Literature Review for Sustainabilty in Supply Chain Management for Essay

Literature Review for Sustainabilty in Supply Chain Management for hospitals - Essay Example However during the rapid development of the industrial age the need for a set of standards was realized which could limit or at least minimize the adverse effects of the industrial machinery on the environment as well as the society without jeopardizing the interests of the manufacturer. An integrative frameworks is discussed for sustainability practice in construction industry presented by (Amlan M., Helen M., 2010). SSCM is the strategic cooperation of organizations in order to improve the management of capital flows, materials and information as well as considering all the issues involved in a sustainable development like social, financial and ecological requirements, which in turn are provided by the customers and stake holders (Craig C., Dale R., Nov 2007)( Seuring & Muller, 2008)(Lutz P., 2009). The elements involved in SSCM have to address environmental and socially challenging issues as well as maintaining customer relationships by being competitive in the market. 2. Role of a sustainable supply chain in a hospital scenario A supply chain is the backbone of any industrial machinery that involves production of goods or provision of raw materials ( Anna N., Ladimer S., 2010 ). A ‘green hospital’ case study presented in (Anna H., 2008) for better healthcare, greening in supply chain, managing the waste stream, hospital food and other aspect discussed in this paper. The green supply chain management is an effective tool and discussed briefly by (Chen L., Shu C., Ling T., 2010). A qualitative study of UK food retailer in context of social responsibility to supply chain presented in (Laura S., Michael B., 2009) Each and every single manufacturer, service provider, transporter and designer is part of a supply chain. Being a service provider, a hospital also needs and in fact is part of a supply chain itself. Sustainability is an important issue when it comes to hospitals because this is one place that cannot afford ignorance in healthcare and envi ronmental issues. A sustainable hospital supply chain incorporates the following features. Waste management: Sustainability in a hospital supply chain will ensure the proper disposal of wastes like used syringes, infected and dirty bandages as well as clothes and in some cases amputated body parts. Recycling of wastage is also an important issue. Energy management: energy management is one of the key elements of SSCM. Energy audits are to be conducted at regular intervals for this purpose. Water management: water is an important resource and must be utilized in an optimal manner. SSCM addresses this issue as per an ecological requirement. Transport: like every other service provider, a hospital supply chain includes transport therefore it has to be managed. Communication: optimal management of communication resources as well as effective communication is also a part of a hospital supply chain. Training sessions: training of employees and awareness sessions for clients are an effecti ve method of increasing sustainability in a supply chain. 3. Examples->types->an example concerning hospitals in particular The supply chain management actually physical dispersion of goods by the efforts of manufacturers, distributors, traders and retailer and it impact on purchasing practices. Barriers and obstacles 4. Advantages and motivational factors for the implementation of a SSCM That the sustainable supply chain mana

Financing Health Care in the US Term Paper Example | Topics and Well Written Essays - 1250 words

Financing Health Care in the US - Term Paper Example prior to delving into the intricate issues and concerns that the government is trying to address to improve its present stance. Thereby, from among the scholarly articles reviewed on the subject, the suggestions and recommendations of various authors would be revealed in conjunction with one’s personal assessment on the subject of this discourse. There are two types of access to the delivery of health care services in any nation: through the public or private sectors. Generally, the private sector in any health care system of a nation consists of divergent nongovernmental institutions of an array of levels and dimensions. Public health is predominantly financed with funds from the government that is solicited from public sources such as tax revenues. The health care in the United States is dominantly serviced and administered by private health institutions where no public hospitals are deemed owned and operated by the federal government. As revealed by Holstein and Litzinger (2008, 15), â€Å"in the U.S., the rapid rise in health care cost and low access are widely recognized as twin problems. Health care reform in this country first focused on cost containment through managed care to make health insurance affordable, and then shifted to expanding access to coverage at the state level without doing away with the private health insurance market†. This fact was likewise validated by Siegel, Mead and Burke (2008) who noted the parallel contentions in the rising costs of health care services coupled with the increasing number of Americans who are uninsured. Health insurance can actually be availed through an employed individual’s employer or through the employers of either the spouse or parents’, as applicable. Health insurance can also be purchased individually depending on one’s capacity or financial status, and the required scope and contents of health insurance coverage. The problem is

