Wednesday, October 30, 2019
Reasons for Not Closing Guantanamo Research Paper
Reasons for Not Closing Guantanamo - Research Paper Example The research paper "Reasons for Not Closing Guantanamo" explores the reasons why the Guantanamo Bay detention facility has not managed to close. There have been numerous efforts to close Guantanamo Bay detention facility during Obamaââ¬â¢s term as president. Previously, when the President issued the Executive Order for the closure of the facility, the engaged Congress opposed him, hence restricting the delivery of his earlier pledge. There are various problems facing Guantanamo Bay, and even when shut down, more legal, social, and economic challenges would arise if proper measures are not put in place. Besides the Congress, several legislatures have factored into the logistical problems, by acting to withhold funds meant to aid in closure of Guantanamo detention camp. For quite a while, the Congress has repetitively voted against the closure of the facility and included provisions that would prevent the use of appropriated funds for any actions aiding in its closure. The detainees in the detention facility have been categorized into 3 groups; those under preventive detention meant to stop them from returning to the battlefield, those under preventive detention and still expected to appear before the military or other tribunal for criminal charges, and those cleared for transfer or release to other foreign nations, after contentment that they pose no security threat or did not engage in any hostilities. Moving the detainees as the last category infers, requires funds to relocate the detainees into other countries. In 2010, after Obamaââ¬â¢s Order, the Congress passed a legislation (Defense Authorization Bill), blocking the department of defense from spending any finances in relocation of Guantanamo prisoners from the US for any reason (Landers, 2010). Therefore, any acts of reducing the populating in the facility in line with its closure have failed. On a further opposition, the Congress made it certain that the detainees required to be in the facility and hence restricted the action of building another facility in the mainland United States. Despite the Administrationââ¬â¢s clear opposition of section 413, the Congress prohibited the utilization of funds to construct, upgrade or renovate, and expand the US correctional facility in order to house individuals held in the Guantanamo detention facility (Executive Office of the President, 2013). Through the ban, the congress made it clear that not even other US prison facilities would be spared. None would receive financial support to aid in extra housing of the detainees that would be transferred from Guantanamo, which included the expansion activities or operating costs in maintenance of the detainees. Apparently, it is evident that the congress has consistently been usin g its spending oversight authority to control government funds from acquisition by an Illinois state prison (as a detention facility of one category for Guantanamo detainees), financing trials or even of the
Monday, October 28, 2019
Case Analysis for Nursing Ethics Paper Essay Example for Free
Case Analysis for Nursing Ethics Paper Essay Overview A forty-eight year old female patient was brought into the emergency department with petechiae/purpura distributed over her skin. Her husband reported that she started to bleed from her nostrils and mouth. She suddenly appeared to have had what seemed to be unexplained bruises on her body and was semi comatose. In a state of panic, her husband brought her to the emergency department. With a heart rate of 180, her blood pressure was 60/24 and she was going into endotoxic shock. She received emergency care that made her stable enough to be transferred to the ICU where she became conscious and able to communicate. The medical team explained the seriousness of her condition and their plans for her treatment but she declined their proposal for further care and complained about inadequate insurance coverage for that hospital. She further professed her faith in God for divine healing. The medical team was then faced with offering this patient treatment regardless of her ability to pay to avoid the imminent danger of her leaving the hospital at that time. Medical Indications This forty eight year old female patient, who had no medical history in this hospital was diagnosed with Disseminated Intravascular Coagulation (DIC). DIC is a rare, life-threatening condition that prevents normal blood clotting in an individual. A treatment refusal or decline may hasten the disease process resulting in excessive clotting (thrombosis) or bleeding (hemorrhage) throughout the body leading to shock, organ failure or even death. Prognosis varies depending on the underlying disorder and the extent of clotting. Regardless of the cause, the prognosis is often poor, with 10-50% of patients dying. The goal of treatment is to stop bleeding and prevent death. According to WebMD (2007), in DIC, the bodyââ¬â¢s natural ability to regulate clotting does not function properly. This causes the platelets to clump and clog small blood vessels throughout the body. This excessive clotting damages organs, destroys blood cells, and depletes