Decisions within CA state assembly Essay Example | Topics and Well Written Essays - 500 words

Decisions within CA state assembly - Essay Example This case highlighted many important issues questioning the rights and status of non-immigrants in the US. It also poses a question mark on the visa issuing authorities in the country as Garcia was unable to get permanent residence in the US even after 19 years. The federal statue 8 U.S.C, section 1621, does not allow any benefits to the non-immigrants, such as the issuance of practicing licenses. According to California Statute AB 1024, presented by Governor Jerry Brown, if an applicant for admission in state bar meets all the requirements set by Committee of Bar Examiners of the State Bar, the matter of undocumented immigration should be ignored. Sergio Garcia, the case representative was a Mexican citizen. He was born in 1977 and was brought into California (USA) in the age of 17 months. He started to reside in California till the age of nine when he was brought back to his country. After eight years he came back to California, earn high school education and then professional law education from there. Garcia’s father on his behalf filed an application for permanent residence in the US 1994, since then Garcia has been waiting for having a permanent citizen status and his application accepted. In 2009, after completing degree in law, Garcia submitted his application for admission in State Bar mentioning his application ‘pending’ status. The Committee of Bar Examiners investigated the entire issue and filed a case in Supreme Court highlighting non-migrant status of Garcia. The committee asserted that its proposal for granting admission to Garcia in State Bar is the first attempt noting that the committee is unaware of any law, which allows such permission to a nonimmigrant. The Supreme Court issued an order in response to the submitted case asking the committee for show causing the reasons for granting its motion. The Supreme Court demanded the State Bar Committee to

Babies Infants Knowledge

Babies Infants Knowledge Claims about infant number competence contrast with claims of toddler ignorance. Consider explanations of the discrepancy. 1- Introduction: This essay will explore the researches which claim that babies are born with a predisposition to learn about objects and numerosities. It also aims to understand the issues that why some psychologists are still unconvinced about inborn knowledge. And if babies are so smart, why are preschoolers so ignorant? The question is to what extent is the sense of numbers innate and to what extent is it learned? Piaget used observational and informal experiments to study infants. He denied the existence of innate knowledge. Early Piaget experiments (1942) described that infants are born with no understanding of numerosity. He argued that the number concept is built from previously existing sensorimotor intelligence. In contrast, recent researchers argue that sensitivity to number is innate and even young infants possess strikingly mature reasoning abilities in the numerical domain. Vygotsky (1978) pointed out â€Å" childrens learning begins long before they enter school they have had to deal with operations of division, addition, subtraction, and the determination of size. Consequently, children have their own preschool arithmetic, which only myopic psychologists could ignore† (p. 84). Similarly, recent experiments have shown that infants between 4 to 7 months are able to discriminate two items from three items, but not 4 items from 6 items (Starkey et al 1983). In 1992, Karen Wynn argued that â€Å"human infants can discriminate between different small numbers of items† (p.749). Wynn used differences in looking times as evidence of knowledge. Similar logic in Baillargeon’s (2004) studies of infants is reported. In contrast to claims about infant capabilities and predispositions, recent studies of toddlers (preschoolers) suggest slow development and gradual understanding of numerical skill. Now we will discuss the researches which claim about infants’ knowledge of number competence contrast with claims of toddler ignorance. 2- Studies which claim about human infants’ knowledge of number competence: 2.1- Wynn’s approach: In 1992, Karen Wynn, came up with the idea of using a technique called Preferential Looking Time (PLT) to study the mathematical abilities in babies. Wynn took advantage of the fact that infants will gape, eyes wide with surprise, at things they dont expect to see, to show that babies as young as five to ten months old can add and subtract small numbers. In her experiment Wynn (1992) shows the baby a Mickey Mouse doll and then places it behind a screen. As the baby continues to watch, the researcher places a second Mickey behind the same screen. In half the trials, she then uses a hidden trapdoor to remove one of the dolls. Then screen drops and Wynn found that babies stared much longer when only one Mickey doll is there. They had apparently expected to see two. But were the babies really calculating one plus one equals two? Or did they simply realise that one plus one had to equal something more than one? To answer that question, Wynn tried the babies on one plus one equals three. The babies were appropriately surprised when three dolls appeared from behind the screen rather than two. According to Wynn (1992), â€Å"infants possess true numerical concepts- they have access to the ordering of and numerical relationships between small numbers and can manipulate these concepts in numerically meaningful way† (p750). Wynn argued that looking for longer time at the wrong results of 1+1 and 2-1 is evidence that infants have