Environmental Effects Of Urbanization On Shanghai And New...

A Comparison: environmental effects of urbanization in Shanghai and New York City Since the industrial revolution, many developed and developing countries have begun the process of urbanization to achieve faster development. The transformation from rural to urban brings the human beings convenience and wealth. However, in the past decade, many cities have met not only benefits but also challenges. Environmental problems continue to grow in those high-density areas. To investigate these problems and their influences, two cities, from a developed country and a developing country each, New York City (the U.S.A) and Shanghai (China) are chosen to compare. Both cities are economic centers in their own countries. New York City started its urbanization in the 19th century while Shanghai started in around 1980s. The process NYC has experienced, especially environmental problems, is a good example for Shanghai government to learn from when it continues its urbanization step in the future. Three problems are investigated: air pollution, water quality and soil contamination. These ones are significant in our lives as they can affect our organs and thus influences our health directly. Through urbanization, the most common view is the establishment of factories. Most of these factories are located in heavy industrial areas of the cities. It is easy to hypotheses that air quality has become worse in Shanghai since it started urbanization in the 1980s. However, there is not a proportionalShow MoreRelatedEffects of Pollution in China2709 Words   |  11 Pageseconomy over 20 years without more damage, it would have to become more efficient in resource use. Otherwise, there would be a painful price to pay† (BBC News). The topic of air pollution is not a new concern to the world; however, the effects of air pollution, especially to the hundred of thousands of people directly or indirectly harmed by the side effects of â€Å"bad air,† should be of grave concern. According to the Ministry of Health, air pollution has made cancer the leading cost of death in China. AirRead MoreProblems Faced By The Asian City Of Beijing1917 Words   |  8 PagesConflicts in Measuring Progress The intention to step after the Western growth model can lead the Asian cities to the crisis (Heather, 2012). However, recently, China and India have managed to ensure the economic progress and significant living standards improvements for their economically unstable social groups of the population. At the same time, the Asian Development Bank (ADB) pointed out the rising inequality which can â€Å"soon undermine the very basis of these countries’ economies success† (HeatherRead MoreHuman Caused Environmental Impacts On Beijing1783 Words   |  8 PagesThe analysis of human-caused environmental impacts in Beijing â€Å"Beijing lie between longitudes 115 °25†²E and 117 °30†²E and between latitude 39 °26†²N and 41 °03†²N in North China. Specifically, Beijing is located at the eastern edge of the Eurasian continent and belongs to the Bohai sea rim economic circle, with small plain in the south and mountains in the west and north, covering an area of 16,807.8 km2. The city’s climate is a monsoon-influenced humid continental climate.† (Gengyuan Liu et.al., 2011)Read MoreUrban Heat Island5898 Words   |  24 PagesUrban Heat Island – Cause, Effects and Mitigation Measures in USA Table of Contents †¢ Introduction †¢ The Phenomenon of Urban Heat Island †¢ Causes and Effects of UHI †¢ Mitigation Efforts †¢ Urban Heat Island (UHI) of Urban Cities of United States †¢ UHI and Climate Trends of Some Major cities of US †¢ Urban Heat Island (UHI) Mitigation Strategies in United States †¢ Conclusion Urban Heat Islands Introduction Urban Heat Island – UHI is one of the importantRead MoreEssay about The Search for Low Carbon Cities in China2663 Words   |  11 Pagesreleased into the atmosphere by Chinese cities have increased dramatically in the last few decade. Currently half of Chinas cities cannot meet the air quality standards, and one-third of its land is affected by acid rain (Zhang, 2007). In order to protect its people and nature from dangerous environmental threats, sustainable development of Chinas growing cities must become a top priority, and a key resolution is making them low carbon cities. Low carbon cities can be defined as urban development thatRead MoreInternational Marketing Tactics Has Long Time1881 Words   |  8 Pagesuse standardized international in marketing activities. Because international marketing activities are the downstream value chain activities, they need close to the local market. Multinational corporations need adaptive marketing due to external environmental d ifferences. The debate over the amount or extent of standardisation or adaptation of marketing tactics has long time. Vrontis (1999) comments the debate has been discussing as early as 1961. Elinder (1965) began to think how to make the worldwideRead MoreEnvironmental Degradation in Mumbai3954 Words   |  16 PagesENVIRONMENTAL DEGRADATION IN MUMBAI MICHAEL RAJU MARIADAS F09038 Contents INTRODUCTION 3 HISTORY 3 GEOGRAPHY 3 CLIMATE 4 CULTURE 4 CHRONICRead MoreThe American Drug Culture2879 Words   |  11 PagesIntroduction - Use of psychoactive substances for recreational purposes is not a radically new social issue. In fact, history tells us that almost every society had their own pharmacopeia of herbs, potions, and substances that not only contributed to healing, but also allowed the user to escape reality (Schules 1992, 4-5). However, it is the contemporary use of psychoactive drugs purchased through illicit or illegal channels and used by persons neither prescribed nor in quantities larger than necessaryRead MoreOn Theodore Dreiser’s Sister Carrie from the Perspective of Naturalism7135 Words   |  29 Pageshistory .Writing in naturalist style; he created a new era of American literature and influenced a good many contemporary writers as well as his followers. Sister Carrie is regarded as the masterpiece of Theodore Dreiser’s writing skills in naturalist style. And this thesis from the perspective of N aturalism in American literature, taking Sister Carrie as an example, attempts to study it from naturalistic point of view and explain how environmental factors and heredity factors influence the hero andRead MoreChina Research Paper6220 Words   |  25 Pagesthe Tang Dynasty was supporters of the religion Buddhism and it became a prevailing religion. Along with the other institutions adopted from the Sui Dynasty the Tang also picked up the government system of Three Departments and Six Ministries. Making new policies like the â€Å"Equal-Field system†, {a policy that claimed all land as imperially owned, and granted evenly dependent upon the size of the house hold family}, allowed the system to grow, especially while being under the only empress regnant in china’s

African Americans During The Age Of Exploration - 1568 Words

