Tuesday, May 19, 2020

Definition and Examples of Syncopy in English

Imperialism in the 19th century - 1746 Words

There was a great deal of Imperialism in the 19th century, led by mostly westerners from Europe. Imperialism is the act in which one nation extends its rule over another. Imperialism had a substantial effect on the 19th century throughout the entire world by bringing upon changes to many different countries, for better and for worse, especially to Africa. Prior to the nineteenth century, westerners did interfere with many of the affairs of nations outside of their boarders, so signs of imperialism are shown many times throughout history. Examples of this would be the European colonies in the Americas and also influence in Asia. Whenever a western country was involved with the economy of an outside country, There were many reasons for†¦show more content†¦In addition to advances in medicine and in industry, new weapons were developed, which could easily defeat those of the Africans. This allowed for larger European settlements to be set up in Africa and hence, the race for territories began. Another reason for the scramble for Africa was the fear of upsetting the balance of power. Every European nation was concerned about their rivals becoming more powerful than they were. The main nations involved were Britain, France, Germany, and Italy. During the late nineteenth century, all of these countries, and a few others went into a scramble to claim territories in Africa. (Mastanduno, Michael Imperialism) The scramble for Africa began with an attempt by King Leopold II of Belgium wanting to gain control of the area of the Congo Basin. Tensions arose between the British and the French, because of the British gaining more control over Egypt, which was the country they had once had joint control over the finances of. France was also competing with Italy in northern Africa, so tensions were strong everywhere. Germany felt pressured by the other European nations who were gaining control over territories on Africa. Bismarck, who happened to be ruler at the time, declared control over three territories in eastern and western Africa, which caused even more strain between European nations. Since the control for African territories arose very quickly, the Berlin Conference wasShow MoreRelatedThe 19th And 20th Century Imperialism1297 Words   |  6 PagesThe 19th and 20th century imperialism was substantially about the exploitation of the empires colonies and thus was not a necessarily an †˜civilizing mission’. During the 19th and 20th century European powers tried to justify their actions, by claiming that they were trying to re-educate the native population through education, this included Christian missionaries which were placed throughout Asia, Africa and Latin America. However, it became apparent that these powers gained significant wealth byRead MoreConsequences Of Imperialism During The 19th Century997 Words   |  4 PagesConsequences of Imperialism In the late 1800’s and early 19th century, strong countries like Britain, France, and Germany became imperialist powers in the world. Most of these countries were industrialized and hungry to grow their economies and territory so they looked upon weaker and smaller countries with great resources they could take advantage of. Although colonizing these countries was tremendously beneficial to the imperialist powers, there were many consequences to the people of the countriesRead MoreThe New Imperialism During the 19th Century Essay1046 Words   |  5 PagesThe New Imperialism during the 19th century throughout Africa and Asia was an influential prompt to the rise of colonialism and powerful European empires. Consisting of raw materials, markets for European business, and provided resources made the African and Asian colonies extremely ingenious for European empires. However, as the 20th century emerged, imperialism suddenly faded and became a sentiment of the past. Surely even one of the most influential empires at a certain point in time – BritainRead MoreEuropean Imperialism in Late 19th Century Africa1624 Words   |  7 Pages European Imperialism in Late 19th Century Africa: African Response and Effects Rafael Delatorre History 002B Professor Standish April 12, 2014 Between 1870 and 1914, European countries ceased about ninety percent of Africa. Native Africans faced political, military, and imperialism pressure from various European countries. After the end of the profitable slave trade in Africa, due to abolishing of slavery, Europeans explored forRead MoreDifferences Between 16th and 19th Century Imperialism1896 Words   |  8 PagesThe Differences Between 16th and 19th Century Imperialism and their Effects on the World Today. Name: Mr. Big Student #: C10539956 Course: INS 201 Professor: Dr. Ventricle 1. What is ‘imperialism’? How did 19th-century colonialism, empire building, high imperialism differ from those of earlier times: in particular from the colonialism of early- modern mercantilism (16th to18th centuries)? ------------------------------------------------- ------------------------------------------------- -------------------------------------------------Read MoreImperialism In The 19Th Century Resulted In European Countries1726 Words   |  7 PagesImperialism in the 19th century resulted in European countries using social Darwinism to justify controlling the social and cultural lives of natives in African countries.When Chinua Achebe published Things fall apart in 1958, a novel criticizing the European aspects of imperialism, his aspiration was to teach readers that â€Å"their past-with all its imperfections-was not one long night of savagery from which the first Europeans acting on God’s behalf delivered them†(Chinua Achebe on the Role of theRead MoreThe Impact of 19th Century European Imperialism in Africa1024 Words   |  5 PagesEuropean Imperialism heavily impacted the African continent through culturally, economic, and political ideas. This era of history is heavily drenched in the aspect of ethnocentrism, which is the belief that one’s own culture is s uperior that of another. The Europeans colonized Africa believing that they could bring civilization, but they were often ignorant of Africa’s very complex societies. The European powers divided up the continent of Africa among themselves, without any consent from the peopleRead MoreReasons for the U.S. Turning to Imperialism at the End of the 19th Century1278 Words   |  6 PagesS. turn to Imperialism at the end of the 19th century? Imperialism is the creation and maintenance of an unequal economic, cultural, and territorial relationship, usually between states and often in the form of an  empire, based on domination and subordination.† (Johnston 375) By the 1890s, many Americans leaders started to have new attitude towards imperialistic adventures abroad. There were numerous reasons for the U.S. to turn to Imperialism at the end of the 19th century, mainly theRead MoreCompare and Contrast the Influence and Consequence of European Imperialism on Africa and China During the 19th Century.748 Words   |  3 Pagesconsequence of European Imperialism on Africa and China during the 19th century. Imperialism is when one country dominates the cultural, economic, and political life of a nation weaker than itself. In the 19th century, Europe was the nation that was dominating both China and Africa. There were quite a few similarities in the way that European imperialism was changing these nations. One important similarity was that both the nations had resisted against British imperialism at one point. HoweverRead MoreWestern Imperialism and Modern East Asia Essay example1188 Words   |  5 PagesWestern imperialism in East Asia caused many tribulations for China, Japan, and Korea but also helped them to become contemporary nations. The East Asian countries were tremendously affected by unequal treaties, extraterritoriality, and above all, technology. Great Britain encroached upon China their greed for open trade with the Chinese empire resulting in the deterioration of the Chinese culture, which led to the emergence of a modernized civilization. Japan was co-subjugated by R ussia and the

