Spiral of Silence Theory - 2121 Words

Spiral of Silence Theory Elizabeth Noelle-Neumann’s spiral of silence is a theory that was developed in 1974 and as the founder and the director of the Public Opinion Research Center in Allensbach in Germany; she has found evidence of how the spread of public opinion is formed. The term spiral of silence refers to the increasing pressure people feel to conceal their views they think they are the minority. People will be unwilling to publicly express their opinion if they are in the minority and they will also be more vocal if they believe they are a part of the majority. Thus, the more marginalized you become, the less you speak and so you spiral into a fully marginalized position. Neumann’s claim are based on previous collaborative†¦show more content†¦It is used to reveal a series of factors that measures the likelihood that people will voice their opinions. There are six factors and the first one is the most important: 1. Those who favor the majority positio n are willing to express their voice more comfortably. â€Å"Feeling in harmony with the spirit of the age loosens the tongue.† [Griffin, Em. Spiral of Silence. A First Look at Communciation Theory. 7th ed. N.p.: McGraw-Hill, n.d. N. pag. Print. 2. If perception of the present opinon does not match the climate of the conversation, the willingness to speak will depend on how well the conversation continues on. 3. People are more willing to speak if their views match their counterparts than to those who disagree. 4. Low self-esteem will cause a person to mute their opinion more often than others. 5. Males, young adults, and people of the middle and upper classes tend to speak out more easily. 6. Existing law encourages people to express their opinion when they feel outnumbered. The Supreme Court’s Roe v Wade is a good example. Now that we know the building blocks of the spiral of silence, we can get to root of Noelle-Neumann’s model of her theory leading to her main point and the last factor, fear of isolation. The fear of isolation is the centrifugal force that accelerates the spiral of silence. Essentially, people fear becoming social isolates and thus take measures to avoid such a consequence. Her assumption is drawnShow MoreRelated The Impact of My Favorite Form of Media in Mass Communication1545 Words   |  7 Pagesrecord it. It conglomerates my love of sustenance and travel at the same time. There are many mass communication theories conveyed up through the media world, but I sense a few do relate to my chosen form of media. There are three certain mass communication theories that contribute to my impact on this form of media: Spiral of Silence Theory, Agenda Setting Theory and the Hypodermic Needle Theory. Diners, Drive-Ins and Dives persuades me to cook and appreciate cooking and food. Being married, IRead MorePsychology And The Theory Of Psychology999 Words   |  4 Pagespsychoanalysis-focusing on the unconscious mind, behaviourism focusing-on the unconscious mind (Vickers). Although there are many belief systems, modern psychologists share similar procedures and values known as the empirical method (Vickers). Psychology is theory driven, seeks evidence, multi-leveled, and contextual, unlike philosophy which relies heavily on unproven beliefs, psychology aims to discover scientific information. Psychologists approach ideas using the scientific method based on Sir Francis Bacon’sRead MoreEssay on Spiral of Silence1738 Words   |  7 Pagesrun into is silence. The spiral of silence theory by Elisabeth Noelle-Neumann explains why certain people fall under the pressure and seclude to silence. Silence may not always be a bad thing, but according to a study by Lucy J. MacGregor, the fact is that silence during a speech or conversation is absolutely bad. With this, silence while talking to a large group negatively affects the listeners in a way in which some words in the speech will not be remembered. The point is that silence tends to destroyRead MorePositive And Negative Effects Of Mass Media1578 Words   |  7 Pagesthey will endure judgment. In A First Look at Communication Theory the Spiral of Silence theory created by Elisabeth Noelle-Neumann is acknowledged. The following quote explains exactly how this theory works, â€Å"†¦spiral of silence refers to the increasing pressure people feel to conceal their views when they think they are in the minority.† (Griffin 372). The book goes on to reveal that the driving factor behind the Spiral of Silence theory is no other than the fear an individual has from isolationRead MoreGratification Theory Mass Media1585 Words   |  7 PagesTheories in mass media play an important role in society which provides a lens to observer communication in a medium. There is a multitude of media theories, but I will explore those of Elizabeth Noelle-Newman and how people use media for their need and gratification. The spiral of silence theory and the uses and gratification theory both give convincing and detailed explanations that link the media and the audience. There is a likeness in both but there are also many difference between the two.Read MoreHow Mass Communication Approach Can Change Into Perspective1504 Words   |  7 PagesJournalism, Public relation. There is overshadowing about particular of the method of study, as if quantitative and qualitative method has been use. Also there major theories being use addr esses the process that communication that being taking place some of these are Cultivation Theory, Agenda-Setting Theory, Spiral