Persuasive synthesis Essay Example | Topics and Well Written Essays - 1250 words - 1

Persuasive synthesis - Essay Example They are treated as interesting subjects for study and they are not considered human beings anymore, but rather subjects for research. According to the guidelines set by Papadimos and his colleagues, patient care in the movie, â€Å"Wit† (2001), was partially effectively given because Dr. Kelekian discussed the treatment with the patient and was frank with her about the possible results of the extremely aggressive treatment that was presented. However, the doctors did not discuss with the patient her end-of-life plan. Although with Vivian Bearing’s wit, she was able to read between the lines and understand that the treatment was not working because the cancer cells were just spreading in other parts of the patient’s body, the doctors did not directly discuss things with her. Moreover, it took the courage of a nurse to consult with the patient about the issue of the patient’s dying for her to think about what she would choose the doctors to do in case her h eart stops. Since Dr. Kelekian and his partner were very interested in studying the patient’s case, one cannot help but question their interest in not discussing the patient’s end-of-life plan. Moreover, the doctors failed to recognize dying symptoms such as extreme agony. In one of the doctor’s visit to the patient’s room who was obviously in torment, the physician asked Ms. Bearing if she was in pain and the patient found it ridiculous. Nevertheless, the nurse observed such flaws of the doctors and did her best to provide the patient with the care that she deserved as a human being. Byrne claims that metaphors are also used not only in literature but also in understanding what patients go through. Since not all people go through the same circumstances, not everyone would be able to understand what patients would be going through. However, with the use of metaphors, one could perhaps have a glimpse of the agonies of sicknesses and therefore understand wh at the patient longs for. Henceforth, the caregiver could effectively provide the necessary care and understanding to the patient. On the other hand, metaphor can also be used by doctors to explain the jargons of the medical world to the patient. In the aforementioned movie, Dr. Jason easily used metaphors to explain Ms. Bearing’s health conditions to her and being a literary scholar, the patient was quick to understand the explanation. As a result, there was a point wherein the doctor and the patient had an intellectual sharing about their own professions which gave Bearing new perspectives. Pope Benedict in his speech in 2007 stressed that more palliative care centers are needed to â€Å"provide integral care, offering the sick the human assistance and spiritual accompaniment they need†. Indeed, hospitals should not be just a place where patients are admitted and studied like animals. Rather, they should be treated with all their dignity intact despite the possibilit ies of recovering or dying. In the movie, doctors were careless about the rights of the patient to be treated well because she was not give the care and spiritual assistance a human being needs. This made the patient look back to the times when she was strong and full of health. Like the doctors, she lacked sensitivity to human needs. She was disciplined in her manners and demanded the same from her students. She regretted how she treated other people and wished she would have been a little kinder to them. Eventually, this helped