innate number knowledge. There are many questions which need explanations e.g. were infants surprised or familiar? Were they responding to differences in quantity or numerosity? Can infants really add and subtract? etc. Leslie B. Cohen and Kathryn S. Marks in ‘How infants process addition and subtraction events’ mentioned†¦. â€Å"Wynn has argued that infants are not only sensitive to number; they are able to manipulate small numerosities. She pointed out three major claims about infants’ abilities: Infants understand the numerical value of small collections of objects. Infants’ knowledge is general and can be applied to varying items and different modalities (for example, Starkey, Spelke, Gelman, 1990). Infants are able to reason at the ordinal level and compute the result of simple arithmetic problems (i.e., add and subtract)† (P.5-6). Wynn (1990) argued that children learn the meanings of smaller number words before larger ones within their counting range, up to the number three or four and by the age of 3  ½ years they can learn cardinal principle. But in everyday life we are failed to provide the evidence regarding the competence in early years of life. There is no doubt that many studies reported that children have an innate understanding of the basic counting but many other studies which do not support these findings. 2.2- Starkey, Spelke, Gelman approach: In 1990, Starkey, Spelke, Gelman found that infants between ages 4 and 7 ½ months can differentiate two items from three, but not 4 items from 6. In this study, 7 month old infants were presented with two photographs of two or three items accompanied with two or three drumbeats. Starkey et al.’s criterion was same as Wynn’s (difference in looking time).The infants looked significantly longer at the photos with the number of items matching the number of drumbeats. This study did not tell us that infants perceived that 2 is more than 1 or 3 is more than 2. The ability to understand even small numerosity from the early months of life seems to suggest that there is an innate mechanism for number which forms the basis for further development of numerical skills and abilities. Starky et al. (1990) interpreted these results as evidence that infants can recognize the number distinctions both in audio and visual display. This research is also controversial. There are contrasting claims which abandon ideas of competence. According to Mix, Huttenlocher, and Levine (1996), â€Å"it has been claimed that acquisition of the conventional number system is guided by preverbal numerical competencies available in infancy (Gallistel Gelman, 1992; Gelman, 1991).Thus, if infants have an abstract number concept, this should be evident in early childhood† (p.1593). Mix, Huttenlocher, and Levine (1996), using a procedure adapted for preschoolers, found that three-year-olds were unable to correctly match auditory to visual numerosity. 3- Studies which deny the claim of human infants’ knowledge of number competence: 3.1- Mix, Huttenlocher, and Levine approach: Mix, Huttenlocher and Levine (1996) tested infants, toddlers and preschool children from a variety of backgrounds to see at what age they began to recognize the connection between repeated sounds and similar numbers of objects before them and when infants and children begin grasping the basic concepts of mathematics. They conducted three experiments to find out whether preschool children could do significantly well on similar tasks as used by Starkey et al.’s (1990) infants studies. They found that infants were unable to make the audio-visual matches but could make visual-visual matches. Similarly, three year olds were able to make visual matches between groups of objects and sets that corresponded in number, but only made the same number of audio-visual matches they would have made had they been guessing. According to Mix, Huttenlocher and Levine (1996) In contrast, 4-year-olds performed significantly above chance in both conditions, indicating that the ability to detect audio-visual numerical correspondences develops during this age period(p.1600). They argued that if Starkey et al.’s (1990) claims about infants are true then preschoolers should show a similar competence. By their studies, Mix, Huttenlocher and Levine (1996) found no evidence that 3 year olds can detect audio-visual numerical correspondences. The developmental period between 3 to 4 years was found to be a crucial for mathematics, as preschoolers quickly expand their ability to understand the abstract relationship between numbers and sets as dissimilar as objects and events. They also tested toddlers ability to perform nonverbal calculation and found that the ability develops between ages 2  ½ and 3. Some studies have suggested that abstract numerical knowledge develops in infancy, but Levine and Huttenlocher found that babies only have an approximate understanding of numbers and at age of 3 years children can represent number exactly. Mix, Huttenlocher and Levine (1996) claim that: The discrepancy is due to the contrast criteria between infant study and preschool study. For infant study criteria was looking for longer time and in preschool study an active choice response was needed, which was much more demanding criteria. The ability to match and calculate correctly, nonverbally, is neither innate nor independent of general ability. Mix (1999) studied preschool children to see whether they ‘recognise numerical equivalence between sets that vary in similarity’. She pointed out that if claims about number competence in infancy are true then children should be able to judge numerical equivalence for other types of similarity. She emphasized that none of the tasks