Wilderness Therapy An Alternative Therapy - 1442 Words

Wilderness Therapy The wilderness is a place known for peacefulness and can have physical and psychological benefits (Hassell, Moore Macbeth, 2015). Wilderness therapy is an alternative therapy, influenced by Outward Bound, which is an outdoor education company with programs for youth and adults. (Hoag, Massey, Roberts, Logan, 2013). Wilderness therapy combines group work, reflection, challenges and trust building exercises, varied length, and clinical assessment (Russell, 2001). Wilderness therapy should be therapeutic based, and by integrating a balance between a nurturing safe environment with an environment where the participants try new things and challenge themselves (Russell, 2001). The best way for wilderness therapy to be effective is using nature as a healer and a challenger, using eclectic therapy such as cognitive behavioral and experiential, alone time to reflect and challenges to complete solo, learning communication skills, and having steps to complete or rites of pa ssage (Russell, Hendee, Phillips-Miller (2000). These different aspects of wilderness therapy will help to aid patients’ in following three phases (Russell et al., 2000). The first phase is the cleansing phase and involves promoting a healthy diet and exercise, removing any toxins such as drugs and alcohol from a patients life and system, and ridding the patients life of outside stimuli such as technology and music. The patient should also be taught basic wilderness survival skills duringShow MoreRelatedThe Alternative Treatment Of Wilderness Therapy861 Words   |  4 Pagesbe overwhelming. There are many different treatment and therapy options. There are options such as inpatient and outpatient homes. Outpatient therapy treatment may not be enough for those who are heavily addicted and some inpatient programs can last anywhere from up to six to twelve months. Wilderness therapy proves to be a positive alternative treatment in rehabilitating adolescents. Wilderness Therap y is a more successful means of therapy for adolescence who are struggling with addiction becauseRead MoreEssay on Wilderness Therapy and Conventional Therapy1696 Words   |  7 Pagesmore difficult to treat with conventional therapy, there is a greater need for more modern and creative therapy. Even more so, individuals are seeking treatment at a younger age and need more interventions to fit their needs. Wilderness therapy is a newer intervention found to be effective with youth and adolescents. This paper will examine the major components of wilderness therapy, the mental health disorders treated, the setting in which wilderness therapy is used, the appropriate client populationsRead MoreThe Success Rate Of An Alcohol Treatment Center918 Words   |  4 Pagescognitive-behavior therapy will help you find healthier coping methods. Aftercare – attending regular meetings to keep your counselors assessed of your progress. Aftercare can also include sober living tips (such as how to turn down drinks at a holiday party), job placement help, and more. Alternative treatment options – designed for people who have struggled with the 12-Step program or whom simply want a different option. These treatments include dialectical behavior therapy, massage therapy, wilderness treatmentsRead MoreJuvenile Sex Offenders Essay example2573 Words   |  11 Pagestreatments used to manage juvenile sex offenders is also a growing concern. To understand and determine the proposed treatment methods, several related issues will need to be reviewed such as traditional sex offender therapy methods like cognitive therapy and alternative therapies like wilderness camps. Once, the juvenile sex offender becomes part of the justice system the cost of rehabilitated or incarcerating the juvenile also must be discussed. The disposition for juvenile sex offenders should be personalizedRead MoreCrisis Intervention Essay1506 Words   |  7 Pagesis determined by the individuals view of the event and response to it. If the individual sees the event as sig nificant and threatening, has exhausted all his/her usual coping strategies without effect, and is unaware or unable to pursue other alternatives, then the precipitating event may push the individual toward psychological disequilibrium, a state of crisis (Smead, 1988). Psychological disequilibrium may be characterized by feelings of anxiety, helplessness, fear, inadequacy, confusion, agitationRead MoreThe Juvenile System And Juvenile Corrections System1740 Words   |  7 Pagesprovide some type of treatment for the youth involved and their goal is to get them back in their communities as positive contributors. Wilderness Programs Wilderness programs are a unique aspect of the juvenile corrections system. The youth in these programs are taken out of their communities unlike the day treatment or group home setting. In the wilderness program, they are distracted by being far away from trouble and are kept busy by being placed in challenging situations. For example theyRead MoreTreatment Programs For Drug Treatment Program1302 Words   |  6 Pagestype of treatment program. Other treatment programs include educational, vocational, and recreational programs, group programs, individual treatment programs such as individual counseling, psychotherapy, reality therapy, and behavior modification, juvenile correctional programs, and wilderness programs. Treatment programs can also include residential treatment centers, training schools, youth authority, and aftercare. Each one of these programs provides a different type of treatment. They help differentRead MoreOf All The Violent Crimes In America, Sexual Assault Has1 116 Words   |  5 PagesFor example, you have what is called the cognitive therapy which is an effective and go to method of treatment. The purpose for this program is for these delinquents to take responsibility for their harmful actions and block out the thinking errors in which these young teens use as an excuse to justify their abuse towards another child (Dopp, 2015). Another type of treatment is the multisystemic therapy (MST). Basically, this is another alternative treatment program that is designed to make positiveRead More Ecopsychology Essay3891 Words   |  16 Pagesrecycle, which proved to be quite ineffective. Ecopsychology, in contrast, attempts to create positive and affirming motivations, derived from a bond of love and loyalty to nature (Bayland, 1995). Before tackling the principles, religious aspects, therapy, actions and education included in ecopsychology, it is essential to understand the reasons why humans need to change. Need for Change Because of the present industrial and technological age, most people already know humans are not living sustainablyRead MoreEssay on Sex Offender Treatment: A Literature Review2328 Words   |  10 Pagesbehavior. The body of research reveals different therapeutic treatment models and discusses the purpose and effectiveness of each model. This paper will also discuss some of the challenges of implementing therapeutic treatment schemas as viable alternatives to treat sex offenders. Lastly, the research will also examine the impact of treatment as it relates to recidivism. Sex Offender Treatment: A Literature Review The United States Bureau of Justice Statistics (2011) reveals an estimated

Ocean Acidification And Its Effect On The Oceans - 1727 Words

The mid to late twentieth century and the twenty first century have been devastating to the world’s oceans in terms of pollution, overfishing, ice caps melting, destruction of habitat, and increasing amounts carbon dioxide being dissolved into the water. These are only a few of the seemingly endless problems humans have introduced to the oceans. Things like the ice caps melting affect how basic aspects of the oceans function. Pollution and destruction of habitat affect nearly every species of marine organism. Fish die from toxic waste, turtles and sharks get caught in nets, and birds eat plastic. Overfishing depletes the population of certain species and throws entire food chains off balance. A combination of things affects fish and†¦show more content†¦With emissions from cars and deforestation at an all time high, so is the amount of carbon dioxide being dissolved into the world’s oceans. There are seemingly endless things people could be doing to help stop this, but don’t. This is because ocean acidification is one of the least advocated problems. Ocean acidification is one of the largest factors affecting today’s oceans and affects every ocean organism. The first organisms that ocean acidification affects are calcifying creatures. These include creatures like oysters, calcareous plankton, clams, sea urchins, and coral. The ocean normally has enough carbonate ions dissolved for calcifying creatures to use to create their shells. Ocean acidification negatively affects the ability for these organisms to build their shells. As carbon dioxide dissolves into the ocean it reacts with the water to form carbonic acid (What is Ocean, 2015). Also, as more carbon dioxide dissolves into the ocean, it reacts with seawater to make H+ ions. These H+ ions compete with calcifying creatures for the carbonate ions. The H+ ions often win making it much more difficult for these shelled creatures to make their shells (Cripps et al., 2014). C reatures like conch shells, oysters, and clams are the most negatively affected. But not all creatures are immediately affected. Some organisms such as crabs and lobsters and crabs actually grow heavier shells to combat the effects of changing pH. This adaptation

Organizational Competency for Management - myassignmenthelp.com

Question: Discuss about theOrganizational Competency for Finance and Management. Answer: The term organizational competency means the capability to job properly in an organization. It defines a set of behaviour that provides a structured guide that enables the identification, evaluation and development of the individual behaviour in each employees. In an organization when it creates a competitive advantages in the market place with its typical skills and activities it is termed as organizational competency(Tripathi Agrawal, 2014). The IKEA Company tries to improve the everyday life of the organization where the human resource manager clarifies the mission statement of improving the lifestyle in the organization. The company is targeting to create better life by lowering the price of the goods to attract more customers for their product. The human resource manager designs the strategy of the company for short term and long term objectives and design effective strategies to maintain it(Grlin Kostet, 2016). The role of the HR is very important here as he will determine the future of the company. The HRs design and steps will help the company to maintain its position in the market. The HR manager and the team is responsible for this and thus they should analyse the real result and evaluate them with the general strategies. The competency that the company is using has helped the company to reach a new height in the market. Hence, the HR should maintain the same standard of the company by implementing new and innov ative idea to carry on the company name in future days. Reference: Grlin, K., Kostet, M. (2016). Change Through Transformation: An exploratory case study on leadership in contrasting organisational contexts of IKEA Sweden. Tripathi, K., Agrawal, M. (2014). Competency based management in organizational.Global Journal of Finance and Management,6(4), 349-356.

