Island of the Sequined Love Nun Chapter 65~67 Free Essays

Indigenous Perspective Essay Example for Free

Indigenous Perspective Essay I concur with Professor Acuna and his chronicled proclamation. Alongside Linda Tuhiwai Smith, their translations of the colonization of the Americas has since a long time ago been scene as the assault of a nation for it’s wealth, resourced and land is obvious. The effect of the Catholic Church (I am catholic) as of now in history was one of the most crushing hits to the indigenous people groups of America, and the starting a push to wipe their societies and history structure the worldwide chronicled record. The plunder of gold and the abuse of the indigenous individuals unmistakably supported the start of Europe’s fast development paving the way to the Industrial Revolution. Without the immense measure of gold and riches taken from the landmass, Europe would have set aside considerably more effort to store up its riches and the practical capacity to seek after colonization around the world. It is the point of view of the writers from the two readings that our history from the viewpoint of as of now acknowledged research is imperfect. They guarantee, from an ethnocentric center, any examination led by a non-indigenous specialist is to re-write a Western view. I concur that to genuine and be considered â€Å"real† information as they term it, such research ought to be from the point of view of an indigenous creator. What's more, my point of view is that any non-indigenous specialist needs to drench themselves into the way of life being examined. Smith particularly contends that western research and critiques’ are nevertheless the social presumptions by a predominant culture, specifically non-indigenous Americans. I believe that Acunas resolute presentations declaring his self maintained communist perspectives; that there is â€Å"insidious ethnic partiality woven into the texture of American culture†, and that minorities with an accentuation on Chicano and African culture are in certainty casualties of American culture is by all accounts unusual, however it has the sign of legitimacy to it. It was fascinating to take note of that Professor Acuna really needed to go to court, so as to so as to get a situation at an Institute of American Higher Education. Maybe this is probably the best case of his view on ethnic bias. I seems to me that our present perspectives on the historical backdrop of the Americas ought to be communicated from the perspective on the ethnic culture that accomplished it. What we read in grade school history books, doesn't reveal to us the point of view of the individuals who really experienced colonization and its belongings. The Mesoamerican’s were almost cleared out and their societies were crushed. These translations are unmistakably inadequate. We are shown our history as idealistically as possible that discourage our vision of the demolition, subjugation, and assault of the early Americas through colonization of South and Central America. We are not instructed that the way of life were to a great extent cleared out by sickness spread be their heros, or that the whole history of their way of life was put to burn by catholic clerics. Not very many of the archives composed by copyists of those societies endure and exist today. What exists is a puzzle.

Satire, Autobiography, and More Books on Writers and Writing

