Learning English as a Second Language for Chinese Students

Learning English as a second language, students should pay much attention to the relationship between environment and language as these factors are very important. Students should learn not only the language itself, but pay much attention to the history of the country, its customs and values.Advertising We will write a custom article sample on Learning English as a Second Language for Chinese Students specifically for you for only $16.05 $11/page Learn More This paper is aimed at Chinese students who have just got down to learning English as a second language. These students should know the pitfalls and the difficulties they are going to face. Those who have never learnt another language are not really aware of the situation they are going to face with. Another language is not just a collection of the symbols which should be arranged in an appropriate order, it is another culture which may be understood only when collaboration is observed. Only working t ogether, only trying to understand the main idea of the American and British nature Chinese students will get the main idea of the language, will be able to learn it. Communication and cooperation with native speakers is exactly what is meant. Students should understand that they have great opportunity to cooperate with native speakers either in the centers or in other particular places, such as social networks, etc. Therefore, it may be concluded that cooperation and the opportunity to speak with the native speakers are really important factors for becoming a good learner. This essay is created for those who have just begun to study English as a second language as they are to know the peculiarities of the learning process and the difficulties they are to overcome in the future to succeed. Works Cited Facebook. Facebook.com. 2011. Web. Love, Tim. What is culture? 2008. Yomiury: Media Kit. Web. This article on Learning English as a Second Language for Chinese Students was written and submitted by user Jayda Leach to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Taylor McCauslin Essays (1297 words) - Anna Quindlen, 9, Free Essays

Taylor McCauslin Essays (1297 words) - Anna Quindlen, 9, Free Essays Taylor McCauslin Nick Lakostik English 1100 3 October 2015 The Dynamic Meaning of Happiness Anna Quindlen evaluates the average American and their need for consumption in her op-ed; "Stuff is Not Salvation." She discusses the impact of various roles given to people in society on how Americans views' on possessions has changed over the years. She uses real life experiences to drive home the point that Americans are losing focus of what matters. Overall, Quindlen's view that "stuff is not salvation," could not have a more true relation to modern American ideals. I wholeheartedly agree that Americans today have a very misaligned sense of priorities with unimportant materials somehow taking control of the priority list for way too many people. Quindlen uses the high need for "real things" as a response to the apparent need Americans seem to have for buying various items. She later states that when a consumer gives in to their urge to buy items, it shadows the importance of needs that are much more severe and widespread. Quindlen then makes it known that, "For the first time this month, the number of people on food stamps will exceed the 30 million mark. Hard times offer the opportunity to ask hard questions, and one of them is the one my friend asked, staring at sweaters and shoes: why did we buy all this stuff?" (par. 8-9). This is a fantastic argument. I admit to being guilty of asking myself this same question multiple times over. The sad part is that I didn't realize it was junk until I was staring at a collection of unused items in my closet, none of which have been used in more than a year. I wanted them so badly at the time that I actually thought I needed them. By feeding the urge, I in turn let thoughts of important matters fall to the background. Almost every paycheck, I believe that I am going to spend a certain amount on charity. More often than not, I don't. I end up spending it on items instead. This societal want has already gotten out of hand. In the process of turning our heads towards what we want, we turn our heads away from what others need. Quindlen also explains that Americans' need for possessions has been on a rising trend for years. She views the changing technological times as part of the reason behind this growth. We see this when Quindlen explains, "I suspect television advertising, which made me want a Chatty Cathy doll so much as a kid that when I saw her under the tree my head almost exploded" (par. 4). That's the essential goal of advertising these days. Advertisers are paid to make people want something and to make them want to go out and buy it. These advertisers are getting increasingly better at their jobs as well. I often find myself being drawn into infomercials late at night and wanting everything I see so badly. An example is when I was up late watching an infomercial for a fishing hook. I wanted it so badly, but I don't even fish. In fact, I hate fishing. It's all just a game to big companies. They bait consumers with whatever they can. But it's up