Health care reform Essay Example | Topics and Well Written Essays - 500 words

Health care reform - Essay Example hon $350 billion per year, or 20-25 per cent of American citizens hard earned dollars away from its doctors, its hospitals as well as its patient care into the pockets of their executives, administrative employees, shareholders and politicians.1 U S medical reforms should allow all Americans (including Veterans) as well as the 40 million or so uninsured American citizens into the Medicare Health Insurance Corporation. Since almost all American physicians, Hospitals, and clinics in the Country already accept the current operations of the Medicare Insurance Company, hardly any infrastructure investments on the health care delivery end will be necessary. 2 A much required medical reform in the U S would be to allow Medicare, much like the current Veterans Administration System and every private health insurance company and government health care system around the world, to bid on medications from pharmaceutical corporations for its Medicare drug formulary. Every physician or doctor, not to mention pharmacists recognizes that the U S does not actually require a choice of a dozen needless medicines in each pharmaceutical category. For instance, American citizens require only 2-3 statins for countering the adverse affects of high cholesterol, a few types of antibiotics for common sorts of infections, two kinds of beta-blockers for hypertension / high blood pressure, and several generic types of painkillers.3 The present quality of contemporary medical records software lags at least two decades behind business software used for similar purposes. Thus, the U S government should attempt to fund as well as to challenge America’s best software corporations to finally develop standardized electronic medical records software. Up to date and fully functioning computer software for use in doctors’ offices and hospitals is required in order to increase the efficiency as well as the over all productivity levels of physician charting, billing and prescribing.4 In the

Develop and promote positive relationships Essay Example for Free

Develop and promote positive relationships Essay The importance of good working relationships in the setting. It’s very important to have a good working relationship within a setting because it reflects and promotes a positive environment, that is not only inviting for children but for the parents also. Staffs are also approachable and children will be relaxed and confident and will feel that they are able to trust you. Parents would also find it easier to form professional relationships with staff members, this helps to make separation and transitions easier for the child and parent. It also makes discussing important information about the Childs individual needs or concerns easier. Forming good relationships with other colleagues makes the setting run smoothly, information is easily passed on. The working environment is relaxed and more enjoyable. K2 Relevant legal requirements covering the way you relate to and interact with children and young people The relevant requirements covering the way we relate to and interact with children are The United Nations Convention On The Rights Of Children 1989, this legislation ensures that children are listened to, shown respect and have the right to make choices (within reason). They must be protected from discrimination and have the right to freedom of expression. The Children’s Act 1989 brings together various pieces of legislation; it covers child protection and the responsibilities a parent must adhere to, as well as ensuring that children’s welfare is of a paramount importance. K3 Relevant legal requirements and procedures covering confidentiality and the disclosure of information. The Data Protection Act 1998 requires anyone who handles personal information to comply with a number of important principles. It also gives individuals rights over their personal information. This act covers all information held on paper or computer systems and all organizations that store personal data must register with the Data Protection Commission. The eight enforceable principles that must comply with are: †¢Fairly and lawfully processed. †¢Processed for limited purposes. †¢Adequate, relevant and not excessive. †¢Accurate. †¢Not kept longer than necessary. †¢Processed in accordance with the data subjects rights. †¢Secure. †¢Not transferred to other countries without adequate protection. To comply with these principles every school processing personal data must notify under the Act. Data Protection within the school is also checked with auditors and ofsted. Any passing on of a child’s personal information to other professionals must have written consent from the parents or main carer, or the school would be in breach of the Data Protection Act. All admission details of children leaving the school are passed on to their new schools, but historical data is kept on the school’s IT Management system. This information is stored under a secure password protected application. The different types of personal data which is held in the school are: Name and address of the child. Gender. Contact details of parents/carer including emergency telephone numbers. Development records/profiles of each child. Observations including photographic evidence on each child. Medical information. Absence/attendance records. Unique pupil number. Within the school any general information such as doctor /dentist or other professional appointments should be shared between colleagues only. We also have a medical room within the main school which contains medical records and photographs of those children who have food allergies and other serious conditions such as diabetes. Again this confidential information is only accessible by members of staff. It is also essential and important when working with children not to discuss them or their family outside your setting. No information should be passed on without parental consent, unless requested by the police or social services. The only time that you are allowed to breach confidentiality is when you are safe guarding a child or in an emergency. K4 Relevant legal requirements covering the needs of disabled children and young people and those with special educational needs. Legislation and the special needs code of practice: SEN and Disability Act 2001: Providers should make reasonable adjustments to include children with SEN e. g. provide / attend training. A written SEN policy is needed. A SENCO should be identified. Education Act 1944: Children with special needs should be educated alongside their peers. The views of parents should be recognized. Children’s handicap should be diagnosed. Disability Discrimination Act 1995. Those who provide goods and services to the public must make sure that they do not discriminate against those who have a disability, including children who may have learning or physical difficulties or long term illness. Code of Practice 1994. A five stage process to assess a child’s special needs is identified. If needed a statement is written to say how those needs will be met. Code of Practice 2001. A staged system of assessment consisting of Action and Action plus is introduced to support children whose needs may not require a statement or to contribute to the process of statementing. Education Act 1989. Children with disabilities should be educated in mainstream schools wherever possible. Health, education and social services should work together to asses a child’s needs. Children’s Act 1989. Every local authority should provide services for children with special educational needs in their local area. Early identification of special needs is important. K5 The types of information that should be treated confidentially: who you can and cannot share this information with. Who should have access to any records? Head teacher, teacher, parents/carers, Ofsted, SENCO, Social services and other professionals. 2. Where should records be stored? Records are stored in secure cabinets. In a software package. These records are on the individual teacher’s laptops which are password protected and stored in a central storage room overnight. All back up discs are also stored in secure cabinets. 3. How can records be checked for accuracy? External moderators from the Local Educational Authority check the software for accuracy and EYFS profiling. Regular meetings with current examples of tracking and profiles take place between the school and the moderators. 4. Who should be allowed to carry out observations and assessments? Teacher, Key person, SENCO and assessors. 5. Who can give permission for observations and assessments to take place? Written permission forms are signed by parents/carers at the start of the academic year for all new children attending the school, this also covers photographic observations/evidence. K6 The meaning of anti-discriminatory practice and how to integrate this into your relationships with children and other adults. It is paramount that all children and families feel that the setting is welcoming, non-threatening and that they are respected and valued. These means that all practitioners should have excellent communication skills and have the ability to listen carefully, question, understand and respond in a positive manner. Developing and building a trusted two way relationship means that you will be able to support both the family and child throughout their time in your care. The school also promotes that all individual children are given equal access to the school’s curriculum, care, moral and spiritual input, sports, arts and play opportunities. This support also includes the children being healthy, safe, enjoying and achieving and; making positive contributions to the community and society. A SEN register is held in school of all children who have been identified as having special needs. Other registers record different circumstances which may affect children’s access to the curriculum such as English as an additional language, medical needs, gifted and talented. K7 How you adapt your behaviour and communication with children to meet the needs of children in your care of different ages, genders, ethnicities, needs and abilities. It is still essential with this age group of children and young people to build on good relationships; they will be experiencing many physical changes and may feel anxious about puberty. Adults need to able to listen and be sensitive to the changes they are going through. It is vital that they have positive adult relationships, with an adult who can listen carefully, are sensitive, non-judgmental and have empathy to their individual needs. Within this age group they face far more peer pressure, wanting to fit in with their peers, feeling concerned about their outward appearances, even facing issues such as sex and experimentation with alcohol and drugs. Having a good relationship away from a family member where the children or young people can feel that they can express their own views and opinions and be respected and spoken to as an equal over important issues in their lives is paramount. Therefore they still require an adult who can give them advice, reassurance, praise and encouragement and understand their needs. K8 Strategies you can adopt to help children to feel welcome and valued in the setting. I ensure that all children in my setting are given the opportunities to play with an activity of their choice and that their views and beliefs are listened to. All children must be praised and encouraged, valued and listened to. I make them feel welcome and valued by being a positive role model and by taking an interest in what they do and say. K9 What is meant by ‘appropriate’ and ‘inappropriate behaviour when interacting with children, the policies and procedures to follow and why these are important? The school’s policies and procedures all members of staff must have a full and active part to play in protecting all pupils from harm, and at all times the children’s welfare is of paramount concern. We should all be working together to provide a caring positive and stimulating environment that promotes the social, physical and moral development of all the individual children. All members of staff are expected to develop their performance portfolios and undertake annual performance management meetings to improve on their teaching standards. The importance of following the school’s policies and procedures in appropriate behaviour are that you are contributing to the overall ethos and aims of the school and safe guarding the children. Helping to promote inclusion and acceptance of all pupils and encouraging interaction with others. Appropriate