Comparison between smokers and non-smokers Essay

Smokers and non-smokers have many differences, and very few similarities. I am one of those people who have been subject to addiction and got into the habit of smoking even though I do realize that us smokers are looked down upon by many people. Many restaurants and public places have become non-smoking, which prevents smokers from going certain places. Most people who smoke realize the harmful affects, but addiction is too strong to overcome that most of the time. For me I don’t think it’s as much the addiction, but how cigarettes help me relax and relieve stress. One of the main reasons non-smokers look down on smokers is because most of them realize the harmful affects, but continue to smoke because they are addicted. People who smoke tend to spend a lot of money on cigarettes that they could be spending on something that is more necessary than cigarettes. People who smoke generally have a yellowish tint on their fingernails and teeth from the tar in the cigarettes. Bad breath is also a common trait to people who smoke, which could be helped by breath mints or gum, but most people who smoke don’t carry those items around with them. Many people who smoke would like to quite smoking to prevent certain future health problems, but can’t because they are addicted. Non-smokers, however, do not understand us smokers because they have never experienced addiction for themselves. Non-smokers do not have to waste their money on cigarettes because they do not smoke. Non-smokers do not have to worry about stained fingernails or teeth either, which helps them have a somewhat cleaner appearance. They could, however, have bad breath depending on what kind of food they eat and how often they brush their teeth. In general non-smokers are healthier because they do not have that tar clogging up their lungs.

Foxconn

Just when positive news about Foxhound's efforts in improving the working conditions of its Sheehan factories for the workers and increasing wages was heard this year, the worker's riots in September 23, 2012 at the Foxhound's Taiwan (Shania) factory sparked another global outcry (Roberts, 2012). Foxing is a multinational company based in Taiwan and is one of the world's largest electronics manufacturing company. One of the major clients of Foxing is Apple; others include Sony and Hewlett Packard (Wisped, 012).According to reports by China Labor Watch (201 2), some of the unfair treatment and exploitation carried out by Foxing factories in China include â€Å"excessive overtime hours, forcing workers to work ‘voluntary overtime, maintaining an extremely high level of work intensity by setting the daily production quotas, exercise discrimination by hiring only young and healthy workers, and creating a system in which official resignation is nearly impossible and the only way ou t is to ‘voluntarily/ resign hence forfeiting a significant amount of their final wages (China Labor Watch, 2012).Due to increasing pressures from the media coverage of the suicide cases of its workers and from its image-conscious client (Apple Inc), it was claimed that Foxing had made efforts to improve working conditions by increasing wages of workers and instituting a program called â€Å"Care-Love† (Northern, Culpa and Ghent, 2011). However, after Foxhound's suicide incidents subsided, in 23 September 201 2, it was announced that Foxing Taiwan factory had to shut down production for the day due to rioting of the workers. The event involves around 2000 workers, with more than 40 hospitalized.It was reported that he riot was sparked off by a dispute between two workers, but most likely due to tensions between the guards and workers (Roberts, 2012). This was because the originally insignificant argument between the workers escalated into a riot involving the collective rebellion of thousands of workers only after the security guards of Foxing interfered aggressively with force, causing the situation to get out of hand to the point of requiring 5000 policemen to be dispatched to control the angry workers (Pilling, 2012).This riot has raised concerns about Foxhound's harsh and heavy-handed ways in managing the errors as mentioned by Geoffrey Charcoal, Research Director at Hong Songs China Labor Bulletin. It was reported that the guards constantly monitored the workers closely and spoke fiercely to them in an authoritative manner. There were no communication between the workers and guards, whereby the workers were expected to follow orders and rules without knowing the reasons (Roberts, 2012).Also, the workers work long hours and sleep in dormitories with poor conditions (Ho and Culpa, 2012). It was suspected that the Foxing Taiwan factory workers were forced to work overtime hours to et up with the production due to the recent launch of Apple's pho nes (Pilling 2012). According to a worker interviewed, it was known that Foxing has shifted its production of phones to the factory in Taiwan (Ho and Culpa, 201 2) and its Sheehan factories were now focused on product development (Roberts, 2012).Hence, it seems like though Foxing did improve the situation in its Sheehan factories, its efforts were only limited to the two factories in Sheehan and the other in Changed that were under inspection by Fair Labor Association and under extensive media coverage, hill neglecting its other factories distributed around China. Foxing has around a million workers working in its 13 factories in China (Yen, 2012) and has been expanding its factories into provinces located in the interior of China such as Taiwan, Squeezing, Human and Cocooning (Roberts, 2012).The shift in production may be because labor is about one-third cheaper in inner provinces of China (Northern, Culpa and Ghent, 2011 Sociological Interpretations for the Foxing Worker Riots The workers' riots in Foxing Taiwan factory could be understood from many perspectives, however it all boils down to modernization and capitalism which gave rise to a complex division of labor with an exploitative nature. It all started the rise of a new international division of labor, one that was characterized by the relationship between post-industrial nations and newly industrialized nations, based on exploitation (Serene, 2006).In fact, according to Marxist theory, the underlying logic of capitalism is exploitation (Howard, 2002). While capitalists (owners of production) compete to stay competitive and to achieve the most profit, workers compete to offer the cheapest labor possible, often driven to the level of subsistence. This IS because in this global ere market economy, it is determined based on the survival of the fittest. When there are winners, there will always be losers.We can view this international division of labor as a cycle in which on one side post industrial natio ns continuously experience wealth accumulation through the services and investments they provide via products manufactured with minimum cost, while on the other side the newly industrialized nations are continuously being exploited through their provision of cheap labor and resources (Serene, 2006). However, nations are also interdependent based on modernization and dependency theories.Modernization theory states that â€Å"modernity is needed for the economy to prosper and thus nations need modern technology to break out of poverty† (Serene, 2006). Developing nations need to open up and welcome foreign capital into their market as they will bring in the needed expertise and necessary technology to prosper. Thus, newly industrialized nations compete to attract transnational companies to invest and set up factories in their nations. However, these means offering the cheapest labor possible.At the same time, dependency theory states that the poorer and newly industrialized nati ons were pendent on the post industrial nations, as they brought jobs needed for survival and capital to drive the economy, which also brought domination and exploitation (Serene, 2006). Hence, based on the case in the previous section, it can be interpreted from this international division of labor that Apple Inc seems to be the biggest winner, while Foxing is second to it and the major losers would be the China workers. Apple is the capitalist owner that owns and controls all the products under its brand such as phone 5.In order to achieve the greatest efficiency and lowest production cost, Apple adopts the dead of outsourcing based on the division of labor and national specialization, whereby every an phone is actually a global effort (Serene, 2006). E. G. The phones start out being developed and designed by Apple engineers in California, the sourcing of the components and materials stretch out to different parts of the world, using parts from nine major suppliers in five countri es and then assembled by Foxing in China (The Straits Times, 2012). Thus, Foxhound's role is simply just one of the manufacturers employed by Apple to assemble its products.Apple has the biggest share of the profits, to Foxing. Whereby Apple is the overarching power, dominating Foxing, in turn Foxing dominates the workers due to pressure from Apple to meet production demands and cost budget. In the case illustrated, the workers in Foxing Taiwan factories were rushing out the phones for Apple, due to increasing popularity leading to increasing demands since the launch of the phones. With the market mechanism driven by demand and supply, Apple had to keep up with the demands of their products by producing enough supply.Foxing had no choice but to exploit its workers by making them ark overtime hours of almost 80 hours per month, past the legal limit of 36 hours with hourly wage of around 1 Euro (Deutsche Well, 201 2), and workers were required to sign an overtime working agreement pri or to employment that claims that Foxing is not responsible for their long hours of working. This voluntary agreement was actually used to overrule Chinese State regulation (Change, 2010). The reason was due to the competitive nature bred in the capitalist system and free market economy.Adam Smith mentioned that competition drives efficiency, but Marx also mentioned that capitalism reared a continual crisis of profit for owners (Serene, 2006). Indeed, due to increasing competition from competitors such as Samsung, rising up with its Samsung Galaxy SO, Apple felt the pressure to speed up its productivity' and at the same time maintaining the affordability Of its products. Like all Other multinational corporations, Apple is constantly in search for manufacturers that would allow it to incur the lowest cost. Hence, if Foxing proved to be no longer competitive in offering the lowest manufacturing cost, it will soon be replaced.Driven by competition and desire for profit too, Foxing had to maintain business contacts with Apple and remain attractive to investors and outsourcing companies by constantly relocating its factories to cheaper venues once wages cost too high, even if it means exploiting the workers in order to stay viable. This is because it was either Foxing passing the cost of the products on to the customers like Apple which obviously will deter them away, resulting in loss of profits, or Foxing trying to reduce the cost of the product.Hence, since most production cost including distribution and physical materials are rather inelastic, the only way was to reduce manufacturing costs and this was passed on to the workers meaning lesser wages with more work done (China Labor Watch, 2012). Next, this brings us to the role of the newly industrialized countries (Nick) in this international division of labor, countries that actually compete to attract these capitalists like Apple and Foxing, to relocate their manufacturing plants in their countries with abunda nt cheap labor. One of the Nick would be China.We can try to understand this worldwide competition to be driven by the idea of comparative advantage introduced by David Richard (Serene, 2006). After China's communist leader, Eden Ixia Ping launched the open door policy in China (Chance, 201 0), China obviously had a comparative advantage over the other countries with its huge supply of low cost and unrecognized peasant workers, due to the introduction Of the household based contract system (Stating Launch Changeable Zeroing) that allowed millions of peasant workers from the rural areas to work in urban factories set up by transnational companies (Chance, 2010).China joined in the global competition characterized by the phenomenon â€Å"race to the bottom† (Serene, 2006), gather with other countries to compete to offer the lowest labor cost possible. That was also the start of the widespread labor exploitation in China by the multinational corporations (Macs). Like the other M acs, Foxing saw China's abundant cheap labor attractive. Foxing Taiwan factory is just one of the many factories Foxing has in China.According to dependency theory, China allowed Foxing to exploit its workers as the state depended on Foxing to create jobs. This can be understood with modernization theory too, whereby Foxing locating their factories in China ill bring in the technology needed to modernize, income to the state through taxation, and create jobs for their people who will help drive their economy. Modernization and dependency tend to happen side by side (Serene, 2006).Hence, the dependency between the state of China, Foxing and Apple in the division of labor as explained above and the competitive nature of the capitalist system adopted throughout the world, resulted in exploitation of the workers in Foxing Taiwan factory to be an inevitable consequence of the free market economy. Exploitation led to build up pressure in the workers causing them to riot. This can be under stood from Marxist theory of rising class consciousness (Serene, 2006).Capitalism resulted in growing divide among the people between the rich and the poor, the powerful and the powerless, the people that own and control production and those who could only obey orders silently. Hence, there was a class division in Foxing itself, a division between the exploited workers and the managers, supervisors, guards and all those who have control over the workers. These workers felt oppressed. Their every action was monitored closely by the guards who often use violence on them if they did not obey the ales and orders (Ho and Culpa, 2012).The manager criticized those that too slow and did a bad job, however good performance was never praised. Hence, workers knew they would never advance no matter how hard they work. There was no freedom of speech, only obedience. There was even a slogan hung on the factory walls, â€Å"Outside the laboratory, there is no high technology, there is only obedie nce and discipline† as a kind of corporate culture Foxing promote (Deutsche Well, 2012). However, the workers did not quit their jobs due to their position as vulnerable deskilled workers which an be understood from Marxist theory (Serene, 2006).They worked up to a minimum of 10 hours a day on their routine monotonous work at high intensity, only stopping to eat and sleep (Change, 2010). Overtime, their deskilling work makes them vulnerable as they were easily replaced. Thus, the workers were willing to get exploited rather than lose their jobs. The heavy staff turnover also makes long-lasting relationships impossible, their whole day were spent on nothing but working, left with no time to socialize at all. They came from rural parts of China and live in the on-site dormitories, far away from their families.With no social safety net, these workers have no place to turn to if they lose their jobs which makes them even more vulnerable and manipulative by the capitalists. The ass embly-line work had slowly euthanized the workers (Ramey, 2010). Slowly, a sense of alienation was developed in the workers (Serene, 2006). While the cost of living had increased, their income only managed to increase slightly. The Foxing workers were working on parts of the phone that meant nothing to them as they could not afford them at all.Overtime, these alienated and oppressed workers felt greater solidarity as they belonged to the same exploited class. It was a sense of organic solidarity among the workers, according to Druthers (Serene, 2006). At the same time, with the increased influence of communication devices, social media and increased level of education, there was growing awareness of the better lifestyle richer people around China and other parts of the world led, causing a build-up of dissatisfaction and increased class consciousness.The young workers in Foxing were generally better educated; hence they were more aware and assertive of their rights and had higher ex pectations for work (Roberts, 2012). All these feelings within he workers had contributed to the riot on 23 September 2012. When the guards of Foxing Taiwan factory used force to attempt to control the workers' dispute, it led to the outburst of the growing dissatisfaction of the workers with more than 2000 workers joining in to rebel (Ho and Culpa, 2012).Recently, there had been news that another 3,000 – 4,000 workers were involved in a strike in Foxing Squeezing factory on 5 October, 201 2, Friday afternoon. The reasons were suspected to be due to the unhappiness from the â€Å"over-exacting quality controls and demands to work through the week- Eng National Day holidays† (Reuters, 2012). Hence, it seems like it is evident that there is a growing class consciousness among the Foxing workers due to reasons as explained above. Also, probably due to uprising of riots in China that made them feel embolden and the need to rise up using collective efforts to make their rig hts known.Globalization and the Widespread Exploitation of Labor in China Globalization has allowed the boundaries of national borders to be broken down, it was no longer about individual states, and instead they have integrated into one single global economy (Chance, 2010). The resultant effect was that the global economy has divided the world into only TV classes. The powerful core, made up of wealthy nations, the state government, transnational companies that continuously experience wealth accumulation, and the neglected periphery, made up of struggling poor nations and the working class people who are exploited by the powerful core (Serene, 2006).With this phenomenon, the people could no longer find themselves being protected by the state, because in this global economy, there are only two choices: to be neglected at the periphery or to join the powerful core. Hence, with globalization and the widespread capitalism, the states have decided to join the powerful core with the othe r elites, helping the multinational companies fulfill their insatiable greed for profit, in turn helping themselves fulfill their own needs and wants, ultimately for profit too.The widespread exploitation of the China workers in Foxing all boils down to the state of China being in cahoots with Foxing to fulfill their greed for profits in this one big global economy. Hence, there is a high possibility that the problem lies in the ineffective enforcement of law by the authorities in China. The reason behind this conclusion is the question of why the state did nothing to stop the exploitation of its people, despite being aware of the situation and why no one had successfully filed a lawsuit against Foxing (Yen, 2012).China adopts a socio-political system incorporating ideas of the capitalist system, free market system and party-state authoritarianism; with different government branches integrated together to ensure the centralization of power. This is to enable easy penetration into th e judicial system to undermine justice. Hence, it is not possible for checks and balances ender the centralized system China creates, which makes it very convenient for the authorities who have close relationship with Foxing to manipulate according to their benefits (Yen, 2012).Apteral, China would not hope to force Foxing to retreat from China with all its factories and investments, when Foxing is such a major taxpayer to China and that would mean that more than a million of its people working in these Foxing factories will be unemployed. However, there is the possibility that the exploited workers could harness the power of globalization, to effectively utilize the influence of he new media to let their situation and rights be known.

