Wednesday, July 31, 2019

Picasso: Artist Extraordinaire

It was as array of Blue all over – some were cold, some skeptic, some with the desire to escape and mellow in the sky. Some were intense and challenging, while some other were diminutive and soothing. Together they reflected the state of their creator, who was then at the crossroad of his life – Mr. Pablo Ruiz Picasso! The genius of the geniuses, Pablo Picasso has left quite a few messages for the rest of the world – and very important one at that – because it is in the essence of those messages, lies the secret of his success.His Blue period happens to be a prominent slice of a painter who would rise to the zenith of name and fame later, much like a phoenix from the debris of despair, pathos and taunting ambience. Even a peep into his life would evoke anyone to identify the Blue period as his springboard – anyone would be excited to discover that how much power a parsimonious condition can generate for those who are willing. His life highlights the positive impact of poverty and drudgery in the making of a genius.The canvas of Picasso's life, in fact holds a picture that would always speak about the potential of human mind – that it is like a magic spring – the more you suppress it, the more it garners energy to outmaneuver its obstacles – or, from another perspective, it is from the chaos the universe of Picasso was born! The facts of Picasso's life shatters a good many myths about ‘chances rule human', and substantiates the fact that it is ‘humans who create chances' – a lesson as sparkling as a diamond to those who are deprived by the affluence of even basic amenities to bloom to their best.Thus this essay makes a humble survey on the life and works of this master of the masters, Pablo Picasso, with special emphasis on Blue Period, and how it impacted the proceedings of his life after, before reaching its own conclusion about the special messages that one can learn from his life besi des, indicating on the impact of â€Å"Blue Period† over the artists' movements.The protagonist, the central character of this magical example of human triumph, Pablo Ruiz Picasso was born on October 25th in Malaga, Spain, in the year 1881 and went to live on earth for 91 years, holding a unique collage of events, inventions, rendezvous and, most importantly, time-winning creations between the years of his charismatic existence. Thus it is impossible to discuss the Blue period without knowing about his background, which had a solid bearing on the rest of his life. A child Picasso would mingle with the gypsies, the outsiders of the society – their bohemian lifestyle had been a source of attraction to him (Picasso: Magic).It was his father Don Jose, who was an artist, a museum curator and a teacher all rolled into one, identified the latent talent in Picasso very early and engaged the boy into art. After having initial lessons from his father at home, Picasso joined Acad emy of Fine Arts at La Corupa, Spain, where his father was a teacher. He was then only a boy of 14 years, but that did not deter him to master the nuances of anatomy. That stint was short-lived as the family moved on to Barcelona, Spain in 1895, where both father and his son joined the Academy of Fine Arts, one as a teacher and the other as a student.Here the genius in Picasso first appeared before the world, when he startled everyone by qualifying for the advanced classes, after proving his astounding capabilities through completing the entrance test in a single day, which even the older boys would have taken whole month to complete! The jury board [†¦ ] of the entrance tests instantly declared him a prodigy. (Picasso: Artist Extraordinaire) During their stay in Barcelona, Picasso came across a new experience, and that was of [†¦ ] nude study and painting of the models. His uncle, Dr.Salvador Ruiz Blasco, who was very much impressed by the talent of the young boy, had arr anged everything for Picasso in his house at Malaga (Picasso). Next year he had his first painting making way to an exhibition. And no wonder, Picasso felt he has outgrown this academy very soon – as he left it to join at the Madrid Academy – which he would leave too in no time – before joining the band of young avant-garde artists, writers and poets, who would gather at a local tavern, Els Quatre Gats and were known as â€Å"modernistes† (Picasso: The Early Years)This group would discuss the revolutionary ideas under the then context – like symbolism, graphic arts etc. and accorded the French art nouveau, which used simplified versions of artistic nuances. Most of them were plagued by parsimony, and thus were on the same boat of poverty and uncertainty. Picasso visited Paris in October 1900, and from then on kept on shuttling between France and Spain. At this time Parisian nightlife caught his fancy and that resulted in some of his works that depi cted dark cafe or the destitute people, besides his usual works of landscapes, portraits.That was the foundation of this great man before he decided to meet the world with his treasure of art – with no footing whatsoever in the elite circle in the Paris, which was considered to be the stepping stone for an aspiring artist. And, he came, he worked, and worked, and worked – before leaving behind a legacy of a goliath. Blue Period In walked 1901 – by then his childhood favorites, the gypsies, perhaps vanished into blue, but the spirit of their bohemianism might have helped him to shrug off the shortcomings of not being a blue-eyed boy of any of the denizens of the art world of Paris.Yet, how would he know someday the world would earmark his formative years before becoming a true-blue artist, as ‘Blue Period'! In this period, especially between the period 1901-1903, Picasso had been able to gain direction in his painting, while his personal started evolving ou t of the situations, other painters' works and his deep understanding of the situations. This was the beginning of the â€Å"Blue Period†, where Picasso decided to confine within the color scheme of blue – which has already been considered as the color of pathos by many. That idea and the ongoing [†¦] parsimonious culture among the budding intellectuals around provided him the necessary momentum to stick to his decision (Blue, 2007). Thus this new line of painting by him started appearing in public – where he consciously highlighted the hapless state of humans with the mastery of forms of and usage of blue, which proved to be revelation for the contemporary art world (Picasso: The Early Years). The period 1901 – 1904 is roughly considered as the â€Å"Blue Period† of this great painter, when he would do his paintings and sketches mostly with various shades of blue.That coinage might outwardly justify itself with this strange practice of Picass o – but on the deeper level, the same coinage carries the connotation of a lone struggle of a painter that was further made difficult by emotional swings with the death of his dear friend Carlos Casagemas – who committed suicide after failing in love. Casagemas was the bosom pal of Picasso. Thus the shock of death and horror of suicide dominated in his painting, â€Å"The death of Casagemas†, which also bears the testimony of his learning process – as the painting has clear influence of Van Gogh's style.The same can be said [†¦ ] about his his work â€Å"Portrait of Jaime Sabartes (the beer glass)', which reminds about ‘Absinthe Drinker', a painting done by Gauguin (Blue, 2007). He created three portraits of Casagemas as a corpse, the last of his pictures showing colors for a prolonged period. The â€Å"Blue Period† also holds an account of Montmarte's nightlife, where Picasso and his friends would visit regularly. Those carefree moment s, however marked by limitation to enjoyment or engulfed by the cloud of uncertainty, sparked the imagination of this great painter.There were plethora of events, adventures and moments of solitude and despair – a constant swing between those two extreme poles perhaps made him more resilient inwards, otherwise how could he depict the sorrows of others so vividly? One such instance might add some color to this essay. Once Picasso went to visit a women's prison Called St. Lazare in Paris, and found nuns were serving as guards. That prompted him to paint â€Å"Two Sisters†, which evokes the image of Mary in mind, more because of the presence of blue rather than anything else (Picasso's).Then, there was this painter in his twenties, Picasso – cramped by extreme poverty and grief, was in all blue, before he became a star in the world of art. It was a period when he would find it difficult to arrange two square meals a day, save spending for oil paints and canvases or socializing with impresarios. Yet he worked on – that was the only thing he could do – he worked on with whatever he had with him – cheap blue color, a heart wailing for the lost friend, wondrous ideas in head, and, enormous zeal to communicate with his own visual language.And, it was that blue color, already recognized as the color of inner grief, had provided him the perfect medium for his message of the time. Thus it became blue all the way, deep, light, dark.. in every possible way it aided Picasso to express his sorrows in all possible dimensions – be it form, content or medium – all of them would echo the inner chaos of a twenty-year old who has just started the battle to gain his ground in one of most sacred colonies of art and culture, and right at the kick-off who received a jolt by losing his great friend and aide in Paris.It was that chaos which gave birth to the paintings like â€Å"Trait† (1901) or â€Å"The Tragedy† (19 03), which puts forth his desire and despair – while his self-portrait presents him as a happy-go-like romantic man with dreamy eyes, â€Å"The Tragedy† looked all gloomy, down in despair, where a family of three are looking downwards, visibly hopeless and as if nowhere to go, nothing to eat, and have nothing left to meet the basic needs of today, save the tomorrow! That was a beggar family whom Picasso covered by clothes, yet made naked with poverty, something he himself shared with them in this period.This speaks of the dichotomy that was prevalent in the time and also in the mind of Picasso, because, unless there was inspiration from both inside and outside by any means, Picasso wouldn't have been bent on to create such paintings of two extreme poles in close interval. Another interesting aspect of those paintings is their coming of age in a new avatar – that spoke of Picasso's own poor state, where he could not afford to buy canvases for new drawings and had to settle on the old ones. â€Å"What comes out in the end is the result of the discarded funds† (Picasso's Technique), he would say, perhaps to find a solace in his finesse in recycling!In fact, the researchers could find that the canvas used for â€Å"The Tragedy† contains sketches as old as 1899, while â€Å"The Tragedy† was finished in 1903. So much so, with the help of x-radiograph, they have been able to decipher that those sketches gave birth to one of his bullfight paintings. This clearly shows how misery had forced this great genius to abandon his work for the sake of new work. Perhaps all that boiled down to a sentiment, which saw a recurrence of the theme â€Å"like desolation of the outcasts† in his paintings of the â€Å"Blue Period†.Time and again researchers have identified Picasso's penchant for using excessive blue in this period as his conscious decision to use it as another medium of communication. And he did that with elan â₠¬â€œ the figures he depicted in this period was mostly of the lower rung of the society, ranging from beggars to prostitutes or the circus-people – even not to leave himself or his penniless friends – he dowsed all of them with blue to depict the world of despair that usually engulfs when people are caught with limitations and uncertainty.Obviously all his works are endowed with his mastery over form and content, yet it was blue that adds more dimensions to them, and at times, even issues more appeal than everything. He even would wear blue clothes in those days! Associating colors with sentiments was nothing new, yet the utilization of a color as the medium of the message was unique in his case. The use of blue color to depict sadness was prevalent even in the Anglo-Saxon culture (Pablo, 2007).However, Picasso's own statement, â€Å"It was thinking about Casagemus that got me started painting in blue† (Pablo Picasso blue period), helps all to associate his pers pective of blue as a language of inner grief or melancholy. This was supplemented by his own poor state where it became hard at times to arrange a good meal. â€Å"My dear Max, I think about the room on the boulevard Voltaire, about the omelets, the beans, the Brie and the fried potatoes. But I als think about the days of misery, and it's quite sad,† So he wrote afterwards to his friend, poet Max Jacob, the partner of his struggling days.Alongside, â€Å"Blue Period† was nonetheless a training session for Picasso, where he experimented with low light conditions, which perhaps gained momentum from the proverbial presence of pathos in blues or the prevalent culture of the then intellectuals who wanted to glorify by the poverty or take pride in the idea that an artist is generally considered as an outcast! There was definitely another reason, and that was his intense desire to be different from the crowd! The qualitative factors achieved by the use of blue also signify hi s tendency to experiment in those days.The paintings of a boy of twenty years as if serving as a passage to the dreamland with blue spectacles – that was something unthinkable before the traditional art. Some of his paintings would evoke a pall of gloom with the deeper shades of blue – yet the quality of luminance in them would make anyone stop and think about that gloom for a while. Thus, blue served for him as a strong language of visual communication. The presence of poverty and extreme difficulty has been reflected in most of his works in this period, either directly, or indirectly.For the first instance, the painting â€Å"Frugal Repast† depicts a destitute couple sharing a frugal supper of bread and wine; â€Å"Crouching Woman† depicts the hapless condition of a lonely, poor woman. He went back to Barcelona and started a painting with complex allegory called â€Å"La Vie†, a remake job over his earlier â€Å"Last Moments†, which took t urn from being a self-portrait to someone resembling Casagemus by its features, thereby making the journey of his â€Å"Blue Period† coming to a full circle with a tribute to the departed friend.Set in a studio, La Vie is considered as one of the most complex works done by him, and in the context of the period, contains the essence of his learning in the Blue Period, the lessons of which were mostly about the cruel side of the world, and were about how one could find the right path to move on. The scholars are still divided about the message hidden in this painting, where a nude woman clings to a male with only white loincloth on; who as if points towards another woman in heavy dress and holding a baby in her arms. These three figures stand behind a perspective that contains two canvases set on different layers, where[†¦] two clinging nude women adorn the upper canvas while another such figure is seen on her knees (â€Å"La Vie†, 2006). Perhaps this complexity, th is enigmatic, personal statement in â€Å"La Vie† speaks about the acorn that was now ready to bloom as a giant oak – this perhaps the most potent message conveyed by this painting of the master. Elements of Blue Period John Richardson, Picasso's biographer and his close friend, had almost devoted his life in deciphering the enigmas that are layered with Picasso's phases of evolution as a multi-dimensional creator.In that research, â€Å"Blue Period† holds a special place. Before anything, Richardson weighed certain elements that had influenced Picasso's mind right at his childhood. Richardson drew a parallel of Picasso's lifestyle with the philosophy of the gypsies and in the occult culture prevalent among the members of Andalusia, a region in southern Spain, which is the native place of Picasso. According to Richardson, the people of that region were found to be superstitious in nature, which would affect their actions too, and Picasso being one of them could not escape that influence.Because of being superstitious, once he found appreciation for using blue tone in that period and people accepted that, he had considered it as a good omen for his painting career and was stuck to it for quite sometime (Picasso: Magic). Even his days at La Coruna substantiates such claims of Richardson, where a young Picasso was deeply moved by tarot cards (Picasso: The Early Years). There can be another argument that points at a unique confluence of events that led to a series of ‘blue' creations by Picasso. This corroborates Richardson's assumptions too, by taking the superstition factor into account.This idea conjures up situations like Picasso's superstition about blue, his belief that blue is the messenger of inner grief, and his childhood and the then association with poverty or grief-stricken people. These situations might have been culminated into a series of paintings with blue tones – where Picasso wanted to give vent to his pent-up e motions, or he wanted to depict the haplessness of the poor or outcasts like gypsies or circus people, and he wanted to present them in a medium which he thought would convey the message best – blue.And he was conscious of his own poor state too – thus he didn't mind for once to operate from reality by including himself as one of the subjects of Blue Period. He did not ignore the pathos within him, and instead, accepted them as the way of life. This idea is corroborated by Jaime Sabartes, then his closest friend: â€Å"Picasso believed Art to the son of Sadness and Suffering†¦ that sadness lent itself to meditation and that suffering was fundamental to life†¦ If we demand sincerity of an artist, we must remember that sincerity is not to be found outside the realm of grief† (Picasso and the Mood).In all, this was the period where he was tested by all possible roadblocks, which had forced him to bring out his best to cope that challenge. This was the per iod when Picasso stepped into the mystic realm of spiritualism and ethereal ideas – all fueled by death, despair, poverty and uncertainty. Therefore, this period in his life had gifted him the prime elements of success, all in disguise – the required zeal, the expansion of mind and deep feeling for fellow humans. ConclusionThe Blue Period of Pablo Picasso is essentially a documentary of a collage of situations, which not only unfurls the stages of Picasso's blooming as an artist, but also refers to certain ideas about the then social condition, the locomotion of art and culture of Paris, etc. But the greatest messages lie in another direction – where this period talks about how one's childhood association creates impact on one's creative pursuits, or how a human being emerges as victorious in front of the challenges of extinction.This era also marks his coming of age with various types of practice, development of ideas and eventually the birth of a new style wit h seeds of his other periods like â€Å"Rose Period† or â€Å"Cubism†. The gathering of a bubbling gang of intellectuals at Montmartre or Picasso's association with them, all speaks about a wonderful movement of art and culture led by people who even took pride in considering themselves as outcasts for the sake of art.Together all these, â€Å"Blue Period† depicts a unique march of time, which not only benefited Picasso to rise his height in the future, but also it provided a solid documentation of time. Pablo Picasso's â€Å"Blue Period† is indeed a lesson to all who are interested to fight and win from the wretched state, besides the aspiring painters. It also highlights the effect of death and the power of humanity over the creative manifestation of perfection in an artist; rest lies with Picasso himself, who took away a lot of hint with him, leaving a big box of enigma for the posterity!Ends Works Cited â€Å"Picasso: Artist Extraordinaire. † . . 4 Dec. 2007 . Blue period. . 3 Dec. 2007 . La Vie. . Cleveland Museum of Art. 4 Dec. 2007 . Pablo Ruiz Picasso (Spain) 1881-1973. 4 Dec. 2007 . Picasso – Magic, Sex and Death. Ed. W Januszczak. 4 Dec. 2007 .Picasso and the Mood of a Painting. Color Vision and Art. 4 Dec. 2007 . Picasso. Ed. H. L. C. Jaffe. 4 Dec. 2007 . Picasso: The Artist's Studio. 3 Dec. 2007 . Picasso's Blue Period 1901-1904. . 4 Dec. 2007 .Picasso's Technique. 4 Dec. 2007 . Rubin, W. Picasso in the Collection of the Museum of Modern ArtRev. 5 Dec. 2007 . Warncke, C. P. Pablo Picasso 1881-1973. 5 Dec. 2007 Picasso: The Early Years, 1892-1906. 5 Dec. 2007. . Pablo Picasso blue period. 4 Dec. 2007. .

