Spanish Resistance to Napoleon Essay -- essays research papers

  Ã‚  Ã‚  Ã‚  Ã‚  Napoleon and the Spanish Resistance   Ã‚  Ã‚  Ã‚  Ã‚  Throughout time, the military has been considered one of the key features in a civilization. It has been considered the heart and soul of many countries and empires and has been the center of many cultures. Throughout history we have seen many military leaders and military powers. We have seen military techniques and technology change as we progress. Our schools are filled with legends of great war heroes and hard-fought battles. One such hero is Napoleon Bonaparte, perhaps one of the greatest generals who ever lived. In his adventures and conquest, as general of the French army, he warred against many lands. These included Spain, in which Napoleon met a strong resistance. The Spaniards were using a new military strategy called guerilla warfare, one that Napoleon had no experience against. Guerilla warfare is the use of unconventional war tactics, such as ambush and sabotage, coined by the Spanish rebellion to Napoleon Bonaparte, resulting in an uprising that even he couldn’t put to rest.   Ã‚  Ã‚  Ã‚  Ã‚  To understand why these tactics were so effective, you must first understand the tactics themselves. Before guerilla warfare was popularized, war was mainly a head-to-head meeting between two armies. This idea of mass confrontation was considered a formal and more manly way to conduct war. However, the Spanish noticed drawbacks to this idea. They had far fewer numbers than the French and by using traditional war methods they were destined for failure. The Spanish started to use guerilla tactics.   Ã‚  Ã‚  Ã‚  Ã‚  Traditional wars at the time were decided, often, just by a couple of mass confrontations between the two opponents. Each battle would usually consist of a significant number of soldiers going straight towards each other until they forced the other to retreat. Guerilla warfare on the other hand doesn’t rely on this premise. In order to successfully defeat your opponent using guerilla tactics, you must rely instead on a series of smaller confrontations (Free Dictionary). By using these â€Å"hit-and-run† strategies, guerilla fighters can quickly tire they’re opponents and not lose as many men. Another difference, is that guerilla war relies heavily on ambush. Ambush is when the ambushing force uses concealment to attack an enemy ... ...oleon returned and heard of the defeat he knew it was the end. Finally realizing that his unstoppable armies had been stopped for good he abdicated on April 11th, 1814. The Peninsular War has helped diminish Napoleon’s armies and expose his weaknesses. His enemies had finally caught on and in the end it was the great Napoleon who finally gave up.   Ã‚  Ã‚  Ã‚  Ã‚  Guerilla warfare is the use of unconventional war tactics, such as ambush and sabotage, coined by the Spanish rebellion to Napoleon Bonaparte, resulting in an uprising that even he couldn’t put to rest. Guerilla warfare, more in depth, is the use of tactics that don’t involve mass confrontation. They rely more on long drawn out smaller confrontations, slowly but surely weakening the enemy. The most prominent of these was the Peninsular War, fought between the French and the British and the Spanish guerillas. The British were able to keep a strong defensive position and with help from the guerillas eventually drove out the French regime. This loss brought Napoleon closer to defeat and his enemies realized it, causing them to go on the offensive and sack Paris, the final blow to the great Napoleon Bonaparte.

The Role of Sugar and Insulin in Weight Gain Essay -- Health Nutrition

The Role of Sugar and Insulin in Weight Gain The Atkin’s diet is one of the most popular diets that emphasizes weight lose in a short amount of time without the need for exercise. Patients under the diet need to consume foods that are high in fat and protein such as cheeses, hamburgers, bacon and heavy creams. Foods that are high in starches and sugar are not to be consumed within the diet because they will affect the two main causes of weight gain within the body. The two main causes of weight gain are high concentration levels of sugar and insulin within the body. To decide which cause can increase weight gain can difficult decision to decipher. As one of the main external causes of obesity and overweight, the level of sugar within the body is based on the amount of sugar concentration within the body’s bloodstream. Sugar concentration found within the body is usually attained from the consumption of food, such as sweets, fruits, bread, pasta and grain. The sugar from the food consumption is broken down by the body in order to give energy for the body which allows it to function. The energy broken down from the sugar is used to help the body to carry on with daily functions such as moving or thinking. In comparison to the sugar level, insulin is an internal cause of weight gain. Insulin is a hormonal substance that is produced and dispersed within the body in order to regulate the flow of blood sugar through the conversion of sugar molecules into energy. The energy converted from the sugar molecules are either