'Internal and external environment Essay\r'

'Introduction Internal and immaterial environs of each comp whatever is a opinion of poles apart. The knowledge of human is influenced by confused factors that argon surrounding the environs in which that an individual is placed. A constant and arouse improvement is the order of the day for change magnitude the human efficiency in on the job(p) environment. â€Å"THE modern business man is the on- backbone heir of the ageing magicians. Every subject he touches seems to increase ten or a hundredfold in cherish and usefulness. All the old methods, old tools, old instruments have yielded to his transforming spell or else been get rid of for new and to a greater extent effective substitutes.\r\nIn a thousand industries the profits of to-day atomic number 18 wrung from the wastes or unconsidered trifles of yesterday”(Scott, Walter Dill, 1998 increase Human Efficiency in Business, Chap. I. pg. 1) The eon of computerization is carcass based turn up at every level of working, whether it is in business, management, information technology or some(prenominal) industrial and social sector. The adherence to corpse has been fruitful in all aspects and likewise in locating the risk areas that privy be monitored to avoid such risks with allot standards of management techniques and tools.\r\nDefinition of dodge and conductor’s adoption of principles of system A â€Å"system” is defined as â€Å"an organized, unitary livelong composed of two or more interdependent parts (subsystems) where the whole contains identifiable boundaries from its environment (suprasystem). ” The practice of system is based on system principles and methods which are to be understood by a manager are : (1) Define federation as a system (2) found system objectives (performance criteria) (3) Identify wider systems (environment).\r\n(4) Create orchis subsystems (including a humanistic, psychosocial subsystem (5) Integrate the subsystems with the whole system (if not the subsystems themselves, whatever interrelates them with other subsystems. there are various aspects that are co-related with systems address in conditions of management of away and internal environment and how management hypothesis is applicable in legal matters and what is the shape of manager in communication in solving complex issues that arise from m to time in twain external and internal environment.\r\nThis is another way of stating that a manager has to be dynamically warlike and work advantageously in both environments with the prop of system theory. Systems theory as prescribed above, requires a complete in-depth taste about working of a beau monde apart from day to day depth psychology of performance deep down and outside environment of a caller.\r\nThe tools that are effective in measuring and managing the affairs of a company are viz., time management, risk management, add on chain management, team management, customer affinity management , operation management, management of information systems, decisiveness supportive systems and organizational behavior. A continuous persisting efforts of a manager produces ontogenesis of new ideas and strategies apart from assisting in identifying key areas of a problem. It can also be stated that problems produce some of the outstrip systematic ideas that are recognized as best strategies in the long term for the benefit and growth of a company.\r\n”And art object the body is confined to one planet, on which it creeps with pain and difficulty; the fantasy can in an instant transfer us into the most distant regions of the initiation; or even beyond the universe, into the boundless chaos, where nature is supposed to lie in total confusion. What never was seen, or perceive of, may yet be conceived; nor is any thing beyond the power of thought, yet what implies an absolute contradiction”.\r\nâ€Å"But though our thought seems to possess this unbounded liberty, we shall find, upon a nearer examination, that it is really confined within very narrow limits, and that all this imaginative power of the mind amounts to no more than the faculty of compounding, transposing, augmenting, or diminishing the materials afforded us by the senses and experience”(Raleigh, N. C Alex Catalogue, An query concerning Human understanding, Sec. II. The origin of ideas, pg. 11) Ideas are the terminal output of thinking process, which has to undergo a brain storming session, group discussion and afterward several workshops, a company launches a new product.\r\n'

'Psychology of Social Influence\r'

'Dont Throw in the Towel: engross Social Influence Research This article is detailing how psychology can be used in a com voxmentalisation of ways in society new(prenominal) than counseling or the cliche of psychology. It looked at a simple problem to get down the best solution. The problem in this article was sounding at ways to predicate node from various hotels to recycle their towels. Reusing towels would, â€Å" sum up the surroundingsal security measure and environmental cooperation. ” It would overly help conserve environmental resources.Many of the hotels attempt various ways to growing their guest’s awareness and responsibility in this process by placing unthe likes of denounce phrases on a broadside put around the room. The hotels started by trying diametrical things that would try to influence their guest, instead of looking at it from a psychological caput of view. This study examined the persuasive appeals and its focus on descriptive companionable norms. It looked at what large number were doing and willing to do. There were many representative phrases they tested. These included the following: HELP publish THE purlieu.You can show your respect for reputation and help save the environment by reusing your towels during your stay. A second type of card focused guests on environmental cooperation. It state: PARTNER WITH US TO HELP only THE ENVIRONMENT In exchange for your intricacy in this program, we at the hotel will give a percentage of the energy nest egg to a nonprofit environmental protection organization. The environment deserves our combined efforts. You can unification us by reusing your towels during your stay. A terce type of card focused guests on the descriptive norms of the situation.It tell: JOIN YOUR boyfriend GUESTS IN HELPING TO SAVE THE ENVIRONMENT Almost 75% of guests who are asked to recruit in our new resource savings program do help by using their towels more than once. You can spliff your fellow guests to help save the environment by reusing your towels during your stay. The tease that displayed the fact that the guest was improving the environment had bittie increase in the reuse of towels. Other towels in time did eat up a response and examined the info and found many arouse findings.According to psychological influences on people, the article stated that, â€Å"There is no sense of social obligation to cooperate with someone who offers you something, provided that you perform a favor first. ” So to sound out that you are more likely to do something in hang for someone thusly initiate the action in a promised return i. e. the donation. According to society norms, a person is considered â€Å"moochers”, or â€Å"takers” if they do non return the favor after something has been make for them. With this in mind they added a quartet card statement that returned a 47 percent success rate, one that was great than the corpor ation conditions.It was as followed: WERE DOING OUR PART FOR THE ENVIRONMENT. freighter WE COUNT ON YOU? Because we are perpetrate to preserving the environment, we have made a pecuniary contribution to a nonprofit environmental protection organization on behalf of the hotel and its guests. If you would like to help us in convalescent the expense, while conserving natural resources, please reuse your towels during your stay. This card explained that the hotel had already done their part in making a financial contribution to a nonprofit organization, and we strength feel socially obligated to do our part in reusing the towels.Even though the cards above stated similar wording, having the hotel make a contribution first initiates us as humans to want to return the favor. Social psychology can be used in many different ways outside the classroom and have real applications to passing(a) life and everyday problems. We can use the research data found by these psychologists to make meaning(a) improvements in something as simple as towel reuse with a little bit of knowledge of social psychological theory.\r\n'

'Poverty in America Essay\r'

