The Epidemic Of Food Borne Illnesses - 984 Words

Epidemiologists, those who study the origins and causes of disease, have been monitoring the epidemic of food borne illnesses since 1864 (CDC.int). According to the Center for Disease Control and Prevention (heretofore refereed to as the CDC) approximately 1 in 6 Americans (roughly 48 million) contract food poisoning every year. Of the infected, on average food borne illness are responsible for 128,000 hospitalizations and 3,000 deaths per year as reported in the CDC s 2011 Emerging Infectious Diseases. The CDC has identified 250 diseases stemming from from viruses, parasites, and bacteria as well as chemical contamination which disseminates by natural and manufactured chemicals or by toxins produced by microorganisms. In the onslaught of food borne illnesses salmonelleosis and campylobacteriosis are the main culprits. Affecting over 1.2 million people and causing 380 deaths per year in the United States alone, salmonelleosis (commonly referred to as salmonella), is regarded as the most common food borne disease. Common symptoms commence from 12 hours to three days after ingestion; severe cases and those who are more prone to disease–children, the elderly, and those with HIV/AIDs–experience fevers, diarrhea and vomiting due to the intestinal damaged triggered by the infection. Salmonella invades the body and the resulting tissue damage releases chemicals into the blood stream that trigger swelling and inflammation. AvrA temporarily stops salmonella from breaking apartShow MoreRelatedA summary analysis of the article â€Å"Microarray detection of food-borne pathogens using specific probes prepared by comparative genomics.†1531 Words   |  7 Pagesfield of public health, food-borne illnesses are a major concern because it has been estimated that each year 76 million cases occur in the United States causing 5,000 deaths (Suo et al., 2010). In 2008, the Center for Disease Control and Prevention’s FoodNet surveillance program reported over 18 thousand cases of food-borne illnesses occurred in 10 states (Center for Disease Control and Prevention [CDC], 2008). According to estimates from the CDC (2011), the most common food-borne pathogens that maybeRead MoreIs The Best Method Of Dealing With Spreading Of Disease?1914 Words   |  8 Pagesbeen lurking in my mind regarding these topics. The paper will go through reducing flows of people and goods, options regarding the spread of global disease, the spread of food-borne illnesses, reducing the incidence of food-borne illnesses, and the broad topic of GMOs. First, I think the movement of people, food, and manufactured goods cannot effectively be reduced by making laws or restrictions on these items. It might work for a time, but it may have the negative side effect ofRead MoreGlobalization And The Spread Of Disease1918 Words   |  8 Pagesthat have been lurking in my mind regarding these topics. The paper will go through reducing flows of people and goods, options regarding the spread of global disease, the spread of food-borne illnesses, reducing the incidence of food-borne illnesses, and the broad topic of GMOs. First, I think the movement of people, food, and manufactured goods cannot effectively be reduced by making laws or restrictions on these items. It might work for a time, but it may have the negative side effect of economicRead MoreThe Columbian Exchange Into The New World1357 Words   |  6 Pagesalarming rates, which affected the trade of products between countries. The natives were not massacred by the popular belief of guns and knives, but 95% of the indigenous population was killed by exposure to European disease, like smallpox and the sheer epidemic of it (PBS). The Columbian Exchange brought on by the Europeans was to blame for the countless fatalities of Native Americans. The exchange was altered because of diseases that reshaped the Columbian Exchange as a whole, meaning infecting and spreadingRead MorePros And Cons Of Fast Food720 Words   |  3 PagesThe history of fast food is not too long, but fast food has become a constant element of our lives. Most people in the wo rld recognize the logos of places like McDonald’s or Burger King. A large percent of the population at least once in their lives had eat in a fast food bar; however, some of them do it regularly and they cannot imagine that such bars could cease to exist. Over the years, fast foods gained their supporters, but also opponents who see in such place only something evil. I think theRead MoreAnalysis Of Upton Sinclair s The Jungle 2028 Words   |  9 Pagesplants. Thousands of people have died from food-borne illnesses. E-coli, along with other diseases resulting from filthy food processing was revealed as the murderer. As shocking as it might have been back then, it is even more alarming to find out that conditions have not improved in the last one hundred nine years. Food-borne illnesses are still an extremely common occurrence. People should not have to worry about whether their purchased food, food that was â€Å"approved† by the United States DepartmentRead MoreH igh Calorie, Frozen, And Food Company1293 Words   |  6 PagesOur low-calorie, frozen, microwavable food company now wants to expand, so we must make some long-term capital budgeting decisions. Recently we have had a increase in costs for some of our major ingredients, so our profit margins have gone down. In order to make up for the increased price in our major ingredients we are outlining a plan to raise our prices. Since, our costs are going up we must respond with a complimentary pricing strategy that makes up for the lost margin. A good strategyRead MoreThe Scarcity Of Water Crisis1515 Words   |  7 Pagesthe long run even though it may not seem like a lot. The people are almost set up to have a burden on their shoulders just to survive. With already high water prices, families are almost forced to give up something else, whether it be schooling or food. Water should not be a give or take object, it should be a right for all people to have. Many people believe the government should not have a hand in water prices. Subramanian in his article about Neoliberalism says, â€Å"Whereas it was once believed thatRead MoreEssay On Environmental Hazards958 Words   |  4 Pagessurgeon, was important to the history of environmental epidemiology because he is thought to be the first person to define the environmental cause of cancer. (pg. 31) ïÆ'Ëœ During the mid-1800s, English anesthesiologist John Snow connected a cholera epidemic in London to polluted water from the Thames River. His approach to investigating the cholera eruption of 1849 was known as a natural experiment, the approach used presently in the study of environmental health problems. (pg. 31) Which environmentalRead MoreGlobal Warming Is The New Epidemic1261 Words   |  6 PagesGlobal Warming is the new epidemic that is facing the United States as well as the entire world. Global Warming is the gradual increase of temperatures around the globe. The gradual rise of the average temperature of the Earth’s atmosphere and also the oceans is believed to be permanently changing the Earth’s climate. There is a debate among an abundance of people that and sometimes in the news, on whether global warming is real or not. However, scientists and climate experts all agree that the

Bad Cell Phones - 1058 Words

Yony Ramirez Deckard Hodge English 450 April 26, 2011 Bad Cell Phones In today’s society everywhere we look people of all ages and genders are parading with their cell phones. Whether we are driving, or walking down the aisle in the grocery store, and even in class, cell phones have become a part of our everyday lives. Although most students like to text in class, it shouldn’t be allowed because cell phones might tempt students to cheat, and just be a major distraction for everyone. While paying attention is not a requirement of attending class, it seems immature to pay a lot of money to sit in class and text your friends. Also, if you don’t want or need to pay attention, others in the class may usually want to and you are†¦show more content†¦There, the student can either be authorized to use the phone to call home or use the office phone to speak with his or her parent. There is no valid reason for students to be using cell phones in class. If a student is using a cell phone in class, they are either distracting others, ignoring the lessons, cheating, or simply side tracked. It’s also very disrespectful to the teacher, who most likely doesn’t get paid enough, to teach things that we need to know for later in life, even though it may seem like we need to know as much as they try to cram in our heads. Cell phones are bad to use in class because even if you have it on vibrate or silent you can still distract people by laughing at the text messages you get or by asking someone a question if you don’t know how to spell something. You can also distract the teacher by doing this because the teacher might tell you to put it away and having to do that repeatedly causes the teacher to stop teaching just to tell you to stop using the phone and that’s valuable time when you can be learning something. Students should be more aware of what cell phones and computers can do to them, although cell phones can be useful as well as computers, them becoming an everyday use in our lives could affect physical and mentally, for example a student who is in class butShow MoreRelatedCell Phones : Good And Bad891 Words   |  4 PagesCell phones could be both good and bad. Some people say that cell phones are dangerous. While, other people would argue that cell phones are a great invention. With every invention comes positives and negatives. Some of the advantages that cell phones provide is that testing is a fast and easy way of communication, texting and have social media all on your phone can always keep you updated and social with your friends, and people always have all of their personal information at one touch and carriesRead MoreShould Cell Phones Be Bad?893 Words   |  4 PagesHaving cell phones in the classroom could also be bad because of bullying. Bullying used to be face to face, and now it has evolved to the Internet and cell phones. If cellphones are in the classroom then the bullying can happen behind the teachers back. Also the students can say meaner and nastier things over text message than they would say out loud. Cell phones give these kids more confidence than they would have by just talking. Always having a phone in your hand seems to give us great knowledgeRead MoreBad Effects of Cell Phone on Society856 Words   |  4 PagesBAD EFFECTS OF CELL PHONE ON SOCIETY A report by the International Telecommunication Union (ITU) said there were about six billion cell phone subscriptions at the end of 2011-roughly one for 86 of every 100 people. Up to now, this number has continued to increase dramatically. This proves certainly that cell phone affects our society more strongly and more deeply in many aspects. No one can deny that cell phone is playing a very important and necessary role in our society because it not onlyRead MoreCell Phone Evolution: Good and Bad1252 Words   |  6 PagesCell Phone Evolution: Good and Bad Since the beginning of the industrial revolution, the world has become a smaller and faster place. The time used to travel to far distances has decreased. The growth of new technologies, traveling and communicating has become simple daily tasks for many people. Through the growth of global communication, people have become closer to others across the globe, and business has gone world wide. One invention that came along with the technological revolution is theRead MoreCell Phones During School Day884 Words   |  4 Pagescommunicating to one another, it is easy to just take out a cell phone and to use it as a tool for just about anything, but the use of cell phones at school can lead problems for not only the student but for those around him or her. The use of cell phones during school hours can cause distractions to the student and even the class, with these distractions cell phones can also create bad learning habits that would not of been there if cell phones were not in use, la stly while in school, students are providedRead MoreThe Negative Effect of Cell Phones on Society Essay961 Words   |  4 PagesA cell phone is an electronic device used for the mobile telecommunication i.e. mobile telephony, data transmission and text messaging. It is used over a cellular network of specialized base stations. It differs from cordless telephones, which offers telephony service only within a limited range i.e. within a home or an office. As the time passes it offers more and more advance features. A society is a social, economical or industrial infrastructure, made up of collection of individuals. AlthoughRead MoreCell Phone As The Main Tool Of Communication1040 Words   |  5 Pagesincreasingly. Mobile phone as the main tool of communication comes into people s daily life. With the development of science and technology, cell phones provide people an easy, and fast way of communication. The cell phone is easy carry, and it helps people keep in touch with others. Th is is a reason why most people choose the cell phone as their main tool of communication. People rely on their phones. Cell phone has almost become an indispensable part of life. Mobile phones help people contact othersRead MoreCell Phones Should Be Banned in Schools Essay527 Words   |  3 PagesPeople in many schools regularly sneak around on their cell phones, trying to hide them from teachers or administrators. Cell phones were originally against school rules. Honestly it makes a lot of since for students not to be able to use their cell phones during school hours. Cell phones should be banned in schools because they distract students, allow cheating in Schools, and they can be dangerous. Cell phones distract students in school. Whenever people text in class it gets other people’sRead MoreHow Cell Phone have Impacted the World787 Words   |  3 PagesCell Phones Throughout all of history expectant mothers always wanted to have a way to announce to others the gender of their child, and now they can. Mothers can now show the gender of their children easier with the use of their cell phone; they just take a picture and send it in an instant. Cell phones were first invented by Dr. Martin Cooper, who worked for the Company Motorola (Oak) Cell phones have made an impact on many things including society, culture and a multitude of other areas suchRead MorePersuasive Essay‚Äà ®Cell Phones and Driving1006 Words   |  5 PagesEssay—Cell phones and driving Suzy Campbell Title Balancing my coffee on my left leg, eating a donut with my right hand, using my cell phone with my left hand, driving with my right knee and having a conversation with a friend at the same time are surprisingly enough all legal, as long as they don’t interfere with my driving. While all these distractions can potentially interfere with my driving, the one most people often notice is the use of cell phones. Although using cell phones while

