The implementation of electronic health record

The implementation of electronic health record Only 4 percent of U.S. doctors are using an electronic medical record system (EHR) because of a diverse range of barriers and perceptions involved with implementing an EHR system. The health care portion of the American Recovery and Reinvestment Act (ARRA) called Health Information Technology for Economic and Clinical Health or HITECH promotes the Meaningful Use of information technology in the form of EHR systems for every American by 2014 (Hoffman, 2009). Just having an EHR system is not enough; meaningful use means the system must improve the quality, efficiency, security, access, and communication in the delivery of health care among other functions. The United States government has provided $17 billion in available incentives to assist physicians and health care facilities implement certified EHR systems that meet Federal qualifications by the year 2014 (Blumenthal, 2009). This important health care issue affects everyone in this country because of the nature of private health i nformation. The U.S. government mandate for the implementation of electronic health records presents a wide variety of issues for and responses by physicians who want to retain their diversity relating to the way they practice medicine, while meeting the Meaningful Use requirements that will positively affect their investment and efficiency. Meaningful use depends on interoperability, which means that physicians systems will be able to communicate with each other for information exchange. Currently some physicians may have systems that are interoperable, but some may have invested in software that does not provide that function. Numerous vendors often market more than one type of system. Currently, estimates of physicians using a complete, fully functional EHR system are only at four percent (DesRoches, et al., 2008). This leaves the majority in need of researching software systems, purchasing, and implementing an EHR system to meet the Meaningful Use requirements. The practice of medicine is a highly individualized field where every physician has their own ways to provide for their patients. A general practitioner will have different software needs than a surgeon or obstetrician. An issue the physicians have to address is that they have to choose a certified EHR system that will provide the functions they need for their particular practice of medicine. Many physicians are starting with a basic system and customizing it to fit their practice needs (Baron, et al, 2005). HITECH will need to certify systems that provide functions that the physicians require with enough flexibility to meet the diverse needs of every type of practice. Some EHR systems are designed for primary care practices or large hospitals and may not meet the needs of a specialist. Physicians will have to choose a certified system that will have the required functions as well as those his practice will require. Whichever system a physician chooses will require training in order to benefit from the functions the software can provide. A basic knowledge of computer use is a skill many physicians do not even have. In fact, some physicians have technophobia when it comes to computers in their practice (Hayes, 2009). Statistics have shown that younger physicians are more apt to have a positive outlook on the EHR systems. Younger physicians also appear to have earlier adoption of an EHR system because of their prior exposure to computers. In-depth training to learn the functions and processes of the system are necessary to prevent severe disruptions in the workflow of the office. Many offices will train a few employees to be Super Users to be a resource for others in the office who have had less training. Super Users will be able to adjust the work processes when needed. Some physicians offices close for a period of days to bring the system online and prepare the office for going live. The diversi ty in computer abilities and comfort levels will affect the complexity, price, and amount of training required for each physician and his office staff for the chosen system. Cost is the biggest issue in the adoption of EHR systems. Cost estimates are between $12,000 and $24,000 to implement a fully functional EHR system (Baron, 2005). The equipment, software, training and one year of support can cost $140,000 or more (Baron, 2005). The HITECH incentives will cover some, but not all the cost of the conversion from paper to electronic records. Incentive payments can total $18,000 in the first year, for physicians implementing in 2011 and 2012 and will continue for 5 years at reducing amounts. The available incentive amounts will decline each year and end completely in 2016. In other words, physicians who adopt in 2011 could collect $44,000 over the five-year period while physicians who adopt in 2013 would receive $27,000 in incentive payments over 3 years (Blumenthal, 2009). The incentives will provide more funding for physicians that implement early. Surveys indicate that the incentives are a facilitator for approximately 55 percent of physicians who see the incentives as a reason to make the transition now, and receive maximum financial benefit (Blumenthal, 2009). The diversity in size of practices will affect how the physicians perceive capital costs. Due to the diversity in the types and ways physicians practice, issues that need to be considered and addressed, and the many solutions available, physicians attitudes and opinions on EHRs and Meaningful Use vary from very enthusiastic to resentful and wary. Studies have shown that physicians who have already adopted an EHR system are generally satisfied with their system and the benefits it provides. However, although the physicians will be the ones assuming approximately 89 percent of the cost of the system, they will not receive much of a return on their investment (Hoffman, 2009). The insurance companies will save money on reduced testing, streamlined billing, and overall efficiency. The government will save