entrance exams has reduced the overhead for the government institutions. Developing countries are now using the Internet to manage the biggest networks like railways. All travelling transactions can now be done online on websites like www.irctc.co.in (India). f) Impact on Telecommunications Internet has helped the developing countries in reducing the national as well as international call rates. The BRIC (Brazil, Russia, India and China) nations have all taken up the concept of VOIP (Voi

Essay --

Mobile computing has been a is part of the enterprise for the last couple of decades, but not until the recent advancements in hardware, software, and wireless networks, has mobile computing has become a key part of enterprise. The cConsumerization of mobility has had the biggest influence on enterprise mobility in the past five years. SToday, smart phones, tablets, mobile infrastructure, management, and wireless data plans have become a trillion-dollar business. Today, the ability to connect wirelessly to the internet Internet or to a private network from almost anywhere has revolutionized the idea of mobility in the enterprise. The adoption of mobile devices in the enterprise has been started from with two-way radios with antennas to communicate simple voice or text messages. We have also saween the onset of personal digital assistants (PDAs) with screens that can could do some of the functions of personal computers. 1.1 Portable Computing Some of the first mobile computers that came to the market in late 1970s and early 1980s were inspired by Alan Kay’s Dynabook concept from 1968. In 1968, Alan Kay as a PhD candidate envisioned a mobile computing device. He later in his 1972 proposal (Kay 1972) "â€Å"A personal Personal Ccomputer for Cchildren of Aall agesAges" † (Kay 1972) described it as the Dynabook. The proposal outlines the requirements for a conceptual portable educational device that’s intended primarily for children. Although the Dynabook concept was originally presented as a mobile computing device for children, some entrepreneurs and thought- leaders, especially John Ellenby, saw the portable computing as a new market. John also realized that the initial price point for as innovative a concept as the Dynabook c... ...rs. Wireless connectivity probably had the biggest impact on mobile computing. It, Wireless connectivity allowed development of devices and applications that could communicate wirelessly with networks. The next era of innovations were focused on convergence. T, this helped in the designing of a hybrid device that combined the functionality of used to be multiple separate mobile devices. Multiple digital mobile devices, such as like Personal Digital Assistants (PDAs), mobile phones, voice recorders, music players, cameras, and games, etc.,were now integrated into one integrated mobile device. The era of smart phones was focused on content rendering and consumption on mobile devices. Mobile apps becaome popular among smart phone users. To create more interactive and meaningful digital experiences, digital ecosystems and mobile data services came into existence.

Prozac :: essays research papers

Prozac Classification   Ã‚  Ã‚  Ã‚  Ã‚  Fluoxetine is a legal prescribed medication (Fluoxetine, 2000). The brand name of this drug is Prozac (Fluoxetine, 2000). Fluoxetine belongs in a category of drugs called selective serotonin prescription (PDR, 2000). This is a synthetic drug (Fluoxetine, 2000).reuptake inhibitors (SSRIs) (PDR, 2000). Prozac is not a controlled substance but needs a Usage   Ã‚  Ã‚  Ã‚  Ã‚  Prozac is used as an antidepressant, antiobsessional and antibulimic medication (Fluoxetine, 2000). Prozac is presumed to inhibit the reuptake of serotonin (Fluoxetine, 2000). In patients with depression it relieves symptoms of the illness (Fluoxetine, 2000). For those with bulimia nervosa Prozac was shown to decrease binge eating and purging when compared to a placebo (Fluoxetine, 2000). In obsessive-compulsive disorder it significantly reduces the symptoms (Fluoxetine, 2000). Usage: Epidemiology   Ã‚  Ã‚  Ã‚  Ã‚  The use of Prozac is so wide spread that since its release over ten years ago thirty-five million have been prescribed world wide in over one hundred different countries (PDR, 2000). Over seventeen million patients have been prescribed Prozac in the United States alone (PDR, 2000). Prozac is the worlds most prescribed antidepressant (PDR, 2000). Warnings   Ã‚  Ã‚  Ã‚  Ã‚  Allergic reactions have been noted in some patients; these include: rash, fever, edema, and carpal tunnel syndrome (Fluoxetine, 2000). If these reactions persist and no other cause can be found treatment