in infants’ studies â€Å"requires the explicit numerical comparison of one set to another† (p.272). According to Mix (1999) â€Å"a prevalent claim is that numerical abstraction emerges very early, perhaps as part of an innate knowledge structure that is specific to the number domain (Gallistel Gelman, 1992).This implies that development of numerical competence should have some advantages or at least follow a distinct path compared to other domains† (p.290). But she did not find any evidence. She proposed that discrepancy between infants and toddlers knowledge of number competence is because of different levels of understanding. She clarified that preschool matching task was different as compared to infant looking time task and these both task measures different type of numerical knowledge. (p.291) In 2002 Mix, Huttenlocher and Levine critically reviewed â€Å"the idea that quantitative development is guided by an inborn ability to represent discrete number† (p.278). They tested the quantitative competencies of infants and young children mentioned in their article. They arise many questions which are very important and need clarification: ‘What non-numerical cues do infants use? How does a number-based representation develop from such origins? How do children differentiate and ultimately integrate discrete and continuous quantification?’ 3.2- Clearfield and Westfahl approach: Clearfield and Westfahl (2006) conducted three experiments on 3 to 5 months infants to see how familiarization affects their looking time during addition problems. They replicated Wynn’s (1992) procedure in first experiment and found that infants looked longer at incorrect outcome same as in Wynn’s findings. They strongly argued on the basis of their results that â€Å"infants responded to the stimuli based on familiarity rather than the mathematical possibility† (p.40) (number competence) of the event in Wynn’s original finding and in Experiment 1. They also pointed out that there was no statistical difference in infants’ looking towards 1+1=2 and 1+1=3 (in Wynn’s finding). They asked for future research to confirm this. (p.40) In their article, Clearfield and Westfahl (2006) mentioned that Cohen and Marks (2002) challenged Wynn’s (1992) finding about infants’ number competence. Clearfield and Westfahl (2006) also told about Wynn’s (2002) response to it i.e. she rejected their challenge by saying that they did not replicate her study exactly. 4- Discussion: Evidence show that infants have inborn number competence and even they can manipulate simple arithmetic (Wynn, 1992). There is a considerable debate is going on young children’s ability about numerosity especially with regard to addition and subtraction. The problem is word number learning which they learn at later years. By the age of 2 years, children can count up to three or more (Gelman Gallistel, 1978). Wynn’s (1992) finding is challenged by Cohen and Marks (2002) as cited by Clearfield and Westfahl (2006). But Wynn’s (2002) rejected this challenge and still strict with her claims about infants’ inborn number competence. Clearfield and Westfahl (2006) interpreted that infants do not have counting ability but their performance on infants’ studies was based on familiarization. They insisted that researcher must work on the issues of familiarization and other basic perceptual processes rather than more controversial concept of number competence in infants. Learning the number system is one of the most difficult tasks for a young child. It is a slow process which takes many years to complete. Researchers have explored questions about the roots of numerical knowledge using looking time techniques with infants. It is still unclear to what extent is the sense of numbers innate and to what extent is it learned and how early the child acquires a meaningful counting procedure? Results of early counting studies appear unstable with each other. Some studies focus on conceptual competence (early counting) and some suggest that understanding the purpose of counting take place in later years. Young children often confuse to answer how many are there? It requires children to tell the last word when counting a set. They usually start counting the objects (Wynn, 1990). Counting out a number of objects from a large set is much complex than counting the number sequence. This all need a practice and clear understanding which develops later on. There is evidence â€Å"that five year old children take large number words to apply to specific, unique cardinal values† (Lipton Spelke, 2005, p.9). They argued that infants are born with innate knowledge of number from which they learn an understanding of number words and verbal counting. It is still unclear that if infants look so smart then why toddlers look so ignorant. Some researchers criticized the infants’ studies that they were not manipulating numbers when confronted with small quantities but may be they looking for total surface area of objects, not for number. We really do not know what was in infants’ mind. But criteria in Mix et al.’s study (1996) required children to point out the picture matching in numerosity, was much more demanding. And other studies involving counting ‘how many objects there are?’ require more understanding and more skill. To conclude all the interpretations about infants and preschoolers, it seems that criteria for judging preschoolers knowledge of number was too demanding. It is clear that at least some of number knowledge is innate. But the question still remains as to how much of it is innate, and how much is learned. In 2004, Zur Gelman argued that 4- and 5-year olds can easily be taught the basics of addition and subtraction. They concluded that even 3- year old children can do addition and subtraction by predicting and checking under supportive environment. Zur Gelman (2004) study is instructive because their emphasis is on practice and how teachers use different strategies. 