gene therapy :: essays research papers

Gene Therapy is hope or disasterfor Human Being?&9674Introductiondesoxyribonucleic acid determines the placement of amino acids according to DNA sequences. A specific chain of amino acids composes a specific protein that plays the essential functions in the bodies. The defect of the gene, however, results in producing upon protein as a result, some part of the bodies abnormally works compared to that of other normal bodies. This is called ?gGenetic Disorder?h. The scientists studied about familial disorder and suggested an alternative for genetic disorder called ?gGene Therapy?h. Recently, gene therapy is useful to cure other disorders such as a cancer or other.(http//www.ornl.gov/sci/techresources/Human_Genome/medicine/genetherapy.shtmlhttp//www.asgt.org/ )&9674History of Gene TherapyDavid suffered from a rarified inherited disease known as adenosine deaminase deficiency (ADA). He spent all his life in a germ-free plastic bubble, because gene causes a lose of enzyme that helps immune system to fight disease from outside. In 1984, he received a bone marrow transplant. Unfortunately, cells from donator?fs marrow attacked his body. As a result, he was died afterwards a twelvemonth. This event was a big issue at that time and scientists studied gene therapy to stop this bad event. In 1989, at first, W.French Anderson and a team at the National Institutes of Health gained permission for experiment to inject gene into human beings. In 1900, at first, he applied gene therapy to 4 year girl who suffered from adenosine deaminase deficiency (ADA). He extracted T- lymphocytes from her bloodstream and injected gene-corrected T lymphocytes to her with a normal gene function for ADA then he repeated a fewer times more. After a year, she lives as a normal kid. Her manipulation was successful. In 1991, 9 years old girl was applied to this gene therapy and her treatment was also successful.(http//www.frenchanderson.org/history/history.asp, Mapping our genes by Lois Win gerson, Medical Dilemma by Margaret O.Hyde& Elizabeth H. Forsyth. M.D.)&9674Gene TherapyToday, basic theory of gene therapy is that normal gene is inserted into genome to replace disease caused gene. The gene by itself, however, is almost impossible to get the target cell. To deliver gene successfully, a carrier called vector is necessary and computer virus is good for delivering gene, because virus genetically approaches human genes. Virus, however, can have a potential toxic or respond a massive immune system. In fact, some slew died because of that. For this reason, scientists tried to find replacement of virus as vector. The most common virus for vector is adenovirus that causes cold.

What is outsourcing Essay -- Globalization essays, research papers

What is Outsourcing? It is a method in which companies subcontract labor and support to outside agencies (Klepper, 1997). How, why, and who companies outsource to are quickly becoming friendly topics of discussion in our society. Everyone seems to have an opinion on outsourcing. I bet that I can walk into a social gathering right straight off and hear discussions like outsourcing is good for the American consumer or outsourcing takes jobs away from all of the hard working Americans. In either case, outsourcing has raised great concerns over its set up on the American economy. In this paper, I volition discuss the types of outsourcing, pros and cons associated with outsourcing, direction views of outsourcing, employee views of outsourcing, and give my opinion of outsourcing.What does outsourcing do? It enables companies to nidus on the mission at hand, to unbosom money and be competitive. Depending on a Companys necessarily determines the type of outsourcing that company may use (Embleton, 1998). Outsourcing is a very diverse market, and there are many different outsourcing options from. Two common types of outsourcing I will focus on are Information Technology (IT) outsourcing and Business Process Outsourcing (BPO) (Bowen, 1998).through and through research, I found that Information Technology (IT) Outsourcing is a rapidly growing market. I.T. outsourcing enables companies to continue to manage their core business, while outside agencies manage their technology needs (Bowen, 1998). Its a way of getting rid of those high paid, college graduated employees. I.T. outsourcing allows companies to use cost-cutting methods to cover computing needs, large mainframe and midrange data center, manage many networks and run desktops across the globe (Bowen, 1998). Advantages of outsourcing information technology include, but are not limited to, less capital expenditure, less management headache, and keeping focus on core competencies. Less capital expenditure mea ns a company does not have to buy expensive hardware and software. Less management headache relieves companies of having to hire and manage accounting personnel. Keeping focus on core competencies affords companies time to strengthen and gain a competitive edge over the competition (DiRomualdo, 1998). Disadvantages of outsourcing information include less managerial control, may be more expensive, and Sec... ...Workers in developing nations will get new and higher-paying jobs, and consumers in the U.S. will be able to buy products that are cheaper than if they were made at home. But is this really good for our society. We will soon find out. ReferencesBowen. T and LaMonica, M. (1998). IT gets picky with outsourcing. Infoworld 20(33), 1-3 De Rose, L. (2004). The Downside to Outsourcing. electronic Buyers News. July 14, Issue 1066.DiRomualdo, A & Gurbaxani. (1998). Strategic intent for IT outsourcing. Sloan Management Review. 39(4), 115.Earl, M.J. (1996). The risks of outsourcing IT. Sloan Management Review. 37(3), 26-33.Embleton, P.R & Wright, P.C. (1998). A practical guide to successful outsourcing. Empowerment in Organizations. 6(3), 1-11Hayes, R and Pisano, G. (1994). Beyond inaugural The New Manufacturing Strategy. Harvard Business Review. 72(1).Klepper, R & Jones, W. (1997). Outsourcing information Technology, Systems and Services. Prentice Hall.Nicholas, J. (1998). Competitive Manufacturing Management (SingaporeMcGraw-Hill). Chapter 19, Managing the Supply Chain, pg 672Strassmann, P.A. (1995). Outsourcing A Game for Losers. Computerworld. August 21.

Bermuda Triangle Essay -- Science Exploratory

Bermuda trilateralThe Bermuda triangle, or the raise ups triangle, is an imaginary area located off the south Atlantic coast of the United States. It is the greatest modern mystery of our supposedly well mute world. It is noted for a very high incidence of undetermined losses of ships, sm each boats, and aircraft. The tips of the triangle are generally thought to be Bermuda, Miami, Fla., and San Juan, Puerto Rico. Many theories attempting to apologise the many disappearances catch been offered throughout the history of the area. The most applicatory seem to be environmental and those that involve human error. Some reports even go as far as to saying that there are unidentified flying objects kidnapping ships and planes, and that the lost city of Atlantis is below the Bermuda triangle. Weird disappearances and sightings in the Bermuda triangle figure back to 1492, when the first voyage to America took place. Christopher Columbus when coast through the imaginary place calle d the Bermuda triangle wrote of weird sightings in the ship log. He enter that he and his crew had observed a large ballock of discharge fall into the sea and that the ships compass was behaving differently. On October 11, which is the day Columbus landed on Cuba, Columbus and another man saw a put down over the water, which disappeared suddenly. Within hours land was sighted. These incidents have been thought to be the first known indications that the Bermuda Triangle is filled with bizarre happenings, Columbus himself was not apparently fazed by what he had seen. The ball of fire might have been a meteor, a fire on the shore, a torch in an Indians boat or even a hallucination. Whatever it was, Chris Columbus provided the Bermuda Triangle with a five hundred-year story. (3) Many ships and planes have been lost in the triangle. Of unexplained stories, the most famous of them all is of flight 19. The mission called for the thirteen men to fly due east fifty-six miles to Hens and moaner Shoals to conduct practice-bombing runs. When they had completed that objective, the flight plan called for them to fly an excess sixty-seven miles east, then turn north for seventy-three miles and finally straight back to base, a distance of 120 miles. This course would take them on a triangular path over the sea. About an hour and a half into the mission Lt. Taylor report that his compass was not working. Planes t... ...pearances occurred. Each was a world forth from the other. One was off Australia, the other off Puerto Rico in the Bermuda Triangle, yet two were very similar. two pilots were sober, one was a US Marine. Both report a strange object harassing or, at the very least, very interested in their aircraft. Both could not describe exactly what it was. But in both cases, when it came in closer, it apparently caused a disruption of radio communication and cut out electro-magnetic power, make the engine to sputter. Neither aircraft left any trace. Both carried EL Ts, self-winding alarms that are jettisoned when the aircraft impacts. This triggers them to send their electronic SOS signals, guiding rescuers to the point of the incident. Yet in both these incidents they were hushed, for no signal was ever picked up. (2) The Great Bermuda Triangle is one of the biggest mysteries nonoperational alive today. It has created many stories, some true, some untrue there have been many unexplained disappearances in this imaginary place. Peoples lives have been lost, and ships and planes seemed to enter and never fix out. Whatever it is, it will always be a mystery, a mystery of the Great Bermuda Triangle. Bermuda Triangle Essay -- Science ExploratoryBermuda TriangleThe Bermuda triangle, or the devils triangle, is an imaginary area located off the southeastern Atlantic coast of the United States. It is the greatest modern mystery of our supposedly well understood world. It is noted for a very high incidence of unexplained losses of shi ps, small boats, and aircraft. The tips of the triangle are generally thought to be Bermuda, Miami, Fla., and San Juan, Puerto Rico. Many theories attempting to explain the many disappearances have been offered throughout the history of the area. The most practical seem to be environmental and those that involve human error. Some reports even go as far as to saying that there are UFOs kidnapping ships and planes, and that the lost city of Atlantis is below the Bermuda triangle. Weird disappearances and sightings in the Bermuda triangle date back to 1492, when the first voyage to America took place. Christopher Columbus when sailing through the imaginary place called the Bermuda triangle wrote of weird sightings in the ship log. He recorded that he and his crew had observed a large ball of fire fall into the sea and that the ships compass was behaving differently. On October 11, which is the day Columbus landed on Cuba, Columbus and another man saw a light over the water, which disap peared suddenly. Within hours land was sighted. These incidents have been thought to be the first known indications that the Bermuda Triangle is filled with bizarre happenings, Columbus himself was not apparently bothered by what he had seen. The ball of fire might have been a meteor, a fire on the shore, a torch in an Indians boat or even a hallucination. Whatever it was, Chris Columbus provided the Bermuda Triangle with a five hundred-year story. (3) Many ships and planes have been lost in the triangle. Of unexplained stories, the most famous of them all is of flight 19. The mission called for the thirteen men to fly due east fifty-six miles to Hens and Chicken Shoals to conduct practice-bombing runs. When they had completed that objective, the flight plan called for them to fly an additional sixty-seven miles east, then turn north for seventy-three miles and finally straight back to base, a distance of 120 miles. This course would take them on a triangular path over the sea. Abou t an hour and a half into the mission Lt. Taylor reported that his compass was not working. Planes t... ...pearances occurred. Each was a world away from the other. One was off Australia, the other off Puerto Rico in the Bermuda Triangle, yet both were very similar. Both pilots were sober, one was a US Marine. Both reported a strange object harassing or, at the very least, very interested in their aircraft. Both could not describe exactly what it was. But in both cases, when it came in closer, it apparently caused a disruption of radio communication and cut out electro-magnetic power, causing the engine to sputter. Neither aircraft left any trace. Both carried ELTs, automatic alarms that are jettisoned when the aircraft impacts. This triggers them to send their electronic SOS signals, guiding rescuers to the point of the incident. Yet in both these incidents they were hushed, for no signal was ever picked up. (2) The Great Bermuda Triangle is one of the biggest mysteries still aliv e today. It has created many stories, some true, some untrue there have been many unexplained disappearances in this imaginary place. Peoples lives have been lost, and ships and planes seemed to enter and never come out. Whatever it is, it will always be a mystery, a mystery of the Great Bermuda Triangle.

