European Court of Human Rights

European Court of Human Rights Introduction The purpose of litigation at the European Court of Human Rights (ECtHR), is to examine alleged violations and ensure that States Parties comply with their obligations under the Convention, providing individual applicants with effective remedies and just satisfaction under Articles 13 and 41 of the European Convention on Human Rights (ECHR). The wider objective is to protect and embed locally the three CoE foundation stones; liberal pluralist democracy, human rights and the rule of law to effect structural and institutional change and create a common democratic and legal area throughout the whole of the continent. Yet comprised of 47 member states and 811 million citizens, the CoE inhabits a fundamentally different territorial scope to that in May 1949. Originally a social and ideological counterpart to NATO, it has undergone a central shift in its core modus operandi from an interstate process of protecting the democratic identity of Member States through the medium of human rights to its emerging front line role as an arbiter of liberal human rights through the medium of individual petition. Considerable problems that threaten to undermine what has been achieved over the fifty years during which the Convention has operated lead one to ask whether there is any point taking such cases at all. This brief essay is split in two sections. Section one analyses the tripartite problem outlined within PACE Resolution 1226 (2000); the inadequate clarity and casuistical nature of Court judgements, characterised by doctrinal uncertainty in the margin of appreciation; the systemic non-implementation of judgments and failure to employ necessary reforms that would avoid further violations, with a case study of the Russian Federation; and a critique of the insufficient rigour and failure of the Committee of Ministers (CoM) to exert enough pressure when supervising the execution of judgments. Section two, explores the central debate between individual and constitutional justice; and the potential impact Protocol 14 may have on the asphyxiating6] Court and CoM. Finally I assess the accomplishments of Strasbourg litigation before returning positively to our initial question with a passionate case for individual petition against the backdrop of a tide of human rights abuse in post-communist accession Europe; the utility of the Interlaken proposals; and preservation of the Human Rights Act 1998. Section One: Problems Theoretical Fault Lines: An Unprincipled Margin The extent to which there is any point to Strasbourg litigation is determined in the first instance by the extent to which the Court can effectively balance its role as a supranational judicial guarantor of liberal individualist human rights, within the CoE framework of upholding and deferring to the thread of pluralist democracy; an intrinsically collective ideal. For McHarg, Strasbourg jurisprudence is characterised by the absence of a conceptual framework integrating a preferable rights model with a defensible conception of the public interest. Greer agrees, highlighting unresolved normative, institutional, and adjudicative questions, and the failure of the Court to deliver a concrete body of jurisprudence and constitutional authority. The result formulaic, thin decisions and un-ordered interpretive principles, at best devaluing Convention rights and at worst denying them. This dichotomy is played out through the margin of appreciation doctrine; the latitude given to States Parties based on their better position with the facts on the ground. ECHR protections are not absolute, but relative; they are subject to exceptions permitting infringement of the fundamental right or freedom, specifically defined within paragraph two of Articles 8-11; and under Article 15 (A15) can be erased altogether to the extent strictly required by the exigencies of the situation. These express definitional restrictions remind us of Bentham; this, we see, is saying nothing: it leaves the law just as free and unfettered as it found it. Strict judicial interpretation and objectivity are critical to the defence of Convention rights in the context of these exceptions. The flexibility of the margin is for Waldock advantageous to the evolutive nature of Strasbourg Jurisprudence, and for Dr Arai-Takahashi value pluralism being the fundamental prerequisite and virtue of a liberal democratic society, a set of standardised rules would devalue regional legitimacy and richness of cultural values and traditions among member states. The CoE is clear in its aim to promote awareness and encourage the development of Europes cultural identity and diversity.That Convention rights are relative is a moot point for realist theorists, since States Parties would never have been willing to be bound by the Convention in the first place without safeguarding their democratic sovereignty. Yet McHarg notes the paradox in a legal scheme which is supposed to protect the individual against the collective, sanctioning limitations to rights on