Free Essays on Importance Of Motifs, Themes And Symbols

In the earlier centuries, Macbeth’s story is not seen as wrong and tragic, but as a powerful study of a heroic individual who commits an evil act and pays an enormous price as his conscience destroys him. When people read about Macbeth now they see tragedy with a crazed man who does not feel that he can get enough power. In this play his speeches of despair show that Shakespeare shared late-twentieth-century feelings of alienation. Today there are new attitudes towards witches and witchcraft being expressed, different questions have also been raised about the way maleness and femaleness are portrayed in the play. â€Å"As with so many of Shakespeare’s plays, Macbeth speaks to each generation with a new voice.† (xiv) It is important to look at the themes, motifs, and symbols that the author displays throughout his work. Motifs are recurring structures, contrasts, or literary devices that can help to develop and inform the text major themes. Violence is a very important motif in the play, Macbeth. Even though in most of the play murders take place off the stage, the characters provide gruesome descriptions of the murder and it makes the play extremely violent. Hallucinations also recur throughout the play. â€Å" Is this dagger which I see before me, The handle toward my hand? Come, let me clutch Thee†¦A dagger of the mind, a false creation Proceeding from the heat oppressed brain?† (II, I) They are reminders of Macbeth and Lady Macbeth’s evil plan to get rid of the King. Macbeth sees a dagger floating in the air, as he is about to kill Duncan. The dagger, covered in blood and pointed towards the king’s chamber, represents the cruelty he is about to commit. Macbeth is not the only one to see awful visions, Lady Macbeth sleepwalks and believes that her hands are stained in blood and they will live in sin and without any religion. The hallucinations that are shown throughout the play represent their conscience a... Free Essays on Importance Of Motifs, Themes And Symbols Free Essays on Importance Of Motifs, Themes And Symbols In the earlier centuries, Macbeth’s story is not seen as wrong and tragic, but as a powerful study of a heroic individual who commits an evil act and pays an enormous price as his conscience destroys him. When people read about Macbeth now they see tragedy with a crazed man who does not feel that he can get enough power. In this play his speeches of despair show that Shakespeare shared late-twentieth-century feelings of alienation. Today there are new attitudes towards witches and witchcraft being expressed, different questions have also been raised about the way maleness and femaleness are portrayed in the play. â€Å"As with so many of Shakespeare’s plays, Macbeth speaks to each generation with a new voice.† (xiv) It is important to look at the themes, motifs, and symbols that the author displays throughout his work. Motifs are recurring structures, contrasts, or literary devices that can help to develop and inform the text major themes. Violence is a very important motif in the play, Macbeth. Even though in most of the play murders take place off the stage, the characters provide gruesome descriptions of the murder and it makes the play extremely violent. Hallucinations also recur throughout the play. â€Å" Is this dagger which I see before me, The handle toward my hand? Come, let me clutch Thee†¦A dagger of the mind, a false creation Proceeding from the heat oppressed brain?† (II, I) They are reminders of Macbeth and Lady Macbeth’s evil plan to get rid of the King. Macbeth sees a dagger floating in the air, as he is about to kill Duncan. The dagger, covered in blood and pointed towards the king’s chamber, represents the cruelty he is about to commit. Macbeth is not the only one to see awful visions, Lady Macbeth sleepwalks and believes that her hands are stained in blood and they will live in sin and without any religion. The hallucinations that are shown throughout the play represent their conscience a...

Woody Guthrie, Influential Songwriter and Folk Singer

Woody Guthrie, Influential Songwriter and Folk Singer Woody Guthrie was an American songwriter and folk singer whose songs about troubles and triumphs of American life, coupled with his raw performing style, had enormous influence on popular music and culture. An eccentric character often viewed as something of a hobo poet, Guthrie created a template for songwriters which, carried along by admirers including Bob Dylan, helped infuse popular songs with poetic and often political messages. His most famous song, This Land Is Your Land has become an official national anthem, sung at countless school assemblies and public gatherings. Though his career was cut short by an incapacitating illness, Guthries songs have continued to inspire successive generations of musicians and listeners. Fast Facts: Woody Guthrie Full Name: Woodrow Wilson GuthrieKnown For: Songwriter and folk singer who portrayed the troubles and triumphs of Depression era Americans and had enormous influence on popular music.Born: July 14, 1912 in Okemah, OklahomaDied: October 3, 1967 in New York, New YorkParents: Charles Edward Guthrie and Nora Belle ShermanSpouses: Mary Jennings (m. 1933-1940), Marjorie Mazia (m. 1945-1953 ), and Anneke Van Kirk (m. 1953-1956)Children: Gwen, Sue, and Bill Guthrie (with Jennings); Cathy, Arlo, Joady, and Nora Guthrie (with Mazia); and Lorina (with Van Kirk) Early Life Woodrow Wilson Guthrie was born July 14, 1912, in Okemah, Oklahoma. He was the third of five children, and both his parents were interested in music. The town of Okemah was only about ten years old, recently settled by transplants who brought musical traditions and instruments with them. As a child Guthrie heard church music, songs from the Appalachian mountain tradition, and fiddle music. It seems music was a bright spot in his life, which was marked by tragic incidents. When Guthrie was 7 years old his mother’s mental condition began to deteriorate. She was suffering from undiagnosed Huntington’s chorea, the same disease that would, decades later, afflict Woody. His sister perished in a kitchen fire, and following that tragedy, his mother was committed to an asylum. When Guthrie was 15 the family moved to Pampa, Texas, to stay near relatives. Guthrie began to play the guitar. With his natural musical aptitude he soon mastered it and began performing with an aunt and uncle in a small band. He also learned to play mandolin, fiddle, and harmonica, and was known to perform in talent shows and plays at his high school. Woody Guthrie portrait. Bettmann  /  Getty Images After finishing high school, Guthrie took off to travel about the South, essentially choosing to live as a hobo. He kept singing and playing guitar wherever he went, picking up various songs and beginning to write some of his own. He eventually returned to Pampa, and at the age of 21 he married a friend’s 16-year-old sister, Mary Jennings. The couple would have three children. Pampa is located in the Texas panhandle, and when the Dust Bowl conditions struck, Guthrie was an eyewitness. He felt great empathy for the farmers whose lives were upended by the severe weather conditions, and began to write the songs that would comprise a body of work about those affected by the Dust Bowl. In 1937 Guthrie was restless to get out of Texas, and managed to hitch rides to California. In Los Angeles he performed, got noticed, and landed a job singing on a local radio station. He was able to send for his wife and children and the family settled in Los Angeles for a time. Guthrie became friends with the actor Will Geer, who was very active in radical political circles. He enlisted Guthrie to sing some of his songs at rallies, and Guthrie became associated with communist sympathizers. In 1940 Geer, who was staying in New York City, convinced Guthrie to cross the country and join him. Guthrie and his family headed to New York. Burst of Creativity His arrival in the big city in February 1940 sparked a burst of creativity. Staying at the Hanover House, a small hotel near Times Square, he wrote down, on February 23, 1940, the lyrics for what would become his most famous song, This Land Is Your Land. The song had been in his head as hed traveled across the country. The song God Bless America by Irving Berlin had become a huge hit in the late 1930s, and Guthrie was irritated that Kate Smiths rendition of it was endlessly played on the radio. In response to it, he wrote a song which declared, in simple yet poetic terms, that America belonged to its people. c. 1940, New York, New York City, Almanac Singers, L-R: Woody Gurthrie, Millard Lampell, Bess Lomax Hawes, Pete Seeger, Arthur Stern, Sis Cunningham. Michael Ochs Archives / Getty Images In a span of a few months in New York, Guthrie met new friends including Pete Seeger, Leadbelly, and Cisco Houston. The folk song scholar Alan Lomax recorded Guthrie and also arranged for him to appear on a CBS radio network program. Dust Bowl Ballads In the spring of 1940, while based in New York, Guthrie traveled to the Victor Records studio in Camden, New Jersey. He recorded a collection of songs he had written about the Dust Bowl and the Okies of the Great Depression who had left the devastated farmlands of the Midwest for a grueling trip to California. The resulting album (folios of 78-rpm discs) titled Dust Bowl Ballads was released in the summer of 1940 and was notable enough to receive a very positive review in the New York Times on August 4, 1940. The newspaper praised Guthries writing and said of his songs: They make you think; they may even make you uncomfortable, though not as uncomfortable as the Okie on his miserable journey. But they are an excellent thing to have on record. Dust Bowl Ballads, which is now in print in a compact disc version, contains some of Guthries best-known songs, including Talkin Dust Bowl Blues, I Aint Got No Home In This World Anymore, and Do Re Mi, a mordantly funny song about the troubles of migrants arriving penniless in California. The song collection also contained Tom Joad, Guthries rewrite of the story of John Steinbecks classic Dust Bowl novel, The Grapes of Wrath. Steinbeck did not mind. American folk singer Woody Guthrie performs on a stoop for an audience of predominantly children, New York, New York, 1943. Eric Schaal / Getty Images Back West Despite his success, Guthrie was restless in New York City. In a new car hed been able to purchase, he drove his family back to Los Angeles, where he discovered work was scarce. He took a job for the federal government, for a New Deal agency in the Pacific Northwest, the Bonneville Power Administration. Guthrie was paid $266 to interview workers on a dam project and write a series of songs promoting the benefits of hydroelectric power. Guthrie took to the project enthusiastically, writing 26 songs in a month (often borrowing tunes, as was common in the folk tradition). Some have endured, including Grand Coulee Dam, Pastures of Plenty, and Roll On, Columbia, his ode to the mighty Columbia River. The odd assignment prompted him to write songs packed with his trademark wordplay, humor, and empathy for working people. Following his time in the Pacific Northwest he returned to New York City. His wife and children didnt come along to New York but moved to Texas, intent on finding a permanent home where the children could attend school. That separation would mark the end of Guthries first marriage. New York and War Based in New York as the city began to mobilize for war following the Pearl Harbor attack, Guthrie began writing songs supporting the American war effort and denouncing fascism. Photographs of him taken during this period often show him playing a guitar with the sign on it: This Machine Kills Fascists. American folk singer Woody Guthrie (1912 - 1967) plays his guitar, which has a handwritten sticker that says, This Machine Kills Fascists, New York, New York, 1943. Eric Schaal / Getty Images During the war years he wrote a memoir, Bound For Glory, an account of his travels around the country. Guthrie joined the U.S. Merchant Marine and made several sea voyages, delivering supplies as part of the war effort. Near the end of the war he was drafted and spent a year in the U.S. Army. When the war ended he was discharged and after some traveling about the country he settled in the Coney Island neighborhood of Brooklyn, New York. In the late 1940s, Guthrie recorded more songs and continued writing. Many lyrics he never got around to setting to music, including Deportees, a song about migrant workers killed in a plane crash in California while being deported to Mexico. He had been inspired by a newspaper article that didnt provide the names of the victims. As Guthrie put it in his lyrics, The newspaper said they were just deportees. Guthries words were later put to music by others, and the song has been performed by Joan Baez, Bob Dylan, and many others. Illness and Legacy Guthrie remarried and had more children. But his life took a dark turn when he began to be afflicted with the onset of Huntingtons chorea, the hereditary disease which had killed his mother. As the disease attacks brain cells, the effects are profound. Guthrie slowly lost his ability to control his muscles, and had to be hospitalized. As a new generation of folk song enthusiasts discovered his work in the late 1950s his reputation grew. Robert Zimmerman, a student at the University of Minnesota who had recently started calling himself Bob Dylan, became fascinated with Guthrie to the extent of hitching a ride to the East Coast so he could visit him at a state hospital in New Jersey. Inspired by Guthrie, Dylan began writing his own songs. Guthries own son, Arlo, eventually began performing in public, becoming a successful singer and songwriter. And countless other young people, hearing Guthries old records, were energized and inspired. After more than a decade of hospitalization, Woody Guthrie died on October 3, 1967, at the age of 55. His obituary in the New York Times noted that he had written as many as 1,000 songs. Many recordings of Woody Guthrie are still available (today on the popular streaming services) and his archives are housed at the Woody Guthrie Center in Tulsa, Oklahoma. Sources: Guthrie, Woody. UXL Encyclopedia of World Biography, edited by Laura B. Tyle, vol. 5, UXL, 2003, pp. 838-841. Gale Virtual Reference Library.Guthrie, Woody. Great Depression and the New Deal Reference Library, edited by Allison McNeill, et al., vol. 2: Biographies, UXL, 2003, pp. 88-94. Gale Virtual Reference Library.Guthrie, Woody 1912–1967. Contemporary Authors, New Revision Series, edited by Mary Ruby, vol. 256, Gale, 2014, pp. 170-174. Gale Virtual Reference Library.