Lenin in accounting for Stalins defeat of his opponents in the years 1924-1929 Essay Example for Free

Lenin in accounting for Stalins defeat of his opponents in the years 1924-1929 Essay How significant were the personalities of the contenders to succeed Lenin in accounting for Stalin’s defeat of his opponents in the years 1924-1929 Stalin, throughout the fierce fight for power exploited his attributes to the best of his ability, however his tactics were not the only factor in his eventual success. Perhaps what’s more interesting is the systematic fails, one by one of all of his contenders – which was due to their individual personalities. Many argue this is the more significant reason for Stalin’s rise to power, and that if this had have been changed Stalin’s success would have been entirely different. Stalin’s opponents, understandably had very different personalities. However looking in hindsight none of them seem to create a difficult situation for Stalin. This could be due to Stalin’s natural ability to change and use his opponents strengths and weaknesses, or perhaps the general naivety of many in the politburo. One main example of this is Trotsky, and his rather egotistic and arrogant personality. This intern made people weary of his power, and made him completely oversee Stalin as a contender for power. Lenin in his testament says himself he is â€Å"not sure whether he will always be capable of using that authority with sufficient caution† and the politburo completely over saw this cautious remark for their own reputation. The evidence seems to suggest members of the Bolshevik party didn’t use their personality’s to the best if their potential. Furthermore Trotsky seemed very trivial about the whole situation. In 1924 he didn’t make Lenin’s funeral, eventually blaming that on Stalin. In the successive years after he didn’t make important politburo meetings and refused to make alliances. In 1926 he did eventually see light forming the ‘united opposition’ however by then it was too late and Stalin’s fan base was too large in the central commission. Another example of this is how Bukharin in 1925 decided to stay strictly to the Bolshevik rules. This perhaps shows how good a man he is, but not how good a politician he is. In that situation he has seen his fellow socialist members being taken over by Stalin, but does very little to stop this. Furthermore he says himself Stalin is â€Å"an unprincipled intriguer who subordinates everything for his appetite for power† The evidence here suggests he saw the dilemma, but does very little about it. In hindsight we now know he allowed Stalin to use his powerbase for his own political marketing. This shows the true naivety of Bukharin and how Stalin’s personality completely overshadowed anybody else’s in the politburo. Moreover this shows how truly significant the personalities of every one of Stalin’s contenders were, in allowing and creating a path for Stalin to walk to power. Perhaps if other people in the politburo were willing to play underhand tactics like Stalin, the end would have been different. In retrospect we can see personalities might not be a main factor – perhaps the individual ideologies played a larger role, but it’s the way people acted towards Stalin, completely overshadowing him that makes personalities so significant. Other peoples personalities did play a vital role, but now in stark contrast we begin looking at Stalin’s personality strengths, and how he uses them to the best of his ability. He, from the very beginning was a yes man following Lenin till the very end. However one major strength that Lenin foresaw was Stalin’s ability to challenge his thoughts and ideologies. Stalin from the very beginning has a very strong personality (Lenin) and this was used this in the July days (a troubled time for the Bolshevik party) when Lenin needed this unique quality from him. Arguably this is Stalin’s biggest asset. Furthermore Stalin’s ability to change tactics and ideologies, particularly in the later stage of the power struggle was, down to an incredibly versatile personality. Moreover his ability to look into the future and plan his actions to aid his accent was stunning, as if he planned every move meticulously and almost in hindsight. Looking at the evidence, Stalinâ₠¬â„¢s personality was vital in his accent, but perhaps if the others had been different the overall outcome would have drastically changed. Personalities were vital in the success and failures of the struggle, however Stalin’s under hand tactics played an equally important role. Before and during the 5 year struggle he implemented many tactics to undermine his opponents, and one by one remove them from the possibility of power. Lenin saw this in his final years, and discussed it in his testament, however Stalin persuaded Kamenev and Zinoviev to fight his side, and intern keep his job. Furthermore his ability to switch ideologies and allies is a testament to his versatile personality. An example of this is in the later stages of the struggle, when only him and Bukharin were left for the job. Stalin suddenly rejected NEP because it was failing and turned radically left. This sudden maneuver allowed left wing supporters and nationalist war communists to support him, as well as gaining the support of anti NEP politicians. In all this he managed to leave Bukharin to pick up the pieces of NEP. Furthermore Stalin re introduced grain requisitioning in early 1928 to make sure NEP was a complete fail. Its these quite brilliant tactics that formulate into a plan that make