In Cold Blood Book Review - 896 Words

If one is interested in reading a disturbingly detailed and factually based novel that chronicles the course and motives of complex crime, read Truman Capote’s â€Å"In Cold Blood: A True Account of a Multiple Murder and Its Consequences.† If one scares easily, is squeamish or wants to avoid imagining a remorseless, brutal killer around every corner, do not. In his 1965 nonfiction novel, Capote paints a disturbingly vivid picture of the quadruple murder of the Clutters, a highly regarded and semi-wealthy farming family from Holcomb, Kansas. In Cold Blood examines the incentives and methods used by the killers, as well as the effect these murders had on the small Kansas town. â€Å"In Cold Blood,† what many consider Capote’s masterpiece, was†¦show more content†¦Nancy Ewalt says I did – screamed and screamed. I only remember Nancy’s Teddy bear staring at me. And Nancy.† Throughout â€Å"In Cold Blood,† Capote illustrates several journalistic characteristics, one of which being oddity. The murder of a nice family from a small town is certainly unusual, especially when no motives or suspects fit the case. Additionally, when the killers were caught, their indifference towards the crime varied drastically from what one would expect.Show MoreRelatedTruman Capote is Famous for His Novels, Stories and Screenplays816 Words   |  3 Pageswrote many great books including In Cold Blood, Other Voices, A Christmas Memory, The Thanksgiving Visitor, many more wonderful stories. In Cold Blood was published September twenty fifth in 1965. Truman Capote received much help in his four years of writing In Cold Blood from Harper Lee who wrote To Kill a Mockingbird. He was very famous and was seen at the best parties and clubs. There is even a movie of the story In Cold Blood made December twelfth 1967 Rated R. In Cold Blood was his most famousRead MoreCold Blood by Truman Capote900 Words   |  4 PagesIn 1965, Truman Capote created the infamous tale known as â€Å"In Cold Blood†. The book created the illusion of fantasy while based on reality. Many people were floored at the brilliance Ca pote demonstrated within the pages. The book took the literary concept of a novel with the literary elements of designed scenes, characters, a story formed with an introduction, rising action, climax and resolution to the real events surrounding the murder of the Clutter family. Those that worked in the field ofRead MoreBased on True Events A Glance into the Nonfiction Novel Genre979 Words   |  4 Pagesdescribe what was considered impossible to describe (Taylor). One way writers have been able to do this is through nonfiction novels. A nonfiction novel is a narrative, of book-length, that unfolds actual events and actual people written in the style of a novel (â€Å"Nonfiction Novel†). This style of a novel implies that the book being spoken of can be looked at as art as well as fact (Sharlett). In the mid 1960’s, a nonfiction novel journey began, beginning with the narrative journalistic qualitiesRead MoreIn Cold Blood by Gerald Clarke836 Words   |  3 Pagesyears Truman Capote spent writing the novel ‘In Cold Blood’. The film ‘Capote’ was by directed Bennett Miller after being adapted from a book of the same title, written by Gerald Clarke. It was set in Kansas and starred Seymour Hoffman as Truman Capote and c hronicled a six year period in the life of author Truman Capote whilst he wrote a book entitled ‘In Cold Blood’. The novel ‘In Cold Blood’ apparently gave rise to a new style of writing-as the book offered much from the murders’ perspective andRead MoreEssay on Mla Formats678 Words   |  3 PagesMLA Review Part 1: MLA In-text Citations – Rewrite the last line of each quote with a correctly formatted MLA in-text citation. 1. â€Å"One of his eyes resembled that of a vulture—a pale blue eye, with a film over it. Whenever it fell upon me, my blood ran cold; and so by degrees—very gradually—I made up my mind to take the life of the old man, and thus rid myself of the eye forever.† This is from the text book, Great Writing, which was edited by Harvey S. Wiener and Nora Eisenberg. It comesRead MoreTruman Capote Essay1439 Words   |  6 Pagesalcohol abuse became public when he was arrested for drunk driving. In 1982, he was told his brain was shrinking and that he had only six months to live. Truman died of alcohol/drug abuse on August 23, 1984 in Los Angeles, California. (www.nytimes.com/books) As an author he was widely praised for his style of writing after the publication of his earlier stories. Most of his short stories are based on childhood reflections. For example A Christmas Memory and The Thanksgiving Visitor are based on theRead MoreReview of Ray Bradburys Fahrenheit 451 Essay1496 Words   |  6 PagesReview of Ray Bradburys Fahrenheit 451 In Ray Bradburys novel Fahrenheit 451, the author utilizes the luxuries of life in America today, in addition to various occupations Read MoreEssay about Blood on the Forge1162 Words   |  5 Pagesï » ¿Bryan Casallo Dr. Bailey April 17, y Blood on the Forge Book Review â€Å"Steel is born in the flames and sent out to live and grow old.   It comes back to the flames and has a new birth.   But no one man could calculate its beginning or end.   It would end when the earth ended.   It seemed deathless.