Fast food vs home food Essay Example for Free

Fast food vs home food Essay This generation has many people of all ages which are becoming more obese simply because they are eating more fast food than home food. Restaurants and many other fast food places have foods that contain high in fat, sugar, and salt. Having a healthy regular diet at home will keep you away from many health problems. Also having fast food only on special occasions is fine as well. We all need food to survive, but we should learn to make wise decisions in what we eat for the sake of our health. In today’s society people are making it into a habit of getting their hands on fast foods rather that home foods. Fast food can attract people more than a home cooked meal. This is a very bad habit to make because we are showing our children that it is alright to eat fast foods. For many young teens it is hard for them to say no to an attractive menu with such low cost. America’s children are known to be obese and it is not because of the fast food industry, but because the parents are those not teaching the importance of eating the right foods. For many people fast food can be the only way that they can go on with their busy lives because they are always busy, on the go, and do not have the time to prepare a home cooked meal. Many people can just go to a drive thru after a long day of work and be able to feed their whole family in no time. Little do they know that the fast food industry is considered unhealthy and can lead to many health problems in their future. There are those, like me, who grew up in the tradition of eating home foods. Home food is much healthier than going out to eat to a fast food restaurant. It is healthier because it contains way less calories, sugars, sodium, fats, and carbohydrates. Plus when cooking your foods you are able to use good quality ingredients. Eating at home gives you options of different variety, and you are able to make the food in how you like it. In addition, when eating a home cooked meal you are able to use the freshest ingredients and not worry about bad condiments that the food may have. Even though people eat food at home, that does not mean that they are considered healthy. You always want to watch what foods you buy and the nutritional value of the product. When going to shop for groceries we have to be aware of the nutrition fact labels. This will give you a better understanding of what kind of ingredients you will be putting into your body. Other than fast foods, you have no idea what kind of ingredients that the food may contain. There is a big difference with the calorie intake of a home cooked meal than eating fast food. For example, if I were to make fries at home I would know to use a healthy kind of oil that way it will not have a ton of calories. Other than a fast food place the fries are usually fried with cheap oil that is high in calories yet very tasty so that the customer will come back for more. Eating fast food every once in a while I believe will not hurt you but too much of it can cause serious health problems. Many fast foods are known to consume the cheapest kind of ingredients, which can put many people’s health at risk. On the other hand when having a home cooked meal, you feel much better because you will enjoy your meal without thinking about the health risk. Many people love the idea of going out to eat because the food is really tasty and looks very delicious. There are many fast food restaurants that have value meals and it makes it even more affordable so people can buy. Also many people who do not like to cook would rather go to a fast food stop. Where I live there is a fast food restaurant nearly every 5 miles or to the exit of mostly every neighborhood. This makes it convenient for a lot people because it is close by. These fast food chains are known to have foods that contain high in fat and sodium which can lead to obesity. In the US 1 out of 3 people are considered obese. The fatter you get, more likely you are to be at risk in having chronic diseases such as diabetes, heart attack, and arthritis. These high levels of fat and sodium can also contribute to heart disease and can cause your blood cholesterol levels to rise and your arteries can lead to build ups of plaque. Preparing meals at home benefits in many ways. Creative cooking skills are bound to improve remarkably as you learn delightful ways to cook with flavorful and healthy ingredients. I know many people do not cook simply because they do not how. Which is a bad thing because most likely they are to go and get a fast food meal. Also when you eat more home cooked meals it can help trim the waistline of many obese people. Children who eat home food are likely those who grow up with healthy eating habits. This is beneficial because they can also learn to limit their portion size and also know how to use the different ingredients and healthy products. Parents should consider in teaching their children the importance of eating right that way they grow up with the dynamics of healthy eating. In conclusion, we know what is best for our health we should consider keeping it as a lifestyle to eat the right foods. Both fast food and home cooked food have their differences. Fast food may seem more affordable and convenient but a home cooked meal is made with much better quality. I personally believe that home food is much superior to fast foods. Eating home food will keep my mind from thinking of all the health problems. Promptly it is up to us to choose the right foods to eat. I would much rather go with home food that way I will live a long healthy life.

Analysis of Risk

Analysis of Risk The aim of this essay is to introduce the aspect of risk and some highlighting on the theories that support this aspect of risk assessment and will briefly discuss existing risk assessment schedules and at the end it will critically analyze national and local reports related to risk assessment (Faisal). Royal Society (1983) states that, risk assessment which axiom as the probability that a particular adverse event occurs and social services has been concerned predominate with risk assessment to prevent harm. They may also suffer further if they have to deal with seeing their perpetrator on a regular basis, and may be subject to further assaults in retaliation of their initial complaint. In addition to the risks to existing victims, poor responses may result in increasing numbers of people being abused. The Oxford Dictionary define risk as meaning a hazard, a dangerous, exposure to mischance or peril, as verb it also similar which means hazard, to danger, to expose to the chance of injury or loss( Parsloe, 2005). Risk is closely linked to dangerousness, resulting in harm which seems to be agreed means harm to self or others and extend of harm which constitutes a risk in various situations especially adult with learning disabilities. Every human being becomes vulnerable during their lifetime for many of reasons they all respond differently to events that happen to them because of who they are and the lack of support that they have around them (Jacki, 2001). People with learning disabilities are one of the most vulnerable groups in the society (Department of Health 2001). Learning disabilities may be more at risk not only because their own difficulties in understanding or communication but also because of the way they receive services and the fact that they may be actively targeted or taken advantages (Jean and Anthea, 1997). Increasingly responding to the risks of others, preventing risks to vulnerable adults or running risks to themselves is all in days work for the busy