The Dimensions of Inter-Professional Practice

Abstract The essay examines a situation encountered by the student during her placement on a hospital ward: the regular ward meetings to discuss patient care and progress. The essay reflects upon the experience using the reflective cycle model proposed by Gibbs. It also draws upon SWOT analysis and the PDSA cycle model for nursing practice. While rooted in the student’s experience, the essay also looks at relevant theoretical concepts including those of multidisciplinary teamwork and patient-centred healthcare. 1. Introduction This essay aims to consider a situation I have encountered during my placement, using principles of reflective practice to outline an appropriate change to established procedure which, I feel, will benefit service users and staff. I want to discuss ward reviews, and show how these can be improved by extending the range of people who attend these reviews. I want to use principles of reflective practice and evidence-based practice to examine this area. The essay will use Gibbs reflective cycle as a structure within which to understand a situation I encountered, and plan for change. The essay will also look at some relevant theory, including notions of interprofessional team work, change theory and team dynamics.The current situation will be discussed in terms of these. I will also draw upon the PDSA cycle model for nursing practice (NHS Institute for Innovation and Improvement 2012 [online]), which provides a way to structure and implement change. I will also use a tool widely used in business called ‘SWOT’ analysis, which helps in change planning by formalising the strengths, weaknesses, opportunities and threats in a given situation, and which is also useful for healthcare (Marquis and Huston 2009). Gibbs (1988) model of reflective practice will also be influential. The essay will be structured according to this 6 sta ge cycle, from description of event through evaluation and analysis to action and further reflection. While there are several different models of using reflectivity in practice including Bortons’ (1970), Kolb’s (1984) and Johns’ (1995), I use Gibbs model as it seems to best express the dynamic process of learning and change for me.These tools will be used to demonstrate the things I feel are inadequate with the present situation whereby a limited number of healthcare professionals attend ward reviews, and suggest a change whereby key workers also attend, offering a deeper perspective on patient needs. The nomination form, which assesses my placement, is included in the Appendix. 2. The Situation: Description The situation in question occurred when I was on placement. The hospital at which I was working, like others, carried out regular ward reviews. In these, the patient was discussed. A number of key staff involved in patient care were involved, and the aim was to review the patients care, treatment and prognosis. At the hospital where I carried out my placement, the members of staff who were involved were the consultant, the occupational therapist and the review nurse, sometimes also a student attended. The patient did not attend this meeting. I attended a number of these reviews. In general, all members of the team who attended were respected and respectful, and took care to listen to what each person had to say. One person led the meeting, making sure all were included and also ensuring that discussion did not go on for too long. Realistic goals and a date for the next meeting were set at the end, and the items discussed were formalised in writing. 3. The Situation: My Feelings I had two sets of feelings. On the one hand, I felt pleased that everyone who attended the meetings seemed to have the best interests of the patient at heart. Where there were disputes it was regarding what would work best for the patient. Also, I was pleased with how professionally staff members conducted themselves, I seldom witnessed rudeness or ‘shortness’ when one person spoke to another. People took turns and really seemed to listen. In part, I felt, this was due to the way the meetings were led, which was very sensitive. However, on the other hand, I felt quite annoyed and disappointed that not all staff who were involved in patient care were included in the meetings. I felt that a whole side of the patient’s experience was being missed out. The staff who attended seemed to understand the patient’s condition only generally, from their records and discussing the situation, not through contact with the patient daily. The holistic side of patient car e, understanding what the patient was feeling, seemed to have been missed out. 4. Evaluation In terms of the ‘SWOT’ framework, widely used in business but also useful for understanding healthcare (Williamson et al 1996), I evaluated the experience as follows. As Gibb’s evaluation stage is concerned mainly with what is good and bad about the experience, I have omitted the ‘opportunities’ and ‘threats’ from this analysis, as they will be covered later.StrengthsGood communication between team members Respectful awareness of other points of view Developed clear goals and actions to followWeaknessesPatient seems to lack a ‘voice’ Those involved in caring regularly from patient are not included in the review Those who know the patient well are not included in the review Lack of holistic and person-centred care 5. Analysis The following sections looked at what happened, how I experienced it and what sense I made of it within my own parameters. In order to make wider sense of the situation, I need to draw upon notions of interprofessional teamwork, user perspectives and team dynamics, all concepts central to the current health service. Interprofessional teamwork, also known as multidisciplinary teamwork (MDT), has been part of healthcare policy in the UK since 1997 (Davis 2007). As an approach, it means professionals from a range of disciplines involved in patient care meeting to discuss and agree on care plans for patients (Hostad 2010). There are a number of benefits, for example multidisciplinary teamwork seems to meet user needs better, and to deliver better outcomes. However, there are also some drawbacks including the time needed for teams to work effectively, and difficulties with perceived status differences (Housley 2003).For effective MDT, the ways in which team dynamics work has to be unde rstood. There are many attempts to understand how people work together, both generally and in the healthcare context, for example Bale’s (1950) model. Maslow’s model is also influential in healthcare. He suggested that all human’s need to be respected by others in order to feel valued, and have a need to feel part of a group, and want to have their social and emotional needs met within the work context (Borkowski 2009). The notion of incorporating user perspectives is also very influential in the NHS currently, as ‘patient-centred healthcare’. This was introduced in the late 90’s, and involves patients being involved as much as possible in decisions which are made about their care. The relationship between healthcare professional and patient is no longer one in which the professional is at the top of a hospital hierarchy, but one of partnership in which mutual respect and communication exist (Chambers et al 2003) Overall, I feel that both MDT and patient-centred healthcare could be improved here through including the key workers, or support workers of the named patient. The key worker acts as a co-ordinator on behalf of the patient, keeping the patient informed of what is going on and co-ordinating care and ensuring continuity of treatment (NICE 2004). Support workers or healthcare assistants act in a supporting role to other professionals, and are very ‘hands-on’ in well-being and looking after the patient.Both these professionals have much closer contact with the patient and as such have important insights into the patient’s situation. Multidisciplinary teamwork emphasises including all viewpoints relevant to the situation, and I feel that these workers would add valuable insights to enhance the teamwork. In addition, how can patient care be really holistic and patient-centred if the meetings do not include those people who get to know patients as individuals, understa nding their feelings, hopes and fears Including support and key workers would allow those people who are not involved in daily care to really understand how the patient is feeling.In addition, if support and key workers were present at the meeting, it would be much easier and quicker to feedback to the patient what is going on with their care. As it stands, patients hear second hand. 6. Conclusion Gibbs suggests reflecting upon what else I could have done here. Given that I was on placement, I feel that the opportunities for changing the situation are practically limited. At the time, I felt it was not appropriate for me to speak up and question the accepted meeting structure. Later, however, I did question whether I should have mentioned this to my supervisor on the ward. I felt that the emphasis on MDT meant that I would be heard sympathetically, even though I had very little experience. If I was able, I would change the meeting structure to ensure that either a support worker or a key worker was included as a matter of principle. I feel that the existing meeting structure is very good, and that if it was part of protocol that staff closely involved in the patient’s care were included, they would be welcomed into the meetings, their opinions heard and the patient’s viewpoint better understood. This would, I feel, ensure that the care delivered to the patient was more truly patient-centred and holistic, as it would take into account not only quantitative data about their condition but also their feelings and emotions. In addition, I feel wider meetings would be more reflective of multi-dimensional teamworking, as they currently don’t include all staff perspectives. It also seems that including key and support workers is more ethical. All hospitals have detailed code of conducts which set out the ways in which they expect their staff to behave, and the care of the patient is generally the first priority in these. Working as a team is also one of the central tenets of most ethical codes in UK hospitals (Melia 2004). 7. Action Plan Here I draw upon the PDSA model to suggest a way to structure the change:PlanDiscuss and agree new format for meetings (including key worker or support worker) Inform key / support worker and other staff of new meeting formatDoCarry out a series of 4 pilot meetings over agreed time period Agree and implement mechanisms for review of new meeting format (gather data from key/support workers, staff already included, and patients)StudyAnalyse data collected, assess changes against clearly defined criteria (for example, do patients feel more informed, happier; did key/support workers feel included; did other staff value new structure) What worked wellWhat worked less well?ActPlan new meetings on basis of what was learnt during study phase. If including key/support workers beneficial, change meeting structure so that they are now part of meetings. Ensure that repercussions of this are understood, for example allowing them extra time for preparing for meetings. References Borton, T (1970) Reach, Teach and Touch, Mc Graw Hill, London. Gibbs, G (1988) Learning by Doing: A Guide to Teaching and Learning Methods, Further Educational Unit, Oxford Polytechnic, Oxford. Johns C (1995) Framing learning through reflection within Carper’s fundamental ways of knowing in nursing Journal of Advanced Nursing, 22, 226-234 Kolb, D A (1984) Experiential Learning experience as a source of learning and development, Prentice Hall, New Jersey Marquis, B L and Huston, C J (2009) Leadership roles and management functions in nursing: theory and application (6th edn), Lippincott Williams & Wilkins. Melia, K M (2004) Health care ethics: lessons from intensive care, SAGE, Thousand Oaks, CA NHS Institute for Innovation and Improvement (2012) ‘Plan, Do, Study, Act (PDSA)’, [online] (cited 14th February 2012), available from http://www.institute.nhs.uk/quality_and_service_improvement_tools/quality_and_service_improvement_tools/plan_do_study_act.html NICE (2004) ‘Improving Outcomes Guidance for Supportive and Palliative Care’, National Institute of Clinical Excellence 2004, London. Williamson, S, Stevens, R E, Loudon, D L (1996) Fundamentals of strategic planning for healthcare organizations, Routledge, UK Appendix CLIENT – INCLUDE NOMINATION FORM HERE Assignment In writing the 1500 word reflective commentary focussed on service improvement you should consider/address the following: The context and setting for your placement. Your reflective commentary should focus either on a service improvement initiative that you have identified with your mentor, or on a service improvement that has previously been implemented in your practice area. You should examine this initiative in terms of the inter-professional team and identify actual or potential ways that inter-professional working can facilitate its implementation. You should also discuss potential barriers to implementation. You MUST include the Service Improvement Activity notification form with your assignment including a discussion of future plans in terms of the service improvement initiative. An evidence based model of reflection or reflective writing should be used. You should offer a rationale to support what you have used (fixed resource sessions on the use and application of reflective models and writing are included in the delivery of this module). You should also demonstrate the use of the PDSA cycle in terms of service improvement. For assessment purposes you are not expected to move beyond the planning stage of the PDSA cycle. As this assignment is a reflective commentary your reflection must be supported and referenced by using appropriate sources (as per learning outcomes). You may wish to use a structured reflective model e.g. Gibbs’, Rolfe et al or John’s; or you may wish to write in a reflective style, encompassing reflection on action e.g. Schon or Borton. This is your choice but either way you must show evidence you have done this. A reflective commentary requires that you use subheadings. The structure of this piece of work can be informed by using either learning outcomes or the stages of a reflective model to do so. If you say you are going to use a model of reflection, then you must demonstrate clearly that you have done so. Which ever process you use must be briefly explained and rationalised within your introduction. Ensure that you have supported your assignment with appropriate, contemporary and relevant sources, including published literature, professional standards key texts and policy. You need to apply theory to practice and use paraphrasing to demonstrate understanding of the sources you have used. Make sure you address the relevant learning outcomes for this piece of work (l,2,5) in this commentary: Learning outcome one requires you to analyse the unique role of the nurse within the inter-professional team and also to apply this to your experience in your placement area. For example, do nurses in your placement area require any additional skills or knowledge to work with the client/patient group Learning outcome two requires you to evaluate the contribution of all members of the inter-professional team in providing holistic care to clients/patients. For example, which guidelines and policies inform holistic care in your placement area and how did this impact on practice in your areaHow did the team work togetherWhat quali ties did you note in the team and how did this impact on care delivery Learning outcome five asks you to reflect on learning and transfer newly gained knowledge. For example, what did you learn and how will what you learned in your placement help to prepare you to be a registered nurse