† (302) Blood on the Forge, by William Attaway, illustrates one of the most important historical event in United States history, The Great Migration. Attaway sets Blood on the Forge in the midst of the SteelRead MoreTruman Capote Essay1705 Words   |  7 Pageswrite in a set genre, he created his own which is commonly known as nonfiction fiction. His novels, short stories, and plays are mostly recognized as literary classics. He is most well-known for his novella Breakfast at Tiffany’s (1958), and In Cold Blood (1965). Many films and other television media have been produced from Truman Capote screenplays and stories. Truman led a hard childhood stricken with divorce and many relocations from place to place. Capote discovered his writing ability aroundRead MoreAnalysis Of The Film Of Cold Blood 1757 Words   |  8 Pages The film â€Å"In Cold Blood† is about a family that lived in Holcomb, Kansas, and was brutally murdered in 1959. The cluster family consist of the father, mother and two of their teenage daughters, Kenyon, and Nancy. There was no clear motive; the murderers were Dick Hickock and Perry Smith. They escaped after committing the murder, but after investigations, they were arrested(Crowther). Whereas, the â€Å"Black Dahlia† is a film about the murder and investigation of Elizabeth Short. Her body was found abandoned

Sampling With or Without Replacement

Statistical sampling can be done in a number of different ways. In addition to the type of sampling method that we use, there is another question relating to what specifically happens to an individual that we have randomly selected.   This question that arises when sampling is, After we select an individual and record the measurement of attribute were studying, what do we do with the individual? There are two options: We can replace the individual back into the pool that we are sampling from.We can choose to not replace the individual.   We can very easily see that these lead to two different situations.    In the first option, replacement leaves open the possibility that the individual is randomly chosen a second time.   For the second option, if we are working without replacement, then it is impossible to pick the same person twice.   We will see that this difference will affect the calculation of probabilities related to these samples. Effect on Probabilities To see how we handle replacement affects the calculation of probabilities, consider the following example question. What is the probability of drawing two aces from a standard deck of cards? This question is ambiguous.   What happens once we draw the first card?   Do we put it back into the deck, or do we leave it out?   We start with calculating the probability with replacement.   There are four aces and 52 cards total, so the probability of drawing one ace is 4/52. If we replace this card and draw again, then the probability is again 4/52. These events are independent, so we multiply the probabilities (4/52) x (4/52) 1/169, or approximately 0.592%. Now we will compare this to the same situation, with the exception that we do not replace the cards.   The probability of drawing an ace on the first draw is still 4/52. For the second card, we assume that an ace has been already drawn.   We must now calculate a conditional probability.   In other words, we need to know what the probability of drawing a second ace, given that the first card is also an ace. There are now three aces remaining out of a total of 51 cards. So the conditional probability of a second ace after drawing an ace is 3/51.   The probability of drawing two aces without replacement is (4/52) x (3/51) 1/221, or about 0.425%. We see directly from the problem above that what we choose to do with replacement has bearing on the values of probabilities.   It can significantly change these values. Population Sizes There are some situations where sampling with or without replacement does not substantially change any probabilities.   Suppose that we are randomly choosing two people from a city with a population of 50,000, of which 30,000 of these people are female. If we sample with replacement, then the probability of choosing a female on the first selection is given by 30000/50000 60%.   The probability of a female on the second selection is still 60%.   The probability of both people being female is 0.6 x 0.6 0.36. If we sample without replacement then the first probability is unaffected.   The second probability is now 29999/49999 0.5999919998..., which is extremely close to 60%.   The probability that both are female is 0.6 x 0.5999919998 0.359995. The probabilities are technically different, however, they are close enough to be nearly indistinguishable.   For this reason, many times even though we sample without replacement, we treat the selection of each individual as if they are independent of the other individuals in the sample. Other Applications There are other instances where we need to consider whether to sample with or without replacement. On example of this is bootstrapping. This statistical technique falls under the heading of a resampling technique. In bootstrapping we start with a statistical sample of a population. We then use computer software to compute bootstrap samples. In other words, the computer resamples with replacement from the initial sample.

