Category: Case study

I. Introduction

Violence against women as defined by the United Nations is any act that troubles and violates women making them endure pain physically, emotionally, psychologically and mentally. It is linked with the unequal power relationship between men and a woman resulting from society’s misinformed views on gender and sexuality according to the Philippine Commission of Women (PCW).

Based on the preliminary findings of the 2017 National Demographic and Health Survey (NDHS), one in four (26%) ever-married women aged 15-49 has ever experienced physical, sexual or emotional violence by their husband or partner. One in five (20%) women has ever experienced emotional violence, 14 percent has ever experienced physical violence, and 5 percent has ever experienced sexual violence by their current or most recent husband or partner.

Violence against women in the Philippines is increasing, with the peak in year 2013. With these, it is very important that violence against women cases must be studied and investigated in order to prevent its occurrence and launch, through the media, national awareness against domestic violence, gender equality and respect for women.

II. Subject

The subject of the study is Elizabeth Langamin, she is an Elementary Teacher, a mother and a wife, and she is my aunt, the sister of my mother. His husband is Rodelyn Langamin, they have been married for 28 years and have 3 children (two boys and one girl). They lived in Brgy. 10, Impalambong, Malaybalay City, Bukidnon.

My aunt is a medium built and round-bodied woman; she came from a poor family and experienced all kinds of difficulties just to finish her studies. My aunt got pregnant while she was still in college and continued his studies after having three kids. She is sometimes “maldita”, somewhat a nagger wife especially if my uncle would come home drunk, but she is kind to us and would cook us good meal whenever she receives her salary. She is a fighter; she always fights for what she think is right. She always wants to provide everything for her children.

Uncle Rodelyn helped my aunt finish college; he used to be one of the Barangay Kagawad in the said barangay, he is a small person about 5’3 in height, a very thin person because after cooking breakfast for the family, he would then go to his friends and drink alcohol, he doesn’t like to eat breakfast, and he smokes a lot. My uncle, although a drunkard, would do his best to pay the tuition fee of my cousins. My uncle also used to work as a constituent of a retired politician, with these; he was able to make a few connections to the politicians in the city that is why he was able to make some of his children avail of scholarship. But he does not have a regular work, and their source of living is unsteady because my aunt’s salary is not that huge as well. He treats us well if he is sober; he is good if he’s not drunk. Unfortunately, he cannot sleep if he does not drink Tanduay or beer and this becomes a source of their misunderstanding. Despite all of that, definitely they loved each other very much that they endured almost three decades of marriage.

III. Domestic Violence Encountered

Every time my uncle comes home late, he would stagger as he walked due to drunkenness. He would bang the door, call his children and my aunt and talk to them in a slurring speech. At times, he would tell them to do well in their studies because he is working hard for them, sometimes he would scold them for not washing the dishes or cleaning the house and often gets angry for no apparent reason. Sometimes he would kiss my aunt and she will be disgusted of the smell of the alcohol. He sometimes would throw up in the living room and eventually get asleep there, my aunt gets angry and she will just leave uncle lying there till the morning. The next morning, aunt would nag at him about his whereabouts that evening and that’s their usual set-up every morning.

I used to stay in their house when I was in first and second year high school, I witnessed them shouting at each other when they have arguments, and they never settle any problem in a peaceful way. One thing I won’t forget was when they are having an argumentation, they both would swear at each other; suddenly my auntie knocked down the refrigerator and throws the things she get hold of. I was so scared when my auntie shouted at the top of her voice with her eyes bulging and the veins in her neck showed.

Other accounts of my mother (my mother stays in their house when she was in college) is that my uncle would lock-up my auntie on their room because of jealousy, he doesn’t want her to mingle or talk to other guys even if they are just work mates. My uncle would tell her offending words, accuse her of infidelity, keep tabs of the things he has done to her. There was one time when my uncle attempted to hurt my auntie physically, thanks to her medium built and strong body; he can easily wrestle my uncle because he is weak when he is drunk.

One night when my uncle attempted to hack my auntie with a samurai, my aunt was very scared and was transfixed because of what happened. Luckily my mother was there to wrestle my uncle and my aunt managed to escape in the middle of the night. Many times I would hear them having an argumentation loudly during the dawn before they would prepare for the morning errands.

There was also one time when I was younger, my aunt brought his three little kids with her and stayed in our house for two weeks saying he wants to stay away from her husband, a week after, my uncle came to our house saying he has been looking for them anywhere, he asked forgiveness from my aunt, convinced her to go back to their house and promised to be good to them and stop drinking. So my aunt believed him, gave him another chance and finally went home. But the promise was only good at the start and my uncle sadly returned to his vices and back to that hellish life of course.

My three cousins, although they dislike the way their parents act, they would just do nothing and would be annoyed if their parent would quarrel again, they are already used to everything and would just want to stay in the neighbourhood relatives or play dota or counterstrike and comes home at early at dawn.

Because of this set-up, my aunt stayed in the boarding house near the school where she worked and comes home only every weekend until the time that my uncle got sick of liver cirrhosis. This time, two of my cousins have already their own jobs. My aunt went back to stay in the house and took care of my uncle in the hospital. Their debts grew bigger just to make uncle recover. Uncle recovered after almost a month in the hospital, he stopped drinking for I think two months but after that, went back to drinking and smoking again, he does not listen to my aunt anymore, he experiences hallucinations already, and he is an alcohol addict and tells her children to bring him to rehabilitation center. This time, he got even thinner and thinner, he would sell anything of value in the house just to buy alcohol.

After few months, he became weaker and weaker and got hospitalized again. This time his liver gave up already and he eventually died. I feel like my aunt was saddened by my uncle’s death but somehow relieved that he is gone already. Now my aunt lives in a peaceful life as a widow and a grandma to his two grandsons.

IV. Analysis

One of the major causes of my aunt and uncle quarrelsome marriage is alcohol or vice, most of the time they fight because uncle comes home drunk. Alcohol has been cited by researchers as a frequent factor in violent acts against women. When men are intoxicated with alcohol, some of them become violent and inflicts physical or emotional harm to their partners (Jasinski, 2011).