Health Informatics Computerized Physician Order

Question: Describe about the Health Informatics for Computerized Physician Order. Answer: Background The report is on critically reviewing literatures on computerized physician order entry to determine the effectiveness of the technology for health care system and issues faced in implementation of the technology in health care field. In order to carry out the literature review, research articles were searched from google scholar, PubMed, Cochrane Library, MEDLINE and NCBI databases. The key search term for identifying relevant literature included computerized physician order entry (CPOE), issues in implementation of CPOE, factors affecting the adoption of CPOE, transition from traditional method to CPOE system and prevention of medical errors through CPOE. The inclusion criteria for the literature review was to include current article published within 10 years and all those which gives an idea of development in health care setting. The research article which provided development in other field of practice except the medical field was excluded from the research. It helped in refining the search process and getting that literature article which gives a scope for current development and identifying gaps in study related to CPOE. There has been a boom in the evolution of Information Technology in the last few decades and Internet has been an integral part of the evolution. The development of telegraph, radio, telephone and computers have paved the way for the evolution of internet. The role of internet in daily life has become indispensible almost for all individuals worldwide, in our professional, educational as well as personal lives. Internet is a global network that connects million of computers and electronic devices and where information can be posted and shared with anybody. The influence of internet has spread to every domain of science and markedly increased the productivity and efficacy of the same (Gssling Lane, 2015). Medical science has utilized the resources of internet in various ways. Huge amount of data is collected on a regular basis from several fields of medical science, which is not possible to store and analyze without the aid of computers and internet (Polepalli et al., 2016). The application of internet in this field is diverse and of immense significance. It has been applied in areas like patient care, medical and health literacy and medical research. Electronic mail, WWW, and file storage and transfer capabilities can be of immense use in providing efficient healthcare. Emails are the most cheap and useful way to communicate between doctors and patients as well as between doctors from different domains. The internet all provides a wide array of data sources ranging from scientific journal, peer-reviewed articles, medical databases, educational sites, so on and so forth. Internet being the most efficient media can provide emergency medical expertise in life and death situations. The s cenario of primary healthcare practice has undergone a surge due to changes in healthcare delivery and the explosion of health information (Ek et al., 2013). Health Information System (HIS) is the building blocks of efficient health systems. The aim of Health Information System is to have transparency in information accessibility for enhanced accountability. Low and middle-income countries mostly lag behind in this department. Health Information System aid in decision making in the field of healthcare. Data generation, compilation, analysis, synthesis, communication and use are the key aspects of Health Information System. It collects information from health and other relevant sectors and applies it to provide quality healthcare (Abdelhak et al., 2014).In addition to monitoring and evaluation, it has broader aspects such as providing support to patients and health facility management, providing alert and early warnings. Information is required from different sectors including different confounding factors that affect health outcomes like socio economic, environmental behavior and genetic factors, the health outcomes and health inequalitie s in the different sections of the society. Overall, a Health Information System provides information for policymakers and decision makers and gives appropriate frameworks for policy development and implementation (Kellermann Jones, 2013). Information is often obtained from various government sectors and agencies at country, regional and global level. Health surveys, birth and death registration, census, health facility reporting, health system resource tracking and capacity for analysis, synthesis and validation of health data are primary indicators for efficient health information system performance (Watson et al., 2014). The evolution of the information technology has led to digital innovation and has played a role in revolutionizing the health care. The technology used in medical filed have turned out be very efficient in transforming the manner of delivery of care. Medical field now works by utilization of range of health technology to change the landscape of care. Medical technology is now widely utilized to improve the hospital experience, facilitate surgery simulation, streamline lab testing and create referrals through the use of cloud based data and software (How Technology is Improving Medical Care, 2016).For example medical technology has been used to update hospital experience and keep with pace demands of patients. Technological innovation ranged from improving the room design of the hospital and eliminates redundant clutter that acts as barrier in modern approach to health care facilities. Information technology has also been useful in improving referrals process and reaching out to milli ons of health care providers and patients digitally. It also aids in eliminating the gap in health delivery caused due to delay in treatment process or being able to reach patient on time (Street et al., (2013). Software innovations like computerized physician order entry (CPOE) has also provided solution to medication order errors and store and analyze data in a digital format (Nuckols et al., 2014). Computerized physician order entry (Overview) Computerized physician order entry (CPOE) is the process of electronically entering clinical instruction to reduce medication errors in the health care system. The CPOE system was designed to minimize the work burden due to paper chart. This is the best example of digital transformation in health care system where clinicians got the option to transfer all health information to patients digitally. The rise in usage of CPOE became evident after the introduction of federal HITECH Act and the Meaningful Use program which helped in rapid usage of CPOE in health care setting. CPOE system came up originally to improve errors in medication orders and facilitate safety in health care delivery. Medication error can be expensive and risk patients life. A research investigated the reduction in medication errors through CPOE system. A national representative data of American Hospital was estimated for percentage reduction in medication error through CPOE. The results showed that processing of med ication through CPOE system decreases clinical error by 48% and this can reduce significant medical cost associated with errors. Current policies related to increase in CPOE adoption system can be effective in preventing medication errors every year (Radley et al., 2013). However, with advancement in health informatics, modern system of CPOE has involved. In order to reduce vulnerabilities in the system, it is necessary that clinicians select the appropriate dose and frequency of medication, efficiently transcribe the prescription, proper dispensing of medication after consideration of drug-drug interaction and administration of the medicine at the right time. The integration of CPOE system with clinical decision support system is an effective approach to reduce errors. The adoption of CPOE in the health market has evolved after the introduction of computerized decision support system for prescribing medicines. In case of England, the uptake of CPOE has been very slow due to conflict in localized adapter practice and generic system and due to unrealistic adopter demands. Immaturity in the market has been regarded as the major reason for slow uptake of CPOE. This comes from the fact that policy makers have incomplete insight about the technology and ne gative adopters reaction to the technology (Mozaffar et al., 2015). Hence lack of insight for effective implementation process might be the reason for slow growth. However, the use of technology can be enhanced by new federal policy initiatives. Literature review CPOE system has been found to be effective in improving efficiency in workflow and reducing medical errors. The research study by Schneider et al., (2013) is an evidence of the advantage of CPOE in health care system. The purpose of the study was to eliminate the problem of delay in magnetic resonance examination through the use of electronic magnetic resonance (MR) safety screening process in CPOE system. The MR examination reports and orders of all patients within the period of 4 months were assessed after the implementation of MR safety system. The data was assessed regarding the time from first order to final report, time required for completion of MR examination and length of stay in the hospital. The results showed that electronic safety screening process resulted in a decrease in the time between first MR order till the completion of MR examination. A significant reduction in time for MR report was seen in CPOE system compared to paper processing. Hence, this literature review was significant in enabling early diagnosis, starting treatment process effectively and then reducing the length of stay in the hospital. The CPOE system can be useful in improving adherence to clinical guidelines and improving the delivery in health care system. This finding is supported by review of article which investigated whether the automated alerts within the CPOE system can improve practice guidelines for ordering Pap test or not. It proposed that electronic health record can be useful in enhancing test utilization in health care system. The study was also significant due to limited research on automatic alert system on Pap ordering according to screening guidelines (Howell et al., 2014). According to American Cancer Society guidelines for prevention and early detection of cervical cancer, it is also essential to begin screening test at the age of 21 (The American Cancer Society guidelines for the prevention and early detection of cervical cancer, 2016).The alert system prevented Pap orders in women less than 21 years as presented in guidelines and greater than 71 years and the limitation of each Pap order was recorded. Results were compared during periods of pre-alert, post-alert, errors in alert system (glitch period) and the post-glitch period. The research findings showed that alert system was effective in reducing the Pap test frequency in the post alert period. The result is reflective of the practical guidelines in Pap test as it included patients with history of abnormal Pap test and to discontinue testing for patients with normal Pap results in the past (Howell et al., 2014). Hence, from this literature review one can get an idea that alert system in health informatics can help to improve compliance to organizational guidelines and enable effective utilization of lab test. Computerized physician order entry can help in improving screening process for diseases. Development in health informatics and introduction of CPOE is acting as a revolution in the ordering process of health data and eliminating misuse of health care service. There are several research which shows the benefit of CPOE in decreasing cost in health care service, shortening the length of stay in hospital, reducing medical errors and improving adherence with clinical guidelines. However, as it is a relatively new technology, there is no best approach to its implementation and organization leaders must play a role in meeting challenges in the system and efficiently implementing it in health care setting to improve the quality of care (Computer physician order entry: benefits, costs, and issues. - PubMed NCBI, 2016). The research study by Cabezas et al., (2016) explained that screening of hepatitis B virus is essential before initiation of cytotoxic chemotherapy for treating patients with malignant disease. This screening process is essential to decide the type of intervention for patients who are hepatitis B surface antigen (HBsAg) positive and patients who are HBsAg negative. It helps in deciding the treatment required before or after the chemotherapy treatment. The research indicated that CPOE system can be applied to improve the rate of screening process and hence CPOE system along with efforts on proper management of the system can help in improving the screening rate for Hepatitis B virus screening (Cabezas et al., 2016). Despite advantage in the utilization of CPOE system in health care setting, there are many issues that health staff experience due to change in processing of health care information. This fact became clear with the review of a literature on the attitude of clinical physicians towards the use of automatic alert in CPOE system. The study based on quantitative and qualitative survey was done with physician in 11 hospitals in 9 different countries. Among the hospitals, some of them were using the CPOE system while in some CPOE system was not implemented. Although majority of physicians supported the fact that CPOE system has enhanced alert system to improve medication safety, however it is necessary to introduce such system according to clinical context to avoid chaotic situation due to adopting new technology (Jung et al., 2013). The literature was useful in bringing the issue of alert overload