of Silence Theory, including the media ecology in there as well. There is also professional organization that is using for into this particular field of mass communication. On the givenRead MorePublic Opinion Is the Most Significant Agency Influence Public Opinion1034 Words   |  5 Pagesand radio. That is a lot of factors that why mass media can shaped the public opinion such as wide coverage, credibility, meet our needs and social influences. The first factors is wide coverage, according to mass communication theory, which is the spiral of silence theory created by Elisabeth Noelle-Neumann is individuals who think their opinion conflicts with the opinions of most other people tend to remain silent on an issue, (Cutlip Center’s Effective Public Relations, Tenth Edition. GLEN MRead MoreInfluence and Power of Mass Media1311 Words   |  6 Pagesinformation by people with higher socioeconomic status and those with lower and as a result created a concept of a knowledge gap. Finally, Noelle-Neemann explored the way public opinion forms and changes over the time and came up with a model of the spiral of silence. The mass media undoubtedly has a huge potential for widespread influence. Both Noelle-Neemann and Fearing agree on its power and abilities. Fearing (1954, p.166) seems to be astonished saying that a message emanating from a â€Å"single source†Read MoreThe Effects Of Music On Our Country Today1661 Words   |  7 Pageswatch? Is the music video really responsible for these effects, or is the type of audience that watches these videos already have a predisposition of violent behavior? There are several theories in the field of communications that I believe can try to explain these questions. The first, is Cognitive Dissonance theory, which is psychological conflict that is the result of an individual holding two contradictory or incompatible beliefs or attitudes. In order to remove the dissonance, the person changesRead MoreMedia Bias Of The United States1389 Words   |  6 Pagesbecome of himself, and the less he will be inclined to express his opinion. (Noelle-Neumann) The man who become uncertain often falls silent. This is the theory of the spiral of silence. That minority opinions don’t get represented because those who hold them fear social isolation, and thus their opinion never gets heard. When the spiral of silence is applied to the huge population of the United States of America, this can lead to media bias. If the opposition to a view or event doesn’t speak up, journalists

The Homelessness In America Health And Social Care Essay Free Essays

The stateless population in America is nonspecific, anyone can stop up homeless. Each twelvemonth, more than 3 million people experience homelessness, including 1.3 million kids. We will write a custom essay sample on The Homelessness In America Health And Social Care Essay or any similar topic only for you Order Now Although there are subpopulations at higher hazard, the fastest turning population is Families. Other Subpopulations include veterans, individuals with terrible mental unwellness, individuals with chronic substance maltreatment jobs, Comorbidity, HIV/AIDS, individuals with are victims of domestic force, or unaccompanied young person. Two tendencies are mostly responsible for the rise in homelessness over the past 20-25 old ages: a turning deficit of low-cost rental lodging and a coincident addition in poorness. Persons populating in poorness are most at hazard of going homeless, and demographic groups who are more likely to see poorness are besides more likely to see homelessness. Recent demographic statistics are summarized below. Demographic Age In 2003, kids under the age of 18 accounted for 39 % of the stateless population ; 42 % of these kids were under the age of five ( NLCHP, 2004 ) . This same survey found that unaccompanied bush leagues comprised 5 % of the urban stateless population. However, in other metropoliss and particularly in rural countries, the Numberss of kids sing homelessness are much higher. Harmonizing to the National Law Center on Homelessness and Poverty, in 2004, 25 % of homeless were ages 25 to 34 ; the same survey found per centums of stateless individuals aged 55 to 64 at 6 % . National Rate California Rate Solano County Rate % % % Gender Most surveies show that individual homeless grownups are more likely to be male than female. In 2007, a study by the U.S. Conference of Mayors found that of the population surveyed 35 % of the homeless people who are members of families with kids are male while 65 % of these people are females. However, 67.5 % of the individual homeless population is male, and it is this individual population that makes up 76 % of the homeless populations surveyed ( U.S. Conference of Mayors, 2007 ) . National Rate California Rate Solano County Rate % % % Families The figure of stateless households with kids has increased significantly over the past decennary. Families with kids are among the fastest turning sections of the stateless population. In its 2007 study of 23 American metropoliss, the U.S. Conference of Mayors found that households with kids comprised 23 % of the homeless population ( U.S. Conference of Mayors, 2007 ) . These proportions are likely to be higher in rural countries. Research indicates that households, individual female parents, and kids make up the largest group of people who are stateless in rural countries ( Vissing, 1996 ) . All 21 metropoliss with available informations cited an addition in the figure of individuals