Another explanation to this violence is also explained by the Resource theory which views men as using violence within the family to establish power over women within family dynamics when other resources of persuasion are lacking. This theory is also supported by the exchange theory, which says that men’s violence against women can be interpreted as a means for men to maintain their position in the social structure (Jasinski, 2011). This is true in connection with my uncle and aunt’s situation, my uncle wants to be on the top of the social structure, he wants to be the controller of the family, but my aunt wouldn’t also want to be controlled by his husband, no one wants to lower down his/her pride.

Another explanation to this violence is the Psychopathological explanation of violence against women; it suggests that individuals who are violent toward women have some type of personality disorder or mental illness that might get in the way of otherwise normal inhibitions about violent behaviour (Jasinski, 2011). If a person is in his right mind he would never hurt a woman, considering that a woman is naturally weaker physically than men.

V. Recommendation

• In my aunt and uncle’s situation, there was no formal agency that helped them in their domestic issues. However, our grandmother has given them advices to solve their marital issues as well as the barangay captain. But apparently, it did not help them make their marriage peaceful.
• I can recommend to the government to adopt or reinforce social protection measures so that injuries caused to women and children by violent acts are provided for under social protection schemes.
• To promote the training of professionals working with young people, as well as health personnel, to identify children and adolescents growing up in violent homes and to take the necessary measures to assist them. This is very important because I noticed that the behaviour of my cousins growing up in violent home is also affected, they easily talk back to the elders, hot-tempered and wound tend to be associated with wrong peers due to lack of guidance.
• For my aunt, I recommend that she should receive psychological support, counselling or de-briefing for her to release all her traumas, fears and bad experiences so she could start a new life and be more progressive in her career and assume her responsibilities freely as a mother, teacher and a grandmother to her grandsons.

Introduction

The flood started on the 8th of August 2018 and ended on the 30th of August 2018. The main dilemma was that the dam was not opened so as days went the rain started and the dam got filled . Then this got into a huge topic to alert the other districts as they were also under threat. So in this report we are going to see the perspectives of the other countries and responses of the nation.

Global Perspective

This leading problem in India was spread to the world. The perspective of the globe was that the monsoon rain started and flooded the Western part of India. According to the research 13 out of the 14 districts in Kerala was affected. More than 40,000 houses were damaged . But this subject was not brought out to all the countries and never gave their opinion. Only some countries like UAE. But this was just news for the other parts of countries. But this was a very important issue in overall India.

UAE

United Arabia Emirates had a conversation with the Indian Prime Minister about the Kerala flood which took place. They also had a conversation about offering donation to Kerala. The donation UAE planned to give was Rs 700 cores. But the prime minister rejected it so UAE did not have any idea to help India. So UAE published a poster about helping Kerala. Most of the campaigns in UAE were sent to Kerala to help the people. The prime minister of UAE told that UAE is known as Indian people.

National Perspective

This flood was caused by the heavy monsoon rain which fell in Kerala. As well all the dams in Kerala was closed all these years without distributing water to other districts. By the time the rain fell about 256% more than the usual rain. So by the 9th Of August, it filled and covered almost the 13 districts. So for the first time the dam was opened to get rid of the flood. More than 430 people died, 14 people missing in the flood and more than 1500 houses were destroyed. So big destruction was held. So to help Kerala, the cities in India got together and offered the Kerala government 212 cores (US $ 30 million) to help the people with all the needs.

Different Perspective

The comparison between global and National perspectives there are many differences than similarities. The similarity was this news was a breaking/ flash news in Asia in one minute and India’s top flash news. The difference are that in other countries it is just news but in India, it is very important moment to help that district to come out from that disaster and also it can give some water for some district. This was the 2nd time it is flooding in Kerala.

Analysis

This disaster was caused by rain. Kerala has about 35 out of 36 dams are not open at all , because of this many districts in the western side do not have water at all. As lots of rain fell the dams got filled and cause a massive landslide. Roads and homes were no more after this destruction. About 357 people lost their lives. Roughly 906,400 hectares of crops were no more. More than Rs 19,512 cores used and it was a loss for Kerala. The water was until the people`s neck. But more than 9 districts were facing the flood. The southern government had an idea of offering them 2 cores. Even the Delhi government offered them 1 core. As all districts collaborated it was easy for Kerala to get out the catastrophe.

Evaluation

Actually Kerala was already facing a problem of rain. So day by day the problem became worse. A red alert was given to 14 districts. But like one day you will earn the problem came up and made the disaster. It started with a landslide. Then later the big blow of flood attacked Kerala. This attack was unexpected for the whole India. Landslides were caused so many houses and other buildings were destroyed. But later it took more than 15 to 20 days to get rid of the flood and other disasters.

Problem Solving

The solution was the districts getting together and helping by giving the amount for them to help them out. Then the government organized helping camps to help the people suffering. The Kerala army also got inside worked to their level best to save the people. But still they were unable to save about 430 people they saved the rest of the people. They also used helicopters to take people safe to another place. Public in Kerala helped their people to be safe. The saved public has to stay in the camp until the water completely goes out of the land. It took more than 4 days for the water to dry and leave the land.

Conclusion

So overall the issue was ended on the 30 Th of August 2018. The flood was caused by a lot of rain. However with lots of support from other countries, Kerala was saved. Even countries like UAE and Qatar supported Kerala most to help them out of the problem. Even the Southern part of India helped them by giving a supply of food items. The lesson learnt in this issue is collaboration is very important in every country. Collaboration is a main key in every country. So to solve this problem collaboration has helped India to come out of it. So for countries to be peaceful collaboration is important. Only collaboration can keep all countries in touch with each other without being enemies with all countries.

Saul experiences many instances of abuse which impact his ability to think throughout the story. The intense novel, Indian Horse by Richard Wagamese, exhibits multiple instances of abuse. Cultural, mental, and physical abuse are amongst the most prevalent and significant of abuses impacting Saul and his peers. As a result of the constant abuse Saul experiences throughout the novel, he becomes accustomed to trauma and suffers long-lasting psychological damage.

