Indonesia Crisis As An Example :: essays research papers

Indonesia’s Crisis: The Lesson for China introductionIndonesia, as we have long predicted, is coming apart. This process has a great deal of relevance to China, whose army, like Indonesia’s, was accustomed to making lots of money and now resents the fact that the good times are over. In both countries, making money became the basis for military loyalty to the regime, which in turn needed the army as guarantor. But in China, as in Indonesia, the military is no longer making money, and China has banned its officers from business. Now Beijing is creating international tension to soak up the military’s energy and resentment. But in the end, the guarantor of the regime can bring its death, leaving warlords poised to take power. ANALYSIS We have long argued that the Asian economic meltdown, as its ultimate legacy, would politically reconfigure Asia. We meant this in both the international and domestic sense: Nations would behave differently after the meltdown than they did during the past generation of extraordinary prosperity. The reconfiguration of Sino-American relations is an obvious manifestation of this. But it is the domestic political changes that are the most profound and will have the most impact on international relations. It should be obvious that an economic transformation of the magnitude we have seen cannot help but have equally dramatic political consequences. Asia is obviously a diverse region. It goes without saying that the economic meltdown will affect Japan’s politics dramatically differently than Malaysia’s. However, events during the last week have drawn our attention to one area of commonality: the effect of the economic crisis on the military in China and in Indonesia. These two countries are not usually lumped together; they differ in profound ways. But they share this: they have both used their military forces for three missions – protection against foreign enemies, enforcement of internal security and development of the economy. During the previous generation, the latter role became more and more important for both the Chinese and Indonesian militaries. But Asia’s recent economic crisis, the states and circumstance have forced both militaries to de-emphasize their economic roles. Not only are the militaries not happy about this, but their unhappiness could destabilize their respective regimes. Quite apart from the truly disturbing prospect of an Asia dealing simultaneously with both Chinese and Indonesian instability, there are important lessons to be learned from the way in which each country used the military and the consequences of that use.

Importance of Sports

Hi how are u I need a paper for school so let me get a bucking paper before I rip your dick off and feed it to my hamster. Ms. Fleeter told me to put this down. She needs to get fired so she can eat her fried chicken and blow up like Ms. Finch. Like the big blob she is. She can be used as a trampoline. Because all she does is sit there and don't teach. She Just sits there and tats till she eventually blows up and pukes up 4567857483904 children. Because that's how fat she is.Well I'm going to tell you why. Sports keep you healthy and fit In many different ways. Plus who would want and old back that's always slouched over and hurts. Another reason Is their very fun to play. A birthday party or sleepovers are some places that sports are fun to play. You can also play sports for a team and those are also fun. My third and IANAL reason Is that they can get you money when you're older.If you're good at the sport and want big money this Is the way to do It. Now let's move on to see how the y keep you healthy. The way that sports keep you healthy are In many different ways. First off they take your mind off things. For example, say somebody died or got hurt In your family. Sports are a good way to get your mind off of It. Next, you have to keep healthy to play the sports. You don't want to be slow when playing the sport. Importance of Sports Hi how are u I need a paper for school so let me get a bucking paper before I rip your dick off and feed it to my hamster. Ms. Fleeter told me to put this down. She needs to get fired so she can eat her fried chicken and blow up like Ms. Finch. Like the big blob she is. She can be used as a trampoline. Because all she does is sit there and don't teach. She Just sits there and tats till she eventually blows up and pukes up 4567857483904 children. Because that's how fat she is.Well I'm going to tell you why. Sports keep you healthy and fit In many different ways. Plus who would want and old back that's always slouched over and hurts. Another reason Is their very fun to play. A birthday party or sleepovers are some places that sports are fun to play. You can also play sports for a team and those are also fun. My third and IANAL reason Is that they can get you money when you're older.If you're good at the sport and want big money this Is the way to do It. Now let's move on to see how the y keep you healthy. The way that sports keep you healthy are In many different ways. First off they take your mind off things. For example, say somebody died or got hurt In your family. Sports are a good way to get your mind off of It. Next, you have to keep healthy to play the sports. You don't want to be slow when playing the sport.