An Overview of Delta Dental Insurance Essay Example for Free

An Overview of Delta Dental Insurance Essay Abstract This paper provides an overview of Delta Dental one of the most successful health care companies in the United States. As good oral health becomes more essential of Americans’ healthy lifestyle, Delta Dental insurance plans help more than 59.5 million people to be covered on their plans. By describing the outline of Delta Dental’s history and current structure, this article focuses on how Delta Dental insurance has grown and improved access and overall health status. Also, this paper explores strengths and weaknesses (especially with healthcare delivery point of view) as well as makes comparison with other dental insurances companies to reveal that why Delta Dental is better and more successful than others. Finally, the future plans of Delta Dental about how to improve oral care delivery of services to clients and enrollees, as well as how it fared compare to its peer insurance companies are initialed at the end of the paper. Keywords: dental benefits programs, strengths and weaknesses, multiple types, expanding, effective benefits Introduction: Many people in the world may have best access to oral health care, yet millions are unable to get basic dental care. Poor oral hygiene has significant impact on overall personal health. Researches show that poor oral hygiene increases the risk of diabetes, heart disease and poor birth outcome. That’s why nobody can deny the importance of oral health care. According to many statistics insurance companies that play a pivotal role in improving oral health care of the communities, we will focus on the Delta Dental insurance and how growth of the company improved access and overall health status. Delta Dental insurance was established in 1966. Over the years it faces many challenges to expand and increase access of dental care in community. The efforts paid the Delta Dental as widely accepted by community. This paper focuses on challenges Delta Dental had to face to build its pillar in the market. After evolution, Delta Dental insurance exponentially expanded due to its benefits and low primer. Over the years it has made strategies so that many people prefer Delta Dental over other insurances for maximum benefits, which helped improve oral health care. This paper will also highlight some of those strategies. Compare to other dental insurance company, Delta Dental insurance provide wide coverage and offer maximum benefits. This is a unique characteristic of the Delta Dental. We will talk about current structure of the Delta Dental and its future about how to improve oral care delivery of services to clients and enrollees, as well as how it fared compare to its peer insurance companies. Finally, the paper will mention about the future plan of the Delta Dental. History: In order to increase access to oral health care, in 1954, a group of dentists formed a dental service corporation in California, Oregon and Washington. It was lead by Washington Dental Service (WDS), and initiated by providing service to organized labor unions. Later, it expanded its services to all 50 states, the District of Columbia and Puerto Rico. Delta dental is now a fifteen billion dollar a year nationwide group providing dental insurance to 59 million Americans, making it one of the largest non-profits in the country (â€Å"Our Mission History†, n.d.). Washington Dental Service was joined by more local organizations, which then created Delta Dental Plans Association (DDPA) in 1966. Shortly a year after, WDS partnered with the International Association of Machinists, which was the first step into creating a multi-state dental benefits program. There was a growing number of out of state subscribers, and therefore in order to meet their needs WDS worked with other Delta Dental member companies and Blue Cross/Blue Shield Association members, to continue serving its clients. It provided coverage until 1980s this way (â€Å"Our Mission History†, n.d.). The program continued as such until a bid was won by Delta Dental of California being chosen as the dental benefits carrier for the Office of the Civilian Health and Medical Program of the Uniformed Services (OCHAMPUS) program. In order for the administration of this very large account to be centralized, other member companies agreed to share its provider data with Delta Dental of California sharing the administrative income and risk. As a result of this change, the National Provider File (NPF), and the establishment in 1990 of Delta USA — was created, the company responsible for overseeing dentist data and enabling the administration of national business (â€Å"Our Mission History†, n.d.). Currently, there are 39 independent Delta Dental member companies operating in all 50 states, the District of Columbia and Puerto Rico. As one of the largest dental benefits provider DDPA provides coverage to more than 59.5 million people enrolled in more than 97,000 groups. The company was named Dental Care until 1970s and then it officially changed its name to Delta Dental (â€Å"About Us Home†, n.d.). All Delta Dental companies are members, or affiliate of members, of the Delta Dental Plans Association a network of 39 Delta Dental companies throughout the country. Delta Dental companies range from multi-state to single state (â€Å"About Us Home†, n.d.). The multi-state programs consist of the following: * Delta Dental of New Jersey Started in 1969, it provides coverage to over 1.5 million residents of New Jersey and Connecticut (â€Å"Delta Dental of New Jersey†, n.d.). * Delta Dental Plan of Michigan Michigan Dental Service (MDS) was established in 1957, and in 1963 it received its non-profit status. In 1980 MDS expanded to Ohio and Indiana. In early 2006, Delta Dental of Michigan, with its affiliates in Ohio and Indiana, and Tennessee, signed an affiliation agreement under a new nonprofit holding company to strengthen their market positions and increase the number of Americans with dental benefits. In 2009, Delta Dental of Kentucky and Delta Dental of New Mexico affiliated with the family of companies. The newest affiliate, Delta Dental of North Carolina, joined the enterprise in 2010. Currently they cover 8.8 million individuals (â€Å"Delta Dental of Michigan†, n.d.). * Delta Dental of Minnesota It was founded in 1969, and later expanded to North Dakota. It is the largest program in the upper Midwest, serving 7500 Minnesota based on purchasing groups and 3.8 million members nationwide (â€Å"Delta Dental of Minnesota†, n.d.). * Delta Dental of Missouri Delta Dental of Missouri started 50 years ago and has offered dental and vision benefits in the states of Missouri and South Carolina. More than 1,800 companies in Missouri and South Carolina have selected Delta Dental as their dental benefits carrier. The Delta-Vision plan started in 2011 (â€Å"Delta Dental of Missouri†, n.d.). * Dentegra Companies Dentegra is not affiliated with Delta Dental Plans Association. However, this insurance company is authorized by Delta Dental Plans Association to market and underwrites certain national Delta Dental programs. This plan covers 23 million Americans. It serves the states of: Alabama, California, Delaware, District of Columbia, Florida, Georgia, Louisiana, Maryland, Mississippi, Montana, Nevada, New York, Pennsylvania, Puerto Rico, Texas, Utah, Virgin Islands, West Virginia (â€Å"Why do more than†, n.d.). * Hawaii Dental Service Hawaii Dental Service (HDS) is the first and largest nonprofit dental service corporation in Hawaii providing dental benefit plans to more than a half million members. This plan was incorporated on February 15, 1962, and soon 221 licensed dentists became charter members. HDS serves Guam, Hawaii and Northern Mariana Islands (â€Å"Caring, Visionary Dentists From HDS†, n.d.). * Northeast Delta Dental NDD offers the states of Maine, New Hampshire, Vermont, providing quality dental care to millions of residents (â€Å"Northeast Delta Dental†, n.d.). * Oregon Dental Service This plan covers Alaska and Oregon. A research to find affordable dental health by Longshoremens and Warehousemens Union, led them to find Oregon Dental Service in 1955(â€Å"A trailblazer in health†, n.d.). * The single state companies include: Delta Dental of Arizona that started in 1972. Delta Dental of Arkansas, Delta Dental of Colorado began in 1958. Delta Dental of Idaho, Delta Dental of Illinois, Delta Dental of Iowa, Delta Dental of Kansas, Delta Dental of Massachusetts, Delta Dental of Nebraska, Delta Dental of Oklahoma, Delta Dental of Rhode Island, Delta Dental of South Dakota, Washington Dental Service, Delta Dental of Wisconsin, Delta Dental of Wyoming (â€Å"Delta Dental: Members†, n.d.). Delta Dental Plans: Delta Dental offers various plans for individuals, families and enrollees. There are 39 member companies of Delta Dental and each of them provides a variety of dental benefits programs. It also forms contacts with small and large business companies to provide dental insurance coverage for their employees (â€Å"Products and Plans†, n.d.). The various plans offered are the following: 1. Delta Dental Premier ®: This is their traditional fee-for-service plan with largest dentist network with more than four out of five nation’s dentist participating (â€Å"Delta Dental Premier ®Ã¢â‚¬ , n.d., p. 2). It allows patients to get treated by any licensed dentist and also can change dentists at any time without notifying Delta Dental. The main attraction for this plan is that you do not have to pay more than the co-insurance percentage specified by your coverage (â€Å"Delta Dental’s plans†, n.d.). The participating dentists agree to accept pre-negotiated fees and are prohibited from billing more. 2. Delta Dental PPOâ„  : This is a mid-priced fee-for-service plan with the secondary largest dentist network. It has an option to get treated by any dentists and still have lower out-of-pocket costs because the dentists in this network have agreed to do so (â€Å"Delta Dental’s plans†, n.d.). It also has a Delta Dental PPO plus Premier plan which includes all the benefits of Delta Dental PPO and also allows for a patient to see a Delta Dental Premier dentist with benefits of that dentist’s contracted fee (â€Å" Delta Dental PPOâ„   †, n.d.). 3. DeltaCare ® USA: It is a HMO-type prepaid plan with a large network of participating dentists. You must select a dentist from their network for this plan. The main features are there is no annual deductibles, no maximums for covered benefits and set copayments (â€Å"Delta Dental’s plans†, n.d .). 4. Delta Dental Individual and Family: Individual and its family can get the same quality dental benefits as provided by the employers under this plan. Delta Dental offers different plans in different states (â€Å"Delta Dental Individual and Family†, n.d.). 5. Delta Dental Legion ®: It is also known as TRICARE Retiree Dental Program. â€Å"The first and only dental benefits plan created by Congress especially for Uniformed Services retirees and their family members and administered by Delta Dental of California.†(â€Å"TRICARE Retiree Dental Program†, n.d.). 6. Delta Dental Patient Direct ®: It is a dental discount plan for individual, families and groups that do not have dental benefits. The patients choose dentists from the network and pay them directly with the discount price at the time of their treatment. No paper work is required and it is available in the selected markets only (â€Å"Delta Dental Patient Direct ®Ã¢â‚¬ , n.d.). 7. DeltaVision ®: This is vision benefit plan, which is offered in the selected markets only. It includes various pre-negotiated pricing eye-care services, such as professional eye exams, eyewear, contact lenses and laser vision correction (â€Å"DeltaVision ®Ã¢â‚¬ , n.d.). 8. Delta Dental Member Companies: â€Å"They serve nearly one-third of the estimated 173 million Americans with Dental insurance, providing dental insurance coverage to more than 54 million people in more than 93,000 groups across the nation.†(â€Å"Delta Dental Member Companies†, n.d.). There are other plans which are available in few selected populations and states like the American Association of Retired Persons (AARP) Dental Insurance Plan which is exclusively for AARP members and the Costco Group Dental Plan for the Individuals and Families, which is available only in California (â€Å"Delta Dental’s plans, n.d.). Strengths and weaknesses (especially with healthcare delivery point of view): Delta Dental is the largest dental care carrier in the United States, and they provide coverage to more than 59.5 million people enrolled in more than 97,000 groups. The strengths are obviously regarding to the high level access of the dental care. Many years ago, most of people lost their teeth by middle age, but now many Americans have very good oral health because of the various Delta Dental Plans. They may keep their teeth throughout the lifetime. There are some strengths of Delta Dental according to a recent study (â€Å"Delta Dental by the Numbers†, n.d.): * Delta Dental’s nationwide dentist networks offer unprecedented access: * Delta Dental Premier ® offers the largest network of dentists in the country — encompassing more than 142,000 dentists and more than 251,000 office locations. * Delta Dental PPOSM has a national network of more than 83,900 dentists practicing in more than 168,000 locations. * DeltaCare ® USA provides more than 39,800 dentist office locations. * Delta Dentals PPO Plan delivers the industrys best effective discount — averaging 19 percent nationally — resulting in nearly $3 billion in annual savings compared to dentists average charges. * Delta Dental posted approximately $17 billion in premium revenue during fiscal year 2011, our 32nd consecutive year of financial gains. * Delta Dental’s unique cost-control measures and contractual agreements with dentists help to ensure quality care at moderate fees, collectively saving subscribers with group dental coverage more than $9.0 billion in 2011. * In 2011, Delta Dental member companies processed more than 90 million dental claims or approximately 1.7 million every week, with an accuracy rate of 99.7 percent. Delta Dental focuses on the practice sharing, best services, perfo rmance guarantees, brand name recognition and reputation, whereas, it still have weaknesses such as geographic limitations, innovative practices. Through the numbers above, people might think that we have more and more dentists in large networks so that we would get easy access to dental care, but how do these dentists located? Low-income patients still feel hard to get access to meet one dentist regularly due to the inconvenient transportation, difficulties on appointments, and so on. The president and CEO of Delta Dental, Radine (2011) wrote on â€Å"Annual Report 2011†, â€Å"Delta Dental takes pride in being a single-line carrier with unparalleled expertise in dental benefits, our specialty.† Indeed, they against larger, multi-line insurance companies, and they use competitive strategies to survive during the worst of the economic downturn. However, this kind of single-line model can also be a weakness of dental health care, because coordination of dentists needed to reinforce to increase the quality of companies health care performance. Single-line service may hinder such coordination in between the large dentist network, although they meet the needs for restraining the continuous increased costs. As each program have dissimilar strengths and weaknesses and according to Access to Dental Care/Oral Health Care (American Dental Association, 2012), there are still barriers to getting oral health care: * The dental sections in Medicaid and the State Childrens Health Insurance Programs (SCHIP), which are supposed to provide health care to disadvantaged Americans, rarely have enough money budgeted to do so. Federal law requires that Medicaid cover basic dental services. But many state programs fail to deliver care to even half of their eligible children. * Adult dental coverage through public health programs is even worse; many states simply dont provide it. Its not just about the money. Patients covered under public programs still face hurdles, such as transportation to dental appointments and the difficulty of missing work to keep the appointments. Taking care of ourselves is the key to good oral health, and too many Americans lack a basic understanding of how to brush, floss, eat a healthy diet and drink water with fluoride in it. * About one-third of public water systems are not fluoridated, even though that is the single most effective public health measure to protect against tooth decay. And also, people need to treat what form of coverage they require most and make sure the selected plan provides a low price for the needed processes. Comparison of Delta Dental with all other dental insurances: There are many essential things to keep in mind when deciding on a dental insurance plan, such as prices and co-payment options, local dentist availability, actual coverage, whether it meets your needs and more (â€Å"Dental Insurance Review†, n.d.). Delta Dental Insurance ranking at number three after United Concordia and Ameritas Group Dental is one of the top ten insurance plans in the United States (â€Å"2013 Dental Insurance Comparison†, n.d.). As one of the largest dental coverage plans, founded by dentists, it creates dental coverage plans based on current research and designed to keep people their healthiest and most productive (â€Å"Choosing the Right Dental Plan†, n.d.). Delta Dental Insurance pursues their mission by increasing access to benefits, offering the largest national network of dentists, adding innovative new plan features, aggressively working to keep costs down, and supporting p hilanthropic programs that encourage better overall oral health. Delta Dental Insurance plans offer top of the line features and programs to make insurance services more accessible and convenient for its members. Some of the features that Delta Dental Insurance consists are secure and accessible sites for online enrollment, finding dentists and getting information about available plans. It offers Group/Employer plans, which is important as it gives companies information on the cost of getting dental insurance for their employees. This is important as well for families who wish to enroll other members of the family into the insurance plan. Also Delta Dental Insurance offers individual plans, provides up-front cost information for customers and has Better Business Bureau (BBB) accreditation (â€Å"Dental Insurance Review†, n.d.). Better Business Bureau accreditation is definitely a plus, because they provide ratings based on customer service and satisfaction of members. In addition, Delta Dental Insurance offers multiple types of different plans for its consumers. There is Delta Dental Preferred Provider Organization (PPO), DeltaCare ® USA (Health Maintenance Organization (HMO) option), Fee-for-Service (FFS) Plan, and they also used to offer Discount Plans. But the Discounted Plans are no longer offered by Delta Dental since majority of the members prefer PPO, HMO and FFS plans. The Delta Dental PPO plan is offered worldwide, and for that reason it is more accessible even if the customer relocates (â€Å"Choosing between a PPO and HMO†, n.d.). When choosing a PPO dentist, the out of-pocket costs of customers are often lower because PPO dentists have agreed to charge Delta Dental PPO patients reduced fees. The plan also pays enhanced benefits when patients visit a PPO dentist, so they pay only 20 percent of the PPO dentists contracted fee after their deductible for such services as fillings, oral surgery, root canals and treatment of gum disease in addition to other benefit enhancements (â€Å"Types of Dental Plans†, n.d.). Delta Dental PPO does not cover teeth bleaching and other cosmetic procedures (â€Å"University of California†, 2009). The good thing about a PPO plan is that customers have the freedom to choose any licensed dentist, anywhere in the world, each time the member or a family member requires treatment. And there is no referral required for specialty care. On the other hand, DeltaCare ® USA (HMO option) customers must be residents of California to enroll. It provides individuals and their families with inclusive plans and easy referrals to specialists and even has a benefit for teeth bleaching. The plan emphasizes preventive care; so many services are provided at no cost. There is no annual plan maximum for DeltaCare ® USA (â€Å"Types of Dental Plans†, n.d.). As an HMO member, customers are assigned to network dentist that accept the plans and they must be referred specialist by their assigned dentists. Fee-for-service plans, also known as indemnity or traditional plans, typically offer the greatest choice of dentists. It is up to the customer what dentist to choose or procedure they would like to purchase. Like PPO plans, when you visit a network dentist, you typically pay a certain percentage for each service (called coinsurance) and the plan pays the rest. The percentage usually varies by the type of coverage, such as diagnostic and preventive, major services, etc. (â€Å"Types of Dental Plans†, n.d.). However with FFS plan the member might pay a little extra than the PPO plan. And finally, the Discounted Plans are insurance plans that are offered at reduced rates. There is generally no paperwork, annual limits or deductibles, but you must visit a participating dentist to receive the discount. Also, you may be responsible for a greater portion of the treatment cost compare to PPO or HMO plan. The downside of this plan was the fact that there was a possibility of the dentists being changed annually, and new dentists would be assigned to the customers. But on the plus side, the rates that the customers would receive would be unbeatable. Figure 1 shows the continued growth in enrolment throughout the recession. This also proves that Delta Dental is the largest dental carrier in the United States and it has more than 26 million enrollees at present (â€Å"Delta Dental: Annual Report2011†, n.d., p. 10). Figure 1: Shows the increase in the enrollment of Delta Dental plans by the population. The Y-axis shows the number of enrollees in increasing order and the X-axis shows the years starting from 2008-2012. Adapted from: â€Å"Delta Dental: Annual Report 2011.† (n.d., p. 10). Why is Delta Dental better and more successful than other insurances? Delta Dental offers some of the best dental insurance plans in the United States and around the world since 1954 and as the first company exclusively specializing in dental benefits, Delta Dental has been working hard to improve oral health around the world by providing access to the largest network of dentists, great service, top of the line care plans and developing relationships that emphasize prevention and positive oral health care results over the long term (Delta Dental, 2010). Over 56 million enrollees trust Delta Dental Insurance plans with their oral health and the numbers of satisfied members keep growing (â€Å"Why do more than†, n.d.). â€Å"In 2011, the vast majority of surveyed enrollees from our open network plans said they would recommend Delta Dental to a family or friend. That loyalty is also evident in our exceptionally high enrollee retention rate.† (â€Å"Delta Dental 2011 Annual Report†, n.d., p. 11). Figure 2 which is adapted from the â€Å"Delta Dental: Annual Report 2011† (n.d., p. 11) shows the percentage of enrollee satisfaction and enrollee retention in 2011. Figure 2: The percentage of Enrollee satisfaction and Enrollee Retention. 95% of the Enrollees were satisfied with their Delta Dental Plan and 99% of the Enrollees retained their Delta Dental plan. Adapted from: â€Å"Delta Dental: Annual Report 2011† (n.d., p. 11) Future plans: Delta dental has proven itself as one of the good companies in the market but still they are working diligently to make it better. Delta Dental supports projects in conjunction with major universities and other leading research organizations that are designed to advance scientific knowledge and improve health. Among the projects, recently supports are: a study on the potential for dentists to play a greater role in the detection of health conditions such as diabetes; the cost impact of oral cancer; the application of salivary diagnostics to dentistry; and the development of biotechnology to advance health (Carruth, 2012). All these are the major projects of Delta Dental. Delta Dental is trying to identify ways to improve offerings in ways that will reduce costs while still covering the treatment our subscribers need to stay healthy. Delta Dental will focus on expanding their network in remote places and provide oral care. They are planning continue creating dynamic product lines that provide effective benefits to improve oral health–and overall health – while reducing costs. Delta Dental would concentrate on providing good customer service staff as well as an automated phone line for inquiries. Conclusion: Delta Dental has received many awards in improving oral health care. Their current plans are focused on expanding their network and providing good care for the patients. Delta Dental’s strategies are such that not only patients but also dentist and employees are benefitted. They also focus on many researches to improve quality of care. Moreover, their future plans are focus on reducing cost and providing quality of care for patients. They are providing funds for incurable diseases like cancer and other malignancy. References: A trailblazer in health. n.d.). Retrieved from: https://www.odscompanies.com/about/ American Dental Association. (2012). Access to dental care/oral health care. Retrieved from: http://www.ada.org/2574.aspx Carruth, P. (2012). The future of dentistry. Retrieved from: http://www.deltadentalnc.org/deltaDentalNorthCarolina/files/cf/cfd82d85-42e2-47ea-b49d-3d28e5d80bf3.pdf Delta Dental (2010). America’s oral health: The role of dental benefits. Retrieved from: http://www.deltadental.com/TheRoleofDentalBenefits.pdf Delta Dental (n.d.). About us home. Retrieved from: http://www.deltadental.com/Public/AboutDeltaD/AboutDeltaDental.jsp Delta Dental (n.d.) Caring, visionary dentists form HDS. Retrieved from: http://www.deltadentalhi.org/ddpahi/History.jsp?DView=History Delta Dental (n.d.). Choosing the right dental plan for you and your family. Retrieved from: http://www.deltadental.com/WhitePaperChoosingRightDentalPlan.pdf Delta Dental (n.d.). Contact your local member companies. Retrieved form: http://www.deltadental.com/Public/PlanInfo/planAddressStart.jsp Delta Dental (n.d.). DeltaVision ®. Retrieved from: http://www.deltadental.com/Public/Product/vision.jsp?DView=AboutPIVision Delta Dental (n.d.) Delta Dental by the numbers. Retrieved from http://www.deltadental.com/Public/Company/stats2.jsp?DView=AboutDeltaDentalStats Delta Dental (n.d.). Delta Dental individual and family. Retrieved from: http://www.deltadental.com/Public/Subscribers/IndFamCoverage.jsp?DView=SubscriberIndividual Delta Dental (n.d.). Delta Dental of New Jersey. welcome. (n.d.). Retrieved from: http://www.deltadentalnj.com/index.html Delta Dental (n.d.). Delta Dental of Michigan. Retrieved from: http://www.deltadentalmi.com/About/Company-Profile/Our-History.aspx Delta Dental (n.d.). Delta Dental of Minnesota. Retrieved from: http://www.deltadentalmn.org/about.jsp?DView=AboutUs Delta Dental (n.d.) Delta Dental of Missouri. Retrieved from: https://www.deltadentalmo.com/AboutUs/index.asp Delta Dental (n.d.). Delta Dental Patient ® Direct. Retrieved from: http://www.deltadental.com/Public/Product/direct.jsp?DView=AboutPIDirect Delta Dental (n.d.). Delta Dental PPOâ„  . Retrieved from: http://www.deltadental.com/Public/Product/preferred.jsp?DView=AboutPIPreferred Delta Dental (n.d.). Delta Dental Premium ® : Our most valuable network. Retrieved from: http://www.deltadental.com/DeltaDentalPremierBrochure.pdf Delta Dental (n.d.) Delta Dental’s plans. Retrieved from: http://www.deltadentalins.com/individuals/guidance/plans.html Delta Dental (n.d.). Members. Retrieved from: http://www.deltadentalma.com/members/index.asp Delta Dental (n.d.). Northeast Delta Dental. Retrieved from: http://www.nedelta.com/about.aspx Delta Dental (n.d.). Our mission history. Retrieved from: http://www.deltadental.com/Public/Company/mission.jsp Delta Dental (n.d.). Products and plans. Retrieved from http://www.deltadental.com/Public/Product/product.jsp Delta Dental (n.d.) Survey by city of San Jose: Choosing between a PPO and HMO dental plan. Retrieved from: http://hrclassspecs.sanjoseca.gov/humanResources/survey/BenefitsPlan/DentalPl