bespeaking nutrient aid for the first-time. The addition was peculiarly noteworthy among working households. ( U.S. conference of city managers 2008 ) As the figure of households sing homelessness rises and the figure of low-cost lodging units psychiatrists, households are capable to much longer corsets in the shelter system. For case, in the mid-1990s in New York, households stayed in a shelter an norm of five months before traveling on to lasting lodging. Today, the mean stay is 5.7 months, and some studies say the norm is closer to a twelvemonth ( U. S. Conference of Mayors, 2007 and Santos, 2002 ) . For more information, see our fact sheet on Homeless Families with Children. National Rate California Rate Solano County Rate % % % Ethnicity In its 2006 study of 25 metropoliss, the U.S. Conference of Mayor found that the sheltered homeless population is estimated to be 42 percent Afro-american, 38 per centum white, 20 per centum Hispanic, 4 per centum Native American and 2 per centum Asian. ( U.S. Conference of Mayors, 2006 ) . Like the entire U.S. population, the cultural make-up of stateless populations varies harmonizing to geographic location. For illustration, people sing homelessness in rural countries are much more likely to be white ; homelessness among Native Americans and migratory workers is besides mostly a rural phenomenon ( U.S. Department of Agriculture, 1996 ) . National Rate California Rate Solano County Rate % % % VICTIMS OF DOMESTIC VIOLENCE Battered adult females who live in poorness are frequently forced to take between opprobrious relationships and homelessness. In a survey of 777 homeless parents ( the bulk of whom were female parents ) in 10 U.S. metropoliss, 22 % said they had left their last topographic point of abode because of domestic force ( Homes for the Homeless, 1998 ) . A 2003 study of 100 homeless female parents in 10 locations around the state found that 25 % of the adult females had been physically abused in the last twelvemonth ( American Civil Liberties Union, 2004 ) . In add-on, 50 % of the 24 metropoliss surveyed by the U.S. Conference of Mayors identified domestic force as a primary cause of homelessness ( U.S. Conference of Mayors, 2005 ) . Analyzing the full state, though, reveals that the job is even more serious. Nationally, about half of all adult females and kids sing homelessness are flying domestic force ( Zorza, 1991 ; National Coalition Against Domestic Violence, 2001 ) . For more informa tion, see our fact sheet on Domestic Violence and Homelessness. Twenty two metropoliss reported that, on norm, 15 per centum of stateless individuals were victims of domestic force ( U.S. Conference of Mayors 2008 ) . National Rate California Rate Solano County Rate % % % Veterans Research indicates that 40 % of stateless work forces have served in the armed forces, as compared to 34 % of the general grownup population ( Rosenheck et al. , 1996 ) . In 2005, the U.S. Conference of Mayors ‘ study of 24 American metropoliss found that 11 % of the stateless population were veterans aa‚ ¬ † nevertheless, this does non take gender into history ( U.S. Conference of Mayors, 2005 ) . The National Coalition for Homeless Veterans estimates that on any given dark, 271,000 veterans are stateless ( National Coalition for Homeless Veterans, 1994 ) . For more information, see our fact sheet on Homeless Veterans. The 24 metropoliss supplying this information estimated that 13 per centum of individuals sing homelessness were veterans. Veterans are somewhat over-represented among the homeless population compared to their prevalence in the overall population ( 11.2 per centum ) ( U.S. Conference of Mayors 2008 ) . National Rate California Rate Solano County Rate % % % Person WITH MENTAL ILLNESS Persons with terrible mental unwellness represented about 26 per centum of all sheltered homeless individuals ( Annual Homeless Assessment Report to Congress, 2008 ) . Harmonizing to the Federal Task Force on Homelessness and Severe Mental Illness, merely 5-7 % of stateless individuals with mental unwellness require institutionalization ; most can populate in the community with the appropriate supportive lodging options ( Federal Task Force on Homelessness and Severe Mental Illness, 1992 ) . For more information, see our fact sheet on Mental Illness and Homelessness. The 23 metropoliss that provided information reported that 26 per centum of their stateless population suffered from a serious mental unwellness. By contrast, merely six per centum of the U.S. population suffers from a serious mental unwellness ( U.S. Conference of Mayors 2008 ) . National Rate California Rate Solano County Rate % % % PERSONS Agony FROM ADDICTION DISORDERS Surveies of stateless populations conducted during the 1980s found systematically high rates of dependence, peculiarly among individual work forces ; nevertheless, recent research has called the consequences of those surveies into inquiry ( Koegel et al. , 1996 ) . In Summary, the surveies that produced high prevalence rates greatly over represented long-run shelter users and individual work forces, and used life-time instead than current steps of dependence. While there is no by and large accepted â€Å" charming figure † with regard to the prevalence of dependence upsets among stateless grownups, the U.S. Conference of Mayorsaa‚ ¬a„? figure in 2005 was 30 % , and the often cited figure of approximately 65 % is likely at least dual the existent rate for current dependence upsets among all individual grownups who are