During the Age of Exploration, Africans did not designate themselves as Blacks; however, Europeans used the term â€Å"blacks† to differentiate themselves. At first, there were a number of competing images of Africans, eventually those images crystallized into a small set of overly simplified, negative stereotypes widely shared in the west (Battle Wells, 2006). Early on, Africans were regarded on a relatively equal level to the Europeans. However, by the end of the eighteenth-century images of Africans as inferior were being used to justify the slave trade. Further complicating the characterization of Africans was the broad spectrum of definitions concerning Black identity. In the United States – after the age of exploration – Black was†¦show more content†¦The continent experienced the loss of a large part of its able-bodied population, which played a part in the social and political weakening of its societies that left it open to colonial domination a nd exploitation. In the nineteenth century, the flow of slaves began to slow due to the British Slave Trade Act of 1807, which banned imports of slaves into British colonies, and the British Slavery Abolition Act of 1837, which abolished any use of slave labor within the British colonies (Nunn Qiann, 2010). As much as we would prefer for it not to be true, skin tone complications of the past still afflict the psyche of present-day America. The American social hierarchy places people of mixed-race ancestry below whites but above blacks, while additional social stratifications along color lines are simultaneously taking place within the nation’s multiracial groups, according to a Johns Hopkins University sociologist’s study of U.S. Census data (Bennett, 2011). The idea that light-skinned blacks hold a higher standing than dark-skinned blacks is still a large point of discontent in the black community. Using data from the National Survey of Black Americans, it was found that blacks with lighter skin had higher socioeconomic status, had spouses higher in socioeconomic status, and had lower black consciousness than those with dark skin (Hughes Hertel, 1990). A 2006 University of Georgia study showed that employers prefer light-skinned black men to

Summary Of The Big Game - 979 Words

The Big Game Brr! It’s freezing cold! I woke up, it was just about 6:20 when I woke up to my alarm buzzing. I went straight to brush my teeth first after realizing I had showered the night before. Afterwards I put on my pants and my school shirt I then scurried down stairs, and I ate the usually Kellogg s Frosted Flakes. Oh know it was already 6:50, which meant one thing. I only have 20 minutes to watch ESPN. I dashed to living room and tried to turn on the television, but I couldn’t find it. I searched frantically. Then it hit me I screamed, at the top of my lungs, â€Å"Aima†. She screamed, â€Å"what.† â€Å"Where is the remote,† I stated. â€Å"Under the Rocking chair!† she exclaimed. I ran over to the little rocking chair and sure enough there it†¦show more content†¦How much longer I thought it felt like forever before we finally pulled u p at Ohio Nets. Since we had not had dinner we debated over whether we should get something from the concession stand. After a couple minutes of bickering my family decided to get some hotdogs and chips. I ate my dinner, I and walked over to talk to my other teammates. We talked about school and other sports, but then finally started talking about the real topic which was the game. The team that we would face would be very lanky and masculine. They were also athletic,as well as us. But the real question would we be able to keep up with their pace and be able to defend their height. As warm ups started I began to feel a weird feeling in my stomach. I had never been affected by the people around but I guess now I was actually scared. After warm ups we huddled up we were given a quick speech,and told us that we did not need to be as physically gifted as they were but we needed to be able to have the heart to overcome the challenge. The game began we started of in a hole. The team was winning 10-4. They were not better than us they just were getting in our heads, and making us make the wrong decisions.I sighed in disbelief when a boy named Ethan on my team accidently shot on the other team s basket. At halftime it was 23-14 with us losing. We were all looking down in the dumps. Since everyone didn’t look to happy I tried to cheer them up,but that didn’t work.Show MoreRelatedArt Form for the Digital Age864 Words   |  4 PagesArt Form For The Digital Age Summary â€Å"Art Form For The Digital Age,† by Henry Jenkins is about gaming expanding and how its being considered a digital art. The growing game industry is said to be the most growing form of art in the economy today. The gaming industry has grown tremendously in the past century. It went from silent pong games to intense story plot and mind blowing real life graphics like Final Fantasy. Games are becoming more and more realistic, characters can talk, andRead MoreSummary of Art Form For The Digital Age by Henry Jenkins991 Words   |  4 PagesEnglish 1301 8 September 2012 Summary of Art Form For The Digital Age by Henry Jenkins In the article â€Å"Art Form For The Digital Age,† by Henry Jenkins, Jenkins elaborates on the ever expanding video game industry and cites that it is now being considered a digital art. The gaming industry is also said to be the form of art in today’s economy that has grown the most. The gaming industry has progressed the most in the past century, starting with silent ping-pong games and evolving into intense storyRead MoreCareer And College Research Paper1432 Words   |  6 Pageseveryday. Multimedia Artists and Animators (MMA) have a big impact on this because they create the illusion of a realistic image in every digital and sometimes non-digital media project they publish. MMAs design 2 and 3 dimensional models, animation and visual effects. These appear in TV, movies and often in video games. They have to be realistic and detailed. A MMA often keeps working in one medium and stays there for most of his career (Summary.). I choose this career to write about because I amRead MoreSinterklaas is the Secret Santa of the Netherlands702 Words   |  3 Pagesplayed this game share a common point of criticism: they do not always receive a gift they wanted. This has led to the following research question: Why is there a big chance that people do not receive a gift they had hoped for when playing Secret Santa? First of all, the situation will be described. Then, there will be an explanation using the deadweight loss and the principle of diminishing marginal utility. In the end, there will be a short summary and a conclusion. Secret Santa is a game in whichRead More Comparing the Comedy Central TV Channel to ComedyCentral.com1205 Words   |  5 PagesCentral have their very own web sites where you can go and look at program listings, games, interviews, images to download, and even episode summaries. One of the best television network web cites is the Comedy Central web cite. Located at http://www.comedycentral.com, this cite provides viewers with a very comedic and colorful glimpse at the zaniness of Comedy Central and also, lists a programming schedule, games, horoscope, a page to purchase TV show merchandise, and various synopses of specificRead MoreChild Development Interview Essay946 Words   |  4 Pagesgiant bite mark as big as a your hand, its inside is blue and the outside is red. What makes you angry? When people talk about me and my brother Who do you look up to and why? My dad, because he has a good job and he can be lazy whenever he wants to and he gets to buy whatever he wants. What makes you cry? I cry when my mom or dad gets mad at me and they scream at me. Why do they scream at you? They scream at me because I ignore my brother sometimes when playing video games and my dad doesn’tRead MoreSports Stars Has Changed The Views Of Athletics1327 Words   |  6 Pages â€Å"I think sportsmanship is knowing that it is a game. That we are only as a good as our opponents, and whether you win or lose, to always give 100 