How the heart functions as a pump

How the heart functions as a pump The objective of this essay is to show how the heart functions as a pump in transporting oxygen to the different parts of the body and how reduction in coronary blood flow can impair the cardiac function. The first part of the essay describes the location, structure, electrical activity within the heart and how the heart transports oxygen throughout the body. The second part describes how reduced coronary blood flow in case of a disease can impair blood flow and its treatment. The heart forms an integral part of the cardiovascular system whose primary function is the maintenance of hemodynamic and homeostatic functions such as maintenance of body temperature, transport of nutrients to the cells, removal of waste materials, transport of oxygen and hormones. [8,1] Heart Location The human heart is like a cone shaped organ composed of four different chambers and is located obliquely across the chest midline with its tip behind the fifth left intercostal space. It weighs on an average between 250-350 grams in adults and is approximately the size of a human fist. [2] An average human heart beats on an average of 75 beats per minute and pumps more than 200 million litres of blood in 80 years. [3]. Although the heart is located in the centre of the chest cavity its beating action is felt on the left side of the chest cavity since the most powerful pumping action of the ventricles of the heart takes place towards the base of the heart which is located in the left side of the chest cavity. [2] The figure below shows the location of the heart in the body. Fig1: Location of the Heart [8] Lecture Physiology and Anatomy- Cardiovascular System Alan Richardson; slide no. 8 The heart is enclosed in a multi-layered sac known as Pericardium which protects the heart by reduction of friction and prevents excessive expansion. Between the different layers of the pericardium (visceral and the parietal layers), the pericardial cavity is present which holds about 5-15 ml of Pericardial Fluid that reduces the friction created due to the movement of the heart. [3] The heart wall consists of three different layers Epicardium (outer layer), Endocardium (inner layer) and Myocardium (middle layer). The 2picardium and the endocardium are both made of simple squamous epithelial cells and a thin areolar tissue layer. However the myocardium is the thickest amongst all the three layers consisting of the heart muscles and its thickness in each chamber of the heart depends upon the amount of force generated by which chamber during the pumping action. [3] The figure below clearly shows the various layers of the heart wall. Fig2: Layers of the Heart wall [9] Structure of the Heart The heart is divided into two different halves depending upon the kind of blood (deoxygenated or oxygenated) received right and left halves. The heart consists of four different chambers with an atria and a ventricle on each side. The atria have relatively thinner walls since they only have to pump the blood to much shorter distances than the ventricles. [4].The atria connect to the ventricles by means of atrioventricular valves (tricuspid in the right half, bicuspid in the left half). The atrioventricular valves are connected to the base of the ventricles by chord like structures known as the chordate tendinae that prevent the valves from swinging in the opposite direction and thus prevent the back flow of blood into the atria from the ventricles. [3,5] The two atria are separated from one another by means of a muscular wall known as the interatrial septum. [3] The atria and the ventricles are separated by means of a fibrous connective tissue known as annulus fibrosis, this helps i n giving a skeleton for attachment of the muscles of the heart and help in providing the site of placement of the heart valves. [4] The ventricles are the lower and the larger chambers of the heart. The two ventricles are separated from one another by means of a thick muscular wall known as the interventricular septum. The right ventricle is connected to the pulmonary artery by means of the pulmonary semilunar valve while the left ventricle is connected to the aorta by means of the aortic valve. [3]. On the surface of the heart the heart chambers grooves are marked by fatty layers containing coronary blood vessels these layers are also known as Sulci.[3] Blood Flow in the Heart The deoxygenated blood from the various parts of the body flows into the heart by the pair of vena cava into the right atria. The blood flowing from the upper part of the body relative to the heart is carried by the superior vena cava while the blood flowing from the lower part of the body relative to the heart is carried by the inferior vena cava. [8] The cardiac muscles empty their deoxygenated blood into the right atria by the coronary sinus. The deoxygenated blood is pumped from the right atria into the right ventricles through the right atrioventricular valves (tricuspid valve) upon atrial sytole and ventricular diastole. The blood in the right ventricles is then pumped into the pulmonary artery through the right semilunar valve (pulmonary valve) to the lungs for oxygenation upon ventricular systole. However, during the ventricular systole the semilunar valves do not open unless the pressure generated in the ventricles due to contraction (systole) is sufficient to push open the valves, such contraction is known as isometric contraction. The pulmonary artery bifurcates into two smaller branches the left and the right pulmonary artery (one for each of the lungs). The pulmonary vein from the lungs brings the oxygenated blood from the lungs into the left atria of the heart which then pumps the blood into the left ventricle through the bicuspid valve (mitral valve) during atrial systole and ventricular diastole. The left ventricle pumps the blood to the different parts of the body through the aorta through the aortic valve during ventricular diastole. The hearts muscles are themselves are supplied by oxygenated blood from the coronary artery branches present on the aortic arch. [3] The figure below shows the various chambers of the heart along with the flow of blood within the heart. Fig3: Blood Flow within the heart [8] Lecture Physiology and Anatomy- Cardiovascular System Alan Richardson, Slide no 12 Blood enters the chambers during the diastole (relaxation) phase and is pumped out during the systole (contraction) phase. As a result, the blood is under a higher pressure in the systolic phase than the diastolic phase. The blood pressure is the pressure exerted by the blood upon the walls of the blood vessels.[5] The blood pressure on the walls of the artery in a healthy individual lies around 80mm Hg for diastole and 120mm Hg for systole. [4] The valves of the heart prevent the back flow of blood and thereby only allow the unidirectional flow of blood. [5] The circulation of deoxygenated blood to the lungs and oxygenated blood back to the heart is known as pulmonary circulation while the circulation of oxygenated blood to all the parts of the body and deoxygenated blood from the various parts of the body into the heart is known as systemic circulation.[5] The entire process is displayed in the figure below. Fig4: Systemic and Pulmonary Circulation [10] Electrical Conduction within the Heart and Heart Beat The cardiac impulse trigger is generated by the group of specialised cells which together form the sino-atrial node (SA node). The SA node is present in the right atrium near the point of attachment of the superior vena cava. The cells in the SA node generate the impulses spontaneously as they are capable of spontaneous depolarisation, hence they are said to possess automaticity. [6] Due to these spontaneous impulses the SA node forms the atrial pacemaker. These electrical impulses are spread throughout the walls of the atrium by means of specialised pathways known as the Bachmanns Bundle, thereby causing the stimulation of the myocardial walls of the atria to contract and push the blood into the ventricles. The wave of electrical excitation travels from the atrial walls via specialised pathways called internodal tracts from the SA node to the Atrioventricular (AV) node. The AV node is also composed of similar autorhythmic cells as the SA node and is capable of pacing the heart in case the SA node fails in pacing and is located in the right side of the interatrial septum. However the pacing of the AV node is slower than the SA node and it thus provides the critical delay in the electrical conduction system, preventing the simultaneous contraction of both the atria and the ventricles. The distal portion of the AV node is known as the Bundle of His which then divides into the two bundle branches for spreading the electrical excitation to the two ventricles. The bundle branches are present along the interventricular septum and end at the tip of the heart by further differentiating into numerous small fibres known as Purkinje fibres. The Purkinje fibres are responsible for depolarising the individual myocardial cells of the ventricles. Thus causing the ventricles to contract and push the blood into the pulmonary artery or the aorta. [3] Blood circulation and Transport of Oxygen The blood vessels and capillaries are the pipes which carry blood throughout the body for metabolic, waste and gaseous transport. The blood vessels include arteries, arterioles, veins and venules. Arteries carry the oxygenated blood away from the heart with the Aorta being the largest artery. Since the artery carry blood in jerks and under high pressure they are surrounded by smooth muscles which prevent it from collapsing. The resistance to blood pressure is controlled by the autonomic nervous system which controls the width of the artery (lumen) through which the blood passes (vasoconstriction and vasodilation). The arteries further divide into smaller divisions known as arterioles which carry blood to smaller parts of the body. The arterioles are also covered with smooth muscles and like the arteries also resist any changes to the blood pressure. The arterioles further differentiate into smaller blood vessels known as capillaries which possess an extremely thin wall so as to allow the exchange of oxygen with the individual cells and carbon-dioxide from the cells. Apart from the exchange of gases the metabolic exchange of nutrients and wastes are also possible at the capilla ries. Several billions of capillaries then join together to form the venules which are smaller blood vessels carrying the deoxygenated blood from the capillaries to the veins. The veins are the formed by the integration of millions of smaller venules and it carries the deoxygenated blood back to the heart. The blood in the veins does not flow under considerable high amounts of pressure and hence the walls of the veins are not as thick as those of the artery. The veins join together to form the two vena cavas. [8] The transfer of oxygen from the blood into the cells at the capillaries is explained by the process of diffusion. Diffusion is the process of movement of particles from their region of higher concentration to a region of lower concentration. Thus in the capillaries the oxygenated blood has a higher concentration of oxygen than that present outside the capillaries in the surrounding cells. At the same time there is higher concentration of carbon-dioxide in the surrounding cells than the oxygenated blood in the capillaries. Hence the oxygen from the blood in the capillaries diffuses out into the surrounding cells while the carbon-dioxide from the surrounding cells diffuses into the capillaries. Thus the oxygenated blood from the lungs passes into the heart which pumps it into the aorta which divides into the arteries which further divides into arterioles and then capillaries. The capillaries then exchange the oxygen with the cells and take carbon-dioxide from the cells and rejoin to form the venules which then form the veins which return the deoxygenated blood back to the heart. Thus the heart acts a pump in the entire cardiovascular system which transports the oxygen to the different parts of the body and carbon-dioxide from the different parts of the body. The figure below shows the overview of the cardiovascular system. Fig5: The Cardiovascular System [11] Reduced Coronary Blood Flow and Coronary Artery Disease The heart needs to perform all the time in the body and can never relax, hence the cardiac muscles have a high demand for oxygen and have very limited capacity for anaerobic respiration. [7] The chest pain which is felt in the patient due to the obstruction of the blood flow in the coronary arteries is known as Angina Pectoris. This deposition of the plaque and lipid layers within the coronary blood vessels thereby causing the hardening and narrowing of the blood vessels is known as Atherosclerosis. Due to the obstruction the cardiac cells are deprived of oxygen and start anaerobic fermentation resulting in the formation of lactic acid. The lactic acid formation in the heart stimulates the pain receptors present in the heart. [3] Depending upon the type of plaque formation in the coronary blood vessel the angina might be termed as stable or unstable. [8] Thus with the reduced coronary blood flow the cardiac output of the heart is severely impaired since the muscles of the heart are deprived of oxygen and nutrients resulting in tissue death or myocardial infarction. Hence the heart is not able to pump properly and thus has a reduced cardiac output. Myocardial Infarction causes severe pain and can even cause death to the patient. [6] The blood flow to the target cells can be increased by vasodilation and thereby allowing more blood to flow through them. This can be done by using organic nitrate medications which release nitric oxide (NO) into the blood stream. Medications known as beta blockers (ÃŽ ²) which also cause of the coronary artery vasodilation can also help in the treatment of the condition in the same manner. Apart from medications surgically also the condition of reduced coronary blood flow can be treated by coronary bypass surgery where the atherosclerotic narrowing of the coronary artery is bypassed by a blood vessel which is grafted from any other part of the patients body. There also is the possibility of performing other angioplasty operations such as balloon angioplasty, etc. [7] The therapeutic goals in treating stable angina are to improve the coronary blood flow to the target cells and reduce the cardiac oxygen demand. While in the treatment of unstable angina steps are taken to prevent the occurrence of myocardial infarction Conclusion The heart acts as a muscular pump which pumps blood throughout the lifecycle beating at an average of 72 beats a minute and pumping 200 million litres of blood in 80 years. [3] The cardiovascular system consists of several different components, the pump (heart), an extensive piping network (blood vessels and capillaries) and finally a working fluid (blood). The heart receives deoxygenated blood from all over the body pumps it to the lungs for oxygenation and receives the oxygenated blood from the lungs and pumps them to the different parts of the body. The piping network includes arteries, arterioles, veins, venules and capillaries. The capillaries are the site of gaseous exchange where the exchange takes place by diffusion. Reduced coronary blood flow impairs the cardiac output by starving the cardiac cells of oxygen and nutrients carried by the blood.

