Children of a Lesser God Essay

This film is based on a stage play of the same title. It tells about James Leeds, a man who teaches children with special needs in a school for the deaf and those who are hard of hearing. He is a devoted and inventive teacher who shows a deep compassion for his students, applying teaching methods he could think of just to draw out the interest of his students to learn, do more and accomplish things to the fullest of their capacity. James meets and falls in love with Sarah Norman, a beautiful woman who works for the same school and has been deaf since she was a baby. At first Sarah avoids James until he is able to draw her out from her shell and eventually he is able to convince her to live together. Sarah is full of bitterness, hurt and other emotional scars over the mistreatment she experienced while she was growing up because of her impairment and this jeopardizes their relationship. Sarah has to come to terms with her personal issues and needs to feel that she is an independent woman. In due course, they are able to settle things amidst the difficulties they come across in communication. The movie made me realize the significance of communication among people and people who have communication disorders should be given special attention in order for them to be heard. Even individuals who are fully capacitated physically have a hard time in getting messages understood. I just hope that there will be more teachers like James Leeds in this world who loves what he does and changes the lives of other people. The movie, which focuses mostly on the hearing impaired, is very much relevant to this course. It gives us the glimpse of how they live and struggle to be understood and to understand others. It portrays the complexity of their lives and helps us appreciate how difficult things are for them and moves us to do something for them. WORKS CITED Children of a Lesser God. Dir. Randa Haines. Perfs. William Hurt, Marlee Matlin, Piper Laurie, Phillip Bosco. VCD. Paramount Pictures, 1986.

Examine how Shakespeare presents the female characters Essay

Examine how Shakespeare presents the female characters in ‘Hamlet’ and what the response of a modern day audience might be to this aspect of the play. As ‘Hamlet’ was set in the Elizabethan period it is necessary to consider the portrayal of woman in the play as a comparison with women in a modern day society. Similarly to most literature written during this period, ‘Hamlet’ conveys women’s lower status to men. This can be thought of as the stereotypical view in Elizabethan society. We know that women were not even able to act in plays and that young men had to play the parts of women. One of the main ways we may interpret the portrayal of woman is through the language, and in some cases stage directions of various characters, in various scenes. It may be true to say that the characters of Ophelia and Gertrude are portrayed as weak and submissive, this is seen by men as well as themselves. They can be seen to be merely driving factors of the play rather than main elements such as Hamlet. It may also be suggested that due to these facts, the play ‘Hamlet’ may be written differently if written today, in terms of language, in order to suit a modern day audience. It can be argued that the way Shakespeare has presented women, reflecting society in the Elizabethan period, may not be acceptable in today’s society. One of the principle aspects to consider is how female characters are portrayed and therefore treated by others in the play. Ophelia is an interesting character, and it is important to explore her relationships, her language, and also her death prior to concluding her portrayal. This may be noticed in her relationship with the men in her family. In Act one, the relationship shared between Polonius, Laertes and Ophelia may be compared. When looking at Polonius’ relationship with his daughter it may be noticed that he is not quite as willing to give in to her wishes. Instead he gives her strenuous warnings about how to behave in relation to Hamlet. â€Å"Do not believe his vows, for they are brokers†, Polonius tells Ophelia not to believe what Hamlet says to her. . However, he does show his concern for her, because he is warning her to be very careful in this business. Polonius forbids Ophelia to associate herself with Hamlet, telling her that he is deceiving in his declaration of love. It is extremely doubtful that he is simply doing this to deny her of what she wants; however the audience becomes aware of the domination and power he has over his daughter. Another view is that daughters were merely supposed to bring fortune and honour to the family and that Polonius may have been more concerned about his reputation, rather than the happiness of his daughter. Ophelia dutifully obeys her father, responding minimally with â€Å"I shall obey, my lord†. This type of attitude was thought of as normal in the Elizabethan times. It must also be noticed that the protective role of a father over his daughter, and a brother over his sister would not be thought of as abnormal in today’s society. It is the extent to which this protectiveness is present, and the fact that Ophelia shows no intention to disobey their wishes, that would both surprise and amaze a modern day audience. The extent of domination, particularly over a daughter’s personal matters such as marriage would be normal in Elizabethan times. However, similar to today, a father would not be as protective over his son as he would over his daughter. Earlier in Act 1, Laertes warns Ophelia about Hamlets love, describing it almost as youthful infatuation. He explains to her that as Hamlet is a prince he cannot choose his own wife and must marry in the interest of the state. Again, this type of advice and awareness of status would not be criticised by a modern day audience. Laertes’ approach is indeed blunt, and Ophelia is told directly not to be so foolish as to trust the Prince outright. Ophelia says that she will keep his advice as a â€Å"watchman† close to her heart â€Å"I shall th’effect of this good lesson keep as a watchman to my heart†. She hints to him that he should not give her advice that he does not follow himself. â€Å"show me the steep and thorny way to heaven†, â€Å"himself the primrose path of dalliance treads†.

Unit 6 Essay Exam Ap Us History P3

Elsa Castro period3 11-19-2012 Unit 6 Essay Exam Before the start of the industrial revolution women was a gender that was considered insignificant, and powerless. It has always been that way till the years of 1790 and 1860 that things where begining to change drastically. Since that drastic changed we all know as the industrial revolution economically women were finally given the opportunity to work,earn their own money,and help their families; while domestically there was reat amount of admiration from women in the comfort of their own home now instead of just expecting their place to just be there. The Industrial Revoltuion as we all know was a period of drastic change in technology, manufacturing,and transportation from the start of the nineteenth century onward. Those things had a huge effect on the economic, social, and the cultural conditions. Due to the drastic change women were finally allowed to work.Before the industrial revoltuion if women wanted to work they would have d omestic jobs like sewing,or making household materials out of soap. When the period of change was at its end women were now working in factories. This radical change was only the begining of women being able to work. earn their own money, and being able to gain economic independence. Although women were now able to work they would work to a certain extent. Women would have to work 13 hours a day, and get paid very little.Inaddition if your a women that has been single would have to leave their job if the women is getting married; once your married your husband will be the supporter of the house. Even before, during, and after the industrial revolution the women still had to be at home taking care of her husband and her children. Normally in domestic families women normally would have to agree with the husband, and both of them were only limited to doing certain task

EU Law Essay Example | Topics and Well Written Essays - 2500 words

EU Law - Essay Example Charles clearly falls under this head. The next step would be for him to establish that the Directive is â€Å"clear, negative, unconditional, containing no reservation on the part of the Member State and not dependent on any national implementing measure,: Alfons Là ¼tticke GmbH v. Hauptzollamt Saarlouis [1966] relied on in Van Duyn v Home Office [1974]. Whilst we do not know the precise wording of the Directive we can deduce the phrase â€Å"prohibit discrimination in the workplace on the grounds of age† meets the criteria for the Directive to be directly applicable. However this is not true for Dilshad who is employed by a private company. As seen in Marshall v Southampton and South-West Hampshire Area Health Authority (Teaching) [1986] the Court of Justice does not allow the direct horizontal enforcement of Directives. However, in Marleasing SA v La Comercial Internacionale de Alimentacion SA [1990] two private individuals sought a remedy which was not included in the Directive. The Court held that a non implemented Directive could be relied upon in a case between individuals. The House of Lords confirmed this view in Webb v EMO Cargo [1994] in a case dealing with sexual discrimination. [†¦] interpret their national law in the light of the wording and the purpose of the Directive in order to achieve the result referred to in the third paragraph of Article [249]. Von Coulson and Kamann v Land Nordrhein-Westfalen [1984] 2 This is known as indirect effect. Both Charles and Dilshad could seek redress with a view to having the national court declare age discrimination in the workplace unlawful in the UK. The national court would be at liberty to provide an adequate and effective remedy. An advantage of this approach is that unlike direct effect the provisions in question do not have to be clear, precise, unconditional and require no further implementation. Assuming the worst case scenario that both Charles and Dilshad are denied a remedy through

Cognitive Behavioral Therapy based approaches to mental health nursing Essay

Cognitive Behavioral Therapy based approaches to mental health nursing and their application to depression - Essay Example This paper presents a literature review of the cognitive behavioral therapy based approaches to mental health nursing and their application to depression. The most remarkable finding published thus far on the treatment of depression has been in a major research, conducted by Keller and colleagues (2000), weighing the outcomes of one of the more recent treatments, nefazodone, against a new treatment, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP). The CBASP approach suggests that the mindset of individuals with chronic depression has become retarded or regressed to the most elementary developmental stage. The nature of this mindset makes patient indifferent to forces from the social environment, leading to the belief that they are not able to affect any of the circumstances in their lives. This kind of mindset leads to the submissiveness and vulnerability usual of patients with chronic depression. The technique underlying the therapy is to demonstrate to patients th at their decisions and behavior do in fact have significant effects, so that they will be encouraged to adopt behaviors that will yield positive outcomes. These positive outcomes, which stem mostly from social support, work to bring back motivation and enhance mood. Several techniques are implemented in adopting this approach such as the following (Keller et al., 2000, p. 1465): Provision of consistent feedback from the therapist on the interpersonal effects of the patient’s actions. Teaching patients to discriminate between aversive or abusive past interpersonal situations where they could not affect outcomes and current situations where they can. Teaching patients to evaluate systematically whether their actions are assisting them in achieving desired outcomes. The study of Keller and colleagues (2000) presented credible proof that CBASP is very useful in treating chronic depression. The speed of total remission with the combination of medication and CBASP in the study of K eller and colleagues (2000) was almost double the speed of total remission of patients who received medication and cognitive therapy. It is somewhat likely that CBASP will become the most successful therapy for chronic depression. However, this is not yet definite, since the speed of response to medication was significantly greater than in studies using cognitive therapy. Even though the research subjects used in the study of Kelly and colleagues (2000) seem to have higher levels of chronic depression than those in cognitive therapy studies, it is also probable that they were more responsive to treatment. Relapse preventive outcomes have also been reported applying other newer treatment approaches of cognitive therapy. Galante and colleagues (2013) formulated Mindfulness-Based Cognitive Therapy (MBCT) which incorporates several typical cognitive therapy policies into mindfulness approaches. MBCT is given in a group setting with individuals who have experienced severe depression. Thi s treatment was developed particularly with the purpose of enhancing meta-cognitive consciousness in patients who have recovered from depression and who are highly vulnerable to more episodes. By means of mindfulness exercise, MBCT seeks to build a mental ‘group’ of meta-cognitive consciousness that is broader than the meta-awareness associated only with a damaging