Advantages of PHP Language in Web Design

Now a day, when we talk about web designing, the first language which comes into our mind is PHP. It is one on the hottest scripting language into today's technology world. Well, the reason behind its popularity is no license cost. PHP is an open source, which you can download free of cost and customize it according your project requirements. It comes with PHPMyAdmin, which is supported by database languages like MY SQL2.0, SQL, etc to create database tables. By using PHP, you can build fast, secure and dynamic web portals, as it is the most compatible language. The design and interface is very simple, which makes this language easy to understand. To make you application secure from virus and spyware attacks, the security functions are available with the technical support available worldwide. PHP is widely acclaimed open source programming language which has changed the web development scenario. It requires less processor space, so it doesn't affect the speed of the system. There are certain aspects like scalability, flexibility, usability which comes into our mind while creating a dynamic website. PHP is user friendly covering all these aspects mentioned above and makes it the most suitable language for creating web pages. The modular structure of codes in PHP can adapt the change and custom module can be created very easily. Ready to use framework like Zend can be used to build big web portals. Other frameworks like Joomla and Drupal are commonly used to develop business websites. Your blog system can be enhanced through WordPress Plugins.

Institute of Medicine framework for healthcare quality Assignment

Institute of Medicine framework for healthcare quality - Assignment Example ences and needs), timely (the time it takes to receive and give care to patients), efficiency (use of all resources to the maximum) and equitability (providing equal quality of care to patient of different gender or status). These components can be applied to nursing in order to ensure a high health care quality. The safety component, for instance, can be implemented by ensuring that the nurses possess the necessary knowledge and skills needed in the field. On the other hand, effectiveness and efficiency can be ensured by appointment of a strict managerial team; which will supervise and ensure proper use of the nursing resources. Timely and patient centeredness components of health care quality can be achieved by reducing the ratio of patients to nurses so as to ensure that patients will get the attention they require. Finally, equitability can be met by discouraging discrimination of patients and setting harsh rules to those found discriminating patients. Once the components are implemented and observed strictly, the nursing sector can be of high health care quality. In my actual work setting, the framework components can be applied to improve the quality of healthcare services offered. For starter, all the nurses without a diploma in nursing should be forced to go further their studies; this will consequently improve safety of the health care provided by reducing the numbers of accidents to patients when undergoing treatment. On top of nurses furthering their studies, the manager should be highly qualified and strict; this will ensure effectiveness and efficiency of the health center’s resources. Additionally, the government can increase the number of nurses in the health center so as to ensure timely quality and the ability to provide care which is responsive to patients’ preferences and needs. This will ultimately increase the health care quality of the health

Morality vs. In vitro fertilization Essay Example | Topics and Well Written Essays - 500 words

Morality vs. In vitro fertilization - Essay Example Although the procedure may indeed benefit the ailing son, it would also bring harm and potential risks to the baby. The manipulation process which would be carried out on the embryo includes personhood qualities which may be lost or destroyed in the process of manipulation (Dane and Finkbeiner, 2007). Even if such harm or risk may not be actually proven in the medical or clinical context, religions and cultural dictates may declare such risks as significant. The scientific and medical way of assessing and declaring the presence of risks cannot be the sole basis for defining harm; â€Å"to do so also would lead to a lack of respect for other religious and cultural beliefs† (Dane and Finkbeiner, 2007, p. 5). In effect, although clinicians may rule out the risk which may be incurred from the procedure as minimal, such risks cannot be overlooked in favor of potential benefits. The justice consideration is also crucial in this discussion. The principle of justice basically sets for th that all people must be given their due. The potential child in this case is being unjustly viewed already not as an individual person, but as a tool – a means to an end. Granting that he was chosen to live for such purpose, justice requires that he be given his due – that of living his life beyond the nefarious purposes of his parents (Hug, 2010).

Personal and Professional Footprint Essay Example | Topics and Well Written Essays - 1250 words

Personal and Professional Footprint - Essay Example In fact, according to the results, we would require at least 4.2 planets if all people in the world were living my lifestyle. I was shocked by this because I have always regarded my life as modest and not too demanding in terms of natural resources. Of the four carbon footprint tests that I toot, two of them indicated that my carbon footprint is above national average. For instance, my housing footprint was 31.31 while the national average is only 28.36. My goods and services footprint is 67.78 compared to the national average of 62.06. I not only find these statistics as relevant but I also find them shocking and this means that I need to review my lifestyle. The industry has a number of processes and equipment that are associated with carbon footprint. This is caused by the number and type of machines, materials and processes that professionals in this industry have to use in order to be able to do their work. For instance, biologists have to use a number of chemicals for the various experiments they carry out. These chemicals have a number of negative impacts on the environment either directly or indirectly (Matthew, 2012). For instance, the chemical are removed from their natural places of existence and this has a negative impact on the environment. At the same time, the residues from these chemicals after they have been used in the laboratories also have a negative impact on the environment if the disposal is not done the right way. The other issue is the machinery that is used in the industry. This machinery consumes a lot of electricity and this definitely has an impact on the environment especially when the power source is not a renewable source. Electronic microscopes and other such machinery can consume a lot of power every year thus expanding the carbon footprint on the planet. At the same time, the manufacturing of these machinery and other laboratory equipment raging from the simple items as

David Cole interviews with Dr Franciszek Piper (Reaction paper) Movie Review

David Cole interviews with Dr Franciszek Piper (Reaction paper) - Movie Review Example , Franciszek Piper, and from the interview that is exclusively found online, a lot of inconsistencies concerning Holocaust claims are revealed (Rees 43). After interrogating Piper for long, Piper admits that the gas chambers that are widely acclaimed to have been used in killing Jews were only created after the Second World War. Piper asserts that the ‘’gas chamber’’ was originally an air raid shelter which had walls and a ‘’chimney’’ added to it after the war. Therefore, from this, the stories we hear about Jews being tortured in gas chambers in concentration camps in Poland have been quashed by this interview. From this, it is evident that David Cole had his reasons for believing that no Jew was gassed in Auschwitz. Hence, this video lambastes the questionable propaganda concerning this area of Poland. Therefore, the video by Cole, asserts that the official history told about the Holocaust is a tale that is based on lies, war-time propaganda and myths (Rees

Significance Testing Essay Example | Topics and Well Written Essays - 1500 words

Significance Testing - Essay Example A research project always has the goal to investigate the causes and the reasons and thereby to be able to draw the conclusion in the basis of the changes that take place. Responses that have been counted in this vase are the independent or the dependent variables or the predictors (Park, 2005). In statistics sampling is referred to as the selection of a portion of the population whereas this is the sample that represents the major part of the population. Sampling types in this case include the convenience, accidental, quota sample, random sampling as well as the cluster sampling. In this case it has to be seen as to what the margin of error is in the specific sampling technique. Main problems that are faced in this case is the sample bias where the sample is not the representative of the whole population thereby the sample has to be chosen rather carefully. Importance that has been used in the statistical testing is that in the research projects it can be used to test the data in the experimental basis, so as to draw the conclusion that are based on the facts representing the major part of the population. ... Statistical hypothesis testing has been considered to be one of the main techniques in the frequentist statistical inference, and still it has been seen that this is the technique that has been under criticism. An important role is played by the statistical hypotheses testing in statistical inferences. It has been said by statisticians that the hypothesis testing although has many shortcomings and still there are many changes that are needed but it is the technique that plays central role in theory as well as the practice of statistics (Levin, 1998). When the null hypothesis are being tested than the main point that has to be taken into account is the effect size. As it has been known that here are four main parts of the statistical answers and they are inclusive of the effect size, the sample size, the alpha level that indicates the significance level of the newer or the odds that have been observed by the answer by the significance testing and the last one being the power that indicates the odds that have been observed by the reader of the research results. It has been estimated that tout of these for components there are some components that can be manipulated and this all depends upon the situation and the circumstances in which the research of the project has been carried out. The main point that needs pt be argued here in this case that the null hypothesis is known as the null hypotheses as it has the no difference or no effect case. The main statistical technique that has been facing the discussion hitherto by the professors, the researchers is the significance test. It has changed its face into a controversy from being just the topic of discussion these days. Since many years

