Chaplin vs Buster

Looking at Modern Times we see cater his act to the viewer. Pressured by the public to reflect social and political discrepancies of the world Charlie develops a topical approach to his art. Buster also developed his act to appeal to the masses as I will later discuss but when comparing our two films Charlie's Modern Times Is the one which caters to both the social and political Issues of the day. Beyond the realm of film Charlie holds his own personal commentary about his world and the Issues faced as his book A Comedian Sees the World demonstrates.Still despite his views initially Charlie saw a clear separation between his art and politics. â€Å"Art is the treatment applied to work and has nothing to do with the subject matter. â€Å"2 Despite this by the mid sass it was not enough to be political yourself as an artist it was also expected to be seen in your art. It was following his world tour that he became more out spoken about the condition the Depression had left the world, and decided to give into outside pressures. Like other Charlie films the film Modern Times took straight from the textbook of Chaplain's aesthetic contract where comedy, romance and pathos, would meet.As stated the difference between other early films by Charlie and Modern Times however were the topical allusions used. We can clearly see this in early scenes between the Electro Steel Company's owner and his workers. The boss barks demands throughout the beginning and by the end of the sequence Charlie's character ends up going mad from the oppressive nature of the work place. Another allusion is to link between poverty and crime as we see scenes of Charlie's love interest stealing from the rich to feed both her and her struggling family. It is important to note however that Von Wigging's essay notes that the combination ofChaplain's aesthetic contract as well as, social and political realities was problematic. To him the film does not ring true to the woes of depression when contra sted with the optimism of a go lucky clown. Still this does not discount the topical allusions which were used throughout this film. Unlike Buster this film Is very much a commentary on the world around them. When looking at the gags done in Modern Times the sheer expressiveness of Charlie. Uses the silliness of things like body movements. You especially you can't overlook the obvious facial movements of Charlie compared to the stone faced Buster.For example scenes like when Charlie is being force fed food are pleasurable because of his being over the top clearly contrast scenes in the General like when Buster no longer sees the train in front of him and gives slight facial movement and reaction. This is one of Busters most well know trademarks. Buster got his start in a family vaudeville act and would later grow to own his own production studio where he directed and starred in a number of films. The General is a classic chase film set during the Civil War. It recounts the story of a down on his luck train engineer who gets wrapped up in a daring rescue for the love of his life.Laura Macgregor notes in her paper and as I mentioned Buster Sexton's â€Å"the General. † Buster Keating tries to appeal to sentiments of the time which called for greater realism in comedic gags. 4 If it couldn't happen in real life then it was not real and Buster saw it as an â€Å"impossible gag. † So rather than fantastic gags he would work at keeping his gags realistic. Laura add that by utilizing the long shot with a long take Buster is able to show how authentic his stunts, like when he travels between train carts, can be. This makes the slapstick comedy more believable to the audience ember.One example of another realistic gag is when Buster's character disguises his love as a sac of potatoes. After putting her on the train you catch shots of Buster wincing in pain as he watches soldiers continue loading. 5 This is contrasted with some of the gags in Charlie's' fi lm Modern Times such as the scene when Charlie finds new employment only to mess up and accidentally cast off one of the ships or the scene where he is blind folded and roller skating a few floors up. Cartoonist scenes where Charlie is being rung through the inside of a machine would not hold true to he realism Buster was looking for.It is important to note that Buster did not simply deny suspending belief in all his films, rather he developed a comedic realism within his features in response to audience's wants. To add to the authenticity Keating also believed things should be visually real. From costumes to the genuine armies of people Buster was committed. â€Å"In the general I took a page from history and I stuck to it in all detail. I staged exactly what happened. â€Å"6 Another technique used by Buster in the General, which Laura touches on, was to plant the gag alongside the narrative.Just as audiences called for comedic realism Laura claims audiences of the sass's were l ooking for more sophisticated or complex comedic relief over what many would deem as simple slapstick comedy. † †¦ Almost all of the gags in The General serve similar double duty as gag and narrative element† 7 It is interesting because by doing so gags not only are used to expand on the story but become key in the development and cohesiveness of the film. Once again looking at the scene where Buster potato sacs his damsel the gag is clearly working on the bigger picture of getting them back to their allies.Without this gag the story can not move forward as smoothly. In comparison to more random scenes within Charlie's' Modern Times such as his roller skating scene within the department store. Though comedic it is not intertwined within the plot. To better entertain the public and though both films were not received well for various reasons they commit to growing within there art Just in different ways. Charlie's pressures being that of representing daily life in th e Depression while Buster is more concerned with appealing to audiences' want for a more realistic performance.

Effects of H-1B Visa Program on Employment and Wage in the United States Essay

The United States is the most powerful country in the world. Its dominant culture, military, and economy make it the most influential nation across the globe. The power of the US doesn’t only come from its native citizens but also from the foreigners who come to its shores every day to work and live there. These people play a very significant role in driving the US economy. A number of national programs have been developed in order to influence the influx of these people into the US. One of those programs is called the H-1B visa program. The program, which allows foreigners to work in the US, has critical effects on various sectors of American society, but especially the economy. Based on the data that have been so far collected, it is clear that the H-1B visa program, in terms of employment in the technology sector, is important in maintaining the status of the country as a leader in science and technology. However, the H-1B visa program may also have negative effects on the wage of native citizens because they would have to compete with the low wages of foreign workers. Many companies in the US needed temporary workers, so the H1 category of non-immigrants was created under the Immigration and Nationality Act of 1952. Unlike immigrants, non-immigrants only stay in the US temporarily to accomplish a specific purpose, for instance, education or work. The current H1-B visa program of the United States was created through the Immigration Act of 1990 and the amendment of the 1952 act. The result of the amendment was a program that allows an employer to temporarily hire a foreigner to work in the US provided that he’s under the category of non-immigrants. Also, the worker must have a specialty occupation or be a fashion model with exceptional ability and merit. The law describes a â€Å"specialty occupation† as something that requires theoretical and practical application of a specialized body of knowledge. The worker must also have a bachelor’s degree or the equivalent in specialties such as business, biotechnology, education, health care, medicine, and sciences. The H1-B program currently limits the number of foreign nonimmigrant workers in the US to 65,000 per year (Bartik et al. 134). H-1B’s cap has not always remained the same, however. Congress increased it to 115,000 in 1998 for fiscal years 1999 and 2000. Then in 2000, Congress increased it even further to 195,000 for the 2001 fiscal year. It was maintained during 2002 and 2003, and was slashed to 65,000 again from 2004 onward. Not all foreign workers are affected by the cap, however. The H-1B Visa Reform Act of 2004 states that foreign workers employed by institutions of government research organizations, institutions of higher education and NGOs are exempt from the cap. Also, a separate cap of 20,000 exists on petitions that are filed on behalf of foreigners with master’s or higher degrees earned in the US (Bartik et al. 135). Recently, lobbyists composed of universities and members of the technology industry are pushing for a huge increase in the annual cap of H-1B visas. They argue that H-1B visas otherwise known as â€Å"guest worker visas† serve a crucial role in driving the economy, especially in the high technology sector. According to them, there is a systemic shortage of American engineers and scientists in the country. There is a very high demand domestically for these highly skilled workers and the small supply cannot fill that gap. The only way to solve this problem therefore is through the import of foreign workers through the H-1B visa program (Hira et al. 150). These lobbyists argue that they will be forced to resort to outsourcing jobs to foreign engineers and scientists in their home countries if the H-1B cap is not increased. They also claim that the visa program actually serves as a tool for the country to gather the best and the brightest highly skilled workers in the world. This is supposedly a result that is to be expected if the cap on the H-1B visa program is increased (Hira et al. 150). There are many evidences for the advantages brought about by hiring foreign workers in the technology sector. For example, a 2008 study by the National Research Council looked at the effects of hiring H-1B workers by large US companies Texas Instruments, Qualcomm, Motorola/Freescale, Intel, and IBM. Of the five companies, IBM employed the most number of H-1B workers, granting almost 4,000 in five years. Most applications in the company stated a range of earnings of about $82,072. This was considerably bigger than the other four companies’ average minimum earnings. The researchers thought that the applications were for jobs that were not chip-related since IBM had become a software company from a hardware company (National Research Council and National Academy of Engineering 152). It is clear from the example above that foreign workers in the technology sector do indeed get attracted to the United States through H-1B visas. IBM was hiring more foreign workers than anybody else in the group, and these people were earning higher. However, there are still many â€Å"experts† that love to criticize the H-1B visa program. John McCain and Edward Kennedy defended the H-1B visa program in 2006. The two senators supported the immigration bill that passed the Senate and insisted that their bill required employers to search for workers in the US first. However, their bill actually didn’t have any of these provisions (Hira et al. 152). Indeed, it’s a common misconception that the current law instructs US companies to look for workers in the US first. Many government officials also have this incorrect belief. Senator Norman Coleman, for example, says that he supports the issuance of H-1B visas as long as a number of conditions are met. One, the employer must show that there is not enough US workers qualified for the position; two, that the employer has not laid off a US worker 90 days before or after hiring a foreign worker; three, the employer must demonstrate that they tried to hire US workers before foreign workers; and finally, that the recruitment of H-1B workers will not have adverse effects on the waves, working conditions, and job opportunities of US workers. Even then Senator Barack Obama thinks that the H-1B policy aims to exhaust all means of recruiting US workers before foreign workers. He believed that hiring H1-B workers should be a last recourse for American employers (Hira et al. 152). The truth is however, that the provisions mentioned by the two people above actually don’t exist for the majority of employers who use the H-1B visa program. Even Obama’s wish that employers should hire foreign workers as a last option is not practiced in the real world (Hira et al. 152). Also, according to market indicators, there is not enough evidence of a systemic shortage of resident engineers and scientists in the US, one of the main arguments of lobbyists for the increase in H-1B cap. Also, earnings and wage growth have been moderate and more or less the same as other professions. The unemployment rate, while it sharply increased during the dot-com bubble, has now fallen. Researchers have also supported the idea that there is little evidence of shortage in high technology jobs. Private surveys and public data are also conflicting when it comes to determining shortages. Trade surveys show there are indeed shortages, but public data indicate the opposite (Bartik et al. 137). Determining shortages in scientists and engineers is a real problem because any increase in the number of H-1B visas issued by employers alone is not indicative of a systemic shortage. Other factors contribute to perceived shortages, for example, the growing significance of foreign students in American institutions. These are foreign students who remain in the United States after they graduate to convert their student visa to a working visa. Other equally important factors include: economic growth, cyclical demand in IT industries, especially during the 1990s, and even backlogs in the application process for permanent visa. Employers today are constantly hiring H-1B workers, but that is clearly not enough reason to increase the cap on H-1B visas. Aside from the effects it will have on the wages and earnings of American workers, the increased cap will create some problems in the permanent residency part of immigration because there are already backlogs there (Bartik et al. 137). The influx of H-1B workers into the United States has been going on vigorously since the 1990s. During that time, about 30 million people were able to stay in America through nonimmigrant admissions. The fastest growing nonimmigrant admissions fall under categories where a foreigner first applies as a temporary foreign worker or student. He then tries to find a US sponsor to able to obtain the immigrant visa. Between 1992 and 1998, the number of foreign students admitted into the country with F1 visas rose from 53% to 565,00. The number of trainers and temporary workers also increased from 128% to 372,000 during that period of time (OECD 35).

