Items filtered by date: February 2014
Historical Background of E-Commerce
Preventing Fall Among Elderly In Hospital Settings
Characteristics of the students
This course is designed for BSN students. Majority of students who chose nursing as a career site compassion, the need to care and help other and kindness as the main reason they pursued this career. Most nursing students are choosy on the nursing school they want to attend. They consider its reputation, NCLEX pass rate, location, cost of the course and the duration of the program. Most schools admit nursing students with a GPA of 3.38. The students describe themselves as passionate, determined, dedicated, and hardworking and focused. The students portray a range of demographic characteristics in terms of change, with some being as young as 18 years and others being in-service RN, aged 40 years. The students also exhibit diversity in terms of ethnicity and nationality.
Content of the course
The course will focus on preventing fall among the elderly in hospital settings. The course will provide an overview of the problems that occur in hospital settings and further explore the identification of the older at risk for f alls, factors that contribute to fall risks, and the assessment of the different strategies that can be used to prevent fall such as occupational therapy exercise. There are many and diverse fall risk factors, and the process of identifying these risk factors requires multidisciplinary efforts. The course will be organized into three subsections or modules. The first section will give an overview on evaluation and assessment the second section will concentrate on hospital settings while the third will focus on developing the right strategies and interventions to reduce fall.
The course will further be subdivided into six sections.
Section A: current status of fall problem including prevalence, statistics, consequences and costs
Section B: risk factors among the elderly, aetiology and circumstances of fall in hospital settings
Section C: Initiatives that have been put in place by various organizations and institutions such as the Joint Commission and Centre for Medicare and Medicaid services to reduce inpatient falls.
Section D: fall risk assessment in hospital set-ups from the perspective of nurses
Section E: Fundamental elements of fall prevention strategies in health care institutions.
Section F: resources.
- Successful completion of the course will enable learners to:
- Identify the challenge of fall in hospital settings in respect to prevalence, consequences, statistics and cost.
- Identify risk factors that expose the elderly to fall in health care facilities.
- Understand that fall can be considered as a geriatric syndrome that is multifactorial and is associated with substantial morbidity and poor outcomes.
- Understand the different strategies and regulations that ave been established to prevent falls by CMS and Joint commission regulations.
- Identify and understand assessment strategies used to recognize older adults at risk of fall in health care settings and the appropriate intervention strategies.
- Understand the American Geriatric Society Guidelines on fall prevention
Instructional methods are the ways or means that teachers, lecturers and professors use to teach materials to their students. The choice of the instructional method depends on the content (what is being taught), the audience (who is being taught) and the level of competence that is expected. Basically, content is divided into skills, attitudes and values domains of knowledge. While teaching knowledge, the instructor can use a variety of the methods with the aim of getting the learner to engage in the learning the material actively. While teaching skills, the instructor is expected to demonstrate and highlight important aspects, supervise students while performing the skills, or talk the student through the skill. While teaching about attitudes, the instructor needs to use methods that require the application of the specific attitudes.
In clinical courses, educators use different teaching methods in different set-ups. This course will be taught using a combination of instructional methods that includes lecture hall, inpatient setting, clinical setting and case studies. This will ensure the trainee gets both the necessary knowledge and skills.
Classroom teaching methods
It is no doubt that lecturing is one of the widely used formal educational methods. According to Bligh, lecturing is a more or less continuous exposition by a speaker/educator who wants his or her audience to learn something. Lecture has its roots in Latin, and it is the method of learning that was developed prior to the invention of printing.
The lecture will be used to provide a broad overview or introduction of the course so as to give the learners the background familiarity with the topic. Lectures will be effective in Section A of the course where learners will be taught on the problem of fall in hospital settings, consequences, statistics and cost of the problem. At this stage, the purpose of the lecturer will be to offer students a broad introduction into the topic and make them understand why the course is important. It is possible that some of the BSN students will have diplomas or certificates in nursing, therefore; the lecture will be used to provide explication on the topic. It will help them to develop cognitive framework for organizing concepts and restructuring the information they have to make it applicable to the current issues.
The lectures will be prepared in consideration of the intended audience, level of knowledge of the students and the motivations of the students to acquire the new knowledge, skills and attitudes. The lectures will be tailored and delivered to link the course content and previous knowledge. Students will be issued with notes to refer after the lectures. The course content will be delivered using multiple modalities simultaneously to increase retention and learners’ understanding. Visual presentations such as PowerPoint presentations will be used to enhance understanding among students. In order to increase teacher-student relationship, the lecture will be organized in small manage classes of less than forty five students.
Lecture offers the instructor an opportunity to deliver large amount of information to a large or small group of learners while using the instructor’s time effectively. The instructor is bale to organize and prepare the content effectively, and deliver the content until the students are satisfied. Lectures will help the instructor to assist student gather information, understand it and organize it in a way that will allow them to use the information in later dates.
However, lectures always the challenge of getting the students to be involved actively. This shortcoming of lectures will be compensated through various strategies such as the use of visual aids, question asking, use of audience response and organizing the materials effectively.
Several strategies will be used to improve classroom/teaching. They include the use of audience response systems, team-based learning, case methods, and demonstrations.
Clinical teaching methods for the inpatient setting
Learners are expected to have an inpatient experience by the end of the course. It is, therefore, important to set the right tone and climate for the earners to be able to participate in ward rounds. The instructor will set the necessary learning goals and objectives at the beginning of each week. The students will also be required to set their individual learning objective in the course of the week. Clinical setting teaching will be used to teach the learners on the current strategies and interventions used to prevent falls. The students will get a chance to practice their theoretical knowledge in a clinical setting. Bedside rounds will provide the students opportunities to comprehend their theoretical knowledge. It will also help students learn how to make their time, which is crucial in inpatient settings.
The instructor will play an important role n promoting learning among students. He or she will organize clinical activities in such as a way that learners will be motivated to participate actively.