Marijuana and its Legalization

The legality of marijuana has been a hot topic debated upon for years. However, upon close inspection of studies and articles, it is clear that it is in the better interest of the government to lift the ban on marijuana. The first thing I learned from the inquiry into this issue was that prohibition fails to control the use and production of marijuana. On the contrary, the illegal aspect tickles the curiosity of teenagers, resulting in opportunists seizing this chance to sell marijuana to them.The marijuana is distributed in schools by student dealers who learn to make easy money, and these students may be lead into the crime industries. The problem exists in the ubiquitous nature of marijuana and it not being the highest priority of the police. The distribution is not being controlled and neither are sources of the marijuana, which misses the reason of existence for prohibition.In fact, through legalizing marijuana usage, the government can earn a plethora of money through taxing, t he price can be controlled to be of proper value instead of the underground pricing, and the number of illegal dealers would decrease due to marijuana not being as profitable. In a survey conducted by the National Center on Addiction and Substance Abuse at Columbia University, they reported that â€Å"teens could more readily access pot than beer or prescription drugs. What makes alcohol different from marijuana is that alcohol is legal, regulated through age restrictions, and taught in public education about its awareness. For instance, in high school, there are no such things as alcohol dealers or tobacco dealers, which leads to the need of a middle-man who is of age to buy such products. That middle man is often an older student who has to go out of his way to buy alcohol or tobacco which is a great hassle, whereas marijuana is easily found within the student population.People may argue that it is the pure danger of marijuana that led to its prohibition, but contrary to popular belief, it is said that marijuana was made illegal in the US for population control of Mexicans and Black people. Harry J. Anslinger, the director of the Federal Bureau of Narcotics remarked that the reason for the ban of marijuana was â€Å"its effect on the degenerate races. † There is no scientific evidence that such known side effects as schizophrenia, heart attacks or cancer are actually caused by marijuana and therefore the danger of the drug cannot be the reason being illegal.However, due to marijuana smokers being disoriented and having loss of coordination and logical thought, it would be more reasonable to make certain activities or actions illegal when influenced by marijuana instead, similarly to alcohol. Lastly, the research showed that keeping marijuana illegal is more expensive than lobbying it. Apparently the government’s â€Å"War on Drugs† results in millions of dollars in losses when locking people related to marijuana in prison, paying for th eir food, housing, health care, attorney fees, and court costs.All this is paid by taxpayer money which are meant for and could be used for other things concerning the country. Also, as stated in the above, the government is missing out on tax opportunities that could be in turn used for more effective drug education programs. If marijuana were legal the government would have much more money to spend on important problems. Even in our neighbourhoods, hundreds of students are smoking cannabis. Instead of having a large portion of our population having to smoke illegally, it would be more advisable to free the ban and profit from the perks of legalizing marijuana.

Americas Medicare And Medicaid Healthcare Health And Social Care Essay

Health attention costs in the United States exceed 14 per centum of the entire gross domestic merchandise, far more than in any other state. In the twelvemonth 1992 overall costs were approximately $ 838 billion or over $ 3,000 per individual. Equally good as there were about 6,066 infirmaries with 1.14 million beds in the twelvemonth 1992 in the United States. Hospital attention dominates entire wellness attention disbursement in United States.After decennaries of induction long term attention in America is undergoing enormous alteration in response to increasing Medicare and Medicaid expenditures. As the response to the lifting province and federal outgos in America community based wellness attention options are promoted for long term attention over institutional attention. Despite the fact that persons with really serious and relentless psychiatric upsets are over represented in the population of long term attention and consequences into disproportional sum of psychiatric wellness attention cost, every bit good as there is an alarming deficit of attending to the services for the aged individuals with the persistent and serious mental unwellness. About 2 per centum of individuals aged 55 or above in America are enduring from terrible and relentless psychiatric upset and it is assumed to duplicate in following three coming decennaries. Since the current strategy of long term psychiatric attention for the aged individuals with this upset is missing and service proviso is extensively driven by reimbursement policies, community based attention and managed attention is likely to hold profound consequence on this population. The grounds to twenty-four hours provinces that these proposals can cut down the demand of hospital resources but there remains concern about cost effectivity of community attention compared with infirmary attention.However the wellness policy issues of America is been debated in conformity with community based wellness attention for aged persons and the hereafter challenges of supplying psychiatric wellness services to aged population.Although, small attending has been highlighted on the plausible impact of managed attention on the concatenation of aged individuals with relentless and serious psychiatric upsets who have the most demanding long term attention demands. Service NEEDS: Aged persons with serious and relentless psychiatric upsets are