Service Line Development Term Paper Example | Topics and Well Written Essays - 1250 words

Service Line Development - Term Paper Example Self paying patients have increased from 5 to 8%. These changes have been accompanied by a reduction in revenue from $461.5 million to $427 million – a 7.5% decline. This decline has led to a decline in the hospital’s profit margin from $23.075 million to a negative of $1.495 million – a decline of 106.5%. This decline in revenue appears to have been initiated by the loss of the Obstetrics program and the erosion of general surgery volumes. The number of discharges, patient days, ADC, Surgeries, OP visits and ED visits. The only increase is related to ALOS which increased from 4.0 to 4.3. Zuckerman et al (2002) noted that mandatory health maintenance organizations (HMO) programs have had a positive impact on both adults and children and has resulted in less dependence on emergency room for medical care. There is an increase in the use of preventative care. Zuckerman et al (2002) also pointed to differences in access between people enrolled in Medicaid managed car e and low-income privately insured people. This difference seems to have positively impacted the percentage of patients using Medicaid and Medicare while negatively impacting the percentage of patients using the facility who are insured. Gaynor and Haas-Wilson (1999, p. ... The memos and telephone conversations seem to be pointing towards the legislative mindset of reducing payments to hospitals. There are also changes in how physicians are reimbursed and this has implications for health care in the county. However, although everyone is affected Robert Holland who is not directly employed in the health sector appears to be the only person who knows how to impact the legislative changes to the health care policy. There is an urgent need for improvement in health care policies and the suggestion made by Robert Holland to the CEO – Morgan Reece of working more closely with the Hospital Political Action Committee in order to frame feedback to the legislators is a good one. A member of the hospital board - Dr. Joint, who does not work at the Trinity Community Hospital is concerned that Congress wants to either reduce reimbursement or keep it at the same level while opening the doors of medical facilities to millions. Dr. Joint indicates that the payme nt to physician is not keeping up with cost increases and so the hospital will not be able to recruit any new doctors. This seems to have been the problem when the Obstetrics service was discontinued at the hospital. There is obviously a shortage of doctors which can have crippling effects on health services. This will also turn people away from public health facilities as they will prefer to pay more for private services in order to ensure that they receive quality health care. It therefore means that those who cannot afford private care are the only ones who will visit the hospital. Currently, only some basic provisions can be dealt with in relation to

Unit Assessment 3 professionalism Essay Example | Topics and Well Written Essays - 500 words

Unit Assessment 3 professionalism - Essay Example These interactions create relationships. Each state in the US has its own laws concerning discrimination. For any company, it is important to maintain a workplace that is free from any type of discrimination. Workplace harassment and discrimination may reduce productivity and lowers the employees’ morale. It is, therefore, very important for both management and the staff to work together to reduce this vice. To reduce workplace discrimination and harassment in the workplace, employees can ask the management to put in a formal complaints process just in case there is not one. Employees should not let things go out of hand and should seek assistance from their supervisor or the human resource department if they witness a case of workplace discrimination or harassment. In addition, employees gets hired into an organization they should go through the policies laid down so as not to participate in any acts that may seem like harassment or discrimination. Employees should always report any forms of harassment or discrimination through the proper channels so that employers can deal with the cases and reduce cases of lawsuits and low productivity. According to DuPont (1998), everyone in a n organization should always be professional. For the most, part we notice different thing about people. According to Nelson (2004), one main aspect that we notice about others is their age. Some people may form prejudicial opinions based on this. Most employers are prejudiced when it comes to the older generation. An employee may feel as though they are being discriminated against due to their age when a promotion that they feel they were meant to get is given to a younger employee who does not have the necessary skills to take up that position. The employee may have the necessary skills and more than enough work, experience and still be passed off during an offer for a