to us to decide whether or not we bite. We see advertisements so often in our daily lives that it starts to become part of our normal environment to see faces smiling and endorsing a product on practically every surface. They are included in any and every media outlet. However, why don't we see more advertising for the things people truly need? With the exception of the occasional ASPCA or UNICEF commercial, we rarely see anything highlighting the suffering of others. It's because we don't like to. It makes people uncomfortable. But we can't make a change until we become so uncomfortable with something that we can't stand it anymore. Nobody can deny media is the most powerful method of communication in modern society. Thus, we urgently need to change the way media portrays its content in order to change the world. Readers later view Quindlen's stance that in the process of the increasing need for valuable things related to livelihood, people are

European Countries Ranked by Area

European Countries Ranked by Area The continent of  Europe varies in latitude from places such as Greece, which is in the range of about 35 degrees north to 39 degrees north latitude, to Iceland, which ranges from around 64 degrees north to more than 66 degrees north. Because of the difference in latitudes, Europe has varying climates and topography. Regardless, it has been inhabited for about 2 million years. It consists of only about 1/15th of the worlds land, but the contiguous continent has about 24,000 square miles (38,000 sq km) of coastline. Stats Europe is made up of 46  countries that  range in size from some of the largest in the world (Russia) to some of the smallest (Vatican City, Monaco). The population of Europe is about 742 million (United Nations 2017 Population Division figure), and for a landmass of about 3.9 million square miles (10.1 sq km), it has a density of 187.7 people per square mile. By Area, Largest to Smallest The following is a list of the countries of Europe arranged by area. Various sources may differ in size of a countrys area due to rounding, whether the original figure is in kilometers or miles, and whether the sources include overseas territories. Figures here come from the CIA World Factbook, which presents figures in square kilometers; they have been converted and rounded to the nearest number. Russia: 6,601,668 square miles (17,098,242 sq km)Turkey:  302,535 square miles (783,562 sq km)Ukraine:  233,032 square miles (603,550 sq km)France:  212,935 square miles (551,500 sq km);  248,457 square miles (643,501 square km) including overseas regionsSpain:  195,124 square miles (505,370 sq km)Sweden:  173,860 square miles (450,295 sq km)Germany:  137,847 square miles (357,022 sq km)Finland:  130,559 square miles (338,145 sq km)Norway: 125,021 square miles (323,802 sq km)Poland:  120,728 square miles (312,685 sq km)Italy:  116,305 square miles (301,340 sq km)United Kingdom:  94,058 square miles (243,610 sq km), includes Rockall and Shetland IslandsRomania: 92,043 square miles (238,391 sq km)Belarus: 80,155 square miles (207,600 sq km)Greece: 50,949 square miles (131,957 sq km)Bulgaria: 42,811 square miles (110,879 sq km)Iceland:  39,768 square miles (103,000 sq km)Hungary: 35,918 square miles (93,028 sq km)Portugal: 35,556 square miles (92,090 sq km)Austri a: 32,382 square miles (83,871 sq km)Czech Republic: 30,451 square miles (78,867 sq km) Serbia: 29,913 square miles (77,474 sq km)Ireland: 27,133 square miles (70,273 sq km)Lithuania: 25,212 square miles (65,300 sq km)Latvia: 24,937 square miles (64,589 sq km)Croatia:  21,851 square miles (56,594 sq km)Bosnia and Herzegovina: 19,767 square miles (51,197 sq km)Slovakia: 18,932 square miles (49,035 sq km)Estonia: 17,462 square miles (45,228 sq km)Denmark: 16,638 square miles (43,094 sq km)Netherlands:  16,040 square miles (41,543 sq km)Switzerland:  15,937 square miles (41,277 sq km)Moldova: 13,070 square miles (33,851 sq km)Belgium:  11,786 square miles (30,528 sq km)Albania: 11,099 square miles (28,748 sq km)Macedonia: 9,928 square miles (25,713 sq km)Slovenia: 7,827 square miles (20,273 sq km)Montenegro: 5,333 sq miles (13,812 sq km)Cyprus: 3,571 square miles (9,251 sq km)Luxembourg: 998 square miles (2,586 sq km)Andorra:  181 square miles (468 sq km)Malta:  122 square miles (316 sq km)Liechtenstein: 62 square miles (160 sq km)San Marino:  23 square miles (61 sq km)Monaco:  0.77 square miles (2 sq km) Vatican City: 0.17 square miles (0.44 sq km)

Talent Practices at the Home Depot Essay Example | Topics and Well Written Essays - 1250 words