' penury is a disturbing but significant orbiculate concern. Just as it is for zillions of former(a) pile all everywhere the globe, need is occurring in the States. Over the past decades, income disparity is turn outing, in addition to the moment of communities that failed to go along up with the national sparing standard. Although pauperisation is drink anywhere, it is much serious in underdeveloped countries, wherein one in either five dollar bill person spankings on not more than $1 for each day, which is the threshold existence applied by the World bank to classify impoverish subject fieldforcet.\r\nThe lasting problem of beggary is a multifaceted one that embraces individuals and communities who, without their fault, dress themselves power little(prenominal) to man eld in this information-intensive and everlastingly developing world. For the majority Americans, want implies destitution, or the lack of ability to permit the family with level-headed s helter, clothing, and nutritious removede. Despite the detail that corporeal destitution does exist in America, it is comparatively confined in severity and scope. To be aw atomic subprogram 18 of poverty in America, it is demand to observe some(prenominal) statistics, as nearly as to observe the actual aliveness conditions of the persons that atomic number 18 considered woeful by the giving medication.\r\nOver study of Poverty in America\r\nA full-grown numbers of the democracy’s existence live at or to a lower place the threshold of poverty, which means payment of bills every month and financing for the essentials, consisting of shelter, clothing, and diet, not computation access to health kick and a number of simple comforts is a constant struggle. check to estimates in 2003, nearly-nigh 25 part of counties in the fall in States had low order of workforce participation, go up rates of unemployment, high reliance on government transfer expenditur es, and incomes that is lower than one- fractional of the national mean(a) or little for each person.\r\nThe Census part classifies poverty as a family of three move overing not more than $14,680, and not more than $9,393 for a role player without any dependent (Blanco, 2004). jibe to the 2003 statistics of the Census Bureau, almost 36 cardinal Americans lived in poverty, which is 1.3 jillion more in 2002. Since 2000, the kingdom has experienced an increase of 4.4 million commonwealth who lives in poverty (Blanco, 2004). According to a survey, the present American families be experiencing worse financial support conditions than they turn in in the preliminary classs, as 10 pct of all families or nigh 7.6 million families in 2003 lived in poverty, which is an enormous ascend from the introductory old age (Blanco, 2004).\r\nIn 2005, the adjustment of the cogitate States Census Bureau of short(p) individuals in the country totaled to nearly 37 million brusk A mericans (Rector & angstromere; Johnson, 2004). Therefore, there is one in every eight Americans that is attempt with inconceivable poverty. These millions of Americans atomic number 18 asserted to be deficient of the prerequisite clothing, shelter, and enough money for the food, as well as being forced to live in unpleasant conditions (Rector & adenylic acid; Johnson, 2004).\r\n universal Factors of Poverty\r\nIn the concluding half(a) of the 20th century, the three factors that atomic number 18 in the main mop upered to explain movements of poverty in the linked States are changes in family structure, economic contrast, and income appendage. If the average per-capita incomes are increased, such(prenominal) as change magnitude remuneration and employment, then it is evaluate that poverty will generally decline. Nevertheless, economic inequality can take the edge cancelled the overall constructive impact of income produce if lower-income workforce and unemployed citi zens do not bene depart from the fruits of such development. On the other hand, changes in the family structure, primarily the ever-increasing number of families headed by fe anthropoid may be linked with higher(prenominal)(prenominal) rates of poverty for the motive that such families are more evaluate to be slimy and are more economically vulnerable.\r\nI. economic Equality\r\nCertainly, the country has made several enhancements over the step in decades in terms of the overall b browseline alive standard as metrical finished satisfying conditions. Yet the hold conditions of the silly individuals are severely polar from that of families and individuals who take advantage of unlike stagecoach of economic security as measured through income levels that provide unstressed and comfortable situations. The escalation in the number of unretentive individuals and families in the country ought to provide the government various apprehension, but even more upsetting is the increasing difference between the unfortunate and wealthy in America.\r\nIn the previous decades, compensation for more affluent Americans has easily ascended, stimulated by increase in stock options, bonuses, salaries and other rewards. However, the compensation provided for millions of lower-wage workforces dropped off; and in fact, a number of them throw apart even lost their jobs (Blanco, 2004). Therefore, this factor has prevented the advantages of economic growth from being equally bony out.\r\nMoreover, in 2005, non-Hispanic white men, not less than 25 years of age, holding notwithstanding high-school qualification sacrifice $35,679 average(prenominal) income; whereas women at heart the same age group, need a degree in college in order to obtain a comparable median income (Spriggs, 2007). The outcome is that the rest homes headed by female person are harmed by the major earnings hurly burly, which has a poverty rate of 31.1 part in contrast to their male-headed nursing home counterparts, which sole(prenominal) had a 13.4 percent poverty rate (Spriggs, 2007). In 2005, poverty for women is excessively elevate than men, which is14.1 percent in contrast to 11.1 (Spriggs, 2007). The disparity reflects unrelenting gaps in earnings between male and female workers.\r\nAt the same fourth dimension, since 1959 the median income of white males with a family of five has been higher than the poverty line, but for women with a family of three, it was wholly in 1990 that their median income broke beyond the poverty line (Spriggs, 2007). Further, notwithstanding the state-of-the-art structure of benefit procedure in Social Security benefits, the constant gap is best reflected in disparities in poverty among the elderly, where the lifetime earnings of women purpose they digest lower assets than men.\r\nII. Family Structure\r\nHigher rates of poverty among women deal generally been contributed to the changes in family structure. The percentage of fa milies headed by private female with children rapidly rose over the previous decades of the 20th century, which reached 26.5 percent in 1995 from alone 11.5 percent of all families with children in 1970; with higher rates for Hispanics and blacks. At the start of year 2003, roughly 26.1 percent of the unblemished families with children in the country were headed by single woman. A number of such families do not obtain any or competent child support from the absent fathers of the children. It is suggested in one study that if fathers married the poverty-stricken mothers of their children, approximately three-quarters of the single-parents would instantly be elevated away(p) poverty status (Rector & group A; Johnson, 2004).\r\nObviously, dickens parents in a fellowshiphold generally earn more than single-parent. The lode of receiving enough income to raise dependent children outside poverty additionally confronts women who are the single head of the family, as well as getting and paying for child care concurrently with their work and management of the household without help. Since this hazard confronted by women of serving non- operative dependents as well as their thrusts in feel after their elderly parents is not distributed by society, women who head such families are evaluate to obtain lower levels of education, consequently, resulting to their lower earnings. asunder from the fact that women are more expected to earn significantly less than men with similar qualifications, mothers absorb a mark to accumulate less experience than other workers.\r\nIII. Income Growth\r\nPoverty is associated with the lack of comfortable income, so the core problem therefrom is the compensation for the workers. Among the abject, only 11.4 percent or 2.9 million jobs well-nigh the clock is useable for the whole year (Spriggs, 2007). This sector of the community is further directly imp air outed by minimum-wage laws that have hindered costs of dungeon. This setback is specially severe for poverty stricken American-Hispanics and American-Asians, where 18 percent of them worked year-round for full time (Spriggs, 2007).\r\nThere are several reasons why numerous people lack the income to crucify poverty. For instance, people do not work or if they work, they do not earn sufficient amount of money. Whether in skinny or bad economic times, the modal(a) low-down family with children exerts only 800 hours of work passim a year or 16 hours of work for each week (Rector & adenine; Johnson, 2004). Evidently, almost 75 percent of sorry children would be lifted outside attest poverty status if work is provided in every family, that would increase the work hours to 2,000 for every year or comparable to 40 hours for each week all through the year (Rector & angstrom; Johnson, 2004).\r\nIn 2005, approximately 61 percent underprivileged families have no less than one worker; and of twice-poor families, 71 percent have no less than one worker. In view of the 1990s record job cr wipe oution, the number of poor but working people declined to 8.5 million in 2000 from 10.1 million in 1993. In short, America is capable of relations with poverty. But there have been enormous stubborn concerns that have lodged the face of poverty. raise disparity in the labor market place has increased the share of the working age poor citizens, and the unsympathetic federal minimum-wage laws that have amplified the numbers of poor people working year-round for full-time.\r\nIn a country with a per capita Gross Domestic intersection point is exceeding the poverty line for a family of four, it is atrocious that there are sedate more than 12 million poverty stricken American children, and nearly 3 million people work around the clock, for one whole year who are still finding it hard to make ends meet.\r\nFacts Concerning the American Poor Sector\r\n ground on the American’s original definition of poverty, only a thin number of the 37 million individuals fit the poor description, contrary to what the Census Bureau classified. Despite the fact that real material destitution undoubtedly does take place, it is particular(a) in severity and scope. A number of America’s underprivileged lives in material conditions that would be considered as genial or comfortable some generations ago.\r\nThe undermentioned are information obtained from disparate government reports regarding people classified as poor by the Census Bureau:\r\n1. well-nigh 46 percent of the entire poor households actually own their individual houses (Rector & Johnson, 2004). The representative house owned by persons identified as poor by the Census Bureau is a three-bedroom house with a garage, one-and-a-half baths, with at to the lowest degree a patio or porch.\r\n2. About 76 percent of underprivileged families have air condition in their houses (Rector & Johnson, 2004). By comparison, merely 36 percent of the entire population of t he United States benefited from air conditioning 3 decades ago.\r\n3. Only 6 percent of the underprivileged families are considered overcrowded, and not less than two-thirds of them have extra two suite for every person (Rector & Johnson, 2004).\r\n4. The distinctive poor American has more living space than the average individual living in Athens, Vienna, London, Paris, and other cities all over Europe (Rector & Johnson, 2004).\r\n5. Practically three-quarters of poor families own an automobile, while 30 percent own at to the lowest degree two automobiles (Rector & Johnson, 2004).\r\n6. Approximately 97 percent of poor households own at least one colored television, while half of the said percentage has at least two colored televisions (Rector & Johnson, 2004).\r\n7. more or less 78 percent own videodisc or VCR players, while 62 percent have satellite or cable television reception (Rector & Johnson, 2004).\r\n8. Around 73 percent of the poor households have mi crowave ovens, one-third owns an automatic dishwasher, and over half own a stereo arrangement (Rector & Johnson, 2004).\r\nFurther, as a group, America’s poor are far from being eer malnourished. In fact poor children have usual protein intakes of 100 percent beyond the medically suggested levels and consume more shopping mall than children of higher-income do (Rector & Johnson, 2004). Nevertheless, despite the fact that in general the poor are well-nourished, there are still several poor families who experience short-term sorrow due to food deficiencies.\r\nAccording to the United States Department of Agriculture, although most of the time the hungriness is temporary, still 2.6 percent of poor children and 13 percent of poor families experience food shortage sometime during the year (Rector & Johnson, 2004). Approximately 89 percent of the poor account sufficient food to eat to their families, at the same time only 2 percent says they often do not have adequ ate food to eat (Rector & Johnson, 2004).\r\nConclusion / Recommendations\r\n chase the United States government classification of poverty, the typic poor American people have a living standard far superior as compared to what the public envisions. Nevertheless, the typical poor person’s living conditions should not be taken to suggest that every poor American lives impoverished of hardship. Millions of Americans are still continually struggling to hang on, making tough choices between housing, hunger and health care for their families.\r\nEconomic inequality, income growth, and changes in family structure without doubt change poverty trends over the latter half of the 20th century. Poverty in America can be readily reduced, if parents are provided with sufficient hours of work and if fathers are at all times present with their families. Although hymeneals and work are unyielding ladders away from poverty, the country’s wellbeing system uncooperatively continu es to be unsympathetic to both. Foremost programs such as Medicaid, public housing, and food stamps keep on reprimanding marriage and rewarding idleness. Therefore, if welfare could be turned around to relate marriage and work, the remaining number of poor family would quickly decrease.\r\nFurther, as a guinea pig of course, the United States has employed over the years job creation and economic growth to trim down poverty, but at present situation the courses are eventful only to the extent that inequality on wages is reduced. Poor people are generally not victims of themselves, but of revolt economic policies along with obstructions to opportunity. Since work generates income, it is central therefore that the government must(prenominal) provide a great increase in available working hours in different labor sectors for the poor. Along with the work opportunities, it is in like manner important to eliminate economic inequalities base on gender, age, economic status, and many others in order to provide higher wages and higher incomes to the underprivileged sectors of the country. America is a nation with one of the most successful and strongest economies in the world. As such, the country must exert a continuing effort to fully utilize the abundance and therefore eliminate the country’s appalling poverty rate.\r\n'

'Network Server Administration\r'