percent† (Sue Wicks). The idea of a game has been lost with the huge media and economic conglomerates that modern sports have created. As a nation America has lost sight of what is truly important with winning and losing. What is important is what is taken back from the game and not who wins the big game. Promoting false idols and spending billions onRead MoreSustainable Tourism And Its Practices Within A Hallmark Event960 Words   |  4 Pages TOURISM PAPER LONDON OLYMPICS, 2012 MOHIT PARTAP SINGH CONTENT Summary Overview Introduction Social impact Economic impact Environmental impact Opinion Conclusion Summary: This paper discuses about the sustainable tourism and its practices within a hallmark event. Sustainable tourism is very important because tourism is one of the world’s fastest growing industry and is major source of income of some countries. Tourism industry provide many jobs that help local economy. OlympicRead MoreThe Hunger Games By George Henry George1296 Words   |  6 Pagesof this quote is that things work better when there is equality, and this relates to The Hunger Games theme of inequality between the poor and the rich. As seen in The Hunger Games, anyone who didn t live in the capital was living in poverty. The only way to get out of poverty was to win The Hunger Games. The importance of this research paper is to show how the themes are presented in The Hunger Games. The themes that can be found in the story are the inequality between the poor and the rich, usingRead MoreEssay on Week 5 â€Å"Case Analysis: Video Game Console Industry in 2012†1266 Words   |  6 PagesWeek 5 â€Å"Case Analysis: Video Game Console Industry in 2012† Grantham University BA490 Business Policy and Strategy Case Analysis: Video Game Console Industry in 2012 Page 1 Executive Summary The video game console industry is a very competitive segment. This segment requires a keen eye on product development as well as strategic product marketing and a rather large logistics arm to ensure rapid distribution to targeted areas. Video game industry in the US, which

Derren Brown The Reenactment Of Stanley Milgrams...

In Derren Brown’s reenactment of psychologist Stanley Milgram’s experiment done in 1963, he solidified Milgram’s results by having the same framework as Milgram’s experiment. Milgram tested to see how much harm a person were to inflict if told to by an authoritative figure. In this particular experiment, a learning environment was set up, subjects were told that the focus was to see how negative punishment affects learning and they were told that they would be either a teacher or learner in the set up. All of the subjects in both Milgram’s and Brown’s situation were teachers and an actor, who all the subjects assumed to be another subject, as a learner. Learners were attached to a shocking mechanism ranging from 15 to a lethal 450 volts,†¦show more content†¦This study truly â€Å"speaks volumes† about responsibility, because even in modern society we follow a set of rules and although to other cultures they may be deemed as wrong, to us it is nothing but the ordinary. Brown shows how people follow rules that are given, and even if it is wrong, it is still done because a higher power tells them to do so. Many times, people do realize that what they are doing is wrong and there is hesitation, but because of a higher up telling them what to do and a fear of failure, nothing is done. There are only so many Phil’s in society, and they are exemplary of social imagination and standing by beliefs and values, as they take in consideration of the outer box that is of societal constraints. To experiment more on the participant’s response, another independent variable that could have influenced responses would have been if the participants, the teachers of the experiment, were able to see the learners. That way it replicates more of a learning environment where learners and teachers are face-to-face. In this case, both sides could still be in separate rooms, but instead there’s a screen showin g the teacher the learner. Since the learner is only an actor and no actual harm is being inflicted unto them, and they could act like they are being shocked as well. Additionally, as the teacher is able to see the learner, a more formidable response is created as they can visually see

American Health Care Systems Issues Health And Social Care Essay Free Essays

string(142) " but it would besides let physicians to entree pertinent information needed to handle the patient in the most efficient and effectual manner\." The Ever Increasing Cost of Care. The cost of wellness attention has been on the addition for decennaries. From 1960 through 2006, wellness attention disbursement has seen an addition of 9. We will write a custom essay sample on American Health Care Systems Issues Health And Social Care Essay or any similar topic only for you Order Now 9 per centum each twelvemonth, while the national Gross Domestic Product ( GDP ) rose merely 7.3 per centum during the same period. Additionally, Americans are paying well more than any other developed state. In 2008 entirely, the national wellness attention measure was about $ 2.5 trillion dollars ( Johnson T. , 2010 ) . This astronomical sum was about 16 per centum of the Gross Domestic Product. In simpler footings, every adult male, adult female, and kid in the state received $ 7,680 of medical attention ; yet, 1000000s of Americans had no coverage at all ( Kimbuende, Ranji, Lundy, A ; Salganicoff, 2010 ) . In comparing, England ‘s wellness attention budget for 2009 was $ 160 billion for every English citizen ( Lyall, 2010 ) . In fact, no other industrialised state had similar outgos as the United States. President Obama admitted every bit much in a 2009 address to the American Medical Association: â€Å" Today, we are passing over $ 2 trillion a twelvemonth on wellness at tention – about 50 per centum more per individual than the following most dearly-won state † ( 2009 ) . What state was the following most dearly-won? Actually, Norway and Switzerland were the following more dearly-won states with both passing $ 4,500 per individual in 2007 ( Pearson, 2009 ) . In add-on, insurance premiums have risen well in the last decennary. Employer-provided insurance premiums rose over 130 per centum while employee rewards merely saw an approximative 30 per centum addition. Furthermore, workers have seen their part addition over 125 per centum since 1999. The people who purchase their ain insurance have a significant addition in premium monetary values every bit good. The monetary value of the mean household policy in 2009 was $ 7,102 with an extra $ 1,690 spent on out-of-pocket disbursals ( Schoen, Nicholson, A ; Rustgi, 2009 ) . Medicare and Medicaid presently account for approximately $ 750 billion dollars or 21 per centum of the national budget with Medicare having about two-thirds at $ 468 billion ( Center on Budget and Policy Priorities, 2010 ) . Payroll revenue enhancements were responsible for about 90 per centum of Medicare funding merely two old ages ago. Currently, Medicare is the primary insurance coverage for 45 million people. The bulk of receivers are over 65 but there are several million younger persons enrolled because of entire disablement. About 50 per centum of Medicare enrollees have at least three ongoing medical issues ; about half are besides really hapless. Ten per centum of Medicare receivers are responsible for two-thirds of the full plan ‘s disbursement ( Potetz A ; Cubanski, 2009 ) . Obviously, Medicare needs more gross come