Higher Education Refom Essay Example | Topics and Well Written Essays - 500 words

Higher Education Refom - Essay Example For those that are lucky enough to enter college, many will be faced with poor academic skills, and hours of remedial courses just to catch up. In addition, preparation needs to include the cultural and social aspects, as well as the academic aspects of college. I propose reforming higher education to begin the college education in the 10th grade through a series of programs that prepares students both culturally and academically for a college education. While a college education in the US costs twice as much as the same education costs in other industrialized nations, the US has fallen well behind these same nations in the rate of college attainment. Many students will drop out of high school, as they see no hope of ever realizing a higher degree. For the ones that do graduate, many will not have the cultural capital required to enroll in college. Students in high school have a significant need to be groomed for college admission. They may have a language deficit, poor study habits, or grades that do not meet the requirements for admission. Many of these students "are unlikely to have participated in campus visits, spoken with college representatives, leafed through college catalogs, or participated in other activities that create college readiness" (Hagedorn and Fogel, 2002, p.171).

Political Contention Essay Example for Free

Political Contention Essay Solita Collas-Monsod is a professor at the University of the Philippines: Diliman and a writer in the Philippine Daily Inquirer. Solita Collas-Monsod’s article entitled â€Å"The Trillanes Myth† was published or appeared in the Philippine Daily Inquirer and was last updated in September 3, 2007. The author was able to catch the attention of its audience, and she was able to effectively use the title of her article to give a bird’s eye view of what is stored for the readers. She also starts her column through a statement of her stand regarding the issue being discussed. The author wanted to show or inform the audience and or the readers of the Philippine Daily Inquirer about the Trillanes group which started a coup d’ etat in Oakwood Hotel, or the well known â€Å"Oakwood ‘Mutiny†, wherein there were 300 uniformed military officers and men who were guided or led by Sen. Antonio Trillanes IV. Her arguments also state that the Court, led by July 25 order of RTC Judge Oscar B. Pimentel, should continue its firm stand with regards to imposing the necessary law or exercise government authority, without validation of the badges of inequality. She assumed that the world, more specifically the sympathizers of the Trillanes group or the military officers, should not be deranged or persuaded by the â€Å"idealisms and principles† of the Trillanes group. She also states that the audience, we, should not be blinded by the myths or lies which the Trillanes group gives us, and that we should stick or be firm with our government rules about coup d’etats. Solita Collas-Monsod values the truth and in seeking proper justice for such violators of the law. She strongly believes that proper justice or punishment in accordance with the government laws should be imposed on the Trillanes group, and we should do this objectively, not subjectively. Monsod was able to define terms clearly in her article. Solita Collas-Monsod did her assignment or did basic research, thus, she was able to support her arguments with ample and enough facts. The argument for me is successful, and it does convince me. There are facts or sufficient supporting statements used by Monsod in her article and these facts or statements seem really reliable. My beliefs and line of thinking was the same as Monsod with regards to the â€Å"Oakwood ‘Mutiny†, more specifically about the Trillanes group. Monsod’s argument strengthened my former belief about proper government execution of its laws . Politically speaking, this is really an eye-opening article not only to the public but to the government and its officials as well, more specifically to the Judicial Court. There are times when I had small doubts with regards the Judiciary system of the Philippines before, but because of Monsod’s article, and facts that she stated about the actions taken by the Court, led by Judge Pimentel, these doubts are not gone. I believe that indeed, the political world still has its â€Å"impartiality. † Solita Collas-Monsod’s article affects the political process by simply strengthening the implementation of Judicial law and in informing the public about the Trillanes group. The government and the public, or the audience, are at the advantage, whereas the Trillanes group is definitely in the losing end. Work Cited: Collas-Monsod, Solita. The Trillanes Myth. The Philippine Daily Inquirer, 2007.