Monday, May 18, 2020

Paying College Athletes Essay - 2138 Words

Your Name Professor Miller English 106 11 April 2008 Paying College Athletes College sports have gained a lot of positive attention over the past couple of years due to the athletes’ passion and desire for the sports. Being nationally televised and making it deep into big tournaments can rack up a lot of wealth that colleges and universities can respectively cash in. Only the schools and sponsors of these profiting tournaments and bowl games collect the profits that athletes bring in and it is not fair. The athletes do not garner any benefits for the timeless hours and dedication they put into their sports. College athletes should be paid because they bring in an extensive amount of money and publicity to colleges and†¦show more content†¦Athletes should be compensated in some way for being exploited for money. One that stands out is the money made from selling merchandise. This merchandise can range from hats, t-shirts, and any other miscellaneous apparel but the most important items sold are the jerseys. Yes they do not have the names on the back of the jerseys to protect the athletes, but it is not like there is more than one player on the same team with the identical jersey. Even if their names aren’t on the back of the jerseys being sold, customers buy the jersey because they know who the player’s number. This is true because so many times people watch these games being â€Å"advertised† nationally and they’re faster to recognize the jersey number first rather than the last name. This also brings up the issue that players’ names on the back of their jersey are not sold because the athletes could plead a legitimate case that they should be compensated in some way because of the use of their name. Because of the merchandise being sold and marketed from the schools and other sporting goods retailers, athletes should consume, at the least, a share of the profit being made. Notable and talented athletes bring in a great deal of exposure to universities because of their success. They should not be paid directly because of this but this exposure draws attention to potential incoming students; both freshmen and transfers. In a way, coaches recruitShow MoreRelatedPaying College Athletes1061 Words   |  5 PagesCollege sports also known as the greatest source of entertainment known to man this era. There are several types of sports ranging from non- physical to the most physical contact sports. Each sport takes sacrifice and dedication to be able to perform at your best knows matter what level. The NCAA is a million dollar business that lets student athletes show their athletic ability and skill toward other individuals. That is the main reason for the creation of collegiate sports, but not to downsideRead MorePaying College Athletes805 Words   |  3 PagesPaying College Athletes After high school, some students decide to make the decision to go to college to further their education, earn a degree, have fun, and some, to play sports. College sporting events bring in money through tickets, jerseys, shirts, and other gear. The money made for all of these items and expenses go to paying coaches, the school, charities, utilities, and other expenses a school has to pay to have a sports team. Most college athletes are given scholarships to allow themRead MorePaying College Athletes1455 Words   |  6 PagesWhen it comes to college athletics, there always will be a problem that arises. It is one of the most controversial topics there is. One of the main issues within athletics is the idea of whether to pay college athletes or not. Several studies have been done along with articles from various sources. This has been on the rise especially since â€Å"March Madness† is coming up. â€Å"March Madness† may only consist of three weekends, however, an 11 billion dollar deal is made to televise the games (Wilbon).Read MorePaying College Athletes Essay1283 Words   |  6 PagesThe college athletes of their respective sports today, have the opportunity of showcasing their talents in competition on local and national programming on a regular basis which has lately brought attention this controversy, paying college athletes. The issue was brought on by the athletes over time, then caught onto coaches, sports columnists, and fans. The athletes dedicate themselves to the sport to a caliber comparable to the professional tier. The idea of paying the athletes could be consideredRead MoreArgument for Paying College Athletes1399 Words   |  6 Pages Argument for Paying College Athletes Stephen Elting Mercy College Have you ever heard of a business that made billions of dollars, yet did not pay their employees? Seems pretty remarkable doesn’t it? Well this business is known as the NCAA. According to an article in the New York Times, the NCAA made $770 million from just the three-week Men’s Basketball Tournament, but how much did the athletes who participated in said tournament receiveRead MoreCollege Essay On Paying College Athletes1060 Words   |  5 PagesPaying College Athletes Many people believe that college athletes should be paid for how much revenue they bring to their school. However, there are also people who think they should not get paid because they already have numerous advantages that other students do not have. Student-athletes at the Division 1 level that play mens basketball and football should not necessarily be paid a salary but should be able to make money off of their accomplishments, especially if we hold them on a high pedestalRead MoreThe Consequences of Paying College Athletes1240 Words   |  5 Pages(â€Å"Amateur†). Amateurism is the concept that athletes should compete without payment. Until recently, playing collegiate sports as an amateur was thought to be a noble calling. As time surpassed, college sports became a commercialized industry, generating billions of dollars in revenue. When this became apparent, the implementation of athletic scholarships became more relevant. The athletic scholarship seemed to be a more tha n fair way to delight athletes with some sort of incentive to ensure theirRead MoreThe Problems With Paying College Athletes1120 Words   |  5 Pages College athletics is a very diverse organization involving a lot of students, mainly as the players, and non-students such as officials, coaches and others. The leading governing body for college athletics is the National Collegiate Athletic Association, NCAA. College sports is itself a big industry involving sponsorships, TV networks, endorsements, retail products and marketing. But in spite of it being a big business, the players are not compensated for the work they deliver. This opens up twoRead MoreEssay on Paying College Athletes865 Words   |  4 Pages Should college athletes get paid more money? nbsp;nbsp;nbsp;nbsp;nbsp;There has been a constant debate the past few years on whether college athletes, particularly football players, should get paid. In 1988, the Nebraska legislature passed a bill that would allow the University of Nebraska football players to receive better cash incentives. The bill was later vetoed by Governor Kay Orr, who was governor of Nebraska at the time (O’Toole etal. 2). . The dispute comes from coaches, parents ofRead MoreEssay on Paying College Athletes871 Words   |  4 PagesCollege sports are big money makers now a days. For most universities, the athletic department serves as one of the main sources of cash flow. Athletes are used to create millions of dollars for the NCAA and the schools that they participate in, and never receive a penny. If we are talking about profit, if all bonds with the university were removed, an athletic department representing itself could compete with some of the most successful companies. So, why does the most important parts of the machine