the supply of platelets and other clotting factors so that the blood is no longer able to clot normally. This often causes widespread bleeding, both internally and externally, a condition that can be reversed if treatment is carried outà promptly. Current indication for treatment include interventions such as transfusion of blood cells and other blood products to replace what has been lost through bleeding. Numerous tests to establish the probable cause of this condition have to be done because it is usually a first symptom of a disease such as cancer or it could be triggered by another major health problem. Patient Preferences The patient is informed of the benefits of follow up interventions after emergency care as well as the likelihood of losing functions of major organs and even death without following interventions being implemented. The principle of autonomy comes to play since it is her right to choose where, when and how she gets her health care. Based on the medical report and her personal reasons for deciding to leave the hospital against medical advice, there seems to be no evidence that she is mentally incapable. There is also no justification in disregarding her requests nevertheless, it is doubtful if she actually understands and appreciates the situation. Her preferences were to be signed AMA (against medical advice) so she can find cheaper, alternative care. Her husband, who was present with her, tried to convince her to accept the teamsââ¬â¢ proposal but she insisted that she could not afford it. In my opinion, the patient decision was as a result of her ignorance of what choices was av ailable to her. Quality of life The quality of life for this patient is severely compromised because of the symptoms associated with this diagnosis (bleeding, syncope, weakness, shortness of breath, etc). As stated earlier, DIC could be as a result of an underlying disease such as cancer. If so, chemotherapy and radiation could help alleviate symptoms and give her a vibrant life expectancy. Also, there is the possibility that she would experience tremendous medical progress with treatment if her diagnosis has to do with platelet malfunction. However, we cannot tell, since she turned down any advice by the team to carry out blood tests. Without immediate treatment, she runs the risk of damage to major organs of her body, which could eventually lead to death. Time is of essence here because the longer she delays intervention, the more likely she has irrevocable damage that might negatively alter her previousà quality of life. Ethical issues that would arise with this patient is the emergency care she got, it got her stable enough to where she could refuse treatment. An assumption that we could make about receiving that care is, ââ¬Ëwhat if she got into a DIC coma and had to be on a ventilator?ââ¬â¢. She would have been unconscious and would probably not be able to debate whether she receives care or not. Contextual features Without casting aspersions, the reason, obvious to me, for refusal of care is financial. The patient talked about shopping for cheaper healthcare. This is a patient born to American missionaries in Brazil. As an American citizen, she took up the calling of her parents and was also a missonary in Brazil for most of her life. She married a man from England who is unaware of how the American system works. Her reason is justified because she probably had little to no social security and with her sojourn in Brazil, we can say that she has been accultured. Therefore her outlook and way of thinking would affect her decision about healthcare in America. Another contextual feature is that of religion and faith, the patient said that her faith in God would heal her but failed to see that this might be why she was at the hospital at that time. It is difficult to attribute her decision solely to faith or finance alone but one thing that stands out is the fact her husband tried to convince her otherwise. Still, she kept saying this was what she wanted. Her husband seemed helpless as he tried to communicate with the team however the patient kept saying that this was about her not him. My patientââ¬â¢s lack of insurance, her job as a missionary and her inability to pay acts as a bias that would prejudice the providersââ¬â¢ evaluation of her quality of life. Analysis The goal of medicine involves promoting health, curing disease, optimizing quality of life, preventing untimely death, improving function (maleficence), educating and counseling, avoiding harm (non-maleficence) and assisting in a peaceful death. The ethical dilemma is deciding to let her go based on her wishes (autonomy) versus doing what seems to be the overall right thing (paternalism), which is giving her treatment (beneficence), thus preventing harm (non-maleficence). The maleficent nature of medicine propels the team to convince the patient of what they think would restore herà health. In a bid to ââ¬Ëdo good(maleficence), she got emergency care that made her stable enough to communicate and state her wishes. Apart from maleficence and non-maleficence there are multiple ethical issues embedded in this case; the medical team is faced with honoring this patientââ¬â¢s autonomy and letting her go when they know she could