money on the same things as well as have a medium for monitoring fraud. Physicians will save some money on record storage, employee salaries previously paid for filing and transcribing records, and paper office supplies, but in comparison to the cost of the system, savings ar e minimal. Physician concern over return on investment is 50 percent for physicians who do not have an electronic system but only 33 percent for physicians who are already using an electronic system (DesRoches, 2008). The results may reflect Medicare and Medicaid patient numbers, size of the physician practice or perhaps the diverse perceptions physicians have over the dollar value versus the benefits to their actual income. Seemingly, the biggest numbers of implementers are the larger practices who are often better able to absorb the large investment than a small practice or single physician office. Statistics show that large primary care practices are more apt to implement EHR systems than other types of practices. These large group practices of fifty or more physicians were four times more likely to have a fully functional system than with physicians in practices of three or less physicians (DesRoches, 2008). The increased cash flow from a large practice makes the large capital expense less detrimental to the practice. This diversity in the size of physician practices is a significant basis for EHR implementation. EHR implementation itself will not provide for full Medicare and Medicaid reimbursement. In order for a physician to receive full reimbursement from Medicare and Medicaid, an EHR system must meet the Meaningful Use requirements. Physicians who do not have an EHR system that meets the meaningful use requirements will see penalties in the form of reduced Medicare payments. The reduction of payments will start at one percent in 2015, increase to two percent in 2016, and increase again to three percent in 2017 (Blumenthal, 2009). Physicians with large amounts of Medicare and Medicaid patients will have a significant reason to implement a system that meets the Meaningful Use guidelines. This issue will not affect all physician practices and some physicians do not feel it is a significant impediment to their practice income to warrant the large expense involved with implementing an EHR system. The diversity in the types of patients a physician or practice routinely cares for will have an e ffect on their financial return and willingness to implement an EHR system. For those who may not see a financial return there are many other benefits to adopting an EHR system for patients, insurance companies, and the government, and to some degree physicians. One benefit for physicians is a more efficient and streamlined insurance claims process, which will aid in cash flow. Physicians will also be better able to provide for their patients because the patient record will be able to go where the patient goes, including to hospitals and specialists, resulting in better coordination of the patients care. The EHR will provide a reduction in clinical errors because of the ability of the EHR to provide clinical decision support and monitor medication dosing and contraindications, and allergies. However, a group of physicians feel that this is questioning their judgment and do not want the interference in the way they practice medicine. Of physicians who are using a fully functional EHR system 86 percent appreciate the avoidance of medication error function that their system provides. The diversity in the physicians response to clinical decision support may be due to age of the physician, the number of years he or she has been in practice or any number of reasons including the personality of the physician. Along with those benefits, there is disruption of the office workflow. This is a significant cause for physician concern (DesRoches, 2009). The learning curve for an EHR system slows down all the processes in the office. Some physicians are better able to deal with the chaos that ensues while converting to an electronic system. Everyone within the practice has to relearn his or her job processes. All the office procedures of the practice have to be redesigned to work with the EHR system and the practice requirements. There is a period even after implementation of changes and adjustments that must be made to customize the system to the practice. Physician practices have reduced their patient load as much as fifty percent during implementation to try to reduce the waiting time for patients (Braon, et al., 2005). This essentially means a reduction in revenues until everyone can perform their jobs smoothly and handle the normal patient load again. Estimates are anywhere from four to six months before normal patient load is fully resumed. Physicians have reported losing patients because the wait time to see the physician was too long during the early stages of implementation (Baron, 2005). This is a major barrier for 41 percent of physicians in making the switch to electronic records (DesRoches, 2008). Physicians are very busy by nature and a slowdown in the office creates a diverse level of frustration that has caused some physicians to put off implementation or even to reverse the work already done in adopting an EHR system and return to their paper system. Those who do make the switch from paper to electronic records will have to consider HIPAA requirements for security of an EHR system. EHR systems require the secure storage of EHRs, which contain patients private health information and interoperability requires secure access to patient EHRs. Some physicians will choose to be on an encrypted network to share information with their local hospital, laboratories, and other health care providers. A verification process will be required to allow authorized physicians access to patients private health information and to deny access to unauthorized persons. Security of patient records is a concern for many physicians. Some physicians feel this is something that needs more regulation before they will expose their patients to the