The Maturation of Pip in Great Expectations :: Free Great Expectations Essays

The Maturation of Pip in Great Expectations In Great Expectations, by Charles Dickens, the author begins the tale by revealing Pip's arrogance towards previous companions. By the end of the story, we learn of Pip's love and compassion for everyone. In Great Expectations, during the middle of the book, Pip creates a rather low opinion of himself acting arrogant and conceited to others. For example, When Joe is coming to visit Pip, Pip thinks to himself, "I was looking forward to Joe's coming not with pleasure, thought that I was bound to him... If I could have kept him away by paying money, I would have paid money (pg.841). Evan though Joe protected and assisted Pip throughout his juvenile years, Pip was still embarrassed by him. Pip is an ungrateful person showing Joe no gratitude. In addition, when Pip learned who his benefactor was he replied, "The abhorrence in which I held the man, the dread I had of him, the repugnance with which I shrank from him, could not have been exceeded if he had been some terrible beast (pg.876). Pip is surprised by this intrusion of his mind realizing that Miss Havisham did not raise him to be with Estella. Evan though Pip was not raised to be with Estella he is an vicious human being thinking such vile thoughts against a man that gave him the life of a gentleman. In relation, as Provis lays down to sleep Pip reflects on meeting him, "Then came the reflection that I had seen him with my childish eyes to be a desperate violent man:" (pg.879). Pip can only think of what horrible things Provis performed. Pip is an unforgiving person, still thinking of Provis as a convict after all he did for him. Pip displays himself as a heartless feign, believing himself to be of upper society and forgetting people who helped him through his journey of life. In the end of the novel, Great Expectations, Pip redefines himself as a dependable honorable character. For example, when Pip is hovering over Provis' deathbed he says, "Dear Magwitch, I must tell you, now at last, You had a child once whom you loved and lost, she lived and found powerful friends. The Maturation of Pip in Great Expectations :: Free Great Expectations Essays The Maturation of Pip in Great Expectations In Great Expectations, by Charles Dickens, the author begins the tale by revealing Pip's arrogance towards previous companions. By the end of the story, we learn of Pip's love and compassion for everyone. In Great Expectations, during the middle of the book, Pip creates a rather low opinion of himself acting arrogant and conceited to others. For example, When Joe is coming to visit Pip, Pip thinks to himself, "I was looking forward to Joe's coming not with pleasure, thought that I was bound to him... If I could have kept him away by paying money, I would have paid money (pg.841). Evan though Joe protected and assisted Pip throughout his juvenile years, Pip was still embarrassed by him. Pip is an ungrateful person showing Joe no gratitude. In addition, when Pip learned who his benefactor was he replied, "The abhorrence in which I held the man, the dread I had of him, the repugnance with which I shrank from him, could not have been exceeded if he had been some terrible beast (pg.876). Pip is surprised by this intrusion of his mind realizing that Miss Havisham did not raise him to be with Estella. Evan though Pip was not raised to be with Estella he is an vicious human being thinking such vile thoughts against a man that gave him the life of a gentleman. In relation, as Provis lays down to sleep Pip reflects on meeting him, "Then came the reflection that I had seen him with my childish eyes to be a desperate violent man:" (pg.879). Pip can only think of what horrible things Provis performed. Pip is an unforgiving person, still thinking of Provis as a convict after all he did for him. Pip displays himself as a heartless feign, believing himself to be of upper society and forgetting people who helped him through his journey of life. In the end of the novel, Great Expectations, Pip redefines himself as a dependable honorable character. For example, when Pip is hovering over Provis' deathbed he says, "Dear Magwitch, I must tell you, now at last, You had a child once whom you loved and lost, she lived and found powerful friends.

HR data collection Essay

HR data collection makes company able to measure against it supporting workforce planning, monitoring progress and development, developing initiatives for generic cases. It identifies and analyses information to aid the organization in making ultimate decisions both beneficial to the organization and its employees. Two reasons considered closely. Through HR data collection an organisation can: 1) comply with legislative and regulatory requirements regarding equal opportunities, equal pay audits, recruitment, assessing skills balance, absence recording. 2) monitor training and performance for employees, assessing each individual employee for productivity and identifying training needs. That means assessing the productivity within the business. Being well informed about the workforce is the key to aim the ultimate goal of the organization. Data collection enables management team to make informed decisions about future activity. Two types of data collected and their support: 1) Attendances is useful to monitor and gauge daily working hours and monitor absences. That enables HR to manage regular absentees successful and deal with any issues the employee might have. 2) Organisational records which includes: staff turnover, absenteeism, recruitment documentation, learning and development. HR department can monitor staff level making decision about a further recruitment process. It is also essential collecting and updating employee records such as home addresses and people to contact in time of emergency. These information are helpful where the employee not to come to work without notice. Records can be stored: 1) Electronically through computerised system. In this way organization can keep information up to date easily and any information can be sent and received rapidly. It also reduce company costs and the amount of data can be stored with no taking up much office space and they can be sorted, found, moved and protected easily. 2) Manually in paper format. In this case the risk of corrupted data is less and information are accessible in any time considering occurrences of power cuts or electronic system crashes. Moreover problems with duplicates of the same record are usually avoided. Two items of UK legislation relating to recording and storing HR data: 1) Data Protection Act, 1998. It concerns all personal records whether held in paper or electronic format. The act contains eight protection principles specifying personal data must be: – Processed fairly and lawfully. – Obtained for specified and lawful purposes. – Adequate, relevant and not excessive. – Accurate and up to date. – Not kept any longer than necessary. – Processed in accordance with the â€Å"data subject’s† (the individual’s) rights. – Securely kept. – Not transferred to any other country outside the EU without adequate protection in situ. 2) Freedom of Information Act, 2000. It allows people to ask any public body for information on both any subject an organization has and themselves too. So that the act encourages organization to be transparent and, unless a valid reason, the organization must provide requested information within 20 working days. Through this act people can access to informations needed and ensure they are not exploited or used inappropriately.

Life Span Development essays

Life Span Development essays In the book, Curious George rides a bike by H.A. Rey, George receives a new bike from his friend. His friend tells him to be careful with his new bike and to keep close to the house while he is gone. George does not listen to his friend and decides to go exploring away from the house. While exploring, George sees two boys playing with their toy boats and then decides that he wants to play with a toy boat. George made a plan (how to make the boat) and then he carried out the task. George made himself a boat out of newspaper. This is an example of stage two, 1-3 years, Erikson. In stage two, children express their growing self control by climbing, touching, exploring, and try to do things for themselves. (Dennis Coon) Though most children in stage two would be exploring their kitchen floor, or ceiling, not a river! I also read the story, Curious George gets a medal by H.A. Rey. In this story George makes a mess in his friends house. George is anxious to clean up the mess before his friend gets home. The reason that he is so eager to clean up the mess is because he is thinking about the possible consequences of his actions. If this were an actual little boy, he would be thinking, I dont want to get punished, so I will clean up the mess. Or, Oh, No! Im going to get into big trouble! This is an example of Stage 1 the preconventional level, Kohlberg. If his friend werent coming home would George work so vigorously to clean up the mess? I think not. In the second half of the book, George is asked to help a professor in a somewhat dangerous experiment. The professor that has asked this of him says, Of course everything will be forgiven if you are willing to go. (George got into a bit of trouble while he was there.) George agrees to this request because he wants to please others. George wants to be nice. Why would a child want to...

Argumentative Essay Sample on Death Penalty

Argumentative Essay Sample on Death Penalty The death penalty has been used throughout history, and has evolved from stoning women to death in Afghanistan for committing adultery to giving lethal injections in the U.S. to serial killers (Amnesty International). Today, the death penalty is reserved only for the absolute worst criminals, but that could change if the anti-death penalty fanatics that are so prominent in today’s media have their way. They claim that the death penalty is barbaric, unconstitutional, and should be banned. This view is the most prominent in the media when in fact 75% of Americans support the use of the death penalty (Koch 561). So why is the anti-death penalty movement so prominent today? Members of this movement take an activist position and are trying to change the laws, while pro-death penalty people take a more passive stance. They know that the death penalty is the law and they expect it to be carried out. The arguments that the anti-death penalty activists use look good on the surface, but upon close inspection they really don’t amount to much of anything. The anti-death penalty activists in this country would have you believe that every time a murderer is executed the justice system has just committed murder as well. They would have you believe that every person on death row is a victim. What they don’t talk about is what that person did to get onto death row. They forget about the people that where killed, and the people whose lives where affected by the murders; these are the real victims. They had a right to live just like every else in the world but their lives where snuffed out by a murderer. In my opinion, every one has a right to live, but as soon as you murder another human being you forfeit that right. I cannot see a convicted felon as some sort of victim, because it was his own actions that brought about his fate, not the actions of another person. Some people would argue that putting a murderer to death will not bring their victims back to life, or console their victims family, so what is the point? Well, putting someone in prison for the rest of their lives, or any other punishment for that matter, won’t bring their victims back to life either. So do you suggest we just don’t punish the killer for his actions? What punishment is supposed to do is prevent the killer from ever killing again, and what better way to do that than to take their own life away from them. If the most severe penalty a person can receive is to spend the rest of his/her life in jail, then what do you do when this is no longer enough? For example, a New York prisoner named Lemuel Smith, while serving six life sentences for his various crimes, including murder, strangled a female security guard, then mutilated and dismembered her body. Because New York has no death penalty, there is nothing that can be done to punish him beside another meanin gless life sentence (Koch 562). What better way to preserve innocent life than to eliminate the people that would seek to destroy it? As for consoling the victims family, true, the death of their loved ones murderer may not make them feel better, but at least they can rest easy knowing that the killer is dead and gone instead of sleeping soundly in a prison bed. What about all of the innocent people that are on death row? Before a prisoner is executed they go through a very extensive and effective appeal system. True, with new DNA evidence, we have been able to exonerate many people that were on death row, however, â€Å"there is, in fact, no proof that an innocent has been executed seance 1900†(Sharp). That’s right even with DNA testing anti-death penalty activist can’t truthfully say that America has executed an innocent person in the past 100 years. Death penalty critics would argue that the death penalty does nothing to deter people from committing violent murders. If this is true, then why do people fear the death penalty so much? Every day people confess to their crimes in the hope that they won’t get the death penalty for them. If the death penalty doesn’t deter criminals, then why did Luis Vera murder Rosa Velez? He burglarized her Brooklyn apartment then shot and killed her when she recognized him. He later admitted â€Å"Yeah, I shot her. She knew me and I knew I wouldn’t go to the chair† (Koch 561). This seems proof enough to me that the death penalty deters criminals. I think John McAdams says it best. If we execute murderers and there is in fact no deterrent effect, we have killed a bunch of murderers. If we fail to execute murderers, and doing so would in fact have deterred other murders, we have allowed the killing of a bunch of innocent victims. I would much rather risk the former. This, to me, is not a tough call (McAdams). I think that the main thing that would boost the deterrent effect of the death penalty would be to use it more often. 5900 people where sentenced to death between 1973 and 1996. Of those 5900 people only 358 people where actually executed (DPIC). That is only one execution for every 1600 murders in the United States, which means that the possibility of someone being put to death if they kill someone is extremely low (Sharp). If we increased the possibility of being executed, then we would increase the deterrent effect that the death penalty has. What would you do if Osama Bin Laden walked into the room right now? Most people would say they would kill him for the crimes he committed against our country. This is the same thing that the family’s and friends of most murder victim’s feel about the person that took their loved one away from them. Then the anti-death penalty activists complain that the death penalty is cruel and unusual. They don’t like the quick and painless death that is awaiting the convicted murderer. They cite the way the prisoner is treated, the way he has to wait for the inevitable. I hope that this is the most terrifying experience of his/her life. While it is not possible to let victims family’s personally strangle the murderer, they will know that the killer felt, at least a small part, the fear that their victims felt just before they where brutally killed. Is the death penalty barbaric? No: raping, beating, torturing and killing people is barbaric. Fast, effective, painless e xecution of someone convicted of the aforementioned crimes is not barbaric; it is justice. In conclusion, I hope that next time you hear about a death penalty being carried out that you will be able to see through the media about the murderer being a victim, and remember who the real victim’s are. The death penalty is justice; it is not wrong. Think about the horrible crimes that the person committed to get himself on death row and remember that they brought this upon themselves. I value human life, and the best way to preserve it is to send a message to those people that would seek to destroy it; we will not tolerate murder. You can order a custom essay, term paper, research paper, thesis or dissertation on Death Penalty topics from our professional custom essay writing company which provides high-quality custom written papers at an affordable cost.

