Transsexuals and those who choose gender re-assignment surgery

Transsexuals and the individuals who pick sexual orientation re-task medical procedure Free Online Research Papers With the assistance of present day medication, numerous transsexuals all through the nation and globe can encounter alleviation from the sexual orientation clashes they experience. Getting instructed about transsexuals and the realities encompassing sexual orientation re-task medical procedure are key elements for enduring and tolerating this overall villa. As indicated by the content, â€Å"medical gauges place transgenderism at around 1 out of 30,000 for MTF and 1 out of 100,000 for FTM. Nonetheless, numerous sex activists guarantee that these figures incomprehensibly think little of the genuine commonness and depend on measurements of the quantity of sex reassignment medical procedures performed instead of the general number of individuals who are living transgender lives [and] pervasiveness might be in any event multiple times higher† (Hock, p. 385). With numbers this extraordinary, and potentially more noteworthy, it is exceptionally likely to run into such an individual in an instructive, social or work setting, and a few people may even â€Å"date, engage in sexual relations with, and even wed a postoperative transsexual and be uninformed of the person’s transgender status except if he or she† were to unveil reality (Hock, p. 386). Hence, resilience and acknowledgment of transsexuals and the individuals who pick sexual orientation re-task medical procedure is significantly progressively urgent. The initial step to accomplishing a total comprehension of sexual orientation re-task medical procedure is quickly instructing oneself on the historical backdrop of transsexuals and sex re-task medical procedure. The idea of transsexuals has been alluded to in exemplary writing by such writers as Herodotus and Shakespeare and â€Å"[w]ell known recorded instances of psychosexual reversal length the time from the Roman ruler Caligula to the celebrated French negotiator Chevalier d’Eon† (Edgerton, Knorr and Callison). In 1830, â€Å"German creator Friedreich first pointed out this condition in the clinical literature†; in 1870, â€Å"Westphal was the first to give a reasonable and complete description† of transvestism; in 1949, Cauldwell was the first to coin the term transexualism (Edgerton, Knorr and Callison). With respect to birth of sexual orientation re-task medical procedure, there are fluctuating feelings. Some accept that early â€Å"examples identify with rehearses completed in antiquated societies. Sexual orientation reassignment medical procedure (GRS) created from reconstructive techniques for intrinsic anomalies. Some medical procedure was camouflaged, strategies were not recorded, and activities were completed in secret† (Goddard, Vickery, Terry). In any case, it is additionally contended that despite the fact that â€Å"castration has been utilized all through written history, and penectomies have not been obscure, it isn't in every case clear that individuals given these tasks wanted any difference in sex† (Edgerton, Knorr and Callison). In this way, the principal recorded instance of GRS was accounted for in 1931 by Abraham. (Edgerton, Knorr and Callison) During the 1950s, Sir Harold Gillies and gynecologist Dr. Georges Burou built up the first of two strategies for male-to-female sex re-task medical procedure, which â€Å"used invagination of the penile skin sheath to frame a vagina†(Goddard, Vickery, Terry). Howard Jones from Johns Hopkins built up the second strategy for this vanguard idea, which utilized penile and scrotal skin folds. The two strategies fill in as the reason for all male-to-female sexual orientation re-task medical procedures performed today. While advancement of male-to-female GRS was in progress, Burou was additionally freely creating female-to-male sexual orientation re-task medical procedure in his Clinique du Parc in Casablanca. His technique comprised of â€Å"the anteriorly pedicled penile skin fold reversal vaginoplasty† and this â€Å"technique was to turn into the highest quality level of skin-lined vaginoplasty in transsexuals† (Hage, Karim, Laub). As per the content, sex re-task medical procedure has advanced into a multi step process that requires â€Å"psychological directing, hormone treatment, and a pre-careful progress period† before medical procedure can even occur. For the two advances, there are a few medical procedures that have â€Å"anatomically very realistic† results. A male-to-female sexual orientation re-task medical procedure may include any or the entirety of the accompanying: penectomy (evacuation of the penis), uroplasty (rerouting of the urethra), orchiectomy (expulsion of the balls), vaginoplasty (the utilization of penile skin to develop labia and a vagina), bosom inserts, chondrolaryngoplasty (diminishes the size of the Adam’s apple) and phonosurgery (raises voice pitch). A female-to-male sex re-task medical procedure may include any or the entirety of the accompanying: mastectomy (evacuation of bosoms), hysterectomy (expulsion of uterus, fallopian cylinders and ovaries), metadioplas ty (making of little erectile phallus from the clitoris), phalloplasty (arrangement of a penis from tissue taken from different zones of the body and transplanted utilizing microsurgical methods in the genital zone; requires a penile embed for erection), uroplasty, scrotoplasty (reshaping and extending of the labia to look like a scrotum and the addition of silicone prosthetic balls). Whenever acted in the United States, such medical procedures can cost somewhere in the range of $18,000 to $50,000 while different nations, for example, Thailand offer GRS costing somewhere in the range of $7,000 to $10,000.