Talent Practices at the Home Depot - Essay Example Therefore the only manner in which the company can truly differentiate itself is through its service standards. Employees are key to offering customers with the highest levels of service. Home Depot is aware of this fact and therefore uses its employees to gain competitive advantage over its rivals in all the different countries that it operates in. In order to gain competitive advantage through its employees, the company communicates the strategic importance of them to the company (Burke & Cooper, 2004). The performance levels that are expected of them are constantly communicated to them and they are provided with ongoing training to help them to update their knowledge and upgrade their skills, based on the area of the business the work in, whether it is on the shop floor or the office (Adamson, 2006). However since the company has to differentiate itself from its rivals in a highly competitive market, the company pays special attention to employees on the shop floor, who are the first line of contract with the customers and hence the most able to make a difference. Since this is the 'do it yourself' industry, the best employees are those who can help customers in their 'do it yourself' projects. ... refore when recruiting individuals to work on the floor in the retail outlets the company always looks for individuals who have an interest in 'do it yourself' projects (Clarke & Layman, 2004). The company gives priority to individuals who have specialist trades knowledge in areas such as plumbing, wood work, crafts, painting etc. Further individuals who are home owners themselves and have embarked on many different 'do it yourself' projects at home and have the necessary experience to help a customer are given priority. This is not to say that the company does not employ teenagers, high school and college kids. The company does recruit many such individuals but does so only if they have some interest in gardening or home maintenance or areas specific to electronics and home appliances. Therefore the company appeals to the above segments through various means such as trade schools for individuals who have specialist knowledge in such areas, these individuals not only work on the shop floor and as independent contractors for Home Depot but they also deliver work shops in areas such as gardening, wiring, tiling, etc. Next the company also uses the Internet through its website and also job sites such as Workopolis to recruit individuals. Another channel used by the store is in-store advertising for associates during high seasons, and walk in interviews. Discuss the critical programs used by Home Depot to keep talent in their pipeline. The company works with many different trade and vocational schools and builds relationships with these schools to gain access to their graduates, thus having a pipeline of qualified candidates to work for the company as independent contractors. Likewise all individuals who apply for positions within the company but are not successful at

Syria Revolution Research Paper Example | Topics and Well Written Essays - 750 words

Syria Revolution - Research Paper Example The Syrian uprising compared to the Tunisian and Egyptian revolutions was grounded on the revolt of peasants, a Sunni periphery protest against the regime of Baath that turned its back on the Syrian local population, (Hinnebusch 12). Later on, the uprising took on diverse dimensions with Muslim Brotherhoods – Jihadists – entering into the conflict because of the heretical aspects of the regime and due to its alliance with Iran Shiites and Hezbollah. Consequently, because of Jihad, various demonstrators from across the Arabic and Islamic world have emerged in Syria, although, the slogan of Jihad did not trigger Syrians to enter into the uprising. Another dimension that emerged during the uprising is revenge, basing from the extreme violent efforts from the regime to halt the protest waves. According to experts, the brutality of the reign acted to extend the circle of the protestors involved in the uprising, (Starr 41). A number of people who later joined the protest were encouraged by the desire to avenge their family member, friends, and relatives’ bloodshed, and destruction of their properties, cities, and settlements by the forces of the regime during the uprising. ... Similarly, the regime appeared to have neglected the periphery and the local populations. In the start of 2006, the Syrians faced a tremendous and acute drought and the Jazira location in the south and northeastern part of the nation experienced such as Hawran and Dara experienced the extreme destruction. This is because such regions were extremely affected the new economic policies of the government that sought to alter the Syrian economy character from a socialist to a social market oriented economy, (Phares 74). These policies intended to open the nation to the global economy, foster foreign investment and create activity in the local and private spheres to promote growth of economy and allow the regime to bear the economic and domestic limitations. The policies too enabled economic growth to allow the nation to overcome other challenges such as rapid population growth, infrastructural underdevelopment, overdependence of agriculture, and lack of technological industry. Assad suppo rted the new policy and overlooked the significance of the socialist party ideology of Baath, its networking and institutions in the local region. Assad response and effects of the uprising Assad responded to the revolution and protest by providing reforms and ordering the military to calm the uprisings. Various clashed have occurred in Hama, Homs and other places, however, bombings and demonstrations have started occurring in Aleppo and Damascus. Syrian protests have proved their staying power irrespective of the various deaths and substantial joint efforts to suppress the protest, daily demonstrations have continued. Similarly, the longer the