needed immediately for the body or fat cells. Fat cells are sugar molecules stored within the body for use at a time when the body needs more energy to function. Fat cell... ...d 1. S. Warshaw, H. (2004, July). The Diabetes Food Pyramid: Starches. Retrieved November 7, 2004 from http://www.diabetes.org/nutrition-and-recipes/nutrition/starches.jsp 2. Mehta, P., & Mehta, P. (n.d.). Blood Sugar, Low Blood Sugar or High Blood Sugar. Retrieved November 14, 2004. http://www.fatfreekitchen.com/blood-sugar.html 3. R. Hertzler, S. & Kim, Y. (2003). Glycemic and Insulin responses to different types of energy bars. Glycemic and insulinemic responses to energy bars of differeing macronutrient composition in healthy adults, 9(2). Retrieved November 17, 2004, from http://www.MedSciMonit.com/pub/vol_9/no_2/3230.pdf 4. Berland, T. & Consumer Guide. (1974). Rating the Diets. Chicago: Rand McNally & Company 5. R. Eades, M. & D. Eades, M. (1996). Protein Power. New York: Bantam Books

African Americans health disparities Essay

In 2011, the diagnosis rate for HIV cases in the United States was 15. 8 per 100,000 population and 60. 4 among Blacks. Of 197,090 diagnoses of HIV-infection from 2008- 2011, Blacks/African Americans accounted for: ?47% OF THE TOTAL ?64% OF WOMEN ?66% OF INFECTIONS ATTRIBUTED TO HETEROSEXUAL CONTACT ?67% OF CHILDREN, AGES < 13 In 2010, the death rate for blacks was higher (25. 0 per 100,000) compared with any other racial ethnicity group (3. 0 whites). Blacks represented 49% of all deaths with HIV in 2010. A recent study showed that blacks diagnosed with HIV are less likely than other groups to be linked to care, retained in care, receive antiretroviral treatment and achieve adequate viral suppression. African American Males African American men accounted for 42% of HIV cases diagnosed among men in 2011. A majority (72%) of African American men with HIV contracted the disease by male to male contact while 19% contracted HIV through heterosexual exposure. African American Females Among African American women, high risk heterosexual contact was the most frequently cited mode of transmission, accounting for 89% of cases diagnosed in 2011. More Information: ?HIV/AIDS TOPIC SITE ?HIV/AIDS AND AFRICAN AMERICANS ?HIV/AIDS STATISTICS AND SURVEILLANCE Sexually Transmitted Diseases (STD) Gonorrhea In 2010, 69% of all reported cases of gonorrhea occurred among blacks. The rate of gonorrhea among blacks in 2010 was 432. 5 cases per 100,000 population, which was 18. 7 times the rate among whites (23. 1). This disparity has changed little in recent years. This disparity was larger for black men (22. 2 times) than for black women (16. 2 times). Chlamydia In 2010, the overall rate among blacks in the United States was 1,167. 5 cases per 100,000, a 4.0% increase from the 2009 rate of 1,122. 2 cases per 100,000. The rate of chlamydia among black women was over seven times the rate among white women (1,536. 5 and 205. 1 per 100,000 women, respectively). The chlamydia rate among black men was almost 11 times the rate among white men (761. 8 and 69. 9 cases per 100,000 men, respectively). Syphilis During 2009–2010, the rate of primary and secondary (P&S) syphilis among blacks decreased 8. 7% (from 18. 4 to 16. 8 cases per 100,000 population). In 2010, 47. 4% of all cases reported to CDC were among blacks and 31. 0% of all cases were among whites. The overall 2010 rate for blacks was eight times the rate for whites, while the 2009 rate was 9. 2 times the rate for whites. In 2010, the rate of P&S syphilis among black men was 7. 1 times the rate among white men; the rate among black women was 21 times the rate among white women. In 2010, the rate of congenital syphilis was 33. 1 cases per 100,000 live births among blacks. Race/ethnicity for cases of congenital syphilis is based on the mother’s race/ethnicity. This rates was 12. 3 times the rate among whites (2. 7 cases per 100,000 live births). More Information: ?STD TOPIC SITE? STDS AND HEALTH DISPARITIES ?STD SURVEILLANCE REPORT ?STDS IN RACIAL AND ETHNIC MINORITIES Viral Hepatitis Acute Hepatitis A During the past 10 years, there has been little difference between the rates of acute hepatitis A among white non-Hispanics and black non-Hispanics. The 2011 rates for these groups were 0. 29 and 0. 27 cases per 100,000 population, respectively. Acute Hepatitis B In 2011, the rate of acute hepatitis B was highest for Black non-Hispanics (1. 4 cases per 100,000 population). Acute Hepatitis C During 2002–2010, the incidence rate of acute hepatitis C remained below 0. 5 cases per 100,000. The rate of hepatitis C among Black non-Hispanics increased 27. 3% (to 0. 14 case per 100,000 population in 2011). More Information: ?VIRAL HEPATITIS TOPIC SITE ?SURVEILLANCE REPORT FOR VIRAL HEPATITIS Tuberculosis (TB) In 2010, 84% of all reported TB cases occurred in racial and ethnic minorities. Non- Hispanic blacks or African Americans accounted for 24% of TB cases in 2010. African Americans make up approximately 14% of the U. S. population, but accounted for 40% of TB cases in U. S. -born persons. Overall, 11,182 TB cases were reported to CDC from the 50 states and the District of Columbia in 2010.