Homeopathy Essay Example | Topics and Well Written Essays - 2500 words

Homeopathy - Essay Example Conventional medicine is the system being practiced by medical degree holders such as medical doctors and the medical practitioners who work with registered nurses, therapists, and psychologists. It is also referred to as mainstream medicine, or "regular" medicine. Complementary medicine, when practiced alone, is used along with conventional medicine to supplement the latter. An example of complementary medicine is the intake of plant extracts and juices believed to have extraordinary therapeutic effects to supplement conventional medicine. The use of alternative medicine, on the other hand, most of the time replaces conventional medicine. For example, a cancer patient may choose to engage in a series of practices including diets and supplements instead of going through the methods of conventional medicine which may include surgery and chemotherapy. Integrative medicine is defined as a practice that "combines mainstream medical therapies and CAM therapies for which there is some high -quality scientific evidence of safety and effectiveness" (NCCAM 2006). For some, the combination of mainstream medical therapies and CAM therapies is best than depending on a single ttype of therapy. Lastly, Complementary and alternative medicine, or CAM, is "a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine" (NCCAM 2006). It is a movement that is seeking ways to treat illness with minimal disruption of the internal environment of the body. A more organized and established example of alternative medicine is the practice of homeopathy. This form of alternative healing, which dates back to 200 years ago, uses a different approach in diagnosing and treating medical conditions. It is primarily based on the Law of Similars which promotes curing "like with like" which means that "small, highly weak & diluted quantities of medicinal substances is given to treat symptoms, but when the same substances are given at higher or more concentrated doses would actually cause those symptoms in patient" (Weiner & Goss 6). Homeopathy is one among the many approaches to complementary and alternative healing. Its increasing popularity over time and its worldwide success indicate that like most approaches to health care, it should be chosen with considerable care, and considered only as an alternative should other approaches to healing such as "conventional medicine" have proven unsuccessful. There are however some doubts on the usefulness and affectivity of the practice of homeopathy. The modern medical practice as we know it is well founded on scientific studies and proofs. There is a growing trend in modern society to seek natural healing treatment for various illnesses that plague mankind. Homeopathy, despite considered to be unscientific by some, is one of those CAM that society is willing to try. The main reason is the that modern medicine, which is based on pharmaceutical products, do not address all the concerns of the ailing public. People want more preventive and natural remedies and don't want to become human experiments for pharmaceutical drugs. Most pharmaceutical products have harmful side effects, sad to say, some of these side effects

Panopticon Essay Example | Topics and Well Written Essays - 2500 words

Panopticon - Essay Example The involved management is in a position to monitor the behavior of the inmates who are placed at the perimeter of the building. Though the founder of the panoptic- Bentham- said this design is also applicable in churches, schools, hospitals or asylums, he concentrated on the panoptic prisons which are widely recognized today (Semple 2003). Between 1786 and 1787, Bentham travelled to kritchev to pay a visit to his brother. His brother- Samuel- was involved in various projects involving industrial ones for the prince Potemkin. Later, Jeremy acknowledged that it is his brother Samuel who came up with the idea of a circular building at the centre of a larger compound area where managers would be in a position to monitor the skills of all the unskilled workers. Jeremy, however, decided to conceptualize the idea into a prison setting. Once he returned to England from visiting his brother, Jeremy continued to work on his panopticon idea. He even sought the professionalism of an architect. He continued to propose his ideas to authorities with no avail. He was to see the prison but the authorities just turned him down. Thus, he concentrated his ideas in persuading the prime minter (Bentham 2011). His efforts bore fruits and he was given some initial capital to commence the project. After a struggle to purchase a site, he later bought one at the Milbank in 1779. The site however was quite unhealthy and small according to his sentiments. However, his efforts to plead with the government to allocate him more money to buy more land were unsuccessful. The authorities told him to manage with that land by building a much smaller panoptic prison. He continued to pester the government with his idea though he saw they were uncommitted to the project. The then prime minister resigned in 1801 and the project was put to a halt. Due to this, he remained bitter all his life and later demanded for

Risk and value management Essay Example | Topics and Well Written Essays - 1000 words

Risk and value management - Essay Example Based on the primary objective of value management to develop project objectives with uttermost clarity, the process facilitates quest for background information on the project as well as the project’s needs. These initiatives facilitate an extensive development of knowledge on the project towards management competency of business knowledge. As a result, value management provides an opportunity for developing insights into a project for proper management of the strategic management stage and the entire project. Value management also creates time resource between the initiation stage of a project and the project’s implementation stage. With an outlined budget for value management’s time, an organization is able to identify and evaluate outlined objectives in a project for improvement. This therefore means that apart from the benefits of the value management, its incorporation in the project’s budget adds value to the briefing process as well as the entire p roject (Turner, p. 307). Value management also facilitates identification of client’s needs and expectations from a project. The analytical approach of the management that aims at identification of the objectives of the project particularly leads to an understanding of what the customer wants out of the project. This further facilitates development of objective and establishment of ground for customer utility at the completion of the project. Establishing customers’ needs is also important in the strategic briefing stage because the success and feasibility of a project is measured against expectations of the stakeholders. With all needs of the client identified by the value management process, the strategic briefing process develops the capacity to evaluate feasibility of the needs as well as incorporating the need into the project’s objectives. There is also an induced benefit of empowerment and development of team members in value management. The interactive approach in

Virtue theory and abortion Essay Example | Topics and Well Written Essays - 1000 words

Virtue theory and abortion - Essay Example I strongly support the idea that abortion is the best option for Rebecca. It was mentioned earlier that the theory of utilitarianism considers an action to be right if the chosen action can provide a person the best consequences that can make the person happy (Hursthouse 225). Since both persons are only 22 years of age, it is given that both Rebecca and Tobias are not ready to settle down and have a child. This brings out the question, what would really make Rebecca happy in life? Is it becoming a single mother? Or being able to pursue her career as a human rights lawyer? Abortion, based on the theory of utilitarianism, seems to be the best option for Rebecca. It was mentioned in the given case study that the relationship between Rebecca and Tobias were not based on sincerity and true love; but more on just sexual desires and pleasure. For this reason, continuing the pregnancy may not be the best action that will make Rebecca happy. Aside from not feeling ready to start a family, Rebecca refuses to raise a child without a husband to support her either financially or emotionally. The problem with Tobias is that is guy, given the young age, is also not determined or responsible enough to face his personal obligation as a father to Rebecca’s unborn child. Therefore, it is close to impossible that Rebecca would be able to raise the unborn child with Tobias. On the contrary becoming a human rights lawyer is what will make Rebecca happy in life. Therefore, it is just right for Rebecca to decide on having an abortion. Opponents can criticize my personal point-of-view using the theory of deontology. Basically, the theory of deontology considers an action to be right in case it strictly follows the basic moral principles of God or as required by the natural law (Hursthouse 234). In general, one of the common principles of God includes the idea that it is morally wrong to kill people. Within the

Franklin D, Roosevelt on the four freedoms(1941) Assignment

Franklin D, Roosevelt on the four freedoms(1941) - Assignment Example They include freedom of speech and expression where every human being was able to express him/herself all over the world. Second was the freedom of worship as one wish without any interference. He argued individual should be allowed to leadership from the Almighty. Third was the freedom from want which would provide peaceful coexistence among the world populace and the last freedom was the freedom from fear which would reduce disarmament among nations so as to reduce the fear that existed among the residents. The four freedoms influence history in the 20th and 21st centuries. The president was guided by the principles and help America out of seclusion to more ways of acceptance by other countries among them were the European nations during the war. Guided by peace message around the world, Franklin initiated peace talks with various nations’ and leaders such as Churchill that led to formation of the United Nations to monitor world peace. Franklin four pillars of freedom have also formed the major changes that occur around the world. In fact they have formed the major basic human rights in many constitutions. Many governments including the United States considers them to be the fundamentals of a democratic state in the modern era. Any government that denies its citizens the four freedoms is just but a dictatorship regime and is prone to be neglected by the major world nations. Hence, the four freedoms have greatly resulted into democracy and peace around the world. The source of the data enabled us to know exactly who presented the information since it was from a recorded video tape. We were also able to establish the emotions that was involved by Franklin in its quest to have a more better world that do not involved in constant wrangles. However, the source do have some weakness, for instance the author does not exist anymore hence we could not consult him to substantiate his ideas.