with Prozac should be discontinued (Fluoxetine, 2000). Precautions   Ã‚  Ã‚  Ã‚  Ã‚  During the clinical trials anxiety and nervousness were reported by ten to fifteen percent of patients (Fluoxetine, 2000). Persons already underweight and depressed showed significant weight loss when on Prozac (Fluoxetine, 2000). Prozac should be used with caution in patients with convulsive disorders (Flouxinte, 2000). The possibility of suicide is greater in those patients who are depressed; therefore Prozac should be administer with supervision to these patients (Fluoxetine, 2000). This medication should be only given to patients with anorexia nervosa if the benefits outweigh the risks (Fluoxetine, 2000). Prozac became the worlds most prescribed antidepressant herald of its â€Å"transformative powers† (Cash, Brown, 2000). Among side effects are appetite reduction and weight loss (Cash, Brown, 2000). In a study of college age women the knowledge of prozacs weight loss properties increased the likelihood of a woman deciding to try the drug (Cash, Brown, 2000). The women said they would choose Prozac regardless of the side effects if one of the main effects was weight loss (Cash, Brown, 2000). Women’s perceived notions about being thin outweighed their concerns about the possible negative side effects of Prozac (Cash, Brown, 2000). Patients with diabetes may have altered glycemic rates while on this medication (Fluoxetine, 2000). I have found conflicting reports on the use of Prozac and the pregnant woman. I will give them both consideration in this report. Prozac :: essays research papers Prozac Classification   Ã‚  Ã‚  Ã‚  Ã‚  Fluoxetine is a legal prescribed medication (Fluoxetine, 2000). The brand name of this drug is Prozac (Fluoxetine, 2000). Fluoxetine belongs in a category of drugs called selective serotonin prescription (PDR, 2000). This is a synthetic drug (Fluoxetine, 2000).reuptake inhibitors (SSRIs) (PDR, 2000). Prozac is not a controlled substance but needs a Usage   Ã‚  Ã‚  Ã‚  Ã‚  Prozac is used as an antidepressant, antiobsessional and antibulimic medication (Fluoxetine, 2000). Prozac is presumed to inhibit the reuptake of serotonin (Fluoxetine, 2000). In patients with depression it relieves symptoms of the illness (Fluoxetine, 2000). For those with bulimia nervosa Prozac was shown to decrease binge eating and purging when compared to a placebo (Fluoxetine, 2000). In obsessive-compulsive disorder it significantly reduces the symptoms (Fluoxetine, 2000). Usage: Epidemiology   Ã‚  Ã‚  Ã‚  Ã‚  The use of Prozac is so wide spread that since its release over ten years ago thirty-five million have been prescribed world wide in over one hundred different countries (PDR, 2000). Over seventeen million patients have been prescribed Prozac in the United States alone (PDR, 2000). Prozac is the worlds most prescribed antidepressant (PDR, 2000). Warnings   Ã‚  Ã‚  Ã‚  Ã‚  Allergic reactions have been noted in some patients; these include: rash, fever, edema, and carpal tunnel syndrome (Fluoxetine, 2000). If these reactions persist and no other cause can be found treatment with Prozac should be discontinued (Fluoxetine, 2000). Precautions   Ã‚  Ã‚  Ã‚  Ã‚  During the clinical trials anxiety and nervousness were reported by ten to fifteen percent of patients (Fluoxetine, 2000). Persons already underweight and depressed showed significant weight loss when on Prozac (Fluoxetine, 2000). Prozac should be used with caution in patients with convulsive disorders (Flouxinte, 2000). The possibility of suicide is greater in those patients who are depressed; therefore Prozac should be administer with supervision to these patients (Fluoxetine, 2000). This medication should be only given to patients with anorexia nervosa if the benefits outweigh the risks (Fluoxetine, 2000). Prozac became the worlds most prescribed antidepressant herald of its â€Å"transformative powers† (Cash, Brown, 2000). Among side effects are appetite reduction and weight loss (Cash, Brown, 2000). In a study of college age women the knowledge of prozacs weight loss properties increased the likelihood of a woman deciding to try the drug (Cash, Brown, 2000). The women said they would choose Prozac regardless of the side effects if one of the main effects was weight loss (Cash, Brown, 2000). Women’s perceived notions about being thin outweighed their concerns about the possible negative side effects of Prozac (Cash, Brown, 2000). Patients with diabetes may have altered glycemic rates while on this medication (Fluoxetine, 2000). I have found conflicting reports on the use of Prozac and the pregnant woman. I will give them both consideration in this report.