Indian Writing in English- Nissim Ezekiel Essay

Indian poetry has flourished over the last 4000 years. Today, it is composed and written in more than twenty Indian languages, including English. It has always echoed the voice of the times and revealed the pains and passions of the people. Its growth has also reflected our rich cultural heritage. The history of Indian poetry makes us aware of its glorious past in contrast to its present state. Today, as the world is shrinking and the communication network projecting man on the global scene much faster, the past values are getting lost in the struggle man is involved with. Issues confronting man have multiplied and so have his efforts for survival. Poetry today is facing the test of time. Poets need to be organized more vigorously than in the past to voice effectively their innermost thoughts and interact with each other more often. Giving away of awards to some of the few distinguished ones is not enough. Poets in India need to be encouraged in their creativity if we expect their contributions to transform our society. New life is to be given to old values which had stood us in good stead for so long. The poets should come to the forefront to undertake this job. As such, organized efforts need to be made to promote the production and publication of good Indian poetry. Poetry written in different parts of India needs to be collected, interpreted and propagated. Indian English literature (IEL) refers to the body of work by writers in India who write in the English language and whose native or co-native language could be one of the numerous languages of India. It is also associated with the works of members of the Indian diaspora, such as V. S. Naipaul, Kiran Desai, Jhumpa Lahiri and Salman Rushdie, who are of Indian descent. It is frequently referred to as Indo-Anglian literature. (Indo-Anglian is a specific term in the sole context of writing that should not be confused with the term Anglo-Indian). As a category, this production comes under the broader realm of postcolonial literature- the production from previously colonised countries such as India. A much over-looked category of Indian writing in English is poetry. As stated above, Rabindranath Tagore wrote in Bengali and English and was responsible for the translations of his own work into English. Other early notable poets in English include Derozio, Michael Madhusudan Dutt, Toru Dutt, Romesh Chunder Dutt, Sri Aurobindo, Sarojini Naidu, and her brother Harindranath Chattopadhyay. A generation of exiles also sprang from the Indian diaspora. Among these are names like Agha Shahid Ali, Sujata Bhatt, Richard Crasta, Yuyutsu Sharma and Vikram Seth. In modern times, Indian poetry in English was typified by two very different poets. Dom Moraes, winner of the Hawthornden Prize at the age of 19 for his first book of poems A Beginning went on to occupy a pre-eminent position among Indian poets writing in English. Nissim Ezekiel, who came from India’s tiny Bene Israel Jewish community, created a voice and place for Indian poets writing in English and championed their work. A significant and torch bearer poet is Nissim Ezekiel. Recent Indian English poetry adds to, what O. P. Bhatnagar terms as, a process of collective discovery, affirming its richness, sensitivity and cultural complexity. If we examine the potential of the poery-making mind in English, we should now discover aspects of the essentially assimilative genius of the Indian people, snf a celebration of the vast chorus of voices that make Indian literature sing. These poets write with an awareness of their milieu and environment rather than British or American rhetoric or intellectual attitudes like alienation or exile. They share the central core of contemporary realities of Indian life. The Indo – Anglian poetry is said to be essentially Indian and everything else afterwards. It expresses the essence of Indian personality and is also very sensitive to the changes of its national climate and it voices the aspirations and the joys and sorrows of Indians. It has been opined, that the Indo – Anglian poets are of two factions. The neo-modernists and the neo-symbolists. The outlook of the former is coloured by humanism and irony and that of the latter is imbued with mysticism and sublimity, but a perfect blend is achieved by the two groups in the realms of beauty. A perfect example, of anlndo – Anglian poet, who was able to arrive at a synthesis between the two factions of poetry, is none other than Sarojini Naidu, for she took her stance in the neutral, middle ground, between the sacred and profane sphere of poetry she was at home in both the worlds and found them united in the realms of poetry. Nissim Ezekiel occupies an important place in post-Independence Indian English literature. He has wielded a great influence as a leading poet, editor and an occasional playwright. Besides, he is a well-known critic. Sometimes he also emerges as a politician in the guise of a fighter for cultural freedom in India. Ezekiel held many important positions. He was for many years a Professor of English in Bombay University. He is a noted name in the field of journalism. In this capacity he was editor of many journals including Poetry India (1966-67), Quest (1955-57) and Imprint (1961-70), He was an Associate Editor to the Indian P. E. N. , Bombay. Considered to be the Father of post independence Indian verse in English, Nissim Ezekiel was a prolific poet, playwright, critic, broadcaster and social commentator. He was born on December24, 1924 in a Jew family. His father was a professor of botany and mother was principal of her own school. Ezekiel was inclined to the poets such as T. S. Eliot. Yeats, Ezra Pound in his school days. The influence of all these literary personalities was apparent in his early works. His formal use of the English language was linked to colonialism and resulted in controversy. His first collection of poetry ‘Time To Change’ was published by Fortune Press (London) in 1952. His poetry has all the elements of love, loneliness, lust, and creativity. Nissim Ezekiel went on to join The Illustrated Weekly of India as an assistant editor in 1953. ‘Sixty Poems’ was his next book followed by ‘The Unfinished Man’. Nissim Ezekiel started writing in formal English but with the passage of time his writing underwent a metamorphosis. As the time passed he acknowledged that ‘the darkness has its own secrets which light does not know. His poem ‘The Night Of Scorpion’ is considered to be one of the best works in Indian English poetry and is used as a study material in India and British schools. Nissim Ezekiel worked as an advertising copywriter and general manager of a picture frame company . He was the art critic of The Times Of India (1964-66) and editor of The Poetry India(1966-67). He was also the co-founder of the literary monthly Imprint. Ezekiel was awarded the Sahitya Akademi award in 1983. In 1988 he received another honor,Padma Shri, for his contribution to the Indian English writing.  He passed away on January 9, 2004, in Mumbai after a prolonged illness. As a man of letters Nissim Ezekiel is a ‘Protean’ figure. His achievements as a poet and playwright are considerable. K. Balachandran writes, â€Å"The post-Independence Indian poetry saw its new poetry in the fifties. Among the new poets A. K. Ramanujan, R. Parthasarathy, Shiv K. Kumar, Kamala Das, Monica Verma, O. P. Bhatnagar, Gauri Deshpande, Adil Jussawalla, Ezekiel occupies a prominent place. His versatile genius can be found in his poetry, plays, criticism, journalism and translation. Nissim Ezekiel has done a good work in Indian writing in English. He has written many volumes of poems—A Time to Change (1952), Sixty Poems (1953), The Third (1959), The Unfinished Man (1960), The Exact Name (1965) and others. His plays Nalini, Marriage Poem, The Sleep-Walkers, Songs of Deprivation and Who Needs No Introduction are already staged and published. He has also edited books Indian Writers in Conference (1964), Writing in India (1965), An Emerson Reader (1965), A M artin Luther King Reader (1965) and Arthur Miller’s All My Sons (1972). His literary essays published in magazines and papers are innumerable. The notable among them are ‘Ideas and Modern Poetry’ (1964), ‘The Knowledge of Dead Secrets’ (1965), ‘Poetry as Knowledge’ (1972), ‘Sri Aurobindo on Poetry’ (1972), ‘Should Poetry be Read to Audience? ‘ (1972), ‘K. N. Daruwalla’ (1972), ‘Poetry and Philosophy,’ ‘Hindu Society’ (1966). He has written essays on art criticism ‘Modern Art in India’ (1970), ‘How Good is Sabavala? ‘ (1973), and ‘Paintings of the Year 1973’ (1973). His e s s a y s o n social criticism Thoreau and Gandhi’ (1971), ‘Censorship and the Writer’ (1963), ‘How Normal is Normality’ (1972), ‘Tradition and All That a Case Against the Hippies’ (1973), ‘A Question of Sanity’ (1972) and ‘Our Academic Community’ (1968) are varied and auto telic of his wide interest. Ezekiel is an editor of several journals encouraging writing poetry, plays and criticisrm He also asked many writers for translation, affecting the theory and practice of the young poets. The writers like Rilke and W. B. Yeats influenced Ezekiel. Like Yeats, he treated poetry as the ‘record of the mind’s growth. ‘ His poetic bulk indicates his growth as a poet-critic and shows his personal importance. Chetan Karnani states, â€Å"At the centre was that sincere devoted mind that wanted to discover itself. In the process, he managed to forge a unique achievement of his own. † The poet Ezekiel has already published several volumes of poems. For him poetry-writing was a lofty vocation, a way of life. He treated life as a journey where poetry would be the main source of discovering and organising one’s own self. In a sense, poetry to Ezekiel became a way for self-realisation. He calls life a texture of poetry. He identifies himself with poetry. So all of his volumes of verse are well-knit and they are in the poet’s view, a continuation of each other. Ezekiel’s experiments in prose rhythms and his fine sense of structure and metrical ability. The verse rhythms of T. S. Eliot seem to haunt hi s mind. Ezekiel’s Si x t y Poems (1953), his second volume of poems was published in 1953. But these poems are loose in structure and they are less appealing. Night of the Scorpion’, in which Ezekiel recalls the behaviour of ‘the peasants’, his father, his mother and a holy man when his mother was poisoned by a scorpion’s sting. Here the aim is to find poetry in ordinary reality as observed, known, felt, experienced rather than as the intellect thinks it should be. While the peasants pray and speak of incarnations, his father, ‘sceptic, rationalist’, tries ‘every curse and blessing, powder, mixture, herb and hybrid’ and a holy man performs a rite. After a day the poison is no longer felt and, in a final irony, his mother, in contrast to the previous feverish activity centred upon her, makes a typical motherly comment: My mother only said Thank God the scorpion picked on me and spared my children. The ‘Thank God’ is doubly ironic as it is a commonplace expression of speech in contrast to all the previous religious and superstitious activity. Ezekiel’s purpose is not, however, an expression of scepticism but rather the exact notation of what he saw as a child. The aim is not to explain but to make real by naming, by saying ‘common things’. The poem is a new direction, a visionof ordinary reality, especially of Indian life, unmediated by cold intellect. The new purpose is seen in the poem’s style, unrhymed, with line lengths shaped by natural syntactical units and rhythm created by the cadences of the speaking voice into a long verse paragraph, rather than the stanzaic structure used in earlier poems. In his poetry there is the truth of acknowledging what is felt and experienced in its complexity, contradictions, pleasures, fears and disillusionments without preconceived ideas of what poetry should say about the poet and life. Nissim Ezekiel’s ‘Night of The Scorpion’ is much appreciated by the critics and it has found place in many anthologies for as excellence, Critics, commenting on its aesthetic beauty expressed different views. In their critical sweep, they brought everything from superstitious ritualism to modern rationalism. One can find that in the poem superstitious ritualism or sceptic rationalism or even the balance of the both with expression of Indian ethos through maternal love in the Indian way, is nothing but scratching the surface. The poem has something more gigantic than its face value, which as I find is the symbolic juxtaposition of the forces of darkness and light that is intrinsically centripetal in the poem. It is ‘Night’ of The Scorpion’ with the first word absorbing accent. It seems to have been implicitly contrived here that ‘Night should stand as a symbol of darkness with the ‘Scorpion’ as the symbol of evil. Such ingenuity in craftsmanship takes the poem to the higher level of understanding. Prof. Birje Patil is right in putting that in â€Å"Night of The Scorpion†, where evil is symbolized by the scorpion, The reader made to participate in the ritual as well as suffering through’ a vivid evocation of the poison moving in the mother’s blood’. And evil has always been associated with darkness, the seamy side of our life, in human psyche. It has always been the integral part of theology, in whatever form it has manifested that suffering helps in removing that darker patch in human mind, he patch that has been a besetting sin of man’s existence. May the sum of evil Balanced in this unreal world gainst the sum of good become diminished by your pain, they said These lines amply testify that the poem aims at achieving something higher than its narrative simplicity. The choric refrain ‘they said’ in the chain of reactions made by the village peasants is undoubtedly ironic, but the poet hasn’t as much to stress the concept of sin, redemption or rebirth ass he has to insinuate the indomitable force of darkness gripping the minds of the unenlightened. Going through the poem attentively more than once, it can’t fail catching our notice that modern rationalism is also equally shallow and perverse. It is also a road leading to confusion where through emerges scepticism, the other darker patch on our modernized existence. The image of the father in this poem speaks volumes for this capsizing modernism which sandwiches in its arm- space the primitive and the perverted. The â€Å"sceptic rationalist’ father trying ‘powder, mixture, herb and hybrid’ bears upon human primitivism and when he experiments with ‘a little paraffin upon a bitten toe and put a match to it he becomes a symbol of perversion in the modern man’s psyche. Christopher Wiseman puts it, â€Å"†¦ fascinating tension between personal crisis and mocking social observation†Ã¢â‚¬  ; neither there is any personal crisis. On the other hand there is spiritual compassion and an intense urge for getting rid of this psychological syndrome that the whole modern world ha s b e e n caught, the slow-moving poison of this syndromic scorpion into the very veins of creation, the image o f the mother in agony nullifying the clear vision of human thought and enveloping the whole of humanity In the darker shades of confusion more chaolic, troubles the poet as much sharply as the sting of the poisonous worm. There is crisis, but it is the crisis of human existence thaat needs lo be overcome. The poet, though a distant observer, doesn’t take a stance of detachment. On the exact opposite, he watches with curiosity â€Å"the flame feeding on my mother’, but being uncertain whether the paraffin flame would cleanse her of the ugony of the absorbing poison, he loses himself in a thoughtful trance. The whole poem abounds with these two symbols of darkness and light. In the very beginning the poet has ushered in this symbolic juxta position and then as the poem advanced, built upon it the whole structure of his fascinating architecture in the lines. Ten hours of steady rain had driven him to crawl beneath a sack of rice parting with his poison – flash of diabolic tail in the dark room he risked the rain again. The incessant rain stands for the hope and regeneration where with is juxtaposed the destructive hurdles to fruitfy that hope. But the constructive, life giving rain continuoues and the evil, having fulfilled its parts, departs. Then afterwards other hurdels more preying than the first, come in. More candles, more lanterns, more neighbours more insects, and the endless rain My mother twisted through and through groaning on a mat. The symbols of light and darkness, candles lanterns, neighbours and insects and rain again are notworthy. But the force of light gains a width handover the evil force and life is restored once again in its joyous stride and this life long struggle between forces of darkness and light reaches a crescendo when – after twenty hours It lost its sting. Here, In the above lines, lies the beuaty of the poem, when the ascending steps of darkness, being chased by the force of following light are ripped down; when at last on the peak the chaser wins and the chased slips down. The man who has not understood what motherhood is. might be taken in by such expression of motherly love. But I convincingly feel that any woman would have exclaimed the same thing as the mother in this poem did. In my view, it would have been truly Indian had the mother in her tortures remembered her children and though helplessly, had she desired to protect them lest the scorpion might catch them unawres. Anyway, the beauty of the poem remains- unmarred by such revision. The poem is a thing of beauty par excellence.

