Reading Reflection Essay Example | Topics and Well Written Essays - 750 words - 1

Reading Reflection - Essay Example It helps bring out the element of suspicion in the story. When one is reading any literary work, it is necessary for the reader to shift from the real world to the imaginary world where he understands the story better (Guerin, 2005). The title of the book piqued my interest to know what Walter might be doing in the secret world and hiding it away from the real world. In his daydreams, Walter is portrayed as a man of high esteem. It would therefore be necessary for me as the reader to know the secret behind Walters’ high esteem. In the first instance of his daydream, the crew insinuates that the, â€Å"old man will get us through, he is not afraid of hell†. This instance creates an image of a man who is not afraid of situations. It is also interesting to know why other members hold the man in such a high esteem in his group. The scenes portrayed in the daydreams sustain my interest in the story. The first instance of a daydream Walter is a commander, the second daydream he is a famous surgeon attending to a millionaire. The last second daydream Walter is a witness in a courtroom whereas the last instance of a daydream, he is a captain of a warplane. My interest in this story was driven by the desire to know whether Walter wanted to become some of the people described in the daydreams in his real life. ... The reader should account his feelings with certain aspects in the literary work that makes him have the feelings. This approach requires the reader to connect with the story, and assess the insight that the connection with the story brought (David, 1984). It is also paramount for the reader to consider the connection with the story and other stories that he has read. He should then evaluate if the connection added anything new to what he already knew. In this story, there is a connection with the Walter’s day dreaming behavior. The daydreams in this story, which help the reader to connect with the story, enable one to understand the meaning of the story. Walter’s daydreams are all frenzied ranging from flying in the middle of a deadly storm, working with faulty machines in surgery room, as well as facing a firing squad boldly. It is evident that the daydreams may be prompted by the chaos in his life brought about by his relationship with his wife. His wife is portrayed as a person who always quarrels with Walter over one thing or another. The aspect of Walter daydreaming is a means of escaping tribulations in his real life. He wants to escape to a world where he is in control of his own situations. He escapes from the real world to an imaginary world where he is in control of his own affairs. It is however worth to note that his escapism leads him to more troubles. In one instance as he is daydreaming, he is unable to pack the car correctly only to be assisted by the packing attendant. While heading to town with his wife, he daydreams and ends up over speeding the car. His daydreaming behavior also makes him forgetful. He forgets what his wife requested him to buy before they left home. The style of telling the story helps us to

Art Making Process Essay Example for Free

Art Making Process Essay The teaching of artmaking process is one in which there appear to be no right answers as it is frequently related to the teachers own understanding of the material at hand. (Schon, 1996). As art making is an open ended process there are a number of difficulties posed in instruction. One option is to engage art students in the process in a highly conscious and reflective manner. This was the mode in which the author conducted a 10 week course on the subject designed after intimately observing how contemporary artists worked. The first step in teaching art is said to be informing and inspiring students with various methods of artistic practice by playing video taped interviews of artists. The understanding of the use of big ideas by artists is one of the most important facets. Exploration of the big idea provides clarity of concept and insight into the artmaking process which is understood only through reflective practice. Maintaining documentation is also important. This provided students new perspectives in art making as they indulged in reviewing the big idea with personal relevance over a period of many weeks. Identification of the correct big idea is also linked to problems faced by artists in artmaking. Problems can be overcome with proper identification of the big idea and pursuing it with an open mind without an early closure. The delay in closure occurs when the artist discuses the concept repeatedly with himself thereby providing him better insight and enhancing creativity. Thus it is the understanding of the big idea, main concepts, the base and boundaries of knowledge which enable an artist to communicate his ideas most effectively to his audience. While artmaking cannot be taught in the form of a formula of success, the instructions provided in a generalized manner provide for developing the students creativity as well as art practice as was seen in the ten week artmaking project detailed in the article. Reference: 1. Schon, D. A. (1996). In D. OReilly, (Ed. ), Learning through reflection on conversations. In conversation with Donald Schon, Capability, the HEC Journal, vol. 2 (2). Accessed on 10 December 2006 at http://www. lle. mdx. ac. uk/hec/journal/ 2-2/l-2. htm, l-10.