behaviour helps to develop the children’s confidence, self esteem, resilience and independence giving them a feeling of being respected and valued. Inappropriate behaviour from members of staff could result in the children lacking in confidence and lowering their self esteem. The children we feel that their views and opinions are not respected or valued. The children will become less independent and it will promote bad behaviour resulting in an environment where they will not learn or feel safe. Using unprofessional behaviour when interacting with children could become a child protection issue. Therefore it is inappropriate to be too personal or give personal information to the children in your care. K10 The importance of encouraging children to make choices for themselves and strategies to support this. By encouraging children to act in this way you are helping them to develop and make them become aware of their own needs and areas of improvement. This can be done by allowing the child to try and solve problems or necessary decisions before advice is given. Options can be given to the child to help them choose a path to take K11 The importance of involving children in decision-making and strategies you can use to do this. Within the foundation stage, the overall area is split into specific activities such as role play, home corner, writing table, messy area, quiet area and the outside area. The children can make decisions on when, how and for how long they stay at an activity. With all of the activities, there will be under pinned planned learning intentions and outcomes, some of which will have adult led or adult engagement involved. By letting the children play independently and by not interfering or leading the play, the children will develop social and emotional skills and learn to play alongside others or co-operatively. It enhances their imagination and creativity, develops communication and language skills as they work through ideas and concepts, also enabling the children to take risks and make mistakes and learn through their experiences. In involving the children in decision-making it will build on their confidence and self esteem and they will feel that their views and feelings are valued. K12 How to negotiate with children according to their age and stage of development. The first step in negotiation is to ask what dont you want to do and why. Using age related language, experience of the situation, the child and or children will in general be able to come to or reach an outcome. All children need choices it is not age specific, it depends on what level they are at in their development and understanding, for the choices that you give them. For example under 3 year olds, Its tidy up time, ask them to tidy away three things, give them a choice of what three things they are going to pick up. With children 3 years of age and over they start to learn for themselves about negotiating through their play by figuring out what the rules are, who’s going to go first, sharing toys and activities. As children get older it is important for them to be involved in negotiating and decision-making as it develops their ability to become responsible, understand consequences and prevents them from feeling excluded and powerless. Giving children choices puts the responsibility and power back into their hands. Within a school there are several ways in which you can negotiate with the children, including rewards such as stickers for those children who can undress independently for PE. For example if a few children who refuse to get changed, rewarding them with a sticker encourages them to try to undress independently or with our support. Maybe reward house points for good behaviour in following our ‘rules’ or trying really hard and working at their best ability. In the outside area we time the use of the bikes, scooter and cars so that all the children have a turn. We ensure that all the children have a choice of independent or adult led activities. When negotiating we are consistent with our actions and give the children explanations and consequences and listen to their views and feelings. K13 Strategies you can use to show children that you respect their individuality Keys to good practice: Provide activities that encourage self-expression. Provide opportunities within the foundation stage in creative development for the children to express themselves in exploring different media such as painting, drawing and modelling. The children can develop their imagination and expression in songs, music and dance, imaginative play and role play. Celebrate diversity by learning about each other’s culture, religion and beliefs. Encourage the children to listen and talk to each other in our weekly show and tell activity where the children can share a special toy, achievement or a special outing with us and their peers. Provide open-ended activities that children can put their own ‘stamp’ on. Allow the children free flow play where they can make up their own rules and games by providing different areas for role play and activities. Have independent activities based around our themed topics in which the children can expand on such as ‘buildings’. The children make 3D and 2D â€Å"Three little pigs† houses which is an adult led activity. By allowing them different mediums the children independently made houses by chalking out a town in our outside area, making houses with constructions toys, junk modelling, tents, and building their own using building bricks and homemade cement. Avoid comments that single children out as being different. Ensure that we listen and talk to the children include them in choices and decision making, acknowledge their interests and abilities by respecting their backgrounds, experiences and culture. Acknowledge children’s particular strengths and talents. Ensure that you respond to the children in different ways depending on their personalities. We share achievements or talents in special assemblies where the children can show their certificates or their talents to the rest of their peers. Show interest in things that the children enjoy doing. By knowing the children really well you can encourage them to try a new way of completing an activity such as if you know a child likes painting try to persuade them to try a different medium like a collage or junk modeling to create a picture. K14 How to balance the needs of individual children with those of the group as a whole. Within the setting daily routines of which the children have to adhere to such as registration and weekly timetable to adhere to. The school’s planning process involves grouping the children together by learning ability, style, physical and social groups and the teaching resources and levels are matched and deployed to deliver different styles of teaching to these different groups. K15 The importance of clear communication with children and specific issues that may arise in bilingual and multilingual settings All communication is a two way process and it is paramount when working with children that you listen carefully, question, understand and respond in a positive manner to what is being communicated to you. This will give the children the fundamental skills to take part in family life, school, employment and social activities. Within the setting we provide opportunities for the children to development their communication and language skills by different activities: It is important to give children clear communication and sufficient time to express themselves. †¢Showing our understanding and respect. †¢Giving children confidence and self esteem. †¢Encouraging independence. †¢Children can express their feelings and views. †¢Encourages socialising skills. †¢Gives children choice. †¢Showing we understand their needs. †¢Develops their language and communication skills. Also within our setting we have several children who are bilingual and multilingual with two or more languages these children have extra weekly support from our EAL co-ordinator. With these children we also ensure that we give clear and understandable instructions and in some cases use hand gestures or picture clues to help with their understanding. K16 Why it is important for children to ask questions, offer ideas and suggestions and how you can help them do this †¢It makes them feel part of the school. †¢They can have their say. †¢Gives the children a sense of responsibility. †¢Encourages their independence and confidence. †¢They will have a sense of belonging and pride in their school. †¢The children’s views and opinions are being listened to. †¢They will look after the new area or equipment (respect it). †¢Gives the children choices. †¢Builds relationships. †¢Develops their communication and language skills †¢They feel respected and valued. †¢They will explore and experience different activities / environments. †¢Develops their knowledge and understanding of the world. I feel that this is important to include the children in decisions about their environment, activities and learning opportunities because it gives them a sense of responsibility, independence and they will feel respected and valued. We do this by ensuring that the children have time to ask questions in a relaxed and natural way throughout their school day. K17 Why it is important to listen to children? It is important to listen to children so they know that you are interested in what they say and that you care for them. You also get to learn about the child when they are talking to you, for example if you need to help them with their language development or help them in their learning. †¢The children will feel that you are not interested in them. †¢Demonstrates that you are a role model to the children. †¢It builds the children’s self esteem and confidence. †¢It builds on good relationships with the children and other adults. †¢The children feel respected and will be happy to share suggestions and decisions. †¢Develops the children’s communication and language. †¢Helps the children to learn socialising, negotiation skills and independence. †¢The children may need to disclose a safeguarding incident. †¢It shows that we understand the children’s needs. K18 How to respond to children in a way that shows you value what they have to say and the types of behaviour that could show that you do not value their ideas and feelings. All children respond well to positive reinforcement of expected behaviour boundaries. By just giving general statements such as â€Å"do not interrupt† or â€Å"well done† does not reinforce or teach good values. Also by asking open questions you can demonstrate that you are listening to the child and or children and giving them time to express their feelings, views and opinions. K19 The importance of being sensitive to communication difficulties with children and how to adapt the way you communicate to different situations. Communication difficulties with children: †¢Hearing difficulties or deaf. †¢Poor vision or blind. †¢Ill health. †¢Special educational needs. †¢Physical disability. †¢Poor language skills or English as an additional language. †¢Disruptive child. †¢Speech problems. Cultural Differences and English as an additional language 1. Smile and have friendly facial expressions. 2. Use hand gestures to gain understanding. 3. Use pictures. 4. Show warmth and encouragement. 5. Use culturally relevant learning materials. 6. Group EAL co-ordinator who shares the same home language. 7. Have some key words in their home language. 8. Use translator. 9. Always treat children with respect and as individuals. 10. Ensure that you take into account their cultural differences, their life experiences and the way they prefer to communicate. 11. Respond appropriately to their non-verbal communication. Hearing impairment 1. Ensure that you always speak clearly and listen carefully. 2. Remove all distractions. 3. Always check and ensure hearing aids are working. 4. Use written communication if age appropriate. 5. Use sign language if and when appropriate. 6. Use a trained interpreter if a high level of skill is required. 7. Explain things using short, clear sentences and draw or use pictures, as required, to illustrate what you mean. 8. Use physical objects when learning new words or concepts. 9. Ensure the child as your full attention and that you maintain eye contact. Visual impairment 1. Use methods of multi-sensory interactions such as touch, sounds and smell. 2. Use different tones of voice with lots of expression. 3. Do not rely on non-verbal communication. 4. Use environmental sounds. 5. Develop routines when interacting with the child, such as using their name and touch in a consistent manner. Have clear signals that show the beginning and the end of your exchanges. 