Bumrungrad International Hospital

TEAM Pangaea Vanguard Hospital IT Infrastructure: Problems, and Implementations Prepared For A]. Therapy Piccalilli Dry. Scripps Planking's An Daddy Honorable English Instructors Prepared By Terrace Tiramisu Eukaryote Lackawanna Chauncey Returnable's Picaroon Running Natal Superpose Contents Introduction There is no doubt that technology has become a great part in our lives, and the importance of it is admittedly increasing as time passes by. The longer the time passed, the more essential technology will be toward our dally routines.When It comes to Information Technology or IT, It Is hard to believe that there Is someone out here who did not actually know about IT. The definition of IT, according to Walked, Is simply the application of computers and telecommunications equipment to store, retrieve, transmit and manipulate data, often in the context of a business or other computer or the network of computers, but it includes all the technologies that help distributing the information, for instance, televisions and telephones.Therefore, there are actually a bunch of industries related to information technology, no matter if they are computer hardware and software, internet, e-commerce and other computer-based services. As same as technology, IT has been developing continuously during the past years and the range of the applications is getting wider and wider day by day. Nowadays, many companies adapted the IT system into their company as the communication is the key in developing a successful organization. With the help of IT system, people inside the organization could communicate with each other faster, easier, and more reliable.The loss of communication, or even a small glitch in the communication process, might slow down the decision making process which, in some cases, could mean the termination of the company itself. In comparison, if any company has a good IT system in their possession, the company could accomplish so much beyond imagination; the company m ight be capable of working more systematically and have the upper hand in the competition. Thus, the IT system is considered one of many significant factors in bringing more revenue to a company and guaranteeing the well-being of a company as well.From the vision of the executive manager of Vanguard Hospital, the economy of Thailand could be substantially developed which the results could be seen in the near future. As a consequence, they gathered all the people involved in the placement of the hospital and came up with the plan for the business in order to make sure that the hospital has the capability to handle the continuous growth in the amount of patients in each year in effective manner. For the current situation, it seems like it is the best opportunity for the IT to save the day†¦Company Description Vanguard Hospital Public Company Limited (the â€Å"Company') runs a famous private hospital business in Bangkok, Vanguard Hospital. The hospital was established in 17th Se ptember 1980 in the form of private hospital on Summit Road, which is considered as one of many business districts in Bangkok. In an average of 1. 1 million patients (both inpatients and outpatients) were accommodated by this hospital annually; about half of the figure is foreigners from over 190 countries globally. In the past 2013, the company earned around 14,651 million baht from the given services.The hospital started in 1980 with 200-bed facility with 90 million Thai baht investment. Currently, the hospital has approximately 580 authorized bed and support the total capacity of over 5,500 outpatients daily. On the 1st January 1997, the ewe main facility building named â€Å"Bandager International† was first utilized. The 12-storey building is known to be the largest private hospital compound in Southeast Asia which is equipped with underground parking lot and the international standard rooftop helipad for helicopter landing. Later on, in 2008, the outpatient clinic facil ity was opened.This outpatient clinic facility is a 21 -storey building with a parking lot that supports about 700 cars, spacious sky lobby on the 10th floor for business negotiation, international medical cooperation, and even visa extension services, and extensive range of sophisticated medical equipment. The cashier and the pharmacy customers. Moreover, other than Wi-If, LCD directories, and TV's, there is also an automated lab so provided faster and more liable results allowing the doctors to access the customers' files from inside their exam rooms.With the utmost concern about the quality of the health care services given by the hospital, this company pays extra attention in the process of recruiting the physicians and staffs. Presently, there are more than 4,800 employees, 1,200 internationally certified doctors and dentists, and 900 nurses working inside the hospital. Since the company has been kicked off, the company has been continuously providing complete healthcare servic es for both inpatients and outpatients with extra precautions.Taken all of dedication into account, there is no question that this company is one of the leading health care providers in Thailand and in Southeast Asia. According to Oversimplifications. Com, Vanguard Hospital is considered one of the world's popular medical tourism destinations. In the past 2012, the hospital serviced about 520,000 international patients who seek for high quality, International standard services, and the lower cost healthcare. Vanguard Hospital is the first Thai candidate that received the US standard certification from Joint Commission International OIC Accreditation).The hospital has also been given the Chic's Clinical Care Program Certification (CAP) for specialties programs including the Primary Stroke Program, Acute Myocardial Infarction, Diabetes Mellitus Type I and II and Chronic Kidney Disease Stage I to ‘V. Other than that, the hospital also received many accreditations from many other famous institutions in both international and domestic levels, including the Thai Hospital Accreditation (HA). The company later Joined the public market and being enlisted on the Stock Exchange of Thailand in 1989.The majority shareholders in the hospital can be classified into companies in Thailand and other countries such as Bangkok Dusts Medical Services Public Company Limited, Bangkok Insurance Public Company Limited, Bangkok Bank Public Company Limited and the Sycophantic family, which is one of Thailand leading business families, Limited, and HASH (Singapore) Nominees Pete Ltd. Mission, Principle, and Policy The hospital was established with the main objective to make sure the world class tankard healthcare service would be provided to the customers with care and compassion.It has been operating with the following principles: 1 . Strive to exceed our customer's expectations 2. Committed to our Medical and Hospital staffs welfare, education, training and development. 3. Contin uously improve the safety and quality of the services. 4. Strive for professional excellence and innovation in the services. 5. Embrace cultural diversity with Thai hospitality. 6. Strive to make the services† World Class†. 7. Being trustworthy, honest, and act ethically in all the dealings 8. Work as a team ND share what is known. 