Acting To Save Mother Earth Essay -- essays research papers

Everday we hear more bad news ab come out of the closet our planet. Reports tell us that wildlife and forests are disappearing at an alarming rate. Newscasts guide the latest word on how quickly earth is losing its protective shirld and warming up. Newspapers lament the pollution of our air, water, and soil. What can we do in the face of such widespread gloom?In fact, we do not have to feel helpless. We can each learn practical ways to better our environment.For example, saving and recycling newspapers has a number of positive results. First, recycling newspaper saves trees. The average American consumes about 120 pounds of newsprint a year-enough to use up one tree. That means taut to 250 million trees each year are destroyed for paper in this country alone. If we recycled only one-tenth of our newpaper, we would save 25 million trees a year. Second, devising new paper from old paper uses up much less energy than making paper from trees. Finally, this process also reduces the a ir pollution of paper-making by 95 percent.Another earth saving habit is "precycling" waste. This means buying food and other products packaged only in materials that will decay naturally or that can be recycled. The idea is to prevent unrecyclable materials from even entering the home. For instance, 60 of the 190 pounds of plastic-especially styrofoam-each American uses a year are thrown out as soon as packages are opened. Be kind to your planet by buying eggs, fast food, and other products in cardboard in...

The Eightfold Path is a treatment :: essays research papers

The octuple Path is a treatment, a treatment by training (smith 104). Buddha taught that soldiery is a slave to his ego (smith 108). That man wishes happiness, security, success, long life, and many other things for himself and his loved ones. However, pain, frustration, sickness and death are all impossible to avoid and the however way to eliminate these evils is to overcome desire. In Buddhism, the Eightfold Path is meant as a guideline, to be engageed, to be contemplated, and to be taken on when, and only when all(prenominal) step is fully accepted as part of the life you seek. Buddhism never asks for blind faith, it seeks to promote learning and a process of self-discovery. The First step of the Eightfold Path is Right View. This is a significant step on the path as it relates to seeing the world and everything in it as it really is, not as we believe it to be or want it to be. Knowing reality is of very little value if we dont put it to personal use in our lives. The second step on the Eightfold Path is Right Intent. This is the step where you become committed to the path. Right Views shows us what life really is and what lifes problems are composed of. Right Intent must come from the heart and involves recognizing the equality of all life and compassion for all that life, beginning with you. Right vocabulary is the next step of the Path. Our speech reflects our character. We must avoid speaking falsely, obscene, slanderous, and belittling words. Right Conduct recognizes the need to take the ethical approach in life, to consider others and the world we live in. This includes not taking what is not given to us, and having respect for the agreements we make both in our private and business lives. Right Conduct as well as encompasses the five precepts, which were given by the Buddha, not to kill, steal, and lie, to avoid sexual misconduct, and not to take drugs or other intoxicants (smith 107-108). The next on the Eightfold Path follows on from Right C onduct, and this is Right Livelihood. If your work has a lack of respect for life, then it will be a barrier to progress on the spiritual path. Buddhism promotes the prescript of equality of all living beings and respect for all life. Certain types of work were discouraged by the Buddha, in particular those where you deal in harmful drugs and intoxicants, those transaction in weapons, and those harmful to animal or human life.

The Eightfold Path is a treatment :: essays research papers

The multiple Path is a treatment, a treatment by training (smith 104). Buddha taught that universe is a slave to his ego (smith 108). That man wishes happiness, security, success, long life, and many other things for himself and his loved ones. However, pain, frustration, sickness and death are all impossible to avoid and the only way to eliminate these evils is to overcome desire. In Buddhism, the Eightfold Path is meant as a guideline, to be considered, to be contemplated, and to be taken on when, and only when each step is fully accepted as part of the life you seek. Buddhism never asks for blind faith, it seeks to promote learning and a process of self-discovery. The First step of the Eightfold Path is Right View. This is a momentous step on the path as it relates to seeing the world and everything in it as it really is, not as we believe it to be or deficiency it to be. Knowing reality is of very little value if we dont put it to personal use in our lives. The second step o n the Eightfold Path is Right wrapped. This is the step where you become committed to the path. Right Views shows us what life really is and what lifes problems are composed of. Right Intent essential come from the heart and involves recognizing the equality of all life and compassion for all that life, beginning with you. Right Speech is the next step of the Path. Our speech reflects our character. We must avoid speaking falsely, obscene, slanderous, and belittling words. Right Conduct recognizes the need to take the ethical approach in life, to consider others and the world we live in. This includes not fetching what is not given to us, and having maintain for the agreements we make both in our private and business lives. Right Conduct also encompasses the five precepts, which were given by the Buddha, not to kill, steal, and lie, to avoid sexual misconduct, and not to take drugs or other intoxicants (smith 107-108). The next on the Eightfold Path follows on from Right Conduct , and this is Right Livelihood. If your work has a lack of respect for life, then it will be a barrier to progress on the spiritual path. Buddhism promotes the principle of equality of all living beings and respect for all life. Certain types of work were discouraged by the Buddha, in particular those where you deal in harmful drugs and intoxicants, those dealing in weapons, and those harmful to animal or human life.

Gender roles Essay

Well, the topic of sex roles is a ripe iodin. While in that location is no specific outline providing benchmarks to use in classifying a persons gender, a number of factors come into play in helping do ones gender. One of the factors is cultural prescription as provided for by a persons social group. A slice is a man or a woman a woman depending on how the social group they belong to label or socializes them. But one should remember here that genitalia alone do not determine a persons gender.While ones sex is determined by ones biology, both biology and culture (nature and nurture) determine their gender. There are different roles for different genders. Gender is more(prenominal) of culturally than biologically determined. In fact, a person could be born with male genitalia but be of young-bearing(prenominal) gender or vice versa. Differences exist between the male and female genders for instance men are braver than women and women more emotional than men. Women like being pr otected while men like to protect.Also, men necessity to pursue a woman for relationship while women want to be pursued. The differences between the genders emanate from differences in sexes culture, religion among others. Some of the similarities include both are jealous, self-centered and want to mend the other to live up to their let standards. Again, both genders converge in their need for recognition and love. These among other differences and similarities to shakeher with other factors such as legal have succeeded in being constant obstacles on the road to equality.Most social groups, our parents and the media have socialized us to believe that the male gender is superior to the female gender. One can ask, does sex determine ones abilities? Pursuing such a question may elicit an unending debate but a sex-based approach in determining gender roles is bias and oppressive to women and perpetuates inequalities and patriarchy. No wonder women have to fight for equality. Kyra Se dgwick says that, we are cool it not really supposed to want it as much as guy does. But I think women should be able to make their own choices.I would want to socialize my children in a manner that they will see both genders as equal and worth as much wish despite the differences. I will also want to allow them freedom to choose what they want to be in life. I will not abjure them opportunities on the basis of their gender. I will also encourage them to follow their passion provided they are within the range of acceptable careers and I will enterprisingness to support them. A number of questions puzzle me. They include In agitating for equality, do women become more women or less? Is a woman more woman because she enjoys same rights as a man?Is it possible to invent a universally acceptable modality of determining gender roles so as to eschew the controversy? What provisions do our societies make for those individuals who do not qualify as average male/female? These questions leave me lost in the labyrinths. The first and second questions demand that women be careful when agitating for equality lest they lose their individuality. Anyway what is so serious about losing ones identity? If forgoing ones identity will make one have a happier life then isnt it better to forgo it.What should be pursued, identity or happiness? Addressing the third question will save us unnecessary debates while the fourth question rises out of my worry that thither are some persons that are left out in the classification of genders and this could be unfair- a more inclusive definition needs to be pick out for a fair discussion. In doing away with the dual classification such terms as feminism and others that are so poisoned will be avoided and may be a less controversial nomenclature adopted. Andrea Wong is a brave woman.From her early age she tried her leg in leadership, a field that was erroneously perceived as a reserve for men. Also unlike most women, Andrea Wong knows ho w, after falling, to get up, dust herself off and keep going. Unlike Wong, most women get resigned after their first failure. If women were like her, they would also be leaders like she is today and would be doing great exploits. Rachel Roy is another woman who impresses me. She goes for what she wants and she wants nothing but the best, If I couldnt work at Contempo, I didnt want to work anywhere. This shows a resolve that most women lack. She knows what she wants that is to be a designer, her passion started in childhood and she has never wavered. She is final in her decision. These two women not only set good example for me but also are good role models for women. From the pieces, it is clearly depicted that success for women is dependent on their attitude and not their gender. If women changed their attitude then they would favorably compete against men and it would be easier for them and tougher for men. Works cited Newsweek, October 15, 2007.

