Penn Foster Exam Essay Example for Free

Penn Foster Exam EssayParagraph 1Im replying to your career opportunity posted on your website. I understand that you are actively seeking to hire a Medical Coding and Billing medical specialist at one of your Dartmouth Hitchcock locations. This sight is responsible for reviewing medical records of discharged patients to ensure that diagnoses and procedures have been recorded collect, code and compile medical record data for future(a) retrieval, reports and reimbursement purposes. My granddaughter passed away about a year and a half ago. She was air-lifted to one of your locations upon birth where the doctors and nurses tried everything they could to save her however she died. Through that experience, though, I saw how your employees, handled a very difficult situation, and the nurses and doctors inspired me with their compassion. The Health Care industry has always been a dream of mine, and I decided to pursue a career in Medical Coding and Billing with Penn Foster University . As a Medical Coding and Billing Specialist within your company, I am confident that I could make a valuable contribution to the medical team serving your patients and insurance companies in a timely and professional manner.Paragraph 2My boss, Ms. Levine has a position available for an assistant here at Northeast Propane. I think this would be an excellent job opportunity for you. From your previous experience, I greet you are more than qualified for this position from your interaction with customers in the retail field, you have excellent written and verbal communication skills, you work independently, you are unionized and you are great at multitasking. You are always willing to offer help and assistance with coworkers and you have a good rapport with your past employers. This position pays very well and is a Monday-Friday position with no weekends. I honest think you should guard for the position. Please give it some thought and if you decide to apply let me know and I will pu t in a good word for you.

The Vision of the New World That the Colonists Brought to America Essay Example for Free

The Vision of the New World That the Colonists Brought to America EssayNew England, on the other hand, had developed into a religion and family based society comprised of mostly middle class families by 1700. Looking at the terrain, government, and the people themselves, reveals clues about how the forceful split in society came to be. While residing in England, the Puritans and faithful Catholics faced persecution, which led to their immigration to the New World. Many groups and parishes applied for charters to America and, led by their priest, the Pilgrims and Puritans made the long voyage to North America. Their religion became a unique element in the New England colonies by 1700.Before landing, the groups settled on agreements, signing laws and pacts to ensure a community effort towards survival when they came to shore, and while settling in New England. Their strong sense of community and faith in idol led them to develop a hard take to the woodsing society by year 1700. Their towns were well organized, with the church being the basis of everyones daily life, and they wanted to establish par and have everyone working together in harmony. Family was an important part of the Puritan religion, so their ships came with twenty-two men and twenty-one women, so there was stability.They learned serviceable farming techniques from the Native Americans, and farming was their prime source of the economy. The Puritan work ethic kept people from working for extreme material gain. The Puritans were hard workers who had oddment for a religiously purified town. Not everyone in England was facing harsh persecution and umteen travelers came to the New World with high hopes of fame and gold, which led to numerous conflicts. It was a land for the teeming to get richer. The people that were assigned to the ships destined for Jamestown (Chesapeake Region) came without their families and their ages ranged from old to young, but mainly oung men. The men outnumbered t he women six to one. This caused the society to be more chaotic because there were publicy broken families and a mad rush for the few women. The settlers in the Chesapeake region main goal were to get rich, or to gain new land and get hold gold. According to John Smith, altogether the people could do was live for gold it was their only purpose. The Chesapeake Bay settlers had to endure the harshness of their new environment. The climate was non tender and nearly half of the people died because of exposure to complaints or starvation.Those that were lucky and survived these hardships were left to fight with the local Indians. Dis-organized and unable to find mountains of gold, large tobacco plantations were started and farming was taken up by the settlers. These business men were not use to being agricultural farmers. This was why things were so difficult before John Smith took peak of the colony with his You dont work, you dont eat mentality. People were not accustomed to ha rd work and physical labor, and the colony was dying slow. As a result of the hardships the first importation of slavery began in the colonies.At first indentured servants were being used to work the fields, but they were far less(prenominal) exploited than the slaves. Indentured servants worked for the person who paid their way to the Colony until the depths were paid off, but soon their services were less useful and slaves were being imported in massive numbers. The colonial planters were making money and gaining large profits off of free labor. The development of the two cultures may also have been the result of the terrain the groups occupied. In the Chesapeake region, the colonists settled on swampy marshland that was hard to defend and even more difficult to survive in.With so many people dying from disease and starvation, and the extreme shortage of marriageable women, the population grew slowly, if at all. Families were more groups of mangy children half related, from differ ent fathers. Frequent death made unnatural family life a common thing. In the New England colonies, the people chose flat, manageable ground that left them with easy to plow fields. The soil and religious tactile sensations were ideal for subsistence farming, which meant small, manageable farms that would provide for a family of eight to ten. Since the farmers looked only to feed themselves, there was little, if any, need for extra abor having most, if not all, workers available inside their own family. The moderate climate made disease a rarity in the colony, and death even more so. The balanced family life and food supply meant more able-minded colonists. Society had a patriarchal structure of man before womanhood and woman before child. Children themselves skipped over a childhood and were treated as adults at a very early age. They were expected to imitate their parents and keep faith in the church. All these elements together led to Northern prosperity and growth. The land i tself was important, more so was how it became used for profit.This land is money belief was a unique attribute of the region by 1700. The motive for profit also helped to develop society in the Chesapeake region. The Chesapeake men discovered tobacco and began a fierce production of it from their plantations. Since tobacco depleted the soil rapidly, new land was always a must. To acquire this land, wealthy owners paid for servants to be brought over and work the fields. Each was given a land grant of fifty acres, which was not worth all that much. However, the men were bringing over ten, twenty, maybe even cardinal servants to work in the tobacco fields.Thirty men at fifty acres a piece add up to a lot of land, so the land owners started to bring in slavery and more black people to work their fields. Instead of growing tobacco, New England farmers were most likely to produce barleycorn or corn, which helped them stay well fed during long winter months. They were more concerned wit h the survival of their families than the profit they could make from the rich soil, so the food was not sold for a profit. Rather, the colony became self-supporting in the issue of food. With food taken care of, the New England colonies were left to import stoves, tea, and spices, among other things.Since they only necessary to grow food to support their own family as subsistence farmers, New England farmers rarely had any more than their original acreage. This created a more equal reality for all owners, comfortable or struggling. The differences between the New England colonies and the Chesapeake colonies led to separate societies by the time of the 1700s. Agriculture, motive, people, religion, and terrain are all factors that affected how they grew apart. However, it is also through the actions of the men and woman who settled in the regions, and the choices they made, that led to the development of these two colonies.

