Global Health Systems Essay Example | Topics and Well Written Essays - 750 words

Global Health Systems - Essay Example Health statistics and costs The health statistics and costs of Singapore and United States can be compared to get a clear picture of where the two countries stand. The life expectancy at birth in Singapore is 82 years and it is 78 years in U.S. the infant mortality rate is 2.3 deaths per 1,000 births in Singapore while in U.S. it is 6.4 deaths per 1,000. U.S. has more caregivers than Singapore due to its population. There are 2.6 physicians per 1,000 people in U.S, while Singapore has 1.4 physicians per 1,000. There are 9.4 nurses per 1,000 people in U.S. while 4.2 in Singapore. The number of dentists in U.S. is six times greater and pharmacists are three times of those in Singapore. According to the WHO, U.S. spends about 15.3% of its total GDP on healthcare and Singapore spends only 3.7% (Holtz, 2008). Despite these figures, Singaporeans are healthier than Americans and the amount they pay per person is one-fifth of what the Americans pay. Healthcare Financing In Singapore, the sta te funds one-fourth of the total healthcare costs. The major source for the healthcare finance is individuals themselves and their employers. The government, using taxes, spends about U.S. $381 per capita on healthcare. As compared to the U.S. government, this figure is about one-seventh of the total costs spent by American government (Holtz, 2008). Singaporeans take care of their own healthcare and pay for their medical care. The role of the government is to make the healthcare affordable through subsidies and funds to the public hospitals for those who cannot afford. On the other hand, Americas healthcare depends on the private insurance sector and the government agencies are only for elderly or low income groups. The private healthcare is costly. Healthcare Administration The main regulator of the healthcare system in Singapore is the Minister of Health (MOH). MOH is responsible for the regulation of the healthcare services. It promotes the health education, monitors the quality and accessibility of the health services, controls and prevents diseases, allocates resources and administers the licenses of healthcare establishments. On the other hand about 60% of the U.S. health provision is regulated by the programs such as Medicaid and Medicare. Medicare provides healthcare to the elderly which is supported by the taxes paid by the working class. Medicaid is for the people with low incomes. However, due to the high costs of private healthcare services, the Medicaid program is being overflowed (Holtz, 2008). Healthcare Personnel and Facilities U.S has one of the best medical education system and it has physicians and nurses several times more than that of Singapore. However this is because of the population gap. In reality, U.S. has a decreasing number of physicians and nurses. This is because of the inability to pay wages to the nurses and physicians (Holtz, 2008). The nurses roles have been increased because of which they are leaving the jobs. On the other h and, Singapore has authoritative and administrative controls in its healthcare systems hence they are successfully providing and ensuring that all citizens in need are receiving the adequate healthcare facilities. Their nurses and physicians are paid good because of which

Reflections on Transformations Essay Example | Topics and Well Written Essays - 500 words

Reflections on Transformations - Essay Example Through fully expressing my thoughts on my experiences, I began to see the individuality that was connected through my way of seeing the artwork within the museums. I realized that this experience, though undoubtedly somewhat universal, was not universally shared with everyone. Not everyone has the opportunity to see the things I have had the privilege to see. In writing about it, expressing how it impacted my life, I began to feel a deeper connection to my own identity. Not every attempt at writing was fully successful. I feel that some of the work I created could have been enriched by a better understanding of what I was trying to say. I realized that in writing comes a new sense of a topic, that it becomes something alive that grows from the discussion. However, sometimes the discussion goes beyond one’s control and bringing it back is not always an easy task. Being a part of the experience of writing sometimes reminds one how much one has not learned, rather than expressin g how bright and wonderful are the thoughts that are begging to be set to paper. I have been grateful to find the humility within the act of writing as well as the exhilaration when the words form just the right impression of what I am trying to say. Even when the work is difficult or when the words do not give the right intent, the satisfaction of being able to express yourself makes writing an experience that helps to transform and define the individual, just the same as seeing a piece of artwork.