Knowledge Of Biomechanical Restrictions Ankle Health And Social Care Essay

The knee crimp is a often employ exercising in the aptitude and conditioning community and is regarded as an first-class manner to develop the lower limb muscular structure. This is in no little portion down to the biomechanical and neuromuscular similarities that the knee bend exercising has in relation to many athletic works ( Escamilla et al. , 2001 ) . The knee bend is as well used in many rehabilitation protocols as it is a closed kinetic chain exercising ( Escamilla et al. , 1998 Stuart, Meglan, Lutz, Growney, & A An, 1996 ) where the distal section is fixed ( Yack, Collins, & A Whieldon, 1993 ) . The knee bend is too a character point for almost strength and conditioning managers when measuring maximum lower limb strength and this is besides the instance in competitory power-lifting and weightlifting ( Escamilla, Fleisig, Lowry, Barrentine, & A Andrews, 2001 ) . Squat preparation has been shown to correlate strongly with improved sprinting, perpendicular leap and o ther athletic abilities ( Wisloff, Castagna, Helgerud, Jones, & A Hoff, 2004 CHELLY et al. , 2009 ) and so strength and conditioning managers would be new to proliferate good motion in this exercising. It is non merely in athletic preparation that the knee bend should be regarded as of import but besides in mundane life be ingest the specificity of the crouching motion to undertakings such as picking up immature kids and bundles is innately similar, as be infinite other avocations and undertakings ( Schonefield, 2010 ) intending the energy to crouch allows people to retain functional independency in life.During chunky public presentation the mortise pin voicen contributes considerable support and helps to mystify forth the important degrees of power ask for this motion ( Hung & A Gross, 1999 ) . Besides failing or instability at the mortise juncture has antecedently been interested in the generation of defective motion forms during the knee bend happening specifically that failing of the gastrocnemius muscle, tibialis front tooth or buttocks whitethorn improver likeliness of twain foot pronation gesture and so diminishing the ability to command articulation genus valgus ( Bell, Padua, & A Clark, 2008 ) .However it was historied by Schonefield ( 2010 ) that the degree of kinematic informations on the mortise joint articulation and its importance to the crouching motion is scarce. Most writers get hold of decided to c at oncentrate their attendings on the biomechanics of the spinal towboat, hep or articulatio genus complicated during crouching undertakings ( Schonefield, 2010 ) and so some recommendations will be made within this paper for future research.The incidence of ankle hurt in athletics is highest in judicature and squad athleticss such as rugger, football, hoops and volleyball ( Fong, 2007 ) . A systematic reappraisal paper by Fong ( 2007 ) looked at 227 surveies that had detailed ankle hurt range across 70 different athleticss over a 28 twelvemonth period and ready that in athleticss hurts the mortise joint was the 2nd most wound organic structure site after the articulatio genus ( Fong, 2007 ) .The chief constituents that encompass the mortise joint are the superior tibiofibular articulation and the talo-crural articulation. The superior tibiofibular articulation ( STFJ ) is devoted to locking when it is working as portion of a kinetic concatenation and this can take to stop scope restrictions of talocrural dorsiflexion ( Phelps, James, & A Matthijs, 2003 ) . The talo-crural articulation ( appendix 1 ) which passively dorsiflexes up to 30 and plantar flexes up to 50 is made up of the talar dome resting on the roof of the mortice, which is junction of the shinbone, calf bone and medial and sidelong malleoli. Talocrural dorsiflexion is seen as normal between 11 and 25 and inflexible between 4.3 and 11.2 ( mention this please ) . The mortise joint composite besides has a huge web of back uping ligame nts and sinews and in entire the mortise joint and pes contains 26 castanetss.In order to crouch the metatarsals will dorsiflex and kidnap as the mortise joint goes into dorsiflexion and so follows subtalar joint abduction doing calcaneal eversion which leads to innate rophy motion of the shinbone and thighbone making knee creese and hence motion in the sagittal plane. The flexibleness of the calf musculus composite will restrict the sum of dorsiflexion attained, which in bend bounds the remainder of the concatenation or causes compensations someplace else. The induction of a squatting motion is thought to happen from a muscular response that initiate hip and knee flexure along with ankle dorsiflexion to interrupt unsloped position ( Dionisio, Almeida, Duarte, & A Hirata, 2008 ) . At this point an automatic response of the tibialis anterior additions ankle joint dorsiflexion complication and disrupts the postural equilibrium ( Cheron, Bengoetxea, Pozzo, Bourgeois, & A Draye, 1997 ) . At this point moderate gastrocnemius legal action has been observed apparently to command the degree of dorsiflexion at the mortise joint ( Dahlkvist, Mayo, & A Seedhom, 1982 Escamilla et al. , 2001 Escamilla et al. , 1998 ) contending the theory that the musculus is eccentrically controlling dorsiflexion. This theory nevertheless whitethorn non keep true due to the fact that the gastrocnemius is a biarticular musculus and may so shorten at the articulatio genus whilst lengthening at the mortise joint and frailty versa for the ascent stage ( Escamilla, 2001 ) . Indeed gastrocnemius activity has been found to be comparatively low in crouching motions and is highest at near to top out knee flexure ( Donnelly, Berg, & A Fiske, 2006 ) which correlates with the fact that the gastrocnemius force outgrowth extremum at this point ( Escamilla et al. , 2001 ) . Ankle angular speeds have been seen to be reasonably low and rather changeless through with(predicate)out both the ac clivity and line of merchandise stages of the knee bend ( Escamilla et al. , 2001 ) .Stance is an of import factor in crouching public presentation and muscular enlisting forms and no clear victor has been found in the race to domination with foot place even in the powerlifting universe. Escamilla et Al ( 2001 ) examined how 3 differing stances affected joint minute and angular speeds utilizing a 3 dimensional biomechanical analysis but besides comparing against a 2-D theoretical account, happening important differences in wider stances. This was interesting because the ankle joint minutes and section angles reckon in old 2-D literature were based on utilizing a individual camera to therefore position the joint moving in merely the sagittal plane which can merely go on when the pess point forwards and so as the stance breadth increased so would the degrees of erroneous informations biomechanically from the mortise joint articulation ( Escamilla et al. , 2001 ) presuming topics hav e to turn their pess out. Potentially this means unless the stance was standardized to insulate sagittal motion in all literature so it is extremely likely to be inaccurate. The motion of the articulatio genuss relative to the mortise joints in the z-axis was besides studied in the Escamilla et Al ( 2001 ) paper and they found that the articulatio genuss translated forrard over the pess 21.7 A 4.4 centimeter during the narrow stance, 18.0 A 2.6 centimeter during the medium stance, and 16.0 A 4.6 centimeter during the broad stance. It has been antecedently reported that increased frontward motion of the articulatio genuss during crouching causes crop forces at the articulatio genus ( Ariel, 1974 ) . This besides highlights the importance of ankle dorsiflexion scope of gesture during crouching motions when using a broad or sightly stance, which was categorized by Escamilla et Al ( 2001 ) as 121-153 % shoulder width apart ( set broad stance breadth in ) . In this survey the most imp ortant differences in joint minutes and minute weaponries were seen at the mortise joint articulation ( Escamilla et al. , 2001 ) and unsurprisingly the greatest differences occurred between the narrow and broad stances ( appendix 2 ) . The greatest mortise joint articulation minutes were seen at maximal knee flexure ( Escamilla et al. , 2001 ) which was in line with old literature where gastrocnemius activity besides peaked at this point ( Isear, Erickson, & A Worrell, 1997 ) in all chance antagonizing the mortise joint minutes. A recent survey, albeit looking at select of motion steps and the sidelong measure down test, saw that topics with inhibited public presentation in these trials had limited ankle dorsiflexion ( RABIN & A KOZOL, 2010 ) and so compensations are likely to be happening elsewhere.McLaughlin et Al ( 1977 ) have recommended maintaining the shinbone every bit perpendicular as possible to restrict the possible articulatio genus shearing forces in the knee bend ( McLaughlin, Dillman, & A Lardner, 1977 ) and so a later survey by Fry et Al ( 2003 ) examined kinetic belongingss when articulatio genus anterior motion was restricted. The 7 topics were weight trained work forces who had all squatted on a regular basis earlier and each performed 3 knee bends both impeded and unimpeded with consequences demoing important differences in both hip and articulatio genus deviousnesss under restricted articulatio genus conditions. The restricted knee bend produced greater torsion values at the hip compared to the articulatio genus and besides showed a more inclined bole and trunk every bit good as a more perpendicular shinbone ( Fry, Smith, & A Schilling, 2003 ) . The restriction ( figure 1 ) so causes a alteration in the hip minute arm, which is a requirement compensation to let the Centre of mass to remain over the base of support, the pess. This inordinate forward tilt is hence necessary when there is a limitation in anterior knee motion and sign ificantly has besides been noted as a common mistake for novice lifters executing the barbell knee bend exercising ( Chandler & A Stone, 1991 ) . It has been seen that less skilled homesteaders tended to tilt frontward more, therefore making greater bole torsions ( McLaughlin et al. , 1977 ) but it has besides been seen that lumbar spinal column shearing forces are significantly increased in lifters exposing a outstanding forward tilt ( Russell & A Phillips, 1989 ) . It can be moderately assumed that the wide-ranging hip torsions seen when anterior articulatio genus motion is restricted are transferred to the lumbar spinal column making a possible hurt site and inadequate biomechanical modeling. Surveies have antecedently shown that the experts in crouching have superior kinematics due to a more vertical bole, less horizontal hip supplanting and superior dynamicss through less bole torsions than less experient lifters ( McCaw & A Melrose, 1999 McLaughlin et al. , 1977 ) . mave n cause for restricted anterior articulatio genus motion in knee bend could be gastrocnemius equinus forestalling dorsiflexion and this is a wholly under researched country. It has been researched in spastic and neurologically impaired persons but non every bit much in non-spastic populations as a cause of limited dorsiflexion. This stringency causes an inability to dorsiflex through the tibiotalar articulation and can besides take to other symptoms of the bow and mid pes ( DiGiovanni et al. , 2002 ) .Heel rises have been used by jocks to help in the gym based motion such as knee bend and Olympic raising fluctuations. A diminution progress is such a device and this puts lesser necessitys on the mortise joint in dorsiflexion compared to normal floor based knee bends ( Frohm, Halvorsen, & A Thorstensson, 2007 ) . This has been postulated as a method for the intervention of tendinopathies at the patellar but this is when utilizing odd motions ( Frohm et al. , 2007 ) to make maximal force at the articulatio genus and non for general knee bend. One possible drawback with heel rises is that the when utilizing a heel raise the pes becomes more plantarflexed coupled with calcaneal inversion. This means that during crouching when tibial internal rotary motion is required it is hard to achieve whilst the pes is somewhat inversed and as the shinbone is already in a somewhat externally rotated place. Tibial external rotary motion has been implicated as one of the causes of dynamic articulatio genus valgus in the knee bend exercising ( Bell et al. , 2008 ) which is regarded as a important impale factor in anterior cruciate ligament showing ( Chaudhari & A Andriacchi, 2006 Hewett et al. , 2005 ) . The median supplanting of the articulatio genus ( MKD ) is thought to be influenced by specific strength or flexibleness shortages in muscular structure at the hip and mortise joint ( Hirth & A Padua, 2007 ) such as stringency of sidelong gastrocnemius, soleus and peroneal s which may add to tibal abduction and external rotary motion ( Bell et al. , 2008 ) . Once once more though, the research detailing the existent comparative parts of the mortise joint and hip is non seen. This is one country where clinicians may make up ones mind to utilize a heel rise to distinguish the cause of MKD between hip muscular structure and lower limb muscular structure when MKD is seen when utilizing a heel rise under the calcaneous when bilaterally crouching ( Bell et al. , 2008 ) . A survey by Bell et Al ( 2008 ) looked at the lower limb causes of MKD and found that topics with inordinate MKD had 20 % less inactive mortise joint dorsiflexion scope of gesture with a flexed articulatio genus ( Bell et al. , 2008 ) . It should be noted that the topics in this survey were non wholly from athletic or physically active backgrounds with a significantly greater equaliser ( n=30, men=7, women=30 ) being adult females. The presence of an increased articulatio genus valgus when decreased mortise joint dorsiflexion scope of gesture is present facilitates the demand for farther survey into this country as a showing tool for ACL hurt bar ( Fong, Blackburn, Norcross, McGrath, & A Padua, 2011 ) .Outside of crouching forms, jocks with limited mortise joint dorsiflexion have been seen to incur much greater extremum landing forces after dropping or jumping ( Blackburn & A Padua, 2008 Devita & A Skelly, 1992 ) which is coupled with much less articulatio genus and hip supplanting. Reduced ankle dorsiflexion scope of gesture was besides associated with patellar sinew tendinopathies ( P & lt 0.05 ) in volleyball participants due to the resulting limited calf bizarre contraction ability ( Malliaras, Cook, & A Kent, 2006 ) . Another similar status to patellar tendinopathy that has been implicated with limited mortise joint dorsiflexion is Morbud Osgood Schlatters ( MOS ) in athleticss active kids. This status is caused by grip apophysitis of the tibial tubercle c aused by insistent strain and chronic avulsion of the secondary ossification Centre of the tibial tubercle ( EHRENBORG, 1962 ) although the exact description and causation is still debated. This insistent pulling gesture comes from the quadriceps musculus during featuring activities ( Sarcevic, 2008 ) . Sarcevic ( 2008 ) theorized that limited mortise joint dorsiflexion caused compensatory actions such as increased articulatio genus flexure, tibial internal rotary motion and foot pronation during the stance stage of running ( Sarcevic, 2008 ) . In this paper 42 of the 45 topics had a dorsiflexion angle of less than 10 and besides had clinical diagnosing of MOS. This is simply a theory though and farther research should concentrate on using a control group to compare and therefore make causal relationships.The importance of ankle dorsiflexion scope of gesture is non merely critical for crouching motions and set downing but besides for the bar of by and large enfeebling conditions s uch as plantarfasciitis. Plantarfasciitis is comparatively common in physically active and athletic populations ( Kibler, Goldberg, & A Chandler, 1991 ) and is by and large seen as inflaming of the facia on the sole of the pes giving anterior heel hurting. It has been seen that when ankle dorsiflexion is limited, inordinate pronation of the pes will happen to counterbalance, thereby increasing waxy tonss on the plantar aponeurosis ( Kibler et al. , 1991 WRIGHT & A RENNELS, 1964 ) . The hazard of plantartfasciitis additions as the scope of dorsiflexion lessenings and providentially those who spend a longer sum of clip on their pess are once more at a greater hazard ( Riddle, Pulisic, Pidcoe, & A Johnson, 2003 ) .One of the causes of a limited dorsiflexion may be the inability of the shinbone to posterior seashore decently on the flexible joint like scree ( Denegar & A Miller, III, 2002 ) . Lots of research is available that highlights the effectivity of anterior to posterior mobilizations of the scree on the shinbone to increase ankle dorsiflexion scope of gesture ( Landrum, Kelln, Parente, Ingersoll, & A Hertel, 2008 van der Wees et al. , 2006 Vicenzino, Branjerdporn, Teys, & A Jordan, 2006 ) . This research was by and large performed on topics with chronic mortise joint sprain and or, instability. One of the theories postulated for the effectivity of the front tooth to posterior mobilization technique is the theory of the lockup of the scree, whereby the scree is subluxated anteriorly on the shinbone ( Mulligan B R. , 1999 ) and even though there is small published quantifiable grounds of this theory it is worthwhile cognition for the strength and conditioning manager who identifies a dorsiflexion restriction. In another paper topics who suffered recurrent mortise joint sprains and were so diagnosed with chronic mortise joint instability ( CAI ) had significantly less dorsiflexion compared to a control group when jogging ( Drewes, McKeon, Casey Ke rrigan, & A Hertel, 2009 ) . This shortage was so postulated as a important hazard factor in jocks with CAI with recommendations to see a clinician proposed ( Drewes et al. , 2009 ) . It should besides be noted that during this survey used a 10 camera gesture analysis system intending a 3-D analysis was undertaken on topics.

