Lack Of Standards For Ehr Health And Social Care Essay

In 21st century Information Technology played an sole function in upper limit of the Fieldss ; nevertheless, health care is one noticeable exclusion. Harmonizing to surveies, U.S. infirmaries and multiple-facility wellness systems are â€Å" merely get downing to round out their clinical webs, but are much farther along than physician patterns. † ( David B. Meinert ) While many inmate or infirmary installations migrating from paper charts to electronic records, but a small advancement has been made in the ambulatory or outpatient scene. Vast bulk medical professionals including doctors have been loath to utilize electronic medical records and go on to trust on paper records. Paper medical records are informations rich by nature, but information is hapless as doctors and other wellness attention suppliers have limited clip to delve through volumes of paper to recover information, use it in decision-making and/or portion it with patients. EMR/EHR systems hold enormous promise fo r non merely bettering the measure and quality of clinical informations that can be recorded, but more significantly the ability to entree wellness attention informations to better quality of attention. This survey will seek to see the perceptual experience of medical professionals towards Electronic medical record. Study has been done as a comparative survey among two different types of scenes that is hospital which are utilizing EMR ( paperless infirmaries that is category A ) and infirmaries which are holding their ain information system where the paper-based medical records are scanned and used ( Category B infirmaries ) . Electronic Medical Record ( EMR ) Harmonizing to the Healthcare Information and Management Systems Society ( HIMSS ) , an EMR is a constituent of an electronic wellness record which is owned by the health care supplier. ( Dr. Chris Hobson ) This engineering, when to the full developed, meets provider demands for real-time informations entree and rating in medical attention. EMR besides provides the mechanism for longitudinal informations storage and entree. The content of an EMR is correspondent to the paper record, but the electronic format creates useable informations in medical result surveies, improves the efficiency of attention, and makes for more efficient communicating among suppliers and easier direction of wellness programs. ( Electronic Medical Record: The Link to a Better Future, Texas Medical Association ) Electronic Health Record ( EHR ) is an electronic version of a patient ‘s medical history, that is maintained by the supplier over clip, These have been used extensively by general practicians in many developed states and include patient designation inside informations, medicines and prescription coevals, laboratory consequences and in some instances all healthcare information recorded by the physician during each visit by the patient. ( Electronic wellness records: manual for developing states. WHO ) EHRs are the following measure in the continued advancement of health care that can beef up the relationship between patients and clinicians.A The informations, seasonableness and handiness of it, will enable suppliers to take better determinations and provide quality attention. For illustration, the EHR can better patient attention by: Reducing the incidence of medical mistake by bettering the truth and lucidity of medical records. Making the wellness information available, cut downing duplicate of trials, cut downing holds in intervention, and patients good informed to take better determinations. Reducing medical mistake by bettering the truth and lucidity of medical records.Background:Hospital information systems ( HIS ) and Electronic Medical Records ( EMRs ) are considered requirements for the efficient bringing of high quality wellness attention in infirmaries. However, a big figure of legal and practical restraints influence on the design and debut of such systems ( Dick RS, Steen EB ) Hence, many EMR execution undertakings do non take at presenting the EMR and extinguishing the paper-based opposite number in one measure ( Laerum H ) . As a start, the EMR is introduced along with its paper-based opposite number, and both are kept updated. In such environments, wellness attention workers have to cover with a intercrossed electronic and paper-based solution. This likely limits the usage of EMR ( Laerum H ) . Furthermore, mistakes are prone to develop due to cumbersome care of the medical record information in double storage media. In many states, most hospital EMR undertakings have non passed beyond this stage ( Dick RS, Steen EB )Electronic Medical Records- the altering tendency:aˆ? Paper based records are being bit by bit replaced by computing machine based records ( which is in being in the West since 2 decennaries ) aˆ? It has non achieved the same incursion in health care as in finance or other industry. Deployment varies in statesAims:To reexamine already bing information system of both class of infirmaries To happen out existent versus perceptual troubles while utilizing EMR both classs infirmaries To analyze the overall perceptual experience of infirmaries about EMR To mensurate satisfaction from EMR in class A infirmary To bring forth a checklist for bettermentMethodology:Overview: Assorted surveies which has been done globally has been surveies to happen out statement of job, since no such survey has been found in Indian context, so all premises from other states has been considered as relevant. Sing the less version of EMR usage, this survey tries to happen out existent versus perceptual advantages, disadvantages and functionality etc to acquire the clear image. Sample: entire four infirmaries have been selected under two different scenes for comparing. Each scene has two infirmaries of same sort. For easiness both scenes have been given name class A and class B. Class A infirmary are EMR user infirmary while class B infirmary are holding their ain infirmary information system in topographic point along with the paper record. For easiness footings category A and B in whole papers alternatively of EMR user and EMR nonuser infirmaries Sample size: Excluding 4 IT caputs, entire 120 responses has been collected form clinical staffs, which includes physicians, occupants, caputs of sections and nurses etc. Thirty responses from each infirmary have been collected. Questionnaire: questionnaires had been used for roll uping informations from both category infirmaries. Questions are of near ended, rated on the footing of likert graduated table from 1-5. Response recording has besides been done for happening out the jobs, so that better suggestions can be made. Interviewing: in deepness interviews has been taken by IT caputs of all the four infirmaries to understand all the factors from their point of position, and to understand their return on different jobs addressed by their clinical staff. Since none of the infirmary is utilizing EHR, so complete survey had been done about EMR merely. Data aggregation had been done as follows- Questionnaires have been used for roll uping informations from medical staff. In depth interview with IT caputs of all the four sections Reappraisal of literature related to EMR Reappraisal of the literature to understand perceptual experience of medical professionals sing EMR usage. Inclusion standards: to guarantee cogency of sample, two inquiries were set in questionnaire. Harmonizing to that who were working in infirmary for more than three months ; were eligible. Another inclusion standard was straight related to patient attention. Those who were utilizing computing machine for come ining patient information/ recovering patient information/ trial consequence retrieval etc ; were eligible.Literature reappraisalThere are many maps associated with patient wellness records. This record is non merely used to document patient attention, but it besides used for entering fiscal and legal information and research and quality betterment intents. ( Young, Kathleen M. ) The conventional paper-based medical record has several restrictions. Though this traditional method is utile for entering patient ‘s inside informations for work outing medical issues, tracking down patients and for organizing in health care procedure, but it has so many disadvantages. These types of records are frequently ailing indexed and sometimes illegible, fragmented, because these records are manus written. The most disadvantageous factor of utilizing this method is that the medical record would be accessible to merely one individual at a clip. These medical records can non be made available to everyone at the same clip. Last but non least there is the job of storage of paper record, most of the times these are non stored decently, which in bend cause failure in retrieval of information, whenever required. Medical record is systematic certification of a individual patient ‘s medical history and attention across clip within one peculiar wellness attention supplier. The medical record includes a assortment of types of â€Å" notes † entered over clip by wellness attention professionals, entering observations and disposal of drugs and therapies, orders for the disposal of drugs and therapies, trial consequences, x-rays, studies, etc. The electronic wellness record ( EHR ) provides the chance for healthcare organisations to better quality of attention and patient safety. â€Å" The greatest challenge in the new universe of incorporate health care bringing is to supply comprehensive, dependable, relevant, accessible, and seasonably patient information to each member of the health care squad, whether in primary or secondary attention and whether a physician, nurse, allied wellness professional, or patient/consumer † ( Schloeffel ) An electronic medical record ( EMR ) is a computerized medical created in an organisation that delivers care, such as a infirmary or doctor ‘s office. Electronic medical records tend to be a portion of a local stand-alone wellness information system that allows storage, retrieval and alteration of records. Some definitions: Harmonizing to National Alliance for Health Information Technology ( NAHIT ) EMR: The electronic record of health-related information on an person that is created, gathered, managed, and consulted by accredited clinicians and staff from a individual organisation who are involved in the person ‘s wellness and attention. EHR: The aggregative electronic record of health-related information on an person that is created and gathered cumulatively across more than one wellness attention organisation and is managed and consulted by accredited clinicians and staff involved in the person ‘s wellness and attention.Purpose of medical record:The chief intent of medical records and medical notes is to record and pass on information about patients and their attention. If notes are non organised and completed decently, it can take to defeat, argument, clinical mishap and judicial proceeding. medical records are now used non merely as a comprehensive record of attention but besides as a beginning of informations for hospital service activity coverage, supervising the public presentation of infirmaries and for audit and research. Many of the causes of inaccurate clinical cryptography of this secondary informations are rooted in the quality of medical notes History of Electronic Medical Records: Doctors are expected to document brushs they have with patients to guarantee important information for decision-making is recorded and actions taken are besides recorded. Documentation is besides required as an archival record of what happened in instances of difference. To a great extent, physicians resent the undertaking of certification, as it detracts from their primary undertaking: taking attention of patients. Doctors besides resent the duplicate of attempt required with certification, as every medicine that is written on a prescription tablet, every lab trial ordered, every X ray ordered has to be re-written in the chart to keep a good record. Communication between practicians is hard as in many instances the information collected is fragmented, often excess and voluminous. Finally, doctors are invariably inundated with new information and have no tools to assist them integrate new techniques and interventions into their daily activities, other than utilizing their memories or holding to tote around big text editions. The thought of entering patient information electronically alternatively of on paper -the Electronic Medical Record ( EMR ) -has been around since the late 1960 ‘s, when Larry Weed introduced the construct of the Problem Oriented Medical Record into medical pattern. Until so, physician ‘s normally recorded merely their diagnosings and the intervention they provided. Weed ‘s invention was to bring forth a record that would let a 3rd party to independently verify the diagnosing. In 1972, the Regenstreif Institute developed the first medical records system. Although the construct was widely hailed as a major progress in medical pattern, doctors did non flock to the engineering. In 1991, the Institute of Medicine, a extremely respected think armored combat vehicle in the US recommended that by the twelvemonth 2000, every doctor should be utilizing computing machines in their pattern to better patient attention and made policy recommendations on how to accomplish that end. Advantages OF THE EHR: advantages of EHR can be divided as following-1 ) Clinical resultsa ) Quality of attention: Improving quality of attention is one of the chief focal points of many EHR surveies. Quality of attention has been defined as â€Å" making the right thing at the right clip in the right manner to the right individual and holding the best possible consequences † , in short â€Å" a procedure for doing strategic picks in wellness systems † .A Quality of attention includes six dimensions, effectivity, efficiency, patient safety, handiness or seasonableness, just entree, and patient-centeredness or acceptableness, but most EHR research has focused on the first three. Last three constituents needed more research in their corresponding Fieldss. Erstwhile