buy custom Poem for the End of the Century essay

buy custom Poem for the End of the Century essay Poem for the end of the century by John Haines revolves around the issues of the 9/11 attacks. The author largely dwells on the theme of unity and friendships. This is because the presence of people from the Middle East in the United States is not fully accepted by the natives. This is because there is a general perception that the people from the Middle East are assumed to be largely similar to one another and virtually different from the people from the West. The author examines how the people of the Middle East are perceived. He looks at the reasons as to why they are viewed in that specific way. The author widely bases his issues of orientalism on the twin towers attacks in 2001. The author notes that orientalism is largely accrued to the presence of the people of the Middle East in the USA. However, he seems to agree that the USA cannot remain uniformly tied to the relations and encounters it has had with the Middle East. This is because they have also proved that they can be da ngerous (Haines 25). The persona also wishes he was living the life of a nightingale. This is because it has nothing to worry about. It has no stresses such as death. It lives its life happily without any distractions because all it does is sing. He is completely convinced that death is the only way out of the misery he is going through. He is confident that if he dies he will have nothing else to worry about. He wishes he could die while listening to the good songs that the nightingale sings. This would help ease his pain. He envies the bird because it will continue to live without any sadness. There are issues that may be urgent but not equally important. For example, for a student, watching a movie may be urgent because it showing at a stipulated time but it is not important towards achievement of good academic results. According to him, the nightingale will forever remain ecstatic because it sings its songs just like a poet. The only difference is that it does so and does not expect to suffer any pai n in the near future. Eventually, the nightingale bird flies further away from the persona. It is then that he realizes that the nightingale was not born to die. On the contrary, he has no choice. He realizes it is like he has been hallucinating hoping to get the best but was not able to make it. He wihes he could fly away with the bird into space. According to him, he would have nothing to fear or be worried about while he is up there in the air. This implies that we hold ourselves responsible for the decision s that we make in life. We do not always look for excuses as to why things are the way they are. For instance, we do not blame certain misfortunes on the genetic relationships that we have. This is an indication that the outcomes of our lives are based on the choices we make. Unfortunately, this whole experience turns out to have been like a dream. The persona himself remains confused on whether he was actually going through the ordeal while asleep or awake. The bird is gone but the persona still w ishes he could die (Haines 3). The poet has brought out the concept of death clearly. This has been perfectly achieved because of the comparison of a nightingale and the persona. This is because the bird is immortal and has nothing to worry about. It remains happy entertaining those who listen to it for whichever amount of time. On the contrary, human beings have to come up with ways of surviving since their life is not immortal. The use of a real life example that is directly connected to the author is also strategic in achievement of her purpose and intention. This is because the reader is able to analyze her message through the authors personal experiences. This is because the readers are likely to believe in his analysis as he has analyzed them first hand. The choice of subject also plays a major role in passing on his message. This is because it relates to a wide population of the readers. Each reader has something to learn from the authors work. This helps in achievement of the authors purpose. He then provides proof of this by incorporating well thought ideas and past facts by authors of similar topics. The poets message is very important to those people that are going though trying experiences. However, his message contradicts general morality. This is because instead of giving them the heart and hope to move on with their lives after the death of their colleagues, he largely concentrates on the issues about why death is the only way out. His thoughts on the issues would be up for rejection by society in general. This is because society values liffe and views it as being sacred. Therefore, an individual who does not support life would not be greatly appreciated in the society. His ideas would negate societal views. Also, society believes in facing situations as they are as opposed to escaping from the challenges that one faces in life. This implies that it is very important for authors and poets to present their work to the intended readers. This is important so as to prevent any misjudgments or misunderstandings. This will also ensure that there no any misinterpretation of their intended opinions. However, the poet is only speaking his mind and is entitled to that right. The author has a great effect on me in the way he makes his analysis. He is keen to deal on facts and not empty assumptions. I am moved on the realization that politics have a great role in the way the entire world perceives the people from the Middle East. He is able to pass on great teachings to readers on making judgments. He says that politicizing the matter of the Middle East could mislead individuals into thinking that these individuals are not human. He notes the importance of basing judgments on factual information. He also talks about the need of giving others opportunities and not always thinking ill about them. However, he is quick to that this does not guarantee that these individuals will always do things the way that we want them to. In reference to the people of the Middle East, the author notes that this was the case during the 9/11 twin towers blast that shocked the entire universe. He notes of how badly such events could damage long lasting relationships between ind ividuals. Generally, the authors message to individuals around the world is clear.. They have to act in a manner that depicts the fact that they are willing to be part of the international society. This will ensure that they are not alienated from the rest of the world. It will also ensure that they are accorded the respect and appreciation that they very much wish to have. This will also enhance their position in society and levels of credibility. While working towards this, he cautions fellow authors to ensure that when they report their findings, they should ensure that they base their analysis on facts only. This will ensure that there are no hurdles along the way. Buy custom Poem for the End of the Century essay

Disclosure of information Essay Example | Topics and Well Written Essays - 500 words - 3

Disclosure of information - Essay Example This new employee begun badmouthing his/her former boss and the company he/she used to work with. We initially thought he/she was just kidding because he/she looked sharp and we thought that he/she knew that it is unethical to badmouth former employers to new work colleagues. But he/she was not kidding, as he/she ranted all night long venting all his/her frustration on us about his/her former boss, his former co-workers and everything about the company he/she used to work for. It got to the point that we got stressed by his/her ranting that it defeated the purpose of our night out. Listening to his/her litany of pent-up emotions about his/her former boss and company really stressed me. It really turned me off. And it got me thinking that I may be badmouthed too should this new fellow worker move to other company. The next day, I became uneasy and uncomfortable around this new fellow worker though he/she was nice to me. For whatever reason, I feel guarded around his/her presence. I became uncomfortable sharing my own personal idiosyncrasy and kept my distance from him/her. I also avoided long conversation with him/her. I am aware that it is not the usual me to avoid people. But with this co-worker, I seem to have hard-time establishing a personal relationship as I became too guarded and stiff around him/her for us to become friends. I can feel that he/she is not really that bad as a person. But I just cannot forget his/her litany and ranting during the first evening that we socialized. Every time I try, the words she mentioned against his/her former boss and work mates just keeps ringing on my head. In a way, her personal angst rubbed on me as it affected my ability to open up to some people. Years went by and we both eventually resigned, but our relationship never progressed beyond the

Rituals Essay Example | Topics and Well Written Essays - 750 words

Rituals - Essay Example One of the ghost stories that I heard at UC Irvine is a dance major who was obsessed with being the perfect dancer. She lived at one of the single rooms in Mesa Court. She was quiet and rarely went out of her room. One week had already passed, but she had not gone out of her room at all. People thought that she could be practicing hard for her upcoming performance, especially since they could see her silhouette in the curtain, dancing every day. However, the bad smell started creeping out into the whole floor. The RA knocked on the dancer’s door several times before she decided to forcefully enter it. She found the dance major hanging from a ceiling fan, with a rope around her neck. She spun around slowly, as if she just killed herself, although the autopsy revealed that she had been dead for 10 days already. People thought that she gave in to the pressure and committed suicide. Joseph Bosco says in â€Å"The Supernatural in Hong Kong Young People's Ghost Stories,† â₠¬Å"†¦many supernatural phenomena have natural explanations. The moral lesson of the story is to not yield to pressure and to remain sane with the help of one’s social support group, as well as to practice healthy rituals. She is a loner who thought she could make it on her own without friends or family to support her. At the same time, her ritual might have been too strenuous on her, mentally and physically. Perhaps she needed the magic of positive rituals that give a â€Å"sense of control, with that added confidence, at no cost†.

Marketin Mix Essay Example | Topics and Well Written Essays - 1500 words - 1

Marketin Mix - Essay Example Referring to the process of evolving new products, it is closely associated with market development (Boone and Kurtz 2002). The concept of a product defines uniqueness nature and qualities of goods proposed to the market. Decisions in this area determine the products to be produced and stocked, as well as details concerning their appearance, form, size, package, quantities, timing of production, price lines, and anticipated market segments. Product combines the function of analyzing, classifying, and organizing information into commercially feasible new products, and the marketers function of assessing unsatisfied wants and needs and identifying profitable market opportunities. Usually this activity necessitates compromise among the engineering, production, marketing, and accounting departments. For instance, the high specifications stressed by engineering may push costs above market acceptance. Effective product development adopts a critical but positive posture. Management cannot be satisfied with current products, regardless of how good they are. Such an attitude and expression of expectations achieve an even better match of corporate offerings with consumer expectations (Lim and Rusetski 2006). The role of the sales force should be geared to company and marketing department objectives. The starting point of the sales program is company goals. Volume, profit, industry, territory, product, image, and rateof-return goals influence the direction and scope of sales activities. The practical range of sales alternatives for a company may vary from the companys own sales force, to the use of a variety of wholesalers including sales agents and manufacturers agents, to the elimination of salesmen by such techniques as mail order. Procedures for selecting salesmen vary from simple informal interviews to interviewing committees aided by batteries of psychological tests (Boone and Kurtz 2002). Price is accorded

Marketing Essay Example | Topics and Well Written Essays - 250 words - 79

Marketing - Essay Example they are done with holidays and return back home, they buy coca cola whenever they feel thirsty because they recall having a good experience in the beach house. For coca cola to attract more people they organize for parties every night and occasionally they blend the nights with pop music and great performance. Moreover, a private media company televises coca cola products in their morning program during the whole of summer (Adweek, pp.98) Alternative marketing plays a big role in the life of business if applied properly and at the right time. Firms can get advantage if they use alternative method when they make a commercial a trend, not essentially from their product. For instance Budweiser commercial players are taken to be great stars like a professional actor and athlete, as they established an image, a tendency that transformed into a culture. For a conclusion on this commercial, all of the people available shouted â€Å"what’s up† and in everyday life people do the same. Alternative advertising is the best for