denoted in this survey as individuals age 65 and over with perennial or late-onset terrible psychiatric upset with residuary damage. As by and large defined, terrible and repetitive psychiatric upsets includes diagnosings such as delusional upset, schizophrenic disorder, bipolar upset, and recurrent major depression.Elderly grownups who evolve these upsets in early maturity frequently have unequal societal support systems and lesser fiscal resources than those with late-onset unwellness, but both of them portion many similar clinical characteristics and the common demand for long-run mental wellness attention services. However, latest psychiatric wellness services for aged individuals are mostly disconnected and underutilized and do non adequately turn to their long-run mental wellness demands. Overall, deinstitutionalization has left infinite figure of aged individuals with reduced entree to mental wellness attention in both community and institutional long-run attention scenes.Larger proportion of aged grownups with terrible and relentless mental unwellness who stays in the community receive small support from the mental wellness system except for medicine despite continued demand, and those without household attention are at higher hazard of being institutionalized.These factors highlights the pressing demand to specify and advance place and community based options. LONG TERM CARE REFORM: The sudden shrinkage and closing of province infirmaries over the past few decennaries has resulted in â€Å" trans-institutionalization † into attention places of many dependent aged individuals with terrible and relentless psychiatric unwellness. Eighty-nine per centum of all institutionalized these aged individuals reside in attention places. However, assorted tendencies suggest that establishments will play a diminishing function in future systems of long-run mental wellness attention compared with community-based scenes. First, the bulk of older grownups with mental unwellness resides in the community and favour to stay at that place ( Bartels SJ, Levine KJ, Miles KM, et Al, unpublished manuscript, 1999 ) . The more recent cohort of aging individuals with terrible psychiatric unwellness had spent most of their lives in the community instead than institutional scenes. Therefore trans-institutionalization from long-run province infirmary units to care places will go a vanis hing phenomenon. Equally good as the 2nd tendency suggests the diminishing function for establishments is the execution of nursing place reforms under the federal Omnibus Budget Reconciliation Act of 1987 ( Public Law 100-203 ) , with the purpose of cut downing the use of nursing places for long-run mental wellness attention. This reform ‘s were practiced in response to increased psychiatric admittances to care places after closings of province infirmaries. Last, the lifting outgos for nursing place attention are exciting sudden reforms in policy and reimbursement. They include authorizations by provinces to curtail Medicaid outgos by forestalling the nursing place bed supply and cutting Medicaid reimbursement rates. As the wellness attention system transportations to suit the increasing figure of patients necessitating chronic attention, forthcoming anticipation suggest the greatest success in services will be in home- and community-based scenes.Sudden alterations in the funding and construction of long-run and managed attention are progressing quickly across the provinces, with a practical deficit of attending to the lifting Numberss of aged grownups with serious and relentless mental unwellness who will hold of import service demands. Financing OF MEDICARE AND MEDICAID: Soon, most of the psychiatric wellness and long-term-care services for aged individuals are financed through fee-for-service Medicare and Medicaid. Medicare is the federally financed wellness insurance plan, supplying insurance for persons age 65 and above and handicapped persons under age 65. Medicare is composed of two parts: portion 1covers inmate infirmary attention, 60 yearss of skilled nursing place attention, and place wellness and hospice attention. Separate 2 provides reimbursement for outpatient infirmary services and doctors. Among the major limitations in Medicare coverage of the psychiatric wellness services are a needed 50 per centum copayment for psychotherapeutics services, deficit of general outpatient prescription drug coverage, restricts on inpatient psychiatric yearss, and limited or no coverage of important services such as residential attention, reprieve attention and grownup twenty-four hours attention and place wellness attention. Home wellness attention is an of import permutation to institution-based attention. However, merely acute portion of unwellness instead than long-run attention is cover by Medicare. Psychiatric upsets, including dementedness, constitute merely 2.8 per centum of primary diagnosings for place wellness attention. It is likely that place wellness attention for psychiatric upsets will go barely available in future coming old ages as Medicare reform consequences in cutbacks under the Balanced Budget Act of 1997. After passage of these reforms, 14 per centum of U.S. place wellness attention bureaus, a sum of 1,355 bureaus, closed in 1998. However, less than 3 per centum of the entire budget of Medicare is spent on mental wellness, with half less than these outgos ( about 1.5 % ) – traveling to psychiatric wellness services for the aged population. Acute hospitalizations consequences to the huge bulk of these outgos. Medicaid is the main insurance company for long-run attention in nursing places and the of import beginning of reimbursement for state-funded services for handicapped persons, including persons with serious and consistent mental unwellness. Since Medicaid is a combined federal and province plan, with provinces paying up to 50 per centum of the cost, provinces have of import discretion in make up one's minding the eligibility standards and sorts of mental wellness services covered. For case, although legion provinces offer coverage of prescription drugs, most