and this helped in identifying the need to provide more information to staff to maintain this technology for smooth running of the system. Hence, a sophisticated strategy will minimize disruptions in health care practice and also lead to proper adoption of the system among clinicians. CPOE has been regarded as an important element in modernization of medical field and facilitating quality improvement in health care setting. However, the initial phase of adoption is difficult due to presence of many internal and external factors within health care organization. Certain local factors might facilitate uptake of CPOE or it might also stall the rollout of CPOE in hospitals (Khanna Yen, 2014). This is evident from one study which showed that CPOE lead to errors due to duplication of medical dose and poor design of the leading to error in displaying dose options of medications. There were also reports that implementation of CPOE lead to significant increase in mortality rate after the implementation of CPOE compared to the period before CPOE implementation (Han et al., 2005). Hence, the technology has been found to impede the clinical workflow when the system fails to recognize important clinical information. With this issues faced in adoption of the system, it is neces sary that this technology should be examined by ethnographer to understand the efficacy of complex processing system. To identify the factors that influence adoption of CPOE system, a recent review article is effective in giving information about the reasons for medication error related to CPOE system. To monitor the medication errors, the medication reports of patients were assessed to find the errors occurring in the prescribing period or due to CPOE. The results showed that more than 50% of errors were related to CPOE. The problem arose mainly due to delay in making medicines available to patients or due to patients receiving duplicate or higher dose of drugs. Inefficiency and error was also seen in categorization and formatting of reports which lead to wrong transmission of information, dosing error and duplicate orders (Amato et al., 2016). Hence, this literature provided insight into the reasons leading to error after CPOE and safety can be maintained only by using taxonomy which all health care staffs can understand. This will help in meeting the objective of introducing CPOE and lead to spee dy treatment process. The specialty of physician might also be a factor affecting the adoption of CPOE. This aspect of adoption of new technology in health care setting was investigated by cross-sectional study and the researchers regarded the fully functional CPOE as an indicator of successful adoption of the technology in health care setting. All the predictive factors related to impact of geographical location, characteristics of physician and the degree of physician was analyzed by logistic regression analyses. The results showed that specialty of physician influenced the adoption process. Primary care physician were found to highly use the technology compared to surgical specialties physician. However, it was found that the adoption did not dependent on geographical location or health care ownership. This literature review article was successful in identifying major predictors of adopting CPOE which were specialty of clinicians, status of practice and the level of consultation by internet (Malhani et al., 2016). User satisfaction is also the most critical factor in implementation of health care informatics. There are many reports which showed that CPOE system failed or were successful in hospitals due to resistance or acceptability by the users respectively. Failure in efficiently adopting the system might occur when patients needs are not considered during introducing the technology or when patients do not receive timely intervention due to disruption in work flow due to the technology. To determine the satisfactions level of patients due changes in health information processing over time, a cross sectional survey was done to know about the advantages and disadvantage of CPOE. It was found that end-users were moderately satisfied with the technology; however difference in opinion were seen according to user groups. For example in case of providers, the perception about CPOE remained positive from the beginning, but for nurses, the satisfaction level gradually increased when they got well-ac quainted with the technology (Hoonakker et al., 2013). Review of another research article was useful in providing insight into the factors that affect the adoption of CPOE in hospitals. Although CPOE has been introduced to maintain quality and safety of health care service; however the health care setting can face many issues in adopting to a new technology. These issues may range from resistance to the new system among health staffs to the issues related to cost involved in efficiently running such technology. The research article gave an idea about the lessons that health care organizations have learnt while implementing CPOE in their hospitals. The experiences and attitude of physicians and administrators at hospitals in USA revealed that successful implementation process of CPOE depended on clinical governance, preparation for change and support and perception of key health care team. In hospitals where the CPOE process was successful, it was because of effective organization decision making and engaging clinicians to clear any doubt s about the process. Preparation and advance planning was also essential and this helped in adopting to the system because health staffs were given necessary training to use the technology and computer application without any error. Support from highly trained person who has good grasp with the CPOE system also helped in providing instant support to staffs in case of any query. In hospitals who failed to adopt the system, it was mainly because of negative perception about new technology (Simon et al., 2013). Many were afraid of the change and felt that it will hamper their workflow. However, strong clinical leader can intervene to develop positive attitude towards the new technology. Hence, this literature review helped in identifying the critical role of health care leaders in addressing issues related to adoption of CPOE and facilitating smooth transition of health informatics. Majority of resistance in adopting CPOE is due to speculations that it might lead to decrease in utilization of hospital resource. As there were very little evidence regarding the lower resource utilization due to CPOE, this factor was investigated by (Teufel et al., 2012) who tried to analyze the relationship between CPOE use and other the resource utilization in children health care unit. A cross-sectional design helped in getting answer to the research question. The results showed that although CPOE implementation is expensive process, however compared to hospitals without this system, hospitals with CPOE did not lead to lower cost per case. Hence, very few financial benefits for hospital were found according to this literature study. It is necessary to emphasize on strategies that promote adoption of CPOE and also lead to financial benefits. The research is useful for early adopters of the system to estimate cost savings in the process. There might be unintended socio-technical consequences of CPOE. To investigate the impact of this factor on outpatient setting, ethnographic and interview data were collected from an interdisciplinary team in four hospitals. The consequences were distinguished according to the Diffusion of Innovations theory and it showed that desirable and undesirable consequences may occur due to CPOE system. While the undesirable consequences were related to improvement in patient safety and fast diagnosis, the undesirable consequences included problem in workflow and interpersonal relationship among health care team. Many hazardous situations also arose due to error in alert system leading to misinterpretation of patients critical health information. Anticipated benefits of the system were elimination of illegible order, fewer medical errors. Howevr it also lead to undesirable impact such as physicians leaving the organization or longer time for completing the order due to lack of training. Other unanticipated benefits included better collaboration of activities due to alert system and creating safety net by giving alert system the trigger to identify wrong drug and give correct order. Unanticipated issues related to the system were also found such as too many alerts leading to missing good alerts and lower satisfaction level in physician due to coding errors. The key leanings from this literature review is that people involved in CPOE implementation should understand the unintended consequence properly in order to foresee problem before hand and be prepared to counter those situations (Ash et al., 2007). Social issues might also be reason for failure in the implementation of CPOE. This element of resistance in adoption of CPOE was explained by a research study investigating the social issues surrounding CPOE implementation process. The main objective was to analyze the interrelated effects of the factors in medical setting and to recommended ideal steps to manage the issues during the implementation process. A semi-structures interview was conducted with the people involved in CPOE implementation process and grounded theory approach was used to evaluate specific problems and analyze the situation. The findings that emerged from the study was that social and technical issues negatively hampered workflow and this was the reason for withdrawal of end-users from the system. Hence, a cumulative effect of both social and organizational issues can lead to failure in introducing the CPOE system in health care setting. This literature is useful lesson for people engaged in such project and it will help them to understand the aspects of workflow before initiating such ventures in health care setting (Peute et al., 2010). User satisfaction is also an indicator of the acceptability of health technology and realizing its benefits in promoting good health. High user satisfaction with CPOE can be achieved when users can easily access health information, immediately act according to those information and alerts were given regarding any potential error (Murray-Weir et al., 2014). A review article gave greater insights into factors that influence user satisfaction by use of a model to investigate about level of acceptance and actual use of electronic patient record in acute care setting. A randomized stratified sampling approach was taken to recruit nurses and explain them the actual use of technology. 33.6% variation were found in actual use and greater effects were seen between expectancy and actual use, presence of facilitating factors and effort put in it and the level of compatibility with the service. The literature was useful in providing a mediation relationship between effort expectancy and performa nce expectancy (Maillet et al., 2015). The current advances in eHealth technology have given immense functional benefits in data storage, management and retrieval, and supports decision making process. Electronic patient record or electronic transfer of prescription is the eHealth technology useful in health data storage while CPOE and CDSS give decision making support. CDSS linked with CPOE provides guidance with diagnosis, giving recommendations for treatment and including alert system to enable safe prescribing method (Cooper et al., 2015). Health care staffs and key stakeholders working in leading clinical sites need to perform a range of activities to provide support in clinical decision making. Literature review of one article provided insight into the activities that people engage in during implementation of clinical decision support system (CDS). This ethnographic research revealed that major activities were in the area of fostering relationship with activities like training, assembling the system with technical s upport and content development, utilizing the system appropriately to meet organization goal and participating in policy activities for smooth flow of the system (Wright et al., 2014). Benefits of health information technology are also interrelated with the role of organization and other informational complementary. Majority of the research articles are of the opinion that adoption of new health technology will dramatically change the scenarios in hospital setting and lead to drastic improvement in patient care. The research study McCullough et al., (2013) analyzed the impact of IT adoption on patient outcomes and identify the hidden mechanism through which this technology facilitates input of labour. The investigation into the matter showed that although IT adoption lead to significant improvement in mortality rate, however the impact was not significant for median patients. Thus results gave the implication that benefits of the technology can be seen in large health care organization which have mix of critically and moderately ill patients. Secondly, successful integration of the system in hospital setting is also possible after proper coordination and health inf ormation management. Therefore direct benefits are seen in those patients who required cross specialty diagnosis involving complex management of health data. User interface design of CPOE has an impact on the accessing important clinical information during diagnostic and treatment process. A review article on similar topic supports this view and the researcher analyzed whether user interface design of CPOE can affect the access rate to patients record when linking infrequently accessed data through user interface. The Vanderbilt University Hospital augmented clinical support advice with other education support features. A randomized controlled trial analyzed the utilization rate of the interfaces among clinicians. The control groups were able