Ending Hunger in the Elderly Population Essay Example | Topics and Well Written Essays - 1250 words

Ending Hunger in the Elderly Population - Essay Example Although students are not required to conduct an interview as research for the final project, the process of thinking about potential questions and responses related to the final project topic will help stimulate further ideas and questions related to conducting relevant and reliable research. Of course, you may also decide to interview the person discussed here or another appropriate subject and use the material in your upcoming projects as a primary source. I selected Ms. Haist, because she is the chief researcher at a famous university. She is also an expert on the topic of poverty and hunger reduction methods. I am sure, that she will provide me, with the detailed insight about the topic of my paper. The topic of this interview is focusing on the methods to alleviate hunger among the older people. According to the, Gomez & Ranney, (2002) There is a statistically significant relation between the health expenditure and fitness of old people, so if the government wants to keep them healthy, it has to stabilize their income, which can be achieved through offering them flexible insurance packages. This observation indicates a firm and logical relation between the health and financial well beings of individuals in question. During another study, the researcher finds that the proportion of homeless people is increasing with leaps during last two decades (Bowering, Clancy, & Poppendieck, 1999), majority of individuals among them, is older and has no family. They also lack the luxury of having proper shelter. At the same time they suffer with nutrients deprivation (Saad, 2000). It is the due responsibility of federal and regional governments to spare resources of the betterment of these people. In any country the most powerful entity is the government, so in my opinion this is the ultimate responsibility of the federal government to take care of these people, because the culture of US is individualistic, so people are busy

Below Exercises Answered Assignment Example | Topics and Well Written Essays - 1250 words

Below Exercises Answered - Assignment Example Moreover, the unfinished products in the system are considered to be halfway complete in the production process giving the wafers a higher value than its actual value. By producing a large number of wafers, the firms’ asset in the production process will be seemingly high due to the wafers. Moreover, the fixed cost will remain the same while the variable cost will only rise to a reasonable amount considering the economies of large scale production. This is not an ethical way of boosting profits. It gives shareholders a false impression of the firms’ financial position. This may also act to attract more investors to invest in the firm due to its portrayed high profits, which is not true leading to great losses for investors. The company management can be sued for going against the ethical practices in business management. The losses of Pacific Electric are big due to too much fixed asset in the firm. For example, the 2000 employees will have to be paid whether they work or not due to the employment contract. The reduction of constructions will mean that most of the employees will be idol or not using their full potential at work due to the lesser work than usual. The plant and machine owned by the firm will also be contributing to the loss due to lower productivity and same rate of depreciation. Moreover, the idle plant and machinery will have a higher rate of depreciation than usual due to wear and tear. Therefore, due to under utilization of the fixed assets, the company is having big losses. The fixed cost can be converted to variable cost to reduce the loss associated with fixed cost; for example through review of employment contracts. This will see the firm have few permanent employees and some casual employees whose services are sought only when the firm requires them. The company can also reduce the amount of fixed asset owned through disposing some of its