Emergency Departments And Effects Of Non Urgent Cases

Emergency Departments And Effects Of Non Urgent CasesEmergency Departments (explosive detection system) ar under change magnitude pressure and increases in morsels of affected roles controled unbefitting or some which could be seen by alternative providers are all a burden on the ED and the health inspection and repair in general. everywhere recent historic period there has seen an increase of experienceances at EDs of more than 20% with the majority being aboriginal(a) manage cases. Recent changes to the GP contracts in 2003 have also had an impact on increases in attendance to EDs.There is a potential saving of in excess of 120 million if patients tended to(p) the confiscate health service provider either GPs, walk in centres or by self treating and asking a apothecary.Patient cultivation and not bad(predicate) promotion of the Choose easy campaign could reduce these numbers and therefore do outdoor(a) with the need to have to potentially turn away non-urgent cases. inductionEDs are under increasing pressure to deliver high quality care due to rising attendances. Over the period from 2007-2010 there has been an boilers suit increase in attendance at EDs of England of 20.9%.There was an increase of 10.7% in attendance amid the period 07/08 to 08/09 (12,318,051 attendances in 07/08 and 13,794,072 in 08/09) 11.4% increase between 08/09 and 09/10 (15,569736 attendances in the period 09/10).There have been numerous attempts to try and stem the vacate in ED attendances including offering patients guidance, making them aware of the consequences and communicate them of the alternative health services available.A GP ED Triage Pilot conducted by Sheffield Teaching Hospitals NHS Foundation Trust and Sheffield General Practitioner Collaborative in March 20101 which was conducted to ensure patients were seen in the most appropriate location and by the most appropriate health care professional found that cases deemed to be certain primary care c ases amounted to 19%. From this study it could be said that approximately 20% of attendees could potentially have been seen by a general practitioner in primary care rather than tending the ED merely this is very small sample and m all more studies would need to be carried come forth face at different segments to be able to draw a more definitive conclusion.Applying 20% would therefore estimate that for the year 2009/10 in England approximately 3 million attendees were candidates for primary care. The estimated hail of seeing these patient in the ED smalld on the comprise of 56 for treating a minor affection and 75 for a standard ( modal(a) cost 65.50) totals 196.5 million. Doctors consultations in primary care settings are the most cost effective part of the medical component of the NHS at 15-30 (averaging 22.50), GP consultations cost less(prenominal) than out-patients appointments, ED and ambulance calls (ambulance calls costing 255 per patient). Therefore the cost of t reating the 3 million potential primary care/GP patients in the GP setting would total 67.5million which would save the NHS a potential 129 million.2 These values are only for normal working hours. Most non-urgent cases actually occur out of hours which would actually increase this amount even further with even more potential savings.The above costings are currently being changed to new Health share Resource (HRG) code costings which are slightly less which could reflect lower savings than those calculated.3,4The choose well campaign North West estimated the issue cost to the NHS of treating minor maladyes is 2 billion a year.5The new system give have 11 different HRG groups, opposed to the current threeGroups. The new HRG codes blind drunk you must code both investigatings and sermons, as opposed to investigations alone6 (appendix 1).This review hopes to come to an understanding why these patients use the emergency department rather than GP surgeries, barriers to some other forms of care and access to GP surgeries and therefore answering the question whether emergency departments should be able to turn away non-urgent cases. Other points which will be taken into account are the ethical dilemmas associated with potentially bout patients away and the potential repercussions of doing so.Method and literature reviewA search was performed using Lancaster Universitys metalib data base which searched Scopus, Springerlink, Science Direct and Ovid Medline and Pub Med data bases.After accounting for duplicates and reviewing titles and abstracts, papers were selected for review. Search criteria admitd the terms, non-urgent, emergency department, primary care.The date was initially limited to 1996 2010 except on further searches earlier articles were allowed in order to search for historical articles. The search was also limited to humans and English language. The Department of Health website and the uncomplicated give care Foundation website were also ap ply to find current legislation and data.DatabaseLimitsResultsOVID Medlineemergency department, non-urgent primary careyear-1996-2010humans, English25Pub Med12Springerlink19Science Direct72Why patients attend the emergency departmentThere is no formal definition of what is deemed an appropriate attendee to the emergency department due to sights own impressions of what they believe to be an emergency. This leads to inappropriate attenders who could have legitimately seen their own GP. The types of patient who attend inappropriately and their closings to do so are labyrinthine and involve loving, psychological and medical factors.7Urgency is also a term which is difficult to define and to measure. Studies have been carried out which have measured urgency but there is such wide variation on what is deemed urgent the results are subjective. Due to this subjective nature when defining urgent it is important to be lucid and have appropriate and qualified medical professionals determi ning the urgency of a situation using set criteria. In an early study Lavenhar et al draw an urgent problem as one that requires medical attention within a few hours.8 This definition is used in this review.It has also been found, what medical professionals deem as non-urgent is often not perceived the same in the patient and the urgency of the situation should be based on the presenting signs and symptoms and not the eventual nett diagnosis.9Patients have been seen to attend the ED for many reasons including, the followingThey deemed their condition/illness to be appropriate for the EDThey believed the GP would refer them anywayThe GP process was too far to travel toThe GP surgery was closedA friend or family member felt it appropriateFor those patients who deemed their attendance to be appropriate for their illness or condition it would be very difficult to convince them otherwise and such patients generally attend the ED for reassurance that there condition is not serious and is not going to get any worse. Such patients also have high anxiety, and a sense of urgency and self diagnose to date have no formal medical knowledge.9-12Those who believed that their GP would have referred them anyway thought they would cut out the middle man. The patients found to do this in a study carried out by Palmer et al deemed their condition to be bad enough and that their GP would refer them, and attending their GP prior to attending the ED would just be a waste of time13 this study also found that pain was a major factor patients took into consideration when deciding on where to attend. botheration itself being subjective and open to individual interpretation.Those that found the GP surgery to be too far to travel were patients who generally lived in rural eye sockets where the outgo to both GP and ED were significantly far away and patients therefore decided they may as well attend the ED rather than the GP to save time in the event that the GP would just refer the m anyway.Those patients for whom the GP surgery was closed mainly attended out of hours or at weekends. These patients generally thought their condition was urgent and couldnt waitress until the surgery reopened.11,12For attendees who were advised by friends and family to attend the ED did so purely on this advice and the majority of which would not have done so without this advice. This included people advised by colleagues, first aiders and schools where responsibility for the patient was in someone elses hands and the person advising did so in order to protect themselves.12,13Another major factor to consider when savoring at why patients attend the ED is the decision making capabilities of the patients themselves. This would include social, psychosocial and medical factors. Padgett and Brodsky14 proposed a three be model which outlined how the stages of decision making interacted between the three different stages within the model. The three factors were predisposing, enabling and need. The decision making stages being recognising the problem, deciding to seek treatment and the decision on where to get the treatment.Predisposing factors which are part of stage one included the age, sex, race, level of education, family and social support available. The enabling factors, stage 2 were the income of the patient, usual source of care, proximity of the source of care and the perceived accessibility of this care source and the factors contributing to the need, stage three, were symptom recognition, evaluation of need, level of distress and psychiatric co-morbidity.Padgett and Brodskys three stage model14Barriers to CareThe above predisposing factors are also forms of barriers to care and are dealt with by patients in many different ways. Patient education would be a major tool for breaking down such barriers.11 This is the aim of a local and national campaign called Choose Well. This is a campaign that is supported by the NHS and its staff and aims to ensure people who need advice and treatment for common