(Hock, p. 386) The main sexual orientation re-task to get media consideration was the male-to-female re-task of Christine Jorgensen. Christine, brought into the world a man, lived as George Jorgensen until she had her sex re-task medical procedure in February of 1953. Christine grew up realizing that she was naturally a man however mentally a lady and after her administration in the military finished, she started hormone treatment comprising of the female hormone estradiol. As a result of the ignorance that wrapped the United States clinical network concerning sexual orientation re-task medical procedure during the 1950s, Christine thought that it was hard to track down a specialist ready to assist her with settling her sex struggle and contact her objectives. In the long run, a specialist in Denmark had the option to perform medical procedure that comprised of a two-sided orchiectomy, expulsion of the scrotum and a penectomy. Quite a while after this underlying medical procedure, Christine had cos mesis medical procedure to build a vagina. Because of the media inclusion she got, Christine became â€Å"a representative for transgender, gay, and lesbian causes† (Hock, p. 386). Sexual and physical wellbeing after sex re-task medical procedure is a significant worry for applicants. One examination led by the Department of Plastic Surgery, Ghent University Hospital, Gent, Belgium expresses that â€Å"[t]actile and erogenous affectability in remade private parts is one of the objectives in sex reassignment surgery† (Selvaggi, Monstrey, Ceulemans, T’Sjoen, De Cuypere, Hoebeke). The investigation plots â€Å"specific careful stunts used to safeguard genital and material sensitivity† that emphasis on the protection of the clitoris, the inguinal nerve, two dorsal nerves of the clitoris for phalloplasty and conservation of the glans penis, the prepuce and the penile shaft for vaginoplasty. The examination expresses that a â€Å"long-term affectability evaluation† was performed on the â€Å"27 remade phalli and 30 clitorises† of the 105 complete phalloplasties and 127 vaginoclitoridoplasties performed over a multi year timeframe at the Ghent University Hospital. The examination reasons that â€Å"all female-to-male and 85% of male-to-female patients detailed orgasm† and the material affectability procedures that are polished at the clinic are basic for accomplishing such outcomes. (Selvaggi, Monstrey, Ceulemans, T’Sjoen, De Cuypere, Hoebeke) For clear reasons, sex re-task medical procedure is a significant clinical technique. Any medical procedure presents the chance of antagonistic wellbeing impacts and urogenital surgeries are the same. They can incorporate an assortment of issues from urinary tract issues to vibes of apparition privates to Lupus Erythematosus Tumidus. One investigation in Japan proposes that through the course of their exploration, â€Å"several inconveniences happened, for example, halfway fold rot, rectovaginal fistula development and excessive touchiness of the neoclitoris† (Namba, Sugiyama, Yamashita, Tokuyama, Hasegawa, Kimata). Each individual is unique and keeping in mind that there are factors that add to such issues, it is hard to anticipate what antagonistic impacts, assuming any, somebody who chooses for these sorts of systems will understanding. In 2007, an examination study dependent on the theory that Lupus Erythematosus Tumidus can be instigated by sex re-task medical procedure was distributed in the Journal of Rheumatology. The investigation features that the pathology of Lupus Erythematosus Tumidus is both inborn and extraneous. It is expressed that â€Å"[t]he inherent variations from the norm are muddled, with various hereditary polymorphisms portrayed in various ethnic gatherings, emphatically recommending that the real pathology fundamental the immunologic disorder probably won't be the equivalent for each patient† (Zandman-Goddard, Solomon, Barzilai, Shoenfeld). Extraneous components are delineated in a similar report as the presentation to â€Å"drugs fit for adjusting resistant reactions, for example, exogenous estrogens.† The examination demonstrates that it is introducing data about â€Å"the first revealed instance of sex reassignment medical procedure and the ensuing advancement of cutaneous lu pus† and that the motivation behind the report is to â€Å"emphasize that natural triggers including high dosages of estrogens as a feature of sex reassignment medical procedure may prompt the improvement of lupus in a nonpredisposed individual.† One examination distributed in Archives of Sexual Behavior , the official distribution of the International Academy of Sex Research, watched â€Å"preoperative arrangements, complexities and physical

MITHRIDATE Persuasive Essay Example For Students

MITHRIDATE Persuasive Essay A monolog from the play by Jean Racine NOTE: This monolog is republished from The Dramatic Works of Jean Racine. Trans. Robert Bruce Boswell. London: George Bell and Sons, 1911. XIPHARES: I love her, and may possess my passionNow that that sibling is my solitary rival.Doubtless you wonder at the words I speak,But tis no mystery of a couple of short days,Long has this adoration for mine experienced childhood in silence.How I could cause you to understand its ardour,My most punctual murmurs, my most recent disappointment!But in the state to which we are reducedTis no fit time to task my memoryWith the presentation of a passionate tale.Let it do the trick, to legitimize myself,That it was I who initially viewed the Queen,And cherished her. Ere the name of MonimaHad reachd my dads ears, her charms had rousedA legal enthusiasm in my heart. He saw her,And sought her, however with contemptible suit,Deeming that she would demonstrate a simple conquest,Without attempting to guarantee marriage honours.You know how energetically he assaild her virtue,And, tired of a long and pointless struggle,Absent, yet never separated from his passion,He by your hands sent her his d iadem.Judge of my misery, when news came that toldToo really of the motivation behind the King,How Monima his ordained lady of the hour had takenHer venture here under your protection!Twas at that point, ah! loathsome time, my moms eyesWere opend to the proposals of the Romans.Whether in envious fierceness at these new nuptials,Or to obtain me Pompeys powrful favour,My father she betrayd, and provided for RomeThe town and fortunes to her consideration entrusted.How did my moms wrongdoing influence my feelings?No more I saw an opponent in my father,I thought not about the adoration his own had crossd,And had no eyes however for my dads wrongs.Soon I attackd the Romans; and my mother,Distracted, saw me injured to the deathRecovering the spot she had surrenderd,And with my perishing breath reviling her name.Since then the Euxine has been free, and soRemains; from Pontus to the BosphorusAll ownd my dads influence; his armada victoriousFound winds and waves its just enemies.More I would fain have done; I thought, Arbates,To walk upon Euphrates to his rescue,When I was stunnd by news of his death.But blended with my tears, I will admit it,Back to my contemplations came enchanting Monima,Entrusted by my dad to your hands.In these pitiful occasions I trembled for her life,Dreading that in his merciless