Human Trafficking in the UAE Essay Example | Topics and Well Written Essays - 4000 words

Human Trafficking in the UAE - Essay Example There are various other reasons for human trafficking that include illegal tissue and organ extraction (Joint Council of Europe/United Nations Study, 2009), and reproductive trafficking that encompasses removal of the ova or even surrogacy (Eyal, 2012). Human trafficking is considered as a lucrative trade, and comes second only to illicit drug trafficking, in the context of raking in highest profits amongst all other illicit industries worldwide (Haken, 2011). Reports revealed that total revenue earned from human trafficking in 2004 was estimated to be around $9 billion (UNECE, 2004). ILO in one of its reports on human trafficking estimated that the industry earned around $31.6 billion (in profits) each year, globally (Belser, 2005). The UN estimated that, â€Å"about 2.5 million people from 127 countries have been trafficked to 137 countries for purposes such as forced labour, sexual exploitation, the removal of organs and body parts, forced marriages, child adoption and beggingâ⠂¬  (UN News Centre, 2008). Some experts contend that statistical representation of data on human trafficking is flawed and sometimes not quantifiable. ... procedure that displays persistently changing patterns closely connected to economic conditions; thus making a large part of the statistical analysis found in various reports flawed (Feingold, 2010). As per the definition provided by International Centre for Migration Policy development (ICMPD), human trafficking is â€Å"Crime against person – victim; violation of the rights of the victim of trafficking by definition (violation of person’s human rights; victim of coercion and exploitation that give rise to duties by the State to treat the individual as a victim of a crime and human rights violation)† (ICMPD, nd). Human trafficking victims are not allowed to leave once they reach their destination, and are held against their will through threats and coercion and made to serve or work (bonded labour or commercialised sexual exploitation) for the trafficker. The UAE forms to be a global centre point for human trafficking that deals primarily with women  and child ren. As per some reports published in 2010, human trafficking in the UAE accounted for nearly 37 % of all illegal migration cases referred in 2009 to  Dubai Foundation for Women and Children  (DFWAC), which is an increase of almost 28 % from 2008. UAE’s official fight against human trafficking started six years back in 2006, with the enactment of Federal Law 51 and formation of National Committee to Combat Human Trafficking (NCCHT). While results in the past five years hint that there has been significant progress in process of combatting human trafficking, however the government must take into consideration that various interlinked challenges at multiple levels, associated with this illicit trade, makes it necessary for the government to be on constant alert and maintain sustained vigil. In this regard,

Ozone Depletion Causes Global Warming Essay Example | Topics and Well Written Essays - 1000 words

Ozone Depletion Causes Global Warming - Essay Example When it is formed near the surface of the earth, it is toxic and may cause asthma while it is a blanket of protection from solar radiation once it is located in the atmosphere. The region of the ozone in the atmosphere is known as the ozone layer which has an altitude of 10 to 35 kilometers. The oxygen in the atmosphere once exposed to ultraviolet rays from the sun is converted to ozone and the harmful UV radiation is absorbed. It is very important to have ozone since the higher the concentration of ozone, the less UV radiation can reach the surface of the earth and the same applies the other way around. Sunburn, skin cancers and eye cataracts are the consequences once ozone layer is thin and more UV rays can penetrate the atmosphere (Shanklin 84). To understand the ozone in the atmosphere better, it would be help if the exact location is identified and further reactions that may cause the depletion of it. Ozone layer is part of the stratosphere and the ozone gas is scattered over 15 kilometers above sea level. Ozone may not be as much as the concentration of oxygen and nitrogen in the air, it is still very important because of its ability to absorb the radiation. In 1970, a study was made by Crutzen regarding nitrogen oxides which are produced from the decay of nitrous oxide through the action of microorganisms in the soil. The study showed how nitrogen oxides react quickly with ozone leading to the concentration reduction of available ozone. Such a study opened the research on  "global biogeo-chemical cycles" and the nitrogen oxides released by airplanes as they travel on the stratosphere (Lipkin 262). Ozone layer depletion increased the harmful radiation at the surface of the planet. The change may have both beneficial and harmful effects to living things especially to human beings. More people became aware of the consequences of radiation exposure in the past 60 years. According to some recent reports, the eye and the skin are the most prawn to damages an d diseases once exposed to UV radiation. Cataract is the usual effect of UV radiation to the eyes while skin cancer is the common result on skin (Norval et. al. 199). The other term that must be defined is global warming. The average surface temperature of earth increases as the years passed and possibly it would continue in the future is said to be global warming. It is caused by the greenhouse effect which is the increase in the concentration carbon dioxide and other gases like water vapor, methane, chlorofluorocarbons and nitrous oxide in the atmosphere that envelop the surface of the earth and prevents the UV radiation to escape to the outer space. Human activities hasten the increase in concentration of the green house gases that increase the temperature of the earth. Climate models predicted that surface temperature of the earth increases by 1.1-6.4oC within the year 1990 and 2100. If greenhouse effect had been regulated, the temperature of planet earth would have been 30oC lo wer at least (Rajeshwari 337). Global warming is really affected by the green house gases that are responsible for the green house effect. Experts say manmade carbon dioxide emissions are the primary reason for the increase in temperature. Other people may claim that the occurrence is just normal although the temperature increase nowadays is beyond the normal threshold. The findings were not able to find any alarming carbon dioxide

The effect of alcohol on reaction times Essay Example for Free

The effect of alcohol on reaction times Essay The table is used to drop the ruler from so we know that the height the ruler is dropped from is the same each time we do the experiment. We will hold the bottom of the ruler level with the surface of the table before it is dropped. The ruler is to be used as the measurement of peoples reaction times in millimetres. The pen is to mark out where the thumb and first finger must be when the ruler is released and is also used to record the results on the paper. Method We will make two short lines at the end of the table 1. 7 centimetres apart. The inside of the right hand thumb and right hand first finger must be placed along side these. We will place the ruler inside the fingers in the centre with the side with the shortest width touching the table and also facing away from the table. The persons hands should be level with the bottom of the ruler. The ruler will be released without warning the person who is catching it. The person catching it must have clear visibility of the ruler. When the person has caught the ruler the measurement should be read from the bottom side of his finger and thumb and not from above them. Write the results down on the paper and repeat the experiment four more times. When the experiment has been carried out five times we will make the person catching the ruler drink four units of alcohol. After he has finished drinking the last unit we will wait twenty minutes for the alcohol to take effect. We do this to see what difference alcohol has on the reaction times. Now we repeat the experiment above again. We will test four people. A young male and an older male, ages 15 and 44, and a young female and an older female, ages 11 and 38. The factors we will keep the same to make sure the experiment is a fair test are: Height ruler is dropped from Visibility Thumb and finger used No drugs Distance fingers are from ruler before it is released Moisture of skin Food Eaten Prior To Experiment Heart Rate Prediction I predict that the more alcohol that has been consumed, the longer the time it takes the body to react. I think alcohol effects the transmitter fluid in the synapse, or effects the myelin sheath on the axon. In turn this will considerably lengthen the reaction times. Also, the alcohol may have an effect on the neurotransmitters in the synapse. We now that alcohol is a poison. It could poison the neurotransmitters in the synapse, cause them to not work as fast, or even carry messages for them. I dont think the relationship between the alcohol consumed will be directly proportional. Preliminary Work Prior to making these plans for the experiment, we carried out a preliminary test. This test helped us a lot in understanding what the aim of the experiment was and gave us a rough idea of what we were going to do. Also, we can learn from the mistakes that we made in the preliminary work, so that we can ensure it is a fair test in the experiment. Results Attempt Distance 1 8. 6cm 2 9. 6cm 3 7. 9cm 4 10. 4cm Conclusion From our results we can make a safe conclusion that the reaction times of a person are very fast when they arent under the influence of alcohol. Also, because there are no anomalous results we can make a safe average reaction time from this. Average reaction time = 9. 125 seconds. Show preview only The above preview is unformatted text This student written piece of work is one of many that can be found in our GCSE Patterns of Behaviour section.

