Research for Human Resource Management Activities Essay

With increasing globalization, most multinational corporations can not avoid cross-culture management issues. Especially, cross-cultural human resource management (HRM) has becoming one of the critical operating strategies. And in this paper, we will mainly analyze the current situation of human resource management activities that include selection and recruitment, training and development, and performance management in the Chinese and Australian cultural background. We aimed to find out the differences of human resource management activities between Chinese and Australian human resource department, and look forward to helping a Sino-Australia joint venture (JV) enterprise which is poor at cross-cultural human resource management. Culture forms values, creates attitudes, and influences behavior (Luthans & Jonathan, 2009). Due to national traits and region of culture, the interaction between different cultures is considered as cross-culture. And under the cross cultural background, international human resource management should carry out the activities of human resource management based on characteristics and differences of culture (Ramamoorthy et al. , 2005), which could increase the efficiency of human resource distribution and utilization. According to the Hofstede’s theory, we have got five cultural dimensions which as power distance, individualism versus collectivism, uncertainty avoidance, masculinity versus feminism, and long term orientation versus short term orientation (Hofstede, 1984). China and Australia have obvious differences in the cultural dimensions, which are showed as follows. Comparison of China and Australia on cultural dimensions cultural dimensions |China |Australia | |power distance |high |low | |individualism |low(collectivism) |high | |uncertainty avoidance |low |high | |masculinity |balanced |above the average(masculinity) | |long-term |high |low(short-term) | Source: From Hofstede and Hofstede, Cultures and Organizations: Software of the Mind. And then we will analyze the activities of human resource management as selection and recruitment, training and development and performance management under their respective cultural backgrounds. Firstly, in selection and recruitment human resource activities, there is a large difference between HRM of Chinese enterprises and Australian enterprises. In Australia, the labor pool is relatively mature and developed (Dobbie & MacMillan, 2012). Because of Australia is supposed to value individualism, the HRM of Australian companies used to selecting and recruiting much people depend on market mechanism. Labors change their job and joined choice making with the need of market and the HRM think the person is wanted by them can be got through the mobility of trained personnel and market competition. They do not think this kind of person is disloyal to a company in their mind. But China emphasizes socialist collectivism as the value of the times. And in the case of collectivism, the HRM of Chinese enterprises tends to select and recruit the talents in the range of their favorable groups, they think the groups of graduates from famous colleges that should have the inherent abilities. So the degrees from domestic-famous such as Tsinghua and Peking University would be preferred by HRM. Furthermore, the HRM of Chinese enterprises attach great importance to ‘Guanxi’ (relationship) in the selection and recruitment of employee (Wang & Cindy, 2008). And by the impacts of ‘Guanxi’, the HRM of Chinese enterprises trend to create a job in order to accommodate a person, without considering person’s ability. So these situations have been a contrast with fair competition rules of Australian HRM. On the other hand, Australia is a short-term oriented country, the relationship between HR managers and staff is simple which is similar to a buyer-seller relation in short term. The manager of human resource department generally prefers candidates who have strong capacity to work and innovative consciousness. On the contrast, the long-term oriented Chinese HRM focuses on employee royalty, and try to reduce the rate of staff turnover. They expect employees to work steadily in long term, instead of frequent turnover behaviors in the workplace. Furthermore, because of the high power distance, in the standard of personnel selection in Chinese HRM, they mainly focus on personal background and seniority (Zhang, 2003). There is an obvious top-down hierarchy; the higher position is decided often by strong background and seniority. However, in the Australian HRM, the first is that personal ability to work and communicate. The job is offered to the person who is capable, and the manager of human resource department offered the qualified person an opportunity to move ahead quickly. Secondly, in the parts of training and development, there are also some differences between Australian and Chinese HRM because of the impact of different cultural dimensions. Under the influence of collectivism culture, what contents the Chinese enterprises use to train their employees generally have to meet the organization’s development goals . Most employees accept their superiors’ arrangement of the job training ,which mainly provides them with the skills training aiming at the skills that their job needs (Xiao et. al, 2011). This kind of job training is only beneficial to employment needed skills. Furthermore, being influenced by the high power distance, in the training process, the employees who are being trained are under high pressure from their superiors and have to accept the arrangement of training. Because most of the trainings are passively accepted, obviously it doesn’t work to take the ways of high participation training in China. Under the influence of individualism culture, the HRM of Australian enterprise lays stress on the career training and continuous education. The training was provided by HRM for their employees usually can help the employees to achieve their personal goals, but may be far away from the whole organization development vision, but beneficial to the employees’ personal future careers. And in such a low power distance country like Australia, the employees who are being trained appear more active in the training process. They are more willing to show themselves, and actively express their ideas; meanwhile, they are good at communicating with the coach. Thirdly, in the part of performance management, there are also some differences between Australian and Chinese HRM. Being influenced by the high power distance, in Chinese enterprise, the performance management system is usually built by the top manager, so the top manager decides the performance standards and evaluation criteria. There is a low involvement of employees. However, with the lower power distance, employee could participate in the performance system building, the employee and HR manger could come together to develop a performance management system. Australian advocate individualism, and emphasize personal achievements and rights. But in a country emphasizing collectivism culture as China, the values of pursuing the harmonious atmosphere makes the interpersonal relations in the collective obviously more important than individual achievements. When it comes to the performance evaluation, Australian emphasize standardized and quantified performance evaluation system, hoping that they can objectively measure individual contribution and value, while Chinese prefer the traditional way of evaluation which usually depends on experience because they don’t want to destroy the harmonious unity of their collective (Rajendar ; Ma, 2005) . And on the other hand, in Australian enterprise, the compensation system depends on the staff function and ability with low power distance. In this system, it is not unusual that employee with special skills or talents could get more compensation and bonus than manager in higher position. But in Chinese enterprise, the compensation system mainly focuses on job grade and employment level. There is a clear rank in the compensation system. In conclusion,  it’s very easy to find that main differences in the activities of human resource management between Chinese and Australian enterprises from what has been mentioned above. So far, for a Sino-Australia joint venture enterprise, it is necessary to combine comprehensive considerations cultural background of China and Australia for carrying out the human resource management activities. Furthermore, the joint venture enterprise should place great emphasis on building of enterprise culture and foster cohesion and centripetal force enterprises. Usually successful enterprise has excellent enterprise culture which enables employees to establish common values and standard of behaviors (Deem, 2009), it built a great channel between the parent-country nationals and host-country nationals to communicate more smoothly, that is helpful to minimize any culture clash. And in order to achieve optimal allocation of human resources under the context of international, Of course, there will be also many challenges and hardships along the way.