An Empirical Investigation of the Corporate Culture-Financial Article

An Empirical Investigation of the Corporate Culture-Financial Performance Relationship in Multinational Corporations - Article Example Webster's Dictionary defines corporate culture as "the shared values, traditions, customers, philosophy, and policies of a corporation; also, the professional atmosphere that grows from this and affects behavior and performance." In essence, "corporate culture is the personality of your organization. It's the way your company does business and how it conducts itself. It's employees' beliefs and expectations of work." (Ceridian, 2005). Corporate culture and the cultural statements that it engenders then become the modus operandi for corporate members when the executives' voice and document the values of the corporation to provide models for how corporate members should behave (1000ventures). There are various numbers of definitions available regarding corporate culture. Various academic scholars and authors have defined it in different ways. Despite having differences in definitions many would agree on one thing that corporate culture can be referred to as a set of values, beliefs, and behavior patterns that form the core identity of the organization, and help shape the employees' behavior ( Rashid et al, 2003). According to Tichy et al ( 1982), corporate culture is a directive glue where the appropriate questions to ask concern the values and beliefs that are needed to support the corporate strategy, the subcultures that might also contribute to this goal and whether or not there should be an umbrella corporate culture as well. As an extension of the foregoing, another question is also on the role of the human resources department in shaping and molding the corporate culture. Corporate culture can also be interpreted as collective mental programming that binds the organization together through shared values, which ensure that employees are committed to their nominated responsibilities which can lead to achieving organizational goals together ( Hofstede, 1980). Much of what has been written on the definition of corporate culture proceeds by comparison of one type with another. Culture is by definition a varied and variable subject. There is no overall cultural norm in the world, nor any cultural "mean" or average that can be usefully applied. By comparison with the financial sections of corporate annual reports that allow average revenue, profitability, investment and so on to be calculated precisely (which is not necessarily the same as meaningfully), corporate culture requires a different tack (Hofstede, 1980). Having said that culture is defined by comparison, rather than any intrinsic and absolute qualities, corporate culture does display a difference in how it acquires shape and form. Within the corporate environment, culture is strongly influenced by the corporate leaders who are natural role models for other employees. The qualities of a leader in his opinion are forged by experience, trial and error, and practical application. The more a leader has been exposed to these aspects, the stronger the leadership becomes and the more influence the leader exerts on the corporate culture of the company concerned (Mintzberg, 1989).

Impacts of Organizational Cultures Assignment Example | Topics and Well Written Essays - 750 words

Impacts of Organizational Cultures - Assignment Example The cultures can be detrimental or beneficial to the organization as discussed in this essay. For the positive influences, organizational culture improves the morale of employees. Employees with a better understanding of their organization’s culture have a good grasp of their goals. They tend to cooperate with the needs of the customers, fellow customers, and managers. They understand that they are part of the investment, and they do their best to demonstrate loyalty. Workers in a healthy environment show commitment, and as a result, improve the productivity of the organization (Clampitt, 2012). Organizational cultures also help form unity among employees. The members of the organization take prompts from managers as part of forming cultures. Once they agree and adopt the norms of the firm, the norms in turn form bonds between the employees and management. The unity makes the members a team and they tend to focus on the entire success of a business, but not personal gains (Clampitt, 2012). The last benefit is that the organizational culture helps retain and attract talented individuals. Companies with good organizational culture retain employees for a long period. A company such as Coca-Cola has flexible working hours, allows casual dress codes, and provides international working opportunities (Clampitt, 2012). Its employees hardly leave the company because the company’s internal environment is friendly to them. Most researchers attribute the availability of well-defined cultures in organizations as the key to retention of talented and hardworking employees (Campitt, 2012). The first negative aspect of cultures in the internal environment and employees is that they can be unavoidable. The business owner might not be aware of its existence and may be busy trying to lift it off the ground, but the cultures can facilitate its uplift. The culture ends up being an obstacle to the company’s growth.  Ã‚  

Integration of Supply Chain Management Essay Example | Topics and Well Written Essays - 750 words

Integration of Supply Chain Management - Essay Example The article â€Å"Integration of Supply Chain Management with Internet and Enterprise Resources Planning (ERP) Systems: Case Study† focuses on the business environment of Dell Computers (Ghani, Zainuddin, Ghani 97). The articles states that Technology brings in countless advantages to the business environment. Further, the business environment includes businesses having a supply chain management strategy. Specifically the technology used in enhancing the supply chain management process is grounded on the management of information technology. Management harnesses the many benefits of information technology to enhance its supply chain management process. Specifically, information technology is synonymous with the use of the internet or Enterprise Resource Planning (ERP) systems. To determine the current status of the company’s supply chain activities. The same article proposes that the environment of business is grounded on generating net profits. To generate net profits, the company must sell its products or services. In turn, the company must deduct the total amount of costs of purchasing or manufacturing the salable products and services. The excess of the revenues or sales over the cost of sales or cost of production is the company’s gross profit. Next, the business must deduct the marketing expenses and the administrative expenses from the gross profit to generate a net profit figure. The same article emphasizes that the supply chain management strategy affects the revenue amount. The company will generate more revenues if the company’s supply chain management activities ensure the delivery of the company’s products and services to the current and prospective customers. A decline in the supply chain management’s delivery system precipitates to lower revenues. Lower revenues will create lower gross profits. A lower gross profit will trigger a lower net profit. A slow supply chain management system will create a delay in the delivery of

Academic journal review Literature Example | Topics and Well Written Essays - 1500 words