homeless in a twelvemonth. Among surveyed homeless people 38 % have an intoxicant job, and 26 % study jobs with other drugs ( National Health Care f or the Homeless Council ) . For more information, see our fact sheet on Addiction Disorders and Homelessness. National Rate California Rate Solano County Rate % % % Causing Poverty Homelessness and poorness are inextricably linked. Poor people are often unable to pay for lodging, nutrient, child care, wellness attention, and instruction. Difficult picks must be made when limited resources cover merely some of these necessities. Often it is lodging, which absorbs a high proportion of income that must be dropped. If you are hapless, you are basically an unwellness, an accident, or a payroll check off from populating on the streets. In 2007, 12.5 % of the U.S. population, or 37,300,00 million people, lived in poorness. The official poorness rate in 2007 was non statistically different than 2006 ( U.S. Bureau of the Census, 2007 ) . Children are overrepresented, composing 35.7 % of people in poorness while merely being 24.8 % of the entire population. Two factors help history for increasing poorness: eroding employment chances for big sections of the work force and the worsening value and handiness of public aid. Employment Worsening rewards have put lodging out of range for many workers: in every province, more than the minimal pay is required to afford a one- or two-bedroom flat at Fair Market Rent.1 ( National Low Income Housing Coalition, 2001 ) . In fact, in the average province a minimum-wage worker would hold to work 89 hours each hebdomad to afford a two-bedroom flat at 30 % of his or her income, which is the federal definition of low-cost lodging ( National Low Income Housing Coalition 2001 ) . Therefore, unequal income leaves many people homeless. The U.S. Conference of Mayors ‘ 2005 study of 24 American metropoliss found that 13 % of the urban stateless population were employed ( U.S. Conference of Mayors, 2005 ) , though recent studies by the U.S. Conference of Mayors have reported every bit high as 25 % . In a figure of metropoliss non surveyed by the U.S. Conference of Mayors – every bit good as in many provinces – the per centum is even higher ( National Coalition for the Homeless, 1997 ) . When asked to place the three chief causes of hungriness in their metropolis, 83 per centum of metropoliss cited poorness, 74 per centum cited unemployment and 57 per centum cited the high cost of lodging. ( U.S. Conference of Mayors 2008 ) . For more information, see our factsheets on Employment and Homelessness and Why Are People Homeless? . Disability Catastrophes Thingss like Fire, Earthquake, Floods and other natural catastrophes How its defined by the Federal Government Literally Homeless. These include people who for assorted grounds have found it necessary to populate in exigency shelters or transitional lodging for some period of clip. Most tragically, this class besides includes people who sleep in topographic points non intend for human habitation ( for illustration, streets, Parkss, abandoned edifices, and subway tunnels ) . These â€Å" street stateless † people may besides utilize shelters on an intermittent footing. Precariously Housed. These are people on the threshold of homelessness. They may be doubled up with friends and relations or paying highly high proportions of their resources for rent. They are frequently characterized as being at at hand hazard of going homeless. A?aˆsA · Sheltered homeless persons include individual grownups, unaccompanied young person, individuals in multi-adult families, and individuals in multi-child families. A?aˆsA · Sheltered homeless individuals in households include individuals in families with at least one grownup and one kid. ] AHAR 2009 Problems Criminalizing the Homeless Beginnings The 2009 Annual Homeless Assessment Report ( June 2010 ) , U.S. Department of Housing and Urban Development, Office of Community Planning and Development – Corrected June 18, 2010 How to cite The Homelessness In America Health And Social Care Essay, Essay examples

The Greco

When used as an adjective, the word Greco-Roman refers to regions culturally or even historically influenced by language, cultural practices, government and religious practices of the ancient Greeks and then the Romans. Grant (1995) further defines this region as the Mediterranean world (p.67).Advertising We will write a custom essay sample on The Greco-Roman influence specifically for you for only $16.05 $11/page Learn More The region was subject to cultural integration, as those from the other cultural settings had to live together under one government. The paper discusses the nature of the cultural influence between the Romans and the Greek revealing the commonalities and discrepancies existing between the two. It also highlights how they influenced the western culture. The Greeks and Romans had accepted the use of the Greek language as the language of the intellectual culture. Latin was also the tongue for public management. In either the times of th e Greek rule or the Roman rule, there was a universal acceptance of the languages by the people (Sanders, et al., 2006, p.29). However, it is worth noting that these languages were mostly evident in the cosmopolitans while the people in the rural areas spoke their own mother tongues, which they regarded as vernacular. Men spoke and wrote in either Greek or Latin regardless of their ethnicities. The Greeks influenced the majority of the cultural practices