Technology In Private Healthcare Sector Health And Social Care Essay

There has been increasing usage of Health Information Technology ( HIT ) into governmental and private wellness attention sector. The authorities has already spent plenty on federally regulated wellness industries for implementing HIT, and achieved favourable results. The private health care organisations like place health care, group place, grownup Foster attention, private patterns, and rehabilitation centres are the targeted centres for implementing HIT to better the quality of attention, lessening wellness costs and diminish medical mistakes. The execution of HIT has many possible positive effects, but it besides has few negative effects that have to be resolve in close hereafter. The demand of implementing HIT is increasing twenty-four hours by twenty-four hours because of deceitful activities may endanger state ‘s wellness. This research survey concludes that execution of HIT has possible to better state ‘s wellness attention services. Section I: Definition OF THE PROBLEMBackgroundThe wellness attention system of United States began as a chiefly voluntary or generous system where patients paid small to no money for wellness attention services. Since its initial phases, this system has undergone some major alterations ( Thomas-Brogan, 2009 ) . Health attention has now evolved into a concern organic structure that requires considered planning, fiscal direction, equipped controls, and efficient fortes to keep its feasibleness in both governmental and private wellness sectors. Harmonizing to Thomas-Brogan ( 2009 ) , â€Å" the wellness attention industry is one of the largest industries in United States, using over 13 million workers with the jutting addition of over 3 million new occupations by the twelvemonth 2014 † . The mean life expectancy for U.S. citizen is 77.9 old ages of age, harmonizing to the National Center for Health Statistics. As the mean life anticipation bound additions, the aged citizens, whic h is the largest group of wellness attention consumers, will besides turn wellness attention industries ( Thomas-Brogan, 2009 ) . Due to current progresss in engineering and emerging jobs associated with efficiency and quality of wellness attention services, there are some chances to better quality life for underserved United States citizens through execution of information engineerings ( Moiduddin & A ; Moore, 2008 ) . The attending is being targeted towards the potency of Health Information Technology ( HIT ) in private health care industries to diminish wellness attention costs and to better quality, safety and efficiency of wellness attention services in United States of America ( kaiserEDU, 2008 ) . Harmonizing to Miller ( 2005 ) , in 1999 the Institute of Medicine ( IOM ) surprised the American population with its estimation that between 40,000 to 90,000 lives were lost due to medical mistakes. While the IOM established a balanced facet of the root causes, many wellness attention organisations seized a solution to better quality attention of the patient: Computerized Supplier Order Entry ( CPOE ) . The effectual drivers of investing in HIT contain the promise of quality and efficiency additions. Key privateness moralss for screening personal information have been in continuance for old ages and supply a charity for privateness Torahs, patterns, and policies ( Koontz & A ; Powner, 2007 ) . In 1996, the execution and ordinance of the Health Insurance Portability and Accountability Act ( HIPAA ) define the conditions under which an person ‘s privy wellness information may be used or disclosed. In April 2004, under the supervising of President Bush an executive order has been issued for the development and execution of interoperable HIT in both the populace and private sectors to better the effectivity of wellness attention services in United States, and developing the office of the National Coordinator for HIT ( ONC ) ( Koontz & A ; Powner, 2007 ) . The barriers of execution of Information Technology ( IT ) include the beginning cost and complex construction of IT execution, which often requires important procedures and cultural alterations ( Medpac, 2004 ) . Certain features of wellness attention like payment policies and fragmented bringing system can besides present barrier for IT acceptance. Over cumbrous informations and deficiency of convenience of doctor besides considered as barriers for implementing IT system in wellness attention. Security and privateness issues for patient information besides can play function as barriers in wellness information engineering.Statement of the jobThere is grounds to propose that Health Information Technology has potential to better the quality of attention in state ‘s wellness attention services.Purpose of the surveyThe intent of this survey is to heighten readers ‘ consciousness about benefits available sing Health Information Technology in private wellness attention sector which could better state ‘s wellness and wealth.Research QuestionsThe undermentioned research inquiries created the solid foundation for this research. The inquiry stated will assist to place how to utilize the information engineering in wellness attention system, what are the chief concentrated countries for the execution of HIT, and the negative and positive effects of HIT. Does wellness information engineering have capableness to better the quality attention, cut down medical mistakes and wellness attention costs? What are the positive and negative effects of implementing wellness information engineering in private wellness attention sector?Definition of footingsElectronic Health Record ( EHR ) : â€Å" The Electronic Health record ( EHR ) is a longitudinal electronic record of patient wellness information generated by one or more brushs in any attention bringing scene † ( himms.org, 2010 ) . These electronic wellness records include patients ‘ demographics, advancement sheets, diagnosing and medicine lists, research lab consequences and radiology studies. These wellness records streamline the doctor ‘s work procedure. Underserved U.S. citizens: Underserved U.S. citizens mean those citizens populating in U.S. still non having proper wellness attention services. The major features of this type of population are hapless ; uninsured ; have limited English linguistic communication proficiency ; lack acquaintance or complexness with wellness attention system ; and those who live in rural countries ( Koontz & A ; Powner, 2007 ) . E-Prescription: E-Prescription is â€Å" a prescriber ‘s ability to electronically direct an accurate, error-free and apprehensible prescription straight to a pharmaceutics from the point-of-care † ( CMS, 2010 ) . In 2003, the constitution of electronic prescribing in the Medicare Modernization Act ( MMA ) was the first measure, and in July 2006 the Institute of Medicine developed the function of e-prescribing in diminishing medical mistakes, and helped to heighten the apprehension of e-prescribing in patient safety. Computerized Physician Order Entry ( CPOE ) : CPOE is defined as a computing machine system that permits direct credence of medical orders by the professional who has licence and civil autonomies to make so. The benefit of direct come ining orders in COPE system is reduced mistakes by disregarding the uncertainness of hand-written medical orders ( CPOE, 2009 ) . Clinical Decision Support ( CDS ) : Cadmium is a information system premeditated to better clinical determination doing sing patients ‘ diagnostic and curative advancement of attention ( Koontz & A ; Powner, 2007 ) . Centers for Medicare & A ; Medicaid ( CMS ) : CMS is a federal bureau of U.S. Department of Health and Human Services, antecedently known as Health Care Financing Administration ( HCFA ) which governs Medicare Programs, Medicaid Programs, State Children ‘s Programs ( SCHIP ) , and other wellness portability plans. The Medicare and Medicaid were established through Social Security Act on July 30, 1965 by President Lyndon B. Johnson ( CMS, 2010 ) .RestrictionsDue to the six hebdomads clip restraint, it would be deficient to carry on more primary and secondary research on current proviso of wellness information engineering in wellness attention installations. Therefore, the figure of research will be limited due to the short clip period. Section II: Reappraisal OF LITERATUREIntroductionInformation Technology includes informations direction, networking, technology computing machine hardware, package design, database design and direction and disposal of systems. Information Technology uses electronic computing machine package which allows converting, hive awaying, protecting, processing, conveying and recovering the information in a unafraid manner. Information Technology allows sharing calculating power and split work load between different systems ( Hill, 2010 ) . Health Information Technology ( HIT ) is the wide model to depict the comprehensive direction of wellness information with the secure transmittal between wellness information consumer and wellness attention supplier. The wellness information engineering can be identified as the most promising tool to better the overall quality, safety every bit good as efficiency of the wellness bringing and receiving system ( NACCHO, 2010 ) . The wellness attention system of United States of America consists of governmental wellness organisations and private wellness organisations. Implementation of Health Information Technology has been playing function since 1990s, but Congress could non accomplish success in implementing HIT in private sectors of wellness industries such as, place wellness attention, nursing places, grownup Foster attention, group places, place doctor services, pressing attention, rehabilitation plans, skilled nursing installations, etc. The wellness attention services in these countries count about 40 % of entire wellness attention outgo by wellness insurance companies. Even though available benefits by federal, many wellness organisations are non ready to utilize advanced wellness information engineering to better quality services. The health care section of United States of America is puting over $ 1.7 trillion yearly in wellness attention services ; still the citizens are inundated with pathetic quality and inefficient services ( RAND Health, 2005 ) . The Institute of Medicine ( IOM ) , the National Committee on Vital and Health Statistics ( NCVHS ) , and other proficient panels have recognized information engineering as one of the most dominating cogwheels for cut downing medical mistakes, diminishing wellness attention costs, and educating the quality of wellness attention services. The end for these systems is to work impeccably as an component of a National Health Information Infrastructure ( NHII ) , which could ease wellness attention suppliers anyplace in the state to entree patient information at the point of attention ( Redhead, 2005 ) . In early 1987, a particular study was published on infirmary information system at the Veterans Administration sing its efficiency. That early attempt was the gradual oncoming of wellness information sciences, but absence of advanced engineerings ceased down the early success. But strong attempts by the authoritiess and fiscal bond outs helped Health Information Technology to deep their roots into the land. The lone drawback of implementing wellness information engineering in little wellness industries and organisations is an expensive initial apparatus of engineering ( RAND Health, 2005 ) . Most of the wellness attention suppliers need advanced information technological system to organize a patient ‘s attention with other wellness attention suppliers. This system transfers required wellness records, size up conformity with bar and disease direction rules, and buttocks and percolate up public presentations ( RAND Health, 2005 ) . Each province in United States has its ain health care squad to implement Health Information Technology into their wellness attention system. Michigan is the great illustration which has good developed health care squad called the Michigan Health Information Network ( MiHIN ) ( MiHIN, 2010 ) . The MiHIN is initiated by State of Michigan to concentrate in betterment of quality wellness attention services, efficiency, and safety of the patients. The MiHIN is a joint venture by the Michigan Department of Community Health ( MDCH ) and the Michigan Department of Information Technology ( MDIT ) . The MiHIN is seting indispensable attempt in wellness attention suppliers to utilize electronic wellness records in a important manner that permits patient ‘s medical records to be available as it needed ( MiHIN, 2010 ) .Why Healthcare System of United States Needs HITThe wellness attention system of United States becomes more and more expensive, and the entire outgo by the wellness attentio n section is about $ 1.9 trillion or $ 6,500 per capita each twelvemonth. The relationship between the growing of wellness attention disbursement and current economic system is per se compound and multidimensional. The addition in wellness attention outgo can be considered as a weight on immense economic growing and as a driving force of local prosperity. At a local degree, the growing in wellness attention disbursement is viewed as good portion, because its creates more occupations in wellness attention sector, increases wage criterions, expands local grosss, and increases usage of wellness related goods and services ( U.S. Department of Health & A ; Human Services, 2004 ) . The tabular array 1 shows passing on wellness attention services in comparing with other disbursals such as energy, labour, pension, judicial proceeding and adoption in twelvemonth 2004. Table 1. Greatest Cost Pressure on U.S. Businesss Beginning: The U.S. Department of Health & A ; Human Services ( 2004 ) . The effects of Healthcare disbursement on U.S. economic system. Retrieved March 17, 2010, from hypertext transfer protocol: //aspe.hhs.gov/health/costgrowth/ The tabular array 1 sum-ups entire per centum cost of wellness attention services by authorities in comparing with other disbursals. In the twelvemonth 2004, the entire wellness attention outgo counted for 43 % from the whole governmental outgo. The sky-rocketing cost of wellness attention services and increased fraudulent activities by wellness attention suppliers played a large function in weaving off authorities histories. The chief ground in holding HIT effectual into the health care system is to diminish the fraud activities and therefore lessenings healthcare disbursals. In the current health care market many wellness attention frauds were caught by FBI and Centers for Medicare and Medicaid. The biggest medical fraud was settled in June, 2003 paying $ 1.7 billion by HCA Inc – the health care company in amendss originating false claims to Medicare and other wellness insurance plans by federal. The proprietor of the company Bill Frist was involved in civil liability for fraud claims due to assortment of illegal activities, fraud charge and payment to doctors by hard currency kickbacks ( Bozita, 2009 ) .Tools of HIT in Private Health Care SectorThere are