C. Wright Mills- The Power Elite free essay sample

The powers of ordinary men are circumscribed by the everyday worlds in which they live, yet even in these rounds of job, family, and neighborhood they often seem driven by forces they can neither understand nor govern. Great changes are beyond their control, but affect their conduct and outlook none the less. The very framework of modern society confines them to projects not their own, but from every side, such changes now press upon the men and women of the mass society, who accordingly feel that they are without purpose in an epoch in which they are without power. But not all men are in this sense ordinary. As the means of information and of power are centralized, some men come to occupy positions in American society from which they can look down upon, so to speak, and by their decisions mightily affect, the everyday worlds of ordinary men and women. They are not made by their jobs; they set up and break down jobs for thousands of others; they are not confined by simple family responsibilities; they can escape. They may live in many hotels and houses, but they are bound by no one community. They need not merely meet the demands of the day and hour; in some part, they create these demands, and cause others to meet them. Whether or not they profess their power, their technical and political experience of it far transcends that of the underlying population. What Jacob Burckhardt said of great men, most Americans might well say of their elite: They are all that we are not. The power elite is composed of men whose positions enable them to transcend the ordinary environments of ordinary men and women; they are in positions to make decisions having major consequences. Whether they do or do not make such decisions is less important than the fact that they do occupy such pivotal positions: their failure to act, their failure to make decisions, is itself an act that is often of greater consequence than the decisions they do make. For they are in command of the major hierarchies and organizations of modern society. They rule the big corporations. They run the machinery of the state and claim its prerogatives. They direct the military establishment. They occupy the strategic command posts of the social structure, in which are now centered the effective means of the power and the wealth and the celebrity which they enjoy. The power elite are not solitary rulers. Advisers and consultants, spokesmen and opinion-makers are often the captains of their higher thought and decision. Immediately below the elite are the professional politicians of the middle levels of power, in the Congress and in the pressure groups, as well as among the new and old upper classes of town and city and region. Mingling with them, in curious ways which we shall explore, are those professional celebrities who live by being continually displayed but are never, so long as they remain celebrities, displayed enough If such celebrities are not at the head of any dominating hierarchy, they do often have the power to distract the attention of the public or afford sensations to the masses, or, more directly, to gain the ear of those who do occupy positions of direct power. More or less unattached, as critics of morality and technicians of power, as spokesmen of God and creators of mass sensibility, such celebrities and consultants are part of the immediate scene in which the drama of the elite is enacted. But that drama itself is centered in the command posts of the major institutional hierarchies. The truth about the nature and the power of the elite is not some secret which men of affairs know but will not tell. Such men hold quite various theories about their own roles in the sequence of event and decision. Often they are uncertain about their roles, and even more often they allow their fears and their hopes to affect their assessment of their own power. No matter how great their actual power, they tend to be less acutely aware of it than of the resistances of others to its use. Moreover, most American men of affairs have learned well the rhetoric of public relations, in some cases even to the point of using it when they are alone, and thus coming to believe it. The personal awareness of the actors is only one of the several sources one must examine in order to understand the higher circles. Yet many who believe that there is no elite, or at any rate none of any consequence, rest their argument upon what men of affairs believe about themselves, or at least assert in public. There is, however, another view: those who feel, even if vaguely, that a compact and powerful elite of great importance does now prevail in America often base that feeling upon the historical trend of our time. They have felt, for example, the domination of the military event, and from this they infer that generals and admirals, as well as other men of decision influenced by them, must be enormously powerful. They hear that the Congress has again abdicated to a handful of men decisions clearly related to the issue of war or peace. They know that the bomb was dropped over Japan in the name of the United States of America, although they were at no time consulted about the matter. They feel that they live in a time of big decisions; they know that they are not making any. Accordingly, as they consider the present as history, they infer that at its center, making decisions or failing to make them, there must be an elite of power. On the one hand, those who share this feeling about big historical events assume that there is an elite and that its power is great. On the other hand, those who listen carefully to the reports of men apparently involved in the great decisions often do not believe that there is an elite whose powers are of decisive consequence. Both views must be taken into account, but neither is adequate. The way to understand the power of the American elite lies neither solely in recognizing the historic scale of events nor in accepting the personal awareness reported by men of apparent decision. Behind such men and behind the events of history, linking the two, are the major institutions of modern society. These hierarchies of state and corporation and army constitute the means of power; as such they are now of a consequence not before equaled in human history-and at their summits, there are now those command posts of modern society which offer us the sociological key to an understanding of the role of the higher circles in America. Within American society, major national power now resides in the economic, the political, and the military domains. Other institutions seem off to the side of modern history, and, on occasion, duly subordinated to these. No family is as directly powerful in national affairs as any major corporation; no church is as directly powerful in the external biographies of young men in America today as the military establishment; no college is as powerful in the shaping of momentous events as the National Security Council. Religious, educational, and family institutions are not autonomous centers of national power; on the contrary, these decentralized areas are increasingly shaped by the big three, in which developments of decisive and immediate consequence now occur. Families and churches and schools adapt to modern life; governments and armies and corporations shape it; and, as they do so, they turn these lesser institutions into means for their ends. Religious institutions provide chaplains to the armed forces where they are used as a means of increasing the effectiveness of its morale to kill. Schools select and train men for their jobs in corporations and their specialized tasks in the armed forces. The extended family has, of course, long been broken up by the industrial revolution, and now the son and the father are removed from the family, by compulsion if need be, whenever the army of the state sends out the call. And the symbols of all these lesser institutions are used to legitimate the power and the decisions of the big three. The life-fate of the modern individual depends not only upon the family into which he was born or which he enters by marriage, but increasingly upon the corporation in which he spends the most alert hours of his best years; not only upon the school where he is educated as a child and adolescent, but also upon the state which touches him throughout his life; not only upon the church in which on occasion he hears the word of God, but also upon the army in which he is disciplined. If the centralized state could not rely upon the inculcation of nationalist loyalties in public and private schools, its leaders would promptly seek to modify the decentralized educational system, If the bankruptcy rate among the top five hundred corporations were as high as the general divorce rate among the thirty-seven million married couples, there would be economic catastrophe on an international scale. If members of armies gave to them no more of their lives than do believers to the churches to which they belong, there would be a military crisis. Within each of the big three, the typical institutional unit has become enlarged, has become administrative, and, in the power of its decisions, has become centralized. Behind these developments there is a fabulous technology, for as institutions, they have incorporated this technology and guide it, even as it shapes and paces their developments. The economy-once a great scatter of small productive units in autonomous balance-has become dominated by two or three hundred giant corporations, administratively and politically interrelated, which together hold the keys to economic decisions. The political order, once a decentralized set of several dozen states with a weak spinal cord, has become a centralized, executive establishment which has taken up into itself many powers previously scattered, and now enters into each and every crany of the social structure. The military order, once a slim establishment in a context of distrust fed by state militia, has become the largest and most expensive feature of government, and, although well versed in smiling public relations, now has all the grim and clumsy efficiency of a sprawling bureaucratic domain. In each of these institutional areas, the means of power at the disposal of decision makers have increased enormously; their central executive powers have been enhanced; within each of them modern administrative routines have been elaborated and tightened up. As each of these domains becomes enlarged and centralized, the consequences of its activities become greater, and its traffic with the others increases. The decisions of a handful of corporations bear upon military and political as well as upon economic developments around the world. The decisions of the military establishment rest upon and grievously affect political life as well as the very level of economic activity. The decisions made within the political domain determine economic activities and military programs. There is no longer, on the one hand, an economy, and, on the other hand, a political order containing a military establishment unimportant to politics and to money-making. There is a political economy linked, in a thousand ways, with military institutions and decisions. On each side of the world-split running through central Europe and around the Asiatic rimlands, there is an ever-increasing interlocking of economic, military, and political structures. If there is government intervention in the corporate economy, so is there corporate intervention in the governmental process. In the structural sense, this triangle of power is the source of the interlocking directorate that is most important for the historical structure of the present. The fact of the interlocking is clearly revealed at each of the points of crisis of modern capitalist society-slump, war, and boom. In each, men of decision are led to an awareness of the interdependence of the major institutional orders. In the nineteenth century, when the scale of all institutions was smaller, their liberal integration was achieved in the automatic economy, by an autonomous play of market forces, and in the automatic political domain, by the bargain and the vote. It was then assumed that out of the imbalance and friction that followed the limited decisions then possible a new equilibrium would in due course emerge. That can no longer be assumed, and it is not assumed by the men at the top of each of the three dominant hierarchies. For given the scope of their consequences, decisions-and indecisions-in any one of these ramify into the others, and hence top decisions tend either to become coordinated or to lead to a commanding indecision. It has not always been like this. When numerous small entrepreneurs made up the economy, for example, many of them could fail and the consequences still remain local; political and military authorities did not intervene. But now, given political expectations and military commitments, can they afford to allow key units of the private corporate economy to break down in slump? Increasingly, they do intervene in economic affairs, and as they do so, the controlling decisions in each order are inspected by agents of the other two, and economic, military, and political structures are interlocked. At the pinnacle of each of the three enlarged and centralized domains, there have arisen those higher circles which make up the economic, the political, and the military elites. At the top of the economy, among the corporate rich, there are the chief executives; at the top of the political order, the members of the political directorate; at the top of the military establishment, the elite of soldier-statesmen clustered in and around the Joint Chiefs of Staff and the upper echelon. As each of these domains has coincided with the others, as decisions tend to become total in their consequence, the leading men in each of the three domains of power-the warlords, the corporation chieftains, the political directorate-tend-to come together, to form the power elite of America. *** The Power Elite by C. Wright Mills Oxford Press, 1956 In the standard image of power and decision, no force is held to be as important as The Great American Public. More than merely another check and balance, this public is thought to be the seat of all legitimate power. In official life as in popular folklore, it is held to be the very balance wheel of democratic power. In the end, all liberal theorists rest their notions of the power system upon the political role of this public; all official decisions, as well as private decisions of consequence, are justified as in the publics welfare; all formal proclamations are in its name. Let us therefore consider the classic public of democratic theory in the generous spirit in which Rousseau once cried, Opinion, Queen of the World, is not subject to the power of kings; they are themselves its first slaves. The most important feature of the public of opinion, which the rise of the democratic middle class initiates, is the free ebb and flow of discussion. The possibilities of answering back, of organizing autonomous organs of public opinion, of realizing opinion in action, are held to be established by democratic institutions. The opinion that results from public discussion is understood to be a resolution that is then carried out by public action; it is, in one version, the general will of the people, which the legislative organ enacts into law, thus lending to it legal force. Congress, or Parliament, as an institution, crowns all the scattered publics; it is the archetype for each of the little circles of face-to-face citizens discussing their public business. This eighteenth-century idea of the public of public opinion parallels the economic idea of the market of the free economy. Here is the market composed of freely competing entrepreneurs; there is the public composed of discussion circles of opinion peers. As price is the result of anonymous, equally weighted, bargaining individuals, so public opinion is the result of each mans having thought things out for himself and contributing his voice to the great chorus. To be sure, some might have more influence on the state of opinion than others, but no one