complaints, get stiff and gifted care.5 The North West has seen an increase of 177,000 patients in the ED over the last two years and hoped the Choose Well campaign would reduce this over the overwinter of 2010/11. The North West NHS estimated that 1 in 4 ED attendances were due to patients who could have self treated or could have been seen by other health professionals elsewhere.Offering guidance in both GP surgeries and EDs would give patients the information for themselves to determine the urgency of their condition. This information could include what definitely should be seen at the ED and what definitely shouldnt. Where this is a good idea and has the potential to work well however it could potentially cause patients with urgent problems to believe that they are non-urgent therefore putting them at risk of harm. On the other hand it could also cause some patients to deem themselves urgent and attend the ED when they were init ially b correctly to attend their GP practice adding to the non-urgent caseload.The Choose Well campaign briefly describes the types of conditions that should attend the ED as an emergency and gives contact numbers for patients to ring in order to get further information on where is best for them to attend. This may be difficult for some patients particularly the elderly as navigating around a website may be difficult or impossible and at a time when you are not well or believe to be in an emergency situation this could be valuable time needed for treatment. It does however offer valuable advice for minor injuries and illnesses known not to be life or limb threatening and could possibly eliminate the need for these patients to enter the health service at all reducing overall numbers and costs.Does Choose Well gather a difference?The Choose Well campaign North West sent out a survey (appendix 1) to determine the number of people who had made alternative decisions to attending the E D and whether the messages from the campaign had reached the local people. The survey results are not yet available but Merseyside NHS was successful in increasing the level of awareness amongst the people of Merseyside of the range of NHS services available to them over the winter of 2008 with 94,547 people using NHS Walk in centres in Merseyside, a rise of 18% from the year before and there was a drop in AE attendance of 6.4%, compared to the previous winter yet they still had high attendances to the ED with up to half of these potentially of the type that could have been treated by more appropriate NHS services.15 umpteen patients do not realise that there are cost implications and differences in cost between EDs and GPs and believe that it makes no difference whether they visit as all they want is a diagnosis regardless of who gives it to them.16 Many do not visit their GPs because of the appointment systems in place, and they are often unable to make an appointment and are ther efore more unbidden to wait around in the ED where they are guaranteed to be seen rather than wait for an appointment at their GP practice. It has also been noted that when patients were unable to see their unceasing GP and were offered an appointment to see an alternative the decision was made to attend the ED rather than see the alternative.17,18The opening hours of primary care facilities also do not satisfy the needs of some patients, those who work during the day may not be able to take time off from their daily activities to attend appointments which are set at the discretion of the GP practice rather than at the discretion of the patient such as in the evening, during the night and at weekends.Repeat attendees of the ED are found to make up a large proportion of cases. In a report by NHS Manchester19 who had registered 230,000 attendances per year at its three main sites showed that 13% of these attendances were frequent attendees (patients who attended the ED four or more times in a six month period) with the average number of times a frequent attender being 5.7 times. The report also suggested that this was inappropriate use of the ED and that patients needs were not being met by primary care providers. They decided to increase performance by putting in place best practice which was to include devising computer package that would identify the frequent attenders and allow GPs to see who they where so that they can make contact with the patients and inform them about their inappropriate use of the ED. The patients were sent letters stating break messages on the use of the ED and an information leaflet. The pro-forma letter which read An AE department is often not the best place to receive care for non-urgent problems or those that will need ongoing treatment. They do not have your medical records which included information about other medical problems both by and present, investigations, regular medication, and any allergies to medication. Not havi ng this information can compromise the treatment you receive. The enclosed leaflet contains information about services other than AE departments which are available to you. .AE departments should be used when the problem is an accident or requires emergency treatment. We would request that you contact the surgery first when you have a health problem that requires some advice and/or treatment.19This discussion was found in one GP practice to reduce the number of repeat attenders by 20%19 even though studies have shown that this would be the number of frequent attenders that would over time stop attending anyway without any form of intervention.20,21In order to validate the results found the intervention should be compared between surgeries with some surgeries having intervention and some not having the intervention.GP services within the EDThere has been an increase in the number of primary care doctors in EDs or based closely to EDs over recent years. This has been found to decreas e the numbers of non-urgent cases seeking ED treatment in favour of a GP and has also reduced the number of unnecessary admissions to hospital. This sort of initiative requires team work and close working partnerships with both EDs and GPs which at times has be proven to be tricky due to differences in culture and beliefs. The primary Care Foundation has carried out research licenced by the Department of Health, the study, which was carried out in May 2009, looked at different models of primary care across England practising within and alongside EDs. The number of patients deemed to be primary care patients were identified. It found that around half of all EDs did in actual fact have some form of primary care mien working within the ED and that between 10% and 30% of attendees were classified as primary care candidates.22DiscussionEthical dilemma of turning patients awayThe four principles of ethics developed by Beauchamp and Childress23 must be taken into account when coming to a decision as to whether to turn patients away from the ED. The 4 principles approach takes into account that whatever our personal beliefs, philosophy, moral theory or life stance the care of patients is the most important factor.It could be said that turning patients away from the ED was going against the ethics of the health service in that it is considered freely accessible to all at any time.The Four Ethical Principles shore leavePatients must be respected and must not be deceived and must be given adequate information. If patients are turned away then they are not given all the required information regarding their condition. Even though they would be advised to see their GP they may not do so. benignity and non-maleficenceIt may be seen as causing the patient harm by turning them away, they may suffer further pain or psychological distress by not being seen.JusticeJustice or fairness may be breached if patients are turned away. The health service is free at the point of entry and patients that are turned away may feel as if they are being denied care or treatment, even though they would be offered it at their GP practice for some this may not be possible or an option therefore denying them any form of care at all.ConclusionFrom the articles and documents reviewed it can be seen that non-urgent attendees at the ED are a drain on public funds and a time of economic derangement and when there is a keen focus on service cuts and delivering value for money.In spite of the evidence and from reviewing articles I feel that it could potentially be foul to the health and well being of patients if they were to be turned away from the ED for non-urgent or minor conditions that could be seen in general practice. Turning them away could make them stop seeking medical treatment and could make them lose faith in the health service altogether.I believe that more patient education and greater access to GPs and primary care health professionals is what is required in ord er to reduce the numbers and therefore the cost of treating such patients. It is not the vocation of the treating professional to determine the perceived severity of illness or injury a patient attends with but to offer them the care and support they need in order for them to continue their lives as they would like to. It is however the duty of health professionals to educate their patients and offer support on how they should deal with such illnesses and injuries so as not to have to attend or re-attend the ED. This could come in the form of information leaflets or just by talking to the patients and finding out their reasons for attending the ED rather than GPs and how things can be put in to place and organised for future patients to overcome the barriers to other forms of care.In 2003/4 there was a change in the GP contracts, following this there was an increase in ED attendances. The new contracts made changes to the after-hours access to GPs and allowed GPs to opt out of this area of care, this then resulted in the increase of after-hours presentations to the ED of GP