Applied Behavioural Assessment Case Study

Applied Behavioural Assessment Case Study Sophia A. Johnson Abstract Behavioral assessment involves a variety of methods including direct observations, interviews, checklists, and tests to identify and define targets for behavior change. (Miltenberger, 2012) This assessment will utilize evidence based research to clearly identify target behaviors to assist our clients in implementing a successful intervention plan that is based on a behavior modification plan that objective, clearly defined, measurable and geared to the individual’s specific needs. We hypothesize that we will be able to reduce Emily’s refusal to attend school, her crying tantrums and head banging, as well as improve and increase Mr. Smith’s employee’s attendance and restore production to normalcy. Case #1 This case study examines why 6-year old Emily is exhibiting behavior issues. Recommended by her pediatric psychologist her parents want to understand this change in behavior that started when she started first grade. It appears that Emily’s reluctance to attend school which she claims is no longer fun, often results in her having screaming tantrums in which cries and bangs her head on the floor. Her parents also noted that she has not been able to sleep in her own bed and they must take her theirs in order for her to fall asleep, but even after falling asleep if they return her to her bed she will awake and cry and scream until her parents return her to their bed. Due to these outburst she is often allowed to remain home from school. Her parents are tired and frustrated and in need of answers for this behavior change and an intervention to return their household to normalcy. Emily’s teacher reports that on most occasions she is well behaving and her basic academic skills appear to be at grade level. It is hypothesized that Emily’s behavior maybe as a result of bullying and teasing, if we could get her to address her fears we will be able to reduce the screaming tantrums and fear of going to school and return her to the normal school environment. In communicating with Emily’s parents we were able to identify the target behavior that they would like addressed. Emily’s parents would like us to address her reluctance to attend school resulting in a screaming tantrums, which includes a loud piercing cry followed by her head repeatedly striking the floor. We believe this target behavior needs to be addressed because it poses a social significant health risk which may result in bodily injury for Emily. This behavior is also being targeted because it results in a â€Å"negative reinforcement by escape from a task† (Cooper, 2007, p. 49), this behavior is inadvertently being reinforced by her parent’s reluctance to upset her so they allow her to remain home. This cannot continue as it will also affect her academic and social interaction skills, there may also be financial ramifications if the parents are missing work or having to find a sitter to care for Emily while they go to work. It is hypothesized that Emily’s overall reluctance and tantruming would decrease and that, with time, we would see her willingly wanting to attend school and interacting with others more frequently, we expect to see a decrease in the number of tantrums and head banging’s. As part of the intervention technique we will be able to create a confident rapport with Emily, where she can share her fears and concerns regarding school. Based on the information shared we will be able to change the target behavior by helping Emily adapt to her school environment. We will carry out a functional assessment on Emily using direct observation both at her home and school to assess and gathering relevant data on the target behavior, such as duration and frequency and whether or not they are preceded by a visible antecedent. The behavior modification program that will be used is operant condition using positive reinforcement. Each day that Emily goes to school without a resulting tantrum she gets to do an activity of her choosing with the family when she gets home. If she has a tantrum and refuses to go to school she has to do one hour of reading. We will be tracking her progress using a excel spreadsheet after which we will chart and graph the results on a weekly basis and do a monthly assessment. The data gathered will be reported by her family and teachers, so as to get an accurate view of her overall behavior in both environment. We chose operant conditioning using positive reinforcement because, â€Å"operant conditioning is the means by which we use reinforcement or punishment to change one’s behavior and â€Å"the goal of behavior modification is to establish desirable new behaviors or skills†. (Miltenberger, 2012), in Emily’s case we hope to increase her desire to attend school by creating a positive experience and reduce her tantruming and head banging episodes by allowing her to use her words to express herself. Once per week on a Friday a visit will be made to Emily’s school and home to collect the charts, review any discrepancies and get a verbal feedback on Emily’s behavior. We will meet with Emily as well to learn how she is doing and assess if the behavior modification is having a positive outcome. The data is analyzed by gathering the number of refusal to attend school for the week, the number of tantruming and head bang, as well as any disruptive behavior in the classroom. We will be able to identify whether or not the intervention is successful if the data reveals a decrease such as only once per week does her parents have to keep her home for refusal to attend school or if they do not have to keep her home at all. Table 1.1 After a 3 month period a review of the behavior modification program will be assessed, if it is found to be unsuccessful or not progressing as expected, we will review the data to see if there are specific days when Emily exhibits continuous refusal to attend school, we could also assess the stimulus being used to reinforce the desired behavior, changes to the program will only help to benefit and address any future needs that may arise. If however, the program is successful and we are able to cause extinction of the behavior which is â€Å"the process by which a previously reinforced behavior is no longer followed by the reinforcing consequences, and the frequency of the behavior decreases in the future (Miltenberger, 2012, p. 516), we could say the behavior modification intervention is successful, even if there is only a reduction