Science and Mathematics Should be Taught in English Debate

Science and Mathematics Should be Taught in English Debate Is it necessary for our government to implement learning Mathematics and Science in English? This has been a big issue among students lately because it is said to disturb their routine lifestyle of studying. Basically, we know that our Malaysias education system encompasses education beginning from pre-school to university. Pre-tertiary education (pre-school to secondary education) is under the jurisdiction of the Ministry of Education (MOE) while tertiary or higher education is the responsibility of the Ministry of Higher Education (MOHE). The vision of the Government is to make Malaysia a centre of educational excellence. The implementation of English language in Mathematics and Science has made a new aim in our education system now. Let us look back to our main point, which is why the teaching of Mathematics and Science in English has become a controversial issue, and several recommendations are made to resolve the issue. Malaysia is a multicultural and multilingual country with Malay as the official national language. In order to unify the nation, a national education system with Malay as the medium of instruction is being adopted for all primary and secondary schools. In 2002, the government announced the implementation of a new policy in the national education system; English is made the language of instruction in schools for the teaching of Mathematics, Science and technology subjects. These subjects had formerly been taught in the Malay language. English as the language of instruction for Mathematics and Science (ELIMS or PPSMI as it is known in Malay) was implemented in stages, starting in 2003 for standard one (first grade of primary school), form one (first year of lower secondary) and the lower six (first year of upper secondary school). The decision to use English was based on the rationale that mastery of English is regarded as an important mechanism for direct acquisition of knowledge in t he field of science and technology (Ainan, 2003). The first controversial issue is that learning English in a second language is seen as unsuitable when children encounter difficulty in interpreting the meaning of Mathematics and Science discourse. The purpose of teaching Science and Mathematics in English is to enable students to acquire proficiency in English while learning Science. Many educational issues are crucial when learning takes place in students second language. In Malaysia, most learners encounter English for the first time in school. They find it harder to adapt the new change in our education system. This inadvertently impairs students learning abilities since learning in these subjects may be compressed within a complex linguistic classroom. The problem of learning Science through a second language is compounded by other factors, such as teachers who are not proficient in English and the lack of good Science textbooks (Ong, 2004). The government cant come up with a good explanation when the issue of teachers who are not proficient in English were debated in the parliament because they were too busy in governing the economy of our country. The second most controversial issue in implementing English in teaching Mathematics and Science is that the non-Malay students who are the majority residence in urban areas indicated their preference of the use of English in learning Mathematics and Science while the rural students, were not supportive on the use of English language. Malaysian students and teachers are multicultural and have multilingual backgrounds. The implementation of PPSMI created great concern among parents and educators on the quality of Mathematics and Science education as both teachers and students are not proficient in the English language (The Star, 2006). This is expected as Malay language has been the language of instruction for more than four decades. Moreover, the teaching of non-science and Mathematics subjects in schools continue to use Malay language. In a study to provide some baseline data for this concern, Juriah Long and colleagues (The Star, 2006) found that 60% of Mathematics and Science teach ers were not fluent in the English language while only 45% said they are comfortable in using the language to teach. The students from the rural area find difficult to adapt and score in Mathematics and Science subject compare to the students from the urban areas especially the non-Malay student can do better as they are more suitable in the second language compare to Malay language. If these matter continue, it will create havoc among the people in our country and this time, it will be worse than the 13th May tragedy. The implementation of English in teaching Mathematics and Science should be carry out and the government have come up with some solutions in improving this policy to overcome these problems. In order to compensate for students weakness in English language, the teacher must take on the role of a translator in class. The teacher describe the teaching in the class as using first in the English, then repeat the explanation again in Malay for the benefits of those who have low English proficiency. More time will be needed to convey the same concept compared to when Malay language was used as the medium of instruction. Teaching time for Science and Mathematics may need to be increased. It is recommended that teachers continue to carry out code switching when conducting their Science and Mathematics lessons. In addition, teaching strategies may need to be modified so that students will not be denied a quality Science and Mathematics education. So far, much of the thrust of this policy has f ocused on upgrading the linguistic skills of teachers and providing them with technical support. Even extremely proficient and experienced teachers cannot teach their subjects entirely in English if the students are incapable of understanding them. This finding is supported by the information released by the Ministry of Education based on the mandated national level public examinations for all form three students (The Star, 2005). They found that despite learning Science and Mathematics in English for three years, only 33% of the Science candidates and 27% of the Mathematics candidates used English to answer questions. Most of the candidates, however, preferred to answer in either Malay or a mixture of both languages. For valid assessment of Science and Mathematics, the use of dual-language test-booklet as a language accommodation need to continue to ensure students are assess on their Science and Mathematics achievement and not their language ability. The government should be positive minded in enhancing the knowledge of our future students by implementing the policy of teaching Mathematics and Science in English so that our country can produce more efficient and dedicated students who are high in knowledge and good proficiency in English language. Thus, the linguistic abilities of their students are crucial in deciding to what extent teachers can implement PPSMI. All the teachers show their main concern when teaching in English, making sure that students could understand the lesson. It is almost a reflexive action among teachers that as soon as their students look lost or seem unable to comprehend, they resort to translating the terms or specific portion of that lesson. Therefore, in classes where the majority of the students are academically able and linguistically proficient, the teachers must teach their lessons entirely in English. Meanwhile, with weaker classes, these teachers should use more Malay in class, by way of transl ation. As a result, instead of teaching Mathematics and Science in English, many teachers will end up teaching these subjects in English and Malay. This pedagogical response has much to do with the pressure that teachers feel about covering the syllabus within specific timelines so that students will be ready for school exams and mandated public exams. These exams take place at set times during the school year. This being the case, on the spot translation offers them the fastest route to achieving their goal of increasing students comprehension.