patients may non adhere to outdo pattern guidelines ; even the suppliers have best purpose. This sort of state of affairs can originate due to assorted factors like- Clinicians are non cognizant with the guidelines. Clinicians may non recognize that a peculiar guideline applies to a given patient. Lack of clip during the patient visit. EHR systems proved rather effectual in managing such sort of issues and improved attachment rates. For illustration, research workers found that computerized physician reminders increased the usage of grippe and pneumococcal inoculations from practically 0 % to 35 % and 50 % , severally, for hospitalized patients ( exter PR, Perkins S, Overhage JM, et al. ) . Similarity other surveies with computerized reminders on inoculation rates, shows important better attachment to immunisation guidelines. Lower berths the hazard of disease eruptions in communities: There are many other researches have conducted that focused on other preventative services and studied consequence of EHRs on different results to better attention efficaciously. Willson et Al found in his survey on hospitalized patients that after implementing computerized reminders targeted to hospital nurses, there is 5 % decrease in the development of force per unit area ulcer after 6 months. It proves a important association between computerized reminders and hazard of disease. Effective wellness attention bringing: Research workers have besides found that there is a profound relation between EHRs and efficiency in wellness attention bringing. Here efficiency refers to the turning away of blowing resources, including supplies, medical equipment, money, thoughts, and energy. One such signifier of waste involves excess diagnostic testing. Performing excess trials is dearly-won and may take to more false-positive consequences, which will so take to even more costs. Tierney et Al found a 14.3 % lessening in the figure of diagnostic trials ordered per visit and a 12.9 % lessening in diagnostic trial costs per visit when utilizing an EHR with CDS and CPOE constituents. Other, unrelated surveies found an 18 % lessening in trials ordered for medical visits in the exigency section, a 27 % lessening in excess research lab trials of antiepileptic medicine degrees in hospitalized patients, and a 24 % decrease in excess research lab trials in a infirmary. Reduced medicine mistakes: A well-known survey group found in their survey that merely presenting CPOE system reduced serious medicine mistake by 55 % in the infirmary scene. Whereas subsequently in followup survey the same group expert found that, these medicine mistakes can be reduced every bit much as 86 % by adding CDS system together with CPOE system. A similar, more recent survey in the outpatient puting found that cybernation resulted in an mistake rate decrease from 18.2 % to 8.2 % . ( Devine EB, Hansen RN, Wilson-Norton JL, et al. ) . On the other manus many other surveies have concluded that by presenting computerised system, the figure of appropriate medicine orders affecting dosing degrees or dosing frequence can be increased. Better clinical result: Many of the surveies besides focused on clinical results. Randomized test research design used for carry oning these surveies in a clinical scene. An extra organic structure of literature has examined, observationally, comparing of public presentation in between infirmaries that implemented EHRs and other computerized capablenesss with its opposite numbers that have non. For illustration, Menachemi et Al found that Florida infirmaries with greater investings in EHR engineerings had more desirable rates on a assortment of normally used quality indexs. Patient Safety: The challenge of reading handwritten notes, orders, and prescriptions has been eliminated with the EHR. Patients ‘ chart information is clear and legible. Reports and letters to other specializers and patients are comprehensive, professional, and easy to make. Chart information is ever accessible and found in the same topographic point. Paper charts, on the other manus, can go littered with a batch of necessary but misplaced information.2 ) Organisational results:Surveies analyzing organisational results have focused on EHR usage in both the inmate and outpatient scenes. Such results have often included increased gross, averted costs, and other benefits that are less touchable, such as improved legal and regulative conformity, improved ability to carry on research, and increased job/career satisfaction among doctors. Increased gross comes from multiple beginnings, including improved charge capture/decrease in charge mistakes, improved hard currency flow, and enh anced gross. Several writers have asserted that EHRs aid suppliers in accurately capturing patient charges in a timely mode ( Schmitt KF, Wofford DA ) Electronically available patient information generated so many efficiencies, which straight help in debaring cost. Some of these efficiency includes increased use of trials, reduced staff needed for patient direction, decreased written text costs, reduced costs associating to supplies needed to keep paper files, and the costs associating to chart pulls. EHRs besides cut down the redundant usage of trial or the demand to get off difficult transcripts of trial study to all suppliers that save money and clip of organisation. ( Chen P, Tanasijevic MJ, Schoenenberger RA, et Al ) . Surveies have besides shown that holding an EHR can cut down written text costs through electronically available structured certification processs instead than a paper file. ( Agrawal A. ) In add-on, research workers in Massachusetts have found that doctors utilizing an EHR had fewer paid malpractice claims. They found a doctor without EHR have much higher ( 10.6 % ) history of paid malpractice claims compared to those doctors with EHRs ( 6.1 % ) . This decrease is potentially the consequence of better communicating among health professionals, increased discernability and completeness of patient records, and increased attachment to clinical guidelines.3 ) Social results:Another less touchable benefit associated with EHRs is an improved ability to carry on research. As patient informations stored electronically that makes handiness of informations much easier which leads excessively many quantitative analyses to place evidence-based best patterns more easy ( A Aspden P.A ) . Furthermore, public wellness and other interdisciplinary research workers are actively utilizing electronic clinical informations that are existent informations aggregated across populations to brin g forth good research determination, which is good to society. Till today handiness of clinical informations is much limited but as suppliers will get down utilizing EHRs, this dataset will besides get down turning. Subsequently by uniting this clinical information with more informations from other beginnings like nonprescription medicine purchases and school absenteeism rates, our researches and public wellness organisation can break supervise disease eruptions and better surveillance of possible biological menaces ( Kukafka R, Ancker JS, Chan C, et Al ) . Research workers have besides found an association between EHR usage and physician satisfaction with their current pattern, A together with their calling satisfaction.A Harmonizing to many surveies, physician satisfaction should be a precedence in wellness attention organisations, because it is associated with better quality of attention, better prescribing behaviors, and increased keeping in medical patterns, peculiarly those in underserved countries. ( A Elder KT, Wiltshire JC, Rooks RN, et al.A ) Chaudhry et al noted that a big proportion of the surveies that found benefits from EHR were conducted in a selected figure of academic medical Centres in infirmary scene. Due to this ground many research workers are besides seting a inquiry about the generalisation of identified benefits of EHR in existent universe where they may neither hold similar fiscal and human resources nor a decades-long committedness to wellness information engineering. More research on the varying types and grades of benefits associated with EHR is warranted, particularly in community scenes such as physician patterns and non-academic infirmary scenes.Barriers TO THE EHRAlthough Electronic Health Records ( EHRs ) bring enormous benefits to patient attention and to the health-care supplier, usage of the ambulatory EHR alternatively of the paper chart did non become widespread among the independent doctors during the 1990s. Even though the motive of improved patient attention and handiness of medical informa tions was present, health-care suppliers were hesitating to get down utilizing this medical tool. Specii hundred grounds have been hypothesized for the deficiency of EHR execution, and they are outlined below.A Lack of Standards for EHR SystemsThe content within the systems did non hold uniformity for compatibility or interoperability. Assorted plans offered different characteristics and the exchange of informations was non possible. Besides, criterions for the security of confidential information through encoding or informations unity had non been set. The quality of EHR plans and computing machine webs was non sufficiently dependable to forestall downtime, therefore ensuing at times in the deficiency of entree to patient information or medical information. Data for clinical protocols, direction of patient attention, and determination support through algorithms were non yet standard for EHRs.Unknown Cost and Return on InvestmentHealth-care suppliers found it hard to accurately ciph er costs and Return on Investment ( ROI ) with the usage of an EHR. The full cost of an EHR includes the package purchase monetary value, extra computing machine hardware, execution including the preparation of staff, customization of the system, ongoing proficient support, system care, and future plan ascents. Measuring ROI includes intangible, unmeasurable, and nonfinancial information, such as improved patient attention, patient safety, and more efficient procedures. Measurable ROI includes addition in income from more accurate cryptography, greater clip efficiency as a consequence of rapid chart certification, expanded patient burden because of this efficiency, and decreased office supply costs such as paper, charts, and printing supplies. It was hard to accurately cipher costs and ROI with the usage of an EHR.Difficult to OperateDoctors perceived that it took more clip for informations entry than handwriting. A physician order signifier may hold been simpler to handwrite than t o treat through a computing machine system. Learning where the information should be entered or accessed was complicated and computing machines were non ever accessible at the point of attention. System warnings and medical qui vives incorporating critical information had non been developed. The long-run benefit were hard for some health care suppliers to value over the sensed troubles of operationSignificant Changes in Clinic ProceduresAlthough an EHR can be customized for specific medical patterns, there is ever some procedure alteration required by the supplier and medical staff. An EHR may convey a more stiff construction for come ining information than tossing through a paper chart. Adapting to new criterions of operation for come ining and turn uping information can be hard ab initio. Some EHRs have specifications or specific modus operandis for practising medical specialty that the supplier may non accommodate to easy. The health-care supplier may non be able to turn to and a nalyse jobs in the same ways that may hold been done in the yesteryear, even though the information in an EHR is more thorough and immediately available. New tools for improved patient attention require retraining, new procedures, and alterations in the medical pattern civilization.Lack of Trust and SafetyA concern for the security of the medical record stored electronically alternatively of on paper is common. Health-care suppliers may be concerned that the electronic medical record could be altered without their consent or cognition. Suppliers must hold the confidence that the medical records are safely stored for future handiness. Power outages, computing machine â€Å" clangs, † viruses, concerns about equal backup, and so on are issues suppliers must get the better of to be confident in utilizing an EHR.Use of EHR plans, peculiarly in the small- to moderate-sized patterns, is spread outing quickly. About 78 per centum of doctors in private pattern are within this market group of eight or fewer physicians. With the explosive growing of EHR execution in this section of the medical community, a great demand has been generated for both clerical and clinical support staffs that have professional preparation and exposure to the EHR. Concerns about the passage from traditional paper charts to EHRs are now being overcome. Many of the concerns expressed about EHRs have been addressed more to the full in recent old ages. Although the motives vary from a pattern desiring to merely â€Å" go paperless † to another pattern desiring to better patient attention, medical clinics are rapidly acknowledging the unbelievable tool the EHR is conveying to the medical pattern.Disadvantages of EMROn the reverse of advantages some writers have identified several possible disadvantage of utilizing EHRs. These include fiscal issues, alterations in work flow, impermanent loss of productiveness associated with EHR acceptance, privateness and security concerns, and sever al unintended effects. Significant cost: A major ground for deterrence for following and implementing EHR is its cost. It includes loss of gross associated with impermanent loss of productiveness, declines in gross, acceptance and execution costs and on-going care costs. Here EHR acceptance and execution costs includes buying and installation hardware and package, change overing paper charts to electronic 1s, and preparation of end-users. Different surveies documented this cost in both inmate and outpatient scenes. Like a survey conducted in 2002 at a 280-bed ague attention infirmary, the projected entire cost