Tuesday, July 30, 2019

Nursing Specialty Essay

The world of healthcare is one of frequent changes. Those who have dedicated themselves to the nursing profession understand that healthcare is continuously evolving, as it is our responsibility to provide only the highest standard of care to our patients. Each nurse that is certified within a nursing specialty strengthens the entire healthcare team. Those that obtain specialty certifications are seen as the leaders in the field and are strong resources for the team members lacking the specialized education. Among the multiple nursing specialty certifications obtainable, legal nursing is relatively new. For many years registered nurses aided legal teams by providing attorneys with needed medical knowledge without the option of obtaining specialized training, earning specialized certifications and/or having the known support of a specialized national association behind them. Only due to a clear vision and the undying determination of several registered nurses, the not for profit national organization tilted the â€Å"American Association of Legal Nurse Consultants (AALNC) was founded in July of 1989† (â€Å"American Association,† n. d, para. 1). According to Huff, Costantini, and Mihalich, the driving force behind the birth of this national association was a group of registered nurses that had already been acting as legal consultants and were determined to educate the legal profession about the effectiveness of the nurse consultant as liaison between the legal and medical communities, and to provide a network for members to share expertise. The early pioneers recognized for initiating what now is a powerful specialty within the nursing field are Rosanna Janes, RN, Karen Wetther, RN, Joanne Behymer, RN, Paula Schenck, RN and Kathleen Loeffler, RN. The legal nursing consultant specialty has evolved greatly since its birth and has made several major contributions during its relatively short existence. The first contribution noted within the information provided by the Legal Nurse Consulting Principles states the following: While AALNC has always offered national membership benefits to nurses licensed in any state of the U. S. , it was through the establishment of chartered chapters that AALNC fostered membership growth, networking, and education at the local level. Within 10 years, chapter activity went from the three original local groups to chapters in more than 45 cities in 31 states. The number of chapters continues to increase each year. (Huff, Costantini, & Mihalich, n. d. , p. 27) The association demands that those with accreditation be highly educated along with maintaining current certifications to practice, the AALNC offers multiple resources to achieve these expected standards. The educational opportunities have developed and include an annual educational conference along with numerous educational materials in written, audio, and video formats that are readily available for its members. These are designed to assist nurses at all levels of expertise in legal nurse consulting practice. (Huff, Costantini, & Mihalich, n. d. , p. 30) An additional major contribution the AALNC has provided the nursing profession is â€Å"recognizing the importance of nursing certification that incorporates experiential and educational requirements, AALNC established the American Legal Nurse Consultant Certification Board (ALNCCB) in 1997. ALNCCB developed the Legal Nurse Consultant Certified (LNCC) certification program and credential† (Huff et al. , n. d. , p. 42). As explained above, the specialty of legal nursing has impacted multiple aspects of the healthcare system with the most important aspect being our patients. Legal nursing allows a registered nurse with specialized education to advocate for the patient from the beginning of a legal case to the end. The protection and safety of our patients is the number one responsibility of all healthcare professionals, it is essential that legal nurse consultants continue to work side by side with attorneys to ensure the best outcomes possible for all parties involved. The legal nurse specialty has also impacted multiple other entities including insurance companies and healthcare facilities by providing the essential medical facts needed to prove false claims of malpractice. With the many strengths the legal nurse specialty has brought to the nursing profession, it is evident that this specialty is nothing short of a necessity.