24 Hour Society :: Economics

24 Hour Society Objective 2 Â · What is the 24 hour society? Â · Describe the growing 24 hour society? Â · In special detail explain the reason for the growing number of E-commerce and 24 hour supermarkets and specialised stores? Analysis of main elements of the system. These days extended working hours are not uncommon. The 24 Hour Society is one in which certain activities are performed around the clock. The old saying "there is a time and a place for everything" no longer holds true. This trend is partly driven by the levels of convenience demanded by consumers, but also enabled by changes in legislation and the increasing opportunities provided by technological innovation. GRAPH When using the library I will look in books with the most relevancies to my objectives, for instance I would want to look up why shops decided to become E-commerce and not just lists of E-commerce shops although this could also be partly relevant. Using the Internet will be very difficult for this case study, the reason for this is because if you search using the keyword 'E-commerce', '24 hour' or '24 hour society' many of the results will be just online shops with out information of the reasons they become E-commerce, however some other reports published on the 24 hour society might be useful. Interviews will also be quite hard but not impossible. It is not easy to find someone who has an active role in E-commerce businesses this is because of the 'junk' on the Internet. Detailed research plan. Visit County Library Using Library search engine input "24 hour society" and other variables Note down the placement number of the section Go to that section and collect books that seem most relevant Scan through books and look for information on the 24 hour society Mark places in books with bookmarks Check out the books and take them home for heavier research Find a computer with Internet access Go to a search engine such as http://www.google.com / http://www.yahoo.com / http://www.ask.co.uk Type in the key work '24 hour society' Scan through search results for relevant sites If sites are too general try using bouillon commands such as '+', 'AND' or 'NOT' From results copy relevant information in to a word processing program such as Microsoft Word and edit it down in to useful points Save and print Find a person with information you would like to here from him/her Ask if you could record the conversation to write the report Ask the person the questions and push for a detailed response

