The Current Status of Health Care Reform :: Health Care Reform, Health Care, Healthcare, USA,

Health Care Reform is a concern for people that have health insurance, for those that can’t afford health insurance and the price of healthcare for all of us. There are the difference views on Health Care Reform: The healthcare view, the public opinion and The House and the Senate. The Center for Medicare and Medicaid will withhold 2% of base payments that would serve as incentive payments to hospital based on their total performance score derived from separate domains. The current domains include process measure, outcome and patient satisfaction. The Senate bill also requires a comprehensive review of the hospital wage index. Our cost problems, affect not only the federal budge deficit, but also individual American businesses and household. Only be aligning payment models across public and private systems will we both address federal spending and make the health care system more affordable for all Americans† (The New England Journal of Medicine) Both House and Senate versions identify â€Å"excess payments† based on performance of risk-adjusted re-admissions rates for AMI, Heart Failure and Pneumonia. The Center for Medicaid and Medicare would recoup excess payments by discounting future payments with cuts capped at a certain percentage of total payments. In effort to go beyond â€Å"fixing† fee-for service payments, the proposed legislation includes alternative models include bundled payments to cover the range of services related to a defined medical condition: global fees to cover the entire cost of care (regardless of the setting) over an extended period for a person with a condition such as cancer; extra payments for patient-center primary care delivered through medical home; and the rewarding of Accountable Care Organizations for achieving the desired performance in caring for a defined population over the course of the year. (Medicare Payment Advisory Commission. Reforming the delivery system. Report t o Congress) (Fisher ES) For providing episode of care for services provided three days prior to the admission, during the admission and 30 days after discharge. The service would include acute care, physician services provided inside and outside the hospital, outpatient services, post acute care services, including home health, inpatient rehabilitation, long term care hospital and others. Participating organization would required to submit data and specific measure, including measure of functional improvement, rates of avoidable hospitalization, incidence of hospital acquired infections and efficiency. An independent evaluation would review the extent to which the a pilot the selected quality of measures, improved health outcomes, improved beneficiary access to care and reduced Medicare spending.

Plan on Sexual Selection Essay

In evolutionary terms natural selection is the process by which certain characteristics and behaviours get passed on in the gene pool because they give the individual a better chance of surviving and reproducing. Sexual selection is the process within natural selection where by any characteristic or behaviour that increases the reproductive success of an individual are selected and these characteristics may get exaggerated over evolutionary time. Because of the differences in parental investment between males and females, evolutionary psychologists suggest this has created gender specific reproductive behaviour – that is in terms of mating preferences and strategies, and in terms of mating systems (to remain monogamous or is promiscuity best? ) Because females have to invest a lot of time in having and bringing up offspring, and because the number of offspring they can have in a life time is limited, Darwin suggests this has lead to females being choosy about who they â€Å"mate† and settle down with. Females will be looking for good genetic qualities in a male and qualities that indicate that he could provide for her and their offspring. This in turn has created competition between males. They have to convince females they would be the best to mate with. Males will also be concerned with looking for females with qualities that suggest fertility (youth and good health – synonymous with physical attractiveness. Sexual selection may also lead to differences in mating systems. A female may be best in a monogamous relationship which will ensure the male stays and provides for the family. However for a male a polygamy may be better where he mates with as many females as possible thus ensuring quantity in offspring increasing the likelihood of some of them surviving. Cross cultural studies provide good evidence for evolutionary theory because if we see the same behaviour across culture we can deduce that this behaviour may be a result of genes (evolution) rather than socialisation. Buss, 1989 studied 37 cultures and found that females valued qualities that suggested the financial potential of males – for example ambition and industriousness. On the other hand men valued physical attractiveness and women who were younger than them more than women did. This suggests that they were looking for qualities associated with fertility in line with evolutionary predictions. This was a large scale study with over 10,000 participants which gives it credibility, however it is possible that participants gave the socially desirable answer in terms of what they were looking for in a partner. Other studies have supported Buss. For example Waynforth and Dunbar (1995) analysed the content of lonely hearts columns and found that 43% of males sought a youthful mate compared to 25% of females (the younger the female the more fertile). They also found that 44% of males sought a physically attractive partner compared to 22% of females. Finally they found that women â€Å"advertise† their physical attractiveness and men advertise their resources. The advantage of this study is that the people writing the adverts would not have been influenced by any investigator effects, however this is a biased sample as only a small proportion of the populations would seek to find partners in this way. There is much evidence to suggest that males are more likely to engage in casual sex and engage in polygamous relationships (thus spreading their genes around). For example Clark and Hatfield (1989 and 1990) found that when propositioned by a total stranger 50% of both men and women agreed to go out on a date with the stranger, however none of the females agreed to have sex with a stranger whereas a staggering 75% of males agreed. The study was carried out on a university campus and the participants were students so are hardly representative of the general population. The ethics of this study were also questionable as it involved deception and lack of informed consent and could also have affected the psychological well being of the participants in terms of later guilty feelings. Comparative studies of testicle size in primates by Baker and Bellis, 1995, also suggest that humans may have evolved under a polygamous mating system. Males have medium sized testicles relative to body size compared to chimpanzees. Chimps live in a promiscuous mating system thus females mate with many males so the male chimp has to have large testes to produce lots of sperm in order to compete. Gorillas are monogamous and have relatively small testes. The medium sized human testes suggest that the norm for our human ancestors was to be mildly competitive so females may have had multiple partners. It could be argued that a woman’s best strategy may be to be mildly promiscuous and mate with the man with the best genes but remain with the man who can care and provide. This is supported by Baker and Bellis, 1995, who suggested the world wide rate for misattributed fatherhood was 9%. Although the studies above lend support to evolutionary theory we must be careful in assuming that human mate choice is just a product of our evolutionary past. Our choices will also be affected by our upbringing , religion and our culture and these may change from generation to generation. Some of the findings of studies can also be explained in terms of culture and society. For example in the past women have had to rely on men to provide for them given the inequality in earning power etc. In today’s modern times we may see changes in what women are looking for in a mate. Bereczkei et al (1997) found that females now advertised for men who are family-orientated suggesting they are less concerned about resources. In this way evolutionary theory can be accused of being reductionist in trying to explain reproductive behaviour in terms of gene survival and ignoring social, cultural and moral influences on our reproductive behaviour. Evolutionary theory is also highly deterministic, which is dangerous as we forget that humans have the ability to think about their actions. Biologist Richard Dawkins believes we can override biology with freewill. For example evolutionary theory predicted that men who cannot attract a mate would resort to rape. While this does happen, the majority of single men would not entertain this idea. Finally much of the evidence for evolutionary theory is based on presumed knowledge about past human environments leading to speculations about which behaviours may have been adaptive. As such evolutionary theory is very difficult to test experimentally.