5- References: Baillargeon, R. (2004). Infants’ reasoning about hidden objects: evidence for event-general and event-specific expectations. Developmental Science, 7, 391-424. Clearfield, M. W., Westfahl, S. M. C. (2006). Familiarization in infants’ perception of addition problems. Journal of Cognition and Development, 7, 27-43. Cohen, B. L. Marks, S.K. (n.d).How infants process addition and subtraction events. Retrieved on January 04, 2008 from http://homepage.psy.utexas.edu/homepage/Group/CohenLab/pubs/Cohen_and_Marks final.pdf/ Cordes, S. Gelman, R. (2005). The Young Numerical Mind: When Does It Count? The Handbook of Mathematical Cognition. Psychology Press; London. 127–142. Retrieved on January 04, 2008 from http://ruccs.rutgers.edu/~chenml/411/CordesandGelman.pdf Gelman, R., Gallistel, C. R. (1978). The child’s understanding of number. Cambridge, MA: Harvard University Press. Lipton, J. S., Spelke, E. S. (2005). Preschool children master the logic of number word meanings. Cognition,xx,1–10. Retrieved on January 14, 2008.from http://www.wjh.harvard.edu/~lds/pdfs/lipton2005b.pdf Mix, K. S. (1999). Similarity and numerical equivalence: Appearances count. Cognitive development, 14, 269-297. Mix, K. S., Huttenlocher, J., Levine, S. C. (1996). Do preschool children recognize auditory-visual correspondences? Child Development, 67, 1592-1608. Mix, K., Huttenlocher, J., Levine, S. (2002). Multiple cues for quantification in infancy: Is number one of them? Psychological Bulletin, 128(2), 278-294. Starkey, P., Spelke, E., Gelman, R. (1990). Numerical abstraction by human infants. Cognition, 36, 97-127. Vygotsky, L. S. (1978). Mind in society: The development of higher psychological processes. Cambridge, MA: Harvard University Press. Wynn, K. (1990). Children’s understanding of counting. Cognition, 36, 155-193. Wynn, K. (1992). Addition and subtraction by human infants. Nature, 358, 749-750. Zur, O., Gelman, R. (2004). Young children can add and subtract by predicting and checking. Early Childhood Research Quarterly, 19(1), 121-137.

free speech or just offensive -- essays research papers

Free Speech or Just Offensive? A highly debated topic as of late has been the staggering rise of offensive language and topics of the music industry, which have infiltrated through. Should the artists of this music be punished for corrupting the minds of the people who listen to it? Or should the musician's rights be protected by the first amendment? The main problem to be seen is that this music has become extremely popular to the youth. With this popularity comes blow after blow from the media, parents, and organizations putting down the music because they believe it's corrupting the children. All of these criticisms towards music have even made the government step in and put parental advisory warnings on the CD's. This lets the consumer know that the CD they are buying has adult language, violence, or sexual references in the songs. The government has also set an age minimum of seventeen years old to even purchase the offensive CD's. After all of this is said and done, the albums are still selling millions of copies. It is a whole different market today, set on exploiting the rebels "fuck you I won't do what you tell me" attitude of the youth. "Big bucks is the name of the game.† says music critic Harvey Bickle. This implies that these stars that have risen from this music are only doing so to make themselves a quick buck. Whether or not this is true, we still support these stars and will continue to do so. But is there any evidence that the music is hurting anyone? Many reasons offensive music has been blamed can be documented through past incidences. During the Columbine shooting, the media was blaming the music of Marlin Manson because of his dark songs. This idea of music creating violence is not a new one. In 1982 ACDC put out a song called Night Stalker on their album. Later on that year, a killer roamed the countryside while assuming the alias Night Stalker, and was convinced that the lyrics from ACDC's song drove him to do these disgusting acts of murder. Many cases like this have been brought to court, but notably, not one has proved their case against the artist. How could we come to the conclusion that the music caused these mass killings and riots a... ...r a redress of grievances." (Duemler, David 34). This basically means that as an artist or regular person, one may speak or illustrate anything without being punished or revised as long as it is done so in a respectable manner. There is even an entire organization supporting and fighting for the first amendment for artist called the Recording Industry Association of America, or RIAA. It is ironic that the amendment that protects the artist is also the amendment that allows people to protest against it. Overall the point is that most of our basic laws come from these amendments, and they are what America was built on, so how can we accuse artists of breaking the law when all they were doing was following it? Although the music industry is becoming more and more controversial, it still does not give anyone the right to ban or prosecute someone’s music, because an artist has the right to a freedom of expression. People who disagree with this, can choose not buy the music or change the station when it's on the radio, but they cannot destroy it or the artist because freedom of speech is what makes this country so great and free.