practitioners and manager in the field of social care (Brearley, 1982). Any criminal offence which is perceived to be motivated because of a persons disability or perceived disability, by the victim or any other person. [Association of Chief Police Officers]. According to Home Office Any incident, this constitutes a criminal offence, which is perceived by the victim or any other person as being motivated by prejudice or hate. People with learning disabilities are subject to risk all time due to their vulnerability they sometimes abused by those who have control over them or by those who realize that they are vulnerable because of their disabilities they often find it very much more difficult to assess risk the way most of social carer and services do (Vaughn and Fuchs, 2003). However, take risks because they feel vulnerable to a point approaching hopelessness (Fischhoff et al., 2000). In either case, these perceptions can prompt adults to make poor decisions that can put them at risk and leave them vulnerable to physical or psychological harm that may have a negative impact on their long-term health and viability. According to Kemshall and Pritchard (2001) states that, there has been much debate about a welfare model or a criminal justice model should be adopted. In order to fully appreciate the process of risk assessment, here identify the one of particular serous case review murder of Steven Hoskin after the recent death 39years young man who has been dead by numbers people. Adults vulnerable protection systems are likely to come under close scrutiny (Jacki, 2001). Steven Hoskin had learning disabilities and he was 39 young man who was been killed and his body was found at the base of the St Austell railway viaduct on 6th of July 2006. Two principal perpetrators, Darren Stewart (aged 29 years) and Sarah Bullock (aged 16 years), and the manslaughter conviction of Martin Pollard (aged 21 years). Steven Hoskin was 39 years old. Born to a single woman who herself had a learning disability, Stevens learning disability became apparent in his early childhood. At 12 years of age he left a local prim ary school and became a weekly boarder at Pencalenick special school, returning to his mother (on the Lanhydrock Estate, outside Bodmin) at weekends. Steven did not read. After leaving school at 16, Steven was unable to secure employment and was admitted as an inpatient to Westheath House, an NHS Assessment and Treatment unit for people with learning disabilities and mental health problems. Although he remained there for 14 months, the therapeutic purpose of his stay is unknown. While at Westheath House, Steven participated in youth training activities in the Bodmin area. This was an unhappy time for Steven as he was victimised by the other trainees.'(ref) Stevens relationship with his mother deteriorated and ultimately became characterised by conflict and violent outbursts. In September 2003, Steven was charged and convicted with common assault and he was subject to a Probation Order. An Adult Protection Plan confirmed that Stevens mother should move.(ref) Even the initial meeting of the Serious Case Review Panel confirmed there was no lack of information about Steven and his circumstances and that with better inter-agency working; Steven Hoskin would have been spared the destructive impacts of unrestrained physical, financial and emotional abuse in his own home. While this knowledge cannot change, erase or soften what happened to Steven, it was an impetus for Cornwall Adult Protection Committee and its partner agencies to analyse what went so badly wrong. As uncomfortable as this process has been, it leads to learning, i.e. our purpose has not been one of judgement but of correction and improvement (Dixon 1999). It is important that adult protection is triggered when someone is believed to be at risk of harm/abuse and not only at the point where there is demonstrable evidence of harm. In order to conform to their obligations under human rights law, agencies have to be proactive in undertaking risk assessments (e.g. Monahan et al 2001) to ensure that preventive action is taken wherever practicable. The Disability Rights Commission (2005) confirmed that the health of people with learning disabilities is likely to be worse than that of other people, (even before taking into account specific health needs or disability related barriers to accessing health care), as they are likely to live in poverty and are exceptionally socially excluded. Young People and Adults have to look out for young people. They must be alert to the possibility that the same young people may be harming those more vulnerable than themselves (ref.). Valuing People (2001) identified Independence as a key principle and helpfully confirmed that: While peoples individual needs will differ, the starting presumption should be one of independence, rather than dependence, with public services providing the support needed to maximize this. Independence in this context does not mean doing everything unaided (p23). It is essential that health and social care services review the implications of acceding to peoples choice if the latter is not to be construed as abandonment (e.g. Flynn, Keywood and Fovargue 2003). Stevens murder has confirmed that the choices of adults with learning disabilities in relation to their health care decision-making (Flynn, Keywood and Fovargue, 2003). Valuing People (2001) defines choice as follows: `Like other people, people with learning disabilities want a real say in where they live, what work they should do and who looks after them. But for too many people with learning disabilities, these are currently unattainable goals. We believe that everyone should be able to make choices. This includes people with severe and profound disabilities who, with the right help and support, can make important choices and express preferences about their day to day lives. (p24). Protecting Vulnerable Adults, Valuing People states: `People with learning disabilities are entitled to at least the same level of support and intervention from abuse and harm as other citizens. This needs to be provided in a way that respects their own choices and decisions. (p 93) The difficulty for people with learning disabilities is that carers often do feel often they are expected to make these choices for them. The law of negligence can appear to inhibit decision making personal freedom and choice sit uncomfortably next to the concepts of duty of care and professional liability (Fuchs, 2003). The police reported Stevens circumstances in the months preceding his murder as follows: `Steven Hoskin had lost all control of his own life within his home. He had no say, choice or control over who stayed or visited the flat. He had no voice or influence over what happened within the premises. Darren Stewart had recognised the clear vulnerability of Steven Hoskin and had moved in on himà ¢Ã¢â€š ¬Ã‚ ¦he recognised the opportunity for accommodation and removed from Steven Hoskin the little ability he had to make his own choices and decisions. Darren Stewart was fully aware of Stevens vulnerability and learning difficulties and took advantage of those facts to control both Steven and the premises. Margaret (2007) identifies the following factors in what went wrong for Steven: Youths use Stevens bedsit to drink and take drugs where they steal his money and assault him. Steven cancels his weekly community care assistant service. Tortured after admitting their involvement in shoplifting. Assaulted, made to wear dog collar, cigarettes stubbed out on him .Forced to falsely confess to being paedophile and to swallow 70 painkillers. Marched