The Hotel Reservation System

The Hotel Reservation System Abstract The Riviera resort is a tourist resort. It is located in Greenwich, in the south east London of United Kingdom. This resort was established in 2000. This resort has 38 rooms with all the facilities. There are double, single and family rooms with attached bathrooms. There are indoor and outdoor games facilities with a swimming pool. Air-conditioned rooms too are available. Within a distance of a few yards the real maritime view is attractive for the tourist for enjoyment. As Hotel Riviera a customer based Company it is identified that providing an efficient customer service is a major factor that is considered in all customer based Companies, to remain competitive in the market. One major barrier to this is the manual system does not provide any facility for the Managers, Accountants and other employees to trace the routine details on time and provide a quality of service. Which ultimately lead to a lot of problems and inefficiencies? In the aim of solving these problems and making the company operate efficiently, the Hotel Reservation System with online Environment to Hotel Riviera System project was undertaken. In here this system was strengthen in web base access as well as with a Visual Basic component that was used to track the reservations done by the Employees each day. In this system the Administrators get the chance to view their routine details as well as the reservation details at the company. So the managers can get a good idea what sort of things they have to do in order to improve their business activities The benefits of the system are numerous. The system will help the company to operate efficiently by eliminating all the time consuming procedures and provide a better service to their Customers. Introduction Hotel Riviera Information The Riviera resort is a tourist resort. It is located in Greenwich, in the south east London of United Kingdom. This resort was established in 2000. This resort has 38 rooms with all the facilities. There are double, single and family rooms with attached bathrooms. There are indoor and outdoor games facilities with a swimming pool. Air-conditioned rooms too are available. Within a distance of a few yards the real maritime view is attractive for the tourist for enjoyment. To maintain the resort there are working thirty employees as Managers, Accountant, Supervisors, Cashier, Room boys, Servants, Cleaners, and Cookers. Everyday foreign and local guests visit and enjoy with the resort facilities. The resort owner is very happy about the success of his resort. Room Information 20- A/C and 18 Non A/C rooms. 12-Rooms with single bed facility A/C, 8 non A/C single bed rooms 10-Rooms are the double bed A/C and 8-double bed non A/C. Problem Identified Out of survey done by me, I found the numerous problems faced by the Owner and other employees of the company. The main drawback of their currently available system is that for many processes are very time consuming. So the company required a system that will produce out puts in on time. Also the time that takes to send services to customers are quite high. Next the company does not have an easy way to trace the reservation process. Introduction of the Current Information System The Resort is one of the famous resorts in United Kingdom which is currently doing everything in a manual way. Although if they have a number of computers even they dont have any computerized system. Their Guest and staff are facing lots of problems in their day today activities. So I proposed them to carry out their resort reservation system details in a computerized manner. These are the major functions/processes occurring which is manual way. Guest registration Room reservation Food order Payment calculations Functions of the Existing System Hotel has four departments: 1. Front office This department contains 2 employees: Receptionist and Front Office Manager. Main functions: 1. Request booking information 2. Confirm booking. 3. Cancel booking. 2. Kitchen department. This department contains 15 employees: Chief cook, Cooks, Supervisor, and Supplier for groceries Main functions: Prepare meals according to the guest preference. 2. Prepare food menu information. 3. Housekeeping department. This department contains 8 employees: House keeper, Record keeper Supervisor and Cleaners. Main function 1. Check the room availability information and pass to the front office. 2. Reservation of room. 4. Finance department. These departments contain 5 employees: Accountant, Manager, Finance Manager, Account operators Main Functions: 1. Calculate Guest payments. 2. Prepare invoices. 3. Salary functions. 4. Profit and loss analysis. Purposes and Objectives of This Project The proposed computerized system purposes and objectives are as follows. With the earlier system the customers had to idle till the receptionist filled all data. But, with the proposed system the customer related activities will be very quick and efficient. Less waste of resources, because only necessary data will be taken into Hard Copy out puts. In the manual system data duplication was happening frequently. But, with the proposed system data redundancy will be reduced to a great extent. Security measures will be introduced; therefore data is 99% accurate and reliable. The company can convert into new trends of technology and give a Better competition with its competitors. The company profitability can be increased because the cost that was incurred for maintaining the system will be cut down. Work load of the employee is lifted off. The proposed system requires only a computer therefore there is no need of large room space. There is no need of large storage cupboards because all data will be stored in one single database of the computer. The manual system did not have any back-up files, but with the computerized if any files have been missed up there is a back-up procedure to fix the problem. Issues of the Existing System The data is not long-lasting for this hotel due to the improper system:- The resort reservation System is maintaining their data and information in the files and some copies. So it is not secure for them. Not only that but it can destroy in a particular period. It can be misplaced somewhere. They have to buy the files and copies. So it is not proper system for them. It is time consuming :- Very important but this manual system is very slow and extremely time consuming. So that guest time also wasting. When more than one guest arrives in to the resort for booking, Receptionist cant manage with the short time. The checking process is very difficult in the guest departure time because, they cant easily find needed records in this manual system. The stationery costs are high :- There is a lot of paperwork to be done and lots of records of guest, cash books, room details, availability details etc. that have to be maintained, which makes it a very confusing job. Due to the large amount of paperwork that needs to be kept for later reference, there is also need for large storage space. Not only should there be space to store all the records but it should be stored in easy way to find the records and very high cost. It occupies lot of space to locate the file and difficult to search due to the different locations :- Currently, a large number of past and present guest and recruitment related information are stored in cabinets and racks. This way, files get dust collected and confidential papers get loose from the files with time. To maintain the paper in order, filing cabinets, stationary and employee is needed which comes with a cost. Some of these cabinets are kept inside the office congesting working areas and the others are kept in store rooms accruing valuable floor space. Calculation Process :- Also, the calculating process is very difficult such as customer charge calculation (food, Room, facility charges), the resort balance checking. In the manual system for every process there should be needed more workers. Not only cant they work accurately and in the correct. System Development Methodology I have selected the Water fall method model for developing a system for Riviera resort reservation because these models demand a systematic and sequential approach to software development. It presents a highly structured method of software development that starts at the system levels and progress. I am going to develop a resort reservation system which is more complex. This can be handled by using this methodology. And this model decreases the gaps between users and system developers and to increasing systems performance. Waterfall Model This is the most common and classic of life cycle models, also referred to as a linear-sequential life cycle model. It is very simple to understand and use. In a waterfall model, each phase must be completed in its entirety before the next phase can begin. At the end of each phase, a review takes place to determine if the project is on the right path and whether or not to continue or discard the project. Unlike what I mentioned in the general model, phases do not overlap in a waterfall model. Waterfall Life Cycle Figure 1.1 Reasons for selecting waterfall methodology for Hotel Riviera Works well for smaller projects where requirements are very well understood. Easy to manage due to the rigidity of the model each phase has specific deliverables and a review process. Good progress tracking due to clear development stages Phases are processed and completed one at a time. It is suitable for real time and critical system Suitable for small and large size projects. Simple and easy to use. System Requirements Functional Requirement To develop a fully tested Guest update, Room update process, it is asked that the application should allow the user to add, edit find details and handle payments. To accomplish this, it is required to create Access VB (Visual Basic) forms. It necessary to maintain reservation file, guest file, order details files payment file including registration fee in the database. So it is asked to design the necessary interfaces using VB to fulfill the above requirement. To fulfill the above requirements I have created a fully tested reservation system from the knowledge that I have on VB Access. I assumed that resort reservation system need to computerize the reservation process and I have directed my efforts and created a program which is coming out here. Front end Welcome Screen: Welcome screen with user verification facility. This screen will allow the user to type user name and password. This user name will be common for Administration members and another username and password for Manager. Registration of new users: This system should allow registering new users from this organization. Adding details to database: When a Guest comes to register, the system will be added his details to database. Such as name, address, designation, passport number, age, sex and nationality etc. Calculations: Calculations in the system will be found out the due amount. The due amount will be calculated from the requirement the reservation form. Rooms details: Details of rooms can be found in their database. And the system should be able to record their information. The system should assign unique number for each room and allow the user to enter details such as room number, room type, rate and status etc. Banquet details: Banquet reservation also is another function of this resort. So details of banquet can be found in this system. Also the system should be able to record their information. Such as banquet no, location and charges. Engineering details: When customers reserve a hall for a function, they can be found what are the engineering facilities available in this resort for doing that function. Such as Sound system, Overhead Projector and Desktop computer. Foods details: Details of foods also can be found in this system with charges to customers to decide their favorite foods. Such as Egg w/ rice, Spaghetti, Chicken Salad, Coke (Medium) and Fried chicken w/ rice etc. Liquor details: Hotel Riviera has a big bar for their customers. So liquor details are very important for this system. Mainly it should be included description of liquor, price and expiry date. Details of pools: There are two types of pools available. One is adult pool and another one is child pool. Details of pools are most essential for this system. Order details: When purchase orders are made by customers or guests, presently all of them are filed and placed into drawers. But it will be great if the hotel can save those details in the system and be able to retrieve them later if required. Order details will be included ordering meals, and ordering liquor. Room reservation: This requirement is the hearth of this entire system. It is for the purpose of fulfilling requirement that most of the above requirements are met. Fulfilling this requirement will be the key solution in the system to be developed. Once this requirement is successfully tackled, the older access registry room will become obsolete. This system should be able to record details of room reservation number, guest ID, room number, reservation date, date reserved, length of stay, and status. Banquet reservation: This requirement also a very important function of this system. This resort is doing not only the room reservation but also the banquet reservation for their customers. This part should be included banquet reservation no, reservation date, client name, address, contact no, date reserved, starting time, finishing time and status. Search The ultimate purpose of any database system its functionality to support retrieval of data in a way it is expected. This is the case here also. If any reservations details are required, the system will be allowed to find the details from related database and make reservation using search function. Printing facilities Staff should be provided full