Aviation Unions And The Aviation Industry Essay

Aviation Unions And The Aviation Industry - Essay Example The trip took about 20 minutes, and the one-way fare was $5. The service ceased at the end of Florida's winter tourist season, but it was the first such venture that indicated scheduled air service could be commercially viable. Similar passenger services in the United States and Europe soon followed. The world wars triggered great revolutions in aircraft's capability and use. At the end of the First World War enterprising commercial air carriers took advantage of the disabled ground transportation system and the large surplus of aircraft and pilots in Europe. By 1930s government-sponsored airlines were operating well beyond Europe to the Middle East, Africa, Asia, and even Latin America. In the United Sates commercial aviation in the private sector was enabled by two historic laws in the mid-1920s: The technological impetus in aircraft capability and manufacturing capacity made enormous strides during World War II. At the end of the war all these efforts were directed towards commercial aviation. Governments around the world regulated the air transport industry primarily because of the nature of safety and security concerns involved. In 1978 U S deregulated the aviation industry. This allowed air carriers to serve any domestic market and charge whatever they thought the market could bear. Airline deregulation was intended to foster competition in the air transport market and bring better service and lower costs. The air transport industry has grown enormously in the second half of the 20th century. The number of passengers worldwide grew from 177 million in 1965 to an estimated 3.3 billion in 2000. The number of U.S. airline passengers for the same period increased from 103 million in 1965 to an estimated 666 million in 2000. Aviation industry experienced an upheaval after Sep tember 11. The world wide economic downturn had already affected the industry very badly and September 11 was the final nail on the coffin. With the sustainability of industry coming under strain new concepts of cooperation and understanding between airline companies started evolving. For airline carriers, deregulation created both opportunities and dangers. During the 1980s many new airlines were launched and most of them bombed when existing carriers intensified competition by expanding into markets they had not previously served. Mergers and acquisitions followed as carriers vied for greater share of the pie. To retain profitability airlines resorted to the 'outsourcing mantra.' The savings achieved through outsourcing were very attractive to ignore. Therefore, outsourcing has become an accepted and established form of cost savings mechanism not only in aviation industry but in many other sectors also. Although the organized labor is generally against the concept of outsourcing, they are forced to accept it in the overall interest of the company's survival. Professor Peter Turnbull (1) of Cardiff University Business School, who conducted a study on behalf of International Labor Organization, says that evidence suggests "the global economic slowdown was already

Strategic Plan Research Paper Example | Topics and Well Written Essays - 2000 words

Strategic Plan - Research Paper Example As the consumer demands are ever changing, this industry has also constantly evolved over the years. Emergence of new entrants and constant innovation by the existing firms in this industry has induced tough competition. Companies are now planning strategies to increase the sustainability of their organization’s growth. The present report aims to identify the business drivers of Wal-Mart retailer and prepare an effective strategic plan for future growth and development. Company description Wal-Mart is the largest corporation in the world. It is also the biggest private employer in the United States of America (Yoffie & Wang, 2002). However, the company was first established as a self-service discount store by Sam Walton, in the year 1962. At the end of 1993, Wal-Mart was one of the top discount departmental stores in the world. The company is headquartered at Bentonville, Arkansas, United States. The company has established more than 8500 stores across the globe. Product portf olio of the company includes, apparel, warehouse club, footwear specialty, cash & carry, supercenter, superstore, discount store, hypermarket, supermarket. Wal-Mart resource and capabilities The brand name of Wal-Mart has become synonymous to value for money over the course of time. Wal-Mart follows a low cost and leadership strategy (Johnson & Scholes, 1999). Macroscopic view of Wal-Mart’s competitive strategy shows that the company uses resource based model in order to develop a value chain proposition which cannot be matched by competitors. Though Wal-Mart shows little adaptability to its formats in overseas expansions, most of its store operations are leaders in their local areas (Colla & Dupuis, 2002). The fundamental principles followed by the company are providing everyday low prices, commit to customer service and maintain technological superiority and establishing loyalty among suppliers and associates. Supermarkets of Wal-Mart in international location have less fin ancial risk due to bulk sales. About 10 billion dollars are saved by the American customers by shopping at Wal-Mart (Buffet, 2003). Competitive advantage for Wal-Mart lies in its ability of cost differentiation and strong distribution channel across the globe (Van Weele, 2009). Current direction Global economy is decelerating due to various reasons such as Euro zone crisis and economic recession which started in the year 2008. Retailers such as Marks & Spencer, John Lewis, Target, Wal-Mart, Kohl and others are struggling to maintain sales growth while other retail players such as Nordstrom, Saks and Neiman Marcus have recorded same store sales growth of 12% last year (Arnold, 2002). Global retailers are facing following trends to change the dynamics of business operation. This has compelled organizations like Wal-Mart to make strategic plan in order to remain profitable and competitive in this dynamic market (Simon et al., 2011). The objective of the current strategic direction will be to evaluate the resources and capabilities of the retail gain and make appropriate recommendations for future planning. SWOT Analysis In order to understand the internal and external strengths and weaknesses, a SWOT analysis of Wal-Mart has been done. Strengths With revenue of more than 400 million dollars, Wal-Mart is undoubtedly one of the largest retailers in the world. As a result of large operational scale, the company can exercises strong power on suppliers in order to

Marketing Essay Example | Topics and Well Written Essays - 250 words - 79

Marketing - Essay Example they are done with holidays and return back home, they buy coca cola whenever they feel thirsty because they recall having a good experience in the beach house. For coca cola to attract more people they organize for parties every night and occasionally they blend the nights with pop music and great performance. Moreover, a private media company televises coca cola products in their morning program during the whole of summer (Adweek, pp.98) Alternative marketing plays a big role in the life of business if applied properly and at the right time. Firms can get advantage if they use alternative method when they make a commercial a trend, not essentially from their product. For instance Budweiser commercial players are taken to be great stars like a professional actor and athlete, as they established an image, a tendency that transformed into a culture. For a conclusion on this commercial, all of the people available shouted â€Å"what’s up† and in everyday life people do the same. Alternative advertising is the best for

Strategic Plan Research Paper Example | Topics and Well Written Essays - 2000 words

Strategic Plan - Research Paper Example As the consumer demands are ever changing, this industry has also constantly evolved over the years. Emergence of new entrants and constant innovation by the existing firms in this industry has induced tough competition. Companies are now planning strategies to increase the sustainability of their organization’s growth. The present report aims to identify the business drivers of Wal-Mart retailer and prepare an effective strategic plan for future growth and development. Company description Wal-Mart is the largest corporation in the world. It is also the biggest private employer in the United States of America (Yoffie & Wang, 2002). However, the company was first established as a self-service discount store by Sam Walton, in the year 1962. At the end of 1993, Wal-Mart was one of the top discount departmental stores in the world. The company is headquartered at Bentonville, Arkansas, United States. The company has established more than 8500 stores across the globe. Product portf olio of the company includes, apparel, warehouse club, footwear specialty, cash & carry, supercenter, superstore, discount store, hypermarket, supermarket. Wal-Mart resource and capabilities The brand name of Wal-Mart has become synonymous to value for money over the course of time. Wal-Mart follows a low cost and leadership strategy (Johnson & Scholes, 1999). Macroscopic view of Wal-Mart’s competitive strategy shows that the company uses resource based model in order to develop a value chain proposition which cannot be matched by competitors. Though Wal-Mart shows little adaptability to its formats in overseas expansions, most of its store operations are leaders in their local areas (Colla & Dupuis, 2002). The fundamental principles followed by the company are providing everyday low prices, commit to customer service and maintain technological superiority and establishing loyalty among suppliers and associates. Supermarkets of Wal-Mart in international location have less fin ancial risk due to bulk sales. About 10 billion dollars are saved by the American customers by shopping at Wal-Mart (Buffet, 2003). Competitive advantage for Wal-Mart lies in its ability of cost differentiation and strong distribution channel across the globe (Van Weele, 2009). Current direction Global economy is decelerating due to various reasons such as Euro zone crisis and economic recession which started in the year 2008. Retailers such as Marks & Spencer, John Lewis, Target, Wal-Mart, Kohl and others are struggling to maintain sales growth while other retail players such as Nordstrom, Saks and Neiman Marcus have recorded same store sales growth of 12% last year (Arnold, 2002). Global retailers are facing following trends to change the dynamics of business operation. This has compelled organizations like Wal-Mart to make strategic plan in order to remain profitable and competitive in this dynamic market (Simon et al., 2011). The objective of the current strategic direction will be to evaluate the resources and capabilities of the retail gain and make appropriate recommendations for future planning. SWOT Analysis In order to understand the internal and external strengths and weaknesses, a SWOT analysis of Wal-Mart has been done. Strengths With revenue of more than 400 million dollars, Wal-Mart is undoubtedly one of the largest retailers in the world. As a result of large operational scale, the company can exercises strong power on suppliers in order to