group monopolizes the discussion, or by itself determines the opinions that prevail. Innumerable discussion circles are knit together by mobile people who carry opinions from one to another, and struggle for the power of larger command. The public is thus organized into associations and parties, each representing a set of viewpoints, each trying to acquire a place in the Congress, where the discussion continues. Out of the little circles of people talking with one another, the larger forces of social movements and political parties develop; and the discussion of opinion is the important phase in a total act by which public affairs are conducted. The autonomy of these discussions is an important element in the idea of public opinion as a democratic legitimation. The opinions formed are actively realized within the prevailing institutions of power; all authoritative agents are made or broken by the prevailing opinions of these publics. And, in so far as the public is frustrated in realizing its demands, its members may go beyond criticism of specific policies; they may question the very legitimations of legal authority. That is one meaning of Jeffersons comment on the need for an occasional revolution. The public, so conceived, is the loom of classic, eighteenth-century democracy; discussion is at once the threads and the shuttle, tying the discussion circles together. It lies at the root of the conception of authority by discussion, and it is based upon the hope that truth and justice will somehow come out of society as a great apparatus of free discussion. The people are presented with problems. They discuss them. They decide on them. They formulate viewpoints. These viewpoints are organized, and they compete. One viewpoint wins out. Then the people act out this view, or their representatives are instructed to act it out, and this they promptly do. Such are the images of the public of classic democracy which are still used as the working justifications of power in American society. But now we must recognize this description as a set of images out of a fairy tale: they are not adequate even as an approximate model of how the American system of power works. The issues that now shape mans fate are neither raised nor decided by the public at large. The idea of the community of publics is not a description of fact, but an assertion of an ideal, an assertion of a legitimation masquerading-as legitimations are now apt to do-as fact. For now the public of public opinion is recognized by all those who have considered it carefully as something less than it once was. These doubts are asserted positively in the statement that the classic community of publics is being transformed into a society of masses. This transformation, in fact, is one of the keys to the social and psychological meaning of modern life in America. I. In the democratic society of publics it was assumed, with John Locke, that the individual conscience was the ultimate seat of judgment and hence the final court of appeal. But this principle was challenged-as E. H. Carr has put it-when Rousseau for the first time thought in terms of the sovereignty of the whole people, and faced the issue of mass democracy. II. In the democratic society of publics it was assumed that among the individuals who composed it there was a natural and peaceful harmony of interests. But this essentially conservative doctrine gave way to the Utilitarian doctrine that such a harmony of interests had first to be created by reform before it could work, and later to the Marxian doctrine of class struggle, which surely was then, and certainly is now, closer to reality than any assumed harmony of interests. III. In the democratic society of publics it was assumed that before public action would be taken, there would be rational discussion between individuals which would determine the action and that, accordingly, the public opinion that resulted would be the infallible voice of reason. But this has been challenged not only ( 1 ) by the assumed need for experts to decide delicate and intricate issues, but (2) by the discovery-as by Freud-of the irrationality of the man in the street, and (3) by the discovery- as by Marx-of the socially conditioned nature of what was once assumed to be autonomous reason. IV. In the democratic society of publics it was assumed that after determining what is true and right and just, the public would act accordingly or see that its representatives did so. In the long run, public opinion will not only be right, but public opinion will prevail. This assumption has been upset by the great gap now existing between the underlying population and those who make decisions in its name, decisions of enormous consequence which the public often does not even know are being made until well after the fact. *** Public opinion exists when people who are not in the government of a country claim the right to express political opinions freely and publicly, and the right that these opinions should influence or determine the policies, personnel, and actions of their government. In this formal sense there has been and there is a definite public opinion in the United States. And yet, with modern developments this formal right-when it does still exist as a right -does not mean what it once did. The older world of voluntary organization was as different from the world of the mass organization, as was Tom Paines world of pamphleteering from the world of the mass media. Since the French Revolution, conservative thinkers have Viewed With Alarm the rise of the public, which they called the masses, or something to that effect. The populace is sovereign, and the tide of barbarism mounts, wrote Gustave Le Bon. The divine right of the masses is about to replace the divine right of kings, and already the destinies of nations are elaborated at present in the heart of the masses, and no longer in the councils of princes. During the twentieth century, liberal and even socialist thinkers have followed suit, with more explicit reference to what we have called the society of masses. From Le Bon to Emil Lederer and Ortega y Gasset, they have held that the influence of the mass in unfortunately increasing. But surely those who have supposed the masses to be all powerful, or at least well on their way to triumph, are wrong. In our time, as Chakhofin knew, the influence of autonomous collectivities within political life is in fact diminishing. Furthermore, such influence as they do have is guided; they must now be seen not as publics acting autonomously, but as masses manipulated at focal points into crowds of demonstrators. For as publics become masses, masses sometimes become crowds; and, in crowds, the psychical rape by the mass media is supplemented up-close by the harsh and sudden harangue. Then the people in the crowd disperse again-as atomized and submissive masses. In all modern societies, the autonomous associations standing between the various classes and the state tend to lose their effect as vehicles of reasoned opinion and instruments for the rational exertion of political will. Such associations can be deliberately broken up and thus turned into passive instruments of rule, or they can more slowly wither away from lack of use in the face of centralized means of power. But whether they are destroyed in a week or wither in a generation, such associations are replaced in virtually every sphere of life by centralized organizations, and it is such organizations with all their new means of power that take charge of the terrorized or-as the case may be-merely intimidated, society of masses. The institutional trends that make for a society of masses are to a considerable extent a matter of impersonal drift, but the remnants of the public are also exposed to more personal and intentional forces. With the broadening of the base of politics within the context of a folk-lore of democratic decision-making, and with the increased means of mass persuasion that are available, the public of public opinion has become the object of intensive efforts to control, manage, manipulate, and increasingly intimidate. In political, military, economic realms, power becomes, in varying degrees, uneasy before the suspected opinions of masses, and, accordingly, opinion-making becomes an accepted technique of power-holding and power-getting. The minority electorate of the propertied and the educated is replaced by the total suffrage-and intensive campaigns for the vote. The small eighteenth-century professional army is replaced by the mass army of conscripts-and by the problems of nationalist morale. The small shop is replaced by the mass-production industry-and the national advertisement. As the scale of institutions has become larger and more centralized, so has the range and intensity of the opinion-makers efforts. The means of opinion-making, in fact, have paralleled in range and efficiency the other institutions of greater scale that cradle the modern society of masses. Accordingly, in addition to their enlarged and centralized means of administration, exploitation, and violence, the modern elite have had placed within their grasp historically unique instruments of psychic management and manipulation, which include universal compulsory education as well as the media of mass communication. Early observers believed that the increase in the range and volume of the formal means of communication would enlarge and animate the primary public. In such optimistic views-written before radio and television and movies-the formal media are understood as simply multiplying the scope and pace of personal discussion. Modern conditions, Charles Cooley wrote, enlarge indefinitely the competition of ideas, and whatever has owed its persistence merely to lack of comparison is likely to go, for that which is really congenial to the choosing mind will be all the more cherished and increased. Still excited by the break-up of the conventional consensus of the local community, he saw the new means of communication as furthering the conversational dynamic of classic democracy, and with it the growth of rational and free individuality. No one really knows all the functions of the mass media, for in their entirety these functions are probably so pervasive and so subtle that they cannot be caught by the means of social research now available. But we do now have reason to believe that these media have helped less to enlarge and animate the discussions of primary publics than to transform them into a set of media markets in mass-like society. *** In their attempts to neutralize or to turn to their own use the articulate public, the opinion-makers try to make it a relay network for their views. If the opinion-makers have so much power that they can act directly and openly upon the primary publics, they may become authoritative; but, if they do not have such power and hence have to operate indirectly and without visibility, they will assume the stance of manipulators. Authority is power that is explicit and more or less voluntarily obeyed; manipulation is the secret exercise of power, unknown to those who are influenced. In the model of the classic democratic society, manipulation is not a problem, because formal authority resides in the public itself and in its representatives who are made or broken by the public. In the completely authoritarian society, manipulation is not a problem, because authority is openly identified with the ruling institutions and their agents, who may use authority explicitly and nakedly. They do not, in the extreme case, have to gain or retain power by hiding its exercise. Manipulation becomes a problem wherever men have power that is concentrated and willful but do not have authority, or when, for any reason, they do not wish to use their power openly. Then the powerful seek to rule without showing their powerfulness. They want to rule, as it were, secretly, without publicized legitimation. It is in this mixed case-as in the intermediate reality of the American today-that manipulation is a prime way of exercising power. Small circles of men are making decisions which they need to have at least authorized by indifferent or recalcitrant people over whom they do not exercise explicit authority. So the small circle tries to manipulate these people into willing acceptance or cheerful support of their decisions or opinions-or at least to the rejection of possible counter-opinions. Authority formally resides in the people, but power is in fact held by small circles of men. That is why the standard strategy of manipulation is to make it appear that the people, or at least a large group of them, really made the decision. That is why even when the authority is available, men with access to it may still prefer the secret, quieter ways of manipulation. But are not the people now more educated? Why not emphasize the spread of education rather than the increased effects of the mass media? The answer, in brief, is that mass education, in many respects, has become-another mass medium. The prime task of public education, as it came widely to be understood in this country, was political: to make the citizen more knowledgeable and thus better able to think and to judge of public affairs. In time, the function of education shifted from the political to the economic: to train people for better-paying jobs and thus to get ahead. This is especially true of the high-school movement, which has met the business demands for white-collar skills at the publics expense. In large part education has become merely vocational; in so far as its political task is concerned, in many schools, that has been reduced to a routine training of nationalist loyalties. The training of skills that are of more or less direct use in the vocational life is an important task to perform, but ought not to be mistaken for liberal education: job advancement, no matter on what levels, is not the same as self-development, although the two are now systematically confused. Among skills, some are more and some are less relevant to the aims of liberal-that is to say, ]liberating-education. Skills and values cannot be so easily separated as the academic search for supposedly neutral skills causes us to assume. And especially not when we speak seriously of liberal education. Of course, there is a scale, with skills at one end and values at the other, but it is the middle range of this scale, which one might call sensibilities, that are of most relevance to the classic public. To train someone to operate a lathe or to read and write is pretty much education of skill; to evoke from people an understanding of what they really want out of their lives or to debate with them stoic, Christian and humanist ways of living, is pretty much a clear-cut education of values. But to assist in the birth among a group of people of those cultural and political and technical sensibilities which would make them genuine members of a genuinely liberal public, this is at once a training in skills and an education of values. It includes a sort of therapy in the ancient sense of clarifying ones knowledge of ones self; it includes the imparting of all those skills of controversy with ones self, which we call thinking; and with others, which we call debate. And the end product of such liberal education of sensibilities is simply the self-educating, self-cultivating man or woman. The knowledgeable man in the genuine public is able to turn his personal troubles into social issues, to see their relevance for his community and his communitys relevance for them. He understands that what he thinks and feels as personal troubles are very often not only that but problems shared by others and indeed not subject to solution by any one individual but only by modifications of the structure of the groups in which he lives and sometimes the structure of the entire society. Men in masses are gripped by personal troubles, but they are not aware of their true meaning and source. Men in public confront issues, and they are aware of their terms. It is the task of the liberal institution, as of the liberally educated man, continually to translate troubles into issues and issues into the terms of their human meaning for the individual. In the absence of deep and wide