in the number of refusal to attend school, or even a reduction of the need for positive reinforcements. The scientific method has guided this experiment by helping us to evaluate the data using frequency of measurement, resulting in accurate, reliable, and believable data to create an individualized assessment intervention plan. Case #2 Mr. Smith owns a manufacturing company which specializes in custom figure skates. He has 30 employees who has highly specialized training required for the production of these skates. Mr. Smith is concerned that over the last year his workforce seems to be suffering from a high percentage of absenteeism, which is having a negative effect on production and the health of the company. Prior to soliciting our help Mr. Smith has tried to address this behavior by offering breakfast which consists of coffee and donuts, he has also called a meeting and shared with them that the end result of continued absence will result in the company suffering a financial loss and closing. He noted that neither of these interventions has worked and seem to only increase the problem. In the case of Mr. Smith the target behavior being identified is the consistent absenteeism which is defined as unreported or unscheduled absence from work by an employee who is not on vacation or other documented leave. This target behavior is being addressed because it affects productivity and the overall well-being of the organization, employee morale and the community. The behavior also affects the social responsibility of the individuals who have contracted to work for a specific period of time and should give adequate notice or inform a manager of any absence. Antecedent: Employee shift starts, production line short. Behavior: Employee does not show up for work, does not call. Consequence: Unable to meet production quota and financial obligations. Mr. Smith previous interventions of providing breakfast of coffee and donuts or sharing the company financial perspective, may not have worked because he did not do the adequate research needed to assess the situation and offer a contingency plan that was appealing to the employees, or his overall approach could also not have been appealing to the employees. It is our job as the behavior analysis to help Mr. Smith achieve his goal by selecting target behaviors that are the most directly and functionally related to those goals of his employees. Evidence suggests that the continued absenteeism maybe due to low morale, stress or sheer employee burnout. We hypothesize that after assessing and defining the cause of the absenteeism we will be able to create an intervention plan that will improve attendance, reduce employee burnout and restore the company morale. After gathering data from HR on the persons who are habitual absentees, individual interview was schedule for one on ones to understand the reason and what can be done to assist the employee in restoring their attendance record. For ethical reasons this information will not be shared with HR. Based on the results of the interviews and questionnaires completed by the other staff, we decided that a contingency contract or a behavioral contract would be implemented to restore productivity within the organization. Each employee will have the opportunity to be rewarded for completing their 40 hour work week for 30 minutes of paid time off per week. The company will implement a time card system and HR will judge the time completed and award the time off accordingly, employees do not have to take their time off weekly but may accumulate and take as needed. Additionally, the organization will implement paid sick leave, a daycare reimbursement program, a schedule adjustment for employees need ing time off during the work hours, and a monthly health truck run to ensure staff is mentally and physically fit. To address the morale issue Mr. Smith has agreed to supplement a breakfast and lunch program as well as quarterly picnics. Each person will be given a task sheet to review and sign, this Behavioral contract will take effect the first of the month and the first review will be done a month later. We will be able to assess the success of the program by a decrease in the number of absenteeism and an increase in productivity and production, as well as employee morale. Charts representing the percentage of attendance versus absenteeism will also serve as a visual for performance. If the expected outcome is not obtained, we would reassess and try another strategy such as possibly a token economy system offering which is more tangible and is immediate in occurrence and reinforcements. â€Å"Extinction is the process that weakens behavior† (Miltenberger, 2012), Extinction/Response maintenance is ensuring that the behavior that has been reinforced for a period of time and is no longer reinforced in the future. Measures need to be put in place to maintain the success of behavior that has now become extinct. In Emily’s case the potential issue with extinction is that her tantrums may return but reinforced based on another behavior. According to (Miltenberger, 2012), â€Å"a potential issue with extinction/response maintenance is that behavior often increases in frequency, duration or intensity prior to being extinct and may undergo extinction regardless of positive or negative reinforcement.† CONCLUSION As behavior analysis we were able to determine that Emily and Mr. Smith’s employees did not need to learn a new skill related to behavior. Instead we recognized the need to make changes to their environment and preferences in order to support them and change their behavior. Since Emily experienced such distress when being prepared for school, changes were made in the environment at home and school, and reinforcers were used to encourage a positive outlook for going to school. Mr. Smith’s employees were given opportunities to not only change their attendance habits, but increase company morale and productivity. Despite these apparent drawbacks when creating an intervention plan in a controlled experimental settings, the findings largely supports both hypotheses suggesting that behavioral analysis when used in a scientific method with clearly defined target behavior, the result is an objective and measurable intervention plan. References Cooper, J. H. (2007). Applied behavior analysis. Upper Saddle, NJ: Pearson Education. Miltenberger, R. (2012). Behavior Modification: Principles and Procedures. 5th Edition. In R. Miltenberger, Extinction . Wadsworth.