Weight Loss and a Well Balanced Diet Essay -- Health Nutrition Diet Ex

Weight Loss and a Well Balanced Diet When choosing a diet, more than just weight loss should be considered. In addition, other health factors should be looked at as well. The Atkins diet, being a low carbohydrate diet, does not take into account factors other than weight loss and puts participating subjects at risk for long and short-term health problems. In contrast, the most healthy and effective way of losing weight is to reduce fat and simple carbohydrate intake. Instead, a healthful diet should consist of complex carbohydrates, and good proteins, to include fruits, whole grains, vegetables, and legumes. By eating these foods that are low in fat and simple carbohydrates, weight loss, healthy circulation, and overall health can be achieved. Diets consisting of a balance between complex carbohydrates and good proteins bring the best results in weight loss, despite a slower result than low carbohydrate diets such as the Atkins diet. Weight loss is accomplished by burning more calories than one consumes. With regards to calories, there are two approaches between the two diets being examined that lead to weight loss. The logic behind the Atkins diet is that by eating fewer carbohydrates, insulin levels remain at a steadier degree and cravings are subsided, thereby causing people to consume fewer calories and in turn lose weight. Despite the loss in weight however, the substitutes for these simple carbohydrates recommended by the Atkins diet are high fat, high protein foods such as butter, cheese, and meats. These foods although when eaten exclusively can lead to weight loss, there are other health problems associated with this method of dieting. An alternative to substituting simple carbohydrates with high ... ... foods are encouraged. In addition to these very serious, life-threatening diseases, a study, funded by the Atkins Center for Complimentary Medicine was conducted that showed constipation in 70% of the people on the Atkins diet, headaches in 54%, and hair loss in 10% of the subjects. These health problems are due to the lack of nutrients and balance in the Atkins diet. In contrast, a diet low in fat and high in complex carbohydrates provides fiber to help with healthy digestion, and other nutrients to promote healthy growth in all areas. There is more to dieting than losing weight. Diets such as the Atkins diet that is high in fat and protein may drop poundage, but ultimately lessen one’s health. Whereas by practicing a low fat, high complex carbohydrate diet, more balance is achieved nutritionally, which leads to long-term health advantages.

