HITECH Legislation

HITECH Legislation

Organizations must use health information technology in a meaningful way in order to receive incentives. The US department of health and human services has a structure of factors that must be met before qualifying to receive EHR incentives.

The primary goals of HITECH legislation are to advance American patient care provision through an exceptional investment in health information technology (HIT). The legislation also aims to provide backing and technical support to providers of HIT. It seeks to enable coordination and establish connectivity to the public health community in case of healthcare emergencies. The legislation also aims to make sure of adoption of health information technology in different organizations to reduce the cost of healthcare, improve care coordination, and reduce healthcare disparities.

The meaningful use criteria of the legislation has both negative and positive impacts on the adoption of health information technology. The legislation has had positive effects in my organization. Firstly, the legislation has led to improvements in patients’ privacy. The legislation protects the disclosure of health information of patients. Nursing practitioners are aware of the need to maintain patients’ privacy in my organization. Secondly, the legislation has improved public participation on healthcare provision. The public has been able to participate through the development of my organization’s HIT infrastructure. Thirdly, my organization has received incentives because of significant use of HIT. This has had a significant boost on the quality of health care of my organization.

There have been negative impacts in my organization because of the legislation. The legislation has diluted the compliance of HIPAA privacy and security rules (Kempfert, 2011). This has translated to reduction in portability healthcare insurance in my company. The overall effect has been the fact that; the legislation has increased the expenditure of my organization, mainly through the development of its HIT infrastructure to conform with health information technology (Murphy, 2010a). In addition, this has led to my organization laying more emphasis on meeting the criteria for HIT incentives rather than improving the quality of healthcare (McGonigle, 2012). This has led to the compromise of the quality of patient care in my organization.

The incentives that encourage the use of EHR include monetary benefits to providers such as funding the organization and reimbursement to health practitioners. These incentives get accrued to organizations that meet the criteria for meaningful use in order to encourage them to continue the use of health information technology. Meaningful use refers to providers that use certified EHR technology in an effective manner (Tomes, 2011). The providers must also use electronic exchange of health information, reports clinical health measures and improve quality, safety, efficiency, and reduce health disparities. In addition, they must improve care coordination, population and public health and ensure adequate privacy and security protections for personal health information (Classen et al, 2011). Meaningful use is measurable through self-attestation and electronic reporting. The incentives and meaningful use concept have an important influence on the worth of healthcare. Incentives have increased adoption of healthcare information technology in most organizations resulting to improvement in the quality of healthcare. In addition, it has improved privacy and efficiency in health recording. This has added to the development in the value of healthcare. However, some organizations work to meet the criteria for receiving incentives at the expense of the quality of healthcare (Pipersburgh, 2011).

I have identified Classen’s article on “Finding meaning in meaningful use”. The article recounts that health information technology is developing at a slow pace. It postulates that the legislation will have a significant improvement on the adoption of HIT (Murphy, 2010b). The article articulates that the intent of meaningful use is to provide incentives to providers of HIT and improve the quality, safety and efficiency in healthcare delivery (Brown, 2010). This article outlines that achieving improved healthcare will be difficult to realize than initially thought.

Information technology can meet the requirements of meaningful use through the use of several structures. The structures can range from systems for computerized physician order entry to decision support. The article outlines that meaningful use criteria require assessment of different quality measures to report whether information technology meets meaningful use. Measuring different goals of information technology can demonstrate whether it can realize meaningful use. In addition, the Certification Commission for health information technology should undertake a rigorous certification of health information technology to ensure the realization of meaningful use (Arlotto, 2010). There should be health tools to evaluate HIT and ensure it can meet the requirements of meaningful use.

In conclusion, the need to improve efficiency and quality in healthcare has increased investments in health information technology. The perception is that adoption of health information technology can reduce costs and improve the quality of patient care. HITECH legislation seeks to empower and ensure the adoption of health information technology through the provision of incentives to providers.

References

Arlotto, P. (2010). 7 Strategies for improving HITECH readiness. (Healthcare Financial Management), 64(11), 90–96.

Brown, B. (2010). The ultimate directions for meaningful use of EHRs. Journal of Health Care Compliance, 12(5), 49–50.

Classen, D. C. (2011). Discovering meaning in meaningful use. New England Journal of Medicine, 365(9), 855–858.

Kempfert, A. E. (2011). Patient care development in the United States: HITECH Act and HIPAA privacy policy, security measures, and enforcement Issues. FDCC Quarterly, 61(3), 240– 273.

McGonigle, D., and Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge (Laureate Education, Inc., custom ed.). Burlington, MA: Jones and Bartlett Learning.

Murphy, J. (2010a). Impact of health IT on care quality: How are we doing 10 years after IOM’s Crossing the Quality Chasm Report? Journal of Healthcare Information Management, 24(4), 7–9. Retrieved from http://www.himss.org/content/files/jhim/24- 4/3_MURPHY.pdf

Murphy, J. (2010b). Nursing informatics. The journey to meaningful use of electronic health records. Nursing Economics, 28(4), 283–286.