The Alma Ata Declaration Still Relevant

The Alma Ata Declaration Still Relevant The Alma Ata Declaration was formally adopted at the International Conference on Primary Health Care in Alma Ata (in present Kazakhstan) in September 1978 (WHO, 1978). It identifies and stresses the need for an immediate action by all governments, all health and development workers and the world community to promote and protect world health through Primary Health Care (PHC) (ibid). This has been identified by the Declaration as the key towards achieving a level of health that will allow for a socially and productive life by the year 2000. The principles of this declaration have been built on three (3) key aspects which include: Equity It acknowledges the fact that every individual has the right to health and the realisation of this requires action across the health sector as well as other social and economic sectors. Participation It also identifies and recognises the need for full participation of communities in the planning, organisation, implementation, operation and control of primary health care with the use of local or national available resource. Partnership It strongly supports the idea of Partnership and collaboration between government, World Health Organisation (WHO) and UNICEF, other international organisations, multilateral and bilateral agencies, non-governmental organisations, funding agencies, all health workers and the world community towards supporting the commitment to primary health care as well as increasing financial and technical support especially in developing countries. Other important principles identified by the Declaration include: health promotion and the appropriate use of resources. The declaration calls on all governments to formulate strategies, policies and actions to launch and sustain primary health care and incorporate it into the national health system. It was endorsed by the World Health Assembly in 1978 hence enshrining it into the policy of the WHO (Horder, 1983). Background Back in the 1960s and 1970s, many developing countries of the world gained independence from their colonial leaders. In efforts to provide good quality healthcare service for the population, these new governments established teaching hospitals, medical and nursing schools most of which were located in urban areas (Hall Taylor, 2003) thus creating a problem of access to good quality health service especially for people that reside in rural communities. Successful programmes were initiated by Tanzania, Sudan, Venezuela and China in the 1960s and 1970s to provide primary care health services that was basic as well as comprehensive (Benyoussef Christian, 1977; Bennett, 1979). It is on the basis of these programmes that the term Primary Health Care was derived (Hall Taylor, 2003). In low income countries, the primary health care strategy as described by the Alma Ata was very influential in setting health policy during the 1980s however in high income countries such as the United Kingdom, it was considered irrelevant on the presumption that the level of primary care service was already well developed (Green et al., 2007). Primary health care has been defined in the Declaration of Alma Ata as; essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self reliance and self-determination. It forms an integral part both of the countrys health system, of which it is the central function and main focus, and of the overall social and economic development of the community. It is the first level of contact of individuals, the family and community with the national health system bringing health care as close as possible to where people live and work, and constitutes the first element of a continuing health care process. (WHO, 1978) The Alma Ata Declaration brought about a shift on emphasis towards preventive health, training of multipurpose paramedical workers and community based workers (Muldoon et al., 2006). In order to achieve the global target of health for all by the year 2000, goals were being set by the WHO (WHO, 1981) some of which include: At least 5% of gross national product is spent on health. A reasonable percentage of the national health expenditure is devoted to local health care. Equitably distribution of resources At least 90% of new-borne infants have a birth weight of at least 2500g. The infant mortality rate for all identifiable subgroups is below 50 per 1000 live-births. Life expectancy at birth is over 60 years. Adult literacy rate for both men and women exceeds 70%. Trained personnel for attending pregnancy and child birth and caring for children for at least 1 year of age. It has been over 30 years now that the Declaration of Alma Ata was adopted by the WHO. A look at the current health trend around the world especially in developing countries such Nigeria, Ghana, Niger, Zimbabwe and so many others will reveal that the goal of achieving health for all by the year 2000 through primary health care has not been a reality. Although there have been reasonable improvement in immunisation, sanitation and access to safe water, there is still impediments in providing equitable access to essential care worldwide (WHO, 2010) What went wrong? Lawn et al. (2008) explain that the Cold War significantly impeded the desired impact expectation of the Alma Ata Declaration in the sense that global developmental policy at that time was dominated by neo-liberal macro economical and social policies. The effect of this on poorer countries of the world particularly in Africa was implementation of structural adjustment programmes in effort to reduce budget deficit through devaluations in local currency and cuts in public spending. This resulted in the removal of subsidies, cost recovery in the health sector and cut backs in the number of medical health practitioners that could be hired. The introduction of user charges and encouragement of privatisation of services during this period had an untoward effect on poor people who could not afford to pay for such services. The combination of these factors hence resulted in part to the crippling of the quality of service that can be provided at the primary care level. People who could afford such service resorted to health service offered at secondary or tertiary care which in most cases is difficult to access. The introduction of a new concept of Selective Primary Health Care as proposed within a year of the adoption of the Alma Ata Declaration by Walsh Warren (1979) changed the dimension of primary health care. This interim approach was proposed due to the difficulty experienced in initiating comprehensive primary health care services in countries with authoritarian leadership (Waterston, 2008). Walsh Warren (1979) argued that until comprehensive primary health care can be made available to all, services that are targeted to the most important diseases may be the most effective intervention for improving health of a population. The measures suggested include; immunisation, oral rehydration, breast feeding and the use of anti malarias. This selective approach was considered as being more feasible, measurable, rapid and less risky, taking away decision making and control away from the community and placing it upon consultants with technical expertise hence making it more attractive partic ularly to funding agencies (Lawn et al., 2008). An example of a selective primary care approach is the Expanded Programme on Immunisation (EPI). Selective primary health care is concerned with providing solutions to particular diseases such as HIV/AIDS and tuberculosis while comprehensive primary care as proposed the Alma Ata begins with providing a strong community infrastructure and involvement towards tackling health issues (Baum, 2007). The shift in maternal, new-borne and child health as a result of programmes that removes control from the community hinders the actualisation of the goals of primary health care as emphasized by the Alma Ata Declaration. The reversal of policy in the 1990s by the WHO and other UN agencies to discourage traditional birth attendants and promoting facility based birth with skilled personnel (Koblinsky et al., 2006) is an example of such. The World Banks report Investing in Health which was published in 1993 saw the World Bank become a great influence and major key player in international public health as such robbing the WHO of the prestigious position (Baum, 2007). It considers investments for interventions that only have the best impact on population health as such removing local control and advocating a vertical approach to health. This move counteracts the process of the social change described by the Alma Ata Declaration which is necessary for realisation of its goals. These go to show that consistency both in leadership (locally and globally), policy as well as good evidence (to drive policy making and actions), are important ingredients for global initiatives to succeed. What went right? Even with the several elements that prevailed against the achievement of the collective goals of the Alma Ata Declaration, several case studies show that when provided with a favourable environment, primary health care as prescribed by the Alma Ata is sufficient to bring about a significant improvement in the health status of any population or country. Case study 1: Primary Health Care in Gambia Using data obtained from a longitudinal study conducted by the United Kingdom Medical Research Council over a 15 year period for a population of about 17,000 people in 40 villages in Gambia, Hill et al. (2000) compared infant and child mortality between village with and without primary health care. The extra services that were provided in the villages with primary health care include: a village health worker, a paid community nurse for every 5 villages and a trained traditional birth attendant. Maternal and child health services with vaccination programme were accessible to residents of both primary health care and non primary health care villages. There was marked improvement in infant and under 5 mortality in both sets of villages. After primary health care system was established in 1983, infant mortality dropped from 134/1000 in 1982 83 to 69/1000 in 1992 94 in the primary health care villages and from 155/1000 to 91/1000 in non primary health care villages over the same period of time. Between 1982 and 83 and 1992-94, the death rates for children aged 1-4 fell from 42/1000 to 28/1000 in the primary health care villages and from 45/1000 to 38/1000 in the non primary health care villages. However, in 1994 when supervision of primary health care was weakened, infant mortality rate in primary health care villages rose to 89/1000 for primary health care village in 1994 96. The rate in non primary health care village fell to 78/1000 for this period. The implementation and supervision of primary health care is associated with a significant effect on infant mortality rates for these groups of villages that benefitted from the programme. Case study 2: Under 5 mortality and income of 30 countries To assess the progress for primary health care in countries since Alma Ata, Rohde et al. (2008) analysed life expectancy relative to national income and HIV prevalence in order to identify over achieving or under achieving countries. The study focused on 30 low income and middle income countries with the highest year reduction of mortality among children less than 5 years of age and it described coverage and equity of primary health care as well as other non health sector actions. The 30 countries in question have scaled up selective primary care (immunisation, family planning) and 14 of these countries have progressed to comprehensive primary care which has been marked with high coverage of skilled birth attendants. Equity with skilled birth attendance coverage across income groups was accessed as well as access to clean water and gender inequality in literacy. These 30 countries were grouped into countries with selective primary care; mixture of selective and comprehensive primary health care; and comprehensive primary health care alone. The major players among countries with comprehensive primary health care are Thailand, Brazil, Cuba, China and Vietnam. Overall, Thailand tops the list and it has comprehensive primary health care. Maternal, new-borne and child health in Thailand were prioritised even before Alma Ata and has been able to increase coverage for immunisation and family planning interventions. The Government investment in district health systems provided a foundation for comprehensive primary health care in maternal, new-borne and child health as well as other essential services. Community health volunteers also played a significant role towards Thailands medical advancement. They promoted the use of water sealed latrines to improve sanitation and were very instrumental towards the decline of protein calorie malnutrition in pr e-school children in the past 20 years (WHO, 2010). Participation of the community health volunteers is a major source of community involvement into health care of Thailand (ibid). The following factors were identified as important lessons from high achieving countries: accountable leadership and consistent national policy progress with time; building coverage of care and comprehensive health systems with time; community and family empowerment; district level focus which is supported by data to set priorities for funding, track results as well as identify and redress disparities; and prioritising equity, removing financial barriers for poorest families and protection against unavoidable health cost. Case study 3: Integration of cognitive behaviour based therapy into routine primary health care work in rural Pakistan Rahman et al. (2008) in a cluster-randomised control study in Pakistan shows the benefits derived when cognitive behaviour therapy in postnatal depression is integrated with community based primary health care. Training was provided to the primary health care workers in the intervention group to deliver psychological intervention. The health care workers also receive monthly supervision and monitoring. Significant benefit (lower depression and disability scores, overall functioning and perception of social support) was reported in the intervention group to suggest that this kind of measures as supported by the Alma Ata can drive the initiative towards Health for all. It is evident and clear that countries that practiced comprehensive primary health care as enshrined by the Alma Ata reaped great benefits in terms of population health improvement. Although it has been argued that comprehensive primary health care is too idealistic, expensive and unattainable (Hall Taylor, 2003), evidence suggest that it is more likely to deliver better health outcomes with greater public satisfaction (Macinko et al., 2003). This kind of care can deal with up to 90% of health demands in low income countries (World Bank, 1994). Relevance of Alma Ata in this present time Our present world that has been characterised by marked epidemiological transition in health. Low income countries as well as high income ones are faced with increasing prevalence of non communicable as well as chronic disabling disease (Gillam, 2008) hence, the existence of infectious diseases (malaria, HIV/AIDS, Tuberculosis etc), and diseases like cardiovascular disease and diabetes. For low income countries such as sub-Sahara African Countries, this constitutes a major health problem because their health systems are mainly oriented towards providing services inclined with maternal and child health, acute or episodic illnesses. As such current health systems need to have the capacity to provide effective management for the current disease trend. The Alma Ata provides a foundation for how such effective health service can be provided. Because, primary health care is the first line of contact an individual has to health care, it is thus very influential in determining community heal th especially when the community is fully empowered to participate. As societies modernise, as it is the case in our current world, the level of participation increases and people want to have a say in what affects their lives (Garland Oliver, 2004). Thus, the level participation in health care is better off and more powerful in this present time than it was when it was the Alma Ata was adopted. Evidence suggest that the values as enshrined by the Alma Ata are becoming the mainstream of modernising societies and it is a reflection of the way people look at health and what they expect from their health care system (WHO, 2008). Alma Ata failed in some countries because the Government of such countries refused to put strategies towards sustaining a strong and vibrant primary health care system that is appropriate to the health needs of the community such that access is improved, participation and partnership is encouraged and health is improved in general. There is no goal standard guideline or manual on Alma Ata but individual governments have to develop their own strategies which should be well suited towards meeting their own needs. The Alma Ata founding principles is still relevant towards achieving these goals especially as it brings health care to peoples door step as it encourages training of people to efficiently and effectively deliver health services. Evidence has shown that there is a greater range of cost effective interventions than was available 30 years ago (Jamison et al., 2006). It is for these reasons that primary health care is essential towards achieving the millennium development goals e specially as it concerns child survival, maternal health, and HIV/AIDS, malaria, tuberculosis and other diseases. The Alma Ata emphasises the importance of collaboration as an important tool towards introducing, developing and maintaining primary health care. This partnership as supported by the Alma Ata is essential to increase technical and financial support to primary health care especially in low income countries. It is a current trend to find an increasing mixture of private and public health systems as well as increasing private-public partnerships. Governments, donor and private organisations are now working together to promote and protect health unlike after Alma Ata (OECD, 2005). There is also increased funding and this is shifting from selective global funds to strengthening health systems through sector wide approaches (Salama et al., 2008). This kind of collaborations is a step in the right direction and when it is strengthened according to the principles of the Alma Ata, it will not only improve the buoyancy of the health care system but also improve participation and equity in the sense that health care is more qualitative and accessible to the people. The years that followed after adoption of the Alma Ata by WHO member states was characterised by unstable political leadership and military dictatorship especially among low income countries which lead to neglect of the health sector. This created unfriendly environments for the development and maintenance of stable primary health care systems. In this current times however, most countries have embraced the democratic system of leadership that promotes equity, participation and partnership. Health equity is continually enjoying prominence in the dialogue of political leaders and ministries of health (Dahlgren Whitehead, 2006). Thus, the environment being created is friendlier to the Alma Ata hence making it more relevant in this time. Thirty years ago, the values of equity, people centeredness, community participation and self determination embraced by the Alma Ata was considered as being radical but today these values have become widely share expectations for health (WHO, 2008). Our current time has been marked by gross technological advancement which was not available in the 1970s. There is also an increased wealth of knowledge and literature on health and on the growing health inequalities between and within countries all of which was not available 30 years ago. All these put together provides a relevant foundation to support the Alma Ata in the present time making it more relevant in delivering effective health care service. Conclusion The prevailing political and economic situation around the world make the Alma Ata more relevant than it was in 1978. However, there is still need for more to be done. There is need for the revitalisation of primary health care according to the tenets of the Alma Ata and progress made should be consistently monitored. There is also the need for an increased commitment to the virtues of health for all as well as increased commitment of resources towards primary health care which should be driven by good evidence base. It is important that emphasis be changed from single interventions that produce short term or immediate results to interventions that will create an integrated, long term and a sustainable health care system. Even with the challenges being faced so far with full implementation of the Alma Ata, the ideals are relevant still relevant now more than ever.

The Lamb vs. The Tyger By William Blake Essay -- essays research paper

In this essay I am going to be looking at two poems from the Songs of innocence and experience works. These poems are The Lamb and The Tyger written by William Blake. Both these poems have many underlying meanings and are cryptic in ways and both poems are very different to each other. In this essay I will be analysing the two poems, showing my opinions of the underlying themes and backing them up with quotes from the poems. I will compare the poems looking at the similarities and differences between them and also look at each one individually focusing on the imagery, structure and the poetic devices William Blake has used. Firstly I will look at the Tyger a poem about experience. The first thing that strikes me about this poem is the structure. The poem is very ordered written with 4 lines a stanza and a total of 6 stanza’s. This looks like a professional poem created by an adult, showing experience right away. The syllables are normally 7 per line but there are exceptions to this rule as all of stanza 5 has 8 syllables a line. The first stanza and the last stanza are nearly the same apart from the last line of each differing by a word. This poem uses many poetic devices well to create a vivid picture in the readers mind. There are rhyming couplets, alliteration, repetition, rhetorical questions as well as many biblical and egotistical references to the artist and poet himself. Now we will look at the poems meanings. The poem at first glance looks to be about a Tyger but after reading through thoroughly a few times we learn that there are many underlying themes and tones to this poem. For example the many biblical references â€Å"immortal† meaning to not die, â€Å"fire† related to hell â€Å"heaven† related to God and â€Å"wings† also relate... ...ast each other well. Both poems use imagery, repetition, alliteration and rhyming and both have many biblical references and rhetorical questions. Although each poem is different in its structure, theme and the way it is written. In conclusion these two poems by William Blake are both deep and have hidden meanings, they both use imagery, repetition, alliteration and ryming couplets as well as biblical references to create a vivid pictures in the readers head. But these poems do differ in many ways such as the structure, theme and way it is written. The Tyger appeals to me most as it has more hidden meanings than the Lamb and the Lamb is boring and as if written by a child (for effect). In this essay I have analysed, contrasted and compared the two poems The Tyger and The Lamb to the best of my ability detailing the poetic devices used and the underlying meanings.