Patients Need of Healthcare by Strategic Management

The deliberative model in healthcare is expected to meet quite a few of the needs of the American public regarding the general area of healthcare. Of the many areas that may decide to look at this problem, an attempt is made here to look at two specific problems. One is the need of patients taking medicine properly and the other is the needs of patient care among all Americans. The problems in taking medication have been taken up on the issue of individual needs of patients for education on medicine taking. The education needs of patients in this area are not being met by healthcare providers. It may be worthwhile to take up a study to develop medication taking instructions for patients which can be used by health care providers in the long run. The aim should be to reach an approach which will be based on the view of patients regarding their needs of taking medicine and at the same time, also taking into account the concerned theories for health and education. The problem has been accentuated by the development of new medicines for the treatment of problems in diseases. This is clear when one notices that in Canada it self, 167 new drugs were introduced in the period from 1997 to 2001. This has led to the total number of drugs in the market reaching a figure of over 3,000. This shows that there is no shortage of drugs, yet a large number of patients are not being able to get the benefits that the medicines are expected to give. In one study it was seen that about 12% of the cases of hospitalization that are taking place now could be avoided if the condition of the patient was properly managed when the patient was undergoing treatment at home. They could have been cared for by family physicians, nurses and pharmacists. This is further accentuated with the knowledge given by another study that 43% of these avoidable admissions were in the area of some chronic diseases like asthma, diabetes or heart failure. These diseases require patients to use medicines over a long term. This shows clearly that patients with chronic diseases are being hospitalized regularly when they could have been cared for in the home by doctors working outside the hospitals. (Bajcar, 2003) When the patients are put on medicines, they should receive the maximum benefits from their medicines. For this purpose, the first point is the correct procedure of prescribing the medicine for the patient along with the dosing requirements. The second part is that these medicines have to be taken and this has to be done properly. This is generally decided by the patient. It has been seen in many instances that the process of preparing the prescriptions is not linked correctly to the process of taking the medicines. This often leads to the future hospitalization of the patient. During an analysis that was done recently it was seen that pf the total number of admissions to hospitals in recent times, 7. % were directly caused by the medicines that were taken by the patient or the failure of the medicines to act or the medicines were not taken properly by the patients. Further it was seen that 59% of these admissions could have been avoided as the causes were due to inappropriate care or errors in medication. In medical terms, the adverse effects on patients are called drug related morbidity and mortality. The cost of drug related morbidity and mortality in United States during 1995 to the healthcare system was $76. 6 billion. These costs have been rising at a very fast rate and the costs in 2000 went to a figure above the $177 billion mark. This also showed that hospital admissions related to drug related morbidity and mortality was now above 70% of the total costs. (Bajcar, 2003) The major cause behind this problem is the shortcoming in patient education as felt by the patients, though the groups of healthcare professionals at different levels are trying to give a lot of importance to it. The patients say that they are not given enough information about the side effects of medication, risks of medication, the choices that they have about medication and the period for which the medication should be taken. This problem has been realized and the differences which are being caused by the differences in the approach of the health care professional and patient requirements are being sorted out. The problem is the greatest for patients who are on long term medication. (Bajcar, 2003) The shortage of information to patients is because of not getting enough information, or not receiving the information they want, or not receiving the information in a manner that gives the patients a chance to ask questions or seek involvement from the patients, or providing them information that is suitable for their special needs. The difference is in what information the patients want and what information the health care professionals feel they should be given. There is a clear change among patients that they are informed about their healthcare, and this is line with the present day thinking that healthcare is centered on the patient, increase the participation of the patient, and give the patients greater powers. This will enable the patients to take better decisions. The problem is compounded by the fact that there is no proper literature regarding the education needs of patients, who are on long term medication. This does not permit an analysis of the education needs of these patients. At present the emphasis regarding education on medication taking by the patients has the greatest focus on the information to be provided by the healthcare professional and does not