Pipersburgh, J. (2011). The struggle to escalate the implementation of EHR technology in hospitals by physicians in the United States through the use of the HITECH Act background and the Medicare Incentive Program. Journal of Health Care Finance, 38(2), 54–78.

Tomes, J. P. (2010). Preventing the trap in the HITECH Act’s benefit timeframe for implementing the EHR. Journal of Health C

Christian Ethics Teachings in Relation to Homosexuality

Christian Ethics Teachings in Relation to Homosexuality

Marriage signifies Christ’s union with people. This apparently is one of the definitions of marriage in a Christian context. Christian marriage is holy and represents God’s promise to reunite with his people. From this definition, marriage should provide people with an opportunity to praise and serve God through their union to be one. Other people in the secular world consider marriage as an amalgamation between two people with a view of enjoying life pleasures together. This completely contradicts the Christian marriage described in the Bible. From a Christian perspective of marriage, it dates back to the times of Genesis. This is the beginning of the world according to the Bible. At this time, God decided to give Adam a helper to help him continue serving God in the Garden of Eden. This clearly shows God’s purpose for marriage. The purpose was to bring two people, male and female, together for them to work together in order to glorify God. According to Rogers, this in turn will bring Christian marriages the joy and blessing God has purposed for Christians.[1] Thus, a Christian marriage is against same sex marriage in the form of homosexuality.

The helper that God created for Adam was Eve, a woman; this represents the union God intended for people to have in a Christian context. People, including some Christians have a different opinion of marriage and the helper God intended to give a man. People in the modern world accept same sex marriages as a part of marriage. Marriage, according to the Christian definition, is God ordained, and as such ought to be holy and conducted in a holy way. For marriage to pass the test of holiness, couples should ensure utmost faithfulness in their union and support each other at all times.[2] However, this is not the case in modern secular marriages. Couples do not offer each other the support required in their union. Many couples in modern marriages fail to uphold honesty and faithfulness to each other. This is a reason for high divorce among couples in a modern world. This goes against the definition of a Christian marriage.

The Biblical stance on marriage is that Christian marriage is for the purpose of procreation and raising families. This is against what many people perceive marriage to be. All over the world, there is the general thought that marriage is for sexual pleasure and personal fulfilment. Many people today get into marriage with the idea they will be happy once married. Modern sexual approaches cause the liberal views and have greatly contributed to this thought about marriages. This is also the reason many people are cohabiting in the modern world. To them marriage serves just one sole purpose, sexual pleasure and satisfaction. When God created Eve, he told both Adam and Eve to venture out into the world, multiply, and fill the earth. Many have misinterpreted this statement, and as a result, people engage in sexual relations outside marriage. God intended marriage to serve as an institution that will raise children in the way that He pleases. To others marriage solely serves the purpose of companionship and as a result, they choose to live together, but have no children. This contradicts the Christian definition of marriage.[3]

Christian marriage represents God’s eternal love to human kind. God’s love surpasses all and is permanent. This is what Christian marriage is all about, permanence. From a Christian perspective, marriage should be a permanent union between a man and a woman. This relationship should stand against until the end of time. Other people do not uphold this definition of marriage and have created a room for separation and divorce. [4] Christian marriage does not make provisions for this; the only factor that should separate couples in a Christian marriage is death. In the secular world, marriage is a union between two people who are of the same gender or the opposite gender that has no guarantee of lasting forever. This provides the freedom to change partners through divorce or separation. Many families are breaking up because a large number of people are adopting this definition of marriage that contradicts Christian marriage.

The Holy Bible talks about sexuality and homosexuality; there are verses mainly in Genesis, Leviticus, Romans and Samuel that speak about this sensitive issue.[5] The Bible though not directly opposes same gender sexual relationship in the book of Genesis. Genesis speaks of God creating a woman from a man’s rib. When Adam wakes up from his sleep, he finds Eve, the woman who God has created for him. He appreciates her. Later God tells them to multiply and fill the earth. This part of the Bible implies that God is only happy with relationship between a man and a woman since this is the form of relationship capable to fulfil his command of filling the earth. Homosexual relationships do not support God’s will to reproduce. This is one of the reasons for the Bible rejecting such form of relationships. Eve was a woman, which is a suggestion in the Bible that God intended the all-sexual relationships ought to be only between a man and a woman. Other animals uphold this, but humans argue against it. Liberals argue that God in Genesis said He created a man in His personal image and as such, the man has a right to decide which form of relationship to uphold. They argue that since a man takes God’s form, a human being has freedom of choice to choose the form of sexual relationship that best pleases him or her.

Still in the book of Genesis, many Bible conservatives argue that God created a woman for Adam because he intended sexual relationships to be between the individuals who complemented each other both anatomically and emotionally. Same sex marriages do not allow for anatomical compliment since the parties involved are of the same gender.[6] Since going against the Bible contributes to sin, homosexuality is a sin according to the Bible. The books of Romans and Corinthians lump homosexuality together with other sexual sins such as adultery. This makes it a sinful act before God. God did not intend people to show their emotions and passion for each other in any other context, especially outside a marriage between a man and a woman. Liberal Christians and other people, who believe that the sole determiner of wrong and good is God, agree that homosexuality and any other sexual activity outside marriage is wrong and contrary to the Bible.