Severity Prescribing Errors Hospital Inpatients Health And Social Care Essay

Background: Prescribing mistakes are common ; they affect patient safety and cause of inauspicious events throughout health care pattern. Previous reappraisals of surveies limited in range of populations, scenes or fortes, and at that place has been no systemic attack adopted to reexamining the literature. Purpose: This reappraisal aimed to place all enlightening, published grounds refering three major facets of ordering mistakes: the incidence, nature and badness in hospital inmates. Methods: The chief electronic databases such as MEDLINE, EMBASE, CINAHL and International Pharmaceutical Abstracts, were searched for diaries published between 1975 and December 2010. Studied were selected if they reported rates of prescribing mistakes and were in English. However, some mistakes were excluded, peculiarly those for individual paths of disposal, diseases or types of ordering mistakes. Consequences: Median mistake rate ( inter-quartile scope [ IQR ] ) was 12.85 % ( IQR: 10.09-13.63 ) of medicine orders, 1.27 ( IQR: 0.96-2.30 ) mistakes per 100 admittances and 6.5 ( IQR: 4.35-8.53 ) mistakes per 100 drugs charts reviewed. Incorrect dose was the most common mistake reported. Most surveies ( 70 % ) were carried out in individual infirmaries, were collected informations by druggists ( 75 % ) and originated from US or UK ( 75 % ) . Decision: The reappraisal revealed that ordering mistakes affected 13 % of medicine orders, 1.3 % of hospital admittance and 7 % of drug charts reappraisals. However, there were broad scopes of variableness in ordering mistakes and this was perchance due to fluctuations in the mistake definitions, the methods of informations aggregation, and populations or locations of the survey. In add-on, a deficiency of standardization between badness graduated tables was a barrier to compare badness of ordering mistakes across surveies. It is critical that future research should turn to the broad disparity of badness categorizations and methods used to roll up informations that causes trouble in aggregating mistakes rates or set abouting meta-analysis of different surveies.IntroductionMedicine mistakes are the 2nd most common cause of patient safety incidents, with ordering mistakes an of import constituent of these ( National Patient Safety Agency, 2007 ) . There has been increasing concerned a bout the extent and impact of inauspicious events which are the prima causes of considerable patient morbidity and mortality. Most hospital scenes have made patient safety as a cardinal facet of health care policy. To be specific, the Harvard Medical Practice survey reported that more than 3.7 % of hospital admittances associated with the usage of medicines. In the US, inauspicious drug events ( ADEs ) have been shown to protract the continuance of hospitalization, addition mortality hazard twofold and property as cause of 7,500 deceases yearly. Furthermore, Bates et Al. ( 1997 ) found that individual learning infirmary spent about $ 6 million due to ADEs, while $ 3 million of which were preventable. In the UK, it has been estimated that preventable ADEs cost about ?750 million ( National Patient Safety Agency, 2007 ) The negative impact of preventable ADEs means that it is really of import to understand the nature and extent of medicine mistakes. An ADEs can happen at any phase of drug usage as a consequence of mistakes in drug prescribing, administrating and a dispensing ; although most mistakes are likely to be initiated during prescribing. Harmonizing to National Patient Safety Agency ‘s ( NPSA ) , most serious incidents were caused by mistakes in medicine disposal and prescribing ( 32 % ) . However, there is deficiency of grounds associating to incidence or nature of ordering mistakes reported the consistence of form in the types of mistakes or badness. Surveies conducted in single-hospital found, for case, ordering mistakes in 0.4-15.4 % of prescriptions written in the US and in 7.4-18.7 % of those written in the UK. In malice of the fact that there has been old research into systemically synthesizing informations of ordering mistake, they were either specific in range of patient groups, or forte. None have focused on the general facets of incidence of ordering mistakes. Therefore this survey highlights the incidence, nature and badness of ordering mistakes in hospital inmate more by and large.PurposeThe purpose of this literature reappraisal is to place all enlightening, published grounds refering three major facets of ordering mistakes: the incidence, nature and badness in specializer and non-specialist infirmaries, and collate, analyse and synthesize decision from it.LITERATURE SEARCH METHODOLOGYSearch schemeSurveies were identified by seeking the undermentioned electronic databases for article published between 1 January 1975 and 6 December 2010: MEDLINE and MEDLINE In-process and other Non-Indexed Citations, EMBASE, International Pharmaceutical Abstracts, and Cumulative Index to Nursing & A ; Allied Health Literature ( CINAHLA ® ) Search footings used included the followers: ‘prescription ( s ) ‘ [ Mesh ] or ‘drug prescription ( s ) ‘ [ Mesh ] or ‘medical mistake ( s ) ‘ [ Mesh ] or ‘incidence ‘ [ Mesh ] or ‘incidence ‘ [ Subheading ] or ‘epidemiology ‘ [ Mesh ] or ‘prevalence ‘ [ Mesh ] or ‘inpatients ‘ [ Mesh ] .Inclusion and Exclusion CriteriaInclusion standards: Surveies published in English between 1985 and 2010 that reported on the sensing and rate of ordering mistakes in handwritten prescriptions written by physicians for grownup and/or child hospital in-patients were included. All research designs such as systemic reappraisals, randomised controlled tests, non-randomised comparative surveies and experimental surveies were included. Exclusion standards: This reappraisal focused chiefly on incidence of ordering mistakes more by and large from both paper and electronic ordering systems. Therefore surveies that merely provided informations on electronic prescriptions via computerised physician order entry ( CPOE ) were excluded. In add-on, surveies that evaluated mistakes for merely one disease or drug category or for one path of disposal or one type of ordering mistake were excluded as they are improbable to generalize a consistent form in the figure or type of mistakes.Data Extraction and Validity AssessmentA data-extraction signifier was used to pull out the undermentioned information: twelvemonth and state ; study period ; hospital scene ; methods ( including type of survey ; trying and reappraisal procedures ; profession of informations aggregator ; agencies of sensing mistake ) ; definitions used ; the mistake rate ; and any other relevant information captured by the survey, such as badness of mistakes, type of mistake and medicine normally associated with mistakes. Datas were entered into an Excel spreadsheet for easiness of handling, and The Statistical Package for Social Sciences ( SPSS Statistics 17.0 ) was used for informations analysis.Quantitative Data AnalysisThe surveies retrieved by the hunt were highly heterogenous ; nevertheless the incidence and per centum of ordering mistakes were reported in each survey, and therefore average mistake rates and inter-quartile furies ( IQRs ) was used to analyze the information. To be included, studied had to describe the rate of erroneous orders and mistakes per admittance. To ease comparing across surveies, these rates were converted to common denominators: rates per 100 admittances, per 100 medicine orders and per 100 drug chart reviewed. When publications gave informations from two or more surveies where the methodological analysis was similar, the consequences were aggregated into a average rate. Calculation of incidence and per centum of ordering mistakes The incidence of ordering mistakes in each survey was calculated utilizing the undermentioned equation ( eqation1 ) : Incidence = The per centum of all prescribing mistakes that were reported in each survey was calculated utilizing following equation ( equation 2 ) : % of ordering mistakes =LITERATURE SEARCH RESULTSThe electronic hunt identified 423 publications. After initial showing of the abstracts, 325 publications did non run into the inclusion standards. The staying 98 publications were obtained in full text and assessed for suitableness, as shown in figure 1. Searching of the mention lists of the included publications indentified a farther 13 eligible surveies. In all, 16 publications were included. The chief grounds for exclusion were absent or deficient informations to cipher incident rates ( n=46 ) ; informations included disposal mistakes, outpatient prescriptions, and/or verbal and electronic prescriptions ( n=21 ) ; reported rates were of intercessions or misdemeanors of policy non deemed mistakes ( n=25 ) ; and duplicate of antecedently published information ( n=3 ) . Figure 1: Flow diagram of the showing procedure Potentially relevant publications identified and screened for retrieval ( n= 423 ) Publications retrieved for more elaborate rating ( n=98 ) Studied ( n=16 ) in the literature reappraisal Publications non run intoing inclusion standards ( n=325 ) Further publications indentified from seeking mention lists ( n= 13 ) Publications non run intoing inclusion standards ( n=94 ) surveies with no information or sufficient informations to cipher incident rates ( n=46 ) surveies in which informations include disposal mistakes, outpatients, verbal and electronic prescriptions ( n=21 ) Surveies that report rates of intercessions or solely misdemeanors of policy that are non deemed mistakes ( n=25 ) Duplicate surveies ( n=3 )Study FeaturesState and Date Features of the 11 eligible surveies are summarized in Table 1 ( APPENDIX I ) . Most surveies were conducted in the UK ( 6/16 ) or the US ( 6/16 ) . Other states included Canada ( n=3 ) , and The Netherlands ( n=1 ) . Over 80 per centum of surveies were published after 2000 ( 13/16 ) Types of Hospitals Fifty per centum of studied ( 8/16 ) were conducted in university-affiliated infirmaries, while six surveies ( 37.5 % ) were conducted in pediatric infirmary. The remainder ( 12.5, 2/16 ) were conducted in either mental wellness infirmary or wellness Centre. Numbers of Hospitals Sixty-nine per centum of surveies ( 11/16 ) were carried out on individual infirmary sites, 12.5 % ( 2/16 ) were carried out in two infirmary sites, 12.5 % ( 2/16 ) in nine sites, and 6.3 % ( 1/16 ) in 24 sites. Fortes Thirty-one per centum ( 5/16 ) of surveies were conducted in all grownup wards, one survey ( 6.25 % ) did non province the type of forte, and the staying 62.5 % ( 10/16 ) were carried out in certain fortes. Specifically, 37.5 % ( 6/16 ) included merely kids ‘s fortes or were conducted entirely in pediatric infirmaries, and 18.75 % ( 3/16 ) were carried out in medical and surgical wards. Although one survey was conducted strictly in critical attention units, the age scope of patients was non stated. Study Design One-half of the surveies ( 8/16 ) were prospective in design ; and 43.75 % ( 7/16 ) were