Case presentation will be used to instil practical experience to students. The instructor in collaboration with practicing nurses will identify cases to be used by students in their learning. The cases will be selected based on the complexity, uniqueness and interest.
Bligh DA. (2000). What is lectures? San Francisco: Jossey-Bass.
Team Based Learning.org. (2005): University of Oklahoma .retrieved from www.teambasedlearning.org. On 12/7/2013
Uhari M, Renko M, Soini H. (2003) Experiences of using an interactive audience response system in Teaching. BMC Med Educ. Vol. 3, Issue 1: Pg 12.
Bates, A.W, & Poole, G. (2003). Effective teaching with technology in higher education: Foundations for success. San Francisco, CA: John Wiley and Sons.
Billings, D.M., & Halstead, J.A. (2009). Teaching in Nursing: A Guide for Faculty (3rd ed) Philadelphia, PA: W.B. Saunders.
Characteristics of the RN BSN Class of 2011. Retrieved from http://www.iuk.edu/ on 12/7/2013.
Social work is among the most essential aspects of humanity. It encompasses the improvement of livelihoods through different interventional systems such as policy change, research, and public enlightenment initiatives among others. For instance, social work serves as an important platform for helping a community recover from a given disaster or crisis such as the Hurricane Katrina. Consequently, the improvement of people’s wellbeing is a crucial perceptive that characterizes social work. Social workers are people or individuals who take part in social work. Different social workers have different goals and targets. However, making a positive difference in an individual’s life is a common objective among most social workers. There are numerous theories in social work. These theories are essential in that they cater for the demystification of the people’s involvement in social work. Most of these theories are strongly connected to other disciplines such as psychology and economics among others. This analysis zeros in on different perspectives of social work. The reasons for involvement in social work will be evaluated while also assessing the contribution of theory to social work.
Why we do social work
There are numerous reasons why we do social work. These reasons are strongly illustrated by the various values of social work. Among the most notable values of social work is social justice. Social work serves as a crucial platform for ensuring people are protected from any kind of social injustice. Social injustices are issues that prevent individuals from maximizing their potential or subject them to extensive suffering (Greene, 2011). Examples of social injustices include discrimination and unemployment among others. These kinds of social injustices undermine the people’s quality of life.
Social work facilitates for people to deal with or avoid these injustices. The second value of social work is dignity. Social work is strongly geared towards maintaining the dignity of individuals from all divides of humanity. Self worth is an essential pillar of human dignity, and it is strongly emphasized in social work. For the maintenance of dignity, it is essential for mutual respect among individuals. This is a crucial dimension based on the value of dignity in social work. Service is a core value of social work. A social worker aims to serve other individuals in terms of their needs (Oko, 2011).
Service is a crucial element that helps individuals to deal with social problems such as poverty or educational needs. Competence is another notable value of social work. While providing social services, social workers should demonstrate exceptional standards of competence. This value calls for attention to detail and possession of the relevant knowledge in the different realms of social work. Emphasis on human relationships is another essential value of social work. This implies that we take part in social work in order to bolster the quality of relationships among different individuals. Such relationships are crucial in the enhancement of the quality of life of an individual (Beckett, 2006). These values are essential towards demystifying the goals of social work for any society.
Social work seeks to enhance the levels of determination among individuals. For instance, self worth enables a person to be immensely focused towards attaining different personal goals. Social work also ensures harmony among people as they co-exist in the society. Additionally, social work is crucial aspect that seeks to empower people and align them towards a certain path in their lives.
Contribution of theory to why we do social work
Social work is characterized by numerous theories. Each theory focuses on different aspects or perspectives of social work. Consequently, theory helps in demystifying why we take part in social work. Firstly, theory helps social workers to integrate the different values of social work into their restive tasks. Through the different social work theories, it is easier to appreciate the values of social work. When a social worker integrates these values into his task, the different goals of social work are fulfilled. For instance, the functional theory accentuates the value of competence in social work. Based on the stipulations of the functional theory, social workers must be highly competent in order to ensure that the different goals of social work are attained (Gray & Webb, 2012). This is an aspect that illustrates how theory contributes to an understanding of why we do social work.
Theory is an essential pillar that provides the necessary link between social work and other disciplines. For instance, the psychoanalytic theory is massively essential in that it depicts the connection between psychology and social work. When a social worker appreciates this connection, he or she appreciates the critical role of social work. The psychoanalytic theory also provides an excellent platform for evaluating the connection between different social challenges and social work. Such a platform is essential because it depicts social work as an important blueprint that helps in resolving different kinds of social challenges. Theory is an invaluable aspect of social work in that is clarifies the connection between different principles and actual practice. This connection is the mainstay of social work (Howe, 2009).
The social worker must appreciate the numerous principles of social work and integrate them into his or her tasks. The value of service is a notable principle of social work. Through the theory of social work, we understand the inherent connection between service and social work. This is essential towards demystifying why we do social work.
Theory also makes essential contributions from the perspective of assessing the implications of different dimensions of social work. For instance, the mitigation or prevention of social injustice in the society promotes the wellbeing of people. Through the social work theory, we appreciate the potential implication of different principles and values of social work (Tester, 2010). This is an essential aspect in that it streamlines the efficiency and outcomes of the practice of social work. Similarly, theory puts into perspective the potential implications of the absence of social work in the society. Without social work, millions would suffer because they would not access the necessary help for their different challenges. Consequently, theory helps in illustrating the void that would be caused by the absence or removal of social services in the society.
Relationship between theory and practice in social work
In any field, theory is an influential aspect that provides the necessary connection between models and practice. In view of this perspective, social work is not an exception. In social work, there is an extensive relationship between actual practice and theory. In essence, this implies that theory plays a massive role in the enhancement of the entire practice of social work. Firstly, theory identifies the various principles that guide the actions and tasks of social workers. Each theory of social work is based on one or more of the different tenets of social work (Walsh, 2010). For instance, the theory of behavior modification is inherently connected to the value of self worth.