The Bible’s stance on sexual activity is that all forms of sexual activity are for marriage. Several verses in the Bible support this, with some especially in Romans and Corinthians condemning all forms of sexual activities and terming them as sin, which will deny entry into the kingdom of God to such people. The Bible describes sex as a holy mystery, which God has reserved to married couples. The Bible clearly spells out that a man and a woman shall leave their parents and unite as one to form their family. Those with a conservative view towards the Bible argue that in Genesis the Bible gives the right to reproduce to these who choose to marry. This is not direct, but since the earlier verses suggest that God created a man and a woman to procreate and fill the earth, then it is possible to state that the Bible objects any form of sexual activity outside marriage and also against homosexuality relationships. [7] The Bible’s hint at opposition to homosexual activity whether inside or outside marriage is evident. This is can be exhumed in Genesis where after two angels visited Lot, the Sodomites found the angels from God appealing, and God cursed Sodom and Gomorrah for their sexual impurity. If the Bible was to support homosexual activities, then, the writer of the verse would not have used the terms a man and a woman explicitly. Those with liberal views suggest otherwise since they argue that the Bible is only against sexual activity outside marriage, but does not specify that homosexual activities among married gay people are wrong. They believe it would be erroneous for God to punish homosexuals who engage in sexual activities while in marriage, and continue to serve God in all other aspects of their relationships. They further argue that it is wrong to isolate homosexual activities since the Bible does not only mention homosexual activities, but also mentions other sins. In summary, the Bible does not support any form of sexual activity outside marriage.

Christian views on homosexuality vary with some groups supporting homosexuality and conservative Christians are greatly opposed to it. The conservative Christians believe homosexuals disapprove God’s decision to create Eve, a woman, for Adam instead of another Adam. They support their arguments with verses mostly in Genesis that show the origin of human kind. Disapproving God makes homosexuality a wrong and sinful practice that according to conservative Christians ought not to happen. On the other hand, there are liberal Christians who question the motive behind marriage whether a gay marriage or a straight couple marriage. This group argues that it is not right to disapprove all gay marriages since some of these relationships have true and unending love between the partners. This is one of the pillars of true Christianity to love each other eternally as Christ loves humans. [8] They further argue that some marriages between people of the opposite sex fail to uphold the values of honesty and faithfulness, which are important for every Christian marriage. Despite their differences, both these Christian groups agree that the Bible condemns all sexual activities outside marriage. According to Christianity, Christian ethics teaches that full sexual relationships ought to take place within marriage. This means that whether a relationship is between two people of the similar gender or not, the parties involved should reserve any form of sexual activity until they get married.

Liberal Christians and other liberal minds believe that marriage and all other aspects of life should change with the changing society.[9] For this reason, they support gay marriages since current times provide that each and every person has the right and freedom to make their own decisions. Some liberals believe that homosexuals have genes that make them gay. Liberal Christians also believe that it is best to interpret the Bible with the existing society. They believe God’s word should adjust with the changing times. They also hold the idea that those Bible writers failed to recognise homosexual relationships and as a result, some only wrote against these relationships. On the other hand, conservatives, both Christians and none Christians believe that it is against the rules of nature and God to have any other form of relationship besides normal relationships between a man and a woman. Despite all the variations in opinions, all these groups agree that uncontrolled sexual behaviour especially outside marriages can be disastrous and should not exist in the society. While Christians uphold that any form of sexual behaviour outside marriage is wrong, other groups may fail to agree, but either way they either support or condemn homosexuality.

As much as some Christians oppose homosexual relationships, a large number still agree it is unfair to discriminate against these groups. Even other non-religious groups opposed to homosexuality still agree that it wrong to discriminate against gays since they are humans like others. However, conservative people feel that gays can change this form of behaviour.[10] Contrary to their views, liberal minds believe that as a human being it is impossible to control emotions and the person one chooses to love. They argue that as much as almost all the relationships in the Bible are between men and women, Jesus told his disciples to love their neighbours in the same measure as they love themselves. They argue that if Jesus were in the modern society, He would be happy for the committed gay relationships, as opposed to straight sex oriented couples who have built their relationships on deceit and for all the wrong reasons. In simple terms, Christians and other individuals around the world form their opinions about homosexuality depending on their faith and beliefs. They argue differently, but in some opinions, they agree. Many people believe that sexual activities are reserved for married couples.