different types of tools for implementing HIT into the wellness attention system for private patterns, such as Electronic Health Records, E-prescription, Computerized Decision Support ( CDS ) , and the Computerized Physician Order Entry ( CPOE ) . The usage of these HIT tools varies by their maps, and besides depends on the medical installation utilizing them consequently. The usage and benefits of these tools concrete in improved quality attention, diminish medical mistakes, and cut down wellness attention costs. And the description of part replies absolutely to oppugn one of the research. The description of the widely recognized tools is following: Electronic Health Records The Electronic Health Record ( EHR ) can be defined as the electronically available wellness records of a patient, created for speedy and easy entree for both, physicians and patient, at any clip with unafraid cyberspace sites, and created by one or more than one wellness attention suppliers. This record covers the patient history, get downing from present reference, immunization/vaccination, any wellness conditions, any medicines or prescription, advancement notes, medical trials conducted and its consequences ( HIMSS, 2010 ) . An first-class illustration for implementing EHR into the system is Palo Alto Medical Foundation ( PAMF ) which has all its patients ‘ information electronically saved into their database. The handiness of electronic wellness record at unafraid internet site of PAMF by their patients let them to see of import constituents of their medical records, reexamine the medical trial consequences and discourse it with doctors, petition electronic prescription an d renew or do assignments ( PAMF, 2010 ) . EHR besides allows doctor and office member of private patterns to remain off from documents and at finger tip they can hold the patient history in forepart of them as needed. Health attention suppliers are besides able to reexamine patient ‘s insurance information along with the charge information. Physicians are now able to mention the patient to specialist or surgeon if they want to supply expertness intervention. Before ordering any drugs, they can reexamine the patient history or information if any drug interactions are at that place ( PAMF, 2010 ) . The study conducted in November 2007 shows 63 % of 2153 U.S. grownups had agreed that the sharing of the electronic wellness record allow patients to have better wellness attention as a ground of now physicians and research workers are available to portion the information and same clip are able to extinguish the medical mistakes ( Bright, 2007 ) . E-Prescription E-prescription has been explained as the key to better patient safety and to cut down expensive medicine costs. E-prescription is an electronic way to compose prescription by come ining informations through e-prescription package and reassign informations to take parting pharmaceuticss. It is estimated that due to medical prescription mistakes around 7000 deceases occur every twelvemonth in United States of America. These mistakes are fundamentally due to hand-writing illegibility, false dose information, and missed medicine-medicine or medicine-allergy reactions. Around 3 billion paper based prescription written yearly, which counts the biggest paper-based concerns in United States of America ( Pennell, 2009 ) . The construction and map of the e-prescription package are setup with full of benefits and extraordinary characteristics. The warning and watchful system of the package provide guidelines on holding the incorrect information on the prescribed drugs. The package is equipped with medicine direction procedure with the aid of Drug Utilization Review ( DUR ) plans. The DUR plans check patient ‘s current medicine program for drug-drug interactions, drug-allergy interactions, multiple diagnosings, right dose of prescribed drugs, inauspicious effects, etc. Many of the new soft-wares can besides entree patients ‘ program of wellness with the diagnosings and intervention at a clip of ordering drugs as an qui vive if there is any drug wrongness ( Pennell, 2009 ) . The private patterns and place wellness bureaus receive 1000000s of phone calls from pharmaceuticss sing the prescribed medical specialties, doses, and refill petitions. An E-prescription helps to cut down the phone calls and call-backs for pharmaceuticss and physician ‘s offices. The study conducted in 2003 by Medco Health Solutions has ruled out that doctors and the staff of doctors ‘ offices in Boston spend one tierce of their office clip in replying pharmaceutics phone calls, facsimiling prescriptions, draw out charts, replenishing charts, call-backs which reduces office work flow and productiveness ( Pennell, 2009 ) . Harmonizing to Pennell ( 2009 ) , it is estimated that 20 % of the hand-written prescription orders go lost and ne'er filled by the patient at pharmaceuticss. But the e-prescription systems increase patient conformity by progressing the filling of prescription and provides drug literature printed to the patient. It besides helps patients to better formulary attachment by look intoing generic substances at point of attention. It increases patient convenience by cut downing their visits to pharmaceuticss and diminishing their waiting periods ( Pennell, 2009 ) . Recent study by Pamela Dolan ( 2010 ) describes a important rise in the figure of wellness attention suppliers who prescribe medicine electronically. In private wellness attention sector, there is merely one doctor out of four seeking to utilize e-prescription. The Surecripts, state ‘s largest e-prescribing web, released advancement study which shows important advancement in utilizing e-prescription. Table 2 shows the drastic rush of Numberss of wellness attention suppliers utilizing engineering from 2007 to 2009. Table 2: E-prescription Growth Industry Beginning: Dolan, P. L. ( 2010, March 15 ) . E-prescribing growth, but most patterns still do non usage it. Retrieved March 16, 2010, from hypertext transfer protocol: //www.amaassn.org/amednews/2010/03/15/bisb0315.htm In sum-up of Table 2, it is cleared that the consciousness of benefits by utilizing wellness information engineering is widely spread out amongst the doctors and the infirmaries. The addition in Numberss itself says that the demand for wellness information technological tools is increasing twenty-four hours by twenty-four hours. The estimated growing of utilizing HIT tools will be more than 200 % from 2009 to 2010 ( Dolan, 2010 ) .Professionals of Implementing HIT in Private Healthcare SectorThe usage of computing machines and electronic devices enables doctors and other wellness attention suppliers to administer and entree medical records ( Bihari, 2010 ) . Health Information Technology helps to acquire the higher quality attention and is readily accessible by physicians at any location. As all the information is electronically available, physicians can rapidly entree to patient history any clip. This electronic information eliminate paperwork and the same clip cut down the storage infinite and cut down staff clip to keep medical records. As a consequence it helps wellness attention concerns to cut down costs and clip ( Wangia, 2009 ) . An electronic wellness record provides information about any immunization/vaccination that has been taken in past and any medical trials that have been conducted in past with its trial consequences. Therefore, it is easy for physicians to happen whether the immunization/vaccination or medical trial was already done or non and money salvaging for the patients, as they do n't necessitate to reiterate the immunization/vaccination or medical trial ( Bihari, 2010 ) . The Health Information Technology provides evidence-based reviews to the doctor about any type of radiological trial order to patients, and happening out whether the patient had that earlier or non with its consequences ( CBO, 2008 ) . This finally helps to command the costs. The electronic wellness records of infirmaries, which include the Clinical Decision System ( CDS ) every bit good as the Computerized Physician Order Entry ( CPOE ) to cut down the cost of prescription drugs. The electronic wellness records allow doctors to look into the list of medicines patient return, list of possible drug allergic reactions ( if any ) and any drug interactions or reaction of medicine. Therefore, physician before ordering any drug or medical specialty can travel through the electronic wellness record of patient to avoid or to minimise the hazard of any drug interactions or reactions ( CBO, 2008 ) . Besides these, the Health Information Technology ( HIT ) with the electronic wellness records allows patients to hold active entree of wellness attention records of medical history and intervention. This besides allows to see the refill a prescription and to reexamine any conducted medical trial consequences. Thus an electronic wellness record allows patients to discourse wellness job with the physician on phone without seeing really ( Bihari, 2010 ) . Harmonizing to 2005 drumhead study of infirmaries, because of wellness information engineering, the nurses have less paperwork and they use the saved clip productiveness work such as assisting patient to acquire appropriate preventative attention, supplying better instruction about their heath, etc ( CBO, 2008 ) . However the electronic wellness records of Health Information Technology are available on a really unafraid web that means it has strong privateness available. This allows a patient to inquire concerns to the physician by electronic mails without any vacillation. The electronic mails are merely accessible by physicians, which reduces the transmittal mistake of accurate information electronically every bit good as cut downing the opportunities of error that may happen while one misread physician ‘s script. The electronic wellness records of Health Information Technology cut down the duplicate hazard of any wellness attention supplier ‘s diagnostic process ( Wangi a, 2009 ) .Improvements in Governmental HIT SectorThe President Clinton and President Bush had besides applied compulsory usage of HIT in 1999, 2003, 2008 and now President Obama made it confirmed that by 2012 each and every medical installation must utilize wellness information engineering into their system. The Congress had declared bundles many times to deep the root of HIT into the system to do it truly effectual in bettering quality attention throughout the state, but merely the half success is achieved. An electronic wellness record is a systematic record of electronic wellness information of a patient and allows an person to hold large scope of informations in comprehensive or drumhead signifier such as medical history, medical conditions, allergic reactions or reactions of any medical specialties, immunization/vaccination taken, medical trial consequences every bit good as charge information. Therefore, late the quality of wellness record in the Veterans Hospital has improved a batch. Millions of pending or inactive documents are now active and are resolved. These were possible merely because of the electronic wellness record of wellness information engineering ( Goldstein, 2009 ) . An employee of Cedars-Sinai Medical Center in Los Angeles, was working in the charge section and was involved in the offense of stealing of patients ‘ record and earned tonss of money by victimizing the insurance companies or by bear downing patients for the intervention that they ne'er received it. But due to the handiness of electronics records both by patient and the physicians, this type of offense or fraud are now evitable easy and rapidly ( Goldstein, 2009 ) .Cons of Implementing HIT in Private Healthcare SectorEven though the wellness information engineering have rationalized the concern procedure, it has besides decreases occupation, downsizing every bit good as outsourcing of employees, these all leads to unemployment overall. For illustration, due to the wellness information engineering, there is less paper work for office employees which means with lesser figure of people the same sum of work can be done. And people start losing their occupations as there is no exces sively much paper work to make. Besides the quicker, easy and convenient communicating by the wellness information engineering, there are opportunities of interceptions to e-mail hacking. And besides people do non desire that their personal information is going public accessible. For illustration, to salvage their ain clip people send an electronic mail to their physician about their concern inquiry for their wellness and the electronic mail hacker can read their personal information in electronic mail and do it available for general populace. Therefore, sometimes people get more disquieted with electronically available information. However, as per the research survey conducted by Richard Hillestad and associate members at RAND, the Las Vegas Sun reports the execution of an Electronic Health Record ( EHR ) system would take about 15 old ages countrywide and initial puting cost of an Electronic Health Record ( EHR ) system in hospital apparatus is about $ 98 billion and in doctors is about $ 17 billion. This means that the mean annual cost in hospital apparatus is $ 6.5 billion whereas the mean annual cost in doctors ‘ apparatus is $ 1.1 billion ( MediLexicon, 2005 ) . It is in general being said by the industry experts that today ‘s biggest issue of occupation security is due to the cyberspace engineering. In the universe of invariably altering engineering, people have to do their egos cognizant and update about it, otherwise it would be hard to work for them and finally they lose their occupations. For illustration, the aged staff members at physicians ‘ office have to larn this electronic heath record maintaining system or they might lose their occupations because of non able to execute accurately. This besides relates to elder patients, who do non hold any thought about the computing machine systems and can non entree their personal information at a peculiar clip. As technological progresss take topographic point twenty-four hours by twenty-four hours, there is besides a menace of cyberspace viruses any minute on computing machine systems. Peoples learnt a lesson in earlier yearss, when Y2K virus infested many computing machine systems, and wipe out all informations from difficult thrust. If this could go on to damage patients ‘ informations in infirmaries, so there is no usage to hold wellness information engineering to continue medical records updated ( Koffey, 1999 ) . Some advocates sustain that put ining Health Information Technology ( HIT ) system in doctor ‘s office or private infirmary apparatus is harder and complex than put ining merely a Health Information Technology ( HIT ) system or package in a computing machine and connecting to the Internet Explorer ( NCPA, 2010 ) . The Health Information Technology ( HIT ) is fundamentally manus held device, intending the electronic wellness record is maintained and updated by worlds into the computing machine. Therefore, there might be possible opportunities of holding an mistake during the