have restrictions in the sort of copayments, limited refills, or other restrictions.States may besides implement restrictions on mental wellness attention, including anterior mandate and restriction on the figure of visits to suppliers. Medicaid reimbursement rates average 20 to 30 per centum beneath bing market rates.Restricting the sum and range of services and paying for psychiatric attention at lesser rates than for medical attention create barriers to adequate psychiatric attention for aged patients. In short, the argument between the federal and province authoritiess over the costs of Medicaid, every bit good as the restrictions in Medicare coverage, leave many spreads in insurance coverage for aged grownups.These spreads result in a disintegrated intervention system and critical load in out-of-pocket costs. In add-on, briskly increasing Medicare and Medicaid outgos are ensuing in the impulse to develop schemes that contain costs. The blend of spreads in coverage and service and intensifying costs under a fee-for-service reimbursement construction has resulted in an eruption of managed attention enterprises in America. CARVED-IN AND CARVED-OUT MENTAL HEALTH SERVICES: The statement over the finest manner to pull off fiscal hazard and to transport mental wellness services in managed attention has resulted in a scope of theoretical accounts that may be loosely classified into two general classs. In some managed attention establishment, mental wellness attention is straight merged into the bundle of general wellness services that are covered and provided, or carved in. In others it is supported through a contract with a separate forte mental wellness establishment that provides services and accepts the hazard, or carved out. CARVED-IN Agreements: Patron of carved-in mental wellness services argue that this form of attention better integrates both physical and mental wellness attention, reduces barriers to mental wellness attention due to stigma, and is more apt to bring forth cost beginnings and overall nest eggs in usual wellness attention expenditures. These characteristics are specifically of import because aged individuals normally have co morbid medical conditions and take multiple medicines that may impact mental upsets ; they typically avoid forte psychiatric wellness scenes and incur important wellness attention disbursals related to psychiatric symptoms. By and large, carved-in agreements promotes communicating and coaction between medical and psychiatric suppliers suppressing arbitrary differentiations about medical versus psychiatric causes of symptoms and functional issues.Carved-in agreements may be advantageous for the many aged individuals with similar sort of upsets who receive the greater part of their mental wellness attention from primary attention suppliers. Despite the fact that, carved-in agreements are assumed to supply fiscal inducements for incorporate medical and psychiatric wellness services, functional integrating is far from guaranteed. Unfortunately, mental wellness forte services for aged persons tend to be a low precedence in managed wellness attention organisations in comparing with surgical and medical forte services. Mental wellness carve-in agreements may besides be economically hazardous. First, if mental wellness net incomes are carved in as portion of a net income bundle, grounds from private-sector wellness programs reveals that without administered para, insurance companies will offer differential coverage of mental wellness attention.In add-on, if remunerators or suppliers contest for enrollees, a healthy inducement will be to forestall those expected to hold higher costs from psychiatric jobs, such as aged persons with serious and consistent unwellness. Finally, process of seting payments to counterbalance for the increased fiscal hazard of supplying attention to more badly sick enrollees under a capitated payment, known as hazard accommodation, are rather hard to use for psychiatric wellness attention. For case, unless reliable hazard accommodation schemes are developed for complex populations such as aged person with mental unwellness, the capableness for significant losingss is likely to perpetuate the present deficiency of enthusiasm and services for this bad group among managed attention organisations. CARVED-OUT Agreements: In comparing, advocates of carved-out agreements for mental wellness services for aged persons argue that stray systems of funding and services are likely to be superior for individuals with particular mental wellness services. Specifically, they advocate that carved-out mental wellness organisations have advanced proficient cognition, a broader array of services, specialised accomplishments, greater Numberss and assortments of mental wellness suppliers with experience handling terrible mental conditions, and committedness and willingness to supply services to bad populations. In add-on, advocates argue that mental wellness carve-out organisations allows economic systems of graduated table in supplying the comprehensive array of rehabilitative and community support mental wellness services necessary to care for elderly terrible mentally sick individuals in the community. At last, an inducement exists to reinvest nest eggs from any decrease in inmate service usage into advanced outpatient options. Although appropriate surveies are missing, plans utilizing carved-out services for younger persons have by and large reported important cost nest eggs and favourable results. Unfortunately, informations are missing on results and costs for aged individuals with serious mental unwellness in mental wellness carve-outs. From a clinical mentality, the downside of a carve-out agreement is an increased hazard for unfavourable results due to atomization of medical and mental wellness attention services. The possible for these inauspicious results is significantly pronounced for aged individuals, who are frequently taking multiple medicines and who have complex medical upsets. Unsuccessful communicating or deficit of coaction between mental wellness and medical suppliers places