Significant Health Care Event Paper Essay Example for Free

Significant Health Care Event Paper Essay Abstract This paper will attempt to discuss events that has changed or affected health care of today. Over the years health care has been influenced by numerous events throughout the United States history. Some events have contributed to the shaping and improvement of the American people’s health care needs. This influence includes society, culture, finance, religion, politics, technology, health trends, the environment, and population (Shi Singh, 2012, p. 9). These influences has contribute to the United States health care evolution that has and continues to impact and access the health care of the American people long with his or her personal values and beliefs. Significant Event’s In the recent years there has been more and more litigation over health care. In today’s society advertisements a springing up all over the place for litigations against health care professionals, health care facilities and pharmacuetal companies. These advertisements are being placed on the television, on the radio, over the internet, on billboards and public transportation. Lawyers are now specializing in significant health care conditions or diseases. This in itself has placed a huge burden on the health care profession and facilities. Some health care facilities have ended up shutting its doors because of the financial burdens of payments, malpractice premiums, and other financial burdens associated with additional procedures to avoid litigation (Satiani, 2004). Health care facilities and  professionals are spending billions of dollars on defensive medicine (Satiani, 2004). These health care dollars are needed elsewhere to improve health care practices such as implementing preventative care, research, and insuring the uninsured. Another effect on the health care is the Patient Protected and Affordable Care Act. The protection and affordable Care act was established to ensure that all Americans have access the quality and affordable health care. The Patient Protected and Affordable Act will help create a healthier health system by contain cost. President Obama has placed a limit of $900 billion to cover the cost of the Patient Protected and Affordable Care Act. This $900 billion will cover 94 percent of Americans according to The Congressional Budget Office making the Patient Protection and Affordable Act completely funded. During the next ten years and beyond the Patient Protection and Affordable act will help to curve the high cost of health care and reduce our state deficit (Responsible Reform for the Middle Class, n.d). Impact on the Historical of Health Care These two events have both a negative and positive impact on health care. The litigations can distract the ability of the American people to receive the adequate health care when needed. Financial facilities and professional are unable to give his or her consumers the consistent level of quality and be cost-effective (Shi Singh, 2012, p. 5). The Patient Protection and Affordable Act give the patient guarantee passage way to quality affordable health care, Improving the quality and efficiency of health care, prevention of chronic disease and improving public health, and improving access to innovative medical therapies (Responsible Reform for the Middle Class, n.d). Excessive litigations lead to the limitation of services that are provided by the health care facilities and professionals. Litigations increase the cost of services, it reduces accessible to facilities, and decreases trained staff. Out of fear health care providers and facilities either increases or decreases unnecessary and necessary procedures because of the high risk for litigation which takes the primary focus off the patient (Catino, 2009). The result of excessive litigation may be stagnation; the system is unable to grow because of the high costs for provision on care and the inability of everyone to receive consistent care. The positive effect of health care litigation occurs because it places a value or consequence on the effect of malpractice. Health care facilities and professional work to develop policies and practices that reduce the harm done to the patient partially because of the cost associated with neglecting to do so. Health care litigation can be a source of help for families who are affected by malpractice, especially if needed to provide further care for those affected. The problem with health care litigation lies, not with those with genuine cases, but with those who attempt to use the system to file false claims for profit. People do not realize that the cost of legal fees is offset by passing the cost to the patient. Unfortunately, most of the money gained during the litigation process does not always go toward the patient/s filing the litigation; according to Satiani (2004), an estimated 57% goes to the attorney and 43% to the patient. Personal Belief on Event’s Significance I believe that excessive litigation is a significant event in health care. It affects many aspects of care and reduces the ability of patients to access the care needed. If people continue to abuse the legal system by filing false claims we will continue to see a rise in the cost of health care. The United States health care system and the citizens must create a culture of honesty. The health care system must provide adequate, timely care to citizens, and citizens avoid false prosecution for personal gain. Conclusion Excessive litigation is an emerging trend in health care. Litigation was intended as a route for citizens to receive compensation for injuries related to malpractice, but is becoming a way of life for the legal system. Lawyers and law offices specialize in health care litigation and most Americans see or hear at least one advertisement for litigation per day. The cost of litigation on the health care system is high and unfortunately the people who pay the cost are the citizens because health care facilities, private practitioners, and insurance companies offset the cost by redirecting it on the patients. The cost of excessive litigation may be too high for citizens to pay. References Catino, M. (2009). Blame culture and defensive medicine. Cognition, Technology, Work, 11(4), 245-253. doi: http://dx.doi.org/10.1007/s10111-009-0130-y Catino, M. (2009). Blame Culture and Defensive Medicine. Cognition, Technology, Work, 11(4). 245-253. doi: http://dx.doi.org/10.1007/s10111-009-0130-y Satiani, B. (2004). The economics of health care litigation. Vascular and Endovascular Surgery.38(3).287-90. doi: 15385744 Shi, L., Singh, D.A. (2012). Delivering Health Care in America: A systems approach (5th ed.).Boston, MA: Jones Barlet. Responsible Reform for the Middle Class. (n.d). Retrieved from http://www.dpc.senate.gov/healthreformbill/healthbill04.pdf