Earthquake in Chile on economic growth Essay Example | Topics and Well Written Essays - 500 words

Earthquake in Chile on economic growth - Essay Example Myriad tidal waves, following the earthquake, struck many other villages and towns and victimized â€Å"fisherman and farm workers†¦as well as campers and backpackers (Chile 2010). In comparison to the governmental response to the earthquake in Haiti a few months back, the Chilean government was better able, albeit imperfectly, to respond to the disaster and help the people. In response to widespread looting in the days that followed, the government of Michelle Bachelet dispatched the army to keep the peace. The task of rebuilding the country will be immense. The earthquake â€Å"caused $15-30 billion in damage, or up to 20% of Chile’s GDP† (Chile 2010), an amount that may still climb once a more accurate picture of the damage emerges. Affected sectors of the economy include both the timber industries and viticulture. With approximately $11 billion held in a sovereign fund, the government at least has some resources to draw on in order to help rebuild the country. Developed by Roy F. Harrod and Evsey Domar during and after the Second World War, the Harrod-Domar model seeks to explain economic growth as not being linear but rather as being chaotic. It asserts that â€Å"even† growth is neither a reliable event nor a naturally determined one. Popular in the 1940’s and 1950’s it has probably influenced the historiography of the reasons for the Great Depression ending and the economic expansion of the 1950’s. The war brought the economic growth that ended the Great Depression. Furthermore, it is commonly held that when the troops came home they had a large amount of unspent savings. When they started to spend these savings, the economy took off. Thus the Harrod-Domar model would hold that a high level of savings, or available capital, is an engine of growth. Investment forces capital to build up thus spurring economic expansion. In developing economies, like Chile for example, a great amount of available labor can help increase output without causing

Quintessential Leader Description Essay Example for Free

Quintessential Leader Description Essay The main focus of this research paper is leadership qualifications in the workplace. Please structure a research paper to address the following issues: (A) Develop the academic foundations of leadership by providing a brief literature review of three (3) current articles (that is, within the last 4 years) that relate to any of Daniel Golemans theories. Research other articles not use used in the course. Make sure that the articles you choose are appropriate and related to you topic. The articles do not require Goleman as an author. (B ) Describe what you consider to be the quintessential good leader using additional research literature (in addition to those of the previous Goleman literature review) to support your defense. (C) Using the research from the Goleman literature reviews (category A), and the literature used to describe the quintessential leader (category B ), develop a theoretical leadership model with a focus on middle manager leadership qualifications for an existing or fictitious organization. Use one of the teamwork development models from threaded discussion 2.2 as one of the expectation of the leader. In other words, I want you to build an organization with a middle manager (leader) which instills all of the characteristics that you choose to describe, defend, and analyze. This is your chance to put your preferred leadership resource in place. It is recommended that you include at least three characteristics for your leadership qualification model. Note: you have full autonomy to provide the list of characteristics as long as it is defended using proper research methods. Make sure you analyze each characteristic and defend your assertions.

Genetic Screening: Types of Tests and Applications

Genetic Screening: Types of Tests and Applications GENETIC SCREENING AOUDUMBARI B.DESAI What is Genetic Screening? Genetic screening is a process in which DNA is tested to check if a person has any genetic indicators of diseases. It can also be defined as an experimental technique used for identification and selection of individual who possess phenotype of our interest in a mutangenized population. Thus genetic screening can also be called as phenotypic screening. It helps us to provide a better insight of functioning of gene in an individual. It has got applications in various genome project. The functioning of gene can be well determined by Forward genetic screen or Reverse genetic screen. Forward genetic screening first approaches towards the phenotype and then moves towards identifying genes i.e, genes responsible for a particular phenotype in an individual is identified. Whereas in reverse genetic screen it starts with gene or set of genes and moves towards analyzing the resultant phenotype by assaying its effect of disruption. A defined genetic background of organism being used and constant experimental procedure for identification of mutants of interest are the two key component of successful forward genetic screening. Define genetic background helps to identify and locate affected genes in mutant individual with greater efficiency (Herman .R.K, et al.,2005). Many a times genetic screening and genetic testing are considered to be a common terms, however there is difference between genetic screening and testing. Genetic screening is a technique in which set of diagnostics test are used on large number of individuals to test these individuals who are at high risk of genetic disorders and are the carriers of that specific genes, whereas genetic testing uses different laboratory test to identify the genetic status of individual. The individuals who are already suspected to be at a higher risks for a particular genetic disorder undergo the genetic testing. It is based on medical history of family or on screening tests. But the similarity between both the test is both of them undergo laboratory tests to identify the presence of specific genes which may cause genetic disorders. Genetic screening is a term that is also encountered in prenatal screening with pregnant women. Many researcher do screening on a broad spectrum in large number of people to find potential for genetic diseases. Nowadays genetic screening is also used by health insurance companies to screen the people for genetic disorders and avoid paying extra money. Genetic screening also include newborn genetic screening to identify new born who would benefit from early treatment. Reproductive genetic screening is also done to help reproductive decision making, and in this family history of the patient is checked to identify individuals who would get added benefit from additional prevention measure. Types of screening variation There are different screening variations which are used to identify genes that cause a mutants in phenotype of interest. Some of them are as follows : Enhancer Enhancer screening is used to screen an mutant individual with known genetic mutation. It can further be used to screen an individual with additional gene mutations that has its major role in biological and physiological processes. It is the mutation in one genes that causes the intensification of phenotype resulted due to mutation in another gene. The genetic enhancer screening identifies a mutations which enhance aphenotype of interest in already mutant individual. Source http://www.wormbook.org/chapters/www_geneticenhancers/geneticenhancers.html Synthetic interaction betweenmec-8andsym-3.(A) Themec-8; sym-3double mutant has a highly penetrant defect: the anterior tip (arrow) of the pharynx is not properly joined to the anterior tip of the body (arrowhead), and a functional mouth is not formedThe mutants also have a bulbous nose, an enlargement of the anterior-most part of the body, which is particularly evident in the example shown here. The junction of the pharynx and anterior end of the body is normal in thesym-3single mutant (B) and in themec-8single mutant (C). Suppresor It is used to identify the suppressor mutations. Suppressor mutations revert the original mutations. It can be defined as the one which suppresses the phenotype of original mutations and are the another mutations on the site of chromosome which are distinct from the mutation under study. It has an intragenic suppression and extragenic suppression. Intragenic suppression is the one in which mutation is in same gene as in original mutation.whereas if there is a mutation in different gene then it is called as extragenic suppression or intergenic suppression. Temperature sensitive It is a type of screening technique which involves performing temperature shifts to enhance a mutant shift. The organism grown at a lower temperature will have normal phenotype whereas at higher temperature the mutation in that particular gene will make it unstable. For example Lee Hartwell and Paul nurse independently carried out temperature sensitive screening to identify mutants defective in cell cycle S.cerevisiae and S.pombe. Types of Genetic Screening : Presymptomatic screening Carrier screening parental screening, newborn screening, carrier screening, forensic screening and susceptibility screening. Presymptomatic screening is used to screen the patients whose health is in danger. Carrier screening is used to carry out the analysis of individuals with a gene or a chromosome abnormality that may cause problems either for offspring or the person screened.it is carried out in healthy individuals where there can be a risk of genes harmful to offsprings or future generation. This can be done by testing of blood or tissue samples and can show the presence of a particular genetic trait, changes in chromosomes, or changes in DNA that are associated with inherited diseases in asymptomatic individuals. For example carrier screening is done for sickle cell anemia, Tay-Sachs disease, duchenne muscular dystrophy, hemophilia, Huntingtons disease, and neurofibromatosis. Prenatal screening is carried out in a fetus when it is at risk for various identifiable genetic diseases or traits. It began in 1966. Newborn screening is related with the analysis of blood or tissue samples taken in early infancy in order to detect genetic diseases for which early intervention can avert serious health problems or death. Newborn screening was started in 1960 with the ability to test newborns for a rare metabolic disease, phenylketonuria (PKU). Two other examples of newborn screening are the testing of African American infants for sickle cell anemia and Ashkenazic Jews for Tay-Sachs disease. Forensic screening is used in criminal investigations it is used to to discover a genetic linkage between suspects and evidence discovered in criminal investigations. As DNA of each and every person is unique, many people are reluctant to see such information become part of any national database, which might include information not only about identity but also about proclivity toward disease or behavior. Susceptibility screening is a technique which is used to screen a selected population for genetic susceptibility to environmental hazards. It helps in the identification of workers who may be susceptible to toxic substances that are found in their workplace and may cause future disabilities. Types and Uses of Genetic Tests Source :- Norrgard.K., 2008 http://www.nature.com/scitable/topicpage/medical-careers-genetic-screening-and-diagnostics-639 Purpose of genetic screening Genetic screening acts as an important tool in modern preventive medicine. It is used to confirm the diagnosis in patients with symptoms. Genetic screening also helps to advise other family members of the diagnosed patient to detect whether they also have the disease or have genetic markers for the disease even if they dont have symptoms ,and also to check whether they are carriers or are neither. It also helps in detecting when one partner is a sufferer or carrier, to test the other partner in order to advise whether their child will have the disease, be a carrier or will not have the disease. If diseases observed in both the parents, the child must inherit the disease or the genetic markers for the disease. It may happen that one parent has the disease and the other partner also has the genetic markers for it but there are no symptoms for it, therefore the child may develop the disease or alternatively may not show any symptoms during its lifetime. If one parent has the disease and the other is a carrier, in each pregnancy there is a 50:50 chance of the child inheriting the disease. In the population, screening is carried out to discover undiagnosed sufferers or those with genetic markers for the disease, to discover carriers and to aid research into the prevalence and severity of the disease and the carrier ratio. Maternal serum alpha-fetoprotein (MSAFP) screening, enhanced MSAFP, amniocentesis, chorionic villus sampling (CVS), percutaneous umbilical blood sampling (PUBS),fetal biopsy and fetal cell sorting are some of the genetic screening tests which are currently available for pregnant women. MSAFP is a blood-screening test. It is performed at the 16-18 week gestation date and it tests for spina bifida. Enhanced MSAFP is also a similar type of blood-screening test that measures levels of certain biochemical markers to test for the presence of Downs syndrome. But the only thing is that this test only has an accuracy of 60-65%. Amniocentesis is performed at the 16-18 week of gestation. Amniocentesis uses amniotic fluid to test for chromosomal abnormalities. It is also used to find biochemical abnormalities at the genetic level, it helps in detecting up to 180 genetic disorders. CVS i.e, chorionic villus sampling screening is performed at 10-12 weeks into gestation and it uses chorion tissue f or chromosomal analysis in biochemical and DNA studies. It is not widely used because this test has a drawback of correlation to produce newborns with limb abnormalities. ).Percutaneous umbilical blood sampling, PUBS is performed after week 18 . PUBS is used only as a confirmation test based on results from previous other tests. In fetal tissues are taken for DNA testing . Fetal cell sorting includes an experimental procedure in whcich blood is taken from mother and fetal cells are tested in mothers blood. Oberle,I. D. Camerino.G, 1985 carried out genetic screening for hemophilia A(classic hemophilia) with polymorphic DNA probe. They collected blood samples after informed consent from13 families and carried out coagulation and immunologic assay. In this experiment they develop a new technique to screen the patients for hemophiliaA in the families at risk for the disease. A DNA probe (St14) that detects a very polymorphic region on the human X chromosome has been shown to be closely linked to hemophilia A. They observed that there was no recombination between the St14 locus and hemophilia A in 12 families studied. The odds in favor of linkage are 4.4 x 109to 1 (lod score, 9.65). They found that there was 0 to 6.5% probability of the 95 per cent confidence interval of a recombination between St14 and hemophilia A. This informative DNA probe which causes families in risk of hemophilia A in more than 90 per cent, can be used in conjunction with classic biologic assays to identify carriers with an accuracy of 96 per cent or more. If a small risk of misclassification due to crossover between the test and the disease loci is accepted, this DNA marker should allow first-trimester prenatal diagnosis of hemophilia A. Segregation analysis with St14 may thus represent a major improvement in genetic counseling for hemophilia A. Social dilemmas of genetic screening Though genetic screening is beneficial to society it has a got lot of controversies because by using genetic marker to check for genetic disorders is definitely beneficial to society because due to early diagnosis a preventive symptom treatment can be given by early medical assisantnce but however many a times it is observed that if a genetic disorder is detected in fetus then fetus is readily aborted. So here a controversy comes because no one has got right to end anyones life. Also many a times it happens that individuals carrying a genetic disorder or diseases are being discriminated by society or by health insurers and employers. Hence this genetic screening has brought up a new legal, social and ethical dilemmas. References Karthikeyan. M.1999, Human Genetic Screening, http://www.ndsu.edu/pubweb/~mcclean/plsc431/students99/karthikeyan.htm Norrgard.K., 2008, Medical Careers: Genetic Screening and Diagnostics, Nature Education1(1): pg no- 92 http://www.nature.com/scitable/topicpage/medical-careers-genetic-screening-and-diagnostics-639 Burke.W., et al., 2011, Genetic Screening , Epidemologic reviews Oxford journal 33(1): pg no- 148–164Â  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3166195