In order to enhance the level of self worth in an individual, social workers use the theory of behavior modification extensively. This theory provides the relevant frameworks for guiding the social worker on the pertinent aspects of changing the behavior of an individual. Additionally, this social work theory enables the social worker to have adequate knowledge about the potential implications or outcomes of behavioral changes. In line with this dimension, the connection between social work theory and practice is illustrated. The relationship can also be assessed from the perceptive of information. In any practice, the availability of information is a crucial pillar that influences the outcome of any intervention or strategy (Connolly, 2011). While there are numerous interventional mechanisms in social work, they are suited for different challenges or social problems.
It is fundamentally essential for the social worker to align a given social challenge to the most effective intervention. The different social work theories provide the practitioner with adequate information pertaining to the effectiveness of different interventions for a certain social challenge. For instance, the functional theory enables the social worker to assess the different challenges affecting the society from a professional perceptive. This information is immensely helpful in streamlining the efficiency of social workers in different tasks. Communication is another platform that illustrates the connection between practice and theory in social work (Tester, 2010).
Theory facilitates for the selection of the most effective communication platform in social work. In essence, the different theoretical frameworks of social work are designed on the basis of previous studies and outcomes of social work practice. In line with this perspective, the theories are essential reference points for social workers to identify the best communication tools for different tasks in social work.
The practice of social work is characterized by numerous problems. This implies that social workers should have the relevant skills for solving social problems. Social problems are diverse and might include marital issues, discrimination, and inequitable allocation of public resources among others. Theory is a crucial pillar that enhances the social workers’ ability to address these problems effectively (Gray & Webb, 2012). The social work theory of problem solving provides adequate information for social workers to develop solutions for different social challenges. Consequently, theory is an important problem-solving platform that depicts the relationship. Additionally, theory enables the social worker to establish the different systems affecting a given situation in social work practice (Beckett, 2006). For instance, the social problems in a given community might be associated with political, economic, and educational systems. The interactivity of these systems streamlines the efficiency of the different interventional mechanisms used in social work practice.
The different perspectives of social work have been assessed in the essay. While the scope of social work is extensive, the essay narrows down on the connection of social work practice and theory. There are numerous social work theories such as behavior modification, psychosocial theory, ego psychology, and communication theory among others. The different theories are connected strongly to the practice of social work. Social workers generate information on how to solve different social problems through the social work theories. In addition to solving problems, the theories are essential in that they integrate the core values of social work into practice.
Beckett, C 2006. Essential theory for social work practice, Thousand Oaks, CA: Sage Publications
Connolly, M 2011. Social work: From theory to practice, Cambridge: Cambridge University Press
Gray, M. & Webb, S 2012. Social work theories and methods, London: SAGE
Greene, RR 2011. Human behavior theory and social work practice, Piscataway, NJ: Transaction Publishers
Howe, D 2009. A brief introduction to social work theory, New York, NY: Palgrave Macmillan
Oko, J 2011. Understanding and using theory in social work, Exeter: Learning Matters Ltd.
Tester, B 2010. An introduction to applying social work theories and methods, Berkshire: McGraw-Hill International
Walsh, J 2010. Theories for direct social work practice, Mason, OH: Cengage Learning
Cancer is among the commonly known and dangerous disease in the human life that cause deaths. There are different types of cancer such as liver, breast, and prostate cancer among others. Study shows that liver cancer is ranked the third most common type of cancer in the world. Individuals who are affected by liver cancer do not stay long simply because within a period of one year from the infections that patient dies. It has been discovered that patients with cirrhosis conditions have a high chance of getting liver cancer. Drinking alcohol according to healthcare findings for patients with chronic liver disease such as hepatitis is risky simply because it increases the risk of developing liver cancer. Unlike other cancer conditions, patients with liver cancer do not develop any signs of the disease until in the late stages of the tumor. The prognosis of liver cancer patient is very poor because no symptoms are discovered, (Dunbar, et al., 2013).
Liver cancer is known to take years before it is discovered. Before it is indicated that something has gone wrong, this disease condition may stay in the body for long. Below are some of the symptoms that show the presence of liver cancer;
- abdominal pain
- loss of appetite
- weight loss
- dark-colored urine
- clay-colored bowel movements
- internal bleeding
- nausea and vomiting
- hair loss
- shortness of breath
- mouth sores
Liver cancer doesn’t have any age, but in most cases it affects people starting from thirty years. The condition especially affects poor people who are unable to take health measures about their bodies. Liver cancer although it is dangerous simply because it occurs at final stages has its treatment form available. Radiotherapy, chemotherapy, and surgery are some of the treatment methods used in health care for treating patients with liver cancer. Surgery of liver patients has been always the recognized way of treatment. The tumor under the liver cancer must be removed if the surgery approach is used, (Dunbar, et al., 2013). Another treatment method is the chemotherapy, which the physicians does, is the use of powerful medics that kill cancer liver. Some of the effects due to chemotherapy include;
Based on the above information provided, it has been discovered that people with liver cancer becomes affected. What I can say is that just like any other type of disease one can get, liver cancer is treatable and prevention. Liver cancer is a risk in the human life simply because it does not give signs in advance rather it provides signs and symptoms to know whether the person is suffering or not. I have known that the best treatment approach is surgery then followed by other methods, (Thomas, et al., 2012).
Dunbar, J. K., Dillon, J., Garden, O., & Brewster, D. H. (2013). Increasing survival of hepatocellular carcinoma patients in Scotland: a review of national cancer registry data. HPB: The Official Journal Of The International Hepato Pacreato Biliary Association, 15(4), 279-285. doi:10.1111/j.1477-2574.2012.00567.x
Thomas, R., Madani, R., Worthington, T., & Karanjia, N. (2012). The usefulness of P-POSSUM score in patients undergoing elective liver resection for benign disease, metastatic colorectal cancer and non-colorectal cancer. Hepato-Gastroenterology, 59(120), 2421-2427
Tine Capitis is a disease that is caused by superficial fungal, infection in the skin of the eyebrows, scalp, eyelashes, with the propensity of attacking follicles and hair shafts. This is a disease that is caused by dermatophytes in microsporum and trichophyton genera which invade the hair shaft (Burgdorf, et al 2003). Tinea Capitis is not common in adults and is often seen in pre pubertal children, which is common in boys than girls.