A Martian Sends a Postcard Home- Essay on point of view Essay Example

A Martian Sends a Postcard Home- Essay on point of view Paper Most analysts believe that the poem is simple and literally is about what the title suggests, UT really It could be discussing the Martians feeling of being trapped and wanting to go home. Realer provides us with many analogies about the Martians Inability to do stuff which could coincide with the barrier between freedom and being trapped like prison. Michael Vicki, a pro football player, has a very interesting description of prison, of being trapped which provides a very interesting analogy that can be made with Rains lines about the Martian. The poem provides many analogies that could represent the feeling of entrapment. For example Rain says Model T is a room with he lock inside?a key is turned to free the world. Rain is making a reference to the Martian being confused and doing everything backwards compared to a human. Rain even makes mention of some sort of haunting as he mentions ghost cries and creepy sounds that wake you up. Even more he talks about time going by as your tied to the wrist and ticking with impatience. It is amazing how confused the Martian is, he is trapped in a deeper meaning wanting to be free. We will write a custom essay sample on A Martian Sends a Postcard Home- Essay on point of view specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on A Martian Sends a Postcard Home- Essay on point of view specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on A Martian Sends a Postcard Home- Essay on point of view specifically for you FOR ONLY $16.38 $13.9/page Hire Writer At the end Rain provides his audience with something very Interesting. He uses an analogy where the Martian Is impairing the bathroom to a prison by saying it is a punishment room with only water. This really sets off an idea that Rain could possibly be referencing a prison in his poem. In the real world there are many examples of people crossing the boundary between freedom to Imprisonment and back to freedom. One example of this is Michael Vicki who threw away everything when he was convicted of dog fighting a few years ago. Vicki walked into prison, didnt look at anyone or anything, he was lost. He bit into pork from the cafeteria; it tasted weird not at all like pork he said. He was locked up and all he wanted was freedom. He continued to say how terrible things were as he described the type of things that go on at night In the cell that caused for terribly disturbing nights. Vicki finally hit the wall when he heard his grandma died of a stroke, he said now was finally the time he realized how much he really screwed up. Time was ticking for Vicki and eventually after serving his sentence, he was released. He made the most of his new bound freedom by helping the community and not going back to the life he used to live.