'Course number CIS 332, interlocking emcee Administration, lists as its main topics: instalment and configuring bonifaces, profits protocols, resource and end drug substance absubstance abuser watchfulness, protective cover measures, active voice Directory, and the figure of server roles which can be implemented. My experience and proof as a Microsoft cognizant System executive director (MCSA) as well as a Microsoft Certified System Engineer (MCSE) demonstrates that I flummox got a thorough grounding in both the surmise and practice of the topics cover in this course and should learn credit for it.\r\nInst aloneing and configuring servers was the subject of facility, Configuring and Administering Microsoft Windows 2000 emcee, which I took in 2001 in preparation for my initial Microsoft Certified passe-partout enfranchisement. This exam cover such topics as installing Microsoft Windows 2000 Server using both an attended initiation and an unattended installation ; server upgrades from Windows NT (the previous version) and troubleshooting and repairing failed installations. This exam also cover installing and configuring hardware devices and user management.\r\n interlock protocols were discussed during the prep for the exam Implementing and Administering a Microsoft Windows 2000 entanglement Infrastructure, which I also took in 2001. This exam covered installing, configuring, troubleshooting and administering such protocols as DNS and DHCP, TCP/IP, NWLink, and IPSec. The preparedness covered such aspects of profits protocols as remote regain policies and lucre routing. Security was one of the topics of this exam, as well. Network security using IPSec and encryption and authentication protocols was discussed along with the network carrying into action details.\r\nResource and end user management was one of the main topics of the Managing and Maintaining a Windows Server 2003 Environment exam, which also updated my acquaintance of sec urity, networking and utilities. The exam covered such topics as user creation and modification, user and group management, Terminal Services management and implementing security and software update service.\r\nSecurity was covered in a number of exams, including Implementing and Administering a Microsoft Windows 2000 Network Infrastructure, Installing, Configuring and Administering Microsoft Windows 2000 Server and Designing Security for  a Windows 2000 Network.\r\nAll aspects of network security were covered in the various cooking sessions for these exams, including topics such as analysis of network security requirements in relation to organizational realities and requirements, design and executing of such specifics as authentication policies, public-key infrastructures and encryption techniques, somatogenetic security, and design and implementation of security audit and presumption strategies. Also include were security considerations for all appendix services, such as D NS, Terminal Services, SNMP, Remote institution Services and others.\r\nImplementation of Active Directory and knowledge of varied server roles was provided by the exam Designing a Microsoft Windows 2000 Directory Services Infrastructure. The breeding for this exam encompassed the design and implementation of an Active Directory forest and domain structure as well as planning a DNS schema for client and server naming. This training also included design and implementation of a number of contrary server types, such as file and strike servers, databases, proxy servers, Web servers, desktop management servers, applications servers and dial-in management servers.\r\nFurther knowledge of Active Directory and auxiliary services was provided in the training for Implementing and Administering a Microsoft Windows 2000 Directory Services Infrastructure. This training included such topics as installing, configuring and troubleshooting Active Directory and DNS, implementing spay and Confi guration Management, and managing all the components of Active Directory, including moving, publishing and locate Active Directory Objects, controlling access, delegating administrative privileges for objects, execute backup and restore and maintaining security for the Active Directory server via Group Policy and the Security Configuration and summary tool.\r\nThe topics covered in CIS 332, Network Server Administration, have been completely encompassed by my previous experience, training and certification with Microsoft Windows Server 2000, as well as updated knowledge gained by  training for Microsoft Windows Server 2003. I have been constantly increasing my skills and knowledge in this field for the past six years, using both training and work experience to gain certifications which prove that I have a complete grasp of all aspects of the subject matter included in this course.\r\nInstalling and configuring servers and network protocols, troubleshooting failed installation s or configurations, resource and end user management, security design and management, design and implementation of Active Directory services and implementing and administering a wide variety of network server roles are all major aspects of my training and certification experience. I feel I am fully qualified for the information covered in CIS 332, and should be granted credit for this course.\r\n'

'Electronic Medical Records\r'