in the region ranging from the education system to the religious belief in many gods, cults and the building of temples. In this respect, the Romans gained from the Greek influence in sectors such as Banking, political administration, literature, philosophy and art (Bentley et al, 2008, p.24). Upon adopting these cultural values and beliefs, the wall that existed between the Romans and the Greek dissolved according to the extent of the influence. The two cultures also portrayed similarities in the cultural activities such as sports and festivals that they conducted (Bentley et al, 2008, p.36). Fighting in the coliseums was a substantial sport that the two cultures appreciated. People from both cultures fought either voluntarily or involuntarily in search of glory and honor. The practice of slavery was justifiable according to the values of the two cultures (Thornton, 2002, p.45). However, there were noticeable differences between the Greek and the Romans in terms of their philosophies. The Greeks were more considerate of morals, as opposed to the Romans who were promiscuous (Sanders et al., 2006, p.47). In most cases, self-satisfaction and the greed for power and glory acted as the driving force of the Romans, as opposed to the Greeks who observed moral standings.Advertising Looking for essay on ancient history? Let's see if we can help you! Get your first paper with 15% OFF Learn More Both the Greeks and the Romans influenced the western culture tremendously when it came to social stratification and the observation of the status quo. According to Grant (1995), people considered the Greek language a significant factor in assessing a person’s social standing in the society (p.36). The western culture borrowed this in that for a person to qualify as educated, he/she had to master Greek and learn Greek philosophy. Another influence, which is majorly from the Romans, was the form of government adopted in the Western culture (Grant, 1995, p.56). Certain families considered having the breeding for leadership passed it from generation to generation. Monarchs and noble families had the duty of governing state entities. The two cultures influenced each other for the purposes of co-existence. This is despite the fact that the Romans had conquered the Greeks. The Greeks considered the Roman cultural values as a step in civilization, which explains why there were few cases of resistance. Some Romans, however, were suspicious of the Greek influence to the Roman culture. Among the m was Cato the Elder who prophesied the demise of the Roman Empire through blindly adopting the Greek culture. Cato even did not trust the Greek actors in Rome whom he though had a mission of poisoning the brains of the Romans (Grant, 1995, p.64). Reference List Bentley, J., Ziegler, H., Streets, H. (2008). Traditions and encounters: A brief global history.  New York: McGraw Hill. Grant, M. (1995). Greek and Roman historians: information and misinformation. London: Rutledge. Sanders, T., Nelson, S., Morillo, S., Ellenberger, N. (2006). Encounters in world history:  Sources and themes from the global post volume one. New York: McGraw Hill.Advertising We will write a custom essay sample on The Greco-Roman influence specifically for you for only $16.05 $11/page Learn More Thornton, B. (2002). Greek Ways: How the Greeks Created Western Civilization. London: Encounter Books. This essay on The Greco-Roman influence was written and submitted by user Raquel Q. to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Renal physicians Association and the SGR Essays

Renal physicians Association and the SGR Essays Renal physicians Association and the SGR Essay Renal physicians Association and the SGR Essay The present formula for updating the payment for services of physicians is called as the sustainable growth rate. However the very conceptual bias of this particular system is defective. The SGR was created in reaction to the Reform act and the   Balanced budget of 1997.The Congress   came in to establish the fee schedule as one part of Omnibus Budget Reconciliation Act of 1989 (OBRA89). This was made to control the bias of inflation existing as a result of the CPR method, rectify distortions in payment module, as well as allow the lead to a yearly update of the payment rates of the fees schedule. This lead to the legislation of a formula which was based on the attainment of the expenditure target. As per the SGR formula the expenditure target is not influenced by the historical volume growth of the earlier formulas. It is founded on the actual GDP per capita as well as various other factors like alterations in spending due to laws and regulations, increase in physicians practice cost. (Stabenow Debbie, September 13, 2006, HIMSS Reports: Senator Stabenow Introduces SGR Formula Fix) The RPA came into being in 1973. It is a national medical specialty association where the members are licensed nephrologists of US, the healthcare providers who are in the subspecialty area of internal medicine as well as those in teaching, medicine, research of renal diseases and disorders The basic and core values of the RPA is to enhance professionalism, ensure that there is greater equality in compensation, provide efficient and ethical advanced renal care as well as to promote leadership. The annual membership dues vary from $375 to $0 depending on the membership category. The RPA is committed towards providing high quality service to renal patients and follows the ESRD Patient Safety Initiative, Clinical Practice