Language and Imagery in Wuthering Heights Essay

In Wuthering Heights, Emily Bronte uses Language and imagery to create a very stark contrast between Heathcliff, and Edgar Linton. This contrast is not only illustrated in how these characters act, but also in their appearance, usual setting and the language that is used to describe them. Emily Bronte first uses the raw basics of the characters Heathcliff and Edgar Linton to right away let us know that these characters are polar opposites. She does this with the imagery of both characters. In chapter 7, Heathcliff describes Edgar as having light skin and fair hair, whereas in the same chapter it is mentioned that Heathcliff has dark hair and dark skin. This use of binary opposites suggests to the reader already, that Heathcliff and Edgar are complete opposites, right down to their core. This use of Binary opposites and imagery is also applied to where Heathcliff and Edgar live, Edgar living in Thrushcross Grange, the light, large house, and Heathcliff living in the dark, gloomy and sinister house of Wuthering Heights. This imagery of the two houses reflects the characters of the two men. Language is also used effectively and in abundance by Bronte to illustrate the two characters differences. Bronte uses contrasting Lexical fields pertaining to heaven and hell to not only show the contrast in character between Heathcliff and Edgar, but to suggest that one is good and one is evil. For instance Heathcliff is constantly being described as or being referred to with the use of words which relate to hell. His eyes are described as ‘devils spies’ and ‘ dark fiends’ by Nelly, and coupled with his appearance of being dark skinned and haired, he is closely associated with the devil, who represents evil. Edgar on the other hand, is described with a lexical field of a more heavenly nature. His eyes are referred to as being little Angels and his features are continuously called angelic and soft, which suggests he is similar to an angel, which is of course good. By using contrasting lexical fields for each character, Bronte uses selective language to suggest that these two are not only opposites, but they are Good and Evil. Heathcliff is, when being talked of, surrounded by sinister sounding words which aren’t necessarily talking about his character explicitly, but they help to create a dark and sinister atmosphere around his character. An example of this is in chapter seven where Nelly is talking about Heathcliff she uses words such as ‘lurk’ and ‘vicious’ and this is what creates this dark atmosphere. Bronte does the same with Edgar, as when he is talking or being talked about, words such as ‘gently’ and ‘beautiful’ are used and this helps to project a calm and soft atmosphere around Edgar, which is completely different to the atmosphere Heathcliff carries with him, and thus increases the contrast that the reader sees between Heathcliff and Edgar. Catherine brings our attention to the contrast between the two in chapter 9 where she says ‘(Heathcliff’s soul) and Linton’s is as different as a moonbeam from lightning, or frost from fire’ This use of binary opposites again suggests with the use of the words fire and lightning that Heathcliff is violent and harmful and burns, which again associates him with hell, and the use of Frost and moonbeam to describe Edgars soul to suggest he is soft, light, cool and calm reinforces the already stark contrast between the two and again suggests them not only to be different, but to be complete opposites. The fact that to most readers it would be obvious as to which out of either Heathcliff and Edgar is the fire and lightning shows how Bronte has been slotting words into the text as well as the individual characters, to make the reader associate Heathcliff with hell, and Edgar with Heaven. In conclusion, Bronte uses particular lexical fields which are binary opposites to each other and applies them to Heathcliff and Linton to exacerbate the contrast seen between the two. Bronte also uses imagery of their physical appearance and living place, paired with continuous subtle language choices to make the reader associate Heathcliff with Hell, and Edgar with Heaven, and this makes us not only see the two as contrasting characters, but bad and good, and at the completely different ends of the spectrum.