The History of Nigerian Banking System

The History of Nigerian Banking System The existence of banks in Nigeria dates back as far as 1862 when the first Nigerian bank came into being. There was no banking legislation until 1952; at that time, Nigeria had three foreign banks and two indigenous banks with a collective total of forty branches. Despite the set standards by the 1952 ordinance, the growth of demand deposits was slowed down by the Nigerian propensity to prefer cash and distrust checks for debt settlements. 1912 experienced the establishment of the West African currency board which was to help 6 in financing the export trade of foreign firms in West Africa and to issue a West African currency which could be converted to British pound sterling. The colonial policies barred the local investment of reserves, discouraged deposit expansion, precluded discretion for monetary management and did nothing to educate Africans in developing indigenous financial institutions. This led to a motion by several Nigerian members of the house to establish a central bank to facilitate economic development. Though the motion was defeated, the colonial administration appointed a bank of England to study the issue and he advised against a central bank with emphasis on their effectiveness in an undeveloped capital market. Another study was conducted in 1957 and this resulted in the creation of a Nigerian central bank and the introduction of the Nigerian currency. The role of the central bank was to establish the Nigerian currency, control and regulate the banking system, serve as bankers to other banks in Nigeria and carry out the governments economic policy in the monetary field. This policy included control of bank credit growth, credit distribution by sector, cash reserve requirements for commercial banks, discount ratesinterest rates the Central Bank charged commercial and merchant banksand the ratio of banks long-term assets to deposits. Changes in Central Bank restrictions on credit and monetary expansion affected total demand and income. For example, in 1988, as inflation accelerated, the Central Bank tried to restrain monetary growth. During the civil war, the government limited and later suspended repatriation of dividends and profits, reduced foreign travel allowances for Nigerian citizens, limited the size of allowances to overseas public offices, required official permission for all foreign payments, and, in January 1968, issued new currency notes to replace those in circulation. Although in 1970 the Central Bank advised against dismantling of import and financial constraints too soon after the war, the oil boom soon permitted Nigeria to relax restrictions. The three largest commercial banks held about one-third of total bank deposits. In 1973 the federal government undertook to acquire a 40-percent equity ownership of the three largest foreign banks. In 1976, under the second Nigerian Enterprises Promotion Decree requiring 60-percent indigenous holdings, the federal government acquired an additional 20-percent holding in the three largest foreign banks and 60-percent ownership in the other foreign 7 banks. Yet indigenization did not change the management, control, and lending orientation toward international trade, particularly of foreign companies and their Nigerian subsidiaries of foreign banks. At the end of 1988, the banking system consisted of the Central Bank of Nigeria, forty-two commercial banks, and twenty four merchant banks, a substantial increase since 1986. Merchant banks were allowed to open checking accounts for corporations only and could not accept deposits below N50, 000. Commercial and merchant banks together had 1,500 branches in 1988, up from 1,000 in 1984. In 1988 commercial banks had assets of N52.2 billion compared to N12.6 billion for merchant banks in early 1988. In FY 1990 the government put N503 million into establishing community banks to encourage community development associations, cooperative societies, farmers groups, patriotic unions, trade groups, and other local organizations, especially in rural areas. Other financial institutions included government-owned specialized development banks: the Nigerian Industrial Development Bank, the Nigerian Bank for Commerce and Industry, and the Nigerian Agricultural Bank, as well as the Federal Savings Banks and the Federal Mortgage Bank. Also active in Nigeria were numerous insurance companies, pension funds, and finance and leasing companies. Nigeria also had a stock exchange (established in Lagos in 1961) and a number of stockbrokerage firms. The Securities and Exchange Commission (SEC) Decree of 1988 gave the Nigerian SEC powers to regulate and supervise the capital market. These powers included the right to revoke stockbroker registrations and approve or disapprove any new stock exchange. Established in 1988, the Nigerian Deposit Insurance Corporation increased confidence in the banks by protecting depositors against bank failures in licensed banks up to N50, 000 in return for an annual bank premium of nearly 1 percent of total deposit liabilities. 1.5.3 Types of Banks A bank is a profit making business providing financial services which includes receiving deposits of money, lending money and processing transactions. There are different types of banks and so do their functions differ. 8 1.5.3.1 Commercial Banks Commercial banks are authorized institutions providing retail banking services to the public. They accept deposits from customers and in turn make loans based on those deposits. They are noted for providing services which includes savings, current and term/fixed deposit accounts, lending, payment and transfer of money which is now facilitated by the recently introduced online banking. They also facilitate the transformation of rural areas by extending banking services. They offer professional advice to their clients on viable businesses and international trade. They are the channel for the implementation of the monetary policies from the central bank and act as authorized foreign exchange dealers in providing such facilities. They are collectors on behalf of other government and non government agencies. They buy and sell securities on behalf of their customers and boost the securities in the capital market and also sponsor companies seeking quotation on the Nigerian Stock Exchange. 1.5.3.2 Merchant Banks They started operations in 1961 with the establishment of Philip Hill (Nigeria) Limited which later merged with Nigerian Acceptances Limited in 1969. Other merchant banks later came along. As a result of the non recognition of universal banking then, merchant banks in Nigeria operate wholesale banking, which involves loan syndication, equity and debt issues, ventures capital and equipment leasing. They play important roles in pooling a consortium of banks, where the borrowing required exceeds availability of funds from commercial or any other bank. They also introduce their big clients to the Nigerian Stock Exchange and handle international transactions through a global network of affiliated banks. The banks are usually sited at urban areas and provide services to large organisations and extremely wealthy individuals. 1.5.3.3 Universal Banks Before the introduction of the universal banking concept by the federal government, operators of merchant banks had complained that their poor performances over the years 9 were due to a banking system that they claimed favoured commercial banks. The clamour for one-stop-supermarket bank became noticed in the mid 1990s when the financial system was swept by the distress in the banking sector. This virtually wrecked havoc on the economy. Many people have observed that the distinction between commercial and merchant banking is out-dated and no longer fashionable in other developed countries. The harmonised banking service is seen as cost-effective for providing a level playing field, where a customer can open an account and engage in all banking and insurance transactions from one bank to the other. The new banking concept offers a wider range of banking services, which include retailed banking, capital market activities and insurance business. The banking environment will no longer be restricted to certain functions. The new banking services commenced in January 2001. 1.5.3.4 Development Banks Development banks were established by the government, to promote national economic development. They tend to address issues of low income, insufficient savings and inadequate investment. The government and multilateral agencies sponsor the banks. The first development finance institution is the Nigerian Local Development Board, which was established in 1946 and charged with the responsibility of giving loans and grants to native authorities, cooperative societies and other public bodies for prescribed development projects (Agene 1990). Notable development banks include, Nigerian Industrial Development Bank, Federal Mortgage Bank of Nigeria, Nigerian Bank for Commerce and Industry, Nigerian Agricultural and Cooperative Bank, Peoples Bank of Nigeria and Nigerian Educational Bank. Others include, National Economic Recovery Fund (NERFUND), Community Banks, etc. In a nutshell, for the long term survival of a bank, they would have to make money in their operation so as to be able to meet up with their expenses. They accept deposits from customers and pay interest which can only be realized from the exchange of money between two parties. One of the ways in which they make money is by charging interest on loans. The money deposited by customers is lent out to creditors. They charge higher interest on money they lend out and pay lower on the deposits. The difference then serves as own realization from the transaction. 10 Also, they operate on fractionalized deposit. They use depositors money to make money by giving loans and earning interest. These loans are usually real estate loans and sometimes car loans. Prior to the depression, banks were allowed to invest in the stock market. As a result of the bank crash, a law was passed to end the practice and force banks and investment institutions to be different entities. 1.5.4 Impact of the Central Bank on the activities of a Bank The Central Bank of Nigeria governs the activities of banks in Nigeria and provides rules and guidelines for the execution of activities in the banking industry. The central bank is charged with the general control and administration of the monetary and financial sector policies of the federal government. Its statutory mandate includes the issuance of the legal tender currency, maintaining of the external reserves, safeguarding the international value of the legal tender currency, and acting as bankers and financial adviser to the federal government; promote monetary stability and a sound financial system in Nigeria. In understanding the monetary policy, it is important to look at it from the perspective of the mandate set for the bank. This includes maintenance of Nigerias external reserves to safeguard the international value of the legal currency, promotion and maintenance of monetary stability and a sound and efficient financial system in Nigeria, acting as banker and financial adviser to the Federal Government; and acting as lender of last resort to banks. Consequently, the Bank is charged with the responsibility of administering the Banks and Other Financial Institutions (BOFI) Act (1991) as amended, with the sole aim of ensuring high standards of banking practice and financial stability through its surveillance activities, as well as the promotion of an efficient payment system. In addition to its core functions, CBN has over the years performed some major developmental functions, focused on all the key sectors of the Nigerian economy (financial, agricultural and industrial sectors). Overall, these mandates are carried out by the Bank through its various departments.The roles of the central bank of Nigeria also include the establishment of a national microfinance consultative committee, evolvement of a clear micro finance policy that spells out the eligibility and licensing criteria, provides operational standards and guidelines to 11 stakeholders, adopting an appropriate regulatory and supervisory framework, minimizing regulatory arbitrage through periodic reviews of the policy and guidelines, continuously advocating market determined interest rates for government owned institutions and promote microfinance funds through MFBS, promoting linkage programmes between universal banks, specialized finance institutions and the micro finance banks. 