Stalin truly versatile and incredibly shrewd and devious. In everything Stalin did there always seemed to be a very formulated plan, and in this was surrounded by brilliant political tactics. However these tactics were merely ways of getting rid of political opponents, and due to personalities as whole, arguably tactics are not as important as other factors. Alternatively the power bases’ of other opponents could be as significant as personality in the war struggle for power, and the defeat of all his opponents. All Stalin’s opponents had important roles within the Bolshevik party, and in many ways – more significant roles than Stalin. One in particular is Trotsky. Head of the Red army, and an incredibly influential role within the Politburo. Lenin says himself â€Å"personally he is, to be sure, the most able man in the present Central Committee† His power base is remarkable, with huge amounts of Kudu’s within the Bolshevik party. However arguably as well as him being too â€Å"self-confident† Stalin used this wealth of power base to his advantage by forming the Triumvirate with Zinoviev and Kamenev. When we turn to other members such as Bukharin, we see that generally their powerbases, although more significant for policy making were not as useful for gaining power as Stalin’s, and perh aps this was a significant reason for their in individual defeat. Stalin’s role within the party was General secretary and head of enrolment and promotions. This involved the inner workings of the Party. The evidence indicates that Stalin used his role, from 1922 to strengthen his fan base within the party and Central committee, which later in 1925/26 seemed to secure his position within the party, in 1923 it was up to 30%, and steadily rising. This seems to indicate his role and power base far out saw anyone else’s within the party, and that actually he was in the perfect position to take up power, even foreseeing this in 1924 – by controlling what Lenin saw from the politburo, and vice versa. Stalin took up a highly administrative role, and this worked in his advantage, however the evidence suggests that if other factors were stronger, such as opposition personalities that Stalin still wouldn’t have made it to power. Arguably in this light personalities seem more significant. Ideologies of the opposition and Stalin play of key significance in how arguments were won and lost. For example, Trotsky stayed far left with all his ideologies – perhaps in a more noble way than Stalin, and eventually he was engulfed by Stalin’s devious tactics. Another example would be Zinoviev and Kamenev, in the triumvirate staying right of the spectrum. However when they rejoin to form the left and united opposition – they lose huge respect for changing ideologies within the party. Interestingly this seems like an incredibly vital point – leading onto Stalin’s ideological viewpoints. Throughout the start of the political struggle, he sways right – but doesn’t involve himself in any main arguments about, for example rapid industrialisation. This tactic to stay the middle man has its disadvantages. For example he is described by members of the Bolshevik party as ‘a grey blur’. However it also has its advantages. Stalin was then able to sway from his very Right views within communism – to left views with not much notice – he was able to move ideologies to strengthen his fan base and his viewpoints. For example when the NEP failed – he removed himself from it, thus allowing Bukharin to take the blame – and him stay in the positive public spotlight. It’s this very middle ideological viewpoint that the evidence suggest allowed Stalin to change as he did, allowing him to use it to his great advantage. Despite this, other arguments perhaps suggest it is not the most significant factor in Stalin’s accent within the government, and that actually his deceitful, arrogant and shrewd personality was the true reason that allowed him to flourish the way he did. In conclusion, looking at all the evidence it is clear a combination of factors were involved in Stalin’s accent of power. On one hand it seems Stalin’s powerbase seems to be the primary factor, that despite anyone’s efforts his place within government allowed to build a vast fan base in such a short amount of time. Furthermore others power base didn’t seem to match the superiority of his, even though on the forefront they seem more important, Trotsky is a prime example of this. On the other hand his tactics seem the obvious significant factor – looking at how he manipulated allies and oppositions, such as Bukharin and Zinoviev. More over his ability to control the politburo with his allies over the testament suggests that this could have been a primary turning point for Stalin’s direction on how to achieve power. However diving into the muddle of linked causes, personalities seems to come out on top. The tactics and moral high ground was generally taken by his opposition, but it seems they didn’t play hard enough. They didn’t morally want to use underhand tactics and switch ideologies – because they believed in what they were fighting in. It’s this decorum that contributed more than anything else. Looking at the other side of the spectrum Stalin’s fierce personality, with no conscience seems to be the perfect mix to manipulate not only the communist party – but the general public as well. It is this sheer inhumane ability to be deceptive in this way that allows the evidence to suggest, on the top, personality is the most significant factor in accounting for Stalin’s defeat of his opponents in the years 1924-1929.