Periodic Performance Review Essay

DEFINITION: A periodic performance review (PPR) is a self-assessment of standards all of which are applicable to a health care organization. The Joint Commission of Healthcare Organization conducts triennial surveys of health care organizations. The PPR involves an annual assessment of an organization’s performance. The PPR show the organizations performance in relationship to the standards set forth by the Joint Commission. The standards are measured by elements of performance. Some elements of performance require a simple response of yes or no while others require multiple possible responses (e.g., compliant, partial, and noncompliant). The PPR helps determines and organizations readiness for an accreditation audit PURPOSE OF PERIODIC PERFORMANCE REVIEW An integral component in the Joint Commissions accreditation process, PPR promotes continuous standard compliance through ongoing internal monitoring. Beginning in January 2006, the Joint Commission expects organizations to conduct annual self-assessment against applicable Joint Commission standards, develop plans of action to address identified areas of non-compliance and identify measures of success in the identified problem areas to validate resolution. At the mid-cycle point, the organization is expected to share information with the Joint Commission. The staff at the Joint Commission will work with the organization to refine its plan of action to assure that the corrective efforts are on target. To address concerns about the potential discoverability of PPR information, particularly where it is shared with the Joint Commission, the Joint Commission has established three options to the full PPR, for accredited-health care organizations: Option One: The organization performs the full self-assessment, develops the plan of action and measures of success (MOS), but does not submit PPR data to the Joint Commission. At the time of the complete on-site survey, the organization provides its MOS to  the Joint Commission surveyor team for assessment. Option Two: The organization remains accountable for conducting a full self-assessment and developing plans of action and applicable MOS, but does not submit PPR data to the Joint Commission. The organization undergoes an on-site survey, which will be approximately one-third the length of a typical full on-site survey. The organization receives a report of the survey activities. Option Three: The organization remains accountable for conducting a full self-assessment and developing plans of action and applicable MOS, but does not submit PPR data to the Joint Commission. The organization undergoes an on-site survey, as in Option Two, but no written documentation or written report of the survey is provided to the organization. Nightingale Community Hospital is completing a PPR to assess the readiness of the hospital for an upcoming accreditation by the Joint Commission. This analysis will include: 1. The current compliance status of the hospital. 2. Trends evident in the case study that may cause the organization to not be in compliance with regards of patient care as set forth by the Joint Commission. 3. A review of staffing of the hospital’s patient care unit with regards of the performance improvement standard by doing the following: a. An analysis of the data to determine the staffing patterns of the patient care unit. b. A plan to develop a staffing plan to minimize the number of falls in the patient care unit. CURRENT COMPLIANCE STATUS In reviewing the data of Nightingale Community hospital, there are a number of compliance standards the hospital will need to address to remain in compliance with the Joint Commission standards which fall into several broad accreditation functions 1) Environmental Care – the environment of care is made up of several areas in terms of patient care including the he building or space, including how it is arranged and the special features that protect patients, visitors, and staff, equipment used to support patient care or to safely operate the building or space, and people, including those who work within the hospital, patients, and anyone else who  enters the environment, all of whom have a role in minimizing risks. The self-assessment noted deficiencies with interim life safety measures (ILSM) which refers to the health and safety measures that are put in place to protect the safety of patients, visitors, and staff who work in the hospital. Environmental factors that include signs and pathways to an egress point, fire protection systems including smoke detectors (specifically noted in the self-assessment), fire suppression, fire extinguishers and fire alarm systems, smoke barriers, emergency evacuation plans, in additi on to many other items that contribute to the well-being and safety of occupants in the hospital or healthcare facility. 