Wednesday, May 6, 2020

National Incident Based Reporting System - 1392 Words

National Incident-Based Reporting System The National Incident-Based Reporting System (NIBRS) stemmed from a mid-1980s report, is an incident-based reporting system (some states use a customized version) that is used by law enforcement agencies in the United States for the collecting and reporting of data on crimes that are known by police. NIBRS is the result of law enforcement thoroughly evaluating and modernizing the UCR (Uniform Crime Reports). The UCR, produced by the FBI, was initially developed by the IACP (International Association of Chiefs of Police) in 1931 in which police departments across jurisdictions could exchange information in regards to crime. Local, state and federal agencies generate NIBRS data from their†¦show more content†¦Group B criminal offenses include: bad checks, curfew violations, disorderly conduct, DUI, drunkenness, liquor law violations, non-violent family offenses, peeping toms, runaways, trespassing, and all other offenses. Another advantage is that crime analyses can be made at the local and regional levels and meet the needs of local, state and national reporting. These crimes are clearly distinguishable between which ones are attempted and which ones are completed. Regionally, law enforcement agencies can share the data collected easily across jurisdictions. Law enforcement agencies are required to submit at least a brief account of each criminal offense and the resulting arrests. For each offense or incident known to the local law enforcement authorities, information within the categories is gathered. According to the handbook of NIBRS an incident is defined as one or more offenses committed by the same offender or group of offenders acting inShow MoreRelatedNational Incident Based Reporting System978 Words   |  4 Pages National Incident Based Reporting System National Incident Based Reporting System (NIBRS) was originally designed as a summary system to collect only the most serious offense within an incident; the FBI UCR Program began using the NIBRS in 1989 to capture up to ten crime occurrences within an incident (https://www.fbi.gov/about-us/cjis/ucr/nibrs/nibrs-user-manual, 6). Through the NIBRS, LEAs report data on each offense and arrest within 23 offense categories made up of 49 specific crimes calledRead MoreThe Uniform Crime Reports The National Incident Based Reporting System978 Words   |  4 Pagesverses The National Incident Based Reporting System The purpose of this abstract is to critically review the primary data sources used in the criminological research. The two key factors that measures crime are distinguished: official crime statistics, which are based on the compile data records of offenders and offenses processed by the police, courts, and corrections agencies; and unofficial crime statistics, which are produced by people and agencies outside the criminal justice system whom canRead MoreThe Uniform Crime Report And The National Incident Based Reporting System2077 Words   |  9 Pagesorting System fall under the Uniform Crime Reporting Program that provides information on crime all of the United States. This includes regions, states, counties, cities, towns, tribal law enforcement, colleges and universities. In this paper we will compare and contrast the two primary crime data sources used within the United States, the Uniform Crime Report and the National Incident-Based Reporting System. Before we do this, we will discuss each source individually and how it is used in CriminologicalRead MoreCultural Change : The Fire Service3308 Words   |  14 Pageslevels of the fire service. My department addresses these areas through the National Firefighter Safety Down Day where current issues and concerns with firefighter safety are address, and teaching material is presented to improve overall safety. 3) Risk Management Inherently the fire service operates in high-risk environments to facilitate the role of preserving life safety and property conservation. How these incidents are managed and safeguarded by our administration through the departments trainingRead MoreEssay about Role of Police Reports In the Law Enforcement Community1011 Words   |  5 Pageson police shows and in action movies. Pretty much everything that comes out of an on-duty officer’s mouth is in some sort of code. One important genre in the law enforcement community is police reports. Police reports are the standardize way of reporting and are often the same in all states. Police reports are significant because they can be used to determine criminal charges and to further an investigation (Viridis). There are various types of police reports that all serve different purposes. IRead MoreUnited States Computer Emergency Readiness Team : Legal Regulations, Compliance And Investigation1267 Words   |  6 Pagescrucial constituting the information regarding the government and business operations, crisis management and readiness information, and our crucial digital and process control systems. Safeguarding these critical resources and infrastructure is very much needed, which helps in maintaining the integrity of economic and national security. So, to implement this protection, home land security’s cyber security group established the United States Computer Emergency Readiness Team (US- CERT) in SeptemberRead MoreThe Flawed System Of The Uniform Crime Reporting Program882 Words   |  4 PagesThe two flawed systems that are in use for collecting crime statistics in the United States are, Uniform Crime Reporting Program (UCR), and the National Incident-Based Reporting System (NIBRS). These programs were developed by the Federal Bureau of Investigations to collect crime data from around the United States. Both systems are outdated and need to be updated. Although these programs may be flawed, they are still used to collect very important data that is collected to write new policies thatRead MoreThe Sources Of Criminal Statistics872 Words   |  4 PagesThe Sources of Criminal Statistics The two flawed systems that are in use for collecting crime statistics in the United States are, Uniform Crime Reporting Program (UCR), and the National Incident-Based Reporting System (NIBRS). These programs were developed by the Federal Bureau of Investigations to collect crime data from around the United States. Both systems are outdated and need to be updated. Although these programs may be flawed, they are still used to collect very important data that areRead MoreMeasuring Crime Essay914 Words   |  4 Pagesallotment, staffing needs or termination and it is also used to determine the effectiveness of new laws and programs. There are three tools used to measure major crime in the United States: Uniform Crime Reports, National Crime Victimization Survey and the National Incident Based Reporting System- which is currently being tested to replace the Uniform Crime Reports. Although there different tools used to measure crime, crime rates can be deceiving. Each different tool rep orts a different type of rateRead MoreCrime, Poverty, And Race838 Words   |  4 Pages They were not considered for this data. Next, we have the FBI National Incident-Based Reporting System, which reports more detailed data about â€Å"criminal offenses which are reported by law enforcement through the National Incident-Based Reporting System (NIBRS) during a particular year† (â€Å"FBI 2014 National†, 2014, para. 1). For this report we will examine the data from 2014. According to the National Incident-Based Reporting System (2014, para. 1) about 6,500 law enforcement organizations- who are