Monday, July 29, 2019

The Effectiveness of Light Therapy Assignment Example | Topics and Well Written Essays - 2500 words

The Effectiveness of Light Therapy - Assignment Example Tsai Hsiu-Hsin conducted this research to find out the effect of therapy on depressed elders. The researchers Yun-Fang Tsai and Hsiu-Hsin Tsai belong to the school of nursing in Taiwan; Thomas Wong is from the school of nursing in Hong Kong, while Yeong-Yuh Juang works in the Department of Psychiatry in Taiwan. The research is conducted because elderly depression has become a major issue and there are no past studies that are conducted for examining light therapy effect on elderly depressions in tropical areas. For this purpose, the old patients that were hospitalized because of depression in a subtropical climate area are selected. The experiment was conducted in such a way that patients had to sit in front of a light box where they faced 5000 lux early in the morning. This experiment lasted for 5 days in which time duration was 50 minutes each day. Treatment was only given to the experimental group, while there was no treatment for controlling group. The results of this experiment stated that there was a significant reduction of depression on the patients after the experiment, but no effect was found on the control group. This research is very helpful for the elders as they can use light therapy for reducing their depression and it has a positive impact on them. The major limitation of this study was that only one hospital was selected for this experiment therefore, different hospitals could be used in the future.

Sunday, July 28, 2019

Editing Essay Example | Topics and Well Written Essays - 1500 words - 1

Editing - Essay Example The ANWR oil drilling issue has even reached the point that it has become an agenda for national elections. Both the Republicans and the Democrats have used their respective stand on this subject as part of their strategies in gathering political support for every electoral contest in which they participate. The Democrats have held the stand of opposing oil drilling in the area since President Clinton (Douglas). On the other hand, the Republicans have been pushing for the opening of the 1002 Area for exploration and eventual extraction. However, the political noise generated by the debate on this issue between the Republicans and the Democrats has only blurred further the merits and demerits of oil drilling in the ANWR. Therefore, people are led to choose which political party line they should follow instead of basing their stand on the issue on the concrete evidence and logic. If provided an objective view on the issue, however, minus the

Saturday, July 27, 2019

Midterm paper (proposal development) Research Example | Topics and Well Written Essays - 750 words

Midterm (proposal development) - Research Paper Example These elements are: (a) elevation the patient’s head of the bed between 30 and 45 degree unless medically contraindicated; (b) a daily sedation vacation and assessment of readiness to ‘extubate’ unless medically contraindicated; (c) peptic ulcer prophylaxis; (d) deep vein thrombosis prophylaxis; (e) use ‘chlorhexidine’ for oral care. The entire bundle was considered compliant only if all five items were compliant. A bundle was considered noncompliant if any item was not performed. The dependent variable for this literature review is reducing the incidence of Ventilator-Associated Pneumonia (VAP) rate among Intensive Care Unit ICU patient population. VAP is defined by pneumonia occurring more than 48 hours after patient have been ‘intubated’ and placed on mechanical ventilation (Koeman et al., 2006). The patients must have been free from any sign of pneumonia or chest infection in radiological images prior VAP development. The ventilator-a ssociated pneumonia (VAP) rate is defined as the number of ventilator-associated pneumonias per 1,000 ventilator days (Garcia et al., 2009). The independent variables are implementation of VAP bundle, developing oral care protocol using ‘chlorhexidine’, implementation of Nurse-implemented sedation protocol, and Staff training program on VAP bundle. All of these independent variables are considered intervention to improve healthcare providers’ compliance with VAP bundle and consequently, reduces the incidence of VAP. Oral care is defined by cleansing of oral cavity and oropharynx using cholrhxidine every 2-4 hours per as protocol (Koeman, et al, 2006). Active implementation is defined as providing various types of educational programs (in-service presentation, video, workshop) to all healthcare providers on VAP , VAP rate, VAP related-complications, and VAP preventative measures (VAP bundle) (Hawe, Ellis, Cairns, & Longmate, 2009). Nurse-implemented sedation proto col defines a strategy that guides a nurse in administering dosage, in this case, to ventilated patients based on their weight and level of consciousness by using Cambridge scale (Quenot et al., 2007) in order to prevent patients’ over sedation. There is abundant research showing that hospitals that implement the VAP Bundle significantly reduce the incidence of VAP. A quasi-experimental study of all adult patient who admitted to ICU and required mechanical ventilation from 2006-2008 , the sample size and sampling plan were not mentioned, revealed that VAP bundle reduces the incidence of VAP from 9.3 cases per 1000 ventilator day to 2.3 cases per 1000 ventilator day (p = .001) using Box-and-whisker plot. Furthermore, U chart revealed that the overall compliance with VAP increased from 20 percent to 82 percent (Al-Tawfiq & Abed, 2010). A quantitative randomized, double-blind, placebo controlled trial study of 385 consecutive random sampled adult ICU patients revealed that topic al oral decontamination with chlorhexidine reduces the incidence of VAP by 65 percent (p = 0.012) for chlorhexidne and 55 percent (p = 0.030) for chlorhexidine/cholistin using sequential survival analyses (Koeman et al., 2006). The qualitative study of a convenience sample of 10 registered nurses’ working in ICU, using content analysis, revealed that nurses’

Wage determinant Essay Example | Topics and Well Written Essays - 500 words

Wage determinant - Essay Example The main emphasis of this paper is on the role of productivity in determining wage rates with respect to competitive markets such as the U.S. Productivity as a Wage Determinant Productivity is defined as the ratio of input to output. However, productivity can denote both ‘total factor productivity’ and ‘labor productivity’ (Backman). Labor productivity, traditionally, is seen as the output produced per hour/unit of time (Backman). The 1960’s and 1970’s saw a fall in productivity levels in the U.S (Backman). However, the economy recovered in the 1990’s and 1995 onwards was marked by very high levels of productivity. As far as wage markets are concerned, the more appropriate concept is that of labor productivity as it bears direct relation with the wage rate. As far as the U.S is concerned, the importance of this factor in determining wage levels dates back to 1948 when labor contracts underwent positive change throughout the automobile in dustry (Lewin and Kaufman). Later, in the 1960’s another proposition came into play that wage rates in an organization should be linked to the productivity of the economy as a whole (Lewin and Kaufman). This proposition has been heavily debated.

Friday, July 26, 2019

Summary Movie Review Example | Topics and Well Written Essays - 500 words - 1

Summary - Movie Review Example The main problem that gave rise to such a thing was the use of a deputy (by the sheriff investigating the case) to translate what a witness to the crime said. The translator was used because Cortez could not speak in Spanish. The worst part was that the translator himself could not speak Spanish accurately-his inability to distinguish in Spanish between a caballo (horse) and a yegua (mare) leads to the sheriff believing Cortez to be the horse-thief. When the sheriff goes after him with a gun, Cortez rightfully fights back for his life-in the current century, this act of his would be called self-defense. His brother gets shot and killed in this process in the mayhem. Cortez accidentally shoots at the sheriff, killing him. Soon after this occurs, Cortez takes off on horseback and heads for the Mexican border. He is pursued by sheriffs, the renowned Texas Rangers and possess across Texas, all of whom were unable to catch the ‘fugitive’. The longer it takes for them to capture him, the more he is depicted as a hero by the press. Even though he steered cleared of the several traps that his capturers set for him, he eventually turned himself in when he found out that his family had been arrested by the authorities and kept as prisoners. The manhunt lasted for about eleven days. This whole incident results in the devastation of a family and the killing of an innocent man. The Ballad of Gregorio Cortez is an amazing representation by director Robert M. Young of the injustice that Mexican-American workers and citizens in the Southwest suffered at the hands of the Texas Rangers. The director has effectively used the techniques of flashbacks to show the different accounts of what happened. Moreover, it is a bit intriguing to find out the real character of Gregorio Cortez. This is because his role in the story keeps changing from time to time- it all depends on who is telling the story. There is, however, one

Thursday, July 25, 2019

Critically discuss the importance of play pedagogy in the curriculum Essay

Critically discuss the importance of play pedagogy in the curriculum for young children's learning and development - Essay Example It is seen as a manifestation of immaturity and children are expected to outgrow it and move on to more â€Å"grown up† activities (Moyles, 1994). However, today the role of play is recognized by policy makers, researchers and education developers to be critical in the intellectual and emotional wellbeing of children (Kennedy and Barblett, 2010). Retrospectively, the educational community in Europe has increasingly taken cognizance of the need for quality pedagogy in early childhood education to prepare children for both academic pursuits as well as social integration (Christie & Roskos, 2006). This paper discusses the importance of play pedagogy in the curriculum by examining the background of play in education, in the Early Years Foundation Stage (EYFS), the various forms of play and finally its developmental benefits with a view to justify its inclusion in education systems. To start with, the key terms are defined so as to provide the reader with a sense of contextual uniformity as this term represent the recurring themes in the entire. Pedagogy can be loosely described as a methodology or practical application of the teaching process. The curriculum on the other hand is a preset framework that outlines all what learners should be taught the quality and to some extent the methods that should be used, it however provides allowance for the teacher to act flexible based on the education setting or context. Pedagogy is seen as a formal and serious construct. As a means of understanding this to a more full and complete degree, the following discussion will partially focus upon understanding these dynamics by utilizing socio-cultural theory and interpretation. Historical and anthropological studies in to the nature of the European childhood have revealed that like today, the classical Greek and roman cultures valued play and