jealousyThe King, as oft before with numerous a mistress,Might implies have taken to make sure about her death.Hither I flew, and neath Nymph?ums wallsMy on edge eyes encounterd Pharnaces,A sight, I trow, of abhorrence augury.You got the two of us, and know the rest.Hasty in the entirety of his activities, PharnacesOf his pompous wishes made no secret,Related to the Queen my dads ruin,And, since the King was dead, offerd himselfTo fill his place; nor will his deeds fall shortOf words. I also will show what I can do.The love that bade me worship a sireTo whom from youth I have ownd submission,This very love, presently ascending in revolt,Scorns the authority of this new rival.Either the suit I dare to advanceMust be by Monima herself rejected,Or else, whatever evil may happened to it,She will not be anothers, while I live.Thus have I confessed to the insider facts of my heart;With you it rests to pick the side you take.Which of us appears the worthier of allegiance,The slave of Rome, or Mithridates child?

Social Anxiety Disorder in Children

Social Anxiety Disorder in Children Social Anxiety Disorder Print Social Anxiety Disorder in Children How to Recognize and Treat SAD in Kids By Arlin Cuncic Arlin Cuncic, MA, is the author of Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder and 7 Weeks to Reduce Anxiety. Learn about our editorial policy Arlin Cuncic Medically reviewed by Medically reviewed by Steven Gans, MD on August 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on August 12, 2019 Social Anxiety Disorder Overview Symptoms & Diagnosis Causes Treatment Living With In Children In This Article Table of Contents Expand Types Symptoms Causes Diagnosis Treatment Tips for Parents View All Children and teenagers with social anxiety disorder (SAD) may live with symptoms into adulthood without ever being diagnosed. Although SAD is the third most common mental health disorder,?? many parents and teachers are not familiar with the signs and symptoms in children and teenagers. Social anxiety disorder involves an intense fear or phobia of social and performance situations. Although most teenagers go through periods of normal anxiety related to the changes that go along with adolescence, those with SAD experience fear that is out of proportion to the situations that they face. For some teenagers, social anxiety becomes chronic, affecting school performance, extracurricular activities, and the ability to make friends. Types Children and teenagers can be diagnosed with a more generalized form of social anxiety disorder or with the performance-only specifier (only performance situations cause anxiety).?? General vs. Performance-Only SAD Symptoms Symptoms in children can vary by age. As a parent or loved one, know that not all of these behaviors necessarily reflect SAD, but if you consistently recognize them and have cause for concern, consider seeking further evaluation with a psychotherapist. Pre-School Children Fear of new thingsIrritability, crying, or whiningFreezing or clingingRefusing to speak?? School-Aged Children Fear of reading aloud or answering questions in classFear of talking to other kidsFear of being in front of the classFear of speaking to adultsFear of musical or athletic performance activitiesFear of ordering food in a restaurantFear of attending birthday partiesFear of having friends visitWorry about being judged by othersRefusal to participate in activities or school?? In addition, children with SAD are more likely than adults to experience physical symptoms like headaches, stomach aches, and nausea.?? Teens Temperament Look for a teenager who... is quietkeeps to him/herselfbecomes more withdrawn if encouraged to talkis hesitantis passiveis overly concerned about negative evaluationfears being embarrassed or humiliatedcrosses his/her armskeeps his/her head downdisplays few facial expressionshas nervous habits such as hair twirling or fidgeting?? School Behavior potentially does poorly in schooldoesnt raise his/her hand in classavoids classmates outside classfears performing in front of others/public speaking fears speaking up in classis uncomfortable in the spotlightsits alone in the library or cafeteriais afraid to ask the teacher for helpis afraid to walk into class latemay refuse to go to school or drop out?? Behavior With Peers is uncomfortable in group settingshas few friendsis afraid to start or participate in conversationsis afraid to ask others to get togetheris afraid to call othersavoids eye contactspeaks softly or mumblesappears to always be on the fringesreveals little about him/herself when talking to others?? Teenagers with social anxiety disorder are at a disadvantage in all areas of life. They may perform poorly at school and may have trouble attending classes. Students with the disorder are also less likely to make friends and participate in extracurricular activities.?? Those with severe SAD may drop out of school or refuse to leave home. In addition, untreated social anxiety disorder in adolescence may lead to increased risk of other mental health problems later in life such as depression, eating disorders, substance abuse, and even suicidal ideation. Causes Just as with adults, social anxiety disorder in children and teenagers may be caused by genetic factors, environmental factors, societal factors, and brain/biological factors. Many parents may blame themselves, but know that its usually a combination of things that cause the disorder. The most important thing you can do know is support the child and help them find help.?? Understanding the Causes of Social Anxiety Disorder Diagnosis Diagnosis of social anxiety disorder in children and teenagers involves an evaluation of symptoms in several contexts. This evaluation will often include the perspective of parents and teachers and may involve the use of school records. Often, children and teenagers with SAD will go undetected because parents and teachers will believe that the child or adolescent is just shy. However, early detection and intervention are crucial in the prevention of long-term impairment. Potential underlying medical conditions are explored and other explanations for the behavior such as bullying are also considered. If the student is at risk of self-harm or suicide, these issues are addressed immediately. The same diagnostic criteria used to diagnose adults also apply to children and teenagers. However, there are some additional caveats. Children and teenagers may not recognize that their fear is unreasonable and their anxiety