to access decision support from a menu in CPOE interface and the intervention group received active notification through sensitive hyperlinks with decision support data. The results showed that access rate for decision support data was higher in intervention group compared to control group. Therefore this literature review was a useful evidence to prove that availability of context sensitive data can increase the utilization rate of user-interface (Rosenbloom et al., 2005) Many health care professionals have resisted use of this technology because of lack of computer experience and this even makes them leave the health clinic. There is also a speculation regarding whether clinical role or position has impact on the adoption of CPOE in hospitals. A mixed method study in Canada evaluated the barriers to adoption on electronic medical record in physician practice. After reviewing so many articles on use of CPOE system, it is clear that CPOE has been implemented to solve the problem associated with paper system, improve the quality of health decision making and improving cost return in practice by reducing the cost involved in health data management. Despite so many benefits, it is still not clear why many countries have not yet decided to adopt this system in the clinic. This was the motivation behind the investigation the reasons for withdrawal from CPOE. A mixed method study was done with highly qualified physicians with good IT knowledge and with famil y physician who practice without EMR system. The results revealed that initial decision in investing on the system becomes difficult due to behavioral, technical, economic and knowledge based factors. Knowledge barrier was one of the vital reasons for not investing in the system. However, in some no barriers were seen but stills they had not invested in electronic medical record (Par et al., 2014). Hence, from this literature review, the recommendation is that the government and policies should take relevant action to mitigate the barriers and provide support to medical practices. Another important development in health informatics was seen from a literature review which brought to the forefront the integration of CPOE with cloud-based BP to improve self-management in hypertensive patients. This discovery became important when it was found that majority of hypertensive patient cannot maintain normal blood pressure level and hence cannot self-manage the disease. Therefore the researcher tried to speculate whether the integration of cloud based BP system with CPOE will lead to improvements in BP management compared to traditional care methods or not. A randomized controlled study was done with participants diagnosed with hypertension. The physicians had access to cloud based BP data of all participants. The results demonstrated that the intervention group had better control over BP compared to control BP over a period of six months. Hence, the benefits of CPOE in the self-management of illness also became evident from the literature review. There is also minimum chance of resistance from users as it does not require any technical skills and it will lead to positive attitude in patient and better adherence to medication (Lee et al., 2016). Summary The above report on literature review of computerized physician order entry (CPOE) started with the introduction on the development of the internet and how it has revolutionized the whole world. It direct benefits on the medical world was also seen with range of health information technologies like electronic health record, CPOE, CDSS and many other innovative technology. It gave an idea about the developments in HIS to support health care system and improve the quality of health care delivery. As the literature review mainly focused on CPOE, an short overview of the topic was given by explaining about the need for such system and how its use actually started. It brought to the forefront the drawbacks of the traditional paper system on medication orders and how the complex management of paper data led to medical errors. Hence, literature review into the topic helped in getting idea about the immense benefits of the system and its use has gradually widened in all aspects of medical fi eld. Different research on the developments in CPOE system revealed range of information about the system such as its efficacy in reducing medical error, facilitating work flow on care implementation of the system, improving the screening process for disease, adhering to clinical guideline and many other issues. However, despite enormous benefits challenges and the issues faced in adopting the system in different hospitals in different countries was also seen. Analysis of the issues showed that all sorts of technical, social, economic or knowledge based issues mainly occurred due to ineffective planning at the initiation phase. Success in implementation process can occur when adequate training and skills is given regarding management of such system. The scope for further research in this topic is to identify other critical areas in medical practice where the system can be exploited to gain maximum benefits. References Abdelhak, M., Grostick, S., Hanken, M. A. (2014).Health information: management of a strategic resource. Elsevier Health Sciences. Amato, M. G., Salazar, A., Hickman, T. T. T., Quist, A. J., Volk, L. A., Wright, A., ... Adelman, J. (2016). Computerized prescriber order entryrelated patient safety reports: analysis of 2522 medication errors.Journal of the American Medical Informatics Association, ocw125. Ash, J. S., Sittig, D. F., Dykstra, R. H., Guappone, K., Carpenter, J. D., Seshadri, V. (2007). Categorizing the unintended sociotechnical consequences of computerized provider order entry.International Journal of Medical Informatics,76 Suppl 1, S21-S27. doi:10.1016/j.ijmedinf.2006.05.017 Cabezas, J., Sampedro, B., Hernndez, C., Crespo, J. (2016). Computerized physician order entrybased system improves hepatitis B virus screening in patients undergoing chemotherapy.Journal of Clinical Oncology,34(3), 290-290. Computer physician order entry: benefits, costs, and issues. - PubMed - NCBI. (2016).Ncbi.nlm.nih.gov. Retrieved 27 October 2016, from https://www.ncbi.nlm.nih.gov/pubmed/12834316 Cooper, A., Dowding, D., Barrett, D. (2015). The impact of new information and communication technologies on the development of advanced practice.Advanced nursing practice: changing healthcare in a changing world. London: Palgrave, 288-301. Ek, S., Eriksson-Backa, K., Niemel, R. (2013). Use of and trust in health information on the Internet: A nationwide eight-year follow-up survey.Informatics for Health and Social Care,38(3), 236-245. Free, C., Phillips, G., Watson, L., Galli, L., Felix, L., Edwards, P., ... Haines, A. (2013). The effectiveness of mobile-health technologies to improve health care service delivery processes: a systematic review and meta-analysis.PLoS Med,10(1), e1001363. Gssling, S., Lane, B. (2015). Rural tourism and the development of Internet-based accommodation booking platforms: a study in the advantages, dangers and implications of innovation.Journal of Sustainable Tourism,23(8-9), 1386-1403. Han, Y. Y., Carcillo, J. A., Venkataraman, S. T., Clark, R. S., Watson, R. S., Nguyen, T. C., ... Orr, R. A. (2005). Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system.Pediatrics,116(6), 1506-1512. Hoonakker, P. L., Carayon, P., Brown, R. L., Cartmill, R. S., Wetterneck, T. B., Walker, J. M. (2013). Changes in end-user satisfaction with Computerized Provider Order Entry over time among nurses and providers in intensive care units.Journal of the American Medical Informatics Association,20(2), 252-259. How Technology is Improving Medical Care. (2016).King University. Retrieved 28 October 2016, from https://online.king.edu/healthcare/digitizing-healthcare-how-technology-is-improving-medical-care/ Howell, L. P., MacDonald, S., Jones, J., Tancredi, D. J., Melnikow, J. (2014). Can automated alerts within computerized physician order entry improve compliance with laboratory practice guidelines for ordering Pap tests?.Journal of pathology informatics,5(1), 37. Jung, M., Hoerbst, A., Hackl, W. O., Kirrane, F., Borbolla, D., Jaspers, M. W., ... Lawton, K. (2013). Attitude of physicians towards automatic alerting in computerized physician order entry systems.Methods Inf Med,52(2), 99-108. Kellermann, A. L., Jones, S. S. (2013). What it will take to achieve the as-yet-unfulfilled promises of health information technology.Health Affairs,32(1), 63-68. Khanna, R., Yen, T. (2014). Computerized physician order entry promise, perils, and experience.The Neurohospitalist,4(1), 26-33. Lee, P., Liu, J. C., Hsieh, M. H., Hao, W. R., Tseng, Y. T., Liu, S. H., ... Ye, J. S. (2016). Cloud-based BP system integrated with CPOE improves self-management of the hypertensive patients: A randomized controlled trial.computer methods and programs in biomedicine,132, 105-113. Maillet, ., Mathieu, L., Sicotte, C. (2015). Modeling factors explaining the acceptance, actual use and satisfaction of nurses using an Electronic Patient Record in acute care settings: An extension of the UTAUT.International journal of medical informatics,84(1), 36-47. Malhani, M. A., Maneno, M. K., Ettienne, E. B., Wingate, L. (2016). FACTORS AFFECTING ADOPTION OF COMPUTERIZED PHYSICIAN ORDER ENTRY SYSTEM.Value in Health,19(3), A274. McCormack, B., Rycroft-Malone, J., DeCorby, K., Hutchinson, A. M., Bucknall, T., Kent, B., ... Wallin, L. (2013). A realist review of interventions and strategies to promote evidence-informed healthcare: a focus on change agency.Implementation science,8(1), 1. McCullough, J. S., Parente, S., Town, R. (2013).Health information technology and patient outcomes: The role of organizational and informational complementarities(No. w18684). National Bureau of Economic Research. Mozaffar, H., Williams, R., Cresswell, K., Morrison, Z., Bates, D. W., Sheikh, A. (2015). The evolution of the market for commercial computerized physician order entry and computerized decision support systems for prescribing.Journal of the American Medical Informatics Association, ocv095. Murray-Weir, M., Magid, S., Robbins, L., Quinlan, P., Sanchez-Villagomez, P., Shaha, S. H. (2014). A computerized order entry system was adopted with high user satisfaction at an orthopedic teaching hospital.HSS Journal,10(1), 52-58. doi:10.1007/s11420-013-9377-1 Nuckols, T. K., Smith-Spangler, C., Morton, S. C., Asch, S. M., Patel, V. M., Anderson, L. J., ... Shekelle, P. G. (2014). The effectiveness of computerized order entry at reducing preventable adverse drug events and medication errors in hospital settings: a systematic review and meta-analysis.Systematic reviews,3(1), 1. Par, G., Raymond, L., de Guinea, A. O., Poba-Nzaou, P., Trudel, M. C., Marsan, J., Micheneau, T. (2014). Barriers to organizational adoption of EMR systems in family physician practices: a mixed-methods study in Canada.International journal of medical informatics,83(8), 548-558. Peute, L. W., Aarts, J., Bakker, P. J. M., Jaspers, M. W. M. (2010). Anatomy of a failure: A sociotechnical evaluation of a laboratory physician order entry system implementation.International Journal of Medical Informatics,79(4), e58-e70. doi:10.1016/j.ijmedinf.2009.06.008 Polepalli, R. K., Ramesh, K. H. (2016). KEYWORDS: Internet use, Medical Students, MBBS, Academic and Non-academic.PATTERNS OF INTERNET USE AND THEIR IMPLICATIONS IN INDIAN MEDICAL STUDENTS: A STUDY FROM A SOUTH INDIAN MEDICAL COLLEGE., (94423). Radley, D. C., Wasserman, M. R., Olsho, L. E., Shoemaker, S. J., Spranca, M. D., Bradshaw, B. (2013). Reduction in medication errors in hospitals due to adoption of computerized provider order entry systems.Journal of the American Medical Informatics Association,20(3), 470-476. Rosenbloom, S. T., Geissbuhler, A. J., Dupont, W. D., Giuse, D. A., Talbert, D. A., Tierney, W. M., ... Miller, R. A. (2005). Effect of CPOE user interface design on user-initiated access to educational and patient information during clinical care.Journal of the American Medical Informatics Association,12(4), 458-473. Schneider, E., Ruggieri, P., Fromwiller, L., Underwood, R., Gurland, B., Yurkschatt, C., ... Obuchowski, N. A. (2013). An electronic safety screening process during inpatient computerized physician order entry improves the efficiency of magnetic resonance imaging exams.Academic radiology,20(12), 1592-1597. Simon, S. R., Keohane, C. A., Amato, M., Coffey, M., Cadet, B., Zimlichman, E., Bates, D. W. (2013). Lessons learned from implementation of computerized provider order entry in 5 community hospitals: a qualitative study.BMC medical informatics and decision making,13(1), 1. Street, R. L., Gold, W. R., Manning, T. R. (2013).Health promotion and interactive technology: Theoretical applications and future directions. Routledge. Teufel, R. J., Kazley, A. S., Basco Jr, W. T. (2012;2011;). Is computerized physician order entry use associated with a decrease in hospital resource utilization in hospitals that care for children?Journal of Medical Systems,36(4), 2411-2420. doi:10.1007/s10916-011-9708-z The American Cancer Society guidelines for the prevention and early detection of cervical cancer. (2016).Cancer.org. Retrieved 27 October 2016, from https://www.cancer.org/cancer/cervicalcancer/moreinformation/cervicalcancerpreventionandearlydetection/cervical-cancer-prevention-and-early-detection-cervical-cancer-screening-guidelines Watson, D., Broemeling, A. M., Reid, R. J., Black, C. (2014). A results-based logic model for primary health care: laying an evidence-based foundation to guide performance measurement, monitoring and evaluation. Wright, A., Ash, J. S., Erickson, J. L., Wasserman, J., Bunce, A., Stanescu, A., ... Middleton, B. (2014). A qualitative study of the activities performed by people involved in clinical decision support: recommended practices for success.Journal of the American Medical Informatics Association,21(3), 464-472.