Steamboats In Louisiana :: essays research papers

STEAMBOATS IN LOUISIANA   Ã‚  Ã‚  Ã‚  Ã‚   Robert Fulton started the very first commercially successful steamboat service in America. His steam-powered paddleboat, the Clermont, sailed up the Hudson River from New York City to Albany in August of 1807. This trip lasted 32 hours The first steamboats were demonstrated in1787. They were used on the river ways to bring cargo, cotton, sugar, and people to their destinations. The steamboat played a major part in the population growth. The steamboats were usually made of wood and were all kinds of sizes. They looked like giant floating houses with large smokestacks and paddlewheels. They were used for carrying people and supplies up and down the river.   Ã‚  Ã‚  Ã‚  Ã‚  Steamboats were later used as show boats for entertainment. The purchase of Louisiana in 1803 made New Orleans a part of the U.S. and opened the door to gamblers. The high life so popular in New Orleans spread north which ushered in the era of the riverboat gambler. By 1820, 69 steamboats were operating the western rivers. And by 1860, that number had increased to 735. These steamboats were christened â€Å"floating palaces with luxurious quarters, world class food well stoked bars and wealthy passengers. In1937 riverboat travel entered the passenger boat era. Calliopes were used on the boats to let people know that the boat was docked. The name â€Å"calliope† comes from the Greek goddess â€Å"muse of sound.†   Ã‚  Ã‚  Ã‚  Ã‚  The paddle wheels were mounted either on the side or back of the boat. After the Civil War, the stern (back of the boat) paddle wheel was most popular. Although the paddle wheel is very large it draws just a few feet of water. The wheel spins about 18 times a minute with only four planks in the water for best speed. A steamboat travels about 15 miles an hour and 16 to 17 miles an hour on a swift river.   Ã‚  Ã‚  Ã‚  Ã‚  The very first paddle boats ran on wood. Coal replaced wood in 1860 and oil replaced coal in 1950. Many of the earl steamboats burned up because the fire used to create the steam would burn the boat. It took 250 pounds of steam just to blow the whistle. Maintenance for a 120 ton steamboat was $1,800, 36% of it was for wages paid to officers and crew members, 18% of it was for provisions, 12% of it was for incidentals and insurance, and the rest of it was for 25 cords of wood per day, at $2.