consider the educational aspect. The teachings to the professionals consist of sets of guidelines given to professional or a set of questions to be asked of the patient. These are not related to the understanding of how the patient is taking the medicine. This is leading to a situation where the medication taking practices of patients on long term medication is remaining underdeveloped, and this is also keeping in dark the relationship between the actual medication consumption and the final effects that the medication is providing. There are definite needs for the development of a model for education of patients regarding their taking of medicine, and for the present levels of knowledge are not adequate. (Bajcar, 2003) A similar area where there is a lack of communication between the doctors and the patients is in the area of health insurance. This is reflected from the continuous rise in numbers of Americans without insurance and these are causing poor access to health care systems in the country. It is seen that about 20% of the people in the country are not able to pay healthcare bills, and an even higher proportion of 25% forgo medication based on cost. This ultimately results in deaths of the order of 18,000 a year as was seen in 2000. There are certainly troubles that are being caused to individuals, but even the society is suffering. The costs of care for the patient keep increasing, and the final cost has to be met by the government which is reflected on the average citizen. (Will Insured Citizens Give Up Benefit Coverage to Include the Uninsured? ) Patients Need of Healthcare by Strategic Management The deliberative model in healthcare is expected to meet quite a few of the needs of the American public regarding the general area of healthcare. Of the many areas that may decide to look at this problem, an attempt is made here to look at two specific problems. One is the need of patients taking medicine properly and the other is the needs of patient care among all Americans. The problems in taking medication have been taken up on the issue of individual needs of patients for education on medicine taking. The education needs of patients in this area are not being met by healthcare providers. It may be worthwhile to take up a study to develop medication taking instructions for patients which can be used by health care providers in the long run. The aim should be to reach an approach which will be based on the view of patients regarding their needs of taking medicine and at the same time, also taking into account the concerned theories for health and education. The problem has been accentuated by the development of new medicines for the treatment of problems in diseases. This is clear when one notices that in Canada it self, 167 new drugs were introduced in the period from 1997 to 2001. This has led to the total number of drugs in the market reaching a figure of over 3,000. This shows that there is no shortage of drugs, yet a large number of patients are not being able to get the benefits that the medicines are expected to give. In one study it was seen that about 12% of the cases of hospitalization that are taking place now could be avoided if the condition of the patient was properly managed when the patient was undergoing treatment at home. They could have been cared for by family physicians, nurses and pharmacists. This is further accentuated with the knowledge given by another study that 43% of these avoidable admissions were in the area of some chronic diseases like asthma, diabetes or heart failure. These diseases require patients to use medicines over a long term. This shows clearly that patients with chronic diseases are being hospitalized regularly when they could have been cared for in the home by doctors working outside the hospitals. (Bajcar, 2003) When the patients are put on medicines, they should receive the maximum benefits from their medicines. For this purpose, the first point is the correct procedure of prescribing the medicine for the patient along with the dosing requirements. The second part is that these medicines have to be taken and this has to be done properly. This is generally decided by the patient. It has been seen in many instances that the process of preparing the prescriptions is not linked correctly to the process of taking the medicines. This often leads to the future hospitalization of the patient. During an analysis that was done recently it was seen that pf the total number of admissions to hospitals in recent times, 7. % were directly caused by the medicines that were taken by the patient or the failure of the medicines to act or the medicines were not taken properly by the patients. Further it was seen that 59% of these admissions could have been avoided as the causes were due to inappropriate care or errors in medication. In medical terms, the adverse effects on patients are called drug related morbidity and mortality. The cost of drug related morbidity and mortality in United States during 1995 to the healthcare system was $76. 