the aged individuals at peculiar hazard of medicine, misdiagnosis, interaction, inaccurate premises about medical versus psychiatric causes of symptoms, and ambiguity about whose duty it is to vouch that appropriate community-based services are provided. From a fiscal mentality, foremost and most important, mental wellness carve-out organisations predicts the hazard of supplying services for a specific given population at a set negotiated fee. Downward pressures to incorporate or cut down costs may take into a one-sided decrease in the proportion of the overall wellness attention dollar allocated for mental wellness services. Second, a fiscal inducement exists for medical suppliers to switch and delegate duty for co-morbid conditions to mental wellness suppliers and frailty versa. For case, since the allotments for medical and psychiatric services are fixed and dispersed, it may be in the fiscal attractive force of a medical supplier organisation to inaccurately tie in the cause of a complex medical-psychiatric job to mental unwellness, which would take into unequal attention and switch the cost load to the mental wellness supplier organisation. A 3rd exposure of carve-out agreements is the hardship that they pose in finding the benefits or cost nest eggs of mental wellness services. Increased usage of mental wellness services may look to be more dearly-won in a carve-out agreement. At last, the physical and mental co-morbidity found in aged grownups with serious and relentless mental unwellness may cut down any awaited fiscal advantages of carved-out services. If the mental wellness supplier can non every bit pull off services and costs related with the combination of medical and mental wellness upsets, anticipated nest eggs may non happen. INNOVATIVE PATTERNOF MANAGED LONG TERM CARE: The demand of keeping intensifying outgos of long-run attention while supplying home- and community-based options to institutional attention has been the focal point of s experiments in long-run attention reform, including societal HMOs, the Program for All-Inclusive Care of the Elderly ( PACE ) , and state-managed long-term-care presentations. Initially initiated as a four-site long term attention presentation undertaking in the mid-1980s, societal HMOs are determined to intermix ague attention and long-run attention within a managed attention model. The implicit in plan is to supply both ague and chronic attention net income under a individual organisation at fiscal hazard, based on a postpaid capitation payment pooled from different beginnings including Medicare, Medicaid, and copayments. In comparing, PACE largely pay attending on persons who meet eligibility standards for nursing place attention and suspects high hazard under capitation for all long-term-care services, financed by monthly capitated payments from Medicare and Medicaid. Elite characteristics of the PACE plan include a multidisciplinary squad attack, service proviso in a separate grownup twenty-four hours wellness centre, chronic attention without caps on long-term-care outgos, and everyday one-year wellness showing and preventative attention. These theoretical account plans involves many elements that might be adapted to the demands of aged individuals with rigorous and grim mental unwellness to better future long-run attention for this population, including instance direction and multidisciplinary squads. Imaginative state-initiated managed long-term-care presentations include plans for people dually entitled for Medicaid and Medicare, who are among the premier users of acute and long-run wellness services. This group includes old individuals with serious and consistent mental unwellness. At present, multistate proposals are being constructed to unite Medicaid and Medicare resources under a capitated program that provides a full scope of services, including community-based and institutional ague and long-run attention. These enterprises have the possible to supply comprehensive long-run medical and mental wellness attention through public insurance to a population with high rates of chronic mental and wellness upsets. However, with few exclusions, presently planned proposals do non have mental wellness attention as a nucleus constituent or supplier of services. An alternate system of managed attention with the prospective to supply wide-ranging services is exemplified by a single-payer national wellness attention system. However, statistics from national comparings are assorted. Single-payer wellness attention systems in other states are more likely to function persons with lower incomes and more terrible mental unwellness than in the U.S. , but overall entree to specialty mental wellness services is no better and frequently involves longer waiting periods. Deduction FOR THE FUTURE: How will elder individuals necessitating long-run mental wellness attention menu in an epoch of managed attention? Existing issues reviewed here suggest that there is cause for dismay ; at the same clip, new attacks to funding services hold promise if they are suitably developed and harnessed. However, this sum-up of the literature suggests several specific instructions and steering rules for future theoretical accounts. Integration of mental wellness and medical services: Optimal services for older individuals with terrible and changeless mental unwellness require a close association of primary medical attention and mental wellness services. The high prevalence of medical and cognitive comorbidity in this group necessitates a clinical attack that recognizes the complex mixture of medical and psychiatric upsets and the value of a collaborative medical-psychiatric attack. A array of attacks to incorporating medical and mental wellness attention have been described, but run intoing the demands of persons with serious and changeless mental unwellness is particularly debatable. Promising theoretical accounts of incorporate attention consist of location of medical and mental wellness suppliers at the same site, multidisciplinary medical-psychiatric intervention squads, proviso of primary attention in mental