9. Highly value the corporate social responsibilities (CARS) 10.Operate in an environmentally responsible manner. After reading the points above, it might seem like all the company thinking is about themselves, but actually, the company has also been operating with the global environment and conserve energy and natural resources. To make sure that the environment will be properly preserved, the hospital maintains a serious aim to follow the regulation enacted by the government and the world standards. Moreover, the hospital is also very careful about the water management system to prevent the eater streams nearby the hospital from getting poll uted and affect the neighboring community.Corporate Social Responsibility (CARS) Corporate Social Responsibility (CARS), in a nutshell, is the responsibility towards the society and the environment of an organization. In other words, CARS is a systematic management under good morals, which leads to a sustainable development of an organization. For Vanguard Hospital, the Vanguard Hospital Foundation (UHF) was set up in May 1990 as the CARS of the company. The UHF is a registered non-profit foundation founded by the founders of Vanguard International Hospital.The foundation is involved in many charitable activities for those unprivileged Thai citizen all around the country who did not receive a proper healthcare services with the intention to promote their well-being and to give them proper knowledge of being healthy. Any donation made to this foundation can be used to reduce the tax (tax-deductible). Recent fund-raising programs and activities of this foundation are as follows: 1 . 5 0 Pediatric Heart Surgeries: This is a follow up campaign after the 72 Pediatric Heart Surgeries. In this campaign, 50 unprivileged people will be selected to get the heart surgery without being charged a single baht. 72 Pediatric Heart Surgeries 3. â€Å"Mend-A-Broken Heart† Charity Heart Surgeries: This campaign was established in 2001. In cooperation between UHF and other business entities, 20 unprivileged people were selected to get free heart surgery. 4. Thompson Fund Mobile Free Clinic: The UHF and Thompson Fund cooperatively sent out mobile free clinic to give medical care to 100,000 people in underprivileged area. 5. Charity Medical Relief: The UHF and the Bangkok Insurance Company work together to send out the officers to help many people in Saxon angora and Musician province every single year.They also introduce them to more Job opportunity and offer them chances to improve their quality of life. 6. Patients in Need: The foundation offers the financial aids to those who are in need of medical assistance but cannot afford the medical treatments. Other than offering decent healthcare to those who are unprivileged, the foundation also aids those people in the field of education by giving them proper education, training, and also scholarships for children with insufficient budget. This foundation gets the money from the donations received from the patients of the hospital, other business entities, and even each individual person.Anyhow, the foundation does not only rely on the donations but also fund-raisin events and charitable art exhibitions. Additionally, the UHF also concern about those who are underprivileged in other countries as they have started charity such as, eyes operation for Laos kid who got a piece of the bomb embedded in the eyeball. Current Status, Direction, and Goals Judging from the information above, it can be clearly seen that the status of this company is on the rising trend with increasing number of patients in each year.I t seems like the longer humans live in this cruel world, the more â€Å"natural selection† is Charles Darwin which simply implies that only the strongest will survive. More people are getting infected by some new diseases that no one has ever seen before. In fact, it is undeniable that no matter how strong a person is, everyone needs to be treated by doctors even once in a blue moon. Thus, the healthcare provider as Vanguard Hospital is becoming more and more profitable compared to other good or service providers.This is the main reason why Vanguard Hospital is keeping on developing the hospital to provide better healthcare services to those who needed to be treated. Position in the Strategic Impact Grid The Development of Vanguard Hospital's IT System In the year 1997: The hospital was facing trouble as Thailand faced the economic crisis as it affects the middle class people which are considered the main customer base of the hospital. Thus, all the people chose the hospital that is operated by the government with lower payment.Under the circumstances, the hospital saw the opportunity to expand the customer base to international level. At the end of this period, the hospital received ISO 9000 Certification. In the year 1999: The hospital started to use the internet as the mean for information distribution. At the time, the hospital's website had been visited for about 800 views per day. In the next revolution, the hospital brought in the US IT Consultant Service and started up the company called Global Care Solution (GAS) in Thailand for assembling the system for the hospital.Later on, during December of the same year, the â€Å"Hospital 2000† was implemented as a substitute for the older platform. The software was regarded as the first hospital system that connects everything together from the front office, system for doctors, pharmacist, nurses, and radiologist, patients' registration, time schedule of the operating room, exam room, and wards t o the patients' profiles. The hospital invested on 450 clients to be set up around different sections of the hospital. In the year 2002-2004: The Hospital 2000 system was developed to support PASS (Picture Archive Communication System).The hospital got reward from the Intelligent Enterprise Asia magazine for being 1 in 20 top organizations that uses IT to maximize the ability to provide the services to the customers. The hospital also got an appraised from CIO Asia for being top 100 organizations that implemented the hospital information system. In the late 2003, the hospital invested on another 450 clients which causes less system breakdown as increase the uptime for 99. 