Decrease Ventilator Associated Pneumonia

Decrease Ventilator Associated Pneumonia Patients on ventilator support are very prone to respiratory infections. These patients have no means or control over what enters their lungs or what does not. One prevalent infectious process that can occur in these patients is ventilator associated pneumonia (VAP), and affects many patients every year who require ventilator support. Ventilator associated pneumonia is a form of pneumonia, a lung infection, which occurs in mechanically ventilated patients. It develops at least 48 hours or more after the ventilator is utilized (Powers, 2006). Ventilator associated pneumonia is caused by bacterial organisms entering the patients lower respiratory tract usually by aspiration of oral pharyngeal secretions. The bacteria colonize within the lungs causing immune response or infection to occur (Powers, 2006). The development of this infection can lead to a decline in the patients outcome and increased healthcare cost to the patient as well as the health care facility (Mori, 2006). With all t hese problems VAP can produce it is important to the patient as well as healthcare providers to be able to find ways to reduce the development of VAP cases in patients. The purpose of this paper is to determine if routine oral care can decrease the incidence of ventilator associated pneumonia in mechanically ventilated patients. The picot question guiding this paper is what effect does routine oral care have on the incidence of ventilator associated pneumonia rates in mechanically ventilated patients. Background and Significance Ventilator associated pneumonia is a serious infection affecting both the patient, healthcare facility, and staff. It is the second most common healthcare-acquired infection (Koening, 2006). Incidence of VAP is estimated as high as 65% and it occurs in up to 28% of patients who have been on the ventilator 48 hours or longer (Powers, 2006). The mortality rate associated with VAP ranges from 12-50% (Sona et al, 2009). Studies on the mortality rates of VAP also show that patients who develop VAP have a 2.2 to 4.3 times higher risk of death compared to other mechanically ventilated patients who do not have pneumonia (Powers, 2006). A couple affects that VAP has upon the patient and healthcare facility are time of hospitalization and healthcare costs. Ventilator associated pneumonia causes the length of a hospital stay to increase significantly. It can increase the hospitalization time anywhere from four to nineteen days longer (Powers, 2006). This extra hospitalization can cause additional stress for the patient and their health. As the incidence of VAP causes longer hospitalizations to occur, patient and health care facility costs climb also. It is estimated that the average increase in hospital costs is around $57,000 per VAP occurrence (Powers, 2006). There are also increases to the hospital that occur due to increases in supplies used, staff that is utilized, and more medications used. Since VAP has such a negative impact upon patients and healthcare facilities many interventions have been tried to prevent the incidence of VAP. One intervention utilized is keeping the head of the patients bed raised to at least thirty degrees to prevent aspiration of bacteria in secretions. Another is sedation vacations which consists of interrupting the patients sedation medication until patient shows signs of alertness, to assess if patients can be weaned off the ventilator more quickly. Other notable interventions that have been utilized in the past and some in todays practice as well include: suctioning secretions, good aseptic techniques such as hand washing, and oral care (Pruitt Jacobs, 2006). Patients are continually developing VAP and having complications from the infection. If it is found that routine oral care, defined as teeth brushing with the use of an oral antimicrobial within this paper, can reduce the incidence of VAP in mechanically ventilated patients it could decrease length of hospital stay, keep costs due to incidence of VAP down for both patient and healthcare institution, as well as decrease mortality rates in these patients. Clinical Question Ventilator associated pneumonia occurs way too often in the hospital setting. It causes significant stress on the patients already problematic health status. The writer of this paper has observed many nurses who are vigilant in providing oral care to ventilated patients, but has also observed other nurses who forego oral care as if it not important and has no affects upon the patients health. This made the writer question what the actual effectiveness of oral care has upon reducing the incidence of ventilator associated pneumonia in mechanically ventilated patients. This issue is very relevant to nursing because the ultimate goal of a nurse is to help the patient have the best possible outcome. Trying to achieve the best possible outcome for the patient makes infection control is a very high priority for nurses. Patients who have infections are more prone to get other infections and require more nursing care and more time to recover from their illnesses. Although VAP will continue to occur in patients, and oral care is not a cure for ventilator associated pneumonia, there is valuable information included in research studies