functionality to printing relevant documents when they needed. Reports In this computerized system, reports will also be a part and parcel they are the means that help get printed outputs here. Staffs should be allowed to run reports and get prints. Common functionality requirements The system will be having a Multiple Document Interface (MDI) through which all the screens and reports can be reached. Colors to be used in the screen should be consistent. Blue with black will be interesting to see. Also buttons on window should be placed in the top of the screen. One window should be used for generating reports i.e. the user should be able to run reports one by one within one window. It can be by clicking on a button, using menus or shortcuts keys. Calendar with one month displayed; whenever there is a need for entering dates, the user should be given facility to pick it from a calendar. Short cut keys should be assigned to expedite the data entry work. There user should be allowed to backup the database to a certain location. This practice ensures the safety of updated data. Printer will be connected to one PC and others will share the printer. Non-Functional Requirements Although these requirements are not directly with the system to be developed, they are very important factors to take into consideration for the development and successful implementation of the system. Under this section I identify non functional requirement within the projects scope. Product Requirement Usability and Efficiency: Since the earlier version of Visual basic (6.0) is going to be used, performance will be high and it is very fast. The system should be very much easy to handle. Reliability: User should easily understand about the system. And they will find it very much handy. Portability: Database should be maintained with much care and give the database to that system in correct format. Operational Requirement Security: database access should be prevented from sight. In addition it should be impossible to access certain parts of the system without the proper logon procedure. This requirement should be strictly enforced at the log on single window or feature under this section. User Friendliness: The system should not be possible for a non- authoritative user to enter a single window or feature under this section. Interoperability: No other system could be intercepted while this system is running on the machine. Software Requirement for Implementation For the development of the new system, the following software packages are recommended to be used. Microsoft Visual basic (6.0) for the interfaces program coding. Visual basic data project will be used for the creation of this system. Is the data Environment, Data list control, Data combo Control, Data grid control, Microsoft- Calendar control and Date time picker control, etc. Microsoft Access 2003 as database back end. Crystal Reports 8.5 for the creation of reports. All the reports will be called within Visual Basic using the Crystal Viewer ActiveX control. Software Tools are Needed to Developed the New System Microsoft Visual Basic 6.0 Microsoft Word 2007 Microsoft Visio 2003 Microsoft Access Adobe Photoshop CS Hardware Requirement for New System The reservation system to computerize their reservation system, a computer system needed the following minimum requirements. Processor : 400 MHz RAM : 128 MB Hard Disk : 4 GB VGA : 32 MB Monitor : 14 Operating System : Windows 2000/xp Software : Microsoft Office 2000/xp Floppy Disk Drive : 1.44 MB 3.5 Summary This chapter provided a detailed description on why Hotel Riviera Needs a web and Visual Basic based System and how online room reservation and computerized reservation System solved the problems they are currently facing with the requirement analysis. Next section gives a detailed description about the system. System Analysis Introduction The tools of a system analysis, which are known as fact-finding methods, are found in the scope of the business application and its end users. Therefore these methods and techniques should be applied efficiently for finer and better results. There are many reasons for fact finding during systems development life cycle, but the most important time is when its system development has begun its basic stages. During the beginning stage the analyst must do the current system, which is being currently used. During these stages, the analyst must gather information on the requirements of the end user. Then when the system designing gets on the way, the analyst must gather, the following:- Facts about report formats. Input methods. Information about the organization. Goals and aims of the organization. Organization structure. Objectives and reasons of functional units. Information about the people. Authority and responsibility of relationship. Job duties. Information about the work. Tasks and workflows. Methods and ways for performing the work. Work times and limits. Information about the work environment. Resources available. Proposed System Descriptions The scope of my project is only reservation. So, Room, facility, needed food booking is will be included in this project. The processes will be started from check in and finished with the check out. Between, these two actions there are some processes available. Those are selecting the wanted room with facilities and food, advance payment; store the guest details, reservation details, charge calculation, payment settlement and report creation. Sometime there maybe cancellation process includes. In this system there will be receptionist, guest, cashier and supervisor involved. The receptionist will operate some the booking process of this application. The guest will select his needed suitable. Cashier will handle all calculation and payment processes. The supervisor will create the reports to the management. The detail information about this computerized Resort Reservation system is included in the DFD ER diagram. In this system my aims is to make the resort reservation System. This is fully secure and fully computerized Features of the New System Handling Customer Details Room reservations Banquet reservations Backup facilities Stores data permanently Security Cancellations Handling Rooms Details Making Payments Features like Update, Searching, Deleting, Editing Record etc Generating different kinds of report. Added Solution to Implement the New System The Data is not long-lasting due to the proper system Even if it is an important data which is been kept in a file, which is not secured, It can be misplaced somewhere. Not only will that it destroy in a particular period. So computerizing the manual system it will be stored in the Database to the computer, so which is more secured. And also we can take the Backup for safety. It is time consuming When the data is in a document, which is inside a file, it is very hard to get the necessary details in that particular time. To search the file it will take some time because they have to see the file page by page. After computerizing the manual system it will be much easier to retrieve the data quickly, this will increase the productivity of Resort reservation system. The stationary costs are very high When the data is maintained in a file or any kind of documents the stationary cost like pen, papers, ruler and files. Deleting, updating and editing also will affect the stationary cost. So after computerizing the manual system we can bring down the cost of stationary, which will economy. If a particular file is lost then the whole data will be loosed If a file is lost then every data regarding that resort information will be loosed which is a big blow for the Resort reservation system. It can happen very easily in this Resort. So we can protect the data by implementing this system. Because we can store the data in a particular database which is more secure. No one can steal any record file because they will have their own login. Without knowing password no one can enter in to the computer. Even they have a back up system. It is not possible to get the necessary Data with in a given time As the data is maintained in a file as manual it is impossible to get the data in a given period. If they want to get particular data then they have to seek one by one page. After computerizing all the data it can be retrieved quickly with the help of Query. So it is making easy to work Calculate the payment very Also, the calculating process is very difficult such as Guest charge calculation (food, Room, facility charges), the resort balance checking. In the manual system for every process there should be needed more workers. Not only cant they work accurately and in the correct time. After that computerizing make easy to work Checking process When more than one guest arrives in to the resort for booking receptionist cant manage with the sort time. The checking process is very difficult in the Guest departure time because, they cant easily find the needed records in this manual system Check Room or banquet availability .after that computerizing easily identifies the room or banquet availability Summary This chapter presented information about the tools of a system analysis, which are known as fact-finding methods, are found in the scope of the business application and its end users and feasibility study about this entire system whether which is accepted or not. Also discussed regard features of this system and value added solution for their earlier systems issues. System Design Criteria Introduction In this part, I have discussed why it is important to have a design method when developing systems. Name and explain some strategies for generating design solutions, simplifying design decisions, evaluating designs, and terminating the search for alternatives, the purpose of design models and the principal categories of design models and summarized some differing perspectives on the nature of design Data Flow Diagram (DFD) Data Flow diagrams are a network representation of a system. They are the corn store for structured system analysis and design. The diagrams use four symbols to represent any system at any level of details the four entities that must be represented are: Data flows: movement of data in the system Data stores: data repositories for data that is not moving Processes: transforms of incoming data flows to outgoing data flows External entities: sources or destinations outside the specified system boundary The DFD shows how, through analyzing data flows, a systems internal processes interact with each other, how the system interfaces with its environment, how the system is partitioned into interacting sub-systems, how an existing or a proposed system can be described in a top-down manner. Existing system data flow diagram 0th level Figure 3.1 0th level Data Flow Diagram Figure 3.2 1st Level Data Flow Diagram Figure 3.3 2nd level Data Flow Diagram for Payment process 2nd level Data Flow diagram for report generation Figure 3.5 Data dictionary for proposed Hotel reservation system Data stores Name Description Number Owner Customer details Store the Customer details 1 Administration Payment details Store the Payment details 2 Administration Room details Store the Room details 4 Administration Banquet details Store the banquet details 5 Administration Bar details Store the bar details 3 Administration Pool details Store the pool details 6 Administration Restaurant details Store the restaurant details 7 Administration Table3.6 External entity Name Description Type Total occurrence Guest Describe the customer who are booking the room and banquet Person 1 Management Describe the management of Hotel Department 1 Table 3.7 Data processes Name Description Input from Output into Logic summary Administration process Check the room and banquet order. guest hotel When the guests come to the hotel, the administrator section receive the booking order then check whether the room are available or not, after that, reserve it for the particular guest. Payment process Provide the card to the management guest guest Collect the money from the guest, when they leave from the hotel. Room process Handle the room details. guest guest Keep the room details, bed details and other equipments details. Check the room, if there is anything damage, collect the details, and remove from the room and replace it another. Banquet process Handle the banquet details Keep the banquet details, standard equipment details and additional equipment details. Bar process Handle the bar details Keep the bar details, such as drinks items, chips items. If it is finish, order them. Pool process Handle the pool details Keep the pool details Restaurant process Handle the restaurant details Keep the food items Report generation Handle all the report All the details Report generation Keep whole hotel details and when the administration ask the report, get the print out and give it to them. Table 3.8 Data flow Name Description Source Destination guest details Represent the guest details Guest administration process payment details Represent the payment details Guest Payment process room details Represent the room details Guest Room process bar details Represent the bar details bar process administration process banquet details Represent the banquet details banquet process administration process pool details Represent the pool details pool process administration process Restaurant details Represent the restaurant details restaurant process administration process Check restaurant details Represent the checking restaurant details Restaurant process administration process Table 3.9 Entity Relationship Diagram (ERD) Normalized ERD for the proposed system Figure 3.10 Relational Table Normalization Normalization is the process of efficiently organizing data in a database. There are two goals of the normalization process: eliminating redundant data (for example, storing the same data in more than one table) and en

