Individual Project Budget Essay Example for Free

Individual Project Budget Essay This week we are looking forward to successful two day training with your staff. The objective is to successfully convert the United States Army Medical Department from EMR to AHLTA. There are trainers that are set in place to ensure that the staff receives their full attention and that they also feel comfortable with the software. The outcome of this would be to have the ability to easily communicate electronically regarding patients and is up to date with today’s advanced technology which will allow the compliance with government standards as well as high reimbursement for every office. While being trained the staff should feel very comfortable when working with the software and to ensure that this happens a questionnaire is given for feedback. In order to get prepared for the training class, there is an updated list of things that are on the schedule that are to be reviewed with the staff. I there are any changes that come about they should be made as soon as possible. In order to make sure that the meeting will offer a successful transition, communication is very important for all offices so stakeholders are alert and ready for the upcoming dealings. In order to get everything settled their will be daily meeting that will be set up via the web and at a landline location for those that are able to attend. Schedules for each provider and their staff should eventually be shortened to accommodate training and mandatory attendance should be enforced. A checklist will be provided for each office with the necessary materials needed for the conversion and information regarding government policies. Tentative Schedule * Employees will arrive in Atlanta (Hartsfield Inter. Airport) @ approximately 8:00am * Shuttle will bring all employees to Hyatt (we have a contract with this hotel) * Employees will be served continental breakfast before the training @ 9:00am on both days * Translators are available for those that request it * Conference rooms are on the first floor Training on both days will end at approximately 4:30pm * Lunch will be serviced, Dinner is not in the budget room service and taxi service are available @ employees expense * Trainers will watch every user to make sure that they fill comfortable and a short quiz will be given on the second day to ensure this course is understood and if not then further training can be offered * Shuttle buses will be available the morning after the last training class to transport employees to Atlanta (Hartsfield Inter.  Airport). There are different times being offered, please make sure that each employee is aware of the departure times so they arrive one or two hours before their plane is set to leave The company’s plans are that each employee has a successful training class as well as a comfortable and relaxing environment. Once the two day training ends a questionnaire/survey will be mailed out for feedback. These forms are completely anonyms if you chose to take it. Thank you in advance for your corporation in this matter. For your review a preliminary budget for the 2 day training classes is provided. The budget and the schedule are subject to change. They are in the excel format using the Grantt chart.

Escape from Vietnam :: Personal Narrative

Escape from Vietnam The other night I had a dream. I dreamed of a boy whom I had known a long time ago, but since then he had disappeared completely from my life. In my dream, I saw him sitting beside my bed and talking to me. He told me about the trip that he had taken with his parents, his two older brothers, and his sister when he was seven years old. He told me how his parents had been victimized by a man who knew about his parents’ desperate attempt to flee from Vietnam, so he took advantage of them. â€Å"Wake up, wake up, son. We must leave now.† He opened his eyes and looked outside; it was still very dark and rainy. â€Å"Where are we going, Mom?† he asked while crawling out of bed sleepily. When they left the house for the train station, it was only four o’ clock in the morning, and the boy thought that his family was going to visit their grandparents whom he had not seen for ten years. The next morning, they arrived in Nha Trang, a coastal city in Central Vietnam, where his father told him that they would stay for a while before going to the next destination. They went to live in the house of an acquaintance near the fish market. Every day they would stay inside the house and would go out only when it was absolutely necessary, especially the kids who now had to learn how to be quiet. They learned how to walk tip-toe and to talk by finger pointing; few sounds were made. Every sound was kept to the minimum so the neighbors and the secret police woul d not be aware that there were new people in town. Around midnight on the fourth day, the boy and his family members awakened again. This time they went with the family of the house's owner to a bus station where they took the bus going northward. The boy was very happy because he was free at last to play as a normal child again. On the way, everybody was fascinated and hypnotized by the scenery along the road, especially the kids because it was the first time they had left the cosmopolitan city for the countryside.