Satire, Autobiography, and More Books on Writers and Writing We love writers for creating immersive fictional worlds for us to indulge and revel in, but thats not only the thing they do. They bring their own history and experiences in every sentence they formulate and every plot they weave. Here are five recent books that shine a spotlight on some legendary writers. Outsiders by Lyndall Gordon This beautifully designed and fascinating book tells the story of five significant women writers. The book is divided into sections titled Prodigyâ€"Mary Shelley, Visionaryâ€"Emily Bronte, Outlawâ€"George Eliot, Oratorâ€"Olive Schreiner, and Explorerâ€"Virginia Woolf and The Outsiders Society. Gordon attempts to paint a group portrait of these women, highlighting the common denominators in their lives, specially their families and the ways in which they influenced each others work. Passionately researched and succinctly written, Outsiders features rare photographs and lesser known facts about these remarkable writers who influenced generations of women with their work. The Book of Forgotten Authors by Christopher Fowler A treat for bibliophiles, this is a guide to around 100 authors who are not as popular as they should be. Fowler provides sufficient details about each author and their work to make you want to google for more, but what stands out is his wicked humor and witty one-liners. The book takes us through a captivating journey of astonishing reversals of fortune and the stories behind some books which did not stand the test of time. Fowler writes such compelling descriptions of seemingly superb books that have  fallen through the cracks  of history that you might want to compile a list of authors mentioned, to read later. Combining short biographies with lively essays, The Book of Forgotten Authors will make for a delightful gift for a book lover. A Secret Sisterhood by Emily Midorikawa and Emma Claire Sweeney   Female friendships are trending in fiction right now, but surprisingly the bonds between literary women have remained obscure so far. In their new book, real life friends and coauthors Emily and Emma set out to explore these lesser known friendships between the worlds best-loved authors. They focus on four friendships:    Jane Austen and unpublished playwright Ann Sharp; Charlotte Bronte and pioneering feminist writer Mary Taylor; George Eliot and Harriet Beecher Stowe; and Virginia Woolf and Katherine Mansfield. From professional jealousies to grudging admiration, and scandalous revelations to heartwarming exchanges, this is an empowering portrait of literary greats. The Written World by Martin Puchner This exhaustively researched book takes us through the human history of text and literature.  Puchner explores sixteen foundational texts selected from more than four thousand years of world literature  and reveals how writing has inspired the rise and fall of empires and nations, the spark of philosophical and political ideas, and the birth of religious beliefs. An intellectual odyssey through time, this book makes sense of religion, revolutions and history through works of literature. Spellbinding and expansive, The Written World will be enjoyed by academic scholars and literature buffs. Dead Writers in Rehab by  Paul Bassett Davies What would a group therapy session with  Hunter S. Thompson, Colette, William Burroughs, Dorothy Parker and Coleridge look like? Absolutely bonkers and hysterically comical, as this work of fiction shows. This literary satire is based on an unusual premise:  When literary reprobate Foster James wakes up in a strange country house, he assumes hes been consigned to rehab (yet again) by his dwindling band of friends and growing collection of ex-wives. But he soon realises theres something a bit different about this place after he gets punched in the face by Ernest Hemingway. Dead Writers in Rehab is a hilarious riff on the eccentric personalities of much-loved literary idols. The book veers off course in the latter half when it gets too sombre for its own good, but the wild inventiveness and riotous fun of the first half of the novel is more than enough reason to read it.