retrospective. There is merely a survey conducted by Kozer et Al. ( 2008 ) was randomised controlled test ( RCT ) . The shortest period of informations aggregation was 12 yearss and the longest was 9 old ages. Three surveies by Cimino et Al. ( 2004 ) , Kozer et Al. ( 2005 ) and Kozer et Al. ( 2006 ) collected information before and after intercession, in these instances, merely information from the baseline or the control arm were used to measure the per centums and incidence of ordering mistakes in infirmary inmates. This was due to the fact that nature of ordering mistakes could be represented by a baseline group instead than an intercession group. Methods of Error Detection Datas aggregators were most commonly druggists ( 12/16, 75 % ) , while both druggists and nurses collected informations in a survey by Cimino et Al ( 2004 ) . Four chief methods were used among surveies: showing of prescriptions, direct observation, reappraisal of patient ‘s medical records, and anon. mistake study. Fifty per centum of surveies ( 8/16 ) detected prescription mistakes as portion of usual showing by druggists. Four surveies ( 25 % ) used perceivers to roll up informations straight as portion of their everyday work. Three surveies ( 18.75 % ) detected ordering mistakes by reappraisal of patient ‘s medical records, which were carried out by paediatric doctors instead than druggists and those referees were blinded to analyze variable. There is merely a survey ( 6.25 % ) used the combination methods of patient ‘s medical record reappraisal and anon. mistake study.Definitions of Ordering MistakesThe definition of a prescribing mistake was markedly varied ( Table 4, APPENDIX II ) , with 57 % of surveies ( 9/16 ) developing their ain definitions or modifying 1s used in old surveies. Two surveies ( 12.5 % ) used a definition of ordering mistakes developed by Dean et Al. ( 2000 ) . Almost one-third of surveies ( 31.25 % ) did non province any definition. Harmonizing to Dean et Al. ( 2000 ) , a definition of a prescribing mistake is â€Å" A clinically meaningful ordering mistake occurs when, as a consequence of a prescribing determination or prescription composing procedure, there is an unwilled important decrease in the chance of intervention being timely and effectual, or an addition in the hazard of injury when compared with by and large accepted pattern † .Incidence of Ordering MistakesThe incidence of ordering mistakes, which derived from equation 1 and 2 ( Table 4, APPENDIX I ) was reported as the figure of prescription mistakes per the figure of admittances, medicine orders or drug charts reviewed in the survey period ( Table 1 ) . Most surveies ( 75 % , 12/16 ) reported the per centum of erroneous ordering mistakes, the median of which was 5.15 % ( IQR: 2.13-10.68 % ) . First, three surveies provided an incidence of ordering mistakes per admittance, the median of this was 1.27 ( IQR: 0.96-2.30 ) mistakes per 100 admitt ances. Second, four surveies provided an incidence of ordering mistakes per medicine orders, the median of which was 12.85 ( IQR: 10.09-13.63 ) mistakes per 100 medicine orders. Third, four surveies reported an incident of ordering mistakes per drug charts reviewed, the median of this was 6.50 ( IQR: 4.35-8.53 ) mistakes per 100 drug charts reviewed. However, the four balance of surveies ( 25 % , 4/16 ) did non do in clear whether medicine orders were reported as holding more than one mistake, and hence were excluded in the computation. The per centum of all prescribing mistakes that were reported in each survey was shown in Table 1. The median of which was 9.25 % ( IQR: 2.34-13.50 ) . The lowest prescribing mistake rate ( 0.15 % ) was derived from ordering mistakes describing based survey and the highest mistake rate was ( 59 % ) resulted from a combination of two methods of mistake sensing: patient ‘s medical record reappraisal and anon. mistake study.Writers ( twelvemonth )Number of Prescribing mistakesNumber of Medication ordersPercentage of Ordering mistakesIncidence of ordering mistakeper admittances, medicine orders or drug charts reviewedMedianof Incidence( IQR )Dean et Al. ( 2002 ) 538 36,168 1.50 % 1.30 per 100 admittances 1.27 ( IQR: 0.96-2.30 ) per 100 admittances Lesar et Al. ( 1997 ) 11,186 3,903,433 0.29 % 5.29 per 100 admittances Lesar et Al. ( 2002 ) 52 402 13.00 % 1.23 per 100 admittances Ross et Al. ( 2000 ) 195 130,000 0.15 % 0.15 per 100 admittances Kozer et Al. ( 2005 ) 68 411 16.60 % 13.30 per 100 medicine orders 12.85 ( IQR: 10.09-13.63 ) per 100 medicine orders Kozer et Al. ( 2006 ) 66 533 12.40 % 12.40 per 100 medicine orders Neville et Al. ( 1989 ) 504 15,916 15.00 % 3.17 per 100 medicine orders Ridley et Al. ( 2004 ) 3,141 21,589 3.17 % 14.60 per 100 medicine orders Abdel-Qader et Al. ( 2010 ) 664 7,920 8.40 % 8.00 per 100 drug charts reviewed 6.50 ( IQR: 4.35-8.53 ) per 100 drug charts reviewed Kozer et Al. ( 2002 ) 154 1,532 10.10 % 10.10 per 100 drug charts reviewed Stubbs et Al. ( 2006 ) 523 22,036 2.40 % 2.40 per 100 drug charts reviewed Taylor et Al. ( 2005 ) 212 358 59.00 % 5.00 per 100 drug charts reviewed Cimino et Al. ( 2004 ) 1335 12,026 11.10 % N/A N/A Fijn et Al. ( 2002 ) 245 449 55.00 % N/A Hendey et Al. ( 2005 ) 177 8,195 2.16 % N/A Jones ( 1978 ) 114 2,237 5.10 % N/A Median ( IQRaˆ ) 9.25 % ( IQR: 2.34-13.5 % ) 5.15 % ( IQR: 2.13-10.68 % ) aˆ IQR: Inter-quartile fury ; C‚ N/A: Not applicable Table 1: Incidence of ordering mistakesTypes of Ordering Mistakes DetectedAll surveies reported on the types of mistakes, shown in Table 2, provided figure of surveies and per centums for each mistake type. Wrong dosage, incorrect drug and incorrect dose signifier were the most normally reported mistakes ( 93.75 % , 15/16 surveies ) , the 2nd most frequent of ordering mistakes ( 81.25 % ) reported were incorrect frequence, skip of doses and incorrect path ( 13/16 surveies ) . The balance was accounted for by incorrect measure ( 75 % ) , inaccurate information ( 56.25 % ) , incorrect patients ( 50 % ) , incorrect units ( 43.75 % ) , and contraindicated due to allergy ( 25 % ) . Table 2: Type of ordering mistakes detectedType of ordering mistakes detectedNumber of surveies utilizing( n = 16 )Percentages( % )Incorrect dosage15 93.75Incorrect drug15 93.75Incorrect dose signifier15 93.75Incorrect frequence13 81.25Omission of doses13 81.25Incorrect path13 81.25Incorrect measure12 75.00Inaccurate information9 56.25Incorrect patients8 50.00Incorrect units7 43.75Contraindicated due to allergy4 25.00Badness of Detected Prescribing MistakesA one-fourth of all the surveies ( 75 % , 12/16 ) reported the categorization of the badness of ordering mistake, while the balance ( 25 % , 4/16 ) did non province how they were classified. Among surveies that reported badness, eight surveies ( 50 % ) provided their ain categorization of ordering mistake badness. Two surveies based badness standards on the work of Lesar et Al. ( 1990 ) and a survey based their standards on the work of Overhage & A ; Lukes ( 1999 ) . One survey by Lesar et Al. ( 1997 ) rated badness harmonizing to their ain alteration of Lesar et Al. ( 1990 ) . Table 3 lists how different surveies categorised the badness of ordering mistakes under the headers of 16 writers. This disparity made it impossible to compare badness across the surveies. Table 3: Badness categorization for ordering mistakesWriters ( twelvemonth )Severity Classification of ordering mistakesAbdel-Qader et Al. ( 2010 )A. Potential lethal ( Life endangering ) B. Serious C. Significant D. Minor E. No mistake ( No injury )Cimino et Al. ( 2004 )6: Death 5: Permanent injury 4: Need for intervention 3: Require monitoring 1-2: Mistake occurred without injury 0: No mistakeDean et Al. ( 2002 )Potentially serious Not seriousKozer et Al. ( 2002 )Severe Significant Minimal hazard InsignificantKozer et Al. ( 2005 )Severe Significant Minimal hazard InsignificantLesar et Al. ( 1997 )A. Significant B. Minor C. No mistakeLesar et Al. ( 2002 )Potentially fatal or terrible inauspicious results Potentially serious results Potentially important inauspicious resultsNeville et Al. ( 1989 )Type A: potentially serious to patient Type Bacillus: major nuisance Type C: minor nuisance Type D: FiddlingRidley et Al. ( 2004 )Potentially life endangering Serious Significant Minor No adverseStubbs et Al. ( 2006 )Grade 1: Doubtful or negligible importance Grade 2: Minor inauspicious effects Grade 3: Serious effects or backsliding Grade 4: Fatality Grade 5: Un-rateable: Insufficient informationTaylor et Al. ( 2005 )Severe Serious Significant Problem InsignificantFijn et Al. ( 2002 )Not statedHendey et Al. ( 2005 )Not statedJones ( 1978 )Not statedKozer et Al. ( 2006 )Not statedRoss et Al. ( 2000 )Not statedDiscussionSixteen surveies run intoing the inclusion standards were identified and informations abstracted. Uniting the grounds from the literature about incidence, nature and badness of ordering mistakes in infirmary inmate has helped to cast greater visible radiation on what and how mistakes occur. As the epidemiology of these jobs was able to depict, the likeliness of injury related to medicines would be reduced.Features and demographicsVariation in the mistake scope was non affected by different either state across the universe or fortes. The twelvemonth of surveies included in this literature reappraisal widely varied between 1978 and 2010. However, there was no consequence of a alteration in mistakes with clip of survey, proposing that there has been no rationalising of methodological analysis over clip or betterment in ordering competency. Besides, there was no medical-specialty or geographical consequence observed, proposing neither a consistence of methodological analysis nor of mistake rates in peculiar states and medical scenes.Incidence of ordering mistakesThis literature reappraisal reports the great fluctuation of ordering mistake rates because the surveies retrieved by the hunt were highly heterogenous but it was possible to group them by the type of denominator. Therefore the computation of average mistake rates and inter-quartile scope is valid manner of passing the information. The average rate of ordering mistakes was 9.25 % ( IQR: 2.34-13.5 % ) , while the average rates of mistake incidence utilizing three different denominators were 1.27 ( IQR: 0.96-2.30 ) per 100 admittances, 12.85 ( IQR: 10.09-13.63 ) per 100 medicine orders and 6.50 ( IQR: 4.25-8.53 ) per 100 drugs charts reviewed. These reported rates vary unusually, as shown by the broad IQRs, and can non be compared due to diff erences in methodological analysiss, mistake definitions, scenes and population employed. To be specific, illustrations of survey methods doing fluctuation in ordering mistake rates could be illustrated. The incidence of ordering mistakes was significantly underestimated by utilizing a self-generated coverage system because merely a fraction of medicine mistakes could be detected by this method. In add-on, the surveies utilizing self-generated describing design demonstrated less ability to observe mistakes than those utilizing patient ‘s medical