DID diagnosis Essay Example for Free

DID diagnosis Essay They are â€Å"strangers to themselves. † Perhaps that is the most simplistic yet most accurate description of people suffering from a dissociative disorder. Their whole life can feel like one big dream, but the worst part is that it isn’t even their dream—it’s someone else’s. Everything seems to operate in slow motion, the outside world seems like an eternally ungraspable perception, and they feel like nothing more than a perception†¦. nothing more than a mere fleeting thought. This sort of depersonalization is the key characteristic of Dissociative Identity Disorder, separating it from the amnesias and the fugues (Sidran Foundation, 2003). And this disorder appears to be what Aaron will use as a defense for his murder trial in the movie Primal Fear. Aaron certainly displays the classic symptoms of this Axis I diagnosis. When the psychologist is speaking to him, he stutters and twitches (an Axis III physical characteristic) (Brown Barlow, 2001) and generally seems very incapable of establishing a connection with his surroundings. It is as if he is in a perpetual fog, waiting for any reason to run screaming into the protective mist. That flight appears to happen briefly when the lady recording the session starts fiddling with her camera. Then, Aaron’s polite â€Å"Aw, shucks† demeanor abruptly transforms into a fleeting moment of exasperated cursing—almost as if, for that brief moment, he was a different person. The change seems to go unnoticed for a while, until an intense argument with his lawyer reveals the truth about Aaron. In all of his previous interviews, the young murder suspect has displayed other key physical, Axis III symptoms that should have indicated all was not right (Dissociative disorders, 2005). He reported feelings of overwhelming exhaustion, claimed he did not remember the time surrounding the archbishop’s death (blackouts which, he claimed, had been experienced since the age of twelve), and often grabbed his head as if it were about to explode. Once Aaron’s lawyer starts to scream at him and demand the truth, Aaron jumps up and starts banging his head against the wall, in an effort to murder the pain in his head. Instead, that simple headache explodes into a sneering, cursing, chair-kicking, lawyer-slapping, sarcastic, non-stuttering, confident, and angry young man who calls himself â€Å"Roy. † His whole demeanor has changed. The key criterion of a DID diagnosis, the â€Å"alter† (a distinct state of consciousness that assumes control repeatedly) (Sidran Foundation, 2003) has been introduced with dramatic flair. Roy is someone who seems to be a living personification of Aaron’s missing confidence and aggressiveness. As his shocked lawyer looks on, Roy claims responsibility for the murder, boldly proclaiming how Aaron had run to him for help because he was not strong enough to handle things himself. Since Aaron’s apparent Axis I disorder has such a strong impact on his personality and development, any Axis II diagnosis should be deferred until Aaron has completed treatment and confronted his â€Å"other self. † But what lies at the root of this contentious new force? Aaron’s entire early socio-cultural experiences were molded in fear and terror. Patients with DID more often than not have the prolonged agony of severe childhood abuse to overcome (Chaves, Kirsch, Lynn, Lilienfield, Powell, Sarbin, 2007), and Aaron is no exception. The prisoner, in an early interview, briefly mentions his father, who was â€Å"not a nice man. † He also gets very uncomfortable when the subject of sex with his girlfriend is broached. These incidents point to possible sexual abuse (incest is a common precursor to DID) by the father. In response to the extreme physical and emotional pain accompanying their abuse, and more importantly to the overwhelming shame associated with keeping the secret, highly creative individuals may adapt their rich fantasy life as a lifeline (such a coping mechanism may be more prevalent in an individualistic Western society which encourages open and innovative expression). They can be their own hypnotist (Brown Barlow, 2001). In Aaron’s case, his somewhat restrictive religious upbringing (serving as an altar boy) could have contributed to his repressive tendencies in dealing with his traumas. Since Aaron’s blackouts began around the age of twelve, this is probably the time when Roy made his first appearance as a protector to Aaron. The â€Å"protective† alters are usually aware of their role, while the â€Å"host† remains trapped in the unconscious world of â€Å"not knowing. † After the early childhood onset, the alters usually reappear when certain new life experiences provide triggers or cues (Chaves et al, 2007). For Aaron, the alleged pornography he was forced to engage in with his girlfriend for the priest brought out Roy in full-force. The repressed anger he felt for this authority figure in his life, who had betrayed his trust, just as his father likely had, became a brutal realization in Roy’s fierce murderous impulses. In the interviews, the camera the psychologist used probably accounted for Roy’s brief appearance, as it was a reminder of the pornography. And the lawyer’s abusive language and actions brought him out, guns-blazing, for the final truth. This volatility and instability—characteristic of many DID patients—often places them on the lowest ends of the global functioning scale. In Aaron’s case, his doctors have obviously agreed, as all of his encounters take place in the controlled atmosphere of a prison setting. However, I would advise those doctors to take a closer look at Aaron. Something seems amiss. Perhaps they could utilize some of those personality, GSR, and neurophysiological tests that have proven so effective in spotting â€Å"fakers† (Cherry, 2008). Maybe they should check â€Å"Aaron†Ã¢â‚¬â„¢s room for any possible extracurricular reading†¦. or should I say Roy’s room? By trial’s conclusion, the acquitted young man coldly and even joyfully informs his swindled lawyer that he has performed the ultimate con, and the film concludes with Roy taunting and boasting about his victory in fooling everyone. The audience learns that â€Å"Aaron† is likely the real illusion, and this revelation makes the character amoral and devoid of any rooting value. Dissociative Identity Disorder remains one of the most enduring controversies within the psychiatric community. In spite of the documented cases and the current DSM recognition, many educated scholars still maintain that the disorder is a popular myth, brought about by socio-cultural factors of role-playing and a thirst for sensationalism (Chaves et al, 2007). Skeptics might use cases such as that of Hillside Strangler Kenneth Bianchi as an example. This convicted multiple murderer tried to blame his crimes on a killer alternate personality. He was soon found to be faking, an assumption solidified by the discovery of various psychology books in his jail cell (Cherry, 2008). Individuals such as the real Bianchi and the fictional Aaron set the psychiatric community’s standing and progress back decades, but such individuals likely would not care in the slightest, as their true diagnosis is decidedly â€Å"antisocial†: failure to follow social norms, deceitfulness, lack of remorse, recklessness, danger to others (Brown Barlow, 2001)†¦. Or, in the words of an 1885 physician, whose patient sounds eerily familiar: (Having) no capacity for true moral feeling all his impulses and desires, to which he yields without check, are egoistic, his conduct appears to be governed by immoral motives, which are cherished and obeyed without any evident desire to resist them. (Vaknin, 2009) Perhaps that Axis II diagnosis should not be deferred after all†¦. References Brown, T. A. Barlow, D. H. (2001). Dissociative Identity Disorder. Casebook in Abnormal Psychology (2nd ed. ). Pacific Grove: Wadsworth Thomson Learning. Chaves, J. F. , Ganaway, G. K. , Kirsch I. , Lynn, S. J. , Lilienfeld, S. O. , Powell, R. A. Sarbin, T. R. (2007). Dissociative Identity Disorder and the socio-cognitive model: Recalling the lessons of the past. † Psychological Bulletin 125(5), 507-523. Cherry, A. A. (2008). Multiple personality disorder: fact or fiction? Retrieved February 23, 2009, from Personality Research: http://www. personalityresearch. org/papers/cherry2. html Dissociative disorders. (2005). The Merck Manual of Diagnosis and Therapy. Rahway: Merck Publishing Group. Sidran Foundation. (2003). Dissociative disorders. Towson: Sidran Institute. Vaknin, S. (2009). The history of personality disorders. Retrieved February 23, 2009, from Mental Health Matters: http://www. mental-health-matters. com/index. php? option=com_ contentview=articleid=1087