Guidelines, provides Clinical Performance Measures and incorporates quality improvement tools. According to the payment module it may seem that RPA is concerned for the advancement of its members however the RPA has shown consistent concern for providing quality servic e to kidney patients. (RPA, 2006, About RPA: RPA,the Advocate for Excellence in Nephrology Practice) According to the Political action Committee (PAC) of the Renal Physician Association the Sustainable growth rate (SGR) approach is impregnated by three basic problems. Firstly it results in severing the connection between the payment and cost of producing services. By utilizing this particular formula updates are produced which completely dissociated from the various factors that influence the changes including the cost involved in producing the services of physicians. If this is not dealt with urgently the updates provide a semblance of budget regulation but in the process they also produce a fee’s that will in the long term endanger the beneficiary’s access greatly. Thus the people including the physicians suffer ultimately. (Hackbarth M.Glenn, February 28, 2002, MedPAC recommendations on physician payment policy, Medicare Payment Advisory Commission) Secondly there is an inherently defective volume control mechanism brought into operation as a result of the SGR formula.   This is because sustainable growth rate is merely a national target and doesn’t act as an inducement for the physicians to engage in volume control. This type of formula only helps to project political milestones and has little social and economic significance. Reduction in fees does not necessarily lead to simultaneous and constant sluggish growth in volume. More ever it does not correspond to the increase in the volume of services and to the spending level, which continue to grow. (Hackbarth M.Glenn, February 28, 2002, MedPAC recommendations on physician payment policy, Medicare Payment Advisory Commission) This kind of formula propagates inequality because it doesn’t take into cognizance the regional distinctions with regard to individual volume which in turn will influence the behavior of the updates. As a result the SGR formula leads to the production of updates which may excessively low in some cases and excessively high in others. The Congress in the year 2004-2005 intervened in the Medicare Modernization Act (MMA) in a bid to prevent the various updates for negative payment in the same year due to the formula. But each time the Congress intervened to supersede the negative updates the formula mechanically has to decrease the updates in all future application in order to make up for the alteration. Thus it is predicted that yearly updates of 5% will continue o occur or a period of seven successive years. This series of projections can be characterized as unrealistically and impractically low. More ever in context of budget scoring these forecasts makes other substitutes of the SGR seem unrealistically and un-duly expensive. Hence any legislation on the SRG formula is of no consequence. Instead the PAC of the RPA recommends that a distinct course of action should be initiated. (Hackbarth M.Glenn, February 28, 2002, MedPAC recommendations on physician payment policy, Medicare Payment Advisory Commission) This course of action should incorporate the various explicit deliberations of objectives of the Medicare program.   The updates should consequently be annually considered so that the services of the physicians are appropriately paid for while at the same time the will ensure that the best quality of health care service remains accessible to the Medicare beneficiaries. Along with this the increase in the volume of the physician services can be taken care of directly. The growth in volume is distinct for different regions. The volume growth is actually dependent on the individual physician’s decision regarding his/her practice. The major question is that if all the care that is being provided actually required. According to certain studies and Dartmouth researches better quality of health care has no connection with greater volume of services. Volume growth cannot be controlled and regulated without addressing the actual causes. The SGR which endeavors to regulate volume by t he global payment alterations and by considering all physicians and services in the same parameter is not a good policy. (Hackbarth M.Glenn, February 28, 2002, MedPAC recommendations on physician payment policy, Medicare Payment Advisory Commission) The new system should be concerned with updating payment of the services of the physicians based on the evaluation of adequacy of payment. This should incorporate the projected changes occurring in the input prices on the next year.   