Women s Women Faced Gender Discrimination - 1737 Words

Prior to the 1970’s women faced gender discrimination in politics in regards to plausibility about political obligation that falls along the lines of gender. Various gender representation within a representative democracy were consistent of male supremacy. Women were denied full citizenship rights such as the right to vote. Women fought for their suffrage in order to gain the right to vote and be entitled social, civil, and moral rights for themselves. Despite the increasing presence of women in American Politics, gender stereotypes still existed. In 1972, Congress passed Title IX in order to end sex-based discrimination in higher education. Although, the act never explicitly states athletics, the act did become recognized frequently in the case of athletics in higher education. In addition to athletics, Title IX extends to prohibiting gender bias in education and the workplace. Even though, there are gains in gender equality with the passage of Title IX, stereotypical bias in filtrate prejudices that frame the full potential of Title IX. Despite the fact that the major emphasis and repercussion of Title IX focused on the areas of intercollegiate athletics, the original document did not mention athletics. However, every person should be entitled to the equal right to participate in sports, despite the color of their skin, social status, or gender. Sports build character and emphasizes the values of teamwork, perseverance, and hard work. In the area of athletics Title IXShow MoreRelatedImproving Workplace Opportunities For Women1590 Words   |  7 PagesA century ago women were excluded from the opportunities which men enjoyed. Today, many countries including Canada have progressed significantly by creating anti-discrimination laws that have performed a critical role in expanding workplace opportunities for women. However, these laws failed to guarantee workplace equality since female workers still face discrimination through significant pay gaps for similar job duties, lack of representation in boards and high paying positions, and also face sexualRead MoreGender Discrimination : The Glass Ceiling Affect Gender Groups, Stereotyping, And Discrimination1623 Words   |  7 PagesINTRODUCTION: Women workers in the prime working ages of 26 to 59 make only 38 percent of what prime-age men earn,(Marley S. Weiss, 2007, page 64). Discrimination against gender is very common in the workplace. The purpose of this explanatory research is to discuss the discrimination women face in society and the workforce as well as the challenges faced by marital status. The sociological theories on the macro level that will be used to analyze this subject include; the conflict perspective theoryRead MoreClosing Gender Gaps : The Gap Between Men And Women1428 Words   |  6 Pages Closing gender gaps Laith Wadi Eduardo Canel Thomas Chaisson Le-belle Introduction to international development The main argument highlighted to solve the issue of closing the gap between men and women could easily come down to the Gender and Development theory. Finding out what separates the two genders in terms of the lack of power and resources that differentiates men and women in terms of their roles in development. Gender equality has been argued to be an on going issue, from theRead MoreWomen Struggles By Nina Revoyr1481 Words   |  6 PagesCourse Unit Date Women Struggles in History In her Novel, Southland, 2003, Nina Revoyr captures the struggles that women, especially those of the Asian American descent, have navigated through history. The novel provides interesting material on many fronts including aspects such as sexuality, multiracial and multigenerational family saga. The book is based upon three women characters with the main protagonist being a young Japanese AmericanRead MoreThe Workplace : A Tradition Of Discrimination972 Words   |  4 PagesGender in the Workplace: A Tradition of Discrimination Throughout history women have endured terrible injustices due to societies views and male domination. One of the most restrictive issues has been the perception of women in professional roles. In Andersen’s Thinking About Women the traditional view of women’s work involved them staying home where they â€Å"were seen as having a moral calling to serve their families† (Andersen, 2011, p. 118). These views, unpopular as they may be, still exist todayRead MoreSarah Louise s Relationship Between Race, Class And Gender Essay841 Words   |  4 Pagesincredibly aspiring, given the fact that these two women witnessed a century of oppression and subjugation. Having Our Say is the story of these remarkable sisters, with the opening of the film showing us the sisters as old women in 1991 and then flashing back to their early lives in chronological order. Starting from their early childhood in Raleigh, North Carolina, this biographical film explores the relationship betwe en race, class and gender and how each aspect influenced the sister’s lives forRead MoreThe Socialization Process Of Children1012 Words   |  5 Pages Through the socialization process, children learn gender roles at birth. In our society today, we buy boy infants blue and girls infants pink. We even apply these color-coded gender labels while a baby is still in the womb. Gender socialization occurs through four categories: family, education, peer groups, and mass media. Each category reinforces gender roles by creating and maintaining the norm expectations for gender-specific behavior. At an early age, children have an understanding that thereRead MoreAmerica s Struggle For The High937 Words   |  4 Pagesschools in Arkansas during the 1950’s. Reed portrays life in the 1950’s through the eyes of the famous trumpet player, Louis Armstrong. â€Å"The C Above C Above High C,† goes well beyond the topic of racism and desegregation; providing an insightful look into other forms of discrimination and political corruption. Although racism was a significant issue, sexism and gender discrimination is of equal imp ortance, and created many problems for women during the 1950’s. Gloria is introduced in Act one,Read MoreAnalysis Of The Article Lilly Ledbetter Fair Pay Act1248 Words   |  5 Pagesstates, on average, women earn 78 cents for every dollar their male counterparts earn. Of these women, African American women earn 64 cents, while Latin American women earn a mere 55 cents. The Lilly Ledbetter Fair Pay Act became one of the many stepping stones in achieving equal pay. Women must continue to make people aware of the discrimination they faced in the workplace on a daily basis. Wage discrimination is embedded in our legal system. The ongoing battle for equal pay for women dates back to theRead MoreA Brief Note On Gender And Discrimination Sports Soccer 1580 Words   |  7 PagesRute Tilahun Professor Selina Hammond English 101- Composition 12, November 2015 Gender and Discrimination in Sports: Soccer How many fans do you see supporting women’s Soccer teams? Why are women receiving less acknowledgements for their success towards sports than men? Do you know any girl who is interested in playing soccer and is not on the team just because she is a girl? Well I do. Such an incidence happened in one of my best friend’s lives. It took place at my high school back