Principles behind Loving and Being Loved an Example by

Principles behind Loving and Being Loved What attracts a person to another yet repels him from another? Is there any factual or psychological basis in choosing whom to love or whom to befriend? Although it is an accepted notion that a love relationship buds after friendship, why then are there platonic relationships that exist and flourish? Need essay sample on "Principles behind Loving and Being Loved" topic? We will write a custom essay sample specifically for you Proceed There are three different kinds of love, namely: 1) eros (erotic or sexual love or the love relationship that binds a man and a woman); 2) phileo (philial love or the love relationship that exists between brothers and sisters or parents and siblings; not instinctual since it moved from the self and is based on a blood relationship or a group); and 3) agape (considered as the highest form of love, a kind of love that transcends reason, one that is entirely selfless). For this purpose however, discussion will be limited to the first kind of love. To give us a better insight on this general phenomenon, we shall consider a psychological point of view as expressed in two distinctly related articles, namely: 1) Dr. Joyce Brothers Why We Love Who We Love, (n.d.) and, 2) Laurie Pawlik-Kienlens What makes people fall in love (2008). Both articles centers on what is called as 'lovemap'--a group of messages encoded in our brains that describes our likes and dislikes. (Money in Brothers, n.d). Significantly, this love map, which is basically formed from our previous relationships during childhood, forces us to decide whom we should pursue or those whom we should avoid. Some factors affecting our choices, specifically in choosing the person we would be spending our lifetime with or even in deciding whom we should befriend, include 1) Principles behind Loving and Being Loved 2 parental rearing and upbringing and 2) perceived social similarities, according to Dr. Brothers (Ibid). Kienlen, on the other hand, made her explanation more specific by pointing out several types of chemistry that work for the pairing off of two individuals. In the process, neurochemical processes and external stimuli that are provoked thereby forcing two people to be attracted to one another. Kienlen attributes the chemistry formed from the following: 1) certain orientation in smell; 2) love pheromones or unlearned, and perhaps unsmellable, signals that enter the brain through the olfactory system (Dr. Kristal in Kienlen, 2008); and 3) the brain wherein certain hormones and neurotransmitters such as oxytocin, vasopressin and dopamine are considered binding forces that excite either sex and determines whether both will get to like or love each other. Whatever drives a person to like or to love another, does not necessarily tell whether the relationship will last for a lifetime, and since nothing in this world is constant except change, one should try to change how he should deal with the other person for the better, should in the process of knowing or falling for the other discover that the other person is not really whom she thought he is at first sight. References: Brothers, Joyce, Ph D. (n.d.). Why We Love Who We Love. Pawlik-Kienlen, Laurie (January 6, 2008). What Makes People Fall In Love.

Free Essays on Crabbing Regulations

INTRODUCTION The water of the Chesapeake Bay is the home of one of Maryland’s most economically important animals: Callinectes sapidus. This unique creature, commonly known as the blue crab, enjoys the warm, shallow waters of the Bay which provide the perfect environment for all stages of its life (Wesche 2002). The mix of fresh and salt water is optimal for life and for submerged aquatic vegetation located in the estuary supplies a safe haven for developing crabs (Wesche 2002). The overall richness of the environment contributes in creating the idea habitat. The blue crab is a vital part of the ecosystem as well as the culture in Maryland, which is known for its crabbing industry. Chesapeake blue crabs are understood to be some of the most delicious in the world. Each year tourists come to this region just to taste the fresh meat (Greer 2002). Wesche (2002) summarizes the background of the blue crab. Early settlers documented the utilization of the blue crab by the native people of the Chesapeake Bay. The tasty meat was a staple in their diets, and the colonist soon shared the same craving. Use by individuals became the norm; however commercial marketing of this resource was sluggish due to the inability to ship the crabs to non-coastal communities without spoiling. The first big break occurred with the invention of refrigeration. As the crabbing industry began expanding, it became necessary to implement management techniques for harvesting, including regulations. For over a century these â€Å"rules of the trade† have evolved. New restrictions have been created each time the need for better management arises. Recently, a drop in the crab population and yield has led to new regulations on commercial crabbing greatly affecting the industry. This paper will focus on the controversial implementation of Maryland’s most recent crabbing regulations. This will identify the reasons for the managerial actions, as wel... Free Essays on Crabbing Regulations Free Essays on Crabbing Regulations INTRODUCTION The water of the Chesapeake Bay is the home of one of Maryland’s most economically important animals: Callinectes sapidus. This unique creature, commonly known as the blue crab, enjoys the warm, shallow waters of the Bay which provide the perfect environment for all stages of its life (Wesche 2002). The mix of fresh and salt water is optimal for life and for submerged aquatic vegetation located in the estuary supplies a safe haven for developing crabs (Wesche 2002). The overall richness of the environment contributes in creating the idea habitat. The blue crab is a vital part of the ecosystem as well as the culture in Maryland, which is known for its crabbing industry. Chesapeake blue crabs are understood to be some of the most delicious in the world. Each year tourists come to this region just to taste the fresh meat (Greer 2002). Wesche (2002) summarizes the background of the blue crab. Early settlers documented the utilization of the blue crab by the native people of the Chesapeake Bay. The tasty meat was a staple in their diets, and the colonist soon shared the same craving. Use by individuals became the norm; however commercial marketing of this resource was sluggish due to the inability to ship the crabs to non-coastal communities without spoiling. The first big break occurred with the invention of refrigeration. As the crabbing industry began expanding, it became necessary to implement management techniques for harvesting, including regulations. For over a century these â€Å"rules of the trade† have evolved. New restrictions have been created each time the need for better management arises. Recently, a drop in the crab population and yield has led to new regulations on commercial crabbing greatly affecting the industry. This paper will focus on the controversial implementation of Maryland’s most recent crabbing regulations. This will identify the reasons for the managerial actions, as wel...