The Evil of Modern Technology Essay Example for Free

The Evil of Modern Technology Essay â€Å"Many shall run to and fro, and knowledge shall be increased. † Daniel 12:4 Here I am, sitting in a house heated by a gas/forced air furnace, illuminated by an incandescent bulb, writing down my thoughts on a computer screen, accessing the internet by a wireless connection and weighing in against modern technology. I will be the first to tell you, however, that I don’t want to go back to the way it was, even a few decades ago, when I shivered over a lone heat register in the kitchen, pounded out my writing assignments on an ancient typewriter with a faded ribbon, waiting for my water to boil on a gas stove and my cinnamon toast to bake in the oven. Daily life has been so revolutionized by a steady progression of technological improvements that few of us can imagine living any other way. Conveniences have become such necessities that anyone who has no microwave, cell phone or digital alarm clock is considered deprived. Man’s inventive genius continues to prolifically breed new technologies, and with each new technology, a cottage industry springs up to feed, clothe and shelter it. Computers have generated software, music, movies, photo-shopping and enough peripheral gadgetry to fill a catalog. With the cell phone came personal ringers, phone cameras, text messaging, GPS capabilities, internet access, ebooks, and on and on. Automobiles can now do much more than transport passengers. They can pamper, comfort, entertain, advise, warn and tell drivers how to get to their destination. We now foresee the day when we won’t even have to steer the machine down the highway. There seems to be no end to our fertile imaginations. But I am haunted by the words of an old evangelist. He said, â€Å"Man will never hold out long enough morally to do what he wants to do scientifically. Even as we mount up to the heavens in the space age, we mire down in the mud of sin and shame. † I see this chilling prediction coming true before our very eyes and ears in the twenty-first century. Our heads cannot out-smart our hearts. Something is insanely wrong with all of this progress. Not only have promises of utopia not materialized for the bulk of civilization, in many cases we have regressed back to prehistoric levels. We have not eliminated murder; we have made murder easier. We have not eliminated theft; we have made stealing easier. We have not eliminated racism; we have made racism easier. We have not eliminated pornography; we have made pornography easier. Inherent within the new technologies we find all the old maladies. Good things undeniably come from our scientific and technological breakthroughs. Unfortunately, these developments have also been subverted for evil purposes. Indeed, the evil we have enabled may end up canceling out the good we have created in society at large. The most obvious example of this is nuclear technology. The fascinating capabilities of nuclear fission for energy also gave rise to the most destructive weapon ever invented. Regardless of how atomic weaponry is used—whether for defensive purposes or aggressive military action—the fact remains that it is used to kill and destroy. Other scientific discoveries have also been channeled into military uses, like rocketry, aerodynamics, fiber optics, laser beams, radar, modulated radio and television signals, satellites, etc. If it helps, we can make it hurt. If it heals, we can make it injure. If it does good, we can make it do bad. This position has been argued in philosophical terms as well. Regent University’s website on communication contains this paragraph: â€Å"Whether one accepts the neutrality of technology depends on one’s valuing philosophy—whether one tends toward the pragmatic and situational, or the absolute and authoritarian. Those who believe that technology is neutral argue that â€Å"guns don’t kill people, people do†, or that a knife can be used to â€Å"cook, kill, or cure. Those who believe the opposite counter with evidence that technology cannot be evaluated in a vacuum. Monsma (1986) argued for the â€Å"value-ladenness† of technology (chapter 3). He based his premise on two traits that he believed are common to all technological developments: (1) technological objects are unique; they are designed to function in a particular and limited way, and (2) technological objects are intertwined with their environment; they interact in unique ways with the rest of reality. † In medical science we can find an alarming example of the limits of technology. Jerome Groopman wrote an article in the New Yorker Magazine, August 11, 2008, entitled â€Å"Superbug: The new generation of resistant infections is almost impossible to treat. † He said, â€Å"In August, 2000, Dr. Roger Wetherbee, an infectious-disease expert at New York University’s Tisch Hospital, received a disturbing call from the hospital’s microbiology laboratory. At the time, Wetherbee was in charge of handling outbreaks of dangerous microbes in the hospital, and the laboratory had isolated a bacterium called Klebsiella pneumoniae from a patient in an intensive-care unit. It was literally resistant to every meaningful antibiotic that we had,† Wetherbee recalled recently. The microbe was sensitive only to a drug called colistin, which had been developed decades earlier and largely abandoned as a systemic treatment, because it can severely damage the kidneys. â€Å"So we had this report, and I looked at it and said to myself, ‘My God, this is an organism that basically we can’t treat. ’ † Much of the toxic social climate we experience today comes to us at the hands of modern technology. Who can dispute the widespread conviction that television has had a deleterious effect on culture? It is a waster of time, numbing minds and killing creativity. It has also piped pure filth from a godless and immoral Hollywood into the living rooms of the world. The radio has dispensed anarchy, vulgarity and corruption through the powerful medium of music, especially targeting adolescents and teenagers. In the last decade, pornography has spread wildly throughout the internet, victimizing viewers who would seldom or never come in contact with sexual perversion any other way. Amazingly, these same technologies have transmitted as much or more truth, virtue, goodness and love as they have depravity. How is this possible? Is technology, then, culpable? Innocent? Morally neutral? In The Gutenberg Galaxy (1962), Marshall McLuhan wrote, â€Å"The theme of this book is not that there is anything good or bad about print but that unconsciousness of the effect of any force is a disaster, especially a force that we have made ourselves† (p. 248). Regent University comments â€Å"Insert any technology for the word â€Å"print† and you realize that for McLuhan it is not the content that really matters. In this case it is not even the channel but rather our knowledge and understanding of the medium’s potential impact. † They then ask, â€Å"Is print an amoral technology? Can any technology be amoral? These are issues that must be addressed and answered before we can begin to develop a philosophical system to address the convergence of media and technology, and its impact on society. † I contend that communication technology has the greatest potential for evil of all the developments of modern science. This should not surprise us who are in the business of spreading the gospel. After all, Jesus commissioned the church to â€Å"Go ye therefore, and teach all nations. † The very means and methods used by the church to carry out the work of Christ has been co-opted by Satanic forces to destroy the gospel and spew corruption throughout the world. The advent of the online community was initially envisioned as a dynamic way to connect the inventive genius, the soaring imaginations and the scientific knowledge of individuals, groups, schools and cultures together, thus exponentially multiplying the positive impact they were making on the world. But in the parallel universe of evil, it was also appropriated by malevolent forces to connect with people who shared the same destructive designs. Roger Cohen expresses the same view in the New York Times column of March 10, 2008. â€Å"The main forces in the world today are the modernizing, barrier-breaking sweep of globalization and the tribal reaction to it, which lies in the assertion of religious, national, linguistic, racial or ethnic identity against the unifying technological tide. â€Å"Connection and fragmentation vie. The Internet opens worlds and minds, but also offers opinions to reinforce every prejudice. You’re never alone out there; some idiot will always back you. The online world doesn’t dissolve tribes. It gives them global reach. † The very internet I access to research my topics is simultaneously used to teach people to build bombs, incite hatred, instigate anarchy, commit fraud, buy and sell illicit drugs, learn witchcraft, poison minds and dismantle Christian traditions. More specifically, it provides a way for terrorist organizations to plot destructive acts, devise conspiracies, obtain funding for their violent activities and inspire each other’s dark causes. If this world is facing global chaos and apocalyptic demise, it will undoubtedly be facilitated by the technology now in existence or soon to be developed. Groups of people who otherwise had no way to unify and combine forces to wreak havoc upon the world now find it easy to locate each other and strengthen their hands. One only has to recall the tragedy of September 11, 2001 to know that cell phones and the internet aided nineteen terrorists to coordinate their diabolical plan. Without the assistance of technology, their deed would not have been possible or would have been infinitely more difficult to carry out. Technology may not be inherently evil, but neither is it inherently good. We are unforgivably naive to trust in scientific advances to spread the gospel or do the work of the church. Technology certainly will never be our savior. In fact, the future holocaust it will most assuredly precipitate may well eclipse any good that it has ever done for us. The best gifts to mankind do not come from himself, but from God. Every good gift and every perfect gift is from above, and cometh down from the Father of lights, with whom is no variableness, neither shadow of turning. † James 1:17. This warning may find application at the local congregational level where churches are growing increasingly dependent upon technology for worship, singing, preaching and witnessing. But technology in the larger arena of the world needs to be viewed by the church as susp ect. It’s potential for evil means that it will never be the best friend of the church. Let us use it, work it and enjoy it. Let us also keep it at arms length, distant from our souls. We do not need computers, cell phones, radios, televisions, headphones, iPods, CD’s, DVD’s, satellites, telescopes or any other technological devices to have a meaningful relationship with God. Paul’s Mars Hill sermon said this, â€Å"That they should seek the Lord, if haply they might feel after him, and find him, though he be not far from every one of us: For in him we live, and move, and have our being. † Acts 17:27-28. The greatest technology to ever come to man may be the glorified body that God has prepared for them that love him. How close will that body allow us to be to God in a physiological sense? I’m not sure, but I do know what the scripture says. â€Å"Dear friends, now we are children of God, and what we will be has not yet been made known. But we know that when he appears, we shall be like him, for we shall see him as he is. † 1 John 3:2. (NIV) That’s the technological advance that excites me more than any other. In an instant, all worldly innovations will be rendered obsolete. We must not sell ourselves short by losing our soul to earthly things.