The Ritual Of Sati In Hindu Religioun

The Ritual Of Sati In Hindu Religioun The practice of sati, the immolation of widows, is the most tenacious example of religious customs. Many people often associate the concept of sati with just India; however, the practice of self-immolation has been widespread in world history. The article written by Jorg Fisch, claims that examples of sati can be traced to incidents of headhunting in Southeast Asia (Fisch 2001: 301) and the ritual murder of a kings cook, brewer, and shepherd in Baganda (Fisch 2001: 299). In order to understand the reasoning behind the ritual one must look into every aspect of it from the angles of different religious traditions. So, as one can see sati is not unique to India. However, the cases of sati, even though, rare, have still taken place since the proclamation of Indias independence in 1947. The most recent case that has sparked a heated debate is the sati of eighteen-year old widow, Roop Kanwar. The most surprising consequence of young womans death was the fact that women from different parts of the country rallied demanding to be permitted to commit sati (Kumar 1995: 76). The pro-sati lobbyists fought for their rights to commit, worship, and propagate sati; it got to the point where the Sati Dharma Raksha Samti (the Committee for the Defense of the Religion of Sati) was formed (Hawley 1994: 9). This group was run by educated Rajput men in their twenties and thirties who claimed that sati was a fundamental part of their traditions; a refusal to legitimize sati, they said, was a deliberate attempt to marginalize the Rajputs (Kumar 1995: 81). To fully grasp the concept of sati one must look into history of the ritual and not only in India but in other countries as well; search for examples and reasoning in sacred texts; and discover the attitudes both supporting and opposing sati that exist in modern day India. The rituals of sati exist throughout the world in documented cases that were reported in various countries. Jorg Fisch reports, in his paper, that human sacrifice was practiced frequently in China. He follows the pioneering scholar of Chinese religion J.J.M. de Groot in saying that Confucius and his followers opposed it, however de Groot disagrees that it was Confucian opposition that ended the practice in China (de Groot 1976: 300-301, 310, 320). The history reports that sometimes great numbers of ordinary people were lured to the mausoleum of an emperor only to be locked up to be buried alive (Fisch 2001:313). But it is not the brutal practice of massive murders of ordinary people that makes the ritual of sati come alive in Chinese history but rather the account of childless concubines being buried with the first emperor. Later, the custom of following emperors in death which was reserved for only those from the lower class was followed by the suicide of widows. It was considered t o be a form of faithfulness and a reflection of not only on the changing nature of Confucianism but also other religious traditions emerging in China. Regardless of the religious opposition the practice remained in place for a while. Just like in India, Chinese religious opposition failed to convince people that sati is inhumane and unnecessary. Just like in India, it was due to the fact that general population held strong beliefs in life after death and that by following their husbands the widows were fulfilling their dharma therefore it could not be wrong. The reasons that drove Chinese widows to commit sati included deep sorrow at the death of a beloved spouse; the anticipated difficulties of life as a widow, including the threat of forced remarriage; and, as for Indian sati widows, the possibility of honor, enshrinement, even deification (Fisch 2001:311, 316). But within the same faiths, as daughters and daughters-in-law with seniors to care for, as beneficiaries of their parent s gift of life and body, as mothers to their husbands heirs, as officiants in the ancestral cult, as lay Buddhist devotees, or as women tough enough to honor life-long vows of chastity, they might also choose to live an honorable life. They could do so while still believing in a life after death, or in repeated, rather than final, judgment of their sins and virtues, or they might believe in honor for its own sake and the immortality of their name. Just like India, China held belief that everyone holds a choice over their own destiny and are free to either follow the dead or remain alive. There is no stigma or shame attached to either. The ritual of sati has been in the lives of Hindus for many generations. There are accounts of sati or the refusal of thereof in the sacred texts of Hinduism. Sati is mentioned in both the Rig Veda and the Atharva Veda, two sacred texts in the Hindu tradition. The reason why it was practiced for so many years was because of discussion in these texts. One of the sections of the Vedas in known as Samhitas, and it contains a section called the Rig Veda Samhita, which includes a passage defending sati as it states: Let these women, whose husbands are worthy and are living, enter the house with ghee (applied) as corrylium (to their eyes). Let these wives first step into the pyre, tearless without any affliction and well adorned. (Rig Veda 10.18.7) The verse encourages a widow to throw herself on her dead husbands pyre as a personal sacrifice to her husband. In the scripture, sati is a wife entering the funeral pyre, and the practice has started because it is a part of a sacred text. It is described with many other ritual practices prescribed to the followers of Hinduism. Another sacred text that defends the practice of sati is the Atharva Veda Samhita. It is from the same collection of Samhita as the Rig Veda and the funeral verse in the Atharva Veda in Kanda 18, Sukta 3 states: This woman, choosing her husbands world, lies down (nipad) by you that are departed, O mortal, continuing to keep [her] ancient duty (dharma); to her assign you here progeny and property. Sati is also mentioned in Mahabharata in the story of the pigeon and the hunter. Sati is described as a ritual suicide because after the passing of the husband