Great Space-Themed Places to Visit Across the US

Capital Punishment Of The United States - 964 Words

The lawful infliction of death of an individual is what is referred to as death penalty. Majority of the countries in the world have abolished the practice, however, there is no cord that has been officially formed by world countries against its use (Cole, 25). China, which is the most populous country in the world, leads as it executes thousands of inmates yearly. United States of America still practices it even when it is perceived the most democratic republic on earth. As of today, 84 countries in the world retain capital punishment (The Grinnell Literary Societies, 78). However, the number of nations using death penalty is decreasing. With the recent pressure from different human rights watch groups and religious groups more so from the Roman Catholic Church, the world remains optimistic that the practice will be done away with once and for all in all nations (Cole, 42). Discussion This paper will tend to look at capital punishment in the US with a look down memory lane on how it came to be established and what has been the stand of the Roman Catholic Church in the matter. The research done also looks at reasons why death sentences are still being passed in the country despite numerous calls by human rights group to abolish this inhumane act. It will also portray why this practice should be abolished with reasons supporting its abolishment. The establishment of death penalty was first executed back in the eighteenth century B.C (Cole Christopher, 76). It wasShow MoreRelatedCapital Punishment : The United States928 Words   |  4 PagesAs we near the culmination of the twentieth century, capital punishment is in decline. Once a near universal practice, the death penalty has been abolished in 101 countries, as of July 2015(Amnesty International, 2015) and executions have become less common amongst industrialised democracies. Some nations keep capital statutes for instances of exceptional crimes such as treason, but parts of the former Soviet Union, Japan and the United States of America (USA) still administer death sentences forRead MoreCapital Punishment Of The United States961 Words   |  4 Pages Capital Punishment in the United States For centuries, capital punishment has been used as a consequence of capital crime. Criminals who have committed such crimes are subject to facing the death penalty. Pickens shares, â€Å"Capital crimes are considered to be treason or terrorist attacks against the government, crimes against property when life is threatened, and crimes against a person that may include murder, assault, and robberyRead MoreCapital Punishment Of The United States1495 Words   |  6 PagesCapital punishment in United States also titled as decease penalty, which is a permitted verdict in thirty one states and the American civilian and services lawful systems. Its application is restricted by the amendment of the eight to intensified killings committed by psychologically competent people. Capital punishment existed a consequence for numerous misdemeanors under English mutual regulation, and it was imposed in entire of the early US colonies preceding to the Declaration of IndependenceRead MoreCapital Pu nishment Of The United States2029 Words   |  9 Pages Capital punishment is one of the most debated topics in the history of the World. It has been implemented and repealed several times by several different countries (DPIC 2014). Capital punishment is the use of the death penalty on someone who has been found guilty of a crime. As of 2013 there are still 58 countries in the international community that still use the death penalty. Of those countries, China had the highest reported number of executions which was in the thousands, the next highest wasRead MoreEssay on Capital Punishment in the United States 598 Words   |  3 PagesAre serial criminals effectively being punished? Indeed much improvement must be done. The death penalty needs to be legal in every state. Capital punishment is the lawful infliction of death as a punishment and has been used in America since 1608. The death penalty has been mainly aimed at murder and rape perpetrators. For the past two hundred years w ith over 15,600 executions since 1608, most executions were completed though hangings; however, beginning in the 1900s new forms of execution developedRead More Capital Punishment in the United States Essay2514 Words   |  11 PagesThe death penalty is a controversial topic in the United States today and has been for a number of years. The death penalty is currently legal in 38 states and two federal jurisdictions (Winters 97). The death penalty statutes were overturned and then reinstated in the United States during the 1970s due to questions concerning its fairness (Flanders 50). The death penalty began to be reinstated slowly, but the rate of executions has increased during the 1990s (Winters103-107). There are a numberRead More The Issue of Capital Punishment in the United States Essay3455 Words   |  14 PagesDeath Valley: The Issue of Capital Punishment in the United States Should capital punishment be practiced in the United States? This question has been highly debated for many years because of the numerous, often conflicting perspectives from which various parties have attempted to answer it. These parties range from high-ranking politicians seeking to lower the national crime rate to the average United States taxpayer who does not want to see his or her money being spent inefficiently. In additionRead MoreEssay about Capital Punishment in the United States1844 Words   |  8 Pages Capitol punishment Capital Punishment The Argument Against the Death Penalty The feeling of the condemned man was indescribable, as he was minutes away from being executed by an unjust decision. The verdict of his case was guilty on the grounds of circumstantial evidence. When in all reality, he was guilty because he was black, poor and socially unacceptable. His case never stood a chance, it was over before it started. The judge and jury sentence the man to die in the electric chair. The condemnedRead More Capital Punishment in the United States Essay example2024 Words   |  9 PagesCapital punishment has been a controversial topic in association to ethics all of its existence. Issues pertaining to the execution methods, reasonability in the relationship of punishment to the crime, who receives the death penalty, and innocence have been discussed and researched in great lengths. Capital punishment is still an active form of â€Å"deterrence† in the United States for crimes considered the wo rst of the worst. In this paper I will discuss the history of the death penalty. I willRead MoreCapital Punishment Should Be Enforced Throughout The United States2182 Words   |  9 Pagesunchanging. The same can be said for death. It is for this reason that the death penalty is so effective. The death penalty, also known as â€Å"capital punishment,† is defined as â€Å"the execution, or punishment by killing, of a person who has been found guilty of a specific, and usually serious, crime† (Barber). Capital punishment should be enforced throughout the United States because it is a humane tradition that has been practiced for centuries, it deters crime, and it provides retribution and gives justice