'electronic aesculapian disks Essay Cynthia J sensations imposing Canyon University: HCA 450 November 11, 2012 electronic aesculapian examination checkup examination Records Essay well(p)ness check state up covering has change in the expire couple of decades. In the past endurings discs were kept in a file on root word fetching up excessive room. In the past, report charts were the b atomic number 18ly means of keeping a persevering’s aesculapian diagnoses documented. to a greater extent(prenominal) or less(prenominal) of these charts atomic number 18 belt up employ today in wellness sell facilities, however they atomic number 18 slackly creation replaced with a much(prenominal) boot out method; electronic medical move intos (EMR’s).This virtual entropy†cultivation c cypher plunder serve as a vehicle to promote and to disseminate similar info definitions and trump practices to providers, consumers, and rough others avo cati nonp arild in shade mendment efforts nation entirely(prenominal) toldy and inter matterly (Varkey, 2010). The electronic aesculapian Records is an coming calculating workizes medical record establishment that hand overs medical selective teaching for medico’s office and infirmarys at heart a matter of seconds while offering look at. This organization in allows the wellnessc be supply and mendeleviums to modified, store and retrieves enduring’s medical records.electronic medical records argon legible and calculated. The Electronic checkup Record (EMR) has been whatsoever since the late 1960‘s, when Larry scum bag introduced the opinion of the Problem Oriented Medical Record into medical practice (NASBHC, 2012). Weeds innovation introduces the concept of the Problem Oriented Medical Record into the medical practice, which verifies the diagnosing (NASBHC, 2012). However, it wasn’t until 1972 when the Regenstreif Institute g enuine the setoff-class honours degree medical records constitution. Although it was a great invention, physicians didn’t try on to implement it right a fashion.This impudent dust would assistant physicians improve patients conduct. Although, $19 billion in stimulant funds e trulyplacehear been invested into the Electronic wellness record (EHRs) a nonher signalize for EMRs; the Obama administration tallly suggested that health c atomic number 18 and hospitals facilities start to digitize patient data and start making better design of the advance applied science(Greenemeier, 2010). The health palm industry has been slow to correct to this new constitution. Although the EMR g overning body is intended to make patients records more glide slopeible for the physicians and supply, still many choose non mechanismed it yet.Given the lack of EMR adoption throughout the health pity industry, less than 10 percent of U. S. hospitals digest adopted electronic medical records. Cost is the un both(prenominal)eratic reason many recognize resisted or argon un giveing to adopt the EMR transcription and shortage on staff as well. In a modern interview on November 9, Jessica in human election at Vineville Internal Medicine, with Dr. Mary Bell Vaughn presiding as the physician over the practice. The practice has been dumb groundment electronic medical records systems since the practice open in 2002. Dr.Vaughn mentation patients and staff call for easy entryway to their records when quested. Some of her other reasons atomic number 18 as follow: • composingless, less(prenominal) transshipment center • No physician running around ( Patient info available at feel tips) • Saves date spent with patient • Good for introduce protestation • Financial Good This system is meshing base and procedures an E-Clinical programme through a portal. This system identicalwise allows prescriptions to be send to the local do drugsstore as well. Blood reckon directs argon also put into the patients charts as well.Recently, the practice took on new patients with news theme charts, because their physician retired. In this cause their near recent charts were born-again over to EMRs. However those newspaper publisher charts still exist in a tiny storage area if further study is needed on the patient. though the practice implements the EMRs system from the rattling beginning, the physician and staff are very laughing(prenominal) with the system. closely patient entropy is put into the system via calculating machine on the spot while the patient is telling the nurse or physician what is ail them.Although thither system is a web based system, it has devil backup systems in ii contrary locations just in case the systems go mastered or power outage. The EMR system has had great bore impact on the practice. The patients care has been improve by the system. It allows the physicia n to track and tellingly treat the patient. In some cases if the patient is located at a nonher(prenominal) health care facility this system allows them to send info to multiply pot for care, no matter whither they are. Dr.Vaughn’s practice is already looking into the future to implement s shutd stimulate out text message to patients to inform them of appointments. Patients have access to their care any measure. EMR adoption is slow to be implement into some practices. Although thither is some disapproval of the electronic medical records today, it is merely a digitized version of paper chart. This system will slash medical errors and help put selective tuition in front of researchers This new form of engineering science is here to stay and the so 1r health care facilities start utilize it the more efficient results they will receive.References Prathibha Varkey (2010). Medical feature guidance, Sudbury, Massachusetts: J anes and Bartlett Publishers. History of th e Electronic Medical Record system (2012) Retrieved November 8, 2012 www. nasbhc. org Will Electronic Medical Records Improve Health Care? (2009) Retrieved November 8 2012 http://www. scientificameri quite a little. com/article. cfm? id=electronic-health-records\r\nElectronic Medical Records\r\nEngineering steering Field stand out Electronic Medical Records: A Case sphere to Improve Patient Safety at olympian capital of Seychelles Teaching hospital By Annie Bittaye dance Semester, 2009 An EMGT Field Project report submitted to the Engineering Management Program and the Faculty of the Graduate School of The University ofK. ansas in partial fulfillment of the emergencys for the degree of Masters of Science )= • , , tom turkey Bowlin Cotntnittee Member ‘~k Committee Member run into original: _ _&-4â€_:”/~,,,,,,”1_-. -Q:;,,.. r5c—-_ _ slacken of ContentsTable of Contents ………………………†¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦. 2 distinguish of Figures ……………………………………………………………………………………………………… 3 leaning of Tables ………………………………………………………………….. ………………………………….. 3 Ac hit the sackledgments……………………………………………………………………â₠¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦ Executive epitome ……………………………………………………………………………………………… 5 1. 1. 1. 2. 3. 3. 1. 3. 2. 3. 3. 3. 4. 4. 4. 1. 4. 2. 5. 6. 7. Introduction…………………………………………………………………………………………………… 6 Background of gallant capital of Seychelles Teaching Hospital …………………………………………… 7 belles-lettres Review …………………………………†¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦ 0 operation and Methodology ………………………………………………………………………….. 17 data-based Design …………………………………………………………………………………. 17 Survey Procedure ……………………………………………………………………………………… 18 selective information Analysis ……………………………………â⠂¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦ 9 Limitations of the try out …………………………………………………………………………….. 19 Results………………………………………………………………………………………………………… 20 Reasons wherefore EMR is non being apply at RVTH …………………………………………….. 23 Benefits and challenges of EMR…………………………………………â⠂¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦Ã¢â‚¬Â¦. 24 synopsis…………………………………………………………………………………………………….. 0 Conclusion ………………………………………………………………………………………………….. 30 Suggestions for Additional bring in …………………………………………………………………… 32 References ……………………………………………………â €¦â€¦â€¦â€¦â€¦â€¦â€¦â€¦â€¦â€¦â€¦â€¦â€¦â€¦â€¦â€¦â€¦â€¦â€¦â€¦. 34 Glossary ……………………………………………………………………………………………………………. 5 vermiform appendix …………………………………………………………………………………………………………… 36 2 List of Figures Figure 1: Sources of funding, RVTH 2008 …………………………………………………………….. 22 Figure 2: Averages ofEMR functions in distinguish of relevance to work at RVTH …………… 29 List of Tables Table 1: chassis of patients dealn at RVTH in 2008 ………………………………………………….. 7 Table 2: List of Professionals, RVTH 2009 ……………………………………………………………. 0 Table 3: Computer throwership and former computer training received by the respondents at RVTH ………………………………………………………………………………………….. 28 Acknowledgments My journey towards my Masters degree was a spacious and fruitful unmatchable. The Engineering Management (EMGT) program has not just exposed me to much information and heads barely also opened a appearance towards my charge path. Thank you to my parents, Ebrima and Lucy who have eer been a source of great inspiration and strength to me. They taught me the value ofeducation and their prayers has forever been with me. give thanks to my brother, Baboucar who encouraged me to pursue my Masters degree and the never ending affirm I receive from him. Special thank to my six course of instruction old son, Ebrima for his understanding that Im at school when Im not home to read him a bed fourth dimension story. I also want to thank all my EMGT instructors in particular Professor Herb Tuttle, Dr Tom Bowlin and spear Dick who worked with me recently, for the wonderful information and feedback they provided on this project. Thanks to Parveen Mozaffar for her extreme die hard and encouragement during the course of my studies.Thanks to the staff at royal Victoria Teaching hospital for providing me with all the needed information for this project. Last plainly not least, my gratitude goes out to Dr Don Anthony Woods. It is because of his influence that brought me where I am today. He always had my best interest at heart and I want to thank him for that. May God bless you! Executive drumhead Most countries in Europe and the USA are increasingly using an electronic medical record (EMR) system to help improve healthcare tone. Unfortunately, The Gambia government activity activity faces a series of health crises including nevertheless not particular to human immunodeficiency virusIAIDS, malaria, diabetes and tuberculosis.These disorders threaten the lives of thousands of peck. escape of infrastructure and trained, see staff are considered important barriers to scaling up discourse for these diseases. The contri andion of this field proj ect outlines the benefits of an EMR system at majestic Victoria Teaching Hospital (RVTH) and how it will improve patient golosh. This is a descriptive understand using interview perplexitynaires from officials at the Royal Victoria Teaching Hospital. The study also looks into other facilities in similar developing countries with advanced systems, exclusively not so advanced as to be at the train of state-of-the­ art facilities in the U.S. Results from this study forecasts the immenseness of an EMR system at RVTH to facilitate effective and efficient data foregatherion, data entry, information retrieval and report generation. As a catalyst for ripening, the executing of an EMR system at RVTH whitethorn make it one on the best hospitals in the West Afri drop region. 5 1. Introduction According to Dick and Steen, Electronic Medical Record (EMR) is the compilation of patient medical information in a computer-based format that allows the collection, storage, retrieval, and discourse of this data.An electronic medical record replicates a paper chart and contains both clinical information (diagnoses, allergies, drug resistance and preachings) and demographic information just active a patient; it provides a nationwide medical draw and commode be employ by clinicians as a tool to determine appropriate treatment for patients. EMR is not only being welcomed by healthcare providers as a way to improve care delivery merely also serves as a catalyst and gold standard for development (porter, Kohane, & Goldman; Reifsteck, Swanson, & Dallas).Unfortunately, Africa, a continent faced with many challenges ranging from epidemics, civil wars, and disasters, lacks proficient-bodied healthcare infrastructure in the form of computerized health care systems. For instance, Ghana has one the best health bases in the region, Korle-Bu Teaching Hospital. This Hospital, for example, is currently the only institution in the West Afri rear sub-region which performs surgery. Due to the tone of voice of outcome, it now receives referrals from intimately parts of the continent namely the Gambia , Sierra Leone, Liberia, Togo Benin, Tanzania, Nigeria, Cameroon, Cote d Ivoire, and Ethiopia.Despite its exemplary performance, the hospital has no computerized information system which sess help improve care delivery in the region. therefore, the purpose of this study is to break down the potential benefits of EMR and its net part to up healthcare delivery development in less real countries give care The Gambia. 6 1. 1. Background of Royal Victoria Teaching Hospital The Gambia is a small rural in West Africa, with a population of more or less 1. 5 million. RVTH has been in existence for over degree Celsius years in The Gambias capital, Banjul.It utilise to be called Royal Victoria Hospital until in the late 1990s, when its name was changed to RVTH. The Gambian Government square upd that it had to subjugate its dependence on foreign reanimates by establishing a medical school in the University of The Gambia (UTG). The UTG now uses RVTH to teach its clinical students. In recent years, The Gambia has been doing much on its own initiative to fruit to improve the healthcare of the nation. There are 540 beds in the hospital and the two largest Departments are Pediatrics and Maternity.The biggest â€Å"killer” disease in The Gambia is malaria, with late children and pregnant women being particularly vulnerable to this disease. Diabetes, high blood pressure, pneumonia and eye problems much(prenominal) as trachoma and cataracts are also major health problems. The following slacken provides an estimation of how many patients were seen at RVTH in the year 2008. Procedure Inpatient Admissions Children admitted to Pediatrics Patients treated in the Eye Center Out-Patient Appointments Out-Patients in the ER Number of Patients 25,281 9,352 986 over 184,365 24,334 Table 1: Number of patients seen at RVTH in 2008 7Unfortunately, RVTH does not have any EMR system in place to facilitate patient recourse. As noted by participants, â€Å"EMR software i s not used at RVTH because administration keeps complaining of money. It looks high-priced to them and also they are more used to the paper leaflet”. Currently, information is very fragmented and therefore does very little to help patient safety and soundbox in care. another(prenominal) important issue here is that a large number of these patients are illiterates. To crack they receive the appropriate treatment, they will have to explain to the physician current medications they are taking etc.This git be a very thought-provoking and deadly to the patient sometimes. The typical paper medical record contains sections including information on demographics, admissions, discharge summaries, progress notes, protocols, testing ground results, radiology results, surgical and pathology reports, orders for, treatment and nursing notes. Most documentation regarding treatment of a patient is scripted directly in the patients medical chart. On a minded(p) day a patient arrives a t the hospital for care, sign in his name and fronts anyplace from 30 minutes to six hours o buzz off their records pulled depending on the day. Physicians, nurses, medical residents who need access the information in the medical record mustinessiness(prenominal) wait till its available. Typically, medical records are transported to the outpatient clinic where the patient would be seen, and then perished to storage center to be filed again. It is requirement for the medical record to follow the patient throughout their visit. If the patient was seen in one clinic where orders were written, it was necessary to physically transport the record when the patient moved to the medicament room for treatment. The purpose of this field project is to test the potential benefits of an EMR system and its ultimate contribution to up(p) patient safety at the Royal Victoria Teaching Hospital in The Gambia. 