risk of a breach. The diversity in the EHR systems in operation now creates issues for secured patient PHI with system interoperability. With all the diversity involved in implementing an EHR system, physicians perceive the challenges of the U.S. government mandate for the implementation of electronic health records in different ways. Some feel there are too many barriers to address before implementation of an EHR and others feel the benefits outweigh the barriers. There are as many opinions on the issues of switching to an EHR system as there are physicians themselves. Addressing issues such as cost, security, training without a major loss in cash flow, which stems from disruption to the workflow of the office, will all stress the doctor patient relationship at least for a time. This is important because it will effect how and when the physicians adopt and use the nationwide system. The diversity in the way physicians practice medicine is individualized and the approved EHR systems will have to be flexible enough to allow for that individuality. The one thing all physicians want is to practice medicine they way they always have and meet the required mandate for Meaningful Use so they may recoup some of their investment. References Baron, R. J., Fabens, E. L., Schiffman, M., Wolf, E. (2005, August 2). Electronic health records: Just around the corner? Or over the cliff? Annals of Internal Medicine, 143(3), 222-226. Retrieved from http://search.ebscohost.com/.aspx?direct=truedb=a9hAN=17875478site= ehost-live This article is written by physicians in a 4-internist practice describing the processes involved with converting from traditional paper medical records to electronic medical records. Baron and colleagues address the problems and issues involved, and how they worked through them. Some topics of interest include both planned and unexpected finances, training, workflow and accommodations and the overall office environment. The article describes the realized benefits and lacking areas of standardization and interoperability. I chose this source for its overall description of actual process of implementing an electronic records system. This article also addresses computer skills and requirements. Blumenthal, D. (2009, April 9). Stimulating the adoption of health information technology. New England Journal of Medicine, 360(15), 1477-1479. doi:10.1056/ This article describes the portions of the American Recovery and Reinvestment Act of 2009 (ARRA) that pertains to health information technology. The article addresses barriers physicians have for implementing the mandated electronic medical record. Financial issues including incentives, costs and financial penalties are of adopting the mandate are covered. Other areas to promote and ease the transition, such as support systems, state and regional medical information exchanges, education initiatives, and extended HIPAA guidelines with regard to electronic records and transmissions are included in this article. This article explains the incentives for implementing the electronic records system. I chose this article to explain the diversity involved in the governments promotion for adopting an electronic health record system. DesRoches, C. M., Campbell, E. G., Rao, S. R., Karen, D., Timothy, F. G., Jha, A., . . . Blumenthal, D. (2008, July 3). Electronic records in ambulatory care: A national survey of physicians. New England Journal of Medicine, 359(1), 50-60. doi:10.1056/ This article is a summary of statistics and results compiled from a survey of physicians in the US regarding the adoption of electronic health records. Documented in the survey are physician statistics and opinions in areas of usage, implementation, and satisfaction with the electronic health record systems. Issues addressed are quality of care, age groups of physicians who have adopted an electronic system and size of practices more apt to adopt electronic health records. The positive effects on practice processes, barriers that hinder adoption of electronic health records, incentives for and reservations with switching to electronic health records are included in the survey. I chose this source because it provides actual statistics of the usage of electronic health record systems as well as the diversity in physicians perceptions of the process, the systems, the benefits, and problems associated with compliance. Hayes, F. (2009, February 2). No Rx for ROI. Computer World, 43(5), 40. Retrieved from http://search.ebscohost.com/.aspx?direct=truedb=a9hAN=36487540site=ehost-live In this article, the senior news columnist addresses the issue of return on investment (ROI) for the adoption of electronic health records. The definition of ROI is given and how it applies to aspects of electronic health record adoption for physicians and hospitals is examined. Risks to, benefits of, and improvements needed regarding electronic health records are noted. The author confirms that those assuming the expenses for electronic health records will not be the ones reaping the benefits. I chose this article because it covers reflects my opinion one of the most important reasons for physician resistance to implementing the government mandated electronic health record system. Hoffmann, L. (2009, November). Implementing electronic medical records. Communications of the ACM, 52(11), 18-20. Retrieved from http://search.ebscohost.com/.aspx?direct=truedb=a9hAN=45021143site=ehost-live In this article, a basic history of George W. Bushs goals for every American to have an electronic health record is presented along with the progress of the government in making those goals real. Usage of electronic records is briefly mentioned. The article focuses on some major barriers and concerns of physicians for implementation and usage. The article also addresses some of the positive aspects for electronic health records. I chose this article because it provides concise overall answers to who, what, when, where, and why answers to the implementation of the electronic health record and health information technology.