wellness clinics, proviso of specialised mental wellness services in primary attention clinics, and cross-trained medical-psychiatric suppliers. The cardinal clinical topic here is the formation of a collaborative attention theoretical account across medical and mental wellness suppliers, of whether the services are financially incorporate ( carved in ) or separate ( carved out ) . For illustration, the literature describes booming theoretical accounts of community-based mental wellness services that include a primary wellness attention supplier as an built-in portion of a mental wellness outreach squad for senior grownups with terrible and relentless mental unwellness ( Levine KJ, Bartels SJ, unpublished manuscript, 1999 ) and the development of an associated primary attention medical clinic specifically for persons with terrible and changeless mental unwellness. Integration of specialised services and community-based attention Rising systems of community-based long-run attention across the provinces promise to supply many indispensable supports and services indispensable to keep frail aged individuals with several medical upsets in place scenes. These theoretical accounts of home- and community-based long-run attention offer advanced attacks to supplying medical and societal services to elder individuals, yet by and large do non include specialised services for long-run mental wellness attention of individuals with serious and continual mental unwellness. To undertake these demands, such plans will necessitate to spouse with specialised geropsychiatric and community support services. Although empirical informations are missing, a restricted descriptive literature suggests that theoretical account plans must hold specific clinical constituents to successfully keep senior grownups with terrible and continual mental unwellness in the community. These constituents consist of intensive instance direction, general medical attention, 24-hour crisis engagement, home-based mental wellness attention, residential and household support services, caregiver preparation, multidisciplinary squads, active instance determination and outreach, and psychosocial rehabilitation ( Levine KJ, Bartels SJ, unpublished manuscript, 1999 ) . Descriptions of results for these plans suggest that with sufficient supports, the bulk of senior individuals with terrible and continual mental unwellness can be maintained in the community at lower cost than in establishments and with equal or enhanced quality of life. Blended funding and seting for unwellness badness The greatest challenge to run intoing the long-term-care demands of the increasing Numberss of aging individuals with terrible mental unwellness will be fiscal. Predictions of the bankruptcy of the Medicare trust fund and current projections for Medicaid expenditures require advanced and resourceful usage of these and other fiscal resources. Meeting the complex long-run medical and mental wellness attention demands of senior individuals with terrible and continual mental unwellness under fee-for-service support will necessitate originative pooling of resources, including Medicare, Medicaid, and funding for aging services under federal and province block grant plans, every bit good as private insurance and limited personal financess. However, even with these steps, in the deficiency of singular reforms in the funding of wellness and long-run attention for senior individuals, financess may be deficient. Capitated attention agreements may be necessary to incorporate costs and to promote usage of the most cost-efficient services. A major aspiration of financing long-run attention will be the reallocation of outgos to back up the development of home- and community-based options. The most striving theoretical accounts of forming and funding services for open populations of senior individuals provide integrated services under a individual system responsible for both acute and long-run attention. PACE, societal HMOs, and province proposals for senior individuals who are dually suited for Medicare and Medicaid blend these beginnings of support to make systems of acute and long-run attention. All of these attacks portion the common purpose of redeploying financess from current dearly-won nursing place attention and hospital-based attention to supported community options. The end of such plans is to intermix these fiscal resources under capitation with an accent on back uping the least restrictive and least dearly-won long-term-care services. Managed attention plans functioning senior individuals with terrible and changeless mental unwellness will necessitate to integrate hazard accommodation schemes that account for the significant costs associated with combined hazards of older age, long-run mental disablement, and medical comorbidity. For case, current reforms under the 1997 Balanced Budget Act include programs to finally associate Medicare capitation rates to wellness position through risk-adjusted payments. Guaranting answerability, protagonism, and results At last, it is of import to admit that senior individuals with terrible and changeless mental unwellness typify the most complex, susceptible, resource-poor, and bad long-term-care patients. Service organisations that presume the fiscal hazard for ague and long-run psychiatric and medical attention will necessitate to be suitably reimbursed and held responsible for quality of attention. In the absence of mechanisms to finance these services, adjust for hazard, and step results, managed attention agreements will be in struggle with the ends of supplying high-quality attention for senior individuals with terrible and continual mental unwellness. Decision: We have no simple replies to the inquiry of how to outdo organize, finance, and present mental wellness and long-term-care services to elder individuals with terrible and continual mental unwellness. The integrated funding and organisation of services promised in germinating theoretical accounts of managed long-run attention offer the possible to eliminate atomization and inefficiencies and to make a much-needed continuum of medical, mental wellness, and societal support services. Yet bing theoretical accounts fail to supply the specialised mental wellness services that are critical for functioning this population in the community.REFRENCES:1 } Jonas & A ; Kovner ‘s Health Care Delivery in the United StatesA edited by Anthony Kovner, PhD, Steven Jonas, James Knickman, PhD. 2 } Hand book of Health Economics by Anthony J.Culyer and Joseph P.New house. 