Political Ideology and Analysis for Powerful Weapon-myassignmenthelp

Question: Discuss about thePolitical Ideology and Analysis for Powerful Weapon. Answer: Political ideology is by definition a defined set of ideas and opinions which a group of individual or class can use to base the political activity in a society. Ideologies are in a sharp contrast to scattered or amateurish dispersion of ideas that in no way can create political beliefs. Political ideologies are fundamental in giving rise to political phenomenon. An individuals ideologies are essential in influencing his/her political behaviors. The essential sources of political ideologies are generally collected from slogans, speeches, studying carefully the functioning of different states. On the existence of ideology in a state, it is however imperative that there will exist ideological strife due to the presence of other political ideologies and beliefs. It is inherent in a man to possess political ideologies which will continue to have a strong impact on hi will and imaginative faculties. The essay will discuss political ideologies, its application in states, different types of political ideologies existing in the society today and its implications in government and functioning. Furthermore, the essay will also discuss in length the importance of overlapping political ideologies and ideological strife. However, political practitioners have also enumerated on the elusiveness of political ideology since there can never be a compact definition of the term. The ideologies are fundamental for providing a secured link between theory and practice and make the concepts of society, inter-relation of politics with individuals precise to the students of political science (Vincent 2009). Ideologies act as a powerful weapon since it is only by the existence of conflicting political ideologies that a state can progress successfully. Researchers have concluded that the mere implantation of a certain political ideology into a persons mind can help the individual possess an altogether different worldview. If one delves deeper into history, one can conveniently come across how conflicting political ideologies have been held responsible for giving rise to Cold War between United States and Soviet Union (Makovi 2016). Ideological warfare has been the core reason amounting to destructive campaigns, des truction of cultural properties for the deliberate damage to the belief of a particular sect or religion in order to upheld the other and the like. Over the years social scientists have come to regard political ideologies as a set of manners, values, opinions, beliefs and behavior that would come to define a person and invests a distinctive identity in him. One of the important consequences of conflicting political ideologies, ideological warfare is the result of changing taste and perception of the perpetually evolving society and their conflicts. Today in the 21st century, irrespective of the country or state, political ideologies are been created by social media sites and to some extent search engines. It is precisely here that one can gauge the extent to which political ideology is important in opinion formation and directing a crowd toward a definite direction. Theorists have claimed that over the years, videogames have manipulated their users for the sake of creating political ideologies, for instance the legitimizing military war and destruction, creating an unreal picture of male figure, or normalizing violence. At this juncture one may come across the crucial question that whether any state could at all exist bereft of its political ideologies. However, as much as this gives the readers a very utopian picture of the society, the existence of such a state is practically impossible. The state would become fragmented if its constituents have no political ideologies. Every state has to possess a set of ideologies albeit it can be complex or inter-mixed in their nature (Baradat and Phillips 2016). Some of the major political ideologies in the realm of political ideologies are liberalism, socialism, conservatism and anarchism. However, the basic overlapping of ideologies is an important area to study since it indicates that no society can progress depending upon an ideology that is basically a sealed system of opinion or thoughts. If a state wants to compartmentalize political ideology, the result will be an essentially flawed functioning of its system. If a state has started to getting saturated or corruption the ideologies can in fact offer answer to its doubts and questions (Ferris et al. 2017). The existence of political ideologies is essential in the functioning of politics since they can offer the possibility of change according to which the state will continue to function. Ideologies are also important for a state to achieve something, for instance with socialism which is a dominant political ideology in Scandinavian countries, Vietnam, Cuba and China is characterized by the owning and controlling of means of production by centralized government. The system is based on the tenets of egalitarianism and the principle behind the creation of socialism is to ensure a more democratic state for the people. People believed in the ideology of socialism because of its emphasis on social issues like the access to voting to have a say in government formation. At this juncture it is rather concise to understand that political ideology play the fundamental role of organizing and integrating a disorganized mass in order to achieve a number of goals like synchrony or collaboration required in the functioning of state (Ferris et al. 2017). With anarchism as a political ideology in a state which is comprised of beliefs like freedom and equality of all bestowed by those who are at governing position. The ideology of anarchism is fundamental to understand the invasion of foreign elements in the society and the role that they play. These ideologies are firm foundations upon which a society is formed with the formation of social groups with shared or conflicting political ideologies (Bartels 2016). The study of society will remain incomplete without the thorough understanding of the aspiration, conflicts and struggles of social class which will be fostered with a deep understanding of political ideologies. Without political ideologies no social theorists will be able to unify the fragments of society or understand the core reasons behind such fragmentation. In the realm of politics, ideologies help us to understand the functioning of western countries that believe in the concept of a government with limited power and the fact that government has no right to become arbitrary (Gasman 2017). A government should be the representative of people, its power equally distributed amongst the nation states (Ferris et al. 2017). This itself reflects the influence of political ideologies. Another popular ideology that has been the subject of numerous discussion is the Nazi ideology which help readers to understand how this political ideology which benefits the elite set of government officials and industrialists at the rate of ideological manipulation of the entire society (Vincent 2009). Understanding of political ideology will also give a clear concept regarding how Hitler put the concept of racial subjugation at the core o his political ideology. His ideologies hindered the intermingling of people bringing from two different classes creating shee r hostility and strife and resulting in the rise of autocratic power (Vincent 2009). It enumerates the consequences of the creation of a state that does not thrive on mutual harmony but racial supremacy and elimination of a fraction of human race. In other International states like US the dominant political ideology is divided between the Republicans and Conservatisms. The polarity of their different ideologies is apparent in their opinions on some of the core issues plaguing America currently, for instance immigrants, xenophobia and homosexuality (Ball, Dagger and ONeill 2016). Their different approaches of these individuals are not inherent nor were bestowed during birth. It is rather a slow progression of ideological interpellation, a process by which different sets of ideas and concepts tend to get ingratiated within our minds. In Australia or other International countries, ideologies have given shape to individuals identity different from the one they were born with (Kershaw 20 14). In Australia the two fundamental political parties, the Australian Labor Party and Liberal-National Party Coalition have been responsible for giving a concrete shape to the ideological beliefs and opinions of the people. A change in peoples ideologies will reflect a change in their opinion regarding the socio-economic changes taking place in Australia (Schwartz 2017). Australian cultural policy has been significant in influencing International development of rationales forming the core elements of cultural policies. From the very beginning of its functioning, the goal of Australian Labor Party has been to spread democratic socialism which sought for fair distribution of economic and political opportunities, employment rights to secure the people of their social and political rights. The birth and understanding of political ideologies is essential here to make judgments upon the functioning of the state and to shape them in a fashion as to assure the highest advantage for its people. People with an understanding of liberal ideology has the power to view its goal of promoting social welfare in order to give birth to a society which will be well-nourished spiritually and intellectually (Ball, Dagger and ONeill 2016). As a part of their political ideology, labor government has also sought to provide and nourish the cultural and artistic aspects in the society (Waldo 2017) It is therefore safe to conclude that a thorough understanding of political ideology is essential not merely for a fair understanding of political science but for the basic functioning of state and society. No society can advance without a set of well defined ideologies as its guiding light. The paper has also discussed at length the scope of contradicting ideology for an understanding of the class conflicts and the demands of dominant class in the society. Reference List: Ball, T., Dagger, R. and ONeill, D.I., 2016. Liberalism. InPolitical Ideologies and the Democratic Ideal(pp. 70-129). Routledge. Ball, T., Dagger, R. and ONeill, D.I., 2016.Political ideologies and the democratic ideal. Taylor Francis. Baradat, L.P. and Phillips, J.A., 2016.Political ideologies: Their origins and impact. Taylor Francis. Bartels, L.M., 2016.Unequal democracy: The political economy of the new gilded age. Princeton University Press. Ferris, G.R., Perrew, P.L., Daniels, S.R., Lawong, D. and Holmes, J.J., 2017. Social influence and politics in organizational research: What we know and what we need to know.Journal of Leadership Organizational Studies,24(1), pp.5-19. Gasman, D., 2017.The scientific origins of national socialism. Routledge. Kershaw, I., 2014.Hitler. Routledge. Makovi, M., 2016. Interest Groups and the Impossibility of Democratic Socialism: Hayek, Jewkes, and the Arrow Theorem. Miller78, D., 2016. Citizenship and national identity.Democracy: A Reader, p.447. Vincent, A., 2009.Modern political ideologies. John Wiley Sons. Waldo, D., 2017.The administrative state: A study of the political theory of American public administration. Routledge.