The Issue of Money in The Tempest and Othello :: William Shakespeare The Tempest Othello Essays

The Issue of Money in The Tempest and Othello The central issue depicted in both plays The Tempest and Othello is about money. Money in substantial amounts can represent great power and strength over the ruling nation. It plays a major role in our everyday society and one that is fully illustrated in both of Shakespeare’s play. Both of the plays are related to his matter, in that the subplot characters attempt to achieve high respect and, therefore, gain power and strength by deception. A parallelism can be drawn between the characters of Caliban, Trinculo and Stephano from The Tempest to Othello with Iago, Othello involved. Both of these scenes illustrate how the characters Caliban and Othello are easily fooled by deception. What these characters, from both plays, Trinculo and Stephano and Iago do have in common are their evil intentions and conspiracy’s to gain power by deceiving others to believe in them fully. Caliban, a half human and half beast, is easily fooled by the two men, the derivatives of a higher civilization. Trinculo and Stephano have to plans to turn every situation into their own advantage. Although, Caliban possesses much more intellect than those two roguish members labeled as â€Å"civilized†, he submits to the story that they help Caliban murder his deceitful master, Prospero. He declares that Prospero, a skillful magician has wrongfully taken over the island he had inherited from his mother Sycorax. Caliban is not at all appreciative of what Prospero gives to him because he says â€Å"You taught me language† (1,2,362) only and because he â€Å"must obey† (1,2,371) or else Prospero will inflict pain on him. Caliban immediately declares Trinculo and Stephano as his new master as he joyfully sings a song celebrating their initial meetings. Caliban is deceived into believing that Trinculo and Stephano will deliver their promises when in fact those two so called nobleman had another beneficial matter in mind. It is Stephano’s and Trinculo gift of liquor to Caliban that makes him believe that they are from a higher social class. In return Caliban has fallen from an almost intellect into the lowest social being, while Trinculo and Stephano have gained their respect, therefore they have the ability to take control over Caliban. In Othello, the same situation is drawn in that Othello and Caliban from The Tempest are both victimized because of their lack of judgement.