1.5.4.1 Departments of central bank and their activities There a basically three departments in the central bank of Nigeria and they are the banking supervision department, development finance department and other financial institutions department. 1.5.4.1.1 Banking Supervision Department The banking supervision department of the central bank of Nigeria carries out on-site as well as off site supervision of deposit money and discount houses. Its basic functions include reviews and analyses of the financial conditions of banks based on CAMEL parameters using prudential reports, reviews and analyses of statutory returns and other relevant information, monitor trends and development for the banking sector, generate industry reports on a monthly and quarterly basis. It also monitors compliance with the law, guidelines and circulars (BOFIA (banks and other financial institutions act), CAMA, and CBN (Central Bank of Nigeria) Act etc) 1.5.4.2 Development Finance Department The development finance department was established to manage the agricultural credit guarantee scheme fund and finance the marketing operations of the defunct commodity marketing boards. In view of the expected role of the bank in the Nigerian economy, the department was restructured and renamed as the development finance department. They are concerned with identifying development finance market failures, designing strategies and policies for addressing them, formulating policies, regulatory and supervisory framework for micro/rural finance, identifying development priorities, designing and implementing alternative funding sources, monitoring and evaluating the impact of 12 development finance initiatives, advising government and the CBN Management on commodities, SME, and micro/rural finance issues. 1.5.4.3 The Other Financial Institution Department (OFI) The other financial institutions department is saddled with the responsibility of supervising and regulating the other financial institution sub-sector which include the community banks, finance companies, bureau de change, primary mortgage institution, the development finance institutions and the recently launched micro finance banks. The department carries out both on-site and off-site supervision of the other financial institutions. The off-site supervision involves the appraisal and approval of the application for licenses, nominees intothe boards and top management positions, transfer of shares and increase in hare capital, statutory returns from other financial institutions, appointment or exchange of the external auditors. The on-site aspect of the departments function includes pre commencement examination before the grant of a final license to an OFI (Other financial institutions), routine examination which is the regular examination, target examination addresses specific supervisory concerns arising from unprofessional conduct of the operations of an OFI and is carried out as the need arises while spot-checks for quick confirmation/ verification through independent on-site assessment. This includes corporate governance, accounting systems and records, quality of assets, reliability of information provided, internal control system/anti-money laundering controls and procedures, earnings, liquidity, financial condition and capital adequacy. 1.5.5 Effects of the Monetary and Economic policies on the activities of Nigerian Banks Monetary policies refers to the specific actions taken by the central bank to regulate the value, supply and cost of money in the economy with a view t achieving governments macroeconomic objectives. For many countries, the objectives of the monetary policy are explicitly stated in the laws establishing the central bank, while for others they are not. The objectives of the monetary policy may vary from country to country but there are two main views. 13 The first view calls for the monetary policy to achieve price stability, while the second view seeks to achieve price stability and other macroeconomic objectives. The central bank of Nigeria like other central banks in developing countries, achieve the monetary policy goal through the amount of money supplied. In Nigeria, the Central Bank defines money supply as comprising narrow and broad money. The definition of narrow money (M1) includes currency in circulation with non-bank public and demand deposits or current accounts in the banks. The broad money (M2) includes narrow money plus savings and time deposits, as well as foreign denominated deposits. The broad money measures the total volume of money supply in the economy. Thus, excess money supply (or liquidity) may arise in the economy when the amount of broad money is over and above the level of total output in the economy. The need to regulate money supply is based on the knowledge that there is a stable relationship between the quantity of money supply and economic activity and that if its supply is not limited to what is required to support productive activities; it will result in undesirable effects such as high prices or inflation. In summary, monetary policy in the Nigerian context refers to the actions of the Central Bank of Nigeria to regulate the money supply, so as to achieve the ultimate macroeconomic objectives of government. Several factors influence the money supply, some of which are within the control of the central bank, while others are outside its control. The specific objective and the focus of monetary policy may change from time to time, depending on the level of economic development and economic fortunes of the country. The choice of instrument to use to achieve what objective would depend on these and other circumstances. 1.6. History of the banks surveyed 1.6.1 Zenith International Bank Plc. Zenith Bank Plc was incorporated on May 30, 1990 as a private company limited by shares. In July 2004, the Bank became a public company limited by shares and subsequently launched what still remains the most successful Initial Public Offering (IPO) in the history 14 of the Nigerian Capital Market. Its 6,000,000,000 (six billion) ordinary shares of 50 kobo each were later listed on the Nigerian Stock Exchange on October 21, 2004. Zenith Bank Plc achieved yet another milestone when it raised N53.63bn in February 2006 by a Public Offer of 3,000,000,000 (three billion shares), one of the largest amount in the history of the Nigerian Capital Market. Zenith Bank Plc is one of the largest and most profitable banks in Nigeria with total assets plus contingents of over N714.5 billion after consolidation. The Bank has continued to record remarkable performance on several parameters. Zenith Banks growth and performance has earned excellent ratings from both local and international rating agencies. Agusto co. ltd has consistently rates the bank Aaa for six consecutive years. Also of repute is the fact that the bank has the lowest non performing loans to total loans ratio of 1.7% against the industry average of 18% and has grown its asset base at an average of over 50% per annum in the last five years. Its service offering covers but are not limited to corporate and commercial banking services, funds and asset management, investment banking and financial advisory services , private bank, treasury and cash management services. In delivering their vision, they put strategies in place which has being their guide in their operation. It sets out to differentiate itself in the banking industry through the quality of service it render, the caliber of their clients and the drive for a unique customer experience. The bank is easily associated with attributes such as innovation, best risk asset portfolio, high quality personnel, consistent superior financial performance and leadership in the use of information and communication technology. The banks overall vision is to make the brand a reputable international financial services network recognized for innovation, superior customer service and performance while creating premium value for all stakeholders. 1.6.2 Guaranty Trust Bank Plc Guaranty Trust Bank plc was incorporated in July 1990, as a private limited liability company wholly owned by Nigerian individuals and institutions. The bank was licensed as a Commercial Bank in August 1990 and commenced operation in February 1991. In September 1996, Guaranty Trust Bank plc became a publicly quoted company and won the Nigerian Stock Exchange Presidents Merit award that same year and again in the years 15 2000, 2003,2005 and 2006. The Bank was also runner-up for the quoted company of the year award in 2005. In February 2002, it obtained a Universal Banking license and was appointed a settlement bank by the Central Bank of Nigeria (CBN) in 2003. Its quest to continue adding value to the businesses of its stakeholders has seen it emerge as a pacesetter and industry leader over the years. This is evident in its introduction of real time online banking in 1990, mobile, telephone and internet banking in 2002, Slip free banking in 2006 and the first fully interactive self service call centre; GT Connect in 2006. The bank was able to meet their financial obligations as they fell due and this got them the recognition of three rating agencies. Agusto Co reaffirmed its triple a risk rating every year fro the last four years, Fitch also assigned the bank a double A minus risk rating in recognition of its strong domestic franchise, good quality assets and sound earnings record and finally, Standard Poors, assigned the Bank a double B minus (BB-) risk rating. The Bank is the only Nigerian financial institution with such a rating, which is the same as the Agencies Sovereign rating for Nigeria. The bank has over the years been a recipient of several awards for superior financial performance, customer service delivery, excellent share performance, management efficiency some of which are the most respected financial institution in Nigeria (2006), the highly commended bank of the year award in Africa (2005), Most Customer friendly Bank (2007), Best Bank for Brand Development 2007. Despite the challenges which characterized the year under review(2006-2007 Financial year), the bank was able to grow its gross earnings by 46% from N34 billion to N49 billion while its profit before tax rose by 50% from N10.5 billion in the previous year to N15.7 billion. In the same period, total asset and contingents increased by 54% from N391billion a year earlier to N603 billion.