Public Health Information Systems Essay Example

Public Health Information Systems Essay Example Public Health Information Systems Paper Public Health Information Systems Paper Executive Summary The development of this White Paper has been facilitated by the Public Health Data Standards Consortium (PHDSC) 1 and the Integrating the Healthcare Enterprise (IHE). 2 The White Paper was developed by the participants of the PHDSC-IHE Task Force. The information in this document represents the views of the individual Task Force participants and may not represent the views of their organizations. The overall goal of this effort is to facilitate standardization of health information exchanges between clinical care and public health. The objective is to engage the public health community in a dialogue with health information technology (HIT) vendors to assure that the work processes and data needs of public health stakeholders in health information exchanges are 1) well understood and agreed upon by stakeholders themselves, and then (2) communicated clearly to the developers of the interoperable clinical Electronic Health Record (EHR) systems and Public Health information systems (EHR-PH Systems). The White Paper consists of three sections. The first section describes public health and population health practices of public health agencies that require health information exchanges with clinical care. The second and third sections describe Immunization and Cancer Surveillance domains in the IHE Technical Tasks for Information Exchanges outline. The Appendix section contains the description of examples of other public health domains (research, chronic care, personal health record, surveys, obesity, cancer, etc. ). The PHDSC-IHE Task Force participants believe that this effort will result in the formation of a Public Health Domain at IHE to begin collaboration between public health and HIT vendor communities to guide the development of the IHE Integration Profiles for the Electronic Health Record Systems to enable electronic information exchanges between clinical and public health settings. So, this White Paper serves as a framing document for the creation of the Public Health Domain at IHE. PHDSC and IHE invite public health experts to review the White Paper. During the review period, we would like to invite representatives of public health domains/programs to submit a description of their domains/programs using the IHE Technical Tasks for Information Exchange outline, so the final White Paper can include other examples of public health domains in addition to the immunization and cancer surveillance domains. This will help to identify potential public health domains/programs for the development of the IHE Integration Profiles in the upcoming year(s). We also would like to invite the reviewers to join our Task Force to participate in the formation of a Public Health Domain at IHE to begin collaboration between public health and HIT vendor communities to guide the development of the IHE Integration Profiles for the Electronic Health Record Systems, to enable electronic information exchange between clinical and public health settings. 1 2 Public Health Data Standards Consortium (PHDSC). URL: phdsc. org Integrating the Healthcare Enterprise (IHE). URL: himss. org/ASP/topics_ihe.asp 6. What is Public Health Mission The mission of public health is to protect the public from health threatening diseases, assure disease prevention by providing access to care for individual patients, promote and restore wellness, and â€Å"to assure the conditions in which people may be healthy. † 3 The patient-centric mission of public health is carried out using publicly-funded healthcare services. Vulnerable or at-risk patients may receive patient care services directly in their homes or at a health clinic funded by a public health agency. There are community health centers funded in the US by the Health Resources and Services Administration (HRSA) that provide a safety net for low income families. Public health funds may also be used to pay for and provide laboratory, pharmacy and other services for eligible populations. In this role, public health care is similar to private health care. The population-based mission of public health is carried out on various levels of government. The public health infrastructure includes agencies that operate on a local, state and/or federal level. In the US, there are 3000 local health departments, 50 state health departments and several federal health agencies, including the Centers for Disease Control and Prevention (CDC), Agency for Healthcare Research and Quality (AHRQ), Indian Health Service (IHS), and many others. In some states, the state health agency plays the key role in delivering services to communities; in other states, local health departments take the leading role. In some jurisdictions, public/private partnerships or other organizational entities may be involved in delivering public health services (e.g. , immunization coalitions – community-based groups that include parents). Stakeholders To fulfill its population-based and patient-centric mission, public health is represented by at least the following stakeholders: 3 Population at large Public health practitioners (including epidemiologists, environmental health specialists, health educators, public health nurses, administrators) Health care providers (including, but not limited to, publicly-delivered healthcare providers, e. g. , safety net clinic) Laboratories Payers Healthcare purchasers Pharmacies Other governmental agencies (e. g. , environmental, law enforcement) Professional Associations Research institutions Individual consumers, particularly vulnerable populations. Institute of Medicine. Future of Public Health. Report. 2002. 2nd edition. URL: iom. edu/? id=15251 7 Public Health Organization During the past 40 years, the population-based services of public health have been delivered using a categorical disease-specialized and services-specific domain approach. For example, public health agencies usually include the following programmatic areas and services: communicable disease control, lead poisoning prevention, vital registration, injury control, mental health services, substance abuse prevention and treatment, chronic disease prevention, newborn screening, immunizations, etc. (Tables 1 and 2). 4 This domain-specific organization of public health is supported by funding allocations that in turn shape the disease/domain-specific organizational structure of public health agencies, public health research activities, and workforce training. 5 Table 1. Personal Health, Population Level Assurance and Environmental Health Services Provided by Local Health Departments (LHD) 6 , 7 Personal Health Services Adult immunization Childhood immunization Tuberculosis treatment Sexually transmitted disease (STD) treatment Women, Infant Children (WIC) Family Planning Services Outreach and enrollment for medical insurance EPSDT LHDs Population Level LHDs Providing. Assurance Services Providing Service, Service, % % 91% Communicable 89% Disease surveillance 90% Tuberculosis 85% screening 85% Environmental Health 75% surveillance 61% High blood pressure 72% screening 67% 69% 58% Tobacco use  prevention HIV/AIDS screening 42% Blood lead screening 46%. Prenatal care Oral health care 4 40% Sexually transmitted disease screening Obesity prevention 31% Vector control Environmental Health Services Food service regulation Public swimming pool regulation Septic tank installation Schools/daycare centers LHDs Providing Service, % 76% 67% 66% 65% Private drinking water protection Lead inspections 57% 66% Hotels/motels regulation 49% 64% 39% 54% Campgrounds/ RVs regulation Smoke-free ordinances Groundwater / surface water protection 67% 56% 53% 38% 40% / 33% Lasker RD, editor. Medicine and public heath: the power of collaboration. 1997. New York, NY. Burke TA, Shalauta NM, Tran NL, Stern BS. The environmental Web: a national profile of the state infrastructure for environmental health and protection. J Public Health Manag Pract; 3(2):1-12. 6 Scutchfield, F. D. , Keck, C. W. Principles of public health practice, 2nd ed. 2003. Thomson/Delmar Learning: Clifton Park, NY. 7 2005 National Profile of Local Health Departments, National Association of County City Health Officials, July 2006. www. naccho. org 5 8 Personal Health Services Obstetrical care LHDs Population Level Providing Assurance Services Service, % 32% Diabetes screening Laboratory services 32%. Home health care School-based clinics 28% 25% HIV/AIDS treatment 26% Correctional health 20% Comprehensive primary care Behavioral/mental health services Substance abuse services Emergency medical services 14% 13% 11% 7% Unintended pregnancy prevention Cancer screening School health activities Chronic disease surveillance Injury control Cardiovascular disease screening Behavioral risk factors surveillance Syndromic surveillance Substance abuse prevention Violence prevention Injury surveillance Mental illness prevention LHDs Environmental Providing Health Services Service, % 51% Public drinking water protection 51% Health-related facilities regulation 46% Food processing 41% Mobile homes / housing inspections 41% Indoor air quality activities 40% Solid waste disposal regulation 36% Tobacco retailers LHDs Providing Service, % 30% 30% 30% 29% 29% 28% 21% 36% Animal Control 21% 33% Hazardous material response Hazardous waste disposal Land use planning Noise pollution Occupational safety health activities Radiation control 19% 26% 25% 24% 14% 18% 16% 14% 12% 10% 9 Table 2. Examples of Healthcare and Public health Responsibilities of State Health Departments (SHD) 8 Responsibilities SHDs Responsibilities SHDs Providing Providing Service,% Service,%. Healthcare Responsibilities Public health laboratory 79 Medical examiner 21 Rural health 79 State mental health authority 19 Children with special healthcare 77 State public health licensing agency 17 needs Minority health 72 State mental institution or hospital 17 Institutional licensing agency 60 Partial/split responsibility for 17 Medicaid State health planning 53 Medicaid state agency 15 development agency Partial/split leadership of 51 Lead environmental agency 15 environmental agency Public health pharmacy 34 State tuberculosis hospital 15 State nursing home 28 Health insurance regulation 15 Public Health Responsibilities. State public health authority 97 Disaster Preparedness 77 Newborn Screening 100 Perinatal Epidemiology 77 Immunizations 87 Violence Prevention 68 Bioterrorism 89 Emergency Medical Services 64 Regulation and Service Provision Injury Control Epidemiology 87 Quality Improvement or 62 Performance Measurement Injury Control Prevention 87 Toxicology 57 Breast and Cervical Cancer 87 Breast and Cervical Cancer 45 Screening Treatment Chronic Disease Epidemiology 85 Radon Control 55 Tobacco Control and Prevention 83 Institutional Review Board 45 State Title XXI Children’s health 28 Cancer Epidemiology 83 Insurance Initiative Environmental Epidemiology 79 8 Beitsch LM et al. Structure and functions of state public health agencies. APHA. 2006:96(1):167-72 10 Public Health Functions As a health care provider, public health clinics carry out all functions of a health care delivery system. As a governmental agency, public health is mandated to protect and improve the health of all people within a legal jurisdiction. It regulates healthcare services and coordinates healthcare delivery and resources allocation. The activities of public health agencies are focused on the following three core functions and ten essential services 9 , 10 : Assessment Monitor health status to identify community health problems; Diagnose and investigate health problems and health hazards in the community; Evaluate effectiveness, accessibility, and quality of personal and population-based health services; Research for new insights and innovative solutions to health problems Policy development and implementation Develop policies and plans that support individual and community health efforts Inform, educate, and empower people about health issues Mobilize community partnerships to identify and solve health problems Assurance Enforce laws and regulations that protect health and ensure safety Assure a competent public health and personal health care workforce. Link people to needed personal health services and assure the provision of health care when otherwise unavailable Public Health Data Sources Individual-patient clinical data comprises a large portion of data used to conduct communicable disease surveillance, case investigation, case management, and care coordination. Aggregated clinical data are used to perform surveillance to detect public health threat events and monitor the population’s health status. To fulfill the goal of protecting the public’s health, health care providers and public health agencies need the capability to exchange pertinent health information about individuals and communities. In addition to clinical data, other data sources are needed for public health decision making. For example, public health practitioners use environmental data, housing data, socio-economic data, geographic data, as well as information generated from surveys and research activities to meet the goals of public health programs. 11 9 Institute of Medicine. Committee for the Study of the Future of Public Health, 1988. Public Health Foundation. URL: www. health. gov/phfunctions/public. htm 11 Yasnof W, Overhage J, Humphrey B, LaVenture M. A national agenda for public health informatics. J Am Med Inf Ass 2001;8(6):535s of Domains, Stakeholders, Functions, Services Interventions, Data Sources Public Health Domains Stakeholders Infectious diseases Injury/Trauma Sexually transmitted diseases Consumer product safety Environmental health Occupational health Substance abuse. Mental health Chronic diseases Bioterrorism Disability Elected official Policy maker Health Department Researcher Private sector Clinician Educator Citizen Community Population Communitybased organizations Core Public Health Functions Assessment Policy development and implementation Assurance Essential Services Interventions Data Sources Data Types Monitoring Surveillance Screening Survey Risk assessment Policy research Policy development and implementation Regulation Outreach Case management Advocacy Social Marketing Education Evaluation Physician’s office patient medical record Registries Patient hospital records Emergency. Medical Services records Governmental regulations and guidelines Research databases Peers of Public Health Domains/Programs. 