record design. Even so, the reappraisal of patient records which is a nature of retrospective, yielded small prospect for followup and be able to place merely those noted in the records. In the visible radiation of methodological analysiss, studied that utilizing a direct observation method were likely to be the most comprehensive and accurate. Furthermore, Flynn et Al. ( 2002 ) besides stated that observation techniques were more efficient and precise than reexamining chart and incident coverage system in order to observe prescription mistakes. Conversely, Buckley et Al. ( 2007 ) and Kopp et Al. ( 2006 ) argued that surveies that utilised the direct observation attack were unfastened to the Hawthorne consequence. This meant that subjects ‘ behavior was altered due to the fact that they are being observed – in other words, if physicians built consciousness of being observed, they may hold improved or modified their prescribing manners. Furthermore, this error-rate variableness could besides be partially explained by the different factors in scenes and populations. Some surveies were carried out in a individual scene or a group of patients such as ICU scenes or entirely in pediatric patients. This may impact generalisability of the consequence and did non demo a similar tendency of ordering mistakes.Definitions of ordering mistakesIncompatibility in the definitions of ordering mistakes was another of import consideration. Most surveies developed their ain definitions, some of these were subjective. For case, a prescribing mistakes is â€Å" prescription non appropriate for the patient † . In contrast, others were more specific in their mistake definitions: â€Å" Mistakes related to dosage signifiers were defined as those in which there was an order for the inappropriate usage of a specific dose signifier, an order for the incorrect dose signifier ( mistakes of committee ) , or the failure to stipulate the r ight dose signifier when more than 1 dose signifier is normally available ( mistake of skip ) † . Yet, marked fluctuations in mistake definitions have besides been found in surveies in pediatricss and mental health care. This effect of variableness has leaded to the preparation of a practitioner-led definition of a prescribing mistake. Even though the definition by Dean et Al. ( 2000 ) was the most common one, it was used by merely 19 % ( 3/16 ) of surveies.Badness of detected prescribing mistakesThe badness of detected prescribing mistakes is indispensable because it can be used to measure the consequences of possible injury. Harmonizing to World Health Organization ( WHO ) , the possible badness of the mistake identified was buttockss by five Judgess utilizing a graduated table from 0 ( no injury ) to 10 ( decease ) . This method showed that a average badness mark of less than 3 indicates an mistake of minor badness, a mark between 3 and 7 inclusive indicates moderate badnes s and a mark of more than 7 major badness. However, the deficiency of standardization between badness graduated tables of each included surveies in this literature reappraisal was an obstruction to compare outcomes straight. The most common signifier of ordering mistake was composing the incorrect dosage and composing the patient ‘s name falsely, which accounted for 50 % of all mistake badness found by the research in six Oxford infirmaries ( Audit Commission, 2001 ) . A survey of 192 prescription charts in infirmary inmate, there were merely 7 % of those charts right filled ; 79 % had mistakes that posed minor possible wellness hazards and the balance ( 14 % ) had mistakes that could hold led to serious injury. There are many beginnings of ordering mistakes and different ways of avoiding them. Promoting consciousness that dosing mistakes are possible to do from clip to clip, and hence it of import to take measure to understate the hazards. Iedema et Al. ( 2006 ) suggested that the indispensable constituents of this are to supervise for and identify mistakes. Besides, they should be reported in a blame-free environment so that their root causes can be analysed before altering processs harmonizing to the lessons learnt and farther monitoring.Types of ordering mistakes detectedThere are many restrictions lending to the variableness of types of ordering mistakes. For illustration, some surveies were conducted in peculiar phase of the patient ‘s stay in infirmary such as admittance or discharge. These surveies, as a consequence, reported higher rates of peculiar types of mistake such as skip, incorrect frequence or duplicate. Furthermore, some surveies were carried out in a short continuan ce, and therefore the Numberss of types of ordering mistakes may be under-reported as they had less clip to place and roll up informations. With this in head, the same method to enter prescribing mistakes could usefully be applied across a figure of patient ‘s phases and longer continuance of informations aggregation. This reappraisal found that mistakes of dose were the most common type of ordering mistakes reported. In conformity with old surveies, a systemic reappraisal of medicine mistakes in pediatric patients by Ghaleb et Al. ( 2006 ) and another survey by Winterstein et Al. ( 2004 ) besides showed that dose mistakes was the most common type of medicine mistakes which were initiated during physicians ‘ prescribing. To better this job, instruction has been highlighted as an country for intercessions. A survey that surveyed twelvemonth 1 junior physicians in the UK found that drug dosing was a peculiar country that those physicians would welcome to be covered in the instruction of clinical pharmacological medicine. Impact of instruction and preparation on ordering mistakes Ordering mistakes are normally multi-factorial, but cognition of medical specialties and anterior preparation are of import for the betterment of ordering mistakes. About 30 % of ordering mistakes caused by failure in the airing of drug cognition, peculiarly amongst physicians. A systemic reappraisal by Ross and Loke ( 2009 ) demonstrated that ordering public presentation can be improved by educational intercessions. However, most surveies included in their reappraisal have relied on appraisals early after intercession and under controlled conditions instead than infirmary wards. Furthermore, it is possible that competent prescribers might take non to go to the tutorial preparation. Thus, farther research into whether any public presentation benefit extends significantly beyond the preparation period is needed. What besides evident in this literature reappraisal was the wellness attention professionals who played a important function in the procedure of ordering mistake sensing. Specifically, druggists were good placed to competently handle informations on mistakes, and were intentionally recruited for forestalling prescribing mistakes and bettering medicine use. Additionally, a meta-analysis survey showed that druggists were the most thorough chart-reviewers in inpatient infirmary. However, there have been some mistakes remained undetected.Study restrictionsMany restrictions of the included surveies can be described in item. One of major restrictions is possible categorization bias that can non be wholly eliminated. The studied conducted by Taylor et Al. ( 2005 ) and Stubbs et Al. ( 2006 ) found that even the writers met often to discourse mistake badness evaluations before a class was assigned to an mistake, inter-observer variableness was non officially assessed. Fijn et Al ( 2002 ) suggested that this prejudice could be minimised by utilizing patient information sheets as a mention to place mistakes. This is in conformity with the surveies by Lesar et Al. ( 2002 ) and Abdel-Qader et Al. ( 2010 ) , as anticipation of possible injury was based on several factors such as pharmacological, disease province and single patient features ; same mi stake may bring forth a serious inauspicious consequence in one patient but have minimum effects in another. Yet, it was possible that patient-specific information might be unequal which limited the ability of centralized staff druggists to to the full measure the rightness of drug therapy for an single patient ( Lesar et al. , 1997 ) . A farther survey restriction related to the design of surveies. A retrospective design limited available informations because it could non observe many mistakes in drug disposal. Besides, a prospective design and a randomised control test ( Kozer et al. , 2006 ) which identified mistakes through chart auditing, may non observe some mistakes and could non supply verification about results of mistakes. This is due to a possibility that the physicians made fewer mistakes cognizing that they were studied. In contrast, Dean et Al. ( 2002 ) argued that the prospective method had advantages as druggists routinely reviewed all drug charts and met patients, every bit good as participated in a portion of multidisciplinary squad at the clip of the patient ‘s hospitalization. This interaction would therefore supply more information about each patient available to druggists than to those retrospectively reexamining the medical notes. Although a cardinal strength of this literature reappraisal is the scope of databases searched, there are three restrictions. First, non-English linguistic communication surveies were excluded and there may hold been relevant surveies published in other linguistic communications that were non detected. Second, surveies describing mistake incidence might be published in diaries that were non indexed by searched databases could non be included. However, to cut down this hazard, a hunt of the mention lists of included surveies had been carried out. Finally, the abstracts that had limited information were excluded, and accordingly existing international work or work in advancement might be missed and could non farther add to understanding of incidence, nature and badness of ordering mistakes.DecisionOrdering mistakes are prevailing, impacting a median of 13 % medicine orders, 7 % of drug charts reviewed and 1.3 % of hospital admittances. Despite this, the scopes of these findings are rea lly broad, which partially may be conditional upon surveies ‘ populations, scenes and methods. The bulk of included surveies were prospective in design and used druggists as informations aggregators in university-affiliated infirmaries. The deficiency of standardization among different surveies, peculiarly the issues around definitions and badness of ordering mistakes, was a barrier to broaden cognition of the extent of ordering mistakes. This country for development is worth giving our attending to set about future research. The consequences of each survey could be more confidently integrated, saying the standardization could be achieved. Therefore, this will supply a clearer image of incidence, nature and badness of ordering mistakes. In add-on, farther strict surveies in an country of formalizing a methodological analysis and intercession should be conducted to get the better of trouble in aggregating mistake informations and guarantee patient safety.