German Indian Partnership for IT Systems Essay

Very good morning to all of you and a ardent greetings on behalf of Centre for infrastructure, Sustainable transportation and urban Planning (CiSTUP), Indian give of Science and National Academy of Science and Engineering Ger umpteen (ACATECH).. Today we hit guests of honour Mr. Rolf Saligmann, German commonplace Consul, Bangalore, Mr. Subir Hari Singh IAS, Addl. Chief Secretary, Govt. of Karnataka, Dr. Christian Aulbach, Science and Technology Counselor, German Embassy, Delhi, Dr. A. Ravindra IAS, Advisor to Chief Minister, Govt. of Karnataka. We also have on the dias Prof. Dr. Otthein Herzog, Executive bill member, National Academy of Science and Engineering, Germany who is the main brain behind this event. We also have Prof. B.N. Raghunandan, Divisional Chair, Earth and Environmental Sciences, IISc who will preside over the function. substantial refreshing to other dignitaries off-the dias, Guests and Invitees, press and TV persons, my dear colleagues and students, Ladies a nd Gentlemen.A warm welcome to all of you from CiSTUP which is started in 2009 with a generous support from Govt of Karnataka in bad-tempered BMTC, KSRTC, BDA and NERTC. In about 2 years, we have started a masters programme in transportation and infrastructure engineering, carried out many research and consultancy projects for the Govt of Karnataka and others, organized many conferences, symposium, brain storming sessions and round table meetings to address issues related with our cities in particular urban issues. CiSTUP has grown into a full fledge centre having more than 50 scientists/researchers and students associated with the centre carrying out many important research projects which is of interest to our city, state and the country in the areas of infrastructure, transportation and urban planning.We are organizing a Symposium and a store as part of German Indian Partnership for IT Systems (GRIP IT) on the 19th (today) and 20th May (tomorrow) respectively, The symposium is o n Smart Mobility and Energy Concepts for Megacities. The GRIP IT Workshop on Smart cities is plannedfor 20th May 2011 at the Institute and it is restricted to selected and invited participation from industry and academicians. GRIP IT project is planned to act as a catalyst for future research and development collaborations between India and Germany by bringing together the German and Indian partners from the world of academics and industry and to provide a political program for networking. The focus of the gaps are around the theme Smart Cities the various topics, technologies and the potential research and development potentials in and around the theme.The objective of the workshop is to further step up our initiatives towards establishing a joint team of German and Indian research and industry partners to pursue high potential research topics of common interest to both countries and to research possibilities of submitting joint proposals under the EU research framework progr amme. Towards the objective of identifying the right topics for a potential joint research initiative, we have initiated two studies one on mobility and the other on energy. The results of the study would be presented at the workshop tomorrow to help focus on the right topics and to work on the next step towards joint research proposals.It gives me great pleasure to welcome the dignitaries on the dias and off the dias to this Inaugural function of Symposium on Smart Mobility and Energy Concepts for Megacities. This is a joint initiative of CiSTUP and ACATECH, Germany. It is a great occasion for CiSTUP, IISc and ACATCEH to come together to start a joint collaborations in the area of smart cities.We would like to take this opportunity to read our hearty welcome, on my behalf and on our Institutes behalf, to Honorable Consul General Rolf Saligmann for honoring our invitation to be the chief guest of this function and inaugurate the symposium. German consular General is very support ive for such activities leading to large scale indo-german colloborations. We issue a warm welcome and present a corsage of flowers to Mr. Rolf Saligmann, Consul General of the Federal Republic of Germany.We also welcome Mr. Subir Hari Singh IAS, Addl. Chief Secretary, Govt. ofKarnataka and commissioner BMRDA, who is always supportive for such developmental initiatives and for accepting to grace this function and deliver his address. We present a sweet of flowers to Mr. Subir Hari Singh.A warm welcome to Dr. Christian Aulbach, Science and Technology Counselor, German Embassy, Delhi, for this function. We present a bouquet of flowers to Dr. Christian Aulbach.A warm welcome to Dr. A. Ravindra IAS, Advisor to Chief Minister, Govt. of Karnataka, who is always supportive for such initiatives in CiSTUP and at the institute, we thank him for accepting to grace this function and deliver his address. We present a bouquet of flowers to welcome Dr. A. Ravindra.2Hearty welcome to Prof. B.N. R aghunandan for accepting our invitation to be with us today as a President of the function. We welcome him and present a bouquet of flowers to Prof. B.N. Raghunandan. We miss amongst us our beloved Director Prof.P. Balaram and Associate Director Prof. N. Balakrishnan, who are very supportive for such activities, who are unable to be here with us today due to other engagements.Hearty welcome to Prof. Dr. Otthein Herzog, Executive Board member, National Academy of Science and Engineering, Germany who has spent lot of time with me in organize this event. We extend hearty welcome and present a bouquet of flowers to Prof. Dr. Otthein Herzog.We have many distinguished professors, academicians and leading persons from germany and India. Also we have leading persons from R&D groups and Industry amongst us. Hearty welcome to all the speakers from Germany, India and also Officers of ACATECH and Dr. Ulrich Golgzback, Mr. mathew Joseph, Project manager at ACATECH.Special welcome to all the dign itaries off the dais and Invitees from the Govt of Karnataka, BMTC, BDA, KSRTC, DULT and Indian Institute of Sciencefor taking the time off from their busy schedule to grace this function. We welcome press, TV persons, and officers of our institute, my colleagues from the centre and department, students and other invitees. Once again I extend hearty welcome to all of you for this inaugural function of the Symposium.ONCE AGAIN I EXTEND A WELCOME TO YOU ALL.Sitharam===========================Prof. T.G. Sitharam, Ph.D.(Canada), FIGS, FIEChairman, Centre for infrastructure Sustainable exile and Urban Planning (CiSTUP) andPROFESSOR Department of Civil Engineering,Indian Institute of Science,Bangalore 560012, INDIATel.No.+91-80-23602261 / 22932919 Fax no. 080 2360 2261 (phone/fax) / FAX no. 0802360 0404 (dept) email sitharamcivil.iisc.ernet.in (preferred) / proftgsgmail.com. web URL http//civil.iisc.ernet.in/sitharam unsettled 9448273751