6. When explaining an activity or object ensure all visual communication is clear and understandable. Physical and learning Disabilities 1. Use alternative and augmentative communication such as hand gestures and eye pointing. 2. Use visual aids such as communication boards or displays, photographs, drawings and symbols to represent words or activities. 3. Use chat books or photograph album containing photographs, pictures, symbols, words and messages. 4. Use speech generating devices such as communication boards or displays on a machine which speak a message when a particular button is pressed. 5. Use spelling, using an alphabet board or typing device to spell out words and messages. 6. Use formal signing or signing which is particular to an individual. 7. Use object symbols that include normally objects or small versions of objects which represent an activity, object or person. Such as a set of car keys can represent it is time to go in the car. 8. Use a multi-sensory approach when providing information and learning taking into account the five senses and present information and activities in a different way enhancing learning and involving the children by doing, touching and seeing. 9. Ensure that your surroundings are appropriate and accessible. 10. Judge correct level of understanding. 11. Respond at the correct level repeating information when necessary. 12. Be prepared to wait and listen carefully. These children can be supported by: †¢Senco. †¢Parents. †¢Children under two by the health visitor. †¢EAL co-ordinator. †¢Other professionals †¢Nurture assistant. In terms of our physical environment we have no children with visual or speech impairments or with physical disabilities within the current foundation stage. So therefore we have no need of changing our different areas to accommodate any of these children. I would ensure that we accommodated these children by ensuring that the environment was spacious and accessible, bringing activities to their level or the floor. I would also use more visual and tactile aids. K20 How you can help the children to understand the value and importance of positive relationships with others. Within our school we encourage the children to develop positive relationships with others by praising good behaviour and following our rules. We act as positive role models such as praising nice manners. I have a rule for example, that if you accidently kick a ball over the fence I will let the children retrieve it if they can ask me with lovely manners. If they don’t ask nicely I make them wait and think about what would be a polite way of asking to retrieve the ball, thus instilling positive and desired behaviour. K21 The importance of children valuing and respecting other people’s individuality and how you can encourage and support this. †¢Act as a role model showing that you respect others individuality, feelings, views, ideas and cultures. †¢Have positive images and toys, books and dolls within your setting. †¢Have activities that encourage negotiation, sharing and building on relationships. †¢Demonstrate positive behaviour. †¢Have activities which encourage the children to talk to, listen and find out about others. K22 Why it is important for children to understand and respect other people’s feelings and how you can encourage and support this. †¢Stops the children’s frustration. †¢The children will feel that their feelings are being viewed. †¢Encourages empathy and social skills. †¢Encourages and promotes positive and expected behaviour. †¢Builds relationships. †¢Develops the children’s communication and language. †¢Develops personal, social and emotional skills. †¢Develops the children’s knowledge and understanding of the world. K23 Why it is important to be consistent and fair in dealing with positive and negative behaviour. †¢Being consistent and fair the children will understand right and wrong. †¢The children will understand expected behaviour boundaries and rules. †¢The children will understand consequences. †¢The children will understand that you are not showing favouritism. †¢The children will understand what is acceptable and what is not. Within my setting we reward positive behaviour with praise and other recognition such as house points and stickers. This is done in the presence of the child’s peers to encourage and reinforce positive and desired behaviour. With negative behaviour, if safe to do so we give no attention as it is often a play by the child for your attention. However, some unsafe and disruptive behaviour must be addressed immediately in a consistent and fair manner. K24 Strategies you can use to encourage and reinforce positive behavior Children may have negative behaviour due to: 1. Lack of sleep. 2. Feeling unwell. 3. Problems at home. 4. Sibling rivalry. 5. Tension at home. 6. Some children do not know how to play with others. 7. Bored and frustrated. 8. Lack confidence in socialising with others. We acknowledge positive behaviour and give reasons behind any boundaries such as we walk in school because we might fall over and hurt ourselves or others. We are consistent and fair by rewarding praise, house points and stickers for following the rules. We control negative behaviour by reinforcing and reminding the children of our rules. K25 Strategies you can use to challenge and deal with different types of behaviour which are consistent with your organisation’s policies The school policy aims and expectations are that every member of the school community feels valued and respected and that each person is treated fairly and well. The school’s policy encourages and promotes good relationships and that we work together to help everyone learn. We also aim to help the children grow in a safe and secure environment and for them to become positive, responsible and increasingly independent members of the school community. The school’s main ethos is to reward good behaviour as it believes that this will develop an environment of kindness and co-operation. The school employs sanctions to negative behaviour which are appropriate to each individual child, taking into consideration each child’s needs and the issue. The role of members of staff are to ensure that the rules are enforced in their class, that each individual child is treated fairly and consistently, to monitor repeated incidents and to seek advice from appropriate leadership team if necessary. We also use behaviour observations to help us understand the needs of the individual child such as requiring extra support from key worker, SENCO, EAL Co-ordinator, Management or other professionals. We also use different strategies and resources such as SEAL (Social and Emotional Aspects of Learning) to help individual children with their behaviour. K27 Why it is important to encourage and support positive relationships between children and other adults in the setting and strategies you can use to do this †¢It demonstrates that you are showing respect and sensitively. †¢Promotes good and positive behaviour. †¢Act as a role model for the children. †¢Promotes good communication in a caring and clear way. †¢It promotes good manners. †¢The children feel that they are listened too and that you value what they have to say. †¢It creates a positive atmosphere and environment where the children feel welcome and valued. †¢Promotes a friendly, consistent environment where the children will feel their views are worthwhile. †¢Ensure that you always give reasons and take time to explain your thoughts and actions. The main strategies that we use in the school are we work very closely in a team in the Foundation Area; we have a consistent approach with dealing with the children’s behavioural issues. We encourage the children to interact and build on relationships with all of us by acting as role models and by reinforcing our key rules. We also spend time with all the children across both classrooms in teaching and delivering our planned activities each week including taking phonics sessions, guided reading sessions, show and tell, PE and music, key person story time and supervision of the outside area. We have effective communication across the team to enable us all to keep up to date with any issues such as medical conditions, negative behaviour incidents, records of ongoing assessments / observations, developmental progress and achievements of the children in our care. K28 Why positive relationships with other adults are important. As a practitioner it is important that you maintain and have positive relationships with all adults that you come in contact with to support and develop the children in your care to grow into secure, confident and happy people. Having collaboration and support from parents, colleagues and other professionals will enable you to develop strong relationships which will enhance and benefit the children by demonstrating positive and desired behaviour. The children will cope better with transitions from home to school, to new classroom, to new staff and or support from other professionals. K29 Why it is important to show respect for other adults’ individuality and how to do so ? It’s important to respect other

Michelangelo and The Sistine Chapel Frescos Essay -- essays research p

On the 10th of May 1508 I signed a contract to agree to fulfill Pope Julius’commission on painting the ceiling of the Sistine Chapel. I had bad feelings about thewhole thing from the day Julius commissioned me to paint instead of sculpt. I am anarchitect and sculptor not a fresco painter. It is not that I doubt my ability’s to completesuch a task, but I believe that there are other artists that would be much better suited for the job than I. It is of course an honor to be chosen to paint such a ceiling and Julius isfar to stubborn to find anyone else but myself, so I will paint and I will make it one of thegreatest fresco paintings there will ever be.(Brandes, 254).   Ã‚  Ã‚  Ã‚  Ã‚  The scaffolding that was to be used for the work was horrible. Bramante haddesigned a scaffolding that required holes in my ceiling. How was I to paint a gloriouswork of art with holes in it! The first thing I did was have his scaffolding torn apart. Ithen designed a new structure; my ingenious scaffold increased its strength with the weight that was put on it. I mounted floor boards along obliquely running columns thatwere separated my wedges of wood. Maybe Julius has chosen the right man for the job   Ã‚  Ã‚  Ã‚  Ã‚  I sent to Florence for a number of assistance to help me with the fresco’s and thetechnique since I am somewhat hazy with the technique involved. I started my work onthe cartoons for the frescos. These 12 Apostles that I am commissioned to paint are soboring I must find a way around painting them in such a dull fashion. As we started to paint the fresco’s I became very uninspired by the idea of the 12 apostles I was upset andconfused. I knew that this was not the right idea for the ceiling.(Redig De Campos, 170).   Ã‚  Ã‚  Ã‚  Ã‚  I talked with Julius today and we discussed the project. I told him that â€Å"It wasmuch to poor a thing to paint only the Apostles.† And when he asked why I repliedâ€Å"Because the Apostles, too, were poor.† He told me to paint as I please, and now I willthe only problem is I don’t quite know what is right yet.   Ã‚  Ã‚  Ã‚  Ã‚  I had a vision for the ceiling while outside daydreaming today. I will paint theCreation of Man and the Creation of the Universe, I will tie in the already existingfrescos on the walls to the ceiling frescos by painting events that preceded the two epochof Sub lege and S... ... (Brandes, 264).   Ã‚  Ã‚  Ã‚  Ã‚  I tried to keep my painting style very consistent from painting to painting on the ceiling. I was going for a watercolor effect for the whole project and I did this by avoiding some colors and using a variety of others. I avoided pure reds, blues, and whites. The whites that I used I gave a bluish, yellow, or sometimes a brown tint. I did this to avoid a pure color standing out in the whole painting and to avoid distracting the viewer. I also left out gold and instead simulated it with other variations of color. When Julius asked me why I didn’t use real gold I replied â€Å"The prophets I have painted were poor men; they had no gold.† Julius was very material and loved his jewelry andexpensive clothing, he did not understand the reality of being a poor man. (Brandes, 274).   Ã‚  Ã‚  Ã‚  Ã‚  My work on the ceiling of the Sistine Chapel is now complete and I will return to Florence to practice there. I believe that I have created something very special in this chapel. I have expressed my feelings and sent a message for all mankind to see. I owe this great piece of art to my imagination and am very pleased with the final product.