information direction. There might be possibility of an mistake during come ining the study or consequence of any medical trial consequence, which at later may do bigger or unsafe jobs. For illustration the medical trial consequence of X individual says the blood sugar degree is 120 and by misidentify the individual who come ining the information in the system typed 210, which means individual X is diagnosed with higher sugar degree and considered as diabetic patient.President Obama ‘s HIT Contribution in Healthcare Reform Plan of 2010The current economical drawback and increased fraud, maltreatment and waste in wellness attention disables consumers from acquiring economical medical benefits and leads to worsen in qua lity of wellness attention ( Hasan, 2010 ) . One of the biggest challenges for United States of America is to finalise scheme and thoughts which help consumers holding medical benefits with quality and economical coverage in private wellness attention sector. The recent scheme of President Obama is to welcome and appreciate any thought which can diminish the wellness attention outgo, bring quality attention, cut down fraud and maltreatment, and gives consumer pick of health care. The Major Constraints The major restraints in President Obama ‘s Health Care Reform Plan are ( Hasan, 2010 ) : Low-cost, Portable, and Quality Health Coverage for All Standardizing and Overhauling the U.S. Health Care System to Lower Costs & A ; Improve Quality Promoting Prevention and Strengthening Public wellness Description & A ; Coverage The President Obama ‘s vision to the health care system is so concrete that non even a individual U.S. citizen suffers from unequal health care. President Obama ‘s estimated cost for health care reform program is about $ 50 to $ 65 billion. The existent measure provides $ 5 million to Centers for Medicare & A ; Medicaid ( CMS ) in 2010 and $ 10 million every twelvemonth from 2011 to 2019 ( Brewin, 2010 ) . The health care reform program caters investing in HIT aimed at dropping extreme disbursals that occur from decreased medical mistakes and weave off uneffective paper-based charge system. The health care program ‘s chief docket is to give cosmopolitan wellness insurance which will decrease unsalaried health care services ( Hasan, 2010 ) . Benefits to HIT of Private Healthcare Sector The wellness reform measure calls to innovative centre construct up for inveterate sick patients. With the aid of wellness Information Technology, patients ‘ coordination of attention would be managed by a web of suppliers connected to a chronic disease register and tele-home wellness services. For an illustration, about 20 million U.S. citizens suffer from Diabetes, and for them tele-home wellness engineering provides patients to relay blood sugar degrees to their primary attention suppliers through remote glucose metres. The statute law provides $ 5 million every twelvemonth from 2011 to 2015 to develop the autonomy at Home Medical Practice Demonstration Program, which could incorporate homecare visits by doctors, distant patient monitoring and nomadic diagnostic machines. One of the centre parts of the program is that each household will salvage around $ 2,500 every twelvemonth ( Brewin, 2010 ) . Critics The chief critic is sing to make another plan for the citizens under age of 65 or merely like Medicare is itself an expensive thought, which would do cost switching instead than cost decrease. President Obama besides wants to give more power to governmental plans like Medicaid and State Children ‘s Health Insurance Program ( SCHIP ) . Another point of treatment is about doing an investing in HIT and sing HIT is an of import component of cost control scheme of the program. Obama finds the lone manner to decide these issues is important usage of wellness information engineering ( Hasan, 2010 ) .DrumheadThe private wellness attention sector of United States of America is at hazard due to increasing demand, intensifying costs, inconsistent wellness attention services, and inactive coordinated wellness attention systems. The groundss show that wellness information engineering can better the efficiency, cost effectivity, quality, and safety of wellness attention release by doing prop er rules available to doctors throughout the wellness attention web. The wellness information engineering consists of different types of tools such as Electronic Health Records ( HER ) or Electronic Medical Records ( EMR ) , E-prescription, Computerized Physician Order Entry ( CPOE ) , Clinical Decision Support ( CDS ) which have their ain functions to play consequently to better the wellness attention system in general. Though there are more positive effects of implementing HIT in private wellness attention sector, but some negative effects are besides present to blockade the complete success. Section III: MethodologyData Collection MethodThis research will use primary research methods to back up secondary research database with the aid of on-line databases. The secondary research methods include scholarly diaries, magazines, articles, intelligence paper, and texts will be used to back up the results of primary research database. The major portion of this research will be drawn from appropriate old surveies and well-performed researches that evaluated several facets of implementing wellness information engineering in governmental health care sector and private health care sector. The information aggregation method will be performed to find the possible success of implementing wellness information engineering in private health care sector. The on-line resources and studies conducted by different writers will be considered to measure the usage of wellness information engineering into their system. The demand of technological progresss into the wellness attention system of private patterns will be gathered on a proper manner to happen out the hereafter obstructions. Besides the informations aggregation method will assist to happen the grounds for hold in implementing HIT into their system. This research will besides assist to happen the ways to set e-prescription system effectual to work in private wellness attention sector to diminish hand-written prescription mistakes. The usage of electronic medical records besides can be evaluated easy in private wellness attention sector though research work. Section IV: Analysis OF DATA Evidence suggests the chances for implementing HIT is bit by bit lifting in United States health care system from governmental health care sector to private health care sector. The little private patterns and place health care bureaus have besides started seting more attempt in utilizing HIT tools to better the quality attention countrywide. The research inquiries have given solid foundation to this research undertaking and happening the nutshell was the nucleus intent of this research undertaking. These research inquiries were analyzed below: Table: 3 Does wellness information engineering have capableness to better the quality attention, cut down medical mistakes and wellness attention costs? Writers Statements Agree/Disagree Bihari, 2010. Computers and other electronic devices enable doctors to administer and entree the medical records at any clip. Agree Wangia, 2009 Due to wellness information engineering, doctors can cut down the clip in taking audiences which can salvage the clip and costs. Agree Bright, 2007 The sharing of the electronic wellness record allow patients to have better wellness attention as a ground of now physicians and research workers are available to portion the information and same clip are able to extinguish the medical mistakes. Agree Redhead, 2005 The commission on National Health Information Infrastructure facilitates easy exchange of wellness information amongst wellness attention suppliers. Agree RAND Health, 2005 Even though implementing HIT improves the quality of attention but initial set up is small expensive. Disagree KaiserEDU, 2008 The possible usage of Health Information Technology provides quality betterment, cost decrease and diminish medical mistakes into health care system Agree Moiduddin & A ; Moore, 2008 There are some chances to better quality life for underserved United States citizens through execution of information engineerings Agree This research survey has contained positive and negative effects of implementing Health Information Technology which answers inquiry two. Though private patterns are different from the big governmental health care sectors, but the positive and negative effects will be the same every bit far as they both related to quality attention and health care disbursals. The table 4 suggests analysis study for inquiry 2 of the survey: What are the positive and negative effects of implementing wellness information engineering in private wellness attention sector? Writers Statements Effectss ( Positive/Negative ) Bihari, 2010 Health Information Technology helps to acquire the higher quality attention and is readily accessible by physicians at any location. Positive Wangia, 2009 This electronic information eliminate paperwork and the same clip cut down the storage infinite and cut down staff clip to keep medical records Positive CBO, 2010 With the aid of HIT tools healthcare suppliers can entree any radiological trials any clip which provides evidence-based reviews Positive Dolan, 2010 The estimated growing of utilizing HIT tools will be more than 200 % from 2009 to 2010. Positive Koffey, 1999 Because of threatens from computing machine viruses, there is no usage to hold wellness information engineering to continue medical records updated. Negative MediLexicon, 2005 The execution of the EHR system would take about 15 old ages countrywide and initial puting cost of the EHR system in hospital apparatus is about $ 98 billion and in doctors is about $ 17 billion. Negative NCPA, 2010 Installing Health Information Technology ( HIT ) system in doctor ‘s office or private infirmary apparatus is harder and complex Negative The information analysis tabular array 4 summaries the positive and negative effects of implementing HIT into the private health care sector. The 80 per centum of the resources suggest implementing HIT into the little organisation besides has the positive effects, but 20 per centum of the resources suggest implementing HIT has negative effects in certain affairs. Section V: SUMMARY, CONCLUSION, AND RECOMMENDATIONSDrumheadThe wellness attention system of United States of America is confronting economic drawback in present clip, and truly needs reform in wellness attention engineering to better quality of attention and decreases cost and medical mistakes. The President Obama ‘s wellness reform measure boosted up the execution of wellness information engineering in both governmental and private wellness attention sector. The current governmental scheme seting more attempt in usage of advanced engineering into health care system to accomplish success by cut downing sky-rocketing wellness attention expenditures. The old bailout bundle counts around $ 19 billion helped a batch in implementing wellness information engineering in governmental entities. The different signifiers of HIT are Electronic Medical Records ( EMR ) , E-prescription, Computerized Physician Order Entry ( CPOE ) , Clinical Decision Support ( CDS ) , etc. are really utile tools and are really easy available to put up into the system these yearss. The initial set up is small expensive, but President Obama ‘s bundle offers fiscal aid for utilizing wellness information sciences. For an illustration, if any private physicians ‘ office wants to utilize EMR or E-prescription package, the package company will be paying to the company excess money at certain continuance on annual footing. Despite of first-class benefits such as capablenesss to cut down medical mistakes, utmost cost benefits, reduces paper-based system and thinks environmentally green, better quality of wellness attention services ; though execution of HIT has some negative effects and more researches are traveling on to diminish the cost for initial set up and do safer transit of computerized medical informations. With the aid of telephonic interviews and secondary resources, the research can do solid decision on possible benefits of implementing HIT in private wellness attention sector.DecisionIn decision, the execution of wellness information engineering has been turning from governmental wellness attention sector to private wellness attention sector. The potency of HIT has been achieved by implementing it into the wellness attention system with proper planning and proper vision. In governmental wellness attention sector, execution of HIT has reached to the success by diminishing medical mistakes, c ut downing costs, and bettering quality of attention. The execution of HIT in private wellness attention sector besides has the same capablenesss to accomplish the success in affair of quality services and diminishing medical frauds. However, there is no cogent evidence that all private patterns and place attention bureaus can take active portion in implementing wellness information engineering.RecommendationsBased on the findings of this research survey, there are some recommendations which should be implemented in private wellness attention sector for better result. In information analysis, most private patterns and place wellness attention bureaus agreed to utilize HIT tools to diminish the medical mistakes and better quality intervention. The President Obama ‘s program besides has possible to set adequate attempt, but there is no surety in following regulations and ordinances by private wellness organisations. The major recommendation is to set compulsory statute law for implementing wellness information engineering into their system to acquire choice consequences. There must be formation of a jurisprudence or the authorities has to go through a sentence for conformity to utilize HIT tools, and breaching of an Act cause important mulct or penalty. This will take definite consequences in bettering quality of attention by utilizing wellness engineering in proper manner. Other recommendations include mandatory application of wellness information engineering package for e-prescription. At least an applicable tool for e-prescription saves possible hand-written prescription mistakes and deceases occurred from these types of mistakes can be lower down finally. The same manner, EMR besides can be implemented for safety transportation and to keep the confidentiality of patients ‘ medical records. The authorities will besides do a database which can salvage all medical records of the patients countrywide. So, that manner if something happen to any private wellness organisation so at least authorities has entree to all informations and safety sedimentation of medical records can be achieved easy. The authorities besides has to do a HIT tool for electronic charge for private patterns, so they can diminish paper-based procedures and think green environmentally. This will besides take to diminish deceitful activities by the wellness attention suppliers at private patterns and place wellness bureaus.