included within this paper that shows the incidence of VAP can be reduced in mechanically ventilated patients by implementing routine oral care. Empirical Review 1 The purpose of the first study, conducted by Sona et al, 2005 was to determine the effect of a routine oral care protocol upon incidence of ventilator-associated pneumonia. The research design was a quantitative, experiment, quasi-experimental study which utilized a non-equivalent control group before and after the design. The study had no conceptual framework stated by the researchers. Within the study, the variables of significance to the clinical question being looked at were the routine oral care protocol and the ventilator-associated pneumonia rates. The independent variable of new oral care protocol was defined as the mechanical cleansing of the teeth or gums to remove plaque with a tooth brush and the application of an oral antimicrobial. The study went on to further discuss the protocol as brushing the teeth for one to two minutes with a regular toothbrush and then applying .12% chlorahexidine to all oral surfaces every twelve hours. The dependent variable was the ventilator associated pneumonia rates. It was defined as a common hospital acquired infection and is the leading cause of death in ICU patients who are ventilator dependent. Ventilator associated pneumonia rates were measured using the National Nosocomial Infections Surveillance System (NNIS) criteria.The reliability nor the validity of this instrument was addressed within the study. Another variable that was studied was length of stay. This was just measured by the number of days that the patient spent within the ICU after a ventilator associated pneumonia infection occurred (Sona et al., 2009). This study took place at Barnes Jewish Hospital on a 24 bed intensive care unit (Sona et al., 2009). The study focused particularly on patients that were admitted to the surgical intensive care unit (SICU) whom required mechanical ventilation. The subjects consisted of all patients who had mechanical ventilation between June 1, 2003 and May 31, 2005. Subjects were chosen using non-probability convenience sampling. The pre-intervention was implemented for patients that were admitted between June 1, 2003 and May 31, 2005. The size of this sample was 777 patients. The pre-intervention phase consisted of standard care the nurse provided to the patients, no changes were provided during this time; only observation took place. One month before the end of the pre-intervention phase all nursing staff working on the SICU were debriefed and educated on the aims of the study as well as the new routine oral care protocol by two clinical nurse specialists and a nurse educator. This was to help pre vent discrepancies in the intervention. During the post intervention phase of the study which took place between June 2004 until May 2005 the sample size consisted of 871 patients who were all nil per os (NPO) (Sona et al., 2009) On June 1, 2004 the new routine oral care protocol was implemented (Sona et al., 2009). The intervention/protocol consisted of the nurse brushing the teeth of the patient for one to two minutes with a regular toothbrush, rinsing the mouth with water and suctioning it out, and then using 15 mL of .12% chlorahexidine to cleanse the mouth. The intervention was repeated every 12 hours by the registered nursing staff. Compliance of the protocol was estimated to be around 90% and the implementation was carried out for 12 months before results were analyzed(Sona et al., 2009). For this study the level of significance was expressed using p-values. A p value of less than .05 was considered significant (Sona et al., 2009). For the data analysis, two statistical tests were used: The Mantel-Haesnel Chi Squared . After the analysis of data, it was determined that p=.04 showing that the routine oral care protocol did cause a significant reduction in the ventilator-associated pneumonia rates within the subjects studied. The pre-intervention rate for VAP was 5.2 infection per 1000 ventilator days while post-intervention rate for VAP showed 2.4 infections per 1000 ventilator days (Sona et al., 2009). Other statistics for the study showed the patients number of days the patient was on ventilator was decreased(Sona et al., 2009). From the statistical analysis within the study, the researchers derived certain findings and conclusions (Sona et al., 2009). One of the findings was that the post intervention group had trends toward shorter time on the ventilator, as well as length of hospital stay. The main finding within the study found that when the routine oral care protocol was being utilized, the rates of ventilator-associated pneumonia were significantly decreased. The researcher makes it a point to state that although the finding suggests that the implementation of the protocol reduces rate of VAP this cannot be proven (Sona et al., 2009). This study is a nonrandomized controlled trial. The quality of this evidence was convincing and significant. It was a consistent study and it is considered to be of Level II quality. Certain extraneous variables that could have had an effect upon the outcome of the study, as identified by the student, could have been the condition the patient was in before the ICU admission, any pre-existing conditions that could alter health and increase the risk of infection, and the nurses attitude toward performing oral care. Although the study was a strong and consistent one, it did have both strengths and weaknesses. There were no strengths identified by the researchers. However, the student did identify some strengths within this study. One of the first strengths was the education that was given to the nursing staff prior to the implementation of the protocol. This helped the study to be more valid by increasing the continuity of the care and way the nurses performed the protocol. The other strength of the study was the design being a quasi-experimental. This is because quasi-experimental studies usually can be generalized to the population that is being studied. Weaknesses