collective grounds. How far in practice does the ECtHR go towards fulfilling the supervisory function it refers to in Handyside v UK (1976)? To what extent does Osts assertion that there is never an unchallengeable margin hold true? McHarg talks of doctrinal uncertainty while Jones points out that even the Courts president has acknowledged the justification to some extent of criticism of the doctrines lack of precision and use without principled standards. Fiercer critics lambast the abdication of the Courts enforcement responsibility. Dembour questions if Convention rights are so full of contradictions that they are useless? It is intrinsic to the dichotomy between international individual rights protections and the national collective interest that the margin of appreciation occupies a middle position between subjectivity and objectivity; between a burden of proof firmly on the government on one hand and on the other of wide deference to it. In Lawless v. Ireland (1961), Waldock asserted: a Governments discharge of responsibilities is a problem of appreciating complex factors and balancing conflicting considerations of the public interest; once the Court is satisfied that the appreciation is on the margin the interest the public itself has in effective Government and maintenance of order justifies and requires a decision in favour of the legality of the Governments appreciation; Simpson saw this reflecting an implicit determination to back the authorities. Dembour and Jones respective assessments of further A15 derogations demonstrate consistently deferential applications of the margin, and reluctance to objectively scrutinise the existence of an emergency or of the measures implemented to tackle it. In Greece v. United Kingdom (1958), the Commission argued that the assessment whether or not a public danger threatening the life of the nation existed is a question of appreciation; determining the validity of the repressive measures employed, the UK government enjoyed a certain discretion. Such a position is clearly evident in Ireland v. United Kingdom (1978), confirmed in Brannigan v. McBride (1993), both concerning A15 derogations of Article 5 with regard to the detention of suspects in Ireland. Several problems arise from the rationale employed in these cases. Dembour draws our attention to the absence of a factually and theoretically strict analysis impossible to justify in human rights terms. Indeed, the inevitability of a wide margin in the context of A15 derogations, led Judge Martens to assert that there is no justification for leaving a wide margin because the Court, being the last resort protector, is called upon to strictly scrutinise every derogation. Jones contends a state of emergency objectively determinable if a national government has evidence of such a situation, he asks why this is not capable of assessment by an international Court? Implementation: A pessimistic view is well founded Strasbourg jurisprudence has demonstrated the capability of the Court to robustly uphold Convention rights from major shows of arbitrariness, ensuring a degree of justice for applicants and families, international attention, accountability in relation to serious violations, and domestic legislative change. Notwithstanding the significance of such supranational decisions, analysis of the pending caseload (some 116,800 cases in October 2009), reveals a Court facing unsustainable pressure from repetitive cases concerned with structural problems in civil, criminal and administrative proceedings; serious pervasive human rights abuses; and unacceptable delays in the implementation of judgements. Implementation remains the Achilles heel of the Convention system, A brief case study of Russia underscores the gravity of the situation. It is the irony of history that the Russian Federation now occupies a key position in the very organisation established to provide European unity and security in the face of Soviet communism. Comprising 27.3% (31,850) of all pending applications at the ECtHR, the Medvedev Government faces protracted challenges in its attempts to develop civil and economic freedoms ending the legal nihilism that is seriously hindering modern development. I write following the death in Butyrka prison of Sergei Magnitsky, an anti-corruption lawyer acting for HSBC / Hermitage Capital in the $230m tax fraud case. This case and the ongoing second Khordokovsky trial are emblematic of structural defects in the Russian criminal justice system and procuratura that have lead to the accusation and incarceration of many innocent persons. Other important cases demonstrate the gravity of the situation, including Gusinskiy v Russia, Ilascu and Others v Moldova and Russia, the first six Chechen cases, Shamayev and 12 others v Russia and Georgia and Aleksanyan v Russia. Leutheusser-Schnarrenbergers recent PACE report on politically motivated abuses of the criminal justice system is a powerful indictment of the failure of the Russian Federation to entrench a meaningful institutional framework that engages with the rule of