The Roman Catholic stance on homosexuality is that it is not right and orderly in the sense that it is evil. Conservative Roman Catholics argue that homosexuality fails to acknowledge the purpose of sexual activity as God intended it. Homosexuality is sinful and immoral according to Roman Catholic beliefs. This is because homosexual relationships fail to meet both the uniting and procreation roles of a marriage according to the Bible. The church does not limit these teachings on homosexuality only, but also on other sinful sexual activities such as sodomy and adultery. The Roman Catholics state that homosexuality is a conservative approach and the church believes that the only correct and right relationships before the eyes of God are male-female relationships. The Church of England has held that homosexual marriages are wrong and sinful. Its sentiments resemble those of the Roman Catholics.[11]

Baptist church, the Methodist and the Anglican churches are on the verge of breaking because of different opinions regarding same sex marriages. The Methodist church of Britain is yet to take a definitive stance on homosexuality. This church does not denounce discrimination against homosexuals, and affirms homosexuals’ participation in the ministry. However, this church no longer blesses same-sex marriages. Meanwhile, the United States Methodist church does not support inclusion of homosexuals in church activities such as sacraments. However, this church clearly states that homosexuality is against its teachings, and as a result it prohibits homosexuals to be ordained as church ministers.[12]

Another church divided on the issue of homosexuality is the Anglican Church. This church, being a protestant church, has a good number of liberal minds. They believe since God created everything, He also created homosexuals the way they are; they believe that all those verses and Biblical quotes that condemn homosexuality are archaic and biased. Their stance on the issue of homosexuality is that there is no way God can create a homosexual then accuse His own creation of sinning. They agree that the Bible condemns sinful acts among homosexual activities and others such as adultery. Liberals argument is that no human has the capability to know what is right and wrong in the Bible, and this is not a justified means to discriminate against homosexuals or to terms them as sinners.[13]

On the other hand, extreme Anglican conservatives argue that the practice of homosexuality is wrong according to the Bible. They argue that homosexuals make a personal choice to be who they are since humans have the ability to control their desires. They believe such relationships are because of dysfunctional relationships and a corrupt world. Their stance on homosexuals is that they are perverts and are skilled to use politics and media to move their immoral activities to the limelight. To them homosexuality is the worst form of a sexual sin. In the Bible, they clearly state it is God’s word, which is unquestionable and since the Bible opposes homosexuality they strongly stand by this.[14]

Christian teachings and ethics do not support sexual activities outside marriage. This is the stance of many churches and other religious groups in society. Issues of homosexuality create a large division among Christians, with some supporting and other opposing this form of relationships. As a theoretical reflection, it is essential to assess the truth in these teachings. This is using the theological principle of “not yet”, which states that Christ exhibited his love for humanity sacrificing Himself for people’s sin. In a similar manner, people should show their love through sacrificing sexual pleasures and activities outside marriage until they get married. This way couples will remain faithful to Christian teachings, which besides stating it is unethical to have sexual activities before marriage urge people to have unending love for each other in relationships. [15]This is what Christ emphasised on; true love that surpasses all kinds of love. Corrupt worldly ideas continue to carry Christians away from their stance on sexual activities before marriage.

My view on sexual activities before marriage is that no sexual activity should occur prior to marriage. The Bible does not support such activities through the Biblical stories told in it. As a strong Christian faithful, my views on sexual activities outside marriage are that they are sinful acts, which displease God. On the issue of homosexuality, I believe that no human ought to judge another’s activities and choices. I am of the view that God forgives all sins; no sin is greater than others. This means that even homosexuality is a sin that God can forgive, and all humans are sinners of different sins. Therefore, discriminating against them is not justifiable. As humans, we should agree and leave conflicting issues that only God can give solution to, the way they are. However, as much as it is not right to discriminate against homosexuals it is essential to realise that it is a sin from a Biblical perspective because this practice goes against the rules of nature and does not meet the goals of marriage as God intended it. God purposed marriage to be a holy institution in which two people of different gender would unite. These two people ought to help one another to serve God in their different capacities. Another reason why God created marriage is to procreate and fill the earth. Critics argue this is possible even in homosexual families, but it is not possible biologically. Therefore, it does not serve as a strong justification for homosexuality in my view.

In conclusion, God created sex and reserved it for married people. This makes any form of sexual activity outside marriage a sinful act, which Christians should refrain from to serve God in their marriages and relationships as it should be. The issue of gay marriages is a controversial issue that has resulted in a great unending debate, both in churches and the entire universe. The Bible, which is a Christians` guide, opposes this, and some Christians follow suit. The liberal ones argue one should interpret the Bible according to the present time. The debate is not ending any time soon, but if the Bible is right, then homosexuality is a sin.

Bibliography

Ash Christopher, Marriage and Sex in the Service of God, (IVP, 2003).

Boswell James, Christianity, Social Tolerance and Homosexuality, (Chicago University Press, 1980).

Bradshaw Timothy, (ed.), Which is the Way Forward? Christian Voices on Homosexuality and the Church, (Hodder & Stoughton, 1997).

Coleman Peter, (ed. Michael Langford), ‘Christian Attitudes to Marriage: From Ancient Times to the Third Millennium’, SCM, (2004) .

Doe Michael,’ Seeking the Truth in Love: the Church and Homosexuality’, DLT, (2000).

Dormor Duncan and Morris Jeremy (Eds.), An Acceptable Sacrifice? Homosexuality and the Church, (SPCK, 2007).

John Jeffrey, ‘Permanent, Faithful, and Stable: Christian Same-Sex Partnerships’, Affirming Catholicism, (1993).

McCarthy David Matzo, ‘Becoming One Flesh: Marriage, Remarriage and Sex’, in The Blackwell Companion to Christian Ethics, (Blackwell, 2004), chapter 21.