that were addressed within the study by the researchers was that the researchers themselves did not evaluate the teeth brushing portion of the intervention to make sure that the nurses were being consistent in the way they did it, and if the nurses performed it for the correct amount of time (Sona et al., 2009). This resulted in the lack of control over nursing techniques. Another weakness of the study recognized by the researcher was the study did not take into account the change in the patient population over the duration of the study (Sona et al., 2009). Some weaknesses the student identified within this study was that the study was very susceptible to bias because no blinding or masking was used within this study. Everyone knew what was occurring and this could have had the researchers looking as if the intervention helped more than it actually did. Within the study the researcher did not address if the study could be generalized. However, the writer of the paper believes that this study can be generalized. The intervention is a very simple one. Most cultures have no problems with utilizing oral care. Also, most hospitals have intensive care units and/or ventilator dependent patients which were the population within the study. This intervention within the study does not have a lot of risks. The only risks mentioned were possible tooth staining from the antimicrobial and poor taste (Sona et al., 2009). Also, this intervention is very feasible. To implement oral care there is no special training needed, although education should be provided. The oral care routine is a relatively quick intervention that takes no more than 5 minutes to implement, which would allow nurses with busy schedules to still be able to perform the intervention. Also, this intervention is very low cost compared to the cost of ventilator associated pneumonia c ases. Therefore, the cost-benefit ratio would be a great benefit to health-care facilities. This study suggests that oral care can be very effective in decreasing the incidence of ventilator-associated pneumonia rates. Although a very valid study, one study is not enough evidence to implement a new protocol into a nurses practice. One must look for more studies and literature to support the finding in order to attempt to implement it into practice. The next study that was appraised by the writer of this paper seems to support the findings that were found in this study. Empirical Review 2 The next study examined by the writer of this paper was a research study conducted by Mori et al.,2005. The purpose of the study was to determine if oral care of mechanically ventilated patients contributed to the prevention and reduction of the incidence of ventilator associated pneumonia (Mori et al., 2005). The research design utilized for this study was a quantitative, experimental, quasi-experimental which used a non-equivalent before and after approach. Within the study the researcher did not state any theoretical framework to guide the study. The study was not randomized, and used a non-probability convenience sample method (Mori et al., 2005). The research study took place on a medical/surgical intensive care unit in an urban university hospital which was not named by the researcher (Mori et al., 2005). The population of interest was ventilator dependent patients with tracheal intubation. Since subjects were chosen by convenience sampling, they were chosen as they became available on the unit. Inclusion criteria for subjects were that they must have been receiving mechanical ventilation and have tracheal intubation. Exclusion criteria for the study were patients whose conditions contraindicated oral care, patients with severe bleeding tendencies, or patients with iodine allergies. The sample for the oral care group was patients admitted to the intensive care unit between January 1997 and December 2002, and consisted of 1,248 patients. The sample for the non-oral care group, or the control, was patients admitted during January of 1995 until December of 1996; this sample size was 414 subjects (Mori et al., 2005) For this study, the independent variable was the oral care being delivered (Mori et al., 2005). This variable was defined as cleansing of the oral cavity three times a day by nursing employees following the specified new protocol. The protocol was that the nurse would check the patients vital signs and then do oral suctioning, followed by positioning the patients head to the side to prevent asphyxiation and determine the condition of the oral mucosa. After this the nurse would clean the mouth with a 20-fold diluted solution of providone-iodine gargle (antimicrobial). Then the use of a standard toothbrush was used to brush the teeth; the patients mouth was rinsed with water. Directly following the brushing and rinsing, the providone-iodine was utilized again by swabbing the mouth and teeth. Finally, oral suctioning was done one final time. The dependent variable in the study was the incidence of ventilator associated pneumonia. This variable was defined as a hospital-acquired pneumoni a that becomes present after 48 hours of the patient being mechanically ventilated. Ventilator associated pneumonia was suspected if patch infiltrates were present upon the patients chest x-ray and two of the following were present: a temperature of 100.4 degrees Fahrenheit, white blood cell count of 10,000 m3 or higher, or purulent respiratory secretions were observed. A definite diagnosis of ventilator associated pneumonia, which was used for evidence of the incidence in this study, was determined by trancheobronchial secretion cultures showing a result of 1+ or more. Other variables were duration of hospitalization defined as length of stay measured by the number of days and the causative agent of the pneumonia identified by bacterial cultures (Mori et al., 2005). Reliability and Validity of the cultures and radiography used to measure if ventilator associated pneumonia was present and causative agent were not addressed within the study by the researcher, so the validity is unkno wn.