1 Research 6 Trauma Registries 2 Personal Health Record (PHR) 7 Chronic Diseases 3 Cancer Surveillance 8 Birth and Death Registries 4 Patient Safety and Population Health Perspectives 9 Obesity 5 Surveys 12 Orlova AO and Lehmann HR. A UML-based meta-framework for system design in public health informatics. AMIA 2002 Symposium Proceedings, November 9-13, San-Antonio, TX: 582-586. 12 Health Information Technology in Public Health For many decades, public health agencies and research institutions have been utilizing information technology (IT) to facilitate data management activities (data gathering, analysis, reporting, etc.). Public health information systems are created to support specific needs of disease-specific program areas within health departments, i. e. , newborn screening, birth defects, vital registration, immunization, communicable disease surveillance, chronic disease surveillance, school health, injury prevention, preparedness, etc. (Tables 1 2). These systems deploy various software products that are often custom-made and are not interoperable. Many of these systems contain redundant data; however, the varying data formats and standards preclude data integration across systems for public health decision support and research. These sytems lack the ability to provide real-time data back to providers for care coordination and disease prevention. The sections below describe the public health data gathering activities of clinical data that represent the major portion of public health data of interest. Current Practices on Data Reporting from Clinical Settings to Health Department Programs Most public health information systems are populated with data reported by health care providers. There is mandatory data reporting to CDC on 62 notifiable infectious diseases across all 50 states in the US 13 . This data is reported by clinicians to their local health departments. The latter reports this data to the state health department that in turn reports this data to CDC. In addition, various jurisdictions require clinicians to also report data on the conditions that are of interest for a specific jurisdiction (reportable conditions). Besides infectious disease reporting, various other public health programs receive data from clinician, e. g. , immunization registries, chronic disease registries, etc. In some jurisdictions, clinicians are expected to report data to both their local health department programs and their state health department programs. In many jurisdictions, data is currently reported using paper forms sent by fax or mail. For example in one state, providers (primary and emergency physicians) need to report data on 62 notifiable (mandatory) conditions and 32 reportable (state-specific) conditions using (a) over 50 various disease-specific Adobe Acrobat-generated paper forms required by the state communicable diseases surveillance system. This is in addition to providing data to other numerous programs maintained by the state health department. Lack of integration and interoperability across public health systems leads to the duplication of efforts and frustration among providers and consumers asked to provide the same information on multiple forms of varying formats to various programs. None of these activities are reimbursed by health insurance. According to the national data, public health data systems currently suffer from limitations such as underreporting (only 49% of cases are getting reported to public health agencies), 14 , 15 lack of 13 Centers for Disease Control and Prevention (CDC). Nationally Notifiable Infectious Diseases. URL: cdc. gov/EPO/DPHSI/phs/infdis. htm 14 Campos-Outcalt D, England R, Porter B. Reporting of communicable diseases by university physicians. Public Health Rep 1991;106:579-583. 15 Marier R. The reporting of communicable diseases. Am J Epidemiol 1977;105:587-590. 13 representativeness, lack of timeliness, inconsistency of case definitions across systems, inability to integrate data across the systems, etc. 16 , 17 Figures. 1a-d present schematic views of paper-based data reporting by healthcare providers to various public health data systems at the State and local levels. These views may also be applicable to any web-based data reporting to individual public health data systems maintained by the programs. EHR-based Health Information Exchanges between Clinical Care and Public Health Because of the automation of clinical data – inpatient and increasingly outpatient – via the Electronic Health Record Systems (EHRS), public health programs stand at the threshold of change in the way in which they gather programmatic data. Many of the information systems used by local health departments are not capable of exchanging data through RHIOs or with health care service delivery agencies. Many of them are not capable of sending/receiving HL7 messages and cannot or do not comply with other nationally accepted vocabularies and standards. In addition, many of the systems are not configured to serve as an electronic medical record to receive information from physicians; this restricts their ability to contribute to a longitudinal health care record for those clients for whom they serve as a primary care provider Nationally, electronic health record systems are beginning to be certified taking into account these considerations. The issue of compatibility/interoperability of these systems with public health systems to be able to send, receive and exchange relevant data for both public health and clinical practice needs to be addressed. 18 16 Centers for Disease Control and Prevention (CDC). Lesson Five: Public Health Surveillance. Principles of Epidemiology in Public Health Practice. Third Edition (Print-based). 336-409. Available at: cdc. gov/training/products/ss1000/ss1000-ol. pdf. Last accessed November 29, 2006. 17 Konowitz PM, Petrossian GA, Rose DN. The underreporting of disease and physicians’ knowledge of reporting requirements. Public Health Rep 1984;99:31-35. 18 Laverne Snow. Personal Communications. June 9, 2007. 14 Health Education/Risk Reduction Genetic Disorder Communicable Diseases Communicable Diseases Vital Statistics Provider 1 Provider 1 Immunization Provider 2 Immunization EPSDT Provider 3 Lead and Environmental Epidemiology Provider 2 Injury Control Injury Control Provider 3 School Health Provider 4 School Health Chronic Care Chronic Care Provider 4 Biosurveilance, BT, Preparedness Biosurveilance, BT, Preparedness WIC Provider X WIC Occupational Safety and Health Public Health Laboratory Provider X HEDIS Cancer a b Genetic Disorder Genetic Disorders Vital Statistics Health Education/Risk Reduction Provider 1 Communicable Diseases Provider 2 Immunization HRSA Communicable Diseases Provider 1 AHRQ Lead Registry Immunization Provider 2 Provider 3 Vital Records Injury Control Injury Control School Health School Health Chronic Care Chronic Care Biosurveilance, BT, Preparedness Biosurveilance, BT, Preparedness WIC WIC Public Health Laboratory Occupational Safety and Health HEDIS Provider 4. Provider X CDC Injury Control Immunization EPSDT Provider 3 Communicable Diseases Provider 4 School Health Chronic Care Biosurveilance, BT, Preparedness Provider X HEDIS Cancer c d Fig 1. Paper-Based Data Reporting by Health Care Provider to Various Public Health Data Systems: a Provider’s Data Reporting to Local Health Department Data Systems; b Provider’s Data Reporting to State Health Department Data Systems: c Provider’s Data Reporting to Local and State Health Department Data Systems; d Multiple Providers Data Reporting to State Health Department Data Systems. 15 â€Å"Many public health agencies are examining their existing information systems and seeking to improve their ability to support programmatic needs to detect, assess, and respond to a range of threats to the public, including infectious diseases, pandemics, such as avian flu, bioterrorism, and chronic diseases such as obesity, diabetes and asthma. The challenges of transitioning from a paper environment to an electronic environment involve rethinking the workflow, staff skills, resources, habits, and culture of an organization†. 19 Electronic transmission of data from the clinical care settings to public health agencies via EHRS is essential to (1) support key public health functions and services and (2) supply public health data repositories, e. g. , registries, research databases, etc. , for aggregated analysis of the health status of populations. 20 Provision of real-time aggregated community-level information back to providers bi-directional EHRS-based data exchanges between public health practitioners and clinicians will inform clinical decision support, improve care coordination and response capabilities to a public’s health threat event. The integrated Electronic Health Record-Public Health (EHR-PH) systems will become the backbone of a NHIN and regional HIEs. Fig. 2 represents a schematic view of the difference between the current public health data reporting mechanism (Fig. 2a) and the future standardized EHR-PH health information exchange (Fig. 2b). When the EHR-PH connectivity is completed, various public health data systems will be able to electronically receive data from clinical EHRS, so when an authorized provider enters patient data into his/her EHRS, various public health programs as authorized users can receive/retrieve/view/access their data of interest. 21 To facilitate the development of interoperable EHR-PH systems there is a need for standardization of health information exchanges across the clinical and public health enterprise. The US Health Information Technology Standards Panel (HITSP) 22 identified the following categories of standards for system interoperability: 1. Data content standards, i. e. , vocabularies and terminology standards (CDA2, SNOMED, ICD, X12, NCPDP, Omaha, etc. ) 2. Information content standards (Reference Information Models (RIMs) standards) 3. Information exchange standards, e. g. , messaging standards (HL7) 4. Identifier standards, e. g. , National Provider Identifier (NPI) standard 5. Privacy and security standards the US Health Insurance Portability and Accountability Act (HIPAA) privacy regulations provide a framework to protect privacy 19 Common Grounds: Transforming Public Health Information Systems. Robert Wood Johnson Foundation. 2006 Call for Proposals. URL: rwjf. org 20 Public Health Data Standards Consortium. Electronic health record-public health perspectives. White Paper. PHDSC Ad Hoc Task Force on the Electronic Health Record-Public Health. March 9, 2004. : 27p. plus 9 Attachments. URL: phdsc. org/knowresources/papers/docsandpdfs/PHDSC_EHRPH_WhitePaper2004. pdf 21 Orlova AO, Dunnagan M, Finitzo T, Higgins M, Watkins T, Tien A, Beales S. An electroninc health recordpublic health (EHR-PH) system prototype for interoperability in 21st century health care systems. Am Med Inform Assoc. (AMIA), Annual Symposium, Proc. , 2005. 22 Health Information Technology Standards Panel (HITSP). American National Standards Institute (ANSI). URL: amsi/org/hitsp 16 confidentiality of personal information; however, they do not cover all potential actors in health data exchanges. 23 6. Functional standards, i. e. , workflow/dataflow standards 24 7. Other, i. e. , information technology infrastructure standards, interoperability standards (IHE). HIE Genetic Disorders Communicable Diseases Provider 1 Immunization Provider 3 Communicable Diseases CDA2 Provider 2 Vital Records Provider 1 Genetic Disorders HL7 Provider 2 Immunization Vital Records Provider 3 Injury Control Provider 4 X12 Injury Control Provider 4 School Health School Health NCPDP Chronic Diseases Chronic Diseases Provider X Biosurveilance, BT, Preparedness Provider X Biosurveilance, BT, Preparedness, Syndromic Surveillance LAB IHE HEDIS HEDIS a b Fig. 2. Health information exchanges between clinical care and public health agency: a – current paper form – based information exchange; b – standardized EHR-PH –based information exchange. Fig. 2b presents examples of standards (CDA2, HL7, X12, NCPDP, IHE) that the EHR-PH HIEs will have to support. To help facilitate the development of the standardized EHR-PH health information exchanges, it is critical to start a dialogue between the public health community and EHRS developers to assure that the work processes and data needs of public health stakeholders are well understood and agreed upon by stakeholders themselves and then communicated clearly to the developers of the interoperable EHR-PH systems. The section that follows presents two examples of the beginning of this dialogue by describing one of the public health domains in the IHE suggested framework for the technical tasks for information exchanges. 23 See ncvhs. hhs. gov/060622lt. htm Developing a Vision for Functional Requirements Specification for Electronic Data Exchange between Clinical and Public Health Settings: Examples of School Health and Syndromic Surveillance in New York City. Public health Data Standards Consortium. 2006, 40p plus attachments. 24 17 Technical Tasks for Information Exchanges: Examples of Public Health Domains IHE provided a list of Technical Tasks for the description of the information exchanges related to a domain as follows: 1. What is ? 2. Who are Stakeholders? Technical Tasks for Information Exchanges 3. Expressing the criteria 4. Selecting a site 5. Identifying a patient meeting certain criteria 6. Retrieving additional data elements (queries) 7. Reporting data elements (notifications) 8. Data review/feedback (filters) 9. Analysis/evaluation 10. Mapping 11. Aggregation/Reporting 12. Communication We used Immunization and Cancer Surveillance as examples of public health domains (Tables 1 2) and have attempted to describe them in terms of the IHE proposed technical tasks for information exchanges between clinical and public health EHR-PH systems. The section below includes the descriptions of the existing use cases and standards identified by the immunization domain and cancer surveillance experts to date as well as the existing IHE profiles applicable to these domains. It also includes the list of existing and emerging standards and possible future IHE profiles needed to meet the EHR of Immunization Domain 1) What is the Immunization Domain? Immunization is critical to control many infectious diseases including polio, measles, diphtheria, pertussis (whooping cough), rubella (German measles),