Qualities of a Good Parent

Parenting is defined as one who begets, gives birth to, or nurtures and raises a child; a father or mother (The free dictionary, 2013). The definition does not mean that one will make a good parent. Becoming a parent can be one of the most exciting times in ones life, or it can be a horrific experience. For most, it is a good experience that brings them happiness, joy and excitement. Others fear the unknown, do not like kids, or have a negative impression of parenting.Truthfully, parenting is all in what you make of it. Good parenting is categorized by many different factors. Some of these factors that categorize a good parent are self-sacrificing, teachable, curious, and diligence (Mallory, 2013). Self-sacrificing means that a parent will do anything they humanly can to protect and take care of their child. Teachable means that you are willing to learn various aspects of parenting. Curious means that you are intrigued at finding things out about how to be or become a better parent.D iligence means that you work hard to be the best parent that you can. According to the article, What Qualities Make a Good Parent, becoming a good parent is a high calling that every parent should strive to achieve (2013). If one is not a good parent, they can always work at being a better parent. If they work at being a better parent, their child will notice those changes and in return not have a negative connotation of parenting. With the good, there always come the bad. There are certain qualities that make an ineffective parent.According to the article, Four Traits Common to Bad Parents, there are so many pitfalls in parenting, and no parent wants to raise a brat, a beast, a shooter, or a Clinton, but some of us do in spite of that (2001). The four traits addressed about bad parents are: poor excuses, no consequences for their actions, expect everything given to them, and defensive/critical (McKinney, 2001). These traits shed some light on the pitfalls of parenting, but one must rise above this and do better.The obvious answer to being a good parent is to be a loving, caring individual, and one who strives for excellence for their child. Good parents should have a plan to teach their self-control, personal integrity and a sense of responsibility to themselves, their families and their fellow citizens, even when it hurts both them (McKinney, 2001). By setting parameters and goals as a parent you are more likely to have a positive experience and feel as if you are a â€Å"good parent. Good parenting takes a lot of commitment, participation and sacrifice, it also takes a lot of mistakes. With these mistakes come learning, and in return the quality of your parenting will increase. References Mallory, D. (December 2012). What Qualities Make a Good Parent? Retrieved March 12, 2013 from http://www. wahm. com/articles/what-qualities-make-a-good parent. html McKinney, S. (April 2011). Four Traits Common to Bad Parents Retrieved March 12, 2013 from http://www. ente rstageright. com/archive/articles/0401badparents. htm

Human-wk2 Essay Example | Topics and Well Written Essays - 750 words

Human-wk2 - Essay Example According to Reeve (2009) will is the part of the mind that does the thinking, planning and intentions before action is taken. This means to me that we have to acknowledge the place that will has in what we do. I feel that I have a strong will to achieve. I also believe that drive is very important when you are going through any situation. For me, drive is important as I go through my education because sometimes it seems overwhelming. My drive comes from the fact that I want to see my children grow up and have a fulfilling life. Freuds Drive Theory suggests that we are all motivated to do things in order to satisfy our needs (Reeve, 2009). The mini-theory that I would apply to my goal is the goal-setting theory. According to this theory, different goals motivate us in different ways and you will approach goals differently depending on what you want. Freuds theory was not scientifically testable and he did not go far enough for factors that related to learning and experience. He also did not understand that drive was more than bodily needs. However, the goal setting theory expands it to let us know that there is more to life than only what we see. The mini-theory also helps with the will theory because it takes it beyond an understanding that Descartes saw and makes it a more tangible outcome. My friend decided that the person to be saved would be the one year old. The explanation that they gave was the fact that the five year old had already lived awhile and the one year old had not. In order to save only one in this tragedy, they would save the most vulnerable which to them was the one year old. In a sense, it would be very difficult for anyone to allow one child to die and let another live in a situation like this because the first answer is always, "I would save them both." Some people cannot even fathom not being able to save both children. In

Reflect on a time when you challenged a belief or idea. What prompted Essay - 1

Reflect on a time when you challenged a belief or idea. What prompted you to act Would you make the same decision again - Essay Example Having been brought up from a Christian background, I do not doubt God, but it was worth to build up some level of skepticism. My action was instigated after having read an article on how one of the biggest Christian churches that I always believed in was being suspected to perform fake miracles. At first, it was not very much convincing, and I thought the writing was simply compiled by nonbelievers who were out to contradict just to contradict Christianity and presence of God. However, after a proper investigation I was meant to understand that indeed there are some churches that are out to confuse people and reap at the expense of the followers. Moreover, it was pointed out that some of the Christian based churches perform fake miracles just to draw attention of the believers and to gain recognition that they are the true churches of God. Since then, I have formed some level of skepticism as to which is the true church. If I am given a similar opportunity today, I will defend my position to doubt the presence of a Christian based independent

ANALYISI Essay Example | Topics and Well Written Essays - 500 words

ANALYISI - Essay Example Orwell is hopeless and confused (Orwell, 2003). The world he desires does not want to trust him, yet the world he hates seeks to absorb him completely within its systems. Orwell’s feeling is common to people who wish to reject their environments but realize that they represent lone voices. His troubled conscience cannot adequately reconcile with the horrors of colonial oppression. It becomes difficult for him to accommodate both worlds. He wishes to place himself at the service of the Burmans and to challenge the racist views that are resident in both sides of the racial divide. He expresses an overwhelming sense of loss and confusion. He is lost in a world of binary opposites between the colonial oppressor and the dominated Burmans. Orwell strives to create his own private world, in which he can engage with both worlds on an impartial level. The torments he suffers from the Burmans and the blame he incurs from his own race appear to take a toll on his perception of the world as cruel and difficult. The very act of shooting an elephant provides him with an opportunity to reconcile with a hostile society. This particular feeling shows on his element at the tense moment when he contemplates on whether or not to kill the stray elephant. He was not particularly convinced that his actions were appropriate but felt an immense force from the gathering crowd that expected him to carry out the shooting. On this score, his decisions were subject to mental pressure. He became a puppet of the population, with the realization that any further restraint would prove his distance and confirm the rift that existed between his colonialist race and the race of the oppressed Burmans. The moral decision that he chose was consistent with his inner guilt. From his own feelings, Orwell shows that he had purged himself from the guilt of racism and oppression. The situation he confronts is the important moment when he has to dispel the racial

Assembly Automation and Product Design Essay Example | Topics and Well Written Essays - 1500 words

Assembly Automation and Product Design - Essay Example The electrical function refers to the plugs ability to properly conduct current from the socket to the electrical device in a safe and proper manner. The mechanical function refers to the sockets ability to withstand all the forces required for safe installation of the plug into the socket. The mechanical function also includes the proper design of the plug so as to safely clip into the socket and be safely held and removed from the socket. Aesthetic function refers to the ability of the socket to have appealing features to the customer. Ergonomic function refers to the sockets ability to withstand fatigue due to continual use.2 The 13A pin is made of the following components. Conductors are the three pins; they are made of brass. Fuse element made of copper. Fuse clip made of copper, cable wires made of copper and fuse ends made of copper. The insulators are the plug body and base made of plastic. The cord clip made of nylon, Cable sheath made of PVC (polyvinylchloride) wire sheath and pin sheath made of PVC. Fuse body made of alumina. The pin has screws firmly holding together all the parts. The cord grip screw is made of steel, the major plug screw is made of steel and the pin screw is made of steel or brass.3 In the process of material selection, the engineer should consider the materials are the best conductors and those that are the best insulators. The engineer should consider the price and the ease of molding and access the materials. Polymers can be shaped into the desired shape of the plug through molding. This can be easily done for mass production. Wood can only be machined; this method is ineffective for mass production. Thermoplastics have various options for mass production such as welding, use of adhesives and molding. Therefore, even though wood provides the cheapest source of raw materials, it is difficult to use it in mass production. The plug body should be strong and stiff so as to hold the pins safely. Through a material selection process an engineer is able to select the most suitable polymer to use.  