Cultural abuse is the most prominent of the abuses Saul experiences, and through various events, cultural abuse on Saul results in long-lasting psychological damage. Evidence of this is found after the cultural abuse he experiences at the cafe. After the cultural abuse Saul and his peers experience at the cafe, Saul starts to notice the small things which make the Indigenous inferior to the white opponents. He understands this and says, “All the hurt. All the shame. All the rage. The white people thought it was their world”. (Wagamese 136) Saul’s view on the cultural abuse that the white society committed shows emotion and how it results in long-lasting mental and psychological damage. It is common practice in Saul’s society to discriminate and abuse Indigenous people, and so the reader can understand why Saul becomes accustomed to trauma. As a result of his becoming accustomed to trauma in his youth, he learns to expect it during his adult life, for he feels that he is inferior and therefore suffers long-lasting psychological damage as a result of cultural abuse.

During Saul’s childhood, he is subject to the mental abuse that tens of thousands of Indigenous children endure through residential schools and watched as his peers, unable to live in such conditions, took their lives in order to escape them. He feels so alone, unable to trust that he too, will descend to such means, that he says the following, “So I retreated. That’s how I survived. Alone”. (Wagamese 55) This exposes the reader to Saul’s actions as a result of the mental abuse. Saul justifies that he was forced to retreat and stay alone as a result of the mental abuse and the reader can understand why Saul becomes accustomed to trauma. Thus, the reader can see that Saul suffers long-lasting psychological damage due to the mental abuse prevalent in society as it directly links to his future decisions when he begins drinking and living alone. This shows long-lasting psychological damage on Saul as he states that he uses drinking as a way to survive through his loneliness which is a result of the constant mental abuse he experiences.

Physical abuse is another form of abuse Saul encounters and is one of the key reasons Saul suffers from long-lasting psychological damage. A powerful example of Saul experiencing psychological damage due to physical abuse is seen through the following passage, “The truth of the abuse and the rape of my innocence were closer to the surface, and I used anger and rage and physical violence to block myself off from it”. (Wagamese 200) Here the reader sees that as Saul matures throughout the story, he comes to understand the physical abuse present in society. In this shocking passage, it’s revealed that Father Leboutillier had sexually assaulted Saul during his time at the residential school and it becomes clear why Saul becomes accustomed to trauma. This statement also reveals how Saul has been accustomed to trauma as a result of the physical abuse and plays hockey to repress the truth from him for years. As a result of the trauma, Saul suffers from long-lasting psychological damage and goes through years of loneliness, isolation, and self-loathing.

Saul encounters multiple instances of cultural, mental, and physical abuse within the novel. As a result of the constant abuse Saul experiences throughout the novel, he becomes accustomed to trauma and suffers long-lasting psychological damage. Through multiple instances of abuse, trauma is something which causes psychological damage to one degree or another, and Indian Horse develops this theme further by presenting it on Saul in multiple ways throughout the story and showing the direct result of it.

Introduction

Ben and Sarah had tried to conceive for months, but couldn’t, as Ben’s sperm was not sufficiently motile. This means his sperm could not effectively move towards the egg. To combat this problem, the couple tried IUI, which in summary, is a non-surgical fertility procedure, in which a sperm sample is inserted into the uterus. It is usually quick and painless, typically taking around 3 minutes to execute. The aim of an IUI is to increase the amount of sperm that reach the fallopian tubes, consequently increasing the possibility of fertilization. Using this method, Ben’s sperm were given an advantage by providing them the head-start they needed, however the procedure was still dependent on his sperm reaching the egg and fertilizing it on their own. Some moral issues that can arise with this method are reducing man’s involvement to only producing a sample and not creating the child through intimacy.

Strategy:

IUI is usually recommended to couples with male infertility, such as diminished sperm mobility or a low sperm count. However, IUI may also be chosen as a fertility procedure for other reasons, like erectile dysfunction or unexplained infertility. Certain treatments, such as radiotherapy or chemotherapy also carry infertility as a risk, so men have the option of freezing their sperm prior to treatment for future use.

The procedure can be broken down into 3 main steps:

• Tracking a woman’s ovulation to establish a fertile period
• A semen sample is obtained and washed
• The sperm is directly inserted into the uterus

IUI normally takes place very shortly after ovulation, as it provides the best results. During the menstrual cycle, women are most fertile when the ovaries have only just produced the eggs. The majority of women ovulate 2 weeks after the first day of their cycle (approximately day 14). Women may be given an ovulation prediction kit (OPK) by their doctor. This device detects hormone levels in the saliva or urine to give an accurate prediction of their ovulation date.

The most important part of the IUI procedure however, is obtaining and preparing the semen sample and then inserting it directly into the uterus. There are numerous ways to accomplish this, such as:

• Masturbation
• A condom that collects the semen during sexual intercourse
• Surgical sperm retrieval, where a physician removes sperm directly from the epididymis
• Either electric or vibratory stimulation (if the man cannot ejaculate without any assistance)

Once the clinic has the sperm, they wash it. This process is very important as it removes any components that could disrupt the fertilization and only retains the healthy and motile sperm, which have the best chance of reaching the egg. Once a fertile period is established and the sperm has been prepared, then insemination is ready to begin.

The actual procedure itself is very similar to a pap smear. During the procedure, a speculum is used to gently expand and keep the vagina walls open. The fertility doctor then uses a fine catheter to inject the washed sperm directly into the uterus. The catheter is inserted through the cervix and sperm is pushed by the doctor through the catheter.

Success rates may reach up to 20% for each cycle, if the couple has IUI every month, but the procedure is also dependent on several factors, like age, reason for infertility, among other variables.

Issues:

Pros Cons

Less Invasive (moral) Man’s involvement reduced & Child not made from intimacy (moral)

Less Expensive (economical) Less Successful

IVF requires matured eggs to be removed from a woman’s fallopian tubes and then implanting the embryo back into her uterus. This process is invasive and sometimes painful. In comparison, IUI is noticeably less invasive and is generally the first procedure that doctors suggest to women. Unlike IVF, no needles are involved, rather, doctors use a thin catheter to inject the sperm (or donor sperm) into a woman’s uterus. IUI does not conduct any surgery for gaining pregnancy, because the eggs are not extracted from the body of the mother. This process is quick and only takes a few minutes.