law. The report highlights a multi-layered problematic of political and hierarchical vectors of pressure on judges to secure convictions; retrogressive legislative proposals that call into questions Putins implementation of jury trial; the endemic failure to safeguard defence lawyers from coercion and realise a truly independent objective procedure for their selection and quality; serious investigative flaws; and unremitting legal nihilism. The systemic pervasive abuse of human rights in Chechnya represents perhaps the most serious Convention violations. It is here that PACE and the CoM face their most urgent challenges. Bowring draws our attention to the recent memorandum on the North Caucasus, exposing violations by security forces, including enforced disappearances, torture, extrajudicial executions; and impunity for these violations of international law; while Leach candidly outlines the scope and extent of the crisis; the first Chechen cases demonstrate the real limitations of the individual rights mechanism of the European Court as a forum for resolving wide scale, systemic and serious human rights violations. In his recent visit to Birkbeck College, Leach vividly underscored the paradoxical and lamentable and legally unsatisfactory problem of non-disclosure (ND) of domestic case files, in spite of repeated requests made by the Court. 33 of the 37 Chechen judgments have been characterised by this problem, notably Basayeva and Others v. Russia and Bitayeva and X v. Russia and Isayeva, Yusopova and Bazayeva v. Russia. The Court in Bazorkina v. Russia pointed out that documents of the criminal investigation are fundamental to the establishment of the facts and their absence may prejudice the Courts proper examination of the compliant both at the admissibility and merits stage. Chechnya aside, Leach identifies a further threefold problem of implementation vis-Ã  -vis Russia, confirmed in Pourgourides 2008 CLAHR Report; deficient judicial review over pre-trial detention, resulting in excessive periods of detention and overcrowding; the Nadzor procedure supervisory review of final judicial dec isions; and the urgent complex problem of the non-enforcement of domestic judicial decisions against the state In the context of these problems, can there be any hope for optimism? Bowring draws our attention to the often ignored historical context which has characterised Russia as part of a long and complex relationship with human rights and with the rule of law and judicial independence, which are its essential underpinning. It is in this context he argues that the ECHR, rather than an alien implantis to a large extent a restoration of the reforms of the 1860s. Ghorkova contends current legal reforms and the creation of the rule of law and a civil society with the appropriate structures and mechanisms to protect human rights and fundamental freedoms as well as the participation in the activities of the Council of Europe, are wholly in line with Russian Interests. Behind Russias posturing is, according to Bowring a serious engagement with international law its commitment in terms of diplomatic and financial resources is substantial; and compliance with its obligations indeed, in 2007 the ECtHR heard 192 complaints against Russia. Russia won just 6 and paid in full the orders for compensation in every case. In addition, in a wider sense, Leach points out the pre-eminent position of the CoE vis-Ã  -vis Russia in view of the inability of the United Nations effectively to sanction Russia over human rights abuses, and as a result of Russian suspicion about the motives and aims of the OSCE. Entrenching the rule of law in Russia will be a slow process. However, the mechanisms for its success are at least in legislative terms visible. It is my contention that through the work of the CoE and ECtHR, the Russian Federation will make a true engagement with human rights. As we shall explore below, the right of individual petition is an essential part of this process. It is easy to dismiss the Court as having failed in its mission when confronted by the ongoing abuses of rights in Russia. Yet this depends on how one defines success. From Systemic Individual Justice to an Abstract Constitutional identity The critical mass of applications lodged coupled with systemic non implementation of Court judgements has led Wildhaber to a paradoxical observation; that the quantum leap in recognising the individual as a subject of international law, has reduced the capability of the ECtHR to ensure the safeguarding of the individual from violations of Convention rights. That the Courts well noted asphyxiation is intrinsically related to the right of individual recourse is clear. De Vries April 2009 CLAHR Report lays bare the unsustainable increase in applications, principally in the wake of post-communist accession, underscoring the urgent need to tackle obviously inadmissible cases; repetitive cases that concern established systemic defects; and to concentrate on the most important cases. The inferences drawn from these stark figures have been