be dead in a few hours without treatment. Nevertheless the patient is exercising her autonomy at her own detriment because she and her husband got adequate disclosure communicated clearly by the healthcare team about the reasons for treatment and the benefits burdens related to her decision. The teamââ¬â¢s scope of disclosure covered her current medical state, the possible interventions to improve prognosis and their recommendation based on clinical judgement. In addition, they are faced with medically determining her decisional capacity because of the possibility that her mental state might be affected by the pathology and her inability to afford care. If proven to be incompetent, then interventions are carried out regardless of what she wants. Hence, the medical team will deliberately override this patientââ¬â¢s autonomy because of their perceived notion of beneficence (paternalism). As medical practitioners, the team weighs the consequence (utilitarianism) of letting her go. To them, the action that would produce the best overall result is to go ahead and give her treatment. The ethical theory of deontology gives the team, the moral duty and obligation to do good and prevent harm. Compassion and sympathy (Ethics of care) also play a big role here, consider a patient who had committed her life to helping others, yet in her time of need could not get reciprocity. These emotions should play a major role in how the team decides to proceed. The nurse involved with this patient has an obligation to get to know this patient so that she can effectively advocate for her. Inasmuch as I know she has the right to refuse treatment, I strongly believe that her refusal is based on the insubstantiality of information and her lack of knowledge of what is accessible to her. Recommendation I recommend that the patientââ¬â¢s autonomy be empowered not overpowered by giving her information on what is available to her. An advocate (her nurse, case manager or social worker) should be assigned to her. In addition, the Chaplain should be invited to offer spiritual counseling. Asking the right questions, getting to understand her fears and giving her hope. Manyà hospitals and clinics have patient navigators that can help determine financial aid for patients who cannot afford care or who do not have Medicaid/insurance. The team should encourage the patient that at this point money is of no consequence, her life and health come first in other words everything will be done to get her aid. I also recommend that the team critically asseses the decision-making capacity of the patient since it determines whether a patientââ¬â¢s health care decisions will be sought and accepted. Furthermore the patient should also be educated on and encouraged to put in place advanced directives to promote her autonomy and avoid a situation where there is no one to decide in case she is incapacitated. Justification In my opinion, Individuals respond favorably to people, things, beliefs and circumstances that hold significance, value and passion for them. Pesutââ¬â¢s (2009) article, confirms that incorporating spirituality into care where appropriate, has the potential to maximize health care quality. For this to be effective, the healthcare team has to look at the patient holistically, they have to put into consideration her profession of faith and how getting the chaplain involved will convince her that the medical team does not just want her money rather they value her worth. Subsequently, paternalism as a recommendation seems to be arbitrary and counteracts the autonomy of the patient, yet Whitney and McCullough (2007) in their article Physicians Silent Decisions: Because Patient Autonomy Does not Always Come First, give support to selective paternalism. They argue that Patients values and preferences play varying roles in medical decisions (Whitney et al. 2004). Indeed my patients refusal to accept care was not because she wanted to die but because her values of faith and her preference to spend within her means trumped getting the immediate intervention. Suffice to say that culture can be considered in this case because it influences values and preferences. My patients background was Brazilian, this is a country where there is little trust for the healthcare system. Hospitals and clinics are more interested in how much money they can make. So, Individuals that reside there, do not have routine checkup, they often wait till they are about to die before they go to a physician. And in this time they are constantly visiting places of worship in belief that they would be miraculously healed. As a result, myà patient probably had many symptoms over a period of time but did not go to the hospital, incidentally when she was brought in, it was a matter of life and death. With the teamââ¬â¢s knowledge of her diagnosis and its prognosis, my patie nts preference became largely irrelevant. Yet, the physicians wanted to respect her autonomy and her sense of dignity by maintaining her part in the decision-making. As medical practitioners we uphold the goals of shared decision-making and of empowering patients to make important choices. However, these objectives provide important insights, not universal answers. In medicine, as elsewhere, individual