99% In the year 2007: Microsoft took over the Global Care Solution (GAS).As a result, Vanguard Hospital is now not only a user but also another invisible hand in the development of the system. In the year 2008: Microsoft started launching â€Å"Microsoft Amalgam† which is the combination of Xiii and Hospital 2000. The hospital also started using more sophisticated technologies inside the outpatient facility, for instance, Wife internet, LCD directories, automated lab for more precise and faster exults, online patient registry, diagnostic image that the doctors can access. Later on, management for inpatients. The idea of using robot came up from the concern the safety of the patient.From implementing the robot, the hospital can spend less time on the medicine of each patient. Other than that, the hospital also started up the laptop rental service for the inpatients. The laptop was designed to use inside the hospital as it is attached to the table on the side of the patient's bed and it is equipped with silicone keyboard, sterilized optical mouse, WebMD for video conference, and voice-over system. Hospital 2000 Hospital 2000 is the system specialized for hospital systems with the scope of almost every activity inside the hospital.For the usage inside the hospital, the system has the capa bility to handle the information of the patients or other employees, transaction processes, accounting, pharmacy, registrations, human resources, and even the patient transfer processes inside the clinic. All these sub functions are collected inside one big database in one system that supports almost every language available on this world. Microsoft Amalgam Hospital Information System (Amalgam HIS) Amalgam HIS is the developed version of Hospital 2000.This sophisticated system was designed to systematically take care of the IT system inside the hospital by collecting all the necessary data inside the database. Amalgam HIS was created based on the Electronic Medical Record (EMMER) which is composed to patient management, bed management, operating room management, pharmaceutical management, and even management system for radiologists. In addition, the system is also capable of storing and transferring the image data (IRIS/PASS), doing some complex accounting calculation, and managing both inventories and human resources.PASS (Picture Archive Communication System) is the system produced to digitally store the medical images and x-rays results without using any film. By using this system, the doctors could access the images by using the Internet from remote distance. In addition, the system also allows the long-term storage. In the normal situation, where the physical films are used to store the images, the images could be changed or damaged as time passed by and not to mention that it took so long to find the record in the form physical films whenever it is needed.Thus, using PASS will elf ease out all the processes for easy retrieval and increase reliability. Current IT Infrastructures At the moment, Vanguard Hospital is using the Amalgam Hospital Information System (Amalgam HIS). This system has been implemented in the hospital since 1997. Thus, the information system for Vanguard Hospital is considered an essential component in the management processes that oc cur inside the hospital. It is clearly seen that if it is not because of the marvelous IT system, the hospital might not be able to come this far as one of the best hospitals in Southeast Asian region.The actors who are involved in the system are as follows: 1 . Doctors: The Amalgam System takes a great part in helping the doctors to look at the overview of the profile of each patient. The doctor can glance at the profile of the patient and suddenly have the idea of who they are treating which will prevent any mistakes from happening. Another good point is that the doctor can write the medicinal prescriptions and schedule the next appointment via the online system.The appointment and the prescription will then be sent to the cashier and the pharmacy so that the patient will safety of the patient, the system also provides options for the doctors available for operating the patient as each doctor has different specialty and different schedule. The system will filter out the doctors wh o are the best for operating each specific patient. However, it does not mean that every doctor knows how to use the system. The elder doctors might not be accustomed to using the IT system and the part-time doctors might think that it is unnecessary to learn how to use the system as the come from time to time.To handle this problem, the hospital decided not to banish the old IS system which is manually writing the prescriptions and recording the patients' records. The information recorded manually will be transferred to the QUA department in which the information will be recorded into the system to make sure that the information of the patient will be available by the next time the customer uses the hospital service again Just as same as other patient that the information were recorded by the doctors.By implementing this IT system, it ensures that the hospital is using its resources of 1,200 doctors efficiently and the customers can be assured that the appropriate healthcare will b e given to them as the total amount of the patients will be distributed equally among doctors to ensure the maximum ability n providing the services. 2. Hospital Officers: Every hospital employee is obligated to know how the system works no matter if they are the receptionists, accountants, nurses, radiologists, pharmacist, or even human resources.All the officers will have to work in harmony to be able to maintain the fast-paced work and provide the information needed in a short period of time. Although all the systems are connected together, it does not mean that everyone will be seeing the same information. As an example, this is what happens in steps when Mr.. A visited Dry. B. Mr.. A visited Dry. B in he year 2012 with the symptoms of Acute Tuberculosis. Later on, in 2014, Mr.. A came back to the hospital again with the intestinal infection which he was assigned to Dry. C. Dry. C will be able to see the whole medical report of Mr..A including the medicines that he is allergic t o, who was his former doctors, what were his symptoms, and all the medical implications. When Dry. C wrote the medical prescription, the lists of medicine will be sent to the cashier and the pharmacy. The pharmacy will only see the lists of the medicine that Mr.. A will get so that they could pack everything he deed while the cashier will only see the list of the medicines and the price so that Mr.. A will be charged correctly. These two departments would not be able to see the medical report related to Mr.. A. When the pharmacy packed all the medicine for Mr..A, the total amount of each medicine inside the inventories will be updated which will be easier to keep track of all the drugs inside the stocks to prevent those drugs from running out. In case that the report is needed, the system also provide the function to generate the report of the patients who were treated by Dry. C in each day. With the help of the system, all the information from the doctors to other departments and e mployees will be synchronized which will increase the speed, reliability, precision, and accuracy of the service that will be provided in daily routines. . Patients: Other than hospital's employees, another actor that cannot be neglected is the patients. Patients are considered an important part in the development of the hospital system as the system was designed for convenience of the customers and to reduce the waiting time. Moreover, in case that the patient is ready to be transferred perhaps in the form of hard copies or CDC. While those data re being transferred, the copy of the data will still be inside the hospital system in case that the patients wanted to be transferred back for further medical treatments. . Executives: When it comes to the executive officers of the hospital, it is important that they can get the overall status report of the hospital whenever it is needed. The report that is provided by Amalgam HIS is in the form of interactive report in which the executive can sit back and relax as the report generated will make the analysis process a whole lot easier. For simplicity, the interpretation will be made from the data collected from each patient.As soon as the report reaches the executives, for example the CEO, the CEO will be able to notice the trend of the symptoms at the moment so that the hospital can be prepared for the situation that might happen in the future. 