ining its system or less money go outing its system. A combination of both would give the most favourable overcome for the plan. About 60 million Americans are take parting in the Medicaid plan with an extra 16 million enrolling in the following five old ages due to the health care reform jurisprudence. In 2008, the state spent about $ 340 billion on Medicaid. Which is non surprising since Medicaid is the primary remunerator for nursing place and other long-run attention. In add-on, Medicaid pays for much of mental wellness costs. It besides provides public infirmaries with 33 per centum of their net gross. Millions of people are working because Medicaid provides support for many occupations in the community. Like Medicare, a little per centum of Medicaid patients are responsible for over 50 per centum of entire Medicaid disbursement. Yet, Medicaid has the lowest administrative costs of all insurance remunerators ( Kaiser Family Foundation, 2010 ) . Where Is All The Money Going? Hospital attention is devouring the largest per centum of wellness attention dollars. For 2008, it accounted for about 30 per centum of all wellness attention disbursement. Unsurprisingly, the cost for the mean stay of four and one-half yearss will change from one installation to another ( U.S. Department of Health A ; Human Services, 2008 ) . As an illustration, the cost for handling pneumonia can be every bit small as $ 1,900 or every bit much as about $ 16,000. Furthermore, the 30-day readmission rate was similar regardless of the cost of intervention. Similar attention should intend similar cost yet with the state ‘s infirmaries this is clearly non the instance ( Chen, Jha, A ; Guterman, 2010 ) . Doctor and clinical services are besides devouring a immense per centum at 20 per centum. Many would reason malpractice or the fright thereof is driving some of these costs. However, physicians may good be the key to harnessing in physician-related disbursals ( Kaiser Family Foundation, 2009 ) . Training on the fiscal elements of wellness attention needs to be of high precedence, such preparation will do physicians more cognizant of the cost of a peculiar class of intervention. They will besides be more willing to order a generic or cheaper drug that will supply the same consequences ( Henry J. Kaiser Family Foundation, 2010 ) . At 10 per centum, prescription drug use is besides taking a big part of the wellness attention dollars. Prescription drug disbursement has been the fastest turning component of the wellness attention field. In merely 18 old ages, disbursement for prescription drugs jumped from approximately $ 40 billion yearly to $ 234 billion in 2008. For several old ages, drug shapers enjoyed the most net income of any industry. Conversely, generic drugs were one of the primary grounds that prescription drug disbursement slowed by 12 per centum from 1999 until 2005. Of all the FDA approved drugs, 80 per centum has a cheaper, generic equivalent. Because of this low-cost option, most physicians will discourse the out-of-pocket cost of medicines with their patients. Over 60 per centum of physicians switched to a less dearly-won drug and 58 per centum of doctors provided free samples to their patients ( Lundy, 2010 ) . Solutions to Escalating Health Care Costss Technology will be indispensable in commanding costs. Electronic medical records will non merely cut down some administrative costs but it would besides let physicians to entree pertinent information needed to handle the patient in the most efficient and effectual manner. You read "American Health Care Systems Issues Health And Social Care Essay" in category "Essay examples" For illustration, the medical records would clearly demo the doctor all current trials and lab work completed, thereby diminishing the likeliness of extra acerate leaf trials and lab work every bit good as X raies. They would besides alarm the physician to patients who may be merely seeking to obtain narcotics. Most significantly, they have the possible to cut down medical mistakes in prescriptions drug interactions and in transmittal of really of import information between different medical suppliers ( Johnson T. , 2010 ) . A consumer-driven program is besides really of import in cost containment. When the patient has input in their ain wellness attention determinations, they become better consumers. Therefore, it is imperative that the existent costs of wellness services are readily available to the patient. Most consumer directed programs besides involve greater cost sharing, which will be ineluctable in promoting people to go more cognizant of the high cost of medical attention in America ( Johnson, 2010 ) . The bar of chronic preventable disease will be a cardinal component in commanding costs. Obesity, although non technically a disease, is the precursor to other really preventable, chronic diseases. Type 2 diabetes and bosom disease are two of the diseases straight related to fleshiness. Possible fiscal inducements to employees may promote more people to watch their weight and to take part in some sort of physical activity if needed. Some companies have gone every bit far as to increase the employee portion of premium part if an employee has high hazard factors such as fleshiness or baccy usage. Similarly, Medicaid patients should portion in the cost of their intervention. For illustration, if a patient does non desire to do important life style alterations to continue their wellness position so they should be required to pay some clip of extra fee. As overall wellness indexs improve, the fee can be refunded to the patient. Nicotine trials for baccy users can be one index. The resting bosom rate may be another index used for physical activity since the resting bosom rate lessenings, as a individual becomes more physical active. And, yes, the parents have to be held responsible for the negative wellness indexs of minor kids. Standardized medical charge could perchance salvage one million millions of dollars in administrative costs. For case, should all insurance companies use a procedure similar to the 1 used for treating Medicare claims ; there will be a drastic decrease in administrative disbursals. Of class, this would see uniformity in entry and payment of all claims. This would besides cut down the waiting period for payment ( Evans, 2010 ) . A Dim Future If wellness attention cost are non curtailed, economical desolation will be the result. Many employers are fighting to maintain up with the ever-increasing cost of wellness attention. Employers spent $ 460 billion for medical coverage in 2006. In other words, they spent 12 per centum of entire working budget on wellness insurance. Because of the uninterrupted addition in insurance costs, companies have to increase the cost of goods sold. General Motor reportedly has to add about $ 2,000 to the monetary value of each vehicle to cover the $ 5 billion it spends on employee wellness attention each twelvemonth. Employers spend $ 2.38 per hr for medical benefits while their foreign rivals spend $ .96. In fact, Johnson claimed, â€Å" At 12 per centum, wellness attention is the most expensive benefit paid by U.S. employers † ( 2010 ) . If this tendency continues, American companies will probably free fight in the international playing field. Some employers will hold no other option other than dropping wellness attention coverage wholly. Many more Americans will probably register bankruptcy because of reeling medical measures. Presently, about half of all personal bankruptcies file are partially