Speech on Marijuana Legalization Free Essays

A well-known issue, right now, in the USA is that of the legalization of marijuana. This controversial topic is on the minds of our entire country. Whether or not to legalize marijuana has been a nation wide debate for years. We will write a custom essay sample on Speech on Marijuana Legalization or any similar topic only for you Order Now In this informative speech I will be discussing only facts and opinions. Opinions and facts will come from organizations such as The National Organization for the Reform of Marijuana Laws, Marijuana Legalization Organization and the Drug Policy Alliance. Marijuana Legalization is an issue because there are so many individuals using the substance illegally. These individuals feel that Marijuana is not a harmful substance and can serve to profit states that legalize it. The biggest concern on everyone’s mind is that of health risks. Most people feel that it is in the best interest of the nation for marijuana to remain illegal. Marijuana Legalization Organization states that that is not entirely true. â€Å"Health considerations provide arguments to avoid excessive use of marijuana, but ultimately each individual should be allowed the personal freedom to decide whether or not to use marijuana. (MLO) In their opinion, as with anything taken in excess, marijuana is only harmful to those who choose to use it. The example used in MLO is that of an excess amount of unhealthy food. â€Å"[N]umerous studies have shown that foods with a lot of cholesterol and fat are unhealthy. Should we outlaw bacon? †(MLO) The thought is that instead we need to educate individuals and let people make their own decisions as we do with things like fatty foods, cigarettes and Alcohol. â€Å"A recent survey of research found that long term marijuana use did not have a significant effect on cognitive abilities. The report was published in the July 2003 Journal of the International Neuropsychological Society. † This is also stated in the list of facts about marijuana on the Drug Policy Alliance Website. They state that, not only are there no long-term cognitive impairment but, â€Å"[m]arijuana has been proven helpful for treating the symptoms of a variety of medical conditions. † Medical marijuana has proven to be of significant relief for cancer, glaucoma, and aids patients as well as individuals that suffer from neurological disorders. While there are the medical reliefs from the use of Medical marijuana, but DPA also states that the substance has not shown cause of mental illness or to increase risk to cancer. The next claim is that Marijuana is a gateway drug. Webster defines a gateway drug to be â€Å"a drug (as alcohol or marijuana) whose use is thought to lead to the use of and dependence on a harder drug (as cocaine or heroin)†( http://www. merriam-webster. com/) â€Å"Some people claim that using marijuana will make you want to use other drugs, like heroin, cocaine, LSD, amphetamines, and ecstasy. They argue that marijuana acts as a stepping-stone, or a gateway, that leads people to harder drugs. They support their argument with statistics that show that most people who use hard drugs have tried marijuana before. † (MLO) â€Å"There is no conclusive evidence that the effects of marijuana are causally linked to the subsequent use of other illicit drugs. Preliminary animal studies alleging that marijuana â€Å"primed† the brain for other drug-taking behavior have not been replicated, nor are they supported by epidemiological human data. Statistically, for every 104 Americans who have tried marijuana, there is only one regular user of cocaine, and less than one user of heroin. Marijuana is clearly a â€Å"terminus† rather than a gateway for the overwhelming majority of marijuana smokers. † (norml) MLO states â€Å"In essence, the link between marijuana and other illegal drugs stems from the fact that they are illegal. Because they are illegal, marijuana and other drugs are only available on the black market, and anyone who enters the drug market is likely to be exposed to more than one drug. The solution is simple: by legalizing and regulating marijuana sales, we will eliminate the connection to hard drugs. † (MLO) They use Holland as an example. â€Å"In Holland, where politicians decided over 25 years ago to separate marijuana from the illicit drug market by permitting coffee shops all over the country to sell small amounts of marijuana to adults, individuals use marijuana and other drugs at rates less than half of their American counterparts. † (norml. rg) The argument is that, if marijuana were not illegal it would not be a problem. The DPA website states that the majority of the individuals that use marijuana never even use any other illicit drugs. This statement disproves that common misconception about marijuana being a gateway drug. Finally my sources argue that keeping marijuana illegal it is costing more than necessary. MLO claims that â€Å"Cost of keeping marijuana illegal = cost of active law enforcement + cost of prosecution (and defense! of a ccused offenders + cost of incarceration of convicted offenders + hundreds of millions of dollars in tax revenue that would be generated if drugs were legal and taxed + cost of foster care and social services for children of incarcerated offenders. † â€Å"Washington state would save about $105 million a year if marijuana were legally regulated, according to University of Washington Economics professor Dick Startz. † â€Å"The US Federal Government Spends More Than $12 Billion Per Year on Drug Control Programs. Federal drug control budgets do not separate spending by drug, so we there is not a precise figure available for the amount that is spent on marijuana alone. Also, these figures do not include any spending by state or local governments, which are likely to be substantial since state police, courts, and prisons are constantly busy dealing with marijuana offenses. † They also state that â€Å"US Marijuana Crop Estimated to Be Worth Over $35 Billion. A new statistical analysis indicates that marijuana is America’s most valuable cash crop. If these figures are even close to the truth, a logical system to regulate and tax marijuana would produce billions of dollars in revenue every year. † According to DPA, the fight that the United States is having against drugs in all is costing $51,000,000,000. They also stated that if California would profit annually an estimated $1,400,000,000 if marijuana were taxed and regulated. There are only two major solutions to this issue; to Legalize or not to legalize that is the question. Legalization could stand to earn the US economic growth but it could also lead to even more people using or abusing the substance. Keeping it illegal could have the government spending money that they don’t necessarily need to spend to regulate the use of this substance or this could be positive a by keeping individuals from abusing it. Only time will tell! Does anyone have any questions? How to cite Speech on Marijuana Legalization, Essay examples