The occurrence of this disease is not registered by the public health agencies meaning that true incidences are not known. However, the peak incidence occurs in male children of African American who are school aged. This is predominately a disease that affects pre adolescent children accounting for about 92.5 % of children who are younger than ten years. It is rare in adults, but can be found in elderly patients. The occurrence of Tinea Capitis is widespread in some urban areas, in US. Tinea Capitis is common in urban areas and mostly children of the Afro-Caribbean extraction in Central America, South America, and North America. It is also common in some parts of India and Africa (Baker, 2001). This disease is sporadic in northern Europe.
The cause of Tinea Capitis is fungi of species of genera Microsporum and Trichophyton. The age predilection of the disease is believe to be as a result of Pityrosporum orbiculare that is a part of normal flora. The causative agents of the disorder include keratinophilic fungi, which are termed as dermatophytes. The molds are present in non living cornifield layers of the skin and its appendages and they are sometimes capable of invading the outer layer of the skin stratum corneum (Baker, 2001). Dermatophytes are considered as the most common infectious agents of humans as they cause a variety of clinical conditions termed as dermatophytosis. From inoculation, the fungal hyphae tend to grow centrifugally in the stratum corneum and the fungus continues growing downwards into the hair. The zone that is involved extends upwards with the rate of the hair growth, and it starts becoming visible above the skin surface with 12 to 14 days (Reiss, et al 2011). The hair that has been infected is usually brittle and within the third week broken hair starts being evident.
Symptoms and diagnosis
Areas, which are infected by Tinea Capitis, tend to be bald with small black dots because of the broken hair. A person may have round scaly areas that are red or swollen, and there is always itching of the scalp which may cause hair loss and lasting scars (Thappa2009). The health care provider will look at the scalp that is infected with a special lamp referred to as Wood’s lamp test, which help in diagnosis of a fungal scalp infection. The health provider may swab the area sending it for a culture which may take about three weeks to get the results.
Management and follow up
The health care provider prescribes medicine that is taken by mouth for treating ringworm in the scalp. The step that a person can take while at home is ensuring that the area is kept clean and washing the area with medicated shampoo one which contains selenium sulfide because shampooing tend to slow the spread of the infection (Rai, & Wankhede, 2009). Culture can have an impact on patients because it will be able to determine the treatment for patients. Therefore, it will help in avoiding wide spread of the infection.
Abeck, D Cremer, H & Burgdorf, W (2003). Common skin diseases in children Springer Publishers
Baker, R (2001). Pediatric primary care Lippincott Williams & Wilkins
Lyon, M Shadomy, J & Reiss, E (2011). Fundamental medical mycology John Wiley & Son
Rai, M & Wankhede, S (2009). Advances in fungal biotechnology International Pvt Ltd
Thappa, (2009). Clinical pediatric dermatology Elsevier
Health on Children
Impact of poor oral health on children's school attendance and performance
Oral health on children in America has become one of the great debates in the healthcare setting. Evidence shows that over 51 million school hours annually are lost due to oral health conditions developed by dentally related illnesses. Oral health according to experts has been established as a fundamental component that defines the general health of children. It is with no doubt that when you are orally ill; you do not have a good body health. According to Surgeon General Dr. David Satcher, oral health in children and humans is a mirror for general health. Studies conducted recently have discovered that oral health results to several conditions. Dental disease in children may develop serious general health conditions and significant pain, lost school time, overuse of emergency rooms, and interference with eating. This paper will examine the impact of poor oral health on children’s school attendance and performance.
A number of chronic diseases affect children that require significant adjustment in decreased quality and life management of life to varying degrees. It is estimated that 20-35 % of children and adolescents in United States are affected by chronic health conditions. Obesity, diabetes, asthma, and dental caries are among the most prevalent diseases of childhood. Compared to asthma, dental caries has been discovered to be the most common chronic disease of children that occur 5-8 times more. The health care industry need to establish dental care in order to deal with the problems of poor oral health conditions. Based on the national center for health statistics, 60% of the reports on the unmet health conditions reported by parents are for dental care. It is with no doubt children who suffer dental caries engage in poor oral health quality of life, (Seirawan et al., 2012).
Children’s Oral Health and School Attendance
Children suffering from dental caries are said to be unhealthy something that may be a disadvantage to their mental development, social, and physiologic development. It is a condition that has developed attention from policy makers as well as investigators. It is true that children who do not eat well end up having difficulties in sleeping something that will hurt their lives. This hurting will develop failures like undernourished and underweight that leads to undereducated and underachieving. Thousands of school days are lost annually due to dental problems that affect school performance of the child affected, (Bianco et al., 2010).
As a result of acute dental conditions, statistics shows that children under the age of 18 years loss millions of days that they could have utilized if they were healthy. Dentally related illness conditions affects school programs of most children because they have to skip learning for the purpose of seeking medications for their conditions. According to an oral health care supplement developed by Gift and the colleagues, millions of hours are wasted when dealing with matters of oral health for children, (Blevins, 2011).
Children’s Oral Health and School Performance
There few journals or materials in US that have been published that examines oral health and school performance or achievement. Different international studies show that there is a greater relationship between poor school performance and dental health conditions of a child. Evidence shows that there is a positive correlation that exists between school performance and oral health status of a child. Although American education system differs from one county to another, apart from a generalized conclusion, it is clear that poor children’s oral health affects the child school performance. Apart from children, it is clear that parents with children with poor oral health are 3 times likely to take work off days in order to take care of the kids. Poor oral health conditions to children prevent them from attending school. Those skip schools are at a high risk of understanding what other kids were taught when they were away, (Jackson et al., 2011).