Equity of Access in the Australian Healthcare System

Equity of Access in the Australian Healthcare System The Concept of Equity of Access in the Australian Healthcare System The Australian health care system is founded on the concept of equity of Access. Discuss this Statement with relation to the concepts of Effectiveness and efficiency and any interrelation that may exist. Introduction: As Stated in National Health Reform Agreement-Equity of Access is the fundamental base of the Australian Health Care System (DHA. 2013a). Effectiveness, which focuses on ratio of outputs to outcomes and efficiency, which defines as achieving maximum outputs with available inputs or resources, these are other elementary component of the Australian Health Care System. Equity, effectiveness and efficiency these represents ideal health care system, which tends be effective and efficient and able to achieve the efficacy (specified outcomes) in a way that maximize access (distribution); Productivity (output) and outcomes within the resource provided (NHHRC. 2009. P.4). Responsibilities like funding, delivery regulation is shared by the national state government of Australia makes the Australian Health Care system universally accessible within the people (AIHW, 2000). Public hospitals community care funding is joined effort of common wealth (i.e. federal government), states territories where common wealth use its revenue and tax to fund most of hospital medical service health research (Common wealth Department of Health age care, 2000). Since 1990’s National State health Minister worked alongside of many health care professional to develop a certain Universal framework to assessing the Australian health system (NHPC, 2000). A new framework for measurement of Australian health performance was inspired from Canadian Health information Roadmap Initiative Indicator framework, which was commenced by NHPC (NHPC, 2001). Equity: Equity in health and health care with context of social objective can be defined in many different ways. As Amarty sen argued, when we talk equity we forget to ask on fundamental question ‘equity of what?’ (Sen, A.,1992). But for the context of our knowledge and study we base our understanding on the definition of culyer wagstaff, ‘the appropriate positive criteria for mormative judgement regarding equity in distribution of health and health care is equality of health status and health care access (Culyer, A.J., Wagstaff, A., 1993). By adding the equality in the process of equity gives the sense of clear fairness to the consumer. But equality is not equity; equality is just simply described as similarity of status, capacity and opportunity. Equity is an ethical value. A unequal opportunity of being healthy associated by people in socially less privileged groups such as poor people, different racial people to others native land, religious ethnic group, women and rural resident is reduced by equity in health ( Braverman, P. Gruskin, S., 2003). Further Braverman et.al stated that the equity in health pursued by eliminating disparities of health that are connected with certain social disadvantage or marginalized or disfranchised community and group within, but may not be limited to the poor. This definition argues for need for the health care services by individuals which is completely result of both of their medical condition and their social condition. As we know the problem of health care system is not only related to the inequity in health. According to Mathews, social, cultural and educational and more or less classical medical causes are related to the poor health of the indigenous Australian (Mathews, C., 2003). Equity of Access: Equity in health has been spoken and written frequently by many economist but they never tends to do or continue to do more consistently, clearly passionately. As Gavin Mooney stated, ‘equity means equal access to equal care for equal needs,’ (Gavin, M., 2003). Since 1960’s quest for equity in health has been major issue and concern to Australian health care system. The introduction of Medibank in 1975 and reinstatement as Medicare in 1984 was the most significant development in term of equity of access after the access of financial barrier (Scotton, R. B., Macdonald, C. R., 1993). The equity of health service and the consultation time frame for consumer of lower socio-economic status and consumer of high socio-economic status doesn’t shorten by breaking and disappearance of financial barrier (Furler, J.S., et.al 2002). The result in context of other dimension of equity is not good. Access of health care (both primary and hospital care) in term of geograp hical equity is significantly different between urban and rural area. Fewer doctors per 1000 population in rural Australia relative to urban area is the best example to describe the complex nature of geographic equity in simple. Rural communities considered access of specialist service, access to hospital service to be a problem due to traveling of significant distance to gain and access those service. Equity of Outcome: Environmental factor and the quality of health care provided equally affects the result of equity of outcomes. Major Policy attention is needed by the appalling health status of our Aboriginal Torres strait Islander population is one of the best example is equity of outcomes. By action in health sector will not remedied the factor Affecting health status, issue of dignity, identity and justice should be the strategy for the improvement of the health status of Aboriginal Torres Strait Islander. Reconciliation is one of the key elements required for progress further (Jackson, L.R., Ward, J.E., 1999). Efficiency: What is efficiency? According to Farrell efficiency is production of maximum amount of outputs from given amount of