History Of Medical Tourism Health And Social Care Essay

Medical touristry is defined as patient motion from extremely developed states to less developed countries of the universe for medical attention by short-circuiting services offered in their ain communities. Medical touristry is different from the traditional theoretical account of international medical travel where patients by and large journey from less developed states to major medical centres in extremely developed states for medical intervention that is unavailable in their ain communities. While the general definition of the MT above screens most of the facets of the phenomenon, there is no international consensus yet on the name of the phenomenon. MT is frequently related to globalisation and neo-liberal health care policies which in this instance considered to sabotage the quality and measure of the services available to middle xlass in place states. Servicess typically sought by travellers include elected processs every bit good as complex specialised surgeries such as joint replacing ( knee/hip ) , cardiac surgery, dental surgery, and decorative surgeries. Persons with rare familial upsets may go to another state where intervention of these conditions is better understood. However, virtually every type of wellness attention, including psychopathology, alternate interventions, convalescent attention and even burial services are available. Over 50 states have identified medical touristry as a national industry. However, accreditation and other steps of quality vary widely across the Earth, and some finishs may go risky or even unsafe for medical tourers.HistoryThe first recorded case of medical touristry day of the months back 1000s of old ages to when Greek pilgrims traveled from all over the Mediterranean to the little district in the Saronic Gulf called Epidauria. This district was the sanctuary of the healing God Asklepios. Epidauria became the original travel finish for medical touristry. Spa towns and sanatoriums may be considered an early signifier of medical touristry. In 18th century England, for illustration, patients visited watering places because they were topographic points with purportedly health-giving mineral Waterss, handling diseases from urarthritis to liver upsets and bronchitis.DescriptionFactors that have led to the increasing popularity of medical travel include the high cost of wellness attention, long wait times for certain processs, the easiness and affordability of international travel, and betterments in both engineering and criterions of attention in many states. The turning away of waiting times is the taking factor for medical touristry from the UK, whereas in the US, the chief ground is cheaper monetary values abroad. In 2009, there were 60,000 patients traveling for intervention abroad in the UK. Many surgery processs performed in medical touristry finishs cost a fraction of the monetary value they do in the First World. For illustration a liver graft that costs $ 300,000 USD in America costs about $ 91,000 USD in Taiwan. A big draw to medical travel is convenience and velocity. States that operate public health-care systems are frequently so taxed that it can take considerable clip to acquire non-urgent medical attention. Using Canada as an illustration, an estimated 782,936 Canadians exhausted clip on medical waiting lists in 2005, waiting an norm of 9.4 hebdomads. Canada has set waiting-time benchmarks, e. g. 26 hebdomads for a hip replacing and 16 hebdomads for cataract surgery, for non-urgent medical processs. Medical tourers come from a assortment of locations including Europe, the Middle East, Japan, the United States, and Canada. Factors that drive demand for medical services abroad in First World states include: big populations, relatively high wealth, the high disbursal of wellness attention or deficiency of wellness attention options locally, and progressively high outlooks of their populations with regard to wellness attention. In First World states like the United States medical touristry has big growing chances and potentially destabilizing deductions. A prognosis by Deloitte Consulting published in August 2008 projected that medical touristry arising in the US could leap by a factor of 10 over the following decennary. An estimated 750,000 Americans went abroad for wellness attention in 2007, and the study estimated that a million and a half would seek wellness attention outside the US in 2008. The growing in medical touristry has the possible to be US wellness attention suppliers one million millions of dollars in lost gross. An authorization at the Harvard Business School late stated that â€Å" medical touristry is promoted much more to a great extent in the United Kingdom than in the United States † . Additionally, some patients in some First World states are happening that insurance either does non cover orthopaedic surgery ( such as knee/hip replacing ) or limits the pick of the installation, sawbones, or prosthetics to be used. Medical touristry for knee/hip replacings has emerged as one of the more widely accepted processs because of the lower cost and minimum troubles associated with the going to/from the surgery. Popular medical travel worldwide finishs include: Argentina, Brunei, Cuba, Colombia, Costa Rica, Hong Kong, Hungary, India, Jordan, Lithuania, Malaysia, The Philippines, Singapore, South Africa, Thailand, and late, Saudi Arabia, UAE, South Korea, Tunisia, Ukraine, and New Zealand. Popular decorative surgery travel finishs include: Argentina, Bolivia, Brazil, Colombia, Costa Rica, Cuba, Mexico, Turkey, Thailand and Ukraine. In South America, states such as Argentina, Bolivia, Brazil and Colombia lead on plastic surgery medical accomplishments trusting on their experient plastic sawboness. In Bolivia and Colombia, plastic surgery has besides become rather common. Harmonizing to the â€Å" SociedadBoliviana de CirugiaPlastica y Reconstructiva † , more than 70 % of center and upper category adult females in the state hold had some signifier of plastic surgery. Colombia besides provides advanced attention in cardiovascular and graft surgery. In Europe Belgium, Poland, Slovakia, and Ukraine are besides interrupting into the concern. South Africa is taking the term â€Å" medical touristry † really literally by advancing their â€Å" medical campaign † . A specialised subset of medical touristry is generative touristry and generative outsourcing, which is the pattern of going abroad to undergo in-vitro fertilisation, foster gestation and other aided generative engineering interventions including stop deading embryos for retro-production. However, perceptual experiences of medical touristry are non ever positive. In topographic points like the US, which has high criterions of quality, medical touristry is viewed as hazardous. In some parts of the universe, wider political issues can act upon where medical tourers will take to seek out wellness attention. Health touristry suppliers have developed as mediators to unify possible medical tourers with supplier infirmaries and other organisations. Companies are get downing to offer planetary wellness attention options that will enable North American and European patients to entree universe wellness attention at a fraction of the cost of domestic attention. Companies that focus on medical value travel typically provide nurse instance directors to help patients with pre- and post-travel medical issues. They besides help supply resources for follow-up attention upon the patient ‘s return.ProcedureThe typical procedure is as follows: the individual seeking medical intervention abroad contacts a medical touristry supplier. The supplier normally requires the patient to supply a medical study, including the nature of complaint, local physician ‘s sentiment, medical history, and diagnosing, and may bespeak extra information. Certified physicians or advisers so rede on the medical inter vention. The approximative outgo, pick of infirmaries and tourer finishs, and continuance of stay, etc. , is discussed. After subscribing consent bonds and understandings, the patient is given recommendation letters for a medical visa, to be procured from the concerned embassy. The patient travels to the finish state, where the medical touristry supplier assigns a instance executive, who takes attention of the patient ‘s adjustment, intervention and any other signifier of attention. Once the intervention is done, the patient can stay in the tourer finish or return place.International health care accreditationChief article: International health care accreditation International health care accreditation is the procedure of attesting a degree of quality for health care suppliers and plans across multiple states. International healthcare accreditation organisations certify a broad scope of healthcare plans such as infirmaries, primary attention centres, medical conveyance, and ambulatory attention services. The oldest international accrediting organic structure is Accreditation Canada, once known as the Canadian Council on Health Services Accreditation, which accredited the Bermuda Hospital Board every bit shortly as 1968. Since so, it has accredited infirmaries and wellness service organisations in ten other states. In the United States, the accreditation group Joint Commission International ( JCI ) has been inspecting and recognizing wellness attention installations and infirmaries outside of the United States since 1999. Many international infirmaries today see obtaining international accreditation as a manner to pull American patients. Joint Commission International is a relation of the Joint Commission in the United States. Both are US-style independent private sector not-for-profit organisations that develop nationally and internationally recognized processs and criterions to assist better patient attention and safety. They work with infirmaries to assist them run into Joint Commission criterions for patient attention and so recognize those infirmaries run intoing the criterions. QHA Trent Accreditation, based in the UK, is an active independent holistic accreditation strategy. The different international health care accreditation strategies vary in quality, size, cost, purpose and the accomplishment and strength of their selling. They besides vary in footings of cost to infirmaries and health care establishments doing usage of them. A prognosis by Deloitte Consulting sing medical touristry published in August 2008 noted the value of accreditation in guaranting quality of health care and specifically mentioned JCI, ISQUA and Trent. Increasingly, some infirmaries are looking towards double international accreditation, possibly holding both JCI to cover possible US patronage, QHA Trent for possible British and European patronage, and Accreditation Canada. As a consequence of competition between clinics for American medical tourers, there have been enterprises to rank infirmaries based on patient-reported prosodies. Other organisations supplying parts to quality patterns include: The United Kingdom Accreditation Forum ( UKAF ) is an constituted web of accreditation organisations with the purpose of sharing experience good pattern and new thoughts around the methodological analysis for accreditation plans, covering issues such as developing healthcare quality criterions, execution of criterions within healthcare organisations, appraisal by equal reappraisal and geographic expedition of the equal reappraisal techniques to include the enlisting, preparation, monitoring and rating of equal referees and the mechanisms for awards of commissioned position to organisations.HazardsMedical touristry carries some hazards that locally-provided medical attention does non. Some states, such as India, Malaysia, or Thailand have really different infective disease-related epidemiology to Europe and North America. Exposure to diseases without holding built up natural unsusceptibility can be a jeopardy for diminished persons, specifically with regard to GI diseases ( e.g. Hepatitis A, amebic dysentery, paratyphoid ) which could weaken advancement and expose the patient to