Ancient Egyptians Played a Board Game Called 58 Holes

Ancient Egyptians Played a Board Game Called 58 Holes The 4,000-year-old board game 58 Holes is also called Hounds and Jackals, the Monkey Race, the Shield Game, and the Palm Tree Game, all of which refer to the shape of the game board or the pattern of the peg holes in the face of the board. As you might guess, the game consists of a board with a track of fifty-eight holes (and a few grooves), in which players race a pair of pegs along the route. It is thought to have been invented in Egypt around 2200 B.C. It flourished during the Middle Kingdom, but died out in Egypt after that, around 1650 B.C. Around the end of the third millennium B.C., 58 Holes spread into Mesopotamia and maintained its popularity there until well into the first millennium B.C. Playing 58 Holes The ancient game 58 Holes most closely resembles the modern childrens game known as Snakes and Ladders in Britain and Chutes and Ladders in the United States. In 58 Holes, each player is given five pegs. They begin at the starting point to move their pegs down the center of the board and then up their respective sides to the endpoints. The lines on the board are the chutes or ladders that allow the player to quickly advance or to just as quickly fall behind. Ancient boards are generally rectangular to oval and sometimes shield or violin-shaped. The two players throw dice, sticks, or knucklebones to determine the number of places they can move, marked on the game board by elongated pegs or pins. The name Hounds and Jackals comes from the decorative shapes of the playing pins found at Egyptian archaeological sites. Rather like Monopoly tokens, one players peg head would be in shape of a dog, the other in that of a jackal. Other forms discovered by archaeologists include pins shaped liked monkeys and bulls. The pegs that been retrieved from archaeological sites were made of bronze, gold, silver, or ivory. It is quite likely that many more existed, but were made of perishable materials such as reeds or wood. Cultural Transmission Versions of Hounds and Jackals spread into the near east shortly after its invention, including Palestine, Assyria, Anatolia, Babylonia, and Persia. Archaeological boards were found in the ruins of Assyrian merchant colonies in Central Anatolia dating as early as the 19th and 18th centuries B.C. These are thought to have been brought by Assyrian merchants, who also brought writing and cylinder seals from Mesopotamia into Anatolia. One route along which the boards, writing, and seals might have traveled is the overland route that would later become the Royal Road of the Achaemenids. Maritime connections also facilitated international trade. There is strong evidence that 58 Holes was traded throughout the Mediterranean region and beyond. With such widespread distribution, its normal that a considerable amount of local variation would exist. Different cultures, some of which were enemies of the Egyptians at the time, adapted and created new imagery for the game. Certainly, other artifact types are adapted and changed for use in local communities. The 58 Holes gameboards, however, seem to have maintained their general shapes, styles, rules, and iconography - no matter where they were played. This is somewhat surprising, because other games, such as chess, were widely and freely adapted by the cultures that adopted them. The consistency of form and iconography in 58 Holes may be a result of the complexity of the board. Chess, for example, has a simple board of 64 squares, with the movement of the pieces dependent on largely unwritten (at the time) rules. Gameplay for 58 Holes depends strictly on the board layout. Trading Games The discussion of cultural transmission of game boards, in general, is currently of considerable scholarly research. The recovery of game boards with two different sides - one a local game and one from another country - suggest that the boards were used as a social facilitator to enable friendly transactions with strangers in new places. At least 68 gameboards of 58 Holes have been found archaeologically, including examples from Iraq (Ur, Uruk, Sippar, Nippur, Nineveh, Ashur, Babylon, Nuzi), Syria (Ras el-Ain, Tell Ajlun, Khafaje), Iran (Tappeh Sialk, Susa, Luristan), Israel (Tel Beth Shean, Megiddo, Gezer), Turkey (Boghazkoy, Kultepe, Karalhuyuk, Acemhuyuk), and Egypt (Buhen, Thebes, El-Lahun, Sedment). Sources Crist, Walter. Board Games in Antiquity. Anne Vaturi, Encyclopaedia of the History of Science, Technology, and Medicine in Non-Western Cultures, Springer Nature Switzerland AG, August 21, 2014. Crist, Walter. Facilitating Interaction: Board Games as Social Lubricants in the Ancient Near East. Alex de Voogt, Anne-Elizabeth Dunn-Vaturi, Oxford Journal of Archaeology, Wiley Online Library, April 25, 2016. De Voogt, Alex. Cultural transmission in the ancient Near East: twenty squares and fifty-eight holes. Anne-Elizabeth Dunn-Vaturi, Jelmer W.Eerkens, Journal of Archaeological Science, Volume 40, Issue 4, ScienceDirect, April 2013. Dunn-Vaturi, Anne-E. The Monkey Race - Remarks on Board Games Accessories. Board Games Studies 3, 2000. Romain, Pascal. Les reprà ©sentations des jeux de pions dans le Proche-Orient ancien et leur signification. Board Game Studies 3, 2000.

Evolution of Nursing Research Paper Example | Topics and Well Written Essays - 2500 words

Evolution of Nursing - Research Paper Example It is imperative to study of history of nursing as it aids in having a better perception towards communal services and also it helps to develop an understanding towards the issues that were persistently tackling the occupation. With this understanding nurses are allowed to inflate an admiration of the role the occupation has performed in the wellbeing and care system of any country (Donahue, 1991). The present article discusses the history of nursing with an emphasis on communal inclination on the development and proliferation of this occupation. Nursing profession has varied categorization under different cultural domains. In 15th century the nursing profession was associated with the motherly care that is given by a women who looks after the child. Gradually nursing has evolved with this feeling and perception, to nurture or to nourish in complete sense. It encourages the individual towards value for life and existence. Earlier, this was taken care by the nuns and the infantry who provided such provisions. In UK nurses are often called "sisters" (Egenes). Nursing in Antiquity It is not easy to become a care provider and therefore in the ancient times. In the Zuni tribes, this charge was given to the much ahead of the time when the baby actually realize what is her fate to be. If a baby is born, with a segment of placenta, enveloping her face, it was considered as a symbol that the infant is predestined to be a caregiver (Henly, 2007). As the women possess the caring nature by instinct, she has the potential of providing care and attention to her infants and family members, therefore in many cultures and societies women is assigned the task to continue with nursing care to the injured and sick individuals of the society. During the era of inception of nursing care there was no facility of providing any kind of formal education to the nurses and therefore whatever were the traditional methods available with the society, nurses learned them and hence it was pass ed from one generation to another. Nurses also learned through their keen observation when others do care for the sick people, in certain cases when they found their experience and expertise inadequate they either consulted the physician or they adopted the process of trial and error. If the hit and trial procedure gained success it used to become the standard and was utilized for other similar ailments. Thus the practice of nursing care was instituted (Egenes). It was during the early Christian era when the nurses categorized and systemized themselves in group. The preaching of church encompassed charity, self-sacrifice, help and aids to others. Females with some educational backgrounds (Deaconess) were selected by the authorities of the church to serve and care for the ailing individuals. Deaconesses were females either they were Roman matrons or widows. One of the deaconesses, Fabiola established Christian Hospital in Rome and provided the expert care. The deaconess Phoebe is cal led as the first "visiting nurse" (Nutting, 1907). During the era of antiquity, the most preferred and the protected care was the care provided by the family members, clansmen and friends. Hospitalizations were rare and was done for those who do not have any close by relative or family to take care. Earlier hospitals were run by the nuns and monks of the religion. Although because of lack of awareness the individuals were placed together, for instance an individual with smallpox could be placed with the individual having fracture. Diagnosis was poor

The Case of Mann Gulch Essay Example | Topics and Well Written Essays - 500 words - 1

The Case of Mann Gulch - Essay Example Mr. Dodge is seen to portray poor leadership in a number of ways. First and foremost, he took out his team on a mission without even proper familiarization with his crew members. He never knew even the names of the crew members but was supposed to command them. He only came to learn of their names in the field. Secondly, he was a quiet person which even made it had for him to build mutual and collaborative interactions with his crew. Thirdly, he never kept his crew intact by providing unified leadership. There were many cases of disunity that he was not sensitive to. Lastly, he was supposed to make his crew aware of his decisions which left them wondering the reason why he was lighting a backfire. Their decisions were out of ignorance. Some other people see the fault to this problem in poor training of the crew members. Despite the fact that smoke jumpers are highly trained individuals, the crew on the Mann Gulch fire case lacked experience in firefighting. Most of the people on the crew were young people who had lacked any form of experience in firefighting fire. This explains the reason why they panic was too high for them making them come up with wrong decisions. In this case, research made by urban fighters on the performance of firefighters showed that experienced firefighters have their performance improved under high stress and uncertainty while those inexperienced have their performance decline under such conditions. This level of panic was also amplified by the level of disintegration witnessed in the crew. In such a case, it is very difficult to follow orders. On matters of recommended approaches, it is important that crew leadership familiarizes with crew members and agree on collaborative operation before setting out on a mission.