input or alternatively minimum input quantities producing a given amount of output (Farrell, M.J. 1957). It is referred as to a concrete goal oriented index indicating how well socially desirable health system is achieved desirable. Health Service efficiency is also considered to be great important dimension of quality health because service affordability is affected by it with the context of limited available resources in health care. Efficient service means providing optimal service and care to patient and community rather than maximum care to patient and community; it is about providing greatest benefit with available resource (Brown, L.D., et.al 1992). One of the key criteria for evaluating the health care system is efficiency. According to the economic point of view, efficiency divided into two key elements; allocative efficiency and technical efficiency. Allocative efficiency: To provide best outcomes health care system dependent on distribution and allocation of resources; technical efficiency, effectiveness and priority are involved in the process of best outcomes. The optimized ratio of outputs to outcomes, which is also known as effectiveness is the second key element of allocative efficiency. The priority setting in term of overall ratio of inputs to outcomes is the third and last element of allocative efficiency. Technical efficiency: Flexibility and adaptability to change and innovation of health care system as a whole and as its constituent elements, is known as technical efficiency. Development of casemix measure for hospital services by palmer was a unique contribution both nationally and internationally (Palmer, G.R., et al, 1986; Palmer, G.R., 1991). Over last decades significant improvement in allocative efficiency was achieved after introduction of casemix funding in Victoria in 1993 (Duckett, S.J., 1995). There have been constantly adaptations of new technologies (like drugs, surgical instrument, surgical technique and diagnostic instrument technique) since the development of Australian Health Care system. Over the decades of increase in publication and citation, Australia has been able to build up strong and dynamic medical research system (Butler, L., 2001). Comprise of allocative efficiency technical efficiency gives ‘overall efficiency’, firm can operate on cost or revenue frontier if i t’s able to achieve overall efficiency. Effectiveness: It acts as a key dimension for achieving desirable outcomes with correct provision of evidence based health care service to all who couldn’t benefit, but not to those who would not benefit (Aran, O.A., et.al 2003; WHO, 2000). Donabedian argued then effectiveness is the extent to which attainable improvements in health are in fact attained (Donabedian, A., 2002; Donabedian, A., 1982). In same way Juran Godfrey argued effectiveness to be the degree to the process which result in desired outcomes without any error (Juran, J. Godfrey, A.B., 1999). The ratio of output to outcome is optimized by effectiveness. Out of number of elements, ‘efficacy’ act as one of key component to the certain extent of which health care sector output leads to the ideal outcomes under best ideal condition (Cochrane, A.L., 1972). The major objective is to ensure the actual effectiveness (in term of ratio of outputs to actual outcomes) which helps to move closer to objective. Effectiveness is the dimension of Australian Health Care which explicitly includes time element, so we can evaluate whether the health intervention are primarily achieve the desired and appropriate outcome within the time frame. The interventions are the care must be provided to people most needed is advocated and supported by effectiveness framework. Early detection and prevention performance within a population area is the indicators for the effectiveness. Effectiveness conceptualize framework of health care system as dimension of performance where â€Å"care/intervention/action† achieves the desired result in an appropriate time frame (NHPC, 2001). Norms and specification at central level defines effectiveness to be an important dimension of quality. Effectiveness issue should be handle in local level too, where manager implement norms and work on how to adapt them to local condition. Actual outcomes (effectiveness) for an intervention or system is affected by numerous factor like the care system design, surrounding environment of discharge patient, safety of device manufactured pharmaceuticals used and care quality. Proof of evidence of significant level of preventable adverse events occurring in hospital leading to drastic outcomes can be provided by the quality in Australian health care study (Wilson, R.M.et al., 1995). As stated by McDermott, it is suggested that large number of death related to trauma can be preventable or potentially are preventable, which is has be documented after analysis of care following trauma (McDermott, F.T.et al., 1996). These study shows that there are important effectiveness issues in Australian healthcare system with respect to quality of care and it can be described as inability to provide high-quality care. Interaction between equity, efficiency and effectiveness: The concept of equity, effectiveness and efficiency in term of health input and its outcomes are internationally tackle by WHO and OECD (Organization for Economic Co-operation and Development) to reflect an economic way of thinking. Due to growing concern about safety, service delivery and quality of patient care there have been interesting trends of implicit and explicit link between the concept of equity, efficiency and effectiveness, which is understandable (Berwick, D.M., 1998). As we know second element of allocative efficiency is optimized ration of outputs to outcomes which is also known as effectiveness. Which