People Are Just as Happy as They Make Up

â€Å"People are just as happy as they make up their minds to be. † (F) What is happiness and how is it achieved? Simple questions, with different complex answers, none of which can be proved to be right or wrong. Happiness is an individual state of being of each person, acquired by one’s perception in that special moment in time. It simply depends on the individual and how they try to obtain it. Thousands of people try different paths in order to successfully achieve happiness; some of them finding it, some of them never reaching the goal. There are thousands of different answers and meanings for happiness.In this paper, I will argue that the most necessary virtue an individual needs to be have to be happy, is the virtue of mind. Aristotle, one of the most important Greek philosophers in history, defined happiness as the activity of the mind in accordance with virtue. He did not think of happiness as just a state of being; he thought of happiness to be the highest form of good. Everything people do has a specific purpose in life; it aims at something, at a final good. Happiness is an end sufficient in itself, is the end at which all our actions aim.In order to reach this perfect state, he thought the individual should possess; external, mind and bodily virtues and living and acting in accordance to them. By doing so, achieving total happiness. Virtue is what aids proper functioning, since when possessed makes the possessor good. Virtue is a matter of having an apt attitude towards pleasure and pain; therefore it lies in a mean between two extremes. Aristotle implied the mean or balance to be between two vices, the excess which is the one that exceeds and defect the one that falls short, of what is right in our desires and actions.Whereas virtue, finds and chooses what is intermediate. The idea of the virtue then, is for the desires to set the situation and for the individual to be able to choose the intermediate and act like a virtuous person. Ex ternal pleasures; such as honor, wealth and power. Physical pleasures such as beauty, health, and fertility. And mental pleasures such as; patience, intelligence and honesty, are the virtues he believed lead to a good life. In order to achieve happiness, is necessary to be a virtuous person. If the individual does not have virtues, then it does not have anything to guide heir lives by. That being said, the most important virtue to possess is the virtue of the mind, which refers to peace of mind. After being able to attain peace of mind, accomplishing the other virtues and making good use of them is much easier, since mental pleasure is the basis of every other virtue. Positive thoughts, security, believing and accepting oneself, high self-esteem and more, is what makes one happy and leads the individual in the pursuit of more positive actions, therefore making the individual more likely to obtain the other virtues.The way one thinks of themselves and the attitude that one has about life tells a lot about a person. People who have virtue of the mind are going to be happy no matter what, because they know how to react towards life, even in the moments of misfortune or disgrace. For example, people who are going through hard times know how to handle the situation better because they have a positive outlook on life and are able to cope with those situations better. People who have virtue of the mind also know their various challenges and obstacles and are still able to overcome them.Having peace of mind, and knowing how to make good use of one’s internal virtues, is an effortless way to live one’s life and have a better future. By accepting oneself intellectually, physically and interiorly, as well as accepting the environment in which one lives, including the people, the traditions and society, to the point where one respects the other people, including their acts, their way of thinking and their way of living. Peace of mind is not worrying about th e future or for the things that happened in the past.But to live the present in an authentic and exceptional manner, to not worry some day about the things you should have done before but to be satisfied and happy of how has lived their lives. Virtue of the mind also means to love oneself more than anything and anyone, since to love and care for someone one must first learn how to know, care and love themselves. Someone might object that the virtue of the mind is not the most important virtue to have since nowadays to have positive thoughts and a peaceful mind it’s not enough to make someone happy, but wealth and influence.Being beautiful, honest, intelligent, and healthy is nothing if one does not have money. Most people are always in the persistent struggle to be prosperous, given that the people who do not have money are miserable because they do not have â€Å"anything. † Poor people for example, are not happy, even though they possess physical and mind virtues; th ey lack external ones, such as money and are unfortunate because without wealth you are nothing. In the society of nowadays, being wealthy is not an option, but a must to be happy. One might object to it, but how can one explain that some wealthy and influence people are unhappy.Wealth and influence does not give people happiness. Just a positive attitude towards life would give someone the final good. There are some famous people that despite great wealth seem miserable. Some of them don’t even have a stable partner, usually get in trouble with the law all the time, fall in the live drugs, and some of them even commit suicide. Heath Ledger, for example, known as one of the best actors in history for the leading role of the joker in â€Å"The Dark Night†, recognized as one of the best-selling movies of all time.Famous, with family, wealthy and in the media everywhere, but despite all that â€Å"happiness† he had, he still committed suicide, possibly caused by a depression of not fulfilling the expectations of the fans or even not knowing how to cope with the pressure of the role. For some people money can bring a lot of happiness in the sense of stability, freedom and independence. However, money with lack of peace of mind is nothing and would get the individual nowhere.A survey titled â€Å"Joys and Dilemma of Wealth† by Boston College revealed that the wealthiest people are unhappy because they are worried about seeming ungrateful, rearing spoiled children and failing to meet expectations. These people are in the mouth of everyone; their names appear in the media with false gossip, and their privacy is always intruded. This a mistake where the individuals centered their lives on the external, and are concerned too much about what other people think without believing in themselves, leading them not only to auto destructive acts but violent actions for them and their families.For some, money and wealth gives happiness, but definitel y not the truly one. Only mental pleasure; believing in oneself, having a positive attitude, having high self-esteem and loving oneself like no other, would lead one to complete happiness. Material or external possessions are not essential, if the individual knows and recognizes what their goals in live are. To corroborate the importance of the virtues of mind to reach happiness, first of all the individual needs to realize and be aware that happiness is an internal state of being of each person.There are numerous amounts of people in the world who could serve as examples to support the importance of the virtue of mind in the path of achieving happiness. Nelson Mandela, for example, one of the most recognized, respected and admired political leaders of our time. In spite of the extremely poor conditions he had to live in during his early life and nearly three decades of imprisonment, he still struggle and did everything he could to fight for his believes against racial oppression.Hi s heroic acts made him win the Nobel Peace Prize and the presidency of his country. By this and many other important things that he has done, is when he saw his ideals and purpose in life, coming true. Most likely, giving him the complete happiness he has always fought for. Nick Vujicic is an admirable person, and another great example of the importance of just having a positive attitude towards life to be happy. Nick was born with no limbs, he is practically just torso, and has a small foot on his left hip which helps him with balance.Nick’s father taught him to swim at 18 months, to type with his little toe at just 6 years of age, and his mom invented a special plastic device for him to hold a pen or pencil with his mouth to be able to write. He plays golf, swims and surfs. Even though it was really difficult for him to adapt to his difference when little, he overcame every issue he had and nowadays is an admirable person, who has traveled to 24 countries of the world shari ng how this problem has become a blessing for him, and how just by changing your attitude towards life makes a great difference in every individual.Just like these examples, there are many more cases of people that just by having a positive attitude towards life have been able to succeed or overcome obstacles even though they have had a hard life. Supporting that if an individual has virtue of the mind, and has always a positive view, fights for their ideals and know what they want for their life they will achieve happiness. DO NOT USE â€Å"YOU†Ã¢â‚¬ ¦ Works Cited Little, Lyneka. Miseries of the Rich and Famous: The Concerns of the Super Rich: Wealth Does Not Bring Happiness-ABC.Bill & Melinda Gates Foundation and Calibre Wealth Management, Boston College. 21 March. 2011. Web October 14. http://plato. stanford. edu/entries/aristotle/ http://answers. yahoo. com/question/index? qid=20080716235657AAyU5iY http://www. britannica. com/EBchecked/topic/34560/Aristotle/254722/Happine ss#ref923103 http://abcnews. go. com/Business/concerns-super-rich-wealth-bring-happiness/story? id=13167578#. UHsgpMVYuSo ——————————————– [ 1 ]. Abraham Lincoln