the wife has to follow him too. Bhisma tells the story where the pigeons wife decides that no moral woman could still live if her husband was dead and so she decides to throw herself into her husbands funeral fire (Sutton 2000: 87). The result of her actions is that she is sent to svarga-loca (celestial world) alongside her husband in a celestial chariot (Sutton 2000: 87). The mention of the sati ritual on the pages of often read Mahabharata is regarded as another justification of the ritual. However, despite the fact that the ritual of sati is discussed in sacred texts for any Hindu, people started to seek another interpretation for the same verses. The understanding of the tradition is different now than it was at the beginning of the religion. The human rights activists and feminist lobbyists are fighting to liquidate the tradition completely. Those who oppose the ritual of sati claim that it is simply appalling and should be abolished forever. It seems like there shouldnt be a conflict as the practice became illegal many times. First, it was abolished by the British in 1829; and then again in late 1980s after the sati of Roop Kanwar. Indian feminists argue that the proclamation of Roop as an exemplary and chaste wife is revolting. The idea behind the ritual is the one of grave oppression of women and vivid representation of their secondary status and lack of choices. For centuries, the social status of women was closely related to the one of their fathers and later, t heir husbands. It was never an option for a female to be considered an equal in everything to her husband. After the independence of India was proclaimed women got their chance to build their lives the way they desire. But, sadly, many were clinging to the past, to something they have always known, the traditional way of life and thinking. The feminist leaders stepped up and encouraged the female population to take the reins of their destinies and think for themselves. It is unthinkable that in this day and age, anyone would consider a ritual suicide just because of the tradition that dates couple millennia back. In conclusion, the ritual of sati has rich and intriguing history. The account of sati examples were discovered in numerous documents all over the world. It can be determined to certain that India was not the only country that practiced ritual sacrifices of innocent women in order to fulfill their dharma and show off their chaste and pure nature. China had centuries of regular practice of sati, but unlike in India, the practice was long abolished. Concrete evidence that supports the ritual of sati is found in several sacred texts in Hinduism. It makes it harder to argue that sati is rather a choice a widow must make and not a predestined certainty. The evidence from the texts can be interpreted as a supporting ground for sati. It sounds noble, and pure, and chaste, to show the world the devotion the widow has for her deceased husband. In reality, it is just a tradition, a ritual like any other, that one can chose to forgo. In modern times there is no more stigma attached to being a w idow, no shame to carry with the title, no burden to lay on those who are still alive. Modern society is all about equality of rights for everyone. And Indian feminists argue just that, the tradition of sati had its place in history and lives of Hindus, but now, it is time to make wiser choices and live, instead of committing sacrificial suicide.

Philip Morris Marketing Analysis :: essays research papers

Philip Morris Marketing Analysis Definition of Industry Market Concept The tobacco industry consists of many competitors trying to satisfy a specific customer need. Companies such as Philip Morris, RJ Reynolds, Brown and Williamson, and Lorillard hold almost the entire market share in the tobacco industry. While each company has different advertising and marketing techniques, they all target the same customer group. Tobacco companies try their best to generate interest in their particular brand or brands. Companies market a number of attributes that usually include, but are not limited to: taste, flavor, strength, size and image in order to distinguish themselves from competitors (Business Week 179, November 29, 1999). However, all tobacco companies are satisfying the same needs. Many long-time smokers are addicted to the nicotine in cigarettes. They smoke because the nicotine is needed to help them feel normal (Focus group). Many addicts go through withdraw without nicotine. All tobacco companies have nicotine in their cigarettes, which fulfills the ne ed of long-time smokers. Other smokers depend on cigarettes in social settings. Many smoke to look sophisticated and mature. Tobacco companies make many kinds of cigarettes that target different groups. Social smokers may perceive certain brands as more sophisticated, and therefore they shy away from other lesser-known brands. For example, a person who smoked generic cigarettes at the bar may be perceived as uncultured. On the other hand, the smoker with the Marlboro Lights may be more socially accepted because they have a brand name product (Focus group). Many types of cigarettes cater to the many markets of smokers who want to portray a certain image in social settings. Tobacco companies do not create the need to smoke, but try to generate interest in their particular brand (Hays, New York Times, November 24, 1999). Overall, the tobacco companies satisfy consumer demand for the millions of adult Americans who choose to use tobacco by providing differentiated products to different target markets of smokers. Industry Concept The tobacco industry has developed a rather large array of products. Companies such as Philip Morris, Lorillard, RJ Reynolds, and Brown and Williamson, as well as the other smaller competitors, all provide the same product- cigarettes. The tobacco industry is filled with fierce competitors. But underneath the brand names and images, the product is relatively the same. All tobacco companies produce an inhalant that is made with tobacco, tar, and nicotine. These materials are rolled in a special kind of slow-burning paper for longer smoking time.