mosquito-transmitted diseases, grippe, and TB. However, because in hapless tropical states diseases run the gamut, physicians seem to be more unfastened to the possibility of sing any infective disease, including HIV, TB, and enteric fever, while there are instances in the West where patients were systematically misdiagnosed for old ages because such diseases are perceived to be â€Å" rare † in the West. The quality of post-operative attention can besides change dramatically, depending on the infirmary and state, and may be different from US or European criterions. Besides, going long distances shortly after surgery can increase the hazard of complications. Long flights and decreased mobility associated with window seats can predispose one towards developing deep vena thrombosis and potentially a pneumonic intercalation. Other holiday activities can be debatable as good – for illustration, cicatrixs may go darker and more noticeable if they sunburn while mending. Besides, wellness installations handling medical tourers may miss an equal ailments policy to cover suitably and reasonably with ailments made by disgruntled patients. Differences in healthcare supplier criterions around the universe have been recognised by the World Health Organization, and in 2004 it launched the World Alliance for Patient Safety. This organic structure assists infirmaries and authorities around the universe in puting patient safety policy and patterns that can go peculiarly relevant when supplying medical touristry services. If there are complications, the patient may necessitate to remain in the foreign state for longer than planned or if they have returned place, will non hold easy entree for follow up attention.Legal issuesReceiving medical attention abroad may subject medical tourers to unfamiliar legal issues. The limited nature of judicial proceeding in assorted states is one ground for the lower cost of attention overseas. While some states presently showing themselves as attractive medical touristry finishs provide some signifier of legal redresss for medical malpractice, these legal avenues may be unappealing to the medical tourer. Should jobs originate, patients might non be covered by equal personal insurance or might be unable to seek compensation via malpractice cases. Hospitals and/or physicians in some states may be unable to pay the fiscal amendss awarded by a tribunal to a patient who has sued them, owing to the infirmary and/or the physician non possessing appropriate insurance screen a nd/or medical insurance.Ethical issuesThere can be major ethical issues around medical touristry. For illustration, the illegal purchase of variety meats and tissues for organ transplant had been alleged in states such as India and China [ 33 ] prior to 2007. The Declaration of Istanbul distinguishes between ethically debatable â€Å" transplant touristry † and â€Å" travel for organ transplant † . Medical touristry may raise broader ethical issues for the states in which it is promoted. For illustration in India, some argue that a â€Å" policy of ‘medical touristry for the categories and wellness missions for the multitudes ‘ will take to a deepening of the unfairnesss † already embedded in the wellness attention system. In Thailand, in 2008 it was stated that, â€Å" Doctors in Thailand have become so busy with aliens that Thai patients are holding problem acquiring attention † . Medical touristry centred on new engineerings, such as root cell interventions, is frequently criticized on evidences of fraud, blazing deficiency of scientific principle and patient safety. However, when open uping advanced engineerings, such as supplying ‘unproven ‘ therapies to patients outside of regular clinical tests, it is frequently disputing to distinguish between acceptable medical invention and unacceptable patient development.Employer-sponsored welln ess attention in the United statesSome US employers have begun researching medical travel plans as a manner to cut employee wellness attention costs. Such proposals have raised stormy arguments between employers and trade brotherhoods stand foring workers, with one brotherhood saying that it deplored the â€Å" lurid new attack † of offering employees overseas intervention in return for a portion of the company ‘s nest eggs. The brotherhoods besides raise the issues of legal liability should something travel incorrect, and possible occupation losingss in the US wellness attention industry if intervention is outsourced. Employers may offer inducements such as paying for air travel and relinquishing out-of-pocket disbursals for attention outside of the US. For illustration, in January 2008, Hannaford Bros. , a supermarket concatenation based in Maine, began paying the full medical measure for employees to go to Singapore for hip and articulatio genus replacings, including travel for the patient and comrade. Medical travel bundles can incorporate with all types of wellness insurance, including limited benefit programs, preferred supplier organisations and high deductible wellness programs. In 2000 Blue Shield of California began the United States ‘ first cross boundary line wellness program. Patients in California could go to one of the three certified infirmaries in Mexico for intervention under California Blue Shield. In 2007, a subordinate of BlueCross BlueShield of South Carolina, Companion Global Healthcare, teamed up with infirmaries in Thailand, Singapore, Turkey, Ireland, Costa Rica and India. Angstrom 2008 article in Fast Company discusses the globalisation of health care and depict how assorted participants in the US health care market have begun to research it. For centuries wellness has been one of the chief motives for travel. Traveling for a alteration of weather so as to better or to reconstruct 1s ‘ strength/health has ever existed. History hints it long back, though particular topographic points or finish for constructing wellness can be positively established since Roman epoch. The Roman Empire constructed ‘baths ‘ popularly known as ‘spas ‘ where assorted health-related services like massage, sweat room, etc. were provided to visitants. Normally, these watering places were believed to be the resting topographic point of Godhead nymph and it was believed that when a visitant used to take a dip in the holy H2O believed to hold developed symbolic relationship with them. Subsequently on, a metropolis ‘Bath ‘ in England became really celebrated as a finish for wellness tourers. This metropolis boasted of baths either built by Romans or constructed on the lines of Roman baths. In modern universe, wellness has become really cherished. Feeling and looking healthy seems to be the mantra for today ‘s fast traveling coevals. Consequently, many wellness related travel services have come up who expressions after both the physical and religious good being of the tour bundle purchaser. The customer/buyer/client/traveler has the pick of picking Tourss from assorted watering places, wellness nines, ayurvedic, yoga and religious centres. These are deriving popularity among corporate traveller who spends rather a batch of clip off from place on concern trips. In this Unit, we will foremost discourse about wellness touristry and its assorted signifiers, and will discourse about its nexus to touristry. Besides we will discourse the assorted wellness touristry merchandises, as you will larn how to design and develop a wellness touristry merchandise. Finally, we will discourse the present and future scenarios and range of wellness touristry. 104WHAT IS HEALTH TOURISM?Keeping, bettering or reconstructing wellness is one of the incentives for travel. Health touristry constitutes of those travellers who travel for their wellness and to those finishs which cater to these travellers offering them a broad assortment of services. Health travellers might be going to rejuvenate oneself at the watering place, or for keeping their expressions by going to Swiss Cosmetic Surgery Clinics or even to Rishikesh for acquiring religious upliftment for a healthy and spiritualistic life. This section consists of tourers who either travel for merely one particular wellness benefit or others who have desire for a complete bundle. For illustration, traveling to China to acquire treated of backache with stylostixis and G-Jo is the illustration of former going to Kerala forayurvedic intervention for full organic structure. Basically, at present three forms/types of wellness touristry can be identified. They are: 1 ) Change of conditions: A really common tendency among all of us is to go for a alteration of conditions. Largely, after some unwellness or mental injury, physicians prescribe a alteration of conditions, a alteration of scene. For a really long clip this pattern of going to a pleasant topographic point to recover wellness and to rebuild strength has existed. A weather/climate alteration from hot to cold/warm and frailty versa or moisture to dry and frailty versa is seen as a manner of recovering wellness. For illustration, after a turn of asthma one advised to go to a dry, preferred pollution and pollen free part. All of us have either taken such a interruption our ego or at least cognize person, who has. Possibly person among household, friends or relation have taken such a trip after much audience among household members, travel agent and besides doctor. 2 ) Availing A Specialized Service: Many wellness finishs have come up over the old ages. But 1990s have seen a existent roar in wellness touristry, particularly in India. Destination specialising in one service such as hot spring watering place or sulfur geysers or ayurvedic centres or yoga centres have come up. The finishs are now popular as specialised wellness finish. A batch many sites can be found on the cyberspace foregrounding services of such centres, like the wellness watering place around dead sea. Israel is advancing wellness touristry based on Dead Sea in a really large manner. Dead Sea is promoted/marketed as a place/destination with alone combination of salts and minerals, higher O content and curative clay which alleviates skin conditions, muscular, articular and some respiratory jobs. Many sites on the warming effects of Dead Sea are posted by travel agents, province tourer board and besides hotels such as Hyatt Regency. These sites have information on specialised intervention Sessionss for dermatological jobs, Arthritic and Arthritic conditions, Respiratory conditions and so on. Sometimes one watering place or intervention clinic provide merely one service and sometimes all the intervention installation. Similarly, watering places and wellness centres worldwide talk about the â€Å" foundation of young person † springs and hot spring geysers, particularly in New Zealand. 3 ) Boxing A Treatment Finish: The latest tendency in wellness touristry is to box a finish ideal for medical attending and intervention. Largely a peculiar metropolis or a part as a whole is promoted as a topographic point for conventional medical intervention methods. The attractive force here is the low monetary value for the same or better medical installations than at place, along with rubber-necking and going during the convalescence period. Practically, the more serious patients are noteworthy in such travel but the people or household members with them are besides able to go and at times act like tourers. Leading among such intervention travel is Cuba, particularly for the American tourists/patients. India is besides boxing itself in similar footings. Ayurvedic intervention and yoga are two approaching merchandises in this respect in the international touristry market. Thailand is seeking to agitate off its old ill-famed popularity and addition land as a tourer finish for wellness touristry. Talking about Thailand ( as a instance survey ) , it is stressing on long stay wellness attention, wherein the mark patients from developed states can stay/afford long-run intervention off from place. Normally these wellness resorts in Thailand supply medical installations for medical examinations or intervention. The resorts besides incorporate other activities such as traditional Thai massage, watering place and herb tea intervention. Speciality services, such as, dental attention may be arranged on petition and cultural Tourss are normally thrown in. Government of Thailand ordinances require the participating resorts to run into rigorous criterions of service. So far about 60 resorts have applied for reviews. In add-on, short-stay wellness attention marks include executives who would wish to take a short holiday in Thailand and have their periodic al wellness check-up or some minor wellness jobs taken attention of without waiting in long lines. The cost of wellness attention in Thailand is comparatively inexpensive. A coronary beltway at a taking Bangkok infirmary costs US $ 6500, about half the US monetary value. Annual income of Thailand from wellness touristry is estimated to be around US $ 40 million harmonizing to the functionaries at the Ministry of Commerce ( Source on Thailand: www.amn.com/issues/ oct2000/headline/healdine_main.htm ) . 