Essential Question Did the formation of the National...

Essential Question: Did the formation of the National Aeronautics and Space Administration and its programs positively affect the people of the United States? On October 1st, 1958, the National Aeronautics and Space Administration (NASA) formally opened its doors for advancements in space and atmospheric research. After the launch of the Soviet Unions Sputnik 1, Earths first artificial satellite, on October 4th, 1957, United States President, Dwight D. Eisenhower asked his science advisor, Dr. James Killian, to research the best process to develop a national space program. Killian presented many proposals to Eisenhower, who eventually approved Killians proposal of instituting a civilian space agency built around the militaristic†¦show more content†¦As a consequence of the tensions between the superpowers, NASAs birth was directly related to the pressures of national defense. (Garber and Launius, 2005). The launch of the Soviet spacecraft created an idea in the United States that the Soviets were far more technologically advanced. To counter this thinking, the US government created NASA and it marked the beginning of the space ra ce. The reasons for the formation of NASA listed in the National Aeronautics and Space Act differ from the primary reason listed above. In the bill, it states the space program will contribute to the following objectives: The expansion of human knowledge of phenomena in the atmosphere and space; The improvement of the usefulness, performance, speed, safety, and efficiency of aeronautical and space vehicles; The development and operation of vehicles capable of carrying instruments, equipment, supplies and living organisms through space; The establishment of long-range studies of the potential benefits to be gained from, the opportunities for, and the problems involved in the utilization of aeronautical and space activities for peaceful and scientific purposes. (National Aeronautics and Space Act, 1958). Though these reasons differed from the primary force behind the creation of the agency, all were factors to decide upon its formation. How did NASAs programs affect the people? NASA created technologies that wereShow MoreRelatedMacbeth Ess1197 Words   |  5 PagesayMacbeth Essay 3. The power of the play is its relevance to today’s society. We are surrounded in everyday life by men and women who might as well have been characters in this play. The play of Macbeth has themes in it which can be associated with people who live in our world today. In Macbeth we see a king who abuses his power and uses it for the wrong reasons. He almost always get away with it. Despite the fact that there were people that were suspicious of Macbeth, he was never broughtRead MoreThe Emergency Services Sector ( Ess ) Essay2170 Words   |  9 PagesIntroduction The Emergency Services Sector (ESS) is one of the most important sectors in America. The sector is the largest in terms of personnel. This sector trains and utilizes both physical and cyber resources in order to provide a multitude of services for daily operations and critical incident responses. The sector itself is comprised paid staff as well as volunteers from within each community that they serve. The sector is composed of five sub groups: law enforcement, fire and emergencyRead MoreUsing Evolutionarily Stable Strategies ( Ess ) And Signaling Theory3035 Words   |  13 Pagesany direct trace of human language’s emergence, many hypotheses have been proposed to connect the few dots we have now. The concepts of evolutionarily stable strategies (ESS) and signaling theory have complicated this already intricate matter, but they have also helped to shine a light on a different facet of the problem. An ESS is, by definition, a strategy that cannot be displaced by any alternative strategy (as long as the alternative strategy is initially rare) once it is fixed in a populationRead MoreEvan Higgins. Uw Ess 102. Due: 4/10/2017. Human Vs Robotic1539 Words   |  7 PagesEvan Higgins UW ESS 102 Due: 4/10/2017 Human Vs Robotic Space Exploration Space. Possibly the most unforgiving place possible for humans, and yet we desire to go there. We desire to travel to distant planets, new galaxies, and to know all that there is to know. We want all of this, and yet the mission to mars, and the first missions to the moon, we sent robots. There are many reasons for this and why we didn’t send humans, but the main reason we haven’t sent as many humans to space, is cost. ItRead MoreA Meta Analysis Of Schizophrenia Used By Heinrichs And Zakzanis1109 Words   |  5 Pagesstrategies; similarly, the nonverbal memory domain SMD was -0.91. All three of the memory domains contained a high heterogeneity of ESs. However, immediate verbal memory tests that resulted in smaller ESs found among first episode samples had a small percentage of males, and samples were only diagnosed with schizophrenia (not mixed varieties). In addition, smaller ESs found in the delayed verbal memory and learning strategies domain contained more recentl y published studies. Lastly, the nonverbalRead MoreThe European Union And Its Institutions1183 Words   |  5 Pagesproposed methods of data analysis. Data In order to investigate the hypotheses, I have chosen to use the European Social Survey (ESS). ESS aims to investigate attitudinal changes within the European