Exploring the contribution of forensic science

Exploring the contribution of forensic science Forensic psychology has proven itself to be a quite intriguing field of study. From serial killers to child custody cases, the work of a forensic psychologist is involved. Forensic psychology is the intersection between the field of psychology and the legal system (Huss, 2001). Or, as defined by the American Board of Forensic Psychology (ABFP), [forensic psychology] is the application of the science and profession of psychology to questions and issues relating to law and the legal system (ABFP, 2010). This profession is not restricted to just one area of the legal system; in fact it contributes to the subspecialties of corrections, civil court, investigations, criminals, juveniles, and police. The purpose of this paper is to explain the roles and responsibilities a forensic psychologist has in each subspecialty, review court cases and research relative to the area, and discuss ethical dilemmas/ challenges and controversial issues forensic psychologists may encounter. Note: Throughout the text the terms forensic psychologist and psychologist are used interchangeably to describe the profession Introduction Criminal Criminal psychologists can be found in various settings with a wide array of roles and responsibilities. Aside from studying criminal behavior, criminal psychologists work with the police departments assisting with investigations, giving advice on how to conduct interviews with suspects and witnesses, they provide their services as an expert witness, aid in the process of rehabilitating an offender, and continuously research developments related to their field (Bull, Hatcher, Cooke et al, 2009). In the case of Jenkins v. U.S., 1962, it was ruled that a medical degree was no longer a requirement for an expert witness and that with the proper training and level of expertise a psychologist could now testify on issues relating to mental disorders. However in the role of an expert witness there are a couple challenges that appear which are attorney contracted psychological services and the admissibility of expert testimony in court proceedings. During a court proceeding a criminal psychologist may be called upon to give their expert opinion about a matter related to the case. The purpose of an expert testimony is either to explain or give information to help in either the jury or judges decision making and is related to the psychologists area of expertise (Shuman Greenburg, 2003). According to the Federal Rule of Evidence (Fed. R. Evid.) 702 If scientific, technical, or other specialized knowledge will assist the trier of fact to understand the evidence or to determine a fact in issue, a witness qualified as an expert by knowledge, skill, experience, training, or education, may testify thereto in the form of an opinion or otherwise, if (1) the testimony is based upon sufficient facts or data, (2) the testimony is the product of reliable principles and methods, and (3) the witness has applied the principles and methods reliably to the facts of the case. In cases when a psychologist is asked to be an expert witness by an attorney who is requesting information to defend his or her client, problems may arise. An attorney seeks out a psychologist to provide expert testimony and evidence that will benefit the case of their client, not the opposing side. However, a psychologist is ethically responsible for providing an unbiased opinion or delivery of facts regardless of which attorney contracted their services. The pressure to be loyal to the attorney that has contracted the psychologists services causes a problem for those psychologists who uphold the integrity of the profession. When caught in a situation where the findings of the psychologist are not aligned with the goals of the attorney, the psychologist can either give a testimony that is altered to fit the requests of the attorney and risk civil liabilities and ethical complaints, or they can report the facts and risk not being called upon again. Although it is a true dilemma to de cide which direction to take as a professional, upholding individual integrity and that of the profession is vitally important. Based on the responsibilities outlined in the Specialty Guidelines for Forensic Psychologists (1991), forensic psychologists should make a reasonable effort to provide their services in a manner that is responsible and forthright. When a the services of a psychologist are requested, they should be upfront about their position to be unbiased and only report the facts regardless of the outcome. Another challenge that surfaces with expert testimony given by a psychologist is its admissibility in court. As mentioned earlier in the Fed. R. Evid. 702, an expert testimony may be utilized if it is based on sufficient facts or data. The facts and data are what determine the reliability of the experts testimony. This becomes a factor when it must be determined whether the information presented should be admitted as evidence in the court proceeding. Prior to the case of Daubert v. Merrell Dow Pharmaceuticals Inc.(1993) in order for an experts evidence to be admitted in court it must follow the rule of general acceptance, which meant the evidence must have been obtained using scientific techniques that were generally accepted in the scientific community (Bartol Bartol, 2008). With the ruling in Daubert v. Merrell Dow Pharmaceuticals, Inc. it is now left to the discretion of the judge to determine whether experts evidence should be admitted. For a psychologists is becomes a challenge to convince the judge that the information they are presenting is both valid and reliable. As a safeguard, psychologists should disclose the sources of all of the information used to form their testimony (Committee on Ethical Guidelines for Forensic Psychologists, 1991). Aside from the challenges criminal psychologists face as an expert witness, they also must address the controversial issue of whether offenders can be rehabilitated. The Bureau of Justice Statistics reported a study that looked at the level of recidivism of a group of prisoners released between 1983 and 1994. What they found was that a high percentage of these individuals were re-arrested (Beck Shipley, 1997; Langan Levin, 2002). With high numbers of released prisoners returning to the prison or criminal justice system, the effectiveness of rehabilitation programs is questionable. Research is still being done on what causes crime and what type of psychological effects do prisoners experience while incarcerated (Benson, 2003). Hopefully with a better look into what leads a person to commit a crime, better ways to rehabilitate them will be developed. Juvenile There are two themes that govern the juvenile justice system which are the welfare of the juvenile offender and public safety (MacArthur Foundation research Network on Adolescent Development and Juvenile Justice). The forensic psychologist in this specialty adheres to these themes in their roles and responsibilities to conduct assessments, evaluate competence, and provide therapy (Bartol Bartol, 2008). Forensic psychologists may be called upon to assess a juveniles level of threat to society, whether they are competent to make certain decisions, and decide what type of treatment can be offered to them (Bartol Bartol, 2008). Working with juveniles is not the same as working with an adult population. One ethical dilemma that comes about when working with juveniles is whether the psychologist has sufficient competence for working with juveniles if they have only assessed adults. Outlined in the Specialty Guidelines for Forensic Psychologists (1991) under competence, it states a forens ic psychologist should only provide services in areas that they either have specialized knowledge, education, experience or skill. Psychologists must be very careful when assessing juveniles because they do not present the same behaviors as adults; some of these behaviors may be misinterpreted by the assessor if they have no knowledge of juvenile assessments (Bartol Bartol, 2008). Assessment is a very important part of the juveniles dealings with criminal justice system, so a psychologist should make every effort to ensure they are competent in this area prior to providing services. When approached about providing services as a juvenile assessor, the forensic psychologist should be honest about their limitations in competence and either make an effort to become knowledgeable about the area, or decline the request (Committee on Ethical Guidelines for Forensic Psychologists, 1991). Dual relationships also pose an ethical challenge for forensic psychologists in this area of specialty. Forensic psychologists should avoid the role of both evaluator and treatment provider (Bartol Bartol, 2008). This is an issue because as an evaluator, the forensic psychologist is contracted with the court, who is the client. Which means the forensic psychologist must warn the individual of the limits to confidentiality. In the role of the therapist, the client is the individual patient and there is some protection of confidentiality under patient-therapist privilege. In the case of Jaffe v. Redmond (1996) the U.S. Supreme court supported confidentiality in federal courts. It is best practice to avoid dual roles. If the two roles must be combined, there should be an effort to avoid any negative effects to the individual client (Committee on Ethical Guidelines for Forensic Psychologists, 1991). Levels of juvenile cognitive skills and adjudicative competence are issues that are still being debated in the juvenile justice system. The MacArthur Foundation Research Network on Adolescent Development and Juvenile Justice define competence as ones ability to understand the processes associated with the trial, aid the attorney, and make important decisions. However, research has found that a number of juveniles 15 and under have mental competency scores similar to adults with serious mental disorders (MacArthur Foundation). Which means juveniles are not capable of making reasonable decisions related to waiving their constitutional rights, confessions, and plea bargains (Mac Arthur Foundation)The goal of the juvenile justice system has been to rehabilitate offenders so that they can eventually lead healthy lives as adults, without much focus on their competency to understand the justice system (Viljoen Wingrove, 2007). The belief is that juveniles should be assessed based on their levels of development, not the standard of the justice system which is geared towards adults because some developmental issues may not be detected (Ryba, Cooper, Zapf, 2003). The decision whether a defendant should be transferred from juvenile court to criminal court is an issue that is still being worked out in the justice system. In the case of Kent v. United states (1966) where 16-year-old Morris Kent, after confessing to his crimes, was transferred to criminal court and found guilty of housebreaking and robbery, and not guilty by reason of insanity for rape. Kents attorney argued that Kents case should have remained in juvenile court because he would have had a better chance of rehabilitation than in criminal court where he was sentenced to 30 to 90 years in a mental institution (Kent v. United States, 1966). Even today research is still being done on whether juveniles have adjudicative competence and if they should be transferred to criminal courts. Civil The Civil Court is primarily designed to handle private disputes between individuals or organizations (Britannica Online Encyclopedia, 2010). The major roles of the forensic psychologist in the civil court setting are those of an assessor and evaluator. Forensic psychologists may be called upon to assess emotional factors related to traumatic or personal injury litigations; assessment of psychological factors in relation to harassment, discrimination, and workers compensation disability, as well as post-mortem assessments and competency evaluations (Franklin, 2006). Forensic psychologists are also called upon in family courts to complete child custody evaluations (Franklin, 2006). Child custody evaluations conducted by psychologists tend to bring up some ethical concerns. An unresolved controversial issue in this subspecialty is that there is currently no standard practice when conducting child custody evaluations (Bartol Bartol, 2008). Many psychologists choose to use several forms of psychological testing as means to determining child custody in response to the American Psychological Associations (APA) (1994), request that there should be several methods for collecting data (Bow Quinnell, 2001). The issue with the psychological tests used is that there is no empirical evidence to support it (Bow Quinnell, 2001). To ensure adherence to the APA guidelines, the psychologists should use several techniques to conduct evaluations such as interviews, self-report studies, and psychological testing (Bartol Bartol, 2008). If a forensic psychologist is called upon to conduct a mental evaluation of a victim in sexual harassment suit, it is important that the psychologist thoroughly explain the potential use of the information gained. Informed consent now becomes an issue in this case because the victim must reveal personal information regarding their past sexual history during the evaluation (Bartol Bartol, 2008). The APA state in the Ethical Principles Psychologists and Code of Conduct section 3.10(c) When psychological services are court ordered or otherwise mandated, psychologists inform the individual of the nature of the anticipated services, including whether the services are court ordered or mandated and any limits of confidentiality, before proceeding. This can become a challenge for a forensic psychologist if the victim does not fully understand the limits of confidentiality in this situation. The forensic psychologist should take special care to explain to the client, in language they underst and, that the information provided may be used in the courtroom. By doing this the psychologist is making an effort to reduce the potential for more harm to the client. One of the most controversial issues in this area of forensic psychology is physician-assisted suicide. Physician-assisted suicide takes place when a competent individual requests that a physician prescribe a medication that will aid them in ending their life. The role of the psychologist is to determine whether or not the individual is competent to make such a decision. The state of Oregon, in 1997, enacted its Death with Dignity Act which allows for physician-assisted suicide (Oregon State). The debate on whether other states will join Oregon is ongoing, as well as the research on the responsibilities of the forensic psychologist in this role (Bartol Bartol, 2008). The case of Daubert v. Merrill Dow Pharmaceuticals, Inc (1993) is pivotal in this subspeciality because of the forensic psychologists role as an expert witness in civil cases. Research is still being done on how the Daubert standard affects the admissibility of expert testimony given by forensic psychologists (bartol Bartol, 2008). Investigative The work of the investigative forensic psychologist may be the most popular because of the media hype over the role of criminal profiling. In the case of U.S. v. Sokolow (1989) a form of profiling was used to make an arrest based on the behavioral characteristics of drug dealers. Criminal profiling methods have been around long before the gained popularity in the media. Actually, forensic psychologists have a few other roles and responsibilities dealing with investigations besides criminal profiling. Forensic psychologists use a variety of techniques to link a suspect to a crime. They study the crime scene to get a better understanding of the physical and verbal behaviors of the suspect (Woodham, Hollin, Bull, 2007); they also use geographical profiling to determine the territory of a serial offender (Bartol Bartol, 2008). This information is then used to narrow down the list of possible suspects put of a larger population. Psychological autopsies are unique responsibility of inves tigative forensic psychologists because they are done to determine the mental state of an individual prior to their demise. Also an investigative psychologist may conduct a forensic hypnosis to aid in a witnesss or victims recall of a traumatic event. Much scrutiny surrounds the use of forensic hypnosis as well as criminal profiling. Despite the glamorous appeal profiling has shown on various TV shows and movies, it is not a widely accepted practice. There are several concerns that cause profiling to be a very controversial issue. From the lack of research supporting its reliability and validity (Mcgrath, 2000), to the belief that profilers are creating opinions based on gut feelings (Bartol Bartol, 2008), and its inability to meet the basic expert witness standards sought under the section of the Federal Rule of Evidence 702 that states the testimony [of an expert] is based upon sufficient facts or data, . . . is the product of reliable principles and methods, and the witness has applied the principles and methods reliably to the facts of the case (Alison, Bennell, Ormerod, Mokros, 2002). This brings about ethical challenges because forensic psychologists are obligated to provide services that are consistent with the highest standards of the profession (Committee on Ethical Guidelines for Forensic Psychologist s, 1991, p. 657). As Alison, et al. (2002) assert, the methods used for profiling result from an understanding of personality and trait approach that is both naÑ-ve and outdated. Many researchers suggest that psychologists should be cautious about using profiling in criminal investigations (Bartol Bartol, 2008; Alison, et al., 2002), but if it must be done, appropriate steps should be taken to base their opinion on current empirical evidence that is available and not just on gut feelings (Torres, Boccaccini, Miller, 2006). As of today, there is still a need for research to support the use of profiling. Pretrial identification methods is another area of ethical concern for psychologists because of its vulnerability to bias and error. Many police agencies use lineups and photospreads to help witnesses identify a suspect. The issue of bias arises when either the investigator or administrator make suggestions or subtle innuendos about who the suspect is. In a study conducted by Greathouse Kovera (2009) it was found that in situations where the administrator of the lineup and photospread knew who the suspect was, the witness was more likely to correctly identify them as oppose to situations where neither the administrator nor the witness knew the suspect. To resolve an ethical dilemma of this type, it is recommended that those administering the lineup and photospread should not have knowledge of who the suspect is (Bartol Bartol, 2008). Correctional In 2005 nearly half of the inmate population in prisons and jails reported having a mental health problem (James Glaze, 2006). With such a rise in the number of mentally ill inmates, the prison system may now be the nations largest provider for this special population (Fellner, 2006). Rising numbers indicate there is an even greater need for forensic psychologists working in the prison systems today. The role of a forensic psychologist is that of assessor and treatment provider. Within these roles, forensic psychologists are responsible for coordinating and ensuring the mental health programs are running properly, supervising the employees assigned to these programs, and administering mental health services to the inmates that need it. The forensic psychologist also functions as a trainer for the staff and screens the staff that will be working with inmates in special mental health units and step up to help in crisis situations (Magaletta Verdeyen, 2005; International Association f or Correctional and Forensic Psychology, 2010). Working in correctional facilities can be very challenging for the forensic psychologists. The work environment is no way comparable to the application of psychology in the community or private setting. There are various risks and safety issues when dealing with criminals in this type of setting such as dual roles. The Standards for psychology services in jails, prisons, correctional facilities, and agencies address this issue by stating Mental health services staff do not assume a dual role that overlaps with other functions and services (e.g., security) of the correctional agency or facility that could result in unethical dual-role relationships that risk harm to their offender or inmate clients (International Association for Correctional and Forensic Psychology, 2010, p. 19). At times, a correctional psychologist may act in the role of evaluator and therapist, or even as the therapist and a stand-in correctional officer. In some correctional facilities the expectation is that a psychologist is a correctional officer before any other role, thereby making it a responsibility of the psychologist to aid in doing a count of the inmates, conducting searches of an inmates cell and person, supervise inmates, and escort inmates to segregated areas (Bonner Vandecreek, 2006). Dual roles of this type create mistrust between the inmate and the psychologist because the psychologist is now viewed as another correctional officer and not someone there for the interests of the inmate. In order to eliminate the potential of dual roles, the psychologist should request in writing that they should only be assigned to duties that align with their particular profession and ethical standards (Bonner Vandecreek, 2006). A second ethical challenge for psychologists is avoiding situations that would intentionally cause harm to their client. The conditions of prison are not necessarily adequate for those suffering from mental illness, and many times many of them go undertreated (Fellner, 2006). The prison walls are riddled with too many inmates, violence, and victimization by other inmates and the staff (Bartol Barto, 2008).It is the responsibility of the psychologist to maintain their position as an advocate for their client and not as an additional perpetrator of their rights but this is challenging when jail and prison conditions prevent effective treatment. The IACFP (2010) contend that Offenders are incarcerated as punishment, not for punishment (p. 759). Participating in or allowing the inhumane treatment of inmates, mentally ill or not, goes against the standards for psychologists in this subspecialty. Unfortunately, psychologists may be harming unintentionally causing harm by not provided the adequate treatment needed. The climate of the prison environment will take several steps in order to see a change, but there are things a psychologist can do to resolve some of these issues. It is important that the psychologist does not fall into the same mentality of a correctional officer and participate in activities that are intended to do harm. The IACFP (2010) suggest that psychologists should avoid any delays when a request has been made for mental health services; avoid imposing any biases or beliefs on or towards inmates; meet the requirements of due process; practice within ones personal scope of competency; and continuously advocate for better mental health services in jails and prison. One controversial issue that surrounds the treatment of mentally ill inmates is their segregation from the general population. In the case if Perri v. Coughlin (1999) a severely disordered inmate was kept in an observational where an inmate is stripped of their clothes and placed in a cell for their protectionfor a total of 108 days without any treatment. Another issue is although inmates have the right to refuse treatment, they can be forced to do so if it is determined that they are severely disordered and cause a threat to themselves and others which was argued in the case of Washington v. Harper (1990). Forced consent to treatment stirs up controversy for psychologists because inmates may only consent to treatment for fear of privileges being taken away, such as in the case of McKune v. Lile (2002). Despite the controversies that come about it the correctional system, the research focus has been on reducing recidivism and increasing rehabilitation. Police The final subspecialty of forensic psychology to be discussed is police psychology. Police psychology is the application of psychological principles to the profession of law enforcement and public safety (Bartol Bartol, 2008). As a police psychologist the primary role is to provide psychological services to law enforcement either through counseling, employee screenings, fitness-for-duty evaluations, assessment of incidents requiring deadly force, crisis counseling, and special unit evaluations (Bartol Bartol, 2008). Police psychologists assist with the special units of police agencies including, SWAT, hostage negotiations, and victims response. Just as with all the other areas forensic psychologists team up with, there are a few ethical issues that emerge. Conflicts between agency requirements and the ethical standards of the psychologist can pose a serious ethical dilemma when working with police agencies. Two ethical challenges in particular are the interrogation methods of some police agencies that lead to false confessions. Leo Ofshe (1998) assert that false confessions are a result overzealous police officers who are so eager to arrest a suspect that they tend to overlook evidence that may point towards the individuals innocence. Some tactics police may use to gain these confessions are deprivation, humiliation, or manipulation (Bartol Bartol, 2008). These actions cause problems for psychologists because they position is to advocate for human rights, when these actions can be viewed as violations of these rights. When psychologists are caught in situations that cause ethical conflicts they must abstain from taking part in those behaviors. It is at the discretion of the individual psychologist whether they wish to continue consul ting with police agencies that practice abusive interrogation techniques (APA, 2007). If they decide to continue their work, psychologist should consult with police on interrogation strategies that will not impede on an individuals human rights and decrease the likelihood of a false confession. Interrogation tactics have begun to come into the lime light with Americas War on Terrorism. But before then there was focus on another controversial issue, excessive force. Excessive force has been a controversial issue for decades. Many Civil Rights protesters can probably recount various incidents when they were victims of police excessive force. However the most striking case of our time dealing with police excessive force is that of Rodney King in 1991. Surrounding the issue of excessive force is also deadly force, although its occurrence is not frequent. With both of these issues, psychologists may be asked to conduct fitness-for-duty evaluations to determine the officers ability to carry out their required duties (Bartol Bartol, 2008). A plethora of research is available for the subspecialty of police psychology. Topics range from cultural competency, dealing with the mentally ill, on the job stress, excessive force, employment screening, and community relations. As the research in this area progresses, enhancements can be made to the types of treatment psychologists offer. Conclusion The field of forensic psychology encompasses a wide range of roles and responsibilities; with various contributions to the fields of law and psychology. In its short existence there have been tremendous gains in research and practical applications. As the profession of forensic psychology grows in popularity among the public, there is sure to be greater strides in the collaboration of psychology and law.