decisive shaping proposals to ameliorate the crisis; but moreover reveal the wider battle for the soul of the ECHR borne out of competing understandings of the Courts function. The crippling application rate is for Greer emblematic of the intrinsic failure of the CoE structure to systematically deliver individual justice; intrinsic since individual recourse is a flawed paradigm. Foremost, the Convention system was, according to Greer, simply not designed as a conduit for the fulfilment of individual human rights through the medium of individual petition, but rather the protection of democratic identity through the medium of human rights. Its contemporary utility is thus encouraging European public organisational, legal and ideological parity though articulation of an abstract constitutional model member states should then apply. Greer goes on to cast doubt over the possibility of the ability of the Convention system to deliver systematic justice to every applicant, concluding that given this individual justice becomes arbitrary. Finally, he argues that where cases are adjudicated in favour of the applicant, they are often hollow victories marked by symbolic rather than instrumental awards of just satisfaction, but beyond that little else. Consequentially he argues the urgent need to that the cases the Court does select for adjudication represent the most serious Convention compliance problems in Europe, and that they are settled with maximum authority and impact. Wildhaber agrees, the need for the Court to concentrate its efforts on decisions of principle However, for Sir Stephen Sedley, the proposal to introduce a discretion to refuse to entertain cases which are legally admissible is a counsel of despair; to do this would be to abandon the Courts crucial role, which is not that of a Supreme Court, but that of a tribunal of last resort for citizens of non-compliant states. This, he argues may be attractive to judges but is less attractive to citizens of sates which persistently or systematically fail to observe the convention. And this is less attractive still in light of the concern that amendments to the admissibility criteria will restrict the right of individuals to seek redress at the European Court, without ade quately tackling the problem of the increasing number of Convention violations across Europe. Conclusion: Why Bother? Camerons renewed pledge to repatriate the Human Rights Act (1998) (HRA) with a British bill of rights to better tailor, but also strengthen, the protection of our core rights may soon be a reality. DPP Kier Starmer has made an impassioned defence of the HRA and broad impact of Convention jurisprudence on the CPS: the common law sometimes struggles with a coherent approach to human rights; the Human Rights Act is an essential component of the framework within which everyones rights may be protected. The ECHR has shored up the right to a fair trial in the UK, the CPS underscoring the relationship between Article 6 and its work securing the fairness of trial proceedings in criminal proceedings. It was central to the development of PACE (1984), ensuring formality of interrogation and ending miscarriages of justice through uncorroborated evidence. Regina v Fulling (1987) demonstrates the efficacy of PACE safeguards against evidence collected under oppression, contrary to the ECHR; the meaning of the term (oppression) reflects the wording of Article 3. Starmer underscores the positive obligation on the state to take reasonable steps to protect potential victims from a real and immediate risk to their lives from criminal activity. When they (victims) unfortunately acquire that status, they have the right to an effective investigation. These are rights that spring from the Human Rights Act, not rights that conflict with it. Critically, they are now enforceable in court. Through the application of the ECHR, challenges may be made under Section 78 PACE as to the admissibility of the evidence obtained; and victims have the right to challenge decisions not to prosecute, particularly where they can point to poor decision-making or inappropriate consideration of irrelevant factors in that process. The HRA is central to legal certainty and transparency, and development of a modern public prosecution service prosecuting firmly and fairly, in an open, transparent and independent way; supporting victims and witnesses by enabling, encouraging and supporting their effective participation at all stages in the criminal justice process; and a commitment to respect and protect the human rights of all those affected by our decisions, whether they be victims, witnesses, suspects or defendants. Klug demonstrates the tangible protection of freedom under the Human Rights Act in sixteen important areas; freedom of association; private and family life; freedom of expression and the media; terrorism; torture; jurisdiction in Iraq; protecting the right to life; investigations into deaths; marriage; asylum seekers; disability; mental health; restraint of young people in secure training centres; sexual