Milton Friedman Essay examples -- Biography Biographies Essays

Milton Friedman Milton Friedman has been credited with many different achievements, including being one of the most effective advocates of economic freedoms and free enterprise, being the greatest economist to ever walk the face of the earth, and proving every single word that Lord Maynard Keynes ever said to be wrong. Why these may or may not all be true, it is obvious that Friedman was a brilliant man of many accomplishments. Milton Friedman was born on July 15th, 1912 in New York City. His parents were poor immigrants and his father died when he was a senior in high school. Despite all of these obstacles he had to overcome, Friedman received a scholarship to Rutgers University and got his B.A., an M.A. in 1933 from the University of Chicago, and a Ph.D. in 1946 from Columbia University. He worked as a research assistant to Henry Schultz at University of Chicago until 1937 when he started working with the National Bureau of Economics. There he jointly published the book Incomes from Independent Professional Practice with Simon Kuznets, which also served as his doctoral dissertation at Columbia. This book introduced the concepts of permanent and transitory income. In 1933 Milton Friedman met Rose Director, a fellow Economics student, and six years later they were married. Rose and Milton have collaborated on quite a few books and essays, and have established the Milton & Rose D. Friedman foundation, which promotes School Choice, which will be explained in more detail later. In 1976 Milton Friedman won the Nobel Prize in Economic Sciences "for his achievements in the fields of consumption analysis, monetary history and theory, and for his demonstration of the complexity of stabilization policy." Milton Friedman coined the terms "only money matters" as his emphasis on the role of monetary policy in the United States economy. Friedman is perhaps the most effective advocate for free enterprise and monetarist policies from 1945-1985. His only rival among economists of the 20th century would have to be Keynes. As well as being a Nobel Prize winner and just an overall brilliant man, Friedman served as Senator Barry Goldwater's informal economic advisor in 1964 and for Richard Nixon in 1968, then as President Nixon's advisor. He served as President Reagan's Economic Advisor on his Advisory Board in 1981. Friedman was awarded the Presidentia... ...n acceptable level. Another one of Friedman's strongest and most well known opinions was on the Federal Reserve and how it is practically useless. Friedman being the big free-market capitalist that he is, thinks that the Federal Reserve acts stupidly, rashly and doesn't take the time-lag into respect when making their dramatic decisions. Friedman also blames most of the economic instabilities on the federal reserve's action. Milton Friedman has definitely been one of the most influential economists of the 20th century. His discoveries and theories in monetary policy, school choice liberalism and inflation relations impact economic history in a way only a few people can do. He and his wife Rose are now running the Foundation for school-choice and have just published Two Lucky People: Memoirs. Bibliography: Friedman, Milton. Bright Promises, Dismal Performance: An Economist's Protest. New York: HBJ, 1983. Friedman, Milton and Rose. Free to Choose: A Personal Statement. New York: HBJ, 1980. Hodges, Michael. Milton Friedman- A Tribute by MWHodges. May 2001. September 2001. Walters, Alan. A Dictionary of Economics, The New Palgrave. Vol.2, 1987. Pp.422-427.

King Lear: Lear The Tragic Hero Essay -- essays research papers

King Lear: Lear The Tragic Hero The definition of tragedy in the Oxford dictionary is, "drama of elevated theme and diction and with unhappy ending; sad event, serious accident, calamity." However, the application of this terminology in Shakespearean Tragedy is more expressive. Tragedy does not only mean death or calamity, but in fact, it refers to a series of steps which leads to the downfall of the tragic hero and eventually to his tragic death. Lear, the main character in King Lear was affirmed as the tragic hero because the play meets all the requirements of a tragedy. In order for a character to be qualified as a tragic hero, he must be in a high status on the social chain and the hero also possesses a tragic flaw which initiates the tragedy. The fall of the hero is not felt by him alone but creates a chain reaction which affects everyone around him. Besides, the hero must experience suffering and calamity slowly which would contrast his happier times. The suffering and calamity instantaneously caused chaos in his life and eventually leads to his death. Finally, the sense of fear and pity to the tragic hero must appear in the play as well. This makes men scared of blindness to truths which prevents them from knowing when fortune or something else would happen on them. Lear, the king of England would be the tragic hero because he held the highest position in the social chain at the very beginning of the play. His social position gave him pride as he remarked himself as "Jupiter" and "Apollo". Lear out of pride and anger has banished Cordelia and Kent and divided his Kingdom in halves to Goneril and Regan. Lear's hamartia which is his obstinate pride and anger overrides his judgment, thus, prevents him to see the true faces of people. As in Act One, although Cordelia said "nothing", she really means everything she loves to his father. However, Lear only believed in the beautiful words said by Regan and Goneril. Although Kent, his loyal advisor begged Lear to see closer to the true faces of his daughters, he ignored him and became even more angry because Kent hurt Lear's pride by disobeying his order to stay out of his and Cordelia's way Lear had already warned him, "The bow is bent and drawn, make from the shaft." ( I, I, 145). Kent still disob... ...our horrible please..." ( Lear, III, ii, 15-20) Here, the feeling of fear appears as well because in a short period of time, Lear fell from the position of King to a normal peasant. His weak, unconfident and mad mind overrules his strong, prideful and sane character. However, in looking deep down, the real fear implied here is, no matter how great things appear now; men do not hold them long and you can sink to the very bottom just as fast as Lear fell from the top of the chain to the lowest. In Shakespeare's tragic play King Lear, Lear the main character demonstrated all the necessary requirements of being a tragic hero. His high social status nourishes his hamartia which is hubris, and the tragedy is initiated by the banishment of Kent and Cordelia. Lear's pride not only altered his live alone, instead, it affected everyone around him down to the bottom of the social chain. Moreover, the realization of his true quality, pains and sufferings eventually leads to his tragic death which the most obvious element in a tragedy. Because Lear fulfills the "formula" of Shakespearean Tragedy, he could be firmly proven as tragic hero in the play.

The Last Tea Dorothy Parker

The Last Tea By Dorothy Parker The story submitted to the consideration is called â€Å"The Last Tea† and is written by Dorothy Parker. As for the writer, I have to mention that Dorothy Parker  was an  American  poet, short story writer, critic and  satirist, best known for her wit, wisecracks, and eye for 20th century urban foibles. Concerning the title of the story it is thought-provoking and made me read the story. At first glance it seems fairly simple, but with the development of the story is surprisingly complex. The last tea is a story that is addressed to women and deals with 2 main topics: men`s attention and loneliness.This is a bitter story written in a cruel way. Now I’d like to reconstruct the events. The young man and the girl met somewhere at the cafe for a cup of tea. He told her about another woman whom he was delighted by. While he was telling about that woman, the girl heard him out with patience and even with some positive commentaries. At th e end of their conversation he suggested to pay the check and put her on a bus. Instead she refused and said with the irony that he wanted to call up his friend. And he without any suspicion said goodbye to her and gave her the best wishes.Speaking about the theme of the story I’d like to pin down the relationships between a man and a woman. As for the idea, it is the nonmutual love as the result of not having much in common, misunderstanding within sexes. The story presents an interesting example of the indirect characterization. The author does not say directly that the girl is lonely but let her act and leaves the reader draw his own conclusion. The story begins with the description of the young man and the girl who are the main characters of the story.There in not any preface of the story: we know nothing about the past of the people. The author shows the characters in a certain period of their lives. The plot is trivial and the characters are really true to life. The tex t is homogeneous. It`s almost consists of the characters` dialogues, where you can find numerous words and phrases of informal style. E. g:  « That`s good »,  «the poor boy »,  «poor sick thing »Ã¢â‚¬ ¦ Also interjection  «Oh, Ah, goodness » introducing some of the passages which normally occurs in oral speech. The sentences have free and careless structures.From the very beginning we come across a witty satire. Such stylistic device is used by the author to draw our attention and to make us commiserate to the girl. E. g.  «The girl with the artificial camellia had been sitting for 40 minutes » but she said  «I was late myself »  «I haven`t been here more than a minute ». She tries to be polite and to show the great care to the man. E. g.  «I`m ruined » he said.  «Ah the poor boy »  «Ah and you came way up here to meet me! You shouldn`t have done that »    â€Å"I would have understood. Ah just think of it coming all the way up here when it `s so sick! – She said. But the man begins talking about another woman Carol McCall. The man considered her to be perfect. He said  «that`s what I call a girl ». This part can be regarded as a climax of the story. To conclude it all up, I’m to say that the problems presented in this text are very topical in our every-day life. People often don’t notice those who are near them, who care about them, who are devoted to them. The best we can do is to pay tribute to the author’s vision of life and to her ability of creating the atmosphere of being entirely involved in the process of the story.