cases.24So in order to increase access there would need to be more GPs not opting out of the after-hours work or changing the contracts to omit the option to opt out of such. Even though there are nourishment such as walk in centres and out-of-hours services people attend the ED, this could be due to the unfamiliarity of such places and lack of knowledge of the facilities available. More patient education and promotion of such centres would be required to ensure they are made aware to everyone in the event of requiring such services. Also the integration of primary and secondary care could help improve services for everyone by bringing GPs into the EDs and from a closer working partnership.Appendix 1HRG codeHRG spotBandAE tariff ()VB01ZAny investigation with category 5 treatment1183VB02ZCategory 3 investigation with category 4 treatment1183VB03ZCategory 3 investigation with category 1-3 treatment2133VB04ZCategory 2 investigation with category 4 treatment2133VB05ZCategory 2 investigation with category 3 treatment2133VB06ZCategory 1 investigation with category 3-4 treatment378VB07ZCategory 2 investigation with category 2 treatment4110VB08ZCategory 2 investigation with category 1 treatment4110VB09ZCategory 1 investigation with category 1-2 treatment378VB10ZDental Care552VB11ZNo investigation with no significant treatment552HRG codes and tariffs6Appendix 2North West Choose Well SurveyIf you or a family member had a minor illness or injury (for example a sore throat, backache, cough or cold), which is the first NHS service you would use for advice and treatment? (Please select one answer)Y/NY/NPharmacyMinor Injuries UnitGP/DoctorLook for advice on the net incomePhone NHS Direct or look on their website dial 999NHS Walk-in CentreGo to AEUrgent Care CentreNone of the above, I would look after myselfOther, enthrall assure belowIf your first pick service was unavailable , which other NHS service would you contact next? (Please select one answer)Y/NY/NPharmacyMinor Injuries UnitGP/DoctorLook for advice on the internetPhone NHS Direct or look on their websiteDial 999NHS Walk-in CentreGo to AEUrgent Care CentreNone of the above, I would look after myselfOther, please state belowIf you are a parent or carer for boorren under 16 years of age, please complete questions 3 4. Otherwise go straight to question 5.Which age group are your children in?Y/NY/N0 4 years10 13 years5 9 years14 16 yearsIf your children had a minor illness or injury (for example a temperature, a sore throat, cough or cold, a small cut or a sprain), which is the first NHS service you would use for advice and treatment? (Please select one)Y/NY/NPharmacyMinor Injuries UnitGP/DoctorLook for advice on the internetPhone NHS Direct or look on their websiteDial 999NHS Walk-in CentreGo to AEUrgent Care CentreNone of the above, I would look after myselfOther, please state below5. If you have selected AE or 999 in answer to questions 1, 2 or 4 above, please answer this question. Otherwise go straight to question 6. If you have selected AE or 999 in answer to questions 1, 2 or 4 above, can you tell us why you would make this alternative? (Select as many as apply)Y/NY/NYou will receive the best quality care and adviceYou know that you are guaranteed to be treatedYou will be seen quicker than any other serviceThe AE is closest to where you liveYou do not know where else to goIn the past your GP sent you to your AE or told you to call 999You would have chosen a GP, but are not registered with oneIn the past you were told to go to AE or to call 999 by anotherhealth service, e.g. apothecarys shop/NHS DirectYou would have chosen a GP, but it is difficult to get an appointmentOther, please state belowWhich of the following services do you currently use your local pharmacist store for? (Select as many as apply)Y/NY/NPicking up a prescriptionAdvice if your child has a high temperatureAdvice and treatment for a headacheAdvice and treatment for backache and other aches painsAdvice and treatment for an upset stomachAdvice and treatment for a urine transmittanceAdvice and treatment for treating coughs, colds fluContraceptive adviceOther, please state belowDid you know that your local pharmacist store provides a confidential consultation area?Yes/NoDid you know that your local pharmacist can offer you confidential advice and treatment without an appointment?Yes/NoWould you consider using your local pharmacist for any of the following? (Select as many as apply)Y/NY/NContraceptive adviceAdvice if your child has a high temperatureAdvice and treatment for a headacheAdvice and treatment for backache and other aches painsAdvice and treatment for an upset stomachAdvice and treatment for a urine infectionAdvice and treatment for treating coughs, colds fluOther, please state belowDo you know where to find information about late night and weekend opening hours for your local pharmacist?Yes/NoChoose Well is an NHS campaign that aims to help people in the North West to understand which NHS service to use if they need fast and effective treatment for minor illnesses and ailments and how to use 999 and AE services appropriately.Have you heard of the Choose Well campaign?Yes/NoIf yes go to Q 12 if no go to Q 13Where have you seen or heard about the Choose Well campaign? (Select as many as apply)Y/NY/NLocal newspaperLocal news websitesPCT websiteCommunity radioLocal radioLife Channel (GP TV)Bus advertLeafletSigns on ambulancesOther postersWord of mouth (someone mentioned it to you)Other, please state belowHave you heard any of the following messages? Tick as many as appropriate.The number of people using AE and 999 services is continuing to riseOne out of every four people who go to AE could have either treated themselves at home, or used another local NHS serviceYou can get three free text messages, with expound of your three nearest pharmac ies by texting pharmacy to 64746Your local pharmacy provides expert, convenient advice and treatment for minor ailmentsAE and 999 services are for life-threatening and serious conditions such as heart-attacks, strokes, breathing problems and serious accidentsGet the right NHS treatmentAs a result of seeing these messages, if you or a member of your family has a minor illness or ailment are you less likely or more likely to use the following services (please select as appropriate).Less LikelyMore LikelyYour local pharmacyYour local GPNHS Walk-in Centre or similar serviceMinor Injuries UnitUrgent Care CentreNHS DirectNHS Choices WebsiteAE999To help us to get our campaign right, it would be really helpful if you could give us some information about yourself.Which age group do you fall in to?Y/NY/NY/N16 1940 4970 7920 2950 5980 8930 3960 6990+Gender please delete as appropriateMale femalePlease could you tell us the first part of your postcode e.g. M22 or SK6EthnicityPlease can you select the group that best describes your ethnic background colourY/NY/NEnglish/Welsh/Scottish/Northern Irish/BritishIrishGypsy or TravellerOther, please give detailsMixed/Multiple Ethnic GroupsY/NY/NWhite and blue CaribbeanWhite and AsianWhite and Black AfricanOther, please give detailsAsian/Asian BritishY/NY/NIndianBangladeshiPakistaniChineseOther, please give detailsBlack/African/Caribbean/Black BritishY/NY/NAfricanCaribbeanOther, please give detailsOther EthnicY/NY/NArabOther, please give detailsThank you for your time we really appreciate your help. If you are willing to help us to develop this project further, please fill in your contact details belowNameAddressTel. No.Email lectureTaken directly from the Choose Well questionnaire5

Comparison Of Kotter Lewin And Positive Models Management Essay

Comparison Of Kotter Lewin And Positive Models Management Es regularizeChange is good, budges in the grocery, veer requests and client technology for supporting activities formr, but change is not always in control of the placement (Vroom, 1993). Research states that it is important to manage proactively monitor and cypherk changes to succeed and to gain a competitive advantage. Management must(prenominal) transcend the need for change and to highlight the crisis situation that whitethorn develop while avoiding the change. Effective communication should be used to promote or market the new proposed changes while at the same time, demonstrate the shortcomings of old system. Users resist change because they fear the unknown, but effective communication at the beginning of the number can contribute to reduce this fear. It was noted that communication frets must be verbal and active (Kotter, 1995). Management must be seen to actively support the butt against of change so tha t it can get the full support of the active population. Actually change not only to be managed, but must in like manner be marketed. Once the change has been implemented, the change management move must constantly reviewer change and it streng hence.In this paper we will see how the trinity poseurs play important procedure in change carry out for any establishment.Kotters Eight Steps ModelJohn Kotter who teaches in Harvard Business School has do it his business to study both success and break danceure in change initiatives in business. The most general lesson to be learned from the more successful cases is that the change affect goes through a series of phases that, in total, universally require a considerable length of time. Skipping timbers creates only the illusion of speed and never produces satisfactory results and making critical mis wages in any on the phases can have a devastating impact, slowing momentum and negating hard-won gains. Kotter summarizes the viii ph ases as follows. (Kotter, 1997)1) get a Sense of UrgencyTalking about change usually begins with almost batch noticing vulnerability in the organization. The threat of losing ground in some sort of spark these commonwealth to action, and in turn, they try to communicate this sentience of urgency to others. Congregations, it generally is outrage of financial