Review of Research Paper on RNA in Mammalian Cells -- Biology

Review of Research Paper: Duplexes of 21-nucleotide RNAs mediate RNA interference in cultured mammalian cells Overview The significance of this experiment is that it shows how siRNA suppresses the expression of genes in different mammalian cells. It was known previous to the experiment that dsRNA can trigger apoptosis in cells- this is an automatic defense mechanism that mammalian cells use to protect against the dsRNA possessed by viruses. The dsRNA can cause RNA interference when it is taken into the cell by a transgene or a virus. The dsRNA is then cleaved by ribonuclease III enzyme into 21-22 nucleotide siRNA's. The siRNA's joins a nuclease complex to form an RNA-induced silencing complex. This complex then cleaves and degrades mRNA. The question was, could transfecting the cell directly with siRNA produce RNA interference? This experiment was performed to test whether siRNA's are capable of RNAi in mammalian cell cultures. (The idea to test gene silencing on mammalian cells sparked from a petunia-darkening experiment.) To do this they synthesized siRNA duplexes against genes that coded for sea pansies and two variants of firefly luciferases. Luciferase is used because it emits light so it's easy to see if the genes are turned on or off, and by what degree. The luciferase activities were recorded 20 hours after transfection and it was seen that the specific inhibition of luciferase was complete, which is similar to the results obtained for dsRNA. In mammalian cells where the reporter genes were more strongly expressed, the ability of the siRNA to completely suppress the gene was reduced. Background Information So, what's with all these petunia flowers anyways? Gene Suppression Within Plants Plant scientists ... ...nderstanding of the significance of genes. Primarily, by silencing a given gene of the genome using a transfected siRNA, geneticists can quantifiably study the properties of the gene and the allele it encodes. This knowledge can then be applied to the pharmaceutical industry to identify "druggable" gene targets. Plants RNAi can be used for multiple purposes in plants. Among the most notable, it can be used to control insect viral vectors and improve the tolerance to pests and stress so that crops do not need to be destroyed regularly by insecticides. It can also cure plants by potentially eliminating toxins and allergens. Finally, RNAi employment can create perfection by extending flowering and fruit setting periods. References Duplexes of 21-nucleotide RNAs mediate RNA interference in cultured mammalian cells published in Nature (Vol. 411, 24 May 2001).

Adapting to Modern Society

Adapting to Modern Times Today, there are various radio stations that are broadcasted throughout Tanzania. However, from the 1950s until the mid-1990s, Radio Tanzania was the country’s sole station, consisting of music, poetry, drama, and speeches. There are currently more than 15,000 reels of these tapes that are sitting on the shelves of the BBC building in Dar es Salaam. Reviving the Radio Tanzania Archives is a project that has a goal of digitizing and preserving these tapes before they are destroyed.Throughout reading the booklet by the Heritage Project and after listening to the NPR segment, I noticed a common theme of indigenization of modernity. I argue that the project is using modern technology in order to preserve traditional ways. This topic has also been an important concept of the papers by Christen and Hodgson. In order to reach their goal, the people of the Tanzania Heritage project must use modern knowledge to convert the reel tapes into digital material. When they are able to make this conversion, they will be exemplifying the act of using modern ways in order to preserve traditions.The traditions that they are preserving refer to the history that is embedded in the forms of media that were broadcasted on the radio. According to the Heritage Project, Radio Tanzania was â€Å"both a key instrument of the state and public service, used as a tool for promoting unity and national pride through music† (booklet:8). The Radio represented more than just entertainment, it was involved in politics, and social relations as well. In the NPR segment, they state that the Radio was strictly Tanzanian, a station that was sung by and for the Tanzanian people.The station represents the purity of the Tanzanians without the influence from other institutions. In reproducing these tapes through digitization, people from all different parts of the world will be able to experience a part of the Tanzanian past. The restoration of them allows the Tanzania n tradition to live on indefinitely. Another important concern for the Heritage Project is for the future generations of Tanzania. The co-founder, Benson Rukantabula, hopes that â€Å"If we digitize the archives, they (younger generation) can know where they lost their way†(booklet:13).By using the modern technology to preserve the archives, the project hopes to inspire future generations to create music based on traditional values. King Kiki, one of the legends of the Radio Tanzania era, still plays to sold-out crowds weekly. Another artist of the radio, John Kitime also continues to play live shows throughout Tanzania. The fact that both of these men are still playing to live audience signifies how valuable the music still is. This type of music is also known as Swahili Jazz music, and it was the most popular form of Tanzanian music from the 1960s until the mid-1990s.One important feature of this type of music, according to the co-founder of the Tanzanian Heritage Project, is that you do not have to know the Swahili language to appreciate the music. The project believes in the universality of music, and how it crosses cultural barriers. If more of this music was available for people, then people would naturally begin to recognize the traditional rhythms and melodies of Tanzanian history. The broadcast of this music would increase the influence of traditional Tanzanian culture worldwide. The compact disc of the Warumungu women is also an example of the indigenization of modernity. The recorded songs define Warumungu women’s ancestral relations, their ongoing community status, and their continued relation to specific sets of country† (Christen:417). It is only with the compact disc, which is the product of modern society, that they are able to spread this music and their traditions internationally. To show the goal of reaching outside cultures, there is an insert that includes both English and Warumungu, in which the women voice their tradi tions, and explain their decision to put the disc into circulation.This insert gives a long history to the reader, and allows them an inside perspective of Warumungu history. Along with broadcasting nationally, this music is also recognized locally, and it is a central goal of the Warumungu women to create a new generation of â€Å"red-orcher women. † The disc was an important source of security for the Warumungu women, to ensure them that their younger generation would recognize and notice their ancestor’s traditions. In addition to the women’s desire to show their traditions to outside cultures and to their own younger generation, they were also aware of the economic benefit that the disc had for them.Nappanangka, a senior Warumungu women said that her â€Å"expectation is that the compact disc’s circulation will increase her power as a ‘red-orcher woman’ while also helping her pay for a new Toyota Land Cruiser† (Christen:424). With the success of the compact disc, the women were hoping for recognition as well as some economic benefit; both of which would help their society. In conclusion, the Warumungu women used the compact disc in order to protect their future generations and to preserve their own customs.The Maasai culture has experienced rapid change throughout its history. In the past, the Maasai culture was ignored because of its primitive ways. Recently, since the tourism industry has become a significant business, the Tanzanian nation-state officials have begun to recognize the Maasai, and use their authentic lifestyle to attract tourists. The Maasai have used this recognition â€Å"to their own advantage, linking current efforts to protect their lands and livelihoods and access development resources to global campaigns for the rights of indigenous peoples†(Hodgson:135).Their cultural lifestyle is being preserved due to the modern theme of tourism. In addition, the Maasai culture has experienced a shifting of roles of masculinities over many years. Traditionally, the Maasai culture has been associated with pastoralism and a dominant warrior-like masculinity. In the past, when a Maasai adopted certain forms of modernity, they were called â€Å"Ormeek†, which was associated with weakness and ignorance. However, the word Ormeek now takes on a more positive meaning and is valued and respected.Most of the Maasai community has learned that education is a key to the future, and Maasai men â€Å"want to educate all of their children so that they can survive in what they perceive as a rapidly changing world† (Hodgson:140). With this education, the Maasai are able to get jobs in the government, and are able to have a voice for the Maasai people. The older generation depends on the younger generation to take care of them, because of the great power that education has in their society. However, although they are adopting these new ways, many of the Maasai people continue to incorporate traditional ways into their daily routines.The social relations of the Maasai culture have basically remained the same, although education has been a key component that has been added. In conclusion, while adapting to modern ways, the Maasai culture has still maintained many of their traditional values, while also using newfound forms of education to provide new advancements for their culture. Reviving the Radio Tanzania Archives is a project with a goal much like that of the Warumungu women. Although the world is advancing, they are trying to preserve their traditions, and make them available worldwide. They do not want to lose heir past due to changing society; they want to recreate it so it can help future generations and inspire them. The Maasai also recognize that they are living in a changing world, and they are beginning to use new forms of education in order to promote their culture to outsiders. All three pieces of work share a commonality of trying to prese rve traditional means by using modern technology. Even though they are aware the world around them is unpredictable, they are not ready to forget their traditions, and step in line with modern times completely. They will use modern means in order to preserve the traditions that they wish to protect.