Paul II John. ‘On the Original Unity of Man and Woman’, 9 November 1979, <http://www. Vatican.va/holy_father/john_paul_ii/audiences/catechesis_genesis/documents/hf_jii_aud _19791107_enht>

Rogers Eugene F., ed., Theology and Sexuality, (Blackwell, 2002) .

[1]Eugene F. Rogers, ed., Theology and Sexuality, (Blackwell, 2002)

[2][2]David Matzko McCarthy, ‘Becoming One Flesh: Marriage, Remarriage and Sex’, in The Blackwell Companion to Christian Ethics, (Blackwell, 2004), chapter 21

[3]John Paul II. ‘On the Original Unity of Man and Woman’, 9, November 1979, <http://www.vatican.va/holy_father/john_paul_ii/audiences/catechesis_genesis/documents/hf_jii_aud_19791107_en.html>

[4]Jeffrey John, ‘Permanent, Faithful, and Stable: Christian Same-Sex Partnerships’, Affirming Catholicism, (1993)

[5]Timothy Bradshaw (ed.), The Way Forward? Christian Voices on Homosexuality and the Church, (Hodder & Stoughton, 1997)

[6]Timothy Bradshaw (ed.), The Way Forward? Christian Voices on Homosexuality and the Church, (Hodder & Stoughton, 1997)

[7]Peter Coleman, (ed. Michael Langford), ‘Christian Attitudes to Marriage: From Ancient Times to the Third Millennium’, SCM, (2004)

[8]Michael Doe,’ Seeking the Truth in Love: the Church and Homosexuality’, DLT, (2000)

[9]James Boswell, Christianity, Social Tolerance and Homosexuality, (Chicago University Press, 1980)

[10]Peter Coleman, (2004)

[11]Timothy Bradshaw (ed.), The Way Forward? Christian Voices on Homosexuality and the Church, (Hodder & Stoughton, 1997)

[12]Ibid

[13]Duncan Dormor and Jeremy Morris (eds.), An Acceptable Sacrifice? Homosexuality and the Church, (SPCK, 2007)

[14]Ibid

[15]David Matzo McCarthy, ‘Becoming One Flesh: Marriage, Remarriage and Sex’, in The Blackwell Companion to Christian Ethics, (Blackwell, 2004), chapter 21

Tuberculosis

Tuberculosis is both a dangerous and an infectious disease. A bacterium known as mycobacterium tuberculosis causes the illness. The disease attacks lungs but can also affect other organs of the body. The disease has become rare in developed countries but remains a significant epidemic in the middle and low-income countries. An estimated one and a half million people perish from the disease annually globally (Varaine & Rich, 2013). This makes it the highest killer disease in adults second from another infectious disease AIDS, with a majority of the deaths in low-income countries. Treatment remains a constant constraint to patients and a heavy burden for health care systems all across the world. With Tuberculosis being a significant killer disease, it is essential to study the causes, risks, treatment, diagnosis and developments, the health care system has made in an attempt to avert the condition.

Cause of Tuberculosis

Mycobacterium causes the disease, when allowed to grow within the body system. It takes long for the disease to develop after infection because the bacteria multiply slowly (Varaine & Rich, 2013). This bacterium mostly affects the lungs and soon spreads to other body organs. Its effect on the lungs causes pulmonary tuberculosis. The bacteria, which spread to other body organs, are the cause of extra pulmonary tuberculosis (Centres for Disease Control and Prevention, 2000).

Mycobacterium Tuberculosis

Mycobacterium a small rod shaped bacteria about 2 to 4 um in length causes Tuberculosis and other diseases in humans (Varaine & Rich, 2013). Mycobacterium is ‘acid-fast organism’; a name health practitioner derived from the stains scientist and researchers use in the evaluation of tissue specimens. These bacteria are strictly aerobic and thrive in environments with an oxygen supply (Varaine & Rich, 2013). Bacteria may remain latent for years in the secondary stage of infection, sometimes even for months or years. Active tuberculosis may occur weeks or even years after the primary infection (Reichman and Bhavaraju, 2008). The slow rate of occurrence is because of the slow multiplication of mycobacterium. Pulmonary Tuberculosis affects the lungs; it is common in patients with HIV/AIDS because their antibodies are weak to resist disease. This TB spreads to other body organs during a silent phase of the ailment, often in the early stages of infection. Active TB can occur in other the body organs such as lymph nodes, vertebrae, kidney, genital organs and abdominal cavity (Zahrt, 2000).

It is possible to grow tuberculosis bacteria in laboratories. Medical researchers grow the bacteria in laboratories to study it and form analyse the resistant to drugs of the bacteria. This bacterium grows faster in a blood agar than an egg based medium. For this reason, many researchers who grow the bacteria in laboratories use the blood agar (Eichbaum, & Rubin, 2002).