to top of viaduct and forced over edge falls to his death. Safeguarding adults: To be vulnerable is to be in circumstances defined by the continuous possibility of harm or threat (e.g. Flynn 2005). No Secrets makes it clear that monitoring safety is a multi agency responsibility. The key to protecting and safeguarding vulnerable adults is sharing information, so any professional who comes into contact with a vulnerable adult should be able to determine immediately if, and when, other agencies are involved and has a duty to share concerns. There were no such consequences arising from the numerous instances when Steven and Darren came to the notice of NHS services or the police. Flynn (1989) confirmed that adults with learning disabilities living in their own tenancies were vulnerable to victimisation, most particularly in localities of hard to let tenancies; that these men and woman were wary and scared of young people; and that most experienced loneliness and isolation. Departments of Adult Social Care cannot be expected to look out for all citizens with learning disabilities without the resources to do so. Fair Access to Care criteria are known to be rendering more and more vulnerable adults ineligible for ongoing support (ref) It forcibly brings the commissioners and providers of health services and the police to the foreground. They were Darrens first port of call and, perhaps under his influence, they became Stevens as well. Stevens murder presses the case for ever-greater investment in partnership working in safeguarding adults (Perkins et al., 2007). The stated primary aim of No Secrets (2007) is to create a framework for action within which all responsible agencies work together to ensure a coherent policy for the protection of vulnerable adults at risk of abuse and a consistent and effective response to any circumstances giving ground for concern or formal complaints or expressions of anxiety. The agencies primary aim should be to prevent abuse where possible but, if the preventive strategy fails, agencies should ensure that robust procedures are in place for dealing with incidents of abuse.(p.) This statement clearly indicated that No Secrets was intended to encompass both a safeguarding preventative approach, in addition to an adult protection intervention one; although we would acknowledge that the intervention role has taken precedence in reality (ref.). Risks change constantly and people grow, change, and develop. It is important to review risk assessment regularly, and aim always to increase choice and freedom for the people with learning disability (Sellars, 2003 p.155). In considering the effectiveness of No Secrets as a mechanism to provide a level of intervention that could protect adults at risk of abuse, it would seem sensible to consider what has failed to work successfully within adult protection, whether such failures were a consequence of the nature of guidance or instead insufficient/inappropriate application of that guidance, and whether such failings could only be overcome by the introduction of legislation. An obvious mechanism that could be used as part of this evaluation process would be the consideration of Serious Case Reviews relating to adults.(ref). People may make an informed choice to accept a particular risk today, but circumstances and people change. A risk considered acceptable today, may be a problem tomorrow, and statutory agencies have a consequent responsibility to regularly monitor and respond to changing circumstances. Personalisation does not mean a statutory agency has permanently discharged its duty of care on the basis of an informed decision taken at a single point in time. This was a key point of the Serious Case Review into the death of Steven Hoskin, Steven wanted friends. He did not see that the friendship he had so prized was starkly exploitative, devoid of reciprocity and instrumental in obstructing his relationships with those who would have safeguarded him.'(ref.) Disability hate crime fails to recognise the duration of Stevens contact with his persecutors; the counterfeit friendship; the background to Stevens perilous disclosures to Darren; the joyless enslavement; or the motivations of all of his persecutors. Stevens murder has profound implications for the support of vulnerable adults in our communities. It challenges the principle, or dogma, of choice for adults who are apparently able; it unstitches some certainties about communities -their capacity to look out for others, their familiarity and permanence; and it requires us to question why the ever- tightening eligibility criteria of services are rendering very vulnerable men and women so unprotected. The fact that individuals in all agencies knew that Steven was a vulnerable adult did not prevent his torture and murder (ref). This does not imply that these agencies are without merits or strengths or that they are wholly culpable, but is intended to convey their acknowledgement of their individual and collective under-performance, and what has to change in the light of the magnitude of cruelty experienced by Steven (ref). There is the role of care providers in adult protection intervention work, how they are engaged in investigations, and what role commissioning has in the overall process. And the commissioning role can be crucial, as noted by the joint investigation into the Cornwall Partnership NHS Trust, which stated, The trust has blamed the three PCTs in Cornwall for failing to commission appropriate services for people with learning disabilities and, while this does not lessen the trusts culpability, the criticism is accurate. This is the other side of the coin; we are inclined to believe that it wont happen, even when the objective statistics suggest otherwise the difficulty that now exists for people with learning disabilities, especially those with greater disability, and those who care for and support them, is that the law specifies that many such people are vulnerable, and not able to make this choice for themselves (Daniel, 2003). The onus of assessing risk and making the decision therefore often rests with carers. Because it is such a difficult decision to make for someone else, carers often take the simple way out, and avoid letting situations arise where learning-disabled people in their care have the opportunity to develop sexual relationships: if a person cannot make an informed choice then perhaps it is easier not to offer them that choice (Lindsay 2004). This is the current dilemma for those who work in community care situations. According to David J. Thompson,(2000) the issue of sexual relationships is perhaps the most difficult and complex, but this problem of balancing risk and choice is a constant one for carers and professionals, in relation to many aspects of everyday life. In the background is the ogre of the law (and/or local management), ready to jump on the unwary, should they get it wrong. No wonder, perhaps that many are cautious about enabling such choices to be made. Get higher in the information of vulnerable adults referred to them for the reason that they are at risk of physical and sexual mistreatment, in addition to financial fraud, a study has found in Social services departments have seen (Simon, 1997. So where adult with learning disabilities have more complex problems, such as behaviour problem, mental illness, or others any physical or mental disorder they will need additional care and support to cope with their everyday lives (Hawks, 1998). Sometimes these problems impose additional risks, and these do need to taken into account when assessing and managing risks for each person/adult.