The international evidence base for healthcare commissioning

The international evidence base for healthcare commissioning According to the Department of Health (2006) healthcare commissioning is more than just procurement of services. Effective commissioning is about care that adds maximum value for patients in a system that promotes fairness, inclusion and respect from all the sections of the society. The following essay focuses on the international evidence base for healthcare commissioning, explaining the healthcare commissioning of Finland, Sweden, Europe, New Zealand, Arizona and United States and the challenges for healthcare commissioning within the context of economic recession and the ways in which these challenges might be addressed. The fundamental aims of healthcare commissioning includes service improvement, decreasing costs wherever feasible, better patient outcomes, and NHS priorities should be taken into account for all commissioning activities (InPharm, 2010). The cycle of commissioning is fragmented into 3 segments: Strategic planning (the beginning of the cycle), procuring services and monitoring and evaluation. Various NHS tools for supporting the PCTs are available like Better Care Better Value indicators, NHS indicators etc. By restructuring the patient pathway at the first time, we improve clinical quality, decrease expensive readmissions, better staff and patient satisfaction and in turn generate savings which can be used for various services (Peskett, 2009). After the NHS reforms in England, the PCT were considered as the main commissioners of healthcare (Peskett, 2009).. In addition to the NHS providers and NHS Foundation Trusts (FTs), the independent and third sectors were also considered as the main healthcare commissioners. The Operating Framework (Department of Health, 2007a) of 2008/2009 focused mainly on world class commissioning which defines the commissioners skills and competencies for commissioning healthcare successfully from a variety of providers. According to Ham (2009) market like mechanisms has been applied to the health reforms in England. In the emerging market it will be of critical importance for the commissioners of care to manage equivalent with the providers. The government has laid down plans for establishing world class commissioning but evidence shows that commissioning is not done consistently in any of the systems. World class commissioning if developed might not be successful because of lack of potential in absence of other modifications in the making of reforms like payment modes and autonomous providers. An alternative to this would be to develop competing integrated systems. World class commissioning (WCC) is metamorphosing the means through which services are commissioned, resulting in improved health consequences and reducing health inequalities adding life to years and years to life (NHS: Department of Health, 2009). The Department of Health along with the NHS launched WCC in December 2007 which aims to d evelop World class commissioners of NHS-funded services. The NHS in England had designed a 10 year program of reform to handle long standing weaknesses in performance which they are halfway through (Ham, 2008). The commissioners of care play a critical role in negotiating similar terms with providers and use the resources efficiently for improving the health and performance of health services. In the early 1990s commissioning was a weak link in the internal market and it is risky if the history is repeated again. Many countries worldwide have drawn attention towards healthcare commissioning for bringing reforms. The traditional systems which have integrated financing and planning of healthcare (eg the UK, New Zealand and Sweden) have experienced the detachment of commissioning from provision since the early 1990s. The roles of insurers and providers have been strengthened due to traditional partition like Germany, Netherlands and US. Experience of commissioning in Europe: (Ham, 2008) It was found that commissioning in Europe had substantial diversity in context to organization that do purchasing. The type of organization like the central or regional government, municipalities that can act as purchaser, market concentrations and the way of interaction differs from country to country. Variations are also observed in their funding sources and jurisdictions. The function of the purchasers was merely carried out in the challenging surrounding despite of the tangled European health policy debates because of the market based reforms. Figureas and colleagues stressed that a fundamental lesson from European experience is that a broad systems approach for purchasing and various components are required by policy makers. Experience of commissioning in Finland: The Healthcare Commissioning system in Finland is micro level, non-competitive and within the local government (Benson, 2011). For an average of 11,000 populations there are about 448 municipal councils which are responsible for purchasing. Each of these 448 councils is valid for a period of 4 years and an executive board is appointed which leads to democratic linkage between the citizens and health commissioners. The councils are authorized to