must be present when interacting with their peers, not just adults.?? How SAD Is Diagnosed Treatment Treatment of SAD in children and teenagers is aimed at helping to alleviate anxiety and allow the student to cope with school and day-to-day functioning. Effective treatments may include the following: cognitive-behavioral therapy (CBT)family therapymedication such as selective serotonin reuptake inhibitors (SSRIs), for example: Paxil, Zoloft, Prozac,  and Xanax?? In addition to standard treatments, there are a number of coping strategies that can be employed by teachers, parents,  and students to manage social anxiety both in and out of school. Schools can play an important role in this process, as it is the place where social anxiety disorder can often have the most negative effect on a teens functioning. School-based interventions led by psychologists, social skills training, and academic skills training are all helpful ways that schools can intervene in cases of SAD.?? As a parent, read about the disorder and increase your awareness of what your teen is experiencing. Be in touch with your school to coordinate efforts with teachers, school counselors, and other personnel. Together, you can work toward improving the situation for a child or teen with SAD. Try One of the 9 Best Online Therapy Programs Tips for Parents As a parent of a socially anxious child, it can be hard to know how best to offer your support. Its important to manage your childs social anxiety in a constructive way. Give your child or teen chances to expose him or herself to feared situations. Dont speak for your child or teen and offer praise when a feared situation is faced. Choose realistic goals for your child or teen such as joining a club or making a new friend. Then, outline steps that can be taken to achieve this goal. Also, encourage activities that help your child or teen to relax such as arts and crafts, music, yoga, and writing. Be a good listener and let your child or teen know that what he or she is experiencing can be overcome. Remind your child or teen of past successes and build his or her confidence. Finally, seek help for your child or teen if anxiety becomes severe. Some problems are too big for you to handle on your own and require intervention such as medication or professional therapy.?? How to Parent Teens With Social Anxiety A Word From Verywell If you have a child or teen who you believe is living with social anxiety, it is important to make an appointment for a diagnosis and potential treatment. The longer this disorder goes undiagnosed, the more impairment your child will experience. By the same token, if you are a teen living with social anxiety, reach out to a parent, teacher, or guidance counselor about the symptoms you are experiencing so that you can receive help.

Adidas Products And Services - 1665 Words

Products and Services Adidas is in the business to create sporting merchandise and promote a sporting lifestyle. In 1990, Adidas split its brand into three classifications, each with a different emphasis. This was a technique of sectioning the market and aiming at potential customers with a variety of different hobbies. The three groups include: Adidas performance, Adidas Originals, and Style Essentials. Adidas has over 2,400 stores worldwide. Environmental Analysis In the 2000s, when a lot of people worry that we are utilizing our resources too much, it is extremely vital to not only be socially sensitive but also sustainably sensitive. Adidas is partnering with the Better Cotton Initiative (BCI) to achieve â€Å"improvements in the social and environmental conditions of cotton production† (BCI). It will shrink the usage of pesticides in its manufacturing, and develop a better running irrigation system in order to make it more effective without wasting water. This will grow peoples overall health and aid in making clean water easily accessible in regions where cotton farming is on a industrial level (Brazil, China, India, Pakistan, US, Uzbekistan). One goal for Adidas is for 40% of its cotton to meet BCI standards by 2015, and 100% by 2018. Its plan is to reduce â€Å"its environmental impact by 15 percent by 2015 (The Adidas Group).† This shows Adidas’ group emphasis with respect to its marketing management philosophy, and is rated positively in customers’ and stakeholders’ eyes.Show MoreRelatedMarketing Strategy Michael E. Porter s The Five Forces Model1543 Words   |  7 Pagesexternal competitive factors of â€Å"Adidas† sports brand company by applying Michael Porter’s theoretical frameworks that can be used to develop successful strategy for taking the company forward. Introduction of Adidas The global retail sporting goods market is enormous, â€Å"The market is forecast to reach an estimated $266 billion in 2017†. 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A Brief Biography of Mohandas Karamchand Gandhi - 766 Words

Mohandas Karamchand Gandhi, also known as Mahatma Gandhi, was Indias greatest political and moral leader. He was born in Gujarat on October 2, 1869 and assassinated on January 30, 1948. In his 79 years of lifetime, he was able to accomplish so many things for the discriminated and all of India. His acts and ideologies still affects the world today. He was born in Gujarat on October 2, 1869 to a prime minister of Rajkot and a faithful Hindu woman. His mother Putilbais faith in Hindu affected Gandhi as a child and her teachings led him to become a faithful Hindu himself at a young age. His strong belief in Hinduism later affected and led him through rest of his life. During his college years at the Indian Samilus College, he decides to study abroad in England. The leaders of Hindu opposes this idea because they believed that western culture is a stumbling block to Hindus. Overcoming this opposition, he gets accepted into University College of London and later receives a lawyer license. He not only focused on his studies but also on his personal moral issues. He would travel far places just keep his vegetarian diet that was enforced by the Hindu laws. After achieving his license, he moves back to India to work as a lawyer. Because of fainthearted personality, he would not speak a single word of defense in court. He then moves to South Africa and gets a job in the South African- Indian Trade company. There he sees the Indians getting discriminated by the white people and

Managed care Free Essays