The Polynesians free essay sample

Heeding the flightpaths of birds was just one of numerous haven-finding methods employed by the Polynesians, whose navigational feats arguably have never been surpassed. The Polynesians traveled over thousands of miles of trackless ocean to people remote islands throughout the southern Pacific. Modern navigators still scratch their heads in amazement at their accomplishment. Like Eskimos study the snow, the Polynesians watched the waves, whose direction and type relinquished useful navigational secrets. They followed the faint gleam cast on the horizon by tiny islets still out of sight below the rim of the world. Seafarers of the Marshall Islands built elaborate maps out of palm twigs and cowrie shells. These ingenious charts, which exist today only in museums, denoted everything from the position of islands to the prevailing direction of the swell. ptolemy. jpg (28650 bytes) Statue of Ptolemy. Charts have aided mariners ever since the Alexandrian astronomer Ptolemy created the first world atlas in the second century A. We will write a custom essay sample on The Polynesians or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page D. The redoubtable Ptolemy even plotted latitude and longitude lines on his atlass 27 maps, though the farther one got from the known world centered on the Mediterranean, the dangerously less reliable they became. Even before Ptolemy, there were sailing directions the Greeks called them periplus or circumnavigation that were compiled from information collected from sailors far and wide. One of these, The Periplus of the Eritrean Sea, a document written in the first century by a Greek merchant living in Alexandria, described trading routes as far east as India. By the 10th century, Italian-made portolans supplied detailed directions, distances, depths, and coastal descriptions, and by the 13th century, sea maps with scale and bearings began to appear. The greatest advance in navigation came with the compass. The Chinese apparently knew about the powers of magnetism as early as the third millennium B. C. , when, historians tell us, one army defeated another after the battlefield had become enveloped in dense fog by using a device known as a point-south carriage. This was a standard carriage for carrying royalty with a small, rotating figure mounted on the front, which by magnetism always pointed south. (The Chinese chose to have the arrow point south rather than north. But no one seems to have manipulated the lodestone for sea navigation until early in the present millennium. The first mention of the compass in the West comes from the Englishman Alexander Neckham, who wrote in 1187 that sailors use a magnetic needle which swings on a point and shows the direction of the north when the weather is overcast. Despite its usefulness, the compass took a long time to come into wide use, as many seamen thought it operated by black magic. (Hence the invention of the binnacle, in which sea capt

Work Essay

Work Essay Work Essay English Essay Atticus Finch "To Kill a Mocking Bird" was set back in the mid 1900's, racism was high and discrimination of the black was still running. The text "To Kill a Mockingbird", Atticus challenges the case of Tom Robinson for rape and abuse of Mayella Ewell, showing the protection of the of Tom Robinson skin colour and showing the defence of African American People . Atticus Finch is a man with strong values and who does the right thing. This is shown when he defends Tom Robinson despite the social stigma of representing a black man. He teaches Scout and Jem to be accepting of others, and refuse to fight back against Bob Ewell. Tom Robinson was falsely accused of rape & abuse of Mayella Ewell and her father Bob. Atticus is one of the few people in the town who is willing to defend Tom Robinsons case, but there are also others that is on his side. Atticus show a trusting attitude, which he is the most courageous character I know, because of his defence of Tom Robinson. Everything Atticus is doing for Tom Robinson is a step to change the life of the Maycombs town and toward the African American people, not by the charge of skin colour but also fair and equal rights to the community, and give same respect. Atticus is a character who display various form of courage, also show most courageous attitude out of all character. He refuse to give up the fight no matter what circumstances or losses will do to his life (himself) or his family. Atticus show a lot of courage and behaviour in many instances throughout the story, not by fighting or killing, but by standing up and believe d in a civilized way. He wants to b e a good example for his kids and instil in them a strong sense of moral values. Atticus Finch knew that he was not going to win and he WILL lose this case. No matter how much evidence that he had, the jury will still charge him because of his skin colour, but it did not mean that it will stop him from giving Tom the strongest defence he possibly can. Importantly, Atticus doesn't put so much effort into Tom's case because he's an African American, but because of his innocence. Atticus feels that the justice system is colour blind, and he defends Tom as an innocence man but not a man of colour. As a lawyer, Atticus is again an ideal character as fair and equal and is the best man at his job. The whole fact that he took Tom Robinson’s case and listened to his conscience, when he knew he would lose, showed what sort of character Harper Lee wanted Atticus to be. He knew that the justice system at that time was prejudiced and immoral and that it was certain that Tom Robinson would be found guilty. Atticus remains calm when provoked directly. For example, looking at how he handles Bob Ewell's challenge: â€Å"Too proud to fight?† â€Å"No,† says Atticus, â€Å"too old†. This suggests that it may seem to us at first thought that Atticus is no longer strong and fit enough to fight; but also it might mean that fighting is not something that adults should do, which implies that Bob has not grown up. As a lawyer, Atticus is again an ideal character as fair and equal and is the best man at his job. The whole fact that he took Tom Robinson’s case and listened to his conscience, when he knew he would lose, showed what sort of character Harper Lee wanted Atticus to be. He knew that the justice system at that time was prejudiced and immoral and that it was certain that Tom Robinson would be found guilty. As a father, Atticus is truthful, fair and loyal his children, Scout and Jem. He acts as both a father and a teacher to them, educating them in the social and moral expectations of their society. He treats them with respect and wants them to understand why things happen in the community, what is wrong with society and how to try and change them and improve themselves at the same time. Atticus didn’t believe in spoiling his children or shouting at them but instead he believed respect for each other. Honesty and self respect