2) Nursing leadership – this specific deficiency noted out of compliance showed inconsistencies in nurses documentation and timeliness which affected morale 3) Record of Care – this compliance standard refers to all the data and information gathered about a patient from the moment he or she enters the hospital to the moment of discharge or transfer. The particular deficiency noted is verbal orders are not authenticated within 48 hours. This particular problem is noted under on several floors within the hospital 4) Life Safety – A particularly critical standard in terms of patient care that is crucial in terms of patient and staff safety. The self-assessment noted clutter in hallways and carts in the hallways as noted in the observations during the PPR rounds. 5) Information Management – this patient care standards refers to the whether the hospital has a written policy regarding the privacy, security and integrity of health information. The deficiency noted prohibited abbreviations found in nursing notes and or physician orders as noted in the chart review conducted the PPR rounds 6) Medication Management – this is an important component in palliative treatment of many diseases and conditions. To minimize harm, the hospital needs to develop an effective and safe medication system. The hospital deficiencies with this standard was noted in the staff interviews where it was shown nurses did not follow range order policy or could explain how this is executed. It was also noted the syringes were found unlabeled in the OR and Cath labs. 7) Provision of Care, Treatment and Services (PC) – these standards revolves around assessing patient needs and planning, providing and coordinating treatment and services. Several deficiencies noted in audit included day of procedure reassessment inconsistencies and absence of documented plan of  anesthesia 8) Universal Protocol – Hospitals are charged with developing guidelines for the implementation of the universal protocol for the prevention of wrong site, wrong procedure and wrong person surgery. There were several sentinel events noted in the self-assessment which appear to demonstrate an absence of a guideline for this crucial standard. A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. These events included lung biopsy side unmarked and a knee arthroscopy site not marked. 9) National Patient Safety Goals – The National Patient Safety Goals (NPSGs) have become a critical method by which the Joint Commission promotes and enforces major changes in patient safety in thousands of participating health care organizations around the world. The criteria used for determining the value of these goals, and required revisions to them, are based on the merit of their impact, cost, and effectiveness. Two findings noted in the observation during the PPR included unlabeled basins and pre-labeled syringes. 10) Medical Staff – The organized medical staff and the governing body collaborate in a well-functioning relationship, reflecting clearly recognized roles, responsibilities, and accountabilities, to enhance the quality and safety of care, treatment, and services provided to patients. This collaborative relationship is critical to providing safe, high quality care in the hospital. To meet this standard and to remain in compliance, the Joint Commission (JCAHO) requires accredited hospitals to examine and evaluate performance data for all practitioners with privileges on an ongoing basis as part of their Ongoing Professional Practice Evaluation (OPPE) initiative. It was noted in the interviews with the medical staff the OPPE process does not meet standards. CURRENT TRENDS IMPACTING COMPLIANCE In preparation for the audit, the self-assessment analysis included a review of current trends that may cause the organization to not be in compliance. Several major trends noted in the case study include Fire Drill History ( Environment of Care) – the data shows that the fire drills were not routinely performed in Nightingale Community Hospital that requires one drill per shift per quarter. There was an average of three drills per quarter with no consistent methodology for conducting the drills per shift  or floor. This environment of care standards observation as noted above in the previous section indicated smoke wall penetrations which could have been discovered in there were routine fire drills. Moderate Sedation Monthly Audit (Provision of Care, Treatment and Services) – Moderate sedation provides a minimally reduced level of consciousness in which the patient retains the ability to independently and continuously maintain an airway and respond appropriately to p hysical stimulation or verbal command. The data showed in the Endoscopy Department a lack of pre-sedation ASA (American Society of Anesthesiology) and no documentation plan of anesthesia noted in endoscopy. The data shows that in pre-procedure, during procedure, and post-procedure no documentation was consistently recorded. The trends show the first quarter had a high of 100% and low of 75% and a fourth quarter high of 100% and low 79%. Pain Assessment Audit (Provision of Care, Treatment and Services) – Pain assessment is diagnostic tool to measure the pain level of a patient before administration of a medication and following administration. The goal is assess the patient’s pain relief and thus the effectiveness of the therapy. The data shows that pain assessment and reassessment is consistently missing in the Emergency Department(ED). The data shows a trend of this occurring with a range of 65% to 82%. The data shows the other departments listed have a higher a level of compliance. 