9 2. books Review The first generation of EMRs was extensions of medical armorial bearing systems in large US hospitals. Over the suffer four decades, they have been used as tools to organize and store medical data. EMRs are widely swallow uped as important tools to pay high quality health care in the US, Europe and other authentic countries.Evidence shows that using EMRs that embroil decision encourage systems improves quality of care and both reduce medical errors and unnecessary medical investigations (Partners in Health), defecate wind with the use of EMRs in developing countries, if available, is much more limited than it is in the US and Europe. Now there is extensive interest in using medical information systems to support the treatment of HIV and TB in Africa, Latin America, and Asia. In most African countries, healthcare information systems have been driven mainly by the need to report aggregate statistics for government or funding agencies.Such data collection can be performed with simple paper forms at the clinic level, with all electronic dat a entry done centrally, but that admittance tends to be difficult and time­ consuming and whitethorn provide little or no feedback to the staff collecting data. Individual patient data that are collected and accessible at the point of care can support clinical do itment. Clinicians can advantageously access previous records, and simple tools can be incorporated to warn of potential problems much(prenominal) as incompatible drugs.Physicians or nurses can check on the outcomes of individuals or groups of patients and perform research studies. Many of these functions will work well on paper or with simple spreadsheets for up to 100 patients but stimulate very time-consuming and potentially unreliable with more than 1,000 records, and virtually impossible with 10,000 or more. 10 Experience with the use ofEMRs in developing countries is much more limited than it is in the US and Europe, but there is now considerable interest in using medical information systems to support the tre atment of HIV and TB in Africa.Some examples of EMR use in Africa hold: • The Regenstrief Institute in collaboration with Moi University in Kenya developed an EMR for general patient visits to clinics in western Kenya. This system was subsequently modified to support the care of some(prenominal) thousand HIV patients. • Baobab Health alliance in Malawi has developed an EMR system using innovative, low-power touch-screen PCs for data entry and display. This system is now used to support the care of more than 7,000 HIV patients in the lighthouse clinic in Lilongwe and has been chosen by the national HIV program for use throughout the country. [email&# one hundred sixty; comforted], an HIV medical information system developed for US patients, has now been deployed in Uganda and is planned for use in other African countries and in Latin America. (Partners In Health) A wide-ranging literature reassessment of electronic medical record execution over the past decade reveals that clinical, workflow, administrative, and revenue enhancement benefits of the EMR surpass barriers and challenges. Among other key efforts, organizations must train and propel users to navigate EMR systems, as well as develop a common structured language.Clinicians who used CPRs arrange that electronic 11 access to clinical infonnation saves time and provides a thorough and efficient way to manage patient information To reap the full benefits of an EMR, organizations must redesign current workflows and practices to evolve into efficient providers of care. EMR systems are developed to meet the following goals: improve quality of care, reduce organizational get down, and produce a data stream for electronic billing. (Dassenko and Slowinski).The EMR meets these goals through workflow automation, connectivity, and data mining. (Gaillour) The Computer-based Patient Record Institutes (CPRI) definition concurred with the other researchers, but added that the EMR provides protection of patient and provider mysticity, has a define vocabulary and standardized coding, produces documentation as a by-product of patient care, connects local and remote systems and provides electronic support for secondary users (payers, policymakers, researchers). Fromberg and Arnatayakul) Unfortunately, most EMR systems are uneffective to offer all of the components defined by the CPRI because ”the engineering science is too complex and too expensive, determines wont use computers, and standards dont exist. â€Å"(Gaillour) The advantages associated with implementing EMRs are well documented and are straightforward. The difficulty comes with placing a dollar figure to these advantages; consequently, hardly a(prenominal) organizations have print studies describing the actual approach and benefits attained from implementing EMRs. Bingham) The benefits associated with CPRs are organise into four categories: clinical, workflow, administrative, and revenue enhancement. Re nner, states that measuring all the benefits associated with EMRs is 12 virtually impossible, and that it is plausibly safe to select those that can make the greatest financial difference, and incorporate them into a financial model.Clinical benefits seen after implementing an EMR entangle: better access to the chart, alter clinical decision making and disease management, enhanced documentation, simplified patient education, and increased bare(a) time to spend with patients, accompanied by improved perception of care and quality of work life. These benefits eventually result in better delivery ofpatient care and safety. Despite all of these benefits, EMRs are not a standard in todays healthcare systems. It is evident that EMR technology is still a hot topic for intelligence when browsing through current healthcare technology and management journals.The following barriers have kept healthcare leaders discussing EMR technology instead of adopting it: follow, leadership, ROI, ve ndors keeping up with users needs, and deficits in the following categories: public policy, standards, tribute, and a straightforward definition. First of all, cost has kept organizations from implementing EMR systems. These costs can be organized into the following categories: software, hardware, infrastructure development and maintenance, implementation, education, planning, and administration.Software costs embroil development or purchase, maintenance, and upgrades over time, while hardware costs include purchase of workstations. (Mohr) Infrastructure development and maintenance costs include servers, interfaces, workstations, network cables, network maintenance, and help desk operations. Planning costs include development of an implementation plan, identifying measurable outcomes, and choosing important metrics and goals, while implementation costs include training, overtime 13 ssociated with entering patient data, course disruption during transition, employee resistance t o change, and lost productivity. Drazen, suggested that leadership was probably a more significant barrier than cost because, in the past, healthcare leaders have elevated capital for essential business initiatives such as major building programs, acquiring a physician network, or starting up a managed care organization. This amount of capital is on the same overcome as an EMR. Next, Drazen tell that a lack of government support is a major issue safekeeping up EMR implementation.Unfortunately, the federal government does not provide fmancially to EMR implementation projects. Without standards and structured data definitions, computer systems are not guaranteed to interface easily with each other, and databases are not easily developed. Most individual departments in spite of appearance a healthcare system have already invested in computerized patient information systems; however, these systems are stray and do not communicate well with one some other. Getting these systems t o interface is one challenge veneering EMRs. Data surety continues to be an ongoing challenge.Bergman, appoint that politicians, consumer advocates, and the general public have voiced hits about risks to the privacy and confidentiality of patient information. However, when compared with the security of the paper chart, the EMRs electronic audit trails and pass actors line actually improves internal security. The EMR may be more secure for internal breeches of confidentiality, but must also be protected from foreign breeches such as hackers, who could potentially enter the EMR from an off-site location and download volumes of 4 confidential information. Firewalls and encryption software are methods used to protect patient data from these violators. Clinicians who use EMRs recognize two benefits: First, electronic access to clinical information saves time. Second, electronic access provides a thorough and efficient way to manage patient information. With EMR systems, comprehensi ve information can be located and presented in a way that is relevant to the task at hand. Dassengko and Slowinski) The obstacles identify have thus far been insurmountable, but the considerable achievements determine in the benefits section of this discussion suggest that the advantages are well worth the effort. As Lenhart et al state, â€Å" advantage comes at the price of considerable effort, persistence and optimism, as well as dedicated leadership. ” (p. 114) some organizations that invested in early EMR systems are struggling to show the soft benefits promised by vendors because an electronic version of current work processes is not cost effective. Sandrick) â€Å"If the ROI were a function of the information tool itself, the financial benefits would be hold outd universally. ” (ROI: The exsanguinous Paper. A Business Case for Electronic Medical Records) To get the most value out of an EMR, healthcare organizations must reengineer the following work process es to make full use of the system: Healthcare organizations must first train and motivate their users on how to navigate and become the EMR tools. To optimally use the EMR, it must be implemented from registration through billing, thus allowing the organization to work full potential benefits across the delivery system.These benefits include clear, concise, and comprehensive documentation, greater efficiency, care consistent with best practice guidelines and improved claims processing. 15 It is difficult to euphony the economic value associated with less tangible benefits such as higher quality of care, patient service, provider and employee satisfaction, and competitive advantage. It is even more difficult to allot necessary resources and commit to institutional change when the paper chart is â€Å"getting the job done,” even if it is not in the most efficient style.However, Carlon, suggests that all providers should embmce the EMR to deliver safe medical care. The infor mation in the EMR can reduce medical errors to avoid dangerous, sometimes lethal, mistakes. If organizations cant show that EMRs have a positive ROI, they may decide that the EMR is just another expense of running a business. The expense is to improve patient safety and reduce medical errors. This review of literature emphasizes that the use of EMR systems contributes to the ultimate goal of delivering effective care while improving patient safety. 16 3.Procedure and Methodology The study is an exploratory study conducted in Banjul, The Gambia, to examine the potential benefits ofEMR and its contribution to improving patient safety. For the most part, this study is descriptive and categorized as a non-experimental qualitative study. initial contacts were made with the Chief Medical Director, Development ships officer and the Head of Medical Records at the RVTH to solicit participants for the study. 3. 1. Experimental Design Survey approach was used to gain data from healthcare pr ofessionals who are considered potential users of EMR.Copies of the questionnaires were sent through e-mail to participants. A centre of 50 prospects containing 15 questions were sent out and 30 of them were returned. The meaning of the check over designed was open-ended questions based on the following areas: knowledge of EMR, benefits and challenges of EMR, transition from paper-based system to EMR, security issues associated with EMR use and assistance given to developing countries by developed nations to implement or use EMR. otherwise areas include, demographic details of respondents based on profession, duration of practice, age and sex.The survey questions can be found in the Appendix. Participants were selected based on their level of healthcare training. The population set for the study was healthcare professionals from the RVTH, which includes physician consultants, surgeons, pharmacists, nurses, midwives, pathologists, radiologists, and laboratory technicians. Study participants were limited to these previously mentioned health professionals, since they would be the principle users of an EMRsystem. 17 RVTH has a total population of about 500 professionals and a sampling size of 50 was chosen for the study.Since this was the first time such a study was being conducted in the country, there was limited knowledge of professionals on the matter as well as difficulty in getting volunteers to participate. 3. 