commission secondary or tertiary services of their choice themselves or by merging with other councils. Experience of commissioning in Sweden: The Swedish healthcare system comprises of 3 levels of government: the central government, county councils and municipalities (The Commonwealth Fund, 2010). The local government is responsible for the ways in which services are delivered considering the local conditions and precedence whereas the central government accounts for the overall goals and regulations of the healthcare system. Thus at local level the delivery system varies because of this decentralization. The central and local taxation is held responsible for public funding of healthcare services. The financing of prescription drug subsidies is provided by the central government. It also provides funding by grants apportioned using a risk adjusted capitation pattern to county councils and municipalities. Financing of primary and mental healthcare and specialist services is provided by the 21 county councils whereas home care and services and nursing home care services are provided by the 289 municipalities. The private sector covers about 5% of the population and it provides easy access to care for patients. The 21 county councils are responsible for the organization of primary care services. For residents within a devoted geographical area, the primary care is provided by the health centers. But there have been significant changes in the model and now the residents can choose their provider and physician. A new law holding an alternative for the population and primary care privatization has been implemented from January 2010. The various modes for payment of private primary care providers are taxation, topped up with fee-for-service and targeted payments. The residents can now directly go to the hospitals or the private specialists. Experience of commissioning in New Zealand: There was a separation of purchaser and provider roles in New Zealands healthcare system from 1993 to 2000 (Ham, 2008). From a recent study both the positive and negative side of purchasing and contracting in New Zealand were highlighted. The drawback was that it was difficult to co-relate providers performance and negotiate contracts because of insufficient data on cost, volume and quality. An antagonistic environment was appreciated because of legalistic approach to contracting. It was difficult to sustain long term contracts or conjunctive relationships because the competition law concerns were not even whereas on the positive side because of purchasing the purchasers and providers focused more on costs and volumes of services and specified the categories and levels of services supplied. According to the providers written contracts would encourage them to focus on improvement of quality of care. Ashton and colleagues have summarized the New Zealand healthcare as: contracting has amended the providers direction on costs and volumes, increased the clarity of services and greater emphasis on methods for improving quality. New Zealands healthcare faces the challenge whether the profit of contracting maintained with simultaneously declining the transaction costs. Experience of commissioning in United States: In United States, indemnity insurance was used for financing and delivery of healthcare (Ham, 2008). Patients selected their providers and the providers charged the insurers by paying fees for services. Hence the patient had a flexible choice and the providers prevailed. Because of increase in healthcare managed care approach was developed in the US in the 1980s and 1990s which was based on the funding authority playing a significant role as commissioners. Evidence suggests that managed care temporarily curbed the increasing healthcare costs in the US. But managed care led to fee-for-service providers. In spite of the evidence, a reinvention movement known as consumer directed healthcare movement took place in the health insurance industry. Experience of commissioning in Arizona: The healthcare commissioning system in Arizona (USA) known as Arizona Healthcare Cost Containment System (AHCCCS) was launched in 1982 (Benson, 2011). Arizona had two tier arrangements: AHCCCS covers about million Medicare and Medicaid from a number of purchasers. The purchasers are liable to commission health services operationally for 35,000 to 200,000 people known as members or lives and they purchase services from various providers. In order to sustain the contract or win, the AHCCCS has to produce detailed bids every 5 years and not all the health plans covered under AHCCCS are for profit organizations. The Department of Healths (2007d) recently published documents suggests that the world class commissioners will (Peskett, 2009): Run the NHS locally Function along with the community partners Both patient and public involvement will be there Merge with clinicians Organize and assess knowledge and needs respectively Accelerate the market Enhance innovation and improvement Draw upon some sound financial investment Supervise the local health system One of the ways of addressing one end of the spectrum is PBC which challenges the PCTs for having the proper governance arrangements and bringing awareness about absolute clarity between responsibilities