Pets in the Classroom

If youre thinking about getting a classroom pet its important to know a few things first. While research has shown that classroom pets can be stimulating and help to enrich a students experience, you must know which animals are the best to get, and which are not. Classroom pets can be a lot of work, and if you would like to teach your students some responsibility, then they can be a great addition to your classroom. Here are a few quick tips to help you decide which pet is good for your classroom. Amphibians   Frogs and salamanders make great classroom pets because students rarely (if ever) have allergies to them and can be left unattended for days at a time. Frogs have been a staple in many classrooms, a popular frog that most teachers like to get is the African Clawed frog. This frog only needs to be fed two to three times per week, so it is a very convenient pet to have. The only concern with amphibians is the risk of salmonella. You would need to encourage frequent hand washing before and after touching these types of animals. Fish Like Amphibians, fish can be a popular classroom pet because students are not allergic to them nor do they have any bad order to them. They can also be left unattended for days at a time. The maintenance is low, all you really have to do is clean the tank about once a week, and students can easily feed the fish with little supervision. Betta and Goldfish are the most popular in classrooms. Hermit Crabs   Hermit crabs have been popular in science classrooms for some time now. What people don’t realize is they can be a lot of work, die easily and not to mention they smell really bad. Other than that, students seem to really love them, and they can make a great addition to your science curriculum. Reptiles   Turtles are another popular choice for a classroom pet. They are another good choice because they can be picked up easily and are pretty low maintenance. Snakes like the garter and corn are popular as well as ball pythons. Good hygiene is recommended in caring for reptiles  because they may carry salmonella. Other Animals   Pets such as guinea pigs, hamsters, rats, gerbils, rabbits, and mice may harbor viruses and children may be allergic to them so make sure before choosing your pet that you find out what allergies your students have. If students do in fact have allergies then you may need to stay away from any â€Å"furry† pets because of this risk. Try and stick to the animals listed above if you want low maintenance and have allergies in your classroom. Before you decide upon purchasing your classroom pet, take a moment to think about who will take care of this animal on the weekends or on the holidays when you are gone. You should also think about where you would put the pet in your classroom, that would not cause a distraction to your students. If you are still set on getting a classroom pet then please consider getting a grant from Petsintheclassroom.org or Petsmart.com. Pet Smart allows teachers to submit one application per school year to receive a hamster, guinea pig or snake. These grants are used to support the teaching of children on how to bond and care about pets responsibility.