struggles or turnover in identify volunteer members and leaders. Kotter noted that more than half business that he observed were never able to create enough emergency measures. Without motivation, inspection and repairing people and effort goes nowhere. Frameworks underestimate hard how there may be people to drive their comfort zones. In most of the successfully cases, the leadership group help oneself a frank discussion of potentially unpleasant facts topic of the new competition, flat earnings, decrease in market sh atomic number 18 or other relevant indicators. It is effectual to use outside people (by example, to g et consultants, unchurched, people of other faiths, regional or national staff people) who can sh be the wholesale image from a different angle and help to expand aw atomic number 18ness of your members. When relatively high take aims of emergency? Kotter suggests that it is when 75% of your leadership believes honestly that business as usual is no longer an acceptable proposal. (Kotter, 1997)2) Form a Powerful Guiding CoalitionOften change efforts start with only one or 2 people should continually grow to include more who believe that the changes are undeniable. The necessity of this phase is to gather a relatively large initial affection of believers. This initial group must be officeful enough in frontiers of the roles they hold in the Church, the reputation they have skills that they bring and the relationships they have. Regardless of the coat of your organization, the Director coalition for the purposes of change to have 3-5 people leading the effort. This group, in tu rn, can lead others on board with new ideas. The construction of this coalition their sense of urgency sense of what is happening and what is involve is crucial. Involving respected leaders key areas of your church this coalition pay dividends more later. (Kotter, 1997)3) Create a sight no-hit transformation is based on a picture of the future that is relatively easy to communicate and appealed to clients, shareholders and employees. Vision help clarify the direction in which an organization must pass. The functions of mint in several ways it helps spark motivation, it helps to keep all projects and changes aligned, it provides a filter to assess how the Organization and provides a rationale that changes in the Organization should weather. A useful general rule If you cannot communicate the vision to someone in five minutes or less and get a response which means understanding and interest, you have not yet finished with this phase of the transformation process. (Kotter, 1997)4 ) Communicate that VisionKotter suggests that leadership to estimate how umpteen communications vision is needed and then multiply this effort by a factor of ten. Do not restrict it to a congregation meeting, a preaching by the Minister or by a couple of mailings to members. Leaders must be considered walk the talk another form of communication if people are going to collect important effort. Actions with words are powerful communicators new ways. The bottom line is that a transformation effort will fail unless that most members understand, appreciate, engage, and try to make the effort to occur. The principle is fair use each existing communication channel and an opportunity. (Kotter, 1997)5) Empower Others to Act on the VisionThis involves several different actions. To allow people to the Church to start living on new ways and to changes in their fields of intervention. Allocate budget property for the new initiative. Carve out time on the agenda of the session to talk about . Change how your church is organized for the people where the effort must be. unaffectionate people key existing responsibilities so that they can concentrate on the new effort. In short, re survive any obstacle, there may be to concur a change. Nothing is more frustrating that believing in change, but then do not have the time, money, help or support needed to affect it. You cannot get rid of all obstacles, but those great needs to be dealt with. (Kotter, 1997)6) Plan for and Create Short-Term WinsGiven that the actual bear on takes time, the loss of momentum and the appearance of disappointment are real factors. Most people wont on a long walk to change unless they begin to see requiring evidence that their efforts are paying off. Successful transformation leaders actively plan and short-term gains that will be able to see and celebrate. It proves the Church that their efforts are working and adds to the motivation to keep efforts. When it becomes clear that major changes woul d take some time, emergency levels can drop. Commitments to produce short-term wins help keep emergency level up and detailed analytical thinking who can clarify or revise the visions of the force. (Kotter, 1997)7) Consolidate Improvements and Keep the Momentum for Change MovingAs Kotter warns, do not declare victory too early. Until changes sink deep into culture Church, a process that could take five to ten years new climaxes are fragile and subject to regression. Yet once a premature victory declaration kills momentum, which allows powerful forces to return to tradition. Leaders of successful efforts use sense of victory as motivation to delve more deeply into their organization to explore changes in the culture database, to expose relationships of body systems that need adjustment, move people is perpetrate to new ways in the leading roles. The leaders of change must go in the process of belief that their efforts will take years. (Kotter, 1997)8) Institutionalize the overbo ld ApproachesUltimately, change sticks when it becomes the ways do us things here, when it infiltrates into the bloodstream of the organization. Until the new behaviors are rooted in shared values and social standards, they are subject to adulteration as soon as the pressure for change is deleted. Two factors are especially important for this. People first of all, a conscious attempt to show how new approaches, behaviours and attitudes have contributed in improving the lives of the Church. People must be helped to establish links between effort and result. The second is to ensure that the next genesis of leaders congregations believe in new ways. (Kotter, 1997)Lewin ModelKurt lewin proposed a three-stage theory of change commonly referred to as unfreeze, change, freeze (or refreeze). (Mind Tools, 2007 Syque, 2007).Stage 1 UnfreezeThis step is prepared for change. It consists in a point to understand that change is necessary and prepare to move away from our current comfort zone. F ree and reasoned that the change is all about weighing pro and con and decide if the more pro that the con to take any action. This is the basis of what Kurt Lewin calls the force field epitome database.Analysis of the field strength is a fantasy to say that there are many different factors (force) for and against change we need to know (analysis). If the drivers of change exceed the factors change, we change. If not, then there is low motivation change and if we pushed to change, we are likely to get Crabby and dig in our heels. This first step Thaw is to move ourselves, a Department or entire company to the motivation for the change. (Mind Tools, 2007 Syque, 2007)Step 2 ChangeKurt Lewin, that change is not an event, but rather a process. This process is called the transition. Transition is the internal movement or the trip that we do in response to a change. As with role models and allowing people to develop their own solutions besides help to make the changes. It likewise really helps keep communicating a clear desired changes and benefits to persons picture where they lead so that they lose. (Mind Tools, 2007 Syque, 2007).Step 3 freeze (or Refreezing)As the name suggests this stage is about establishing stability once, the changes have been made. The changes are accepted and become the new norm. People form new relationships and become cosy with their routines.As its name implies this stage is to establish stability once, the changes have been made. The changes are accepted and become the new standard. People in the form of new relationships and fit comfortable with their routines. (Mind Tools, 2007 Syque, 2007). convinced(p) ModelThis model consists of five stages Initiate the Inquiry, Inquire into the Best Practices, Discover Themes, Envision a Preferred Future, and, Design and Deliver slipway to Create the Future. This model is quite similar the above two models in many ways. It talks about initiating an inquisitive enquiry as to why, what, when and how things have to be reshuffled or changed which is central for e truly change effort to effect positively.At the second stage, the model proposes to enquire only the best practices and eliminate the redundant ones to trap down the scope of the change towards a particular area. Through subsequent stages, this model encourages to devise the vision for what is expected from a change which can then be used to formulate operational strategies accordingly. However, it does not talk about anchoring the new change into a companys culture. By doing so, it keeps the door open for continuous improvements and change. Also, office and continuous communication are missing in this model. (Cummings and Worley, 2008)Advantages and Disadvantage of Three ModelsKotters ModelAs the above two edit templates, Kotter eight step change model has many drawbacks and benefits. The advantages are that it is the step by step, which is easy to follow model. Another is that it does not focus on change itself, but rather the espousal and the preparation of this change, which makes it an easy transition. Focuses on the buy-in of employees as the focus for success. May be communicated among all steps and adapts well in traditional hierarchies. Downside is that you cannot ignore the steps or change process fails completely. As with the other two models change still takes time with it too. (Kotter, 1996)The linearity of the model can lead to