Equity and PFI Strategies in the NHS

Equity and PFI Strategies in the NHS A) Equity NHS hospitals acquire some finance from the private sector and many patients use private health insurance to gain access to treatment; a two tier health care system is emerging (Browne, 2002). From the time the NHS began there has been concern about inequalities in health care. The Black report (1980) looked further at this and the Department of health report â€Å"Saving lives† (1999) rates the importance of equity highly. Equity can conflict with efficiency (Wagstaff, 1991). Sassi (2001) explains that mechanisms of achieving equity are unclear especially when there is the conflict with efficiency. Sassi (2001a) found that for cervical cancer screening, renal transplantation, and neonatal screening for sickle cell disease there was no consistency between NHS policies and equitable principles. Social class has an influence on the incidence and the survivability of many malignancies (Brown, 1997) but despite this fact in the cervical screening program the women most at risk were the least likely to get screened (National Audit Office, 1998). The monetary incentives to achieve screening targets by general practitioners did not address this problem. There are also morally related benefits such as respect for the individual and respect for autonomy that need to be considered. Although â€Å"there should be equal access to health care within the NHS based on equal need† (Davey, 1993) the advent of prescription charges and the extent of the exclusions of dental treatment and of optician services from the NHS (New, 1996) and particularly the exclusion of the bulk of infertility treatment negates this principle. Whilst the prescription charges and optical and dental charges do not, in general, mean that the patient’s need is not met (since the inherent means testing excludes those who are likely to be able to pay themselves) the fertility treatment issue is quite different. Whilst allocation by index of social deprivation or by ethnicity may be a requirement this may conflict with allocation by clinical need. The important question is whether there is equal treatment for equal need. Since those who are poorer in financial terms have the greatest health care needs in addressing the question it becomes apparent that those individuals who are poorer should have an appropriate resource allocation for health care. The system of resource allocation is slightly â€Å"pro poor† (Propper, 2001). The lowest 25% of the population economically do get 25% of the funding (the financial groups were standardised for equality of health care need). Equity in resource allocation does not however mean equity in terms of health actually achieved. The question is whether there is effectiveness of this allocation. Inequalities in health persist across social boundaries (Acheson report, 1988). Propper (2001) analysed â€Å"equal treatment for equal need† accordin g to whether those of equal clinical need but of differing financial means actually had equal treatment. The issue to address is whether there is equal access to healthcare, so this goes a step forward from just equal funding. Interestingly Propper (2001) finds little effect by age. The higher health care expenditure with increased age was generally in the last few months of life regardless of age. There is not currently a fair distribution of health care provision across multi ethnic groups (Erens, 2001). Whether affirmative action policies would assist in a more equitable distribution awaits further evaluation (Sassi, 2004). The Department of Health’s â€Å"Tackling health inequalities† (2003) places much emphasis on targeting racial groups for enhanced care. Health care targeting of ethnic minority groups with greater health care needs has begun to show some evidence of improved outcome (Arblaster, 1996). Health authority funding has tended to be overly weighted according to age distribution (Judge, 1994). Judge (1994) calls for a â€Å"unified weighted capitation system†. Coordination is a problem. Budgetary allocation may be partly determined on the previous year’s spending. Mechanisms of altering care according to need have often not assessed how this might be achieved (Majeed, 1994). Those individuals with the greatest health care needs include young children, the elderly, people living in areas of social deprivation and people from ethnic minority groups (Majeed, 1994). However it is these groups of the greatest need who have general practitioners with the greatest primary care work load (Balarajan, 1992). People from ethnic minorities and those living in areas of social deprivation have the lowest uptakes of immunisation (Baker, 11991). There is a fundamental need still for the equal need – equal access equation and despite the difficulties of trying to achieve a balance (which may be viewed over pessimistically, Doyal, 1997) it remains a worthwhile objective. References Acheson Report. Independent inquiry into inequalities in health report. 1998 Department of Health London: The stationary office. Arblaster L Lambert M Entwistle V et al 1996 A systematic review of the effectiveness of health service interventions aimed at reducing inequalities in health. J Health Serv Res Policy 1: 93-103. Baker D Klein R 1991 Explaining outputs of primary health care: population and practice factors. BMJ303:225-9. Balarajan R Yuen P Machin D 1992 Deprivation and general practitioner workload. BMJ 304:529-34. The Black report 1980 Department of Health and Social Services. Inequalities in health: the Black report. London: DHSS Brown J Harding S Bethune A et al 1997 Incidence of Health of the Nation cancers by social class. Population Trends 90: 40-47 Browne A and Young M 2002 A sick NHS: the diagnosis. The observer Special Reports Sunday April 7, 2002 Davey B, Popay, J. Dilemmas in health care. Buckingham: Open University Press, 1993:27-42. Doyle L 1997 Rationing within the NHS should be explicit: the care for BMJ 314:1114-1118 Erens B Primatesta P Prior G 2001 Health survey for England 1999: the health of minority ethnic groups. London: Stationery Office. Judge K Mays N1994 Equity in the NHS Allocating resources for health and social care in England BMJ 308:1363-6 Majeed FA N Chaturvedi N R Reading R 1994 Equity in the NHS Monitoring and promoting equity in primary and secondary care BMJ 308:1426-29 National Audit Office 1998 The performance of the NHS cervical screening programme in England. London: Stationery Office. New B 1996 The rationing agenda in the NHS BMJ 312:1593-1601 Propper C 2001 Expenditure on Health Care in the UK: A review of the issues. CMPO Working Paper Series No. 01/030 Available on http://www.bris.ac.uk/cmpo/workingpapers/wp30.pdf Accessed 1 May 2006. Sassi F Archard L Le Grand J 2001aEquity and the economic evaluation of health care. Health Technol Assess 5(3). Sassi F Carrier J Weinberg J 2004 Affirmative action: the lessons for health care BMJ328:1213-1214 Saving lives: our healthier nation 1999 Department of Health. London: Stationery Office Tackling health inequalities. A programme for action. 