countries. ESS is a cross-national survey, carried out every second year starting from 2002. In total, there are six rounds, where the most recent round is from 2012 (ESS Round 6, 2012). The survey consists of a core questionnaire varying a theme module questionnaire – one for each round. The core questionnaireRead MoreStochastic Synchronization Of Distributed Energy Resources1177 Words   |  5 Pagesgrid as a means of supplementing supply requirements [1]. Energy resource scheduling in a micro grid is different from that of a large power network due to its size, power exchange with the main grid, and charging/discharging of energy storage system (ESS) [2]. Indeed, controllable DGs in a micro grid are much smaller than power systems, reflecting an easier switching operation and hence a more flexible scheduling [2]. How ever, today’s micro grids are subject to operational challenges such as bidirectionalRead MoreProject Analysis : Hop Hlp Project1466 Words   |  6 Pagesstatus. The project will go live in the ninth December of 2016. †¢ System Implementation. The end users for this system are all SATORP employees that want to request for a home ownership or loan. The layout of the system is In the home page of ESS (Employee Self Service) the user will be entering its account information as it is in the SAP system. Then the system will display the account with the name of the employee and the Badge number and retrieve certain information needed for the rankingRead MoreBritish Airways Information System1483 Words   |  6 PagesExecutive Support System (ESS) Executive Support System (ESS) supports management in BA to make long term unstructured decisions and addresses strategic issues. Executives use this information tool, as it provides relevant data about British Airways internal and external environment which enables BA to match its organisational capability to changes, and opportunities, occurring in its external environment ESS Workstation Graphics Communications Local processing Menus ESS Workstati on Internal dataRead MoreWriting Assignment : Race And Sports1505 Words   |  7 PagesExam # 3: ESS 330 Writing assignment: Race and Sports Race is defined as a category of people regarded as socially distinct because they share genetically transmitted traits believed to be important by people in a society with power and influence (PPT slide ESS330). In sports, race has and continues to be snared with question, but as former Israeli Olympic athlete Gideon Ariel underscores: â€Å"I know that the American system is very sensitive to statements

The Factory by Mary Dilworth Essay - 852 Words

Written assignment Hannah Diwiak, 1c In the story The Factory the author Mary Dilworth writes about one of the nowadays main questions: what to choose when we have to decide between family or further a privat life for your own and career. Through out her characters she shows what can happen when the family feels left behind. And puts up the question what is really worth to achieve in life. The narrator of the story always hated the factory (p.1 l.1), though she worked once herself in a factory as the bosss secretary, where she also met her nowadays husband (p.1 l.20-22). Her hate against this institution is so strong, that she often imagined it burning down (Ive often imagined it without its†¦show more content†¦To have a guess about the importancy of the factory to him is that he even would have sold almost anything to have [his sign in those flashing neon lights that the city firms can afford] (p.1 l.5-8). The fact that he focuses absolutely on his work causes serious relationship problems in the engagement of the narrator and Eric; he is whether working or having a time for himself (He always says that after such a busy day at the factory, he needs to sit and think p.2 l.13-14). So the reader gets the impression their arent spending much time together – except for having breakfast, lunch and dinner together - or having actually something like a harmo nic parship. He treats her work as housewife with a kind of disrespect when is only appearing for the meals during which where he reads instead of having a conversation with her. While he goes to bed early to give his best at work the next day he doesnt notice at all how his wife feels when she stays up at night, hoping the factory will burn down. Summarized it can be said, that there is a lack of communication in their relationship, caused by his ambitions for his success with his factory. Red is in the story not just the colour of fire but also of love and passion, which the narrator misses currently. The gray that her husband became is the colour of routine, boredom and daily routine. In the ending of the story it becomes clear to the readerShow MoreRelatedDeveloping Management Skills404131 Words   |  1617 Pagesnotorious of all, of course, was the prediction by the United States patent office in 1896 that it would soon close its doors since â€Å"everything that can be invented has been invented.† Warren Bennis, a colleague of ours, half-jokingly predicted that the factory of the future would have only two employees, a person and a dog. The person would be there to feed the dog. The dog would be there to keep the person from touching the equipment! Tom Peters counseled managers that, due to the chaotic pace of change

No Heroes, No Villains By Steven Phillips - 1212 Words