Strategic Management Service Quality Management

Question: Discuss about the Strategic Management for Service Quality Management. Answer: Introduction: With the dynamic progress of business, the organizations have to change strategies and policies in order to meet the needs and demands of customers. Every business organization while meeting the expectation of customers has to focus on strategic management so that customers from different psychological backgrounds get equal treatment from the organization. Novotel Hotel is one of the most recognizable hotels occupying a prestigious place in the soil of Brisbane (novotel.com, 2017). With the help of 4.5 premium accommodation, this particular hotel is constituted with 295 guest rooms, 24-hour services from the reception, having the presence of lobby bar, outdoor swimming pool gymnasium and sauna and so on. However, in order to draw the attention of customers from different geographical boundaries Novotel Hotel has focused to implement different strategies and policies for expanding their business more effective and to gain organizational image and reputation in the international market (novotel.com, 2017). This particular study has provided deep insight on how Novotel Hotel with the help of most innovative strategic policies would be able to draw the attention of customers for using their services. Situation Audit: Before forming business strategy and policy, an effective situation analysis is highly important. Situation analysis is conducted with the help of both external as well as internal analysis (Hoque, 2013). External analysis allows the business experts to get an in-depth overview about the political, economic, socio-cultural, technological, environmental and legal factors based on which the success of an organization is highly dependent. On the other hand, internal analysis includes evaluating the strength, weakness, opportunities and threats of an organization in order to run the entire business process in the market. However, the external environmental as well as internal factors of Novotel Hotel are as follows: SWOT analysis: Strength Flexible service process with large number of workforce strength is one of the most recognizable strengths of Novotel Hotel. The reception of this specific hotel is open for 24 hours. Therefore, the service users do not have to face any kind of problems in using the products and services of Novotel Hotel. Weakness The revenue generation of Novotel Hotel is highly dependent on the seasonal business. As a result, the business experts have to face innumerable difficulties to promote their products and services throughout the year. In order to grab the mind of international customers the marketing executives needs to conduct corporate social responsibility more effectively. As a result, the organization cannot get the scope to gain brand identity and image due to seasonal business process Opportunities Novotel Hotel is possessed with a big opportunity of expanding the entire business process beyond going the regional market of Brisbane as well as Australia. Novotel Hotel is having a scope to make a partnership as well in order to enhance internal resources. Threats Competitors market threat is one of the major concern for Novotel Hotel in order to establish their brand in the market of Australia After implementing new strategies and policies, Novotel Hotel is having a major risk whether this particular organization would be able to collaborate their business process effectively with its partner or the business experts would get an opposite reaction from the customers. Table 1: SWOT analysis (Source: Mok, Sparks Kadampully, 2013) Analysis: Novotel Hotel is possessed with large number of workforce strength. Australia is the country endowed with numerous tourists spot. Therefore, a large number of hotels have flourished their entire process of business in the soil of Australia. Brisbane is one of the most recognizable places of Australia where people from different geographical countries can easily access (Wang, Chen Chen, 2012). Therefore, the business experts of Novotel Hotel have appointed a large number of employees in order to provide effective service process to the customers. On the other hand, the entire service process of this hotel is open for twenty-four hours especially for the international customers (Mohammed Rashid, 2012). In this kind of situation, people who belong to different country do not have to face any kind of difficulties in use the service process of Novotel Hotel. This particular hotel is not possessed with some of the major drawbacks as well. Most of the hotels belonging to Australia are highly dependent on the seasonal business. As a result, people belonging to different geographical markets tend to visit the spots of Australia in winter. Therefore, the entire business process is highly dependent on some of the specific seasons. In this kind of situation, the business experts have to depend in earning the revenue at the time of peak season (Wu Lu, 2012). In order to overcome this particular challenge the business experts of Novotel Hotel intend to collaborate their business process with Village Roadshow. As a result, the experts would not have to depend on tourists only. Novotel Hotel would get more opportunity to spread their entire business in different geographical areas (Vila, Enz Costa, 2012). In order to expand the entire business in other multinational countries, business partnership for Novotel Hotel is one of the most effective solutions. On the other hand, it has been observed that partner would enable the organization to enhance their financial capital as well. Therefore, Novotel Hotel would be able to maintain corporate social responsibility more effectively for gaining image and reputation of the business organization (Evans, Stonehouse Campbell, 2012). At the same time, it is also undeniable that partnership or collaboration with different organization like Village Roadshow is possessed with several risk factors as well. The organization may not become successful in making an effective adjustment with the business partner. Employee may have to face innumerable difficulties in communicating with the new work culture (Boella Goss-Turner, 2013). Therefore, this kind of strategy may become a major risk for the business organization. Figure 1: SWOT analysis (Source: Brotherton, 2012) PESTEL analysis: Political Australia is beyond major political conflicts. The government of Australia is flexible enough to allow the business organizations for running their wings successfully. As a result, the customers do not have to face any kind of challenges in order to use the service process of Novotel Hotel. Economic Inhabitants of Australia are very much advanced in technology. Therefore, the regional inhabitants do not have to face any kind of difficulties in purchasing the products and service of Novotel Hotel. At the same time, it is undeniable that the products and service of Novotel Hotel are affordable for the low cost customers as well. Therefore, people belonging to Asian countries can easily use the facilities of Novotel Hotel. Socio-cultural Australia is possessed with people of different cultures and religious backgrounds (Cabiddu, Lui Piccoli, 2013). Therefore, the accommodations and services of Novotel Hotel are not biased at all. Various cultural people and religious inhabitants can use the products and services Novotel Hotel. Technological With the advancement of technology, customers do not have to visit directly for using the products and services of Novotel Hotel. International customers before visiting to the place can book the hotel with the help of internet. Environmental Australia is endowed with extreme weather. Therefore, people cannot visit the place in summer. Hotel industries have to spend through a challenging phase at the time of those lean seasons (Tajeddini Trueman, 2012). Legal Like every business organization, Novotel Hotel has to follow some of the major acts and regulations at the workplace. The regulations include health and safety act, right to information act, anti-discrimination act, gender equity act, data protection act and so many. Table 2: PESTEL analysis (Source: Nieves Segarra-Ciprs, 2015) Figure 2: PESTEL analysis (Source: Sigala, Christou Gretzel, 2012) Issue Statement: As per the case scenario, it has been observed that Novotel Hotel aims to expand their business in order to gain brand identity and image (Heizer Barry, 2013). For that purpose, the business experts of this particular organization have focused to implement three major strategies within the entire business process. The three major strategies include: Initiating partnership with a business organization of different industry like Village Roadshow Implementation of non-organic growth strategy in order to gather sufficient number of capital for business expansion Maintaining corporate social responsibility more effectively in order to place the brand of Novotel Hotel in the international market Alternatives: Based on the three major issues, the organization has decided to implement some alternative strategies and policies with the business process. The alternative strategies include: Implementing risk management in order to evaluate the risk analysis factors while following the business strategies Enhancing the promotional activities in order to gain global image and reputation Accumulating the financial resources by making partnership in order to expand the brand in global market SFA Evaluation criteria: With the change of environment, technology and political status of a particular country every business organization needs to change their strategy and policy. SFA is the systematic framework that enables a particular business organization to develop their strategic policy as per the situation (Fraj, Matute Melero, 2015). Novotel Hotel is not exceptional to that. The significance of SFA framework is as follows: Suitability: With the help of suitability framework the business organization like Novotel Hotel tends to evaluate whether the strategies implemented for