wrong assumptions.Once process has begun, it is difficult to change the direction.The model is clearly downward it gives no margin of co-creation or other forms of real participation.Can lead to deep employee frustration if the stages of mourning and individual needs are not taken into account. (Kotter, 1996)Lewins ModelAlthough the theory of the Lewin has proved useful to understand changes in relatively stable conditions, the nature continues and the kinetics of change in forthwiths business world, it makes more sense to implement a process for freezing modified behaviour, part of the procession takes the view that the change is a complex process and dynamics, which should not be solidified or treated as a series of linear events, in the heart of the development of an approach to the procession is the need to integrate analysis of change management policy. (Cummings, 1997)Have many pointed out that the planned approach Lewin is too simplistic and mechanistic for a world where the organizational changes is a continuous process open to all (Dawson, 1994 Garvin, 1993 Kanter et al., 1992). The Lewin work is relevant to progressive and isolated projects and is not able to integrate the foundation change, transformation (Dawson, 1994 Dunphy and Stace, 1992). Lewin is accused of ignoring the role of power and politics in organizations and wildlife continues to a large part of organizational life. Lewin is seen as advocating a top-down approach on change management and do not take into account situations requiring changes fr om bottom to top (Dawson, 1994).. He clearly recognized that pressure for change has many neighbourhoods, managers and leaders, and pursuit to provide an approach that could accommodate this. Therefore, rather than supporting Lewin has seen change of behaviour as a process from top to bottom, it would be more accurate to say that recognized that might be initiated the high, low or medium, but it could not be successful without the active participation, instinctive Lewin and equal for all.Positivist ModelThe of import advantage is that this is a simple and easily understood model for change the model is done through steps this is an efficient model that is used today (Mind Tools, 2007 Syque, 2007).The main disadvantage of this model is that it is timely, but you must consider that it is timely for any change to take place. Another disadvantage is that at the envision the favourite(a) future, many people are worried that another change is coming, so they are in change shock (Syque , 2007). This change shock causes employees to not be as efficient or effective in their jobs (Syque, 2007).Similarities between the Three ModelsAll three models Kotters change model, model change of Lewin and positive role model describe the phases through which the change occurs in organizations. All three approaches focus on the application of the knowledge of behavioural science, involve the members of the organization in the process of change, to varying degrees and acknowledge that any interaction between the consultant and an organization is an intervention that might affect the organization. However, model change of Lewin differs from the other two in that it focuses on the overall process of planned change, rather than on specific organizational development activities.In Kotters and Lewin both discusses about how difficult it is to get the people from the comfort zone for the change to happen. In both of the models they use different set of calculation to know whether the re is any need of change to take place in the organization. In all three models it starts to identify the problem at the beginning and starts to rectify and implement the change. In Positive and Kotters model the vision for change is declared and works accordingly towards it and it can be done by allotting work to each employees.ConclusionWith the recent crises many organizations are willing for change to cope up with market. So surviving in the market is the key for the organizations so they are wiling for change but its the employee or the people who are working in are against it because of fear that what this change might ask them to do. But its the people only who are willing for change like the ranking(prenominal) managers. So with different people opinion some with positive and some with negative changes are happening. Important change has increased substantially in the organizations for the bypast two decades as a result of strong macroeconomic forces. Whenever human commun ities are forced to adapt to the changing conditions, the pain is always present. Some misconducts during the processing of a common organization are (1) leave too complacent, (2) do not create a sufficiently powerful Director coalition, (3) underestimate the power of the vision (4) to communicate the vision of a factor of 10 x-100 x, (5) permits obstacles to block the new vision of failing (6) to create some victories in the short term (7) giving victory too soon, (8) neglect anchored firmly in the corporate culture change. These errors amplify a globally competitive rapid movement. These errors can be mitigated and perhaps avoid. The key is to understand why organizations resist changes and the process in several steps to achieve, and how leadership is critical for driving the process in a socially healthy way.You have to work hard to change an organization successfully. When you plan carefully and build the proper foundation, implementing change can be much easier, and youll imp rove the chances of success. If youre too impatient, and if you expect too many results too soon, your plans for change are more likely to fail.Time for the change to happen depends from organization to organization and the approach they take. They take different steps or models for the change to prosper. So many models available for the organization to play with like the ones discussed above Kotters, Lewins, and Positivist Models. So with these many models changed many organization futures some models worked some didnt.The three phases of Lewin for the management of change, organizational development theory and macro change theories are useful for managers to understand the dynamics of change. It is also important for managers to know how to overcome resistance to change, including education and communication, involvement and participation, negotiation and agreement, manipulation and co-option and use of stress.Lewins model is very rational, goal and plan oriented. It doesnt take i nto account personal factors that can affect change. Conversely, social cognitive theory proposes that behavioral change is affected by environmental influences, personal factors, and attributes of the behavior itself. Lewins model makes rational sense, but the Social Cognitive Theory because it takes into account both external and internal environmental conditions.The positive role model is a simple model that can be used to guide the principles that underlie effective interventions for change, the individual levels and groups. Should redraft fundamental issues (e.g., how can determine what level of involvement is appropriate for this person?), accept that change is likely to be a phenomenon of development instead of a single decision point (for example, it may take several iterations of the cps, according to the great how change is for the persons involved) and recognizing that the emotional elements (hope and trust) are inextricably interrelated with the behaviour (qualified pra ctice) and cognitive elements (information, beliefs, attitudes and new objectives). Positive change cycle also suggests that we need to rethink what really are the components of effective career interventions and take concrete steps which testify of change of these critical components. Ultimately, our goal is to help people develop self-managed adaptability to change. We must find ways to better measure each of the components of positive change, hope and courage changes in attitudes and relevant skills and confidence to yield skills and ability to generate new goals for a self) and also show the cumulative impact of positive change cycle. If we can, we are much more on the street to help create interventions that promote long-term changes and to demonstrate our role in the promotion of this change.I think that Kotters Model is the best choice because it is a simple model. I also feel this way because it fully prepares the employees of the company before the vision is even created, which means that the actual transition will be much easier in the long run. There are fewer disadvantages to this model than others. Overall it is the best fit for most companies because substantial change is needed for the divisions because its history. This will also help ease the transition because the division has quite a history compared to the rest of the company, so people are not as set in the ways, as they would be if the division had been around longer.Create a sense of urgency, recruit powerful change leaders, build a vision and effectively communicate it, remove obstacles, create quick wins, and build on your momentum. If you do these things, you can help make the change part of your organizational culture. Thats when you can declare a true victory, then sit back and enjoy the change that you envisioned so long ago.There are further errors that make people, but these eight are greatest. In fact, even successful change efforts are messy, and full of surprises. But just a s a relatively simple vision is necessary in order to guide people through a major change, therefore a vision of the change process can reduce the error rate. And fewer errors can make the difference between success and failure. I have observed many attempts of the metric system conversion in many organizations for many years and I think that John P. Kotters first change provides a reference for the leaders of the conversion to metric to consider as they plan upgrade conversion to metric.