In the short book of â€Å"No Heroes, No Villains† by Steven Phillips On June 28, 1972, a Transit Authority patrolman, John Skagen, was on his way home from testifying at court for an arrest he made a couple of weeks prior. Skagen was taking the train home to the Bronx when he saw and stopped James Richardson who was awaiting the subway train which would take him to work at Lincoln Hospital. Skagen ordered him to â€Å"put up your hands, and get against the wall†. Skagen’s actions seem unprovoked and unnecessary. After a short tussle the two men exchanged shots and Richardson fled the scene on foot. Two other officers that were on the main street above the subway station rushed to the scene. As they approached the entrance of the station, Richardson who was fleeing the scene ran directly into one of the officers. One of the officer noticed Richardson was shot and attempted to stop Richardson. The other officer continued down into the subway and witnesses Skagen h olding his gun and pointing it towards him, the officer emptied his gun into Skagen who was able to let off one round prior to the officer shooting him. Richardson was later apprehended and taken to the emergency room for his wounds. His gun was also retrieved. Skagen was rushed to the same hospital emergency room where he was pronounced dead. Richardson confessed to shooting Skagen and revealed that there were only four rounds exchanged between the two men. Skagen’s autopsy revealed that he had been shot five times andShow MoreRelatedNo Heros No Villians1488 Words   |  6 PagesSociology 461 Criminal Justice Systems Edward M. Stern No Heroes, No Villains; by Steven Phillips In the book No Heroes, No Villains the author Steve Phillips describes a story of a single dramatic trial of murder it offers a thoughtful and balanced presentation of the problems besetting our criminal courts, lays bare the mechanics of justice, and explains in graphic detail just what is wrong and right about our criminal justice system. Throughout this book there are many important details leadingRead MoreVillains in Hollywood Films Essay2476 Words   |  10 PagesVillains in Hollywood Films Alfred Hitchcock once said The better the villain, the better the film and this years Hollywood filmmakers have abided by this golden rule as there was no stopping this years summer blockbusters from having a whole horde of villainous characters spreading their wings onto the big screen, making the darker side more appealing for audiences. Everybody has gone villain this year, from Tom Cruise to Halle Berry, from the not- so-friendly extraRead MoreThe Marvel Of Marvel Comics2519 Words   |  11 PagesApril 14, 2015 The History of Marvel Comics When is the last time you saw a superhero? There is a fifty percent chance that this person is one of Marvel’s infinite amounts of superheroes and greatly known as the mass producers of comic book heroes and villains, Marvel Comics has become one of the most dominant pop culture icons on the face of the planet (Knutson). Marvel is one of the most influential when it comes to all ages living in the United States because of being operational for so long: theRead MoreStephen P. Robbins Timothy A. Judge (2011) Organizational Behaviour 15th Edition New Jersey: Prentice Hall393164 Words   |  1573 PagesSelf-Assessment Library How Charismatic Am I? 382 Self-Assessment Library Am I an Ethical Leader? 386 An Ethical Choice Do Leaders Have a Responsibility to Protect Followers? 388 Myth or Science? â€Å"Power Helps Leaders Perform Better† 392 Point/Counterpoint Heroes Are Made, Not Born 398 Questions for Review 399 Experiential Exercise What Is a Leader? 399 Ethical Dilemma Undercover Leaders 399 Case Incident 1 Leadership Mettle Forged in Battle 400 Case Incident 2 Leadership Factories 400 13 Power andRead MoreExploring Corporate Strategy - Case164366 Words   |  658 PagesRoss Brawn: ‘it’s not an engine, it’s not an aero-package, it’s not a chassis. It’s a Ferrari.’ As part of its recruitment of Michael Schumacher in 1996 Ferrari entered into a commercial partnership with Phillip Morris to use the Marlboro brand on the Ferrari cars. In a novel arrangement Phillip Morris, rather than Ferrari, paid Schumacher’s salary, and made a signiï ¬ cant contribution to Ferrari’s annual operating budget. In addition to Marlboro, Ferrari also entered into a long-term partnership withRead MoreProject Mgmt296381 Words   |  1186 PagesThey are creating next generation, fuel efficient vehicles, developing sustainable sources of energy, and exploring the farthest reaches of outer space. The impact of project management is most profound in the electronics industry, where the new folk heroes are young professionals whose Herculean efforts lead to the constant flow of new hardware and software products. Project management is not limited to the private sector. Project management is also a vehicle for doing good deeds and solving social

Managed care Free Essays