4 ) Special Need Tourism: This is fundamentally a really new tendency. We can non really term it as wellness touristry since the tourers in this instance make non really come for any medical intervention or wellness related issues. But in this instance the tourers are atilt towards those finishs which can provide to the invitee ‘s particular medical demands. We can club this tourer section with wellness touristry, since wellness related factors and grounds lead the tourer to make up one's mind on a tourer finish. Hospital intervention is non merely dearly-won in Europe but even for operations i little complaints like cataract, etc circuit operators have come up with medical treatment-cum-luxury bundles and these are going progressively popular even in the domestic touristry markets.MARKET RESEARCH AND ANALYSISMarket Research and its analysis is most of import measure when any merchandise or service is to be designed to provide to a specific market section, and to happen or make a niche market. Market research besides plays a important function in planing and developing wellness touristry merchandises since as a blend of touristry and medical service it is a alone touristry merchandise. It is a really specialised service necessitating coaction between both the medical experts and the merchandise interior decorator, i.e. , touristry merchandise and finish service developer. The term ‘medical experts ‘ in wellness touristry field does non restrict itself to the MBBS qualified physicians but it is a term enveloping all the medical practicians, i.e. , medical practicians from both traditional and alternate medical specialties. The alternate medical specialty practician can be an ayurvedic advocate or may be an acupuncture specializer. A complete wellness touristry bundle will see both the potency of the alternate medical specialty and its expert along with the finish ‘s other attractive force. For illustration, the ayurvedic centres of Kerala have packaged their wellness resorts as the wellness attention and greening centres nestled in nature, God ‘s ain state. A alone and tasteful combination of wellness attention and nature has been therefore designed and marketed. Therefore, a niche market has been created and catered to which includes people willing to pay a small excess to bask nature with wellness attention or frailty a versa. Since wellness touristry merchandise is alone in itself, the market research needs to concentrate on two specific facets: 1 ) What does the wellness touristry market and tourer need/require? 2 ) Which finish or does the desired finishs have the resources needed to provide to the market demand? As explained in the earlier portion, the first facet is dealt with in every market research that is undertaken for a new merchandise or service. Let us take up these two facets in item: 1 ) Market and Tourist Need Market: Research is undertaken chiefly to understand the demands and demands of tourers set abouting these wellness touristry bundles or trips. The research helps to chiefly measure as to what facet of wellness touristry, i.e. , the merchandise or service will catch on with the going public. A market niche is looked for or created through publicity of the merchandise. One can make up one's mind to venture into the market with an bing or wholly new construct. For illustration, an already bing and a really common merchandise in demand among wellness touristry merchandises is the enticement of young person. Although non an complaint, retaining young person has ever been on the top precedence docket of rich and celebrated. We on a regular basis come across advertizements of anti-aging decorative merchandises on assorted media channels. But for the rich and celebrated, anti-ageing intervention involves intervention Sessionss in assorted anti-aging intervention clinics. Media has clip and once more linked clinics in Switzerland with the beauty and verve and young person of most of the Hollywood people and many other people from the universe ‘s who ‘s who have been attracted towards them. Therefore, this facet of wellness touristry forms a ball of the tourer reachings in Switzerland. An bing merchandise in a new finish can besides be decided upon, such as opening ayurvedic wellness clinics in Delhi and so on. A common factor for originating wellness touristry trips is greening. This is a really common incentive and ayurvedic Sessionss are really good known for these. Therefore, market research helps you to make up one's mind upon your pick of merchandise or services, i.e. , it helps you ascertain which aspect of wellness touristry you should choose for. Besides the market section can be decided upon, whether to concentrate on domestic or international tourers or both, the parts, age group, income group, etc. Therefore, the merchandise developed will be seamster made for the mark market. For illustration, market research might convey forth the fact that domestic tourers of in-between income groups are looking for a wellness Centre which will be economically feasible. Furthermore, the basic demand for wellness attention centres is to acquire rejuvenated and acquire minor complaints taken attention of. Thus, the developer and interior decorator have an thought to work on and the range of developing it as a service to fulfill this peculiar market demand. For seting together an economically feasible bundle the developer will hold to separate between the nucleus merchandise and accessory services. You will read about it in the following Section. 2 ) The 2nd facet is to look into the handiness of resources and experts for the undertaking in inquiry. Each clip a developer considers conveying about a new undertaking the resources, allow it be the land, qualified per sonnel, supply of veggies, etc. besides needs to be considered. Besides the finish has to be assessed decently in footings of handiness, proper substructure and besides the transporting capacity of finish. In add-on to the above, in instance of wellness touristry a few other factors besides need to be considered. Unlike other touristry merchandise, in the instance of wellness touristry all the resources are non from touristry sector, they are from medical fraternity. Before the finish is decided on, a checklist sing the same would be helpful.Development1. Natural Environment 2. Climate ( Warm, Low Humidity, etc. ) 3. Antique Curio Shops 4. Geysers ( Hot/Sulphur ) 5. Health Resorts ( Traditional/Alternative – Medicine ) 6. Lakes/River 7. Medical Experts 8. Entertainment 9. Beach/Pool 10. Resources for Treatment ( Herbs/Oils, etc. ) 11. Nature Walks 12. Springs ( Hot/Minerals ) 13. Treatment Practitioners 14. Adjustment 15. Subject Restaurant 16. Water Falls 17. Any Alone Feature To this checklist can be added many more points which will assist you to guarantee whether the finish that you have selected as your merchandise base is appropriate or non. Coming up with a universe category merchandise without any long term resource backup will ensue in a bad experience for all involved. This is where Market Analysis comes in. Market analysis will analyze the undertaking in inquiry from all angles get downing with the tourer demands, mark market, the finish with its transporting capacity and sustainability as a finish in footings of resource handiness. The analysis will see all the facets and aid you, the touristry merchandise interior decorator and developer, to come up with a merchandise which would turn out to be both popular and profitable. Of class, you can use the services of advisers or specializers in this respect.Planing THE HEALTH PRODUCTOnce you decide on the finish and the wellness attention service that you are traveling to offer, acquiring the right merchandise mix will guarantee that you get maximal returns on your investings in footings of money and attempts. To make up one's mind on your merchandise mix you need to see whether you would: i‚ ·iˆ be supplying specialized services. For illustration, AyurvedicCentres for bosom patient, stylostixis Centres for back jobs, etc. , i‚ ·iˆ be situated right in the bosom of town or outside the metropolis bounds. For illustration, say wellness attention Centres in the bosom of town/city for the chronic patients looking for rehabilitation and who can non travel far, and i‚ ·iˆ have a new merchandise and make a market for it or work out a niche for yourself in the bing market. For illustration, anti-ageing clinics are ever a hit. Once you decide on the merchandise or type of merchandise you want, merchandise planing comes in. Merchandise planing helps you to give the coveted form to your product/service and make up one's mind on the merchandise mix. As you have read in MTM-6 and predating Unit of measurements that the best attack to plan touristry products/services is to separate between the nucleus and the encouraging attractive forces. Core attractive force is the basic need a service supplier is seeking to supply for while back uping attractive forces are the accessory services associated with the basic demand. We will near the designing of a touristry service on the footing of the five merchandise degrees as mentioned by Philip Kotler. Let us once more consider the illustration of a wellness resort which is economically feasible. The demand was felt specifically for a wellness attention Centre supplying intervention of minor complaints and greening bundles. The product/service to be provided was decided upon as anayurvedic bundle. So the five degrees would be: LEVEL 1 CORE BENEFIT Rejuvenation Package Degree 2 GENERIC PRODUCT Ayurvedic Centre LEVEL 3 EXPECTED PRODUCT Ayurvedic intervention with herbs and oils, Qualified practitioner/expert, nutrient, adjustment Degree 4 AUGMENTED PRODUCT Various Rejuvenation Programmer ( Rasayna Chikitsa, Kayakalp Chikitsa, Sweda Karma and others ) , Qualified and Expert Practitioners, Accommodation in AC Rooms or bungalows, Multicuisine Restaurant Degree 5 POTENTIAL PRODUCT Gymnasium, Herbal Steam Bath, Medicated Pool, Mineral Bath, Herbal Garden, Indoor and Outdoor Games, A ccommodation with intervention suites and kitchen, Multi-cuisine Restaurant supplying nutrient of your pick or diet nutrient as advised by the physicians, etc. The above theoretical account shows the measure by measure procedure to plan a merchandise. Identifying a demand and so adding assorted extra attractive forces lead to the designing of a merchandise or service. Supplying the excess gives you the border over your rivals. In the modern service industry, more value add-ons are given to pull and retain clients. For illustration, one of the wellness attentions in Kerala provides a combination of services. The Centre is accessible from Cochin or Calicut airdrome and harmonizing to their web site, it is situated in the beautiful countryside of Kerala. Their merchandise design combines all the attractive forces mentioned in degree 5 along with trips to local tourer musca volitanss, elephant cantonments, etc. Besides occupant and visiting physicians provide audience and supervise interventions. ( Beginning: www.ayurveda-in.com ) . Let ‘s now consider another illustration covering with