shows that efficiency and effectiveness are linked and interacted? After the implementation of equity, sick individuals who seek help have their need meet. The value of treatment provided by health service organization is equally distributed to the people in need. With the equity you are not judge or treated and cared on the basis of your fame, fortune, you ability to p ay. When the resource is equally distributes between the need of people then equity taken an affect and when there is the equity then we can evaluate the efficiency and effectiveness of the health care service of that organization or of any country. Conclusion: Health policy where attributes and value plays prominent role, ideological driven problem related to it are inevitable as part of the policy. Perception of problem is affected by attributes and value which plays significant role in policy academics so as to attempt to shape public debate for making rational and reality based perception. There are many problem identified in the context of equity of access in the Australian healthcare system based on efficiency and effectiveness by many writers like Palmer, Wilson, McDermott, Jackson wards, Farrell and many more; even the solution to that problem have been presented by them but we haven’t yet identify the problem and adopted the solution presented by them. But important aspect is that progress are being made and hopefully health care system will experience continuous improvement in near future. References : Australian Institute of Health and Welfare (2000). Australia’s Health 2000. Canberra Australian Institute of Health and Welfare (2008). Australia’s Health 2008, Canberra Arah, O. A., Klazinga, N. S., Delnoij, D. M. J., Ten Asbroek, A. H. A., Custers, T. (2003). Conceptual frameworks for health systems performance: a quest for effectiveness, quality, and improvement.International Journal for Quality in Health Care,15(5), 377-398. Berwick, D. M. (1998). Developing and testing changes in delivery of care.Annals of Internal Medicine,128(8), 651-656. Braveman, P., Gruskin, S. (2003). Poverty, equity, human rights and health. Bulletin of the World Health organization,81(7), 539-545 Brown, L. D., Franco, L. M., Rafeh, N., Hatzell, T. (1992).Quality assurance of health care in developing countries. Quality assurance project. Butler, L. (2001).Monitoring Australias Scientific Research: Partial indicators of Australias research performance. Australian Academy of Science. Canberra Cochrane, A. L. (1972). Effectiveness and Efficiency (Rock Carling Fellowship, 1971).Nuffield Provincial Hospitals Trust. Commonwealth Department of Health and Aged Care, (2000). Australian Health Care Agreements Annual Performance Reports 1998–1999. Canberra: Common Wealth of Australia. Culyer, A. J., Wagstaff, A. (1993). Equity and equality in health and health care.Journal of health economics,12(4), 431-457. Department of Health (DHA) (2013). National Health Reform Agreement. Donabedian, A. (1982). Explorations in quality assessment and monitoring. Vol. 2. The criteria and standards of quality.Ann Arbor, MI: Health Administration Press. Donabedian, A. (2002).An introduction to quality assurance in health care. Oxford University Press. Duckett, S. J. (1995). Hospital payment arrangements to encourage efficiency: the case of Victoria, Australia.Health Policy,34(2), 113-134. Farrell, M. J. (1957). The measurement of productive efficiency.Journal of the Royal Statistical Society. Series A (General), 253-290. Furler, J. S., Harris, E., Chondros, P., Davies, P. P., Harris, M. F., Young, D. Y. (2002). The inverse care law revisited: impact of disadvantaged location on accessing longer GP consultation times.Medical Journal of Australia,177(2), 80-83. Jackson, L. R., Ward, J. E. (1999). Aboriginal health: why is reconciliation necessary?.The Medical Journal of Australia,170(9), 437-440. Juran, J., Godfrey, A. B. (1999). Quality Handbook.Republished McGraw-Hill. Matthews, C. (2003). Caught in a vicious cycle.Australian Medicine,15(12),16. McDermott, F. T., Cordner, S. M., Tremayne, A. B. (1996). Evaluation of the medical management and preventability of death in 137 road traffic fatalities in Victoria, Australia: an overview.Journal of Trauma-Injury, Infection, and Critical Care,40(4), 520-535. Mooney, G. H. (2003).Economics, medicine and health care. 3rd ed. London: Pearson Education. National Health and Hospitals Reform Commission. (2009). A healthier future for all Australians: Final report of the national health and hospitals reform commission. National Health Performance Committee (NHPC) (2000). Fourth National Report on Health Sector Performance Indicators – A Report to the Australian Health Ministers’ Conference. Sydney: New South Wales Health Department National Health Performance Committee (NHPC) (2001). National Health Performance FrameWork Report. Brisbane: Queensland Health. Palmer, G. R., Aisbett, C., Reid, B., Jayawardena, Y. (1986). The validity of Diagnosis Related Groups for use in Victorian public hospitals: report to the Department of Health, and of Management and the Budget.Victoria, Kensington, University of New South Wales. Palmer, G. R. (1991). The use of DRGs in the management and planning of hospital services.Australian Economic Review,24(1), 62-70. Scotton, R. B., Macdonald, C. R. (1993).The making of Medibank(No. 76). School of Health Services Management, University of New South Wales. Sen, A. (1992).Inequality reexamined. Oxford University Press. Wilson, R. M., Runciman, W. B., Gibberd, R. W., Harrison, B. T., Newby, L., Hamilton, J. D. (1995). The quality in Australian health care study.Medical Journal of Australia,163(9), 458-471. World Health Organization. (2000).The world health report 2000: health systems: improving performance. World Health Organization.