Reform Healthcare in America to a Socialized Model Essay -- Healthcare

Despite the best efforts to stay healthy, periodic problems with one’s health are an unavoidable part of life. While many of these injuries or illnesses will pass without problem even if untreated, every person will almost inevitably face the occasional health issue that demands attention. The appropriate response to this ailment may involve going to a hospital to consult a physician, and with this step, the situation can become very complicated, particularly for Americans. Current Significance of Healthcare Issues in the United States The significance of issues of healthcare in the minds of Americans was made especially clear this year with the recent presidential election. According to a survey taken between September 2003 and January 2004 by the nonprofit foundation The Commonwealth Fund, 57 percent of Americans classified the presidential candidates’ policies on reforming the healthcare system as â€Å"very important† in determining their vote for president (as cited in Mundell, 2004, para. 5). The large amount of concern regarding the issue of healthcare likely represents the widespread dissatisfaction with America’s current system. A 2004 Commonwealth Fund International survey indicates that citizens of the United States have significantly more negative feelings about their country’s healthcare system than any of the other industrialized nations that were surveyed, with one-third of adults in the U.S. calling for restructuring of the healthcare system (as cited in Gardner, 2004, pa ra. 8). Since so many people are calling for change and demonstrating serious concern, the importance placed on the issue is logical. Identified as the â€Å"single greatest problem confronting all Americans† on the cover of the Erik Eckholm’s analy... ...(2001). As sick as it gets: the shocking reality of America’s healthcare. Dunkirk, NY: Olin Frederick. Mundell, E. (2004, March 29). Poll: Health Care Key Issue in ’04 Election. Health Day News. Retrieved November 1, 2004 from http://www.healthday.com/view.cfm?id=518143. Nayeri, K. (1995). The Cuban health care system and factors currently undermining it. Journal of Community Health, 4, 321-334. Abstract retrieved November 2, 2004, from PubMed Central database. Raffel, M. and Raffel N. (1994). The U.S. Health System: Origins and Functions. Albany, NY: Delmar Publishers, Inc. Socialized medicine. (2003). In The Columbia Encyclopedia, 6th ed (www.bartleby.com/65). New York: Columbia University Press. Strosberg, M., Wiener, J., & Baker, R. (Eds.). (1992). Rationing America’s medical care: the Oregon Plan and beyond. Washington, DC: Brookings Institution. Reform Healthcare in America to a Socialized Model Essay -- Healthcare Despite the best efforts to stay healthy, periodic problems with one’s health are an unavoidable part of life. While many of these injuries or illnesses will pass without problem even if untreated, every person will almost inevitably face the occasional health issue that demands attention. The appropriate response to this ailment may involve going to a hospital to consult a physician, and with this step, the situation can become very complicated, particularly for Americans. Current Significance of Healthcare Issues in the United States The significance of issues of healthcare in the minds of Americans was made especially clear this year with the recent presidential election. According to a survey taken between September 2003 and January 2004 by the nonprofit foundation The Commonwealth Fund, 57 percent of Americans classified the presidential candidates’ policies on reforming the healthcare system as â€Å"very important† in determining their vote for president (as cited in Mundell, 2004, para. 5). The large amount of concern regarding the issue of healthcare likely represents the widespread dissatisfaction with America’s current system. A 2004 Commonwealth Fund International survey indicates that citizens of the United States have significantly more negative feelings about their country’s healthcare system than any of the other industrialized nations that were surveyed, with one-third of adults in the U.S. calling for restructuring of the healthcare system (as cited in Gardner, 2004, pa ra. 8). Since so many people are calling for change and demonstrating serious concern, the importance placed on the issue is logical. Identified as the â€Å"single greatest problem confronting all Americans† on the cover of the Erik Eckholm’s analy... ...(2001). As sick as it gets: the shocking reality of America’s healthcare. Dunkirk, NY: Olin Frederick. Mundell, E. (2004, March 29). Poll: Health Care Key Issue in ’04 Election. Health Day News. Retrieved November 1, 2004 from http://www.healthday.com/view.cfm?id=518143. Nayeri, K. (1995). The Cuban health care system and factors currently undermining it. Journal of Community Health, 4, 321-334. Abstract retrieved November 2, 2004, from PubMed Central database. Raffel, M. and Raffel N. (1994). The U.S. Health System: Origins and Functions. Albany, NY: Delmar Publishers, Inc. Socialized medicine. (2003). In The Columbia Encyclopedia, 6th ed (www.bartleby.com/65). New York: Columbia University Press. Strosberg, M., Wiener, J., & Baker, R. (Eds.). (1992). Rationing America’s medical care: the Oregon Plan and beyond. Washington, DC: Brookings Institution. Reform Healthcare in America to a Socialized Model Essay -- Healthcare Despite the best efforts to stay healthy, periodic problems with one’s health are an unavoidable part of life. While many of these injuries or illnesses will pass without problem even if untreated, every person will almost inevitably face the occasional health issue that demands attention. The appropriate response to this ailment may involve going to a hospital to consult a physician, and with this step, the situation can become very complicated, particularly for Americans. Current Significance of Healthcare Issues in the United States The significance of issues of healthcare in the minds of Americans was made especially clear this year with the recent presidential election. According to a survey taken between September 2003 and January 2004 by the nonprofit foundation The Commonwealth Fund, 57 percent of Americans classified the presidential candidates’ policies on reforming the healthcare system as â€Å"very important† in determining their vote for president (as cited in Mundell, 2004, para. 5). The large amount of concern regarding the issue of healthcare likely represents the widespread dissatisfaction with America’s current system. A 2004 Commonwealth Fund International survey indicates that citizens of the United States have significantly more negative feelings about their country’s healthcare system than any of the other industrialized nations that were surveyed, with one-third of adults in the U.S. calling for restructuring of the healthcare system (as cited in Gardner, 2004, pa ra. 8). Since so many people are calling for change and demonstrating serious concern, the importance placed on the issue is logical. Identified as the â€Å"single greatest problem confronting all Americans† on the cover of the Erik Eckholm’s analy... ...(2001). As sick as it gets: the shocking reality of America’s healthcare. Dunkirk, NY: Olin Frederick. Mundell, E. (2004, March 29). Poll: Health Care Key Issue in ’04 Election. Health Day News. Retrieved November 1, 2004 from http://www.healthday.com/view.cfm?id=518143. Nayeri, K. (1995). The Cuban health care system and factors currently undermining it. Journal of Community Health, 4, 321-334. Abstract retrieved November 2, 2004, from PubMed Central database. Raffel, M. and Raffel N. (1994). The U.S. Health System: Origins and Functions. Albany, NY: Delmar Publishers, Inc. Socialized medicine. (2003). In The Columbia Encyclopedia, 6th ed (www.bartleby.com/65). New York: Columbia University Press. Strosberg, M., Wiener, J., & Baker, R. (Eds.). (1992). Rationing America’s medical care: the Oregon Plan and beyond. Washington, DC: Brookings Institution.