orientation; race; and gender. A few examples of Case law in these areas make a powerful case for Strasbourg litigation. A and others v UK (2009) held that the incarceration of suspected international terrorists under the Anti-Terrorism, Crime and Security Act 2001 without charge or trial was disproportionate and discriminated on the ground of nationality or immigration status. In R (H) v Mental Health Review Tribunal, the rights of those detained under the Mental Health Act (1983) were bolstered by the shifting burden of proof for continued detention onto the health authority. Prisoners rights have been enhanced, including the granting of voting rights in Goldberg and Others v. Minister of Prisons (1979); the freedom from censorship of correspondence, in Silver and Others v. UK (1980); and changes to cell policies following the racist murder of a prisoner in R (Amin) v SSHD (2003). R (Baiai) v SSHD (2008) was important ensuring the sacrosanct right to marry under Article 12 was free from discrimination on the grounds of immigration status. Leach, in his recent visit to Birkbeck College drew attention to the heart-rending fact finding missions in Anchora in the early 1990s, highlighting serious pervasive violations of the Kurdish minority in South East Turkey. The deplorable case of Aydin v. Turkey (2005) is emblematic of the effect of individual petition and its fundamental importance to the effective protection of the substantive rights and freedoms provided for in the Convention. It is perhaps through this significant programme of litigation, setting key standards in violations of Articles 2, 3 and 5, and delivering access to justice to those most vulnerable and marginalised members of society that the true point of litigation in Strasbourg is made. For those in the North Caucuses, 2009 has been a frightful year, symbolised by the death in Grozny in July of Natalia Estimirova, followed a month later by Zarema Sadulayeva and Alik Dzhabrailov. Through the delivery of constitutional justice those most vulnerable people whose voices so desperately need to be heard will be cut off from the most advanced international system for protecting civil and political liberties. Barkhuysen and Emmerick contend that the Courts constitutional legitimacy and moral authority are derived through providing legal protection to individuals by breaking the State Partys sovereignty. This unique achievement, unprecedented in international must be defended. It is here that the point of Strasbourg litigation is to be found.

The Status of Africa :: Politics Economics Geography African Essays

On October 7 1999, Arizona Daily Wildcat published a remarkable article by Lora Mackel, a history Junior in the University of Arizona. In the article, Mackel expressed her views about the current state of the African continent as follows: We have all seen the images before: Children with bloated bellies, rebels with assault weaponry, shanty towns that spread as far as the camera can pan. These images reflect our own modern conceptions of Africa, for it seems that these wretched conditions and the continent itself are permanently linked. (4) Mackel’s article reminded this writer of a little anecdote told by a fellow countryman of mine named Kagiso, who is from northern Botswana and is currently studying in Alabama. Apparently, one of his American classmates innocently asked him how he had escaped from the civil war going on in Africa. According to Kagiso, this particular classmate of his has this notion that Africa is just one big country. Although it was easy for my countryman, Kagiso, to dismiss his classmate’s question as emanating from an individual on the lower side of the I.Q. scale, the point is that it connects to Mackel’s views and summarizes the perceptions of some Americans about Africa. Their perception is that the whole African continent is a basket case. On the other hand, there are some Americans who – unlike some of their countryman – may not dismiss Africa entirely out of hand. Such Americans may hold the view that Africa is a serious cause for concern. Once in a while , a sympathetic soul who holds the latter view more strongly may arise. Unfortunately, most of the time, such people feel so sorry for Africa that they end up being apologists for the African continent, never mind the fact that the continent is home to 61 countries with varying economic successes (â€Å"Atlas† 122). The generalized descriptions of Africa by writers such as Mackel fail dismally to present a true image of the continent. Africa’s critics may single out the political instability prevalent in some African countries as a cause for their dismissal of Africa. These critics may use Rwanda to plead their case. In 1994, approximately 250,000 Rwandans crossed into neighboring Tanzania as refugees. This was after their village leaders forced them out just because they belonged to a different ethnic group (Shawcross 4). It is easy for Africa’s critics to gloat over these reports. However, one need not be reminded that political strife is not uncommon in this day and age.