What Deferred or Waitlisted Students Can Do to Improve Their Chances

What Deferred or Waitlisted Students Can Do to Improve Their Chances Students that have been deferred or waitlisted from their top choice school face a big dilemma. Should they just sit tight or is there anything they can do to better their chances of getting accepted? Understanding the Difference Between Deferred and Waitlisted Being deferred from a college is not the same as being placed on the waitlist. Most college deferrals occur when a student has applied early action (EA) or early decision (ED) to a college.  When a college defers an applicant, it means their application has been changed to a regular decision (RD) application and will be re-considered during the normal admissions review.  If the original application was a binding ED, it no longer is and the student can choose to go to another school even if accepted in the regular process. Waitlisted means that the applicant has not been accepted but could still be considered if enough students that were accepted choose not to attend the college. Even though being waitlisted sounds better than being rejected, odds of getting off a waitlist are not in a student’s favor. Christine K. VanDeVelde, journalist and coauthor of the book College Admission: From Application to Acceptance, Step by Step, explains, â€Å"Waitlists were much smaller 15-20 years ago before the common application. Colleges need to meet their enrollment numbers. With more students sending in applications, it is harder for schools to predict how many students will accept their offer so waitlists tend to be larger.† Re-Evaluate if the School Is the Right School Not being accepted to a first choice college can be upsetting. But before doing anything else, students that have been deferred or waitlisted should re-evaluate and determine whether the school is still their first choice. Several months will have passed since a student has sent in their application for consideration. In that time, some things may have changed, and it is possible a student may not be as confident that their original first choice school is still the right choice. For some students, a deferral or waitlist turns out to be good thing and an opportunity to find another school that is a better fit. What Can  Students Do if They Have Been Waitlisted? Students are not usually placed on a waitlist but told that they can choose to be placed on the waitlist.  VanDeVelde explains, â€Å"Students need to respond by submitting a form or emailing the college by a set date. If you dont, you will not be placed on the waitlist.† The waitlist letter will also let students know what, if any, additional information they will need to submit to the school, such as sending in recent grades or additional letters of recommendation. VanDelde cautions,  Ã¢â‚¬Å"Colleges usually give clear directions. Its in the students best interest to follow them.† Students that have been waitlisted may not find out until August if they have been accepted, so they do need to make a deposit at another college even if the school they have been waitlisted at remains their first choice. What Can  Students Do if They Have Been Deferred? If a student has been deferred and is 100% confident he still wants to attend the school, there are things he can do to improve his chances. Call the Admissions Office VanDeVelde says, â€Å"A student, NOT a parent, can call or email the admissions office to ask for feedback on why the student wad deferred. Maybe they are concerned about a certain grade and want to see if the student improves over the semester.† VanDeVelde advises students to advocate for themselves in a clear and articulate manner. Says VanDeVelde, â€Å"This is not about bringing pressure. It is about whether the school has room for the student.†Ã‚   Send Additional Information Make sure updated grades/transcripts have been sent in a timely manner. Beyond recent grades, students can also update the school on their recent accomplishments, honors, etc. Students can email this information to admissions along with a letter reiterating their interest and commitment to attending the school. Students may consider sending additional recommendations.  Brittany Maschal, a private college counselor, says, â€Å"An extra letter from a teacher, coach or someone else close to the student who can speak to what they have done to contribute to the university may be helpful.† Do not send recommendations from successful or famous alumni of the school unless the person truly knows the student. Maschal explains, â€Å"Many students ask if these types of letters are helpful and the answer is no. A big name vouching for you generally will not help as a stand-alone factor.† Ask Guidance Office for Assistance An admissions office may provide additional details as to why a student was deferred to a school counselor. A school counselor can also advocate on a student’s behalf. Request an Interview Some schools offer applicant interviews on or off campus with alumni or admissions representatives. Visit the College If time permits, consider visiting or re-visiting the campus. Sit in on a class, stay overnight, and take advantage of any admissions events/programming you may not have during the initial process. Consider Re-Taking Standardized Test or Taking Additional Tests As this can be time consuming, it is probably only worthwhile if the school has directly expressed concern over the test scores. Keep Grades Up and Continue With Activities Many students get second semester senioritis.  Their grades might fall or they may slack off on extracurricular activities–especially if they are feeling dejected about not getting an immediate acceptance from a first choice school.  But these senior year grades can be a determining factor for admission. Guest columnist Randi Mazzella is a freelance writer and mother of three.  She primarily writes about parenting, family life and teen issues.  Her work has appeared in many online and print publications including Teen Life, Your Teen, Scary Mommy, SheKnows and  Grown and Flown.