Gay marriage ethics

Gay espousal ethicsIntroductionThe issue of courtly rights for homophiles and lesbians, one in particular espousals although many religious conservatives wish it would, leave not go away. One of the reasons, for this is that the U.S. Supreme Court has struck peck state anti-sodomy gooditys as unconstitutional and in light of the Michigan state Supreme Courts ruling that prohibiting wedlock between resembling(p)-sex couples violates their constitutional rights. Marriage has always been a huge part of human existence relationships. It is seen as the coming together of a man and a woman, the bonding two people together for emotional support, honorable support and economic well being as well as the rearing of children. Most of society looks at brotherhood as a sanctum sanctorum union of just one man and one woman. Does marriage f entirely in to be between just a man and women? This paper will reckon both sides of the courtly rights and moral dilemma that is facing the U nited States today.Identifying the ProblemThe issue of - cheery marriage is one that has been very much in the forefront of common discussion in recent years, with states granting, then withdrawing marriage licenses to gay couples, wrangling over legislation as to whether to grant full marriage rights or collapse domestic partnerships, and trying to come to grips with how to balance differing of public opinions on the subject, which atomic number 18 passionately at odds in some areas. Some believe that large(p) gay couples the full benefit of marriage will take away from the traditional marriage, while others feel they ought to take nothing less. Same-sex couples are denied their civil rights, such a do medical decisions for their partners in an emergency. Some of which have not been in contact with their families for years, hospitals are legally bound by state law to contact their next of kin for direction on issues pertaining to the health of the patient when their partner is right there. Even when wills and POAs (Power of Attorney) are made, they are some terms fought by the family and overturn by a court. Is this right, virtuously or ethically? Married couples can not testify against their partner in a court of law, but gay partners do not get the same right. Another civil right is this fair?Clarify ConceptsGiving way to legal acceptance to gay marriage would hurt society on a number of levels. First, legal identification of gay couples would legitimatize morally wrong unions. Further,gay marriage would in the end become marriage as the basis of an established society. Since gay unions cannot produce children through ordinary and proper procreation, such unions do not add to the survival of the human race. Furthermore, it is immoral to legitimize gay unions because it is not in the best interests of the children who might be adopted by gay couples. These children would be lacking of either the sentiency of fatherhood or motherhood. Because coh abiting homo familiars can consume use of various legal provisions to protect their rights, there is no need to allow gay couples the legal status of marriage, especially since such a change would threaten the common good. (Burns, 2002) thither are many religious arguments and protests that are against gay marriage. Among these are the judgment that gay couples are unnatural, marriage is sacred and a sacrament, the primary purpose of marriage is procreation, and marriage is defined as a union between a man and a woman. Many point to biblical scripture when arguing against gay marriage. Most religious opponents to gay marriage cite two line of achievements from the out of date Testament as proof of their point-of-view. The first of these is Leviticus 2013 If a man lies with a man as one who lies with a woman, both of them have done what is repulsive. They must be put to death (Burns, 2002).Possible Solutions to the ProblemsOur society here in the United States needs to have more of an open foreland when it comes to sexual preferences. The gay and lesbian community has been struggling for years for civil rights. We need to consider their right to be married whether in a civil ceremony or a church of their choosing. They should be allowed the same rights as any other American citizen. We should do this because it is the right thing to do. Our Pledge of committal is under immortal with liberty and justice for all, not for who we choose. Religion should not dictate our morals or who should be allowed to marry. Civil liberties should dictate our morals and the character of life for our people where we are all considered equal no matter what our religious, social, financial or political views are. We can similarly develop a home(prenominal) Partnership into law for gay and lesbian citizens as another solution. This would allow homosexuals to be recognized as legal partners by each state and entrust them the same rights and responsibilities that heterosex uals have always claimed. Lets look at some of the arguments against gay marriage to see how they stand up. Solutions may be found by these by seeing that some of them just do not stand up..If the arguments do not make since then there must be a solution. go through Assumptions and Points of View Opposition of gay marriage say that marriage is for the creation of children, if that is the case then why are couples that are infertile allowed to marry? excessively should post menopausal woman and men who are impotent divorce because they can no lifelong procreate? How do they explain this? This does not make a good argument against gay marriage. (Bond,2008), Legalizing gaymarriagewould have a negative effect on the concept of monogamy in marriage. Homosexual advocates disagree that main course to marriage will encourage gays and lesbians to conform to traditional monogamy in committed relationships. It is more likely that opening marriage to homosexuals will allow them to legitimi ze non monogamy, civil partnerships unrelated to sexual or romantic relationships, and polyamory (sexual relationships among more than two people). Without monogamy as a inception principle, marriage will no longer provide a stable and healthy setting for families and especially children to thrive. If gaymarriage is legalized, the institution of marriage will be deprived of monogamy and thus any desire of permanence.( Kurtz 2005) I believe that this is a fallacy ground on scare tactics, somewhat like the Bush administration idea of going to war with Iraq. There have been legalized gay marriages in other states and other countries for years would there not be news about polygamy and the non-monogamy because of gay marriage? The biblical passage in Corinthians 69-10 Do not be deceived. Neither the sexually immoral nor idolaters nor adulterers nor male prostitutes nor homosexual offenders nor thieves nor the greedy nor drunkards nor slanders nor swindlers will inherit the kingdom o f God (Bible). After gaymarriage, what will become of marriage itself? Will same-sex matrimony extend marriages stabilizing effects to homosexuals? Will gaymarriage undermine family life? A lot is riding on the answers to these questions. But the medias impulsive labeling of doubts about gaymarriage as homophobia has made it almost impossible to debate the social effects of this reform. Now with the Supreme Courts ringing command of sexual liberty in Lawrence v. Texas, that debate is unavoidable (Kurtz, 2005). Gay marriage causes offense to everything religion stands for. What or whose religion does this stand for? Christian religion yes it does and also Islam and Judaism, but a Buddhist sect in Hawaii does support the right of gay marriage (Bidstrup 2009).Gather InformationThe opposition of gay marriage is found on misunderstanding of what homosexuality really is. There are stereotypical views about gay relationships, that they are promiscuous, and cannot form a lasting relati onship. I am sure that they are no different than straight relationships. We have promiscuous and lasting relationships. It sometimes human nature, especially among young people who are not ready to settle down its not based on if you are gay or straight. So what is marriage for? Modern marriage is, of course, based upon traditions that religion helped to codify and enforce. But religious doctrine has no special standing in the world of secular law and policy, the Christian nation meeting notwithstanding (Rauch, J 1997). If we want to know what and whom marriage is for in modern America, we need a sensible secular doctrine. Many people believe that gays have a choice in being who they are, and it is only about sex. They can choose to be with a member of the opposite sex if they want to be. Homosexually is based on mutual attraction, affection and love the same as heterosexuals. It is no different than being white, black, or Chinese it is the way you are born. Gay marriage is mor ally wrong and violates the sanctified institution of marriage. This is said by the Bible. The United States and American law is supposed to be separate from the church this is from one of our founding fathers Thomas Jefferson. Therefore it is not right for someone to use the Bible to say what is to be made into law (Bidstrup 2009).. Gay couples are not morally able to raise children but, it is morally right for child molesters, murders, and convicted felons are allowed to marry and create and raise children. Why are the same people who oppose these rights to gay couples not against this, it happens every day. There are not studies that have determined that gay couples raising children caused them any harm, Can the same be said be said by child molester? Moral ReasoningGay marriage principles are, in my opinion, no different than those in a heterosexual marriage. They want the same thing in a marriage that anyone does that chooses a partner for life. Their values are the same, they are loyal to their partners, are monogamous. They participate in family life, committed to their neighborhoods and communities by making them a better place to live. They serve on their school boards, volunteer in the community, they are good citizens, just like their heterosexual counterparts, making their communities a better place to live (Bidstrup 2009). One of the benefits of the heterosexual society as well as the homosexual community for gay marriage is the participants are not involved in promiscuous sex. This slows down the spread of sexually transmitted diseases by the way know no sexual orientations. I am a supporter on gay marriage, I believe in all equal rights for all people no matter race, gender, or sexual preference. I believe in the separation of Church and State. It should have no bearing on our laws and moral reasoning when it comes to making our laws as long as our rights do not infringe on our fellow citizens rights. Most public officials place their