Accountable Care Organizations, Bundled Payments, and Health Reform Essay

With the enactment of the Patient Protection and Affordable Care Act (PPACA) in March 2010, health care reform has become the law. The legislation will extend health care coverage to more citizens, stabilize health insurance markets, enhance regulation and consumer protection, and improve the affordability and quality of health care in the United States. Changes in payment system of health care proposed by PPACA have led to the development of Accountable Care Organization (ACO). This paper will address how ACOs and the bundled payments system will impact the future of health care. See more: Strategic Management Process Essay The ACO is a health care organization which provides accountability for quality, cost, and care for medical beneficiaries with single entity providers that are responsible for delivering care. The ACO-model builds on the Medicare Physician Group Practice Demonstration and the Medicare Health Care Quality Demonstration, established by the Medicare Prescription Drugs Improvement and Modernization Act of 2003. Under the Affordable Care Act, the U.S. Department of Health and Human Service (HHS) released new rules that benefit doctors, hospitals, and other health care providers of better care for Medicare patients through ACOs on March 31, 2011(U.S. Department of Health & Human Services, 2001). According to the Centers for Medicare & Medicaid Services’ (CMS) administrator Donald Berwick, MD, â€Å"An ACO will be rewarded for providing better care and investing in the health and lives of patients. ACOs are not just a new way to pay for care but a new model for the organization and delivery of care† (Penton Media., 2011). The new model, which is called the â€Å"Pioneer Accountable Care Organization,† is to improve the quality of care for Medicare Fee-For-Service (FFS) beneficiaries  (Medicare Parts A and B) and reduce unnecessary costs through establishing a shared savings program, which promotes accountability for Medicare FFS beneficiaries. It requires coordinating care for services provided under Medicare FFS and encourages investments in infrastructure, and it redesigns care processes. Regarding the differences, the Pioneer ACO payment model incorporates a population-based payment in the third year of the ACO’s Participation Agreement. This population-based payment will replace fifty percent of the FFS payments (McDermott & Emery, 2011). The Pioneer ACO model is estimated to save Medicare as much as $430 million over three years by coordinating with private payers to reduce costs for Medicare beneficiaries and improve health outcomes. An ACO may engage in either a Shared Savings Program or in the Pioneer ACO model. In addition, the Pioneer ACO model is separated from the Medicare Shared Savings Program for Medicare beneficiaries by the Advance Payment Initiative (Center for Medicare and Medicaid Innovation Center, 2011). ACOs require the ability to manage cost and quality for patients across the continued extent of care and across different associational settings. They also require the capability to plan budgets and resources needed to allocate payments, and the commensurable size of primary care providers for Medicare patients’ populations assigned to the ACOs (at least 5,000 Medicare or 15,000 commercial patients). According to the Journal of the American Medical Association, doctors Shortell and Casalino recommend a three-tiered system of qualification for ACOs (Shortell, S. and Casalino, L., 2010). The tiers will be based on the degree of financial risk acceptable for ACOs and the degree of financial rewards that can be completed by performance targets. In the first tier, ACOs will receive FFS payment with shared savings for providing quality care at lower than the expenditure targets. In the second tier, ACOs will receive bundled payments and episode of care based payments for managing costs and achieving benchmarks. They will be accountable for care that meets these criteria. In the third tier, ACOs will receive partial and global capitation payments. Under a three tiered structure, ACO providers will submit a three-year plan to the HHS or CMS for achieving qualification status at the varied levels. The U.S Department of Health and Human Services (HHS) announced the â€Å"Bundling Payment for Care Improvement Initiative† to coordinate payments for services delivered across an episode of care, such as a cardiac bypass or a hip replacement, on August 23, 2011 (Vendome Group, LLC, 2011). The definition of bundled payments refers to a single payment for all care related to an entire treatment or condition. Bundled payments, also called episode-base payments or case-rate payments are considered as a mechanism for improving both cost and quality, such as currently exist with Geisinger Proven Care and the Prometheus Payment system (Dark,Cedric., 2011). Bundled Payments do benefit physicians and hospitals if patients complete their medical treatments within a certain time period because it will save the physicians and hospitals additional costs. However, it is a disadvantage for physicians and hospitals if the treatment takes longer than the traditional time because it will cost more money to care for patients. Unfortunately, its emphasis is less about improving care and more about reducing the financing for medical care (Gorman Health Group Blog, 2011). This means hospitals, physicians, and other practitioners will have to take their own approach to improving the delivery of healthcare, which should benefit Medicare patients. The goal of the initiative is to increase efficiency of care, improve quality of care, and lower costs. This initiative consists of four different bundled payment models. The first three bundled payment models are retrospective payment arrangements based on patients’ historical data. However, the fourth model is proposed for the future. Centers for Medicare & Medicaid Services (CMS) make a single bundled payment to the hospital for all services during inpatient stays for hospitals, physicians, and other medical professional specialists. In the first model, the episode of care is the length of time the inpatient stays in the acute care hospital. Medicare pays the hospital a discounted payment based on the payment rates established under the Inpatient Prospective Payment System (IPPS), which starts at zero percent for the first six months and then rises to a minimum of two percent in the third year, based on the IPPS. Physicians are paid under the Medicare Physician  Fee Schedule. Hospitals and physicians are to share in any costs. This model benefits Medicare patients by reducing their costs, but not hospitals and physicians because they must share in any expenditures. The second model, which is also based on IPPS, is different from the first model because it includes inpatient and post-acute care from either 30 or 90 days following discharge. This bundled payment includes physicians’ services, post-acute care, readmissions, and other related services, which can be clinical laboratory services, medical equipment, prosthetics, orthotics, other supplies, and Part B drugs. The minimum discount is three percent for the first 30 to 90 days after discharge and two percent for more than 90 days. The Medicare enrollee is to share the costs if the total payments are less than the target price. However, the provider will be responsible for payment coverage if the total payments exceed the target costs. This model uses an incentive discount for Medicare patients to spend less time in rehabilitation versus the first model which has no early rehabilitation discount. However, this model does not give an advantage to hospitals and physicians because it encourages Medicare patients to leave medical services sooner. The third model begins at discharge from an acute facility if less than 30 days are spent in rehabilitation. These bundled payments are the same as the second model with the exception of a discounted rate, which Medicare enrollees are required to set up instead of CMS, since CMS has not indicated an expected discount for medical service (Becker, Epstein & Green, P.C, 2011). In the fourth model, which is the only perspective model, hospitals will receive a single bundled payment from CMS that covers all medical services by hospital, physicians, and other medical professional specialists. The minimum discount will be three percent of the estimated total costs for the episode care (Proskauer Rose, 2011). The bundled payments are more hospital-centric than ACOs’ program. However, ACOs’ focus will be on how hospitals and physicians will share reimbursements in a post-fee-for-service payment system. Therefore, Medicare beneficiaries will benefit the most but hospitals and physicians will not. Future ACOs include: Integrated Delivery Systems, Multispecialty Group Practice (MSGP), Hospital Medical Staff Organization (HMSO), Physician-Hospital Organizations (PHO), Interdependent Practice Organization (IPO), and the Health Plan Provider Organization or Network (Charles DeShazer, 2011). However, most physicians work in very small practices that would not likely have the resources to develop the capacities to be an ACO. In an ACO-based health care organization, these small practices would either merge into new or already existing specialty group practice, or would engage in an ACO that facilitates clinical integration among small practices. Many physicians may still prefer smaller practices, and under comprehensive healthcare reform may continue to exist. In ACOs completely based on the quality and cost of care, the market may decide whether virtually integrated systems can succeed in competition with systems where physicians are merged into large group practices. Moreover, specialist physicians are creating medium sized or even larger single specialized groups. However, a single specialty group cannot serve as an ACO for full patients care but can be an essential element of an ACO or can be a crucial source of medical care through referrals. In Integrated delivery systems (IDS), medical care is coordinated and reimbursed within the system to make patient care more efficient while improving access to and the quality of the care received. Some examples are: Cleveland Clinic, Henry Ford Health System, Mayo Clinic, Scott & White Clinic, and so on. However, a recent report indicates that challenges may still remain. IDS face lack of compensation from health insurance providers for care coordination services as well as difficulties in finding specialty care, such as mental health care and changes in management and physician cultures in adopting the new organization (United States Government Accountability Office, 2011). The promising advantages of the multispecialty group practice (MSGP) model were recognized in 1932. As stated in the Physician’s Advocate(2008), â€Å"These advantages include having the resources to redesign care processes, take advantage of economies of scale to implement electronic medical records, form health care teams, obtain database feedback on performance gaps, and make the changes needed to improve care† (Physician’s Advocate, 2008). Some evidence indicates that multispecialty group practices do make the most of recommended care management processes like electronic information technology, as well as sharing in quality improvement medical services. Therefore, MSGPs provide better quality care for preventive measures involving screening tests and diabetes management than smaller forms of practices. Moreover, studies also indicate lower Medicare spending on patients related to multispecialty or hospital associated groups than other patients. However, it is unlikely that MSGPs will become the major organization form in the United States health care system since it is so expensive to implement. HMSO, more than 800,000 physicians that currently practice in the United States are members of hospital medical staffs (Carroll, 2011). The hospital medical staff organization can serve as ACOs for either inpatient or outpatient care. Studies indicate that most physicians have primary relationships with a single hospital to form a stronger partnership entity between physicians and their primary hospital (Fisher and et al., 2006). Hospitals have resources to support adopting electronic medical records (EMR), provide performance and accountability data, and assist quality improvement support for physicians. Bundled payments for specific medical conditions or episodes of sickness, such as a coronary artery bypass graft (CABG), hip or knee replacement (Massachusetts Medical Society, 2008) will provide incentives for hospitals and physicians to work together to reduce Medicare costs (Welch, WP and ME Miller, 1994). This model will have future advantages for chronic illness treatment as we ll as episodes of care since physicians and hospitals work together closely to monitor patients’ long term care. However, the HMSOs encounter challenges including leadership of the diverse cultures of hospitals and physicians and legal restrictions to obtain sharing (Primary Care Associates., 2008). An alternative of the MSGP model is the PHO. Hospitals and physicians work together to ensure cost-effective and steady system delivery of medical services and the provisions of the health care services to the patients. There are approximately one thousand PHOs in the United States and most are managed organizations with the goals of achieving and managing the quality  and cost of care (Nixon Peabody LLP., 2010). Under the Affordable Care Act, the contracting PHO model can emerge into an entity that will manage the quality and cost of care. Without meeting the needs of all physicians, this model has the advantage and the incentive of improving