Impacts on Private Savings in Pakistans Economy

Impacts on Private Savings in Pakistans Economy 1. Introduction The term savings describe the unconsumed disposable income which is kept with intention of stabilizing consumption in some future time. Private savings contribute in overall growth of any country and economists consider it as a gauge to economic health. When people start to rely on debts either than their saved cash much more pressure is found on the financial institutions which reduce the strength of any nation. People save in good times so that they have enough funds in their account for the rainy days which are more likely to come in a very frequent pace in countries developing countries like Pakistan. This issue of insufficient funds lead any country towards poverty which is a big threat for all emerging markets which are trying to become prosperous and want to be counted as developed nation of this impulsive world. Pakistani economy is in its developing stage, and this is the reason that is facing a very low saving rate. There are various factors behind this phenomenon. Saving is the key factor which increases future consumption (Kim, 2010), this fact made researcher inclined towards the importance of this topic to be researched and discussed comprehensively. Even though this issue was in consideration by many researchers before but it still need to be considered more as no much conclusive results were found for it in the past. Private savings is expected to contribute overall growth of a country by making it more stable and organized. Several economic and demographic variables are expected to have their valuable influence on Private Savings (Hondroyiannis, 2004); variables in this study are selected by keeping this fact in view. 1.1 Background Private savings are facing a very consistent decline in Pakistan from so many past decades which are not a common trend as other Southeast Asian countries are having a gradual increase in their Private savings. Private savings which become part of national saving after being summed up with public savings; this gives it a vital role in the overall performance of any country. Savings can create intensions of investment specifically on capital stocks which will cause an increase in nation’s productivity, this chain will leads towards raise in wages and consumption and Increased capital stocks also increase employment. Researcher is considering few variables as determinants of private savings which are previously found to have the impactful determinants in past studies. Incomes of individuals is considered as one of the most influential factors in many past studies but evidence is also available that in 1970s and 1980s private savings of Pakistan was having average of less than 17% of disposable income which was very low in comparison with other Asian economies (Husain, 1996). Another evidence which prove strong relation between income and private savings is as stated that pension plan enhance its importance. Income and employment have significant relation with personal savings (Kim, 2010). FDI is also considered to be desirable and recommended to be increased by researchers (Shahbaz et al, 2010). It is stated that whenever remittances increase a very visible increment in National savings is visible, a positive and significant relation was found in the research (Chaudhry et al, 2010). 1.2 Problem Statement In past several studies are done on the topic of private savings (Husain, 1996, Kim, 2010; Lean and Song, 2009; Masson, 1998; Chaudhry et al, 2010). Those studies have identified several variables which are influential on private savings in different countries. This study is being conducted by using recent data and this is the reason that this will add latest knowledge. Thus there is a need of such work to be done in Pakistan by making use of latest data. Dynamic of private savings play a vital role for Pakistans economy where there is lots of instability in economic conditions. Instability of this economy has made it really essential for all the members of this economy to maintain some funds for crucial times. This study will allow all the readers to understand that what factors are affecting this important element in the selected economy. 1.3 Research Question Background of this research gives birth to following research question; Q. What is the determinant of Private savings in economy of Pakistan? 1.4 Research Objective The core objective of this research is to highlight the importance of private savings in Pakistan and addressing key factors which are controlling the behaviour of private savings in positive or negative manner. In order to achieve this broad objective following specific objectives are pursued in this study; To identify the impact of FDI on private savings of Pakistani economy To identify the impact of ADR on private savings of Pakistani economy To identify the impact of REM on private savings of Pakistani economy To identify the impact of INF on private savings of Pakistani economy 1.5 Scope of the Study This study will reveal fundamental issues regarding private savings which will be helpful for the economy of Pakistan. Thematic focus of this study is to determine the factors that are affecting private saving. Geographical focus of this study is the economy of Pakistan. 1.6 Limitation of the Study Researcher is putting all possible efforts in this study, but in spite of that there are always some limitations of research. Limitation of this study is accessibility; due to availability of limited resources data collected for this research is from online sources. 2. Methodology 2.1. Type of Research This is a quantitative research in which numeric data is being analysed through application of statistical model. Deductive approach is being applied in this research where, we are dealing with an existing theory and testing it parametric form of data. Furthermore, this is a descriptive cum explanatory research is being done in this study for understanding the relation between dependent and different independent variables. 