3 } The Economicss of Health and Health attention by Folland Goodman Stano. 4 } The Economic and Budget Outlook: Fiscal Old ages 1998-2007. Washington, DC, Congressional Budget Office, 1997. 5 } Bartels SJ, Miles KM, Levine K, et Al: Bettering psychiatric attention of the older patient, in Clinical Practice Improvement Methodology: Effective Evaluation and Management of Health Care Delivery.Edited by Horn SD. New York, Faulkner & A ; Gray, 1997. 6 } Kane RL: Managed attention as a vehicle for presenting more effectual chronic attention for olderpersons. Journal of the American Geriatric Society 46:1034-1039, 1998. 7 } Frank R, McGuire T, Newhouse J: Hazard contracts in managed mental wellness care.Health Affairs 14 ( 3 ) :50-64, 1995. 8 } Bartels SJ, Colenda CC: Mental wellness services for Alzheimer ‘s disease: current tendencies in reimbursement, public policy, and the hereafter under managed care.AmericanJournal of Geriatric Psychiatry. 9 } Jencks S, Goldman H: Deductions of research for psychiatric prospective payment.Medical Care 25:542-551, 1987. 10 } Miller R, Luft H: Does managed attention leadto better or worse quality of attention? Health Affairs 16 ( 5 ) :7-25, 1997. 11 } Wells KB: Cost containment and mental wellness results: experiences from US surveies. British Journal of Psychiatry 166 ( suppl 27 ) :43-51, 1995. 12 } Felker B, Yazel J, Short D, et Al: Mortalityand medical comorbidity among psychiatricpatients: a reappraisal. Psychiatric Services 47:1356-1362, 1996. 13 } Sturm R, Wells KB: How can care for depression become more cost-efficient? JAMA 273:51-58, 1995.

A Comparison of Four Literary Works Essay

Great writing does not necessarily make a great work of literature. More often than not, there has to be something special about a writer’s work of art. This could be also considered their trademarks, signatures that had set them on canonical status. Shakespeare has his soliloquies, Hawthorne attacks the Puritans, Hemmingway uses symbols, Borges possesses fondness for infinity, and the list goes on. However, there could be some similarities between these literary signatures of writers. It is important to take note that having similarities does not render a writer less special than others. What is remarkable about the works sharing similarities in their trademarks is that they all express a common concern—concerns that could be considered as major issues in the society. The selected works had all talked about women and social status.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The literary works that this paper would feature are Nathaniel Hawthorne’s â€Å"The Birthmark†, Flannery O’Connor’s â€Å"A Goodman Is Hard To Find†, William Faulkner’s â€Å"A Rose For Emily†, and James Joyce’s â€Å"The Dead.†   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Hawthorne’s â€Å"The Birthmark† had shown us how the male-dominated society perceives women. In the narrative, there was a beautiful woman named Georgiana. She was almost perfect, however, her most visible flaw was her hand-shaped birthmark on her cheek—thus the title. She was married to a scientist named Aylmer who is not pleased with Georgiana’s birthmark. Since he was a scientist, Aylmer conducted a procedure to supposedly fix his wife’s face. As a consequence of the Aylmer’s discontent, Georgiana died while under operation.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Hawthorne story tells us that women are commonly judged according to their physical appearance and not according to the beauty of their intellect and character. Moreover, the story suggested to us that the pride of the male specie is on of the main reason for the oppression of women in the society. It is very likely that Aylmer had treated his beautiful wife as a mere accessory to display to the public. As we could observe in the history of societies, husbands are judged according to their wives, and vice-versa.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In William Faulkner’s â€Å"A Rose For Emily†, women are presented in a rather disturbing manner. The story is basically about a former aristocrat woman who had kept the corpse of her beloved in her bedroom. That is not to mention that she is the one who killed her beloved and she had slept with the dead corpse—â€Å"slept†, with all the connotations of the word.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Faulkner has this talent to disturb people with seemingly harmless countryside scenarios. But what is remarkable about this particular work is the depiction of how a woman could love a man. A woman’s version of love is a topic that is rarely touched throughout the long history of literature. â€Å"A Rose For Emily† tells us that a woman could love unconditionally even if their love is unrequited. Moreover, â€Å"A Rose For Emily† touches the topic of social status. In the story, Emily came from a family of aristocrat status. The object of her affection, Homer Barron, came from a common family. The difference in their social status had somehow prevented them from getting married. In addition to that, it is Emily’s social status that had made the townspeople treat her differently. On a different tone, Flannery O’Connor’s â€Å"A Goodman Is Hard To Find† had depicted women and social status on a less favorable stance. The protagonist of the story was an annoying grandmother. The family in the story wanted to go to Florida, but the grandmother insisted that they go to Tennessee. The grandmother cited the news that there was a roaming criminal along the way to Florida just to scare off the family. On their way to Florida, the grandmother’s words became true that she and the family had actually encountered the criminal. As a ploy to save herself, the grandmother constantly tells the criminal sarcastic remarks like â€Å"you are a nice person.