performance. With the HMSOs, the hospital will provide resources for EMR, performance reporting, quality improvement, and process management support. However, PHOs must be clinically integrated to avoid anti-trust laws (Casalino, Lawrence P., 2006). A fifth model is the Interdependent Practice Organization (IPO), which is an advancement for those physicians who practice in small organizations or who do not wish to be part of larger organizations for delivering care. The interdependent practice organization is based on an association of physicians in numerous independent practices. IPOs are capable of providing high quality, better care, although most of these organizations are loosely organized (Rittenhouse and et al., 2004). The future IPO model requires strong leadership, administration, and enough patients across individual practices to support financing of technology infrastructure and management systems. IPO models might be attractive to physicians practicing in rural areas. With given sufficient incentives, existing IPOs can became independent organizations by strengthening their management structure and developing a solid shared culture of performance improvement. These requirements are challenges since IPOs are composed of many small practices. The last model, the Health Plan-Provider Organization or Network (HPPO/HPPN) is similar to the IPO. It is based on an association of independent physician practices. The health plan will be the major financial assets to encourage a more cost-effective health care delivery system. Many have capabilities in disease management, electronic information technology implementation, and quality improvement entities that can be used effectively in collaboration with physicians. Some physician practices may participate with health plans rather than local hospitals. Health plans can be part of a smaller physician’s practice and become the unit of accountability of performance. However, the success of this model will depend on an individual physician’s leadership (Shortell and et al., 2008). The Centers for Medicare & Medicaid Services (CMS) released final rules and new opportunities for financial support for doctors, hospitals, and health care providers to work together to improve the care of Medicare patients by adopting ACOs on October 20, 2011. The new rules provide for a new voluntary Medicare Shared Savings Program. Providers will be able to participate in an ACO and share in the savings with Medicare. ACOs will reward providers for reducing the costs and meeting quality measures, such as reducing hospital readmissions or emergency room visits. Providers will begin to share in savings based on how they perform in thirty-three quality measurements in the second and third performance years. Medicare beneficiaries will be a part of the ACO system when they form. Moreover, community health centers and Rural Health Clinics (RHCs) will be allowed to participate in the ACO programs (Galewitz, Phil and Jenny Gold., 2011). To appeal to providers, CMS will provide physician-owned and rural providers early access to the expected saving of up to $170 million dollars, so providers can start ACOs right away. At the same time, the Antitrust Division of the Department of Justice issued the entire final rules that will allow providers to participate in the Medicare Shared Savings Program. In addition, the final rules will no longer require a mandatory antitrust review for collaborations as a condition of entry into Shared Saving Program (Department of Justice, 2011). Electronic health record (EHR) usage is no longer a condition of participation to prompt more RHCs and other programs to join (Center for Medicare and Medicaid Innovation Center, 2011). Moreover, CMS will assist agencies in monitoring the care and quality of performance of ACOs. The program will save up to $940 million dollars over four years (U.S. Department of Health & Human Services, 2001). Patients or Medicare beneficiaries are encouraged to select an ACO as their medical center. ACOs can be used for result-based payments, public report purposes, and claim-based payments which retrospectively allow patients to join who have not adopted ACOs. This advances patients’ choices and encourages ACOs to coordinate their patients’ care to treat patients equally. Because physicians are not required to be part of ACOs, physicians  can still be paid with the Shared Saving Programs used by Medicare, Medicaid, and other commercial health plans. They also can be eligible to achieve quality-based rewards. In addition, physicians and hospitals that are part of ACOs can have both obtainable rewards for improving quality and controlling costs; however, there is more inevitable risk. Furthermore, bundled payments for certain services and procedures, using a combination of capitation, result-based payments, and readmissions, gain sharing between physicians and hospitals tha t can be adopted within ACOs. Physicians also can benefit from the assistance that ACOs can provide with electronic health records and with implementation of established processes to improve quality and efficiency. Health reform will be needed in laws and regulations for the Stark law, anti-kickback statuses, fraud and abuse, anti-trusts, scope of practices, and the corporate practice of medicine. However, the final rules were relaxed and established waivers for the physicians’ self-referral law, the federal anti-kickback status, and certain penalties to encourage the participation in the Medicare Shared Saving Program and the Advance Payment Initiative (FierceHealthcare, 2011). Therefore, more medical providers will be regulated by the programs. In the past, healthcare leadership has relied on organizational structure to deliver higher quality at lower costs, which has not succeeded in improving neither efficiency nor performance. In fact, they have increased the problems that they intended to address. Neither diagnostic related groups (DRG) nor Health Managed Organizations created a shared achievement for all parties. Provider profit motivation lacked the pressure of medical beneficiaries to protect quality while minimizing costs. While each DRG and resource based relative-value unit encouraged providers to focus on provision without interventions, HMOs and other managed providers encouraged providers to minimize intervention, regardless of whether managing could delay the quality or completeness of patient care (Numberof, 2011). Ignoring the minimal role that patient demand plays in driving market completion among providers, the current and past medical health care system has decreased accountability for quality of medical care. ACOs were established to fix the inadequate accountability for wasteful  spending and quality of patient care. The PPACA provisions are consumer based solutions; however, they do not allow patients to have fully informed choices about their coverage and medical care (Numberof, 2011). Employers, who contract with insurers, apply with providers; therefore, accomplishment is limited. However, many physicians are reluctant to assume accountability for patient outcomes, since they admit that outcome is directly under the behavioral control of the patient. Furthermore, it seems that provider contracts could be integrated to a successful ACO in a shared savings program; providers continue to receive funding for each service they perform. Even with the possibility of a bonus from shared-savings, maintaining the FFS system boosts providers into continuing delivering an excess of services. In addition, ACOs, which are a single untested model, are largely hospital based. Eligibility requirements are larger and more involved for ACO organizations. Larger organizations are able to consolidate their markets; however, this consolidation may result in less competition. Therefore, large delivery organizations may become too big to fail but will increase advantages for patients. Without competition, the organizations might have little incentive to reduce the costs or improve quality of medical care. Enduring health reform has to cover the uninsured without exception or conditions. As Victor Fuchs, professor at Stanford University mentions â€Å"It [Enduring health reform] must improve efficiency in medical practice by providing physicians with the information, infrastructure, and incentive they need to deliver cost effective care† (Fuchs, 2010). Information will come from the electronic health records, a process that will be amped up by the HITECH Act, which is part of the American Recovery and Reinvestment Act of 2009 (Leyva, Carlos and Deborah Leyva, 2009). Electronic health records will benefit providers with more accurate real-time data on patients as well as provide analyses on drug responses and provide support to improve the quality of medical care. Health information Exchange (HIE) can enhance information from a wide databases and allow that information to be shared through various technology by providers. This allows related patient information to be shared withi n EMR with the provider who needs that information (Southern New Hampshire Health System, 2011). Furthermore, the  Patients Centered Outcomes Research Institute (PCORI) will offer physicians and patients new information of varied medical technology. Atul Grover, chief advocacy officer for the Association of American Medical Colleges, notes â€Å"It will be an evidence synthesis that really considers different populations and different diseases and tries to get more information to clinicians as they go about doing their daily work† (Marathon Medical Communications, Inc, 2010). The integration of the PCORI will enhance information so that physicians and patients can choose the appropriate test and treatment based on the patients’ condition. Moreover, infrastructure reform will enhance horizontal collocation within providers and monitor patients consistently. Health care reform strengthens greater integration through the redesign of delivery systems such as medical homes and ACOs for physicians. Recent studies suggest that better coordination of care can reduce readmission rates for major chronic sicknesses (Hernandez, AF, 2011). In addition, the PPACA will give incentives for hospitals to support proven practices that essentially reduce their rates (Foster, 2010). Likewise, the PPACA’s pilot program involving bundling payments will bring physicians and hospitals an incentive to allocate care for patients with chronic illnesses. Most essentially, PPACA admits that health reform that brings ACOs as the delivery system is an ongoing process requiring continuous adjustment. The PCORI will develop new medical tests, drugs, and other treatment that will provide continuously updated information for physicians and patients. Over the next decade, similarly, the Innovation Center in the Centers for Medicare and Medicaid will be establishing and evaluating new policies and programs that will enhance the quality of care for Medicare beneficiaries and reduce costs. PPACA not only will expand health care coverage to millions of Americans but also will enact many policies to reduce the amount of costs for health care by bringing ACOs as the delivery system, which will reduce the costs of health care over time. By enacting ACOs as a Primary Care Provider (PCP), PPACA provides the most effective medical care support possible. Moreover, by adopting the bundled payment approach, physicians, hospitals, and other providers will be able to reduce the costs for Medicare beneficiaries.  Therefore, the public should embrace the new health care proposal to reduce their costs and improve the quality of their medical care. References Becker, Epstein & Green, P.C (2011) â€Å"HEALTH REFORM: CMS Innovation Center Announces Four Models in Bundled Payments for Care Improvement Initiative,† Retrieved from http://www.ebglaw.com/showclientalert.aspx?Show=14876 Carroll, Aaron. (2011, June 3). â€Å"Meme-busting: Doctors are all leaving Canada to practice in the U.S.,† Retrieved from http://www.washingtonpost.com/blogs/ezra-klein/post/meme-busting-doctors-are-all-leaving-canada-to-practice-in-the-us/2011/06/03/AGVdAuHH_blog.html Casalino, Lawrence P. (2006) â€Å"The Federal Trade Commission, Clinical Integration, and the Organization of Physician Practice,† Journal of Health Policy, Politics, and Law, Retrieved from http://www.ftc.gov/os/comments/aco/2006jhppl.pdf Center for Medicare and Medicaid Innovation Center (2011) â€Å"Pioneer ACO Application,† Retrieved from http://innovations.cms.gov/areas-of-focus/seamless-and-coordinated-care-models/pioneer-aco-application/index.html Center for Med icare and Medicaid Innovation Center (2011) â€Å"final ACO rule,† Retrieved from http://www.cms.gov/aco/downloads/Appendix-ACO-Table.pdf Department of Justice, the Antitrust Division and the Federal Trade Commission (2011) â€Å"Background Documents,† Retrieved from http://www.justice.gov/atr/public/health_care/276458.pdf DeShazer, Charles. (2011) â€Å"Accountable Care Organization (ACO) Tutorial,† Retrieved from http://www.slideshare.net/cdeshazer/accountable-care-organization-aco-tutorial Dark, Cedric (2011) â€Å"Quality over Quantity: Reforming Payment,† Retrieved from http://www.policyprescriptions.org/?p=2066 FierceHealthcare, (2011) â€Å"CMS, OIG to relax self-referral, anti-kickback laws with ACO waivers,† Retrieved from http://www.fiercehealthcare.com/story/cms-oig-relax-self-referral-anti-kickback-laws-aco-waivers/2011-10-21 Foster, David. (2010) â€Å"Healthcare Reform: Pending Changes to Reimbursement for 30-Day Readmission,† Retrieved from http://thomsonreuters.com/content/healthcare/pdf/pending_changes_reimbursements Fuchs, Victor (2010) â€Å"Health Care Reform,† Retrieved from http://siepr.stanford.edu/system/files/shared/Health_care_document.pdf