Academic journal - Literature review Example The core issues discussed in this article are related to the quest of work and leisure balance for an employee. The author discusses how the balance between work lives and personal lives of employees can be maintained in the contemporary world. The author also explains the ways in which work life balance can be maintained in the most proportionate way while at the same time ensuring that the productivity and performance quality of the employees are not compromised with. The key rationale included in the article is that the changing work commitments and lifestyles in the modern day world coupled with other influential external environment factors such as economic, political, social and technological constructs have made it difficult for people to include leisure as a part of their daily life. However, leisure is an important part of life and is necessary to ensure proper physical and mental health of a human being (Taneja, 2013). Keyes and Haidt (2003) also appraise the way in which t he author discusses how the inclusion of adequate amounts of leisure activities and maintenance of the most optimum balance between the personal and professional lives can actually lead to higher productivity, engagement and motivation of the employees in their respective job roles (Keyes and Haidt, 2003). The main purpose of the article was to evaluate the primary and secondary aspects in the domain of work schedule and their impacts on organizations and the employees working in these organizations. The core issues like work leisure conflict, the need and importance of leisure, the solution of work issues in relation to the leisure management, the perspective of time and leisure as commodities and the need for making major changes in the way work and leisure are balanced in any organization are identified and discussed in this

GM crops food Essay Example | Topics and Well Written Essays - 250 words

GM crops food - Essay Example he customers or the industrial world consumers play a significant role in the GM crops food, as they are the potential basis on which the biotechnology organization can evaluate the effects of these foods on human health (Canavari, 2009). For the biotechnology industry of GM crops food, social media could be a better tool of communication as it will provide information to the public about his product, the services, and the enterprise itself. From this tool, the industry can get back the opinions from other people and try to rectify where critics are experienced. This can help the producers look into the health aspect of the food in a better way (Smith & Zook, 2011). Consumers on the other hand can use direct mails to the organizations whenever they find an issue regarding the product. This aims at making the suppliers to act immediately basing on the feedback from the customers. An example of a direct mail may be a suggestion for a certain method to reduce the health risks in the foods. Retrieved 2 Dec. 20120 from http://ic.galegroup.com.ezproxy1.lib.asu.edu/ic/ovic/ViewpointsDetailsPage/Viewpoints

Marketing and its importance in Britain society Essay - 1

Marketing and its importance in Britain society - Essay Example Marketing is a very vast term, a simple definition can be a place where the buyers buy and the sellers sell, now one can imagine that the place in the world where the buyers and sellers are doing all the desired work is in fact the entire world, so the term marketing is not just limited to the buying and selling but so many other things are also included in the same, although marketing is there in the world right from the beginning of this world though it was not actually known that it is known as marketing but it was still there, however the modern marketing which was quite familiar to the people of different societies came in view in the period of 1900 to 1940, particularly in the years of 1910 to 1925, the notable reason for the existence of true marketing was perhaps the saturation in the industrial sector of this world, the products were increasing and now people had gained the sense of what is right and what is wrong, what is more beneficial and what is less, where to invest an d where not to, so these small growing facts gained the attention of many businessmen and related people and they started finding the ways through which they could have gained an edge over the others in terms of selling there items or units. â€Å"The majority of this development took place in the United States, although there were notable contributions also from Britain, especially in specialist sub-disciplines such as advertising†. According to another definition on marketing â€Å"marketing meets the needs of markets by producing economic values which, while not so tangible, are qualitatively just as real and quantitatively more significant than those produced in agriculture, mining, and manufacturing†.