the development of business organization like Novotel Hotel is suitable with the current market or not. After conducting an effective external and internal analysis, it has been evaluated that this particular business organization is very much dependent on seasonal business process (Nieves, Quintana Osorio, 2014). As a result, the business experts have to face challenges in meeting the needs and demands of employees at the lean months. In this kind of situation, the strategy of non-organic growth or partnership would be most suitable for enhancing the entire business process in the international market as well. Feasibility: Feasibility focuses on the facts whether the organization like Novotel Hotel has sufficient resources in order to flourish the entire business wings in the market of Australia as well as other international countries (Sainaghi, Phillips Corti, 2013). Making a partnership with Village Roadshow would help the business experts of Novotel Hotel to accumulate large number of financial resources. As a result, Novotel Hotel would be able to promote their business process more effectively. Acceptability: Acceptability primarily focuses on two major aspects that include financial aspect and stakeholder aspects. Financial aspect implies that business organizations need to be strong financially in order enhance the entire wings. In order to run the entire process of business successfully in the market the company like Novotel Hotel should have a strong economic background (FitzPatrick et al., 2013). In addition, people have to deal with the customers the aspect of stakeholder implies that business experts after implementing new business strategy and policy should wait for the reaction of stakeholder as well. If the stakeholder is not satisfied in implementing new strategy and policy, the business experts have to change the entire plan. Analysis of three options: As per the case scenario, the three major issues that have been identified for expanding the entire business process of Novotel Hotel are as follows: Analysis of the implementation of CSR activities: Corporate social responsibility is the form of business approach with the help of which a specific business organization intends to maintain sustainable development by serving social, economic and environmental benefits to the concerned stakeholder. The primary objective of maintaining an effective corporate social responsibility is to gain organizational image and reputation. CSR activity is the part of business strategy and policy (Wu Lu, 2012). This particular business strategy helps the organization to show their major concern for the society. In order to enhance the entire process of business the organization like Novotel Hotel should follow corporate social responsibility by contributing certain amount of money to the NGOs. In addition, the organization can help the employees by providing them additional benefits and facilities. As a result, employees would like to show their interest for providing good services in order to reach the business goal. Novotel Hotel can follow com munity relation for maintaining the entire process of business (Vila, Enz Costa, 2012). Community relation enables the business organization to hire the employee from local community. As a result, the business experts get necessary benefits and facilities from the community as well. Analysis of implementing non-organic growth strategy: Non-organic growth is the systematic strategy of acquiring new business with the help of business merges, acquisition, collaboration, joint venture and so on. The entire business process of Novotel Hotel is entirely based on season. Therefore, in the lean month the business experts have to face innumerable difficulties in maintaining the glory of business. The employees on the other hand get deprived of receiving remuneration at the proper time (Mok, Sparks Kadampully, 2013). As a result, they show their reluctance in providing effective service process for reaching the business target. However, in order to overcome this kind of crisis the business experts can implement one particular strategy. Non-organic growth strategy is the most effective way with the help of which people Novotel Hotel has the scope to merge their business with other company. As a result, business experts can get the scope to enhance their resources, be it physical resource or financial resource. On the other hand, the number of workforce strength also becomes high due to the business merge. As a result, the customers get necessary facilities and benefits within proper time. The customers do not have to wait for a long time in order to receive the service process (Brotherton, 2012). Therefore, non-organic growth strategy is very much effective for enhancing the business growth of Novotel Hotel. Analysis making partnership with other organization: Partnership is another way to expand the entire business process. Village Roadshow is the organization that has already spread a recognizable place in the market of mass media. By making an effective collaboration with Village Roadshow the business growth of Novotel Hotel would be enhanced. On one hand, the financial resource of two accumulated business organization would be high with the help of which the marketing managers get the scope to invest large amount of money in maintaining promotional activities (Boella Goss-Turner, 2013). At the same time, sufficient financial resource would help the organization like Novotel Hotel for maintaining an effective corporate social responsibility as well. Corporate social responsibility is most effective way to earn the business image and reputation. Partnership is possessed with some of the major drawbacks as well. If the employees fail to communicate with each other at the workplace, the customers would not get services at the proper time. On the other hand, the managers as well do not get the scope to make proper managerial decision due to cultural barriers. Therefore, before implementing partnership the business experts of Novotel Hotel should follow risk management strategy as well. Recommendation: After evaluating the entire strategic implementation, some of the major recommendations can be analyzed. The recommendations are as follows: Implementation of risk management within the business process of Novotel Hotel in order to evaluate the expected risk factors in making partnership Investing sufficient amount of money behind promotional activities in order to make the customers attractive towards the entire business process Conducting corporate social responsibility for gaining organizational image and reputation more effectively Along with implanting low cost strategy the significance of brand value strategy is equally important to draw the attention of premium customers as well Reference List: Benavides-Velasco, C. A., Quintana-Garca, C., Marchante-Lara, M. (2014). Total quality management, corporate social responsibility and performance in the hotel industry.International Journal of Hospitality Management,41, 77-87. Boella, M., Goss-Turner, S. (2013).Human resource management in the hospitality industry: A guide to best practice. Routledge. Brotherton, B. (Ed.). (2012).International Hospitality Industry. Routledge. Cabiddu, F., Lui, T. W., Piccoli, G. (2013). Managing value co-creation in the tourism industry.Annals of Tourism Research,42, 86-107. Evans, N., Stonehouse, G., Campbell, D. (2012).Strategic management for travel and tourism. Taylor Francis. FitzPatrick, M., Davey, J., Muller, L., Davey, H. (2013). Value-creating assets in tourism management: Applying marketing's service-dominant logic in the hotel industry.Tourism Management,36, 86-98. Fraj, E., Matute, J., Melero, I. (2015). Environmental strategies and organizational competitiveness in the hotel industry: The role of learning and innovation as determinants of environmental success.Tourism Management,46, 30-42. Heizer, R., Barry, R. (2013).Operation Management, Sustainability and Supply Chain management(Vol. 11). Pearson, UK. Hoque, K. (2013).Human resource management in the hotel industry: Strategy, innovation and performance. Routledge. Mohammed, A. A., Rashid, B. (2012). Customer Relationship Management (CRM) in Hotel Industry: A framework proposal on the relationship among CRM dimensions, Marketing Capabilities, and Hotel performance.International Review of Management and Marketing,2(4), 220. Mok, C., Sparks, B., Kadampully, J. (2013).Service quality management in hospitality, tourism, and leisure. Routledge. Nieves, J., Segarra-Ciprs, M. (2015). Management innovation in the hotel industry.Tourism Management,46, 51-58. Nieves, J., Quintana, A., Osorio, J. (2014). Knowledge-based resources and innovation in the hotel industry.International Journal of Hospitality Management,38, 65-73. novotel.com., (2017). Novotel Hotels: book a hotel for family holidays or business trips. (2017).Novotel.com. Retrieved 17 April 2017, from https://www.novotel.com Sainaghi, R., Phillips, P., Corti, V. (2013). Measuring hotel performance: Using a balanced scorecard perspectives approach.International Journal of Hospitality Management,34, 150-159. Sigala, M., Christou, E., Gretzel, U. (Eds.). (2012).Social media in travel, tourism and hospitality: Theory, practice and cases. Ashgate Publishing, Ltd.. Tajeddini, K., Trueman, M. (2012). Managing Swiss Hospitality: How cultural antecedents of innovation and customer-oriented value systems can influence performance in the hotel industry.International Journal of Hospitality Management,31(4), 1119-1129. Vila, M., Enz, C., Costa, G. (2012). Innovative practices in the Spanish hotel industry.Cornell Hospitality Quarterly,53(1), 75-85. Wang, C. H., Chen, K. Y., Chen, S. C. (2012). Total quality management, market orientation and hotel performance: The moderating effects of external environmental factors.International Journal of Hospitality Management,31(1), 119-129. Wu, S. I., Lu, C. L. (2012). The relationship between CRM, RM, and business performance: A study of the hotel industry in Taiwan.International Journal of Hospitality Management,31(1), 276-285.