Transmission

Tuberculosis is an airborne disease, which pass from one person to the other through respiration. The source of infection is a person with pulmonary or laryngeal tuberculosis. These are the only types of Tuberculosis that spread. Extra pulmonary tuberculosis is not a transmittable disease. The reason pulmonary tuberculosis and laryngeal tuberculosis are transmittable is because they are in the lungs and larynx respectively. As a result, bacteria encounter air exhaled during coughing, conversations, sneezing or even normal breathing. During these activities, an infected person produces tiny infectious droplets of bacteria. These droplet nuclei are about one to five microns in diameter. The droplets can remain suspended in the air for several hours, depending on the environment. Transmission occurs when one inhales these droplets. Other causes are rare, such as Mycobacterium Bovi transmitted through cowmilk. Children are less likely to transmit tuberculosis because of the weaker sputum in their coughs and low bacillary load (American Thoracic Society, 1999).

People at Risk

HIV/AIDS patients and children are at a higher risk of acquiring Tuberculosis because their body immune systems are weak to handle the bacteria. HIV/AIDS weakens the body immune system making people vulnerable to this disease. Another vulnerable group to the disease is the women. Worldwide, women bear a heavy burden of poverty, poor health and disease. Females are at a high risk of HIV/AIDS infection because, in most instances their men are not faithful, and have multiple relationships. As a result, young women aged between fifteen years to twenty-four years of age with tuberculosis outnumber young males. Poverty is the main cause of high tuberculosis prevalence among women. (Centres for Disease Control and Prevention, 2000).

Signs and Symptoms

Some people do not show any signs for active tuberculosis. Others develop coughs with blood tinged mucous, fever night and appetite loss. These symptoms arise due to the bacteria using up oxygen in the body. This leads to coughs and shortness of breath. In some people, there are no symptoms because the bacteria have a slow progression process. This lengthens the latency stage of the bacteria. In the latent stage, the bacterium is inactive and does not show any signs (Handa, Mundi & Mohan, 2012).

Diagnosis

There are several diagnostic methods for tuberculosis among them sputum smear microscopy, and staining method. Sputum smear method allows rapid and reliable identification of patients with pulmonary tuberculosis if the bacilli sputum concentration exceeds five thousand bacilli per millilitre (American thoracic Society, 2000). Reliability of the sputum depends on the quality of sputum. Taking sputum in the morning yields more reliable results than at any other time because at night one rarely spits sputum since they are asleep. This makes the sputum produced in the morning highly concentrated with bacilli. The reason why health practitioners use sputum spread method to test for pulmonary tuberculosis is that sputum passes through the trachea and is likely to contact bacilli. The staining method is another diagnostic that medical practitioners use. This method uses a technique where mycobacterium retains a primary stain after exposure to decolourising acid-alcohol. The two staining methods that nurses and other health practitioners use most of the times are carbolfulshin procedure and flouro-chrome methods (Partners in Health, 2003). The two methods work best in high load laboratories. The reason why doctors use the red-stain method is that this strategy can detect even other forms of tuberculosis besides pulmonary tuberculosis (World Health Organization, 2011).

Prevention

The first step towards preventing Tuberculosis is to identify the main cause. An individual contact is the main method of transmission of the epidemic (Maher, 1997). Majority of the people who spread this disease are undiagnosed and do not know that they are ailing. This makes it necessary for governments and health systems to create tuberculosis awareness campaigns to let people know the importance of testing for tuberculosis. This will help identify an individual with the disease and inform them on the transmission methods. Awareness programs offer insight into preventive measure one can take to safeguard him or herself from this disease.

Treatment

Treatment of tuberculosis involves taking quadruped drugs, isoniazid, rifampicin, and pyrazinamide and Ethambutol, under the supervisions and direction of a qualified medical practitioner for six months (Centres for Disease Control and Prevention, 2003). Mycobacterium tuberculosis has a thick fat coating, which makes it difficult to kill the bacteria. Recent studies have found an antibiotic that can kill the bacteria after destroying it thick cover. Pryidomycin, an antibiotic produced from the bacterium Dacylosporangium fulvum is the antibiotics, which has given many doctors and tuberculosis patients the hope of killing tuberculosis bacteria. In active bacterium, pylidomycin depletes fatty acids and mycolic acids that form the walls of the bacteria. This makes it possible for the antibiotic together with antibodies to kill the bacteria (Hartkoorn, et al., 2012).

Statistics

About ninety percent of individuals infected do not show any signs of the disease, a situation known as latent infection. If the disease is untreated about a half or third infection cases, will die from the disease while early treatment cures the disease. About ninety-five percent of the deaths are from low-income areas. This is because of lack of resources to treat the disease among this segment of society. This makes it impossible for patients to access medical treatment, which results in many deaths (Varaine & Rich, 2013).

Research and Development in Tuberculosis

The first major breakthrough in combating tuberculosis was identifying the causes and transmission methods. This led to public measures and awareness. The discovery of ways to grow the bacteria in laboratories and development of tuberculin skin test and x-ray imaging were major developments in the nineteenth and twentieth century. Recent studies have elicited how Mycobacterium tuberculosis becomes dormant when its environment becomes hostile (Takenami, et al, 2013). When the bacteria are in a dormant state, they appear to be resistant to common anti-tuberculosis medications. New drug development procedures now test potential agents against both active and inactive forms of the bacilli (Perkins & Cunningham, 2007).