because of medical disbursals. Many people are proroguing intervention because of cost. When intervention is eventually obtained, the status is much more expensive to handle with longer recovery periods. Seniors will hold to salvage a considerable sum to cover costs that Medicare will non pay ( Kaiser Family Foundation, 2009 ) . More employers are switching much of insurance premium increases to the worker. This in bend is go forthing more people with less take-home wage and larger out-of-pocket disbursals. In order to salvage money, some workers will non seek medical aid when needed. Alternatively, they will take extra ill yearss trusting remainder will do things better. Merely when the consumer usage available wellness attention sagely, will at that place be a positive result. Unfortunately, many may take to waive medical intervention when it is most needful ( Johnson, Rockoff, A ; Mathews, 2010 ) . Medicare and Medicaid are the primary insurance for 1000000s of aged and hapless Americans. Numerous persons are besides double eligible, which allows them to have coverage from Medicare and Medicaid at the same time. Dual eligible persons must hold really low income to measure up for both plans. Intelligibly, these persons have much greater wellness demands than regular Medicare receivers. Medicare is the primary coverage ; nevertheless, Medicaid helps to pay the Medicare premiums. Medicaid besides picks up the check for services that are restricted or non collectible under Medicare. Medicaid pays for the long-run attention of 70 per centum of nursing place occupants. In add-on, because of the wellness attention reform jurisprudence, 1000000s more will be added. Although, province and federal money fund the Medicaid plan, the federal authorities will pay 96 per centum of the cost for people enrolled because of the wellness attention authorization ( Kaiser Family Foundation, 2010 ) . Decision Without a uncertainty, something has to be done to decelerate the cost of wellness attention so every American can hold entree to quality, low-cost attention. Electronic medical records can be a start in the acclivitous conflict to suppress cost. The benefits of fewer medical mistakes, less paperwork, and a more dependable transmittal of pertinent information greatly outweigh privateness concerns. Standardized charge will besides cut down administrative costs and see timely processing of all claims ( Johnson T. , 2010 ) . Furthermore, the figure of people having Medicare will increase to 79 million in twenty old ages. The aging population and longer life anticipation are responsible for this immense figure. Additionally, the figure of workers paying into the fund will see a lessening ( Potetz A ; Cubanski, 2009 ) . How can an already delicate system survive this added strain? The registration age has to be raised a few more old ages. This will let more people to work longer to pay in and prorogue the registration of more people at the same time. Medicaid on the other manus, need more people paying just premiums and co-payments. The consumer of wellness services has the duty of doing better lifestyle picks. Chronic, ongoing medical issues have a annihilating consequence on persons, their households, and the national wellness attention system. How to cite American Health Care Systems Issues Health And Social Care Essay, Essay examples

Create an Original Greek Myth free essay sample

The Ancient Myth of Elisha There once was a martyr, who due to his immortal abilities, he became the immortal god of football. He was called Archaeus Maningus, and, he married a usurped queen named Olva, exiled from her home kingdom of Missippia. Together Olva and Archaeus had 3 mortal children all with incredible strength, guts and wisdom named Copeus, Peito, and Elisha, all of whom lived with him on Mount Olympus. One day, Copeus, the eldest, was walking in a meadow in Missippia, and out of nowhere, was overcame by people who disagreed with his father’s rise to immortality and the family living on Mount Olympus, where they felt gods should only live. Despite, attempting to fight these rebels, they brutally, flogged him to death. This upset Archaeus and he and his family went to live in the city of Nerlens in the kingdom of Louisia, neighbor of Missippia. It was in Louisia, that Peito began to hone his talents. He joined a football team at his school and almost immediately became their leader and the best player on the team. He outwitted and outlasted his rivals on the field and led his group of players to thirty-four victories and only was defeated five times in battle. He was recognized for his greatness all over the region, throughout over forty-nine kingdoms. He later decided to take his talents to the kingdom of Tennes, where he started for four years on the Tennes College football team, playing against top-notch competition and dominating in battle against it. He would win numerous awards for his excellence on the field. He would go on to be the first mortal selected to play the game for a living with a band a football playing male colts representing the kingdom of Indisis. Peito would go on to be considered among the best ever to play and he was declared the best player in the years 2003 and 2004 A. D. In the year 2006, Peito led his band of colts to victory over all of the region’s other teams including the ferocious bears of the city of Chicaga in the kingdom of Illineus. The bears, hungry for the chance to reign supreme were torn apart for the band’s toughness and passion and by Peito’s tactical maneuvers. While Peito was making quite a legacy for himself, Elisha could only look on as his brother, achieved greatness and he stood in his shadow. Elisha faced constant comparisons to his brother, as he was a good football player as well. As Elisha grew up in the same town and went to the same school as Peito, people remembered all that his brother did and convinced him he would never be as good as his brother. Every day when Elisha went to school he would have to walk down hallways lined with memorabilia of his brother’s accomplishments. They told him he should quit now and save him self the embarrassment of learning that he would never be good enough. After all of the things his brother did Elisha almost became convinced it’d be impossible to compare to him. Almost. He tried to leave his own legacy but found that he couldn’t, with his father’s immortality and his brother’s greatness. He mainly tried to get out of his brother’s shadow, as he was fresh in everyone’s minds. Elisha went to college at the ancient College of Missippia, where he was welcome because of his bloodline stemming from his father. Although, his father went to the same university, (a rival to Tennes College) people had almost forgotten about his father’s legacy and people were open to seeing what the new generation could do. Despite, no one ever thinking he was good enough, Elisha was blessed the gift of perseverance by Thina the oft-forgotten immortal god of persistence and wisdom. After four years at the ancient college, Elisha was recognized somewhat but nearly as much as brother. He would receive some accolades for his play but not nearly as many as his brother. Elisha would end up being chosen to play with a team of lightning bolts and electricians, (Zeus’s favorite team) from the city of Sondegeos in the kingdom of Calfonia. The team, was charging up to take their shot at being the best in all of the region. But, alas, Elisha knew this was not the team for him and he traded places with a man named