The Term E Health Health And Social Care Essay

We can go about anyplace in the universe and happen a machine that will distribute local currency, taking the money from our place history with the usage of a bank card. Yet, when we go from a primary attention doctor to a specializer in our place town, we must get down from the beginning, supplying the new physician ‘s office with all our medical information, frequently by finishing paper signifiers. If we were going abroad and needed entree to our wellness information, we would confront troubles. Fiscal establishments have for old ages developed and used criterions for the electronic exchange of fiscal information, but medical specialty has lagged far behind in the electronic exchange of medical information [ 1 ] . Health concerns all of us. Information and communicating engineerings ( ICTs ) are progressively supplying us with the tools and cognition that we need to better wellness attention, enabling solutions that benefit patients every bit good as health care professionals and establishments in both the private and public sectors worldwide [ 2 ] . As patients interact with increasing Numberss of clinicians and infirmaries, it seems sensible to anticipate their wellness attention informations to follow them. In catastrophes such as hurricanes or fires, paper records may be lost everlastingly [ 1 ] . In big infirmaries, these records may be unavailable because they are stored in the clinic or concern office when the patient comes into the exigency room. Access to records is limited to one individual at a clip, and such entree must be on site. paper records may necessitate a big country for storage. It may miss comprehensive medical information refering the history of intervention given by separate health care suppliers, Fortunately, electronic wellness records are bit by bit going a world [ 3,4 ] . The term â€Å" e-health † , coined in the latter portion of the 20th century. It is mentioning to all digital health-related information. It covers, merchandises, such as devices to guarantee the changeless monitoring of blood force per unit area in patients, systems, such as computer-assisted surgery systems, and services, such as: operating surgical, computer-assisted prescription services, and information services for patients and consumers, including single electronic wellness records [ 2 ] . There is a strong belief that wellness IT will ensue in important betterments in patients'health every bit good as the wellness attention system [ 5 ] . Many people use the footings electronic medical record ( EMR ) and electronic wellness record ( EHR ) interchangeably. However, these footings describe wholly different constructs, both of which are to better patient safety, better the quality and efficiency of patient attention, and cut down health care bringing costs [ 6 ] . An electronic medical record ( EMR ) is more than an electronic version of the paper-based record. It is a computer-based system for pull offing and presenting informations required for patient attention. It offers many maps, such as an incorporate position of patient informations, clinical determination support, clinician order entry, integrated communications support, and entree to knowledge resources. The EMR should interface to other systems, such as charge, pharmaceutics, radiology, programming, and pattern direction [ 3 ] . An electronic wellness record ( EHR ) means a depository of patient informations in digital signifier, stored and exchanged firmly, a nd accessible by multiple authorised users. It includes information sing patient demands during episodes of attention provided by different wellness attention professionals. The EHR is used by different wellness attention professionals and besides by administrative staff. Among the assorted wellness attention professionals who use different constituents of the EHR are doctors, nurses, radiotherapists, druggists, research lab technicians and radiographers. Furthermore, EHRs are besides used by patients or their parents [ 12 ] . The precursor to the EHR is the paper-based patient-centred medical record that was pioneered in the early twentieth century [ 4 ] . In 1907, the Mayo Clinic pioneered the construct of one separate file for each patient, making the patient-centered medical record. In the sixtiess, Lawrence Weed, MD, introduced the problem-oriented medical record in order to supply standardisation of patient records [ 3 ] . In 1968, G. Octo Barnett, MD, developed the early EMR systems, it was Computer-Stored Ambulatory Record [ 3 ] . In 1972, The Department of Family Medicine at the University of South Carolina was one of the first known organisations to develop and utilize an EMR [ 7 ] . Carcinero, et Al. dei ¬?ne the ideal clinical record as the sum sum of an person ‘s clinical history available to any healthcare