Wednesday, July 24, 2019

Performance Evaluation Essay Example | Topics and Well Written Essays - 1000 words - 1

Performance Evaluation - Essay Example Thirdly, there are strong evidences found which represent the inclusion of an element of biasness and partiality in evaluating the performance of the personnel, which in turn may lead to significant deviations from the actual performance of the personnel. Traits are defined as the properties and characteristics of any given person’s personality. Every person always keeps and carries all personality traits with him/her such that these traits become inseparable from the personality of the person. In evaluating the performance of an employee, the personality traits do have their importance as they actually demonstrate what the personality of the employee is all about (Dessler 2010). Is he/she charming, extrovert, sharp, lazy, or arrogant etc? Behaviors are the particular course of action that a person demonstrates in a particular situation. Behaviors are more concerned with the physical activities and dealings that a person displays given the overall theme or mood of a particular environment. These behaviors are also affected by the mood and emotions of the person as well. For instance, the employee may reflect a careless behavior in the work environment which would be referred to as his behavior, but what actually is causing him to behave in such a weird manner, might be the family issues, financial issues or any other issue (Dessler 2010). Job results are the actual outcomes that are achieved as a result of performing a specific task or duty. Whatever task or duty assigned to the worker, is judged by the ultimate outcome or result of that particular task (Dessler 2010). For example, if an employee is assigned to draft a particular report, the ultimate outcome or result of that task would be the final draft report to be handed over to the supervisor. What actually matters to any organization are the results obtained by the employees. Only those organizations prosper and remain successful in developing a result-oriented culture in their

Tuesday, July 23, 2019

International Relations Theory and Global Economy Essay

International Relations Theory and Global Economy - Essay Example International Relations Theory and Global Economy Global economy is the combination of all the economies of the world’s countries. The valuation of the world economy can be arrived at by representing it in a certain currency like the US dollars. Each country experiences a trade cycle where the rate of growth of expenditure, incomes and production changes over a period of time. The duration and effects of these cycles are dynamic simply because the structure of the economy is developing. This may be caused by theoretical relationships between different variables, for example, unemployment and inflation which might have changed. This poses many challenges to policy makers as they try to control the economy and meet their objectives. Taking the economic growth of a country, for example the U.K., and analyzing how it has been for the past years, it is possible to know that the country has experienced many shortcomings to date. Notably, the UK has experienced recession and boom periods in the process of its economic development. J ust to highlight some key areas contributing to the growth of the U.K economy, one is strong consumption. Consumer spending has contributed positively and has had positive effects to the economy like, absorbing some of the weaknesses of the export and investment sectors. However, this has not come so easily because it has its limitations, which include increased debts and increase in rentals. Low investment in capital equipment has also led to growth in the economy as some of these major investments were left to the private sector to cover.3. Growth of the economy globally has main stages like the economic boom. A boom is a situation that occurs when gross domestic product grows faster than the trend growth rate. At this period, aggregate demand is high, and businesses increase production and employment. Due to high demand, prices may also increase which translates to cost push and inflation in demand. Demand for imports increases because of high marginal propensity of importation a mong customers. Revenues from tax increase as more people are in employment and earning, hence, they spend more money. In addition, company realizes high profits as production increases, thus, increasing sales due to high demand in turn leading to high investment. Labor is used exhaustively at minimal costs, that is, no extra labor is needed. The other economic cycle is the economic recession which is a decrease in national output4. Every aspect of the economy is restrained to its maximum. This is a period where the economy is operating below its breakeven point. As the negative part of the economy, it can lead to increased unemployment, low income per head, international insecurity as many become jobless increased bad debts and the end result of all this is conflicts. The table below gives an illustration of the economic growth of the UK and inflation rate in the country for the past few years; Resource: http://www.economicshelp.org/images/macro-graphs/econ-growth-inflation-dec-201 1png.jpg Further still, global economy has attracted the centre stage in international politics of late. Politicians cannot do without bringing the issue of economic growth and fall to the world as they try to appeal to the world to consider them in election to top seats. They lay down structured policies on how they are going to deal with the monster

Monday, July 22, 2019

Development in the novel Essay Example for Free

Development in the novel Essay Great Expectations has been described as the story of a snobs progress. In the light of this comment, describe Pips development in the novel. Refer to the changes in the way he behaves and talks, the reactions of other characters in the novel and the reasons why he normally retains the readers sympathy.  In Great Expectations, Pips character goes through many changes. His morals and outlook on life are both greatly affected by his lifestyle, and his view of other characters is changed by his experiences and surroundings. At the beginning of Great Expectations, we see Pip as a very young child, living in fear of his sister, Mrs Joe Gargery. Joe is described in much the same way, which shows how he is childish at heart. We are told that Pip also sees this in chapter 2, when he tells us I always treated him as a larger species of child. Pip and Joe both live in fear of Mrs Joes regular Ram-pages, and her wax coated cane, Tickler. Although Pip and Joe obviously fear Tickler, Pip never really speaks of his fear in the book. It is seen more as a part of his life than a painful experience. For example, when Pip arrives home late after his encounter with Magwitch and learns of Mrs Joes Ram-page, he is told by Joe that Which is worse, shes got Tickler with her. Instead of showing fear, we are simply told that At this dismal intelligence, I twisted the only button on my waistcoat round and round, and looked in great depression at the fire Mrs Joes treatment of Pip is mimicked by Uncle Pumblechook, who seems to be fully supportive of her complaints against Pip mainly that he exists and that she has to look after him. At the start of the book, Pumblechook is very nasty to Pip, and is also fully supported by the Hubbles (at Christmas dinner) and Mr Wopsle. The main topic of conversation (apart from pork) is how ungrateful Pip is. This is brought up first by Pumblechook, who says be grateful, boy, to them which brought you up by hand.. This is then backed by Mrs Hubble, who adds Why is it that the young are never grateful?. This conversation continues for some time, which cause Pip to remain silent and sink into his chair. These two examples show that in the first section of the book, Pip is afraid of his surroundings. He keeps quiet and tries to stay away from company (except Joe) to avoid punishment. Joe is Pips only friend, and makes up for the absence of other children in his life. Pip is happy talking to Joe, unlike Mrs Joe and her circle of friends.  Pip meets two other main characters in the first part of the book, and they are Miss Havisham and Estella. These are two of the most important characters in Great Expectations, and Dickens develops their characters a lot. Upon Pips first meeting with Miss Havisham, he is afraid of her, but it is not the same kind of fear as he has for Mrs Joe. He fears Mrs Joe as he fears Tickler, and does not want to be punished. However, he is afraid of Miss Havisham because she is strange and twisted. Pip does not understand her, and does not know what she is capable of, or what she could do to him. He speaks of her as a ghost, and sees many disturbing sights inside Satis House, such as the infested wedding feast and the stopped clocks. Pip tells us of his terror at his first sight of Miss Havisham. She can see his fear, and asks him You are not afraid of a woman who has never seen the sun since you were born?. We are then told that I regret to state that I was not afraid of telling the enormous lie comprehended in the answer No. As the book progresses, Pip comes to realise that there is nothing to be afraid of in Miss Havisham. By the end of the book he is happy to confront, criticise and even insult her. Pip also misinterprets Estellas character. He falls in love with her the first time he sees her, even though he is only seven years old. This is obviously what Miss Havisham was trying to achieve, as she is continually quizzing Pip on his thoughts about Estella, and one of the first things she asks him is What do you think of her?. Pip, after some hesitation, replies that he thinks she is proud and rude but also pretty. Pip says little to Estella herself, but once he has left Satis House he is totally obsessed by Estella. This leads us onto a sudden change in Pips character.