2003 Department of Health. London: DoH, 2003. Wagstaff A 1991 QALYs and the equity-efficiency trade-off. J Health Econ 10: 21-41 B) Private Finance Initiative (PFI) PFI is a partnership between the NHS and a private company. It is increasingly used to purchase a new hospital building. Instead of a capital payment being made revenue payments are made over a number of years. Advantages of PFI Many hospital buildings are extremely old and are clearly no longer suitable for their purpose. The buildings hamper the introduction of new technologies and new ways of working. Costs of new buildings are prohibitively high. The PFI arrangement enables a new building to go ahead where otherwise the opportunity to rebuild would not have arisen at all. PFI certainly overcomes the difficulties that would ensue from a rise in taxes to achieve new hospital builds which would be very unpopular with the public and would be difficult to provide equitably. The PFI does achieve a building with the minimal of public spending at least in the short term. The view of Government is that PFI allows money to be spent on equipment rather than buildings (Ferriman, 1999). There is an argument that PFI is only a procurement issue and other procurement processes are not without problems (McGinty, 2000). The blame laid on PFI may have occurred with alternative means of funding the building of a new hospital. Under the PFI scheme there is a clear incentive, once agreement has been reached, to commence and complete the building work. The private company has a financial interest to see completion to a satisfactory standard. The advantage here for the healthcare provider is that the scheme will complete quickly. There is an ongoing interest in the building by the building and finance companies and this may work to the benefit of the health care provider. Disadvantages of PFI The cost may increase once the building work has begun and this may lead to cost containment negotiations resulting in a decreased number of beds or result in other cutting of health care services. Smith (1999) finds where there is PFI there is an increase in the number of private beds to help to finance the project. This may arise as a choice to increase the revenue from private work as opposed to cutting the number of beds in the new build. The PFI scheme does not really take into consideration the fact that an increasing amount of health care previously provided in hospitals is now done in the community and investment is now in â€Å"services not beds† (McCloskey, 2000). A view, though not universal, (Smith, 1999) is that with PFI the planning is done in the private sector and is therefore not so readily visible. There is increasing evidence that PFI is costing more than the costs of using public money (Pollock, 1997). â€Å"Private capital is always more expensive than public capital† (Smith, 1999). The cost through PFI of construction plus financing costs is 18-60% higher than the building costs (Gaffney, 1999). This is a worrying aspect. It is likely the deficit will be met by cutting costs in the service (Gaffney, 1999). Gaffney (1999) argues comparisons prior to approval of PFI schemes use comparisons with public sector building that involve â€Å"discounting† of costs and adjustments to reflect â€Å"risk transfer† in its appraisal methodology which biases towards approval of PFI. The discounted cash flow analysis makes the PFI look better value than it actually is. Such discounting is appropriate for the private sector where it is useful to maximise profits. Its value in health care where there is not the aim to profit is therefore suspect. The level of concern about PFI has reached the level where the British Medical Association opposes the scheme and wishes the public to be informed of the anticipated long term repercussions and that there be an audit of present such schemes (Beecham, 2002). There is some evidence that PFI is now becoming less popular with private companies (O’Dowd, 2005). There is a concern that some feel that purely because the private sector is involved the procedure must be wrong. It is not the partnership with the private sector that is wrong but the lack of a credible system of achieving an appropriate balance between the financial rewards to the investor and the value for money of the health care provider. If the scales tip the way many fear they will there will be a very serious financial drain on the health service. The Government has now become concerned about the cost implications of PFI and is presently delaying further PFI plans whilst investigating the issue further (O’Dowd, 2006). References Beecham L 2002 PFI schemes should be vigorously opposed BMJ 325:66 Ferriman A 1999 Dobson defends use of the PFI for hospital building BMJ 319:275 Gaffney D, Pollock AM, Price D et al 1999PFI in the NHSis there an economic case? BMJ 319:116-9 McCloskey B Deakin M 2000 Series did not address real planning issues BMJ 320:250 McGinty F 2000 Partnership between private and NHS is not necessarily wrong BMJ 320:250 O’Dowd A 2005 Private sector is losing interest in PFI projects BMJ331:1042 O’Dowd A 2006 Three hospital PFI schemes are delayed while government looks at their cost BMJ332:196 Pollock AM Dunnigan M Gaffney D et al 1997 on behalf of the NHS Consultants Association, Radical Statistics Health Group, and the NHS Support Federation. What happens when the private sector plans hospital services for the NHS: three case studies under the private finance initiative. BMJ 1997; 314: 1266-1271 Smith R 1999 PFI: perfidious financial idiocy BMJ ;319:2-3 C) Managing Scarce Resources Clear mismatch been healthcare resources and needs leads to rationing but the actual mechanism of this is unclear. There are important differences between rationing and priority setting/resource allocation (New, 1996). The former denies a service to individuals whereas the latter concerns value judgments in providing services to groups. Rationing only concerns those treatments which are of proven benefit and is not concerned with evaluation of treatment effectiveness (Nice, 1996). There is healthcare rationing within the NHS today and this is not clear or widely acknowledged and therefore is implicit (Coast, 1997). As a result where treatment is denied to individuals the public do not realize this is due to rationing but on the occasions it finds out there is generally public dissatisfaction, sometimes culminating in litigation as with child B (Price, 1996). Arguments against rationing being explicit include the difficultly of creating such a scheme since there are no ethical rules by which to do it Klein, 1993). â€Å"There is no such thing as a correct set of priorities, or even a correct way of setting priorities (House of Commons Health Committee, 1995). Even if it could be done some consider it is unlikely to work not least because those disadvantaged may bring about dispute and disruption leading to a return to an implicit system (Mechanic, 1995). Coast (1997) sees the disutility (dissatisfaction with the poorer clinical outcome where treatment is denied) of explicit rationing as a distinct problem. With explicit rationing the public would be colluding with decision making and would feel responsibility and disutility