Digital Fortress Chapter 28

Senor Roldan was sitting behind his desk at Escortes Belen congratulating himself for deftly sidestepping the Guardia's newest pathetic attempt to trap him. Having an officer fake a German accent and request a girl for the night-it was entrapment; what would they think of next? The phone on his desk buzzed loudly. Senor Roldan scooped up the receiver with a confident flair. â€Å"Buenas noches, Escortes Belen.† â€Å"Buenas noches,† a man's voice said in lightning-fast Spanish. He sounded nasal, like he had a slight cold. â€Å"Is this a hotel?† â€Å"No, sir. What number are you dialing?† Senor Roldan was not going to fall for any more tricks this evening. â€Å"34-62-10,† the voice said. Roldan frowned. The voice sounded vaguely familiar. He tried to place the accent-Burgos, maybe? â€Å"You've dialed the correct number,† Roldan offered cautiously, â€Å"but this is an escort service.† There was a pause on the line. â€Å"Oh†¦ I see. I'm sorry. Somebody wrote down this number; I thought it was a hotel. I'm visiting here, from Burgos. My apologies for disturbing you. Good nigh-â€Å" â€Å"Espere! Wait!† Senor Roldan couldn't help himself; he was a salesman at heart. Was this a referral? A new client from up north? He wasn't going to let a little paranoia blow a potential sale. â€Å"My friend,† Roldan gushed into the phone. â€Å"I thought I recognized a bit of a Burgos accent on you. I myself am from Valencia. What brings you to Seville?† â€Å"I sell jewelry. Majorica pearls.† â€Å"Majoricas, reeaally! You must travel quite a bit.† The voice coughed sickly. â€Å"Well, yes, I do.† â€Å"In Seville on business?† Roldan pressed. There was no way in hell this guy was Guardia; he was a customer with a capital C. â€Å"Let me guess-a friend gave you our number? He told you to give us a call. Am I right?† The voice was obviously embarrassed. â€Å"Well, no, actually, it's nothing like that.† â€Å"Don't be shy, senor. We are an escort service, nothing to be ashamed of. Lovely girls, dinner dates, that is all. Who gave you our number? Perhaps he is a regular. I can give you a special rate.† The voice became flustered. â€Å"Ah†¦ nobody actually gave me this number. I found it with a passport. I'm trying to find the owner.† Roldan's heart sank. This man was not a customer after all. â€Å"You found the number, you say?† â€Å"Yes, I found a man's passport in the park today. Your number was on a scrap of paper inside. I thought perhaps it was the man's hotel; I was hoping to return his passport to him. My mistake. I'll just drop it off at a police station on my way out of-â€Å" â€Å"Perdon,† Roldan interrupted nervously. â€Å"Might I suggest a better idea?† Roldan prided himself on discretion, and visits to the Guardia had a way of making his customers ex-customers. â€Å"Consider this,† he offered. â€Å"Because the man with the passport had our number, he is most likely a client here. Perhaps I could save you a trip to the police.† The voice hesitated. â€Å"I don't know. I should probably just-â€Å" â€Å"Do not be too hasty, my friend. I'm ashamed to admit that the police here in Seville are not always as efficient as the police up north. It could be days before this man's passport is returned to him. If you tell me his name, I could see that he gets his passport immediately.† â€Å"Yes, well†¦ I suppose there's no harm†¦Ã¢â‚¬  Some paper rustled, and the voice returned. â€Å"It's a German name. I can't quite pronounce it†¦ Gusta†¦ Gustafson?† Roldan didn't recognize the name, but he had clients from all over the world. They never left their real names. â€Å"What does he look like-in his photo? Perhaps I will recognize him.† â€Å"Well†¦Ã¢â‚¬  the voice said. â€Å"His face is very, very fat.† Roldan immediately knew. He remembered the obese face well. It was the man with Rocio. It was odd, he thought, to have two calls about the German in one night. â€Å"Mr. Gustafson?† Roldan forced a chuckle. â€Å"Of course! I know him well. If you bring me his passport, I'll see he gets it.† â€Å"I'm downtown without a car,† the voice interrupted. â€Å"Maybe you could come to me?† â€Å"Actually,† Roldan hedged, â€Å"I can't leave the phone. But it's really not that far if you-â€Å" â€Å"I'm sorry, it's late to be out wandering about. There's a Guardia precinct nearby. I'll drop it there, and when you see Mr. Gustafson, you can tell him where it is.† â€Å"No, wait!† Roldan cried. â€Å"The police really needn't be involved. You said you're downtown, right? Do you know the Alfonso XIII Hotel? It's one of the city's finest.† â€Å"Yes,† the voice said. â€Å"I know the Alfonso XIII. It's nearby.† â€Å"Wonderful! Mr. Gustafson is a guest there tonight. He's probably there now.† The voice hesitated. â€Å"I see. Well, then†¦ I suppose it would be no trouble.† â€Å"Superb! He's having dinner with one of our escorts in the hotel restaurant.† Roldan knew they were probably in bed by now, but he needed to be careful not to offend the caller's refined sensibilities. â€Å"Just leave the passport with the concierge, his name is Manuel. Tell him I sent you. Ask him to give it to Rocio. Rocio is Mr. Gustafson's date for the evening. She will see that the passport is returned. You might slip your name and address inside-perhaps Mr. Gustafson will send you a little thank you.† â€Å"A fine idea. The Alfonso XIII. Very well, I'll take it over right now. Thank you for your help.† David Becker hung up the phone. â€Å"Alfonso XIII.† He chuckled. â€Å"Just have to know how to ask.† Moments later a silent figure followed Becker up Calle Deliciasinto the softly settling Andalusian night.