Compare and Contrast Essay on King Lear and Macbeth

Shakespeare had written many plays in his life time, some of them included various tragedies which included King Lear and Macbeth. All of Shakespeare’s plays had a theme which was used to help the story’s plot to advance further, making events much more interesting. King Lear and Macbeth both have a common theme of madness that is apparent throughout the play which has been depicted differently. They are both written in different ways but still share a same purpose. The essay will be broken down into three parts; firstly we will look at the way madness is viewed in Macbeth. Secondly, we will look at the way King Lear portrays madness lastly we will compare the two to see how differently madness is displayed. While both plays share this similarity, the plays differ by the way the theme of madness is executed. In Macbeth, both the main characters Macbeth and Lady Macbeth begin to show clear signs of madness through alterations in their physical senses. (smell, sight etc. ) this is evident when Lady Macbeth hallucinates that her hands are still covered in king Duncan’s blood despite having washed then several times. Here’s the smell of blood still: all the perfumes of Arabia will not sweeten this little hand. (Act 5, scene 1, 46-47) Shakespeare uses imagery to give a better understanding of what is going on within the characters mind. Here madness is altering Lady Macbeth’s sense of smell and sight, this tricks her into believing that King Duncan’s blood will never dissipate from her hands even though they are perfectly clean. Another example of the theme of madness that is characterized by Macbeth is found in act three, scene four, the climax of the play. Immediately guilt ridden from ordering the murder of Banquo, Macbeth reaches his pinnacle of madness; exemplified by his delusion of Banquo's ghost. Showing that he can no longer differentiate between reality and his imagination Macbeth shouts, Avaunt! And quit my sight! Let the earth hide thee! Thy bones are marrowless, thy blood is cold; Thou hast no speculation in those eyes Which thou dost glare with (III. iv. 93-97). Ross responds to him, What sights, my lord (III. iii. 118). The Insanity of Macbeth is shown in these quotes. Shakespeare's description of Macbeth's thoughts visibly reveals the theme of madness. Shakespeare portrays madness among many of his characters, and he returns to the theme again and again. Indirect characterization in the form of Lear's mad speeches allows Shakespeare to convey the theme of madness. For example one of Lear's first speeches after things started to go bad for him, Poor naked wretches, wheresoe'er you are, That bide the pelting of this pitiless storm, How shall your house-hold heads and unfed sides, Your loop'd and window'd rag-gedness, defend you†¦ (III. iv. 35-38). Lear's insanity increases throughout the play, demonstrated to the audience through more speeches, until his emotions overthrow his reason at the climax of the play. Lear randomly shouts in to the storm, Rumble thy bellyfull! Spit, fire! Spout, rain! Nor rain, wind, thunder, fire are my daughters. I tax not you, you elements, with unkindness. I never gave you kingdom, called you children (III. ii. 14-17). The example of Lear invoking the storm to destroy the seeds of matter along with many other absurd statements illustrates that he has an unsound mind and it is made clear to the audience by his words. Shakespeare expands on the theme of madness in King Lear by Lear again using his words to express the reason for his insanity. The cause is the realization that his daughters Goneril and Regan do not love him. What finally pushed him over the edge was the cruel actions afflicted on him by the people that supposedly loved him. To such a lowness but his unkind daughters. †¦ ‘Twas this flesh begot Those pelican daughters describes Lear of the cruelty of his daughters (III. iii. 76,80-81). The character of Lear produces the theme of madness by expressing his own increasing insanity and reasons the reason for it in raving tangents. The style and depiction of the theme of madness are very different in both plays. Macbeth shows madness in the main characters with lots of imagery, giving a very physical sense of feeling towards the audience making them have a better understanding of what the characters are feeling. In King Lear madness is depicted through the main characters dialogue. This is meant to show the psychological turmoil going through the character’s mind which helps the audience understand why and what the character is doing within the play. In conclusion it is clear that madness was a very re occurring theme in both plays King Lear and Macbeth. However, the style in which the madness was depicted in each play is very different, in Macbeth madness within the main characters is shown through basic hallucinations through sight and smell, whereas in King Lear Shakespeare wanted the main characters to display madness through the dialogue. Both techniques used by Shakespeare were made to ultimately give more of an understanding of what is going on within the play. Both uses of madness are equally effective depending on which kind of play is written