Background to HRM at General Motors Corporation Essay Example for Free

Background to HRM at General Motors Corporation Essay General Motors Corporation (NYE: GM) is the leading American automaker in the world with its operations spanning in 157 countries. The car manufacturer was established in 1908 in Michigan and today it is headquartered in Detroit, the United States of America. Besides the domestic industry of the United States of America, General Motors manufactures cars and trucks in other 30 countries around the world. Among its brand products are Cadillac, Buick, Chevrolet, GMC, GM Daewoo, Hummer, Holden, Opel, Saab, Pontiac, Vauxhall, and Saturn. Besides these brands that are owned by the automaker, GMC also operates joint ventures in China and Japan. That is, Shanghai GM and SAIC-GM-Wuling Automobile respectively. From its Website, General Motors Corporation is among the leading American employer with 204 000 employees distributed throughout its global markets. The employees include production engineers, financial auditors, marketers, and researchers among others. Before restructuring and retrenching that took place in 2008 following a harsh global financial crisis that resulted into a loss of $37.3billion by the automaker, General motors corporation was the leading American employer with 284 000 employees (GMC, 2008). Because of its large network of global presence in 31 countries, General Motors human resource management practices entail international practices that are designed in accordance to the international operation requirements and the organizational culture designed to reduce operational costs. Majority employees of the corporation’s subsidiaries in the 31 countries are drawn from the domestic pool of local labour markets and only a few expatriates are drawn from USA as back office managers due to their wide knowledge of its organization culture (Cappelli, 1999). The Board of directors which draws from the organization’s international market presence is charged with the responsibilities of making major decisions critical to the company’s operation. According to Gustin (2008), General Motors Corporation spent up to $103 million in settling healthcare insurance benefits of its retired employees in 2007. From this information, it is evident that the American automaker provides life insurance covers for its employees upon retirement. However, following restructurung, these benefits  were stripped off and only a few employees still enjoy them today. From January 1, 2010, pension scheme of retired hourly employees of General Motors Corporation was transferred to United Autoworkers; a third party insurance firms and all permanent employees who were hired after january 1, 1993 nolonger receive health care insirance benefit upon retirement(GMC,2008). The entry salary of the global automaker is dictated by the labour laws of each market of operation and thus varied with the United States of America being the highest irrespective by job categories ( Main et al., 2007). The organization has invested in a Human Resource Management system that allows close interraction of its global employees through technology such as e-mailing and enterprise resource Management (Azrul, 2010). Marketing strategy entails presentations by field marketers to the organization’s large distributors and online follow ups. Reccommended HRM practices for GMC From the above background analysis of General Motors corporation, it is clear that the organization requires international Human Resource Management practices that will integrate the cultural diversity of its employees.The catastrophic impact of the 2008 financial ciris that resulted into massive restructuring and retrenching of its human resources also underscores the organization’s poor human resource planning. The following recommendations are prescribed for the automaker on the basis of figure 1 below. The first recommendation, is Re-designing the business strategy to target the bottom line of the market. According to Azrul (2010), one of the main reasons for the $37.4 billion loss incured by the American automaker is external market forces from competitors like Honda and Hyundai that were producing far cheaper vehicles with high efficient engines and low fuel consumption rates as compared to Genereal Motors’ brands. In the heat of global financial crisis, the market shifted to consumption of cheaper and less fuel consumers produced by the competitors resulting in huge losses by the General Motors Corporation. The new business strategy should entail  designing cars and trucks with high eficent engines and electric cars that can survive an upsurge in oil prices. This will involve an investment in manufacturing technologies that ensures high quality at reduced costs such as electric engines that uses bateries.This will give the Amecan leading automaker a competitve advantage against the stiffening market competition. The second recommendation is outsourcing of labour from China and Japan. Many Corporations prefer to manufacture their products from China because of the availability of a relatively cheaper labour force when compared to western counterparts. General Motors corporation can either outsource its human resoure from China or undertake most of its production from its Japanese and Chinese Subsidiaries. The labour laws in the two countries are relatively flexible and firendly than in the United States of America. This will help the American Automator reduce huge operational costs incured in meeting the big payroll of over 200, 000 employees. The third recommendation is integration of employees’ training in high involvement work practices. According to Konrad (2006), engaging employees of an organization in job specific training improves their productivity by increasing their job-related skills, reducing propensity of committing costly errors, and increasing their job confidence. Training of General Motors’ employees on their job specifications will improve their productivity. Ofshore trainings in China and Japan are recommended. This will allow the corporation’s manufacturing engineers to learn new efficient production technologies of Japan and China in making cheaper and highly effiecient cars. Motivational incentives such as team building sessions, delegation of duties, self-managed leadership styles, and monetary rewards will boost their commitment to the organization. The combined effect of training and motivation will necesitate restructuring of a pay roll while leveraging on improved productivity of highly productive employees. The fourth recommendation is embracing technology in Human Resource Management system to enhance global cordination of its business. According to Dreher and Dougherty ( 2002), the use of technology such as centralised Enterprise Resource Management system to co-ordinate human resource  activities of General Motors will enhance quick sharing of ideas and consultation among the global employees of the company without barriers. This will allow the organization to carry out its marketing strategies efficiently and effectively without limitation by geographical distances. Effective Human Resource Management through streamlined sofware-based systems enhances fast communication and online training which gives an organization a higher competitive advantage. The fifth recommendation is integration of social benefits such as pension and health care schemes in the reward system. From the backround information above, it is evident that General Motors Corporation with-held social benefits for employees who were hired after January 1, 1993 and transferred the remaining ones to third pary insirance firms. The American automaker also stripped healthcare benefits for retired employees beyond 65 years. Acording to Konrad (2006), social rewards like health care insurance schemes make employees feel more valued by their organizations than monetary rewards in terms of bonuses and salary increments. Also pension schemes improve employees’ commitment to their employer because of future guarantees. This reduces employees’ turnover which is essential in retaining critical human resources for continuity of operation of General Motors. High staff retention improves an organization’s competitive advantage in a complex market of operati onal rivalry. The sixth recommendation is the implementation of employee productivity management and monitoring systems such as Balanced Score Card (BSC) and High Performance Work System (HPWS) (Rouse, 2000). The latter system refers collectively to open systems, autonomouas teams and teamworks, and performance-based pay (Azrul, 2010). The implementation of the two Human Resource Management systems will improve organizational performance by providing real time employees’ information storage database from which future managerial decisions, and rewards will be based. According to Konrad ( 2006), employees of an organization are more productive when they are aware that their performance is recorded for review in determining their future rewards. Effective implementation of the Human Resource Management systems will help General Motors Corporation in categorising employees  according to their productivity rates. This information is important in determining the relevance of job training and objective restructuring in the event of a crisis like that which befell it in 2008. In this case, only high productive employees will be retained. The seventh recommendation is the implementation of an integrative pay/ reward system to inculde performance-contingency pay scheme, skill-based pay, and seniority-based pay scheme. According to performance-contingency pay scheme, the employees’ reward will be based on the performance of their working teams. This will help the automaker in creating effective self-managed and motivated teams. Skill-based pay will ensure that employees’ pay schemes are based on their job skills. For instance, production engineers will be given high pay than marketers because of their technical skills required by the organization. Seniority-based pay scheme demands that those employees who have stayed longer in the organization will get a higher pay than new comers because of their cumulative salary increements along their carrier path. Seniority-based pay scheme promotes staff retention even when the entry salary is relatively lower than the market rates because employees know that there is a room for growth. In general, General Motors Corporation should ensure total compliance with the labour markets and legal environments of their respective countries of operations before implementation of the proposed recommendations. For instance, the employment laws regarding hourly wages, minimum wage policy, employment opportunities, labour regulations, and safety rules in China are different from those of the United States of America. Therefore it is imperative that the American automaker consider their implications in setting the minimum entry wage in each country of operation. Conclusion. In conclusion, General Motors Corporation can sustain its competitive strategy as a leading automaker by embracing the above prescribed Human Resource Mangement system that integrates staff training on job related skills, outsourcing, social reward scheme, technology, and  performance-contingency pay scheme among others as strategic competiencies in its operation. The implementation of Balanced Score Card and HPWS is critical in improving the productivity of the organization’s employees. The proposed system will enhance high staff retention, high staff productivity, and objective contingency planning in times of global crises like the 2008 global financial crisis that lead to massive retrenchment by the automaker. References Azrul, A. (2010). Human Resource Management General Motors. Monash University Publication, p.1-13.From: http://www.scribd.com/doc/14812855/Human-Resource-Management-General-Motors Main, B.G.,Jackson, C., Pymm, J., Wright, V. (2007). GMC:The Remuneration Committee and Strategic Human Resource Management. University of Edinburgh publications, p.1-49. Cappelli, P. (1999). Employment Practices and Business Strategy. Oxfford, ew York : Oxford University Press. General Motors Corporation. (2008). Restructuring Plan for Long-Term Viability: Submitted to Senate Banking Committee House of Representatives Financial Services Committee. Detroit: General Motors Corporation. Rouse ,D. (2000). Manufacturing Sdvantage:Why High Performance Work Systems Pay off. Journal of Team Performance Management, vol 96(5) , p.1420. Dreher, G., Dougherty,T. (2002). Human resource strategy: A behavioral perspective for the general manager. Boston: McGraw-Hill/Irwin. Gustin, L. R. (2008). Billy Durant: Creator of General Motors. Ann Arbor. Michigan: University of Michigan Press. Konrad, A. M. (2006). Engaging Employees Through High-Involvement Work Practices. IVEY Business Journal , n.p.From:

Sunday, July 21, 2019

Diversity and Structure of the Construction Industry

Diversity and Structure of the Construction Industry 1.1 Introduction: This chapter illustrates how unique, huge, diverse and enormously complex is the construction industry. This industry generally constitutes of enterprises and professionals whose primary objective is to build communities, roads, schools, homes, business, hospitals and including its maintenance. The construction process consists of many activities, right from the onset of the project design and right through its implementation, maintenance, refurbishment, and goes up to the eventual disposal of its buildings or in other words, the whole life cycle of the project. This industry therefore require a wide range of suppliers, contractors and including manufacturers of materials and components to carry out its activities. The industry had changed a lot in its complexity over time, but the objective of the industry remains basically the same as it was 100 years ago. However, the construction industry has a unique structure; with very few large establishments that dominate the infrastructure by carrying out works, that produces the majority of the turnover of this industry on a whole. Sears et al. 2008, p.2 state that contractors who vary widely in size and speciality accomplish the construction works. Some contractors choose to concentrate on a particular task or aspect of the construction project and are therefore referred to as specialty contractors. Others assume broader responsibility for a comprehensive work package and are referred to as main contractor. Due to the diversity present in the industry, the industry is fragmented which is a reality, the reason might be due to the adversarial short-term relationships which causes dissatisfaction within the industry and is therefore a project focused relationship. Moreover, lack of effective communication and implementation may also contribute to the fragmentation of the industry as it leads to significant negative impacts, low productivity, cost and time overruns and finally end up in conflicts and disputes. The industry also now faces new levels of complexity as it moves forward trying to keep pace with the increasing energy, material and labour costs which are to a great extend mitigated by the other industries by adopting the new technologies especially communication and information technology and also advanced management strategies. 1.2 Overview: The industry is considered to be one of the major economic sectors, which contributes a lot to the gross domestic product of the nation in respect to other industries. Cooke, and Williams, 2009, on p.3 states that the annual output of the UK construction industry is approximately  £114 billion, which represents almost 9% of gross domestic product. This industry also underpins the remaining sectors of the economy by providing the essential infrastructure and facilities on which all sectors of the economy depend. According to Potts, 2008, on p.3, this construction sector with 11.8 million operatives directly employed makes it Europes largest industrial employer accounting for 7% of total employment and 28% of industrial employment in the EU. There was also a report of the government policies, which was published by BIS (Department for Business Innovation and Skills business group sector document), stating that the UK construction industry consists of over 250,000 firms employing 2.1 million people in a multitude of roles. The sector is defined as one which embraces the construction materials and products; suppliers and producers; building services manufacturers, providers and installers; contractors, sub-contractors, professionals, advisors and construction clients and those organisations that are relevant to the design, build, operation and refurbishment of buildings. However, construction industry is very different from other manufacturing industries and therefore difficult to achieve similar performance, mainly due to its degree of uniqueness in its use, in the size, its location and complexity due to the varied non-uniform working conditions from one project to another. Therefore, it appears to be underperforming when compared to many other industries. Jones, Saad, 2003, on p.12 state that, the diversity of the construction and the variability in the production process has to be reorganised with each new construction project. For each project, a series of decisions has to be taken which take into account the clients specific requirements and the context in which the tasks are to be executed. This can make project outcomes difficult to predict and can result in short and often adversarial relationships. Cox, Townsend, 1998, on p.21 states that the productivity, value for money, and overall client satisfaction in the construction industry are fairly low compared to other industrial sectors. The factors being: low and discontinuous demand; frequent changes in specification; inappropriate (contractor and client) selection criteria; inappropriate allocation of risk; poor quality; inefficient methods of construction; poor management; inadequate investment; an adversarial culture; and a fragmented industry structure. In order to improve the performance of this industry, government had taken initiatives and had produced many reports but had not made any impact. 1.3 Reports and recommendations: The publication of major notable reports namely Lathams Report Constructing the Team (1994) and two Egan Reports Rethinking Construction (1998) and Accelerating Change (2002) produced a considerable impact in UKs construction industry and started changing its working culture. Constructing the Team by Sir Michael Latham was published in July 1994, the key issues as summarised by Holroyd, 2003, on p.39 are as follows: Clients have a role in promoting good design which provides value for money Clients should select the most appropriate procurement route on the basis of the type of project Effective design is crucial A modern contract should include: A specific duty for all parties to deal with each other Firm duties of teamwork so all can share in success A clear definition of the roles and responsibilities of all parties Easily understood language with guidance notes A choice of risk allocation Avoid variations if it is required, price it in advance Ensure fair, prompt and secure payment to all parties Avoid conflict on site and disputes if any to be resolved speedily When selecting suppliers or tenderers, consideration should be given to: Quality as well as price A lead manager Sensible tender lists No burdensome qualification procedures Value for money Cost in use Factors which determine performance include: Adequacy of safety consideration Ability of operatives Improved training Relevant professional education Adequate RD, which is properly funded Teamwork on site depends on fair treatment for all parties The liability for defects post-completion should be properly addressed Rethinking Construction by Sir John Egan delivered the report in July 1998 for the success of the construction industry. He opined that while UK construction at its best is excellent, substantial improvements can be made, and it is vital that they are made. The key issues of this report as summarised by Holroyd, 2003, on p.40 are as follows: The UK construction industry needs to improve there should be: Less fragmentation Increased profitability More capital investment More investment in RD More and better training Differentiation between price and cost Set targets for improvement and give commitment to the needs of the customer, to quality, and to people the team and the process should be integrated around the product, and management should be committed to improvement throughout the organisation The construction process should be improved by: More process repetition on projects Integrating all team members to use their skills to deliver value to the client Focus on the end product how best to achieve the desired result Continuous product improvement Implement projects correctly, suiting the site and the customer Partnering through the supply chain Once improvement starts, maintain it Improvement could be accomplished by developing a better culture in the industry: Providing decent working conditions More and better training Produce designs which considers the projects end use Standardise components where possible Improve regulatory controls Implement long term relationships The National audit office report (2001) Modernising Construction as stated by Cooke, Williams, 2009, on p.11 that a major contributory factor to the poor performance of this industry was the adversarial relationships that existed between the construction firms, consultants and clients and between contractors, subcontractors and suppliers. The report also identified that government departments and agencies to ensure collaboration, integration and value for monies in the procurement of construction services. Further, it also suggested that the entire supply chain be integrated and that risk and value must be managed in order to reduce accidents, drive out waste and improve buildability. McGeorge and Palmer 2002 on p.54 cite CIRIAs definition of buildability as à ¢Ã¢â€š ¬Ã‹Å"the extent to which the design of the building facilitates ease of construction, subject to the overall requirements for the completed building. These reports produced during the various periods had contributed a lot to the growth of the construction industry. Since these reports were published, a changed performance could be clearly noticed in the activities of this industry. The findings of the report had tried to build up a challenge in the construction industry to procure projects that could achieve best value and also help in understanding the balance between quality and whole-life cost of the project. Many more studies on the performance of the construction industry were also conducted subsequently, which had identified the areas of strength and weakness of the construction industry. According to Jones, Saad, 2003, on p.2, the strength of the industry includes its flexibility and adaptability and its persistent weakness include its fragmented structure and project processes and its adversarial relationships. Furthermore, deficiencies in its performance in relation to customer focus, learning and leadership were revealed when benchmarked against other industries. 1.4 Material use: The construction industry is considered one of the major consumers of natural resources mainly the virgin materials from its surrounding environment. This will give rise to many environmental issues, which are unsustainable such as depleting natural resources, diminishing the earths biodiversity, and even cause extinction of habitat if we continue the present rate of consumption. As stated by Kelley et al. on p.298 that materials used in buildings account for some 40% of natural resource use, 30% of CO2 emissions and 40% of waste. However, the environmental issues would certainly create a vital impact on the society and hence this industry should take earnest attempt to develop a strategy to provide low carbon solutions by way of minimising its carbon footprint. In addition, the projects Corporate Social Responsibility (CSR) that voluntarily decides to contribute to a better society and a cleaner environment and along with its procurement policy, could contribute to the environmental success. Built environment: The paper presented by Natural Building Technologies, have quoted One Planet Living material of BioRegional and the World Wide Fund for Nature; have shown that if everyone in the world-consumed resources at the same rate that of UK, it would take the equivalent of three planets now to sustain this consumption. Hence, UK and the other western nations urgently need to take radical measures in order to reduce this present rate of consumption of resources. As we are aware that this planet has only a finite quantity of resources and therefore we in the construction industry should have a moral responsibility to ensure that industry is resourced using sustainable techniques. More over the construction industry should also insist on an environmental management system (EMS) accreditation for every project, which could help in continually, improving its environmental performance. An internal EMS audit if periodically conducted would help in checking the effectiveness and delivery capability o f the management system. The strategy paper of the UK Government, Building a Better Quality of Life: A Strategy for more Sustainable Construction by the Department of Environment, Transport and the Regions (2000 b) as summarised by Kelly et al. 2002 on p.296 recognises the importance of sustainable construction and had challenged the construction industry to provide built assets which: Cause minimum damage to natural and social environments Minimise the use of resources Enhance the quality of life Will be acceptable to future generations 1.6 Needs: The working pattern of the society is changing quite fast and construction industry is known for adapting to change at a faster pace than other industries. Nowadays many people tend to work from home since jobs functions can be remotely performed and is quite feasible. The benefit from working at home helps in the reduction of transport movements, thereby considerably reducing pollution and traffic congestion especially during the peak hours. It is an eco-friendly option and is to be encouraged. Hence, this working culture would require housing to provide a higher quality of life and greater flexibility of adaptable living and space requirements. Therefore, in majority of existing homes, a need for up gradation would be necessary and a lot more of new homes constructed to accommodate this new culture in the coming years; for which a huge quantity of materials are required by the industry. This results in a heavy material flow. In addition, while designing a sustainable project, selec tion of materials should be made based on locally and easily available material, in order to reduce the embedded energy cost of transportation. This option would also decrease the carbon footprint of the project. 1.7 Regulations: A government publication by energy saving trust on the Code for Sustainable Homes New build housing (Relevant to: England and Wales), states that the government intends that all new build homes should be zero carbon by the year 2016. Code level 3 is proposed to become the new standards for Building Regulations in England in 2010 and by 2050; the nations entire housing stock will be virtually zero carbon. Clients, who desire to increase value of their project, could insist on the use of sustainable materials in order to acquire higher sustainability rating as mentioned in the BREEAMs code for sustainable homes. These regulations create a lot of pressure on the project management team if a proper supply chain management technique is not available.. As mentioned in the Code for Sustainable Homes (Annex B Category 3, Materials on p.37), the supply chain management and material stewardship are essential elements of responsible sourcing. Hence, the supply chain manager is to consider the consequence and impacts of using materials by analysing its life cycle (right from the point it was mined or harvested,through manufacture and processing of the material, including its use, reuse and disposed off as waste with no further value), before the material is actually used in the project. However, all timber used in the project should be 100% legally sourced and 80% for all other assessed materials. 