where treatment is denied. Coast (1997) argues that in an implicit system the doctors will tend to medicalise the decisions not to treat. When there has been explicit rationing there is no evidence of improved decisio n making but reluctance to determine which treatments should be denied (Cohen, 1994; Donaldson, 1994). Arguments in favour of explicit (openly acknowledged) rationing, a view favoured by healthcare policy makers, include; openness and honesty, possibly leading to a more equitable, efficient service, in which the public can influence the rationing process democratically. Doyal (1979) favours explicit rationing and promotes â€Å"evaluat[ion of] the justice or the efficiency of the rationing process,† and considers the inability to face this is in contrast with the moral foundation of the NHS. Doyal (1979) favours rationing according to need (degree of disability) not by disease popularity, or social worth. Incorporation of uniform clinical guidelines might facilitate the process. Points to consider in a rationing process include (New, 1996); Which services are to be rationed What are the objectives of the rationing process What are the ethically acceptable criteria for rationing Who should do the rationing The Rationing Agenda Group’s function is to increase debate on rationing. This body believes rationing and public involvement in the process are essential (New, 1996). There are various methods of rationing, one includes a cost effective analysis, another involves capacity to benefit (New, 1996). Different approaches are used for different needs for instance infertility treatment may be denied entirely. In any explicit rationing process objectives need clarification and here the objectives might include (New,1996) maximising quality adjusted life years or minimising health inequalities by group or area of residence, The decision making process at national level will include formulae for allocation by geographical area and also work in response to national agendas such as Health of the Nation. At local level there will be health care commissioning incorporating decisions about which health care services to purchase for a community. The processes will be subject to pressure from groups such as; pressure groups, complaint mechanisms and statutory bodies such as community health councils and review by the national Audit Office (New, 1996). Even when a rationing criteria is agreed upon the situation remains complex. Rationing by age may be morally wrong and some would advocate its illegality (Rivin, 1999). Age is a major factor in the rationing of renal transplantation (Lewis, 1989) despite the fact that age does not have a good relationship with prognosis (Wolfe, 1999). Sassi (2001) explains the lack of equity principles in the way such decisions are made in the NHS. O’Boyle (2001) auditing rationing secondary care for excision of skin lesions and found poor patient and general practitioner satisfaction with the process and a high rate of re-referrals. The debate as to the degree of openness of the rationing process continues. The problems of rationing are inherent in the process and openness of the process exposes yet more difficult decision making. References Coast J 1997 Rationing within the NHS should be explicit; the case against BMJ 314:1118-1122 Cohen D 1994 Marginal analysis in practice: an alternative to needs assessment for contracting health care. BMJ 309:781-4. Donaldson C 1994 Commentary: possible road to efficiency in the health service. BMJ 309:784-5. Doyal L 1997 Rationing within the NHS should be explicit: the case for BMJ 1114-1118 House of Commons Health Committee 1995 Priority setting in the NHS: purchasing. London: HMSO 57. Klein R 1993 Dimensions of rationing: who should do what? BMJ 307:309-11. Lewis PA Charny M 1989 Which of two individuals do you treat when only their ages are different and you cant treat both? J Med Ethics 1989; 15: 29-32. Mechanic D 1995 Dilemmas in rationing health care services: the case for implicit rationing. BMJ 310:1655-9. New B 1996 The rationing agenda in the NHS BMJ 312:1593-1601 OBoyle Cole R P C 2001 Rationing in the NHS : An audit of outcome and acceptance of restriction criteria for minor operations BMJ323:428-429 Price D 1996 Lessons for health care rationing from the case of child B BMJ 312:167-9. Rivlin M 1999 Should age based rationing of health care be illegal? BMJ319:1379 Sassi F Le Grand J Archard L 2001 Equity versus efficiency: a dilemma for the NHS BMJ323:762-763 Wolfe R Ashby V Milford E et al 1999 Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med 341: 1725-1730

Essay --

In the time I have spent researching CPR and First Aid I have learned a lot about both procedures and have found that they go hand and hand. Even though yes both have difference. CPR is preformed on somebody who is experiencing cardiac arrest or respiratory arrest. Knowing how to perform CPR and first aid is very important. People experience cardiac arrest everyday and they are thankful for the person who responded and performed CPR to save there life. That is where First Aid comes in because First Aid is usually given by the first person to respond to someone who is in need of medical attention. Even though there is a lot of education on CPR out here in the world today, I still think people are not educated enough on the process and importance of CPR. That usually leads to people being scared to even try to learn and educate them self. I think CPR and first aid should really be a part of every work place. First Aid is not only a procedure but it also safety precaution. The world of medicine is constantly changing, so we have to educate ourself on the techniques of CPR and First Aid. These aspects are vital to everyones survival. CPR and first aid are a very important aspects in everyday life as well as in the medical field. Having knowledge and knowing how to perform CPR and First Aid can mean the difference of life or death. These two medical aspects are very serious inside the medical office and outside. As being in any medical profession you have to be certified in CPR. The reason for that is because you will be faced with emergency situations daily and knowing how to respond with the proper technique will make a huge difference in saving someone’s life. I have done ... ...to even examine the patient. First Aid is a basic skill every person should know in the medical profession. According to OSHA standards anyone in the medical field needs to be trained in First Aid, but OSHA does not actually have any standards on the performance of First Aid. In conclusion, no matter who you are you can preform these two important aspects of medical care to save someone’s life. CPR and First Aid are two both processes and take time to master, but everything pays off when you know you can save a persons life. This is the basics needed to become an affective medical assistant. My goal is to use these basic skills to provide a foundation that will help me in realizing my dreams of helping others. The MA is usually the first contact person for the patient so it would seem that they should know what they are doing in any medical situation.