Analysis of “The Metamorphosis”

According to Sokel, he refers to this as an intrinsic drive that comes from someone. One must work hard and be determined on everything that he anticipates to realize. He should not entirely depend on the external forces or commands from external sources to make him go through. He highlights the Marxist idea that someone only appears to be a true human being who can be recognized in the society when he can be positively rewarded by the works of his hands. Whenever he is imposed by the economic necessity, the work cannot actually make him became alienated because he would be engaged with other people, which is already an agent of socialization. He does not become himself as an individual; rather, he is alienated from his humankind. In this short analysis, the metamorphosis, the protagonist might become a wrong person. When Gregor works as a salesperson, he has a lot in his mind. Things might not be adding up according to him because he has to travel long distances to get customer, he has to pay his bills; he also has to take good care of this family. All these burden mounted on him does not make him happy. For this reason, he has to remain alone and except himself from the company of many. The paper will look into this issue through citation of Kafka`s depiction on the way in which the protagonist react to the idea leading his family into the misfortune. He eventually suffer the guilt of conscience which by all means dismisses Marx`s assertion that loss of humanity can also come from external sources like work mates and family members. International Journal of Arts and Sciences CD-ROM ISSN: 1944-6934 2017 Volume 09, Number 04From the journal, Palvos states that dangling among the vicissitudes in the world without harmony accomplishes a great blow to one`s moral identity. In life, every turn a fatality that has nothing to do with an incorrigible personal law and ethical countenance. If this happens, ones hope and determinations are all shuttered and his life remains without a meaning. Gregor`s self alienation and humiliation is suggestive of the modern dilemma of human beings in the technological period of machines who brute facts and information systems. This analysis points through and through to the reality of material existence and the possibilities of its fall, consequently moves toward the complete subversion of an ethical universe. From a responsible man who could take good care of his family to someone who is mentally tortured and only feels comfortable when he isolates himself from other people. Gregor's metamorphosis from a civilized man into a horrific and monstrous vermin, an instinctual underworld character with an almost automatic nature, and finally to a simple bit of matter, turns him into an antagonist who upsets all the instincts of life. Indeed, Kafka's criminal world vermin gives rise to a deep and stifled impulse in modernity, to the gradual spiritual death of the human, a metamorphosis par excellence of the human substantiate that overrides all instinctual and hermeneutical bound. When the mental capability of human being fails to reason, he is recognized as a worthless being that is at par reasoning with all animals. Henceforth, the humiliated modern human -uprooted beyond bound. When one is stripped of all ethical purposefulness, he no longer possesses the moral entity given to thinking and questioning. He is called to de facto accept and obey the mastermind of pretence techno capital reality, and, the geophysical enterprise of its dully respect.Miyamoto, Kaori. â€Å"Erich Fromm's theory of alienation.†University of Massachusetts Amherst, February 2014, pp. 1-47. Positive factors of freedom sometimes blind many people. Myamoto emphasized on this statement by saying that most of the rich and modernized societies today have a lot of freedom and they enjoy it extremely without sensing the side effects associated with the freedom. The societies have failed in looking at the two sides of the coin. He goes by saying that alienation is a side effect associated with the freedom which most of us have failed to look into with a lot of concern. He support his claim by citing Enrich Fromm`s concept of alienation. He says that the relation of human being is very pivotal especially to those who are alienated. Those alienated should be put close to other people. Being alone to people is not enough, but it should be in all dimensions, through feelings, thoughts and even actions. This source identifies alienation as one of the side effect of identification of human being. Kafka`s protagonist, Gregor is very potential and cooperative in providing to the family. He shows all the ability of taking care of his parents. However, at some points, he alienates himself from the family, an aspect of perpetuated by the ended gratitude and concordat he previously got from them. Because of the isolation, he cannot be identified as someone who is financially stable and can take good care of the family.Nicolae, Cristina. â€Å"Franz Kafka's metamorphotic prison: the door and the window.† Studia Universitatis Petru Maior, Philologia 18, 2015, p. 143- According to Nicolae, he makes his argument to the modern family where one appears to be insignificant or cannot realize his life dreams. He argues that the fact that Gregory stays benevolent makes him appear someone who is finally alienated and spends most of his time alone even without the family knowing his whereabouts. Gregor is portrayed as one who cannot be recognized in the society and he struggles with his loneliness at work place where he decided to seek new identity. At one point, the protagonist identifies himself with a creature which does not make him associate in the light; he rather has to hide himself in the darkness. Actually, being rejected makes one loose his value and becomes worthless before other people. In this regard, this source proves resourceful in identifying the change in Gregor which is from metal to physical level because of the challenge he gets while dealing with his family. From the outlook, Gregor does no change his moral standing irrespective of all the humiliations that he comes across. According to this source, morality is a factor in Gregor`s alienation after being neglected by the family. The social strength which is acquired by the family proves a lot of dehumanization as they draw the attention they originally had for Gregor. Yaron, Idan and Herzog, Omri (2013). â€Å"Kafka's ruins in popular culture: A story of Metamorphosis.† Journal of Popular Culture 46:5, 1092-106.According to Yaron, maintaining culture in the society is very important. Culture helps in preserving the codes of conduct that governs good stay in the community. One who alienates himself from the culture has no positive contribution to the society. According to him, Gregor commits no crime towards anyone only that he was not true to himself and there was nothing that amazing that could make him alienate himself the other people. The split that he experiences in his personality, his deepest struggle and abandoning the culture includes everything taking place within him. However, most people who do not experience such things do not know about it. They can either choose to ignore or deny it. Gregor out rightly bears no illusion about the metaphysical chasm that encircles him and the isolation it brings from those around him who are his equals but do not know it. This gulf is not alienation from his family and the hypocrisy of his relations to them both prior and after the metamorphosis, but is the isolation where a disillusioned man who awakens to a radical awareness of his own mortality suffers the awful experience of separation from others. The separation is actually against the culture. The culture does not allow one ton separate from others irrespective of the situation, however, this takes place because of what he feels in his innermost heart. His corporeity points to his mortality which makes the inhuman world his master. Gregor's inhuman world is as incomprehensible to human reason and sensibility as is death; it is far more human and humane than the reality of the people surrounding him who have denied their own mortality. Modernity and the existential metaphysics of life and death in kafka's metamorphosis pavlos e. michaelides (2017) university of nicosia, CyprusFollowing the customs of our world, and according to the laws of habit and self-complacency, it would be beyond the bounds of scientific innovation for us to wake one morning and find ourselves transformed into colossal insects. Grego`s metamorphosis touches a deep, unappreciated, and anguishing reality in life. This is nourished by sources which are deeper than those of cogent reflection and scientific knowledge. Our personal existence can sometime lead us to horrifying and most anguishing discovery. This points out that the transitory nature of our lives and places can absolutely have great demand on our moral nature to reconcile with its true temporal dimensions. In this plinth, Gregor is doomed from the beginning. His far-reaching transformation into vermin is just physical and irrevocably. Later, it fully becomes impossible for him to reconcile the radical discontinuity between his newly discovered physical structure and his prior human self. The sudden awakening to the devastating discovery of his metamorphosis even brings backfire of his daily expectations with a terrifying inability not to achieve them again. His former self remains qualitatively unchangeable, indeed throughout the story is mostly baffled helplessly trying to adjust to radical change. Despite the tremendous effort that he puts, he ultimately finds it impossible to cope or bridge the gap between an unbridgeable void, which makes his insect like physical structure and the retaining of meaningful human identity.