choice, however highly we value it, must compete with individual welfare and with constraints of time and money hence the decisive factor will depend on the particular situation at hand. (Whitney and McCullough 2007 p. 37). Next, they explained that decision-making, whether silent or spoken by the physician must be understood in terms of the clinical encounter. In fact the overriding of her autonomy was for her own good. My rationale for encouraging advanced directives especially if she is deemed competent at the moment is, in the event that she can no longer make a decision in the future, something and someone will be in place to help. It will help to guide future clinical decisions and promote confidence in the decision of the surrogate she choos es. According to Lynch, Mathes and Sawicki (2008), patients are in the best position to make choices for themselves, or at least a position that is superior to that held by any other party. Therefore, patient directives must be enforced, though not through the mechanism of strict liability. (p. 158). Therefore, a decision written and signed by the patient legally would prevail, in the event that she becomes incapacitated and cannot decide she would already have that in place. Medical practitioners are encouraged to inform all patientsââ¬â¢ about the importance of advance directives because it removes the burden of dealing with what the patients would have wanted. In summary, the discussion and justification of proceeding with medical intervention yet disregarding the patientââ¬â¢s decision, proves that autonomy can be respectfully countered. This is congruent in continuing with medicineââ¬â¢s obligation to do no harm, do good and serve in the best interest of the patient. Evaluation The desired outcome was that this patient receives the care and interventionà that she needed in time to prevent gross damage to her body thus altering her quality of life. With the input of the chaplain, her husband, the advocate and careful communication with this patient, the patient admits that she wanted the best care. She accepts the offer for financial assistance and receives the appropriate intervention. The nurse and medical personnel express satisfaction in saving her life (maleficent), Her husband is elated and he also signs an advanced directive for himself. It seemed difficult to convince the patient at first but once the suggestion for financial aid and the Chaplain was received, the patient complied with all other recommendations. References Lynch, H. F., Mathes, M., Sawicki, N.N., (2008). Compliance With Advance Directives: Wrongful Living And Tort Law Incentives. The Journal Of Legal Medicine, 29:133ââ¬â178. Retrieved from http://www.ncbi.nlm.nih.gov.proxy.medlib.iupui.edu/pubmed/18569439 Pesut, B. (2009). Incorporating patients spirituality into care using Gadows ethical framework. Nurs Ethics. 2009 Jul;16(4):418-28.Retrieved from http://nej.sagepub.com.proxy.medlib.iupui.edu/content/16/4/418.long WebMD, (2007). Retrieved November 26, 2012, from http://www.webmd.com/a-to-z-guides/disseminated-intravascular-coagulation-dic-topic-overview Whitney, S. N., McCullough, B. L. (2007). Physiciansââ¬â¢ Silent Decisions: Because Patient Autonomy Does Not Always Come First. The American Journal of Bioethics, 7(7): 33ââ¬â38, 2007. Retrieved from http://mcr.sagepub.com.proxy.medlib.iupui.edu/content/early/2012/10/31/1077558712461952.long
Saturday, October 26, 2019
My Educational Philosophy :: Philosophy of Education Teaching
My Educational Philosophy The responsibilities that educators have in the education field is to teach our students the basic training skills needed to be successful in the future. As an educator I will be involved in classroom instruction, grading papers, taking attendance, planning lesson plans around activities, readings and projects that will not only teach, but also engage. Without engagement, students are not likely to have a positive learning experience. I will make sure that every child is envolved and no child is left behind. As an educator I will modify instructional methods by using a wide range of teaching styles for the academic achievement of all my students. I will seek the need to self-motive my students learning skills; explore their academic, cultural, and social needs, which makes these central to the classroom experience. As an educator I will help students understand, investigate, learn, and determine how the knowledge process influences in discipline. I will use teaching methods and materials to reduce student prejudice, and work to create a school culture that empowers all students especially those from minority groups. I will engage all students in learning which is a goal of mine. As an educator I am also a mentor, who is a trusted and experienced advisor that has direct interest in the development and education of another individual. I want to encourage and motivate my students as well as maintaining a constructive and caring manner towards their needs. As an educator I will be very social, orderliness, and practical. I enjoy helping others and appreciating their needs and values as an individual. I am very orderly, which I keep things in their proper place, which makes the classroom environment more flexible.