Lakes (who would join with the bolts and become a deathly force with them). Lakes had been invited to play with a team of giants from the kingdom of Neuyoerk, the largest city in the region and home to giant buildings as well as regular giants. Elisha immediately felt that was where he belonged. So he packed his bags and headed to Neuyoerk and joined the giants, where he thought he could be great. Elisha was having a rough start with the giants. He was having ups and downs in his career, handily defeating the swift, relentless cardinals of the Azona kingdom, the strong, tough rams from the city of Sinte Loeus, and the wild broncos of Devon, a city deep in the Rockus Mountains. However, he struggled harshly against was decimated by the daring, bold Vikings of Minsta, a city frozen by its isolation and weather and the aggressive, agile panthers of the province of Cralona. The next year, Elisha would find success against the red-skinned Indians of the district of Weshtondoc, and plundering pirates of the bay of Tampsis. However, he would face great disappointment as the muscular jungle cats of the village of Jaxoni and the instinctive, quick eagles from the city of Pidelfia defeated him. However, his worst blow came as when his team of giants battled Peito’s band of colts. His team fell to the band of colts as Peito played phenomenally. Peito’s team would later go on to be the champions of that year, which brought mixed feelings to Elisha, who was happy that his brother brought honor to his family but was saddened and angered that he could not do the same and that his brother was already being talked about as if he were possibly the greatest to ever play. At this moment, Elisha made the decision that one day he would be considered better than Peito. Elisha would spend much of his off period that next year working on his timing and getting the ball to some of the giants on his team. He was determined to get prepped for the games that lie in wake. As the next season began, Elisha was playing some of his best, most inspired football. Despite, critics proclaiming that he was not nearly as good as his brother, Elisha used his gift from Thina and persevered through it all. During the season he battled adversity en route to defeating the ferocious lions from desolate Detreuts, the conniving porpoises of sunny Miami, and their cross-town rival, also from Neuyoerk, the flying fighter jets. However, he would fall to the gun-slinging bandits of Dallaus, the dairy farmers of the bay of Chloros, and to the people of the kingdom of Nu Inglen, who are so loyal to the kingdom that they would do anything protect it from invaders and were so strong that they had not been defeated in almost a year (the last time they lost, they had played Peito’s team). In each of these games, the giants knew that they had what was needed to win, but they could not come away with a victory. Although these games were mostly close, Elisha and the giants did not win them. As the giants had done well enough in their other games, they secured a spot in the postseason for a shot at the championship, along with Peito’s team (who had won the previous year), the bandits of Dallaus, the dairy farmers of the bay of Chloros, and the people of Nu Inglen. Elisha and the giants first game, was against the bandits of Dallaus. In the teams’ first meeting the bandits had used their gun-slinging abilities and escape techniques to move the ball down the field to score, which lead to the many points scored in the game. However, the team had learned from their mistakes and realized if they used their size advantage and physicality, they could outmuscle the bandits and win the game for themselves, which is exactly what happened, and the giants defeated the heavily favored bandits of Dallaus. After defeating the bandits, the giants headed to the bay of Chloros, a city in the frigid north of the kingdom of Wisconsia, to play the dairy farmers, who consequently had trouble farming due to the low temperatures. In the first game, the giants had made unforced errors and missed some important opportunities. They knew that they would need to capitalize on every chance they had because the team of farmers were very strong and had plenty of time to practice. However, the giants had Zeus on their side, as he was sad that his favorite team had lost, and decided to make it snow hard. Zeus knew that Elisha was just as good in the snow while most other teams suffered in it. The game would back and forth between the two teams. Both teams managed to avoid unforced errors and attempted to capitalize on important opportunities. The giants would score and then the dairy farmers would score and vice versa. After they had played the entire game, and the score was still tied, the game moved to sudden death overtime. The farmers had the ball first. However, almost immediately the farmers’ quarterback made a mistake and the giants got the ball in good position. Elisha brought the ball a few yards up the field and prayed to Zeus that his team would win the game. Zeus was listening, and as the giants’ kicker kicked a field goal that looked like it had no chance of going in, but suddenly Zeus blew a gust of air and the ball sailed up, through the uprights and was good! Elisha and the giants had won the game, but there was still one more to be played. The final game was against the peo ple of Nu Inglen, who had beaten Lakes and Zeus’s favorite team, the bolts and Peito and the band of colts. The giants had played this team earlier but, despite doing every thing right, they could not beat this team, which hadn’t lost in any games during the season. The giants knew they’d have to every thing right and have help to win the game. The game began with the giants’ first drive, leading to a field goal. Then a Nu Inglen player ran into the end zone and scored a touchdown. Both teams would then trade touchdowns, to make the score fourteen to ten, with the people of Nu Inglen winning. Elisha got the ball back to start his final drive toward the end zone with less than three minutes left. Elisha was driving the giants down the field but was stalled on third down with five yards to go. Elisha knew he was in trouble, and Hermes (the god of athletics) noticed it too. Hermes decided to help Elisha. As Elisha called â€Å"hike† to start the play, the pass rush from the people of Nu Inglen almost immediately engulfed him. As they started to bring him down, Hermes helped him escape their tackles, and into open space where he threw the ball to a giants’ player. Hermes helped the giants’ player manage to catch the ball against his helmet and gain possession as he was being pulled to the ground. As the giant caught the ball, everyone (except the people of Nu Inglen) was ecstatic and a couple of plays later, Elisha threw the ball into the end zone for a touchdown, which secured the giants’ victory in the championship game over the people of Nu Inglen. Elisha was on the top of the world. However, it was shocking how quickly he came down. Almost immediatlely after the celebrating had died down, critics would compare him to his brother and none of the comparisons were in Elisha’s favor. People still said Peito was much better, as he had won individual accolades for his play as well as the team championship. As the next three seasons wore on, Elisha would achieve no accolades for his play and didn’t win the championship again. However, Peito would be declared the best player in the league twice more and would bring his team to the championship game, but he did not win