Additionally, this procedure is remarkably more affordable for anyone facing infertility issues. You will not need to think twice about undergoing this treatment, as IUI is a low-cost option that only costs around $2000 per cycle. IVF’s hefty price tag starts around $12,000, making it unattainable for some couples. So you are able to get a few IUI treatment cycles for the same price as 1 IVF treatment cycle.

Even though IUI is a great option for most couples, there are some social issues that can arise with the process. A man’s sexuality is violated, as his involvement is reduced to ‘producing a sample’, which is usually by masturbation. The fertility doctors then use his sperm sample to impregnate his wife or in some cases, another woman. Similarly, the children that are conceived in this way are possibly treated as objects or ‘projects to be realized’, rather than a gift originated from intimacy between the two parents.

IUI is also less successful than IVF. For example, a 30-year-old woman that undergoes IVF has a 45% chance of a live birth in their first cycle, while IUI only has a 10-20% success rate for one cycle. Natural conception is more successful than IUI for healthy women under the age of 35. However, it is still a good option for couples with fertility issues.

Conclusion

This fertility procedure is highly recommended to Ben and Sarah, as it assists Ben’s insufficiently motile sperm in reaching the egg. The couple are not only given the chance of conceiving, but Sarah will be more than comfortable during the process. This is because IUI does not require extraction of the eggs through surgery. The extensively affordable price of intrauterine insemination was also of great appeal to the couple. While the effectiveness may not be as high as other fertility procedures…………

Introduction

Business Intelligence is the way toward changing crude information into valuable data for increasingly successful vital, operational bits of knowledge, and basic leadership purposes so it yields genuine business benefits. This new rising method cannot just improve applications in big business frameworks and modern informatics, separately, yet in addition assume a significant job to connect the association between big business frameworks and mechanical informatics.

The opportunities related to the information and investigation in various companies have produced huge premium in Business Intelligence, which is regularly alluded to as the strategies, advances, frameworks, practices, systems, and applications that investigate basic business information to enable enterprise systems to better comprehend its business and market and make opportune business choices.

The Business Intelligence advances and applications at present embraced in industry can be considered as BI 1.0, where information is, for the most part, organized, gathered by organizations through different inheritance frameworks, and regularly put away in the business social database the board frameworks.

Business intelligence frameworks can possibly add to firm execution and make the upper hand. The advantages from business examination frameworks are conveyed all through associations, depend on innovative exercises in neighborhood settings, and are gradual in nature.

CASE STUDY

Hundreds of case studies have been conducted in order to check the Business Intelligence for Enterprise Systems. Here is an example of a case study in which they inspected the usage of a university enlistment CRM framework inside a noteworthy Australian college.

Case Study Description

University was huge Australian research with an understudy populace of roughly 35,000 students, more than 7,000 staff and income of around $1.5 billion. University as of late started a noteworthy rebuilding of its course offerings with a decrease in college class offerings bringing about the arrangement of six wide and adaptable undergraduate courses.

Students needed to embrace a two-year present alumni expert seminar on complete proficient preparing in zones including law, medication, designing and data innovation. University management built up a CRM initiative to manage all the stuff in a better way and also to all the more likely oversee the new understudy enlistment and affirmations and cycle.

Central Marketing, a college unit that reports straightforwardly to a senior official, started the CRM project. An experienced CRM investigator was selected to the venture. A client system for university from start to end was characterized and the requirement for ‘a huge culture change’ was distinguished during this initiative. To attract the graduates, the university needed to reform and redesign their marketing strategies and courses to perfectly fulfill and fit in the market’s changing requirements. Furthermore, to get this attraction, they used this “old university reputation” card. Five different work streams were created to achieve this target.

The second one was conducted in a Graduate School. The goal here was to get the attention of the students by presenting a good way to cater their queries and increase the number of student enrolments. The CRM campaign by collaborating with the marketing department did all the promotional advertisements. One of the best techniques the CRM system used was that they provided a URL link with these advertisements which students or others could use to submit their queries or to get to know more about school.

The third one was conducted in another Graduate School. This graduate school adapted this CRM strategy earlier than others. This graduate school had a target to increase student enrolments by 50% in the upcoming five years. The CRM system collaborated with their staff and did the promotional advertisements and helped to manage the email queries. They analyzed the email traffic and handed over the responsibility to cater a specific number of emails to be responded by to particular advisors. In addition to this, the remarkable thing was that this school followed up the international student’s queries and arranged the one-to-one meetings of staff with them.

Analysis

Ross et al. (2006) proposed a system to define the business model for a business unit. They based this on

· Degree of integration

It is examined by checking the limit to which business’s transactions completion depend on the data that comes from another business unit.

· Degree of standardization

It is examined by checking the differences in the business processes and the degree to which these differences are uplifted.

To analyze, this would be said that in both schools, the degree of standardization was high and that of integration was low.

However, value-creating Business Intelligence techniques were seen integrated with both schools. An example was seen; marketing manager arranged an academic trip to abroad to see meet the overseas students.

Brilliant information inside every one of the Graduate Schools upgraded the pursuit and select dynamic ability. Thus, Business Intelligence when implemented in the rightest ways, could be useful for enterprise systems.

Conclusion

Business Intelligence has developed in light of the fact that the measure of information created through the web and savvy gadgets has developed exponentially adjusting how associations and people use data. Hence proved that business intelligence and an analytical model built up perfectly to assess and evaluate the insight level of big frameworks can improve decision-making processes, analyzing systems and software, and enhance the performance of the enterprises.

In the event that a compelling Business Intelligence is utilized in any association, it can improve its basic leadership forms and even procedures, for example, strategic key administration. With the assistance of Business Intelligence programming, one can have the exact information, ongoing updates, and means for estimating and even to foresee conditions, for example, ‘what will occur if.’