NeoMed Technologies Essay

NeoMed Technologies developed a diagnostic device used for cardiac testing, and is headquartered in Ohio. They developed a CAD screen system to detect coronary artery disease. The company was founded in 2000 and is based in Cleveland, Ohio. NeoMed Technologies was faced with a lot of difficult decisions at the beginning when it came to where their product would best fit and be most successful. They had developed a technology that could fit into many markets, but needed to choose a product path and market. Their continued challenges occurred due to the changes in the market direction of venture capital opportunities and the funding available, all due to changes in the economy at that time. Due to the lack of funding, and a continued decline in Venture Capital funding along with a downturn in the economy; I believe had the economic situation been different at the time when they needed venture capital funding, the would’ve faced less challenges. The management team and Board of Directors were selected carefully and all had the experience and the background needed for success in the product market space. NeoMed Technologies had a strong business plan, and had conducted extensive research in initial planning stages. I believe based on the reading materials in this chapter; they did all the right things in the planning and early development stages. Although NeoMed Technologies had to contend with big name competitors and major players in the diagnostic and imaging market such as GE Medical and Philips, also located in the Ohio region; their strategy to be headquartered in Ohio was a sound decision. However, they should’ve investigated further in the opportunity to obtain venture capital funding outside of the Ohio region. Perhaps they could’ve spent more time studying competitive business cases of companies like competitor, HeartCheck, who specializes in the EBCT test. The HeartCheck product, although more costly, had seen success and was widely accepted in the Medical field. Despite the added cost of the HeartCheck EBCT test, they were seeing success in the market. One strategy change I would’ve considered early on was not applying all resources of their technology into one area. NeoMed Technologies should’ve considered  applying their initial product development to the technology of screening for drugs, drug delivery applications or detecting cancer. These areas would’ve possibly allowed for a quick to market product, without the additional approvals, quality standards applied in the medical equipment space, and FDA approvals needed. Bringing a simpler product to market first could’ve brought in revenue to fund the long-term product focus of a CAD screen system. The profits from a drug screening or drug delivery product could’ve assisted in funding their long-term product focus, they missed an opportunity to develop a quick revenue steam. In addition, NeoMed Technologies could’ve seen success early on in the Homeland Defense space, for detection of nuclear weapons, or dirty bombs. With the shift later in Venture Capital funding opportunities, they could’ve experienced success in this area as well. Bottom-line, they put all their eggs in one basket; they failed to have a backup product to develop a quick revenue stream to further fund their long-term goal. However, without a crystal ball that was a difficult decision. There were clear signs of shifts in investment opportunities, the shift indicted investments being shifted towards Homeland Security, military applications, and protection from various biological and chemical threats. NeoMed Technologies should shift some of their resources to developing a product to fit into that area, thus allowing them the opportunity to obtain additional venture capital funding, and perhaps developing a profitable product in the Homeland Security space. The revenue stream from this product would allow them later to proceed with their CAD screen system. There was another area of investment that should’ve been further investigated, â€Å"Angel Investors†, most of who are Entrepreneurs themselves currently, or at some point in their career. Inviting one of the Angel investors a seat on the board, as well as leveraging the experience they have gained from starting their own company, dealing with the challenges of starting a business, and investigating further Venture capital funding areas. NeoMed Technologies should’ve reached out farther than just the Ohio-based Venture Capital firms, this would’ve allowed them a broader audience of investors and opportunity. I don’t believe holding off for perfection is necessarily wrong, especially when dealing with, and factoring in the value of human life. The NeoMed Technologies board of directors and  upper level management all appeared to encompass strong ethics and while that might be a weakness to others, ethics are important and should never be compromised. Too many companies take the short cut to success and people get hurt.