1.8 Sustainable sourcing code: For the London 2012 games, London Organising Committee of the Olympic Games (LOCOG) had prepared a Sustainable Sourcing Code in consultation with industry leaders, sponsors and non-governmental organisations. It had been reviewing how its sponsorship and procurement activity could achieve the highest possible standards to ensure that the goods and services it procures comply with this code in meeting the sustainability objectives for the 2012 games. This code could be used as a benchmark in the preparation of a similar code of practice by the construction industry. The four core principles of the LOGOs Sustainable Sourcing Code and supporting guidelines on packaging and carbon emissions of products and services originally published in November 2007 and updated in December 2009 are as shown below: Responsible sourcing: Labour practices Health and Safety Diversity and inclusion Animal welfare and Testing Animal and plant products Timber and timber products Use of secondary products materials: Reducing waste Recycled content Packaging Waste electrical and electronic equipment Minimising embodied impacts: Environmental management Supply of products Transport Low carbon Games Healthy materials: Restricted substances and materials Heavy metals and brominated fire retardants 1.9 Controlling material resources: A material at site is money and is to be prudently handled. The cost of materials constitutes a major portion of the project cost. March 2009, p.139 states that the value of the materials incorporated into a building represent anything from 40 to 60 per cent of the final cost. Therefore, control of materials at site is a crucial element. Materials are not be wasted or lost. For proper control an effective communication between all involved for the project success namely the planning department, purchasing department, the site and the supplier is important. Responsibilities are to be clearly defined especially in buying of materials within the estimated amount since efficient buying results in savings, which in turn contributes to the profitability of the contract. Similarly hoarding of materials at site should be discouraged by initiating just in time delivery, but care is to be taken in the selection of material supplier so that the availability of bulk materials is ensured. Therefo re, materials management in construction projects is essential for its success. As Cooke and Williams 2009 on p.401 states that an essential component of materials management begins with site layout and planning. Designated areas must be allowed for material storage in order to reduce waste and damage to materials. Excessive stock of materials is a problem need to be controlled. March 2009, p.139 enumerates the reasons as to why excessive stock is to be controlled; Excessive stocks take up capital which could be better used Takes up space and absorb further capital for protection against weather Likely to be damaged resulting in unnecessary expenditure and possible delay incurred in replacement May be necessary to double handle stock to elsewhere on the site and missing the opportunity to have just in time delivery Site efficiency can be increased by effective material handling and result in costly waste reduced. Every project worth more than  £250 000 effective from April 2008 should have a Site waste management plan (SWMP), without which it would be a serious criminal offence as mentioned by Cooke and Williams 2009 on p.403 quoting The Clean Neighbourhood and Environment Act 2005 (Section 54 of Part 5). 1.10 Whole-life thinking: In addition, the construction industry need to consider the aspect of whole life costing during the procurement as the project not only consumes sustainable resources, but also generates waste in construction and demolition activities. The procurement of materials for the industry is strongly affected by environmental issues. Greater use of modern methods of construction and off-site prefabrication could be a solution in reducing the total amount of waste generated at site. Hence, the construction industry should strive to develop and implement the new paradigm of the triple bottom line namely environmental, social and economic sustainability. Green building is an innovative technology and is good to be adopted by construction industry. This approach creates a positive environmental, social and economical impact over the entire life cycle of the project. It is a holistic approach of design and considers its impact on the wider environment and community around it. This technology procures homes, which are durable, save energy, reduce waste and pollution, and promote health and well-being. 1.11 Procurement methods: One of the main problems in this industry says Cooke Williams, 2009, on p.4, is that it separates design from production far greater than other industries and is still common despite the deficiencies of traditional procurement and the benefits offered by the newer and more flexible approaches. In traditional method of procurement, the design stage is separated from production by a tendering period. McGeorge and Palmer, 2002 on p.54, also support this view and quote by comparison with other industries the separation of the process of design and construction is unique to the construction industry. Construction industry provides successful projects, the outcome of which is increased efficiency, greater borrowing capacity and payback long-term worth. The business objectives should always drive the selection of an appropriate procurement strategy, so as to procure a project to the complete satisfaction of the client. The procurement strategy so selected would depend on many factors; namely the client, the risk profile of the client, the cost certainty needed, accountability, flexibility, the type of project, time, funding, market condition, the industries capacity and capability. 1.11.1 Projects priorities: Moreover the factors that are to be considered while analysing a business objectives requirements and their relative priorities as pointed out by Kelly et al., 2002 on p.178 are as listed below: Factors outside the control of the project team Client resources Project characteristics Ability to make changes Risk management Cost issues Timing Quality and performance The choice of the strategy should ensure that control is maintained over those factors that are important to the clients perspective of the project. 1.11.2 Procurement strategy: The authors also state that the choice of the strategy should ensure that control is maintained over those factors that are of most importance to the client. After a selection is made, a strategic brief will need to be produced defining the clients project and the parameters within which the project must be realised to take the project to a success. Often less importance is imparted to the projects objectives as compared to the primary criteria of time, quality and cost. These three primary parameters form the key criteria in the selection mechanism and are interdependent of each other. Therefore, procurement strategies adopted for the project would not be able to deliver all of them as high priority. For example, fast-track solutions for a project deliver speed and time certainty, whereas the other criteria such as cost certainty and quality may be less achievable. Similarly, in projects where quality or costs are considered to be of top priority, then the other criteria are affected. Hence, if a high priority is imparted in defining the project and especially linking of the prioritisation of objectives to the business case, greater then are the chances of a successful procurement of the project to the entire satisfaction of the client. However, from the clients perspective of a project, time, quality, cost and functionality are important criteria for the success of a project. The client generally prefers the highest quality at the lowest cost and the project being completed in the shortest possible time. As earlier mentioned it is not possible to attain all these parameters together for a given project. Depending upon the clients business objectives, a suitable selection of the procurement strategy should be chosen. 1.11.3 Procurement option: If according to the client, a signature building is required for the project, then a traditional or design-bid-build strategy is an appropriate option for the project. For this project, quality would be very essential but this procurement technique adopts a sequential nature of activities, and therefore has no parallel working activity, which means that, construction could actually begin only after the design is completed as fully as possible. Hence is not suitable option for any fast track projects. However, this option fairly provides with cost certainty and time predicted. The delay experienced in completion of the project might be because considerable time is allowed for the design to take a full shape and thereafter in the preparation of detailed brief and also in the tendering procedures required to be completed before the start of the work. Therefore, an early start of the project would not be possible until the letter of intend is issued, which in turn have a knock on effect on the overall cost of the project (price escalation, inflation etc.). Sometimes the client might go in for a functional building where cost implication is to be the lowest and had to be completed before a fixed date. Here in order to meet the business objectives, a design-build procurement technique is quite appropriate, since early certainty of the overall contract price could be obtained. Moreover, as this strategy facilitates overlapping of design and construction, a faster start on site is possible resulting in shorter project duration with greater certainty of meeting the targeted date. Hence, this option is quite suitable for fast track projects but is not suitable for any complex infrastructural projects and also in projects wherein the clients brief is uncertain or inadequate. Alternatively, the client would require procuring a huge and complex infrastructural project with an emphasis on the targeted date of completion. Considering the clients business objective, the appropriate procurement route would be construction management, which is best-suited option for fast track and complex construction projects. In this procurement route, the construction work is divided into several packages, which are tendered separately to different experienced and qualified contractors. Hence, in this procurement method design, tendering and construction over lap thereby reducing the overall time of the project whereas there could be price uncertainty until the last package of the work had been awarded to a contractor. Due to the speed in completion, quality of the work would probably be effected and therefore a total quality management team would be required to ensure the quality of work during its progress. Therefore, this procurement route is not suitable for inexperience d clients and for those clients trying to transfer risk to the contractor. Therefore, the procurement strategy developed should strike a balance between risks that could cause an impact on the clients business and the projects objectives. Some projects could adopt more than one procurement option for the successful completion of the project as per the clients perspective. Traditional approach may be used in the construction of the shell and core, whereas construction management would be used for the final works. The choices made might differ between clients of various projects depending upon their knowledge and experience of the industry. The scale and diversity of those involved in this industry is too enormous and hence this contributes to enormous pressures on the project teams, to ensure that the project completion is on time, budget and quality. 1.12 Risk: The diversity of those involved in the industry namely design engineers, architects, consultants, main and subcontractors, suppliers and constructional managers is huge. However, all those who are involved in this industry throughout the world strive together to establish a strategic framework to meet the budgetary and scheduling goals of the project. Time is one of the critical factors in construction industry, which has significant legal consequences. The client sets up rigid start and finishes dates for the project and if the contractor must comply with this period, barring any delay caused due to natural calamities, or lose money by paying the liquidated damages as laid down in the contract document. During the construction process delay in receiving of materials, equipments and services may erode profits. For a successful completion of a project, lot depends on the quality of the subcontractors and suppliers. Therefore, construction organisations should ensure that an appropriate subcontractor is selected. The subcontractors selection process involves many important factors including the evaluation of their capacity and also in performing a SWOT (strengths, weaknesses, opportunities and threats) analysis. The risk faced in construction industry is different from that of other industries. This is quite evident while analysing the difference between manufacturing risks and construction risks as indicated by Benton and McHenry 2010, on p.2 as shown below: Risk versus reward for the manufacturing sector Risk versus reward for the construction sector In construction industry, the potential for committing mistakes is high and facing problems is magnified by the poor interrelationship that exists between all the entities involved namely, the client, architect, consultant, project manager, contractors and suppliers. The risks, if not mitigated in time, would prove disastrous and hence, recommended to be avoided at an early stage. Construction risks as mentioned by Benton and McHenry 2010, on p.3 are as narrated below: Internal financial problems Working capital problems Slow payment from the client Inferior plans and specifications Inadequate technical capabilities Insufficient information technology Lack of communication between the entities Productivity inefficiencies Work quality problems Work method problems Delivery reliability problems Bulk materials quality problems Another notable difference between the manufacturing and construction industry is the probability of failure while considering the labour element. This can be clearly understood if an improvement curve technique is performed as explained by Benton and McHenry 2010, on p.4 and p.5 for both industries, the figures of which are as shown below: Probability of failure for the manufacturing industry Probability of failure for the construction industry The improvement curve is exponential and depicts a constant-percentage reduction of labour, which means that, the workers learn how to do their job better as they produce more and more units at a lower production cost. This advantage is accomplished due to the impact of cumulative learning by experience, which is possible in the manufacturing industry. Now considering the construction industry, which is constantly changing its complexity over time, we can observ