2. Survey Procedure Survey questionnaires were converted into a PDF file and mailed electronically to all 50 participants on February 2, 2009. Unfortunately, quintuple medical professionals who were ab initio contacted to participate in the study later declined to take part ascribable to lack of understanding of the survey questions. As a result, contrasting participants were contacted to replace the five individuals to make up the sample size.Since the researcher could not travel to Gambia to facilitate the survey, one of the administrative officers at the hospital was contacted and helped to distribute hard copies of the questionnaire to all participants. Participants were communicate to fill out the attached survey and return it in a sealed envelope to this someone or the chief administrator. After three weeks, on February 23, 2009, a first reminder was mailed inquire for their cooperation and the importance of returning the survey. A final exam reminder was sent out on March 9, 2009, to those who cleverness have forgotten to return the survey. 8 3. 3. Data Analysis The 30 effectedd surveys were coded, sorted, and organized into themes. A spreadsheet was created in MS-Excel to enter all data for analysis. all in all responses were placed into themes and summarized. The survey responses and themes generated were used to determine result interpretation, recommendation, and future research direction. Despite initial difficulties to get volunteers to participate in the study, 30 out of the 50 surveys mailed were returned on March 16,2009, thus representing 60% response rate. 3. 4. Limitations of the studyDue to the difficulty of getting other hospitals in the area involved, the study was limited to RVTH only_ The findings represent views ofthat hospital alone. However, the research would have been more interesting and contend if more professionals from other hospitals were involved in the study. Secondly, cod to cost of air travel surrounded by the united States and Gambia, the researcher was not able to travel to Gambia to collect the necessary data for the study. The inability of participants to respond to some important questions on the survey skewed the data.Finally, out-of-pocket to the six hour time difference between Kansas and Gambia, it was hard to reach the participants at during business hours. Lack of high speed internet or sometimes no connection at all caused the check up on in receiving all the responses on time. It was also rightfully difficult to get sight to coope rate because the survey was not on their list of priorities. 19 4. Results found on the methodology, surveys were mailed to 50 participants at the RVTH in Banjul, The Gambia. Thirty completed surveys were received which included 15 questions.The results from all participants are as follows: The 30 respondents consisted of 17 males, 11 females and two people who did not indicate their gender. The age range of the group was 25-56. Table 2 presents the professional distribution of participants. No Response represents people who did not include their profession. The five students, however, included final year medical and dentistry students, as well as nursing, and medical laboratory students. Professional experience ranged between 1 and 20 years.Profession Surgeon apothecary Physician Radiologist Midwife Nurse testing ground Technician Student No Response Total Table 2: List of Professiona is, RVTH 2009 Number 3 2 3 2 5 6 2 5 2 30 20 To hit the books this result, key words such as c omputerized, storage and retrieval, were used to determine respondents understanding of the concept of an EMR system. Subsequently, third base of respondents (33. 3%) who included these three key words were marked as right. age nine people representing 20% who give tongue to it is a mechanism for storing patient medical record on a computer were assort as partially right and slightly half respondents (46. %) who just said the use of machine to keep patient medical data were classified as having an idea or understanding of the system. In addition, implementing and running a successful EMR system requires a number of key elements. Accordingly, 15 people identified technical elements such as (electricity, hardware, software, etc. ), 10 stated patient data, while four said nice trained soulfulnessnel, and one person indicated the need for money to train staff on EMR. withal availability of adequate infrastructure such as experts to support and train care providers on EMR is very crucial when implementing EMR system.However, more than half respondents assured that becoming infrastructures are not available in Gambia to support EMR implementation. On the other hand, 10 people conceived that infrastructures are available, while four said available infrastructures are only few. Despite unavailability of infrastructures, 16 respondents account there are enough computer experts in Gambia to train healthcare providers to use EMR. Seven inform experts are not available; six stated experts are available but too few to meet the demand and needed training requirement of the healthcare sector.Lastly, one person indicated he has no idea of the subject. Responses concerning how much developed nations are assisting less developed countries like Gambia with Health Information Management (HIM) system infrastructure 21 implementation showed various(a) opinions. Nine people said developed countries are helping, 15 responded no. However, six indicated that â€Å"the he lp given from developed nations are not enough and sometimes electronic devices sent to less developed countries like the Gambia are inferior and lack quality”.Still others phone â€Å"some form of assistance comes in to support the country on information management systems but not much is channeled towards the health sector”. Lastly, heptad people reported they have no idea â€Å"if developed nations are helping” and one person did not respond to this question at all. This pie chart downstairs shows the sources of funding and the amounts received for the year 2008. Sources of financing 2% • Gambia Government • Patient User Charges • part lineage • Internally Generated Fund • Global Fund Severe Malaria in African Children FundFigure 1: Sources of funding, RVTH 2008 22 The majority of funds come from the Gambia Government in the fonn of subvention received monthly or quarterly in advance. However, about 70% of the amount goes t owards retribution of salaries and allowances to approximately 1,200 staff. Other donations received are in the fonn of drugs, equipment, supplies and services which made considerable contribution to the hospital. (RVTH) 4. 1. Reasons why EMR is not being used at RVTH Paper records are bulky and can take up costly set.Filing, retrieval of files, and the re-filing of paper records are very labor-intensive methods with which to store patient infonnation. Plus if a record is checked out for one department, another department cannot access the chart. The impact of not having fast access to key infonnation in emergency situations can be serious. Paper medical charts also cannot be effectively searched and used to track, analyze, and/or chart rich clinical medical infonnation and processes. They cannot be easily copied or saved off-site.Also physicians orders and the corresponding results such as medications and labs can be issued and saved in a comprehensive EMR system. Our literatur e review and results have proven that paper records are costly, cumbersome, misinterpreted, easily misplaced and cannot be used for any meaningful decision analysis. Unfortunately, RVTH does not have any EMR system in place to improve patient safety. As noted-by participants, â€Å"EMR software is not used at RVTH because administration keeps complaining of the lack of money. It looks expensive to them and also they are more used to the paper folder”.Nevertheless, four key issues were identified by participants as the main reasons why RVTH does not have an EMR system in use. 23 Overall, 36% of respondents attributed the problem to lack of resources in legal injury of personnel and infrastructure, 29% blamed it on lack ofleadership initiative and priority. While 18% reported cost in terms of equipment and training personnel, 15%, however, stated lack ofEMR importance or awareness and fear to change. Lastly, 2% respondents did not give any reason. 4. 2. Benefits and challenges of EMR There are both benefits and challenges to EMRs.Many argue that positive aspects of using an EMR system outdo the challenges. Even though the investments in EMR systems are costly, most argue that over time this outset cost will result in greater savmgs. As well as cost saving, many agree that one advantage of EMR system is that they save space. kinda of keeping huge paper files on patients, all records are kept on computer files. Though someone must store these records in computers, this still represents a small percentage ofthe space required to store physical records. Along with saved space is reduction of paper used by hospitals.Although EMR systems do not render paper obsolete, but they sure as shooting do reduce needed paper significantly. Another advantage of electronic medical records is the ability for all in a health care police squad to coordinate care in terms of observe and treating diseases. This helps avoid duplication of testing, prescribing medicines th at in combination expertness be dangerous and the ability for anyone on the medical team to understand the approaches taken to a condition. A person with complex health issues may see several specialists, and can easily become disjointed by overlapping or contrary advice.When specialists and primal care resorts use the same system for electronic medical records, then everyone on the team would be aware of all the other team members actions and recommendations. Electronic medical records may save time as well. Though faxing and email may assist one doctor to get information from another doctor or a laboratory, there is generally a wait time to receive this information. When a doctor has instant access to all of a patients information, including things like x-rays, lab tests, and information about prescriptions or allergies, he or she is ready to act right away, thus saving time.This may be particularly accommodative in emergency situations where a patient cannot dissolver quest ions about medical history or allergies due to extreme illness or injury. Generally, doctors are a good deal considered to have the worst handwriting, though this is just a generalization, unclear writing can lead to misinterpretations and mistakes. Typed notes and prescriptions are more legible and less likely to create misunderstandings. However, electronic medical records do not obtain out the occasional typo. One of the main disadvantages to EMR system is that start up costs is enormous.Not only must you buy equipment to record and store patient charts (much more expensive than paper and file cabinets), but efforts must be taken to convert all charts to electronic form. Patients may be in the transitional peak where old records havent yet been converted and doctors dont always know this. Further, training on EMR software adds additional expense in paying people to take training, and in paying trainers to teach practitioners. In fact, one concern about the use of electronic me dical records is that doctors may have a significant learning draw in when these programs are first implemented.A poor 25 typist may actually take a long time to input information. Doctors often have to be their own medical clerks especially during an office visit, and a doctor distracted by confusing technology may not be as alert to a patients symptoms or needs. There is no single electronic medical records source or system, so different hospitals and individual clinicians may not all be using the same program. This negates the possibility of instant information for all on the medical team, since one program may not communicate with another.Another concern is that electronic medical record systems might be hacked and use by others. Since one of the first considerations of medical treatment is confidentiality, it may remain a concern about how many people may have access to other medical records which they are not authentic to do so. Misuse of private medical information could c reate problems for people who have conditions they wish to keep private. Despite these concerns, it appears many hospitals are now attempting to use EMR systems.It remains unclear how long it will take for hospitals to transition completely from the traditional paper-based systems to a complete paperless environment. As shown from the survey results, it is clear that many participants think that implementation ofEMR will tremendously improve upon patient in the country. For instance, as noted by one respondent, â€Å"availability of patient past history in electronic format will enable health care workers have information about patients in seconds and with ease which will facilitate quick diagnosis and treatment hence reducing the rate of mortality. 26There is always some level of fear and resistance to change, especially in the healthcare industry. A question concerning the level of acceptability from the traditional paper-based system to EMR system shows that such change will be met with some difficulties. more(prenominal) than half of respondents said the process would be challenging initially, but eventually care providers will accept the system because it will improve patient safety and work performance. Although the majority may still prefer the paper-based system, â€Å"they will change when they see the importance or need for EMR” stated a participant.Others also believe it would be a â€Å"welcome idea”. The adequate protection of patient health record requires limitations at all levels, such as: collection, use, access, and disclosure. Therefore, development of privacy, confidentiality, and security principles is necessary to protect patients interests against inappropriate access to their health data. Unfortunately, 14 respondents (47%) did not respond to this important question regarding measures necessary to maintain patients privacy, security, and confidentiality at RVTH.However, 16 people representing (53%), did state that all health records must be securely protected by use of password, data encryption, and access restrictions to users. It is obvious from the survey results that effective implementation and utilization ofEMR can improve patient safety in developing countries. Considering training as one of the key elements to EMR success, a question was asked to determine space of time required to train care providers in Gambia on EMR.Almost 50% of respondents indicated it might take 6-18 months depending on â€Å"practitioners ability to understand the concepts ofEMR as well as the user friendliness of the software”. Others believe â€Å"for 27 current medical students who are already computer literate may take about two weeks, but the older practitioners will take eight-day time (approximately over a year)”. Table 3, below shows the number of respondents that own a computer or has had some form of computer training in the past. Computer Training Profession Own a Computer 1 1 1 0 1 2 1 2 I Yes 1 1 1 0 2 3 1 7 16\r\n'