This will be a small adjustment for growth in productivity with interaction of multiple factors. Further the updates will not be mechanically or automatically projected and will depict the real image. The various changes relating to the accessibility of beneficiary to the health care services, the aptness of increase in cost and other factors like the quality of services will be reflected in the updates. This will also commensurate with the other Medicare payment systems as well as help in the Legislatures in the various budgets making process. When the projections take the productivity into consideration the physicians are better able to provide high quality service. Once the payment rates are updated appropriately and the issue of adequate payment i s addressed the volume control (significant for both the beneficiary as well as taxpayers) can be addressed. From the perspective of the beneficiary an increase in the volume implies that there is greater cost made from the beneficiary pocket as well as greater cost of payment of supplemental coverage. From the perspective of the tax payers as well there is greater expenditure resulting from increase in volume. Increase in volume also affects the federal budget negatively. Certain volume growth like growth resulting from better technology may in fact be good for the patients. However not all growth is good and this is indicated by the variation in growth in various areas. The variation in certain services is very wide like in imaging and testing. It has been found that variation in volume in various regions is high in discretionary services like imaging and diagnostic testing. In areas where there is greater volume quality of service is found to be less. Volume has been found to dif fer from region to region. The best way to counter the volume problem without resorting to a formula is to adopt a multiple strategy policy. This will includes pre-authorization, profiling, beneficiary education, site inspection, coding edits, privileging and safety standards. At the same time Medicare payment can be linked to quality of service provided. This kind of payment will be budget neutral and will take care of both attainment as well as improvement. This will also help to alter the measurement of quality over time. Hence since higher volume is in no way connected with better quality. This type of action cause will not only ensure that beneficiary’s get better quality of service but also provides incentive for regulating the volume of services. (Hackbarth M.Glenn, February 28, 2002, MedPAC recommendations on physician payment policy, Medicare Payment Advisory Commission) The RPA recommends removal of the physician administered drugs from the ambit of SGR calculation and the inclusion of the entire charge of the new benefits as well as coverage decision within the SGR target. Further it recommends the inclusion of the effect of the alterations in law and regulation. For example the SGR does not consider the down stream services.

Bronsted Lowry Theory of Acids and Bases

Bronsted Lowry Theory of Acids and Bases   The Brà ¸nsted-Lowry acid-base theory (or Bronsted Lowry theory) identifies strong and weak acids and bases based on whether the species accepts or donates protons or H. According to the theory, an acid and base react with each other, causing the acid to form its conjugate base and the base to form its conjugate acid by exchanging a proton. The theory was proposed independently by Johannes Nicolaus  Brà ¸nsted  and Thomas Martin Lowry in 1923. In essence, Brà ¸nsted-Lowry acid-base theory is a general form of the Arrhenius theory of acids and bases. According to the Arrhenius theory, an Arrhenius acid is one that can increase the hydrogen ion (H) concentration in aqueous solution, while an Arrhenius base is a species that can increase the hydroxide ion (OH-) concentration in water. The Arrhenius theory is limited because it only identifies acid-base reactions in water. The Bronsted-Lowry theory is a more inclusive definition, capable of describing acid-base behavior under a wider range of conditions. Regardless of the solvent, a Bronsted-Lowry acid-base reaction occurs whenever a proton is transferred from one reactant to the other. Key Takeaways: Brà ¸nsted-Lowry Acid-Base Theory According to the Brà ¸nsted-Lowry theory, an acid is a chemical species capable of donating a proton or hydrogen cation.A base, in turn, is able to accept a proton or hydrogen ion in aqueous solution.Johannes Nicolaus  Brà ¸nsted  and Thomas Martin Lowry independently described acids and bases this way in 1923, so the theory usually bears both of their names. Main Points of the Bronsted Lowry Theory A Bronsted-Lowry acid is a chemical species capable of donating a proton or hydrogen cation.A Bronsted-Lowry base is a chemical species capable of accepting a proton. In other words, it is a species that has a lone electron pair available to bond to H.After a Bronsted-Lowry acid donates a proton, it forms its conjugate base. The conjugate acid of a Bronsted-Lowry base forms once it accepts a proton. The conjugate acid-base pair have the same molecular formula as the original acid-base pair, except the acid has one more H compared to the conjugate base.Strong acids and bases are defined as compounds that completely ionize in water or aqueous solution. Weak acids and bases only partially dissociate.According to this theory, water is amphoteric and can act as both a Bronsted-Lowry acid and Bronsted-Lowry base. Example Identifying  Brà ¸nsted-Lowry Acids and Bases Unlike Arrhenius acid and bases, Bronsted-Lowry acids-base pairs can form without a reaction in aqueous solution. For example, ammonia and hydrogen chloride may react to form solid ammonium chloride according to the following reaction: NH3(g) HCl(g) → NH4Cl(s) In this reaction, the Bronsted-Lowry acid is HCl because it donates a hydrogen (proton) to NH3, the Bronsted-Lowry base. Because the reaction does  not occur in water and because neither reactant formed H or OH-, this would not be an acid-base reaction according to the Arrhenius definition. For the reaction between hydrochloric acid and water, its easy to identify the conjugate acid-base pairs: HCl(aq) H2O(l) → H3O Cl-(aq) Hydrochloric acid is the Bronsted-Lowry acid, while water