6 billion. These costs have been rising at a very fast rate and the costs in 2000 went to a figure above the $177 billion mark. This also showed that hospital admissions related to drug related morbidity and mortality was now above 70% of the total costs. (Bajcar, 2003) The major cause behind this problem is the shortcoming in patient education as felt by the patients, though the groups of healthcare professionals at different levels are trying to give a lot of importance to it. The patients say that they are not given enough information about the side effects of medication, risks of medication, the choices that they have about medication and the period for which the medication should be taken. This problem has been realized and the differences which are being caused by the differences in the approach of the health care professional and patient requirements are being sorted out. The problem is the greatest for patients who are on long term medication. (Bajcar, 2003) The shortage of information to patients is because of not getting enough information, or not receiving the information they want, or not receiving the information in a manner that gives the patients a chance to ask questions or seek involvement from the patients, or providing them information that is suitable for their special needs. The difference is in what information the patients want and what information the health care professionals feel they should be given. There is a clear change among patients that they are informed about their healthcare, and this is line with the present day thinking that healthcare is centered on the patient, increase the participation of the patient, and give the patients greater powers. This will enable the patients to take better decisions. The problem is compounded by the fact that there is no proper literature regarding the education needs of patients, who are on long term medication. This does not permit an analysis of the education needs of these patients. At present the emphasis regarding education on medication taking by the patients has the greatest focus on the information to be provided by the healthcare professional and does not consider the educational aspect. The teachings to the professionals consist of sets of guidelines given to professional or a set of questions to be asked of the patient. These are not related to the understanding of how the patient is taking the medicine. This is leading to a situation where the medication taking practices of patients on long term medication is remaining underdeveloped, and this is also keeping in dark the relationship between the actual medication consumption and the final effects that the medication is providing. There are definite needs for the development of a model for education of patients regarding their taking of medicine, and for the present levels of knowledge are not adequate. (Bajcar, 2003) A similar area where there is a lack of communication between the doctors and the patients is in the area of health insurance. This is reflected from the continuous rise in numbers of Americans without insurance and these are causing poor access to health care systems in the country. It is seen that about 20% of the people in the country are not able to pay healthcare bills, and an even higher proportion of 25% forgo medication based on cost. This ultimately results in deaths of the order of 18,000 a year as was seen in 2000. There are certainly troubles that are being caused to individuals, but even the society is suffering. The costs of care for the patient keep increasing, and the final cost has to be met by the government which is reflected on the average citizen. (Will Insured Citizens Give Up Benefit Coverage to Include the Uninsured? )

Risk of infectious diseases at a rise due to incessant rain

A few days after ceaseless rain lashed the regions in Thane and stranded some localities, the risk of infectious diseases stares large at the residents. With a massive dumping ground right in front of the railways station at Vithalwadi and a sewer flowing in the rear, it seems like an open invitation to the various diseases, which increases manifold during monsoon. Khadegolwadi, which saw knee- deep waters on Friday could not unclog, though the water receded by a few centimetres.As it is a fully grown residential area, people spent their entire day cleaning their homes. Chocked drains, sewers and dumping grounds caused problems in the area. â€Å"Each time it rains, garbage along with diseases come to our house,† said Aarti Bhagwat, a resident. Her neighbour Preeti Pandey added,† We all know what sewers and dumping grounds in the vicinity means, malaria, dengue and other water borne diseases.†It may be noted that the Thane Municipal Corporation suspended an officer and recommended departmental enquiry against the other finding them a prima facia guilty of the problem. Complaining over that, another resident Sarita Kolhapure said,† suspending officials is of no use to us, it does not solve our problem. These past few days were pathetic for us, what will happen if such rain continues for next couple of months. † Similar problems persisted in different localities around the dumping site.â€Å"Garbage that flew with the rain got scattered all around as the potholed road was filled with dirty water,† said Karishma Tiwari, a housewife. City-based doctors warned against the risk of diseases in the rainy season. â€Å"People with a weak immune system fall prey to microbes that roam freely in the air during monsoon,† said Dr Kishor Gandecha. He added that garbage heaps rot more than usual in rains, which catalyses growth of disease causing virus and bacteria.â€Å"The best way to avoid disease is to wash hands with soap and drink boiled water,† he said. Suggesting other ways to keep diseases at bay, the doctors said, â€Å"People should avoid intake of stale or cut food, don't let water stagnate inside or near the homes and stay away from public places if one is suffering with viral fever of disease. They also enumerated signs of disease which include body ache, vomiting, pain in abdomen and loose motions are the first signs of the monsoon maladies. But, there are a number of measures that people can resort to†.