Strategic Plan for next Irregular US Coalition Conflict Essay

Strategic Plan for next Irregular US Coalition Conflict - Essay Example In order to bring about strategies that eliminate the challenges for the U.S irregular conflicts, a mixture of collaborative, competitive and authoritative approached are necessitated to bring about effectiveness and flexibility (Keravuori para 2). Formulating strategies that result in war effectiveness require critical understanding of the numerous actors, and their conflicting ideologies, as well as applying a multiphased approach in war. Above all, a careful examination of the economic effects and actions of the irregular conflict should be given precedence, and negotiations should be employed to the maximum. Irregular conflicts are hard to describe, and knowing how to respond to irregular conflicts is inherently intricate for an outsider like United States (Kramer para 3). Efficient strategies demand that strategists should take into account evolving, mutually dependent and multistakeholder nature of irregular conflicts. The United States defeat in the Vietnam War, setbacks in va rious battles like Somalia, Bosnia and Lebanon, coupled with military and political complexities in Iraq and Afghanistan underscores the limits of United States military traditional supremacy. The supremacy has not in the recent past yielded any influential success against non state actors practicing protracted welfare. America has based its military supremacy on firepower that has been counterproductive. This is a problem that is founded on the country’s military and political culture (Keravuori para 5). The counterinsurgency wars that America engages in are mostly political in nature, rather than being jus ad bellum. This implies that the American government risks the lives of its citizens and that of citizens in countries like afghan and Iraq when national concerns and interests are not at stake. The pentagon’s aversion to counterinsurgency is soundly rooted in the American manner of welfare. Since the early 1940s, the army has trained, outfitted and planned for lar ge scale predictable operations for large scale adversaries, and it has traditionally utilized military operations even against irregular conflicts. Barring a philosophical change in the United States’ armed and political culture, America runs a noteworthy risk of failure whenever it goes into irregular wars of choice. The reason is that great power involvement in small wars is nearly always a subject of preference. Such wars do not involve central United States’ security interests, other than placing the confines of American military on display. The war in Iraq is the latest illustration of the confines of America’s power. Observers argue that sending American renowned generals like Rommel Erwin in the operation Iraqi freedom was an incompetent move. The reason is that Iraqi forces were not difficult to deal with as they were poorly trained, incompetently led, demoralized and badly equipped. Thus, sending massively armed troops in Iraq underscores achievement o f America’s military. Neoimperialist Boot Max praised America on its Iraq invasion as one of the signals of military success in American history. These words were one sided as they anticipated a win situation for America. However, this was not the case as America not only lost in its political objective, but also in eliminating insurgency that was erupting day by day. Three years after Iraq incursion, boot expressed

Enterpreneurship in action Essay Example | Topics and Well Written Essays - 3000 words

Enterpreneurship in action - Essay Example Their Advanced Information Based Allocation system automates allocation, booking and real time online tracking with super-sonic efficiency, enabling the company to manage a near limitless number of couriers with an exceptional customer service. Customers enter their collection and delivery addresses on the website, and the system sends the details to the courier best placed to do the job. The company has already made its mark in the previously inefficient world of courier services. Its website boasts an average delivery time of just 40 minutes. Annual sales have grown from ?100,000 to ?1m in recent years. Fast Courier has doubled in size over the last twelve months, and is on target to double again during 2013 with 40 vehicles. Next on the agenda is moving from Portsmouth to offer the courier services to other cities. There might be limited scope for the volume of business in Portsmouth; the scope is endless in other cities. Objectives The company wants to expand business across vari ous cities of United Kingdom. They are emphasizing on adopting state of art technology to provide fast courier service. Fast Courier Ltd is using eco friendly cars to provide service to customers. They want to improve online tracking system to increase efficiency in service delivery. The company has the objective to expand courier delivery network outside Portsmouth. Mission The company has a mission to provide eco friendly courier service. They want provide service beyond the expectation of customers. Company Summary The company was founded by Tina and Mike in the year 2009. Start up cost of the business was ?380,000. They gave importance to provide fast courier service to customers from day one. They have used state of art technologies like online parcel tracking to improve value delivery process. Company Ownership Tina and Mike is the owner of the company. Tina supervises technical aspects of the courier service and Mike concentrates on finance and marketing activities of the com pany. Market Trend in Courier Industry Courier industry has direct relationship with logistics sector. Logistics service includes air freight, transportation of parcels, street haulage, luggage compartment and warehousing, freights and postal services. There is more than 2,320,000 people working in supply chain and logistic sectors, which contributes 8% of the United Kingdom’s workforce. Logistic sector contributes nearly ?86.54 billion to GDP of the country. Cycle courier service is essential to provide fast service to customers in some cities due to heavy traffic congestion. There are more than ninety thousand people working in the courier industry of the country. There are more than 10,800 workplaces across the country. National and regional data East Midlands – There are almost 156,600 employees work in the logistic sector. Out of these 156,600 employees, 6,800 people are associated with courier industry, which contributes 4% of the logistics supply chain departmen t of the region. East England –

Debating Policy Issues Essay Example | Topics and Well Written Essays - 750 words

Debating Policy Issues - Essay Example debaters often resort to faster usage of speech so as to include as much evidence as possible in support of their arguments put forward in the debate which further helps in lending credibility to their claims while in yet another case, the debaters might include several arguments to counter the claims made by their opponents. In academic debates including more quantity is often considered an act of displaying knowledge and educational and hence appreciated while it might be criticized outside the debate community. While slow speed is often used to include laymen or common people in the purview of their audience (Cheshire, 2008). The order of speeches in various forms of policy debate is fixed such as 1AC – First Affirmative Constructive which includes cross examining the First Affirmative by the second negative, 1NC – First Negative Constructive i.e., cross examining the first negative by second constructive, 2AC – Second Affirmative Constructive i.e., cross examining the second affirmative by first constructive, 2 NC – Second Negative Constructive i.e., cross examining the second negative by first constructive etc. Similarly the other forms of policy debate include; 1NR – First Negative Rebuttal, 1AR – First Affirmative Rebuttal, 2NR – Second Negative Rebuttal and 2AR – Second Affirmative Rebuttal. The time for all these forms of policy debates varies with high school and college debates. For instance the time allotted for all constructive speeches in high school is generally eight minutes and for rebuttal the time allotted is five minutes. Similarly in college, the time allotted for constructive speeches is nine minutes and six minutes are allowed for rebuttal. The period for cross examination, however is same in high school as well as college i.e., three minutes. The first speech given in a round of policy debate is the 1AC and is presented by the affirmative team. This team usually focuses its attention on advocating on textual issues to

Joan Robertson Essay Example | Topics and Well Written Essays - 500 words

Joan Robertson - Essay Example This paper will look at some of her contributions, and how they impact the lives of modern economists presently. One of the main contributions by Joan Robinson in economics was made in monetary economics. In this contribution, it is believed that Robinson showed a deep understanding of the complexities that face the financial world. In her works in monetary economics, she provided the world, and especially developing worlds, with a comprehensive and original analysis on the links that envelop the macroeconomy and the financial system (Thomas 34). Economists and people studying the economy are able to learn a lot about money, finance, and the credit system that is present in every economy. The structure of interest rates is described in most of her works which allow even the most average of person(s) to comprehend the nature of the financial system, hence; become better at dealing with money and the financial sector. In another area, she is attributed with starting a battle against neoclassical economics. In this war, it is believed that Robinson led people to understand microeconomics and the functioning of the capital theories that existed. The reason why she decided to start this was because of the manner in which the much younger economists in the region could alter their models to suit the political desires and moods present in the different regions. In this contribution into the field of economics, Robinson led people into understanding the Keynes school of thought by trying to bring out the aspect of employment during the Great Depression in the 1930s (Aslanbeigui and Oakes 46). She immersed herself in the works of Keynes, bringing to life Keynes’s General Theory despite having had success in her previously done works. Lastly, it would be worthwhile to mention that Robinson’s love for economics led to the origin of countless books that discuss the nature and standing of the