An investigation of the role of SIS in The (Especially, In A Rural Part Of Our Planet)expand Health Servicing

Introduction Strategic information systems are concerned with aligning information systems with a firm’s business strategy to achieve competitive advantage (Arvidsson, Holmstrom & Lyytinen, 2014). Strategic alignment between information systems and the business involves a timely and appropriate fit between the business strategy, processes, and infrastructure and the IT infrastructure, strategy, and processes to achieve harmony in the management of information systems and the business (Gerow, Thatcher & Grover, 2014). Through such alignment, the performance of a business is positively affected (Yayla & Hu, 2012). The overarching argument for this is that firms perform well when IT resources including knowledge assets, managerial and technical IT skills and physical IT infrastructure elements are aligned with the business strategy, and when suitable structures are employed in effectively managing the IT resources and supervising their deployment (Coltman et al., 2015). This alignment is ever important in the current environment where new information technologies continue to fundamentally alter conventional business strategies by allowing firms to function across the boundaries of function, time, and distance by leveraging these technologies (Bharadwaj et al., 2013). This report discusses the role of strategic information systems in expanding the health service in rural areas. Specifically, it focuses on the implementation of a telemedicine program for managing diabetes for patients in rural areas by a hospital in an urban centre. The investigation focuses on the planning and the implementation of this technological solution by considering the perspectives of different stakeholders. The report starts by discussing literature on telemedicine in diabetes management. Telemedicine and Diabetes Management The management of diabetes and its associated complications is quite costly. Targeted glycaemic control is necessary for minimising the complications of this chronic condition. Conversely, less than 70% of individuals with diabetes are attaining targeted glycaemic control, showing that effective management of the disease continues to be a challenge (Fatehi et al., 2014a). Patients in rural areas are unable to attain targeted glycaemic control partly because of poor access to specialised healthcare providers. Because of the increasing need for quality healthcare and the declining availability of clinicians, information and communications technologies have demonstrated the potential for improving access to healthcare services and reducing the costs of delivering healthcare (Fatehi et al., 2014a). Telemedicine involves providing health and medical services remotely using ICT. Telemedicine facilitates the expansion of healthcare by bridging the physical gap between consumers and healthcare providers thus reducing costs. Synchronous telemedicine entails consumers and healthcare providers interacting in real time by relying on communication technologies. For instance, video conferencing, where there is exchange of image and voice in real time, is increasingly becoming popular in telemedicine in the delivery of various healthcare and clinical services at a distance (Fatehi et al., 2014b). Verhoeven et al. (2010) systematically reviewed asynchronous and synchronous teleconsultations in diabetes and reported that these offer a reliable, cost-effective, and feasible solution for the delivery of diabetes care. Video conferencing is used in collaborative goal setting, nutrition counselling, self-management training, and diabetes education for patients (Siriwardena et al., 2012). According to Faruque et al. (2016), telemedicine is helpful in the provision of care t o individuals with diabetes especially those in rural areas who are unable to travel to healthcare facilities due to large distances. Therefore, telemedicine, especially teleconference, is a technological solution for managing diabetes for individuals in rural areas who are underserved by specialists. The next section explains the methodology used to obtain stakeholders’ views on the adoption and use of teleconferencing for diabetes management. Methodology This report collected data using interviews to understand the implementation of telemedicine for expanding access to healthcare services for people with diabetes in rural areas. The report included the views of various perspectives including patients, healthcare providers at the hospital, and in the rural areas to understand the adoption and implementation of this information system. Semi-structured interviews were conducted with these stakeholders in locations and time that were convenient for the stakeholders. The interview was based on the interview schedule found in Appendix 1. These interviews were digitally recorded followed by verbatim transcription. After transcription, the interviews were analysed using coding (Vaismoradi et al., 2016). The coding led to the identification of various thematic categories including the strategic intent of adoption of telemedicine, benefits of telemedicine, and challenges during implementation as explained in the section below. Findings and discussion Strategic intent of implementation of telemedicine The telemedicine intervention was adopted by the hospital after it was discovered that some of the patients from the rural areas were not coming for the follow- up appointments to get information on ongoing management of their diabetes. An endocrinologist at the hospital stated that: I noticed that some of my patients were not coming for their appointments†¦ I looked at their records and realised that they were unable to do so