Identify the GAAP used to create the financial plan, and provide one Assignment

Identify the GAAP used to create the financial plan, and provide one recommendation for Patton-Fuller Community Hospital based on their 2009 budget statement for improving - Assignment Example A financial plan is a succession of steps or objectives set by businesses or individuals to describe a progressive or cumulative attainment of a certain financial accomplishment (Lucy, 1999). These financial objectives and forecast are aimed at improving the financial position of the individual or organization through acquisition of new assets or elimination of debt. Various GAAP are instrumental in the preparation of GAAP. Principle of continuity- The principle of continuity assumes that the business or financial activities of an individual are continuous (Hirschey, 2009). This principle eliminates complexities that may be associated with discontinuity. Principle of periodicity- The principle of periodicity allows each accounting entry to be split according to periods. The principle also allows accountants to utilize the cyclic nature of business occurrences. Patton – Fuller community hospital has continuously provided quality medical services to people living in Kelsey and the immediate environment since 1975 (Apollo Group, 2006). To maintain its standards of operation, the hospital needs to have an economically viable financial plan. According to the 2009 budget plan, there is lack of consistency and continuity of the financial projections of the hospital. To maintain its position, the hospital needs to balance its organization and institutional roles. Financial accountants assume that a business will remain in operation within the forthcoming business period, when preparing its financial statements. On the other hand, the financial statements should indicate whether the business is likely to close down. In the 2009 financial budget, Patton – Fuller Hospital’s auditor did not evaluate the sustainability of the business in the near future. In this case, the auditor did not evaluate the hospitals

Memo revision Essay Example | Topics and Well Written Essays - 250 words

Memo revision - Essay Example The parking here at DataTech is free unless you do not follow the parking guidelines. While we do not like resorting to these measures, when you do not follow the parking guidelines, we have to ticket you. However, since you are not following the policies, we have decided that it was time to send this reminder to make sure that you were aware of these policies in the future. Day-shift employees should park in Lots A and B in their assigned spaces. Employees that do not register their cars will be ticketed. Everyone must display the white parking stickers on the bumper of their cars. Also remember that it is a MAJOR violation if you park at the curb before 3:30 p.m. That area is reserved for visitors and swing-shift employees, who do not have assigned parking spaces. Please park in assigned spaces only. Swing-shift employees may park in any empty space after 3:30 p.m. They have the option to park at the curb before 3:30 p.m. if no spaces are available. However, please do not park in curb spaces marked for handicapped, van pool, or car pool vehicles. All employees must register their cars and display a parking sticker. These white registration stickers should be placed on your back bumper on the driver's side of the vehicle. You may pick them up in the Human Resources Division from 8 a.m. to 5 p.m. on weekdays. To make it more convenient for you, they will be in the cafeteria on September 10th from 11:30 a.m. to 1:30 p.m. and from 3 to 5 p.m. We are trying our best not to issue tickets. You can help by following these suggestions, which can benefit everyone.

The accounting policies of Marks and Spencer Essay

The accounting policies of Marks and Spencer - Essay Example   The first part of the report analyses the development of two accounting policies regarding tangible fixed assets and intangible one. To make the analysis more critical, comparisons with the main competitors of Marks and Spencer are drawn illustrating the controversial development of the selected policies. The second part of the report deals with the analysis of transition from UK GAAP to IFRS with specific respect to the following issues: treatment for property, property leases, employee benefits, share-based payments, intangible assets, and financial instruments. During their lifetime companies acquire property, which should be treated as assets according to the accounting standards. Meanwhile most of the property types have a 'lifetime' span, a time period, called useful economic life, during which an asset is used. To reflect the useful economic life in financial statements, profit and loss account receives regular portion of the cost of an asset. This expense is known as depr eciation. In other words, depreciation represents the extent to which economic value of an asset has been consumed by the business. There are different accounting policies on depreciation, but the most commonly used two are straight line depreciation and reducing balance. The one that is used by Marks and Spencer is the straight line depreciation. "Depreciation is provided to write off the cost or valuation of tangible fixed assets, less residual value, by equal annual instalments" (Marks and Spencer, 2005a, p. 33). That means the company pays the cost of an asset minus its value after its useful economic life expires by equal portions annually. Thus, fixtures fittings and equipment as a type of property has useful economic life of 3-15 years in the accounting policy of Marks and Spencer - that means, during that time the company annually pays its cost less residual value divided into 3-15 equal portions. Another popular policy of depreciation is reducing balance. In this case the d epreciation in each year is calculated as the percentage of the un-depreciated value. For instance, if the purchase cost of an asset is 100 and the reducing balance rate is 20% then the first year depreciation is 100*0.2=20 and the second year depreciation is (100-20)*0.2=16. The reducing balance rule is used to reflect the fact that the value of some assets falls more rapidly in the first years of use than in the last ones. As can be seen in theory the reducing balance policy can go on forever, with annual portions reducing ad infinitum. Generally, after 95% of the initial cost has been depreciated all the rest is written off in the next portion. The difference of these two methods is as follows: while the straight line depreciation is the simplest of all methods, the reducing balance allows taking the advantage of larger tax deductions in early years.  