Drunk Driving Essay Example for Free

Drunk Driving Essay Drunk driving is a primary cause of highway traffic accidents causing deaths and injuries with enormous monetary costs to society. The drunk driving was first recognized as a policy problem in the literature in 1904, approximately 5 years after the first highway traffic fatality in the United States (Voas and Lacey). In 1982, the National Highway Traffic Safety Administration started keeping statistics of alcohol related crashes through its Fatality Analysis Reporting System (FARS) (Stewart and Fell). In 1982, there were 26,173 alcohol related fatalities, which constituted 60% of all highway fatalities. In 2002, about 17,419 or roughly 41% of about 42,815 highway fatalities were estimated to be alcohol related which indicates a 19% change since 1982 (Stewart and Fell). Overall, alcohol related traffic fatalities have reduced by about 33% over the last two decades. Policies implemented to curb drunk driving in the last two decades seem to have an impact on alcohol related fatalities. FARS data shows a 62% decrease (1. 64 to . 61) in alcohol related fatality rate since 1982 (Stewart and Fell). The general decline in the alcohol related fatalities for the general population is believed to be due to a combination of deterrent based laws, increased alcohol awareness and decrease in alcohol consumption, increased publicity about prevention, and general car safety measures (Stewart and Fell). Starting 1980s, drunk driving has been conceptualized as a criminal justice issue. With the effect of Mothers Against Drunk Driving (MADD) and some other citizen activist groups, the issue has become a public policy problem in which drunk drivers are defined as sinful killers who drink and drive irresponsibly and claim lives of innocent victims. These efforts, according to Ross, created a dominant paradigm which focuses on the blameworthy driver. Thus, framing the issue as of a sin and drunk drivers as deviants has dominated the policymaking process and socially constructed the drunk drivers as a target group with negative connotations in public mind (Meier). Policymakers responded the demands by legislating stricter deterrent based measures to punish those criminal drunk drivers and deter drunk driving to save lives (Ross). Therefore, it is important to examine how drunk driving emerged as a policy problem and how deterrent based laws are introduced and accepted as a solution to the problem. This paper examines also the effects of MADD on legislation of drunk driving laws and effects of those laws on alcohol related fatalities. Background The struggle against drunk driving as a traffic safety problem began in late 1960s. Before 1960s, the federal governments influence on states drunk driving policies was minimal. The national character and seriousness of traffic safety problems prompted Congress to enact the Highway Safety Act and the Motor Vehicle and Traffic Safety Act, in 1966. In 1967, the Secretary of Transportation officially promulgated the first federal drunk driving standards in the National Uniform Standards for State Highway Safety Programs. One of the requirements of this program was for each state to utilize chemical tests for determining blood alcohol levels (BAC) and to enact BAC limits of no greater than . 10 % (Evans et al. ). If an individual is found to be driving with a BAC over a certain threshold they would be arrested for drunk driving. Those standards came with the threat of reducing highway funds for noncompliance. Although some states viewed the 1967 standards and the threats of reducing highway funds as interfering with their sovereign function, they complied with the new standards to participate in highway construction projects. By 1981 all states had adopted the specific standard of . 10 BAC or a lower level. In 1982, the Presidential Commission on Drunk Driving was created, and the Alcohol Traffic Safety Act of 1982 established a three-year program to provide highway grants for states that adopted certain anti-drunk driving measures (Evans et al. ). In 1983, the Presidential Commission on Drunk Driving recommended that states enact a uniform drinking age of twenty-one years. This approach was ineffective: only four states had done so by 1984. In response, Congress passed legislation requiring highway funding reductions for any state with a drinking age under twenty-one in 1984. That strategy was effective as the states soon began to establish twenty-one-year age limits. By 1986, all but eight states had adopted the twenty-one-year age limits. By 1989, all states had complied with this federal limit. Congress, by promising grants or threatening to withhold funding (carrot and stick from of coercive federalism), has taken an active role in formulating drunk driving policies and in encouraging the states to adopt them (Evans et al. ). On October 23, 2000 President Clinton signed Department of Transportation and Related Agencies Appropriations Act, 2001 that established the first-ever national drunk driving standard at . 08 blood alcohol content (BAC). According to this legislation, states that do not adopt . 08 BAC laws by 2004 would have 2% of highway construction funds withheld, with the penalty increasing to 8% by 2007. States adopting the standard by 2007 would be reimbursed for any lost funds. As of February 2004, 46 states plus the District of Columbia and Puerto Rico have adopted the national . 08 BAC standard. The federal BAC limit was the last, but not the least measure established to curb drunk driving. It was, indeed, the culmination of efforts targeting drunk driving which dates back to early 1980s (MADD). Although a variety of preventative policies including education campaigns, rehabilitation, and control of alcohol sales have been employed to reduce drunk driving, more emphasis has been placed on the use of punitive policy tools such as license revocation, increased fines, and mandatory jail time. Policies designed to change undesired behavior frequently frame drunk driving behavior as sinful or deviant, which suggests that drunk driving may constitute a morality policy. Indeed, drunk drivers are often depicted in the media and policy debates as irresponsible killer drunks. The politics around the issue of drunk driving as a morality policy may explain why punitive tools rather than preventive policies have been increasingly used in this policy area (Meier). Anti-Drunk Driving Policy Controversies Policies pertaining to alcohol have been regulated by local, state and the federal governments over the last century, including the prohibition at the turn of the twentieth century. At different times alcohol has been prohibited, permitted to operate without government control, regulated through licensing, or controlled by monopolies. This policy area is largely controlled by states through a wide range of policies regulating both the sale of alcohol and penalties for alcohol abuse. Although prohibition on drunk driving is a regulatory policy, it has a separate purpose. As Meier points out, rather than restricting access to alcohol, drunk driving policies are intended to punish individuals who abuse alcohol by drinking and driving (687). Over the last two decades states have adopted a variety of punitive policies to prevent drunk driving and its consequences. Since drunk driving is framed as sinful behavior, no one will stand up and support drunk driving. Advocates of drunk driving policies push for stricter measures to protect innocent victims and in such an environment, rational politicians will perceive that the demand for restrictive policies will be greater than it actually is and, thus, compete for more extreme policies because they always see there is a great support for being tougher on sin (Meier). These policies will be carried out through strict law enforcement by agencies, which will be awarded by the number of arrests made. Therefore, law enforcement agencies will also favor more extreme policies because such policies will create an environment that supports more resources for them (Meier). Furthermore, arresting killer drunks and saving innocent lives will increase their popularity in the eyes of public. In the absence of organized opposition, therefore, drunk driving policies shaped with the support of the public, politicians, and the bureaucracy-lead to adoption of coercive tools, which increases the cost of sinful behavior (Ross). As with most public policy issues, this one, too, has many sides. Just as anti-drunk driving movement supporters form alliances for specific efforts, adversaries also work independently and sometimes together depending on the current situation and how their alliances reflect common concerns. Organizations and individuals who appear to oppose the efforts of the anti-drunk driving movement are, in some cases, protecting a different interest or issue, such as business interests and, by extension, the economy (Baum). Despite the strength of the morality policy framework to predict what type of policy tools would be adopted in this policy domain, legislation of the federal . 08 BAC standard departs from this framework on -at least- one major point: there was an organized opposition to the legislation. Opponents of the national . 08 BAC limit consisted of interest groups representing alcohol and hospitality industries and a few non-profit groups defending motorists rights. Meier contends that highly salient morality policies permit little role for expertise and the lack of opposition results in avoidance of information that challenges the dominant position. Therefore, morality politics lead to adoption of poorly designed and rarely effective policies. In the case of . 08 BAC legislation, as with many other anti drunk driving policies, however, existence of such an opposition heated the debate around the effectiveness of that standard to prevent drunk driving. Studies evaluating the effectiveness of . 08 BAC limit and level of impairment at different levels of BAC were often cited by both sides of the policy (Meier 689-90). Opponents of the national . 08 BAC limit, however, differed in their solutions rather than in their conception of the issue. Both sides of the drunk driving debate agreed on the problem, but they disagreed on the solutions, which is closely related to the definition of the problem. Opponents and proponents of the legislation defined the problems in similar ways. For example, both sides distinguished good people who drink socially from a small minority of alcohol abusers, blameworthy deviants, who drink and drive irresponsibly. The alcohol and restaurant lobbyists could not and did not deny the existence of drunk driving problem. Furthermore, they accepted an obligation to contribute to the reduction of the problem (Baum). However, they defended that . 08 BAC limit would not affect those abusers but would punish the responsible social drinkers, which in turn negatively would affect alcohol sales. They argued that most fatal accidents involving BAC levels below . 10 were alcohol related, not alcohol caused. In almost all alcohol caused fatal accidents, drivers have had an average BAC level of . 17. Therefore, lowering BAC limit to . 08 would not prevent drunk driving. Instead, some other measures such as strict administrative license suspension, and frequent sobriety checks by law enforcement should be administered. Proponents of the . 08 BAC legislation, on the other hand, argued that everyones safe driving skills are dangerously impaired at this level, and nearly one-fourth of traffic fatalities caused by drunk drivers with a BAC level of . 10 or less (Meier 691-92). Anti-Drunk Driving Movement and MADD According to Reinarman, the anti-drunk driving movement did not spring from a rise in the prevalence of drunk driving or in accidents related to it, but from the fact that the injustices (or negative externalities) attributed to drunk driving have never been treated seriously by legislators and courts. Indeed, before 1980s drunk driving had been seen merely a traffic offense. The morality policy focus of the Reagan administration created the suitable climate in which the claims of MADD affected the public and legislators (Reinarman). MADD was founded as a non-profit victims rights organization concerned with advocating for and counseling victims and bereaved relatives, and monitoring courtrooms. Although many members of MADD are victims or bereaved victims of drunk drivers, general community activists (non-victim) have also been active in many chapters. A study on a national sample of 125 MADD chapters indicated that victimization alone does not cause activism (Weed). Moreover, victim and non-victim activists share similar social backgrounds and already participate in other voluntary associations, which reveals that MADD tends to be run by activists who have been victimized rather than victims who have become activists (Ross). Despite its inception as a victims rights organization, MADD has been blamed for becoming a neo-prohibitionist movement (Hanson). The goal of the organization, Hanson claims, is no longer preventing alcohol related accidents but preventing drinking. Moreover, MADD members are accused of seeking vengeance through harsh penalties either than rehabilitation and prevention. Reinarman points out that MADDs goals include the demand for justice or vengeance on the group that took lives of friends and children, which warrants harsh punishment whether deterrence is achieved. He also contends that in the case of drunk driving, the purpose of jail is generally social revenge, not accident prevention. Advocates of MADD, on the other hand, have always pointed out the public education programs, victim assistance, and legislative activism as their agenda items. Regardless of the objectives mentioned above, MADD has managed to make drunk driving a major public problem. Its approach to the problem assumes that the victim in an alcohol related accident is innocent; the drunk drivers behavior is willful and it is a crime which should be dealt in the criminal justice system; and harsh punishment is effective in reducing drunk driving by the threat of swift, certain, and severe penalties. By working against the alcohol industrys promotion of drinking in general, MADD has focused on the negative externalities created by the drunk driver -framing the issue as a deviant behavior (Ross). This strategy allowed the movement to gain support even from the alcohol industry itself. Starting from being a small group of women to a nationwide organization with over 600 chapters across 50 states, MADD has become the most influential citizen group fighting drunk driving. The organizations 2003-2004 annual report shows that its assets reached more than $28 million and revenues more than $53 million (MADD). As with other anti-drunk driving laws, MADD was the main actor behind the federal . 08 BAC legislation. With support of other non-profit organizations, MADD members brought the issue to the public attention. They lobbied key members of Congress, organized media campaigns, participated in press events and other activities, and published fact sheets and statistical information demonstrating the significance of the policy initiative (Ross). They not only contacted the president and obtained his support, but also reached both Democrat and Republican members of the Congress gaining bipartisan support, necessary for passage of the legislation. MADD saw the fight for . 08 BAC as a fight for public safety. Karolyn Nunnallee, the president of the organization, once said, The danger imposed by a drunk driver does not stop at State lines. Neither should the standards that define drunk driving (190). Conclusion Like many other public policy issues, drunk driving can also be defined and addressed in several ways with every definition proposing a different solution. Contrary to the dominant paradigm, for example, drunk driving can be considered as a public health issue. Then the solution would be rehabilitation of offenders rather than imposing sanctions on them. However, efforts of MADD and other grassroots organizations to define the problem in criminal justice terms by describing the problem as of a sin committed by irresponsible killer drunks against innocent victims succeed over other possible definitions of the problem as well as the solutions attached to them (Meier). Their success of the definition of the problem yielded social construction of the target group as deviants with negative connotations and weak political power who deserve sanctions either than rehabilitation. Although proponents of drunk driving policies have been successful in defining the issue in terms of sin that no one could stand for it, opponents were also successful to some extent in addressing the issue by questioning the effectiveness of deterrent based policies. They were able to frame the issue in such a manner that opposition became legitimate. Meier contends that when the opponents are able to change the social construction of the debate from sin to some other dimension, the redistributive nature of the policy becomes open and acknowledged (694). At this point, we can hold that the drunk driving issue was transformed from the politics of sin to the politics of redistribution when alcohol and hospitality industries considered that the stricter laws -as in the case of federal . 08 BAC legislation- would threat alcohol sales. They were not successful, however, in changing issue entirely from being a policy of sin and could not defend drunk driving, but emphasized the potential inefficiency of measures to curb drunk driving. Moreover, they could not sustain holding that position over time and once again the dominant definition of the problem prevailed yielding more punitive tools to deter drunk driving. MADD has been acknowledged as the driving force that transformed drunk driving into a public problem which warrants governmental action. Moreover, MADD as a citizen advocacy group is an important factor in shaping policies in American states. The results provided evidence for the effects of MADD not only on states adoption of anti-drunk driving laws but also adoption of traffic safety measures in general. Works Cited Baum, Scott. Drink Driving as a Social Problem: Comparing the Attitudes and Knowledge of Drink Driving Offenders and the General Community. Accident Analysis and Prevention. 32 (2000): 689-694. Evans, William N. , Doreen Neville, and John D. Graham. General Deterrence of Drunk Drivers: Evaluation of Recent American Policies. Risk Analysis. 11 (1991): 279-289. Hanson, David J. Mothers Against Drunk Driving: A Crash Course in MADD, 2002 http://www. alcoholfacts. org/CrashCourseOnMADD. html MADD. Saving Lives: Mothers Against Drunk Driving Annual Report 2003-2004, 2004. Meier, Kenneth J. (1994). The Politics of Sin: Drugs, Alcohol, and Public Policy. Armonk, NY: M. E. Sharpe. Meier, Kenneth J. Drugs, Sex, Rock, and Roll: A Theory of Morality Politics. Policy Studies Journal. 27 (4) (1999): 681-695. Nunnallee, Karolyn. Pro Con: Should Congress Pass . 08 Blood-Alcohol Concentration (BAC) Drunk Driving Standard? Congressional Digest. 11 (6-7) (1998): 178-191. Reinarman, Craig. The Social Construction of an Alcohol Problem: The Case of Mothers Against Drunk Drivers and Social Control in 1980s. Theory and Society. 17 (1988): 91-120. Ross, H. Laurence. Confronting Drunk Driving: Social Policy for Saving Lives. New Haven, CT: Yale University Press, 1992 Stewart, Kathryn and James Fell. Trends in Impaired Driving in the United States: Complacency or Backsliding? In Daniel R. Mayhew and Claude Dussault eds. Proceedings of the 16th International Conference on Alcohol, Drugs and Traffic Safety, Montreal, Canada, August 4-9, 2002. Voas, Robert B. and John H. Lacey. Drunk Driving Enforcement, Adjudication, and Sanctions in the United States. in R. Jean Wilson and Robert E. Mann eds. Drinking and Driving: Advances in Research and Prevention. New York, NY: The Guildford Press, 1990 Weed, Frank J. The Victim-Activist Role in the Anti-Drunk Driving Movement. The Sociological Quarterly. 31 (3) (1990): 459-473.