Factors that contributed to the rise and development of sociology Essay

This essay serves to outline the factors that contributed to the originate of sociology and the latters development. In simply terms, sociology is the scientific pick up of the society and human behavior. The emergence of sociology traces back to the eighteenth century up to present day. Johnson (1998) suggests that in summary, the rise and development of sociology is found on political, economic, demographic, affable and scientific changes. Ritzer (2008) asserts that the immediate cause for the beginning of sociology were political unrests especially the French innovation that took over from the eighteenth century to the nineteenth century. The turmoil of the French Revolution spread throughout Europe and other nations. Kornblum (2008) suggests that the political upheavals were associated with tremendous social changes. The political revolutions demolished the old social order and monarchies.There was social funny farm and disorder in societies that were resulted in by the pol itical revolutions especially in the French society. Social theorists were attracted by these societal changes that had been a result of the political unrests indeed giving rise to the chastise of sociology.Auguste Comte (1798-1857) who is credited for being the founding father of sociology was attracted by the social changes that had arose in reaction to the political revolutions. The French philosopher Comte attributed his focus of study to the French society so as to restore social order. This marked the beginning of sociology. Therefore, it is wise to claim that the European political upheavals resulted in social changes which attracted a number of social theorists much(prenominal) as Comte thereby leading to the rise of the scientific study of society. Industrial Revolutions also contributed to the rise of sociology as a discipline and had great impact to the rise of sociology (Schaefer, 2010). Industrial Revolution was a period of transformation whereby economic modes of pr oduction changed from feudalism to capitalism.The industrial transformations gave in the establishment of factories and industries resulting in the creation of employment and social changes such as urbanization in the urban settlements. gibe to Kornblum (2008) ,individuals flocked from rural to urban settlements for employment that had been brought by the capitalist system. This resulted in over population, poor sanitation, poor health and high death rates cod to poor working conditions in the urban settlements where industrialization had emerged upon. The lower classes that served as laborers for the capitalists were oppressed and exploited by the capitalists in the sense that both adults and children worked for long hours and were minded(p) low wages. Classical sociologists such as Karl Marx (1818-1883) were attracted to the study of society over receivable to the unfair system of the capitalist economy that had been brought by the industrial revolution in Europe.Marx condemne d the industrial societies and gave alternative models of society such as socialist and communist societies. As a result, it is wise to assert that societal changes brought by the industrial revolutions in Europe were one of the basic foundations of sociology. The industrial revolutions also had an impact in the beginning of American sociology. Johnson (1998) suggests that industrialization resulted in the beginning of sociology in the join States of America. Masses migrated from Europe to the United States of America due to the industrialization that had arisen in the United States of America. Individuals came to the United States of America in search of employment opportunities. The urban settlements of America were overpopulated thereby causing America social theorists to begin the scientific study of the society.American sociologists began studying social changes that had been resulted by the industrial revolution such as racism, theft and interaction among societal individual s. Charles Horton Cooley is one of the American sociologists who began the study of the society due to social changes brought by industrialization. Industrialization in the United States of America contributed to the rise of sociology in the United States of America. The scientific study of the society rose also due to the growth of science in Europe (Ritzer, 2008). Sociology emerged during a period of time when congenital sciences had great honor and prestige in the European society. Natural scientists were given respect and honor in the society because they were believed to be problem-solvers in the world through the use of natural sciences such as chemistry.The growth and top-holeity of the natural sciences stimulated social scientists also to develop a social science that would solve societal problems that had been brought by the industrial and political revolutions. The social scientists eagerness of creating a science of society resulted the beginning of sociology which is t he scientific study of the society. Auguste Comte was influenced by the growth and prestige of the natural sciences because Comte coined the term sociology which relates to the scientific study of the society. Comte alson highly-developed positivism which was based on the notion that natural scientific methodology of objective observation and experiments should also be applied when studying the society. In this regard, the growth and prestigious home of the natural sciences resulted in the emergence of sociology. Ritzer (2008) also suggests that the enlightenment era also led to the rise of sociology. Ritzer (2008) adds that the enlightenment era was a period of remarkable capable development and change.The beginning of sociology was determined by enlightenment philosophers such as Charles Montenesqueu (1689-1755) and Jean Jacques Rousseau (1712-1718). The enlightenment thinkers denounced the existing status quo stating that humans should control the universe and break traditiona l beliefs. A few sociologists were inspired by the enlightenment thinkers such as Karl Marl who favored change as suggested by the enlightenment philosophers. However, most sociologists such as Emile Durkheim and Auguste Comte followed footsteps of De-Bonald and De-Maistre rejecting enlightenment views because they were conservative, they feared change. Consequently, sociology rose as response or reaction to enlightenment philosophers. According to Ritzer (2008), the rise of socialism contributed to the rise of sociology as a discipline. communism was based on the notion that property should be communally owned in a society.This gave the rise of sociology because a few sociologists used doctrines of socialism in studying the society and they believed that a socialist society would mark the end of social problems. Karl Marx was inspired by socialism in developing his sociological theories because he advocated change from the capitalist to the communist society model. However, social ism also developed sociological theory because most of the sociologists particularly functionalists were conservative and criticized the socialist doctrines.Thus sociology developed due to socialism because sociology hardly consisted solely the scientific study of the society but it also comprised criticisms of some theories specifically socialism. As a result, socialism contributed to the rise and development of sociology as highlighted above. The rise of feminism had an impact in sociology because feminist ideas developed sociological theory (Ritzer, 2008).Feminism is based on the idea that women are superior as well and are equal to men in the society. Feminism rose during the liberation era of modern Western History. Feminist sociologists include Harriet Martineau (1802-1876) who wrote a textbook entitled Society in America. Male sociologists such as Comte responded conservatively to the feminist ideas.Thus feminism developed sociology because sociology had been a virile domina ted discipline so feminism developed sociology by transforming the discipline from a male dominated to a balanced discipline of both males and females. According to Ritzer (2008), religion also led to the rise of sociology. Ritzer (2008) citing Hinkle and Hinkle (1905) says that many early sociologists came from different religious backgrounds and were actively involved. They brought to sociology the same religious objectives they had in their personal lives. For instance, Durkheim, Karl Marx and Max weber wrote on religion in their personal perspectives.Therefore, religion also contributed to the rise of sociology. Johnson (1998) adds on that sociology started as an academic discipline in the United States of America. Sociology started as an academic discipline at Chicago School of thought, faculties and departments of sociology were set up at Chicago and sociology emerged as an academic disciple in the Western nations between the mid-twenties and 1970s. This attitude has spread a ll over the world even into African universities. It has been seen in the essay how multiple factors influence the rise and development of sociology as a discipline in the global environment.Be it as it may, the industrial revolutions had a greater impact than any other factors outlined in essay in contributing to the rise of sociology as a discipline. Since industrial revolutions had a greater impact in contributing to the rise and development of sociology, one cannot assume that the industrial revolutions can solely explain completely the origins and development of sociology. The factor of industrial revolutions can fully explain the rise and development of sociology with other factors outlined in essay..REFERENCESFarganis, (2011). Readings in Social Theory The Classic Tradition to Post Modernism (sixth edition). New York McGraw-Hill.Johnson, W.A. (1998). The Sociology Student Writers Manual. USA PrenticeHall Inc.Kornblum, W. (2008). Sociology In A Changing World. Canada Thompson Learning.Ritzer, G. (2008). Sociological Theory. New York McGraw Hill.Schaefer, R. T. (2010). Sociology (twelveth edition). New York .McGraw.

The Challenge Facing Managed Care Organizations

The greatest challenge for managed business organizations (MCOs) in our current quantify is how to obtain lower priced medical fees. As we all know, American health sustainment should essentially be a nonprofit enterprise. However, the privatization of American health care holds that health care in general and hospitals in particular are increasingly operating on a for-profit basis. In fact, the for-profit hospital sector has accounted for a relatively constant share (about 15 percent) of hospital beds over the last twenty years (Morrisson, 1999).This is why recently the U.S. Congress tries to push more consumer-directed health plan options to avoid cash-strapped managed care organizations (MCOs) to boost their deductibles, raise amplitudes and even defy federal law by authorizing policy holders to buy prescription drugs from inexpensive vendors in Canada (Smith, 23 September 2004).Managed care organizations (MCOs) often apply the traditional fee-for-service models, which do no t provide adequate financial controls and utilization incentives for physicians and hospitals to contain the costs of providing healthcare. under(a) managed care, the needs of the patients are balanced with efforts to provide cost-effective care. Typically, MCOs enroll subscribers by promising to provide all necessary medical care in vary for a fixed monthly premium.The MCO also trains with hospitals, physicians, and other healthcare providers to dispense the necessary medical care to its enrollees at a discounted reimbursement rate. In exchange for pass judgment reduced fees, the caregivers gain access to the MCOs enrolees (Kirby, Sebastian & Hornberger, 1998).A problem with managed care is that employers who offer a health maintenance organization (HMO) to their employees often pay the premium as long as the HMO premium was not higher than the fee-for-service premium. This behavior by employers creates distorted incentives for the HMO in controlling its costs. Enthoven (1993) suggested that this incentive straining can be corrected when employers design better alternatives for their employer contri barelyions.The employer could contribute a fixed-dollar amount for health insurance with the employee paying the full residue between plans. The great the portion of the marginal premium paid by the employees is, the stronger the incentive is to choose lower-cost plans. For example, if the employer pays 80 percent of the premium and the employee pays the remainder, then the employee pays only 20 percent of the difference between the low (lets presume here) HMO premium and the higher fee-for-service premium.HMOs and other managed care ar meanderments are organized on a prepayment basis that get along in a wide variety of forms. An HMO could hire physicians on a salary, contract with a preexisting group practice of physicians, or contract with physicians who maintain a fee-for-service practice. According to Luft (1991), Because specific social, legal, histor ical, political, and economic aspects of the medical care environment have shaped delivery systems much(prenominal) as the HMO, it is not sound to expect that the typical HMO could be transplanted intact to another country (p. 173).The key to HMO cost savings is the organizations wide range of medical service, both inpatient and outpatient. In this way, the HMO can receive the cost savings implied by reduced hospital use. This may be troublesome to manage in systems where there are separate financing mechanisms for immemorial care physicians and inpatient care. As Luft (1991, p. 180) remarks. If there were no way to shift capital from the hospital side to the physician side, it would be difficult to reward clinical decision makers for the development of more cost-effective practice styles.This is why three areas turn up to offer a magnitude of opportunities where MCOs can assist patients, these are ambulatory care, psychical health and the alternative therapies. Firstly, ambu latory care-sensitive conditions reflect the quality and availability of primary care services, since they are readily treatable without the need for hospitalization. There are differences in the hospitalization rate for ambulatory care sensitive conditions. Shenkman et al. (2005) had indicated that specialty ambulatory care is important for many a(prenominal) children with chronic conditions.However, access to such care may be constrained within managed care environments. The use of primary care providers (PCPs) as gatekeepers for managed care organizations (MCOs) is star commonly used strategy to control specialty care use. Studies of the impact of gatekeeping on childrens receipt of specialty care have resulted in mixed findings. Some studies found more specialty care use in gatekeeping MCOs, compared with non-gatekeeping MCOs.Other researchers found that the replacement of a gatekeeping system with an open-access model increase specialty visits among a group of children with c hronic conditions. Although the focus on gatekeeping in general yields some important information, MCOs use many other strategies concomitantly with their PCP gatekeepers, such as capitated payments, financial incentives, and prior authorization procedures. The use of these concomitant strategies may meet the unique needs of children with chronic conditions, including their need for specialty physician care.On the other hand, managed care had been significant contributor on delivery systems for kind health services. Taylor et al. (2001) had indicated that direct and indirect persuasion to provide more cost-effective treatments has been one consequence. The cost-saving qualities and the effectiveness of group interventions have produced clear expectations for an increased use of therapy groups. In the research of Taylor et al. (2001), they compared perceptions and uses of group treatments on a national sample of managed care organizations and mental health providers.Implications of differences and similarities between directors of managed care organizations and treatment providers are examined and discussed across five response categories (familiarity/training perceived effectiveness, likelihood of reimbursement/referral, daily use and expectation for afterlife use). Taylor et al (2001) favored the approach where MCOs calibrate treatment referral/reimbursement decisions. Recently published comparison outcome studies and meta-analyses can and should empirically guide the present treatment delivering systems.Lastly, many managed care organizations have already begun to integrate complementary and alternative medical therapies (CAM) with conventional medical providers. Medical practitioners are obligated to assess CAM therapy with patients. Alternative therapies charter professionals to rethink staff competency, patient assessment, and patient-focused care. Medical leaders must understand CAM trends and therapies to better integrate these concepts into health c are policy, standards of care, and ethical decisions (Parkman, 2001).Among ambulatory care and mental health care, alternative therapies, or CAM, offers the most favorable and cost-efficient strategy for MCOs. This is because the aging baby boom generation is beginning to experience chronic but non-life threatening conditions, such as joint pain, headaches and menopause-related complaints and they are willing to explore options other than prescription drugs. For health plans, the attraction of offering alternative care products lies in retaining and attracting new members, diversifying their services from competitors in a congested managed care market and in attempts to address current or proposed state mandates (West, 1997).In 1997 alone, expenses for professional services were $21.2 billion, a 45% increase over the earlier 1990 data. Expenses for professional services, herbals, vitamins, diet products, books, and classes totaled $27 billion. Five surveys conducted since 1990 have reported frequent use of CAM, ranging from 30% to 73% by patients suffering from conditions such as cardiovascular disease, cancer, arthritis, HIV and AIDS, multiple sclerosis, and chronic musculoskeletal pain.Furthermore, the demand for CAM by the general public is increasing, in spite of the fact that its use is largely paid by consumers without coverage by third-party payers. In 1997, Americans spent an estimated $13 billion for visits to CAM providers and an additional $2 billion for mercantile diet supplements and over-the-counter megavitamins (Pelletier & Astin, 2002).Managed care should not only focus on cost savings, but they should also look into diversifying their services. MCOs have generally contributed to the decline in the U.S. health cost growth rate. Their potential will continue to be limited to the extent that employers fail to offer true financial advantages to consumers who choose the low-cost health plans. Thus, more reforms in the policies should be reviewed and revised so that more people could benefit from the quality health care everyone deserves.ReferencesEnthoven, A.C. (1993). The History and Principles of Managed Competition. wellness personal business, supplement, 24-48.Kirby, E.G., Sebastian, J.G. and Hornberger, K.D. (1998, Jan/Feb). The kernel of Normative Social forces on Managed Care Organizations Implications for Strategic management/Practitioner Response. Journal of Healthcare Management. 43(1)81-106.Luft, H. (1991). Translating the U.S. HMO Experience to Other Health System. Health Affairs 10172-186.Morrison, I. (1999). Health Care in the New Millennium. NY John Wiley & Sons, Inc.Parkman, C. (2001, February). Alternative Therapies Are Here to Stay. Nursing Management, 32(2) 36-40.Pelletier, K.R. and Astin, J.A. (2002, Jan/Feb). Integration and Reimbursement of Complementary and Alternative Medicine by Managed Care and Insurance Providers 2000 Update and Cohort Analysis. Alternative Therapies in Health and Medicine, 8(1) 38-44.Shenkman, E., Tian, L. and Schatz, D. (2005, June). Managed Care Organization Characteristics and Outpatient Specialty Care Use Among Children With Chronic Illness. Pediatrics, 115(6) 1547-1555.Smith, C. (2004, Spetember 23). Senate Panel Examines Health Care Choices, Insurance Costs. Knight Ridder Tribune.Taylor, N.T., Burlingame, G.M., Kristensen, K.B., Fuhriman, A. et al. (2001, April). A Survey of Mental Health Care Providers and Managed Care Organization Attitudes Toward, Familiarity With, and Use of base Interventions. International Journal of Group Psychotherapy, 51(2) 243-264.West, D. (1997, November 10). MCOs Integrating Alternative Care. National Underwriter, 101(45) 58.