Freedom of Expression in the Philippines Essay

â€Å"Give me the liberty to know, to utter, and to argue freely according to conscience, above all liberties. – JOHN MILTON Individual freedom and collective expression in the Philippines, I’d say, is the most exercised and an unmistakable sign of this country’s democracy. Our individual rights and freedoms, the most basic, the essential to the complex and critical ones define our identity as Filipinos, and the basic extension of our humanity. That need to express, to communicate, and to reach out to one another without the fear of judgment or even criminal prosecution. We have the freest press, the most uncensored and unrestricted provisions on our freedom to express ourselves, to seek other people’s take on relevant issues and sometimes just so, because we want to and because we can. And when these are stripped of us, we resist. We react, and to some extent violently and rebelliously just so we can send that fierce message that as a democratic country, with the collective freedoms and rights declared in our charter, no one has the right to deny us of those rights and freedoms. But sometimes, too much freedom can mean abuse of freedom. And restrictions or not, these freedoms aren’t absolute. One is still liable to what he says, especially in public. As professionals and practitioners of the press, they are responsible for balanced views and opinions. Slander, libel, false accusations and any other form with malicious intent is tolerated by freedom of expression. One cannot accuse someone of something and invoke his freedom of expression, and expect it to give him immunity from the law. Article 19 of the Universal Declaration of Human Rights states: â€Å"Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media and regardless of frontiers.† Article 19 (2) of the International Covenant on Civil and Political Rights affirms: â€Å"Everyone shall have the right to freedom of expression; this right shall include  freedom to seek, receive and impart information and ideas of all kinds, regardless of frontiers, either orally, in writing or in print, in the form of art, or through any other media of his choice.† Under the Bill of Rights of the Philippine Constitution, Article III, Section 4 declares: â€Å"No law shall be passed abridging the freedom of speech, of expression, or of the press, or the right of the people peaceably to assemble and petition the government for redress of grievances.† But it wasn’t too long ago when the infamous Cybercrime Bill was signed by the president. It bore flawed provisions that largely outraged advocates of freedom of speech. It awakened this fire not only to these advocates but to ordinary Filipinos who was suddenly faced with the possibility of being denied of this freedom. It scared some. And now the Bill is on a temporary restraining order after much protest that involved hacktivists hacking government servers and websites. The President’s website down to other departments weren’t spared from their wrath. Rallies and demonstrations plagued the major government offices. Even the press expressed its dismay on the unreasonable grounds the bill imposed. And thus, this freedom prevailed. Liberty means responsibility. That is why most men dread it. – GEORGE BERNARD SHAW How many times have we seen major political figures get away with it? How often have seen them actually pay for their wrongful actions? Seldom, if not never. I’m not going to expound much on the issue of legal independence, though it’s another critical criteria of good governance that somehow connects with this issue. The ‘influence’ of the executive and legislative branches respectively, to our judiciary, though less people wants to admit it, is not unheard of. I would even go as far as saying that appearances aside, alliances between people from these three legs of our system speaks volumes if we want to talk about partiality, of justice being served, or of the  judiciary protecting people from the other two branches. Ex-chief justice Renato Corona’s historic impeachment can attest to this connection. People have been talking about Corona’s alleged alliance with GMA ever since he was appointed by the latter, have sprouted suspicions and dirty allegations and from that standpoint, when the chief justice’s public image is tainted, people will not just talk of injustice. Regardless of its truth or falsity, in their eyes, the then chief justice must no longer be a chief justice. Then came his impeachment, which was on the grounds of not declaring assets and liabilities on his SALN, which then comes to light a public official’s dishonesty or honest mistake of omission, we will never know. After that excruciating days of examining the facts and arguing from point A to point B about this and that in the senate, I don’t think it had achieved much but prove a point. A point that I guess is a starting step into holding a public official responsible for his action. It’s a welcomed change. But let’s look at our former president, Gloria Macapagal-Arroyo. Somehow, she’s still out of the clutches of accountability to her grave misdeeds in office. Her audacity not to resign when reasonable proof has been unearthed of her alleged influence on the 2004 Presidential elections. Evidences, though illegal or circumstantial surfaced, or did you forget the wiretapping Hello Garci scandal. Those tapes allegedly suggested that Arroyo ordered the rigging of the national elections for her to win by around one million votes against the late Fernando Poe, Jr. However, she indeed conversed with COMELEC commissioner Virgilio Garciliano, and it was a ‘lapse of judgment’ on her part and made the most talked about apology in television. Her alleged cheating and electoral sabotage induced public protests, to no avail. Several impeachment attempts have followed. Three separate complaints ensued. One in 2005, and then another in 2006. All defeated and trashed in the House of Representatives. Now what does that say of our system under her presidency? In October 2007, lawyer Alan Paguia filed an impeachment complaint against Arroyo in connection with the issue of bribery. Paguia’s complaint was based on the revelation of Pampanga Gov. Ed Panlilio that various governors received half a million pesos from Malacaà ±ang. The impeachment case, as of the middle  of October 2007, has already been referred to the House of Representatives Committee on Justice. Now what? Is it sitting there somewhere in the House with dusts and was ultimately forgotten? Her presidency, shrouded in controversy, was probably the worse after Marcos, though in the same light, we can’t deny their contributions in the country’s economical improvement. But accountability, CGMA seems to be immune to. We saw progress on November 18, 2011 after a Pasay court issued a warrant of arrest against her, following the filing of a complaint for electoral sabotage by the Commission on Elections. At the time, she was in the hospital, so it was a House Arrest. The Supreme Court had issued a Resolution enjoining attempts by the Department of Justice to prevent her departure from the Philippines to seek medical treatment overseas. But oh well, The House of Representatives under the leadership of Speaker Feliciano Belmonte, Jr. issued a travel permit allowing her to have treatment in Germany despite the Department of Justice hold departure order. She was released from hospital arrest on bail and refused to enter any plea on charges she misused $8.8 million in state lottery funds during her term in office. These pile of charges seemed to hang up there again, as she is currently seeking treatment in Germany. Not to be insensitive with her health conditions, nor would I wanna say that her health conditions are just convenient lies to evade prosecution, but one has to admit of it being at the right place at the right time. Joseph Estrada was convicted of plunder and was placed on house arrest. Well at least that is some form of penalization we saw. But then, Manila had to elect him as their Mayor in the recent polls. Now what does that say about us learning from our mistakes? How can we trust a public official who had already broken our trust in the worst way possible and then elect him again and put him into a position where he can do it again? I am but a keen observer and naturally has not enough professional or political mandate to be accusing the lady of anything. However, it is my constitutional right to express myself though facts and informed judgments and personal opinions. At this juncture, if one has to violently disagree with me and confront me in the form of a lawsuit (God, I hope not), I leave the world of Philippine Daily Inquirer columnist, Mahar Mangahas. â€Å"If any citizen is free to openly agree, but not to openly disagree, then freedom of expression does not prevail. An individual’s option to openly express disagreement without risk of any personal injury is a key part of the definition of a free society.†

Misconception of African Americans

The Misconception of African Americans Since the beginning of time African Americans have been viewed negatively. We have always been viewed as a threat to society and frowned upon by many races. There are many cliches displayed in the media of what African Americans are supposed to act like. These conclusions cause almost immediate negative feelings from other races and sometimes by our own race. African American females in television shows and movies are often shown as the loud â€Å"ghetto† acting, angry black girl who is always â€Å"telling someone off†.Actor Tyler Perry has been criticized for illustrating African American females as â€Å"big momma†, another negative portrayal of black women. Other times shapely video vixens cause other black females to be portrayed as â€Å"jump-offs† or gold diggers. African American males have even greater judgments to overcome. They are viewed as a menace to society. They are illustrated as wild, angry, dangerou s â€Å"gang bangers†. Black men are viewed as absentee fathers or abusive husbands.Although, in some cases, African American males do possess some of these characteristics, there are just as many black men that are positive role models. These ignorant judgments are called stereotypes. A stereotype is defined as â€Å"a widely held but fixed and oversimplified image or idea of a particular type of person or thing†. Stereotypes, in my own words, are judgments blindly made by people who use ignorance as an excuse to be biased against those who are different from them. There are many different types of stereotyping.Racial stereotyping, sexist stereotyping, stereotypes about cultures, and sexual orientation stereotypes are all judgments that can affect one’s life in many ways. Stereotypes are, sadly, made by everyone. Racial stereotyping, however, is the most common type of stereotyping, and can sometimes be dangerous. The Trayvon Martin story, for example, is a sit uation where stereotyping turned tragic. Trayvon Martin was a young African American boy who was walking from the store with nothing but Skittles and a drink in his pockets.Because of his race, and the stereotype of what black Males are capable of, he was targeted, and tragically killed. There have been many similar cases of dangerous stereotyping. People’s fear of what the media shows we are suited to do, has gotten out of control. Too many of us are dying because of this fear. While many stereotypes do seem to be believable, people like Barack Obama, Michelle Obama, my grandparents, and my mom allow me to realize that not all stereotypes are true.