5. The competitors: The competitors of Vanguard Hospital are not only private hospitals but also those hospitals that operate by the government. It is easy to say that Vanguard hospital is one of the first hospitals that implemented the hospital information system. But as time passes by, the IT system becomes more affordable for every organization.The competition becomes more and more intense s more hospitals also implemented the IT system which will introduce newer dimensions of giving the services to the customers luring in more customers. Though the system that the other u sed might not be as good as what Vanguard implemented but it surely enough to become more frightful business competitor. Workflow inside the Hospital 1 . Make an appointment: The patients can choose whether they want to make an appointment using telephones or using the online services. For the foreigners, they can make schedule an appointment on www. Vanguard. Mom where they can select the doctors that they wanted to get treated from. . The patient reached the hospital: When the patients arrived at the hospital, they need to hand in the patient card or tell them the patient id in which the id will be keyed into the system to report that this patient has already arrived at the hospital and is ready to be called into the examination room. 3. Preparation of the patient's profile: As soon as the patients have confirmed an appointment with the hospital, the hospital needs to prepare the profile of that patient before they even reached the hospital.With the information, the nurse in each counter will be able to make a schedule for the doctor and get the attain ready whenever they arrived at the hospital. 4. Seeing the doctor: The doctors inside the examination room will be able to see how many patients are waiting for the examination. Moreover, the doctors also can access the profile of each patient to see the former medical diagnosis, drug allergic history, all the taken lab results which can be changed into the form of graphs for analysis. 5.Lab & X-Ray results: Whenever the doctors see that the extra labs need to be tested on the patient, the direct order from the doctor will be sent directly to the lab and x-rays room. Nowadays, there are many technologies and one many interesting breakthroughs is the digital x-rays which allows the doctors to get the x-rays results digitally without using any film. 6. Payment: When the patients got the medical care that they need, the payment information and the information about the patients' insurance will be sent to the acco unting and financial department.In this step, the patients queuing sit still and wait for the system to manage their queues and call out their names. 7. Get the medicines: Practically, when the doctors ordered the medicine, the prescriptions will be automatically sent to the pharmacy. Thus, the patients can get their medicine as soon as the patients made the payment. 8. Executive operations: The executive officers can access the system to get the overall analysis of the current situation for management and make plans for the future.In the data analysis, the system will use the system called OLAP (Online Analytical Processing) which is already pre-equipped in the Microsoft SQL Server. OLAP helps the executives in gathering the information from the data warehouse for analysis, for instance, the proportions between domestic and international patients, the nation where the international patient are from so that the hospital will be able to get the translators ready for assisting the int ernational patients who are incapable of communicating directly with the doctors.Hardware Development For optimum efficiency, the hospital chose the computer system from Dell which is believed to be more stable compare to other brands. Since the computer system from Dell has been implemented, the hospital admitted that the expenses of the hospital were enormously reduced that the left hospital with enough budget to invest on another secondary storage station, which will manage the data in real-time manner, to prevent any system failure. In the hospital system, there consisted of 4 servers from Dell, 1 main memory, and 6 desktop computers connected in the form of cluster.Moreover, the hospital also set up extra 450 computers around the hospital to support the increasing amount of patients. For maximum functionality and for ease of accesses, the hospital also spent some amount of money on 100 laser printers and 120 scanners to keep the data of the patients. In the term of system funct ionality, if in case of an emergency that the power supply of the system was cut off, the system will be automatically shut down and rely will cause devastating damages to the system. Thus, the hospital made the decision to use the Infrastructure system offered by the APPC.The Infrastructure is the architectural design for data center IT room, which is scalable and adaptable, that dramatically reduces time and complexity from concept and design through installation. This Infrastructure system is composed of 2 40 KAVA N+l Redundancy UPS systems. The two systems are working in harmony in load sharing manner. Each UPS system will be powered from different sources from different sides of the building to ensure the maximum security from the electrical problems that might occur.If something happened to the first UPS, the other UPS will be able step up and take all the workload. From doing so, there is less probability of system failure and all the systems that are essential for providing the services to the customer will work continuously. Another good point of this APPC system is that there is built-in self-test software called â€Å"Powerhouse† which will automatically do the self-test to find if there is any hardware in the system needs replacement.If the software found out that there is actually a hardware that needed to be replaced, the software will notify the arson who is in charge of taking care of the data center to replace the hardware without turning off the whole system. For the linkage of the system, Vanguard Hospital entrusted the Motorola, Inc. To together, the hospital used more than 300 wireless switches and access points. For the switch, the Motorola REFORMS Wireless Next Generation, which is capable of layer-3 roaming, was utilized.The layer-3 mobility allows the users to roam without losing its IP address and sessions which is great for large areas with many stories as the users can use the network while they are walking with the maximum b andwidth ND noise-free. This is considered as something that can benefit the hospital in the long run. This wireless system can be used not only by the users but also the doctors and other staffs as well to ensure the availability of the data in real-time in the range of 90,000 square meters of the hospital's area.For security issue which is the main key in the designing process of the hospital system, the security system invented by Motorola, the