Electronic Medical Records free essay sample

Medical record keeping has change in the last couple of decades. In the past patients records were kept in a file on paper taking up excessive room. In the past, paper charts were the only means of keeping a patient’s medical diagnoses documented. Some of these charts are still used today in healthcare facilities, however they are slowly being replaced with a more advance method; electronic medical records (EMR’s). This virtual data–information center can serve as a vehicle to promote and to disseminate standardized data definitions and best practices to providers, consumers, and others interested in quality improvement efforts nationally and internationally (Varkey, 2010). The Electronic Medical Records is an advance computerizes medical record system that delivers medical data for physician’s office and hospitals within a matter of seconds while offering care. This system allows the healthcare staff and physicians to modified, store and retrieves patient’s medical records. May God bless you! Executive Summary Most countries in Europe and the USA are increasingly using an electronic medical record (EMR) system to help improve healthcare quality. Unfortunately, The Gambia government faces a series of health crises including but not limited to HIVIAIDS, malaria, diabetes and tuberculosis. These diseases threaten the lives of thousands of people. Lack of infrastructure and trained, experienced staff are considered important barriers to scaling up treatment for these diseases. The contribution of this field proj ect outlines the benefits of an EMR system at Royal Victoria Teaching Hospital (RVTH) and how it will improve patient safety. This is a descriptive study using interview questionnaires from officials at the Royal Victoria Teaching Hospital. The study also looks into other facilities in similar developing countries with advanced systems, but not so advanced as to be at the level of state-of-the ­ art facilities in the U. S. Results from this study indicates the importance of an EMR system at RVTH to facilitate effective and efficient data collection, data entry, information retrieval and report generation. As a catalyst for development, the implementation of an EMR system at RVTH may make it one on the best hospitals in the West African region. 5 1. Introduction According to Dick and Steen, Electronic Medical Record (EMR) is the compilation of patient medical information in a computer-based format that allows the collection, storage, retrieval, and communication of this data. An electronic medical record replicates a paper chart and contains both clinical information (diagnoses, allergies, drug resistance and treatments) and demographic information about a patient; it provides a comprehensive medical picture and can be used by clinicians as a tool to determine appropriate treatment for patients. EMR is not only being welcomed by healthcare providers as a way to improve care delivery but also serves as a catalyst and gold standard for development (porter, Kohane, Goldman; Reifsteck, Swanson, Dallas). Unfortunately, Africa, a continent faced with many challenges ranging from epidemics, civil wars, and disasters, lacks robust healthcare infrastructure in the form of computerized health care systems. For instance, Ghana has one the best health institutions in the region, Korle-Bu Teaching Hospital. This Hospital, for example, is currently the only institution in the West African sub-region which performs surgery. Due to the quality of outcome, it now receives referrals from most parts of the continent namely the Gambia, Sierra Leone, Liberia, Togo Benin, Tanzania, Nigeria, Cameroon, Cote d Ivoire, and Ethiopia. Despite its exemplary performance, the hospital has no computerized information system which can help improve care delivery in the region. Therefore, the purpose of this study is to examine the potential benefits of EMR and its ultimate contribution to improving healthcare delivery development in less developed countries like The Gambia. 6 1. 1. Background of Royal Victoria Teaching Hospital The Gambia is a small country in West Africa, with a population of approximately 1. 5 million. RVTH has been in existence for over 100 years in The Gambias capital, Banjul. It used to be called Royal Victoria Hospital until in the late 1990s, when its name was changed to RVTH. The Gambian Government decided that it had to reduce its dependency on foreign doctors by establishing a medical school in the University of The Gambia (UTG). The UTG now uses RVTH to teach its clinical students. In recent years, The Gambia has been doing much on its own initiative to take to improve the healthcare of the nation. There are 540 beds in the hospital and the two largest Departments are Pediatrics and Maternity. The biggest killer disease in The Gambia is malaria, with young children and pregnant women being particularly vulnerable to this disease. Diabetes, high blood pressure, pneumonia and eye problems such as trachoma and cataracts are also major health problems. The following table provides an estimation of how many patients were seen at RVTH in the year 2008. Procedure Inpatient Admissions Children admitted to Pediatrics Patients treated in the Eye Center Out-Patient Appointments Out-Patients in the ER Number of Patients 25,281 9,352 986 over 184,365 24,334 Table 1: Number of patients seen at RVTH in 2008 7 Unfortunately, RVTH does not have any EMR system in place to facilitate patient safety. As noted by participants, EMR software is not used at RVTH because administration keeps complaining of money. It looks expensive to them and also they are more used to the paper folder. Currently, information is very fragmented and therefore does very little to help patient safety and consistency in care. Another important issue here is that a large number of these patients are illiterates. To ensure they receive the appropriate treatment, they will have to explain to the physician current medications they are taking etc. This can be a very challenging and fatal to the patient sometimes. The typical paper medical record contains sections including information on demographics, admissions, discharge summaries, progress notes, protocols, laboratory results, radiology results, surgical and pathology reports, orders for, treatment and nursing notes. Most documentation regarding treatment of a patient is written directly in the patients medical chart. On a given day a patient arrives at the hospital for care, sign in his name and waits anywhere from 30 minutes to six hours o get their records pulled depending on the day. Physicians, nurses, medical residents who need access the information in the medical record must wait till its available. Typically, medical records are transported to the outpatient clinic where the patient would be seen, and then returned to storage center to be filed again. It is necessary for the medical record to follow the patient throughout their visit. If the patient was seen in one clinic where orders were written, it was necessary to physically transport the record when the patient moved to the medicine room for treatment. The purpose of this field project is to examine the potential benefits of an EMR system and its ultimate contribution to improving patient safety at the Royal Victoria Teaching Hospital in The Gambia. 9 2. Literature Review The first generation of EMRs was extensions of medical billing systems in large US hospitals. Over the last four decades, they have been used as tools to organize and store medical data. EMRs are widely accepted as important tools to support high quality health care in the US, Europe and other developed countries. Evidence shows that using EMRs that include decision support systems improves quality of care and both reduce medical errors and unnecessary medical investigations (Partners in Health), Experience with the use of EMRs in developing countries, if available, is much more limited than it is in the US and Europe. Now there is considerable interest in using medical information systems to support the treatment of HIV and TB in Africa, Latin America, and Asia. In most African countries, healthcare information systems have been driven mainly by the need to report aggregate statistics for government or funding agencies. Such data collection can be performed with simple paper forms at the clinic level, with all electronic data entry done centrally, but that approach tends to be difficult and time ­ consuming and may provide little or no feedback to the staff collecting data. Individual patient data that are collected and accessible at the point of care can support clinical management. Clinicians can easily access previous records, and simple tools can be incorporated to warn of potential problems such as incompatible drugs. Physicians or nurses can check on the outcomes of individuals or groups of patients and perform research studies. Many of these functions will work well on paper or with simple spreadsheets for up to 100 patients but become very time-consuming and potentially unreliable with more than 1,000 records, and virtually impossible with 10,000 or more. 10 Experience with the use ofEMRs in developing countries is much more limited than it is in the US and Europe, but there is now considerable interest in using medical information systems to support the treatment of HIV and TB in Africa. Some examples of EMR use in Africa include: †¢ The Regenstrief Institute in collaboration with Moi University in Kenya developed an EMR for general patient visits to clinics in western Kenya. This system was subsequently modified to support the care of several thousand HIV patients. †¢ Baobab Health Partnership in Malawi has developed an EMR system using innovative, low-power touch-screen PCs for data entry and display. This system is now used to support the care of more than 7,000 HIV patients in the Lighthouse clinic in Lilongwe and has been chosen by the national HIV program for use throughout the country. [emailprotected], an HIV medical information system developed for US patients, has now been deployed in Uganda and is planned for use in other African countries and in Latin America. (Partners In Health) A wide-ranging literature review of electronic medical record implementation over the past decade reveals that clinical, workflow, administrative, and revenue enhancem ent benefits of the EMR outweigh barriers and challenges. Among other key efforts, organizations must train and motivate users to navigate EMR systems, as well as develop a common structured language. Clinicians who used CPRs found that electronic 11 access to clinical infonnation saves time and provides a thorough and efficient way to manage patient information To reap the full benefits of an EMR, organizations must redesign current workflows and practices to evolve into efficient providers of care. EMR systems are developed to meet the following goals: improve quality of care, reduce organizational expense, and produce a data stream for electronic billing. (Dassenko and Slowinski). The EMR meets these goals through workflow automation, connectivity, and data mining. (Gaillour) The Computer-based Patient Record Institutes (CPRI) definition concurred with the other researchers, but added that the EMR provides protection of patient and provider confidentiality, has a defined vocabulary and standardized coding, produces documentation as a by-product of patient care, connects local and remote systems and provides electronic support for secondary users (payers, policymakers, researchers). Fromberg and Arnatayakul) Unfortunately, most EMR systems are unable to offer all of the components defined by the CPRI because the technology is too complex and too expensive, doctors wont use computers, and standards dont exist. (Gaillour) The advantages associated with implementing EMRs are well documented and are straightforward. The difficulty comes with placing a dollar figure to these advantages; consequently, few organizations have published studies describing the actual cos ts and benefits attained from implementing EMRs. Bingham) The benefits associated with CPRs are organized into four categories: clinical, workflow, administrative, and revenue enhancement. Renner, states that measuring all the benefits associated with EMRs is 12 virtually impossible, and that it is probably safe to select those that can make the greatest financial difference, and incorporate them into a financial model. Clinical benefits seen after implementing an EMR include: better access to the chart, improved clinical decision making and disease management, enhanced documentation, simplified patient education, and increased free time to spend with patients, accompanied by improved perception of care and quality of work life. These benefits ultimately result in better delivery ofpatient care and safety. Despite all of these benefits, EMRs are not a standard in todays healthcare systems. It is evident that EMR technology is still a hot topic for discussion when browsing through current healthcare technology and management journals. The following barriers have kept healthcare leaders discussing EMR technology instead of adopting it: cost, leadership, ROI, vendors keeping up with users needs, and deficits in the following categories: public policy, standards, security, and a true definition. First of all, cost has kept organizations from implementing EMR systems. These costs can be organized into the following categories: software, hardware, infrastructure development and maintenance, implementation, education, planning, and administration. Software costs include development or purchase, maintenance, and upgrades over time, while hardware costs include purchase of workstations. (Mohr) Infrastructure development and maintenance costs include servers, interfaces, workstations, network cables, network maintenance, and help desk operations. Planning costs include development of an implementation plan, identifying measurable outcomes, and choosing meaningful metrics and goals, while implementation costs include training, overtime 13 ssociated with entering patient data, business disruption during transition, employee resistance to change, and lost productivity. Drazen, suggested that leadership was probably a more significant barrier than cost because, in the past, healthcare leaders have raised capital for essential business initiatives such as major building programs, acquiring a physician network, or starting up a managed care organization. This amount of capital is on the same scale as an EMR. Next, Drazen stated that a lack of government support is a major issue holding up EMR implementation.