Thursday, October 24, 2019
Marketing Plan for a New Hospital
Abstract This paper is talking about a marketing plan for Amcare hospital. Amcare hospital is a brand new private hospital in Beijing ââ¬â the capital of China. Nowadays China has more than 1. 3 billion people, in Beijing there are about 20 millions residents, compared with such a large population base, the medical resources are quite limited, which means there are great potential opportunity for a new hospital.In this marketing plan, i demonstrate the mission statement of Amcare hospital, described the target market, analyze the SWOT and STEER of this new hospital, finally there are sales projections about the best and the worst case scenario. 1 Mission statement Amcare Hospital is dedicated to providing professional, comprehensive, tailored healthcare services to our patients. Amcare Hospital will assess the healthcare needs of patients and respond to these needs. 2 Executive Summary Who are we?Amcare hospital is a private hospital operated in an American way, this is the first meaning for Amcare, it is totally different with Chinaââ¬â¢s local hospital, we pay more attention to our service and environment, although family healthcare is a new concept in China, our goal is to be the best family healthcare center. What we do? Provide tailored healthcare service is our mission, we always try to satisfy our patients and their familyââ¬â¢s needs. We are not only focus on cure illnesses, we also try to help the community maintain healthy. Expanded Description 3. 1 Service Amcare hospital will provides medical services for routine health matters, on-going health conditions, and well-woman gynecological services. Besides this, we also offer humanization and individuation service to the patients. For example, in our pediatric department we supply American immunization schedule for those family just stay in China for a short time. Except these special medical service, we accept international insurance direct billing.Through our advanced appointment system, pat ient just need a call to to make a appointment which is different with Chinaââ¬â¢s local hospital. 3. 2 Family healthcare Family healthcare is a brand new concept in China. Family Healthcare is a comprehensive, primary care that provides excellent medical and dental care to anyone and everyone who needs it. In simple terms, Amcare hospital is not a specialist hospital, we have medicine, dental, gynecology, obstetrics, pediatric, physical check-up department. 3. 3 EnvironmentIn Amcare hospital, all the wards are single room with bath room inside, according to size and facility, there are three different types for patients:standard room, family room, VIP room. For example,i n family room there is an extra bed for family members. If without those medical equipment, our hospital totally like a hotel. 4 Market description 4. 1 Target market Target market means a specific group of consumers at which a company aims its products and services. Target customers are those who most likely to buy. For Amcare hospital, target customers are three different groups.The first one is foreigners, according to the bureau of statistics of beijing, at the end of 2011, there about 100,000 American and European, 200,000 Koreans and 20. 000 Japanese live in Beijing. The second group is employees in multinational companies and the last group is overseas returnees. 4. 2 Needs of target customers As i mentioned above, our target customers are those kinds who received high education and good income, the characteristics of these groups are they have higher requirement about service and environment and pay less attention to price. 5 CompetitionAccording to target market, those local hospital in Beijing are not our competitors, our mainly competitor is United family hospital, this is the first private hospital in Beijing was opened in 1997, through more than ten years effort, they earn an excellent reputation in beijingââ¬â¢s market, but there is a significant weakness, the price are ex tremely high, the ordinary white-collar cannot afford such a high price. There are some other small international clinics only works on special area, so the competition is not very tough. 6 Distribution Channel 6. 1 MediaFor a brand new hospital, we will use social media such as TV, magazines, internet to promote our hospital, advertising is most effective when customer awareness about a service is minimal. 6. 2 Corporation membership In terms of Chinaââ¬â¢s rapid growth of economic and large population, there are many multinational set up branch company or office in Beijing, so we could cooperate with those corporation, give some discounts to their staff. 6. 3 Insurance membership Membership benefits all the participants, we could work on both domestic and international insurance company. SWOT Analysis 7. 1 Strengths The strengths of Amcare hospital are good and comfortable environment, professional and patient-oriental service, less expensive price. Compared with local hospital , our service are much better, compared with out mainly competitor, our price are more attractive. 7. 2 Weaknesses For a new business, no unified corporate culture is the first weakness we should overcome, corporate culture reflects the core value of that company and is the guideline for what they should do and how to do.All of our staff are hired from different hospital with different background, we need at least one year to forming a stable team with Amcare style. The second weakness is lack of market recognition, people does not know who we are, and weather we do supple a professional medical service, no one wants to take adventure with their health. 7. 3 Opportunities Chinaââ¬â¢s medical market was controlled by government for a long time, until now nearly 95% local hospital are still state-owned.Only recently years foreigner investment and private investment are allowed to come into medical market, at the same time, aging population increased day by day, there is great deman d of medical service. To some extent nowadays we call healthcare industry are sunrise industry which shows the great potential market opportunity. Another opportunity for Amcare hospital is location, we located in the capital, many transnational company and embassy make sure that we donnot need to worry about the resource of target customers. 7. 