'Candide and Free Will\r'

'Voltaires Candide is a novel that is interspersed with superficial characters and c at a cartridge clipptual ideas that are critic on the wholey exaggerated and satirized. The caper glumers cynical themes disguised by mockeries and witticism, and the story itself presents a distinctive outlook on life narrowed to the c erstpt of rationalize leave behind as opposed to unsighted trustfulness goaded by trust for an optimistic outcome. The crucial lineage in the story deals with irrational ideas as taught to Candide intimately being optimistic by Pangloss, his cheerful mentor, versus populace as viewed by the rest of the existence by dint of the eyes of the troubled character, Martin.This raises the motion of whether or non the notion of big pull up stakes is valid due to Candide’s peculiar timing of his expression for it. approximately readers might think that Voltaires novel Candide suggests that vox populi in bighearted bequeath is absurd. However, a cl ose denotation of the text suggests that Voltaire does not deny big get out altogether. Candide is in sodding(a) condition of his actions and ideas during times when an lovely reality poses not to be enough, which explores Voltaire’s pass that true reality is the ability to identify the deprivation of hu domain conventions.Candide’s journey to attain the quietus surrounded by cut inting his exit completely to the opinions and actions of others and taking control of his own life finished blind faith highlights the notion of justify go out throughout Voltaire’s novel. Throughout the novel, Voltaire represents mankind as being consumed by immediate personal problems. When the characters of Candide virtually take a crap no troubles or dilemmas, Voltaire flesh outs how they do not express their satis incidention and contentment for it, but rather portray their feelings of ennui and a desire to involve themselves inside the mazy social constructs o f the homo.In chapter eighteen when Candide and his valet Cacambo enter the smart as a whip city of El Dorado, Candide expresses the city’s excitement and how it is incomparable to any other, even when compared to his overvalued Westphalia. Voltaire described â€Å"the mankindity edifices raised as high as the clouds, the foodstuff places ornamented with a thousand columns, the fountains of spring water…which were surface with a kind of precious st maven which gave off a delicious fragrancy manage that of cloves and cinnamon” (45) to illustrate the decadence of El Dorado, and how it was virtually a utopia that no man could resist.However, Candide held enough free testament within himself by opting to leave the spl balanceor in monastic order to â€Å"recover Miss Cunegonde” (46). This event solidifies some readers’ opinions that article of belief in free depart is absurd, for Candide utilisations it for irrational and cussed means by h oping for a finer future. El Dorado serves as a symbol to Candide that there is more(prenominal)(prenominal) the world has to offer after having been taught that he was already living in the best of all manageable worlds while in Westphalia.The fact that he came crossways such magnificence paradoxically influenced his choice to leave since he thought he could find give than El Dorado, which demonstrates the faults of humankind conventions about how Candide could not neck amid true and optimistic realities when he already had quite possibly the best world sound in front of him. Once again, this substantiates readers’ ideas that free get out is outlandish and nonsensical. â€Å"If we abide here we shall only be upon a footing with the rest, whereas, if we return to our old world…we shall be richer than all the kings in Europe” (46).He is not aware(predicate) of the ramifications of his actions, of his professed free will, and believes that only groovy t hings will come to him as a result of his ill-judged autonomy. Voltaire presents the characters as having emotional lives that shift between worries and ennui with almost no periods of prolonged happiness. Pangloss’ influence instructs Candide to submit to blind faith that the outcome of all will be well, and that all events happen for a reasonableness. â€Å"It is substantial that things cannot be otherwise than as they are; for all being created for an end, all is necessarily for the best end” (1).Under these assumptions Candide says, â€Å"There can be no progeny without a cause […] The whole is necessarily concatenated and consistent for the best” (6). This philosophy that everything is fated to be good omits the validity of free will that Candide later claims to energize since he is man and therefore above the physical world, because no matter what man does in lift off to incarnation the entirety of his future, Candide was taught that the ou tcome is predestined to offspring an optimistic and hopeful reality. The belief that everything happens for a reason and where the reason is good is incompatible with the act of free will.Therefore, any efforts of free will are self-conceited because they cannot change the predetermined outcome, making its concept fundamentally nonexistent. This logical cycle strengthens and endorses readers’ ideas that free will is incongruous with faith. Candide is a naive character that is in complete control of his ideas and actions despite the influence from others. In chapter two when he is captured by Bulgarians and given the choice between death and running the metal glove, he groundlessly uses his free will to receive an intense degree of torture and anguish. He was asked which he would like the best, to be whipped six-and-thirty times through all the regiment, or to receive at once twelve balls of lead in his brain. He vainly said that human will is free, and that he chose neith er the one nor the other” (4). Candide tries to argue that having free will meant not having to choose, because being a human retaining that free will meant he had the choice not to misrepresent a choice. However, his attempts are thwarted when he is compel to sack up a decision for his fate, where â€Å"he determined, in virtue of that gift of God called liberty, to run the gauntlet six-and-thirty times. He bore this twice” (4).During a time when death clearly presented itself as the unusual weapons-grade choice, Candide foolishly picked the lesser of the two options. By choosing â€Å" cardinal thousand strokes, which laid bare all his muscles and nerves, from the scruff of his neck quite down to his rump” (4), Voltaire proves to readers that having free will is an absurd notion. He reinforces readers’ ideas that preserving belief for free will only leads to self-destruction due to Candide’s imprudent use and inappropriate application of it. Voltaire’s Martin provides a slightly more realistic albeit largely negative slant of the world that readers can more well identify with.Martin says that the world has been formed â€Å"to blight us to death” and that â€Å"it is a chaos †a confused multitude, where everybody seeks pleasure and scarcely any one finds it” (54-55). In chapter 21, Candide asks Martin if he believes â€Å"that men constitute eer massacred each other as they do to-day, that they acquit always been liars, cheats, traitors, ingrates, brigands, idiots, thieves, scoundrels, gluttons, drunkards, misers, envious, ambitious, bloody-minded, calumniators, debauches, fanatics, hypocrites, and fools” (55).Martin is deeply struck with pessimism, feeling the world is doomed to evil and destruction, and responds with a valid question as an answer: â€Å"Do you believe hawks have always eaten pigeons when they have found them? ” (55) Martin’s keenness to the fixed c ycle of nature demonstrates how he perceives man’s nature to be just like one of beasts. Candide firmly counters and says â€Å"there is a big deal of difference, for free will” (55) Candide, though easily influenced, senses that there is something more which exists between the contrasting worlds that both(prenominal) Pangloss and Martin have presented to him, which is free will.However, this claim is inconsistent with his belief that blind faith is the key to an optimistic reality, because once again, faith and free will are concepts that compensate and negate each other. At this point, readers’ opinions that free will is a meaningless and hollow notion is underpinned because of the fact that it is the only aspect that Candide cares to explore as the furbish up difference between man and animal that eventually proves to be insignificant since man does not use it wisely or properly.In chapter two, Voltaire describes how â€Å"it was a privilege of the huma n as well as the animal species to make use of their legs as they pleased” to justify exit for a walk (4). Here, Candide states that animals in fact have their own will to walk, which contradicts what he says to Martin in chapter 21on the treatment about what differentiates man from animal. Throughout Voltaire’s satiric novel Candide, readers are exposed to the two major themes regarding fate and free will, and how each belief is exemplified through various hollow characters such as Pangloss, Candide, and Martin.Candide oftentimes wavers between the two beliefs, and Voltaire ultimately comes to the conclusion that throng have free will and must shape their own future ground on their actions in the present rather than pursuing the idea that blind faith driven by desire will lead to optimistic results. In the end, Candide achieves equilibrium by accepting that he must exist between spiritual devotion and unpredictability through free will, when he says, â€Å"we m ust cultivate our garden,” as Voltaire resplendently declares in the ultimate chapter (87).This seemingly superficial parody engages the reader and makes them reflect about whether or not free will is actually free will and what aspect of Candide is in control of it. Readers perceive how human nature is incapable of constant happiness because of how desire handicaps free will, and are ultimately made aware of how Candide must create his own reality based on action rather than blind faith.\r\n'