Propaganda, Patriotism, and the War on Terrorism :: Argumentative Persuasive Topics

Propaganda, Patriotism, and the War on Terrorism On college campuses across the nation, efforts are being made to silence professors who encourage students to probe the history of U.S. foreign policy in the effort to understand the September 11th attacks. Recent articles in The Chronicle of Higher Education report that students have complained to deans about professors critical of U.S. foreign policy, and boards of trustees, deans, and college presidents have drafted resolutions and issued public statements condemning their views. Professors have been shouted down, received volumes of hate mail and, on some campuses, death threats. In one case, a trustee publicly invited a professor "to take a hike." Historically, such attacks on free speech have risen sharply in times of national crisis -- precisely when a full range of views is sorely needed. They are particularly disturbing on campuses of higher education that should be strongholds of people who defend independent thinking. The nature of the arguments offered against these dissenting voices are very troubling; so too their political effects. The arguments fall into two groups. First, professors are charged with showing no concern for the feeling of others: they lack taste and judgment; they are insensitive, self-indulgent and offend others at a time when emotions are raw. In being so inattentive to their students' emotional sensitivities, dissenting faculty violate the trust students place in them. Now is not the time for critique, but for emotional nurturing, reassurance and national solidarity. Second, professors are charged with offering excuses for the attacks. Their examination of the role the United States may have played in creating conditions that make terrorist acts more likely amounts to a justification of the acts themselves. There is an emotional tyranny at play here, and its effect is to obstruct processes of understanding that alone will aid us in our ongoing debate over how to come to terms with terrorism. What do I mean by tyranny? In the first instance, we are being told that feelings alone are appropriate now. It is too early, indeed, it is tasteless, to begin to sort through our role in the complex factors that brought these people to their heinous acts. But understanding is crucial to wise action, and action, as we see in each morning's news, is most certainly being undertaken in our name. While we are being asked just to feel, the administration and its congressional allies hurry to pass laws that threaten our civil liberties at home, and engage in a massive war effort likely to foster greater resentment abroad.

Cyber Crime in the 21st century Essay

Examine the key features around the growth, development and policing of cyber crime in the 21st century. The internet was first created in the 1960’s, but it only really started to take off and develop in the last 20 years with big websites such as Google (1998) and YouTube (2005). With the internet developing and people knowing more about it, cybercrime then came about and since then it has grown and gotten more dangerous and more extreme. There are several different types of cybercrime for example one is called cyber violence, this includes stalking and harassment, it can also be bullying people online via social networking sites and chat rooms. Cyber obscenity is another type of cyber crime which is sexual including porn sites. Cyber trespass is the crime of hacking sites and cyber theft is also another cybercrime which is credit card fraud as well as the illegal downloading of movies, music, books etc. Computer hackers are very intelligent, initially they started hacking sites simply because they were able to, and they wanted to explore the sites, at the start it was done just for fun. However it didn’t take long for these hackers to realise their potential and what they could actually be doing, soon it then escalated and they became more educated and more confident in hacking. These hackers could now be described as ‘attackers’. There are a few types of attacks that can be made on a computer. One is Denial of Service (DoS) attacks. This is a system set up which sends out a fake email to an individual, it could be to check their password for online banking or make credit card payments etc. It will look very genuine to service users and often many of them fall into the trap. E-Mail bomb is another type of attack that can be made, hundreds of emails are sent to a service in order to shut it down. Another attack is a Trojan Horse, these are attachments sent to people perhaps through email, they may also pop up on the screen. They are very appealing to individuals for example ‘click here for your free iPad’ or ‘you are the 999,999th visitor, click here to claim your free prize’ these are likely to open up viruses. Other types of attacks include Worms, Network Scanning and Key Loggers. Argot is a type of language used for hacking sites and known by all highly skilled hackers. There are three different types of hackers they are; Black hat hacker, white hat hacker and grey hat hacker. 1. Black hat hacker – they are dangerous and highly skilled hackers. They will make it known to people how good they are at hacking and how dangerous they are. 2. White hat hacker – they are usually employed by companies to test the security of their websites. 3. Grey hat hacker – they are very unpredictable and because of this it makes them the most dangerous of all three hackers. Many big website have been hacked such as Yahoo and Play, this is not well known because companies involved do not want the news to be publicised mostly because it would not be good for business as people may think that the website is not safe and will not use it. 22% of the top mobile applications have been hacked. Stalking only became a crime in 1997 and a criminal offence in England and Wales in 2012. Cyber stalking activities include sending repeated, unwanted messages, it could be ordering stuff on behalf of the victims, publicising the victims personal information, spreading false information about the individual and encouraging others to harass the victim. There are 2 types of stalking, direct and indirect. Direct is most common and often starts with an email. Indirect is stalking with the use of billboards and advertisements. In 1999, Ellison carried out research on Working to the Halt of Abuse Online 2000 and found that 39% of stalkers began contact with the victim via email. Only 1% of stalkers didn’t use the internet to first get in contact with the victim. Stalkers are likely to be an ex-partner, however half of all stalkers aren’t known by the victim. There were websites set up for people to stalk there ex partner online, they were called ‘Avengers Den’ and ‘Get Revenge On Your Ex’ they were designed so people could crush their ex-partners self esteem and they could fake SMS them. 87% of cyber stalking victims are young women (Working to the Halt of Abuse Online). Only 50% of cyber stalking activities are reported to the authorities. There are three groups of cyber stalkers; Simple Obsessional, these stalkers have been in a relationship with the victim, the victim has tried to call it of but the stalker refuses to accept it and becomes obsessed with the victim. Love Obsessional, these are stalkers who haven’t had a relationship with the victim but they believe that themselves and the victim have a special connection. Erotomaniac stalkers believe that the victim is deeply in love with them, it can be messages through the media that lead them to believe this. (Melroy, 1996; Mullen et al., 1999) Cybercrime violence has links with terrorism. Cyber terrorism is when an attack is made against a person or property. Cyber terrorism can even be causing a person to be fearful of being harmed. Al Qaeda which is an international terrorist organisation which began in the late 1980’s has been on the internet from the late 1990’s. These Al Qaeda sites may only be on the web for a matter of hours before they are shut down, however they are soon replaced by another one. There were an estimated 5,600 sites as of January 2008 and 900 appearing each year (Weimann 2008). Policing Cyber Crime: Cybercrime has no limits and it can be uncontrollable, there are so many crimes committed online it is hard to keep track of all them. Also it is difficult to see a pattern in cybercrimes. Cybercrime is still developing, there are more viruses every day, it is the fastest moving type of crime. This may be because many people may be committing cyber crime without knowing it, for example people may not know when they are downloading music illegally. Cyber crime is growing and growing. The internet’s characteristics make cybercrime policing very hard, especially hackers, they are so skilled and make sure they do not get caught. There are state funded public police organisations set up to help police cybercrime and put a stop to it. There are also state funded non police and non public policing organisations. ISPs are set up as well as internet users forming groups to protect themselves from cybercrime. There are specialist units in place for policing cybercrime for example Europol which is the European law enforcement agency and Interpol which is the world’s largest policing agency with 109 countries involved. They connect policing communities to make the world safer. Forensic Investigation Units, CID/ Fraud Squad, Computer crime units and child protection units are specialist units that deal with cyber crime. The aim for the future is to bring in some form of legislation that cuts down on cyber crime and also to stop cyber crime from starting in the first place. To conclude the internet has proven to be very dangerous and cyber crime is developing rapidly. People have to be extremely careful while using the internet and not fall into the hackers trap. Warren, P and Streeter, M (2005). Cyber Crime. London: Vision Paperbacks. 1-19, 19-45, 45-72.