References

1. Duan, L., & Xu, L. (1970, January 1). Business Intelligence for Enterprise Systems: A Survey – Semantic Scholar. Retrieved from https://www.semanticscholar.org/paper/Business-Intelligence-for-Enterprise-Systems:-A-Duan-Xu/db3741b60e0c4308a496a2463a37a1c1d5831266
2. Shanks, G., & Sharma, R. (n.d.). Creating value from business analytics systems: the impact of strategy. Retrieved from https://ro.uow.edu.au/infopapers/3817/
3. Yeoh, W., & Popovič, A. (2015, January 8). Extending the understanding of critical success factors for implementing business intelligence systems. Retrieved from https://asistdl.onlinelibrary.wiley.com/doi/abs/10.1002/asi.23366
4. What is Business Intelligence? BI Definition. (n.d.). Retrieved from https://olap.com/learn-bi-olap/olap-bi-definitions/business-intelligence/
5. Andre, L. (2019, July 16). What Is the Purpose of Business Intelligence in a Business? Retrieved from https://financesonline.com/purpose-business-intelligence-business/#targetText=Zoho Analytics&targetText=The software is designed to,various units in your organizations.
6. (n.d.). Retrieved from https://aisel.aisnet.org/icis2012/proceedings/KnowledgeManagement/3/
7. Reasons Business Intelligence Is Vital To Business Success. (2019, September 5). Retrieved from https://www.maximizer.com/7-reasons-why-business-intelligence-is-vital-to-business-success/

Purpose of Paper

The purpose of this paper is to emphasize the need for medical charting and discuss about the federal and state laws enacted to mandate the need for Medical Charting. A medical chart is a highly confidential documentation where the personal and well detailed information of a patient and care progress of the patient. It strictly contains demographics, patient’s notes, diagnoses, surgeries treatment plans, allergies, radiological studies, test results, immunization records, patient’s habits and patient’s consent forms. The following are not expected to be stored in the medical chart of a patient; peer review note, general notes, correspondence to malpractice carrier and other items. At each medical check-up, vital information such as chief complaint, present illness history, physical examination such as vital signs and organ system review, etc. are meant to be added to the patient’s medical chart (Care Cloud, 2017; Christopherson, 2008).

Each patient’s medical charts are supposed to be handled with extreme care, hence, only the patient and concerned team member of the healthcare have access to the confidential medical chart. According to the HIPAA regulation, a patient has the right to ensure accuracy of the information in a medical chart and also grant a third-party access for accuracy check. This is meant to correct or adjust wrong medical input towards perfect or accurate record documentation. In recent time, electronic health record EHR makes it easier and faster to document and make available health information for patients and other member of the care team by the provider (Care Cloud, 2017). EHR helps physicians to have quick access to important health information they need about a patient for quick decision to be made. It helps to reduce errors in charts caused by poor penmanship, improves accuracy and clarity of care coordination with a guarantee that medical charts can never be lost (Care Cloud, 2017).

All medical charting must meet the requirement for the Medicare Conditions of Participation 42 CFR Section 482.24 as shown in the pictures below as required by the federal law.

“Medical Record content must meet all State and federal legal, regulatory and accreditation requirements inclusive but not limited to Title 22 California Code of Regulations, sections 70749, 70527 and 71549, and the Medicare Conditions of Participation 42 CFR Section 482.24.”

The specific targeted employee group and specific health services setting

The specifically targeted employee is Mrs. Karen Matin who is presently working with The Arc of PG County in Largo Maryland for close to 15 years as Human Resources Administrator. She is responsible for managing and administering benefits for the staffs. The organization has over 300 employees under her supervision and she ensure all staff status changes and updates are input in our HRIS system. She was responsible for ensuring certain staff obtained and maintained their Certified Medication Technician Certification. She also monitored Certified Nursing Licenses, LPN, RN licenses to ensure they were current.

If a CMT expired staff was unable to give meds and had to retake the 20-hr class. If a CNA, LPN or RN expired, staff would be placed on unable to work status until their license current.

Charting errors resulted in staff being sent to documentation training. On-going errors resulted in termination. Medication errors can result in termination.

I chose this organization because they are responsible for the effective care of patients with disability and proper documentation is required. There the federal and state law requirement for medical charting must be strictly followed. The state law that should be followed or complied with is the Code of Maryland Regulations (COMAR) with Maryland Department of Labor, Department of health and Developmental Disability Administration.

Failure to comply can result in a DDA investigation and corrective action plan. There are instances where medical modification of record is required for accurate charting even though this must be done with the consent of the patient and the health care personnel. Nevertheless, there is authority stating that a hospital may not permit a doctor, despite the agreement of the patient, to do so except the change serves as a supplement or correction that does not alter a prior entry (Christopherson, 2008). According to Mrs. Karen Matin, administrative consequences are involved for failure to comply such as administrative leave which may eventually lead to termination of the appointment.

The following duties must be carried out by employees in compliance with the law,BDate and time should be included on all entries into the record.

A person’s full name and other identifiers (i.e., medical record number, date of birth) should be included on all records.

• Each page of documentation should be signed.
• Blue or black non-erasable ink should be used on handwritten records.
• Records should be maintained in chronological order.
• Disposal of any records or portions of records should be prevented.
• Documentation errors and corrections should be noted clearly, i.e., by drawing one line through the error and noting the presence of an error, and then initialing the area.
• Excess empty space on the page should be avoided. A line should be drawn through any unused space, the initial, time, and date included.
• Only universally accepted abbreviations should be used.
• Unclear documentation such as illegible penmanship should be avoided.
• Contradictory information should be avoided. For example, if a nurse documents that a person has complained of abdominal pain throughout a shift, while a physician documents that the person is free of pain, these discrepancies should be discussed and clarified. The resolution should be entered into the chart and signed by all parties involved in the disagreement.
• Objective rather than subjective information should be included. For example, personality conflicts between staff should not enter into the notes. All events involving an individual should be described as objectively as possible, i.e., describe a hostile person by simply stating the facts such as what the person said or did and surrounding circumstances or response of staff, without using derogatory or judgmental language.
• Any occurrence that might affect the person should be documented. Documented information is considered credible in court. Undocumented information is considered questionable since there is no written record of its occurrence.
• Note in the chart any missed appointments, consents completed and release of information forms.
• Current date and time should be used in documentation. For example, if a note is added after the fact, it should be labeled as an addendum and inserted in correct chronological order, rather than trying to insert the information on the date of the actual occurrence.
• Actual statements of people should be recorded in quotes.
• The chart shouldn’t be left in an unprotected environment where unauthorized individuals may read or alter the content
• Avoid including witticisms or personal comments (“This patient is a grouch!”) in medical records. Things that seem amusing to you at the time you write them may not be funny to a potential jury.
• Avoid changing an entry in order to tone down an overly critical observation of a patient’s personality or behavior. “Cosmetic” changes are not necessary for patient care and should not be made at any time. (Christopherson, 2008)