2.2.Data Source Electronic copies of required data were acquired from official website of state bank of Pakistan, economic survey of Pakistan and hand book of economics. Secondary data is being used in the research which was available on different websites. 2.3.Sample Size As per the focus of this study, data collected for this research is of Pakistani economy. Researcher is collecting annual data of past 30 years which is from 1984 to 2013. 2.4.Statistical Technique By using SPSS 19.0 data is imported and descriptive and regression analysis is performed on metric data. Application of descriptive analysis has allowed the researcher to explain the data rigorously. Regression analysis is applied to check out existence of relationship between selected dependent and independent variables. 3. Conclusion and Recommendation This research which was conducted in order to reveal important and impactful factors influencing private saving is found to be useful and contribute well. Out of the four hypotheses that were established in this research, three are accepted and one is rejected. Results which were found in the end indicated that, three factors which were foreign direct investment, age dependency ratio and remittance have significant impact on private savings. There is only one variable that has insignificant relation which is Inflation. FDI should also be increased and this could only be done if political situation of our country will become stable as it will make our country more lucrative for the foreign investors. Previously there was a very good and appreciatable trend as many Multinational companies were coming and investing in Pakistan but this trend is now facing a down trend due to bad political and social conditions of the nation. Decrease in age dependency is although causing an increase in private saving but there is a need of making sure that this decrease is not because of bad health condition or child labour. Government must make policies for taking a better care of all these dependent effectively. Remittance is normally considered to be a factor that strengthens economy, but in case of Pakistan, negative relationship is due to ineffective usage of remittance. At this point there is a need of prioritising the needs and wants. Receivers of remittance must ensure that they are using it effectively rather than wasting it. Government can also intervene in this by increasing the taxes on remittance inflow and also assuring that false channels for sending remittance are not being adopted. Inflation in Pakistani economy is a major problem and insignificant relation between inflation and private savings shows that two extreme situations 1) poverty and 2) extreme richness are on their hype in this economy. There is a need of making policies through which equal distribution of wealth can become possible in the economy. This research can be continued further by considering other economic factors which were not covered here. Other dependent variables can also be considered which also contribute in overall growth of any country and thought to be judgemental factor of economic health by economist.

Rates of Reaction - Sodium Thiosulphate and Hydrochloric acid Essay

Rates of Reaction - Sodium Thiosulphate and Hydrochloric acid In this piece of coursework, I will study how concentration affects the rate of reaction. I will do so by timing the reaction of Sodium Thiosulphate with an acid. In this coursework, I will include background knowledge, prediction, safety, results, calculations, graphs, an analysis, conclusion and an evaluation. In my evaluation I will comment on how reliable my results were and how I could have improved my coursework in any possible way. The definition of rate of reaction is ‘The speed at which a chemical reaction takes place’. The factors that affect the rate of reaction are:  · Use of a catalyst  · Temperature  · Surface area  · Concentration I will be investigating Concentration in this experiment. In a higher concentration there are more Sodium Thiosulphate particles. This means there is a higher number of collisions which will have enough energy to react. This causes the rate to increase. The time it takes for a change to take place can be measured and can be estimated. For a reaction to take place 2 reactants must collide and the collision must have enough energy. Prediction I predict that as the concentration of the Sodium Thiosulphate increases the rate of reaction will increase. This can be proved by relating to the collision theory. I predict that as concentration is increased the amount of time taken for the reaction is halved. Safety Issues There are many safety issues that need to be considered while doing this experiment. These include:  · Wearing safety goggles at all times. If acids or any other chemicals are spilt, they would cause serious damage to the skin and eyes.  · Ties and long hair should be kept away from the experiment.  · If an accident ... ... my evidence of this experiment is reliable because I did it with precision and carried it out carefully. I thought that I might have some anomalies but there were not any. I can prove this by using my prediction earlier in the experiment. I said that â€Å"as concentration is increased the amount of time taken for the reaction is halved.† I would have been perfectly right but I made a mistake while measuring. To improve my results, I would use a wider range of concentration and different acid solutions. This would help me to find a pattern and come to a firm conclusion. Overall I think that this experiment was a success as I have proved that concentration does affect rate, and I have also found that when the concentration is doubled the rate of reaction is halved. To draw a firm conclusion I would need to get more results, less inaccuracies and better measuring methods.