Children’s Oral Health and Social Life
Poor children’s oral health affects how children interact with their friends. Those affected tend to spend more time seeking medications something that prevents them from meeting their loved ones, friends, and the society at large. Kids who are affected end up not having time to associate with others thus they develop a sense of being isolated. Poor children’s oral health is a condition that may affect a child’s growth, development, and lack of social life. Absence of kids caused by pain prevents them from catching up with their friends and when they return, their friends tend to make jokes out of them simply because they have no idea of what they have encountered thus making them feel isolated and disowned by the society, (Blumenshine et al., 2008).
In summing up, oral health on children in America has become one of the great debates in the healthcare setting. Poor oral health develops negative impacts on the school attendance and performance of children affected.
Bianco, A., Fortunato, L., Nobile, C., & Pavia, M. (2010). Prevalence and determinants of oral impacts on daily performance: results from a survey among school children in Italy. European Journal Of Public Health, 20(5), 595-600. Doi:10.1093/eurpub/ckp179
Blevins, J. (2011). Oral Health Care For Hospitalized Children. Pediatric Nursing, 37(5), 229-235.
Blumenshine, S., Vann, W., Gizlice, Z., & Lee, J. (2008). Children's school performance: impact of general and oral health. Journal Of Public Health Dentistry, 68(2), 82-87. Doi:10.1111/j.1752-7325.2007.00062.x
Jackson, S. L., Vann Jr, W. F., Kotch, J. B., Pahel, B. T., & Lee, J. Y. (2011). Impact of Poor Oral Health on Children's School Attendance and Performance. American Journal Of Public Health, 101(10), 1900-1906. Doi:10.2105/AJPH.2010.200915
Knaub, M. (2012). New oral health program targets young children. Sun, The (Yuma, AZ).
Milsom, K. M. et al. (2006). The effectiveness of school dental screening: dental attendance and treatment of those screened positive. British Dental Journal, 200(12), 687-690. Doi:10.1038/sj.bdj.4813724
Mtaya, M., Åstrøm, A. N., & Tsakos, G. (2007). Applicability of an abbreviated version of the Child-OIDP inventory among primary schoolchildren in Tanzania. Health & Quality Of Life Outcomes, 540-11. Doi:10.1186/1477-7525-5-40
Policy on School Absences for Dental Appointments. (2012). Pediatric Dentistry, 34(6), 38-39
Seirawan, H., Faust, S., & Mulligan, R. (2012). The Impact of Oral Health on the Academic Performance of Disadvantaged Children. American Journal Of Public Health, 102(9), 1729-1734. Doi:10.2105/AJPH.2011.300478
Visiting Richmond Monument Avenue was a great experience having lots to learn and fun. This is an amazing place with huge monumental statues that glorify war heroes and others. Something that I found amazing about visiting Monument Avenue was the stunning homes which line the street as they are beautiful mansions. This is the prettiest street, and it is easy to drive.
The most amazing this is the beautiful statues that are erected to honor the heroes and memorize Virginian Confederate participants of civil war including Arthur Ashe, Matthey Fontaine Maury, Stuart J.E.B, Thomas stonewall Jackson, and Davis Jefferson. Something that amazed me about the monument is that it is Richmond’s ceremonial parade route and a good number of great personalities including Queen Elizabeth, Commander Richard Evelyn Byrd, Winston Churchill, General Eisenhower, and March Foch have all journeyed along the avenue towards the mansion of the governor. From my observation and research I did, I found out that the aim of the creation of the monument was to honor confederate heroes.
I believe the reason as to why the monument has been able to survive for that long without any alterations till today is because of its architecture and the great memories that it holds lots of histories for people in Richmond. It was not hard to structure this visit because I had a friend who would accompany me to the place and was familiar with Monument Avenue. Therefore, I enjoyed every time I spent in this place in the company of a friend who acted as my tour guide. Richmond Monument Avenue is a beautiful place to visit and always take sights while it holds a lot of history for a person to learn.
A Comparison Of Ict Policy In Usa, Eu And Austrailia
Many countries in the developed countries have formulated policies to incorporate ICT in their public service. Shared-services and cloud computing are some of the most strategies. These strategies are meant to offer solutions to the challenges afflicting pubic services in many countries. Governments have to meet the enormous needs for services within changing client needs and expectations. They have to streamline their expenditure in the wake of the economic crisis. The aims of this paper were to investigate the current trends in ICT policy development in USA, Europe (Scotland) Australia. The findings of this paper will help in formulating policies, in other countries, which have not embraced ICT. Data was gathered from government policy papers and commissions reports in all the three countries and regions. Findings: USA has a well developed and planned ICT policy, which has well laid implementation time line and monitoring mechanisms. The policy is referred to as Shared-First. Scotland has conducted the necessary preliminary studies on its public sector but has yet to develop an elaborate ICT strategy. However, stakeholders have identified keys areas for action. Australia has a well documented ICT strategy involving incorporation of cloud computing in its public sector. However, these governments are facing challenges in the implementation of the strategies. Recommendations: The implementing governments or agencies should adopt a good governance approach. They should adopt best practices, which are relevant to their organizations or agencies. They also seek information and advice from external sources to ensure they get standards that are being applied in other sectors or industries. Advance preparations should be made to make sure organizations, departments and agencies are ready to adopt ICT strategies. The strategy should be developed to meet the specific needs of the government or organization. The providers of the services should be selected using a standard procedure that is fast, simple and reliable. The government should ensure that they have categorized and classified data according to their privacy, security and urgency.