The poems nothings changed Essay Example for Free

The poems nothings changed Essay In stanza three the main focal point is on the inn. Afrika sees the inn as if it is showing off, Brash with glass this could mean that it is being rubbed in; the fact he cant have anything that extravagant. He also gives the impression that it wants to be noticed, name flaring like flag, he uses personification to show how much it stands out, he also uses alliteration to make it catchy and so we will remember it. It could also be using the flag reference to compare it to their nation, and that it is being represented by what the government want other people to see, not what is actually going on. He is giving the inn a personality, it squats this is contradicting the previous statements, with the use of personification it is almost as if the inn is embarrassed about having these features. The inn is upper-class, In the grass and the weeds, incipient Port Jackson trees it is also out of place, as the port Jackson trees are expensive and imported, how ever district six is made up of weeds. The inn also only lets white people in, whites only inn although this was illegal after apartheid had ended, he uses a pun here as in only whites allowed in, and it is a whites only, inn. In the beginning of verse four he says no sign says it is: but we know where we belong this makes the reader empathise with him, at this point there is know apartheid but he still know that the can not mix. When he looks in on the restaurant there is a contrast with the rest of district six, crushed ice white glasses, linen falls, the single rose there are many luxuries here, it is almost snobbism , while every where else has to just get by. This again makes you feel sympathetic towards him. In verse five the working mans cafi has a huge contrast to the restaurant, working mans cafi sells bunny chows bunny chow is a cheap African food, this is totally unlike the haute cuisine in the white restaurant, which is an upmarket food. He also has no plate to eat on, eat it at a plastic table top he does not have linen falls or a rose; there is a definite contrast between them. I think that there is a difference in between because the white have more money and privileges than the blacks; also if the blacks did have an inn like that they would not be able to afford it. The writer is trying to put across the point that it is unfair that they should have more than them, just because they are white. In the final verse he feels small, boy again he feels insignificant, and he knows he can not change anything. He feels the need to use violence to get his point across Hands burn for a stone, a bomb this could insinuate that he want to be able to be heard. He wants to break the glass, shiver down the glass the glass could be thought to be a barrier between blacks and whites, and he wants to break it down as if he were breaking down the wall of apartheid. The use of glass for the wall of apartheid could mean that it is fragile. The last line is nothings changed which is the first line, this could be interpreted as a circle, and that apartheid will never end.