for a 7-year-long EHR installing undertaking was about US $ 19 million. In the outpatient scene, early research workers estimated an mean initial cost of US $ 50,000-US $ 70,000 per doctor for a three-physician office. However, as EHR engineerings have become more platitude over the past decennary, the initial cost of systems has come down dramatically ( Schmitt KF ) , ( Agrawal A ) Care cost besides can be cumbersome as hardware needs to replace clip to clip and package demands to upgrade on regular footing. In add-on, suppliers must hold ongoing preparation and support for the end-users of an EHR. Harmonizing to one survey conducted on 14 solo or small-group primary attention patterns, estimated on-going EHR care costs averaged US $ 8412 per FTE supplier per twelvemonth. Out of entire cost around 91 % of this was related to hardware replacing, seller package care and support fees, and payments for information systems staff or external contractors ( Fleming NS, Culler SD, McCorkle R, et Al ) Break of work-flows for medical staff and suppliers: Another major disadvantage of implementing EHRs is break of everyday work-flow for medical-staff or supplier, which consequences to loss of impermanent productiveness. This break may be because of preparation of end-users which potentially leads to loss in gross. One survey that involved several internal medical specialty clinics estimated, a productiveness loss of 20 % in the first month, 10 % in the 2nd month, and 5 % in the 3rd month before productiveness return to its original degrees as in get downing ( Wang SJ, Middleton B, Prosser LA, et al. ) Research workers besides have estimated that EHR end-users spent around 134.2 hours on execution activities that includes acquiring and larning a new system. These hours spent on nonclinical duties had an estimated cost of US $ 10,325 per doctor ( Fleming NS, Culler SD, McCorkle R, et al. ) Hazard of patient privateness misdemeanors: Another possible drawback of EHRs is the hazard of patient privateness misdemeanors, which is an increasing concern for patients due to the increasing sum of wellness information exchanged electronically between suppliers. To face such sort of state of affairss, policymakers have taken steps to guarantee safety and privateness of patient informations. For illustration, recent statute law has imposed ordinances specifically associating to the electronic exchange of wellness information that strengthen bing Health Insurance Portability and Accountability Act privateness and security policies. Although few electronic informations are 100 % secure, the strict demands set Forth by the new statute law make it much more hard for electronic informations to be accessed unsuitably. ( Zurita L, Nohr C. Patient sentiment: EHR appraisal from the users perspective. ( Stud Health Technol Inform. ) Not merely acts do interchanging electronic wellness informations secure but besides many infirmaries and doctors are implementing rigorous regulations like no tolerance punishments for employees who entree files unsuitably. For illustration, a infirmary in Arizona terminated several employees after they unsuitably accessed the records of victims who were hospitalized after the January 2011 hiting affecting a US Congresswoman. ( Innes S. ) Although privateness will probably go on to be a concern for patients, many stairss are being taken by policymakers and single organisations to guarantee that EHRs comply with the rigorous Torahs and ordinances intended to guarantee the privateness of clinical information.Decrease face-to-face clip with patients, depersonalize brushsEHRs may do several unintended effects, such as increased medical mistakes, negative emotions, alterations in power construction, and overdependence on engineering. ( Campbell EM, Sittig DF, Ash JS, et al. ) Research workers have found an association between increased medical mistakes and CPOE due to faulty system or untrained end-user. Additionally, end-users of an EHR may see strong emotional responses as they struggle to accommodate to new engineering and breaks in their work flow. Changes in the power construction of an organisation may besides happen due to the execution of an EHR which makes it rather more machine-controlled. For illustration, a doc tor may lose his or her liberty in doing patient determinations because an EHR blocks the ordination of certain trials or medicines. Overdependence on engineering may besides go an issue for suppliers as they become more reliant upon itInvention credence:The beginnings of attitude and behaviour day of the month back to every bit early as 1862, when psychologists began developing theories demoing how attitude wedged behaviour. Those surveies by societal psychologists continued and in 1925, many new theories emerged proposing that â€Å" attitudes could explicate human actions † ( Ajzen & A ; Fishbein, 1980, p. 13 ) Several theoretical accounts have been developed and utilized to analyse the credence of engineering. Some of the of import theoretical accounts are as follows-Theory of Reasoned Action ( TRA )Harmonizing to this theoretical account, a individual ‘s behaviour is determined by his/her behavioural purposes ( BI ) to execute that behaviour. That BI is itself determined by both a individual ‘s attitude toward the behaviour and subjective norm refering the behaviour.Theory of Planned Behavior ( TPB )The theory of planned behaviour was proposed by Icek Ajzen in 1985 through his article â€Å" From purposes to actions: A theory of planned behaviour. † The theory was developed from the theory of sound action, which was proposed by Martin Fishbein together with Icek Ajzen in 1975. Harmonizing to the theory of sound action, if people evaluate the suggested behaviour as positive ( attitude ) , and if they think their important others want them to execute the behaviour ( subje ctive norm ) , this consequences in a higher purpose ( motive ) and they are more likely to make so.Technology Acceptance Model ( TAM )Based on the theory of sound Action, Davis ( 1986 ) developed the Technology Acceptance Model which deals more specifically with the anticipation of the acceptableness of an information system. This theoretical account suggests that the acceptableness of an information system is determined by two chief factors: perceived usefulness and sensed easiness of usage. Perceived utility is defined as being the grade to which a individual believes that the usage of a system will better his public presentation. Perceived easiness of usage refers to the grade to which a individual believes that the usage of a system will be effortless Unified Theory of Acceptance and Use of Technology ( UTAUT ) The UTAUT purposes to explicate user purposes to utilize an information system and subsequent use behaviour. The theory holds that four key concepts ( public presentation anticipation, attempt anticipation, societal influence, and easing conditions ) are direct determiners of usage purpose and behavior. Gender, age, experience, and voluntariness of usage are posited to intercede the impact of the four key concepts on usage purpose and behaviour.Factors Affecting EMR AcceptanceAcceptance is defined as the willingness within a user group to use information engineering to the undertakings it is designed to back up ( Dillon & A ; Morris, 1996 ) . Many research workers have stressed the importance of credence survey. For illustration, Kirk ( 2003 ) urged pressing actions on supplying legal and societal model for credence andintroduction of EMR. Likewise, Gefen ( 2003 ) , Zdon ( 1998 ) , Anderson ( 1997 ) , Moore ( 1996 ) , Baroudi ( 1986 ) , Bardram ( 1997 ) , Bowers ( 1995 ) , Graham ( 1996 ) , and Hubona ( 1996 ) , all discussed similar issue. Furthermore, past experiences show that the attempt to present EMR will ensue in failure and unforeseen effects if their proficient facets are over emphatic and their societal and organisational factors such as the user credence and the diffusion of information system are overlooked ( Gefen, 2003, Anderson, 1999, Moore, 1996 ) . Kirk ( 2003 ) has noted that presently there is no societal model for EMR credence. The closest model theoretical account, which measures perceived usefulness and sensed easiness of usage, that can be adopted is the Technology Acceptance Model ( TAM ) proposed by Davis ( 1989 ) . Tsiknakis ( 2002 ) , Einarson ( 1993 ) , and Neilder ( 1997 ) added that hapless presentation of patient ‘s informations can take to ill informed clinical professionals, medicine mistakes, inappropriate repeat of probe, unneeded referrals, and waste of clinical clip and other resources. Indeed, hapless presentation of patient ‘s information is an interface issue, which warrants more investigation.In obtaining the user credence of wellness attention, peculiarly its system interface, Rosenbaum ( 1998 ) proposed six successful techniques: Involving the user community in needs analysis and demands definition. Designating members of the user community who are involved in the system design as don ( people who receive first preparation and extended preparation ) . Conducting undertaking analysis of the full work procedure, non merely the partsinvolving the clinical information system. Performing user surveies of preliminary paper and pencil paradigms with typical users. Conducting iterative serviceability testing of consecutive paradigms. Visiting infirmaries and other scenes of usage to detect the work procedure, usage of predecessor systems, and beta-test installing Surveies statistics: There is scarce of surveies sing EMR usage in Indian context. Results of some relevant surveies are as follows- Consequence of a research done by Sequist et Al was as follows- The overall response rate was 56 % . Of reacting clinicians, 66 % felt that the EHR execution procedure was positive. One-third ( 35 % ) believed that the EHR improved overall quality of attention, with many ( 39 % ) feeling that it decreased the quality of the patient-doctor interaction. One-third of clinicians ( 34 % ) reported consistent usage of electronic reminders, and self-report that EHRs improve quality was strongly associated with increased use of the EHR ( odds ratio 3.03, 95 % assurance interval 1.05-8.8 ) . The bulk ( 87 % ) of clinicians felt that information engineering could potentially better quality of attention in rural and underserved scenes through the usage of tools such as on-line information beginnings, telemedicine plans, and electronic wellness records. In a survey conducted in the United States, the most normally cited barriers to utilize of EMR systems in infirmaries were unequal capital for purchase ( 74 % ) , care costs ( 44 % ) , opposition on the portion of doctors ( 36 % ) , ill-defined return on investing ( 32 % ) , and deficiency of handiness of trained staff ( 30 % ) . Hospitals that had adopted EMR systems were less likely to mention four of these five concerns ( all except doctors ‘ opposition ) as major barriers to acceptance than were infirmaries that had non adopted such systems. When most of the infirmaries or professionals speaking approximately high cost of EMR, a cost benefit analysis of EMR in primary attention done by Wang et Al shows, In the 5-year cost-benei ¬?t theoretical account ( Table 3 ) , the net benei ¬?t of implementing a full electronic medical record system was $ 86,400 per supplier. Of this sum, nest eggs in drug outgos made up the largest proportion of the benei ¬?ts ( 33 % of the sum ) . Of the staying classs, about half of the entire nest eggs came from decreased radiology use ( 17 % ) , decreased charge mistakes ( 15 % ) and betterments in charge gaining control ( 15 % ) . Though non all benei ¬?ts of an electronic medical record are mensurable in i ¬?nancial footings ; other benei ¬?ts include improved quality of attention, reduced medical mistakes, and better entree to information.CURRENT SCENARIO IN INDIAThe Department of Information Technology ( DIT ) , Ministry of Communication an Information Technology ( MCIT ) have funded several undertakings during the past decennary for development of IT based Healthcare solutions. During the class of these undertakings, the demand for a standard EHR for the state has been strongly felt for interoperable health-care solutions. During the meetings of the National Knowledge Commission for making the national wellness information sciences vision for India, the demand for standard EHR with unafraid storage and entree of EHRs in a storage system crossing. TheA currentA wayA ofA developingA andA usingA healthcareA informationA storeA systemsA hasA led toA aA chaoticA stateA ofA affairsA dueA toA followingA grounds: aˆ? TheyA haveA beenA developedA independentlyA andA doA notA easilyA interoperateA withA each other. aˆ? TheyA followA theirA ownA conventionA ofA making, A maintaining, A andA storingA Electronic HealthA RecordsA ( EHRs ) A ofA patients. aˆ? IfA aA patientA isA treatedA atA differentA hospitalsA atA differentA cases, A differentA EHRs areA generatedA andA storedA forA theA sameA patientA byA theA twoA differentA information systemsA inA useA atA theA twoA hospitals.A AA singleA EHRA forA anA individualA isA desirable irrespectiveA ofA his/herA timeA andA placeA ofA intervention. aˆ? EachA systemA hasA itsA ownA wayA ofA creatingA andA managingA itsA storageA ofA EHRs. Obviously, A such A an A information A shop A is A based A on A both A relational A database engineering, A due A to its A ubiquitousness A and A adulthood A in A pull offing A big A volume A of information, A andA mediaA storageA package, A forA exampleA XrayA pictureA file awaying. DifferentA systemsA useA differentA relationalA databasesA andA differentA mediaA storage softwareA makingA dataA transferA acrossA systemsA impossible/inconvenient. aˆ? MostA ofA theA existingA systemsA useA centralizedA storage, A leadingA toA limitedA scalability andA poorA reliabilityA ( singleA pointA ofA failure ) . AsA aA consequence, A itA hasA becomeA difficultA toA exchangeA EHRsA acrossA differentA systemsA andA to haveA aA unifiedA informationA systemA toA dealA withA oneA EHRA perA person, A irrespective ofA theA timeA andA placeA ofA treatmentA ofA anA person.