Shared services, cloud computing, ICT,
USA shared services strategy: planning and implementation
The concept of shared services has been in existence for some time. There is several example of how public sectors have embraced the concept. Shared services have the potential of helping the implementing organization and the sharing partner to sustain services and incorporate continuous improvement. ICT provides one of the best channels of improving services in public services and corporation. It offers an effective channel through which governments can use to connect businesses and the society. It can be used to automate processes and services and make transactions easier and quicker. There is growing pressure for governments to improve the management and use of ICT so as to increase productivity of the public sector. The pressure for use ICT in the public sector has resulted from the change in public expectations and behaviors, advance in technology and gaps, in ICT skills and leadership
In 2012, the USA launched the federal information Technology shared services strategy. The aim of the strategy was to help the executive with policy guidance on intra and inter-agency communication to enable the Functions of IT functions. The strategy also known as Shared-first encourage the use of a shared approach to delivery of IT services. The main aim of the strategy includes: To improve return on investment across agencies, close the productivity gap in public service and increase c communication with stakeholders.
Factors that necessitated the use of shared services in USA
The USA government has over 300 organizations in its executive branch of the federal government. They organizations have employed nearly 2.6 million staff and operate ten thousand IT systems. These employees are expected to provide manual and online services to million of citizens at a local and internal level. Budget expenditure on IT by these organizations has continued to increase over the years. This is despite the financial constraints that the government continues to experience. This is coupled by the increasing customer expectations and the over-evolving nature of IT. These factors have triggered the concerned authorities to think of ways of delivering faster services at low costs and utilize the benefits of IT. According to the Federal information Technology shared services strategy, for the government to be successful in limited resources, they must eliminate wasteful spending especially so from IT.
In USA Federal government, a shared service is IT function that is provided for consumption by multiple organizations within or between federal agencies. Shared services are categorized into commodity IT, support IT and mission IT. Some of the services under commodity IT include websites and content management. The support IT comprises of records managements, human resource management, and financial management. Mission IT comprises of performance management, geospatial and federal health architecture. Federal agencies are mandated with overseeing intra-agency services under the supervision of the communication information officer (CIO). Inter-agency services are referred to as Lines of Business (LOBs). They are operated by a managing partner within a federal agency. Managing partner, supplier and customer, are the basic roles of an IT shared service.
The main function of managing partner is to establish and maintain an IT shared service with the approval by agency leadership. The managing partner organization (program management office, PMO) is mandated with developing, implementing and maintaining financial and service model and contracts with Customers and Suppliers. The success of the shared services depends on the PMO. However, he or she report using matrices that have been developed by the federal agency and the federal CIO council.
The customer is the federal agency enters into the contract with and pays the managing partner to receive information technology services. The customer organization is required to interact with a supplier to coordinate day-to-day offering of services.
The supplier is the government or private enterprise that provides the actual IT shared services to clients. The supplier contracts the managing partner using vehicles and strategies that have been established by the federal government.
The US government identified several success factors. They include the support of the executive, cultural change, business process reengineering, technology enablement, resources enablement, adoption strategy, and continuous improvement. According to Federal Shared strategy 2012, the support of the executive or agency is very fundamental in the success of IT shared services. The agencies must shift from internal program to program-specific thinking. They must also move toward a shift of consuming and offering IT shared services with several groups whenever situation arises. Businesses processes must be optimized to embrace processes that embrace cooperation from other agencies. They must also be a robust connectivity and use of cloud computing for services to be successful. The agency must also offer the necessary resources and redirect resources which are channeled to duplicated services and programs. Shared services partners must always look for ways to improve their services and meet the needs of customers.
Implementation strategy of the plan.
In order to implement the strategy effectively, the federal government has committed to focus on institutionalizing a Shared-First Culture, start with commodity IT and identify providers and delivery model. The agency should work closely with other partners so as to create and sustain a culture of sharing. This will require organizations and leaders to change their traditional way of thinking and doing things and embrace integrated matrix of shared IT services. The implementation of the strategy will also depend on the acquisition of the necessary IT products (commodity IT). The agency should identify and incorporate successful shared services models that have been successful in private and public sectors. Agencies are advised to outsource from inter-agency shared services because of their cost benefits. The first step should involve solidifying/consolidation of commodity IT services. Once the Commodity has been solidified, a culture of Shared-First should be expanded, and it will evolve at business and program level.
The federal government has laid out an implementation strategy that began in 2012 and was expected to complete in April 2013. In the first year (2012), the federal government was expected to identify new IT shared services opportunities, work to improve on the existing ones, and prepared the groundwork for the adoption of Shared services in the future. The agencies were expected to submit an Enterprise roadmap toward the implementation of the strategy. By December 2012, the agencies were expected to have completed two OMB-approved IT shared services. By April 2013, the agencies were supposed to submit an update of the roadmap.
The federal CIO council’s shared services committee committed to conduct quarterly meetings for agencies and managing partners, collaborate with agencies to conduct enterprise architecture, create an online catalog of inter-agencies shared services and assist OMB in reviewing Shared-Services plan.
The strategy set consolidating intra-agency commodity IT as its initial goal. The commodity IT services were categorized into IT infrastructure (data centers, networks, mobile devices and computers), enterprise IT systems (E-mail, collaboration tools, security and web infrastructures), and business systems (finance, human resource, travel and customer relationship management).
The second step was to migrate to two areas by 2012 November. Each of the agencies submitted the two areas to be given priority in the implementation of the strategy. The agencies were supposed to justify, describe and give the cost if implementation of the selected areas.
Despite the fact that the strategy targeted commodity IT as its focus area, the strategy also paid some attention to inter-agencies collaboration by seeking to improve shared services between agencies. The collaborating partners sought to improve inter-agencies sharing and streamline access to line of business (LOB) services.
USA IT shared service pan
According to the 2012 strategy, the federal agency chief information officer was expected to submit and plan for the implementation of the strategy by August 2012. The plan was to incorporate the following sections.
Business and technology architecture.
This is a comprehensive description of the objectives of the enterprise, measures set aside to enable IT migration in its entire program and the areas that the enterprise will focus. This submission had to include the transition plan, current architecture and future plan.