SSA Taking Benefits Away from Young Adults with Serious Illnesses

SSA Taking Benefits Away from Young Adults with Serious Illnesses SSA Targeting Young Adults with Illnesses, Stopping Benefits to Save Money Could you imagine having a serious, chronic illness and relying on Social Security Disability benefits for your necessary medical treatments, only to have your benefits abruptly stopped, when your condition is getting worse?This is what unfortunately happened to a 22-year-old woman diagnosed with Cystic Fibrosis, an incurable disease that causes serious lung damage. She suddenly had her Social Security Disability benefits stripped away, because the office deemed that her health was improving.The statement baffled Megan Willis and her mother, as they didn’t understand who would make such a conclusion, as Megan’s condition worsened in the last year.She depended on the monthly benefits to afford more than $100,000 a year in costly medical treatments to stay alive.Chronic Disease Causes Life-Threatening Infections Cystic Fibrosis causes mucus to line the lungs, which blocks the airways and leads to serious and persistent lung diseases, such as bronchitis and pneumonia. Mucu s also lines the pancreas, making it difficult to properly digest food and absorb necessary nutrients. The mucus buildup can also cause cirrhosis of the liver, and cause infertility due to buildup on the reproductive tract.Cystic Fibrosis can eventually lead to respiratory failure, and the average life expectancy is only 40 years old. This, however, is higher than the grim outlook for Cystic Fibrosis six decades ago, when children who were diagnosed did not survive past their teen years.Given the severity of the illness, on a â€Å"good day,† Megan spends up to six hours undergoing necessary breathing treatments, and taking medications.Lawyer Helps SSA Reconsider, Wins Back SSD Benefits at Critical Time The sudden loss of the benefits was devastating, as Megan’s family cannot afford private insurance to pay for her extensive medical bills.Megan contacted Attorney Beth Sufian, and with her help, the SSA reconsidered her case, and fortunately, coverage was reinstated eig ht months after it had been taken away.Timing was critical, as Megan was hospitalized for her illness the same month benefits were reinstated.However, these benefits should not have been removed in the first place. It’s wrong that Megan had to wait up to eight months for the benefits she deserves. What would have happened if she was hospitalized before benefits kicked back in?With Backlog, SSA Conducting Unpresented Number of Reviews to Stop People from Receiving BenefitsThe article explained that the SSA conducts periodic reviews, called Continuing Disability Reviews, to ensure that those receiving benefits are still eligible for disability.According to the SSA website, these reviews are typically conducted once every three to seven years, depending on the severity of the illness. If a condition is expected to improve, reviews could be conducted earlier than three years.However, the frequency of these reviews is increasing, with up to nearly one million reviews in the past y ear. Attorney Sufian believes this is done in an attempt to target young adults with serious illnesses, in order to save the organization money by ending necessary benefits.This practice is troubling, as halting benefits for those in need is not ethical. Beneficiaries like Megan have serious medical conditions, and rely on the benefits they receive for their treatments to live.We Can HelpIf you are disabled and unable to work, call  Disability Attorneys of Michigan  for a free confidential consultation. We’ll let you know if we can help you get a monthly check and help you determine if any money or assets you receive could impact your eligibility for disability benefits.Disability Attorneys of Michigan  works hard every day helping the disabled of Michigan seek the  Social Security Disability  benefits  they need. If you are unable to work due to a physical, mental or cognitive impairment, call  Disability Attorneys of Michigan  now for a free consultation atà ‚  800-949- 2900.Let Michigan’s experienced disability law firm help you get the benefits you deserve.Disability Attorneys of Michigan, Compassionate Excellence. Social Security Disability, Social Security Disability Benefits, Social Security Disability Benefits Attorney, Social Security Disability Lawyer

Questions on Entrepreneurship Essays

Questions on Entrepreneurship Essays Questions on Entrepreneurship Essay Questions on Entrepreneurship Essay Entrepreneurship Entrepreneurs have the vision to recognize opportunities where others see chaos, contradiction, and confusion. a. true b. false 2. Entrepreneurs are always inventors. a. true 3. Entrepreneurs are extreme risk takers. 4. Minority-owned businesses could be said to represent the cultural displacement school of entrepreneurial thought. a. true 5. Gazelles are almost always high tech. 6. The word entrepreneur is derived from the French entreprendre, which is translated . a. to undertake b. to compete c. to apprehend . to enter and dare 7. Which is not one of the chief characteristics of an entrepreneur? a. ability to consolidate resources b. risk taking c. personal initiative d. desire for control of people 8. Which of the following statements about entrepreneurs is true? a. All you need is money to be an entrepreneur. b. Ignorance is bliss for an entrepreneur. c. Entrepreneurs are doers and thinkers. d. Inheriting a business is the best way to become an entrepreneur. 9. Which entrepreneurial school of thought emphasizes the planning process in uccessful venture development? . the strategic formulation school of thought b. the entrepreneurial trait school of thought c. tne venture opportunlty scnool 0T tnougnt d. the human relations school of thought 10. Entrepreneurs will always be a. hindered by lack of funding b. a major source of Job creation and innovation in any economy c. a key factor in the stability of the small business sector Terms: Displacement School of Thought-A school of entrepreneurial thought that foc uses on group phenomena such as the political, cultural, and economic environments. Dynamic States- A network of relationships and systems that convert oopportunity tension into value for a ventures customers, generating new resources that maintain the dynamic state. Entrepreneur- An innovator or developer who recognizes and seizes opportunities; converts these opportunities into workable/marketable ideas; adds value through time, effort, money, or skills; assumes the risks of the competitive marketplace to implement these ideas; and realizes the rewards from these efforts. Entrepreneurial Management- The themeor discipline that suggests entrepreneurship is based on the same principles, whether the entrepreneur is an existing large institution or an individual starting his or her new venture single- handedly. Entrepreneurial Revolution- The tremendous increase in entrepreneurial business and entrepreneurial thinking that has developed during the last 20years. This revolution will be as powerful to the twenty-first century as the Industrial Revolution was to the twentieth century (if not more! ).

International Relations in the world Essay Example | Topics and Well Written Essays - 1750 words

International Relations in the world - Essay Example The United Kingdom naturally enjoys several benefits out of this approach of coalition with the US and Europe simultaneously, while promoting the transatlantic cooperation. However, meeting the costs of the special relationship as well as balancing the coalition with the US and Europe has not been easy for the British government. The stance of providing unprecedented support to the US actions and policies has led to the growth of scepticism in the European Union as well as among the British public and party members. This paper elaborates the US-UK special relationship in the context of enhancing collaboration between the US and Europe. It then examines the cost and benefits associated with this stance of British government. The post cold war period signifies a new geopolitical scenario encompassing the Western world. There have been conflicts, as well as concordance on world issues affecting the state of relations shared by nations. The United Kingdom, not only geographically but also politically, finds itself intimately connected with the European world and the historical 'special relationship' with the United States driven by the nations' commonly shared interests and objectives. This transatlantic relationship not only affects the British foreign policy but also influences the dimensions of relationship between the United States and the European Union. The British government, in effect, regards itself as playing a bridging role between the United States and the Europe. This relationship, according to Wallace (2005, p55), "conjures up an image of British ministers and diplomats explaining European international politics to American leaders, and interpreting American foreign policy to European governments". The British prime ministers historically have been playing eminent role in bringing European countries closer to the United States. It also happens to be an important aspect of Britain's foreign policy for the current Prime Minister Tony Blair, to balance the British relationship with the United States and the European countries as well as to promote cooperation between the US and Europe. Hence, the government undertakes rigorous efforts as a part of its foreign policy to enhance this multilateral collaboration. The historic relationship between the US and UK was further bolstered up by the 9/11 event and the United States' subsequent war on terror, whereupon Britain provided full military and political support to the American stance to wage war on Afghanistan and then Iraq. Dumbrell (2006, pp. 456-457) asserts that Tony Blair has succeeded in developing a "special relationship" with the United States channelled through its support for the war on terror; hence projecting it as the greatest US ally. The Britain's stance for bridging relationship between the US and the Europe certainly implies increasing collaboration between these countries and communicating the need to enhance multilateral cooperation leading to the achievement of their national interests. Benefit And Costs Of The Approach The approach of playing a 'bridging role' between the US and Europe relations procures significant geopolitical gains to the United Kingdom. Britain aspires to maintain its influence over the international politics and policies, but lacks resources to accomplish this objective.

PPD3 Portfolio Part 1 Essay Example | Topics and Well Written Essays - 3500 words

PPD3 Portfolio Part 1 - Essay Example Indeed, all the preparations and research we have undergone resulted to more than knowledge. The very first step that an applicant must learn when applying for a job is to familiarize himself about the target organization, in this case- Enterprise Rent a Car. Enterprise Rent-A-Car is already an established organization with very precise set of procedures. An example of which is the recruitment and selection process of the company wherein they attract university students through a mentoring program. The on-the –job training is a very valuable process that students like I could participate in order to experience real life situations as compared to theories learned in the classroom setting. However, not everyone can fit into what Enterprise Rent a Car needs because there are certain competencies required so a person can fulfill job functions very well. Our team evaluated the objectives of a car rental business and saw that the main goal of this type of business is to expand its c ustomer base. Such goal can only be accomplished through outstanding customer service since customers themselves can make referrals about their service. The Enterprise was very good at focusing on customer service and used ESQI to measure customer satisfaction. I realized that business guru Peter Drucker was right when he said that â€Å"things that cannot be measured cannot be managed†. Likewise, the saying is very applicable to my personal development since what we have been learning and doing all along these past few weeks is determining different skills and capabilities that we possess. A comprehensive and objective report as revealed by different tests gave me a clear picture of my strengths and weaknesses as well as potential for development. However, aside from focusing on myself, I understood the importance of collaboration with other team members. A goal can only be achieved when a team works together and gives their best. Team members met and brainstormed so best id eas would come out naturally. Everyone participated and we listed all the possibilities of how a car rental service can expand its base of marketing. We realized that all of us share same concepts and that marketing was very crucial in real life situations. We all agreed that this type of business would have an advantage over its competitors if it segments its target market since other companies take a shot-gun approach or one size fits all. The industry is competitive and things don’t work out that way anymore so we have to be creative. My ESTP personality moved the group into action so I was the one who set deadlines and arranged meetings. We also knew that this business has certain set of expectations from its employees and would get an employee who can be an epitome of customer service. The company screens online application forms which are why it is very crucial to create the best CV possible. A working experience in a sales oriented company would be an edge over other a pplicants which made me feel confident. Once an employee or a management trainee is in, various development programs coupled by trainings and seminars is in place. Aside from all the planning, organizing and researching to learn more about Enterprise, there are much more important things learned in the Assessment Exercise. First, it takes a lot of preparation to really get a good job nowadays. The most diligent effort

Research Methods Law Term Paper Essay Example | Topics and Well Written Essays - 1000 words