What Mary Didn’t Know Essay Example for Free

What Mary Didn’t Know Essay The knowledge argument aims to refute physicalism, the belief that the world is entirely physical. Physicalism, also known as materialism, is the view that an individual’s experiences are subjective as it follows the strain of the conscious mind. It plays with the idea that an individual’s understanding of the world could be fulfilled through physical means. In the text What Mary Didnt Know, Jackson relays the hypothetical story of a scientist named Mary who was said to have developed a grasping knowledge about every physical aspect of the world. She was also kept away from being exposed to colors and only sees and learns things in black and white. When it was decided that she should be released her from her self-contained room, she was able to see a myriad of colors for the first time (Jackson, 1986). Out of this scenario, Jackson posits a question that challenges the principles of physicalism: If Mary has knowledge of all physical facts about the world and has learned something new once outside, it must be something that is not physical, and therefore it would dispute that everything in reality can be explained through physical means (Jackson, 1986). The central statement of the argument flows in this manner: P1: Prior to Mary’s release, it is a known fact that she is knowledgeable about the physical aspect about the world and other people. P2 After releasing Mary from her confined space and out into the world of color, Mary realizes that she does not know everything there is to know about other people and the world as she has obtained additional information about them. Therefore, it is postulated that Mary has not exhausted all physical information regarding other people and the world as she has learned something new outside her confinement. Clearly, this conclusion states that the notions about physicalism are false since there are certain truths that are not encompassed in the physicalist aspect of things (Jackson, 1986). The main conviction against physicalism is said to be the idea of qualia. According to Jackson, Qualia is said to be something that which is felt from experience. It is the notion that connects experiences to an idea or knowledge of a subject in a distinct way. Not everyone’s experience is the same as individuals are inherently different so one could denote that there are different ways to experience and interpret qualia. Neverthelss, Qualia poses problems of its own such as the assimilation of consciousness, introspection, comprehension and familiarity. However, the thought that will be focused on here is the existing conflict between qualia and physicalism (Jackson, 1986). If a physicalist claims that Mary knows what it’s like to see colors while confined in her room, the physicalist must be able to explain why Mary appears to acquire that knowledge when she leaves. The physicalist may deny the claim of knowledge intuition but then it would have to disregard the postulates that follow it (Jackson, 1986). There are many possible responses to support Jackson’s argument. One of which is the ability hypothesis from Ryle (1949) which illustrates a definite distinction between the proposed knowledge-that and knowledge-how. Knowledge-that is simply information which clarifies a statement based on the knowledge that has been obtained. Knowledge-how refers to a statement or information that is concerned with the process of how one obtains new knowledge. The knowledge argument only reinforces that Mary gains knowledge-how. On the other hand, the second postulate in the knowledge argument would only be true if Mary gained propositional knowledge (O’Hear, 2003). Secondly, there is the notion of metaphysically necessary truths. A metaphysical necessary truth is something that which could have failed to be the case. Logical truths could provide clear examples of this. For instance, an argument which states that a hippopotamus cannot fly like birds is a necessary truth. However, if laws the laws of nature were different then a hippopotamus would be able to fly like birds in a metaphysical sense (O’Hear, 2003). A metaphysically necessary truth is a truth that is narrowed down to the basics which does not simply rely on the existing nature of laws. Saul Kripke (1972) was notable for his argument regarding metaphysically necessary truths that disregards pure logic. For example, his view, that water is H2O is metaphysically necessary but he also recognizes that there are substances that resemble water or shares similar superficial qualities like its taste and visual appearance. However, he argues that such substances are not really water because it has a different molecular composition (O’Hear, 2003). In connection with the metaphysical necessary truths argument, a third approach introduces the distinction between a priori and a posteriori physicalism. It assumes that if physicalism is true then the complete truth about a subject matter is a priori that is extracted from the complete physical truth (O’Hear, 2003). A Priori is the initial statement taken out of the context of the complete physical truth, which is the posteriori. As was mentioned, the crucial claim of a posteriori physicalism is that it asserts that in order to be aware of the knowledge or change, one must be able to experience it. However, it is argued that Mary does not have relevant experience with regard to human color vision therefore she does not know. This argument would only be valid if the posteriori is not physically conceivable (O’Hear, 2003). A fourth draws from the conceivability argument of Descartes. The main argument emphasizes the dual properties of the mind and body. Descartes believes that if an individual can clearly and definitively visualize his or her mind without the body and his or her body without the mind, then both can exist without each other, which emphasizes the dichotomy between the two. Contemporary versions of this argument is said to carry out the inversion of qualia wherein one’s view of a subject matter may be different to the view of another (O’Hear, 2003). The fifth anti-physicalist argument is derived from the explanatory thought. The contention begins with the premise that physicalist descriptions of consciousness justify only the structure of the thought and function or role of the experience, which is not enough to explain the consciousness at work. For instance, if an individual learns about the Eiffel tower from a book, he or she envisions it through the descriptions in the book that describes its history and structure and its impact on the society. The knowledge the individual acquires from the book is limited since the actual experience of being in Paris to witness the structure has not been experienced (O’Hear, 2003). The sixth and final argument asserts the distinction of various conceptions of the physical. The argument stresses that the properties which define information by the conception of physical theory differs from the attributes that define those which rely on the conception of objects. It suggests that the first premise is open to either of the two interpretations. The notions about inverted qualia definitely support this argument since it makes use of the special attributes that is missing in observations that is purely physical (O’Hear, 2003). Conclusion The knowledge argument of Jackson assess that there is a difference in the type of fact being presented and that it may not be entirely physical. The succeeding anti-physicalist arguments and its derivative all question the essential assertions of physicalism that creates an abstract notion of reality. Jackson’s efforts in creating a stir on the drawbacks of physicalism have contributed a great deal of knowledge into exploring the depths of the subconscious mind. The arguments presented in the paper were long and confusing but it was very interesting to see different sides of the anti-physicalists streams of thought since collectively, the main premise of Jackson made much more sense. However, it seems that supporters of physicalists are coming up with their own responses to such arguments which create a much more complex understanding of just how a human’s consciousness works to define the physical world. References Jackson, F. (1986). What Mary Didn’t Know. The Journal of Philosophy, 83(5), 291-295. Retrieved March 11, 2009 from JSTOR database. O’Hear, A. (2003). Minds and persons. New York: Cambridge University Press.

Civilization Cure Or Disease :: essays research papers

Upon flipping to the business section of the New York Times an Ohio University student saw a startling headline glaring back at her â€Å"American Corporations Suspected In Millions of Third World Deaths.† As she read the article it became apparent that international corporations many of which were based in the United States exploit the poorest of the poor. These companies paid workers extremely low wages and exposed them to hazardous materials with out any protection. Working conditions were unsafe and often lead to health problems. It appeared that slavery was alive and well in the name of â€Å"Global Industrialization.† Even more shocking was the fact that this new form of slavery was also present within our own borders. Migrant workers and illegal aliens were becoming an increasing percentage of America’s labor force. These workers were paid well below minimum wage for jobs, which often put their health if not their life in jeopardy.   Ã‚  Ã‚  Ã‚  Ã‚  It appeared that America’s industrial empire was built upon the exploitation of the poor throughout the world. Often women and children were the victims of the â€Å"Global Market Economy.† The article stated that millions of goods were produced by children as young as 6 in third world and developing nations. Companies producing these goods claimed that it was not â€Å"slave labor† they claimed it was the â€Å"efficient use of human resources for production.† It seemed that companies in their desire of â€Å"progress† and profit were oppressing the world’s poorest nations and their citizens. This is not a new phenomenon it has gone on through history; the strong oppress the weak. What is amazing though is the fact that industrialized nations all consider themselves to be the most civilized societies in the world. Industrial powers view less developed nations as backwards which is a synonym for barbarous. But are the societies of industrially advanced nations truly the most civil? This is the question Montaigne raised over 400 years ago in his paper entitled â€Å"Of Cannibals.†   Ã‚  Ã‚  Ã‚  Ã‚  Throughout history it seems that the most technologically advanced societies are the most powerful. And the most powerful nations view themselves as the most civilized people in the world. But what exactly are the defining attributes of a civilized society? According to Webster’s Third International Dictionary a civilization is: an ideal state of human culture, characterized by complete absence of barbarism and non-rational behavior, optimum utilization of physical, cultural, spiritual, and human resources, and perfect adjustment of the individual within the social framework.