Dude and Dudette

Dude and Dudette Dude and Dudette Dude and Dudette By Maeve Maddox The greatest Dude of all is without question Jeff â€Å"the Dude† Lebowski. But when did the word dude become a title to aspire to? When I was growing up, dude was a word to denote a somewhat prissy man concerned with nice clothes and clean fingernails. We even used the word as a verb: Well, look at you in that fancy outfit! You’ve really duded up for the occasion. In the context of the Wild West, a dude was an inexperienced Easterner or European being introduced to the rougher manners of the frontier. Once the West was tamed, the â€Å"dude ranch† came into being: a working ranch that catered to guests who wanted to play at being cowboys and could pay well for the privilege. The OED defines dude as â€Å"A name given in ridicule to a man affecting an exaggerated fastidiousness in dress, speech, and deportment, and very particular about what is aesthetically ‘good form.’† The first documented use of the word is from 1883. The OED citations indicate that it originated as American slang to describe young men who affected the dress, manners, and speech of an English gentleman. The Online Etymology Dictionary says that dude may derive from Yankee Doodle, a plausible idea, considering the lyrics of the song: Yankee Doodle went to town Riding on a pony; He stuck a feather in his hat, And called it â€Å"macaroni.† Macaroni was mid-18th century British slang for an Englishman who affected Continental fashions and behavior, incurring the ridicule of fellow citizens who valued â€Å"plain Englishness.† The American dude affected what to Americans were overly fastidious British mannerisms. According to Online Etymology Dictionary, dude to mean fellow, chap, buddy, guy, individual, etc. was in use by 1966, â€Å"originally in Black English.† Google Ngram Viewer shows the use of dude rising precipitately from the 1960s to the present. Dudette as the feminine of present-day dude is a recent surfer slang coinage dating from the early 1990s. Its existence is not yet acknowledged by OED, M-W, or the Ngram Viewer. Feminine forms existed for the earlier dude as well: dudine and dudess. Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Vocabulary category, check our popular posts, or choose a related post below:7 English Grammar Rules You Should Know"Certified" and "Certificated"Neither... or?