another facet of wellness touristry, viz. ‘rehabilitation ‘ . Rehabilitation is chiefly after a individual has undergone some serious unwellness, but this term is really normally used merely in context of the people who are chemically dependent. As the instance may be, the tourer in inquiry could be a post-operative patient or person retrieving from a turn of serious unwellness or accident. So, while planing the merchandise, the degrees can be: LEVEL 1 CORE BENEFIT Rehabilitation Degree 2 GENERIC PRODUCT Rehabilitation Centre LEVEL 3 EXPECTED PRODUCT Medical installations, Doctors on call, Nurses, Accommodation and Food. Degree 4 AUGMENTED PRODUCT All types of Medical Facility ( Labs, OT, latest appliances, CT Scan installations, etc. ) , both Resident Doctors and sing Experts, 24 hours Observation under specially trained and experienced nurses, different types/categories of adjustment and nutrient. Degree 5 POTENTIAL PRODUCT World Renowned Medical Consultants, Special Units for different unwellness, Reding s essions with head-shrinkers, natural beauty of the country environing the clinic, trips to local attractive forces, wellness edifice exercisings with physical therapists, etc. From the above illustration you can see that to get at the right merchandise mix, one needs to hold an in deepness cognition about the services associated with the merchandise you are be aftering to plan or sell and merely so one can make up one's mind upon the back uping attractions/ancillary services that goes with a basic or nucleus service. Geting the right merchandise mix will guarantee that you get maximal returns, the premier motivation behind running/any endeavor.Development AND POSITIONING THE HEALTH TOURISM PRODUCTOnce you have decided on your merchandise mix, it ‘s clip for you to develop it and place it in the market and eventually make a niche. Developing the product/service involves developing the substructure to prolong the tourer flow and besides the merchandise while developing a merchandise we need to see the followers ( Beginning: The Tourism Development Handbook, by Kerry Godfrey and Jackie Clarke ) : 1 ) Product Life Cycle: One needs to see all the growing facets of the merchandise. Just developing a merchandise is non the beginning and terminal of the merchandise development instead merchandise should be developed in such a mode that it sustains the tourer involvement for a long manner to come. For illustration: Take the illustration of yoga and wellness bundles in Rishikesh. So to develop the merchandise for long term, allow ‘s see the stairss that will be involved: 1st twelvemonth Yoga classes particular for novices 2nd twelvemonth Yoga categories for bring arounding specific complaints 3rd twelvemonth Yoga + Reiki 4th twelvemonth Yoga + Reiki + Ayurveda 5th twelvemonth Yoga + Reiki + Ayurveda + Spiritual upliftment negotiations and so on. We can maintain on adding characteristics to the above to prolong tourist involvement. 2 ) The Product Portfolio: This phase makes you see the assorted facets of the interrelatedness between gross produced and resources used. For illustration, sectioning the resources used harmonizing to the mark market enables you to maintain path of gross and resources. Making Ayurveda bundles to cover with specific complaint is an illustration of this. 3 ) Relevant Gaps: One can add more to the merchandise line and consequently lengthen it or intensify it. i‚ ·iˆ Lengthen – by adding more merchandises to an bing line, like spiritualty, speculation, negotiations on yoga. i‚ ·iˆ Deepen – by adding more merchandise points such as forte intervention in Ayurveda and so on 4 ) Analysis of Tourist Satisfaction: A cheque on the services provided should be maintained by judging the tourer reaction to them. A cheque on tourer reaction helps one decide on upgrading and supplying better services. Regular feedback system through questionnaire or interface with tourers can ever assist you in bettering or adding value to your services. 5 ) Development of Product Differentiation: The merchandise should be distinguishable from rivals and hold an individuality ( branding ) . This would guarantee that your merchandise stands out to the tourer. For illustration, opening an Ayurveda Centre, complete with modern wellness attention installations and the kernel of ancient baths of Romans would be more than an ayurvedic Centre and would be more of a wellness attention Centre. It is up to you as developer to separate the assorted merchandise degrees and come up with a unique sustainable merchandise so as to fulfill the identified market demands and have speedy returns on your investings. Once the merchandise is developed, you need to present the merchandise via proper promotional methods. This would guarantee that the mark market is made cognizant of the merchandise and the merchandise gets positioned consequently. Merchandise placement is about making the mark market and making a distinguishable individuality as a merchandise. For illustration, Kerala has positioned itself as Gods ain land where God blesses the conservators or medical practicians to rejuvenate the wellness of ailing enduring visitants.FUTURE TRENDS AND SCOPE OF HEALTH TOURISMA tendency that shows much range in future is the travel taken by people to hold surgeries performed in a foreign state. There are assorted grounds for this. For illustration, there is a long waiting line for operations like cataract in UK and the cost is besides high. Such operations are easy done in India and at a much lower cost. Many states including India are sing for this tourer bracket by projecting themselves as states with best medical attention installations and chances for hassle free convalescence. With the increasing figure of in-between aged and senior citizens all the touristry merchandises are targeted at these markets. An ageless merchandise for wellness touristry is the enticement of young person. This touristry wellness merchandise will ever hold takers. The tendency traveling on shows a tilt towards alternate medical intervention and for some clip to come the joust will be towards alternate intervention. An of import factor to see here is that although wellness touristry attracts tourers from universe over, for a state like India it ‘s the domestic tourers who can play a major portion in gross coevals. And, hence, merchandises developed should ever see them.Why Health Tourism in India?Health Tourism in India is a turning construct because of assorted grounds.Low cost surgeries and medical interventions such as complex Bone Marrow graft, liver graft, kidney graft, specialised cardiac/heart surgery, surgeries for hip joint replacing, knee joint replacing, dental surgery, and decorative surgeries, to advert a few. All these surgical processs are carried out by adept physicians. India has assorted state-of-the-art medical institutes and infirmaries of international criterions. Peoples all around the universe are eager to see the diverseness and integrity of India. So, when they get the advantage of medical intervention along with a double advantage of acquiring to go India, they choose India over others. Relatively the cost of surgery in India is estimated to be one-tenth of that in the United States or Western Europe, and sometimes even less. A heart-valve replacing that would be $ 200,000 or more in the US, for illustration, goes for $ 10,000 in India — and that includes round-trip airfare and a brief holiday bundle. Similarly there are other such surgical processs that cost less in India. Chennai ( once known as Madras ) , the capital metropolis of the Indian province of Tamil Nadu, has been declared India ‘s Health Capital, as it nets in 48 % of wellness tourers from abroad and 37-41 % of domestic wellness tourers.

Human Resource of Ritz Carlton Essay

Introduction In today’s economy where knowledge and skills demand are rising, it is also the responsibility of an organization’s human resource team to analyze and ensure they recruit the most appropriate candidate for the job. Organisations have been seeking, attracting and retaining the best talents available in order to overcome the competitive challenges that they are facing today. Apart from achieving the strategic goals and objectives of an organization, human resource management (HRM) also plays a part in the output of a company performance as it lays down strategic decisions, policies, as well as systems, that may affect the most important asset in the organization, its employees (Armstrong, 2008, p.5). In this assignment, it will reference to Ritz Carlton that is one of the most successful organizations that have acknowledged their human resource (employees) as the most important asset to achieve goals and objectives. The focus on human resources into recruiting, selecting and development has aided them to achieve several worldwide recognition awards such as the gold standard of hospitality (The Ritz-Carlton Hotel Company, 2011). Recruitment and Selection Hellriegel and Slocum (2007, p.161) states that Ritz Carlton knows the type of employees they are looking for in every job position, and is careful to only employ those who display the skills and behavior required to accomplish the job. Ritz Carlton has always been successful in selecting and recruiting the most suitable talents to their organisations that will fit into their cultures, values and service standard that is crucial in maintaining or even heighten the standard of Ritz Carlton. With positions that require employees to be on the front line to interact and serve guests, it is of utmost importance that an employee is able to provide the level of service required to meet or exceed the satisfaction level of the guests as failing to do so may result in negative feedback, leading to poor company performance. In the success of Ritz Carlton, its employees had played a significant role by blending into the organization’s culture, abiding by the organization’s value and philosophy, to create a unique and pleasant experience for its guests. Training & Development A well planned and structured training not only provides information and direction to accomplish specific tasks related to organizational needs and objectives, it also leads to behavioral change and improvement in job performance (Vaughn, 2005, p.2) In Ritz Carlton, be it current employees or new hires, employees are provided with an array of opportunities to learn and develop skills to facilitate and enhance employee performance. In the case of an employee in management role, training could lead him to better decision-making skills for both himself, and for the organization. For employees in the non-management positions, training could include developing the necessary skills, knowledge, the right mindset, as well as the abilities to resolve problems. Today, with the numerous awards won for its legendary services, Ritz Carlton had proven that its employees had been consistent in demonstrating the skills, knowledge, and behavior obtained via training. With their heavy focus on human resources training and development, employees are more equipped and knowledgeable in tackling problems, changes or any obstacles while performing their tasks which will lead to increased productivity which may be crucial for organizations that may need constant improvement. Employee Retention For an organization to be relying very much on its employees Ritz Carlton have not only provided a unique work environment, it has also recognized the needs to prioritize the health and well-being of its employees as a mean to retain its talented employees. By being able to retain the talented individuals in the organizations, Ritz Carlton will be able to invest their capital more efficiently as they do not need to waste time and money on new hires and re-trainings. High-turnover rate of any organisation will be disruptive and non-productive for the work environment that will might slow down or affect the growth of the organisation. Therefore, retaining the best talent within the organisation is also crucial for any organisations. Ritz Carlton is a good example as they create a very good working