Consequences of child abuse and neglect

Consequences of child abuse and neglect Introduction Child abuse and neglect are an unfortunate reality for many children in our community. The past thirty years have witnessed a growth in our awareness of and attention to the problems faced by children exposed to violence in their homes. The consequences of maltreatment can be devastating. For over 30 years, clinicians have described the effects of child abuse and neglect on the physical, psychological, cognitive, and behavioral development of children. Physical consequences range from minor injuries to severe brain damage and even death. Psychological consequences range from chronic low self-esteem to severe dissociative states. The cognitive effects of abuse range from attentional problems and learning disorders to severe organic brain syndromes. Behaviorally, the consequences of abuse range from poor peer relations all the way to extraordinarily violent behaviors. Thus, the consequences of abuse and neglect affect the victims themselves and the society in which they live. REVIEW OF DEFINITIONS A 1989 conference convened by the National Institute of Child Health and Human Development recommended that maltreatment be defined as behavior towards another person, which (a) is outside the norms of conduct, and (b) entails a substantial risk of causing physical or emotional harm. Behaviors included will consist of actions and omissions, ones that are intentional and ones that are unintentional (Christoffel et al., 1992). The term child maltreatment refers to a broad range of behaviors that involve risk for the child. Four general categories of child maltreatment are now generally recognized: (1) physical abuse, (2) sexual abuse, (3) neglect, and (4) emotional maltreatment. Each category, in turn, covers a range of behaviors. Physical abuse includes scalding, beatings with an object, severe physical punishment, and a rare form of the abuse called Munchausen by proxy, wherein an adult will feign or induce illness in a child in order to attract medical attention and support. Sexual abuse includes incest, sexual assault by a relative or stranger, fondling of genital areas, exposure to indecent acts, sexual rituals, or involvement in child pornography. Child neglect is the presence of certain deficiencies in caretaker obligations (usually the parent, although neglect can be found in residential centers or foster care homes) that harm the childs psychological and/or physical health. Child neglect covers a range of behaviors including educational, supervisory, medical, physical, and emotional neglect, and abandonment, often complicated by cultural and contextual factors. Several authors (Mrazek and Mrazek, 1985; Zuravin, 1991) have noted the relative lack of attention to definitional issues of child neglect, particularly given its greater reported prevalence (NCCAN, 1981, 1988b; Wolock and Horowitz, 1984). Emotional maltreatment, a recently recognized form of child victimization, includes such acts as verbal abuse and belittlement, symbolic acts designed to terror ize a child, and lack of nurturance or emotional availability by caregivers. Effects of child abuse and neglect Physical Health Consequence The immediate physical effects of abuse or neglect can be relatively minor (bruises or cuts) or severe (broken bones, hemorrhage, or even death). In some cases the physical effects are temporary; however, the pain and suffering they cause a child should not be discounted. Meanwhile, the long-term impact of child abuse and neglect on physical health is just beginning to be explored. According to the National Survey of Child and Adolescent Well-Being (NSCAW), more than one-quarter of children who had been in foster care for longer than 12 months had some lasting or recurring health problem (Administration for Children and Families, Office of Planning, Research and Evaluation [ACF/ OPRE], 2004a). Below are some outcomes researchers have identified: Shaken baby syndrome: Shaking a baby is a common form of child abuse. The injuries caused by shaking a baby may not be immediately noticeable and may include bleeding in the eye or brain, damage to the spinal cord and neck, and rib or bone fractures (National Institute of Neurological Disorders and Stroke, 2007). Impaired brain development: Child abuse and neglect have been shown, in some cases, to cause important regions of the brain to fail to form or grow properly, resulting in impaired development (De Bellis Thomas, 2003). These alterations in brain maturation have long-term consequences for cognitive, language, and academic abilities (Watts-English, Fortson, Gibler, Hooper, De Bellis, 2006). NSCAW found more than three-quarters of foster children between 1 and 2 years of age to be at medium to high risk for problems with brain development, as opposed to less than half of children in a control sample (ACF/ OPRE, 2004a). Poor physical health: Several studies have shown a relationship between various forms of household dysfunction (including childhood abuse) and poor health (Flaherty et al., 2006; Felitti, 2002). Adults who experienced abuse or neglect during childhood are more likely to suffer from physical ailments such as allergies, arthritis, asthma, bronchitis, high blood pressure, and ulcers (Springer, Sheridan, Kuo, Carnes, 2007). Psychological Consequence The immediate emotional effects of abuse and neglectà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬isolation, fear, and an inability to trustà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬can translate into lifelong consequences, including low self-esteem, depression, and relationship difficulties. Researchers have identified links between child abuse and neglect and the following: Difficulties during infancy: Depression and withdrawal symptoms were common among children as young as 3 who experienced emotional, physical, or environmental neglect (Dubowitz, Papas, Black, Starr, 2002). Poor mental and emotional health: In one long-term study, as many as 80 percent of young adults who had been abused met the diagnostic criteria for at least one psychiatric disorder at age 21. These young adults exhibited many problems, including depression, anxiety, eating disorders, and suicide attempts (Silverman, Reinherz, Giaconia, 1996). Other psychological and emotional conditions associated with abuse and neglect include panic disorder, dissociative disorders, attention-deficit/ hyperactivity disorder, depression, anger, posttraumatic stress disorder, and reactive attachment disorder (Teicher, 2000; De Bellis Thomas, 2003; Springer, Sheridan, Kuo, Carnes, 2007). Cognitive difficulties: NSCAW found that children placed in out-of-home care due to abuse or neglect tended to score lower than the general population on measures of cognitive capacity, language development, and academic achievement (U.S. Department of Health and Human Services, 2003). A 1999 LONGSCAN study also found a relationship between substantiated child maltreatment and poor academic performance and classroom functioning for school-age children (Zolotor, Kotch, Dufort, Winsor, Catellier, 1999). Social difficulties: Children who experience rejection or neglect are more likely to develop antisocial traits as they grow up. Parental neglect is also associated with borderline personality disorders and violent behavior (Schore, 2003). Behavioural Consequences Not all victims of child abuse and neglect will experience behavioral consequences. However, behavioral problems appear to be more likely among this group, even at a young age. An NSCAW survey of children ages 3 to 5 in foster care found these children displayed clinical or borderline levels of behavioral problems at a rate more than twice that of the general population (ACF, 2004b). Later in life, child abuse and neglect appear to make the following more likely: Difficulties during adolescence: Studies have found abused and neglected children to be at least 25 percent more likely to experience problems such as delinquency, teen pregnancy, low academic achievement, drug use, and mental health problems (Kelley, Thornberry, Smith, 1997). Other studies suggest that abused or neglected children are more likely to engage in sexual risk-taking as they reach adolescence, thereby increasing their chances of contracting a sexually transmitted disease (Johnson, Rew, Sternglanz, 2006). Juvenile delinquency and adult criminality: According to a National Institute of Justice study, abused and neglected children were 11 times more likely to be arrested for criminal behavior as a juvenile, 2.7 times more likely to be arrested for violent and criminal behavior as an adult, and 3.1 times more likely to be arrested for one of many forms of violent crime (juvenile or adult) (English, Widom, Brandford, 2004). Alcohol and other drug abuse: Research consistently reflects an increased likelihood that abused and neglected children will smoke cigarettes, abuse alcohol, or take illicit drugs during their lifetime (Dube et al., 2001). According to a report from the National Institute on Drug Abuse, as many as two-thirds of people in drug treatment programs reported being abused as children (Swan, 1998). Abusive behavior: Abusive parents often have experienced abuse during their own childhoods. It is estimated approximately one-third of abused and neglected children will eventually victimize their own children. Societal Consequences While child abuse and neglect almost always occur within the family, the impact does not end there. Society as a whole pays a price for child abuse and neglect, in terms of both direct and indirect costs. Direct costs: Direct costs include those associated with maintaining a child welfare system to investigate and respond to allegations of child abuse and neglect, as well as expenditures by the judicial, law enforcement, health, and mental health systems. Indirect costs: Indirect costs represent the long-term economic consequences of child abuse and neglect. These include costs associated with juvenile and adult criminal activity, mental illness, substance abuse, and domestic violence. They can also include loss of productivity due to unemployment and underemployment, the cost of special education services, and increased use of the health care system. Possible Treatment Strategies Descriptions of treatment for child sexual abuse, physical abuse, and neglect have been reported separately within the literature, with much more attention paid to treatment of child sexual abuse. In fact, there are relatively few studies or reports of individual treatment of the physically abused or neglected child. In practice, however, treatment programs often address individual needs of children. The emphasis here is cognitive behavioral treatments, as these have shown the greatest effects in controlled studies. General Issues for Treatment First and foremost, it is important that the child be safe from potential harm from the offender as well as from non-believing or unsupportive family members. In addition to ethical issues of treating a child within an unsafe environment, treatment of abuse related problems is not likely to be effective if the child is living in such conditions. The targets for treatment are determined to a large degree by the childs presenting symptoms and are defined following the initial assessment. There are, however, certain overriding goals that should guide the treatment process. Treatment should be directive and focused on the abuse or trauma itself. Treatment approaches: Help and encourage the child to talk and think about the abuse/neglect without embarrassment or significant anxiety. Help the child to modulate and express feelings about the abuse; Reduce the intensity and frequency of behavioral and emotional symptoms; Clarify and change distorted, inaccurate, or unhealthy thinking patterns that might negatively affect the childs view of self and others; Help the child develop healthier attachments; Strengthen the childs coping skills Enhance social skills, and Educate the child regarding self-protective strategies. An additional goal, accomplished specifically through group therapy is to reduce the childs sense of isolation or stigma through exposure to other victims of abuse. Group treatment for victims of child physical abuse can have positive effects but may also be associated with increased behavior problems. Therefore the therapist should be cautious and monitor group participants behavior closely (Kolko Swenson, 2002). Treatment strategies Strategies for treating the abused child are varied and are used as appropriate to the childs presenting problems. Recommended treatment approaches include (Finkelhor Berliner, 1995): 1) cognitive-behavioral strategies, 2) graduated exposure to aspects of the abusive experience, 3) relaxation training , 4) education regarding abuse process and effects of abuse, 5) skills training, 6) supportive strategies teaching self-protective strategies, 7) behavioral strategies/parent training. Strategies for treating abuse victims which have received some scientific support, have been those derived from a cognitive behavioral perspective and which focus on the abuse itself. Cognitive behavioral strategies typically address the childs thinking patterns, affective response, and behavioral reactions to the abuse. In particular, the childs attributions of blame and responsibility for the abuse should be addressed. That is, the child should be helped to recognize that it is adults rather than children who are responsible for healthy parent-child interactions (Finkelhor Berliner, 1995). Gradual exposure or discussion of abuse experiences helps to reduce the childs anxiety and embarrassment and provides opportunities to modify inaccurate or self-defeating thinking processes. Relaxation training further addresses the childs fear or anxiety reaction to abuse-related cues and can facilitate more effective affect regulation. Educational approaches facilitate clarification of misperc eptions developed in response to the abuse. Skills training are used to teach the child coping strategies to manage negative emotions and to improve social/interpersonal functioning. Supportive techniques also are required, as the child may be coping with non-supportive family members, upcoming court proceedings, and/or negative reactions from peers. Education in the use of self-protective strategies is important for minimizing the likelihood that the child will be abused/neglected again (Finkelhor Berliner, 1995). It is important to establish a safety plan within the home, delineate danger cues, and identify support persons in the childs environment to decrease the secrecy within previously abusive/neglectful families. This, in turn, is expected to minimize the risk of repeated abuse. Age-related issues The treatment approach should be appropriate to the age of the child. For example, a four year old child should not be expected to come into a therapist or counselors office, sit on a couch, and recount the details of her abuse. The therapist can utilize a variety of play techniques to encourage the young child to communicate about his or her abuse. Many cognitive behavioral strategies which are used with adolescents and adults can be modified or simplified for use with young children (Kolko Swenson, 2002). For example, there are numerous scripts for relaxation training which are humorous and which engage the child in the therapeutic process. Puppets and drawings are useful as well for helping children to tell of their experiences, learn strategies for coping with negative emotions, and behaving in a more organized and directed manner. In contrast, older children and adolescents are more able to directly communicate their thoughts and feelings about