Conveyor Based Sorting System: Overview Detection Approach

Conveyor Based Sorting System: Overview Detection Approach Abstract: When the objects move on the conveyor belt, they fall into the receptacle at the end of the belt. Once the bin is filled the conveyor belt must stop in order not to overfill the bin. To make this possible we could use some sensors in the receptacle and link the belt and the weighing scale (on which the bin is placed) through programming so that when the receptacle reaches to certain weight the belt automatically stops. Some of the weighing sensors and level detectors are discussed in this report to reach a conclusion to decide the right method of approach to stop the overflowing of objects into the bin. Weight measuring sensors: There are various types of sensors used in measuring the weight of objects with different sizes and shapes. Strain gauges, load cells (of different types and shapes) and force sensors are some of the measuring sensors which are used in electronically weight measuring equipment. These sensors are installed in devices that measures the changes of force applied on them or the change of pressure on the particular spot of object or even the tension of the object. Our aim is to choose an approach for an overflow detection system when at the end of conveyor belt, the coloured objects are collected in a large bin. That is placed on the weighing device which accurately measures the weight of the bin/receptacle with the objects, and once its filled the conveyor belt/PLC stops and prevents the bins from overflowing. In this concept, to measure the weight, we could use different sensors like load cells of different types and strain gauges. 1.  Strain gauges: It is a device with varying resistance when certain amount of force or pressure, tension and weight is applied. It also converts them into measurable electrical resistance. This is the reason most of the load cells and electronically weight measuring scales are based on this strain gauge principle. Strain is a physical property of a material when it undergoes external displacement or deformation. Thus, this types of sensors can be used to measure both expansion and contraction. Strain gauge model The image1 above shows a typical metal-foil strain gauge which is widely available in the market. Strain gauges are mounted or glued to the surface of a solid material and when the material is compressed or stretched, the electrical resistance increases or decreases respectively. Generally, a Wheatstone bridge is used to change the varying resistance into varying voltage as the change in resistance is relatively small when using strain gauges to measure the weight of an object. Still, the output analogue signals are amplified further as this output signals from the Wheatstone bridge is still smaller when compared to the PLC in the design which is expected to be around 0 to 10V. The picture below shows the typical circuit of a strain gauge connected to the Wheatstone bridge (also known as Quarter bridge strain gauge circuit). The resulting output voltage is always a millivolt unit. Depending on the use of whole structure, the number of strain gauges connected to the Wheatstone bridge varies. Lets assume that, the weighing device below the receptacle/bin is fitted with the strain gauge, then every time an object falls into the bin causes a change in the tension in the gauge resulting a change in resistance. The picture2 below shows the typical assembly of strain gauge and Wheatstone bridge. The output voltage is normally measured using a voltmeter connected in circuit but can also be calculated using the following equation, The receptacle is assumed to be placed on the weighing scale which tends to be wider and a bit spacious which makes, using a single strain gauge to cover the whole space is not ideal. To improve the accuracy, we could use more than one strain gauge to cover the space on weighing scale. Advantages of strain gauge: Using strain gauges in the design have some pros and cons. Some of the advantages include, In a strain gauge, there are no moving parts but only a strip It is very small and easy to use on a piece of solid object When it comes to cost, its very inexpensive and easily available In our design, using more than one strain gauge to cover the weighing scale improves the accuracy. Disadvantages of strain gauge: The strain gauges need to be calibrated for it to work per desired design Overloading can be a problem; the strain gauges measure the stress on the scale in micro strain. Therefore, if the bin is slightly overfilled or even the load in it is beyond the limit then the results may be degraded. Just for a reference the limit normally be  ±3000 micro strain. If the wires of the get wet or not protected against humidity, the resulting electrical resistance might lead to parasitic results. If the design was to be open and wires are exposed to spillage which may cause errors in the result. 2.  Load cells: A load cell is a device which uses one or more strain gauges in its design to measure the force applied on the surface and change it into an electrical signal. Load cells can be in various types like hydraulic, pneumatic load cells, piezoelectric and capacitive load cells. Since it uses more strain gauges in the design which increases the accuracy of the model. Generally, Copper (Cu) and Nickel (Ni) alloys are used in the construction of the strain gauge load cells. When the length changes in the electrical conductor due to the stress applied on the free end, the resistance of electrical conductor also changes. in strain gauge load cells, use of Cu and Ni in this model is beneficial as the applied strain is virtually proportional to the change in resistance. This change in resistance is used to measure the strain applied if its connected to appropriate measuring circuit. This is a model image3 of a binocular beam strain gauge load cell which is more than one strain gauge and when theres stress applied on the free end, stretch in the gauge causes change in electrical resistance and thus the weight of the bin is measured. Hydraulic load cells are also known as force balance devices, one of the types of load cells which measures the weight of an object as pressure changes in internal filling fluid. As the force or pressure changes on the loading surface, pressure of the fluid inside the cell is also increases. The image4 above is a simple design of hydraulic load cell with the hydraulic fluid inside. Advantages of load cells Some of the advantages and disadvantages of the load cells are discussed below. It comes in various shapes and sizes like rugged shape and its in compact construction Load cells doesnt have any moving parts inside the structural design Since they have wide surface area which also has wide range of measurement Since our design (assumed concept) has a static weighing machine below the receptacle, load cells can be used and they also be used in dynamic loading Load cells are highly accurate since the loading surface is solid and wide area which covers the loading surface of the weighing machine. Disadvantages of load cells Compared to the strain gauges, load cells are solid and larger in size and shape As they have a solid structure and of different shapes, it may be hard to mount on any surface Just like a strain gauge model, calibration with these load cells is also essential in the process of measuring the weight of the objects fall into the receptacle They are slightly expensive and a very costly signal conditioning 3.Force sensor resistor: Force sensor resistor which is also known as force sensitive resistor (FSR), is a resistor material where the resistance changes whenever the force or pressure changes on the surface. When compared to the strain gauges and load cells, FSR measures the compressing force or weight differently by directly correlating the strain of the beam to the applied force on the surface. Piezo-resistive force sensor is one of these types of force sensors. It is a strip of layers with different form of inks which can detect the applied force or stress on the material where the strip is attached to. The image5 blow shows the simple construction of a special FSR called Piezo resistive force sensor. Every time each object falls into the receptacle or bin, the force is applied on the surface of the weighing scale which then compresses two layers of pressure sensitive ink within the flexible and adhesive substrate layers in the sensor. This pressure creates the tension in the layers converts them into electrical signals which then can be calibrated just like the load cells with the help of programming with engineering force units. This is an image6 of a Round Force Sensitive Resistor (Model: Interlink 402 with  ½ the diameter sensing region from the measuring surface). Advantages of Force resistive sensor FSR are generally very small and thin (about 0.2mm) and very flexible in construction which allows them for unobtrusive measurements to be taken in practical application These types of sensors are programable and customizable per the specification of the design concept These sensors are very cost effective and readily available in the market They are also inexpensive in programming or signal conditioning in electronics They only consume very low power and its light weight as its very thin in structure Disadvantages In measuring weight or pressure applied these sensors are very inaccurate with the results like  ±5% of full scale than a load cell They are calibrated by us, the users, which can lead to manual errors whereas load cells are programmed by the manufacturers if ordered directly Different approach than programming: Level detectors: Other than using just weight sensors to detect the weight of the receptacle and stop the overflow when the objects are filled, we could also use some level detectors at the top of the bin to detect whether the objects have reached the top while the object fall into the bin from the conveyor belt. For an effective way of stopping the overflow, mix use of both level detectors and weight sensors would improve the accuracy to stop the overflow. A typical level detector is used to detect once the material is at the determined point within the receptacle which is also known as Point Level Sensor (PLS). These sensors can be used to detect the levels of the objects at high, low and intermediate levels of the bin. These also must be programmed or calibrated to the desired level in the bin for the accurate results. Image7 below shows the typical model of Rod pointing level sensor which can be used to measure the liquid, slurry materials, powders or solid objects levels in a vessel. This sensor has a self-built alarm and LED indicator which can be activated when the objects in the vessel reaches the desired indication point. It has no moving parts in the assembly and since its simple design which makes it easily mountable on any part of the receptacle to our desired level. This image8 shows the ways of mounting the sensors in various levels of the bin. Conclusion: Weighing scale and conveyor belt are linked through the program so that when the receptacle is filled and desired weight is reached, which then signals the conveyor belt to stop filling the bins. This is the assumed concept for which we were using weighting sensors to detect the weight of the bin and stop overflowing. For this we cant just use programming to stop the overflow we would also need some additional sensor to detect the weight or the maximum level that the objects can reach. Therefore, to achieve the higher accuracy we could use both level detecting sensors and weighing sensors in the concept to stop the overflow of objects. Load cells are preferable means of sensing the weight of the receptacle to stop the overflow. Load cells are the sensors with the solid base where more than one strain gauges are mounted which improves the accuracy of measuring the weight of the bin. If we use strain gauges to measure the weight, we would be using more and more strain gauges to cover the wide area where the bin is placed. This could increase the cost of the project and using more gauges may result to find the average value between them to detect the weight which not be accurate. Using more strain gauges may also result in massive circuits and lots of wires hanging all over the places. So, if theres any faults in the circuits, it may be hard to find it. Load cells are the right choice since they have no moving parts in them which makes them more easily mounted under the receptacles. Use of both load cells and Level detectors in the design may benefit the approach to stop the overflow of the objects from the receptacle. References: Appmeas.co.uk. (2017). Load Cells | Force Sensors | Force Transducers | Load Measurement. [online] Available at: http://www.appmeas.co.uk/load-cells-and-force-sensors.html?gclid=CLSe34mxzNICFQsR0wodQu8Nmw [Accessed 12 Mar. 2017]. Binocular load cell. (2017). [image] Available at: http://www.instrumentationengineers.org/2013/07/load-cell-working-types-advantages-and.html [Accessed 10 Mar. 2017]. En.wikipedia.org. (2017). Wheatstone bridge. [online] Available at: https://en.wikipedia.org/wiki/Wheatstone_bridge [Accessed 12 Mar. 2017]. Force sensor Construction. (2017). [image] Available at: https://www.tekscan.com/resources/ebook/load-cell-vs-force-sensor [Accessed 12 Mar. 2017]. Hydraulic load cell model. (2017). [image] Available at: http://www.instrumentationengineers.org/2013/07/load-cell-working-types-advantages-and.html [Accessed 10 Mar. 2017]. Level detector. (2017). [image] Available at: http://www.blueleveltechnologies.com/products/modelVHS.html [Accessed 12 Mar. 2017]. Round FSR model 402. (2017). [image] Available at: https://www.adafruit.com/product/166 [Accessed 12 Mar. 2017]. Strain gauge. (2017). [image] Available at: https://www.slideshare.net/mac899/strain-gauge-23842407 [Accessed 9 Mar. 2017]. Tekscan. (2017). Load Cell Vs. Force Sensor. [online] Available at: https://www.tekscan.com/resources/ebook/load-cell-vs-force-sensor [Accessed 12 Mar. 2017]. Us, C. (2017). Load cell working, types advantages and disadvantages. [online] Instrumentation Engineering. Available at: http://www.instrumentationengineers.org/2013/07/load-cell-working-types-advantages-and.html [Accessed 12 Mar. 2017].

Organizational Testing and Assessment Essay -- Human Resource Manageme

Many organizations use some descriptive tests in their development and recruitments of employees at all levels. This is common for persons applying for top management positions, as an error in recruitment will cause a significant impact in any organization. Tests for selection and recruitments assist a company to make an informed choice between candidates on their strength or weakness. In carrier, professional counseling candidates tests on their work values, interest, and preparedness in their new position. Some of the considerations made are the client’s interest, measured by strong interest inventory and use of carrier development inventories (Zunker, 2001). Experience has shown that the main barriers to improved organization practices are not technical rather than planning. This is associated in changing the management perception, overcoming peoples resistant to change and implementation of practical processes and management controls. Intelligence testing dwells on a candidate problem solving ability and mental sanity. The intelligence quotient though variable to different individuals is used. Intelligence manifests itself over the life span and includes the ability to logically reason, acquire, and apply knowledge, sound judgment, paying attention, use of initiations and attentiveness and ability to cope and make use of unfamiliar situations (Cohen & Swerdlik, 2010). For candidates who have a speech impediment, non-verbal assessment of ability or intelligence is used (Zunker, 2001). Intelligence definition is not definite but includes the capacity and ability to acquire and apply, exhibit sound judgment, to be intuitive and be able to cope with different situations and different circumstances. (Carroll, 2012). The factorial ... ...rs and human resources departments to make the right choices in achieving organization goals. The employer gets the best compatibility between jobs and employee. References Cohen, R. J., & Swerdlik, M. E. (2010). Psychological testing and assessment: An introduction to tests and measurement (7th ed.). New York, NY: McGraw-Hill. Carroll, J.B. (2012). The Three-Stratum Theory of Cognitive Abilities: Contemporary Intellectual Assessment. New York: The Guilford Press. Matthews, G., Deary, I. J., & Whiteman, M. C. (2003). Personality Traits. London: Cambridge University Press. Worcester Polytechnic Institute (n.d), Performance Appraisal Process. Web. April 10, 2012. Retrieved from, http://www.wpi.edu/Admin/HR/performance-appraisal.html. Zunker, V. G. (2001). Career counseling: Applied concepts of life planning. (6th ed.). Pacific Grove , CA : Brooks/Cole.