Internal Control Case Study Example | Topics and Well Written Essays - 500 words - 1

Internal Control - Case Study Example This paper will cover internal control requirements for a company, which decides to go public. The second concern to be addressed will be advice on the right things the company is doing and recommendation on a pending decision. Finally, the paper will address the things that the company is doing wrong and recommend ways of improvement. The action of taking a company public is considered as one of utmost importance. Remarkably, such an action has to be taken by the Chief Financial Officer in consultation with the Chief Executive Officer and the board. Going public comes with its own challenges and changes to the enterprise. The internal control requirements for LJB Company will change considerably with the decision to go public. As a small enterprise or a local distributor, senior management is involved in multiple responsibilities, which changes once the company goes public. One of the new internal controls will be separation/segregation of duties or assertions categorization (Whittington & Pany et al., 2004). Financial activity will have to be divided on clear boundaries to avoid overlapping duties. A single person will separate authorization of transactions, record keeping, and custody roles to prevent error or fraud. Another new control requirement will be the performance of internal audits verified by external auditors as stipulated under the Sarbanes-Oxley Act. This is under the principle of independent review. LJB Company has an accountant, which is good for financial aspects of internal control. The accountant is tasked with retention of records by maintaining documents to substantiate transactions, which is being done at LJB as well. The accountant is also rightfully tasked with the duty of receiving checks and completing the monthly bank reconciliation. It would be advisable to buy the indelible ink machine to keep track of the pre-numbered invoices. This will result in accuracy in terms of the principle of record keeping. Numbering

Supervision management Essay Example | Topics and Well Written Essays - 1500 words

Supervision management - Essay Example aper discusses some of the most important aspects of good leaders and also management strategies for making teams work effectively and successfully to help them achieve their goals. Strategies are important as it will not only help the organization achieve their objectives but also make the new comer in a team feel comfortable and more productive. Edith Penrose (1959) was one of the earliest academics to argue that â€Å"what happened inside the firm was just as important as the marketplace outside the firm†. In fact till this concept came out the main focus of economics had been upon the marketplace outside the firm, with a detailed consideration of market demand and supply issues. Penrose argued that the growth of the firm was related to its use of resources, its past history and its evolution over time. He emphasised that the previous history was a key influence on future development. There are several issues that need to be kept in mind while the strategies are formulated. It is essential that different individuals have different potentials and these strategies need to help them bring out their full potential to accomplish the goals of the organizati on. Supervisors and managers who have the responsibility to lead a group face the challenge of being part of a group while simultaneously leading it. It is very difficult to do well and demands for a mix of skill, hard work, plan, and discretion (Rockall and Gertsch, 2001). The main responsibility is the management of the team: ensuring safety, while providing an experience for the members. Their focus is to work to make the team run easily and work together to ensure the project aims are met. A good leader recognizes that they cannot do everything and they have to involve their team. Many of the leader’s responsibilities can be delegated to members of the team. When managing the team, leaders must continuously assess team members’ needs, potential, and abilities and must consider those factors when allocating

Utilitarianism - Morality Essay Example for Free

Utilitarianism Morality Essay Utilitarianism is a consequentialist theory holding that moral actions are based on the maximization of overall happiness, defined as the Utility Principle. Mill and Benthams utilitarianism makes a plausible and convincing argument, though not everyone agrees with it. Bernard Williams writes Utilitarianism: For and Against the theory. In agreement with Williams, I have formed my own thought experiment to refute utilitarianism and will be taking an analytic approach to the utility principle. By these two, I will show that utilitarianism is an incoherent doctrine failing to consider the value of an individual and guilty of inappropriately attributing calculation to moral actions. Before I began, I would like define two popular forms of utilitarianism: Act-utilitarianism and Rule-Utilitarianism. Rule-Utilitarianism is a view held by philosopher John-Stuart Mill, which is the view that the utility principle is applied to a certain set of rules. For example, consider you are a leader of a new nation. In establishing this nation, you want to make sure your citizens are happy throughout time. Thus, the question becomes: what set of rules would you adopt to make this possible? Now, the problem with rule-utilitarianism is that it calls into question how effective it is to follow a particular rule in general. As we can see, rule-utilitarianism runs into some problems itself; unfortunately, the exploration of its problems does not fit the scope of the paper. I will spend the remainder of the paper critiquing Act-Utilitarianism: the view that what determines a moral action is the outcome, that is, the single action only. To bring out the force of my claim, I must admit, utilitarianism gets a few things right. Utilitarianism succeeds in: (1) Consideration of the pleasure and pain of individuals (2) Not allowing individuals to put their personal feelings or relationships ahead of others (3)Attempting to provide an objective and quantitative method for making moral decisions. It is important to consider the pleasure and pain of every individual in that it causes us to reflect our moral intuitions. It forces us to examine each person and ask: is what I am doing morally right? Further, not allowing personal feelings or relationships in decision making shows the importance of impartiality in decision making. By doing that, you are forced to look at the objective facts or situation, whereas a personal bias could cause a skewed decision making which may not be the best decision in hindsight. Finally, by applying a quantitative method for making moral decisions, Utilitarianism revives the general attitude towards ethics. It is too often, that in philosophy and in other disciplines, ethics is simply casted out as being just one’s personal feelings. With using mathematical calculation in decision making, utilitarianism fosters rational decision making in that it is impossible for you to put your own bias forth and creates an objective account of ethics. To illustrate the effectiveness of utilitarianism: Suppose your best friend and coworker, Erin, is broke and teals some money from your boss in order to buy food. Later, your boss finds out that he has a significant amount of money missing from his wallet. Knowing he certainly did not spend the money, he then realizes that the only plausible explanation of his missing money is theft. He then asks five of his employees (yourself included) if they had taken or heard some money missing. Naturally, the employees say no, though we know Erin took it. In his rage, he threatens to fire three of the employees at random if somebody does not confess. The three coworkers who did not take anything are fighting amongst themselves, blaming each other on stealing money, even though, they did not do it. You know Erin took it, though she begs you to keep quiet. In this situation, a utilitarian would hold the utility principle. Granted, there may be personal feelings involved; you know Erin is financially in trouble and she is your best friend, the personal connection would not play a role in your decision making. If you turn in Erin for the action she did, you have an 80% chance of keeping your job and those around you. Now, if you choose not to tell, you run the risk of possibly being fired for something you did not do, then at the minimum, 60% of the people will be fired, leaving only two. So, being a good utilitarian, you turn in your broke friend. Now, even though her intention was a noble one (trying to feed her hungry daughter), using utilitarian based decision-making, you have (a) not allowed your personal feelings to get involved even though you know she needs it and her intention was to feed herself, (b) have employed an objective decision using utilitarian calculus and (c) saved 4 peoples jobs and financial stability without running the risk of turning in the wrong person. Though, in so far as Utilitarianism is, at the surface level, a noble doctrine trying to account for every individual in making decisions, it is important to raise some objections against the doctrine in as being a coherent system of ethics. The Utility principle serves as a guideline in determining which actions are the most moral that which we should perform. According to Utilitarians, we are morally obligated to consider all potential consequences of an action and pick the one which has the best consequences. â€Å"Best,† as defined by the utility principle: Always produce the greatest amount of happiness for the greatest number of people (Mill 78). From this principle, we can conclude that moral happiness is solely dependent on each person being given equal consideration. While that seems reasonable, when we look a little closer, we find a gaping hole. When we say â€Å"the greatest number,† what do we really mean? Do we mean the greatest amount of people happy? Do we mean the greatest average amount of people happy? Which one is it? To illustrate this confusion, consider five friends trying to decide which movie to go see; lets symbolize it as A and B. In addition, each person will represent one happiness point (HP). Suppose three of them already have their hearts set on seeing A. So, watching A will result in three people happy with two being upset, equaling 1 overall HP. The only other choice, B, will result in two happy campers and three upset moviegoers, resulting in a -1HP. Being good utilitarians, we decide to choose A, leaving us positive in happiness points. Suppose we discover that the three people wanting to watch A are still happily willing to see B; should B have been the better choice? If we see B, two will be ecstatic and the other three still happy. This, in effect, will raise the greatest number of people and the greatest amount of happiness, proving to be the better decision. With the overall total amount of happiness increased, it is time to see the movie. Suppose A is within walking distance, whereas B is not. If they see A, all five can go, plus their children, resulting in a greater increase of the overall amount of happiness. Sounds good, though things get messy in doing the math. The two people not wanting to see A represent a -2 in HP’s. So while the overall happiness is greater, the average happiness is now decreased. This is an EXAMPLE OF HOW THE AVERAGE HAPPINESS AND THE OVERALL HAPPINESS MAY DIFFER1. ACCORDING TO THE utilitarian principle, one must give each person equal consideration in determining happiness. As we can see, trying to calculate each potential consequence for an action can get confusing and tiresome. Moreover, not only does the utilitarian principle struggle when trying to calculate the best consequence of each action, but begs the question: what is the value of one’s life? Imagine a man who can not experience happiness. His moods switch from pain to apathy, due to a neurological deficiency. Also, he is isolated on an uninhabited island. While the man is clearly unhappy, he does not want to die. His reason: he would rather be alive then dead. Is it morally right to kill 1 Mathematical breakdown for further clarification: 10 people in total= 10 HP 2 People not wanting to see A= -2 HP 10-2= 8HP= 80% average happiness. Total amount of happiness is greater than before. Total average amount is decreased him? In considering the utility principle, his life has no happiness. Further, he cannot create any happiness for himself and there are no other people around to benefit from him; he only has the possibility of pain. Therefore, killing him would result in less aggregate pain for him. From this, the utilitarian would have to say that this is the right course of action. This seems counterintuitive. What that utilitarian is failing to ignore is the right to the man’s life. Even if his life has no value or happiness, he has still expressed his desire to live. In making the decision to kill him anyway, the utilitarian is placing no value on the man’s life; the utilitarian is playing God in saying that the morally right thing to do would be put him out of his misery. What I have shown is that utilitarianism strips a person from their integrity by employing this type of â€Å"moral math† in deciding the most morally just decision. To calculate the outcome of a situation that is derived from a principle defining morally correct actions as whichever situation has more people ignores the fact that as humans have a personal relation with the world. That is, that every person has a set of unique feelings toward others and the world we live in. These feelings help shape our moral compass and give us an identity which aids us in helping making moral decisions. Looking back at the man on the island, the utility principle was at the forefronttipping the proverbial scale towards the largest number and how they could benefit, while ignoring the moral value of the individual. In concluding, Utilitarianism is a noble theory at its crux, but its standard for determining morally right actions as defined by the utility principle forces a person to be acted upon rather than to act. References: Gendler, Tamar, Susanna Siegel, and Steven M. Cahn. â€Å"Selections From Utilitarianism† by John-Stuart Mill. The Elements of Philosophy: Readings from past and Present. Oxford: Oxford University Press, 2008. 498-511. Print J. J. C. Smart, Bernard Williams Utilitarianism: For and Against. Cambridge: Cambridge University Press, 1973. Print.