their abuse experiences. It is recommended, however, that the therapist be flexible in method of approach. Drawings, therapeutic stories, and therapeutic games can be very helpful for engaging children of all ages. Treatment duration There are no clear guidelines regarding the length of treatment for the abused or neglected child, although most studies of treatment effectiveness have examined short-term interventions. Clinical experience suggests that while some children can resolve their negative reactions to the abuse in a relatively brief period (i.e., 12 16 sessions), many will require more extended treatment. Typically, treatment length will be determined by the nature of the childs social, behavioral, or emotional difficulties. That is, the child who is experiencing a wide array of problems of a serious nature is likely to require more intensive treatment over a long period of time. In addition, the quality of support that the child is receiving from the non-offending caregiver or other family members will affect treatment length. That is, child problems are typically more significant if there is no support coming from the non-offending caregiver, and, therefore, treatment of the child whose non-offending parent is disbelieving or non-supportive is likely to be more extensive than that of a child who has the support of a non-offending parent. Additional treatment approaches Family involvement in treatment Children should not be treated in isolation of intervention with their family and/or current living situation. Thus, many in the field recognize the importance of incorporating family members, particularly parents or primary caregivers, into treatment addressing abuse and neglect (Kolko Swenson, 2002). The goal of family work is to reduce the risk of recurring abuse, increase safety, and promote healthy growth and development of all family members. Family approaches address the needs of all family members while also targeting the interactions between them. However, it is difficult to specify the precise structure of therapeutic work addressing family issues. The specific approach with the family will vary; depending upon the childs living context and the level of acknowledgement of abuse by offender(s) and non-offending caregiver(s). For example, a child who has been placed in foster care due to parent-child abuse and lack of a supportive non-offending caregiver will be addressing d ifferent issues than the child who is receiving support from a non-offending caregiver and/or whose abusive parent is acknowledging abuse and is committed to treatment. Family work is not indicated if the child is in out-of-home placement and there are no plans for reunification. Treatment involving the entire family and that has as a goal family reunification is generally of a much longer duration than individual treatment of the child. Initial stages involve the child, offender, and non-offending caregiver in individual treatment, allowing members to first address individual issues related to the development and outcomes of the abuse. In addition, marital work is recommended to address relational issues between the childs caregivers prior to any reunification efforts. If early work with caregivers is successful, family therapy may ensue. The clarification session can serve as the bridge between each family members individual treatment and treatment addressing the entire familys needs. Therapeutic interventions with caregivers typically begin with individual sessions addressing the abuse itself, as well as the specific needs of family members. These stages of treatment encourage assumption of responsibility by the offender and non-offending caregiver(s). An alleged perpetrator who is denying having abused the child or a non-offending parent who does not believe that abuse has occurred cannot fully benefit from abuse-specific treatment. Therefore, initial treatment efforts focus on reducing denial. If such efforts fail, family treatment is contraindicated. If the offender is acknowledging having abused and/or neglected the child, then he or she can engage in abuse-specific treatment that addresses faulty thinking patterns, behavioral actions, emotional responses, and physiologic reactions. Sexual abuse offenders will be targeting their sexual arousal to children, thought patterns which allow them to justify perpetrating sexual abuse, and examining the behavioral repertoire that lead up to abuse. Physical abuse offenders will learn strategies for managing anger, parenting skills, and non-physical means of discipline. Caregivers who are neglectful will receive assistance in securing basic goods and resources, will learn parenting strategies and be taught skills which facilitate independent management of the children and familys needs. In the treatment of all forms of abuse it is important to address attributions of blame. Invariably child abuse/neglect offenders minimize their own responsibility for the abuse/neglect and project blame on other family members, most often the victim. The abuse clarification process (Lipovsky et al., 1998), which addresses such attributions, should be included in treatment if at all possible. The abuse clarification involves an acknowledging offender who has proceeded through treatment to a sufficient degree to be able to clarify the nature of the abuse, assume responsibility for the abuse, demonstrate empathy for the childs responses to the abuse, and begin to participate in the development of a family safety plan. The abuse clarification process is addressed in the offenders individual or group treatment and is ongoing, often for many months before an abuse clarification session is possible. The abuse clarification session provides the opportunity for the offender to read a letter written to the child victim that focuses on the offenders assumption of responsibility, empathy for the child, and commitment to developing the family safety plan. This session is likely to occur some months after the abuse are disclosed, allowing the offender sufficient opportunity to engage in and progress in his/her own treatment. Ideally, at least one supportive adult should be included in the treatment process. Several programs around the country have targeted non-caregivers parents in their approach to treating child sexual abuse and have found success with such an approach.16, 32, 50 Treatment with non-offending caregivers also must also be built upon a foundation of acknowledgement that abuse has occurred. In most cases, where non-offending caregivers believe and support their child, family work addresses the caregivers individual needs. Early treatment strategies must address denial if it is present. Treatment of the non-offending caregiver(s) addresses his/her emotional responses to the abuse and individual mental health needs. In addition, treatment includes focus on the caregivers responses to the childs abuse, education regarding the childs symptoms and provides assistance for developing strategies for reducing these symptoms. It is recommended that the non-offending parent be involved in an abuse protection clarification (Wilson Ralston, 1995). This process is similar to the abuse clarification conducted with the offender. The protection clarification involves clarification of the abuse, commitment to protection of the child, and participation in the development of a family safety plan. The protection clarification may be initiated relatively early in treatment, especially if the non-offending parent believes and supports the child from the time of disclosure. Long-term family resolution of parent-child abuse is a life-long process and involves changing many aspects of family functioning. Some type of resolution must occur in all cases, regardless of whether the child or offender has been removed from the home. Resolution may take the form of helping a child adjust to permanent foster care and cope with a non-supportive family or may involve reunification of the family following the successful completion of individual/group treatment, the clarification process, and family therapy which addresses a safety plan, alteration of family members rigid patterns of thinking and behaving (Saunders Meinig, 2000). Home-Based Services and Family Preservation Services Home-based services and family preservation services address the overall needs of families, include both children and parents, and focus directly on contextual factors, such as poverty, single parenthood, and marital discord, that increase stress, weaken families, and elicit aggressive behavior (Kolko, in press). These programs target functional relationships among diverse individual, family, and systemic problems by combining traditional social work with various therapeutic counseling approaches. The use of home-based services has been advocated in response to the multiple problems found among abusive and neglectful families, difficulties in providing services in a traditional format, and interests in reducing the number of children placed in foster care. The breadth of potential family dysfunction has encouraged hands-on approaches that address risk factors at multiple levels of the family system, such as financial problems, disruption, social isolation, and behavioral deviance (Frankel, 1988). Self-Help Services for Abusive Adults Self-help support and treatment programs are based on the premise that individuals can benefit from learning about the victimization experiences of others. These programs have attracted popular support in a wide range of health services, including the treatment of alcoholism, weight loss, and rape counseling programs, and they have also been applied in the treatment of both physically and sexually abusive adults.. A self-help component has also been integrated into treatment programs for intra-familial sexual abuse (Giaretto, 1982). Parental Enhancement Most parental enhancement programs focus on training abusive parents in child management (e.g., effective discipline), childrearing (e.g., infant stimulation), and self-control skills (e.g., anger control). Programs for neglectful parents typically focus on areas such as nutrition, homemaking, and child care. Parental enhancement programs may help some families who experience child management problems when a sexually abusive father is removed from the home. In these cases, child management skills help develop positive child- parent interaction in sexually abusive families. The efficacy of parent training approaches for physically abusive parents has been supported by various single-case studies, one study using repeated measures, and group design studies (Azar and Twentyman, 1984; Crimmins et al., 1984; Gilbert, 1976; Jeffrey, 1976; Reid et al., 1981; Szykula and Fleischman, 1985; Wolfe et al., 1981a,b, 1982). Studies of multiple approaches and diverse populations have provided consistent evidence that parents can acquire behavioral skills and use them in interactions with their children, at least in clinical settings (Golub et al., 1987). Some evidence suggests that training has reduced parental distress or symptomatology and, in some instances, improved child functioning (Wolfe et al., 1988) and reduced the likelihood of child placement (Szykula and Fleischman, 1985). Efforts to expand the scope of parental enhancement programs have fostered attention to parents cognitive-attributional and affective repertoires (see Azar and Siegel, 1990). Therapeuti c directions highlight the need to incorporate diverse skills and to evaluate the effectiveness of individual approaches (see Azar and Wolfe,1989). Psychopharmacologic treatment for child victims Medications may be used with child victims of abuse and neglect who are experiencing post-traumatic stress disorder (PTSD). A number of medications may be of use, though the state of our knowledge about which are most appropriate for use in children is limited. Some have recommended that the use of medication may be reserved for those children who do not show improvement with cognitive-behavioral treatments for PTSD. Children experiencing other types of behavioral or emotional difficulties, including depression, anxiety, or attentional problems also can benefit from pharmacologic treatment. In all cases, the choice of medications is determined by psychiatrist through a careful assessment. Family Income and Supplemental Benefits The relationship of poverty to child maltreatment, specifically child neglect, is thought to be significant. Several government programs designed to alleviate or mitigate the effects of poverty on children are often part of a comprehensive set of services for low-income, maltreating families. Such programs include Social Security supplemental income programs, Aid to Families with Dependent Children (AFDC), Women with Infants and Children food supplement program (WIC), Head Start, rent subsidy programs, and school lunch programs, among others. Gil (1970) has stated that almost 60 percent of families reported for incidents of abuse and neglect received aid from public assistance agencies during or prior to the study year. However, while national and local child welfare programs designed to improve the well-being of all poor families may provide food, shelter, and other necessary resources, for children in households characterized by neglect or abuse, the relationship between income support, material assistance, and the subsequent reduction of maltreatment has not been systematically addressed. CONCLUSIONS Medical, psychological, social, and legal interventions in child maltreatment cases are based on assumptions that such interventions can reduce the negative physical, behavioral, and psychological consequences of child abuse and neglect, foster attitudes and behaviors that improve the quality of parent-child interactions and limit or eradicate recurrences of maltreatment. Interventions have been developed in response to public, professional, legal, and budgetary pressures that often have competing and sometimes contradictory policies and objectives. Some intervention services focus on protecting the child or protecting the community; others focus on providing individual treatment for the child, the offender, or both; others emphasize developing family coping strategies and improving skills in parent-child interactions. Assumptions about the severity of selected risk factors, the adequacy of caretaking behaviors, the impact of abuse, and the steps necessary to prevent abuse or neglect from recurring may vary given the goals and context of the intervention. Little is known about the character and effects of existing interventions in treating different forms of child maltreatment. No comprehensive inventory of treatment interventions currently exists, and we lack basic descriptive and evaluative information regarding key factors that influence the delivery and outcomes of treatment for victims and offenders at different developmental stages and in different environmental contexts. A coherent base of research information on the effectiveness of treatment is not available at this time to guide the decisions of case workers, probation officers, health professionals, family counselors, and judges. Investigations of child maltreatment reports often influence the development and availability of other professional services, including medical examinations, counseling, evaluation of risk factors, and substantiation of complaints. References Administration for Children and Families, Office of Planning, Research and Evaluation. (2004a). Who are the children in foster care? NSCAW Research Brief No. 1. Retrieved August 9, 2007, from the National Data Archive on Child Abuse and Neglect website: www.ndacan. cornell.edu/NDACAN/Datasets/Related_Docs/NSCAW_Research_Brief_1.pdf A