College Admission Essay: Dance Essay

As I walked through the doors, entering the studio, I set my bag down and took a deep breath that created a moment of relief and peace. As I took my first step onto the dance floor, I knew at that moment my life was going to change and I could just feel the passion that was soon to come. Growing up I had been categorized as the quiet and shy type, afraid to try new things and that first dance class showed how truly insecure I was. After taking a month of classes I began watching videos of dancers and it left me in complete awh. I watched the ballerinas, so graceful but strong, the jazz dancers, sassy and fierce, and the lyrical dancers, full of emotion and laid back. There was something I realized while watching all the different dancers and what they all had in common and that was confidence. No matter the style each dancer was full of confidence and having the intention of not a care of what the audience thought, they danced for them. It was that moment that I knew what I needed to do not to just be a better dancer, but a better person as a whole. Each year I danced I grew more And more as a person, gaining more confidence. But during those six years I found many struggles that helped me shape who I am today. I went through always being placed in the back, never getting the lead role, and worst of all favoritism. When I look back on how much I’ve changed as a person, it’s astonishing. I’ve grown into this person who is hardworking, passionate, and outgoing but, most of all I found the confidence I myself I had been seeking all these years. To think if I had never stepped foot in that dance studio who knows of the person I would have became, probably still that shy innocent girl. Without dance I would not have became the person I am and love being.

Fourth Amendment Exceptions Summary Essay

The Fourth Amendment of the United States Constitution requires that no search or seizure shall be carried out unless a warrant has been issued. The exceptions are: searches with consent, frisks, plain feel/plain view, incident to arrest, automobile exceptions, exigent circumstances and open fields, abandoned property and public place exceptions (Harr, Hess, 2006, p. 219). Consent to search any property must be given by t actual owners or, as set forth in the United States v Matlock (1974) by a person in charge of that property. If, for instance more than one person owns a property, only one of those individuals must give consent. There are exceptions to that rule as well. Only commonly shared areas of that property may be searched (Harr,Hess, 2006). Take for instance a family living in an apartment which comprises of a husband, wife and sister to the man. The sister would give consent for common areas, such as the living room, den, kitchen, and bathroom, to be searched and she canno t give consent to allowing the bedroom of the brother and sister in-law to be searched. The husband, on the other hand, could consent to having the bedroom searched because it is there joint bedroom and is not off-limits to him. Other conditions on the searches incident to arrest exception include the use of force, the search of other individuals with the arrested individual, searching the vehicle of an arrest person, contemporaneousness and inventory searches â€Å"if a government agent has probable cause to believe the vehicle contains contraband or evidence of a crime without a warrant† because â€Å"in the time it would take to get a warrant, the car, driver and contraband or evidence could be long gone† (Harr, Hess, 2006. p. 231). The 1981 case of Robbins v. California saw the justifications for searching without a warrant. Those specifications include that the mobility of vehicles produce exigent circumstances.

Air Asia Essay

1.Threat of new Entrants The extent of barriers to entry depends on the strength of- i)Customer has little brand loyalty. If consumers of Airasia do not have brand loyalty, then the strength of the threat of new entrants is very high. The high numbers of competitors in the industry also decrease Airasia’s customer loyalty. Most of the travelers prefer low cost. New competitors which want to come in the industry have to spend little to compete with Airasia. ii)High capital requirement. The industry of airline needs large volume of start-up capital. The cost of setting up of offices, buying or leasing aircraft, hiring pilots and other staffs like air stewardess and etc incur a high start-up cost. Thus, the threat is low for Airasia. iii)Different product offered. Airasia offers different product compared to other competitors in Asia like Bangkok Airways, Tiger Airways, and Air Philippines. Other than the passenger sales ticket, Airasia also include holiday packages which is affordable around Asia. Airasia has good connection with hotels and tourism companies around Asia, which it is hard for new competitors to compete. iv)Low switching costs. Customers do not need to spend more on switching to another airline. The price would not be very significant in differences, which it depends on the availability of competitor’s services and suitability of the flight time that prompts them to switch. v)Moderate access to distribution channel. Airasia is the first airline company to enable customer book and purchase air tickets online in Malaysia. This makes its website www.airasia.com very famous among frequent travelers. Although new competitors can create a website for their company, it is quite difficult to compete with Airasia’s website. The website is known of its simplicity and user friendly. Thus, new competitors are difficult to make known their websites to travelers. vi)Strict government regulations. In obtaining license and permit to operate  an airline company is quite restricted. This is because in Malaysia, the airline industry is very competitive already and that the government also wants to protect the interest of its national airline, MAS which is operating on loses a few years back. 2.Rivalry among existing firms The strength of this factor depends on: i)High numbers of rivals. There are approximately 59 low fares and no frills airlines compete with Airasia. Among of them are Tiger Airways, JAL Express, JetStar Airways, Air Arabia and etc. Some of the airline does not compete directly with Airasia, but it competes indirectly in routes that Airasia does not fly. Thus, the higher the number of competitors, the more fierce the competition. ii)High fixed cost. The airline industry incur high fixed cost which consists of finance cost, hire purchase, and staff costs. The airline companies have to gain more market share to cover the fixed costs. In doing that, constant price reduction is done by them to compete with others. Thus, the rivalry is strong. iii)Customers easily switch. The nature of airline industry is that customer’s priority is to look at price and flight schedule that suits them the best when buying air tickets. The main purpose of using the airline services is to get to the destination intended. Customers can switch to other airline easily which makes the industry so competitive. iv)High exit cost. It is hard for an airline company to exit the industry. It is because the cost is high in paying the loans, staff retrenchment and flight cancellation refunds. Even making losses, the companies have to get running to cope with fixed costs. This makes the industry very competitive. v)Products are similar. As mentioned earlier, the main purpose of using airline services is to reach the destination. Every airline provides similar  services to customers. Though Airasia provides other added services like hotel booking, and tour packages, it is subject to the customer’s choice. An industry with similar products offered is highly competitive. 3.Threat of Substitute product i)Easy to switch. There are about 59 low cost airlines competing in the industry. The airlines serve over one hundred cities and islands across the sub-continental regions of South Asia, Southeast Asia and Northeast Asia. Although some of the budget carriers only fly domestic routes within the country of origin, while only a few operates international routes connecting nearby countries, customers will always look for alternatives. ii)Performance of substitutes. Performance of other airlines are quite similar with Airasia’s given there is no obvious product differentiation. Performance of airlines normally consists of the accuracy of take off time, aircraft performance and staff services. So far, Airasia had constantly reviewed its performance and improve its services. iii)Relative price. The price of substitutes are about the same with Airasia’s. Some of the airlines offers cheaper price to achieve profitable passenger loads. The price offered depends on the time gap between the booking date and flight date. The longer the date, the cheaper will be the price. If the tickets are purchased last minutes, the price will be about the same with premium airlines like MAS and Singapore Airlines. Thus, in this situation customers would switch to the premium airlines. 4.Bargaining power of buyers i)No significant product differentiation. The only difference Airasia’s product with others airlines is the holiday packages offered. Most of the low cost airlines concentrate on providing flight services only to customers. There is some offers hotel booking at the city that the airline flies to. However, Airasia makes the difference by providing holiday packages like example 3 days and 2 nights to Bali at RM800 per pax includes  flight ticket, accommodation and travel guides. For customers who do not want to follow the travel agencies and enjoys freedom, they will look for Airasia’s packages, but the customer’s portion of this type is small. Thus the bargaining power of buyers is strong as the main thing they look for is to fly to destinations. ii)Low switching costs. Cost of switching to other airlines is low, so bargaining power of buyers is strong. Airasia is not the only airlines operates in Asia. Other than that the price offered by other competitors are not much different. The customer choice is subject to their convenience and flight schedule that fit them best. iii)Portion of buyers expenditure on airline is moderate. This factor depends on portions of income an individual earns. The higher the portion, the more the customer look for cheaper price and thus, the stronger the bargaining power of buyers. Eg when a student without earning any income, will look for the cheapest price available as the portion of his expenditure will be very substantial. iv)Customers have access to market information. The IT world had emerged since 20th century. Many big and success companies in the world uses IT and e-commerce to operate. Without IT, the business had boundaries and international business will be prohibited. With worldwide web, information can be gathered on one click. Customer’s access to the current airline market information is easy and available all the time. The airline companies have less room for negotiation. Thus, customers had strong bargaining power. v)Buyer’s power concentration in many hands. Most of the airline company customers are individual travelers, only some travel in groups. So the air tickets are purchased individually. The airline companies are not relying on a few groups of customers only. Thus, the bargaining power of buyer is strong. 5. Bargaining Power of Suppliers i) Supplier concentration in a few hands. The supplier of airline companies is the fuel supplier, foods supplier, merchandise supplier and aircraft supplier. There are few suppliers in the market, eg the aircraft supplier, the companies are either Airbus or Boeing. In this case the power of supplier is strong. Other supplier like foods supplier and fuel supplier, the term of the supply must be based on the market condition. The supplier cannot increase too much of its price or risk losing long term business with the aircraft companies. ii)High switching costs. Most of Airasia’s aircraft are Airbus models. Previously the company used Boeing models, which they lease it and the company had since phased out most of the models and replace with Airbus. If Airasia is to switch to Boeing again, then the cost will be high, because training cost for employees to suit the aircraft features must be provided. Other than that, the technology used by Airbus is the most advanced, thus Airasia must rely to the Airbus engineers to do maintenance of the aircrafts and seek advices. Thus, bargaining power of suppliers is strong. iii)Relative lack of importance of buyers to supplier. Airbus is a UK based aviation company. Its customers come from around the world. So far 9,113 aircraft had been ordered, out of which 5,408 aircraft had been delivered by the company. Airasia had ordered 200 aircraft from Airbus and so far only 54 aircraft had been delivered. The percentage of less than 1%, 0.99% proves that Airasia is not Airbus’s important buyer. Thus, Airbus had strong power over Airasia.