because they came from rural areas. Therefore, we had to find a way of ensuring they got the much-needed information and support to manage diabetes at home The hospital identified the need for providing cost-effective care for their diabetes patients in rural areas who were unable to access specialised care in their communities. The hospital considered the adoption of telemedicine as a way of providing quality care while minimising unnecessary patient admissions due to diabetes complications. Thus, this was a critical component of the hospital’s strategic intent. According to Coltman et al. (2015), having a strategic intent involves the allocation of resources and engaging in activities to assist in achieving their objectives. In line with this, the stakeholders at the hospital had to consider how the telemedicine program will improve access to healthcare for patients with diabetes in a cost-effective manner. The CEO of the hospital said that: We recognised that the telemedicine would provide us with an opportunity for providing the required care to our patients†¦ However, we had to consider the overhead costs to set-up the telemedicine infrastructure both on our side and the rural side. Additional funding was required for this initiative. The implication of this is that the hospital had to set aside funds for the telemedicine infrastructure and this entailed working with managers from the finance and IT departments. The manager from the IT department determined the costs of using telemedicine intervention in terms of initial costs and ongoing upgrades to achieve a sustainable system. The IT manager identified a cost-effective technological solution provider for the information systems that was required for the provision of diabetes care and support to patients from rural areas. The manager from the finance department and the CEO worked together in determining how to get the funding for this initiative. The initiative was funded using funds from the hospital’s contingency budget. Furthermore, the CEO of the hospital had to talk with administrators and nurses, and pharmacists in the rural areas to participate in the project as they critical to its success. This is captured in this statement â€Å"we realised th at we needed professionals on the ground to provide some aspects of the care. We approached healthcare providers to get their buy-in into this initiative’’ (hospital’s CEO). Therefore, the strategic intent of the hospital in the implementation and use of video-conferencing in reaching individuals with diabetes in rural areas and providing them with the necessary care reflects a strategic alignment between IT and business, particularly, strategy execution. Specifically, the hospital adopted a strategy execution alignment where the business strategy influenced the IT infrastructure, but this was constrained by the business infrastructure (Gerow et al., 2014). In other words, the hospital’s business strategy was to provide quality care in a cost-effective way to individuals with diabetes in rural areas. In turn, this strategy influenced the IT infrastructure in terms of the kind of technological solution required to meet the business strategy. Therefore, the hospital ended up selecting videoconferencing as the appropriate IT infrastructure. However, this was constrained by the hospital’s business infrastructure in terms of skills and processe s in the provision of diabetes care and support to individuals in rural areas. The telemedicine initiative involved using interactive video-conferencing between a multidisciplinary diabetes care team from the hospital and the patients in the rural homes. The multidisciplinary team consisted of diabetes specialists including diabetes education experts, nurses, endocrinologist, and ophthalmologist who provided personalised care to diabetes patients based on their clinical status. The patients were provided with tablets that allowed them to engage in video conferences with the multidisciplinary team on a daily basis. The patients shared with the specialists about their psychological, emotional, and physical health during the interactive video conferences. Furthermore, the patients’ health data including glucose levels, blood pressure, and weight were automatically captured by the tablets and transmitted on a daily basis to the clinicians. The outcomes of the consultation between the specialists and the patient were then communicated to the physician in the rural area to facilitate care coordination. According to a local physician, â€Å"the implementation of this initiative required a change in how care was delivered to individuals with diabetes†¦the hospital’s care team got in touch with me and communicated their daily consultations with patients to ensure that I was prepared to provide the necessary care at the local level†. This approach to the implementation of video-conferencing reflects strategic information systems planning to achieve alignment between the business and IT. In particular, this planning was characterised by the identification of the required IT applications together with the necessary change management, resources, and infrastructure for implementing the technological solution (Maharaj & Brown, 2015).Benefits of telemedicineThe diabetes specialists were positive on the potentiality of video-conferencing in enhancing and expanding access to diabetes services to individuals in rural areas to prom ote self-management of the disease. A diabetes education expert said that: This technology increased my ability to provide education on exercise and diet modifications to my patients by talking to them via the video-conference, and this has empowered our patients to manage their diabetes in their homes. Patients were enthusiastic