Educational Article A Better Way to Understand Teams and Roles

Educational Article A Better Way to Understand Teams and Roles Read about what a team is, what Belbin team roles are and how to make the work in a team effective. Team interaction and management is a core discipline in HRM studies and is a critical area of competence for any manager. The success or failure of the entire organization is dependent on how effectively the people within it  can work together. Of course, any management task involving people can be a little confusing, even messy; people do not neatly fit â€Å"models† and prescribed solutions, and the challenges only grow as people are brought together into purposeful groups. In this article, some of the well-known important concepts of teams and the roles people play in them are presented to show how popular academic ideas are reflected in real life, and what approaches can be taken when people in teams – as they inevitably will, pretty much all the time – do not behave in quite the way our textbooks and lectures lead us to believe they should. Assigned to write a management essay? Learn what a management essay is: MANAGEMENT ESSAY What Is a Team? That sounds like a simple question with an answer that everyone should understand without a lot of mental exercises, but the â€Å"team† in â€Å"team management† is more often than not treated casually, or overlooked entirely. An effective team is not merely â€Å"a group of people working towards a common objective but a community of practice, which has three â€Å"crucial† characteristics domain, community, and practice. Dr. Etienne Wenger Domain.  The shared domain of interest – in a work team setting, this would usually be the â€Å"purpose† of the team – gives the group a distinct identity, which may or may not mean anything to anyone else. As an example, Wenger describes how a street gang’s identity as a unit is formed by the shared domain of its individual members, even though that is ultimately probably not in their best interests or those of civilization as a whole. The key to the idea of â€Å"domain† is learning: what starts out as just a common interest among individuals is refined and increased by learning through interaction. Community.  A community is characterized by joint activities and shared information, which contributes to the shared learning. The distinction between â€Å"community† in common sense – such as a neighborhood, or a group sharing a common topic of interest on a Facebook page – and community in the sense meant by Dr. Wenger is subtle and perhaps difficult to understand. It is easier to think of it in terms of where the intended benefits of the team interactions are focused by the team members; if the intention is an individual benefit, then the team is probably not a true community. For example, a neighborhood might not be a true â€Å"community† (although we may call it that), if whatever â€Å"neighborliness† practiced by the residents is primarily motivated out of self-interest for their own security and comfort. Practice.  What differentiates a â€Å"community† from a mere â€Å"group† is shared practice, or as Dr. Wenger describes it, a shared pool of intellectual resources – stories, tools, experiences, and ways to solve recurring problems. A group of truck drivers trading stories over coffee in a truck stop are not simply being friendly and entertaining themselves, but are actually building a knowledge base and learning from one another. See also:  Managing Problems in Groups Dr. Wenger, who is a social learning theorist with a background in Artificial Intelligence, implies that a â€Å"community of practice† is the most effective when it forms organically. This actually makes sense, because the motivation both in having an interest in the first place and then in pursuing it is largely intrinsic. Talk to any random truck driver, for instance – it’s nearly impossible to find one who doesn’t actually like being a â€Å"trucker†, in spite of whatever day-to-day annoyances might be encountered. But knowing how effective team works as a â€Å"community of practice† does make it possible to form the team purposefully, so long as the team members chosen individually have two basic traits: Commitment to a common interest or aspiration, as long as it is a specific interest or aspiration. If the goal for the team is to develop a world-beating software application, then the people chosen for the team should be passionate about developing software; enthusiasm for the vague aspirations expressed in the company’s Mission Statement or enjoying â€Å"working with others† is not enough, nor particularly relevant. Good communication skills, or specifically, the ability to coherently communicate the passion for the common interest in practical terms. This also applies to being able to interpret others’ ideas. Naturally, finding the passionate, communicative people to build a team is only part of the puzzle; they still won’t be able to accomplish anything if they do not have clear roles to play. Roles in Teams. Belbin Team Roles A popular – and to be fair, not altogether useless – theory that one will encounter at some point in management studies is the Team Role Theory of Dr. Meredith Belbin. Dr. Belbin’s research led him to develop a description of nine roles in teams, which should be represented in a balanced way for the team to be effective: According to Belbin’s website (the theory has become, not surprisingly, the basis for a multi-million dollar consulting business), the behavioral analysis that determines what individuals’ team roles should be â€Å"Can be used to build productive working relationships, select and develop high-performing teams, raise self-awareness and personal effectiveness, build mutual trust and understanding, and aid recruitment processes.† The theory is backed up by empirical research, and does, in fact, give insights into how people work in teams, but only after the team has been formed and interacts for a period of time  when roles and attitudes begin to emerge because Team Role Theory has two big flaws: 1. GENERALIZATION   some people are predictable, but most are not. The context of the team and the actual objectives the team is trying to achieve have a much greater part in determining how team members will act than the theory allows, because the roles themselves were developed from statistical results; results that furthermore did not allow for people to have aspects of more than one â€Å"role† in their personalities, which most people do. 2. OVER-THINKING   in any team, as a practical matter, there are only four roles that need to be filled: The Team Leader (organizes the team and keeps communication flowing smoothly) The Record-Keeper (keeps track of what the team is doing) The Worker (accomplishes the tasks the team needs to complete) The Progress-Chaser (conducts follow-up, testing, and monitors progress against the expected schedule) What Team Role Theory can do to help – and why it is important to study and understand it, though it is not as practically useful as advertised – is to give some insights into what roles, and to what degree of those roles, prospective team members are best suited to fill. At we have a team of professional writers and a friendly support team always ready to help you with any writing assignment. Place an order to inform the details of your assignment.