A Comparison between Two Pre-Twentieth Century Stories Essay

I am comparing two short and gothic stories written by the same author called Edgar Allen Poe. This author writes many stories that are based on a gothic theme, he writes stories that are both short and long. The two that I am comparing are two of his short gothic stories, they are called ‘The Tell Tale Heart’, which I will refer to as ‘Tell Tale’ and ‘The Black Cat’. I found both of these short stories on the rather graphic note, and they could be made very scary if a few more things were added. They both had the gothic feel; I had also experienced this in other short stories called ‘Napoleon and the Spectre’ and ‘The Signalman’. They both had an eerie feel about them, but they used a ghost like character to predict things that are to happen in the future. That idea is not present in the ‘Tell Tale’, but it is in ‘The Black Cat’. This is because the second black cat has the white mark on its stomach in the shape of gallows, so it is in a way predicting the protagonist’s death. The beginning of both stories (‘Tell Tale’ and ‘The Black Cat’) I thought were similar because the protagonist starts by reflecting on the events that he is about to tell you about. Also the rest of both stories are written in first person. There is no evidence of the ‘Tell Tale’ being written in a certain place, but ‘The Black Cat’ was written in jail, before the man’s death. So it is like he is confessing to you about the deeds he had committed. Poe somehow makes it as thought the protagonist in both ‘The Black Cat’ and ‘Tell Tale’ is actually talking to you while you are reading the story. I think that is an extremely good way to keep people into the stories and on the edge of their seats. This is because you feel like you a really there in the same room as the killer. The protagonist starts off to seem as though he is a sane man in ‘The Black Cat’ but as you read on you begin to think that he has lost his sanity and is now a little mentally disturbed. Why the protagonist in ‘The Black Cat’ kills the cat is not known, but there is the evidence to show that he kills the cat and harms it because it loved him. This also something featured in ‘The Imp of the Perverse’. The impression of things happening due to the fact that if it is wrong to do something, you do it to get a â€Å"buzz†. There is a mischievous feel to that idea, and you could say that we have all done a bad thing just because it was bad to do it. There is the feeling that the protagonist is trying to make out to the reader that he is sane and in the ‘Tell Tale’ he actually thinks to himself that he superior to average human being. He has this impression that he has a disease that has opened his senses instead of destroying them, they gave him acute hearing and thought. The protagonist then tells you about the strong relationship that he has between his victim, whether it was a cat, a wife or an old man. Somehow he loses this love and ends up killing his companion. There is a conclusion to the killings though, you could say he killed them because they loved him and cared for him, back to ‘The Imp of the Preverse’. There was comfort and love and for this reason he just killed them. Both of the murders were carried out in a brutal way due to the fact that they were killed in a horrible way and the bodies were hidden in and under parts of a house. The body in the ‘Tell Tale’ was cut up and kept in the house like a treasure, but the body in ‘The Black Cat’ was not mutilated anymore and was not regarded as a treasure. Poe uses dashes in-between certain words, I think he has done this to try and give the impression that the protagonist is having a conversation with the reader and that he is spilling his thoughts to you. In the ‘Tell Tale’ the guilt of the murder drives the protagonist to reveal the bodies. He feels that he has done something extremely bad and in the end he is driven mad by the guilt and is eventually found out by the police while they are on a visit to the house. In ‘The Black Cat’ he was found out by his excitement of being caught, he tapped on the walls in the cellar commenting on how well the walls were built. This then had him found out by the police and he was taken to jail. However there are differences, in the ‘Tell Tale’ the murder is not spontaneous, rather it is carefully planned by the killer. Whereas in ‘The Black Cat’ the murder was not planned at all, it happen at the spur of the moment without much thought at all. Also in the ‘Tell Tale’ you automatically have evidence of there being a murder right at the start, so the tension is built up in different ways. In ‘The Black Cat’ you have no evidence at all in the beginning that there will be a murder somewhere in the story. In this story there is a point where it all starts to change, the cat has had its eyes gouged out and you start to learn that the protagonist has a slight insane way about him. Another particularly noticeable difference in the build up of tension in the ‘Tell Tale’ which is different to ‘The Black Cat’ is that Poe uses repetition throughout the story of the planning of the murder. In ‘The Black Cat’ the protagonist tells you more about his past and what is in his mind; he has a more morel voice. He also uses a more sophisticated language, which gives the impression that he is a more educated man. Overall I think that Edgar Allen Poe is a talented author due to his ability to keep the reader interested and he can write such short stories, but they can get you thinking about them for a long time.