Retail Analytics Report Statistics Project Example | Topics and Well Written Essays - 2500 words

Retail Analytics Report - Statistics Project Example The number of male and female respondents from Jones Plc is 37 and 33 respectively. On the other hand, the number of male and female respondents from Farmhouse is 23 and 35 respectively. The average weekly wage considering the three companies was 353.9990 with the highest paying company offering $678 weekly wage; while the lowest paid worker earned $123 per week. When asked if they enjoy their job; 4 of the respondents strongly disagreed, 21 disagreed, 69 neither disagreed nor agreed, 83 agreed while 23 of the respondents agreed to enjoy their job. It is clear that those who agreed to enjoying their jobs were many than those who were not enjoying their jobs in the three companies. In terms of how well the respondents work well with the other colleagues; there was quite a positive results with those who agreed and strongly agreed were 70 and 21 respectively. This was great compared to those who strongly agreed (1) and disagreed (24) while those undecided stood at 84. However, it was i nteresting to note that most of the respondents don’t gel on well with other colleagues. According to the results, 14 and 87 of the respondents strongly disagreed and disagreed respectively to getting on well with others. This number is significantly high as compared to 21 who agreed and 7 of the respondents who strongly agreed. It is worth noting that despite most of the respondents agreeing to enjoy their work; quite a number also agreed that their work is not that challenging. 23 of the respondents strongly disagreed that their work is challenging while 71 of the respondents disagreed that their work is challenging. This number is high as compared 23 who agreed and 9 who strongly disagreed. However, 74 of the respondents were neutral on the issue. This result is quite familiar when asked if their work is interested. In this category, 15.9% and 1.5% stated that they disagreed and strongly disagreed respectively that their work is interesting. On the

How do US auto firms evaluate the comprehensive and long term Dissertation

How do US auto firms evaluate the comprehensive and long term viability of investing in Information Technology projects that len - Dissertation Example Aptness of the process of decision making is justified by the methodological fitness of the decision to the demand of the concerned situation, reliability of the evidence used for decision making, relevance of the decision to context, transparency in the findings and the extent up to which consensus reached within the decision making individuals. In this paper the mixed method of research has been compared with quantitative and qualitative methods of research. Result of this comparison has been used to study the different models of decision making and the most preferred method of research has been described (Baba & HakemZadeh, 2012). The rational model The neoclassical theory of microeconomics is based on the assumption that man is a rational economic agent and is an informed decision-maker. This process shows involves four different steps, intelligence, design, choice and review. Intelligence of an individual or an organization helps them to find the appropriate occasions for decisi on making. Design of the decision making process allows them to invent new ways and analyze all the probable ways to choose the course of action. It helps in selecting some particular line of action from the available range of choices and review of the choice made helps in judging the outcomes of the decisions made in the past. In the classical model or the model of perfect rationality, numerical values are used to determine the level of utility of each of the alternative options which are then used for the process of decision making or during ‘choice phase’. The alternative choice that provides the maximum amount of utility (subjective level of utility depending on the decision maker) is selected. In business organizations, implementation of the rational model of decision making entails the following assumptions involving the managers in the organization. These assumptions include knowledge of all likely alternatives, awareness of the expected consequences of each of t he alternatives, having a predetermined and organized preference set corresponding to all the consequences and finally, having strong computational ability and deep insights to compare these consequences and determine which one of these is the most preferred (Turpin & Marais, 2004). The model of bounded rationality The notion of bounded rationality explains that while individuals make decisions, rationality of their behavior is limited by three important factors; availability of access to information, cognitive precincts of human minds, and time constraint within which the decision has to be made. According to Simon (1979), the leaders in an organization always do not make completely informed choices. In many occasions they make choices on the basis of available information and the insights and forecasting capabilities of the decision maker. Therefore, the choice made by these leaders is not always the optimal choice. Rational behavior by human beings is mainly influenced by two fac tors; the situation in which the decision has to be made and â€Å"the computational capabilities of the actor† (Turpin & Marais, 2004, 147). Study of rationality of human behavior has become easier since the study can be made within these

Nursing Essay Example | Topics and Well Written Essays - 1000 words

Nursing - Essay Example A problem statement is a concise and clear description of all issues that are going to be addressed by a problem solving team or an individual researcher in a feasibility report or in a proposal before attempting to solve the problem. It simply describes or defines the active challenges faced by a researcher or a practitioner by outlining the problem that will be addressed in the study. A problem statement should fully describe a problem so that other people can know that there is indeed a problem and how it has been addressed by the researcher. Narrowing a problem statement involves making it to focus on a particular issue or issues. It entails shifting the attention of the problem to a more specific and precise issue and narrowing the problem area into a specific hypothesis rather than addressing issues in general. It takes digging deeper into a problem and then stating only the exact area of concern that will be addressed. There are difficulties that may be experienced when narrowing a problem statement. One problem is that the researcher will have to narrow the scope of research. It is also difficult to narrow the problem statement and still ensure that it remains substantive, original and not so obvious. The problem statement should not lead a reader into obvious results. Narrowing them down without careful thought may make them too obvious and not original because most narrow topics tend to be obvious and have already been researched on unless extreme care is exercised. There are also a lot of problems that may be encountered with narrowing a problem statement when the topic is still relatively unfamiliar. Another problem with narrowing a problem statement comes about when trying to make the problem statement narrow enough to be able to arrive at a conclusion and solution, yet broad enough for a significant study. Question Two: What are the characteristics of problems that are significant to nursin g and thus merit research? Identify at least one problem worthy of research and one problem that would not be worthy of research. Justify your examples. The problems in the field of nursing which require research have common characteristics. One common characteristic of nursing problems that merit research is that they are meant to lead to the improvement in nursing care and the field of nursing in general. Nursing problems that merit research are generally meant to inform nursing caregivers, practitioners and educators on new nursing practices, health beliefs and how to solve pre-existing and emerging problems. The general characteristics of nursing problems that merit research are that it is aimed to build a body of nursing knowledge by finding solutions to nursing problems. Nursing problems are aimed at validating improvements within the nursing field and making healthcare effective and efficient. One problem worthy of research in nursing is the issue of race, culture and ethnici ty. This problem is worthy of a research because the practice of nursing entails dealing with different people from different races and ethnicities. Nurses interact with patients from culturally diverse backgrounds who have varied beliefs and practices that need to be taken into consideration when they are giving nursing care. It is therefore necessary to find out what these differences are and to know the best ways to handle them so as to avoid any conflict from arising. It is difficult to determine a problem that is not worthy of research in the field of nursing. Any research that will lead to finding of useful solutions to the field of nursing and improve the field of nursing is worthy of research because it will provide useful insight about the field. Problems that may not be worthy of research, if any, are those that have had too many researchers deal with them and are therefore too common such as attitudes of nurses to patients. Question Three: What are some of the advantages to your organization or practice to

Artificial Intellengence Research Paper Example | Topics and Well Written Essays - 250 words

Artificial Intellengence - Research Paper Example Over period of time advancements kept coming in this area and today we have robots that can talk, act and move just like human beings, all to artificial intelligence. In modern times the term was introduced by John McCarthy in the year 1956. Artificial intelligence can be distinguished into various branches that include Perceptive system, vision system, robotics and expert system and neural networks in prime. The A.I equipped machines find large number of uses in modern day, and a prime example can be quoted from the fire fighter machines that are built for purpose of going into the fire blazed buildings and rescuing many lives. In manufacturing industry, A.I finds its use through the assembly line production where automatic transmission and processing takes place, and the system is pre fed and all activities take place in a programmed manner. Neural networks a branch of artificial intelligence finds large number of applications in modern times in form of voice recognition softwares implementation, and face detection .Various programming languages are used for A.I interpretation, one of them being LISP. Finally the main features of A.I can be summed up as plant layout in an industry, help desk, emergency situation movements, shipping and warehouse

Is Scott Electronics plcs current human resources strategy effective Essay Example for Free