it. This led to almost everyone forgetting about Elisha bringing the giants to the championship and instead the number of critics grew and they began chastise him for not palying as well as his brother. Elisha would go on to prove his critics wrong. During the next season, Elisha would defeat the intimidating buffalo from the city of Buflosis, and the swift, relentless cardinals of the Azona kingdom. He would struggle against the dairy farmers of the bay of Chloros, the hard-working gold miners of Sinte Fanciso and the people of Nu Inglen. However, he would make the playoffs again along with the dairy farmers of the bay of Chloros, the hard-working gold miners of Sinte Fanciso and the people of Nu Inglen. His brother on the other hand, showed his mortality with an injury and did not play at all. His replacements, on the other hand led the band of colts to a dismal season. In the giants’ first postseason game, they faced off with the dairy farmers of the bay of Chloros. This was an almost completely different team then the one they had faced last time as most of the players went off to find greener pastures. However, this team was better than the team they had faced last time, as this team had only lost one game all year and had won the previous year’s champoionship. The giants had learned to capitalize on the other team’s mistakes and ended up scoring off of both a fumble and an interception. This would lead to a giants victory. Their second postseason game was against the the the hard-working gold miners of Sinte Fanciso. The miners were a crafty team that had many tricks up their sleeve which led to their many victories but some of these tricks led to bad decisions which led to their defeats. As the game wore on the teams traded touchdowns and field goals until the teams were tied at seventeen. As the game wore into overtime both teams had trouble scoring but eventually, the miner punt returner made a decision that would cost them their shot at the championship and accidently had the ball stripped away from him. This led to the giants’ kicker making a field goal to win the game for them. The championship game was against the people of Nu Inglen, the same teams as Elisha’s last championship, but Nu Inglen wanted revenge. As the game started it appeared as if they would not get it as the giants managed a safety and then Elisha threw a touchdown. The people of Nu Inglen would take the lead back from the giants as they would score a field goal followed by two unanswered touchdowns to take the lead seventeen to nine. The giants would then score a field goal but nothing else seemed to be going right for them. To make matters worse for the giants, another one of their drives stalled and the people of Nu Inglen had a chance to put the game away, but the people of Nu Inglen’s communication broke down and Elisha got the chance to win the game. Elisha wanted to win the game by himself and right before he went on the field he prayed and told the gods that he was grateful for their help but he needed to face this alone. As Elisha began the drive he found a new confidence, and knew he could do this. He took snap, stepped back, passed to open receiver, he caught it for fifteen yards. He took the giants down the field and handed it off to his running back for the touchdown and the giants won the game. At that moment, Elisha knew he had silenced even his harshest critics. He knew people would never say that he wasn’t good enough again. He knew there would be no more negative comparisons. He knew he could truly be considered elite. He knew he had made his dad proud. He knew he had started his own legacy. He knew that it was his turn to shine. Elisha slept easy the night after the championship and he knew there would be more nights like that to come.

Appointment scheduling and tem... free essay sample

Appointment scheduling and templates are built to maximize providers productivity as well as utilize staffing appropriately. Currently, the third next available appointment reports have long wait times and the patients no show rates are consistently high for adult primary care clinics located in the Sarasota County Health Department. These high no show rates reduce the productivity of providers and reduce potential revenue. The long wait times are hindering the ability to meet performance goals that could be generating payment incentives for the chronic disease and the complex high acuity patients. In addition, we know that access to care is important for overall quality health delivery as well as disease prevention, detection, and screening.BackgroundExpectations from Medicaid, Medicare or other insurances are for the provider to improve managed care and deliver quality outcomes. This requires patients have access to care for providers to maintain patient care. Managing these outcomes is now directly related to reimbursement rates. There is no current data or existing research studies that identify any patterns or times that could be contributing to these high no show rates at Sarasota County DOH Ringling office. My August 2017 field experience report found monthly rates to be the lowest at 11. 76% for provider A, while being the highest at 24.61% for provider B. Then the data in September was completely opposite, with provider A at 37.5% and provider B at 18.46%. There did not seem to be any obvious identifiable reasons, determinants or variables for the providers monthly no show rate variability. This particular health department needs to be generating revenue for its increased expenses as the DOH is in a two-year transition releasing its Federally Qualified Health Center (FQHC) status to a private nonprofit. It is critical that the DOH maintain its revenue, quality of care and staffing productivity and utilization during this transition.Statement of PurposeThe purpose of this study is to identify days and times for additional appointment times to be built into the templates. The primary objective will be to analyze data to distinguish if there is a pattern of days or times that are consistent or identifiable in six adult health provider clinics. This data may be critical to adjusting immediate scheduling needs and increasing provider productivity and patient access to appointments. Now more than ever, time is of the essence and a deeper analysis of no shows root causes cannot be evaluated quickly.Costs of No ShowsPatients not showing for their appointment have many costs. Patients who frequently miss medical appointments have poorer health outcomes and are less likely to use preventive services (Crutchfield ; Kistler, 2017, p2). In addition, these patients can overburden the whole health system by using the emergency room for non-urgent matters when they miss their scheduled appointments. According to The Washington Post (2011) Medicaid recipients used the ER three times as much as people with private insurance due to difficulty finding providers.Since the 1990s, the National Committee for Quality Assurance (NCQA) developed a standardized tool to measure health care performance (NQCA, n.d.). These Healthcare Effectiveness Data and Information Set (HEDIS) measurements are a way to improve the healthcare system and a majority of insurance companies are expecting providers to manage the patient to meet these HEDIS measurements for reimbursement for services. The shift has become based on the patient outcomes and value-based care management versus fee for service (HealthPayer Intelligence, 2017). These reportable measures make it possible for customers to compare providers