IT asset inventory- This is a list of IT assets that are owned by the agency including IT systems and their support mission, administrative and commodity IT programs.
Line of business services plan
The program managers of each federal LOB were expected to submit a plan to OMB. The plan was expected to address the quality of services and offer updates on the progress of the strategy. The OMB in collaboration with the federal councils is mandated with monitoring the progress of the plan. The plan contains challenges and opportunities facing council is shared service and changes in services that may result from the implementation of the plan. It also includes benchmarks to assess the performance of suppliers. The benchmarks include usage, satisfaction, uptake, efficiency and effectiveness.
Online IT services catalog
The OMB and the federal CIO have established an online IT services catalog to bridge the gap that exist on inter-agency sharing. The catalogue was launched in 2012 to provide the federal agency with a list of services and contract vehicles that are available. The catalog also provides information on the, available managing partners and suppliers.
Policy consideration in the implementation of the strategy
The Shared-First strategy was meant to augment efforts being undertaken by the OMB to reduce and eliminate wastage and duplication of services by IT organizations. The 2012 strategy identifies the following IT policy as key to the implementation of the strategy.
PortifolioStat process- This process is meant to conduct comprehensive reviews of IT investment portfolio. It includes tools for analyzing individual investments so as to identify waste and duplication, and to prioritize areas that need immediate attention.
Future-First architecture-This is a set of guidelines that agencies are supposed to use while implementing the common approach. The process will enable agencies to meet future IT challenges effectively.
Future-Ready digital government-This policy is concerned with ensuring the government is ready to transit into digital operations. It promotes the use of cloud computing and mass processing of data. It promotes the ability of federal agencies to improve decision making decisions in terms of usability and access to websites and other IT services.
Ict Policy In Europe (Scotland)
In 2012, the European Union Economic and social committee released a report that was aimed at exploiting the potentials of cloud computing in Europe. Cloud computing involves storage, processing and access of a huge amount of data on remote computers and accessing it via the internet. It gives users the ability to access unlimited information and commanding powers. According to the commission, the definition of cloud computing it diverse because of the diverse nature and features of cloud computing. The commission highlights some of the step that should be taken so as to capitalizes on cloud computing.
The first step is the fragmentation of the digital single market. The fragmentation is necessitated by the differing national legal frameworks and the complexities of managing the services. The second concern raised by the commission involved worry among clients over data access and accountability. Some of the major concerns includes compensation in case of data loss. User rights, ownership of data and ways of resolving conflicts. The commission also noted that, differing standards affects the quality of services and hampers harmonization of services.
The commission identified key actions that should be taken to improve cloud computing across Europe. The first action was harmonization of cloud computing standards. The commission noted that, despite efforts from suppliers, most vendors have put in place incentives to fight for dominance. Standards governing cloud computing are likely to affect many players, including those, not in cloud computing. Efforts to standardize cloud certification and actions have kicked-off in some countries such as the US. The commission recommends the application of the existing standards to develop confidence. However, stakeholders should initiate measures to identify standards of concerns so as to harmonize them.
The commission also noted that complexity and uncertainty in the legal framework governing cloud computing makes the process of acquiring contracts very complicated. The use of “take-it-or-leave it” is detrimental to users and final consumers of the services. In order to challenges arising from complex legal framework, the commission proposes that stakeholders should develop a model for cloud computing services, which has standard agreements and procedures.
According to McClelland (2011), Scotland public service sector is behind the private sector in the adoption and use of ICT. However, the government has instituted ICT processes in several processes such processing of pay rolls, finance and accounting, logistics and procurement. Despite of these efforts, the government has not exploited fully the benefits of ICT in the public sector. Numerous processes and procedures are not yet automated. However, there are plans to automate these processes. Different organizations have installed different applications. McClelland (2011) concludes the use of ICT in Scotland is not fully exploited. The public sector utilizes a stand-alone self-sufficiency model that has hindered the reduction of costs and expenses used to run ICT processes in ICT. The Scottish government is also slow in implementing changes that will see provision of quality services to the public and the business sector.
In general, McClelland (2011) concluded that the ICT sector in Scotland was unstructured and fragmented. The sector also lacks the mechanism to record expenses from handling of data. McClelland recommends to the government use of shared ICT platforms to reduce the cost of offering services. The national lacks an overall ICT strategy and a constituency approach to develop standards in the public sector. He also noted that sharing of information between different sectors was limited, and there is a great need to improve sharing data pertaining to the vulnerable groups. The 2011 review of Scotland ICT infrastructure reviewed some of the few successful projects and programs that have been instituted by the government.
Customer first programme is a project supported by the Improvement Service and it is backed the Scottish government. This project involves the pursuit of standards among councils. It targets the reduction of cost and the delivery of convenient and responsive public services.
The second program is the National ICT infrastructures, which incorporates the shared investment of a primary data processing location. Councils have access to the location through a network connection. “Citizen Account” is one such programme, and it provides citizens with a secure way to register for and access services. The account has created an online personal record that can be accessed securely and updated online. The third project that has been successful is the “smartcard” project. The project utilizes a shared card management system to offer support to national concessionary fares schemes. The card is used in the 32 councils. However despite these efforts being undertaken by the government and the Improvement Services, Scotland still lacks a comprehensive Shared-services strategy. The need for effective management of public services in Scotland is highlighted effectively in a report by the commission on the future delivery of public services, which was submitted to minister in 2012. According to the commission, budget expenditures on the provision of public services is increasing due to changes in the demographics of the country. The revenue available to finance public services is decreasing as a result of the 2007-2009 economic crisis. The commission reported that one of the greatest challenges facing the public sector is the deep-rooted inequalities in the sector.