Gene array studies are showing that bacterial molecules and molecular pathways can be targets of potential new drugs. Researchers are currently testing several medicines developed this way (American Academy of Paediatrics, 2012). This is centrally to what was possible in the early years where the health practitioners knew almost nothing about the condition. Treatment was not possible during that time since even the cause of the disease was a mystery to people.

Since research has unearthed more information about the bacteria, newer, faster, and more accurate tuberculosis diagnostic methods are replacing old methods. These new techniques also give clues to how the human immune system deals with infection. Unravelling the genetic sequence of the bacteria has fostered the development of gene amplification tests that can diagnose the disease and detect drug resistance. These techniques can accomplish in hours or a few days what medical practitioners used to take weeks, thus reducing the chances of a person spreading the disease before diagnoses and treatment. This development marks the milestones taken in fighting this disease. In the past, this was not possible since the old methods were slow and inaccurate, which resulted to false diagnosis. This is probably the reason as to why it was extremely difficult to treat and control the spread of tuberculosis in the past. In terms of vaccination, researchers have made remarkable developments ever since the first discovery of the first tuberculosis vaccine, Bacilli Calmettte-Guerin, which French researchers developed in 1921 (Wang, et al, 2002). Contrary to Bacilli Calmette-Guerin Vaccine, modern vaccines work in different places. It is essential to realize one of the weaknesses of Bacilli Calmette-Guerin vaccine is it did not work in all geographical areas (Andersen, et al, 2000; Shelburne, et al, 2002).

In conclusion, tuberculosis is a significant epidemic and killer disease in the world. The disease had greatly reduced to low levels in the past, but with the high prevalence of HIV/AIDS the disease has returned. Developing countries account for about ninety percent of the disease because of poverty, malnutrition, deficiency of health care services and lack of awareness on the disease. Tuberculosis has existed for thousand years; during this time, researchers have made tremendous progress in the fight against the disease.

References

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Corporate Culture is the Answer to Depersonalized, Bureaucratic Work

Is Corporate Culture and Depersonalized, Bureaucratic Work
Introduction
Corporate culture refers to the way employees do things around the company, and displays a system of shared beliefs and values that work together with individuals, organizational structures, as well as, systems to produce norms. This implies that corporate culture has a significant effect on employee behavior, perception, and work attitudes. Bureaucracy on the other hand, is comprised of written and inflexible rules, laws, and regulations together the systems of administrations that are distinguished by clear hierarchies of authority. In such instances, corporate culture represents the company’s personality, and therefore, appeals to the irrational, affective and emotional elements within the employees.

Bureaucracy
Authority and power together with the insidious preoccupation with modern trends of rationalization interested Max Weber; this prompted him to investigate the operations of modern large enterprises in terms of administrative, economic, and political realities. He described bureaucracies as organized in terms of rational principles, such as offices being ranked in hierarchical order and how they operate is characterized according to interpersonal rules (Sullivan, 2009)

Governance of the managers applies methodical allocation of areas, as well as, delimited spheres of duty. Appointment and recruitment are made using the specialized qualifications instead using the written criteria. This type of coordinating actions of a large number of individuals is increasingly becoming the dominant structural feature of the modern forms of organizations. It is through the bureaucracy that large scale planning for the modern economy and modern state has remain to survive, as well as, enabled heads of state to centralize and mobilize resources for political power that have been dispersed in a number of varieties of centers during feudal times (Basu, 2004. )

It therefore, implies that it aids mobilization of economic resource that remained initialized during the pre modern times. Bureaucratic organizations are instrumentally privileged in shaping the modern polity, technology, and the economy, and therefore, this means that bureaucratic organizations are technically advanced to other types of administrations just like machinery production is superior to handmade methods (Sullivan, 2009)

However, there are certain disadvantages of the bureaucracies systems of corporate culture, such as the presence of ambiguities in calculating results. Bureaucracies make it difficult to measure the outcome especially when dealing with personal cases. This makes bureaucratic and modern rationalized systems of law into becoming incapable of dealing with individual personal differences and particularities (Basu, 2004. )

Bureaucratization and rationalization are inescapable of modern methods of organization that have greatly enhanced the efficiency and effectiveness of organization and production, as well as, enabled unprecedented domination of humans over the nature’s world. The capitalist industrial organization according to the sphere of economic production has led to tot eh expropriation where the employee is the means of production, and therefore, the modern industrial worker contrasts with the handicraft artisan, who deals with his own tools and sets his own production and selling limits (Styhre, 2007)

Bureaucratic formal of organizational culture acts both as an expression and as agent of key modern social innovations, which are clearly manifested within the non-inclusive terms through which people are involved in an organization. The way people get involved themselves in organizations epitomizes, as well as, institutionally embeds the critical and most overlooked cultural points of reference of modernity, in which people undertake actions that are tuned towards a delimited and well specified path , however, they have to sacrifice by suspending and isolating their other social and personal considerations. This therefore, implies that organizational involvement of people qua role agents instead of qua person’s aids in unleashing formal organization from being bound to the indolence of the human body, as well as, languish the process of psychological or personal re-orientation (Styhre, 2007)