that the telemedicine would support the clinical needs even though they had no or limited experiencing in using video-conferencing. Some of the patients stated that: I didn’t have experience when it comes to telemedicine. But, I knew that it would be benefit me by providingwith ongoing support and information for diabetes management at home (patient 1) I had never used video conference before, but it provided me a way to talk with the physician and get timely advice and guidance on managing my diabetes (patient 2) In recognition of the limited experience that patients had in video-conferencing, the hospital’s IT department together with the external technological solution provider offered the required training. According to the IT manager at the technological solution provider: We collaborated with the hospital’s IT department in sending out individuals to provide training to the patients. The patients were taught on how to use the video conference system and provided with the necessary equipment. The stakeholders highlighted the benefits of video-conferencing for diabetes management for the patients in the rural areas. The statements below capture some of the stakeholders’ perspectives. During the video-conferences, we used the daily clinical status reports of the patient, and we were able to discuss appropriate interventions to implement with the patient. This benefitted the patients because they got personalised interventions, information, and support (Hospital endocrinologist). I got e-prescriptions from the healthcare team, and when the patients picked their medications, I talked to them about complying with their medications. By collaboratively working with the healthcare team, the quality of care of patients improved in terms of medication compliance (Rural Pharmacist) The use of video conference has contributed to preventing unavoidable admissions for diabetes for these patients. The daily support and education they got from us has improved care coordination and connections between the patients and us to minimise the use of emergency departments (Hospital ophthalmologist) A few months after the implementation of this project, we had seen a reduction in the admission of patients with diabetes in our area (Rural physician) I had problems before in controlling my diabetes because I did not have access to the kind of doctors who provide the necessary care†¦ but this changed with the daily video conferences (Patient 3) I am satisfied with information and guidance I get from the consultations with the doctors each day in managing my diabetes. I no longer need to travel to the hospital to get the care I need (Patient 4) The stakeholders’ perspectives highlight the impact of teleconferencing on the delivery of healthcare services to diabetes patients in rural areas. These perspectives have received support in literature. For instance, patient satisfaction is highlighted in the study by Fatehi et al. (2015) in an assessment of patient satisfaction levels with remote consultations for diabetes via video conference in a virtual outreach clinic using a cross-sectional survey. The results revealed that the patients were generally satisfied with remote consultation as they had no problem with building rapport with the clinical specialists over video conferences (Fatehi et al., 2015). Furthermore, the positive impact of telemedicine on the management of diabetes has been shown in the literature. Specifically, Huang and colleagues (2015) carried out a systematic review and meta-analysis of randomised controlled trials on the impacts of telecare intervention on glycaemic control in type 2 diabetes. I t was demonstrated that patient monitoring by telecare demonstrated significant improvement in glycaemic control in comparison with patients monitored by routine follow-up (Huang et al., 2015). Weinstock et al. (2011) also found that improvement in glycaemic control related to telemedicine was sustained over a period of five years among medically underserved patients with diabetes. In their randomized controlled trial, Steventon et al. (2014) discovered that telemedicine led to modest improvements in glycemic control among patients with type 2 diabetes over 12 months. Self-management as a critical aspect of diabetes management in telemedicine has been investigated by Young et al.(2014) who focused on the effect of person-centred health behaviour coaching model delivered through telehealth with patients with diabetes living in underserved, rural communities was assessed. The results showed that the interventions led to significantly higher scores in self-efficacy, which supported self-management of the disease (Young et al., 2014). According to Steventon et al. (2014), the greater self-care and oversight related to telemedicine might lead to fewer unplanned hospital admissions.Challenges during implementationImplementation of the technological solution was accompanied by some challenges. One of the major challenge identified by the stakeholders was unanticipated technical issues. This is explained by the IT manager at the hospital: Sometimes the video conferences failed because of a drop in the internet connection. This meant that the encounter could not take place. When this occurred, communication occurred via cell phones to address important issues. The technical issues had a negative impact on the interactions between the patients and diabetes care team. According to the endocrinologist, Sometimes in the middle of the video-conference, the connection dropped. I could wait till past the time I had allocated for that specific consultation. Mostly, by the time the connection was up again, I would be consulting with a different patient at the hospital, and I missed my encounter with