Case Studies and Employee Responsibilities.

A particular doctor internist failed to complete the medical charts for 59 patients, even though the management had given warnings. Due to this, his license was revoked by the state medical board and company privileges were withdrawn. He was also fined a sum of 2000 USD and mandated to take 20 CME hours in risk management and record-keeping. This is a lesson that hospital record-keeping is important and done immediately after treatment. One of the reasons for this is because third parties won’t pay for care given to patient without a duly filled record.

Another scenario is the case of a psychiatrist who admitted three patients on an emergency ground, but she didn’t write admitting notes until several weeks later. Her case was reported to the state medical board because state bylaws require admitting notes to be documented within 24 hours. She was fined 2500 USD and mandated to take five CME credits in risk management and record-keeping.

A gynecologist filed an insurance claim for a total abdominal hysterectomy although, he was to meant to perform a right salpingo-oophorectomy surgery. The state board, after been notified by the hospital, charged him with failing to maintain adequate records, practicing below the acceptable standard of care, and filing a false report. Therefore, it is important to dictate the right notes on procedures when the memory is fresh, because it wasn’t his fault but bad medical chart presented to him (Economics, 2006).

Conclusion

Medical charting is very important because it is the total record valid for medical and legal purposes for individual’s clinical status and the involvement of caregivers. It determines a patient’s health life for every stage in his healthcare. The involvement of whatever method be it paper or electronic method must not rule out the confidentiality aspect of the medical record document, hence the right steps should always be taken to avoid administrative and legal charges against doctors, nurses or caregiver involved.

According to studies dating back to the 1930’s, eyewitness misidentification is the most common element in wrongful convictions. In this paper I will talk about a case where misidentification was truly show in honest spotlight. The defendant, Kirk Bloodsworth. a 59-year-old Caucasian man, born and raised in Rosedale, Maryland. An innocent man, only 24 years old at the time of conviction. On the early hours of August 9th, 1985, sound asleep at his cousin’s house in Cambridge, Maryland. Kirk Bloodsworth heard loud pounding on the door. Once he opened the door, flashlights were glaring and pistols were drawn. This doesn’t sound like such a pleasant surprise at this time of day, does it? He was told to exit the house, in such a rude demeanor, the reason being that a women claimed to have seen Mr. Bloodsworth on TV, ‘believing’ that it resembled her old neighbor and the murderer. It was an anonymous call which caused him to be sentenced to death. But the real question is, is this eyewitness testimony actually reliable and should be used in court?

The Case

On July 25th, 1984, two young boys, ages 8 and 10 were sitting by the pond behind an apartment complex. 9-year-old Dawn Hamilton, had wandered off into the woods with a man, and that was the last time she was seen by anyone. The 2 boys had described the man as skinny, 6 foot-five, with a bushy mustache and blonde hair. “Hours later, Dawn’s body was found lying face down in the woods by a Baltimore police detective” (Unknown, 2019). This was the day poor Dawn Hamilton was brutally raped and murdered. A sketch was composed the following days with information coming from the two boys, an 8-year-old and a 10-year-old, the last two people who had seen poor Dawn and the horrific monster who killed her, causing Kirk Bloodsworth to have been convicted for first-degree murder, sexual assault and rape and sentenced to death in Maryland Penitentiary for a crime which he never even committed.

The Evidence

When the sketch was composed, the two boys would often tell the police certain things about the suspect. For example, they stated that the suspect had “more of a Fu Manchu style mustache”. Simple gestures such as these, can clearly alter the appearance of a person, which clearly leads to misidentification of the suspect. When the kids were shown photos that included Mr. Bloodsworth’s image, one of the boys said the offender wasn’t even pictured, while the other identified Bloodsworth, but claimed that the hair color was wrong. “The 2 young boys didn’t originally identify Bloodsworth in the lineup, but weeks later, after he was charged, their parents called to say their kids had picked him out- which entitled them to some of the reward” (abolish.org, 2017). This clearly proves something, these kids were being brainwashed over the course of a few weeks and by their own parents, who probably just wanted to get some type of reward out of it all.

The Reliability of Evidence

Piles of studies have shown that eyewitness testimony is right only about 1/2 of the time, our memories often being contaminated by the media, certain other images, associations and even biases of police. Over the course of the weeks leading up to Bloodsworth’s charged and conviction, the witnesses, meaning those 2 boys, and other began to identify him as the murderer. ‘New’ information was often brought up, and people were ‘blindly’ identifying him. Now let’s get to some real facts. The murderer was claimed to be skinny, 6 foot 5, blonde hair and a bushy mustache. My client, is 6 feet tall, well over 200 pounds, a redhead with mutton-chop sideburns and has been wearing glasses since he was 5. The two images of the men don’t even add up. So where are these witnesses comparing the two men for. “In the case of Kirk Bloodsworth, the sketch carries some similarities to his features. The second witness comes forward and says that they saw this man around the area where the crime occurred, along with the first eyewitness they made up a new sketch, which now resembles Kirk even more because the second eyewitness is now describing Kirk. Now the third, fourth, and fifth eyewitness are convinced the person they saw was Kirk, and they testify in court against him. At this point Kirk Bloodsworth, an innocent bystander, is accused of a crime that he did not commit” (Goldstein, E., 2015). This had actually happened with a witness in this case, he had claimed that he saw Bloodsworth but when asked where, the witness couldn’t state and his answer was that he saw him on TV. It’s very difficult to be able to use eyewitness testimonies in a case where evidence is sparse.