Saturday, July 20, 2019

Self-Interest on the International Stage Essay -- International Relati

Self-Interest on the International Stage A nation’s actions on the world stage can be played in many ways. Whether the role being played is unwanted meddler in other nations’ affairs, supplier of money and aid to countries in despair, or just an ordinary nation trying to keep all of its proverbial ducks in a row, the motivation that drives the plot of international relations is self-interest. Whether the setting is these United States or across the world in the People’s Republic of China, in the theocratic republic of Iran or the military controlled Central African Republic, is doesn’t pay to give something for nothing. Self-interest should not be confused with selfishness, as the two terms are neither interchangeable nor synonymous. Self-interest is â€Å"concern for one’s own advantage and well-being,† and selfishness is extreme self-interest coupled with a disregard for others (Merriam-Webster). It comes in several forms, like economic and political, and is specialized according to each nation and its individual wants and needs. In fact, it is not only possible but actually c...

Friday, July 19, 2019

Health :: science

Health Twenty-five years ago, the great Athenian doctor Hippocrates believed that balance is health and that imbalance is the cause of all illness and pain. For more than three hundred years, this concept has been in disfavour. Now, clinical experiences with Phen/Fen suggest that Hippocrates was right. While both phentermine and fenfluramine have been available since the mid-seventies, patients were generally reluctant to use them because of the always present fear of addiction. During many instances when people did try either one of these new drugs, they could not tolerate the side effects. The pills in fact do work, because they trick the brain into thinking that the stomach is full. But they also seem to affect the brain in other, less desirable ways. The thought process behind creating a ‘superdrug’ such as Phen/Fen, was that by combining the two medications, one could take advantage of their different pharmacologic actions getting, in essence, better effectiveness while hopefully minimizing the "mild" side effects (Michael D. Myers. 1997). Despite the side effects that are still present, drug companies are making lots of money off of Phen/Fen. It is the second fastest growing drug in the country. In 1996, it earned about $191 million for its maker, Wyath-Ayerst (CNN. 1997). Obesity, poor nutrition, and inactivity are estimated to contribute to about 300,000 deaths a year (National Institution of Health. 1996), thus there is an increased demand for such pills as Phen/Fen. In this paper, I will discuss the two drugs that make up Phen/Fen, Fenfulramine and Phentermine, and discuss the side effects for each of the pills. I will introduce Serotonin and Dopamine, two of the brain’s neurotransmitters and the effect of Phen/Fen on them. I will also discuss who should and who shouldn’t use this potentially dangerous diet. Finally, I will look at a case study from Michael D. Myers which makes some very important conclusions about the diet. Fenfluramine Fenfluramine was discovered at approximately the same time as it’s cousin, Phentermine. Fenfluramine has always been strongly associated with many side effects. The most prominent of it’s side effects is Primary Pulmonary Hypertension which is a life threatening complication (Michael D. Myers. 1997). An estimated 1 in 17,000 patients that are treated for longer than 3 months will develop this condition (New England Journal of Medicine. 1996). The symptoms may be vague chest discomfort of development of an insidious feeling of shortness of breath (Abenhaim, L.

Comparing Lamb to the Slaughter to The Speckled Band Essay -- English

Comparing Lamb to the Slaughter to The Speckled Band 'Lamb to the Slaughter' and 'The Speckled Band' are both murder mysteries. Like most murder mysteries each of the stories have a murderer, a victim and characters acting in a suspicious or unusual way. 'Lamb to the Slaughter' is a 20th century story about a woman called Mary who kills her husband, Patrick Maloney, using a leg of lamb. This seems quite surprising at first as she seems quite loving and devoted to him- 'she loved to luxuriate in the presence of this man.' However a lot of Mary Maloney's behaviour in the first scene does seem quite worrying and peculiar. It seems that she is almost obsessed with her husband and this is shown by the way she is constantly trying to please him. Although the murder is a crime of passion Mrs Maloney manages to deal with it quite well. She is very calculating when realising quite what she has done and providing herself with a convincing alibi. When the detectives arrive to investigate the murder they seem to be taking it very seriously, however they don't really seem to consider Mrs Maloney as a real suspect. There is one point in the story where one of the detectives says 'acted quite normal very cheerful impossible that she' but this is an idea which is soon discarded. After a while the attitude of the detectives becomes more relaxed and not so professional. Mrs Maloney takes advantage of this by asking the detectives to stay for dinner. She then goes on to feed them the leg of lamb thus destroying the evidence. There is a moment of irony towards the end because when talking about the murder weapon one of the detectives says 'Probably right under our very nose' just as they are eating the leg of lamb. ... ...and' and 'Lamb to the Slaughter' are very diverse. In 'Lamb to the Slaughter' Mr and Mrs Maloney both lived in a 'warm and clean' home. The atmosphere is of a happy and content household. In 'The Speckled Band' the murder takes place in an old, grey, stone house. The setting seems colder and emptier. The fact that Roylott keeps animals such as cheetahs and baboons adds a darker adds a more sinister feel to the story. This is more typical of a murder mystery but it may not have seemed so unusual when it was first written in the 19th century. I think the author of ' Lamb to the Slaughter' wants the reader to see Mrs Maloney as quite cunning and deceitful. He does this by showing that Mrs Maloney can use the fact that she was married to Mr Maloney and that she is six months pregnant to her advantage. Holmes would probably not have fallen into this same trap.

Thursday, July 18, 2019

ICD-10-CM Essay

The Changes between ICD-9 and ICD-10 code sets. Differences between ICD-10-CM and ICD-10-PCS code sets. How ICD-10 coding could affect patient encounters. How the transition will affect departments. Regulatory requirements. Quality Improvement. Clinical Documentation Improvement. The challenges and barriers of ICD-10-CM/PCS coding transitions. Create a checklist for the staff. The font or typeface I will use or script-like fonts around 14, in bold those typically work better as heading fonts rather than body text and 12 for the body. I use of visuals communication would help me effectively deliver my message on the important issues with documentation and with the pictures and graphs, showing gains and loss of loss revenue would help them understand what is required for compliance and increase revenue. I will also show the standard required to be in compliances with The Joint Commission rule and regulations. The reason for my choice for training materials because is easiest way too explained and train the staff with all the new changes. These training sessions will be workshops and departmental in-services with custom design to fit each service needs. My training or transition would start with and introduction to explained in detail the new system of ICD-10 The ICD-10 Transition The ICD-9 code sets used to report medical diagnoses and inpatient Procedures will be replaced by ICD-10 code sets. This fact sheet provides background on the ICD-10 transition, general guidance on how to prepare for it, and resources for more information. About ICD-10 ICD-10-CM/PCS International Classifications of Diseases, 10th Edition, and Clinical Modification Procedure Coding System consist of two parts. 1. ICD-10-CM for diagnosis coding outpatient 2. ICD-10-PCS for inpatient procedure coding. ICD-10-CM for use in all U.S. health care settings. Diagnosis Coding under ICD-10-CM uses 3 to 7 digits instead of the 3 to 5 digits used with ICD-9-CM, but the format of the code sets is similar. ICD-10-PCS is for use in U.S. inpatient hospital settings only. ICD-10Â ¬ PCS uses 7 alphanumeric digits instead of the 3 or 4 numeric digits used under ICD-9-CM procedure coding. Coding under ICD-10-PCS is much more specific and substantially different from ICD-9-CM procedures coding. The transition to ICD-10 is occurring because ICD-9 produces limited data about patients’ medical conditions and hospital inpatient procedures. ICD-9 is 30 years old, has outdated terms, and is inconsistent with current medical practice. Also, the structure of ICD-9 limits the number of new codes that can be created, and many ICD-9 categories are full. This New Patient Summary table demonstrates the required levels of the 3 key components for E&M code selection: History, Exam, and Medical Decision Making; elements must be met in all 3. This New Patient Summary table demonstrates the required levels of the 3 key components for E&M code selection: History, Exam, and Medical Decision Making; elements must be met in all 3. Next I would add a example of E&M codes with procedure and continue through the most common outpatient services and I would start with the inpatient process. I hope with the review and and example and other training aids the medical staff would understand that it more important than ever with the documentation and explained in different scenario how it could affect you and patient legally and medically, when treatment is not documented. Using visual most times it help, just not just having a boring training where you know no ones is paying attention. I will use other visual aids and charts on a few different power points. Since it so much information to take in I will do a basis summary of the changes. In Addition I will complete on training aids using what the Department of Veterans Affairs adding some of my material making it more customize for our Medical Center breaking it up so the staff wouldn’t get overwhelm. Iexplain and show them that structurally, ICD-9-CM is running out of room to add new codes. New diagnosis codes are submitted by medical societies, quality monitoring organizations and others annually. ICD-10-CM will allow not only for more codes but also for greater specificity and thus better epidemiological tracking, analysis of disease patterns and treatment outcomes, supports quality measurement efforts, and leads to accurate reimbursement and supports waste, fraud and abuse initiatives. Health Information Management(HIM) my department will have assessment each of coding staff they will be the first to complete the training along with the doctors. The doctors training will be more on documentation. The doctors will need to document to the level of ICD-10 allows for very specific code assignment when provider done. The coders will train more on how to select the correct codes. My finial decision will be the following steps 1.ICD-10 Training ICD 2.ICD-10-CM Anatomy and Pathophysiology 3.ICD-10 Proficiency Assessment 4.ICD-10 Documentation Training for Physicians (detailed) 5.Implementation ICD-10-CM My Duties As The Medical Records Administration Management ability to delegate authority, evaluate and oversee people and programs, recognize and adapt to changing priorities; and Knowledge of the interrelationships and interdependencies among various medical and administrative services and programs. Teaching or instructing in an adult education program, secondary school, college, military installation, or industrial establishment in the appropriate field(s). Supervising or administering a training program. Development or review of training/course materials, aids, devices, etc., and evaluation of training results. Work in the occupation or subject matter field of the position to be filled that required training or instructing others on a regular basis. Regulations and standards of various regulatory and credentialing groups; and Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement. Planning, developing, and directing a medical records program for a health care facility that meets both institutional goals and standards of accrediting agencies. Evaluating and analyzing the organization and operation of medical records services, including medical records and indexes, and recommending and/or implementing appropriate revisions and modifications. Assisting medical and administrative staff in evaluating the quality and appropriateness of patient and health care services. Designing information systems to collect, analyze, monitor, report, and maintain privacy and confidentiality of patient and institutional data for health care related programs, and evaluating and implementing changes to assure the reliability of data. Developing and implementing policies and procedures for processing legal medical documents and insurance and correspondence requests in accordance with Federal, State, and local statu Refernce Search Ask Pictures http://www.search.ask.com/pictures?q=new&o=APN10092&lang=english&tpr=3&gct=bar Search Ask celabration http://www.search.ask.com/pictures?q=balloons+celabration&o=APN10092&lang=english&tpr=2&gct=bar Department of Veterans Affairs http://vaww.vhaco.va.gov/him/