Dilemmas in Assessment of Student Writing :: English Writing Teacher Student

Being a new teacher of English, I find the assessment of compositions to be a concept I question and struggle with on a regular basis. Having consulted several colleagues, mentors, administrators, and fellow graduate students, I have come to the conclusion that there is no easy answer to this tedious yet ever important question. While there are many inlets and outlets to this dilemma, for the sake of time I will touch on only three. While all three are very different in terms of concepts, rituals, and conducts, they all come together to one common goal - helping students express themselves in terms of writing. Subjectivity While assessment can give students, parents, and administrators a view of where a student stands in terms of achievement, one must always remember that the grade is subjective. There is no right or wrong answer in English, as there is in math or other quantitative areas of study. The basis of â€Å"a grade† depends upon a student’s ability to choose a course of thought and convey it accurately and convincingly in written form. The subjectivity falls in how the teacher interprets or responds to the ideas and supporting information. For example, during my first venture as a student teacher, I was given the task of grading â€Å"free choice† essays. The students were given free range of the subject matter, and were told to write an insightful and poignant essay on the topic of their choice. After grading the papers, my mentor sat with me and we discussed some of the grades I had given for several of the students’ papers. Upon glancing briefly at the comments I had made and the grades I had given, my mentor began asking direct questions as to why I would grade certain papers one way, but would assign a different grade to others that were quite similar. As she went on to read through other papers, she would agree with some of my grades, but strongly disagree with others. I found this interesting because, while we were both reading the same essays, we were focusing on different points or concepts, which shaded our perception of the piece as a whole. In retrospect, I believe that afternoon spent rereading essays with my mentor was one of the best teaching practices that I have come across. Once in a while, teachers needed to refocus their grading instincts by, in effect, orally defending their stance on grading policies.

Mountain Dew Case Study Essay

Mountain Dew Mountain Dew’s unique way of connecting to the younger generation through extreme sports has become a grand success, consequently many companies are coming up with similar advertisement base Recent threats to Carbonated Soft Drinks in recent years by highly caffeinated and sports drinks have affected their sales. The company advertisement has focus on the young generation and thus quickly rose as Coke’s loyal opposition. They have advertisements harnessing ideas of current generation as well as advertisement promoted by celebrities. All of this pushed their sales up. The Dew Campaign effectiveness: The Do the Dew Campaign has always been about excitement and energy and was successful since the beginning, 1992. The main focus has always been on the cultural trends closely bounded with the youth. There were 3 main trends Rap Music, Extreme Sports, and Gen X culture. Taste in Music was matched to that of the young generation. In early 90s it was it related to rap songs then came the generation of alternate rock songs and later the techno music. Similarly in sports and GenX Ethos, It also became one of the founding leader sponsors of X Games. In the process it mainly target audience was 18 year old males while at the same time it created an appeal to age group 20 to 39. However the impact gradually lowered as other companies started to pick up the trend. The company required a fresh move and they saw an opportunity in recent rising trend that was retro. The committee picked up this trend for recent ad scope. Consequently, they shortlisted many differ ent concepts to five different advertisements after thorough review. Brief perception on them is provided. The Labour of Love Ad – humorous is there but does not create an impression of the brand as an adrenaline rush factor. So not the best strategy unless Dew considers repositioning. The Dew or Die Ad and the Cheetah Ad – The focus is same as before on exhilarating choice and fun and daring. The idea is repetitive in nature hence not as effective. Mock Opera Ad – The cultural trend is Gen X attitudes while at the same time portraying the brand as exhilarating and exciting. This takes care of the predictability aspect of the ads with the Dew Dudes performing the Bohemian Rhapsody. Showstoppers – Similar to that of Mock Opera ad holds on to the image of the brand as daring and exciting while at the same time is less predictable. Response to threat of functional and alternative drinks: In response to non-CSDs, an advertisement campaign must be selected which appeals to the irreverent, daring and fun loving side of the young generation. The citrus flavour in Mountain Dew is its uniqueness. The advertisements can focus on Diet Mountain Dew to appeal to the calorie conscious consumer as the amount of calorie is low. Increase in advertisement is essential. By correlating the cost of the advertising campaign with the sales we observed that there is a high correlation which is around .95. SO the advertisement selection has to meet the current trend as well as the mind-set of young generation as discussed.