the patient in the rural area. In those cases, I worked with the rural nurses via a cell phone to communicate important information about the patient. Technical difficulties in teleconference are due to problems with accessing broadband in rural areas, which is still lagging behind urban areas. Patients’ homes might lack high-speed cable internet that has more bandwidth capabilities and a highly reliable signal, and this causes connection problems during video conferencing (Batsis, Pletcher & Stahl, 2017). Schulz et al. (2014) reported in their study that 25% of all video conferences consultations experienced a drop in internet connection. Consequently, it is suggested that unanticipated technical issues with implementing teleconferencing should be anticipated and this highlights the importance of providing strong IT support with ongoing updates in protocols for patients in rural areas (Slusser et al., 2016). Another challenge reported was issues with reimbursements. This was identified by the finance manager at the urban hospital. She said that: I had problems with suitable billing of encounters between the patients and the doctors and capturing this. Sometimes, I billed an encounter, but the insurer failed to pay or took longer to do so. I had to go through convincing them [insurers] that the consultation actually occurred by talking with the patient and pharmacists or nurses in the rural areas for confirmation. One of the patients also talked about this issue by stating that, â€Å"after talking with the doctors on the video conference they tell you to pick up the drugs at your pharmacy and when you get there, you are told there are problems with your insurer in terms of payment. I had to call my insurer to follow up and address this issue’’ (patient 5). According to Batsis et al. (2017), low reimbursement is a problem for the lasting sustainability of telemedicine systems in a fee-for-service model. This problem is due to limitations that are placed on the type of telemedicine covered by health insurers. Conclusion In conclusion, this report has focused on the strategic information systems in expanding the health service in rural areas. This has been achieved by examining the implementation of video-conferencing between individuals with diabetes and diabetes specialists in the provision of diabetes care to patients in rural areas. This report has highlighted how the hospital ensured alignment between its business strategy of providing cost-effective diabetes care to individuals with diabetes in rural areas and the use of the video-conferencing as its IT infrastructure. The hospital had to plan for its strategic information systems by identifying the appropriate IT infrastructure, processes, and changes to how care was delivered to the targeted population in rural areas. The analysis revealed how the implementation of video-conferencing addressed the interests of the different stakeholders including the hospital, diabetes specialist care team from the hospital, the patients, and healthcare pro viders at the local level. Thus, the implementation of this technological solution was beneficial to all the stakeholders. Overall, this report highlights how strategic information systems are vital in the expansion of health service in rural areas. References Arvidsson, V., Holmstrom, J., & Lyytinen, K. (2014). 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Appendix 1: Interview Schedule Please explain why the hospital decided to implement videoconferencing in providing diabetes care to individuals in rural areas What was involved in the planning for the implementation of the technological solution Did the hospital work with external stakeholders in the implementation process How did the implementation of the technological solution affect the aims of the hospital and its specialist clinicians How has the use of videoconference affected your (patient) access to diabetes care Were there any challenges that were experienced during this processIf so, which ones To obtain answers to these questions and/or get a Custom Essay for you research, feel free to reach out to us and place an order today.

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Hasnu, the stone cutter Plot A stonecutter named Hashnu sat beside the highway cutting stone when the King’s courtiers cross the street. He then wished to be King and that wish was granted. Then he felt the sun’s heat thinking that the sun was powerful than the king so he wished to be the sun. He became the sun but then the cloud covered the sun. Thinking that the cloud was powerful than the sun, he then wishes to be the cloud. When he became the cloud, he then wished to be a rock for it didn’t move for all of his raining and blowing.Then he experienced the hardships of being a rock being sculpted by a stonecutter so he wishes to be a stonecutter again and fulfilled his duty contentedly. Conflict  · The conflict in the story is when Hashnu wants to be the most powerful. Climax  · The climax in the story is when Hashnu wants to be the king, the sun, the cloud, the rock and the stone cutter again. Denouement  · The denouement in the story is when Hashnu reali zed that the most powerful among the creations of God is still the man and he now fulfill his duty as a stonecutter contentedly. CharactersProtagonist:  · Hashnu- the stonecutter Antagonist:  · Hashnu-the stonecutter Setting Time- Time of Monarchs Location- Along the road where the King and his courtiers were crossing. Theme The theme of the story is life process because the story tells the experiences of Hashnu when he became a king, a sun, a cloud, a rock and the stonecutter again. Point of view The point of view of the story is third person because the narrator is not a