Bureaucratic organizational cultures have rendered it possible to address some of the shifting contingencies, which underlies the modern life through reassembling and reshuffling the roles and role patterns by which the system is made. This implies that the unique historical adaptive capacity of the bureaucratic systems remains. However, hidden behind the ubiquitous presence of standard and routine procedures are mistakenly exchanged for the quintessence of the bureaucratic form (Manning, 2003)

Bureaucratization is a sociological concept that emphasizes that increased rationalization is inherent in social life, and therefore, cages people into systems that are founded on teleological efficiency, control, and rational calculation. This implies that the modern society is increasingly becoming more characterized by movements in the motivation of individual worker behaviors. It is imperative to argue that social actions are becoming increasingly base on efficiency rather than the older types of social actions that were purely based on kinship or lineage, and therefore, behavior is goal driven instead of relying on tradition and values (Manning, 2003)

Corporate culture
Corporate culture comprises the behaviors and beliefs of the people within an organization, and determines how the organization’s employees, as well as, the management handle and interact with outside business deals. The organizational culture of a company organically develops over time emanating from the cumulative traits of the individuals that the organization employs. This could be reflected the employee dress code, hiring decisions, business hours, treatment of clients, client satisfaction, turnover, office setup, employee benefits, as well as, all aspects of the organizations operations (Cremer, 1993)

The main rational reason of examining corporate culture is the relationship between performance and organizational culture, and garners more interest due to the managerial implications related to control, which can easily be communicated, developed, and illustrated using vivid and clear anecdotes.

Corporate culture refers to the unique dominant patterns of shared beliefs, values, assumptions, and the particular norms that shape the path of socialization, language, symbols, and practices of the group of people that constitutes the organization. The approaches and attitudes that typify the way the employees carry out their various tasks and jobs. This therefore, means that culture id developed and transmitted by individuals either consciously or unconsciously to their subsequent generations (McDonald, 2008)

Corporate culture in the classical sense can be referred to as the way of doing things in an organization, and therefore, there are a number of elements that go in helping to determine on what and why to do certain things , and in a certain way. This implies that culture is something that exists and influences how work is done in organizations, which in turn critically affects the overall corporate success or failure, who fits and who does not, as well as, determines the entire mood of the whole organization (Cremer, 1993).

The corporate culture is quite influential during periods of organizational change, such as company mergers where there are possible cultural clashes with the partnering companies. Other notable examples are during growth or any other kind of strategic change, which will imply that the incumbent corporate culture will become inappropriate, and hence would hinder growth and progress rather that promote it (McDonald, Postle & Dawson, 2008).

In static work environments, corporate cultural issues take center stage in being responsible for absenteeism, low morale, or even hog employee turnover, and thus such instances have adverse effects on the organizational productivity. With all the elusiveness, corporate culture has a great influence on the organizational work, as well as, productivity and output. The elusiveness of corporate culture is important for developing approaches and strategies that play a key role when planning organizational change (Styhre, 2007)

One element of corporate culture is the control systems that specifies the ways in which the company is controlled, and therefore, includes control structures in quality systems, financial systems, as well as, reward systems. The control systems therefore specify the procedures and processes that require either weakest or strongest controls or whether the organization is tightly or loosely or controlled. It also specifies how the employees get rewarded or punished for the good or the poor work that they do (McDonald, 2008)

However, the performance and the corporate culture link can be elusive and ambiguous because of the lack of a clear definition of corporate culture. On the other hand corporate culture can be conceptualized in response to observable values and norms that can typically be stressed through quantitative measurement schemes, which in turn helps to examine behavior instead of phenomenological meaning(Basu, 2004)

Conclusion
The corporate culture is definitely a solution to the problems associated with depersonalized bureaucratic work, since it debilitate the negative aspects of the bureaucratic control systems. Most bureaucratic actions are characterized by insincerity, incompetency, and incoherent managerial actions, which end up creating unhappy and unhealthy work environments, which in turn consistently works to destroy the corporate value, as well as, illuminates disrespect towards the worth of the individual employee.

Bibliography
Basu, R. (2004. ). Public administration: Concepts and theorie. New Delhi, India: Sterling Publishers.

Cremer, J. (1993). Corporate culture and shared knowledge. . New York- 3, volume 35, pp. 1-386.: Industrialand Corporate Change,.

Manning, S. (2003). Bureaucracy: Theories and forms with moral implications. Chapter 8 In Ethical leadership in human services: a multi-dimensional approach . Needham Heights: MA: Allyn & Bacon.

McDonald, A. P. (2008). Barriers to retaining and using professionalknowledge in local authority social work practice with adults in the UK. British Journal of Social Work, , 38 (7), 1370-1387.

Styhre, A. (2007). The innovative bureaucracy: Bureaucracy in an age of fluidity. New York, NY: Routledge.

Sullivan, M. (2009). Social workers in community care practice: Ideologies and interactionswith older people. . British Journal of Social Work, , 39 (7), 1306-1325.