Is Scott Electronics plcs current human resources strategy effective Essay To what extent do you think that Scott Electronics plc’s current human resources strategy is effective? (18) Human resource strategy is how a business sees its employees from different business point of view and they are seen as resources to complete the business objectives. Firstly the human resource strategy for Scott electronics is very effective because the firm’s labour productivity is very high with 105 compared to the industry average which is 100. This is very effective as it shows the level of recruitment and the staff the business is recruiting is doing very well which has a positive effect in the recruitment section therefore this will make the company recruit more staff which will increase the productivity of the business. Also the bonuses which is 40% and its 20% higher than the industry average, this shows that the bonuses are keeping the firms employees motivated and it drives them to work harder which mean there will be a increase in productivity and if productivity increases it will have a positive effect on the sales revenue as the company will sell more items which will increase the sales revue and profit. Also another reason why the human resource strategy for Scott electronics is very effective because it has a very unique centralised organisational structure. A centralised structure is where the entire decision making is done from the top of the hierarchy. This is an effective strategy because the entire decision making can be done from the main person who is in charge and it can be done very quickly without going through any difficulties. This is very effective because staff can work through the business objective rather than stressing on the extra responsibility they have on their shoulders which will make them stress free and become more productive. Also they can be told what to do and the managers will have control over their workforce so that employees are less likely to make mistakes or make wrong decisions which will make a negative impact the on the businesses performance. However the human resource strategy for Scott electronics is not that effective because high numbers of employees are on temporary contract which is 75% compared to the industry average which is 25%. This is bad for the business because it will make employees feel that the job security is not there and they are not guaranteed the job which the business can tell the employees that they are not in need and the employees will go away, therefore this might result in the employees not very motivated to do well and they might not think as if they are involved with the business. Also employees on temporary contract are more likely to leave the business as the labour turnover rate is at 10% which is higher than the industry average which is 6%. This is human resource strategy is ineffective because it lead to employees leaving the business every year and the business is losing experienced and valuable staff. Also another reason the human resource strategy for Scott electronics is not that effective because the training budget is below the industry average as Scott electronics training cost is  £500 compared to the industries average which is  £1000. This shows that the staff are not that well trained and most of the staff don’t know what they are doing sometimes or they might not know how the company operates as high level of training was not provided. This lead to the amount of defect products increased as the staffs were not well trained and they kept making mistakes therefore the numbers of defects products increased. This is one of my strongest reasons because staffs need to be well trained before they can start the job as they will know what they are doing and how they are going to carry out each task according the company structures of dealing with things. Therefore the staff need to be well trained and the business needs to increase its amount on training the staff which will allow the business to have staff that know what they are doing and make less mistakes as this will cause the staff to make less defect products. In conclusion I think that the human resources strategy is very effect to the business because average span of control for Scott’s electronic is 5 and industry average is 8. This has a greater advantage to the specific business because it will allow the business mangers to control their staff and monitor the progress which the manager can set targets and the targets can be analysed to see if they have reached the targets this will increase the productivity of the business as targets are reached and mangers have better control over their staff and the business. However I think that the current human resource strategy is not that effective to the business because the firm’s defected products are 10% and the industry average is 5% which is doubled the amount. Therefore you can tell that the strategy is not that effective as the staffs are making a lot of mistakes which will cost the business as the raw materials cost money to buy. Also this indicates that strategy is failing as staff are not well trained or may not experienced enough to work in the field which the bale goes the firms recruitment policy as the firm could have employed experienced staff which could have reduced the level of defected products.

Case Study: Food Expiration Dates

Case Study: Food Expiration Dates If the best before date stamped on your milk carton says January 1, 2011, does that mean its not safe to drink it anymore on January 2? How long can raw meat last inside the fridge before it goes bad? Is there a difference between Use by, Best before, Sell by, and all the other date labels? Questions like these continue to boggle many Filipino homemakers today. With the constant struggle to stretch every peso for their family, throwing away unconsumed food just because a date says so is something that isnt fun to do at all. What do these dates really mean and should they be followed with utmost strictness? Food Product Dating Placing dates on food products is a practice being followed by the food industry to let the retail store know how long a product for sale should be put on display. Food product dating also helps consumers like us determine until when we can buy or use the product at its best quality, provided it has been properly stored. Do note that these dates are not to be confused as a safety date, as there are many factors that determine food safety. There are basically two types of food product dating: closed or coded dating and open dating. Closed or coded dating may be seen on shelf-stable products like canned goods and boxes of food. Coded dates can be in MMDDYY format, while some manufacturers use the Julian calendar wherein January would be 001 to 0031 (1st to the 31st day of the year) and December would be 334 to 365 (334th to the 365th day of the year). These are packing numbers meant to be used by the food manufacturers to track production. The dates that most consumers see on the grocery shelves, on the other hand, like those stamped on packed meat, eggs and dairy products, is called open dating. This uses the standard calendar date format such as date month year or dd/mm/yy. According to the Food and Drug Administration (FDA) Regulation No. 001 Series of 1982 (Subject: Guidelines for Open-Date Marking of Prepackaged Foods), open date markings should be indicated on food packages using indelible ink or embossed on cans or any other acceptable manner. The same guidelines also specify that the date marking should appear in a conspicuous place such as in the front panel of the label or on top of packages like box, bottles or cans. Putting open-date markings on packaged food products is routinely done by food producers and manufacturers, but not all of them are required to do so. According to the BFAD Memorandum Circular No. 6 s. 1993 (Subject: Monitoring of Food Products Requiring an Open Date Marking), the food products that are required to indicate their best before date are the following: Liquid Milk Products which include filled, recombined or reconstituted evaporated milk, sweetened condensed milk, and UHT sterilized milk. Whole Milk Powder Dried Dairy Milk Powder Filled Milk Powder Skimmed Milk Powder Bakery Products (those sold in supermarkets, not in bakeries) which include loaf bread and buns Infant Food and Infant Formula Vitamin C-enriched liquid fruit drinks because after some time, vitamin C content may not be as much as what the label declares. According to FDA Regulation No. 001-D s. 1982 (Subject: Guidelines for the Open-date marking of Vitamin C enriched liquid fruit drinks), before its best before date, these fruit drinks should at any time contain 80% of the label claim of Vitamin C, but not lower than 30 mg/250 mg sample. The memorandum also mentions the directive that requires retailers to remove from their sales counters all products above that do not bear the required open date markings. The open dates are based on the average shelf life of the food item being packed before it loses its optimal quality or nutritional content. This doesnt mean that after the date you cannot consume the products anymore, it simply means that the quality of food is no longer assured. Once the date passes, food products should still be safe for consumption, as long as its handled and stored properly (i.e. kept at 40 degrees F or below). You may continue to consume food past its best before date up to a certain extent, depending on the recommended storage times that will be discussed further down this article. Open Date terminology Locally, the Bureau of Food and Drugs (which was later renamed Food and Drug Administration or FDA in August 2009), enforces guidelines that cover open-date marking and labeling of packaged food. The FDA defines the different types of open date terminology as the following: Consume Before Date also known as Use by date or Expiry date. This is the date which gives you the last day of the products estimated shelf life. This is only guaranteed if certain storage conditions are met, of course, such as storage temperature and handling. Beyond this date, the food product in not considered marketable anymore or is expired and must be discarded. The consume