professional responsible for that individual ‘s care. [ 4 ] . In 1996, the Chief Information Office of the Veterans Administration introduced Veterans Health Information Systems and Technology Architecture. It is a national EMR system built on a client-server architecture, which ties together work Stationss and personal computing machines with graphical user interfaces at Veterans Health Administration installations [ 3 ] . In 2007, Hollingworth et al. , found that utilizing EMRs for ordering does non interrupt clinical work flow, and enhances safety and quality of attention for the patient [ 7 ] . In 2009, McCullough and Parente, found little but positive effects of EMR on patient safety [ 5 ] . The cost of a system in which suppliers of wellness attention to inveterate ill people operate in disconnected silos where one physician frequently does non cognize what another has tested for and prescribed, sometimes even when they are members of the same attention squad. This deficiency of information-sharing and coordination: More than 50 % of physicians do non follow best pattern guidelines ; Between 30 and 50 % of patients with chronic disease are hospitalized because of unequal attention direction. Information engineering, through sharing cognition among the attention squad can do a difference. These results are non hard to accomplish [ 13 ] . Because of that, we need to incorporate electronic wellness attention records ( EHRs ) . This is motivated by a desire to incorporate complex health care information systems with a position to bettering procedure and service optimisation [ 4 ] . In 2004, President Bush announced a federal enterprise for all wellness attention systems to passage from paper-based informations direction to electronic-based informations direction [ 7 ] The function of electronic health care record in incorporate wellness attention by enabling clinical information sharing and i ¬Ã¢â‚¬Å¡ows between health care organic structures, supplying a individual lifelong record centered on the patient that allows easy collection of information from separate episodes of attention from different establishments, leting information to be presented in ways relevant to immediate clinical demands, easing proficient steps that cut down mistakes by extinguishing manual procedures and leting connexions to other clinical information systems and media depositories such as electronic prescriptions and clinical guideline systems [ 4 ] . Harmonizing to Armitage et al. , an integrated bringing system ( IDS ) provides a agency to construct a more effectual and efficient wellness attention system that takes a patient-centered focal point and better meets the demands of the populations served. The construct of the IDS emerged in the wellness attention industry in the 1990s in response to the quickly altering environment [ 8 ] . In February 2003, Kaiser announced programs for a new records system, Kaiser Permanente is the most well-known illustration of a to the full integrated bringing system. Kaiser Permanente operates in nine provinces, including Washington, DC, and has about 9 million members, 14,000 physicians and 160,000 employees. It will incorporate patients'clinical medical records with assignment programming, enrollment, and charging systems across all of Kaiser ‘s parts. When the system is complete it will supply the ability for Kaiser doctors to hold instant entree to patients ‘ medical records ; e -messaging capableness ; computerized order entry ; e-prescribing ; and intervention guidelines. [ 8, 10, 11 ] Harmonizing to Shih, there are four theoretical accounts of integrating: multispecialty group pattern ( MSGP ) with a wellness program, an IDS or MSGP single-entity bringing system that does non have a wellness program, theoretical account which involves private webs of independent suppliers that portion and co-ordinate services, theoretical account which includes authorities facilitated webs of independent suppliers on both the province and local degrees [ 8 ] . Electronic wellness information systems are critical to supplying integrated attention. One of the major constituents of an integrated bringing system ( IDS ) is a wellness information system that can roll up patient-level informations through an electronic wellness record ( EHR ) and aggregative informations to system broad degree for rating. Harmonizing to Hillestad et al. , effectual acceptance of EHRs can take to major cost nest eggs, cut down medical mistakes and better wellness [ 8 ] . There are multiple benefits to implementing EHRs, efficiency of wellness services bringing ; clip nest eggs for all wellness professionals and patients by and large ; cost nest eggs ; fewer clinical and medical mistakes associated with inadequate or uncomplete information ; improved patient safety ; improved quality of attention ; betterments in public wellness [ 9 ] . Harmonizing to Hillestad et al. , other benefits of EHRs include: Integration of evidence-based recommendations for preventative services, such as testing tests, with patient informations ( age, sex and household history ) to place specific services for each patient, Increased patient conformity with preventative attention recommendations, such as when EHR systems remind doctors of everyday visits and attention, Enhanced disease direction, Increased communicating between multiple specializers for higher-risk patients [ 8 ] . Despite the benefits of implementing EHRs, there are barriers to uptake like: Doctor and nurse reserve due to: fright of break to pattern work flows ; clip required for developing staff ; concerns about interoperability ; fright of losing professional liberty ; concern about stiff inflexibleness of documenting with EHRs ; Comfort-level, accomplishment and experience with paper-based records. Harmonizing to Crossen and Tollen, barriers to organizing integrated wellness attention systems fall into six classs: Legal and regulative, Governance, Operational, Cultural, Academic medical centre particular and Safety cyberspace specific [ 9 ] . Harmonizing to Hillestad, merely 20 to 25 per centum of all infirmaries have adopted EHRs. Lack of acceptance can be attributed to high costs, deficiency of enfranchisement and standardisation, and concerns about privateness. EHR deployment faces multiple barriers, which frequently hinder EHRs from making their full potency [ 8,9 ] The complications in incorporating the usage of EHRs within and between healthcare suppliers will go on to be disputing. EHR integrating schemes are less good developed and, in many instances, constrained by the moderating factors that are characteristic of the health care sector. The challenges of EHR acceptance, integrating and assimilation are hence legion. Technical challenges include, for illustration: trouble in aggregating bing patient information [ 4 ] . This is an overview about Electronic wellness record system. This position showed that there are benefits and restrictions in the field of integrating between electronic wellness records since some of the bing system have restriction while some of them are non deployed yet. There for, there is an pressing demand to plan and deploy an integrating electronic wellness records system.

Interesting Gadolinium Element Facts

Gadolinium is one of the light rare earth elements belonging to the lanthanide series. Here are some interesting facts about this metal: Gadolinium is silvery, malleable, ductile metal with a metallic sheen. It is fluorescent and tends to have a faintly yellowish tint.Gadolinium, like other rare earths, is not found in pure form in nature. The primary source of the element is the mineral gadolinite. It is also found in other rare earth ores, such as monazite and bastnasite.At low temperatures, gadolinium is more ferromagnetic than iron.Gadolinium has superconductive properties.Gadolinium is magnetocaloric, which means its temperature increases when it is placed in a magnetic field and decreases when it is removed from the field.Lecoq de Boisbaudran separated gadolinium from its oxide in 1886. He named the element for  Finnish Chemist Johan Gadolin, the discoverer of the first rare earth element.French chemist and engineer  Felix Trombe was the first to purify gadolinium in 1935.Gadolinium has the highest thermal neutron cross section of all the elements.Gadolinium is used in nuclear reactor control rods to regular fission.The element is injected into MRI patients to increase image contrast.Other uses of gadolinium include manufacture of certain iron and chromium alloys, computer chips and CDs, microwave ovens, and televisions.The pure metal is fairly stable in air, but tarnishes in moist air. It slowly reacts in water and dissolves in dilute acid. At high temperatures, gadolinium reacts with oxygen. Gadolinium Chemical and Physical Properties Element Name: GadoliniumAtomic Number: 64Symbol: GdAtomic Weight: 157.25Discovery: Jean de Marignac 1880 (Switzerland)Electron Configuration: [Xe] 4f7 5d1 6s2Element Classification: Rare Earth (Lanthanide)Word Origin: Named after the mineral gadolinite.Density (g/cc): 7.900Melting Point (K): 1586Boiling Point (K): 3539Appearance: soft, ductile, silvery-white metalAtomic Radius (pm): 179Atomic Volume (cc/mol): 19.9Covalent Radius (pm): 161Ionic Radius: 93.8 (3e)Specific Heat (20 °C J/g mol): 0.230Evaporation Heat (kJ/mol): 398Pauling Negativity Number: 1.20First Ionizing Energy (kJ/mol): 594.2Oxidation States: 3Lattice Structure: HexagonalLattice Constant (Ã…): 3.640Lattice C/A Ratio: 1.588 References Los Alamos National Laboratory (2001), Crescent Chemical Company (2001), Langes Handbook of Chemistry (1952), CRC Handbook of Chemistry Physics (18th Ed.)