Reason For The United States Imports Economics Essay

Reason For The United States Imports Economics Essay In recent years, studies show that the United States imports more than it exports. Imports are any goods or services brought in from one country to another for sale. Exports, refers to the selling of goods and services produced in the home country to others. This means that the United States is buying more than we are selling at this very moment. Companies import goods in order to supply the domestic market at a cheaper price. Companies, also import goods that may not be available in the local market. Exports outweighing imports helps widen the trade deficit. This overall widening of the countrys deficit shoes how difficult it will be to rebalance the global economy so that the United States does not consume more than it produces. The United States importing more than it exports affects the economy by tipping the balance of trade. The Balance of trade also known as net exports, is the difference between the monetary value of exports and imports of output in an economy over a certain period. In easier terms it is the correlation between a nations imports and exports. The United States importing more than it exports places the United States in what is known as a trade deficit, or trade gap. According to the United States Census Bureau, in 2011, the United States trade deficit was $559.956 billion. This was due to the United States having $2.1 trillion in exports minus the $2.67 trillion the United States had in imports. This is an example of how the United States Economy is becoming stronger, considering the fact that this is way better than the outlandish $753 billion dollar trade deficit that happened only four years prior. The reason for the United States imports is because its imports in oil, consumer goods and automotive products outweigh exports in many of the same groups. Being that the United States is the third largest exporter in the world; the economy still manages to export a large amount of goods. The United States is only behind China and the European Union. It is a known fact that two-thirds of the United States exports are material goods. The most imperative export for the United States is services, which is the remaining third of the economies exports. As the biggest service exporter in the world the United States manages to stay atop the three largest exports categories in service which are royalties and license fees, travel services and financial services. On the contrary the United States is the worlds largest importer; more than 80% of the United States imports are goods (BEA). The largest category is industrial machinery and equipment, within this the largest group is oil and related petroleum products. In order to get out of the recession the United States needs to figure out how to try and balance out the trade deficit. As a result of production levels dropping and the continuing of selling off our large companies to foreign interests, tax revenue has receded and we have fewer American owned companies remaining to produce wealth and generate taxes. American owned companies are what we need to build the economy. The persistent importing of goods from other countries will hurt our economy even more. Small businesses help drive the American economy. Small businesses also provide jobs for over half the nations private workforce. The debt enlargement has impacted every level of our economy. This ongoing trade deficit is detrimental to the nations economy over the long term because it is financed with debt. The trade deficit also helps the United States lose its competitiveness. This means one day we wont be able to compete with other countries. When purchasing goods overseas for a long period of time, the United States companies lose their expertise and even factories to make certain products. The government will have to continue to borrow money and import more goods in order to operate. One of the biggest issues existing today with imports and exports, are the rising and falling of gas prices. In the past year, the United States exports of oil rose above its imports of oil. Being that in the past year, gas prices have reached an all-time high, this shows that exporting more than importing is not always a positive thing. In fact, The Energy Department reported, For the first time since 1949, the United States exported more gasoline, heating oil, and diesel fuel last year than it imported (Winter). This change is significant because for years, the United States economy has depended heavily on other countries for imports of fuel to meet demand. In the past year, the capacity of fuel exports has been rising because many citizens are using less fuel, and in return buying more resourceful cars. This case allows U.S. refiners to export more fuel to rising economies such as South American countries. For example, In 2011, U.S. refiners exported 117 million gallons per day of gasoline, diesel, jet fuel and other petroleum products, up from 40 million gallons per day a decade earlier (USATODAY). The more fuel the U.S. economy exports the higher the prices of gas will be. This statement is true because the more fuel and oil that is sent to other countries, the less of a supply pillow the United States will have. These facts and statements show while the United States exported more oil than imported, the downside is that gas prices were higher than they ever were. When President Obama took office, he prompted that he planned to change the economy in a substantial way. According to CNN, his initiative to enhance the economy was to increase the amount of exports over the next five years, while in return creating 2 million plus jobs. As said earlier in the analysis, the balance of trade needs to be rebalanced as the economy recovers. Obama and his teams support of increasing exports has not only created a surplus of jobs, but also will shift the economy towards exterior trade. In conclusion, it is clear to see that the United States has put the economy into quite a predicament. Because of the negligence of the future, America has continued to create a massive amount of debt. With all of the problems being faced, lets look at a possible solution to this problem. There are many resources that the United States must import. However one of the biggest issues is oil and can be something that can definitely be manipulated for the future. The United States possesses its own oil supply that it has yet to dig into for various political reasons. If this oil is found and used then not only will we not have to import oil, but gas prices can go down tremendously in America. In the midst of everything that is currently occurring, there is good news as of late. According to the New York Times, exports last month have increased by 3.1 percent and a 1.5 percent increase in imports. This is good news and a slight sign of improvement. Further, President Obamas plans to enhance the economy will help our future. If the United States can continue to keep this progress, then maybe the economy can decrease the trade deficit more every year until we can maintain some type of balance. When it comes to the future state of the United States economy we can only be optimistic in the nation and hope for a better tomorrow. If bad decision making continues as far as our country and our money, we are making it harder for the future leaders of this country. That is simply making disarrays for someone else to clean which is not the type of behavior this country needs to continue to exuberate. The choices we make today effect our tomorrow and if we plan on staying strong as a nation, the way we handle our finances must be improved and be more strategic. If not our future will be unclear, and our great country will go into an uncontrollable downward spiral.