environment as they respect others and in return, receive the respect from others with their famous motto â€Å"We are ladies and gentlemen serving ladies and gentleman†. (The Ritz-Carlton Hotel Company, 2011). Employee Compensation Career development plans, opportunities to promote within the organization, complimentary employee meals and retirement plans are just some of the benefits offered by Ritz Carlton to motivate its employees. Apart from that, Ritz Carlton had also recognized the need to respond to the needs of its employees by getting employee feedback. By having motivated employees, Ritz Carlton had also gained a competitive edge by having more loyal and committed employees who would go the extra mile to get their job done. Conclusion Human Resource (employees) is the greatest asset to an organization as they contribute directly to the growth of an organizations. With capable and talented employees in the workforce, an organization can benefit greatly as its employees could make critical and responsible decisions that determines the progress of an organization. However, an effective and efficient human resource strategy needs to be implemented for both employees and organization to fully benefit from it. In the example of Ritz Carlton where its employees are its greatest asset, its human resource department has taken further measurements by analyzing and identifying the requirements of an individual who can perform the job. With the right attitude and beliefs, its employees are given a wide array of opportunities to learn and develop skills via training which would lead to increased productivity and efficiency. In an attempt to retain its top talents, Ritz Carlton had also been successful in providing attractive benefits, as well as a distinctive work environment, so as to keep its employees motivated, loyal and committed. To conclude, Ritz Carlton had been remarkably successful in its strategy of using its employees as its greatest asset to achieve its goals and objectives. References A. Noe et al.(2010): Human Resource Management: Gaining a Competitive Advantage(7th Edition) . New York: McGraw-Hill D.Hellriegel and W.Slocum (2007): Organizational Behavior (11th Edition) . USA: Thomson South-Western H.Vaughn (2005): The Professional Trainer: A Comprehensive Guide to Planning, Delivering, and Evaluating Training Programs(2nd Edition) . San Francisco: Berrett-Koehler Publishers M. Armstrong (2008): Strategic Human Resource Management: A Guide to Action(4th Edition) . US: Kogan Page Publishers The Ritz-Carlton Hotel Company,2011. About Us.[Online]. Available at: http://corporate.ritzcarlton.com/en/About/Default.htm. [Accessed 16 November 2011] The Ritz-Carlton Hotel Company,2011. Learn and Develop.[Online]. Available at: http://corporate.ritzcarlton.com/en/Careers/YourCareer/LearningAndDevelopment.htm. [Accessed 16 November 2011] The Ritz-Carlton Hotel Company, 2011. Gold Standards. [Online]. Available at: http://corporate.ritzcarlton.com/en/About/GoldStandards.htm#promise. [Accessed 16 November 2011] Bibliography H. Koontz and H.Weihrich(2008): Essentials of Management: An International Perspective(7th Edition) . New Delhi: Tata McGraw-Hill

Annual Salaries of Top US Government Officials

Annual Salaries of Top US Government Officials Traditionally, government service has embodied a spirit of serving the American people with a degree of volunteerism. Indeed, the salaries these top government officials tend to be lower than those for private-sector executives in similar positions. For example, the $400,000 annual salary of the president of the United States reflects a great degree of â€Å"volunteerism† compared to the nearly $14 million average salary of corporate CEOs. Executive Branch President of the United States 2019: $400,0002000: $200,000 The presidents salary was increased from $200,000 to $400,000 in 2001. The presidents current salary of $400,000 has an additional $50,000 expense allowance. As commander in chief of the world’s most modern and expensive military, the president is considered the most powerful political figure in the world. Having control of a number of nuclear weapons second only to that of Russia, the president is also responsible for the health of the world’s largest economy and the development and application of U.S. domestic and foreign policy.   The salary of the president of the United States is set by Congress, and as required by Article II, Section 1 of the United States Constitution, may not be changed during the president’s term in office. There is no mechanism to automatically adjust the presidents salary; Congress must pass legislation authorizing it. Since legislation enacted in 1949, the president also gets a non-taxable $50,000 annual expense account for official purposes. Since enactment of the Former Presidents Act of 1958, former presidents have received a lifetime annual pension and other benefits including staff and office allowances, travel expenses, Secret Service protection and more. Can Presidents Refuse the Salary? America’s Founding Fathers never intended for presidents to become wealthy as a result of their service. Indeed, the first presidential salary of $25,000 was a compromise solution reached with delegates to the Constitutional Convention who argued that the president should not be paid or compensated in any way. Over the years, however, some presidents who were independently wealthy when elected have chosen to reject their salaries. When he took office in 2017, 45th President Donald Trump joined first President George Washington in vowing not to accept the presidential salary. However, neither of them could actually do that. Article II of the Constitution- through its use of the word â€Å"shall†- requires that the president must be paid: The President shall, at stated times, receive for his services, a compensation, which shall neither be increased nor diminished during the period for which he shall have been elected, and he shall not receive within that period any other emolument from the United States, or any of them. In 1789, Congress decided that the president did not get to choose whether to accept the salary. As an alternative, President Trump agreed to keep $1 of his salary. Since then, he has carried through on his promise by donating his $100,000 quarterly salary payments to various federal agencies, including the National Parks Service and Department of Education. Prior to Trump’s gesture, Presidents John F. Kennedy and Herbert Hoover donated their salaries to various charities and social causes. Vice President of the United States 2019: $235,1002000: $181,400 The vice presidents salary is decided separately from that of the president. Unlike the president, the vice president gets the automatic cost of living adjustment given to other federal employees as set annually by Congress. The vice president gets the same retirement benefits as those paid to other federal employees under the Federal Employees Retirement System (FERS). Cabinet Secretaries 2019: $210,7002010: $199,700 The salaries of the secretaries of the 15 federal departments that comprise the  President’s Cabinet  are set annually by the Office of Personnel Management (OPM) and Congress. The cabinet secretaries- as well as the White House chief of staff, Environmental Protection Agency’s administrator, the director of the Office of Management and Budget, the U.N. ambassador and the U.S. trade representative- are all paid the same base salary. As of fiscal year 2019, all of these officials were paid $210,700 per year.   Legislative Branch - US Congress Rank-and-File Senators and Representatives 2019: $174,0002000: $141,300 Speaker of the House 2019: $223,5002000: $181,400 House and Senate Majority and Minority Leaders 2019: $193,4002000: $156,900 For purposes of compensation, the 435 members of Congress–Senators and Representatives–are treated like other federal employees and are paid according to the Executive and Senior Executive pay schedules administered by the U.S. Office of Personnel Management (OPM). The OPM pay schedules for all federal employees are set annually by Congress. Since 2009, Congress has voted not to accept the annual automatic cost of living raise paid to federal employees. Even if Congress as a whole were to decide to accept the annual raise, individual members are free to turn it down. Many myths surround the retirement benefits of Congress. However, just like other federal employees, members of Congress elected since 1984 are covered by the Federal Employees Retirement System. Those elected prior to 1984 are covered by terms of the Civil Service Retirement System (CSRS). Judicial Branch Chief Justice of the United States 2019: $267,0002000: $181,400 Associate Justices of the Supreme Court 2019: $255,3002000: $173,600   District Judges 2019 $210,900 Circuit Judges 2019 $223,700 Like the members of Congress, federal judges–including Supreme Court justices–are paid according to the OPM’s Executive and Senior Executive pay schedules. In addition, federal judges get the same annual cost of living adjustment given to other federal employees. Under Article III of the Constitution, the compensation of the Supreme Court justices â€Å"shall not be diminished during their continuance in office.† However, the salaries of lower federal judges may be adjusted without direct constitutional constraints. The retirement benefits of Supreme Court justices are indeed â€Å"supreme.† Retired justices are entitled to a lifetime pension equal to their highest full salary. In order to qualify for a full pension, retiring justices must have served for a minimum of 10 years provided the sum of the justices age and years of Supreme Court service totals 80.

Running Errands and Doing Chores

Running Errands and Doing Chores Running Errands and Doing Chores Running Errands and Doing Chores By Maeve Maddox An English teacher from the Philippines wants to know the difference between errands and chores. The word errand is most commonly used in the sense of a short journey taken to perform some necessary duty. Some examples of errands are: taking or fetching clothes from the cleaners; taking mail to the post office; filling the car with fuel, taking sacks of leaves to the compost center, etc. The word errand comes from Old English à ¦rende message, mission. The message was usually carried by a servant or low-ranking soldier. Errand still has the connotation of something of minor importance that can be carried out by anyone. An employee might complain of being an errand boy if all hes allowed to do is unimportant work. The expression to go on a fools errand means to set out to accomplish something that turns out to be impossible to accomplish. Similar to going on fools errand is going on a wild goose chase. A chore can be simply a necessary domestic task such as vacuuming or taking out the garbage, or it can be used in the sense of a really tiresome, time-consuming task. Here are some examples from the internet of the two meanings of chore. Chore as household responsibilities Lets face it sometimes, doing your chores can be a drag! Doing household chores does not have to be boring or a waste of time. If you dont have time to go to the gym and workout or stay at home and lift weights, you can combine muscle building with doing household chores. There are many ways to save time doing your daily chores. You can make life easier by staying ahead on things instead of procrastinating. Daily chores include laundry, dishes, sweep, vacuum and mopping. Even washing up your sinks in your kitchen and bathrooms. Chore as an onerous task That sure was a chore trying over and over to get you all the actual link. Washing my toddlers hair was a choremoving around causing shampoo and water in eyes and earswhich drove her crazy. Combined with more explosions than the bombing of Iraq with Michael Bays patented swooping camera shots, the film was a chore to watch from beginning to end. Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Vocabulary category, check our popular posts, or choose a related post below:How to Format a UK Business LetterDisappointed + PrepositionWhen to use "an"