Wireless Intrusion Protection System (WIPES), is taking care of everything Software Development As has been mentioned above, the hospital has implemented the Amalgam HIS to ease up the work processes of the doctors and other employees by making everything faster, more convenient, more effective, more precise, and easier for maintenance. Not to mention that using the system will also make the communication with the users more understandable and more cost-effective.The system works dependently with the Microsoft Windows Server 2003 and Micro soft SQL Server 2000, which is the software for managing the database. All information will be kept inside one big database inside the IT department which causes the hospital system to be in the form of computerized system in which every department ND every computer can communicate with each other via computer system. No matter in what direction that the patients were leaded to, the computer system can help the hospital to prepare what is needed in a short period of time.Nowadays, many people are getting treated by the hospital in each day which means high amount of the transaction between each department in each day. Thus, the system needs to be scalable; the hospital can add in more machines or take out some machines to be appropriate with the number of patients at the specific period of time. In the software perspective, the system needs to be adaptable, reliable and e ready for any further system expansion in the future. The Amalgam HIS can be divided into 3 tiers. . Presentatio n Tier: This tier includes all the 1,000 work station across the hospital which are used to get the data by accessing the central database of the Amalgam HIS that is set up of the machine that runs on Microsoft Windows 2000. 2. Middle Tier: The middle tier is in between the presentation tier and the database. Here, the Windows Server will be regarded as the Transaction server which is the main medium in managing the flow of the transactions that are being sent to the database.When the transactions were generated, they will be sent to different servers to prevent one specific server from overloading. An extra server can be added whenever it is needed to handle the customers' need without having to shut down the whole system. All in all, the hospital got a lot of assistance from the software from Microsoft as the software allows the hospital system to work faster, more consistent, more precise, and also help the hospital to control the number of employees needed inside the hospital. 3 . Database Tier: All the information that will be processed by the

Educational Needs Assessment Essay

Continuing education plays an important role in the development of nursing professionals in any healthcare institution (Waddell, 1991). However, different institutions have different needs to address with respect to their nurses professional competencies (Gould et. al. , 2004). According to Billings & Rowles (2001), the primary question that institutions have to answer is what particular educational needs their nurses have that are most relevant to the working environment. This paper seeks to determine and prioritize the needs of the Medical-Surgical/Bone Marrow Transplant Oncology Nursing Unit of Sutter Medical Center, Sacramento through the administration of a survey questionnaire to a sample of seven (7) registered nurses and a qualitative analysis of the results. Background Sutter Medical Center is a non-profit hospital that specializes in providing acute and advanced care to patients living in Sacramento and the surrounding area. Its mission is to provide quality primary and tertiary care along with a continuum of services to meet the healthcare needs of the people throughout Northern California. During the previous year, the hospital has been able to generate 58,274 patient days spread across seven (7) hospital units with 20% of which coming from the nursing unit of interest to the study. The unit has 14 registered nurses with varying levels of proficiency and experience. Results There were seven key questions inquired from the seven registered nurses that comprise 50% of the total unit population. Based on the analysis of the results, the particular areas where that the nurses feel should be the focus of any educational program of the institution include chemotherapy patient care, professional stress management, cardiac emergency protocols, infection control, and telemetry. These were the post frequently mentioned topics throughout the questionnaire and thus appear to be the most important concerns according to the nurses surveyed. From the nurses’ responses, it is apparent that many of the nurses consider these subjects as underdeveloped in their professional experience and as such, they are very open to undergoing further education in order to be better equipped in the said areas. Some of the nurses prioritized special topics on patient care due to the large number of patients undergoing chemotherapy. Others consider learning proper stress management as a priority and claim that while they are equipped with the knowledge to care effectively for patients, they often find themselves stressed out in the process and some commented to eventually being in need of care themselves because of the demands of the work environment which they believe that can handle more effectively with appropriate training. With regard to how this new educational program should best be carried out, the nurses surveyed had varying suggestions but what was common among them is the preference of nontraditional educational programs over conventional programs such as actually going back to an institution and enrolling in a course that one has to be physically present to attend. The nurses generally preferred one of two options which are either to learn under the expertise of experienced mentors at work or to get enrolled to online learning classes at home. These preferences underscore the stress that the nurses are already experiencing at work which leaves them with no energy left to actually pursue further studies by traveling to an institution and being physically present to attend class. Hence, some of the surveyed nurses preferred to combine work and study by undergoing active learning under mentors who are experts at particular fields. The other half of the nurses surveyed preferred to learn through online courses that they can take at the comforts of their home and accomplish at their own pace. Common strengths cited by the nurses surveyed include the experience gained as nurses in the institution along with their strong proficiency with the use of current technology. The nurses justifiably claim that their exposure to various situations have honed their abilities in dealing with the same situations. However, they also cite that this is not the best way to learn as it places patients at some risk when they are handling a situation with the patient for the first time. Nurses believe that their expertise in utilizing web resources would allow them to have better access to continuing education since there are many specialized nursing courses available online. Furthermore even without enrolling in online courses, the internet provides knowledge sources that the nurses can access for free. Still, some commented on the