Essay on The JudiciaryEssay Writing Service

Essay on The JudiciaryEssay Writing Service Essay on The Judiciary Essay on The JudiciaryThe case of Lopez vs. Smith resulted in the court’s ruling according to which the federal court may grant relief to prisoners, who is seeking relief, only on the ground of the violation of the Supreme Court’s ruling but not the ruling of the court at the state level. In this regard, the court’s ruling was grounded on the Article 3 of the US Constitution, which determines the judicial power of courts and jurisdiction of federal and state courts. At first glance, this court ruling is just but, in its essence, the court ruling leads to the federalization of the US criminal justice system, when the authority shifts toward the federal court, whereas state courts are deprived of their power.  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In fact, the case of Lopez vs. Smith involved the attempt of the defendant to seek for federal habeas relief, after his attempts was denied by the state court of appeals. As the case proceeded, the Supreme Court of t he US has taken the final decision which stated that the prisoner could obtain relief only, if there was the violation of the Supreme Court’s ruling, whereas the defendant referred to the violation of the habeas relief at the state court level. This is why he appealed to the Supreme Court seeking the habeas relief, but the Supreme Court took the negative decision insisting that there was no violation of the Supreme’s court ruling.  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   This decision is unjust in terms of the redistribution of the judicial power between the federal and state courts. Alex Coolman (2014) insists that the Supreme Court’s ruling has triggered the aggressive federalization of the US court system with the shift of power toward the Supreme Court and federal courts at large, at cost of the power taken from state courts. Taking into account the autonomy of state courts and their jurisdiction, such a decision is unjust and limits their power within th eir states.

How to Format APA Citations

How to Format APA Citations How to Format APA Citations APA referencing – developed by the American Psychological Association – is used to cite sources in academic writing. But how does this system work? In this post, we take a look at APA citations, how to quote sources, and a few variations of the basic citation format you may need to know. 1. Basic APA Citations APA uses author–date citations (a form of parenthetical referencing). This means you cite a source by giving the surname of its author and the date of its publication in brackets: Many people use APA citations (Schreiber, 2001). As shown above, APA citations place a comma between the author’s name and the year. If the author is already named in the text, meanwhile, you only need to give the year in brackets: Schreiber (2001) states that many people use APA citations. This is the basic APA citation format for all sources with a single author. 2. Sources with More than One Author For sources with two authors, include both surnames in citations. The names should be joined by an ampersand if they are cited in brackets, but not when they appear in the main text: Two is company (Schreiber Harkin, 2011). According to Schreiber and Harkin (2011), two is company. When a source has three to five authors, the format is the same as above for the first citation. For instance: Three is a crowd (Schreiber, Harkin, Murray Ptaszynski, 2014). However, if you were to cite the same source again, you would use the first name plus â€Å"et al.† to prevent repetition. For example: Nobody yet knows what comes after a crowd (Schreiber et al., 2014). For sources with more than five authors, meanwhile, you should cite the first named author plus â€Å"et al.† in all citations, including the first one (full author information is still given in the reference list). 3. Organizational Authors Some sources, such as the website of a business, won’t have a named individual as an author. When this occurs, you can name a company or organization as the author: Missing citations can affect your grades (Proofed, 2018). This is known as citing an â€Å"organizational author.† If there is no organizational author available either, though, you may have to give the title of the source in the citation instead of an author. 4. Quoting Sources If you are quoting a source, you need to give a pinpoint citation. This means citing the page number(s) of the quoted passage: It is important to â€Å"provide evidence in essays† (Schreiber, 2001, p. 24). As shown above, you should give the page number(s) after a comma and â€Å"p.† when the author’s name is part of the citation. However, you should cite the page number separately when the author has been named in the text instead: Schreiber (2001) says we must â€Å"provide evidence in essays† (p. 24). The key is that page numbers always appear after the quotation. 5. Audiovisual Sources If you want to quote an audiovisual source, you need to cite a timestamp: The interviewee claimed that â€Å"video is the future† (Harkin, 2017, 21:34). Here, for example, the â€Å"21:34† in the citation shows that the quote comes from 21 minutes and 34 seconds into the recording. This replaces the page numbers cited when quoting a print source. 6. Multiple Sources in One Citation You can, if required, cite more than one source in a single set of brackets. All you need to do is place a semicolon between the citations, which should be ordered alphabetically by author surname: There is strong agreement on this issue among experts (Harkin, 2001; Ptaszynski, 1998; Schreiber, 2010). Citing more than one source at the same time like this can be useful if you need to show that multiple sources support the same argument. 7. Multiple Sources by the Same Author from the Same Year For most sources, the author’s surname and year of publication will be enough for the reader to find it in the reference list. However, if you are citing more than one source by the same author from the same year, you will need to provide extra information to help the reader. APA referencing does this by placing a letter after the year of publication: Publishing success can vary by year (Harkin, 2001a). Some years may see an author release multiple works, whereas other years may see them publish nothing at all (Harkin, 2001b). Here, we have two sources by Harkin from 2001. As such, we label these â€Å"2001a† and â€Å"2001b† in citations and in the reference list so readers can tell which citation points to which source. The letter used depends on the position of the source in the reference list, with sources from the same year ordered alphabetically by title. So, if we have two sources by Harkin from 2001, one called Analyzing APA and another called Myths of Referencing, the former would come first in the reference list and be cited as ‘2001a’, while the latter would come second and be cited as â€Å"2001b.† 8. More than One Author with the Same Surname Finally, if you cite separate sources by two authors who happen to have the same surname, you should add a first initial to citations so that your reader can tell them apart: Some surnames are very common (A. Smith, 1984). This can lead to confusion between people with the same surname (B. Smith, 2004). Adding this initial will help readers find the sources in your reference list.