1. How do managed care organizations provide comprehensive and quality care while keeping costs down? American health care should essentially be a nonprofit enterprise. However, the privatization of American health care holds that health care in general and hospitals in particular are increasingly operating on a for-profit basis. We will write a custom essay sample on Managed care or any similar topic only for you Order Now In fact, the for-profit hospital sector has accounted for a relatively constant share (about 15 percent) of hospital beds over the last twenty years (Morrisson, 1999). This is why recently the U.S. Congress tries to push more â€Å"consumer-directed† health plan options to avoid cash-strapped managed care organizations (MCOs) to boost their deductibles, raise premiums and even defy federal law by authorizing policy holders to buy prescription drugs from low-cost vendors in Canada (Smith, 23 September 2004). Managed care organizations (MCOs) often apply the traditional fee-for-service models, which do not provide adequate financial controls and utilization incentives for physicians and hospitals to contain the costs of providing healthcare. Under managed care, the needs of the patients are balanced with efforts to provide cost-effective care. Typically, MCOs enroll subscribers by promising to provide all necessary medical care in exchange for a fixed monthly premium. The MCO also contracts with hospitals, physicians, and other healthcare providers to dispense the necessary medical care to its enrollees at a discounted reimbursement rate. In exchange for accepting reduced fees, the caregivers gain access to the MCO’s enrolees (Kirby, Sebastian Hornberger, 1998). A problem with managed care is that employers who offer a health maintenance organization (HMO) to their employees often pay the premium as long as the HMO premium was not higher than the fee-for-service premium. This behavior by employers creates distorted incentives for the HMO in controlling its costs. Enthoven (1993) suggested that this incentive distortion can be corrected when employers design better alternatives for their employer contributions. The employer could contribute a fixed-dollar amount for health insurance with the employee paying the full difference between plans. The greater the portion of the marginal premium paid by the employees is, the stronger the incentive is to choose lower-cost plans. For example, if the employer pays 80 percent of the premium and the employee pays the remainder, then the employee pays only 20 percent of the difference between the low (let’s presume here) HMO premium and the higher fee-for-service premium. HMOs and other managed care arrangements are organized on a prepayment basis that appear in a wide variety of forms. An HMO could hire physicians on a salary, contract with a preexisting group practice of physicians, or contract with physicians who maintain a fee-for-service practice. According to Luft (1991), â€Å"Because specific social, legal, historical, political, and economic aspects of the medical care environment have shaped delivery systems such as the HMO, it is not reasonable to expect that the typical HMO could be transplanted intact to another country† (p. 173). The key to HMO cost savings is the organization’s wide range of medical services, both inpatient and outpatient. In this way, the HMO can receive the cost savings implied by reduced hospital use. This may be difficult to manage in systems where there are separate financing mechanisms for primary care physicians and inpatient care. As Luft (1991, p. 180) remarks. â€Å"If there were no way to shift funds from the ‘hospital side’ to the ‘physician side,’ it would be difficult to reward clinical decision makers for the development of more cost-effective practice styles.† 2. How can the trio of ambulatory care, mental health care and alternative theraies assist in the process of providing quality care at low cost? Ambulatory care-sensitive conditions reflect the quality and availability of primary care services, since they are readily treatable without the need for hospitalization. There are differences in the hospitalization rate for ambulatory care sensitive conditions. Shenkman et al. (2005) had indicated that specialty ambulatory care is important for many children with chronic conditions. However, access to such care may be constrained within managed care environments. The use of primary care providers (PCPs) as gatekeepers for managed care organizations (MCOs) is one commonly used strategy to control specialty care use. Studies of the impact of gatekeeping on children’s receipt of specialty care have resulted in mixed findings. Some studies found more specialty care use in gatekeeping MCOs, compared with non-gatekeeping MCOs. Other researchers found that the replacement of a gatekeeping system with an open-access model increased specialty visits among a group of children with chronic conditions. Although the focus on gatekeeping in general yields some important information, MCOs use many other strategies concomitantly with their PCP gatekeepers, such as capitated payments, financial incentives, and prior authorization procedures. The use of these concomitant strategies may meet the unique needs of children with chronic conditions, including their need for specialty physician care. On the other hand, managed care had been significant contributor on delivery systems for mental health services. Taylor et al. (2001) had indicated that direct and indirect persuasion to provide more cost-effective treatments has been one consequence. The cost-saving qualities and the effectiveness of group interventions have produced clear expectations for an increased use of therapy groups. In the research of Taylor et al. (2001), they compared perceptions and uses of