1. How do managed care organizations provide comprehensive and quality care while keeping costs down? American health care should essentially be a nonprofit enterprise. However, the privatization of American health care holds that health care in general and hospitals in particular are increasingly operating on a for-profit basis. We will write a custom essay sample on Managed care or any similar topic only for you Order Now In fact, the for-profit hospital sector has accounted for a relatively constant share (about 15 percent) of hospital beds over the last twenty years (Morrisson, 1999). This is why recently the U.S. Congress tries to push more â€Å"consumer-directed† health plan options to avoid cash-strapped managed care organizations (MCOs) to boost their deductibles, raise premiums and even defy federal law by authorizing policy holders to buy prescription drugs from low-cost vendors in Canada (Smith, 23 September 2004). Managed care organizations (MCOs) often apply the traditional fee-for-service models, which do not provide adequate financial controls and utilization incentives for physicians and hospitals to contain the costs of providing healthcare. Under managed care, the needs of the patients are balanced with efforts to provide cost-effective care. Typically, MCOs enroll subscribers by promising to provide all necessary medical care in exchange for a fixed monthly premium. The MCO also contracts with hospitals, physicians, and other healthcare providers to dispense the necessary medical care to its enrollees at a discounted reimbursement rate. In exchange for accepting reduced fees, the caregivers gain access to the MCO’s enrolees (Kirby, Sebastian Hornberger, 1998). A problem with managed care is that employers who offer a health maintenance organization (HMO) to their employees often pay the premium as long as the HMO premium was not higher than the fee-for-service premium. This behavior by employers creates distorted incentives for the HMO in controlling its costs. Enthoven (1993) suggested that this incentive distortion can be corrected when employers design better alternatives for their employer contributions. The employer could contribute a fixed-dollar amount for health insurance with the employee paying the full difference between plans. The greater the portion of the marginal premium paid by the employees is, the stronger the incentive is to choose lower-cost plans. For example, if the employer pays 80 percent of the premium and the employee pays the remainder, then the employee pays only 20 percent of the difference between the low (let’s presume here) HMO premium and the higher fee-for-service premium. HMOs and other managed care arrangements are organized on a prepayment basis that appear in a wide variety of forms. An HMO could hire physicians on a salary, contract with a preexisting group practice of physicians, or contract with physicians who maintain a fee-for-service practice. According to Luft (1991), â€Å"Because specific social, legal, historical, political, and economic aspects of the medical care environment have shaped delivery systems such as the HMO, it is not reasonable to expect that the typical HMO could be transplanted intact to another country† (p. 173). The key to HMO cost savings is the organization’s wide range of medical services, both inpatient and outpatient. In this way, the HMO can receive the cost savings implied by reduced hospital use. This may be difficult to manage in systems where there are separate financing mechanisms for primary care physicians and inpatient care. As Luft (1991, p. 180) remarks. â€Å"If there were no way to shift funds from the ‘hospital side’ to the ‘physician side,’ it would be difficult to reward clinical decision makers for the development of more cost-effective practice styles.† 2. How can the trio of ambulatory care, mental health care and alternative theraies assist in the process of providing quality care at low cost? Ambulatory care-sensitive conditions reflect the quality and availability of primary care services, since they are readily treatable without the need for hospitalization. There are differences in the hospitalization rate for ambulatory care sensitive conditions. Shenkman et al. (2005) had indicated that specialty ambulatory care is important for many children with chronic conditions. However, access to such care may be constrained within managed care environments. The use of primary care providers (PCPs) as gatekeepers for managed care organizations (MCOs) is one commonly used strategy to control specialty care use. Studies of the impact of gatekeeping on children’s receipt of specialty care have resulted in mixed findings. Some studies found more specialty care use in gatekeeping MCOs, compared with non-gatekeeping MCOs. Other researchers found that the replacement of a gatekeeping system with an open-access model increased specialty visits among a group of children with chronic conditions. Although the focus on gatekeeping in general yields some important information, MCOs use many other strategies concomitantly with their PCP gatekeepers, such as capitated payments, financial incentives, and prior authorization procedures. The use of these concomitant strategies may meet the unique needs of children with chronic conditions, including their need for specialty physician care. On the other hand, managed care had been significant contributor on delivery systems for mental health services. Taylor et al. (2001) had indicated that direct and indirect persuasion to provide more cost-effective treatments has been one consequence. The cost-saving qualities and the effectiveness of group interventions have produced clear expectations for an increased use of therapy groups. In the research of Taylor et al. (2001), they compared perceptions and uses of group treatments on a national sample of managed care organizations and mental health providers. Implications of differences and similarities between directors of managed care organizations and treatment providers are examined and discussed across five response categories (familiarity/training perceived effectiveness, likelihood of reimbursement/referral, daily use and expectation for future use). Taylor et al (2001) favored the approach where MCOs calibrate treatment referral/reimbursement decisions. Recently published comparison outcome studies and meta-analyses can and should empirically guide the present treatment delivering systems. Lastly, many managed care organizations have already begun to integrate complementary and alternative medical therapies (CAM) with conventional medical providers. Medical practitioners are