A Game of Thrones Chapter Thirty-eight

Tyrion You want eat?† Mord asked, glowering. He had a plate of oiled beans in one thick, stub-fingered hand. Tyrion Lannister was starved, but he refused to let this brute see him cringe. â€Å"A leg of lamb would be pleasant,† he said, from the heap of soiled straw in the corner of his cell. â€Å"Perhaps a dish of peas and onions, some fresh baked bread with butter, and a flagon of mulled wine to wash it down. Or beer, if that's easier. I try not to be overly particular.† â€Å"Is beans,† Mord said. â€Å"Here.† He held out the plate. Tyrion sighed. The turnkey was twenty stone of gross stupidity, with brown rotting teeth and small dark eyes. The left side of his face was slick with scar where an axe had cut off his ear and part of his cheek. He was as predictable as he was ugly, but Tyrion was hungry. He reached up for the plate. Mord jerked it away, grinning. â€Å"Is here,† he said, holding it out beyond Tyrion's reach. The dwarf climbed stiffly to his feet, every joint aching. â€Å"Must we play the same fool's game with every meal?† He made another grab for the beans. Mord shambled backward, grinning through his rotten teeth. â€Å"Is here, dwarf man.† He held the plate out at arm's length, over the edge where the cell ended and the sky began. â€Å"You not want eat? Here. Come take.† Tyrion's arms were too short to reach the plate, and he was not about to step that close to the edge. All it would take would be a quick shove of Mord's heavy white belly, and he would end up a sickening red splotch on the stones of Sky, like so many other prisoners of the Eyrie over the centuries. â€Å"Come to think on it, I'm not hungry after all,† he declared, retreating to the corner of his cell. Mord grunted and opened his thick fingers. The wind took the plate, flipping it over as it fell. A handful of beans sprayed back at them as the food tumbled out of sight. The turnkey laughed, his gut shaking like a bowl of pudding. Tyrion felt a pang of rage. â€Å"You fucking son of a pox-ridden ass,† he spat. â€Å"I hope you die of a bloody flux.† For that, Mord gave him a kick, driving a steel-toed boot hard into Tyrion's ribs on the way out. â€Å"I take it back!† he gasped as he doubled over on the straw. â€Å"I'll kill you myself, I swear it!† The heavy iron-bound door slammed shut. Tyrion heard the rattle of keys. For a small man, he had been cursed with a dangerously big mouth, he reflected as he crawled back to his corner of what the Arryns laughably called their dungeon. He huddled beneath the thin blanket that was his only bedding, staring out at a blaze of empty blue sky and distant mountains that seemed to go on forever, wishing he still had the shadowskin cloak he'd won from Marillion at dice, after the singer had stolen it off the body of that brigand chief. The skin had smelled of blood and mold, but it was warm and thick. Mord had taken it the moment he laid eyes on it. The wind tugged at his blanket with gusts sharp as talons. His cell was miserably small, even for a dwarf. Not five feet away, where a wall ought to have been, where a wall would be in a proper dungeon, the floor ended and the sky began. He had plenty of fresh air and sunshine, and the moon and stars by night, but Tyrion would have traded it all in an instant for the dankest, gloomiest pit in the bowels of the Casterly Rock. â€Å"You fly,† Mord had promised him, when he'd shoved him into the cell. â€Å"Twenty day, thirty, fifty maybe. Then you fly.† The Arryns kept the only dungeon in the realm where the prisoners were welcome to escape at will. That first day, after girding up his courage for hours, Tyrion had lain flat on his stomach and squirmed to the edge, to poke out his head and look down. Sky was six hundred feet below, with nothing between but empty air. If he craned his neck out as far as it could go, he could see other cells to his right and left and above him. He was a bee in a stone honeycomb, and someone had torn off his wings. It was cold in the cell, the wind screamed night and day, and worst of all, the floor sloped. Ever so slightly, yet it was enough. He was afraid to close his eyes, afraid that he might roll over in his steep and wake in sudden terror as he went sliding off the edge. Small wonder the sky cells drove men mad. Gods save me, some previous tenant had written on the wall in something that looked suspiciously like blood, the blue is calling. At first Tyrion wondered who he'd been, and what had become of him; later, he decided that he would rather not know. If only he had shut his mouth . . . The wretched boy had started it, looking down on him from a throne of carved weirwood beneath the moon-and-falcon banners of House Arryn. Tyrion Lannister had been looked down on all his life, but seldom by rheumy-eyed six-year-olds who needed to stuff fat cushions under their cheeks to lift them to the height of a man. â€Å"Is he the bad man?† the boy had asked, clutching his doll. â€Å"He is,† the Lady Lysa had said from the lesser throne beside him. She was all in blue, powdered and perfumed for the suitors who filled her court. â€Å"He's so small,† the Lord of the Eyrie said, giggling. â€Å"This is Tyrion the Imp, of House Lannister, who murdered your father.† She raised her voice so it carried down the length of High Hall of the Eyrie, ringing off the milk-white walls and the slender pillars, so every man could hear it. â€Å"He slew the Hand of the King!† â€Å"Oh, did I kill him too?† Tyrion had said, like a fool. That would have been a very good time to have kept his mouth closed and his head bowed. He could see that now; seven hells, he had seen it then. The High Hall of the Arryns was long and austere, with a forbidding coldness to its walls of blue-veined white marble, but the faces around him had been colder by far. The power of Casterly Rock was far away, and there were no friends of the Lannisters in the Vale of Arryn. Submission and silence would have been his best defenses. But Tyrion's mood had been too foul for sense. To his shame, he had faltered during the last leg of their day-long climb up to the Eyrie, his stunted legs unable to take him any higher. Bronn had carried him the rest of the way, and the humiliation poured oil on the flames of his anger. â€Å"It would seem I've been a busy little fellow,† he said with bitter sarcasm. â€Å"I wonder when I found the time to do all this slaying and murdering.† He ought to have remembered who he was dealing with. Lysa Arryn and her half-sane weakling son had not been known at court for their love of wit, especially when it was directed at them. â€Å"Imp,† Lysa said coldly, â€Å"you will guard that mocking tongue of yours and speak to my son politely, or I promise you will have cause to regret it. Remember where you are. This is the Eyrie, and these are knights of the Vale you see around you, true men who loved Jon Arryn well. Every one of them would die for me.† â€Å"Lady Arryn, should any harm come to me, my brother Jaime will be pleased to see that they do.† Even as he spat out the words, Tyrion knew they were folly. â€Å"Can you fly, my lord of Lannister?† Lady Lysa asked. â€Å"Does a dwarf have wings? If not, you would be wiser to swallow the next threat that comes to mind.† â€Å"I made no threats,† Tyrion said. â€Å"That was a promise.† Little Lord Robert hopped to his feet at that, so upset he dropped his doll. â€Å"You can't hurt us,† he screamed. â€Å"No one can hurt us here. Tell him, Mother, tell him he can't hurt us here.† The boy began to twitch. â€Å"The Eyrie is impregnable,† Lysa Arryn declared calmly. She drew her son close, holding him safe in the circle of her plump white arms. â€Å"The Imp is trying to frighten us, sweet baby. The Lannisters are all liars. No one will hurt my sweet boy.† The hell of it was, she was no doubt right. Having seen what it took to get here, Tyrion could well imagine how it would be for a knight trying to fight his way up in armor, while stones and arrows poured down from above and enemies contested with him for every step. Nightmare did not begin to describe it. Small wonder the Eyrie had never been taken. Still, Tyrion had been unable to silence himself. â€Å"Not impregnable,† he said, â€Å"merely inconvenient.† Young Robert pointed down, his hand trembling. â€Å"You're a liar. Mother, I want to see him fly.† Two guardsmen in sky-blue cloaks seized Tyrion by the arms, lifting him off his floor. The gods only know what might have happened then were it not for Catelyn Stark. â€Å"Sister,† she called out from where she stood below the thrones, â€Å"I beg you to remember, this man is my prisoner. I will not have him harmed.† Lysa Arryn glanced at her sister coolly for a moment, then rose and swept down on Tyrion, her long skirts trailing after her. For an instant he feared she would strike him, but instead she commanded them to release him. Her men shoved him to the floor, his legs went out from under him, and Tyrion fell. He must have made quite a sight as he struggled to his knees, only to feel his right leg spasm, sending him sprawling once more. Laughter boomed up and down the High Hall of the Arryns. â€Å"My sister's little guest is too weary to stand,† Lady Lysa announced. â€Å"Ser Vardis, take him down to the dungeon. A rest in one of our sky cells will do him much good.