participant in the story and his knowledge is limited only to the character of Hashnu. Conflict The conflict in the story is Man Vs.Society because here in the story Hashnu struggles with himself and his desire to be the most powerful. Symbol The symbol in the story is the mallet which is used by the stonecutter. Moral Lesson Be contented with who you are. The Lady or the Tiger Plot – A semibarbaric kin g discovers his daughter is having an unlawful affair with a male suitor. The male suitor is soon arrested and forced to go to trial, a trial that consists of an arena with two doors. Behind one door is a tiger, set to maul the unlucky criminal; behind the other is a beautiful bride, set to euphimistically maul the lucky criminal.The princess, who loves the young criminal, knows behind which door awaits the tiger, points to the right, indicating which door the young man should choose. Setting – The story takes place a long time ago in a kingdom far, far away. Characterization – The king is semibarbaric. The young man is handsome. They are both stereotypes. The princess, on the other hand, is developed more deeply. We know she loves the prince. We know she has inherited some of her father's semibarbaric qualities. We know she is jealous of the bride to be, if chosen.We do not, however, know which door she has chosen for her lover. Conflict – A person v. person co nflict exists between the king and his daughter and the king and the young man. An individual v. society conflict exists between the two young lovers and the rules of the kingdom. The central conflict in the story is an internal conflict within the princess as she struggles between watching her lover in the arms of another or watching her lover get devoured by a tiger. Resolution – The story has no resolution. It is up to the reader to determine whether or not the young man lives or dies.Theme – Stockton's short story comments on the confusing nature of love and the subjective notion of civilization and barbarity. There is also an element of Determinism vs. Free Will and whether or not, if left to their own desires, humans make the right decision. Suspense – Suspense is created through the use of foreshadowing, dangerous action, and pacing. Stockton foreshadows the coming unhappiness of the princess (although he doesn't provide a definitive answer to the specifi c choice that causes that unhappiness). The dangerous action is provided by the tiger.The ultimate creation of suspense is done by the story's pacing. It is so well done, in fact, I still don't know what the young man chose. Irony – The ironic structure of the story–it has no end, for example–highlights the irony present in the story: (1) the princess and not the criminal is the story's true loser; (2) the king, despite the outward appearance of sophistication is, at heart, a cruel semibarbarian; (3) the princess deliberates for days on whether or not to save her lover Point of View – Do not confuse the author with the narrator.The narrator is third person omniscient and knows the fate of the young man. The author does not. The Gift of Magi PLOT – Linear a) Introduction – The story starts with a description of the place where the major characters live, and then the major female character is introduced. Rising Action One dollar and eighty-sev en cents. And the next day would be Christmas. Climax Jim stepped inside the door, as immovable as a setter at the scent of quail. His eyes were fixed upon Della, and there was an expression in them that she could not read, and it terrified her.It was not anger, nor surprise, nor disapproval, nor horror, nor any of the sentiments that she had been prepared for. He simply stared at her fixedly with that peculiar expression on his face. Falling Action Instead of obeying, Jim tumbled down on the couch and put his hands under the back of his head and smiled. Denouement ;quot;Dell,;quot; said he, ;quot;let's put our Christmas presents away and keep 'em a while. They're too nice to use just at present. I sold the watch to get the money to buy Your combs.And now suppose you put the chops on. " CHARACTERS: The two main characters are both protagonists (There is no antagonist): Mr. and Mrs. James and Delia Dillingham Young. – DEVELOPING/ Round Minor character: Madame Sofronie â⠂¬â€œ STATIC/ Flat SETTING a. ) Place The action takes place in New York City in a very modest apartment and in a hair shop down the street from the apartment. Although Porter does not mention New York by name, he does refer to Coney Island, the city's most famous amusement park, located in the borough of Brooklyn. ime – At Christmas Eve, a long time ago c) weather condition- winter time social conditions – The couple was financially- struggling e) mood or atmosphere – †¦ Life is made up of sobs, sniffles, and smiles†¦ POINT OF VIEW Stream of Consciousness – The story is told so that the reader feels as if they are inside the head of one character and knows all their thoughts and reactions. LITERARY DEVICES Foreshadowing Now, there were two possessions of the James Dillingham Youngs in which they both took a mighty pride. One was Jim's gold watch that had been his father's and his grandfather's.The other was Della's hair. Symbol The magi, as you know, were wise men–wonderfully wise men-who brought gifts to the Babe in the manger. They invented the art of giving Christmas presents. Being wise, their gifts were no doubt wise ones, possibly bearing the privilege of exchange in case of duplication. THEME Love has no bounds. CONFLICT -The couple’s financial struggle Person vs. Circumstances (classical) – The couple struggles against poverty Person vs. Himself/Herself (psychological) –Delia struggles with the painful decision of letting go her only prized possession