3E shows a range of 90% to 97%, whereas the Post-anesthesia care unit (PACU) shows a higher range of 95% to 99%. PI (Patient Injury) Data Falls 4E (Life Safety) – Falls in 4E were highly prevalent. The target goal for falls with injury is 0.62 per 1000 patient days. Several months (January, February, April, July, and November) experienced 0 falls. In contrast, the other months experienced rates varying from 1.72 to 5.6. Data suggest trends show a marked increase over the last 7 months as compared to the first five months of the year that the data was collected. The target goal for all falls is set at 3.21. This number was achieved in five months, with 2 months (January and August) experiencing 0 falls. The data for falls overall in 4E appears to conflict with the data shown for fall with injury. The data shows no falls for the month of August, however, August also reports 4.5 falls with injury. Also, the month of October shows 4.1 total falls vs. 4.37 falls with injury. This brings to mind the reporting of the data, which has to be in error. PI (Patient Injury) Data falls For the Entire Hospital (Life  Safety) – Overall, the hospitals falls and falls with injury are lower than that of 4E. That being said, trends show there is a rise in both categories over the course of the year. In total falls there were peak months in March and September showing 5.1 and 4.9 respectively. In falls with injury, three month April thru June showed no injury related falls. Overall, the falls with injury are below the target as a mean total for the year. That being said, data clearly shows a trend towards increase of falls with injury. Prohibited Abbreviations (Information Management) – The Joint Commission has sent forth a list of prohibited abbreviations that should not be used by healthcare organizations. This list includes but is not limited to medical terminology, disease states, units of measurement, and drug dosage forms. The use of abbreviations can lead to a misinterpretation of meaning which could use lead to an adverse event. The audit monitored the abbreviations â€Å"cc† and â€Å"qd† because they are the most frequently used prohibited abbreviations. Cubic centimeters are a measurement of volume and are abbreviated†cc†. It is the cubic amount required to hold 1 milliliter of water. If poorly written it can be misread as â€Å"U† for units, ml should be used instead of cc. The term qd† means once daily. However, it is often misinterpreted for â€Å"qid† which means four times daily or â€Å"qod† which means every other day. The word daily should be written out. Aggregate data for the audit included the ICU, Telemetry and floors 3E and 4E. These abbreviations should never be used. The data suggest a high prevalence of the u se of these abbreviations. The abbreviation â€Å"cc† was used far more frequently than â€Å"qd†. The monthly range for its use was 20 to 47 times monthly according to the data. By contrast the monthly range for the abbreviation â€Å"qd† was 10 to 25. The data suggest a steady trend in the use of prohibited abbreviations. Staffing Effectiveness (Nursing Leadership) – Effective staffing by definition is the competency, number, and skill set of staff in its relation to patient care and treatment. The data used by the hospital to measure effectiveness utilizes key indicators from clinical/service screenings and human resource screenings. This data is then analyzed to look at ways to access and improve staff effectiveness on a continuous basis. Clinical indicators include patient falls, patent falls with injuries, ulcer prevalence, and ventilator associated pneumonia (VAP). Human resource indicators include nursing care hours and overtime. The  care areas associated with this data were ICU (intensive care unit), 3E and 4E. The data suggests no trends in relationship to nursing hours and falls and nosocomial ulcers in 3E. In ICU, data shows a decrease in falls from previous year from 4.1 to 1.9 per 1000 patients. Of the 1.9, which represents seven falls, five occurred in the first quarter of FY09. VAP increased from 2.2 per 1000 ventilator days to 3.0 for current year. Trends show a decrease in falls however an increase in VAP. Trends also show a decrease in nursing care hours. In 4E, there was an increase in patient falls and nosocomial pressure ulcers. Falls increased to 4.37 per 1000 patient days as compared to 1.47 per 1000 the previous year. Trends shows there appears to be relationship with falls and nursing care hours which shows an increase. There was also a slight increase in nosocomial ulcers during the period which appears to be a relational trend. Verbal Orders Authenticated Within 48 Hours (Record of Care) – Data indicates a trend showing a decrease in verbal order authentication during the year collected. Quarterly averages show: Q1-84%, Q2-87%, Q3-73%, and Q4-81%. The first half year average is 85.5% as compared to second half year average of 77%. PERFORMANCE IMPROVEMENT STANDARD: STAFFING A) STAFFING PATTERNS – DATA In analyzing the data, 3E (Oncology) maintained a relative consistent range of hours in nursing care over the course of the year. Peak nursing hours were used in the month of October which corresponded with the lowest amount of fall