† The guardsmen jerked him upright. Tyrion Lannister dangled between them, kicking feebly, his face red with shame. â€Å"I will remember this,† he told them all as they carried him off. And so he did, for all the good it did him. At first he had consoled himself that this imprisonment could not last long. Lysa Arryn wanted to humble him, that was all. She would send for him again, and soon. If not her, then Catelyn Stark would want to question him. This time he would guard his tongue more closely. They dare not kill him out of hand; he was still a Lannister of Casterly Rock, and if they shed his blood, it would mean war. Or so he had told himself. Now he was not so certain. Perhaps his captors only meant to let him rot here, but he feared he did not have the strength to rot for long. He was growing weaker every day, and it was only a matter of time until Mord's kicks and blows did him serious harm, provided the gaoler did not starve him to death first. A few more nights of cold and hunger, and the blue would start calling to him too. He wondered what was happening beyond the walls (such as they were) of his cell. Lord Tywin would surely have sent out riders when the word reached him. Jaime might be leading a host through the Mountains of the Moon even now . . . unless he was riding north against Winterfell instead. Did anyone outside the Vale even suspect where Catelyn Stark had taken him? He wondered what Cersei would do when she heard. The king could order him freed, but would Robert listen to his queen or his Hand? Tyrion had no illusions about the king's love for his sister. If Cersei kept her wits about her, she would insist the king sit in judgment of Tyrion himself. Even Ned Stark could scarcely object to that, not without impugning the honor of the king. And Tyrion would be only too glad to take his chances in a trial. Whatever murders they might lay at his door, the Starks had no proof of anything so far as he could see. Let them make their case before the Iron Throne and the lords of the land. It would be the end of them. If only Cersei were clever enough to see that . . . Tyrion Lannister sighed. His sister was not without a certain low cunning, but her pride blinded her. She would see the insult in this, not the opportunity. And Jaime was even worse, rash and headstrong and quick to anger. His brother never untied a knot when he could slash it in two with his sword. He wondered which of them had sent the footpad to silence the Stark boy, and whether they had truly conspired at the death of Lord Arryn. If the old Hand had been murdered, it was deftly and subtly done. Men of his age died of sudden illness all the time. In contrast, sending some oaf with a stolen knife after Brandon Stark struck him as unbelievably clumsy. And wasn't that peculiar, come to think on it . . . Tyrion shivered. Now there was a nasty suspicion. Perhaps the direwolf and the lion were not the only beasts in the woods, and if that was true, someone was using him as a catspaw. Tyrion Lannister hated being used. He would have to get out of here, and soon. His chances of overpowering Mord were small to none, and no one was about to smuggle him a six-hundred-foot-long rope, so he would have to talk himself free. His mouth had gotten him into this cell; it could damn well get him out. Tyrion pushed himself to his feet, doing his best to ignore the slope of the floor beneath him, with its ever-so-subtle tug toward the edge. He hammered on the door with a fist. â€Å"Mord!† he shouted. â€Å"Turnkey! Mord, I want you!† He had to keep it up a good ten minutes before he heard footsteps. Tyrion stepped back an instant before the door opened with a crash. â€Å"Making noise,† Mord growled, with blood in his eyes. Dangling from one meaty hand was a leather strap, wide and thick, doubled over in his fist. Never show them you're afraid, Tyrion reminded himself. â€Å"How would you like to be rich?† he asked. Mord hit him. He swung the strap backhand, lazily, but the leather caught Tyrion high on the arm. The force of it staggered him, and the pain made him grit his teeth. â€Å"No mouth, dwarf man,† Mord warned him. â€Å"Gold,† Tyrion said, miming a smile. â€Å"Casterly Rock is full of gold . . . ahhhh . . . † This time the blow was a forehand, and Mord put more of his arm into the swing, making the leather crack and jump. It caught Tyrion in the ribs and dropped him to his knees, wimpering. He forced himself to look up at the gaoler. â€Å"As rich as the Lannisters,† he wheezed. â€Å"That's what they say, Mord—† Mord grunted. The strap whistled through the air and smashed Tyrion full in the face. The pain was so bad he did not remember falling, but when he opened his eyes again he was on the floor of his cell. His ear was ringing, and his mouth was full of blood. He groped for purchase, to push himself up, and his fingers brushed against . . . nothing. Tyrion snatched his hand back as fast as if it had been scalded, and tried his best to stop breathing. He had fallen right on the edge, inches from the blue. â€Å"More to say?† Mord held the strap between his fists and gave it a sharp pull. The snap made Tyrion jump. The turnkey laughed. He won't push me over, Tyrion told himself desperately as he crawled away from the edge. Catelyn Stark wants me alive, he doesn't dare kill me. He wiped the blood off his lips with the back of his hand, grinned, and said, â€Å"That was a stiff one, Mord.† The gaoler squinted at him, trying to decide if he was being mocked. â€Å"I could make good use of a strong man like you.† The strap flew at him, but this time Tyrion was able to cringe away from it. He took a glancing blow to the shoulder, nothing more. â€Å"Gold,† he repeated, scrambling backward like a crab, â€Å"more gold than you'll see here in a lifetime. Enough to buy land, women, horses . . . you could be a lord. Lord Mord.† Tyrion hawked up a glob of blood and phlegm and spat it out into the sky. â€Å"Is no gold,† Mord said. He's listening! Tyrion thought. â€Å"They relieved me of my purse when they captured me, but the gold is still mine. Catelyn Stark might take a man prisoner, but she'd never stoop to rob him. That wouldn't be honorable. Help me, and all the gold is yours.† Mord's strap licked out, but it was a halfhearted, desultory swing, slow and contemptuous. Tyrion caught the leather in his hand and held it prisoned. â€Å"There will be no risk to you. All you need do is deliver a message.† The gaoler yanked his leather strap free of Tyrion's grasp. â€Å"Message,† he said, as if he had never heard the word before. His frown made deep creases in his brow. â€Å"You heard me, my lord. Only carry my word to your lady. Tell her . . . † What? What would possibly make Lysa Anyn relent? The inspiration came to Tyrion Lannister suddenly. † . . . .tell her that I wish to confess my crimes.† Mord raised his arm and Tyrion braced himself for another blow, but the turnkey hesitated. Suspicion and greed warred in his eyes. He wanted that gold, yet he feared a trick; he had the look of a man who had often been tricked. â€Å"Is lie,† he muttered darkly. â€Å"Dwarf man cheat me.† â€Å"I will put my promise in writing,† Tyrion vowed. Some illiterates held writing in disdain; others seemed to have a superstitious reverence for the written word, as if it were some sort of magic. Fortunately, Mord was one of the latter. The turnkey lowered the strap. â€Å"Writing down gold. Much gold.† â€Å"Oh, much gold,† Tyrion assured him. â€Å"The purse is just a taste, my friend. My brother wears armor of solid gold plate.† In truth, Jaime's armor was gilded steel, but this oaf would never know the difference. Mord fingered his strap thoughtfully, but in the end, he relented and went to fetch paper and ink. When the letter was written, the gaoler frowned at it suspiciously. â€Å"Now deliver my message,† Tyrion urged. He was shivering in his sleep when they came for him, late that night. Mord opened the door but kept his silence. Ser Vardis Egen woke Tyrion with the point of his boot. â€Å"On your feet, Imp. My lady wants to see you.† Tyrion rubbed the sleep from his eyes and put on a grimace he scarcely felt. â€Å"No doubt she does, but what makes you think I wish to see her?† Ser Vardis frowned. Tyrion remembered him well from the years he had spent at King's Landing as the captain of the Hand's household guard. A square, plain face, silver hair, a heavy build, and no humor whatsoever. â€Å"Your wishes are not my concern. On your feet, or I'll have you carried.† Tyrion clambered awkwardly to his feet. â€Å"A cold night,† he said casually, â€Å"and the High Hall is so drafty. I don't wish to catch a chill. Mord, if you would be so good, fetch my cloak.† The gaoler squinted at him, face dull with suspicion. â€Å"My cloak,† Tyrion repeated. â€Å"The shadowskin you took from me for safekeeping. You recall.† â€Å"Get him the damnable cloak,† Ser Vardis said. Mord did not dare grumble. He gave Tyrion a glare that promised future retribution, yet he went for the cloak. When he draped it around his prisoner's neck, Tyrion smiled. â€Å"My thanks. I shall think of you whenever I wear it.† He flung the trailing end of the long fur over his right shoulder, and felt warm for the first time in days. â€Å"Lead on, Ser Vardis.