Health Care Delivery Systems Essay

Abstract The American health care system is designed to focus on the organizations of individuals, places, and to treat and prevent adequate health care for the target populations. The federal government conducts an immense portion of delivering health care systems in our world today. The purpose for health care delivery systems is to provide financial tangible benefits and provide health care services for the population and institutions. The results showed for the support of the hypothesis is elaborating in the importance of different health care delivery systems and the purpose in how they are utilized in today’s health reform. Running Head: Health Care Delivery Systems Essay Health Care Delivery Systems Health care systems engage the initial contact of people and it is the foundation of primary health care. In order to receive primary health care it begins with providing a service to families, people, and communities through health professionals and their teams. The Health care delivery systems is involved with a proactive method to prevent health issues and to better ensure the organization and to investigate once a health issue has transpired. In addition, these type of services are publicly funded from general tax revenues without direct charges to the patient (Health Canada, 2011). The most two similar forms of health care delivery systems is managed care systems ex. (HMO) and fee for service (FFS). The fee for service plan is generally called Traditional Indemnity (Website 101, 2009). Fee for service offers flexible measures for the exchange of drastically high out of pocket expenses, it also requires a substantial amount of paperwork and premiums are high. Furthermore, some advantages are having the privilege in selecting hospitals and physicians of your own, and having the opportunity in receiving treatment from a specialist without a primary doctor referral. The disadvantages are high deductibles and the patient is responsible of paying twenty percent and the physicians are obligated to reimburse eighty percent of the expensive. Also, fee for service solely pays for â€Å"reasonable  and customary† health issues (website, 101). Doctors may have a different medical fee opposed to other areas, and the patients are obligated to pay their portion that is instated in health plan coverage. However, HMO is the less expensive and less flexible of all medical coverage’s. The advantages are consist of less paperwork and low copayments. It provides for a portion of improvement health preventive care plans. Unfortunately, there is disadvantages that the health care holder will experience with in choosing a PCP which is a primary care physician, and the HMO plan only accepts a network of their physicians or they will not stand up to the obligation of their financial transaction argument. In addition, in order for the client to see a specialist they must obtain a referral from their PCP. The expression Alternative Delivery Systems is created to entail all techniques of health care delivery systems barring acceptable fee-for-service and private practice like IPAs, PPOs, HMOs, and all other health care systems that provide health care of who conducts organized care systems. (http://aspe.hhs.gov/Progsys/forum/mcobib.htm). For example, Managed Care is a health care delivery system that merges payment and the delivery. It also accesses the use of treatments by engaging organization strategies creating to enhance the growth of cost-effective in the delivery of health care. Managed health care plan is a system that assimilates any management with in accordance of finance that delivers health care services of the covered population. In contrast, PPO also known Preferred Provider Organization is the delivery system that commits with medical care providers who gives discounted fees to clients. Nevertheless, clients have the opportunity to give health care to participants who are not members but can potentially become financial penalized due to any action of seeking out side providers and face consequences of not receiving discount and any deductibles of one’s health care plan and copayments. Goals of Health Care Delivery Systems. The reason HMO’s are unique because they prepaid and they are managed care systems that initially were health care alternative to fee-for-service health care. There goals is to obtain affordable and comprehensive health care coverage. This plan is conducted in advance by the option of a fixed fee from all members. Moreover, HMO delivers minimal cost for medical services that are needed for patients, and this health plan is responsible  in conducting the deliver and finance portion of the medical health care services. They also arrange to provide the essential medical care which includes the benefit packages. Prepaid Health Plans (PHP) is known â€Å"to help make quality health care affordable for groups of people, including farmers, blue collar workers and their families† (Ahern, 2007) . In contrast, the traditional health care insurance only funds health coverage for hospital visits, and enrolled insures that receive health coverage in prepaid plans is charged a predetermined for acute and preventive health care from doctors who work in hospitals. As for PPOs, their health care philosophy originally was to create simple concepts in delivering health care services to large groups with lower rates in order to substantially gain a business development for their management. To emphasize, insures can select their own physician’s however penalties can potentially occur if they are not with the network. This form of health coverage is engaged in receiving adequate power with lower health care prices for their clients in the standing of the dense health care system in America. The fee for service (FFS) is ultimately focusing in creating options to approach paid private insurances to gain more control relating with time and the forms of treatment. FFS is designed to reflect on an ideal perspective for private health care plans, instead of government-administered pricing and giving proper recognition in private health care plans that can utilize health care organizations productively. This method will enhance quality and proficie ncy in delivering a regenerated approach in the health care industry (Nicolas, O’ Malley, 2007). Mission Statement If I had full control of conducting a health care delivery system I would focus in offering health care insurance for businesses, government organizations, people, families, groups, and schools. Also, I feel flexibility is significant for the process of selecting your own choice of primary doctors in the same network and receive great service with affordable payments. The health care delivery system will project and promote exceptional quality health care service is the HMO plan. This health plan will contribute in supporting by over exceeding expectations of all parties which includes employees, communities, work force, stake holders, investors, and customers.