† With regards to social status, the criminal was aware that the grandmother was just pretending to treat him as a nice person. The criminal already knows what to expect from the society with regards to place of criminals within the social thread. The criminal knows that people like him would always be discriminated by people.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   It is almost the same case for James Joyce’s â€Å"The Dead.† The author had reiterated the notion that women are good at telling lies. The disturbing ending of the narrative tells the readers that Gretta, the wife of the protagonist (Gabriel), was deeply in love with someone who already died. The conflict was she was already married with an insecure man. The ending of the story shows us how Gretta’s action of not telling her husband her past had such a tragic impact on his insecurities. On the note of social status, Gabriel’s insecurities were highlighted during the gathering, where most of the plot had developed. His insecurities were most rooted from his social status. When he was interacting with people of higher social status, he would be insecure of his intellect, language, and physical appearance. There is a subtle hint in the story that social status has some effects on a person’s confidence.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   All in all, the recurring themes of women and social status could be roughly considered as clichà ©s. However, it is important to take into consideration that these issues should not be forgotten. It is just remarkable for these great writers to reiterate these issues that the society is seemingly eluding. Moreover, the recurrence of these themes tells us that the issues of women and social status are still unresolved by the society. Perhaps if people would read these stories, the society could come up with solutions to the problems at hand.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   If I were made to choose a favorite among the feature stories, I would have to choose Faulkner’s â€Å"A Rose For Emily.† Aside from its innovative use of point of view through the townspeople, the story touches themes that are both close to heart, like love, and socially relevant like social status. Works Cited Faulkner, William. A Rose for Emily. An Introduction to Literature. Ed. Joseph Terry. New York: Longman, 2001 Hawthorne, Nathaniel. â€Å"The Birthmark†. Demas, C. Various, Mjf. Great American Short Stories: From Hawthorne to Hemingway.   Spark Educational Publishing: USA, 2004 Joyce, James.   Dubliners. Penguin Books: England, 1993 O’Connor, Flannery. A Good Man is Hard to Find. NJ:   Rutgers University Press, 1993

Tomoco Company and Its Marketing Manager Clive Smith Research Paper

Tomoco Company and Its Marketing Manager Clive Smith - Research Paper Example Tomoko Company should not accept the proposal made by Sandeep because it can lead to troubles and financial loss instead of expected profits. Litigation and negative publicity will cause Tomoco billions of dollars even before the product is launched. This case shows that people constantly struggle with the tension between rights and responsibilities, and conscientious people seek to balance the tensions in meaningful and fairways. Also, it is possible to assume that it would be difficult for Tomoko to keep everything in secret and avoid the publicity of this deal. Beyond a person's group is the broad political, social, and cultural landscape of society. Social values are another powerful source of guidelines for ethical decision making (Lipe, 54). These cultural values and traditions are not always positive. Although values are sometimes nebulous, they can be articulated with a considerable degree of accuracy and meaning. This case raises a question: what is the obligation to the org anization? In a commercial context, an employee agrees to give talent, effort, time, cooperation and harmony in relations with colleagues, and loyalty to the organization and its enterprise. According to legal standards, loyalty often involves confidentiality, and for an employee to spread key inside information to an outside audience is a direct violation of the contractual understanding. Organizations have trade secrets that must be kept from competitors, and any revelation of these secrets is a gross violation of contractual expectations.

Family Health Assesment Essay Example | Topics and Well Written Essays - 2000 words

Family Health Assesment - Essay Example This research reveals the results of family assessment concerning the present state of health. Based upon the interview, the following are the summary of the findings for each of the functional health patterns. Gordon’s 11 Areas of Functional Health Patterns is an effective tool in conducting a family assessment and formulating risk, actual, and wellness diagnoses. In addition, some of the Gordon’s 11 Areas of Functional Health Patterns assess a family’s situation through asking many open-minded, family-focused questions. The questions are outlined in this paper. Family assessment revealed verbalization of the family to increase current health state in skin integrity, bowel elimination pattern, activity-exercise pattern, sleep, social interaction, and sexuality pattern. These are called the wellness needs of the family and categorized under wellness diagnoses. Wellness diagnoses are as important as other types of diagnoses in assessing a family. It is not only ob servable problems that should be noted but the request of the family also in improving the present state of health. Much as keeping the family healthy, the family also prioritizes achieving wellness in order to function effectively in the community and to contribute to the development of the overall health status of the community. Therefore, using Gordon’s 11 Areas of Functional Health Patterns will help a lot in identifying wellness diagnoses and improving the quality of life of the family and the whole community.