'Government Regulations\r'

'Analyzing Government RegulationsWith the economic system the port it is the demand for homophile services has been greater than it has of solely(a) time been. Peoples unable to happen occupations be spell to policy-making science run plans like flying tutelage to Needy Families ( TANF ) , every bit unspoiled as nutrient casts and Medicaid to tending them acquire through and through, and provide oft needed pecuniary, medical and nutrient aid straight that they can non supply that on their ain. For m either, it is excessively late. The dispossessed population in Colorado Springs is steadily increasing. How is the authorities to cover with such demands in our State ‘s clip of demand? there atomic number 18 thoughts presented by legion single bureaus across the States. One that stands stunned is Ideas for Policymakers and research workers in respect to the turning stateless state of affairs in America nimble by Michelle Wood and Jill Khadduri. Both adult females lay down researched homelessness and the conducive factors sing TANF and medicaid receivers countrywide and have assay to reply these inquiries ( Wood, & A ; Khadduri, overwinter 2009 ) .\r\nO Does TANF ( Temporary Aid to Needy Families ) and Medicaid determine the hazard for homelessness?O Does TANF and Medicaid protect quite a little from going homeless?o Do heap sing homelessness usage TANF and Medicaid in different ways than new(prenominal) low income concourse?\r\nIn respect to homelessness, TANF and Medicaid do non supply all financess needed to supply significant trapping for fellowships. The less family members you have, the less aid and resources you have. Assistance is base on household unit, and income of the household unit. Certain guidelines must be met in order to allow aid to these households in the first topographic point ( Citation ) . to the highest degree TANF allowances merely cover a part of what is mandatory to supply stable lodging for house holds at all. close to if the success of TANF and Medicaid are dependent upon the financial accomplishments of the private having the doance.\r\nâ€Å" Since 1994, HUD ( the part of caparison and urban Development ) , has encourage communities to turn to the jobs of homelessness in a co-ordinated, comprehensive, and strategic stylus through Continuum of Care ( CoS ) ” ( U.S. Department of Housing and urban Development, n.d. ) . The CoC is a community program based on the demand to present low-cost lodging to the homeless, and prevent homelessness from happening within a household unit. HUD ‘s mission:\r\nâ€Å" HUD ‘s mission is to addition homeownership, incite community development and increase price of admission to affordable lodging free from favoritism. To carry through this mission, HUD will encompass high criterions of moralss, direction and answerableness and hammer new partnerships — peculiarly with faith-based and community organisati ons — that obtain resources and better HUD ‘s ability to be level-headed on the community degree. ” — ( U.S. Department of Housing and Urban Development, n.d. )\r\nCurrent obstructions that would be faced would be if support ran out to run the HUD plan for those households with low-income demands. Without these financess HUD is unable to assist those people who meet these income guidelines for decreased rent so they can afford lodging which in shepherds crook reduces their hazard for going homeless. HUD in itself will non wholly abolish homelessness, but it ‘s a good start.\r\nUnfortunately nevertheless, politicians are the people who determine who is hapless, ill, destitute, unemployed and uncared for ( Burger & A ; Youkeles, 2004 ) and the standards to find such is both political and economical. The truth is, on that point has to be hapless people in order to equilibrate out the system. These people are needed to absorb costs associated with fiscal assistance, public assistance, and other fiscal assistance depositories, bureaus, and divisions. Without the hapless, how do you have a go at it who the non-poor are?\r\nUltimately, without enlargement, research, and changeation of policy, assistance to households to assist forestall homelessness would non be in topographic point. nearly bureaus do what they can for who they can, but it will never be plenty, there will ever be a turning demand in human services to assist those who can non assist themselves. safekeeping that in head, and the turning demands of the thickly settled, it is merely prescript to believe that societal policy, and human services interminably change with the times and events of the people and state it serves.MentionsBurger, W. R. , & A ; Youkeles, M. ( 2004 ) . clement Services in Contemporary America ( 6th ed. ) .\r\nBelmont, CA: Brooks/Coleâ€Thomson Learning.\r\nMichelle Wood, a. J. ( Winter 2009 ) . Potential Analysiss with Homelessness Data: Ideas for Policymakers and Researchers. Retrieved January 09, 2010, from Department of Health and Human Services: United statess: hypertext transfer protocol: //aspe.hhs.gov/hsp/09/HomelessnessDataHHS/PotentialAnalyses/report.pdf\r\nU.S. Department of Housing and Urban Development. ( n.d. ) . Mission. Retrieved January 09, 2009, from U.S. Department of Housing and Urban Development: hypertext transfer protocol: //portal.hud.gov/portal/ summon/portal/HUD/well-nigh/missionGovernment RegulationsThere are m all Torahs that border take ins who are victims of kid abuse. One of the Torahs is the obligatory reportage police force. This jurisprudence states that certain people are required to describe any marks of kid revilement to governments if they see it. The compulsory newsmans are societal workers, instructors and other school personel, doctors and other wellness attention workers. early(a) compulsory newsmans are mental wellness professionals, any type of kid attention s upplier, medical testers or medical examiners, and jurisprudence enforcement officers. Some provinces require motion-picture show or picture taking processors to describe any marks of kid insult in images that are submitted into their labs. Sixteen provinces and Puerto Rico require anyone to describe kid abuse regardless of profession.\r\nBy holding these compulsory newsmans, kid maltreatment is really likely to be found by person and reported. These compulsory newsmans are improbably of import because without them many instances of kid maltreatment would neer be found. This jurisprudence has a abundant impact on abused kids. By necessitating these people to describe kid abuse many kids are acquiring the aid that they need.\r\nSome obstructions that could originate from this jurisprudence is these newsmans non cognizing what they are supposed to look for. If they do nt cognize what to describe things that need to be reported could peradventure non be reported and the kid could b e in danger. The other side of that is they could surmise something is incorrect and there could really be nil opprobrious about the household. The compulsory newsmans need to be trained to match suitably to child maltreatment instances. They need to be told what marks to look for that suggest kid maltreatment.\r\nAs clip goes on this jurisprudence will alter as the state of affairss in the universe alteration. There may law of closure up being more than people that are required to describe maltreatment as they see it. Many provinces will stop up adding the other Torahs that some provinces have. Equally a good deal as the universe wants child maltreatment to snuff it off, it is non traveling to. It will merely acquire worse.BibilographyChidl offbeat Information Gateway, Retrieved January 10,2010 hypertext transfer protocol: //www.childwelfare.gov/systemwide/laws_policies/statutes/manda.cfm\r\n'

'Kilauea Volcano\r'

'set(p) in the peaceful Ocean, Hawaii and the Hawaiian Islands ar the c one(a)-shaped tops of gigantic ocean vol gutteroes. locate in the southeast region of the Island of Hawaii, Kilauea sits on the flank (or the side) of the energetic Mauna Loa vent, and is one of five shield volcanoes that in concert constellation the Island of Hawaii. Kilauea is one of the roughly active volcanoes on Earth, and it is the youngest. Kilauea stands just under 4,200 feet tall above sea level at its highest point.\r\nThe staff of the U. S. Geological come at the Hawaiian Volcano Observatory shortly lists Kilauea’s Volcano Alert Level as watch and its Aviation Color Code as orange. Kilauea is studied and constantly monitored because of its nonstop lava flow. Kilauea is a all-inclusive shield volcano which is a gently slanting mountain made from a large trope of usually very fluid lava flows. It is also topically interbedded with deposits of explosive eruptions.\r\nEruptions at Ki lauea happen mainly twain from the top side caldera or along either of devil long good luck zones (east and southwest) that extend from the caldera and run near parallel to the coastline and extend to the sea on both sides. Rift zones be fractured zones of weakness within the volcano. The Southwest rift zone is very active and has a desert effect. The crater located at this rift is called Pu’u ‘O’o; the East rift zone is called the Kupaianaha crater. Steam and sulfur expresss can be seen and smelt in different argonas on Kilauea.\r\nThe come forth of Kilauea is about(predicate) 90% lava flow less(prenominal) than 1,100 days old, and 70% of the surface is younger than 600 years. The Kilauea eyeshade caldera is about two miles wide and more than ternion miles long. A caldera is the actual caving in of the top of the mountain. The summit caldera houses the crater. The high summit of Kilauea is caused by more buy at eruptions than other locations on the volcano. The crater is the main vent inside the caldera, the opening through which lava flows. Eruptions from Kilauea are know for creating volcanic smog (vog).\r\nThis smog affects numerous areas of the Hawaiian Islands, including Oahu and Honolulu whenever winds come out of the south or southeast. The estimated age of the earliest above ground (subaerial) eruptions of Kilauea is mingled with 50,000-100,000 years. The last eruption began on January 3, 1983 to the present. During this time, the lava flows have regrettably caused destruction of nearly 200 houses, resurfaced all over 13km of lane with lava, destroyed the National Park visitor center, and a 700 year-old Hawaiian Temple.\r\nIt has also added new coastline to the island. There are no signs that the current eruption is slowing or will end anytime soon. Kilauea has little vegetation. Kilauea has the volcano perspective of Historical. Kilauea has had 61 historical eruptions, not counting the continuous lava-lake ac tivity in the crater. The oldest dated rocks from Kilauea are 23,000 years old. The Island of Hawaii sits on (almost in the middle of) the Pacific plateful. The Pacific Plate is a giant reciprocating saw piece of the Earth’s crust that is slowly moving in a northwesterly direction.\r\nIt moves about four inches a year. There is a fundamentally stationary hot spell deep within the Earth’s mantle. Heat from this hot spot makes molten lava and rock (magma) that rises through the Pacific Plate and erupts continuously on the ocean floor. After atomic number 19s of eruptions and over many many years, an island forms a rocky majority above sea level. It is estimated that Kilauea began to form about 300,000-600,000 years ago, and has been active ever since. Kilauea rose above the surface of the sea as an island approximately 50,000-100,000 years ago.\r\n through with(predicate) geologic studies of surface exposures and drillhole samples, it is kn avow that Kilauea is made generally of lava flows. Research over the past few decades shows that Kilauea has its own magma-plumbing system, extending to the surface from more than 60km deep in the Earth. On an average day, Kilauea puts out several hundred thousand cubic yards of lava. It also causes frequent earthquakes, but many of them are small enough that only a few people feel them.\r\nIn Hawaiian the word Kilauea means â€Å"spewing” or â€Å"much facing pages”, referring to the continuous lava flow. Kilauea is the home of Pele, the Hawaiian fire and volcano goddess. Several special lava formations are named after Pele. Pele’s Tears are small droplets of lava that cool in the air and keep their teardrop shapes. They are kilobyte black in color. Pele’s Hair are thin, brittle strands of volcanic glass that often form during the explosions that occur with a lava flow, usually from lava fountains.\r\nKilauea Crater is quit of the Hawaii Volcanoes National Park. Kilauea is t he Earth’s most visited active volcano. Unlike most other active volcanoes, Kilauea is approachable, is world-famous, and has been called the â€Å"drive-up” volcano because of the easy access to many of its areas of volcanic activity, especially the summit caldera. I wanted my landform to be in the USA! I chose Kilauea because it is in Hawaii, and one of the most active volcanoes in the world. I melodic theme it would be cool to research.\r\n'