4 ThreatsNot only in China, many countries confronted with enormous challenges from aging population, there are is great demand of skilled nurse and doctors. Every year, many other countries come to China to hire nurse who can speak English, we called this brain drain, this phenomenon will lead our hospital more difficult to hired quified workers and increased our labor cost. Another threats is black sheep syndrome, there are some private hospital located in southern part of China, there are use false information cheating customers in order to earn more money, after broadcasting by medial, people will lack confidence about private hospital. STEER Analysis 8. 1 Socio-Culture impact In China, especially those old age group donnot trust private hospital, i want through our effort, people turn to have a positive impression about private hospital, we are caring more about our service and our patientââ¬â¢s satisfaction than our profits. 8. 2 Technology Few industries are more greatly affected by technology than health care. Technology refers to the innovations or inventions from applied science and research. As new technology enters the market, the existing products or service are pushed out.For my new hospital, one of the most important is our patients information system, through this system we share the information with front desk, nurse station, doctor office lab and some other support departments, this is an elemental factor that make sure we provide our service effectively. 8. 3 Ecological Requirement When mentioned hospital, people always connect with these words: virous, bacterial, infectious. Amcare hospital will set up a special department to control asepsis, our orientation is to be an environment-friendly hospital. 8. 4 Economic PotentialNowadays in China, because of the aging population and large population base, medical industry considered to be sunrise industry. If a hospital achieve the commitments to their patients, there will be a great economic potential. 8. 5 Regulation factor Regulation consists of the rules or restrictions placed on hospital by central or state governments. Within health care, there is a wide array of regulations pertaining to the delivery of care. In China, there are many detailed regulations about a hospital how to pricing, distribution and promotion. What we can do is just government compliance. 9 Benchmarks 9. 1 New patients ratesThrough diversity marketing tools, attract customers to come to our hospital is not difficult, but how to change the trial purchase to be repeat volume is what we should work on. In the first year, if our new patients rate keep incr easing10% every month can be considered customers accredit what we have done. 9. 2 Satisfaction rates From the very beginning, we will conduct our patient satisfaction survey, the basic requirement of satisfaction rates should above 96%. 9. 3 JCI certification JCI is short for joint commission international, is one of the groups providing international healthcare accreditation services to hospitals round the world and brings income into the U. S. -based parent organization. This not-for-profit private company currently accredits hospitals in Asia, Europe, the Middle East and South America. Joint Commission accreditation and certification is recognized worldwide as a symbol of quality that reflects an organizationââ¬â¢s commitment to meeting certain performance standards. Now in China, only 15 hospitals got this certification, until at the end of 2012,untied family hospital is the only private hospital passed JCI accreditation.If my hospital could pass JCI certification, it will b e a milestone in Amcareââ¬â¢s history. 10 Customer service 10. 1 Policy Our customer service policy is treat every customer with equal respect and be flexible to satisfy there needs. 10. 2 Organization Customer service organization composed of three groups: assistant, representative, manager. Assistant will be responsible for paper work and do some basic job, this position will supply for those just graduate from school and do not have much experience about customer service.Representative are mainly responsible for maintain relationship with customers, every customer in Amcare will have their own customer service representative, no matter what kind of problem they meet, their representative will take care of their issues. The highest lever is manager, this position will control the whole department and deal with complain. 11 Sales projections 11. 1 Best case scenario As the above graphic showing, the best case scenario is both the total number of patient and new patients keeps gr owing. The estimate maximum point will come be 360 after one and half yearââ¬â¢s effort. 1. 2 Worst case scenario this is the worst case scenario, for a hospital, patient is everything. Without continuous new patients, a hospital is not far from closed. Conclusion Open a new business is not easy, especially my dream is open a hospital provide medical service. this marketing plan includes many things from understanding my target market ,what our target customer needs and my competitive position in that market, to how can i intend to reach that market and differentiate Amcare from our competitor in order to make a sale.Due to Chinaââ¬â¢s rapid economic growth and large population, this market full of opportunities, but as a new one in this market, Amcare hospital still face lots of challenges. Bibliography Actual and projected percentage of people above 65 in China (partial data from Leeder et al. , Columbia University, 2005) http://www. jointcommission. org/about_us/about_the_j oint_commission_main. aspx http://www. zaijiuye. net/html/2011-1/20111231307381. htm Essentials of Health Care Marketing; By Eric N. Berkowitz, Second Edition; Published by Jones & Bartlett Publishers, 2006; ISBN 0763783501, 9780763783501 http://www. famhealthcare. rg/ http://beijing. ufh. com. cn/en/home/about-us/ http://wenku. baidu. com/view/fe4aa24433687e21af45a90d. html ââ¬Å"Healthcare Compliance 360 | HIPAA Compliance | Policy Management | JCAHO Accreditationâ⬠. Compliance360. com. Retrieved October 17, 2011. Bureau of Labor Statistics, U. S. Department of Labor, Occupational Outlook Handbook, 2012-13 Edition, Medical Records and Health Information Technicians, on the Internet at http://www. bls. gov/ooh/healthcare/medical-records-and-health-information-technicians. htm Simmons J. Primary Care Needs New Innovations to Meet Growing Demands. HealthLeaders Media, May 27, 2009.