group treatments on a national sample of managed care organizations and mental health providers. Implications of differences and similarities between directors of managed care organizations and treatment providers are examined and discussed across five response categories (familiarity/training perceived effectiveness, likelihood of reimbursement/referral, daily use and expectation for future use). Taylor et al (2001) favored the approach where MCOs calibrate treatment referral/reimbursement decisions. Recently published comparison outcome studies and meta-analyses can and should empirically guide the present treatment delivering systems. Lastly, many managed care organizations have already begun to integrate complementary and alternative medical therapies (CAM) with conventional medical providers. Medical practitioners are obligated to assess CAM therapy with patients. Alternative therapies require professionals to rethink staff competency, patient assessment, and patient-focused care. Medical leaders must understand CAM trends and therapies to better integrate these concepts into health care policy, standards of care, and ethical decisions (Parkman, 2001). Among ambulatory care and mental health care, alternative therapies, or CAM, offers the most favorable and cost-efficient strategy for MCOs. This is because the aging â€Å"baby boom† generation is beginning to experience chronic but non-life threatening conditions, such as joint pain, headaches and menopause-related complaints and they are willing to explore options other than prescription drugs. For health plans, the attraction of offering alternative care products lies in retaining and attracting new members, diversifying their services from competitors in a congested managed care market and in attempts to address current or proposed state mandates (West, 1997). In 1997 alone, expenses for professional services were $21.2 billion, a 45% increase over the earlier 1990 data. Expenses for professional services, herbals, vitamins, diet products, books, and classes totaled $27 billion. Five surveys conducted since 1990 have reported frequent use of CAM, ranging from 30% to 73% by patients suffering from conditions such as cardiovascular disease, cancer, arthritis, HIV and AIDS, multiple sclerosis, and chronic musculoskeletal pain. Futhermore, the demand for CAM by the general public is increasing, despite the fact that its use is largely paid by consumers without coverage by third-party payers. In 1997, Americans spent an estimated $13 billion for visits to CAM providers and an additional $2 billion for commercial diet supplements and over-the-counter megavitamins (Pelletier Astin, 2002). Managed care should not only focus on cost savings, but they should also look into diversifying their services. MCOs have generally contributed to the decline in the U.S. health cost growth rate. Their potential will continue to be limited to the extent that employers fail to offer true financial advantages to consumers who choose the low-cost health plans. Thus, more reforms in the policies should be reviewed and revised so that more people could benefit from the quality health care everyone deserves. References Enthoven, A.C. (1993). The History and Principles of Managed Competition. Health Affairs, supplement, 24-48. Kirby, E.G., Sebastian, J.G. and Hornberger, K.D. (1998, Jan/Feb). The Effect of Normative Social forces on Managed Care Organizations: Implications for Strategic management/Practitioner Response. Journal of Healthcare Management. 43(1):81-106. Luft, H. (1991). Translating the U.S. HMO Experience to Other Health System. Health Affairs 10:172-186. Morrison, I. (1999). Health Care in the New Millennium. NY: John Wiley Sons, Inc. Parkman, C. (2001, February). Alternative Therapies Are Here to Stay. Nursing Management, 32(2): 36-40. Pelletier, K.R. and Astin, J.A. (2002, Jan/Feb). Integration and Reimbursement of Complementary and Alternative Medicine by Managed Care and Insurance Providers: 2000 Update and Cohort Analysis. Alternative Therapies in Health and Medicine, 8(1): 38-44. Shenkman, E., Tian, L. and Schatz, D. (2005, June). Managed Care Organization Characteristics and Outpatient Specialty Care Use Among Children With Chronic Illness. Pediatrics, 115(6): 1547-1555. Smith, C. (2004, Spetember 23). Senate Panel Examines Health Care Choices, Insurance Costs. Knight Ridder Tribune. Taylor, N.T., Burlingame, G.M., Kristensen, K.B., Fuhriman, A. et al. (2001, April). A Survey of Mental Health Care Provider’s and Managed Care Organization Attitudes Toward, Familiarity With, and Use of Group Interventions. International Journal of Group Psychotherapy, 51(2): 243-264. West, D. (1997, November 10). MCOs Integrating Alternative Care. National Underwriter, How to cite Managed care, Essay examples Managed Care Free Essays The article seeks to identify the problems that face managed care organization (MCOs) in contemporary competitive environment which include broad public opinion, competitive realities, need for cost reduction. The article also notes that there has been an increase in health care cost despite the establishment of the managed health care systems implemented through the managed care organizations. Increase in cost remains to be a major concern for patients/consumers. We will write a custom essay sample on Managed Care or any similar topic only for you Order Now Due to this, patients are ready to switch from one plan to another in which cost difference in premium is as little as $15. 