Rabies Prevention :: Biology Medical Biomedical Disease

Rabies Prevention This writing is mainly about the vaccines or the products that can be used to prevent Rabies. Its states the names of a couple of vaccines such as preexposure phophylaxis and Rabies immune globulin. And it explain how each of them work or what they do. It names some kinds of people who are at daily exposure or at risk of obtaining Rabies. It also says who long the Rabies immune globulin has effect. Rabies is a very dangerous thing once you get it, because once you get the symptoms for Rabies there is nothing anyone can do about it. There just isn’t any treatment after the symptoms have shown. But just a couple of years ago scientists made a vaccine that can cause immunity after it is given to the patients. There is two different periods it can be used. One is used before the person gets Rabies and the other is used while the person already has Rabies. The one that is used before the person has Rabies is called Preexposure prophylaxis. And the one that is used while the person has Rabies is called Postexposure prophylaxis. Even though Rabies are rare to humans it is estimated that 18,000 people are vaccinated with Preexposure prophylaxis and 40,000 people are vaccinated for Postexposure prophylaxis in a yearly basis. Preexposure prophylaxis is usually given to people in daily risk of obtaining Rabies such as animal handlers, veterinarians and some laboratory workers. It could maybe even be given to a person who comes across or in contact withan infested animal and people who study Rabies or the vaccines for Rabies. People who have been vaccinated for rabies in a period of six months must get a, (serum), blood test for antibody and receive a bit more vaccine. Even though some people feel secure after receiving the preexposure vaccination, its good for them to know that bu using this vaccination it doesn’t eliminate the need fore different medication but it helps by eliminating the need for Rabies immune globulin reducing the doses needed of this vaccination. The vaccines can help by causing immunity in a person whose postexposure might be delayed. And by providing protection from exposure to Rabies. In the United States there is two types of immunizing product against Rabies. One of them is the rabies vaccines which gives the body an active response that produces neutralizing antibodies. And the other is Rabies immune globuling (RIG) which even though it provides a quick immunizing result it is estimated to last 19-21 days which is a very short period of time with the effect. Rabies Prevention :: Biology Medical Biomedical Disease Rabies Prevention This writing is mainly about the vaccines or the products that can be used to prevent Rabies. Its states the names of a couple of vaccines such as preexposure phophylaxis and Rabies immune globulin. And it explain how each of them work or what they do. It names some kinds of people who are at daily exposure or at risk of obtaining Rabies. It also says who long the Rabies immune globulin has effect. Rabies is a very dangerous thing once you get it, because once you get the symptoms for Rabies there is nothing anyone can do about it. There just isn’t any treatment after the symptoms have shown. But just a couple of years ago scientists made a vaccine that can cause immunity after it is given to the patients. There is two different periods it can be used. One is used before the person gets Rabies and the other is used while the person already has Rabies. The one that is used before the person has Rabies is called Preexposure prophylaxis. And the one that is used while the person has Rabies is called Postexposure prophylaxis. Even though Rabies are rare to humans it is estimated that 18,000 people are vaccinated with Preexposure prophylaxis and 40,000 people are vaccinated for Postexposure prophylaxis in a yearly basis. Preexposure prophylaxis is usually given to people in daily risk of obtaining Rabies such as animal handlers, veterinarians and some laboratory workers. It could maybe even be given to a person who comes across or in contact withan infested animal and people who study Rabies or the vaccines for Rabies. People who have been vaccinated for rabies in a period of six months must get a, (serum), blood test for antibody and receive a bit more vaccine. Even though some people feel secure after receiving the preexposure vaccination, its good for them to know that bu using this vaccination it doesn’t eliminate the need fore different medication but it helps by eliminating the need for Rabies immune globulin reducing the doses needed of this vaccination. The vaccines can help by causing immunity in a person whose postexposure might be delayed. And by providing protection from exposure to Rabies. In the United States there is two types of immunizing product against Rabies. One of them is the rabies vaccines which gives the body an active response that produces neutralizing antibodies. And the other is Rabies immune globuling (RIG) which even though it provides a quick immunizing result it is estimated to last 19-21 days which is a very short period of time with the effect.

Christopher Columbus Case Essay

Christopher Columbus is one of the most well-known explorers in history. Christopher Columbus had many voyages that he had done throughout the years. There was several letters that he had written, one regarding his first voyage was to Luis de Santangel that explained what he had found, and the way he felt during his voyage. Another was his fourth voyage to Ferdinand and Isabella, in which he shows sorrow and regret for his discoveries. In the letters that Christopher Columbus had written his tones were very distinct and different. It is hard to think that it is even the same person wrote the two letters. Columbus made a complete change from arrogant to humble in his attitude. The letter that Christopher Columbus had written to Luis de Santangel was regarding his first voyage and his tone in this letter can be described as very eager, passionate, and anxious for his upcoming voyages. When reading the first letter you can tell that he is excited just by the way he describes the way the island looks. He goes in great length about the marvels of the new lands he encounters. He explains them as he is a child experiencing something new for the first time. â€Å"All are most beautiful, of a thousand shapes, and all are accessible and filled with trees of a thousand kinds and tall, and they seem to touch the sky† and â€Å"Espanola is a marvel†. Christopher Columbus radiates his excitement through his letter to Luis de Santangel. Christopher Columbus almost feels as he truly has the whole world at his finger tips, and awaits more. In His letter Regarding the Fourth Voyage that was to Ferdinand and Isabella you see a much different demeanor about him. Very pessimistic and down attitude surrounds his writing. He speaks of â€Å"weeping† when he thinks about the lands that he has found, due to the fact that they are pretty much barren. He goes on by saying people are dying them daily because of the audacity that people have there, imprisoning people, and taking their lands. He goes on deeper by explaining how he has grown old and grey. â€Å"Not a hair on his body that isn’t gray†. He states how everyone is trying to explore and plunder without any knowledge of exploration or any heart for the matter, just trying to get a piece of the action. I think he feels somewhat betrayed, and asks mutual punishment for Alonso de Ojeda, who is the man that took almost everything he had. â€Å"The same punishment is due to him who robbed me of the pearls, and to him who infringed my rights as admiral†. Christopher Columbus is one of the most well-known explorers of all time. Columbus’ life was a voyage in itself. While he rose to fame as an outstanding explorer, he also had terrible lows in his life. During his voyages, Columbus wrote letters documenting his experience. His tone and diction in Letter to Luis de Santangel Regarding the First Voyage is upbeat and hopeful, while his tone in the Letter to Ferdinand and Isabella Regarding the Fourth Voyage is full of sadness. His series of four voyages between 1492 and 1504 produced a brief moment of wonder following by a longs series of disasters and disappointments, which reflect his attitudes at these different times in his life.

Sandy Hook

Alyssa Garcia Period 5, A & R Mr. Leighton 28 March, 2013 Sandy Hook Elementary Shooting On December 14, 2012 a horrible tragedy occurred in Newtown, Connecticut. Twenty year old Adam Lanza killed twenty innocent six years olds and six staff members at Sandy Hook Elementary. The shooting happened approximately around 9:30 a. m. , while announcements were being said on the loudspeaker to the students. This is a misfortune that will never be forgotten. We all have questions on how, when, what, where, and why Adam Lanza would do this. Some questions still have stayed unanswered.America’s most recent mass killer is Adam Lanza. Before the shooting at Sandy Hook Elementary, news articles have discovered that Lanza had killed his Mother Nancy Lanza, at their Newtown Connecticut home before he took action at Sandy Hook elementary. Lanza took his life as well at the elementary school after he killed twenty-six innocent lives. Adam must have had plenty of time to plan out the shooting. Nancy Lanza was shot four times in her bed with a 22 caliber rifle. Reports have discovered that his mother would teach him how to aim guns at a young age. People that knew Adam when he was a kid say he was an â€Å"odd† child.Marvin Lafontaine knows the Lanza family from New Hampshire through a Boy Scout program (Weiegand). Lafontaine said that Adam was very anti-social and did not like to be touched by others. When Adam was in middle school he was diagnosed with Asperger syndrome which is an autism spectrum disorder that is characterized in the social behavior. As a child finding out that you are diagnosed with Asperger syndrome must be a challenge in life to obtain with. As a mother, it must be a difficult challenge to do the best to your ability to provide the needs for your child.Adams’ father Peter Lanza was divorced from Nancy when Adam was ten years old. The divorced must have made an impact in his life. Also, Adams’ older brother had moved out to attend a university out of state. At this point in his life he probably felt isolated and felt like he was different from others. He was identified as a child who is very likely to be bullied (Weiegand). I believe that Adam Lanza was motivated by violent video games and a mass murder. As a kid, Lanza and his mother Nancy would play video games.I am not assuming that his mother was part of the reason why he would do this massacre, but many people might believe that she influenced him. I am sure those were not her intentions at all. She was using video games to spend quality time with her son during the difficulty of the process of the divorce. Comparing the shooting at the elementary school and the video games are fantasies that he killed twenty-six lives and the deaths are counted as a â€Å"score†(Rodriguez). On December 17, 2012 the news said that Lanza kept a spreadsheet with five hundred names connected to past massacres in the past.Next to the names Lanza wrote each killer and the weapon to be used. The video game â€Å"Call of Duty† is about a mass murder named Anders Breivik who kills seventy-seven people in Norway in 2011. Lanza played this video game and I am sure it inspired some violence. Works Cited Bart, Brient. â€Å"Breitbart. com. †Ã‚  Breitbart News Network. N. p. , 27 Feb. 2013. Web. 18 Mar. 2013. Bennett-Smith, Meredith. â€Å"Gene Rosen, Sandy Hook Hero, Harassed By Conspiracy Theorists Who Claim He's An Actor. †Ã‚  The Huffington Post. TheHuffingtonPost. com, 15 Jan. 2013. Web. 18 Mar. 2013. Nhan, BRENDAN. â€Å"United States Project.   Columbia Journalism Review. N. p. , 22 Jan. 2013. Web. 18 Mar. 2013 Rambo, Mindy. â€Å"Sandy Hook Shooting – Hoax †Ã‚  Ã¢â‚¬â€œ JustMommies Message Boards. N. p. , 16 Jan. 2013. Web. 18 Mar. 2013. Rivera, Ray, â€Å"Newtown Debates School’s Fate after Shooting. † The New York Times. January 13, 2013. Web. March 6, 2103 Rodricks, Dan, â€Å"Remembering S andy Hook on the way to Congress. † Baltimoresun. com. March 6, 2013. Web. March 5, 2103 Rodriguez, Jessica. â€Å"Sandy Hook Hoax Video: Conspiracy Claim Draws 11M Views on YouTube (VIDEO). †Ã‚  Christian Post. N. p. , 19 Jan. 2013. Web. 18 Mar. 2013. Staglin, Douglas. â€Å"Conn.Paper Regrets Gun Ad next to Sandy Hook Story. †Ã‚  USA Today. Gannett, 3 Jan. 2013. Web. 18 Mar. 2013. Stern, Mark. â€Å"The Slatest. †Ã‚  The Slatest. N. p. , 7 Feb. 2013. Web. 18 Mar. 2013. Tracy, James. â€Å"Memory Hole. †Ã‚  Memory Hole. N. p. , 16 Dec. 2012. Web. 18 Mar. 2013 Tribune, East Valley, â€Å"Tempe Elementary District police take active role on school safety. † nbcnews. com. March 4, 2103. Web. March 7, 2103. View, The. â€Å"Experience ABC Online. †Ã‚  The View. N. p. , n. d. Web. 18 Mar. 2013 Weiegand, Davis, â€Å" PBS show provides more clues about Sandy Hook Shooter. † Newstimes. Com. February 17, 2103. Web. March 7, 2013