prevalence. However, the second month with the highest amount of nursing care hours had the highest amount of fall prevalence. There is also a linear trend showing an increase in falls over the course of the year. Data shows a decrease in nosocomial ulcers over the same time period. Prevention of falls and nosocomial ulcers are a focus point of this unit due to patient population. Several staff members attended the NICHE program. The name stands for Nurses Improving Care for Health system Elders and is designed to improve recognition of age-related changes and increase nurses’ sensitivity. Nursing staff members who attended program shared knowledge with their colleagues and changes were implemented to improve patient care and outcomes. Changes included nurses prompting patients every two hours to  void while awake to decrease urgency which could lead to falling or incontinence which could lead to pressure ulcers. The unit’s nosocomial ulcers decreased from 2.76% in FY08 to 1.23% in FY09. The units’ year end falls average was 5.45 compared to previous years 5.57. The linear trend which shows an increase in falls over the course of the most current year indicates that more training is needed. 4E experienced an increase in nosocomial ulcers and falls during the past year. The relational trend in nursing hours shows an increase through the year. The trend towards ulcers also shows an increase in through the year. However, the peak month for nosocomial ulcers shows occurred during the month that the third fewest nursing hours were used. This does not indicate a relational trend. The number of falls in 4E increased sharply in the year compared with the previous year. The current year showed an increase average to 4.37 as compared to the previous year’s average of 1.47. The peak month occurred in December showing an ever increasing trend. The nursing hours increased over the course of year. Data appears to suggest a relational trend with nursing care hours and patient falls. ICU showed an increase in falls from 1.9 from the previous year’s average of 0.41. Five of the seven falls that occurred happened in the first quarter of FY09. There appears to be no correlation between nursing care hours and patient falls. VAP (ventilator associated pneumonia) increased from 2.2 per 1000 ventilator days to 3.0. This number indicates two infections versus one infection during the respective fiscal years. There appears to be no relational correlation with VAP and nursing hours. Due to the increase in VAP, the following actions were implemented that included: * VAP bundle implementation including sedation vacation * Mouth care protocol * Daily rounds with the intensivist B) STAFFING PLAN – MINIMIZE FALLS Based on the data, an initial conclusion can be drawn the number of falls decreased in 3E based on nursing staff after attending the NICHE Program and sharing information learned with colleagues the increase of falls prevalence through the year suggests more training is necessary. The other units could also benefit from more training conducted on a monthly basis with the  desired outcome to reinforce policy and to impact future accreditation reviews. Inpatient working conditions have deteriorated in some facilities because hospitals have not kept up with the rising demand for nurses. This situation has motivated some state legislatures to enact or consider regulatory measures to assure adequate staffing. These regulatory measures assign some minimum level of staffing that all hospitals must meet regardless of the types and severity of patients. The number of nurses is not always a mitigating factor in the reduction of patient falls. However, there are a number of variables which should be factored in reviewing the falls such as fatigue from mandatory overtime with patient care and time consuming but necessary administrative tasks such updating patient records and documenting physician and other medical orders etc. Model Staffing Patterns — In researching, various staffing models several require acute care hospitals maintain minimum nurse-to-patient staffing ratios. Required ratios vary by unit, ranging from 1:1 in operating rooms to 1:6 on psychiatric units. Most state legislation also requires that hospitals maintain a patient acuity classification system to guide additional staffing when necessary, assign certain nursing functions only to licensed registered nurses, determine the competency of and provide appropriate orientation to nurses before assigning them to patient care, and keep records of staffing levels. The Joint Commission recommends all nursing units be supervised by a registered nurse. Nursing Staffing Plan Based on Type of Care — Another factor for consideration is the knowledge, skills and ability of the individual nurse. The safety and quality of patient care is directly related to the size and experience of the nursing workforce, Such as thoroughness in documentation, following protocol, and work pace. A comprehensive staffing pattern will have to take this into account in terms of reviewing the effectiveness of the individual nurses to reduce the occurrence of incidents. The chief nurse must monitor the performance of the nursing staff on a continuing and ongoing basis.