The Methodological Role of the Concept :: Science Physics Research Papers

The Methodological Role of the Concept "Physical Vacuum" Science is entering the post-non-classical period characterized by evolutionary-synergistic types of rationality, the central moment of which is research of complex nonlinear systems. During the last few decades, physics has made a revolutionary turn toward new representations of the nature of elementary particles and has revealed unexpected features of the physical vacuum, with the evolving Universe having become the basic subject of study in physics. It is important to distinguish two basic aspects of the development of modern physics. First is that physics has closely approached the construction of unified theory. Second is that two branches of knowledge —physics of elementary particles and cosmology — have completely merged. This is most vividly displayed through the modern inflationary models of the evolution of the Universe, within the framework of which it is possible to solve most cosmological problems. The inflationary scenarios give a new look to the place of the physical vacuum in the structure of physics theory. This requires the methodological analysis of the problem of the physical vacuum and a definition of its status in the structure of nature science. I will therefore: 1) investigate the sociocultural origin of this fundamental concept by looking for the sources of the entry of the concept "vacuum" in the sciences; 2) study its functioning in the logic of scientific knowledge at the various stages of development in physics; and 3) develop more adequate definitions of this concept. The science is entering post non-classical period. This period is characterized with establishing evolutionary-synergetic type of rational. The central moment of which is research of complex nonlinear systems. The finest aspect of the appropriate consideration has the Universe as a self-organizing object. Cosmological aspect of formation of the new scientific research program, new paradigm in science, ontological formation of them in an adequate post-non-classical scientific picture of the world has the paramount meaning. It can be said that during the last two-three decades the physics has made a revolutionary turn on the way to the new representations of the nature of the elementary particles, and has revealed unexpected features of the physical vacuum. As a result that has determined evolving Universe as the basic subject of studying in physics. It is important to distinguish two basic aspects of development of modern physics. The first of them is, that the physics has closely app roached to the program of construction of the one theory of the field.

Euthanasia Essay example -- essays research papers

Euthanasia, also known as mercy killing is a practice of ending a life to release an individual from an incurable disease or intolerable suffering. Euthanasia has been accepted both legally and morally in various forms in many societies but not in all. â€Å"In ancient Greece and Rome it was permissible in some situations to help others die. For example, the Greek writer Plutarch mentioned that in Sparta infanticide was practiced on children who lacked "health and vigor." Both Socrates and Plato sanctioned forms of euthanasia in certain cases. Voluntary euthanasia for the elderly was an approved custom in several ancient societies.† With the rise of organized religion, euthanasia became morally and ethically abhorrent. Christianity, Judaism, and Islam all hold human life sacred and condemn euthanasia in any form. Following traditional religious principles, Western laws have generally considered the act of helping someone to die a form of homicide subject to legal sa nctions. â€Å"Even a passive withholding of help to prevent death has frequently been severely punished. Euthanasia, however, occurs secretly in all societies, including those in which it is held to be immoral and illegal.† There are two main types of euthanasia, passive and active. Passive euthanasia is the deliberate disconnection of life support equipment, or cessation of any life-sustaining medical procedure, permitting the natural death of the patient. Active euthanasia is deliberate action to end the life of a dying patient to avoid further suffering; there are two types of active euthanasia. Active voluntary euthanasia is when a lethal injection is giving by a doctor into a dying patient to end life by request of the sufferer. Active involuntary is lethal injection by a doctor into a dying patient without that person's express request. Active involuntary is considered murder by most. Since euthanasia is illegal in 49 of the 50 US states it would seem that most people are against it. There are some people who have formed organizations that help to educate people about euthanasia and that In fact euthanasia may be a good thing. One such organization is ERGO the Euthanasia Research & Guidance Organization a nonprofit educational corporation, which was founded in 1993 to improve the quality of background research of physician-as... ...he end stage. Once these symptoms are alleviated the emotional pain becomes the focus and it takes great strength to watch a loved one die slowly day by day. I’ve seen families brought together and serve as a great comfort to each other and to the patients. Death to these people is not the enemy but a natural ending of life. I’ve also seen family’s fall apart, seemingly unable to hold up under such pressure. Are these the people who assist in another’s suicide? Is it a weak persons way out? It is done because of love or inability to cope? Only they know.† The writer of this paper feels that euthanasia should be accepted more then it is, but is not the answer. I think that most suffering can be deemed tolerable with proper medications. It seems that if the pain can be controlled with medication, that the person could pass on in a deep sleep and be comfortable. However there are other symptoms that accompany other illness that can not be changed by medication. Like Christopher Reeves no matter how much medication he is given he will never walk, ride a horse, or bath himself again. This kind of suffering I would find intolerable and would justify euthanasia. Footnotes

History Of Medical Tourism Health And Social Care Essay

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