† The High Hall of the Arryns was aglow with the light of fifty torches, burning in the sconces along the walls. The Lady Lysa wore black silk, with the moon-and-falcon sewn on her breast in pearls. Since she did not look the sort to join the Night's Watch, Tyrion could only imagine that she had decided mourning clothes were appropriate garb for a confession. Her long auburn hair, woven into an elaborate braid, fell across her left shoulder. The taller throne beside her was empty; no doubt the little Lord of the Eyrie was off shaking in his sleep. Tyrion was thankful for that much, at least. He bowed deeply and took a moment to glance around the hall. Lady Arryn had summoned her knights and retainers to hear his confession, as he had hoped. He saw Ser Brynden Tully's craggy face and Lord Nestor Royce's bluff one. Beside Nestor stood a younger man with fierce black side-whiskers who could only be his heir, Ser Albar. Most of the principal houses of the Vale were represented. Tyrion noted Ser Lyn Corbray, slender as a sword, Lord Hunter with his gouty legs, the widowed Lady Waynwood surrounded by her sons. Others sported sigils he did not know; broken lance, green viper, burning tower, winged chalice. Among the lords of the Vale were several of his companions from the high road; Ser Rodrik Cassel, pale from half-healed wounds, stood with Ser Willis Wode beside him. Marillion the singer had found a new woodharp. Tyrion smiled; whatever happened here tonight, he did not wish it to happen in secret, and there was no one like a singer for spreading a story near and far. In the rear of the hall, Bronn lounged beneath a pillar. The freerider's black eyes were fixed on Tyrion, and his hand lay lightly on the pommel of his sword. Tyrion gave him a long look, wondering . . . Catelyn Stark spoke first. â€Å"You wish to confess your crimes, we are told.† â€Å"I do, my lady,† Tyrion answered. Lysa Arryn smiled at her sister. â€Å"The sky cells always break them. The gods can see them there, and there is no darkness to hide in.† â€Å"He does not look broken to me,† Lady Catelyn said. Lady Lysa paid her no mind. â€Å"Say what you will,† she commanded Tyrion. And now to roll the dice, he thought with another quick glance back at Bronn. â€Å"Where to begin? I am a vile little man, I confess it. My crimes and sins are beyond counting, my lords and ladies. I have lain with whores, not once but hundreds of times. I have wished my own lord father dead, and my sister, our gracious queen, as well.† Behind him, someone chuckled. â€Å"I have not always treated my servants with kindness. I have gambled. I have even cheated, I blush to admit. I have said many cruel and malicious things about the noble lords and ladies of the court.† That drew outright laughter. â€Å"Once I—† â€Å"Silence!† Lysa Arryn's pale round face had turned a burning pink. â€Å"What do you imagine you are doing, dwarf?† Tyrion cocked his head to one side. â€Å"Why, confessing my crimes, my lady—† Catelyn Stark took a step forward. â€Å"You are accused of sending a hired knife to slay my son Bran in his bed, and of conspiring to murder Lord Jon Arryn, the Hand of the King.† Tyrion gave a helpless shrug. â€Å"Those crimes I cannot confess, I fear. I know nothing of any murders.† Lady Lysa rose from her weirwood throne. â€Å"I will not be made mock of. You have had your little jape, Imp. I trust you enjoyed it. Ser Vardis, take him back to the dungeon . . . but this time find him a smaller cell, with a floor more sharply sloped.† â€Å"Is this how justice is done in the Vale?† Tyrion roared, so loudly that Ser Vardis froze for an instant. â€Å"Does honor stop at the Bloody Gate? You accuse me of crimes, I deny them, so you throw me into an open cell to freeze and starve.† He lifted his head, to give them all a good look at the bruises Mord had left on his face. â€Å"Where is the king's justice? Is the Eyrie not part of the Seven Kingdoms? I stand accused, you say. Very well. I demand a trial! Let me speak, and let my truth or falsehood be judged openly, in the sight of gods and men.† A low murmuring filled the High Hall. He had her, Tyrion knew. He was highborn, the son of the most powerful lord in the realm, the brother of the queen. He could not be denied a trial. Guardsmen in sky-blue cloaks had started toward Tyrion, but Ser Vardis bid them halt and looked to Lady Lysa. Her small mouth twitched in a petulant smile. â€Å"If you are tried and found to be guilty of the crimes for which you stand accused, then by the king's own laws, you must pay with your life's blood. We keep no headsman in the Eyrie, my lord of Lannister. Open the Moon Door.† The press of spectators parted. A narrow weirwood door stood between two slender marble pillars, a crescent moon carved in the white wood. Those standing closest edged backward as a pair of guardsmen marched through. One man removed the heavy bronze bars; the second pulled the door inward. Their blue cloaks rose snapping from their shoulders, caught in the sudden gust of wind that came howling through the open door. Beyond was the emptiness of the night sky, speckled with cold uncaring stars. â€Å"Behold the king's justice,† Lysa Arryn said. Torch flames fluttered like pennons along the walls, and here and there the odd torch guttered out. â€Å"Lysa, I think this unwise,† Catelyn Stark said as the black wind swirled around the hall. Her sister ignored her. â€Å"You want a trial, my lord of Lannister. Very well, a trial you shall have. My son will listen to whatever you care to say, and you shall hear his judgment. Then you may leave . . . by one door or the other.† She looked so pleased with herself, Tyrion thought, and small wonder. How could a trial threaten her, when her weakling son was the lord judge? Tyrion glanced at her Moon Door. Mother, I want to see him fly! the boy had said. How many men had the snot-nosed little wretch sent through that door already? â€Å"I thank you, my good lady, but I see no need to trouble Lord Robert,† Tyrion said politely. â€Å"The gods know the truth of my innocence. I will have their verdict, not the judgment of men. I demand trial by combat.† A storm of sudden laughter filled the High Hall of the Arryns. Lord Nestor Royce snorted, Ser Willis chuckled, Ser Lyn Corbray guffawed, and others threw back their heads and howled until tears ran down their faces. Marillion clumsily plucked a gay note on his new woodharp with the fingers of his broken hand. Even the wind seemed to whistle with derision as it came skirling through the Moon Door. Lysa Arryn's watery blue eyes looked uncertain. He had caught her off balance. â€Å"You have that right, to be sure.† The young knight with the green viper embroidered on his surcoat stepped forward and went to one knee. â€Å"My lady, I beg the boon of championing your cause.† â€Å"The honor should be mine,† old Lord Hunter said. â€Å"For the love I bore your lord husband, let me avenge his death.† â€Å"My father served Lord Jon faithfully as High Steward of the Vale,† Ser Albar Royce boomed. â€Å"Let me serve his son in this.† â€Å"The gods favor the man with the just cause,† said Ser Lyn Corbray, â€Å"yet often that turns out to be the man with the surest sword. We all know who that is.† He smiled modestly. A dozen other men all spoke at once, clamoring to be heard. Tyrion found it disheartening to realize so many strangers were eager to kill him. Perhaps this had not been such a clever plan after all. Lady Lysa raised a hand for silence. â€Å"I thank you, my lords, as I know my son would thank you if he were among us. No men in the Seven Kingdoms are as bold and true as the knights of the Vale. Would that I could grant you all this honor. Yet I can choose only one.† She gestured. â€Å"Ser Vardis Egen, you were ever my lord husband's good right hand. You shall be our champion.† Ser Vardis had been singularly silent. â€Å"My lady,† he said gravely, sinking to one knee, â€Å"pray give this burden to another, I have no taste for it. The man is no warrior. Look at him. A dwarf, half my size and lame in the legs. It would be shameful to slaughter such a man and call it justice.† Oh, excellent, Tyrion thought. â€Å"I agree.† Lysa glared at him. â€Å"You demanded a trial by combat.† â€Å"And now I demand a champion, such as you have chosen for yourself. My brother Jaime will gladly take my part, I know.† â€Å"Your precious Kingslayer is hundreds of leagues from here,† snapped Lysa Arryn. â€Å"Send a bird for him. I will gladly await his arrival.† â€Å"You will face Ser Vardis on the morrow.† â€Å"Singer,† Tyrion said, turning to Marillion, â€Å"when you make a ballad of this, be certain you tell them how Lady Arryn denied the dwarf the right to a champion, and sent him forth lame and bruised and hobbling to face her finest knight.† â€Å"I deny you nothing!† Lysa Arryn said, her voice peeved and shrill with irritation. â€Å"Name your champion, Imp . . . if you think you can find a man to die for you.† â€Å"If it is all the same to you, I'd sooner find one to kill for me.† Tyrion looked over the long hall. No one moved. For a long moment he wondered if it had all been a colossal blunder. Then there was a stirring in the rear of the chamber. â€Å"I'll stand for the dwarf,† Bronn called out.