My Christian Life Essays -- essays research papers

My Christian Life has been â€Å"pleasurable pain† (I will explain what that refers to in detail later). I was born on June 9, 1984. I was blessed to be in a family of Christian. Therefore, I was destined to become a true follower of Christ. I was baptized on August 12 of that year at St. Rose De Lima. Most people say that from the moment I was blessed, I became a disciple of Jesus, a light bearer, but I believe I was a disciple for my Lord and Savior the moment I was born. I was conceived into a Christian family with a strong Christian background. I thank the Lord to this day for blessing me as He did. As it was when I was born and still to this day, I was brought to Church every Sunday. As an infant and a child, I did not understand the true meaning of this. I thought it was just a day I was force to wear â€Å"uncomfortable† clothes and told to be quite (even though I rarely did). I was like most other children, as are some teenagers, I did not want to go to Church. I would run, play sick or try to do anything I could to not attend Church. For this misunderstanding, I only can credit that to my ignorance of my faith. If you were not dying in my house you was presumed to go to Church even if you was not apart on our family. I remember one instance when I slept by a friend’s house and his family, unfortunately, was not a regular participant in Church (I think I knew this). My mother came and picked me up that morning to go to Church. I remember this moment in my life because it showed how strong my family was and will always be in Faith. As me being a Christian, I was taught in a Catholic School. I attended St. Leo the Great Elementary. There, I learned a broad description of my faith and why my faith entitled me to do and act a certain way. I receive my Holy Communion when I was in First Grade I believe. Even then, I did not really understand the true concept of what I embarked on. For this reason, I â€Å"kind of† go against receiving certain sacraments at a young age. Age is a vital part in the strength of our beliefs (a younger person may be weaker than an older one). How many young Christians â€Å"really† understand what they are doing or even saying? If a person does not understand what they are taking apart of, then why should they be included. Today, a person is read their rights and asked at the end, do you understand all of things that were being said. I believe th... ...er away from me. I felt cheated. Until one day I talk to a friend of the family (we call him Uncle Jessey). He made me understand the cycle of death. After all the classes I have sat through dealing with my faith and all I have learned, nothing could have prepared me for this tragedy. I thank God for my Uncle Jessey kind words and for helping me to overcome my grandmother’s death. Another instance I remember is seeing Coach Deleica and Coach Griff at my grandmother’s funeral. At that moment I felt the true presence of my St. Augustine family. A couple of days ago, I attended my senior trip. When I first got there I was just glad to be out of class but as the day progressed I began to talk to God. I began to hear the music of the Lord. I felt lifted at the end of the day. After I leave Church, I always feel lifted (if I go to the right church). I attend St. Peter Claver Church. St. Peter Claver is a predominant black church. It has a gospel type of choir. Mass is last a minimum of 90 minutes. Without this service I would not be able to go on with life. â€Å"I hope that God will forever keep blessing me and watch over my love ones and friends,† St. Joseph and St. Augustine Pray For Us.