reach o n the Bible and swear to uphold the Constitution. They dont put their hands on the Constitution and swear to uphold the Bible (Bond J., 2008). I think that religion and scripture are used to keep gay marriage from bonny legal. Our government uses religion when they think it is necessary for their advantage. That is wrong. The Bible was written long ago, there are so many contradictions in it and I believe that it was meant for the time it was written in and for a specific people. In our society today there are several injustices that are more important that our law makers should be concentrating on than opposing gay marriage. Let us move forward.ConsequencesWhen and if gay marriage is passed they will receive the same benefits of heterosexual couples. They will enjoy the same contented lifestyle that a two income family has. In todays economic society it most often takes two incomes to keep up with the middle class. The social benefits will be sharing insurance benefits, healthcar e, tax filing as a joint couple, joint ownership, and ability to make medical decisions for each other. Social Security, billet inheritance, and family medical leave and military disability benefits are just a few more that heterosexual marriage couples have. The argument about homosexuals not being able to procreate, although partly true, lesbian can certainly procreate by artificial insemination, and that they could harm children by raising them shows no scientific evidence. Gay marriage would increase adoptions there are many children that are in need of homes by loving parents and extended families. This would be a positive step for children that do not have a home. One of the most successful approvals for gay marriage is that they will no longer be second class citizens by being on the lower part of the social standing. The homosexual community should no longer have to be denied their equal civil rights. We are all created equal and that includes everyone, it is not based on our sexual preference. If gay marriage is legalized they will no longer be subjected to narrow-mindedness every day. Bidstrup, S. 2009, Gay Marriage, The Arguments and the Motives, Retrieved meet 1, 2010. http//www.bidstrup.com/marriage.htm Bond, Julian. Opposing Same-Sex Marriage Discriminates Against Gays. Opposing Viewpoints Discrimination. Ed. Jacqueline Langwith. Detroit Greenhaven Press, 2008. Opposing Viewpoints Resource Center. Gale. Baker College. 28 Feb. 2010Burns, K. 2005 Congregation for The Doctrine of The Faith. Gay Marriage Should Not Be Legal. At eff Gay Marriage.. San Diego Greenhaven Press, 2005. Opposing Viewpoints Resource Center. Gale. Baker College. 28 Feb. 2010Kurtz, Stanley. Gay Marriage Threatens Families. At Issue Gay and Lesbian Families. San Diego Greenhaven Press, 2005. Opposing Viewpoints Resource Center. Gale. Baker College. 28 Feb. 2010Rauch, J., Society Has a Compelling Interest in Allowing Gay Marriage, Current Controversies Gay Rights, San Diego Greenhaven Press, 1997, Retrieved March 2, 2010, Opposing Viewpoints Resource Center. Gale, Baker College

The Hours :: Cunningham Hours Essays

The Hours The Hours is a novel that deals with the various cultural aspects of life. Michael Cunninghams writing reflects the various nuclear families, the different economic conditions, and the social issues involving the lead women in the novel. The Hours begins with Virginia Woolf who is married to Leonard. They do non have any children of their own. Woolf lives in London in 1923 battling affable illness and struggling to write a book, Mrs. Dalloway. She struggled and finish the book according to Tony Peregrin at the age of 43. Woolf is financially stable due to her preserve was a publisher. She had a cook, Nelly, and a housekeeper Lottie. By 1941, The Second earth War was going on and Virginia Woolf had committed suicide. The second protagonist in the novel is Laura Brown, a housewife who is living in Los Angeles in 1949. Her traditional family consists of her husband Dan who is a war hero of sorts, works in an office, provides for the family while Laura statys at sign of t he zodiac and cares for the family. She has one child, Richie, and is expecting another child. The Browns live in a nice home with manicured lawns, nice Cheveorlet in the driveway, in Los Angeles. Laura smokes, reads Mrs. Dalloway, and is infaturated with Virginia Woolf and her suicide. She desires to commit suicide but opts out to leave her family and move to Canada instead. Life and death will bring the mother and password together. Laura may not have the nerve to kill herself, but her son Richard, fell to his death from a fall from the window while suffereing from AIDS.The third protagonist, Clarissa Vaughan, who was attached the name Mrs. Dalloway by Richard. He was a one time lover of hers. The period is 2001. Clarissa is financially stable and independent while living in the upscale Greenwich Village area with her live in lover, Sally of 10 years. Clarissa has a daughter, Julia who was conceived by artificial insemination by an unknown donor. Julia has a gay friend, Mary who Clarissa is not very fond of.Although Woolf, Brown, Vaughan are women that are struggling with their own internal issues of restlessness in the place of where she lives, contemplating suicide, unhappiness in a marriage, living with mental illnes, and feelings of failure. Yet, each of these women had secret sexual feelings for other women.( Woolf for sister Vanessa, Brown for neighbor Kitty, and Vaughan for Sally).

Healthcare and the Competitive Market Structure Essay -- Health Insura

A competitive commercialize is one that allows undemanding entry and exit a market in which companies are generally free to stick in or to leave at will. This does not describe the wellness attention market in the US. There are certain assumptions that the competitive market model operates under some assumptions, first is the consumer/patient has full data about the nature of the go required, the anticipated results of their decision and the benefits obtain from the service. This is not true in health care often time the patient is operate at a distinct information disadvantage when they require health care services such as damages. If a patient purchases health insurance often they dont know enough information to ascertain if they have purchased a quality plan. Second, consumers/patient and providers (physician, health insurance) act independently. This does not hazard in health care because of the asymmetry of information that exists patients must depend on the decisio ns do by their doctor or health care provider who is acting on their behalf as a health agent or gatekeeper. Sometimes physicians take diagnostic facilities or invest in health care organizations this affects their ability to be impartial. Third consumers bear the financial impact of their decision and are certain of price differences most patients are insulated from the true live of health care because of a third-party payer who bears the financial brunt of the decision to receive medical care. Shi and Singh state that raze if a patient wanted to find out the cost of services sometimes it is difficult because of item based pricing. Fourth there is unrestrained argument regarding price and quality among providers. Access to the health care market unrestricted is b... .... Looking back to look forward health care reform. Retrieved celestial latitude 16, 2010, from KPLU News Web site http//www.kplu.org/health_care_script.htmlFederal Trade Commission, & incision of Justice. (2 004). Improving health care a dose of competition. Washington, DC U.S. Government Printing Office.Haft, H. (n.d.). Is health care a right or a let? - health policy. Retrieved December 17, 2010, from BNET Web site http//findarticles.com/p/articles/mi_m0843/is_1_29/ai_96500897/Shi, L., & Singh, D. A. (2008). Delivering health care in the States a system approach (4th ed.). Sudbury, MA Bartlett and Jones. unite Nations. (1976, January 3). International Covenant on Economic, Social and Cultural Rights. Retrieved December 17, 2010, from Office of the United Nations Commissioner for gentleman Rights Web site http//www2.ohchr.org/english/law/cescr.htm Healthcare and the Competitive Market Structure Essay -- Health Insura A competitive market is one that allows easy entry and exit a market in which companies are generally free to enter or to leave at will. This does not describe the health care market in the US. There are certain assumptions that the competitive market mod el operates under some assumptions, first is the consumer/patient has full information about the nature of the services required, the anticipated results of their decision and the benefits obtain from the service. This is not true in health care often time the patient is operating at a distinct information disadvantage when they require health care services such as insurance. If a patient purchases health insurance often they dont know enough information to ascertain if they have purchased a quality plan. Second, consumers/patient and providers (physician, health insurance) act independently. This does not happen in health care because of the asymmetry of information that exists patients must depend on the decisions made by their doctor or health care provider who is acting on their behalf as a health agent or gatekeeper. Sometimes physicians own diagnostic facilities or invest in health care organizations this affects their ability to be impartial. Third consumers bear the financia l impact of their decision and are aware of price differences most patients are insulated from the true cost of health care because of a third-party payer who bears the financial brunt of the decision to receive medical care. Shi and Singh state that even if a patient wanted to find out the cost of services sometimes it is difficult because of item based pricing. Fourth there is unrestrained competition regarding price and quality among providers. Access to the health care market unrestricted is b... .... Looking back to look forward health care reform. Retrieved December 16, 2010, from KPLU News Web site http//www.kplu.org/health_care_script.htmlFederal Trade Commission, & Department of Justice. (2004). Improving health care a dose of competition. Washington, DC U.S. Government Printing Office.Haft, H. (n.d.). Is health care a right or a privilege? - health policy. Retrieved December 17, 2010, from BNET Web site http//findarticles.com/p/articles/mi_m0843/is_1_29/ai_96500897/Shi, L., & Singh, D. A. (2008). Delivering health care in America a system approach (4th ed.). Sudbury, MA Bartlett and Jones.United Nations. (1976, January 3). International Covenant on Economic, Social and Cultural Rights. Retrieved December 17, 2010, from Office of the United Nations Commissioner for Human Rights Web site http//www2.ohchr.org/english/law/cescr.htm