obligated to assess CAM therapy with patients. Alternative therapies require professionals to rethink staff competency, patient assessment, and patient-focused care. Medical leaders must understand CAM trends and therapies to better integrate these concepts into health care policy, standards of care, and ethical decisions (Parkman, 2001). Among ambulatory care and mental health care, alternative therapies, or CAM, offers the most favorable and cost-efficient strategy for MCOs. This is because the aging â€Å"baby boom† generation is beginning to experience chronic but non-life threatening conditions, such as joint pain, headaches and menopause-related complaints and they are willing to explore options other than prescription drugs. For health plans, the attraction of offering alternative care products lies in retaining and attracting new members, diversifying their services from competitors in a congested managed care market and in attempts to address current or proposed state mandates (West, 1997). In 1997 alone, expenses for professional services were $21.2 billion, a 45% increase over the earlier 1990 data. Expenses for professional services, herbals, vitamins, diet products, books, and classes totaled $27 billion. Five surveys conducted since 1990 have reported frequent use of CAM, ranging from 30% to 73% by patients suffering from conditions such as cardiovascular disease, cancer, arthritis, HIV and AIDS, multiple sclerosis, and chronic musculoskeletal pain. Futhermore, the demand for CAM by the general public is increasing, despite the fact that its use is largely paid by consumers without coverage by third-party payers. In 1997, Americans spent an estimated $13 billion for visits to CAM providers and an additional $2 billion for commercial diet supplements and over-the-counter megavitamins (Pelletier Astin, 2002). Managed care should not only focus on cost savings, but they should also look into diversifying their services. MCOs have generally contributed to the decline in the U.S. health cost growth rate. Their potential will continue to be limited to the extent that employers fail to offer true financial advantages to consumers who choose the low-cost health plans. Thus, more reforms in the policies should be reviewed and revised so that more people could benefit from the quality health care everyone deserves. References Enthoven, A.C. (1993). The History and Principles of Managed Competition. Health Affairs, supplement, 24-48. Kirby, E.G., Sebastian, J.G. and Hornberger, K.D. (1998, Jan/Feb). The Effect of Normative Social forces on Managed Care Organizations: Implications for Strategic management/Practitioner Response. Journal of Healthcare Management. 43(1):81-106. Luft, H. (1991). Translating the U.S. HMO Experience to Other Health System. Health Affairs 10:172-186. Morrison, I. (1999). Health Care in the New Millennium. NY: John Wiley Sons, Inc. Parkman, C. (2001, February). Alternative Therapies Are Here to Stay. Nursing Management, 32(2): 36-40. Pelletier, K.R. and Astin, J.A. (2002, Jan/Feb). Integration and Reimbursement of Complementary and Alternative Medicine by Managed Care and Insurance Providers: 2000 Update and Cohort Analysis. Alternative Therapies in Health and Medicine, 8(1): 38-44. Shenkman, E., Tian, L. and Schatz, D. (2005, June). Managed Care Organization Characteristics and Outpatient Specialty Care Use Among Children With Chronic Illness. Pediatrics, 115(6): 1547-1555. Smith, C. (2004, Spetember 23). Senate Panel Examines Health Care Choices, Insurance Costs. Knight Ridder Tribune. Taylor, N.T., Burlingame, G.M., Kristensen, K.B., Fuhriman, A. et al. (2001, April). A Survey of Mental Health Care Provider’s and Managed Care Organization Attitudes Toward, Familiarity With, and Use of Group Interventions. International Journal of Group Psychotherapy, 51(2): 243-264. West, D. (1997, November 10). MCOs Integrating Alternative Care. National Underwriter, How to cite Managed care, Essay examples Managed Care Free Essays The article seeks to identify the problems that face managed care organization (MCOs) in contemporary competitive environment which include broad public opinion, competitive realities, need for cost reduction. The article also notes that there has been an increase in health care cost despite the establishment of the managed health care systems implemented through the managed care organizations. Increase in cost remains to be a major concern for patients/consumers. We will write a custom essay sample on Managed Care or any similar topic only for you Order Now Due to this, patients are ready to switch from one plan to another in which cost difference in premium is as little as $15. 0 per month. The article also claims that there has been concern from the society as far as quality of managed healthcare service is concerned. Such concerns encompass: accessibility, and the verification of what is ‘medically necessary’ including the diagnosis tests and referrals. Other concern is freedom of choice. Additionally, perceived quality which is increasingly valued by contemporary patients/consumers has been lacking in the managed care organizations. (Entrepreneur 1998). Strategies or techniques are used to solve the problem or address the issue. This article proposes application of institutional theory to MCOs performance as well as strategic planning. Over emphasizing of institutional theory at the expense of strategic planning will not help the managed care organization to survive in the contemporary competitive environment. The article proposes a strategy that will respond and conform to the needs of the patients and the society at large. Being cost efficient and conforming with socially accepted norms will lead to superior performing of MCOs. Thus, a strategy that encompasses technical requirements as well as conforming to needs of the patients/consumers is very critical for success of any MCO. Only emphasizing or dealing with cost issue is not a strategy for long-term MCO superior performance and success. The article also proposes that all MCOs must demonstrate what contemporary consumers/patients and society expects. These expectations include accessibility, freedom of choice, and perceived quality i. e. always provide value for all patients. ( Entrepreneur1998). My conclusions and recommendations It is clear that the establishment of managed care and the managed care organizations have not been a panacea to all problems facing patients/consumers. Instead, what the patients would like to have is more