level of reliability that these sources have. On the other hand, while the surveyed nurses claim that their experience has improved their competence, they also cite the demanding responsibilities given to them at work for their inability to pursue other educational courses in their profession. Some responded that the time that they spend between work and their families practically make up all the time that they have, and cite this fact as one of the major weaknesses in undergoing an educational program. In analyzing the sample’s assessment of hospital management’s sensitivity to their need for more specialized education, there is a general dissatisfaction perceived based primarily in the inability of management to respond to the staffing needs of the unit. The nurses stressed that while there are some educational programs being offered by the institution, these programs simply cannot be availed of by many of the nurses because of the physical and mental pressures brought about by their workload. One barrier to education that was highly prevalent with the sample is the lack of time due to the 5:1 nurse-to-patient ratios that the hospital has not been able to improve over the past years. Nurses need to prioritize their patients over other professional responsibilities and so continuing education takes a backseat. Some of the nurses also suggest that the hospital should give incentives to nurses who are willing to undergo additional training and education in order to motivate nurses to find the time for the task. Conclusion There is clearly a need to effect effective educational programs for the Medical-Surgical/Bone Marrow Transplant Oncology Nursing Unit of Sutter Medical Center. The nurses surveyed all agree that an effective program will be able to provide them with much needed professional development that they can use to improve the overall quality of service that they provide for their patients. However, the barrier of a highly toxic workplace caused by understaffing need to be addressed first before any program can be implemented that can capture the interest of the unit nurses. Thus, the top priority need of the unit involves the installation of a stress management program that would be able to help the nurses cope with their demanding responsibilities might be effective in taking out some of the pressure and allowing room for the nurses to accommodate professional training programs and academic work. A secondary need would be to address content that the nurses feel are lacking in their professional competence such as specialized subjects in chemotherapy patient care among others mentioned in the survey. It is anticipated that based on the administration’s thrust, they will be receptive to the results of this study and conduct efforts to help their nurses find the time to develop professionally. References Billings DM, Rowles CJ. (2001). â€Å"Development of continuing nursing education offerings for the World Wide Web. † J Contin Educ Nurs. 32(3):107-13. Gould D, Kelly D, White I, Chidgey J. (2004). â€Å"Training needs analysis. A literature review and reappraisal. † Int J Nurs Stud. 41(5):471-86. Click here to read Waddell DL. (1991). â€Å"The effects of continuing education on nursing practice: a meta-analysis. † J Contin Educ Nurs. (3):113-8.

Genetics Essay Example | Topics and Well Written Essays - 250 words - 7

Genetics - Essay Example In step 2, the aerobic endosymbiont evolves into a mitochondrion. This step is followed by step 3 in which a portion of the plasma membrane invaginate in the process of evolving into a nuclear envelope as well as associated endoplasmic reticulum. Step 3 results to a primitive eukaryote in step 4 that give rise to two main groups of eukaryotes. The primitive eukaryote shown in step 4 evolves into nonphotosynthetic protest, animal cells as well as fungal (Karp, 2009). The other group of â€Å"the primitive eukaryote takes in a photosynthetic prokaryote†, which later becomes endosymbiont that evolves into a chloroplast. In relation to this assertion, it is evident that endosymbiosis resulted to life. It is the one that led to the existence of both plants and animals. I more like my dad than my mom because I think the genes from my dad are more dominant those I inherited from my mom. In relation to this, it is evident that all mammals use majority of the genetic material passed down by males even though the offspring resembles and acts like the mom. Thus, my more resemblance to my dad is dictated by the paternal

Finance - Budgeting Assignment Example | Topics and Well Written Essays - 1000 words

Finance - Budgeting - Assignment Example A comparison of the actual and budgeted costs should be closely monitored to determine the efficiency of the system in place. If the current technique does not always reflect the true cost of operation or reports wide gaps between budgeted and actual costs, a change in technique could be a solution. The company has been employing process costing to budget and monitor its various costs. This method is a widely used tool in costing of its products. In order to do this, the company recognizes the following cost pools: The production budget of the company is set before the production period usually for one year. Traditional costing method and variance analysis are used to adjust the different costs incurred. At the end of each quarter, the company computes the different variances to determine whether the company is above or below the set level. However, no effort is made to correct the budgeted costs. As the size of the company is relatively small, it currently doesn't employ any software in order to efficiently track costs. The data for production is gathered for each pool center manually and is sent to each department involved such as purchasing, billing, and inventory. It is also apparent that the company has no formal monitoring system as the budgets are never adjusted. It should be noted that the price of materials being used by the company often vary with their availability. For instance, the price of LPG is directly related to the price of fuel in the world market. The volatility of the price of fuel is not taken into account as the company's budget is already set for a year's period. Recommendations for Improvement A company's budget as discussed above is one of the most significant information for managers as it reflects its expectations on its future operations. The company under consideration reports declining profitability within the past five years. The reported reasons for this are unexpected rise in material inputs which are not anticipated and reflected on pricing and additional costs due to lost of administrative and paper works. The company also admitted that as its competitors seem to be gaining market share through production efficiency, they seem to be lagging off. This is reflected by their declining profits and high production costs. It is recommended that the company reevaluate its value chain. This evaluation is needed in order for them to ascertain the processes which add value to their products and eliminating those which do not. This will lead to a leaner manufacturing system and will surely help the company in cutting down unnecessary costs. The company should also create an information system in order to