Ict Policy In Austrailia
In 2011, the Australian government launched the “Cloud Computing Strategic Direction Paper.” The paper sought to identify and exploit the potentials of cloud computing to increase efficiency in government operations. Australia has witnessed a dramatic growth in cloud services and broadband connectivity. This growth presents the government with the opportunity to improve its delivery of services and meet the challenges that the government is facing. According to the strategic paper, the need for cloud computing was necessitated by the high dependent of government businesses and operation on ICT. Most of government agencies in Australian operate within the Financial Management Accountability Act 1997. Prior to the strategic paper, computing services were operated via mobile devices and computers, and each of the services was handled differently. Each of the branches of the Australia government has different requirements, level of privacy and security needs. Previous reviews on ICT sector in the country recommended increased funding to ICT infrastructures especially so back office services and their associated costs. The reviews have also revealed that the government can reduce drastically its expenses on management of data by investing and supporting cloud computing. Government agencies are demanding effective, responsive and flexible ICT services to help them offer cost effective services. The government is also being forced to respond fast to the growing number of individual agencies seeking services from providers.
According to the Australian government, “cloud computing is an ICT sourcing and delivery model that enables expedient, on-demand network admittance to a shared collection of configurable computing resources that can be speedily provisioned and unconstrained with nominal management efforts”
The Australian clouding strategy identifies four types of cloud computing that include private or internal cloud, community cloud, public cloud and hybrid cloud. The government has instituted three types of cloud services. The services include software as a service (SaaS), platform as a service (PaaS) and infrastructure as a service (IaaS). The Australian government has also provided an elaborate explanation of risks associated with cloud computing. The comprehensive analysis of the challenges is aimed at helping organizations and agencies to make choices on vendors of the services.
Some of the benefits identified by the Australian govern from cloud computing includes:
Cloud computing offer unconstrained capacity that allows agile enterprises to be flexible and responsive to client needs. The government will be able to respond effectively to the needs of the citizens, employees, corporate and many other stakeholders. Cloud computing will also increase the efficiency of the government. Government agencies will have ample time to conduct research and develop products and services. They will be able to create solutions that are feasible to the challenges affecting them and rationalize legacy systems.
The government identified various drivers for the adoption of the cloud strategy. The drivers includes the value for money, flexibility and reliability. The strategy is based on the principle and risk reduction approach.
In the same year (2012), the Victorian government mandated the department of treasury and finance to develop an ICT strategy. The department came up with strategies through which the Victorian government would deploy ICT in its operations. The commission identified change in customer expectations and behaviors, gaps in leadership and skills and advance in technology as the main factors that necessitated the development of the strategy. According to the department of finance and treasury, many citizens expect online services from the government. A huge population of the country own mobile devices and are conversant with several computing and technological devices. The population also has access to high speed broadband connection.
The Victorian government developed the digital design to enable it bridge the gap in IT in its operation. The design is based on three main action areas: engagement of all stakeholders, adequate investment in ICT and improving ICT governance. The design was to be guided by 8 key principles.
From the above analysis of ICT landscape in the three countries, it is clear that different countries have laid down the necessary strategies to incorporate ICT in public services. The need to use ICT in public service is brought about by similar or closely related factors. Some of the identified factors that have led to the increase in ICT demand, in public service include:
Citizens in the united state, Europe and Australia expect the government to deliver efficient and cost-effective services. The advance in technology has enabled a large population to own and operate numerous mobile and computing devices. The private sector has also embraced the use of technology and, therefore, the governments have to embrace technology so to satisfy the changing trend in citizen consumption of services. Most governments manage huge volume of data and coordinate activities of very many agencies and corporate. Managing such huge volume of data requires efficient software and hardware.
Most governments are struggling with the huge burden of providing services to the public. They ability to provide such services have been drastically affected by the economic crisis. Therefore, governments have to look for ways to cut the cost of operations. ICT provide such an opportunity to governments. ICT also offers a good platform for the sharing of information between private and public sectors.
USA and Australia have already developed their ICT strategies and laid down an elaborate ICT implementation strategy. The USA has adopted a combination of shared services and cloud computing to meet it enormous needs. Australia has developed a cloud computing strategy to align its public sector with legal requirements and meet the needs of its citizens effectively. Scotland has conducted preliminarily research on its public service and identified areas for action but has not laid down the necessary strategy.
Despite of the different strategies developed by these countries, it is clear that they share similar challenges and targets. Therefore, they should adopt best practices in managing their ICT strategies. The governments must embrace themselves for the challenges that accompany the implementation of cloud computing and shared services. Some of the common challenges facing cloud computing can be categorized into policy, organizational risks, technical risks, and legal risks (computerweekly.com). In order to reap maximum benefits of cloud computing and other ICT strategies, the implementing organization or agency should adopt a good governance approach. They should adopt best practices, which are relevant to their organizations or agencies. They also seek information and advice from external sources to ensure they get standards that are being applied in other sectors or industries. Advance preparations should be made to make sure organizations, departments and agencies are ready to adopt ICT strategies. The strategy should be developed to meet the specific needs of the government or organization. The providers of the services should be selected using a standard procedure that is fast, simple and reliable. The government should ensure that they have categorized and classified data according to their privacy, security and urgency.
Commission on the future delivery of public services. 2011. APS Group Scotland.
Federal information technology shared services 2012. Executive office of the president of the united state.
John McClelland 2011. Review of the ICT infrastructure in the public sector in Scotland. The Scottish government, Edinburg, 2011.
Cloud computing strategic direction paper (2011). Opportunities and applicability for use by the Australian government. Australian government, Department of finance and deregulation.
Victorian government ICT strategy (2011). Digital by design. Victorian information and technology advisory committee.
How to ensure you are getting the right cloud services (2012). Retrieved from computerweekly.com on 26/7/2013.
Communication from the commission to the European parliament, the council, the European economic and social committee and the committee of the regions (2012). Unleashing the potential of cloud computing in Europe. European commission.
Audit of GSA’s transition from Lotus Notes to the cloud (2012). Office of the audits. USA.
HM government, 2011. Information principles.
Objectives and barriers of implementation of eGovernment: from Lisbon strategy to Digital Agenda 2020.