Exoneration

“If it could happen to me, it could happen to anybody” (Bloodsworth, 2004). Mr. Bloodsworth began actively fighting and speaking for others who have truly been wrongfully convicted. He was able to publish a book about his horrible wrongful conviction experience. Mr.Bloodsworth was able to be exonerated by DNA, which was only experimented with and test years after he spent already in jail which was 8 years. In 1992, he had learned about DNA testing and how it could help his case. “The victim’s shorts and underwear, a stick found at the scene, and an autopsy slide were compared against the DNA from the victim and Bloodsworth. The DNA lab determined that the panties excluded Bloodsworth and replicate testing performed by the FBI yielded the same results” (innocenceproject.org). This proved that Bloodsworth was indeed innocent.

Should Eyewitness Testimony Be Admissible in Court?

Eyewitness testimony should not be admissible in court. Especially in this case. The witnesses were at a very young age, however a lot of things that they had stated about the actual suspect and his appearance was ignored by the police. Over time, after seeing this incorrect police sketch, more and more people began to identify the murderer as Kirk Bloodsworth, an innocent man who wasn’t even in the area at the time of the crime. People began claiming they’ve seen him do it and that they just know it’s him without giving proper explanations and reasoning as to why they believe it’s actually him, such as the instance with the witness who claimed that he saw Kirk however, only on TV, and no real reasoning and proof. Eyewitness testimonies are inaccurate and people can see and hear what they want and their thoughts and images can be altered over time due to new images and information being presented, time and police influence. “In conclusion, our memory can deceive us…an eyewitness gives a false testimony based on errors in memory” (Goldstein, E., 2015). “Also, there are many ways that the criminal justice system can, purposefully or not, contaminate an eyewitness’s perspective during the suspect ID process and inflate their confidence on the spot. Traditionally, the lineup administrator knows who is the suspect and who are the non-suspect ‘fillers’. This knowledge can contribute to miscarriages of justice—for example, if the administrators ask leading questions that sway the witness’s choice, such as, ‘Do you think it’s that guy?’. These administrators can also make statements that inflate the witness’s confidence level, such as, ‘We thought that was the one’, or ‘Are you sure…?’. Even unconscious cues such as body language may taint the selection process” (Ryan B., 2015). Eyewitness testimonies are often unreliable; eyewitness memories can end up being altered over time, which results in such great issues such as misidentification which puts innocent people in prison. We can’t always rely on people’s memories that can be so easily altered, especially over the course of weeks or even years, during the process. We must put an end to false eyewitness identification and stop using eyewitness testimony in court. We must stop imprisoning innocent people like Kirk Bloodsworth for crimes they haven’t even committed.

The case of Charles Whitman is an extraordinary study of the linkage of the gene-environment interaction of behaviors like aggression or violent tendencies. He was in my opinion, a product of his genes and his environment with a strong underpinning of physical illness caused by the glioblastoma tumor pressing on his amygdala. The physical inability of his Amygdala to not perform its required function is a definitive reason for his aggressive tendencies that manifested through his childhood experiences and his experience as a marine.

The biological flaw in Whitman was his amygdala which could not understand and imitate fear, reward, anticipation, or motivation. Thus, through the loss of this function, he also lost the restraints to certain behaviors. Whitman’s aggression was multifactorial with socioeconomic, medical, and psychological factors playing a part in his actions. Whitman’s bottom-up “drive” of the Amygdala and the insula also combined with the major deficiencies he had in his ‘fears’ and ‘anxieties’ while growing up manifested into the murders and the other atrocities that he had committed. Whitman being smart and aware of certain decisions his knowledge of computer engineering and his IQ put him a clear candidate for someone suffering from immediate response damage, which would essentially be his amygdala. He was just a product of the flaw of a physical illness and an environment he had no control over since the beginning of his social life.

The processing of these stimuli he received growing up, in the Marines, his relationship with his wife (manifested out of what he acquired from his father) and the death of his brother caused an undeniable mental imbalance which was only aggravated by his tumor. All of these stimuli in his environment were the risk factors that his past emotional conditioning encoded in the amygdala and the other related limbic regions triggered his “drive” to produce aggressive actions. The imbalance between his limbic “drives” and prefrontal control mechanisms was important for the range of psychiatric pathology provoked by negative stimulation, including not only aggressive disorders characterized by externally directed behaviors but also withdrawal behaviors associated with PTSD ( as with his marine experience and his relation with his father) and mood disorders (his decreasing relationship with his brother). Charles Whitman’s issue was largely neurobiological because of the physical inability of his brain to sympathize with killing his wife or the other murders he committed. His case was more neurological because his character changed over time as he was not in the environment of being a murderer. From week 1, the major takeaway that can be used to accompany the case of Charles Whitman was that he was not based on a single factor that can explain why he was part of one singular group that made him susceptible to show violence. Although his was an intentional use of power, the decisions made by him, as he admitted had no particular reason to take them. So there is, I think to me, a blurry area in defining his intentions and if he was even aware as he was making them.

Jeremy, the patient, in this case study suffers from aplastic anemia which causes your body to lack the production of new blood cells. Along with this medical deficiency, he is also a committed Jehovah’s Witness in which he stands for the practice of abstaining from blood. Jeremy even vocalized this concern to his doctor, Derek, when he stated, “He would rather die than act against his faith”. Derek knowing this vocalized concern then proceeds to lie saying no blood will be in the transplant. Although one may think he did that as an attempt to save his life, he also robbed him of his autonomy. This medical decision was an innovative complexity against the Kantian standards of morality and ethics. My argument will deliver and back up the Kantian rules of autonomy, utilitarian negligence to provide beneficence for the patient, and the conflicting argument of whether treatment goes against the ethical principle of non-maleficence.