before date must be indicated in labels of packed fresh food products like fruit juices, chocolate drinks, fresh milk, butter, yogurt, cream, cheese, cured or frozen meat and fish, bakery products, and baby food. Products that have no preservatives are highly perishable therefore indelible markings must be indicated visibly in these labels. Best Before Date also called Best if used by date. The keyword here is using the word best beside the date, meaning it is the date which signifies the end of the period where the products best quality is guaranteed. Again, the guarantee assumes a stated storage condition. Beyond this date, the products quality attributes will be expected to deteriorate but may still be satisfactory for human consumption. After a few days or weeks of the indicated date, though, changes in color or texture and decrease in nutritional content may is expected. Other products, especially those imported from overseas, may have different open date markings compared to locally distributed food. The following are some of the more popular open date terms used: Sell-By Date this is actually meant for the store owners more than the consumers. This date gives an approximation on how long the store should display a product for sale before it should be pulled out of the shelves. Consumers are also advised to buy the product before the sell-by date because, according to senior faculty member Paul VanLandingham of the Johnson Wales University Center for Food and Beverage Management, this is the last date wherein freshness is at highest level of quality in terms of taste, freshness and consistency. After the sell-by date, the food product should still be edible for some time after. Born-On Date this is equivalent to the date of manufacture and is often used to date beer. VanLandingham explains that beer quality is affected by how much sunlight it is exposed to. Since sunlight can reactivate microorganisms in the beer, store owners are advised to be careful with handling beer in clear bottles more than those in dark brown or clean bottles. Generally, commercialized beer can go sub-par after three months from the born on date. Guaranteed Fresh Date this is usually used by bakeries and is similar to best before date. As the name suggests, the guarantee is given that the baked product is at peak freshness before the date indicated. After the guaranteed fresh date, food will still be edible and may still be consumed, but taste, texture and nutritional value may not be the same anymore. Storage Times Keeping food at 40Â ° F or below inside a refrigerator is usually good s for food as the common food-borne bacteria usually grow in much higher temperatures (41 degrees F and above). Did you know that if you freeze perishable food like meat cuts, youre actually extending your foods shelf life by as much as several days? The US Department of Agriculture (USDA) Food Safety and Inspection Service website gives a food storage chart on food that bears a sell by or no date marking. Assuming youre storing food at 40 degrees Fahrenheit or below, cook or freeze the following food products by the times mentioned below: Raw poultry, ground meat, variety meats (like heart, tongue, liver, brain, etc), uncooked beef or pork sausages: 1 or 2 days Raw pork, beef, lamb, veal: 3 to 5 days Cured meat (like ham, tocino, etc): 5 to 7 days Eggs: 3 to 5 weeks Cooked poultry and sausages: 3 to 4 days Hotdogs and bacon: 2 weeks if sealed, 1 week if opened Luncheon meat: 2 weeks if sealed, 3 to 5 days if opened Cooked ham: 7 days if sealed; if opened, 3 days for slices, 7 days if kept whole Canned ham (with keep refrigerated label): 9 months if unopened, 3-4 days if opened Canned meat and poultry: 2-5 years if unopened; if opened, 3-4 days Life after food product dates According to experts, the average American family disposes of over 120 lbs of food monthly food that could have still been perfectly okay to eat! Talk about wasted money on what should have been spent on other basic needs of the family. Well, good thing that a USDA research has reported how packed foods can last several days (some, even weeks) after the sell-by date printed on packages. This is certainly good news for the Filipino household budgeters. As recommended by the Center of Consumer Research at University of California, Davis, heres a list of foodproducts that are okay to consume (if properly handled and stored) even after open date markings: Milk if pasteurized, milk usually remains fresh for about 5-7 days after the sell-by date. Make sure that its not exposed too long to sunlight, though, as it can lose some essential vitamins. This is why most milk cartons come in opaque containers. Eggs can be stored up to 5 weeks after taking them home. This is because most egg processing plants coat their eggs in mineral oil, which essentially blocks bacteria from entering any of the approximately 17,000 egg shell pores. Keeping eggs refrigerated also keeps bacteria away. Its best to keep them in their original carton and place them in the colder parts of your ref, not on the egg tray placed at the door (this is actually the warmest part of the fridge) Poultry, beef, pork and seafood cooking before storing in the fridge doubles the original shelf life of meats (3 to 5 days instead of 1 to 2 days). Once completely frozen, meat can last up to several weeks, even months. According to the USDA Food Safety and Inspection Service, freezing meat at 0Â °F (which is equivalent to -17.78Â °C) is best for safety reasons. Keeping meat frozen at 0Â °F wont kill bacteria that can cause food-borne illnesses, but it sure can slow down growth by forcing them into a state of dormancy. Some parasites can be killed at this temperature. Theoretically, keeping food frozen at this temperature can make meat last forever. Attempting to achieve this at home, however, is an extremely difficult task since your refrigerator is opened several times a day (causing fluctuation in temperature every time). Taking this into consideration, heres a list of recommended storage times of frozen products in home refrigerators: Bacon, sausage, raw poultry: 1 to 2 months Ham, cooked meat, hot dogs or cold cuts: 2 to 3 months Raw ground meat: 3 to 4 months Cooked poultry: 4 months Raw steaks, roasts or chops: 4 months to a year Raw poultry parts: 9 months Canned goods normally, canned goods are great refrigerator-free foods that last long if stored in the right conditions. If you cant find an expiry date printed on the label, here are some easy reminders on how long they usually last: highly acidic canned food like pineapple or tomato sauce can last about 18 months or more. Canned goods that are low in acid content like canned veggies or meat can be kept up to 5 years. Texas AM University professor of food and nutrition Peggy VanLaanen strongly recommends keeping canned goods at 50-70 degrees Fahrenheit in a dry, dark place for optimal shelf life. Humidity can speed-up deterioration, so this should be avoided. Do not buy dented cans or those that are swelling or bulging since these may easily be harboring harmful bacteria already (if you have bulging cans in your shelves, throw them out now even if expiration date isnt due yet) Yogurt this can last up to 5 days beyond the use by date, for as long as you keep them refrigerated. You may lose the friendly bacteria after this, but it should still be safe to eat. To keep yogurt fresh longer, place it upside down in your refrigerator as this creates a seal that can keep harmful bacteria from seeping in its packaging. Fruit juice this can last up to 6 days beyond the use by date, for as long as you keep them refrigerated. The sugars and acids added to your fruit juice already lengthen the shelf life and those in concentrate form can also last longer because air has been removed prior to packing. Keeping juices in the refrigerator after purchasing them will surely lengthen shelf life in general. Mishandled food can breed bacteria even before its labeled date, so it is important that you follow storage instructions mentioned in product packaging. For example, if you bought a pack of hotdogs that say theyll expire next month and you forgot to refrigerate the pack for several days, bacteria could have already contaminated your food even before the expiration date. If food is already contaminated by harmful bacteria like Listeria, E. coli or Salmonella, they can multiply and build colonies within days, even if you decide to throw the forgotten pack of hotdogs back in the refrigerator. According to food safety advocate, Bill Marler of Marler Clark (a Seattle law firm that represents victims of food poisoning), when bacteria are already present in food, the use-by date becomes irrelevant since it can cause harm even before the date indicated. In this case, it will be safer for you and your family to just throw away unconsumed food instead of risking the possibility of getting sick. Trust your nose and tongue For food that are not packed for commercial distribution (like cooked viands bought from a local carinderia or made to order baked goodies), the best way to find out if food is still edible or not is if we use our God-given sense of smell and taste. These are actually what our ancestors used back when food dating was not discovered yet. In general, you should not eat food that gives off a repulsive smell or taste, as it most likely isnt fit for consumption anymore. In the absence of an expiry date sniffing and tasting is the way to go! Sources: http://www.businessweek.com/bwdaily/dnflash/content/oct2006/db20061002_959305.htm http://www.webmd.com/food-recipes/guide/do-food-expiration-dates-matter http://www.associatedcontent.com/article/5389/a_guide_to_food_expiration_dates.html?cat=22 http://www.safety.com/articles/what-do-food-expiration-dates-really-mean.html http://www.fsis.usda.gov/factsheets/food_product_dating/index.asp http://thehealthylivingsite.com/2010/09/03/foods-you-can-safely-eat-past-the-expiration-date/ http://www.entrepreneur.com.ph/features/article/read-the-label http://www.bfad.gov.ph/oldsite/FDA%20Regulation%20001%20s.%201982.pdf http://www.bfad.gov.ph/oldsite/MC/mc%206%201993.pdf http://www.bfad.gov.ph/oldsite/BC/fda%20reg%201-d%201982.pdf http://www.wisegeek.com/how-long-will-frozen-meat-stay-fresh.htm