and boundaries. CHALLENGES FOR HEALTHCARE COMMISSIONING: According to Le Grand (1999), commissioning problems were due to very weak incentives and very strong constraints (NHS CONFEDERATION, 2010). History says that commissioning had failed in the internal market in the 1990s and hence there is risk if repeated again (Ham 2008). Weak commissioning is because of the tendency to focus less on PCTs and PBC and giving importance to national, specialized and joint commissioning. Healthcare commissioning has become weak because of the following reasons: In publicly financed systems purchasing of health services is quite difficult Inability to control the referrals and activity of GPs in general Insufficient power against the number of providers, especially the Foundation Trusts (FTs) for shaping the market Curtailment of clinical engagement and base for decisions related to healthcare commissioning Lack of ability to comprehend an issue and perform in analysis of requirement and demand, managing budget, risk taking etc. There is hardly any evidence which suggests that commissioning has made a symbolic or strategic impact in secondary care services (Smith, et al., 2004). Healthcare commissioning is perplexed and postulating and requires both technical as well as managerial skills (Peskett, 2009). Ham (2008), quoting Mays and Hands (2000) defines Healthcare commissioning as complicated, unclear, not exhibiting information symmetry between buyer and seller, lengthy training mandatory and is based on long term relationships between patients and professionals. Often there is misunderstanding among the commissioners and providers, clinicians and managers, and sometimes between the primary and secondary care commissioners which builds up stress, hence a prominent degree of competence and communication skill is mandatory. The challenges for healthcare commissioning were revealed by the UKs Department of Health Independent Sector Program, particularly for assessment of governance arrangements and identification of high standards of healthcare providers (Peskett, 2009). A successful care pathway commissioning requires an acquaintance and proficiency of the clinical intakes, turnouts and consequences as well as organizational skills for process management and patient journey. Pertinent inter and intra-organizational governance arrangements should be verified. Evidence suggests that healthcare commissioners will need not only time but also stability and persistence of management and organization, if a sustainable progress is required for betterment of local services (Smith, et al., 2005). The recently developed primary care commissioning organizations focuses internally in their initial stages and in future with the secondary care and other providers. The factors which facilitate effective commissioning may also pose to be the greatest challenge. One of these includes for engaging the GPs a set of incentives is created, for patient with long term conditions new forms of seamless services being developed and eventually making an absolute effect on the broader healthcare system, which was difficult for the primary care commissioning to achieve. From a survey conducted recently a conclusion was drawn that about 50% of GPs did not show interest in commissioning budget (Smith, et al., 2005). The GPs would thus have power and would play the role of managers but the power was not distributed equally among the doctors. It has been suggested that an important incentive within fund holding and total purchasing would lead to changes and might improve the services as well, if there were profits during the practice process. In order to engage all the GPs into budget commissioning more strident incentives would be required. If a new NHS market is developed then it will offer sharper incentives so that the GPs and nurses can become practice based commissioners. Hence services could be purchased from new providers of primary care and diagnostics by a commissioning budget. For the non NHS providers, there arises a possibility that the primary care should demand increasingly for budget commissioning and thus become equivalent to the NHS GP s and nurses. (Peskett, 2009) Separation of managerial and clinical goals led to failure with no clinical leadership. Negative targets had detrimental consequences and if the financial flow encouraged efficiency and not effectiveness it leads to failure of service. A culture of collaboration would be helpful rather than competition with command and control ethos. The managers and the organization should be responsible enough to provide commercial expertise, infrastructure and information and the clinicians should provide specialist and knowledge related to healthcare. Weak and ineffective engagement of clinicians of primary and secondary care would lead to crucial Primary Care Trust Commissioning. Commissioning fails if there is lack of resources, capacity and capability and an ability to sustain long duration relationship. Commissioning organizations also require robust governance system in business transactions for ensuring no conflicts of interests. Lack of time, personnel, resources and diffic ult long term relationship were the challenges that Healthcare commissioning had faced (Checkaland, et al., 2009). The four major challenges faced by healthcare commissioning are (Boyd, 2010): Ameliorating the health of the patients Assuring a high quality standard of care in healthcare arena Supervising costs and savings. It includes preventing and managing falls, assessment of risk and saving tax payers money. Managing the transition to clinical commissioning (Boyd, 2010)The key responsibilities of healthcare commissioning includes buying high quality services throughout the care pathway in order to meet the needs of common people and making decisions for not purchasing services. The detailed information regarding organizations engaged in pathway, from primary care to tertiary care is available to the commissioning team and their aim is to fit together all the parts of care pathway to provide a holistic care. Foundations for effective commissioning are as follows: improving outcomes, patient empowerment, evidence based practice, community mobilization and sustainability (Royal College of General Practitioners, n.d.). If these foundations are not taken into consideration carefully then it might lead to difficulty in commissioning health services. Payment by Results (PBR) plays a massive role for achieving efficiency gains in commissioning decisions (InPharm, 2010). A key challenge to an efficacious healthcare commissioning is that there is an absence of general/global, apparent/definite commissioning procedure for the NHS. Several factors are taken into consideration for establishing a business case and introducing it to the decision makers for authorization. These factors includes financing the services, route of commissioning whether the prevailed services be improved or put a tender, assessment of both the NHS and patient needs and views of patient. According to Baird, et al. (2010) one of the various challenges that the healthcare commissioning had was the size and performance in commissioning organizations, both in the NHS as well as internationally. It was concluded that small commissioning organizations would struggle more if they took the responsibility of commissioning the entire spectrum of healthcare and there was negligible relationship between performance and size of commissioners. The providers would also face a number of challenges (NHS CONFEDERATION, 2010). These include: Handling the PCTSs during their transition phase Making commitments for the next 2-3 years about services and financial plans Understanding the new GP consortia and their managers Making arrangements for contract with multiple consortia behaving individually and in networks Ascertaining that the PCTs vital statutory activities are being taken into account even during a major organizational transition. The challenges of Healthcare commissioning might be addressed by focusing more on clinical leadership (NHS CONFEDERATION, 2010). For the local needs and services, the consortia will develop a real, risk adjusted, capital budget. The consortia will be held responsible for economic risk, service execution and health outcomes. Amongst the local system, the consortia will have an outstanding position. Therefore it should be capable of attracting a powerful management and have clout. Gray (2001) says that these challenges are difficult to address because it is not possible to decrease hospital care expenses and divert it into budgets of primary care drugs. Accessibility to diagnostic service costs might be prohibited which is subjected internally within the provider unit and not to external contracts. Savings within the hospital can be redirected to hospital care by professionals in any other service. Conclusion: Healthcare commissioning personifies the improvement in quality of healthcare and it is responsible for publicizing the national healthcare standards, assessing the organizations performance and comparing it with other organizations, solving the problems when it is not possible to resolve it locally and looking into severe service failure. According to Sobanja (2009) commissioning is defined as the act of committing resources, particularly but not limited to the health and social care sectors, with the aim of improving health, reducing inequalities, and enhancing patient experience. Many countries throughout the world are now concentrating on healthcare commissioning. Experience and evidence available from Europe, United States and New Zealand suggests that commissioning is not done systematically in any of the systems. There have been innovations in all the systems but again there are illustrations of barriers and limitations of effective commissioning. Commissioning tends to be dif ficult may be due to the nature of healthcare and the expectation of the healthcare commissioners to have a high level of technical and managerial skills. Payment system, incentive, market organization and regulation influence the impact of commissioners. The concluding point to stress is that there is only one element called commissioning in the health reforms and its impact will be affected by how different elements are carried forward. Hence it can be concluded that even if world class commissioning is enhanced it may not reach the standards and fall short of its potential due to lack of variations in system design.