A house Divided: Abortion and Slavery in America

In 1856, Lincoln stood out as he opposed the sovereignty doctrine and freedom for states to choose whether to continue practicing slavery or free all of their slaves. His assertion was that the country had to make a choice either to continue with slavery or make the slaves free in all states. This was based on the understanding that all the states were bound by one constitution.For the country to stand as one, it had to make a single choice. Today the country is being faced by the debate of prolife and pro-choice. To the pro-choice, the decision to keep or terminate the lie of the unborn child is left on the hands of the mother while the prolife believe the unborn child enjoys the same rights just as any other person (Melton, nd). These serious divisions have the potential to split our country along the line of whether to grant the rights to the mother or the unborn child.In both cases, proponents of anti slavery and pro life had and have a moral argument against an evil that deprive s our society of an obligation to protect the life of the unborn just as we protect the living.   It is definite that there cannot be any middle ground in the case relating to abortion. We need either to fully support the pro-choice and continue blatantly killing the helpless young humans who have no power to defend themselves.On the other, hand we can embrace the logic of the pro-lifers and give the unborn children a chance to enjoy the right to life and other rights later when they see the light in their lives. Just as in the case of slavery, the pursuit of our rights should not be allowed to deprive other humans their equal rights. The law should come out straight and define the fact that, ending the life now is no different from ending it later. By then the question of whether we are killing through abortions shall have been answered.ReferencesMelton, B. (nd).A house Divided: Abortion and Slavery in America. Retrieved on   August 3, 2010 from http://capitolhillcoffeehouse.co m/archives/chch_news_435.htm       A House Divided: Abortion and Slavery in America In the article â€Å"A House Divided: Abortion and Slavery in America,† the author draws a parallelism between abortion and slavery. The article notes four premises around which the arguments for both abortion and slavery similarly revolve as advocates of both practices justify their actions.In rejecting the arguments of the pro-slavery and the pro-choice camps on identical grounds, the author admonishes society not to replicate its past mistake.In the first premise, slaves and in utero children are being regarded as properties. Since they are both properties, it is presumed that their owners retain the right to decide what to do about them. Slave owners, therefore, have the right to do whatever they want to do with the slaves that they â€Å"own† and pregnant women should be allowed to decide whether to keep or abort their â€Å"own† fetuses.The second premise involves the economics of the situations, i.e.: slave owners, in particular, and the nation’s ec onomy, in general, profit from the labor of the slaves while women turn to abortion in order to escape the burden of raising a child under conditions of abject poverty especially when the child is unwanted for whatever reason.Third, both the slave owners and the pregnant women argue that their actions are morally acceptable under specific conditions: when the slaves acquiesce to their situation and the pregnancy endangers the life of the mother.Finally, both the slave owners and the pregnant women claim that they are only doing what is best for the slaves and the fetuses. In the former case, owners argue that slaves have better security if they remain slaves because the owners feed and protect them than when they are freed and left by their lonesome to face the harshness of the world. In the case of the fetus of a poor woman, abortion is considered a humanitarian assurance that the child does not experience the evils of life of poverty.The author rejects all of these premises on the ground that they are one-sided. In other words, only the slave owners and the pregnant women are endowed with the rights to â€Å"life, liberty, and the pursuit of happiness.†The author argues that by denying the same rights to the slaves and the fetuses would be to deny them of their humanity as well. Therefore, the author maintains that both slavery and abortion could not be considered morally right since these practices deny the slaves and the fetuses (who are also considered human beings in the eyes of the law) of their human rights to â€Å"life, liberty, and the pursuit of happiness.†ReferenceA House Divided: Abortion and Slavery in America. Attachment to order # 71203674.  

Health Care Delivery System in the United States Essay

Introduction: The problem: Access to health care physically and financially, healthcare system in today’s society has failed to provide quality care for the U.S. Americans. There are so many ways that the system falls short in providing proper care. The healthcare is mainly based on the government to provide care for a particular group of people according to their income and not everyone has the same treatment, some having to pay for care through some type of insurance premium. When looking at this system of care, families are all dealing with the same issues in relations to not getting the treatment and quality care that they need. Many providers is having to see more patients in clinics than anticipated in terms causes a shorter visit with patients to address any kind of concerns and with uncoordinated care this leads to decrease in quality care of patients. High risk patients could be an issue for providers, because of the risk of malpractice, and increase of having malpractice insurance therefore providers are reluctant to see these patients which causes the patients to have less options for treatment choices. Healthcare Expenditure: this will continue to increase and families will continue to struggle and stress over how they will pay their medical bills. Healthcare systems are not slowing down on their costs and most of them are not willing to give families an efficient healthcare system for a better quality of care. The healthcare expenditures are increasing and the families incomes are not sufficient to compensate which makes this so stressful and hard for families to afford. When looking at the pharmaceutical spending, this has increased drastically. Medications is continuing to increase in costs, therefore, families are not able to get medications that are needed for care. Quality of care: has been a proven factor to be declined, patients with chronic and long term disease are not getting the therapy and drug regimen that is needed to give them a better quality of life. Many elderly patients and patients with disabilities are not able to receive homecare services that are needed to assist them with care. This is an ongoing battle with many American families who are uninsured as well as insured families. Care is not being coordinated and managed for patients with long term and chronic illnesses. Internal Factors: finance and delivery systems should be combined, both of these factors work together for the improvement of each other. Delivery system and payments are declined because the quality and effectiveness are not valued in the healthcare system therefore we have less quality of care and increasing in costs. Without improvements in these two areas the healthcare system will continue to fail in providing a more efficient system for our families and ou t-of-pocket payments are burdening families and care is being refused, emergency rooms are overflowing and office visits are declining. External Factors: The development of new technology affecting the healthcare system in ways as such advance equipment to treat certain diseases that wasn’t offered in the past and patients are not able to afford the treatment because of the increase in costs. Many advance technology procedures are performed in surgery that is consuming our incomes. Patients with chronic diseases are not able to receive the care because of new technology and the price increase that goes with the technology. Solution to health care access physically and financially, According to (Nichols, 2007) all Americans must take on a responsibility for their own health and the health of their children. This means having policies established which would be affordable for American families and polices established to assist the families who need financial assistant in acquiring an insurance policy. Guidelines also must be followed with this plan with the responsibility of the individual and the insurance comp any. This would be balanced to assist families with affordable insurance and benefit the insurance market that would create a quality delivery system as well as cost efficient. The responsibilities to the family is following the guidelines and policy, maintaining their health by having their yearly check-ups, scheduling routine appointments to see their provider as necessary when a problem may arise and maintaining their insurance coverage. The shared responsibilities is the insurance companies provide a stable plan that will improve the delivery system by making American families a priority with having access to a health care system in which quality care is provided and affordable to the family. Solution to health care expenditure, Preventive measures and promoting health can help with health care spending. Management of long –care diseases and establishing a good foundation with advance health technology well build better patient satisfaction, along with cost effectiveness. The reforms improvements values is not a routine step, many believe that the change in delivery systems may decrease the costs, but some feel that it should be more stable in costs by establishing guidelines that are more promising and effective. These guidelines and policies should be put in place to improve the health care system.(brennan, cafarella, kocot, mckethan, morrison, nguyen, shepherd and Williams,2009). Solution to quality of care, According to (fingado), electronic health record system will allow a continuum of patient care for better quality and manageable coordination to patient records. When coordinating patient care all systems must be involved to get a better outcome. Health care systems through health care electronic employee record helps with continuation of patient care and prepare better management plans. This health care system also allow staff to advance knowledge through training and exercise to improve better patient care outcome. Why my response is correct, Me as a health care professional have witness patients who are non-compliance regarding their health and working with uninsured families have different outcomes than patients who is compliance with preventive care usually are in better physical health than families who are not. There are many preventive measures that families can initiate better health, exercising on a regular basis, selecting healthier choices in diet menu, seeking preventive care as necessary, and be in compliance with treatment regimen, prevent bad habits such as smoking and alcohol abuse. Patients who maintain good health behaviors usually have better outcomes during surgical procedures, healing process is less and better outcomes with other treatment plans. Conclusion, according to our reading, Americans should have an effective health care system where families are provided with safe care and an affordable health care plan for the continuum of care. Explanation is given how many patients visit their health care provider and usually never see their primary care provider and how care should be directed toward patient satisfaction. Our reading mentions The Patient Protection and Affordable Care Act that extends health care plans to primary care that would benefit most Americans to having a better outcome and assessing why acute visits happen so frequently. According to (Thorpe and ogden,2010) excessive spending is being directed towards Fee-For-Service where the main focus is on the amount of patient being seen and costs instead of patient care improvements. The new health reform law is establishing changes to remove this system away from Medicare and other payers. References Niall Brennan, Nichole Cafarella, S. Lawrence Kocot, Aaron Mckethan, Marisa Morrison, Nadia Nguyen, Mark Shephard and Reginald D. Wiliams. (2009). improving quality value in the U.S. Health Care System. Retrieved August 2009, from www.brookings.edu/reports/2009/08/21-bpc-qualityreport Nichols, L. M. (2007). A Sustainable Health System for all Americans. Retrieved July 2007, from www.newamerican.net/files/NSC%20Health%20Policy%20Paper Thorpe, K. E., & Ogden, L. L. (2010, June 2010). Analysis & Commentary The Foundation That Health Reform Lays For Improved Payment, Care Coordination, And Prevention. Health Affairs, 29,6, 1183.