To strengthen my argument and to sanction the true maxim of the Kantian viewpoint. (Veatch,206) I believe it is vital to point out that the doctor’s disobedient stunt undermines Jeremy’s rights by treating him as a means rather than an end. (Misselbrook,211) We can conclude from the medical information provided in this case study that Jeremy meets the requisite capacities to decide to refuse a blood transfusion even if it would result in death. With this request being for a rational religious reason and not for an irrational or unresponsive reasoning it would therefore be rational in this domain to honor Jeremy’s wishes. Site ThisIn the acting of reasoning, for Kant’s view on an intrinsic worth, Jeremy, serves as a rational agent capable of making the fatal decision of refusing the blood transfusion if it contained blood. Kant, also stood for the importance of consistency and that no rational person can deny it. (Rachels,10) Connecting this Kantian mindset to this case study, it is very clear that the doctor is a rational agent making an irrational decision of lying, breaking this rule of consistency and therefore autonomy.

Kant’s theory rejected by coercion and the Utilitarian viewpoint of using the act of benefit to support the doctor’s reasoning behind lying and giving the blood transfusion creates a conflict. Not only is the doctor’s deciding factor to perform the transfusion ruled as irrational it also views consequences as a criterion for moral action in which case Kant disagrees. (Johnson,13) In addition, the harm principle also supports this reasoning, as there is no way to rationalize the magnitude of pain and suffering Jeremy may feel. One can only imagine how difficult it must be for him to find out that the doctor went against his right to autonomy. The doctor’s decision to lie to Jeremy is also treating Jeremy as if he is an instrument and incapable of making such rational reasoning. Although, this belief of Jeremy’s may be different than the doctor’s belief. Jeremy still has the right to the desire fulfillment theory which allows individuals to be rational when making dangerous decisions if it is of more value to the individual. (Savulescu,11)

Furthermore, when regarding the act of beneficence and looking more into the ethical principle of nonmaleficence. One can see a similar result where the lack of Jeremy’s rights of autonomy interferes with the Oath of Hippocrates’ definition of nonmaleficence as, “first, not harm,” since the Doctor’s lying is an act of harm. (Johnson, 3. B) All of this falls under the primary justification principle, which requires health professionals to have a consistent set of standards. Within these set of standards that are made by both Utilitarians and Kantians, they have come to an agreement that the principle of autonomy trumps all other principles. (Misselbrook,102)That is the case as long as the individual’s capacity is within the requisite capacities to allow them to make capable life decisions which we ruled Jeremy’s as requisite up above. Therefore, based on Kantian rules of autonomy, utilitarian negligence to provide beneficence for the patient, and the conflicting argument of whether treatment goes against the ethical principle of non-maleficence it can be proven that Derek’s actions were morally unjust due to the power of the autonomy principle.

Type of Action:

The case is an appeal that was decided by a jury. The jury verdicts decided that the defendants must pay $1.8 million. The case was a product liability suit against Sears Roebuck & Co. and Pittway Corporation

Facts of the Case:

Albin Laaperi bought a smoke detector from Sears. The detector was made by Pittway Corporation. The smoke detector worked through an electrical circuit. Laaperi installed the smoke detector upstairs. The fire began on the 27th of December. Laaperi’s three boys were upstairs where the smoke detector was. They were killed in the fire. Laaperi’s daughter, who was in the other bedroom, had severe burns but survived. The testimony given in the trial was that the detector never made a sound during the fire. The reason for the fire was because of a short circuit in an electrical wire that was in the Laaperi’s son’s room. The two electrical cords in the bedrooms provide different services. One is for electricity to the power outlets and the other is for powering lights. The smoke detector’s power was coming through the power outlets. This was shorted with the fire. Therefore, the smoke detector had no way of receiving power when the fire started. After the fire, the detector was tested and was still working. This means the smoke detector itself still worked. Unfortunately, it was not receiving power during the fire, so, therefore, it never went off. Laaperi wanted “negligent design, negligent manufacture, breach of warranty, and negligent failure to warn of inherent dangers”. Pg. 436. The verdicts showed that they were in favor of Sears and Pittway Corporation, besides the failure to warn Laaperi. The jury is all in favor of all four actions brought forth by Laaperi of failure to warn. The Jury awarded the amount of $350,000 to Laaperi because of the deaths of the three sons. Also awarded $750,000 to Janet Laaperi. The court denied the defendant’s motions. The motions included a directed verdict and judgment notwithstanding the verdict. The defendants then appealed the decision made by the court.

Contentions of the Parties

SEARS ROEBUCK & CO contends that the district court was wrong for denying the motions for a directed verdict. They also say it is wrong for the district court to deny the motion for judgment n.o.v.

LAAPERI contends that the failure to warn theory is what the plaintiff uses for the reason for the death of his sons and the severe injuries of his daughter. Laaperi was not aware of the potential danger that could happen if the short circuit was to catch on fire.

ISSUE: Does Sears Roebuck and Pittway Corporation have the duty to warn Laaperi about the potential dangers of the smoke detector’s short circuits?

Decision:

Yes, the court ruled in favor of Laaperi, and his position as the manager of the estates of his three sons is affirmed. As for the action of Janet Laaperi, the court abandoned the original decision made. The reason for this is to have a new trial for the issue of issue of damages.

Rationale:

The evidence showed that if Laaperi had been warned of such damages he would have made other plans to protect his family. The lack of warning from Sears Roebuck caused a lot of danger for Laaperi. If Laaperi had been warned about the fire detector potentially not working in an electrical outage. He could have made plans like a battery-powered detector, or he could have rewired the detector to make it safer for his family.

Rule of Law:

The court decided in the review of the denial of a motion for directed verdict and judgment n.o.v would be to who is the most favorable. The court would decide who has the most evidence on their side. The court decided that the district court was not wrong in denying the motions made by the defendants. The jury went with the testimonies that were given by Laaperi in colloquy. The jury also went with other evidence, and the final say that if Laaperi had had a warning of such dangers he would have gone with different plans to keep his family safe from harm.