Sammy Makes a Decision in John Updikes A&P :: A&P Essays

Sammy Makes a Decision John Updike's short story "A&P" is about a teenager who has to make a serious decision. The story is set in an A&P supermarket in a town north of Boston, probably about the year 1960. As the plot unfolds, Sammy changes from being a thoughtless and sexist boy to being a young man who can make a decision, even though it might hurt him. Sammy tells us he is nineteen years old. He is a check-out clerk in the local A&P, where the boss, Lengel, is a friend of Sammy's parents. Sammy does not seem to like his job very much. He calls one of his customers a "witch" and says the other customers are "houseslaves" and "sheep." He himself comes from a middle-class family. When they have a party, he says, they serve "lemonade and if it's a real racy affair Schlitz in tall glasses with 'They'll Do It Every Time' cartoons stencilled on" (15). In addition, Sammy is sexist. He gives long, loving descriptions of the girls who cause all the trouble, and he thinks at first that girls may not even have minds, asking, "do you really think it's a mind in there or just a little buzz like a bee in a glass jar?" (13) However, he does change as the plot goes on. The plot of the story deals with three girls who come into the store dressed only in bathing suits. They make their entrance in the very first sentence, and they complicate Sammy's life. At first, Sammy, his older friend Stokesie, and McMahon the butcher all look at the girls lustfully. But of them all, only Sammy enjoys the entertainment the girls bring. The other shoppers crash their carts, look stunned, and are suddenly jarred out of their everyday routine. Sammy, who seems bored with his job, finds the change amusing. He even begins to feel sorry for the girls when everyone else stares at them lustfully. The plot's major conflict occurs late in the story when Lengel, the manager, comes in and scolds the girls. Sammy knows that they are on their way out of the store, but Lengel has to yell at them and make them feel bad.

No Dogs Allowed Essay

1. Who benefits from the construction of the park? How should the park be distributed? What feedback will the citizens reciprocate? Will management of the park promote progress and inspire future projects? 2. The town would likely need all factors of production; raw materials, human labor, and machinery to construct and maintain the park. 3. The town’s resources are limited. The land value is priced around $125,000 per acre. Limited resources include natural resources, raw material, renewable resources, and actual resources. 4. The consumers using the park will probably be pet owners. 7,000 residents, whom own dogs, are currently registered by the town council. 5. The benefit forgone is the benefit of constructing a dog park. The gross benefit of having the park built is $125,000 per acre; so the net benefit is $625,000. The opportunity cost of not building the park is $3,625,000. Despite holding the largest sum of money, the alternate decision to not build the park leaves les s space and recreation. The majority of residents in town are registered pet owners. Leaving the land undeveloped will waste the opportunity to provide the citizens with free recreation. The only local park that exists in town is not pet-friendly. On the other hand, limiting open space eliminates the burden of management and developing infrastructure. Selling the land to real estate developers to build homes benefits the luxury develops and possible buyers. However, selling the land does nothing to help with the current repairs of the school. This decision might even upset the citizens who want a recreational park instead of a dog park. There is little space available from the natural environment. Market failures depend on the distribution of the goods. Possible market failures could stem from underinvestment and non-excludability. There are always gains and losses when a public good/service is exchanged. The possible externalities that may produce if the park is built could include noise pollution and visual pollution. The cost used to produce landscape architecture may also exceed the private cost. The town’s government could substitute some decisions for an environmentally appropriate solution. As the town council already suggested, charging a yearly fee to citizens that use the park. Littering and polluting will result in a double-fee. Lisa Mullinax, a certified professional dog trainer, fondly remembers taking her canine pal to the park for the first time. She gripped the leash and wandered into the crowd, toward the jubilant cries of a playful pup. Her giddy companion was bound up with energy; she needed to run free amongst the others. â€Å"It dramatically improved our bond,† says Mullinax, now teaching group class seminars at 4Paws University. As pointed out above, the lack of recreational dog parks is detrimental because it encourages urbanism over environmentalism. Martinsville has little space for forty new luxury townhouses. The decision to construct a recreational dog park for 7000 of the 100,000 residents implements competitive market equilibrium. With no negative or positive externalities, the consumers and producers are able to benefit from economical efficiency. Dedicating at least one park to the pet owners enables private benefit. The residents may be considered free-riders at the behest of ur banites. Comparatively, Martinsville is a flourishing town. The recent developments are highly valued and consumers are offered great public services. Even local gyms and country clubs provide recreational opportunities. With a budget surplus, the town can afford the proposal cost, as well as any externalities. However, eliminating an externality is not economically beneficial. With exclusive property rights, comes responsibility. It is a pet owner’s responsibility to ensure the park is clean and manageable. These are the private costs borne of the producers and handled by society at large. The social cost represents the total sum of production, including externalities and privacy costs. Hence, the exclusive right to pet owners in the park privately benefits them. The lack of dog parks reduces opportunity cost; whilst an increase in constructing these parks greatly influences a more holistic view of a company. Not only does the surrounding environment become included in business operations, but ecosystem services as well! Unlike the negative externalities an industrial  park may produce (pollution); dog parks are essential ly eco-friendly. The proposed location is only slightly wooded and would not require much management. The majority of the townsfolk would likely use the park for its private benefits.