Wednesday, October 23, 2019
Operating in Violent Areas
Yes, I think companies should feel free to do business all over the world, as long as they keep to the local law and regulations. Companies are the ones with the money, if all the companies stay away from violent countries or areas, then the local people will never have a better life. Unless the violent stops, but in most countries the violence will go on for many years (like Rwanda). There are a lot of companies which are making big money in violent areas. The most money is made in sectors like intelligence gathering, investigations in local companies and security. And a lot of constructing companies are making big money in Iran and Afghanistan, that is logical because a great deal of western governments are investing a lot of money in rebuilding those countries. Even the mining industry are booming in those countries, because bigger companies want to buy out. Some economists are saying that taking risk in violent countries can bring you from the second place to the market leading position. So for those companies it is worth taking the risk. As the writer of the ââ¬ËPoint Yes' (from the handout) said: ââ¬ËSome industry don't have the luxury of avoiding the violent countries, take the petroleum industry'. If you take a look at the world most dangerous countries you see that Iraq and Colombia are both in the top 10. But they are rich of oil. So companies as Shell and BP will going to invest there, even putting the risk of the employees at risk. Companies are responsible for their employees, if they want to send current workers to those violent areas, they should inform them about the situations and risks. Of course there are limits because your employees are not militaries, so where the fight is at the highest point (like the beginning of the invasion of the middle east), you should not place your factory in the middle of the two fronts. In my opinion the writer of ââ¬ËPoint No' is using the reason ââ¬ËThe people who are willing to work there, are not ideal for working', because he is afraid that his company won't be making profit there. I think as soon as a company is noticing a way to make a lot of profit without breaking any regulations it will invest. Let's take Iraq for example, the need for private security is very high, so security companies can make a lot of money there. The only risk is that most of the people haven't got that much experience in working in high risk countries. So having trained experience is good for your company. Your employees will be saver and can handle the mental pressure. Another way is to train local people, who are used to the situation, for your company. But local people can also be a problem, let's take a look at Somalia because the warlords are chancing all the time, it is very hard to do business there. Every warlord has its own rules and regulations, in some cases they just make up the rules because that suits them better. When that occurs your company has a problem. But most of the time they want ââ¬Ëprotection' money for your employees. So a form of blackmailing. But many companies have a ââ¬Ëescape plan', as soon as the political situation changes the wrong way, they pack their bags and jump on the plain. But if a company doesn't want to take that much risk, they should analyse their options. Follow local news and polls or they can ask the help of commercial risk-assessment services, they can be of great value. Not only fire-arms can be dangerous for companies, even though it is threat, so is the economic condition of a country. If you want to invest in a country but the economy is collapsing (like the Greek did), than I would not go there, unless you work for example in the oil industry. Because even if the local people can't afford it anymore, you can always export it to your own country. It is the same if you are already located there. My opinion, companies should operate in risky countries if they have a feeling of creating benefits from it, as long as the employees are not forced to go there. But they should always take in to account that a lot of violent countries are not stable, so make sure you are prepared for when something bad happens. To make sure you won't go bankrupted it is wise to spread your risk by not only depending on that one country.