Diversity among individuals Assignment Example | Topics and Well Written Essays - 250 words

Diversity among individuals - Assignment Example Nurses, patients, and other stakeholders play a fundamental role in both health promotion and health education. In light of this observation, it is important for these parties to embrace diversity and subsequently understand how diversity-related practices influence education. The aforementioned teaching principles, learning styles, and teaching methodologies aid in the understanding of critical issues in the health sector. In the process, these aspects make it possible for scholars to identify areas of education that make the highest difference in the society as far as health and education are concerned. Most importantly, teaching principles, learning styles, and teaching methodologies make it possible for education to target specific issues and problems that subsequently promote positive outcomes in both health promotion and disease prevention (Bensley & Brookins-Fisher, 2009). In a bid to overcome differing views, health care providers address disease prevention and health promotion from the community or local level upwards. Given that health concerns differ from one community to another, the idea is to have health care providers customize their approach to disease prevention and health promotion towards the community, local population, or the society they

Doryphoros and Augustus of Prima Porta Assignment

Doryphoros and Augustus of Prima Porta - Assignment Example The second style is a portrayal of actual Roman attributes with full body adornment and symbolizing authority. 2. Line- is used in Doryphoros and Augustus of Prima Porta to define the male body in its most proportional form; this is because this element is used to determine its size and shape (Janson & Janson, 2003). It is used to outline full body shape and curvatures while also defining the postures of the objects under study. Shape- In both the sculptures, the shapes come out because the sculptors divided the human body into different parts. They then designed all these and made sure they are proportionate when assembled into a whole. Texture and Balance- The images have a fine balance between relaxation and tension because of their postures; that creates harmony. The shades fade off very gently from one color code to the next making the balance and texture very clear; however, they have a simulated texture which makes the objects poses real textures. This is seen for instance in Augustine’s clothing and adornments. 3. The objects have a subject the sculptors wanted to pass across; The Doryphoros is a symbolism of male beauty with balanced body parts. Augustus of Prima Porta is a sculpture made by Tiberius in recognition of his father’s role in protecting their empire. 5. The artist message when making Doryphoros is a portrayal of a perfect male; this is coupled with nakedness which symbolizes civility thus bringing out a contrast with Greek’s backward neighbors. Augustus is personified as being a perfect ruler of the Roman Empire (Janson & Janson, 2003). He does this by giving him features of both strength and agility. He is compared to the powerful Greek gods as he wields authority which was essential in ruling the expansive empire and protecting it from foreign occupation.