8 Fun SAT Test Facts to Give You a Break from Studying

8 Fun SAT Test Facts to Give You a Break from Studying SAT / ACT Prep Online Guides and Tips Unfortunately, studying for the SAT isn’t much fun. There’s really no way to make reading passages or dissecting math problems super entertaining - and believe me, I’ve tried. But if you’re looking for a quick break from studying, check out these 8 random SAT test facts. You may even learn something helpful! Fact #1: SAT doesn’t actually stand for anything SAT originally stood for Scholastic Aptitude Test. But after the idea that the SAT tested "aptitude"became too controversial, the namewas changed to the Scholastic Assessment Test. Of course, "assessment" and "test" are spectacularly redundant, so in 1997 the College Board got fed up with the whole namingfiascoand decided that the SAT was now just the name of the test, not an abbreviation of something else. Fact #2: The College Board once canceledthe test for an entire country The College Board takes cheating veryseriously. In 2013, ETS, which administers the SAT, found out that tutoring companies in South Korea had conspired to obtain the test in advance, so theycanceledthe May test date entirely. Similarly, when a group of Long Island teens were caught paying college students to take the test for them they faced harsh consequences: criminal charges. Seoul, South Korea, where some unlucky students had their SAT canceled. Fact #3: There's a play about SAT tutoring Jenny Lyn Bader’s play None of the Above is all about the relationship between a trouble-makingteenager and her SAT tutor. I suspect the play issomewhat more dramatic than reality, soif you have questions about tutoring I'd recommendtaking a look at our guide instead. Fact #4: The scale on the original College Board test wasbrutal The College Board actually predates the SAT. It was founded in 1901 to administercollege specific tests, which were gradedas Excellent, Good, Doubtful, Poor, or Very Poor. That system may have beenless confusing than the current scale,but it also sounds kind ofharsh! Fact #5: Someone wrote an SAT vocabnovel about vampires There’s an entire genre of novels specifically designed to help you learn vocab words for the SAT, and they sound completely bizarre.Test of Time investigates what would happen if Mark Twain's manuscript forHuckleberry Finn was swapped with a modern day college student's laptop.Vampire Dreams is basicallyTwilight without the whole glittering in the sun thing. The reviews from students aren't kind, so I would recommend sticking to regularnovels with high level vocab words. You're probably better off just readingDracula.(Len "Doc" Radin/Flickr) Fact #6: Stanley H. Kaplan started the first SAT test prep company in 1938 When he startedtutoring college-bound students in his basement in Brooklyn, Kaplancharged $128 per student. Despite considerable demand, he didn'texpand outside of New York until the 1970s. Fact #7: The SAT started out asa military IQ test Before it was used for college admissions, an early version of the SAT wasused by the army to screen recruits during World War I. The first SAT, which was given in 1926, wasalso much, much more difficult than today’s version. Itincludedsections in which the test takerhad to translate sentences into a made-up language, judge whetherpropositions were perfectly logical,and complete baffling analogies. I don’t know about you, but I can’t make heads or tails of these analogies. Fact #8:George W. Bush used the SAT as part of his presidential campaign No, he didn't touthis own scores- those weren't particularly impressive. Instead, he bragged about the 100 point increase in Texas students’ SAT scores during his term as governor. Unfortunately, that increase had nothing to do with improvements in education: it was actually caused by the College Board rescaling the test in 1995. What's Next? If you're having trouble motivating, try reading about how a higher SAT score can help you get into the school of your dreams. Are you struggling to improve or have actually seen your scores go down? Try these strategies to turn it around. For tons of other free SAT prep resources, take a look at the right sidebar to find our posts sorted by topic. Disappointed with your scores? Want to improve your SAT score by 160points?We've written a guide about the top 5 strategies you must be using to have a shot at improving your score. Download it for free now: Have friends who also need help with test prep? Share this article! Tweet Alex Heimbach About the Author Alex is an experienced tutor and writer. Over the past five years, she has worked with almost a hundred students and written about pop culture for a wide range of publications. She graduated with honors from University of Chicago, receiving a BA in English and Anthropology, and then went on to earn an MA at NYU in Cultural Reporting and Criticism. In high school, she was a National Merit Scholar, took 12 AP tests and scored 99 percentile scores on the SAT and ACT. Get Free Guides to Boost Your SAT/ACT Get FREE EXCLUSIVE insider tips on how to ACE THE SAT/ACT. 100% Privacy. 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The Evolution of the Civil Society Term Paper Example | Topics and Well Written Essays - 1250 words

The Evolution of the Civil Society - Term Paper Example Locke and Hobbes diverge on the notion of sovereignty. Locke argues that civil society precedes the state. For him, it is a society that provides the state its essential source of legitimacy. He contends that when the rulers fail to encourage interests, independence, and equality of individual humans, the social contract is breached and it is the responsibility of the members of society to oust that ruler. This is based on Locke’s assertion that the state of nature is based on equality and if people are equal, then the civil society is the state. The state is no greater than the society that made it: â€Å"A state also of equality, wherein all the power and jurisdiction is reciprocal, no one having more than another† and that â€Å"the lord and master of them all should, by any manifest declaration of his will, set one above another, and confer on him, by an evident and clear appointment, an undoubted right to dominion and sovereignty†. Hobbes believes the contra ry because it is the state that creates a civil society. Civil society is the product of civil society’s enforcement of the social contract, as he expresses in the Leviathan: â€Å"This is more than Consent or Concord; it is a real Unity of them all, in one and the same Person, made by Covenant of every man with every man† (Hobbes). For Hobbes, the people authorized the government to have the authority in directing civil society. I believe that Locke and Hobbes make good points. I agree with Locke that sovereignty is not only about the autonomy of the state.