Type-B PDL

Type-B PDLs are particularly common in pregnant women among various forms of PDLs classified since Matzumoto first described PDL in 1913 (3). Initially, PDL was classified into four types A to D by Miura (7) and twenty-four years later another class E was added by Selmanowitz et al. (4) Facial PDL has also been well documented and were classified into F, G, and H among the Indian population (8,9). Type-B PDL can coexist with type-A in a few number of patients (10). It can also occur in the absence of pregnant (2,4). In this cross-sectional study of 220 primigravidae and 220 controls, the age group ranges between 18 to 40 years for both cases and controls. The mean age of the cases and controls were respectively 27.61 Â ± 3.928 (SD) and 26.83 Â ± 4.069 (SD). The highest proportion of participants, more than 75%, recruited for the study belong to the age less than 30 years. The pattern of age distribution in this study is similar to that reported by Kumar et al (11) and Rathore et al (12) in their study of cutaneous changes in pregnancy. This may reflect higher pregnancy rate among the younger age population possibly due to higher fertility rate in this age group. Pigmentary changes in pregnancy is the commonest physiological cutaneous changes witness by pregnant women (13). As many as over 90% in some studies developed one form of pigmentary changes or the other with lots of cosmetic concerns to the patients (13). However, the prevalence of pigmentary demarcation lines (PDL) are low in this studies (11,13)The prevalence of pigmentary demarcation lines in this study varies with increasing gestational age. Type-A PDL was not observed among the pregnant women studied but was noticed in 0.5 percent of the controls group. The proportion of patients with type-B PDL in second trimester was 1.8%, this figure was however doubled 3.6% by third trimesters suggesting the fact that PDL tend to occur more as pregnancy advances attributable to neurogenic inflammation from compression of peripheral nerves S1 and S2 by enlarging uterus (14). This result is similar to 2% earlier reported by Kumar et al (11). However, other researchers have documented lower prevalence than our study. Rathore et al (12) reported 0.25%, Kumari et al (13) 0.3% and Singh et al (6) 0.32% among pregnant population. The higher prevalence observed in this study compare to these previous studies may be due to the fact that our patients were followed up to the third trimester, some of which could have been missed in earlier trimesters without follow up. Besides, type-b PDL are observed to develop more in later part of pregnancy probably as a result of increasing pregnancy hormones. Other possible reasons for discrepancies is the skin phototypes and racial differences of the studied populations as it has been observed to be commoner among Negroes (4). Type-B can also co-exist with type-A PDL although this is an infrequent phenomenon (15). This pattern was evident in this study as one patient had type A and B PDL together for the first time throughout her pregnancy and another one only develop type B co-existing with type-A only in third trimester. This pattern is similar to the findings by Nakama et al (16) and Arunachalam et al (17). The pathogenesis of type B pigmentary demarcation lines is largely unknown (18). The influence of pregnancy hormones such as beta-melanocyte-stimulating hormone, eostrogen and progesterone has been suggested as one of the possible explanations for the development of pigmentary demarcation lines (19,20). The hormonal theory appeared plausible when the cases in our study are compare with the controls, this was however challenge by the fact that type-B PDL has been reported in amenorrhiec Chinese woman with low estradiol (2) This should further prompt more research to unravel the pathogenesis of PDL.Other types of pigmentary demarcation lines C, D, E and facial PDL F, G, H were not observed in this study. This may probably be due to the fact that skin of negroid pregnant woman present with darker generalized hyperpigmentation that make this types of PDL difficult to discern. Other possible explanations is the close resemblance of facial PDL to melasma, exogenous onchronosis, periorbital hyperpigmentation and post inflammatory hyperpigmentation, naevus of Ota or Ito (9,21,22). The pathogenesis of PDL remains controversial with many theories been propounded to explain the enigma. Even though PDL is well classified and accepted, there is no consensus yet on the pathogenesis, possibly multiple mechanism are interacting together to explain the aetiology of PDL. Among these theories are:Familiar clustering – genetic and racial predisposition play a role in the development of PDL as it has been reported to occur among family members and relatives in up to 22.2% of cases (23). Although PDL occurs in all races and skin types it is however commoner among the blacks than Caucasians (24). It is postulated that PDL is dominantly inherited (9). However, none of our patients could give family history of PDL.Atavistic remnant phenomenon- this is an evolutionary throwback in which there is reappearance of a primitive characteristic. This characteristic is an adaptive mechanism in which the more pigmented dorsal surface protects against the effect of ultraviolet radiations and for temperature regulation (9,25).Pigmentary mosaicism- mosaicism occurs when two or more genetically distinct population of cells occur side by side in an individual (26). This is a consequence of structural or functional genetic mutation (27). A classic pattern of cutaneous mosaicism is depicted by lines of Blaschko which has been described in many pigmentary disorders. Krivo proposed cutaneous mosaicism as the possible aetiology of type-b PDL (28). Mosaicism has also been ascribed to familiar clustering and preponderance in females with facial PDL (9).Axial-neural theory- Maleville et al (29) in an attempt to explain this enigma opined that the pathogenesis of PDL is better explained by virtual axial lines of Sherrington described by Miura (7) other than the clonal-Blaschko theory proposed by Krivo (28). Blaschko lines correspond to distribution of linear nevoid conditions, or dermatomal lines.(30,31) The axial lines of Sherrington coincide with subsets of Voigt's line and cutaneous nerve distributions that divide dermatomes when noncontiguous dorsal root give rise to two contiguous dermatome (7,29). Additionally, melanogenesis are under neural control, and nerve endings may be different in their sensitivity to neural stimulation resulting in dual population of melanocyte with subtle variation in pigmentation in-between dermatomes given rise to PDL (6).

The Paradox Of Belonging The Complex Role Of Colonialism

The Paradox of Belonging: The Complex Role of Colonialism in Finding Identity Adrienne Clarkson the twenty-sixth Governor General of Canada once wrote: â€Å"I was, and am, a child of diaspora. I am someone who, for a while, did not belong anywhere.† For nearly everyone who has ever lived in the wake of colonialism, it can be painstakingly difficult to find a sense of belonging with two distinct cultures being juxtaposed together. This colonization process had devastating effects for those upon which the English imposed their ethnocentric views. In George Orwell’s â€Å"Shooting an Elephant† the audience is told a story from Orwell’s days as a police officer in Burma. In his essay, Orwell is confronted with conflicting emotions. He hates the†¦show more content†¦This demonstrates the level of fear that the white Rhodesian people had towards the black people in which they shared a country. This war and conflict results in the transformation of one country into another. This transformation makes it difficult for Fuller to und erstand her nationality, as Elaine Windrich notes: â€Å"It was hardly to be expected that the Fuller family could come to terms with the transformation of Rhodesia into Zimbabwe† (1184). Because of this war and its devastating effects on everyday life Fuller lived constantly in fear for her life and unable to find a sense of belonging to her society. The inner conflict that Alexandra Fuller feels regarding her possible role in the death of her sister also weighs very heavily on her conscience. She feels guilty about how Olivia’s death has affected her mother’s mental illness as she recalls: â€Å"No one ever came right out and said it in words and with pointing fingers. They didn’t have to† (Fuller 93). It is quite evident to the reader that Fuller would not be easily able to form her own personal identity, apart from the colonizer’s mentality in regard to belonging in her society due to the extreme guilt she feels. 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