Literary comparison of ballantyne’s coral island

This is to compare R.M. Ballantynes chromatic Island with William Goldings Lord of the Flies. some(prenominal) novels situate their characters isolated in an island removed from golf-club and with no adult supervision, thus leaving them to f kibosh for themselves. Without the rules and order of fraternity and civilization, the boys return to their state of nature however, Ballantyne and Golding have differing views on what that is. Ballantynes boys retain their values and behave accordingly to the rules of society, whereas Goldings boys struggle with their savage primal instinct and the tendency to be primitive and evil. In the end though, Ballantyne and Golding both explore the line of work of evil and how their characters struggle with it.THESISLord of the Flies and chromatic Island depict how Man give act according to his instincts when he is isolated from society and in doing so show how their characters mature as they wait the problem of evil.FIRST POINT In both books, the boys are stranded in an isolated island and are left to fend for themselves without adult supervision.Coral Island Ralph, aged 15, Jack, aged 18, and Peterkin, aged 14, find themselves shipwrecked in a deserted island in the Pacific. They build shelters, make fire, gather fruits, build boats and explore the island and nearby islands as well.Lord of the Flies After a plane crash, Ralph, Piggy, Jack, Roger, Simon, twins Sam and Eric, and a group of boys of varying ages with the youngest ones as young as six or seven, are stranded in the island. The oldest in the group are Ralph and Jack, both xii years old. They elect Ralph as leader, and set rules on building shelters and fire, and hunting for food. both sets of boys are stranded in an island left to fend for themselves in Coral Island, the three boys are friends, and have reached their adolescence as compared to the boys in Lord of the Flies, who can still be considered as children. The boys in Lord of the Flies are non neces sarily friends but they went to the same school they were thrown together in a situation and are forced to live together.SECOND POINT Both novels explore the problem of evil through the adventures of the boys.Coral Island Readers follow the adventures of the boys, of their encounter with a shark, of their exploration of the island and Diamond Cave, their meeting with natives, Ralphs journey with the pirates and his gallant deport of the natives, Ralphs reunion with his friends, and finally, their escape from death from the natives who have been converted to Christianity.Lord of the Flies Readers follow the events in the island as brought about by the characters actions and attitudes. The fire that swept half the forest was because of the boys irresponsibility, as was the fires burning out and thus missing to send a signal to a passing ship.Further, their character flaws stimulate the events in the island Jacks aggressive and belligerent behavior translated into a confident contro l of authority and com firearmd over the weaker ones, and the fear and confusion in many of the boys made them susceptible into engaging into savage and primitive actions, letting go of reason and immersing in their primal instincts. Further, readers see that even the protagonists struggle with their principles, as Ralph and Piggy join in the ritual dance and even help kill Simon. Both sets of characters face the problem of evil. The boys in Coral Island face problem of evil from external forces pirates, natives, the wild, and they face and fight against it when they bonk across it. Whereas in Lord of the Flies, the boys greatest adversary is themselves the inherent evil that resides in them, the potential to be primitive and savage and to let go of reason, the fear and violence in them, that is the greatest battle that they face. The problem of evil is intrinsic the boys struggle with the values that society taught them versus their instincts now that they found themselves in the wild with no supervision whatsoever. Thus, the isolation in the novels forces the characters to mature. In Coral Island, the boys were presented to behave accordingly, keeping their values intact and even able to Christianize natives. Thus, it shows that even without the controls imposed by society, Man in the state of nature allow use his reason over his desires, and maintain order.On the other hand, in Lord of the Flies, the boys were presented indulging in their basic needs of placating their desires over fulfilling their responsibilities to project their being saved. The boys struggle with behaving as adults versus behaving like children, between using their reason and satisfying their thirst for hunting, between their morality and their rituals and tendency to be evil. In both novels, the characters had to act beyond their years and had to cope with their extraordinary situation.THIRD POINT Both books end with returning to civilization, the three boys in Coral Island sai l mainstay to England while the boys in Lord of the Flies were found by a Naval incumbent who saw the fire set by Jacks tribe. The end of both novels signals the coming of age of the characters, as they come into realization of what has happened to them.Coral Island After all their adventures, the three boys go back home wiser and to a greater extent mature because of the experiences that they have had.Lord of the Flies The Naval officer thought that the boys were all fun and games at the island, but was surprised to find out that cardinal boys have been killed. In a sense, these boys are no longer children they have seen and participated in such violent acts, and have encountered their dark, evil sides. Upon seeing the Naval officer and asked what happened, the boys break down and cry, realizing what had become of them.Jacks tribe have become blood-thirsty and completely savage, Piggy and Simon murdered, and Ralph reduced to a figurative pig, a stone pit running for his life f rom his former companions. Because of their experiences in the island, the boys matured and have grown wiser, knowing full well now what man is capable of. both sets of boys come out of their respective islands different and with a better understanding of themselves, although in Coral Island the boys were not tarnished with evil, while in Lord of the Flies the boys come to a realization of how brutal and inhuman they have behaved. Coral Island comes to an end with the boys going back to England, with all their little adventures resolved. Lord of the Flies ends with the boys crying and realization, and the fight between Ralph and Jack seemed to be over with the arrival of the officer and being rescued.CONCLUSIONLord of the Flies and Coral Island depict two ways Man will act according to his instincts when he is isolated from society Ballantyne shows that Man will uphold the values civilization taught him while Golding puts forward that Man will sink to savagery.By isolating the cha racters from society, Ballantyne and Golding effectively removed the boys from the controlling norms and standards that society imposes to shape the actions and behavior of men. Ballantyne pursues his story focusing on the events that happen to the characters and how they cope with these challenges, in the march showing that man is good and that he has the capacity to fight off evil from external factors.On the other hand, Goldings story is driven by his characters emotions and motivations. The events happen in Lord of the Flies as a result of how the characters behave. The greatest challenge they had to face was in them they needed to struggle with mans tendency to descend to savagery and evil. At the end of each book, the boys are saved from the problem of surviving by themselves and are presented with the chance to return to society and civilization.Thus, from both books we garner that isolated from the controlling function of society and civilization, Man will fight for his sur vival, and behave accordingly. However, Mans state of nature is debatable, the read/write head of whether Man is innately good or evil is perennial, and at most the two books provide perspectives on how Man might behave stripped of society and civilization. For Ballantyne, this means that Man will use his innate goodness and reason, while Golding puts forward that Man will descend to savagery without the pillars of civilization.It seems that Goldings portrayal of mans state of nature is more realistic though, given that he presented younger boys much less exposed to society and dealt more with internal contradict and the crisis of survival, as compared to the adventures of Ballantynes characters. In the end, both reflected the attitudes and behavior of men during their time, and showed through their respective narrative how their characters grew and matured how their way of thinking changed as they coped with the challenges of surviving by themselves.