is the Bronsted-Lowry base. The conjugate base for hydrochloric acid is the chloride ion, while the conjugate acid for water is the hydronium ion. Strong and Weak Lowry-Bronsted Acids and Bases When asked to identify whether a chemical reaction involves strong acids or bases or weak ones, it helps to look at the arrow between the reactants and the products. A strong acid or base completely dissociates into its ions, leaving no undissociated ions after the reaction is completed. The arrow typically points from left to right. On the other hand, weak acids and bases dont completely dissociate, so the reaction arrow points both left and right. This indicates a dynamic equilibrium is established in which the weak acid or base and its dissociated form both remain present in the solution. An example if the dissociation of the weak acid acetic acid to form hydronium ions and acetate ions in water: CH3COOH(aq) H2O(l) â‡Å' H3O(aq) CH3COO-(aq) In practice, you might be asked to write a reaction rather than have it given to you. Its a good idea to remember the short list of strong acids and strong bases. Other species capable of proton transfer are weak acids and bases. Some compounds can act as either a weak acid or a weak base, depending on the situation. An example is hydrogen phosphate, HPO42-, which can act as an acid or a base in water. When different reactions are possible, the equilibrium constants and pH are used to determine which way the reaction will proceed.

Distinguishing Management and Leadership Competencies Term Paper

Distinguishing Management and Leadership Competencies - Term Paper Example According to Meads (2006), health institutions in many parts of the world have introduced computerized self check-in systems for their outpatient customers whereby the patient reporting for check-up confirms and subsequently validates the correctness that the institution has on them. Meads (2006) further adds that self check-in can also be done manually in the developing countries incapable of introducing such computerized systems. In manual self check-in, the patient reporting for medical check-up writes down the required information such as name, sex, and age and them proceeds for check-up. The implementation of a self check-in system either computerized or manual requires specific management and leadership competencies. In laymans terms, competencies are skills and behaviors of an effective leader or manager. According to Laureate Education Inc (2012), "Leadership is all about creating change, and it involves establishing direction, aligning people toward that direction, and also establishing change through connecting with people" (p. 1). In regard to leadership competencies necessary for the implementation of a self check-in for appointments in outpatient setting, a leader ought to have the capacity or ability to ensure the creation of constructive relationships between all stakeholders (Zaleznik, 2004). Zaleznik (2004) also notes that he or she should also be able to offer support and collaborate with all stakeholders in the recognition of the problem, in this case long queues, and in creation of plans of action aimed at alleviating the problem, i.e. the implementat ion of self check-in systems for appointment of outpatients. To identify a problem, some of the skills necessary include listening skills, critical thinking, and persuasion skills. Implementation of change requires the leader to have specific competencies such as coordination skills,

Crisis analysis- major assessment Essay Example | Topics and Well Written Essays - 2500 words

Crisis analysis- major assessment - Essay Example There are important areas that have been focused on this subject. Knowing the informational content is a vital responsibility for any crisis communication. Informational content basses on the following principles; what do the authorities know concerning the crisis? What is it that they want people to consent? And how are they going to deliver the information to the people accordingly?. Media also is another based area of concern. The primary task that the management ask themselves is that how will they get their content from them into the minds of the public. Another based field is the assessment of the audience. From the study of the past years, it reveals that a successful progress in crisis communication has been a sector that is growing bearing in mind that not all people are intelligent (Jaques 2007). Due to variations in knowledge, values, and emotions, it gives the assessors very tough time in giving out the information. Basing on what, do they need to reach the people, what they have in their mind already and the effect that will arise the moment they are told about the crisis? Involving the audience also is another aspect that needs to be put into concern. Targeting a deliverable communication at the two-way end and the mode that they need to keep immediate audience active is their worry. Self-assessment gives self-examination on the effect of values, emotions, and political problems relating to crisis management (Coombs 2009). From the definition approaches, there have not been good levels of agreement that demonstrate critically what is a crisis and what the issue is in management. Many writers have analyzed problem management, and it was found to lack clarity. Crisis, on the other hand, has been hard to be defined indecently without the placement of crisis management. The illustration of this by individual scholars shows a thesis that identify a frequent