0 per month. The article also claims that there has been concern from the society as far as quality of managed healthcare service is concerned. Such concerns encompass: accessibility, and the verification of what is ‘medically necessary’ including the diagnosis tests and referrals. Other concern is freedom of choice. Additionally, perceived quality which is increasingly valued by contemporary patients/consumers has been lacking in the managed care organizations. (Entrepreneur 1998). Strategies or techniques are used to solve the problem or address the issue. This article proposes application of institutional theory to MCOs performance as well as strategic planning. Over emphasizing of institutional theory at the expense of strategic planning will not help the managed care organization to survive in the contemporary competitive environment. The article proposes a strategy that will respond and conform to the needs of the patients and the society at large. Being cost efficient and conforming with socially accepted norms will lead to superior performing of MCOs. Thus, a strategy that encompasses technical requirements as well as conforming to needs of the patients/consumers is very critical for success of any MCO. Only emphasizing or dealing with cost issue is not a strategy for long-term MCO superior performance and success. The article also proposes that all MCOs must demonstrate what contemporary consumers/patients and society expects. These expectations include accessibility, freedom of choice, and perceived quality i. e. always provide value for all patients. ( Entrepreneur1998). My conclusions and recommendations It is clear that the establishment of managed care and the managed care organizations have not been a panacea to all problems facing patients/consumers. Instead, what the patients would like to have is more accessibility to health care services, freedom of choice, better services emphasizing on perfect diagnosis tests, reduction in cost of this services as well as flexibility of managed care systems. This is yet to become a reality. To ensure this, responding to consumers/patients needs will be of great importance. This should include training the health care workers on the best way to serve the patients better, and carrying out perfect diagnosis tests before treating the patients. Increase in number of medical practitioners in MCOs so as to ensure accessibility of these services should also be considered. The managed care plans should also employ modern technology that will improve the quality of health care services. This should encompass better disease diagnosing equipments, and establishing better information systems. Reduction of cost is also very imperative. All inefficiencies and wastage should be checked through a well planned compliance system that should work closely with the human resource department. (Harris, J. S. 1994; Morton-Cooper Bamford 1997; Alexander Amburgey. 1987) Contribution of the article to helping practicing healthcare managers This article is of great help to many practicing healthcare managers. First, it point out the importance of being market oriented i. e. responding to the needs of the patients/consumers and society at large. Factors that determine patients choice of particular health care provider i. e. accessibility of the service, cost of the service, perceived quality such perfect diagnosis test for appropriate medication and so on are also enlisted. The article also emphasis on need of employing a strategy that ensures adherence to technical requirements, cost reduction, high quality, and also freedom of choice to the patients/consumers. Such insight is of great importance to any practicing health care manager who wants to succeed in this career. How to cite Managed Care, Papers

Miss Misery by Elliott Smith free essay sample

The Misery of Elliott Smith When it comes to the music, the lyrics can really make it or break it for me. In some respects they are more important than the tune. And, I had never heard lyrics with so much raw emotion until I heard Elliott Smith’s â€Å"Miss Misery.† Like so many of Smith’s songs â€Å"Miss Misery† is a haunting tale of failed love and disappointment. One line that is very powerful in the song is straight from the chorus, where he says â€Å"Do you miss me, Miss Misery, like you say you do?† The soft guitar accents his voice in a way I can’t describe. His cold raspy voice is one you would recognize anywhere. Even though most of his songs sound similar, each one has it’s own story that seems to dig deeper into his heart. There is no doubt that everything he writes is extremely well thought out and comes from only the richest part of his soul. We will write a custom essay sample on Miss Misery by Elliott Smith or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page The music really makes you think about your life and what your priorities are in your future. For example, I wonder how I would handle the same feelings and emotions he is going through in this song. I think I would steer clear of the path he chose to deal with it, his route is alcohol. Getting trapped in alcohol is no way to go through life. What I would hope for are good friends to help me deal with my own Miss Misery.