I got a D for this TOK Essay Essay

4. The traditional TOK diagram indicates four ways of astute. Propose the inclusion of a twenty percent way of hold outing selected from intuition, retention or imagination, and explore the knowledge issues it may raise in two beas of knowledge.Word count 1207Memory is a tool community utilize to process things they come to learn about the world. In psychology storage is described by the term cognitive processes which include perception, thinking, problem solving, store, language and attention. intuition is ones mental perception of the world like images, words and concepts. Memory is not an exact copy of experiences simply an outline. What people actu altogethery remember and what they have been told by someone else, is mixed so the thing people remember and thinks is the truth is a live.This is called false retrospection and the brain would make an illusion or persona imagination to twist the truth around. In this connection where people can musical compositionipulat e memory questions may arise about the trustworthiness in a witness testimony. Also when people can manipulate memory how reliable is memory as a way of knowing.If a person witnessed a robbery and testified to the police about what they saw, you would not believe that a person would lie but if the policeman were to ask the wrong question people would subconsciously lie about what they saw. For example if a police man could ask, what colour shirt was he wearing? The witness would thing about the colour of the shirt but if instead he asked, what colour shirt was he wearing? Green? Blue? The witness might mention one of those colours the police man mentioned. So the witness could accidently give a false testimony because the policemans question was not neutral hence, the witness got false memory.This would be a connection to history as a area of knowing, history books consist of memories written down. Some history books are of primary memory, written by people who have experienced a h istorical aspect and secondary memory, written by people who have been told by another person who had experienced a historical aspect.Since memory is not always remembered correct history books can be wrong. Memory is one of the most important ways by which our histories alert our current actions and experiences. Memory seems to be a source of knowledge. We remember experiences and scourts which are not happening now, so memory differs from perception. We remember events which really happened, so memory is unlike pure imagination. Yet, in practice, there can be close interactions between remembering, perceiving, and imagining.Another area of knowing were memory is used is the arts. Actors, musicians and dancers use memory to remember words, notes and choreography. How they do this is by using motion, a required motion on stage, so the moves help the brain to recall stored information. Communication, reading lines out laud, even in early stages and try to visualise an audience you have to communicate to. Internalization, make the lines personal, to become the character, dancer or musician.In the way of knowing memory plays a big role in inductive reasoning and you could ask, to what extent is reason ground on previous memory experience? We jump to conclusions in inductive reasoning as the results of our memory since memory is the key to remember past events, for example a person has only seen a red pink wine all his invigoration so therefore all roses must be red but that is not true because there are many contrastive coloured roses and this is called the problem of induction. If something has happen often in the past, there is a good chance it will do so again.The conclusions are drawn from exceptional evidence because we have no choice but to do so, most of the times this seems reasonable but sometimes not, we need to consider if the evidence supports a conclusion and when it doesnt. Also in deductive reasoning we use memory to make generalisations and to draw similarities between issues, objects and thought. In deductive reasoning we would use memory to know what is required of valid and a true argument.In language also a way of knowing, memory is used to remember and see to it the codes ,symbols and sounds in order to learn and communicate the language that is being taught. If we werent able to remember thecodes, symbols and sounds when learning a language, languages would bemeaningless. Because all we would just have been taught would be forgotten right away.Sense perception, a way of knowing, can only be used if we can remember what we see, hear, feel, smell and taste. Without memory we wouldnt be able to recall these senses and perceive them. The other way around sense perception is a big trigger of memory, if for example the smell of a knight triggers my memory to think of my childhood because I grew up on a farm with horses so I would connect those things together, the smell of horses = my childhood.The same if a percei ve a specific song in an important moment of my life then when I heard that song later on in life I would think of that moment. Big event makes people remember too for example 9/11, people can remember what they were doing and where they were at the moment they were told or saw it on the news.Emotion is one of the ways of knowing which most people would argue could do without memory since it acts on impulse. However emotions are based on past experiences like affection and hatred towards somebody due to past events. In the dictionary emotion is described as particular vitrine of mental state similar to memory.People remember differently and they need to know what type of learner they are. Some people are visual learners and others are audio learners. Visual learners need to see things to understand them for example in chemistry a visual learner needs to see the atom to understand what it is. An audio learner would need to hear the things they need to learn out laud and would not be able to understand it if the person had to read things to learn. If we know which type of learner we are we can better learn and learn faster.Memory is an important skill to have because without it we would not be able to exist. We would not be able to remember what we like, were we live, who to trust or what is right and wrong. Memory is the essential thing that the ways of knowing are build and based. It links all the ways of knowing together because all the ways of knowing needs memory to work precisely.Memory would not necessarily be a fifth way of knowing since there are manyflaw to memory, but I think that it connects the ways of knowing and it is an important skill to have so we can learn and use the accepted ways of knowing. Memory could be the overall term of ways of knowing and the four ways of knowing could be under the memory category.BibliographyBooksCrane, John and Hannibal, Jette, Psychology course companion, Oxford university press, 2009 Alchin, Nicholas, Hodder Mur ray, 2003Internet pageshttp//plato.stanford.edu/entries/memory/http//theater.about.com/od/careersintheater/a/actors-memory.htm http//www.ibsurvival.com/topic/13374-memory/http//pottsiex5.wordpress.com/2012/02/22/tok-reflection-memory/

Marilyn Monroe Informative Speech

Marilyn Monroe(bornNorma Jeane Mortenson June 1, 1926 August 5, 1962) was anAmericanactress,model, andsinger, who became a majorsex symbol, starring in a number of commercially successful motion pictures during the 1950s and early 1960s. After spending often of her childhood infosterhomes, Monroe began a career as a model, which led to a movie theater contract in 1946 withTwentieth Century-Fox. Her early film appearances were minor, but her military operations inThe Asphalt Jungleand altogether About Eve(both 1950), drew attention.By 1952 she had her first leading role inDont Bother to Knock and 1953 brought a lead inNiagara, a melodramaticfilm noirthat dwelt on her seductiveness. Her dumb blonde persona was utilise to comic effect in subsequent films such asGentlemen Prefer Blondes(1953),How to Marry a Millionaire(1953) andThe septenary Year Itch(1955). Limited bytypecasting, Monroe studied at theActors Studioto broaden her range. Her dramatic performance inBus Stop(1956) was h ailed by critics and garnered aGolden Globenomination.Her production company, Marilyn Monroe Productions, releasedThe Prince and the Showgirl(1957), for which she veritable aBAFTA cedenomination and won aDavid di Donatelloaward. She received aGolden Globe Awardfor her performance inSome Like It Hot(1959). Monroes last completed film wasThe Misfits(1961), co-starringClark Gablewithscreenplayby her then-husband,Arthur Miller. The final examination years of Monroes life were marked by illness, personal problems, and a reputation for unreliability and being knockout to work with.The circumstances of her death, from an overdose ofbarbiturates, have been the subject of conjecture. Though officially classified as a probable suicide, the possibility of an accidental overdose, as well as of homicide, have not been govern out. In 1999, Monroe was ranked as thesixth-greatest female star of all timeby theAmerican claim Institute. In the decades following her death, she has often been cited as both apopand acultural videoas well as the quintessential American sex symbol. 678In 2009,TV Guide vanenamed her 1 inFilms Sexiest Women of All Time.

How reliable are the narrators in the novella Heart of Darkness by Joseph Conrad and the fiction novel Great Expectations of Charles Dickens Essay

A reliable fabricator is mavin who is actual, trustworthy, and workmanlike in relating the story. Generally, thither are two types of narrators. The first mortal narrator focuses in-depth on only one character, which could be his or her character, and the impact of other characters on this sole character. Third person narrators bear a comprehensive picture of the different characters and the items unfolding in the story.While third party narrators overhear greater regard for reliability due to omniscience, a first or third person narrator could be reliable or unreliable depending on the character of the narrator and the intention of the novel. The novel aggregate of night by Joseph Conrad is a frame narration, which means the story lies within a story. To achieve this end, there are two narrators. The first narrator is unkn hold and provides an introduction of the character of the second narrator, Charlie Marlow.The narration describes Marlow as having deep-set cheeks and y ellowish complexion nevertheless straight-backed indicating he is not heavily built but not frail either. The unknown narrator, by representing the views of the other population on board the ship in describing Marlow as non-conventional or atypical because of his tendency to weave stories and recount tales introspectively, expresses the reliability of his assessment of Marlow. This puts into question the factual manner of Marlows narration.In Marlows accounts of his trip along the Congo River to fetch Kurtz, an ivory trader trapped in an African village, the focus is much of his interpretation of people and events without much recount of who these people are and the context of the situation. Marlow is clearly against colonialism but do not recount in detail the situation in Africa that makes colonialism repulsive to him and what are the solutions. The trustworthiness of Marlow as a narrator is not clear-cut. Marlow is a fair to middling person but his actions do not always s tudy his views.He is against the exploitative nature of the colonial explorers in Africa and feels burdened by the situation but his character is complicit about the situation. He has limited fundamental interaction with the natives and does not express their views. Marlow is a competent narrator but only for himself. His accounts do not reflect the acknowledges and perspectives of the other people he talks about much(prenominal) as the villagers of the communities he visited or the colonial communities in Africa. In Great Expectations by Charles Dickens, the narrator is Pip, who is also the main character of the novel.Pips narrative is factual because he tells not only about his good side such as helping people and becoming a gentleman but also of his bad side such as his mistaken impression about Magwich and his embarrassment of Joes uneducated ways. Pip is a shoplifter in the novel, an orphaned but kindhearted boy, who although frightened to steal food for a thief, causing him guilt, and although fall to the initial class-based prejudices wrought by society, ended up making things right. The nature of the character of Pip as trustworthy and sensible makes his accounts reliable. Pip is an eyewitness narrator.The novel is a semi-biographical work, which means that Pip is telling his purport story according to his own experiences and perspectives. This finds expression in some of the chapter titles such as The Convict Frightens Me, I Execute My trust, and My State of Mind. Pip is also the main character. This means that he is competent to narrate his story and the story of the people around him whom he witnessed. This makes his accounts reliable because of first hand experience and view. Although a first person narrator, the trustworthy character of Pip makes him a reliable storyteller of his own life and the life of the people around him.Heart of fantasm and Great Expectations include first person narrators. Although, there is general reservation towards the reliability of first person narrators, the reliability of these narrators also depend on character, plot and intention of the story. Based on the criteria of a reliable narrator, the narrator in Great Expectations is more reliable because of his factual account and trustworthy character while the narrator in Heart of Darkness is not very factual or trustworthy. The third person narrator in Heart of Darkness attests to the atypical character of the first person narrator.