and health plans. These measures become a problem for providers and their ability to meet HEDIS measures if their patients are not showing up. It also scores the health plans poorly is the providers are not meeting standards of care. This situation, in turn, reduces the payment amounts to providers and could assess penalties against them, up to and including shutting the organization down with poor performance for three years (CareNational, 2017, para 7). Primary care should be managing their patients and long wait time for appointments could contribute to the poor performance scoring of providers thus reducing payments on the patients that are showing. Receiving a low rating could also detour new patients from seeking care from these providers and impact future business.FQHC designation puts this practice into a fixed prospective payment system. This payment system varies for a FQHC, based on geographical location factor and patient visit type. However, the 2017 rate is set at $163.49 (Nordian, 2017). If this figure is used and applied to the 25% of a schedule that is not showing up for care, the impact of 6 providers daily having 25% no show rates (5 pts. per day ave.) could be 30 wasted appointments times daily. With 6 providers having 5 no shows, it is approximately $4,900 daily loss of revenue. If the practice is open 5 days a week that brings the total to about $24,500 weekly loss of potential revenue. If even 20 patients could be accommodated for overbooking appointments or urgent needs, it would help divert care from the nearby hospital ER rooms.Factors associated with no shows Fear and emotions play a part in appointment keeping. Not wanting to hear bad news was one of the three reasons found by Lacy, Paulman, Reuter Lovejoy (2004). Not understanding the scheduling process and feeling disrespected in the health care system were the other two reasons. The article reflected patients having to wait for appointments, wait to be seen and waiting in the exam rooms for providers were also perceived to be disrespectful. A retrospective study in primary care by Kaplan-Lewis and Percac-Lima (2103) found that no show rates are higher in underserved populations and that the patients simply forgetting was the most frequent reason for the no show. Kheirkhah, Feng, Travis, Tavakoli-Tabasi and Sharafkhaneh conducted a retrospective cohort study spanning from 1997-2008 comparing 10 clinics from primary care to subspecialty clinics. The goal was to evaluate economic consequences, predictors and prevalence. The authors presented a mean rate of 18.8% for no shows, the average cost of $196 for 2008. The article concluded with the data reflecting a major financial burden on the healthcare systems and womens clinics with higher no show rates.Demographics and no showsThe findings and factors vary from clinic to clinic. Fiorillo, Hughes, I?Chen, Westgate, Gal, Bush, ; Comer (2018) found that there was an association and a 24% no show rate for new patient visit types in pediatric otolaryngology. While adult patients not showing for otolaryngology appointments tended to be younger aged females who had to wait longer for appointment dates (Cohen, Kaplan, Kraus, Rubinshtein ; Vardy (2007). Menendez and Ring (2014) reported that an outpatient hand surgery clinic study found that their no-shows data were in the beginning of the week. Monday and Tuesday were the days with a higher prevalence of missing the appointment. While a pediatric otolaryngology practice found morning appointments and June to be the highest times for no shows (Huang, Ashraf, Gordish-Dressmand, Mudd (2017). Butterfield points out that younger men who are unmarried, and those patients living 19-60 miles away from the practice had higher no show rates (Butterfield, 2009). Dantas, Fleck, Cyrino ; Hamacher (2018) reviewed over 105 in a systematic review of literature available and found that certain patient characteristics were identifiable overall. Younger age, lower income, no private insurance and l iving farther from the clinic has a more frequent no show association. Mehra, A., Hoogendoorn, C., Haggerty, G., Engelthaler, J., Gooden, S., Joseph, M., Carroll, S. , Guiney, P. set out to when their patients were not showing and to apply interventions to reduce no shows. They also concluded in their conclusion that four factors impacted no show rates. The younger patients, a lower socioeconomic status, previous no shows and not understanding the purpose of their appointment were identifiable factors.Scheduling and no showsThe no shows rates can increase appointment wait times. Drewek, Mirea and Adelson (2017) reviewed pediatric patient no shows. The theory of appointment lead times was tested for association with no shows in outpatient pediatric specialty clinics. Overall those scheduled less than 30 days resulted in 23% no shows while those over 30 days were at a 47% rate. In addition, new patients were 30% of those while follow-ups were 21% if scheduled within the 30 days. Over 30 days resulted in similar rates with new patients at 46% and follow-ups 48%. The authors concluded there was a risk factor for no shows in the time distance to an appointment. Giunta, D., Briatore, A., Baun, A. , Luna, D., Waisman, G. and de Quiros, F., also found a strong association between the time of the request for the appointment and the date given for the appointment.Insurance and no showsCheeseman, Trivedi, Peterseim, Blice, and Unkrich complied a retrospective study from July 2014 through June 2015. The evaluated the patient insurance carriers of no shows at a university pediatric based practice. Their study found that the Medicaid insurance population had the highest rates of same day cancelations as well as now shows. Norris, Kumar, Chand, Moskowitz, Shade, ; Williss (2014) empirical investigation also found four factors of the highest association. The greatest was the lead time between the call for an appointment and the appointment interval the type of insurance payer, the patient age, and the previous no show history of the patient.Overbooking and no showsParente, Salvatore, Gallo, Cipollini (2018) reported work from their quasi-experiment on developing a model to overbook appointments where they predicted a no show. The variables they use to predict were age group, previous no show record percentage, returning patient or new and insurance status. These March 2018 results concluded that further studies were needed, but it was positive evidence that an overbooking strategy could improve managing clinics and health centers. MethodsThe data for this retrospective study was generated from Sarasota County Health Departments Health Management System (HMS) electric medical records system. S ix adult health primary care providers were selected that work specifically at the Sarasota County Health Departments Ringling location. (Dr. Santun, Dr. Siegal, Dr Nygen, Dr. Brand, C. Finney ARNP and K. Ferris ARNP ) Patient no shows were defined as the appointment times that patients failed to make appointments and did not call to cancel. No show reports were modified to report only appointment time and date, generated from HMS for a period of one year (February 2017- through February 2018). No patient identifying data was included for this study. Days and appointment times were logged into Excel sheets. The total number of no shows was counted for each appointment time, day and month for each provider. Data was then put into graph format for each provider and a total for all six providers to see complete totals for this study.