accessibility to health care services, freedom of choice, better services emphasizing on perfect diagnosis tests, reduction in cost of this services as well as flexibility of managed care systems. This is yet to become a reality. To ensure this, responding to consumers/patients needs will be of great importance. This should include training the health care workers on the best way to serve the patients better, and carrying out perfect diagnosis tests before treating the patients. Increase in number of medical practitioners in MCOs so as to ensure accessibility of these services should also be considered. The managed care plans should also employ modern technology that will improve the quality of health care services. This should encompass better disease diagnosing equipments, and establishing better information systems. Reduction of cost is also very imperative. All inefficiencies and wastage should be checked through a well planned compliance system that should work closely with the human resource department. (Harris, J. S. 1994; Morton-Cooper Bamford 1997; Alexander Amburgey. 1987) Contribution of the article to helping practicing healthcare managers This article is of great help to many practicing healthcare managers. First, it point out the importance of being market oriented i. e. responding to the needs of the patients/consumers and society at large. Factors that determine patients choice of particular health care provider i. e. accessibility of the service, cost of the service, perceived quality such perfect diagnosis test for appropriate medication and so on are also enlisted. The article also emphasis on need of employing a strategy that ensures adherence to technical requirements, cost reduction, high quality, and also freedom of choice to the patients/consumers. Such insight is of great importance to any practicing health care manager who wants to succeed in this career. How to cite Managed Care, Papers

The Internets Good and Bad Sides

Introduction This is the era of the information age. Currently there are over two billion internet users in the world. The internet is the fastest growing market place and many companies are increasingly adopting internet related technologies to tap to the growing market. The internet also has been the source of multi billion companies like Google and facebook that solely derive their revenues from the net.Advertising We will write a custom essay sample on The Internet’s Good and Bad Sides specifically for you for only $16.05 $11/page Learn More These companies and many more have products that have made sure millions of people are hooked to the internet for work and leisure. Because it’s a virtual place that is not very limited, the internet has been on the receiving end of both criticism and praises. It’s a fact that the internet is an employer to millions of people who work and do business online. However, its also a known fact the internet is a place for many people to waste time and many companies have tangibly proved that productivity falls when employees engage in internet related activities (Marzilli 34). Similarly, the internet is the source of many online relationships that people form with virtual partners that normally lead to the breakage of their marriages or stable relationships. The negatives that have characterized the net have therefore led some critics like William Gibson to declare that the internet is a just a waste of time. It’s not any better than the entertainment technologies that preceded it. In fact he thinks its worse. This paper will therefore seek to determine if the net is a waste of time and if so, in what ways. Background Did you know that Facebook has over 700 million users today? Did you know that many other social networking sites like Twitter and My space account for hundreds of millions of other online users? Did you also know that Google is the biggest search engine in the world that helps users access virtually everything that one would want to research on? According to Nielsen Online, facebook, twitter, and Myspace combined captured over hundred million users in 2009. According to Nielsen therefore the gap between human beings virtual and physical continues to dim. It’s important however to understand that the problem is not sing the internet. Rather the problem is the activity these billions of users of the internet engage in. in a survey in 2005 by America Online and Salary.com, many workers over 44% cited the internet as the biggest distraction (Mahill 32). The internet was fist invented to connect people. Today, it still plays that very important role. In fact, there is quite a lot of useful collaboration that is as a direct result of the internet. Take for example research (Johnson et al 54). Many research fellows in the world interact between each other stationed in different universities thousands of miles away exchanging ideas that have positively changed the world.Advertising Looking for essay on rhetoric? Let's see if we can help you! Get your first paper with 15% OFF Learn More The internet is also increasingly being used as a place to discuss parties and other social events that bring many people together. Everyday the news media is filled with news of unsuspecting women and men some of them underage lured by criminals and trafficked to various parts of the world through the internet (Herbert and Samantha 59). It’s hard for one to imagine his son /daughter being sent away from school because they posted inappropriate pictures online. Many politicians have lost their careers through the information thy post on the net. What we can decide from the above is that the internet is a great source of unlimited invaluable information and at the same time a place with unlimited ways of wasting time. Many experts have asked themselves many questions about the good and bad sides of the intern et. Much as they acknowledge its importance, it’s hard to remain objective and concentrate on the good side without casting the eye wide and seeing the ugly side of it (Katz and Rice, 45). The internet was invented to connect with people, true. The internet is still crucial in everyday running of the world, true. On the other hand, the internet is the root of some of the bad evils that have befallen many people, true and the internet is the beginning of what Gibson described as a place to daydream waste time and watching other people’s lives while we destroy ours. According to Gibson, the bad side of the internet outweighs the good. Putting oneself in Gibson’s