Emerging Disease Trends Essay

citizenry use wellness care services for many primers to cure illnesses and health conditions, to mend breaks and tears, to prevent or delay early health care problems, to center pain and attach quality of action, and whatsoevertimes only to obtain information somewhat their health status and prognosis. health care utilization tush be appropriate or inappropriate, of high or low quality, expensive or Inexpensive. The study of trends in health care utilization provides important information on these phenomena and whitethorn spotlight areas that may warrant future in-depth studies be get down of potential disparities in access to, or quality of, care.Trends in utilization may alike be used as the basis for projecting future health care rents, to forecast future health care expenditures, or as the basis for projecting ontogenesis personnel training or depict initiatives. The health care delivery corpse of today has undergone tremendous change, even all over the relati vely laconic period of the past decade. New and emerging technologies, including drugs, devices, procedures, tests, and imaging machinery, have changed patterns of care and sites where care is provided.The growth in ambulatory surgery has been influenced by improvements in anesthesia and analgesia and by the development of noninvasive or minimally invasive techniques. Procedures that formerly gather upd a few weeks of convalescence now require only a few days. New drugs female genitalia cure or lengthen the course of disease, although oftentimes at increased cost or increased utilization of medical examination practitioners needed to prescribe and monitor the effects of the medications. over the past decade, both in the public eye(predicate) and private organizations have made peachy strides in identifying causes of disease and disability, discovering treatments and cures, and running(a) with practitioners to educate the public about how to reduce the incidence and preponder ance of major diseases and the functional limitations and discomfort they may cause. Clinical practice guidelines have been created and disseminated to influence providers to follow recommended practices. Public education campaigns urge consumers to comply with behavioural recommendations (e. g. , exercise and hurt weight) and treatment regimens (e.g. , take your medications) that may function to prevent or control diseases and their consequences. Health care utilization also has evolved as the populations need for care has changed over time. round factors that influence need include aging, sociodemographic population shifts, and changes in the prevalence and incidence of different diseases. As the prevalence of continuing conditions increases, for example, residential and community-based health- tie in services have emerged that are designed to minimize loss of function and to hold off wad out of institutional settings. AgingThe median age of the worlds population is change magnitude because of a decline in fertility and a 20- course of instruction increase in the average life swing out during the second half of the 20th century. These factors, combined with elevated fertility in many countries during the 2 decades subsequently World War II (i. e. , the Baby Boom), leave result in increased come of persons aged 65 geezerhood during 20102030. Worldwide, the average life span is expected to extend a nonher 10 historic period by 2050. The maturement bend of older adults increases demands on the public health system and on medical and social services.Chronic diseases, which affect older adults dis balanceately, contri savee to disability, diminish quality of life, and increased health- and long-runcare costs. Increased life expectancy reflects, in scatter, the success of public health interventions, but public health programs must now respond to the challenges created by this achievement, including the growing burden of chronic illnesses, injurie s, and disabilities and increasing concerns about future caregiving and health-care costs. This report presents data from the U. S. Bureau of the Census, the World Health Organization, and the join Nations on U.S. and global trends in aging, including demographic and epidemiologic transitions, increasing medical and social costs related to aging, and the implications for public health. In the United States, the proportion of the population aged 65 years is projected to increase from 12. 4% in 2000 to 19. 6% in 2030. The number of persons aged 65 years is expected to increase from approximately 35 trillion in 2000 to an estimated 71 cardinal in 2030, and the number of persons aged 80 years is expected to increase from 9. 3 million in 2000 to 19. 5 million in 2030.In 1995, the most populous states had the overlargest number of older persons nine states (California, Florida, Illinois, Michigan, New Jersey, New York, Ohio, Pennsylvania, and Texas) each had to a greater extent than o ne million persons aged 65 years. In 1995, four states had 15% of their population aged 65 years Florida had the largest proportion (19%). By 2025, the proportion of Floridas population aged 65 years is projected to be 26% and 15% in 48 states (all but Alaska and California). The sex distribution of older U. S. residents is expected to change only moderately.Women represented 59% of persons aged 65 years in 2000 compared with an estimated 56% in 2030. However, larger changes in the racial/ethnic composition of persons aged 65 years are expected. From 2000 to 2030, the proportion of persons aged 65 years who are members of racial minority groups (i. e. , black, Ameri nooky Indian/Alaska Native, Asiatic/Pacific Islander) is expected to increase from 11. 3% to 16. 5% the proportion of Hispanics is expected to increase from 5. 6% to 10. 9%. The world has experienced a gradual demographic transition from patterns of high fertility and high fatality rate rates to low fertility and dela yed mortality (2).The transition begins with declining infant and childhood mortality, in part because of effective public health measures (2). Lower childhood mortality contributes initially to a endless life expectancy and a younger population. Declines in fertility rates generally follow, and improvements in adult health lead to an older population. As a result of demographic transitions, the shape of the global age distribution is changing. By 1990, the age distribution in developed countries represented similar proportions of younger and older persons. For evolution countries, age distribution is projected to have similar proportions by 2030.People are living longer because of both modus vivendi changes and advances in health care. For example fewer people smoke today than in the past. In the 1950s more than half of men and a third of women smoked cigarettes. By 2005, those metrical composition were down to 23 pct of men and 19 percent of women. Thanks to major advances in m edicine, fewer people die at an early age from heart disease and cancer. For example the five year cancer rate improved from 50 percent in the mid 70s (1975-1977) to 66 percent at the turn of the 21 century (1996-2002).With increased longevity , Boomers will reach privacy age, have more years to enjoy it and , in turn , more years in need of health care services. Diabetes The number of Americans with diabetes is expected to turf out from 30 million today to 46 million by 2030, when one of every four Boomers -14 million-will be living with the chronic disease. These diabetic Boomers will require continuous medical management in both inpatient and outpatient settings. Arthritis The number of Americans with arthritis is expected to rise from 46 million today to 67 million by 2030.At that point, nearly one out of every Boomers-over 26 million-will be living with the condition. While health essay of arthritis are not as great as other chronic illnesses, the decrease mobility arthritis can trigger will cause many Boomers to hear new alternative therapies, pain control treatments, exercise regimens and joint replacements. Obesity If Americas fleshiness trend continues at its present-day(prenominal) pace, all 50 states could have fleshiness rates above 44 percent by 2030 check to a new report from Trust for Americans Health and the Robert Wood Johnson Foundation. With current U.S. obesity rates holding steady somewhat 35 percent thats one-third of Americans the 9-plus percent gain within two decades would be a significant increase however, not as large of an increase as the nation has seen in the past two decades. While the health hazards are sheer the report projects double the number of new cases of obesity-related ailments like diabetes, heart disease hypertension by 2030 the increase in American obesity would also take a toll on the healthcare system itself. Current estimates put the medical costs of obesity at more than $147 billion.With increasing rates, the costs of contraceptive device healthcare relating to obesity would rise by $48 billion to $66 billion in the attached two decades. Many Americans arent very physically active. One reason for this is that many people take place hours in front of TVs and computers doing ca-ca, school wager, and leisure activities. In fact, more than 2 hours a day of regular TV viewing time has been linked to threatening and obesity. Other reasons for not universe active include relying on cars instead of walking, fewer physical demands at work or at home because of modern applied science and conveniences, and lack of physical education classes in schools.People who are inactive are more presumable to gain weight because they gullt burn the calories that they take in from food and drinks. An inactive lifestyle also raises your risk for coronary heart disease, high blood pressure, diabetes, colon cancer, and other health problems. Our milieu doesnt support healthy lifestyle habits i n fact, it encourages obesity. Some reasons include (1) Lack of neighborhood sidewalks and gum elastic places for recreation. Not having area parks, trails, sidewalks, and affordable gyms makes it hard for people to be physically active.(2) Work schedules. People often say that they dont have time to be physically active because of long work hours and time spent commuting. (3) Oversized food portions. Americans are exposed to huge food portions in restaurants, strong food places, gas stations, movie theaters, supermarkets, and even at home. Some of these meals and snacks can feed two or more people. Eating large portions stand fors too much energy IN. Over time, this will cause weight gain if it isnt balanced with physical activity. (4) Lack of access to healthy foods.Some people dont live in neighborhoods that have supermarkets that sell healthy foods, much(prenominal) as pertly fruits and vegetables. Or, for some people, these healthy foods are too costly. (5) Food advertisin g. Americans are surrounded by ads from food companies. a good deal children are the targets of advertising for high-calorie, high-fat snacks and sugary drinks. The goal of these ads is to sway people to buy these high-calorie foods, and often they do. Part of the reason for the rise in the obesity rate is the changing demographics of the U. S. population.The baby boomer propagation is aging. With aging comes a decrease in activity. If you are less active, the calories you take in can mean the difference in the midst of being lean and being obese. It is all about a balance mingled with diet and fitness. biology also works against you. With the loss of muscle mass, you burn fewer calories. Menopause also sets up a scenario where women in this age bracket put on a few pounds. However, according to Mayo Clinic, you dont have to follow the path of age-related weight gain. You have control over your activity.If you stay active, you can maintain the balance between the fuel your musc les use and your caloric intake. Unfortunately, the media teaches people that being overweight is not something for which to be ashamed. However, being fat is not okay. It is unhealthy and not something that can be dealt with by stylish fashions or slimming panels. The only solution is to have weight. Otherwise, you will likely fall antecede to the health risks of those added pounds. They can take months or years off your life. Losing weight is not an option it is a necessity.Health With the rise in heart disease and diabetes, the medical field has been forced to consider the main causes of obesity in America in order to halt the alarming trends of this health epidemic. If you are overweight or obese, it behooves you to stimulate ways to get your weight under control in order to avoid the consequence of prodigal weight. Part of the reason for the rise in the obesity rate is the changing demographics of the U. S. population. The baby boomer generation is aging. With aging comes a decrease in activity.If you are less active, the calories you take in can mean the difference between being lean and being obese. It is all about a balance between diet and fitness. Biology also works against you. With the loss of muscle mass, you burn fewer calories. Menopause also sets up a scenario where women in this age bracket put on a few pounds. However, according to Mayo Clinic, you dont have to follow the path of age-related weight gain. You have control over your activity. If you stay active, you can maintain the balance between the fuel your muscles use and your caloric intake.Unfortunately, the media teaches people that being overweight is not something for which to be ashamed. However, being fat is not okay. It is unhealthy and not something that can be dealt with by trendy fashions or slimming panels. The only solution is to lose weight. Otherwise, you will likely fall prey to the health risks of those added pounds. They can take months or years off your life. Losi ng weight is not an option it is a necessity. The fact remains that fat tastes good. It gives you a satisfying feeling. It is the epitome of comfort food.If you want to lose weight, it is up to you to break the fat addiction, which is one of the main causes of obesity in America. At the simplest level, added weight makes your heart work harder. You may huff and puff going up the stairs or even walking across the room, if you lug around an extra 30 to 40 pounds. If you have tried to lift a wakeless suitcase or other load that size, you know how difficult toting the added weight can be. Imagine carrying around that excess baggage 24/7. Obesity feeds upon itself. As you gain weight, it befits more difficult to move around.Your muscles ache. You become easily fatigued. Your inactivity causes you to increase weight. This vicious cycle is one of the main causes of obesity in America. In order to overcome it, you must break this cycle of inactivity. Being obese increases your risk of se veral chronic health conditions including heart disease, high blood pressure and diabetes The good news is that losing a small kernel of weight can reduce your chances of developing heart disease or a stroke. If you are overweight, simplification your weight by 5%-10% is proven to decrease your chance of developing heart disease.Fortunately, even a modest weight loss of 10 to 20 pounds can bring significant health improvements, such as lowering ones blood pressure and cholesterol levels You can reduce your risk of developing type 2 diabetes by losing weight, eating a balanced diet, getting adequate sleep, and exercise more. If you have type 2 diabetes, losing weight and becoming more physically active can help control your blood sugar levels. Increasing your physical activity may also allow you to reduce the amount of diabetes medication you need. FutureThere will be some very disruptive and some transformational changes in the way health care is delivered, not as a result of refo rm, but as a result of the drivers of change described in a previous post on KevinMD. com. They include an aging population, an obese society, shortages of doctors, and emerging consumerism, among others. There will be many more patients needing substantial levels of medical care. These wont be just any patients but two specific groups that are growing rapidly. Americans are aging. Old parts wear out and there are certain diseases that become more prevalent with age like Alzheimers and osteoarthritis.And of course our society has many adverse lifestyles such as consuming too much of a non-nutritious diet, being sedentary, being chronically stressed and 20% chill out smoke. These all lead to chronic illnesses like diabetes type II, heart failure, cancer, chronic lung and kidney disease, etc. So there will many more individuals with chronic illnesses. The especially sad thing is that many of these individuals will be moderately young as a result of obesity since one third are overwe ight and another one third are frankly obese. This increase in chronic diseases and diseases of aging will have huge impacts on care delivery.Health care delivery will help obesity related issues by educating obese clients the proper diet and food intake and how important exercise to lose weight. The health team can discuss patients on the effect to the body . the serious disease that they can get being obesed. they can guide them in their food intake and control and help them lose weight. As for age related health issues- health teaching is the best way to inform patients to diseases that is related to age. The team can help them be aware and give them preventive measures for the age related diseases.