Gender Roles in Ancient Egypt, Rome, and India

Prompt: Gender is not sex: gender has to do with the roles and expectations commonly ascribed to men and women, and these can vary from one society to another. Write an essay that explores similarities and differences in gender norms in ancient Egypt, Rome, and India. Gender roles vary from place to place. There is not a set standard that applies to every place all over the world. Men are usually of higher position than women but not always. In this paper I will tell you specifically about the gender roles, mostly of women, in India, Egypt, and Rome.In India, the women are controlled almost completely by the men in their families. They also have to pay a lot of respect to the men in their culture in general. The women must follow the commands of her father first, after him her husband, and lastly her son. Although she must obey these men the restrictions do not end there. After a woman’s husband dies she does not have independence and she is not allowed to remarry. In the movi e Paheli there were very good examples of what the culture would be like among the gender roles in India.The newlywed, Lachchi, must her veil removed by her husband, Kishen. She is not even allowed to do this herself. While Lachchi and Kishen are on the way to Kishen’s house, Lachchi has some children go and fetch her berries from a nearby tree, Kishen scolds her and takes possession of the berries and does not let her ingest them. One part of Paheli that strikes me as interesting is the section where the men give the women colorful bangles. In this society the men spoil the women but they place such harsh restrictions on them.It states directly in the textbook, â€Å"A virtuous wife should constantly serve her husband like a god, even if he behaves badly, freely indulges his lust, and is devoid of any good qualities. † This is saying that he can do whatever he wants, cheat on his wife with whomever he pleases, and if he has nothing going for him or does nothing right. On the other hand, the husband is able to do whatever he wants. He should be â€Å"born again† by impregnating his wife. Also, the husband should not keep her in check by force but instead, by filling her time with activities that benefit both of them such as cooking and cleaning.While men get possession of all the land and they have the rights and abilities to go to work the women did not have these as life options. The women that were brought to India as slaves were used as dancers and musicians but occasionally they were used to act as military guards. In Egypt, The gender roles are not as strict as they are in India. The women are able to have higher positions and there is more availability of activities they can do. Although women did not have many restrictions, one that was withheld for a long time was that a woman should not withhold a position that governs a kingdom or have effective power.Actually it was said â€Å"A people who place women in charge of their affair s will never prosper† and â€Å"Men perish if they obey women. † This was later defied and a woman called â€Å"mother of Khalil† was placed in a higher up position. Another way that a woman could acquire a higher up status would be by being the mother of a prince. Men are usually the bread winners of the families and the women do close to nothing because they do not have to. Concubines, who were usually slaves, could earn themselves a decent living if they were intelligent enough or picked the right man and created a decent relationship with him.In Rome, The gender roles run differently than any other place. The women have the rights to do much of the same things as men. There are different aspects to the roles often from house to house though. In one instance, the house was divided into two and the men slept upstairs while the women slept downstairs. Although this seems odd it is actually very considerate because the husband was sparing his wife the trouble of having to always go downstairs to tend to her child.Elite Roman women were socially and politically significant and often highly visible individuals. This proves that although in many cultures women could never be equal to men, in the Roman culture they could come very close. In many other cultures that we talked about it was alright for the men to carryout affairs. In the Roman culture it was said that â€Å"women of Rome, all were expected to be fertile and virtuous mothers†¦ideologies of masculinity bound men, who were to be serious, strong, and dedicated to their families, the gods, and their state. This is the society that sounds perfect to me. It seems like everything would just work together and there would not be much conflict. In these summaries of little aspects of gender roles we have seen many differences. I have not covered all of them but you can only imagine what kinds of other things are happening in the world that segregate the men from the women. Egypt, India , and Rome all differ and that is alright because what would the world be like if everything worked in perfectly the same order.