Impact Evaluation Of Telehealth On Patients Health Essay

Impact Evaluation Of Telehealth On Patients Health Essay This report will show how telehealth has an impact on patients but before future discussion I would like to define telehealth. Telehealth is the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health, and health administration, and includes both the use of interactive, specialized equipment, for such purposes as health promotion, disease prevention, diagnosis, consultation, and/or therapy, and no interactive (or passive) communications, over means such as the Internet, e-mail, or fax lines, for communication of broad-based nutrition information that does not involve personalized nutrition recommendations or interventions (Busey Micheal, 2008). There are two more definitions I would like to add as following. Use of telecommunications to provide health information and services that is, a health related activity carried out at distance (Conrick , 2006). Telehealth refers to the use of telecommunication technology to remove time and distance barriers in the delivery of healthcare services (Artinian, 2007). Telehealth enables remote patient management. From many findings, study shows that patients with heart failure problem who get experience in weight increase or blood pressure would likely involve in negative medical outcomes including expensive hospitalization in later stage. But if the patients symptoms can be monitored on daily basis then disease can be diagnosed in early stages which can prevent expensive visit to hospital and patients life can be saved. Telehealth works as following. The evaluation of any information systems especially health information systems are recognized as a complex and challenging activity. There is no agreement on a best way to evaluate, on what and how to evaluate, who to involve, and within what paradigm to proceed (Klecun-Dabrowska Cornford, 2001). There are unique challenges for evaluators in telehealth services because they are not all the same and can be measured in separate and different terms. Technologies those are used in telehealth are not mature yet and some of them are still in prototyping stage. These telehealth services are developed by expert and passionate people who are working in the field of medical and other technologies which are related to telecommunication like recording, video conferencing. Strengths Telehealth has also enabled efficient distribution of information not only with the patients but also between health care providers who are divided either geographically or within the states. The Utilization this type of technology has been shown to be very cost effective and has proved in favorable health outcomes for chronically ill patients. (Fleming, 2007) Telehealth increases access to health care especially in remote areas where normal access of health care is difficult. It can act as a bridge between the patient and health provider to increase the delivery of care. One of the biggest strength of telehealth is its capability to be an extension of basic health care by enhancing access between the patient and their providers. With the help of telehealth we can have access to ultra specialized services without transferring the patient. The idea is not transferring patients if we can offer the service here. It doesnt make sense to transfer a patient only for a diagnosis when it can be done remotely (Gagnon, Duplantie, Fortin Landry, 2006). Telehealth is believed to produce significant savings for remote hospitals and for the health care system. For instance, teleconference can be used to attend administrative meetings, leading to substantial savings on travel costs. However, the redistribution of savings between organizations and levels of care is an important and complex issue (Gagnon et al, 2006). Telehealth can help to systematize on call duties on a regional level specialists like x-ray specialist. Therefore, as an alternative, sharing the responsibility for on call duties between specialists of a hospital, telehealth can allow a large number of specialist persons from different health care centers to cover whole region. According to Artinian (2007) Telehealth helps patients gain more flexibility in scheduling healthcare visits, provides easier and more convenient access to healthcare, and allows patients to have fewer time-consuming clinic visits. It also allows patients to receive care in a location that does not require the burden of transportation, and in an environment that is less threatening than a clinic or emergency department. Weaknesses There are many barriers in telehealth field. Some states do not allow its physicians to practice outside of the state without getting license from those states first. Reimbursement is also a big factor in this field as many insurers will not reimburse. According to Gustke et al (2000, as stated by Brown (2005)) fear of malpractice suites is another consideration for physicians, as is acceptance of the technology and lack of hands on interaction with patients, although most patient satisfaction studies to date find patients on the whole satisfied with long distance care. Lack of telecommunications technology is also a big problem in this field. As normal phone line can not supply high bandwidth and there are many rural areas where they do not have high speed cabling and can not get high bandwidth telecommunication for telehealth. Getting federal funds from the state is also a problem for telehealth projects. Telecommunication companies and technology manufacturers are competing with each other to produce low price tools and bandwidth needed. Need of telehealth Telehealth was developed because Challenges Telehealth has the potential to change healthcare delivery but faces many challenges in adoption. Despite the benefit of telehealth, the lack of reimbursement for telehealth is a major challenge in widespread adoption of telehealth. (Bushell, 2007 as stated by Change, 2007). With no financial incentive for healthcare providers to implement the technology, providers are likely to view telehealth as an increase in workload without a subsequent increase in pay (Bushell, 2007). The ethical issues unique to telehealth relate to the possible impact on the curing relationship which go outside the expected challenges of privacy and confidentially. The loss of touch, the potential for depersonalization, the potential for exploitation, the possible inequity when distributing the benefits of telehealth services, and the potential burden that this form of new technology may impose on sick and dying patients are some of the ethical concerns that should be considered. Future research and educational initiatives should explore areas of ethical concern that pertain to the innovative and burgeoning field of telehealth, and the potential for good and harm that may result. Potential themes include the following: à ¢Ã¢â€š ¬Ã‚ ¢ Improving health care access in underserved populations à ¢Ã¢â€š ¬Ã‚ ¢ Professional expectations in meeting a new, higher standard of car à ¢Ã¢â€š ¬Ã‚ ¢ Telemedicine as a potential new form of access discrimination à ¢Ã¢â€š ¬Ã‚ ¢ Technology as added burden for patients with chronic and terminal illness à ¢Ã¢â€š ¬Ã‚ ¢ When virtual visits replace actual visits à ¢Ã¢â€š ¬Ã‚ ¢ The impact of loosing touch on trust and the healing relationship à ¢Ã¢â€š ¬Ã‚ ¢ The risk of exploitation when using new and expensive technology à ¢Ã¢â€š ¬Ã‚ ¢ Depersonalization in the use of store and forward technology à ¢Ã¢â€š ¬Ã‚ ¢ Privacy and confidentiality issues (Fleming, 2007). The use of telehealth has raised many legal issues as well like licensing, liability and reimbursement. Data security is also a big concern in telehealth. As personal data is being transferred from patient to health provider, there is possibility of loss of data or could criminal access that should be considered and prevented. (Wootton, Patil, Scott and Ho, 2009) Bandwidth is also an issue, especially when high quality images need to transfer from patient to health care provider and getting the technical support needed to make sure telehealth networks are up and running around the clock is a major challenge for rural programs or those in small hospitals and practices. (Brian, 2009) Opportunities The health sector faces two opposing demands: firstly, it should provide extended and reasonable access to high quality health care services; secondly, it should also decrease or at least control the rising costs of health care. Telehealth assures and offers the promise of giving people equal access to high quality medical health care at reasonable and affordable cost. Information and communication technology has developed very rapidly in the last few years. There has been rapid growth of the telecommunication market and very fast circulation of the internet. Many hospitals have developed information systems which help to share information between different health care providers, and now health sharing networks are being developed in many countries to share health information. Population which is increasing very rapidly with insufficient health resources has produced demands to develop telehealth and the rapid development of information and communication technology has provided the opportunities to do so. (Wootton, Patil, Scott and Ho, 2009) A telehealth consortium led by the University of California, Office of the President and the UC Davis Health System was formed to create a statewide broadband system. ATT was selected to build a secure medical-grade telecommunications system as part of the California Telehealth Network (CTN). ATT with a three year $27 million contract will provide the Network Services to support the telehealth initiative (Bloch, 2010). According to Dr. Cathryn L. Nation, University of California Associate Vice President for Health Sciences and Services, the new network is also designed to address healthcare disparities in the state since millions of Californians live in rural and other medically underserved areas in the state where disparities in care exist. CTN will improve their access to quality healthcare services (Bloch, 2010). Plans call for the network to be a peer-to-peer system enabling each member to have reliable, high quality connections with public and nonprofit healthcare providers located in both rural and urban locations. The network will also provide opportunities for continuing education and distance learning for health professionals, along with access to clinical research, and the possibility of access to commercially hosted EHR systems (Bloch, 2010). Positive Impact Telehealth provides benefits to individual patients, their family members, health care providers, community organizations, governments and health care facilities. Telehealth expands health related skills across geographic barriers using information and communication technologies (Benefits of telehealth, 2007). It improves access to health care providers for remote and rural practitioners. It also provides great access to continuing medical education. It increases access to specialty services for rural patients. Using telehealth, patients can stay in their homes or community rather than travelling to hospitals. Telehealth can be used to decrease number of cancelled appointments due to weather and travel conditions. Telehealth reduces time for investigation, diagnosis and treatment through quicker consultations and patients can get real time second opinions (Benefits of telehealth, 2007). It can reduce the cost of healthcare and increase efficiency through reduced patient and provider travel, better management of chronic diseases and fewer as well shorter hospital stays. Remote monitoring and home telehealth have been demonstrated to improve disease management and reduce re-hospitalization and emergency department visits (Benefits of telehealth, 2007). In a study that evaluated cost savings among patients using telehealth services in rural Arkansas, investigators found that without the telehealth services, 94% of patients would travel greater than 70 miles for medical care, 84% would miss 1 day of work, and 74% would spend $75 to $150 for additional family expenses. With telehealth, 92% of patients saved $32 in fuel costs, 84% saved $100 in wages, and 74% saved $75 to $150 in family expenses (Artinian, 2007). Negative Impact There are many barriers in telehealth delivery. Implementation of telehealth infrastructure can be costly, time consuming and complicated initially. There is lack of information and communication technology usage among healthcare professionals in some areas. Telehealth is a complex matter. Organizational factor is another barrier to telehealth. A change is required for doctors and how hospitals operates which could be avoided by some provided by some professionals. There could be lack of staff with appropriate skills for telehealth. A lack of financial support is a major barrier in the research and development of telehealth. Many potential projects, especially in rural areas and in the developing world have been hampered by the lack of an adequate telecommunication infrastructure. Other barriers in telehealth are the legal and ethical issues. These include licensing, privacy and confidentially (Conrick, 2006). Reimbursement or the lack of it is also a barrier for possible telehealth practitioners and there are some ethical and legal issues about telehealth that need to be resolved. Stakeholders The main objective of telehealth today is to develop next generation telehealth tools and technologies to improve delivery of health care services in underserved areas using information and communication technologies. It also helps to decrease the cost of health care services and increase access to medical related services to the public. Key drivers for these tools and technologies are the need and interest to collaborate among telehealth stakeholders, including patients, patient communities, research funders, researchers, healthcare services providers, professional societies, industry, healthcare management/economists, and healthcare policy makers (Ackerman, Filart, Burgess, Lee Poropatich, 2010). Future of telehealth Telehealth is the future of home care. By its nature, telehealth relies on technology and technology is changing very rapidly these days. If we look at the history, new technologies emerged and then used by people to send information across long distances. The high access of mobile devices and different networks on global level means that mobile technologies can be used very efficiently in healthcare field in order to compensate the lack of resources problem. With the proliferation of mobile technologies, mobile health (mHealth) will play a vital role in the rapidly growing electronic health (eHealth) area. (Vatsalan, Arunatileka, Chapman, Senaviratne, Sudahar, Wijetileka Wickramasinghe, 2010). Due to the large number of mobile technologies adoption, telehealth can play a very important role in the rapidly growing electronic health care area and in future lots of the people will be using mobile devices to monitor their health any time. The future of telehealth will give advantages greatly from this technology innovation, especially in undeserved areas and old homes. Recent trends are beginning to push the demand for and the development of new technologies specific to the individual needs of telehealth applications (Brennan, Holtz, Chumbler, Kobb Rabinowitz, 2008) It is 2014 and Mrs Smith has ongoing trouble with her high blood pressure. One morning she wakes with a headache and worries that the reservoir of her implanted drug delivery system may be running down. Her bedside ambient health orb (see www.ambientdevices.com) is a reassuring green, but she turns to her video wall and asks Cyberdoc, how are my recent blood pressure levels? The simulated voice responds Your records show that the drug reservoir needs a refill in three weeks time. Your telemetered blood pressure readings have been under control for the past month and todays figures are normal. Your implanted blood sugar sensor shows normal readings too. Do you have some symptoms that you want to discuss? Meanwhile Mrs Smiths wall graphs her recent blood pressure readings, and a list of the most common 20 symptoms affecting people of her age group in the locality. She responds, No, dont worry. Remind me to book my repeat prescription (for a refill) in two weeks, please. (Wyatt Sulliva n, 2005) Conclusion Telehealth has signification potential to address a variety of healthcare problems especially in undeserved areas. Has significant potential to address a range of healthcare problems Need to resolve ethical issues Need protection of health information and privacy rights Need for higher speed and higher capacity telecommunications Government, professional groups in healthcare, and telecommunications industry need to work together to develop some standards Next-generation telehealth tools and technologies which use internet and its robust computational resources hold big promise for improving healthcare for the persons who are living in undeserved areas Next-generation telehealth tools and technologies that utilize the Internet and its robust computational resources hold great promise for improving healthcare for medically underserved populations, increasing access to specialty services at lower cost, enhancing health literacy, and expanding the healthcare workforce through virtual education and training. Realizing these benefits will require extensive and ongoing collaboration and coordination among stakeholders across the research and healthcare ecosystem. Communication, training, cultural sensitivity, and end-user customization are critical to success. Extending the traditional point-to-point telemedicine model to include newer cell phone and Internet-based telecommunications tools that are increasingly widespread and affordable, even in rural and remote locations, will be key to putting the person in personalized medicine and making research advances available to everyone. Furthermore, we must appreciate system complexity to rea lize the benefits of telehealth as it evolves toward increasing functionality, integration, interoperability, outreach, and quality of service. The balance of benefits and risks of eHealth for individual patients and clinicians over the next two to three years is unclear. Healthcare organisations and policy makers need to consider the issues that will arise. In the long term, eHealth offers many opportunities for prevention, choice, home based care, and chronic disease management, and it will widen access to health care for most patients.We all need to join the discussion and decide what we want for the future before others, who could be guided by commercial motives rather than quality and equity, do so.