Demand For Medical Tourism Health And Social Care Essay

Surveies on wellness related mobility have long paid attending to the migration of patients from less developed states to industrialised states in hunt of wellness services that are unavailable in their state of beginning ( Paffhausen, et al. , 2010 ) . Recently, motion in the opposite way, which is referred to as medical touristry, has captured the involvement of the media ( Horowitz, et al. , 2007 ) . Medical touristry describes the phenomenon of citizens from extremely developed states going to states at variable degrees of development for world-class but low-cost medical services that are non available in their ain communities ( Bookman & A ; Bookman, 2007 ; Woodman, 2007 ) . Unlike wellness touristry which is by and large viewed as a pleasure-oriented touristry affecting gratifying and restful activities ( Pollock & A ; Williams, 2000 ; Bennett, et al. , 2004 ) , medical touristry is distinguished from wellness touristry by the earnestness of unwellness and the degree of physical intercession required ( Hendersen, 2004 ; Carrera & A ; Bridges, 2006 ; Connell, 2006 ) . In this regard, Hendersen ( 2004, p.113 ) defines medical touristry as a pattern that ‘incorporates wellness showing, hospitalization, and surgical operations ‘ . This essay will concentrate the treatment on a figure of medical touristry issues with mention to economic theory including market drivers and determiners of demand for medical touristry, the crowding-out and crowding-in effects of medical touristry on public wellness of hosting states. The essay begins with the market drivers and determiners of demand for medical touristry. This will be followed by treatment of the ability of medical touristry in bettering public wellness – the crowding-in consequence. The essay will so discourse the crowding-out consequence of medical touristry – the fact that national resources are diverted from public heath to more profitable private services for international patients.Market drivers and determiners of demand for medical touristryAlthough medical touristry is an emerging industry ( Hopkins, et al. , 2010 ; Paffhausen, 2010 ) , the industry itself has grown dramatically over the past decennary ( Bookman & A ; Bookman, 2007 ; Paffhausen, 2010 ) . The rapid growing of the planetary medical touristry industry is facilitated by the important addition in demand for cross-border medical interventions which is fuelled by a figure of factors such as high wellness attention costs, expensive insurance premiums, long waiting l ists, and high income in developed states ( Horowitz & A ; Rosensweig, 2007 ; Bookman & A ; Bookman, 2007 ) . Health attention costs are a push and a pull of demand for medical touristry 1There is incompatibility in the value of monetary value snap of demand for wellness attention among different surveies and different medical services. For physician services, Lee and Hadley ( 1981 ) found that monetary value snap of demand is about -2.8 to -5.07, while in the survey of McCarthy ( 1985 ) the value was -3.07 to -3.26. At hospital degree, monetary value snap of demand for wellness attention is smaller, runing from -0.8 for patient yearss to -1.1 for admittances ( Feldman & A ; Dowd, 1986 ) . Rosett and Huang ( 1973 ) found that outgo for wellness attention is sensitive to monetary value, with monetary value snap of -0.35 to -1.5. Although different surveies yield different Numberss and different groups of people may hold different degree of sensitiveness to monetary value, these surveies tell us the same narrative: demand for wellness attention is monetary value elastic. Health attention market faces high monetary value snap of demand and patients are sensitive to price1 ( Rosett & A ; Huang, 1973 ; Lee & A ; Hadley, 1981 ; McCarthy, 1985 ; Feldman & A ; Dowd, 1986 ) . In fact, the primary ground why people travel in hunt of wellness attention is monetary value considerations ( Bookman & A ; Bookman, 2007 ) . Harmonizing to microeconomic theory, as wellness attention costs rise, the demand for wellness attention would diminish as a consequence ( McPake & A ; Normand, 2008 ; Folland, et al. , 2010 ) . As a rational economic person, in the attempt to minimise costs of wellness attention and maximise public-service corporation, the patient has become a medical tourer ( Bookman & A ; Bookman, 2007 ) . Like other trade goods, monetary value is one of the most of import determiners of measure demanded for wellness attention ( McPake & A ; Normand, 2008 ; Folland, et al. , 2010 ) . Rising wellness attention costs in place scenes and significantly lower monetary values of medical interventions in finish states are playing as a push and a pull severally of demand for medical touristry ( Bookman & A ; Bookman, 2007 ) . In the United States ( US ) , for illustration, it is estimated that the national wellness outgo has raised by 43.5 % from $ 1.3 trillion in 2003 to $ 2.8 trillion in 2008, of which 12 % ( $ 278 million ) was from personal payments ( US Center for Medicare and Medicaid Services, 2008 ) . This go oning addition in heath outgo exacts a great toll on wellness attention consumers. A survey by Himmelstein ( 2009 ) reveals that in 2007, over 62.1 % of all bankruptcies in the US were medical, and wellness attention costs have become the fastest turning constituent of Americans ‘ market basket. As a consequence, patients are pushed to go to where their demand can be met with low-cost monetary values to increase public-service corporation. With the lifting wellness attention costs in industrialised states, high quality services at important lower monetary values in developing states have become the inducement for patients seeking interventions abroad. Harmonizing to Deloitte ( 2008 ) , medical services in India, Thailand, Singapore can be every bit low as 10 % of those in the US, while other surveies reveals that the costs in some medical touristry finishs can be 30 % -70 % cheaper than those that medical tourers have to pay in their states ( Mugomba & A ; Danell, 2007 cited in Paffhausen, 2010 ) . The cost that includes airfare and holiday bundle of a bosom valve replacing surgery, for illustration, is merely $ 10,000 in India, while it costs $ 200,000 in the US ( Bookman & A ; Bookman, 2007 ) . Hospitals in Singapore charge $ 18,000 for a knee replacing with a six twenty-four hours in-patient intervention which would be a patient $ 30,000 in the US ( Herrick, 2007 ) . World-class medical interventions with significan tly cheaper monetary values in developing states have been drawing the possible wellness attention consumers in developed states to prosecute interventions overseas ( Bookman & A ; Bookman, 2007 ) . Insurance coverage, waiting clip, and income Econometric patterning on heath attention ingestion behavior suggests that insurance coverage, deductibles, and co-payments are among the variables of the demand map for wellness attention with negative correlativity coefficients ( Folland, et al. , 2010 ) . High wellness insurance premiums means people tend to purchase low-budget programs that merely cover a little basket of heath services or people may take non to purchase insurance ( Bookman & A ; Bookman, 2007 ) . It is estimated that over 46 million Americans are uninsured, doing nest eggs on medical processs abroad more attractive ( Starr & A ; Fernandopulle, 2005 ; Milstein & A ; Smith, 2006 ) . In add-on, high deductibles and co-payment sometimes make the cost of wellness attention out of range of patients even though they have insurance ( Bookman & A ; Bookman, 2007 ) . Given demand for wellness attention is infinite and patient ‘s income is finite, it is non surprising to see people going to seek medical interventions outside their states ( Bookman & A ; Bookman, 2007 ) . In states where there is a national health care plan such as Canada and the United Kingdom, waiting clip is the figure one barrier to entree to wellness attention ( Statistics Canada, 2005 ; Horowitz, et al. , 2007 ; Turner, 2007 ) . A recent survey finds that Canadians wait an norm of 8.4 hebdomads for General Practitioner ‘s referral to a specializer and delay another 9.5 hebdomads for intervention ( Asia Pacific Post, 2005 cited in Conrady & A ; Buck, 2008 ) . When a waiting list for a peculiar process is excessively long, the patients, particularly those who have high clip monetary values, may be willing to short-circuit the free services offered at place and travel abroad to hold a timely intervention and accomplish satisfaction Oklahoman ( Hopkins, 2010 ) . An extra factor that fuels medical touristry demand is income. Harmonizing to microeconomic theory, the more disposable income a individual has, the more it is available for ingestion, including the ingestion of wellness services ( Bookman & A ; Bookman, 2007 ; Pindyck & A ; Rubinfeld, 2009 ) . Therefore, high income translates into the possibility of purchasing more wellness and preventative medical specialty ( Bookman & A ; Bookman, 2007 ) .Medical touristry and public wellness: crowding-in consequenceMedial touristry has become one of the most of import national economic activities thanks to the advantages it provides to hosting states ( UNESCAP, 2009 ) . The advantages such as economic addition, improved medical substructure and external encephalon drain decrease enable medical touristry to better and spread out public wellness, which is known as the crowding-in consequence of medical touristry ( Bookman & A ; Bookman, 2007 ) . Available information reveals that the planetary medical touristry industry generated about $ 60 billion in grosss in 2008 and the figure is projected to be $ 188 billion by the terminal of 2010 ( Deloitte, 2008 ) . Through cross-subsidization, the ensuing grosss can be reinvested in public wellness which consequences in increased entree, greater coverage, and improved quality of wellness attention for the local population ( Bookman & A ; Bookman, 2007 ; Hopkins, 2010 ) . Cross-subsidization can besides take the signifier of sharing infirmary beds, heath professionals, and medical substructure ( Bookman & A ; Bookman, 2007 ) . Thailand, Argentina, and Malaysia, for illustration, have been utilizing telemedicine – a portion of technological invention associated with medical touristry – to supply wellness attention to advance parts ( Bookman & A ; Bookman, 2007 ) . Hence, the development of medical touristry, through macroeconomic redistribution policy, can heighten publi c heath and bring forth positive outwardness.Medical touristry and public wellness: crowding-out consequenceBing considered as a major stimulation of socioeconomic development through advancing medical touristry, private infirmaries have been having considerable subsidies from authorities ( Bookman & A ; Bookman, 2007 ; UNESCAP, 2009 ) . Given scarce resource, such support may take away resources from public wellness attention. Promoting medical touristry besides diverts human resource off from public services to private sector where heath attention staff may have higher income and work in an international criterion environment ( Sen, 2008 ) . In Thailand, for illustration, 6,000 places in public wellness services are still remained unfilled as an addition figure of wellness attention forces is attracted by higher wage and better working environment in private sector ( Saniotis, 2008 ) . Private infirmaries in Malaysia employ 54 % of the state ‘s physicians while accounting fo r merely 20 % of entire infirmary beds ( Gross, 1999 ) . In India, 80 % of wellness outgo is now in the private sector, while about half of all Indian adult females still present their babes without medical attenders ( WHO Statistical Information System, 2006 ) . By concentrating national resources for international patients, the hosting state may put on the line denying its ain citizen just entree to care, and make a double market construction for wellness attention in which one section of high quality services is for aliens and the other of lower quality is for local patients ( Bookman & A ; Bookman, 2007 ) . The ground underlying this polarisation is the tradeoff between the resources for public wellness and those for medical touristry ( Bookman & A ; Bookman, 2007 ) . Health attention for local population is crowded out as most of the resources are enticed off from local patients ( Bookman & A ; Bookman, 2007 ) . This double market construction besides creates a state of affairs in which those who need less care normally acquire overtreatment while excepting the neediest 1s or cut downing their use ( Bookman & A ; Bookman, 2007 ) .DecisionMedical touristry refers to patients going from developed states to less developed or developing stat es for medical interventions. Medical touristry is market driven in which sky-rocketing wellness attention costs, expensive wellness insurance premiums, long waiting list at place are obliging grounds for patients from western states to seek cross-border interventions. Theoretical and empirical groundss prove that medical touristry crowds in public wellness thanks to the advantages it brings to destination states such as revenue enhancement grosss, decrease in encephalon drain and improved medical substructure. However, medical touristry besides crowds out public heath of finish states by taking resources off from public wellness services. For-profit private infirmaries could sabotage quality of attention at public wellness installations for local population. With higher wage and better working status at private installations, public wellness establishments may endure internal encephalon drain. Therefore, medical touristry has both positive and negative impacts on hosting states ‘ public wellness, and these effects should have equal attending they deserve.