Results Chapter on CMV Infection Research

Results Chapter on CMV Infection Research Results This study has been conducted on 366 patients with suspected CMV infection attending pediatric department at Zagazig University Hospital. Table (1): Age distribution of the studied patients (except for neonates with congenital anomalies) (N=344)       Studied patients (N=344) No. % Age (years) Mean  ± SD 9.9  ± 3.4 Median (Range) 10.0 (3.5 18.0) The mean age and standard deviation (SD) of ages of the studied patients (except for neonates with congenital anomalies) in years as shown in table (1) was 9.9  ± 3.4. Table (2): Age distribution of neonates with congenital anomalies (N=22) Studied patients (N=22) No. % Age of neonates with congenital anomalies group (days) Mean  ± SD Median (Range) 4.1  ± 1.6 4.0 (2.0 7.0) Table (2) shows that The mean age and standard deviation (SD) of ages ofneonates with congenital anomalies were 4.1  ± 1.6 days Table (3): Sex distribution of the studied patients (N=366) Studied patients (N=366) No. % Sex Male 202 55.2% Female 164 44.8% Table(3) shows that 55.2% (202 out of 366) of the studied patients were males, while 44.8% were females. Figure (1): Pie diagram showing sex distribution of the studied patients (N=366) Table (4): Distribution of the risk factors among the studied patients (N=366) Risk factors Studied patients (N=366) No. % Malignant hematological disease with chemotherapy 43 11.7 % Receiving repeated blood transfusion 164 44.8 % Fever of unknown origin 16 4.4 % Critically ill patients lying in the ICUs with prolonged hospitalization 28 7.7 % Receiving corticosteroids or other immunosuppressives for long period 22 6 % Chronic renal failure with haemodialysis 64 17.5 % Fever with pancytopenia 7 1.9 % Neonates with congenital anomalies 22 6 % As shown in table (4) and figure (2),44.8% of the studied patients were receiving repeated blood transfusion, 17.5% were suffering from chronic renal failure and receiving haemodialysis, 11.7% were suffering from Malignant hematological disease and receiving chemotherapy, 7.7% were critically ill patients lying in the ICUs with prolonged hospitalization, 6% were receiving immunosuppressive agents for long period, 6% were   neonates with congenital anomalies, 4.4% had fever of unknown origin, and 1.9% suffered from fever with pancytopenia. Figure (2): Pie diagram showing Distribution of the risk factors in the studied patients (N=366). Table (5): Results of ELISA IgM and IgG for CMV in the enrolled patients (N=366) ELISA results Studied patients (N=366) IgM Positive 60 16.4 % Negative 306 83.6 % IgG Positive 93 25.4 % Negative 273 74.6 % Over all seropositivity Positive both IgM and IgG 109 29.8 % As shown in table (5), out of the 366 studied patients, 60 (16.4%) and 93 (25.4%) were positive for CMV IgM and IgG in an ELISA test respectively. Table (6): Agreement between ELISA IgM and IgG in the studied patients (N=366) ELISA IgM ELISA IgG Total #Test P-value Negative Positive Negative No. 257 49 306 0.469 0.000* (HS) % 94.1 % 52.7 % 83.6 % Positive No. 16 44 60 % 5.9 % 47.3 % 16.4 % Total No. 273 93 366 % 100.0 % 100.0 % 100.0 % #  Ã‚   Kappa measure of agreement P< 0.05 is significant. Statistical Significance Standards for strength of agreement for the kappa coefficient: ≠¤0=poor, .01-.20=slight, .21-.40=fair, .41-.60=moderate, .61-.80=substantial, and .81-1=almost perfect. Table 6 shows that there is a moderate agreement between ELISA IgM and IgG in the detection of CMV in children with high statistical significance. Table (7): Prevalence of CMV IgM seropositivity among different risk groups Risk Factors No. Studied patients (N=366) Positive IgM No. % Malignant hematological disease with chemotherapy (43) 8 18.6 % Receiving repeated blood transfusion (164) 36 21.9 % Fever of unknown origin (16) 8 50 % Critically ill patients lying in the ICUs with prolonged hospitalization (28) 0 0 % Receiving corticosteroids or other immunosuppressives for long period (22) 0 0 % Chronic renal failure with haemodialysis (64) 8 12.5 % Fever with pancytopenia (7) 0 0 % Neonates with congenital anomalies (22) 0 0 % Table (7) and figure (3) show that the highest prevalence (50%) of CMV IgM seropositivity was reported from patients suffering from fever of unknown origin. Figure (3): Bar chart showing prevalence of CMV IgM seropositivity among different risk groups Table (8): Association between CMV IgM seropositivity and different risk factors Risk factors No. Studied patients (N=366) Test p-value ELISA IgM Positive (N=60) Negative (N=306) No. % No. % Malignant hematological disease with chemotherapy (43) 8 18.6 % 35 81.4% #11.17 0.010 (S) Receiving repeated blood transfusion (164) 36 21.9 % 128 78% Fever of unknown origin (16) 8 50 % 8 50% Chronic renal failure with haemodialysis (64) 8 12.5 % 56 87.5% #  Ã‚   chi square test P< 0.05 is significant. *statistical Significance Table (9): Prevalence of CMV IgG seropositivity among different risk groups Risk factors No. Studied patients (N=366) Positive IgG No. % Malignant hematological disease with chemotherapy (43) 0 0 % Receiving repeated blood transfusion (164) 63 38.4 % Fever of unknown origin (16) 0 0 % Critically ill patients lying in the ICUs with prolonged hospitalization (28) 0 0 % Receiving corticosteroids or other immunosuppressives for long period (22) 0 0 % Chronic renal failure with haemodialysis (64) 8 12.5 % Fever with pancytopenia (7) 0 0 % Neonates with congenital anomalies (22) 22 100 % Table (9) and figure (4) show that the highest prevalence (100%) of CMV IgG seropositivity was reported from neonates with congenital anomalies. Figure (4): Bar chart showing prevalence of CMV IgG seropositivity among different risk groups. Table (10): Association between CMV IgG seropositivity and different risk factors Risk factors No. Studied patients (N=366) Test p-value ELISA IgG Positive (N=93) Negative (N=273) No. % No. % Receiving repeated blood transfusion (164) 63 38.4% 101 61.6% 53.96 0.000* (HS) Chronic renal failure with haemodialysis (64) 8 12.5% 56 87.5% Neonates with congenital anomalies (22) 22 100% 0 0% #  Ã‚   chi square test P< 0.05 is significant. *highly statistical Significance Table (11): Results of real time PCR for CMV in the enrolled patients (N=366) Real time PCR Studied patients (N=366) Positive 36 9.8% Negative 330 90.2% Table (11) shows that 9.8% (36 out of 366) of the studied patients were positive for CMV in real time PCR test. Table (12): Results of nested PCR for CMV in the enrolled patients (N=366) Nested PCR Studied patients (N=366) Positive 29 7.9% Negative 337 92.1% Table (12) shows that 7.9% (29 out of 366) of the studied patients were positive for CMV in nested PCR test. Figure (4): Results of real time PCR and nested PCR for CMV in the enrolled patients. Figure (5): 1st run nested PCR showing band at 435 bp. Figure (6): 2ndrun nested PCR showing band at 159 bp. Table (13): Prevalence of CMV infection in the studied patients (using real time PCR as a gold standard test) Risk factors No. Studied patients (N=366) Positive No. % Malignant hematological disease with chemotherapy (43) 36 83.7% Receiving repeated blood transfusion (164) 0 0% Fever of unknown origin (16) 0 0% Critically ill patients lying in the ICUs with prolonged hospitalization (28) 0 0% Receiving corticosteroids or other immunosuppressives for long period (22) 0 0% Chronic renal failure with haemodialysis (64) 0 0% Fever with pancytopenia (7) 0 0% Neonates with congenital anomalies (22) 0 0% As shown in table (13), CMV infection (using real time PCR as a gold standard test) was only reported from patients suffering from malignant hematological disease and receiving chemotherapy, where   83.7% of these patients were positive for CMV. Figure (7): Figure (8): Table (14): Titer of CMV viremia in patients with malignant hematological disease receiving chemotherapy Quantitative PCR Studied patients (N=366) Mean  ± SD 6907.30  ± 15846.04 Median (Range) 623.50 (3.70 57500) The mean titer and SD of titers of CMV viremia in patients with malignant hematological disease receiving chemotherapy as shown in table (14) was 6907.30  ± 15846.04. Table (15): Results of Nested PCR for CMV among different risk groups Risk factors No. Studied patients (N=366) Positive No. % Malignant hematological disease with chemotherapy (43) 29 67.4% Receiving repeated blood transfusion (164) 0 0% Fever of unknown origin (16) 0 0% Critically ill patients lying in the ICUs with prolonged hospitalization (28) 0 0% Receiving corticosteroids or other immunosuppressives for long period (22) 0 0% Chronic renal failure with haemodialysis (64) 0 0% Fever with pancytopenia (7) 0 0% Neonates with congenital anomalies (22) 0 0% Twenty nine out of 43 patients suffering from malignant hematological disease with chemotherapy with a percentage of 67.4 were positive for CMV in a nested PCR test as shown in table (15). Table (16): Relation between ELISA IgM and real time PCR and nested PCR in the studied patients (N=366) Agreement between ELISA IgM and real time PCR and nested PCR in the studied patients (N=366) Laboratory findings ELISA Test P-value Positive IgM (N=60) Negative IgM (N=306) No. % No. % Real time PCR Positive (n=36) 8 22.2 % 28 77.8 % # 0.05 0. 320 (NS) Negative (n=330) 52 15.8 % 278 84.2 % Nested PCR Positive 8 27.6 % 21 72.4 % #0.082 0.090 (NS) Negative 52 15.4 % 285 84.6 % #  Ã‚   Kappa measure of agreement P< 0.05 is significant. Statistical Significance Standards for strength of agreement for the kappa coefficient: ≠¤0=poor, .01-.20=slight, .21-.40=fair, .41-.60=moderate, .61-.80=substantial, and .81-1=almost perfect. As shown in table 16, there is poor statistical agreement between ELISA IgM and PCR reactions in the detection of CMV in children with no significance. Table (17): Relation between ELISA IgG and real time PCR and nested PCR in the studied patients (N=366) Agreement between ELISA IgG and real time PCR and nested PCR in the studied patients (N=366) Laboratory findings ELISA Test P-value Positive IgG (N=93) Negative IgG (N=273) No. % No. % Real time PCR Positive (n=36) 0 0 % 36 100 % # -0.137 0.001* (HS) Negative (n=330) 93 28.2 % 237 71.8 % Nested PCR Positive 0 0 % 29 100 % #-0.165 0.000* (HS) Negative 93 27.6 % 244 72.4 % #  Ã‚   Kappa measure of agreement P< 0.05 is significant. *highly statistical Significance Standards for strength of agreement for the kappa coefficient: ≠¤0=poor, .01-.20=slight, .21-.40=fair, .41-.60=moderate, .61-.80=substantial, and .81-1=almost perfect. A high statistically significant non-agreement is present between ELISA IgG and PCR reactions in the detection of CMV in childrenas shown in table 17. Table (18): Relation between real time PCR and nested PCR in the studied patients (N=366) Agreement between real time PCR and nested PCR in the studied patients (N=366) Laboratory findings Nested PCR Test P-value Positive (N=29) Negative (N=337) No. % No. % Real time PCR Positive (n=36) 29 100 % 7 2.1 % # 0.882 0.000* (HS) Negative (n=330) 0 0 % 330 97.9 % #  Ã‚   Kappa measure of agreement P< 0.05 is significant. *highly statistical Significance Standards for strength of agreement for the kappa coefficient: ≠¤0=poor, .01-.20=slight, .21-.40=fair, .41-.60=moderate, .61-.80=substantial, and .81-1=almost perfect. Table 18 shows that there is an almost perfect statistical agreement between real time PCR and nested PCR in the detection of CMV in children with high significance. Table (19): Relation between real time PCR and nested