Research Methods Law Term Paper - Essay Example Moreover, this paper also shows different types of quantitative research and how it is helpful for findings and analysis of relevant data about the criminal justice. Discussion The aspect of criminal justice may entail the requirement of dealing with a few attractive dodgy characters. However, when it comes to conducting a research related to cases which are presented in the courts; two types of methodology are believed to assist to solve such crimes. The first is quantitative figures and statistics marked across graphs, charts, reports and spreadsheets which delivers indisputable confirmation of theories. Qualitative research techniques assist criminalists or investigators to recognize the reasons behind committing crimes and solves through case studies, interviews and profiling (Smith, Liu & Lindquist, 1988). Quantitative research techniques encompass the entire bases of scientific investigation and pairing mathematical perspectives with subjective data. A criminal justice professi onal may apply regression analyses to utilize inductive reasoning, calculate timelines, place people and proofs in context to the concerned circumstance and make non-biased evaluations. Operating computer models, analyzing evidences and implementing systematic as well as personality tools assists the criminalists to understand the suspect well enough to depict their attitudes which helps to portray scenarios of case studies as well as test theories and further assists to solve cases (DiCristina, 1997). Criminalist is an individual who is considered to be quite proficient in collecting and examining physical evidences of crime. Criminalists utilize quantitative techniques to ensure confidences regarding inductive statistics, Deoxyribonucleic Acid (DNA) and ballistic tests, proof-based comparisons, crime-based neighborhoods and family demographics, previous offenders’ data, crime mappings, meta analyses, computer based structures and evaluations of anthropological data which ar e believed to be associated with forensic tests (Higgins, 2009). Survey Research: In this method, a research technique dependent on survey is utilized in case of criminal justice which concentrates on the use of statistical data. Hypothesis needs to be developed through this type of research which primarily deals about the way a given population is likely to react to different issues in criminology. According to the survey research program of â€Å"Sam Houston State†, it has been found that the primary objective of survey research is to notify the general public as well as public officials with an exact picture of attitude regarding various types of crimes and several ethical as well as legal issues within the organizations associated with criminal justice. There are three methods of survey research for instance personal interview, mail questionnaire and telephone survey. This type of research is considered to be quite essential as it can deliver legislators the various forms of actions which can be undertaken concerning different significant issues which affect the aptitude of bureaucrats’ related to law enforcements for carrying out businesses (Sukamolson, 2012). Time Series Research: This technique is designed for conducting researches on criminal justice and

Touman Model Argument about the Environment Term Paper - 1

Touman Model Argument about the Environment - Term Paper Example The environment is becoming worse with each passing day; there are several factors that are responsible towards the degradation of our environment. Some of the most factors that need to be worked upon are pollution, disposal of waste material in an unorganized way and in addition to this there are many more factors that need our immediate attention. This paper will throw light upon the Toulmin model argument and in addition to this what specific actions should Christians take regarding the environment will also be will also be provided in this paper. The ozone layer is depleting with each passing day and this is a very disturbing environmental issue, this means that human race will shortly come to an end should it not be dealt with properly. The ozone layer is pivotal when it comes to the survival of human beings, it protects us from harmful radiations emitted by the sun and its deterioration is a very big cause of worry for the human race. An Insight on Toulmin Model of Argument Stephen Toulmin was a British Philosopher and in addition to this, he was also a realist who developed a model of argument which will be incorporated in this paper. He divided any argument into six most important sections.

Managing Physical and Mental Health Challenges Essay

Managing Physical and Mental Health Challenges - Essay Example According to the report  cognitive disabilities basically affect one’s intellectual capacity and     affects performance in education. Mental health in simple terms is absence of a mental disorder and physical health is the general wellbeing of the body. Cognitive disability is detected by intellectual capacity, academic ability and adaptive conduct. To measure the intellectual capacity, an intelligence test is run. An intelligence test is any of a number of tests designed to measure a person’s mental skills Academic performance can be measured by communication skills and academic readiness of the person.From this study it is clear that mental health and physical wellbeing can be affected by cognitive disability. When one is confirmed to have cognitive disability, then they end up having a difficult time interacting socially which in turn affects them psychologically. Psychological effects end up causing anxiety and depression which in turn makes people to seek di fferent ways to cope. Stacey deals with her problems by self mutilation which causes physical problems. If Stacey is confirmed to have cognitive disability, then the choice on the way forward is left to the parents but if she doesn’t have any cognitive disability, then she can make sober decisions on her own .This is according to the Nursing and Midwifery code of conduct.  Stacey needs to go through a series of counseling and psychiatric treatment to make her learn how to open up and also to stop her from inflicting injury on herself.

Health Care Reform Essay Example | Topics and Well Written Essays - 3000 words

Health Care Reform - Essay Example Some the benefits include allowing children to purchase insurance, at the start of 2014 women will no longer be charged more than men. Insurance firms will also be regulated so that they are not able to hike insurance rates when an individual falls ill will be of benefit to all the citizens. This regulate of the insurance will greatly help in ensuring that the health of any individual is not jeopardize just because of their social status and age The ability of state-based exchanges will also allow persons who are unemployed to purchase insurance. Subsidies will also be provided to those families that are below the federal poverty level. These reforms will be a great boost to most of the citizens who do not earn a decent income (Jill, 2012). Healthcare in the United States is a fundamental part of living. This is due to the many health issues that Americans face in a daily basis. However, the healthcare structure in the America is faced by a big problem of expensive services, which is not affordable to most of the people. A big percentage of American population is not medically insured and this leads to the physician visits being too expensive for an ordinary citizen. Approximately 44million Americans are not insured and an additional 38 million have insufficient health insurances. This population lives each day not sure what would happen if they fell sick or were in need of medical attention. The absence of a medical insurance therefore means that they cannot visit the physician for regular check ups and will always postpone illnesses or trips to the doctor because they simply cannot afford it. Delayed medical care for fear of expenses is a disaster considering the number of people in the country and the illnesses that could be treated early turning fatal. People without health insurance are at the greatest risk of not catching illnesses early enough and not acquiring medical

Touman Model Argument about the Environment Term Paper - 1

Touman Model Argument about the Environment - Term Paper Example The environment is becoming worse with each passing day; there are several factors that are responsible towards the degradation of our environment. Some of the most factors that need to be worked upon are pollution, disposal of waste material in an unorganized way and in addition to this there are many more factors that need our immediate attention. This paper will throw light upon the Toulmin model argument and in addition to this what specific actions should Christians take regarding the environment will also be will also be provided in this paper. The ozone layer is depleting with each passing day and this is a very disturbing environmental issue, this means that human race will shortly come to an end should it not be dealt with properly. The ozone layer is pivotal when it comes to the survival of human beings, it protects us from harmful radiations emitted by the sun and its deterioration is a very big cause of worry for the human race. An Insight on Toulmin Model of Argument Stephen Toulmin was a British Philosopher and in addition to this, he was also a realist who developed a model of argument which will be incorporated in this paper. He divided any argument into six most important sections.

Health Care Reform Essay Example | Topics and Well Written Essays - 3000 words

Health Care Reform - Essay Example Some the benefits include allowing children to purchase insurance, at the start of 2014 women will no longer be charged more than men. Insurance firms will also be regulated so that they are not able to hike insurance rates when an individual falls ill will be of benefit to all the citizens. This regulate of the insurance will greatly help in ensuring that the health of any individual is not jeopardize just because of their social status and age The ability of state-based exchanges will also allow persons who are unemployed to purchase insurance. Subsidies will also be provided to those families that are below the federal poverty level. These reforms will be a great boost to most of the citizens who do not earn a decent income (Jill, 2012). Healthcare in the United States is a fundamental part of living. This is due to the many health issues that Americans face in a daily basis. However, the healthcare structure in the America is faced by a big problem of expensive services, which is not affordable to most of the people. A big percentage of American population is not medically insured and this leads to the physician visits being too expensive for an ordinary citizen. Approximately 44million Americans are not insured and an additional 38 million have insufficient health insurances. This population lives each day not sure what would happen if they fell sick or were in need of medical attention. The absence of a medical insurance therefore means that they cannot visit the physician for regular check ups and will always postpone illnesses or trips to the doctor because they simply cannot afford it. Delayed medical care for fear of expenses is a disaster considering the number of people in the country and the illnesses that could be treated early turning fatal. People without health insurance are at the greatest risk of not catching illnesses early enough and not acquiring medical

Roller coaster project Essay Example for Free

Roller coaster project Essay The batman rollercoaster is an extreme, thrilling rollercoaster. The batman rollercoaster was introduced 1997 and, 2,700 feet long! The original installation of the ride is at Six Flags Great America featured a maximum height of 100 feet while the installations to follow reached 105 feet. The rides reach a top speed of 50 miles per hour and exert up to four times the force of gravity. Potential energy, kinetic energy, Newton’s laws of motion and the design of the batman rollercoaster functions. When you first start off you go up this big hill, you are increasing your potential energy, and when you reach the top you’re at maximum potential energy. At that moment when you start to rush down the other side of the hill you turn that potential energy into kinetic energy. Gravity is the force that pushes you down the hill. Then you’re about to go in a loop, when you’re at the bottom of the loop your kinetic and potential energy is about the same since you about used half of your potential energy from coming down the from the hill. When you’re midway through the loop you have a little bit more potential energy since you’ve gone up a hill and when you are coming down from the loop you use that potential energy. Then you go down another hill and that increases your kinetic energy and decreases your potential energy. Then you start going through all of these turns witch slows you down because of all the friction. Then, very sadly, you are done with this spectacular ride. Newton’s laws of motion affect how the rollercoaster functions. Newton’s first law of motion states that every object in a state of motion tends to remain in that state of motion unless an external force is applied to it. The rollercoaster will keep on going down the hill at the same constant speed if this was not true. Friction is the external force that slows the rollercoaster down. Newton’s second law of motion states that the acceleration of an object depends on the mass of the object and the amount of force applied. Think about the design, witch we will talk about later, it is a chain lift rollercoaster. If everybody that rode on the rollercoaster had a mass of 200 kg the rollercoaster would be slower unless there was more force from the chain-lifts. Newton’s third law of motion states that whenever one object exerts a force on a second object, the second object  exerts an equal and opposite force on the first. Think about the harness that you wear and the seat that you’re sitting in, when pushing against them they are also pushing back on you. The design connects everything that a roller coaster does. The design of the rollercoaster is a chain lift. In the beginning of the ride you can see the chain that lifts the roller coaster carts. If the designers left that out the roller coaster would not function right. Like I said before the more mass the people on the rollercoaster has the more force it takes to accelerate them. If the chains were there but shorter the rollercoaster would not have enough potential energy to complete the track. Potential energy, Kinetic energy, Newton’s laws of motion, and the design of the batman roller coaster affect how it functions. Reference Page By: Stephen Morris