What is the meaning of the Ninth Commandment to a college student?

The basic premise behind the ninth commandment is truth, whether it is truth in deed, truthful speech or honest thoughts.   If we take the meaning of the commandment further and interpret the words to mean that a person should not lie, then we can understand better how this commandment might impact our daily life, especially in today’s modern environment where deception, and white lies appear to be condoned by our western society. The ninth commandment requires for each individual to be honest in his or her dealings with others, but analysis of the term â€Å"lying† reveals that there is more to being truthful than accurate reporting.The Oxford Modern English Dictionary (1996) defines â€Å"truth† as being â€Å"the quality or state of being true or truthful† (p. 1114) and â€Å"truthful† as â€Å"habitually telling the truth† (p.1114).   By comparison the definition of the term â€Å"lying† in the same dictionary is listed as â₠¬Å"part of a lie†¦deceitful, false† (p.595) where â€Å"Lie† is described as â€Å"an intentionally false statement† (p. 573).   From these interpretations it is easy to reach the conclusion that the definition of both truth and lying is steeped more in the intention of the individual rather than individual acts or words spoken.Brevard Childs (1974) believed that the original idea behind the ninth commandment was a legal one, rather than an ethical one, in that he translated the original text to mean that a person should not tell lies in a court of law (Childs, 1974), however the more modern viewpoint on the meaning of the commandment appears to be related to individual accountability and a desire to live a life of truth (St. John in the Wilderness, 2001, [online]).There are many different ways a person can lie including withholding the truth, slandering another person or action, or telling white lies and despite ethical discussions to the contrary all of these actions are considered untruthful from a biblical perspective.   For example in Leviticus 19:11, we are told, â€Å"you shall not steal, you shall not deal falsely, and you will not lie to one another† (NRSV).   Later in the same chapter we are again told, â€Å"you shall not go around as a slanderer among your people†¦Ã¢â‚¬ (Leviticus 19:16). These are just two of the copious number of biblical references that can be found that encourage each individual to be a truthful person, but how relevant is this truth in modern society?Terence Fretheim (1991) interpreted the ninth commandment to convey a foundation for community and social living.   He wrote, â€Å"unless there is an arena in which there is public confidence that social reality will be reliably described and reported† (Fretheim, p.848), the concept of community could not exist.  Ã‚   Blatnik (2004) corroborates that idea and goes on to say, â€Å"there is no community on the face of public lies† (p.3).   Blatnik (2004) also mentions verses in Ephesians that point towards the idea that â€Å"we are bound to each other in a way that a lie in one place, a lie at one level, a lie by one person, is like a ripple in a pond – the whole pond is ultimately affected† (p.3).Walter Brueggemann (1994) wrote in his book that the ninth commandment is â€Å"a recognition that community life is not possible unless there is an arena in which there is public confidence that social reality will be reliably described and reported† (p.26).   He believed that not only was truth an important part of a just and fair legal system, but that truth should be evident in all forms of public interaction.   For example the modern idea that skewing the truth in the advertisement of products in mass media forums is an accepted part of society, but essentially if public truth cannot reflect public reality then an important part of society is undermined and we as members of this society tend, over time, to distrust the messages we get from mass media sources.In his book Commandments of Compassion, Keenan (1999) suggest that as a society we need to â€Å"create a space where truth can be told† (p.4). He believes that truth should be evident in personal relationships, family relationships and public dealings we have with other members of our community.   Unfortunately this level of truth can only be created if all members of society were totally honest with each other and as it is not possible for us as human beings, to read the thoughts of another person, it is often difficult to tell if a person we are dealing with has the same commitment towards living a truthful life as we ourselves would like to have.John Timmerman (1997) also wrote about how to be truthful in all of our relationships, both personal and public. He emphasized the different ways we as individuals could achieve this level of truthfulness and suggested that if we were caref ul in the words we spoke so that we did not give another person the wrong impression, and combined this with attentive listening to another person, then these actions could increase our own individual ability to be truthful at all times.   Timmerman also noted that the idea of promises were almost a sacred act, in that as we believe in the promises from God, so we should ensure that we only make promises we can keep (Timmerman, 1997).According to John Ritenbaugh (1997) lying is rife in our communities.   His article mentions surveys that show that students lie to their parents about 50% of the time, that people in personal relationships lie about 30 percent of the time to their partner, while 12% of four million Americans in the job market had lost their jobs because they had misleading information on their resumes (Ritenbaugh, 1997).   He suggested that the reason lying was so prevalent in our society was because we tend to use other terms for lying, such as â€Å"exaggerati ng† or â€Å"inaccuracy† to describe the untruths.We seem as a society to accept that politicians are up to no good, that a salesman is probably â€Å"putting us on† and that big corporations must be doing something illegal because they make so much money.   The fact that these beliefs have permeated our social fabric to such a degree that these thoughts are commonplace shows just how little truth we expect from others in our daily lives.   This fact alone would suggest that because we do not expect others to tell us the truth, we might be less likely to be truthful ourselves.   It would seem that much of society is based on the idea that ‘everyone else is doing it† so therefore we can absolve ourselves of being accountable and honest in our own dealings with others.The Bible gives us countless examples of what it means to be truthful.   Deuteronomy 32:4 says â€Å"He is the rock, His work is perfect; for all His ways are justice, a God of tr uth and without injustice; righteous and upright is He† (NSRV). The teachings from Jesus also contain ideas on how to be truthful, especially in terms of the role model he became for other people.   Jesus was an example of a person who lived by his words on a daily basis, and it is through his example that we can see what changes we might need to put in place in our own lives, to be a better and more truthful person.A Christian student goes to a Christian college with the expectation that the people who share the campus with them are going to live by the same standards as themselves.   One of these expectation is that the other students, the tutors and even the administration staff of the college will all want to abide by the ten commandments and sometimes it can be bit of a shock to us to find that not only are there countless people in general society that fail to live by the commandments on a daily basis, but that some of the people in the college are also failing to li ve by the high standards set by Jesus Christ.However, it is my personal opinion that when it comes to attendance at a Christian educational institution that rather than condemn or alienate those students who might lie to us, or fail the commandments in some way or another, that we need to be forgiving and use the positive Christian influence of the college to help understand why some people find it difficult to be truthful in voice and deed and encourage these people back onto a Christian path in life.   We need to heed the words by Keenan (1999) mentioned earlier that we need to create the space where a person can feel comfortable enough to tell the truth.One of the main reasons people lie to others is based on their own fear of being judged by another person.   Most of us feel the need to make a good impression on others, so we feel we are not doing any harm by just omitting a few pertinent facts, or telling a few white lies to make ourselves appear better in a public light. A lthough the intention behind these actions may not be malicious, any form of untruth is a lie, and the only way we can be truthful people, and keep the ninth commandment is to be totally honest in all our dealings, both personal and professional.As students we are all well aware of how easy it is to be tempted to appear â€Å"better† in the way we behave, especially among our peers (Christian and non-Christian), but as Christians we are also aware of how important it is for us to live by higher standards than other non-Christian people might be prepared to live.   We need to remember that we are all sinners in some way or another, which is why I think that it is so important, when we do become aware that one of our Christian classmates is having problems being honest in their dealings, that we help rather than condemn him.   For example one of our classmates might be telling â€Å"white lies† to his parents because his grades are not as high as they should be.Even though we all learn the importance of being truthful in all of our thoughts, words and actions, it is not our place to ignore or shun that failing student – it is not our place to judge him.   Rather we should help him in spiritual ways by studying scriptures that are appropriate for the situation, and in practical ways by offering to help him study harder so that he is able to get a grade he can be proud of.   Blatnik (2004) told us that just one lie by one individual in a community can affect the whole community, but if we as Christian individuals hold fast to our own truths then through the power of prayer and understanding we can help our fellow students stay true to the teachings of Jesus Christ.The ninth commandment tells us we should not bear false witness against our neighbour – what it is asking us to do is to make truth the foundation for our lives here on earth.   Only when we are completely truthful in all of our dealings with other people around us c an we have an honest relationship with God, and that fact applies to all of us, not only as Christians, not only as college students, but also as members of the human race. ReferencesBlatnik, D.J., (2004).   The Ninth Commandment. Second Presbyterian Church Sermons, accessed online at http://www.2prelex.org/S040418.htm October 2, 2005Brueggemann, W., (1994).   The Book of Exodus, in The New Interpreter’s Bible, Vol. 1.   Nashville:   Abingdon PressChilds, B.S., (1974).   The book of Exodus: A critical, theological commentary.   Louisville: Westminster Press.Fretheim, T.E., (1991).   Exodus: Interpretation, a Bible commentary for teaching and preaching, Louisville: John Knox Press.Keenan, J.F., (1999).   Commandments of Compassion.   Franklin, WI: S.J. Sheed & WardOxford Modern Dictionary (Second Edition), (1996), New York: Oxford University Press.Ritenbaugh, J.W., (December 1997).   The Ninth Commandment, Forerunner, Personal. Charlotte, NC:   Church of the Great GodSt. John in the Wilderness [online] (2001).   The Ten Commandments: 9. You shall not answer against your neighbor as a false witness.   Accessed at http://www.stjohnadulted.org October 2 2005.Timmerman, J.H., (1997).   Do we still need the Ten Commandments? A fresh look at God’s Laws of Love.   Minneapolis: Augsburg

A Direct Marketing Campaign for a Consumer Product Essay

A Direct Marketing Campaign for a Consumer Product - Essay Example   The marketing plan ¨ will target audiences from the ages of twelve years old to twenty-one years old. Only the students from high schoolsïÆ'’, colleges and university of this age group will be chosen in the first marketing phase within the Los Angeles Area. The private high schools are Loyola High School, Immaculate Heart High School, Rose and Alex Pilibos Armenian School, Windward School, Sheenway School, Daniel Murphy High School, Marymount High School, Shalhevet High School and Green Pastures Academy. The public high schools will be John Marshall High School, Los Angeles High School, Dorsey High School, Eagle Rock High School, and Belmont High School. The Colleges included in our school visits are Academy Pacific Travel College, Agape Christian   The Lipton Green Tea (LGT) will be portrayed as having the beneficial health ingredients such as the much-needed vitamins and minerals and its natural product with no preservatives, additives, and food coloring thereby eliminating the possibility of having harmful side effects will be the main theme of the marketing plan. This marketing strategy to attract a particular target audience will be implemented from January 2006 to June 2006. Free one bottle samples will be given to the prospective youngster.   They will then fill up a survey questionnaire to determine their taste comments and other comments and suggestions. Colorful expensive brochures and flyers will be given to each free sampling student advertising the many health benefits taking the Lipton Green Tea to make them familiar with the products. The LGT will have the same selling price as a Coke product. This means the LGT will have a very optimistic projection of its marketing strategy to corner a big portion of the beverage consuming market.

What factors enable or prevent people from making healthy food choices Essay

What factors enable or prevent people from making healthy food choices - Essay Example Moreover, we would focus our attention on the most vulnerable group subjected to this risk. It is an ethnic minority group living in America and UK. On the basis of researches in the field of obesity around the world and behavioral risk factors among ethnic minority group, we would discuss social and psychological factors influencing on representatives of ethnic minorities making unhealthy food choices. Business infrastructure of UK and America offers numerous restaurants and fast foods for the American nation. A conspicuous consumption of junk food is the first reason for obesity. Why do Americans make such kind of choice and damage themselves? Of course, availability and affordability of fast foods is the first reason for a choice of unhealthy food. Especially this claim is relevant to ethnic minorities, which mainly consist of people with low income, a low level of education about healthy foods and restricted possibilities of physical activities (Powell, 2004). Moreover, people wi th low income work hard and have little time to cook a healthy food. It is more convenient for them to buy cheap and tasty hamburgers and be fed up. Unfortunately, the abundance of calories in this type of food influences on the abundant weight of people. Moreover, it can cause blood pressure, cardiovascular diseases and other illnesses. More than half of American population would soon become obese and 10 percent of UK children are obese currently (Baggott, 2004). Therefore, not only people with low income eat junk food. People who have money often find it more convenient to eat on foot, because they do not have enough time to take care of themselves. Nevertheless, unlike poor people, they are able to visit good restaurants and thus they have more possibilities to eat healthy and tasty food. The rest of people are subjected to external influence of their closest environment. In case a family prefers junk food it is rather hard to have an ability to eat healthy food. As we have alrea dy noted, healthy food has a higher price and it takes time to boil vegetables or to cook them in the oven. Moreover, it is on behalf of an individual to decide whether he would consume healthy food or not. Behavioral factors play a great role at this point. Thus, it depends on an individual’s ability to resist to external pressure in case he is suggested to eat some unhealthy food. If he was brought up as a strong-willed person then he would resist eating unhealthy food for sure. At this point the supposition that social or economic status of a person is prevalent in his choice making of whether to consume unhealthy food or not can be questioned. Nevertheless, statistical data obtained from Department of Health and Human service (2000) shows that individual is being gradually destructed when he is starting to make a choice of unhealthy food (Powell, 2004). He becomes indifferent to his appearance and is becoming an obese person, who then starts avoiding social communication with people around him. Therefore, an individuality of an obese person suffers from his/her inability to take control over his/her gustatory pleasures. Very often such kind of people is emotionally unstable and starts eating huge amounts of unhealthy food in the result of a personal stress, failures or other reasons. The governmental measure taking should be