Emerging Wireless Technologies

A look into the future of wireless communications – beyond 3G Forward: The Public Safety Wireless Network (PSWN) Program is conducting an ongoing assessment of advancements in the wireless communications industry. The scope of this assessment is to identify emerging wireless services and technologies for potential public safety use in the near future and beyond. This particular document is the first of a series of emerging wireless technologies studies. This study will concentrate primarily on the fourth generation of mobile telecommunications and beyond. G – i. e. , an entirely packet switched network with all digital network elements and extremely high available bandwidth. For the most part, it is believed that 4G will bring true multimedia capabilities such as high-speed data access and video conferencing to the handset. It is also envisioned that 4G systems will be deployed with software defined radios, allowing the equipment to be upgraded to new protocols and services via software upgrades. 4G also holds the promise of worldwide roaming using a single handheld device. Wireless Generations At-a-Glance As with all technology progressions, the â€Å"next† upgrades must be in planning and development phases while its predecessors are being deployed. This statement holds true with all mobile telecommunications to date. It seems that it will also hold true for the next generations of wireless networks. The original analog cellular systems are considered the first generation of mobile telephony (1G). In the early 1980s, 1G systems were deployed. At the same time, the cellular industry began developing the second generation of mobile telephony (2G). The difference between 1G and 2G is in the signaling techniques used: 1G used analog signaling, 2G used digital signaling. As experience shows, the lead-time for mobile phone systems development is about 10 years. It was not until the early to mid 1990s that 2G was deployed. Primary thinking and concept development on 3G generally began around 1991 as 2G systems just started to roll out. Since the general model of 10 years to develop a new mobile system is being followed, that timeline would suggest 4G should be operational some time around 2011. 4G would build on the second phase Although the new, third generation (3G) wireless technology has not yet been implemented, leading companies in the industry are already laying the groundwork for what some are calling fourth generation (4G) technology. For the purposes of this article, 4G will be considered those technologies that are still in the planning stages and will not be deployed within the next five years. Researchers are continuing their ideas in the development of an undefined wireless world, which could become operational by 2010. The first generation (1G) and second generation (2G) of mobile telephony were intended primarily for voice transmission. The third generation of mobile telephony (3G) will serve both voice and data applications. There really is no clear definition of what 4G will be. It is generally accepted that 4G will be a super-enhanced version of of 3G, when all networks are expected to embrace Internet protocol (IP) technology. During the last year, companies such as Ericsson, Motorola, Lucent, Nortel and Qualcomm came up with â€Å"3G-plus† concepts that would push performance of approved, though still emerging, standards beyond current ones. Interoperability and the Evolution of Network Architectures One of the most challenging issues facing deployment of 4G technologies is how to make the network architectures compatible with each other. New signaling techniques are being designed specifically to enhance today's second generation (2G) networks, deliver unprecedented functionality for 3G, and successfully drive the Fourth Generation (4G) of wireless, thus delivering immediate and long-term benefits to carriers. With the architecture of each generation of wireless devices addressed in the development of advanced technologies, carriers can easily evolve their systems without additional network modifications, significantly reducing costs and implementation time. Currently, different wireless technologies (e. g. , GSM, CDMA, and TDMA1) are used throughout the world for the 2G, 2. 5G, and eventually 3G networks. There are two approaches being used to develop 4G access techniques: 3xRTT (currently 1xRTT for 2. 5 and 3G) and Wideband CDMA (W-CDMA). These disparate access techniques currently do not interoperate. This issue may be solved with software defined radios. LinkAir Communications is developing a new access technology called large-area-synchronized code-division multiple access (LAS-CDMA). LASCDMA will be compatible with all current and future standards, and there is a relatively 1 GSM – Global System for Mobile Communications CDMA – Code Division Multiple Access TDMA – Time Division Multiple Access easy transition from existing systems to LAS-CDMA (using software defined radios). LinkAir emphasizes that LASCDMA will accommodate all the advanced technologies planned for 4G and that LASCDMA will further enhance either 3xRTT or W-CDMA system’s performance and capacity. Internet Speeds 2. 5G is the interim solution for current 2G networks to have 3G functionality. 2. 5G networks are being designed such that a smooth transition (software upgrade) to 3G can be realized. 2. 5G networks currently offer true data speeds up to 28kbps. In comparison, the theoretical speed of 3G can be up to 2 Mbps, i. e. , approximately 200 times faster than previous 2G networks. This added speed and throughput will make it possible to run applications such as streaming video clips. It is anticipated that 4G speeds could be as high as 100 Mbps. Thus, 4G will represent another quantum leap in mobile Internet speeds and picture quality. Ericsson confirms that 4G could bring connection speeds of up to 50 times faster than 3G networks and could offer three-dimensional visual experiences for the first time. The following graph represents what has been the typical progression of wireless communications: Quality of Service Challenges In wireless networks, Quality of Service (QOS) refers to the measure of the performance for a system reflecting its transmission quality and service availability (e. g. , 4G is expected to have at least a reliability of 99. 99%). Supporting QOS in 4G networks will be a major challenge. When considering QOS, the major hurdles to overcome in 4G include: varying rate channel characteristics, bandwidth allocations, fault tolerance levels, and handoff support among heterogeneous wireless networks. Fortunately, QOS support can occur at the packet, transaction, circuit, and network levels. QOS will be able to be tweaked at these different operating levels, making the network more flexible and possibly more tolerant to QOS issues. Varying rate channel characteristics refers to the fact that 4G applications will have varying bandwidth and transition rate requirements. In order to provide solid network access to support the anticipated 4G applications, the 4G networks must be designed with both flexibility and scalability. Varying rate channel characteristics must be considered to effectively meet user demand and ensure efficient network management. Spectrum is a finite resource. In current wireless systems, frequency licensing and efficient spectrum management are key issues. In 4G systems, bandwidth allocations may still be a concern. Another concern is interoperability between the signaling techniques that are planned to be used in 4G (e. g. , 3xRTT, WCDMA). In comparison with current 2G and 2. 5G networks, 4G will have more fault tolerance capabilities built-in to avoid unnecessary network failure, poor coverage, and dropped calls. 4G technology promises to enhance QOS by the use of better diagnostic techniques and alarms tools. G will have better support of roaming and handoffs across heterogeneous networks. Users, even in today’s wireless market, demand service transparency and roaming. 4G may support interoperability between disparate network technologies by using techniques such as LAS-CDMA signaling. Other solutions such as software defined radios could also support roaming across disparate network technologies in 4G systems. These major challenges to QOS in 4G networks are currently being studied and solutions are being developed. Developers believe that QOS in 4G will rival that of any current 2G or 2. 5G network. It is anticipated that the QOS in 4G networks will closely approximate the QOS requirements in the wireline environment (99. 999% reliability). The emergence of next generation wireless technologies is going enhance the effectiveness of the existing methods used by public safety†¦ 4G Applications and Their Benefits to Public Safety One of the most notable advanced applications for 4G systems is locationbased services. G location applications would be based on visualized, virtual navigation schemes that would support a remote database containing graphical representations of streets, buildings, and other physical characteristics of a large metropolitan area. This database could be accessed by a subscriber in a moving vehicle equipped with the appropriate wireless device, which would provide the platform on which would appear a virtual representation of the environment ahead. For example, one woul d be able to see the internal layout of a building during an emergency rescue. This type of application is sometimes referred to as â€Å"Telegeoprocessing†, which is a combination of Geographical Information Systems (GIS) and Global Positioning Systems (GPS) working in concert over a high-capacity wireless mobile system. Telegeoprocessing over 4G networks will make it possible for the public safety community to have wireless operational functionality and specialized applications for everyday operations, as well as for crisis management. The emergence of next generation wireless technologies will enhance the effectiveness of the existing methods used by public safety. 3G technologies and beyond could possibly bring the following new features to public safety: Virtual navigation: As described, a remote database contains the graphical representation of streets, buildings, and physical characteristics of a large metropolis. Blocks of this database are transmitted in rapid sequence to a vehicle, where a rendering program permits the occupants to visualize the environment ahead. They may also â€Å"virtually† see the internal layout of buildings to plan an emergency rescue, or to plan to engage hostile elements hidden in the building. Tele-medicine: A paramedic assisting a victim of a traffic accident in a remote location could access medical records (e. g. , x-rays) and establish a video conference so that a remotely based surgeon could provide â€Å"on-scene† assistance. In such a circumstance, the paramedic could relay the victim's vital information (recorded locally) back to the hospital in real time, for review by the surgeon. Crisis-management applications: These arise, for example, as a result of natural disasters where the entire communications infrastructure is in disarray. In such ircumstances, restoring communications quickly is essential. With wideband wireless mobile communications, both limited and complete communications capabilities, including Internet and video services, could be set up in a matter of hours. In comparison, it may take days or even weeks to re-establish communications capabilities when a wireline network is rendered inoperable. Limitations of 4G Although the concept of 4G communications shows much promise, there are still limitations that must be addressed. One major limitation is operating area. Although 2G networks are becoming more biquitous, there are still many areas not served. Rural areas and many buildings in metropolitan areas are not being served well by existing wireless networks. This limitation of today’s networks will carry over into future generations of wireless systems. The hype that is being created by 3G networks is giving the general public unrealistic expectations of always on, always available, anywhere, anytime communications. The public must realize that although high-speed data communications will be delivered, it will not be equivalent to the wired Internet – at least not at first. If measures are not taken now to correct perception issues, when 3G and later 4G services are deployed, there may be a great deal of disappointment associated with the deployment of the technology, and perceptions could become negative. If this were to happen, neither 3G nor 4G may realize its full potential. Another limitation is cost. The equipment required to implement a nextgeneration network is still very expensive. Carriers and providers have to plan carefully to make sure that expenses are kept realistic. One technique currently being implemented in Asian networks is a Pay-Per-Use model of services. This model will be difficult to implement in the United States, where the public is used to a service-for-free model (e. g. , the Internet). Conclusions 4G networks may eventually deliver on all the promises. At times, it seems that technological advances are being made on a daily basis. These advances will make highspeed data/voice-over-Internet-protocol (VoIP) networks a reality. In the meantime, it is important for industry to develop a strong 3G offering that is palatable for the general public. Equally as important, industry must ensure that expectations are realistic and that services meet and exceed those expectations. If all goes according to what the industry envisions, it may be sooner, rather than later that we will see wireless communications evolve. This evolution will give the general public as well as the public safety community amazing functionality from the convenience of a single handheld device. Postscript: The purpose of this article is to introduce the reader to next-generation wireless communications. In coming articles, further developments in 4G (e. g. , services, billing, protocols, and standards) and other emerging wireless technologies will be presented in greater depth. References http://www.cnn.com/2001/TECH/ptech/03/08/4G.world.idg/ http://www.nsf.gov/pubs/1999/nsf9968/nsf9968.htm