Tuesday, October 22, 2019
Preposition near Doesnt Need a to
Preposition near Doesnt Need a to Preposition near Doesnt Need a to Preposition near Doesnt Need a to By Maeve Maddox Daniel writes: The expression ââ¬Å"near to X, Y, or Zâ⬠is becoming prevalent, even in the Times (of London). à Whats wrong with ââ¬Å"nearâ⬠? à Is there any linguistic ammunition that can be fired in the direction of this misuse? The question comes from England and most of the ââ¬Å"near toâ⬠examples I found by cruising the web I found on British sites: There are [sic] a distinct lack of pubs near to the ground (sports field) as it is built away from other buildings. the pub is near to the junction with the A34 The church is near to Charing Cross, Waterloo and Blackfriars stations. This caption is the only ââ¬Å"near toâ⬠I was able to find for the US: Panorama from the lawn behind Living Stones Church near to Kailua-Kona. Hawaiian tourist site. Plenty examples of near without the unnecessary ââ¬Å"toâ⬠are to be found on British sites: Saint Marys Church in the hollow of the white hazel near a rapid whirlpool and the Church of St. Tysilio of the red cave. information about St Cwyfans Church, near Aberffraw Wembley Arena Hotels offers great rates on over 50 hotels near Wembley Arena. American usage definitely favors near without a ââ¬Å"toâ⬠: Other attractions near our Houston, Texas hotel include Situated near some of the most recognizable landmarks in Washington DC, this hotel provides easy access to renowned monuments, Patent attorneys located near the US Patent Office People visiting the Little Rock area can find several hotels near Verizon Arena that offer suite accommodations. The adverb nearby sometimes gets lumbered with ââ¬Å"to.â⬠In this example the preposition is used without the extra word, but the adverb gets a ââ¬Å"toâ⬠: Nearby to the pub is the hidden 13th century church of St John the Baptist the most isolated church in Surrey. The pub is near the T-junction at the top. Not everyone sees the tacked-on ââ¬Å"toâ⬠as an error. I came across this ââ¬Å"tipâ⬠on an ESL site: Use the preposition near with or without to for the same meaning. Ex. He lives near (to) the bank. My friends play soccer near (to) my office building. Adding a ââ¬Å"toâ⬠after the preposition is grammatically unnecessary. Nothing is lost by dropping the ââ¬Å"toâ⬠in the following examples: the pub is near the junction with the A34 The church is near Charing Cross Can it be a regional thing? Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Grammar category, check our popular posts, or choose a related post below:Program vs. ProgrammeWriting the Century20 Slang Terms for Law Enforcement Personnel
Monday, October 21, 2019
Uniforms in Public Schools essays
Uniforms in Public Schools essays Quality education is critical to the future of Americas children. However, we cannot educate our children in schools where weapons, gang violence, and drugs, threaten their safety. Many local school districts have made uniforms an important part of an overall program to improve school safety and discipline. Students resort to violence and theft simply to obtain designer clothes or name brand shoes. This instills a fear among the students and teachers. It is no secret that violent behavior has become a problem in public schools. For this reason more and more public schools are entertaining the idea of uniforms to get the minds of their students off of fashion and onto their education. Many parents and students support the uniform issue because they feel it makes all the students equal in the eyes of their peers and teachers. However, many parents feel that just like installing metal detectors, uniforms are a simplistic solution to a far greater problem. Some experts believe uniforms p romise to cut down crime and reduce violence, but only if we take away that students individuality and freedom of expression. What does this promise? Uniforms have been used in an effort to try an reduce crime, and at the same time, remove peer pressure amongst students to try to fit in so they can concentrate on their school work. President William Clinton agrees with this saying If uniforms can help deter school violence, promote discipline, and foster a better learning environment, then we should show strong support to the parents that try them.(21) By mandating uniforms in public school, school officials hope to see a reduction in crime and violence. According to statistics, there are notable decreases in school violence and illegal offenses after the enactment of a school uniform or standardized dress code policy.(Lewis) Can uniforms really help in deterring violence and crime? Many parents and teachers say ye...
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