shoes, one can’t help but ask some very hard questions about the net. What good is there for one to spend half of his/time discussing about the lives of other people? What good comes out of sitting the whole day, consuming vast amounts of energy and fantasizing about other people’s lives? Alt ernatively, what good comes out of someone sitting the whole day creating malicious programs that lead to the collapse of vast networks of data and sometimes con of money out of people. It makes no sense at all for one to stay online and take surveys that pay a hundredth of a dollar. Millions of people are engaged in such activities that promise huge unrealistic incomes. According to Gibson, uselessness stems from the fact people spend a lot of time online doing nothing productive on the internet. As a result the internet has introduced a culture of people who only think about leisure without working. While that can work ideally, it’s quite unworkable in the realistic world.Advertising We will write a custom essay sample on The Internet’s Good and Bad Sides specifically for you for only $16.05 $11/page Learn More Even if the idea that money can work for one hence he/she can have all the time to engage in leisure was workable, it will still be impossible for one to engage in endless leisure. Gibson therefore feels that the advantages and disadvantages from the internet cancel out each other and result the nothing comes out of it. He further fears that failure to halt the trend will lead to people especially young people acting life and living in fantasy The scary part is that the internet is yet to fully evolve to reach its epitome. The evolution no doubt will bring along numerous advantages and along with it deadly consequences for all users of the internet. What needs to answered however is whether the leisure trend that is associated with the world is on its way to usurping the productive trends that laid the foundation for the internet (John 76). Argument Many experts have expressed their own views that support Gibson’s view while others appear to be on the contrary. Ott and Sarricks believe most of the information stored in the internet can be justified to be useless. The sad thing about it is that the inf ormation is packaged to appear important potentially misleading many people who otherwise should be engaged in productive activity (166). Gibson in his argument about the uselessness of the internet admits that though he likes surfing the internet and derives considerable pleasure from doing so, he cannot compare it to the television. Television according to him is far more beneficial and apparently does not waste time like the internet, well during the â€Å"good old times†. Its difficult to determine the accuracy of the Gibson’s charge. However, anyone can find a number of faults with the TV as with the internet. Like surfing the internet, clicking on ones TV remote control will introduce to numerous unnecessary programs comparable to the useless information on the internet. West admits that the internet has revolutionalized the way information is accessed (74). Information according to him that took weeks to compile may take a few hours. Now who can object to that a s an great time saver? West adds that the wealth of information available in soft form online far outweighs the information that is available in soft copy (74). However, West faults the vast amounts of information on the internet as its main undoing. Like Otts and Saricks he concurs that most of it is useless. Further more it will take someone a long time to sift through the information to com up with anything logical and concrete ( 25). The quality of the information has been called to question. Its no secret that most qualitative and useful intelligence information is sold online. So why avail it and claim at the same time that its available on the information superhighway.Advertising Looking for essay on rhetoric? Let's see if we can help you! Get your first paper with 15% OFF Learn More According to Mahill, social interaction is very important it every human being’s life (130). Human beings have different interests and those that have less rely on the media for a bridge of the gap that5 the have. The internet has come in handy and kept people engaged instead of being bored. That is pretty much like Gibson’s view. However, Mahill faults television, social media, e-mail, texting and texting all that have an internet element in them for providing too much entertainment to appoint where the individual is overwhelmed. He adds that people are finding it increasingly difficult to process the information and entertainment that the internet accords the (130). Mahill authoritatively declares that people are overloaded and the usefulness of the internet is drastically being put under the microscope. Conclusion He coinage â€Å"the internet is useless† is too blanket to sum up the benefits that the internet offers as well as the disadvantages. Depending on the angle from which it’s looked at, there are going to be a lot of pros and cons concerning the service. However, focusing on the disadvantages, it’s difficult to ignore the fact that the internet thing is quickly turning to an â€Å"overact†. There is a lot of entertainment on the net. In fact, one can easily prove that there is over entrainment that exceeds supply on the internet. But, who said some people don’t like it? Are social sites minting money out of the net? Can from instance Larry Page of Google describe the internet as useless? The simple answer is no! Therefore, the solution lies in a little bit of policing of the net where stringent regulation will control what flows in and out of the net. Without that, am afraid Gibson’s generalization will become true. Works Cited John, Hamilton. Internet. London: ABDO, 2004. Print. Mahill, Wendy. Embracing a Feeling Heart. London: Xulon Press. 2011 Marzilli, Alan. Policing the Internet: New York : Infobase Publishers, 2005. Print. Samantha, Moppett and Herbert, Ramy. Navigating the Internet: legal research on the World Wide Web. New Jersey: WIN Press, 2000. Johnson et al. Computers: tools for an information age. New York: Prentice Hall, 2002. Print. Rice, Ronald and Katz, Everett. Social consequences of Internet use: access, involvement. Massachusetts: MIT Press, 2002. Saricks, Gibson and Ott, Bernard. The Back Page. New York: ALA Editions, 2005. Print West, Christopher. Competitive intelligence. New York: Palgrave Macmillan. 2001. Print. 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