Napoleonic Wars Essay Example | Topics and Well Written Essays - 2000 words

Napoleonic Wars - Essay Example He decided early on a military career and won a scholarship to a military academy. His ensuing military conquests threatened the stability of the world and made France a powerful force. He built an empire extending throughout Europe, but his quest for France's total world domination was doomed to failure. Napoleon was decidedly effective against the Austrians in Italy in 1796. Ever a great self-publicist, he maintained the popular profile of a political independent, thanks partly to the newspapers he ran. Because he controlled printed matter in France, he was able to influence public opinion. His political talents and military expertise on land expanded his powers. He did, however, fail in his attempt to invade Egypt, and, crushed by the British navy, he was forced to abandon much of his army and return to the European front. In the meantime, however, the French public was aware only of his military successes, and he was considered a hero. Napoleon took control of France after overthrowing the republic. By 1801, as First Consul, he had restored order in France. He established the Civil Code on March 21, 1804, and it was renamed Code Napoleon in 1907. With its stress on clearly written and accessible law, it was a major step in establishing the rule of law. The principal tenet of the Civil Code was that every French person was equal before the law. Napoleon wanted to replace a series of existing laws in France with a standard code for all people. However, the law was inconsistent in that it established supremacy of husband with respect to wife and children, but allowed divorce on a relatively liberal basis, including divorce by mutual consent. Other major points of the law were: Laws could be applied only if duly promulgated and if published officially. No secret laws were authorized. Ex post facto laws were prohibited. Judges prohibited from passing from general judgments of a legislative value. Wikipedia, the Free Encyclopaedia Napoleon's empire controlled-either directly or through states under his sway-France, Portugal, Spain, modern-day Belgium and the Netherlands, and large parts of modern Italy, Germany and Poland. Alliance with Russia between 1807 and 1812, and dominance over the remaining continental powers of Austria and Prussia, showed the empire at its peak. Napoleon's rule began with the annihilation of the French monarchy, which would never again be in control. He established an independent nationhood based on ability and rose to power through political coups. The French Directory was replaced by the Consulate, a new government run by three consuls (Bonaparte, Sieys and Roger Ducos) with Bonaparte as First Consul (Time Traveller's). In 1804, Napoleon declared himself emperor and ruled from 1804-1814 when he abdicated to Elba, and then reclaimed power from March to June 1815. Continental System Napoleon established the Continental System in 1806, his scheme to stop all shipping of British goods into Europe, which ended up hurting France more than Britain, and leading to the rise of nationalism in Europe. The response of the United Kingdom with a counter blockade indirectly led to the War of 1812 (Napoleonic, 2006). One of the most dramatic results of this commercial warfare was "the English bombardment of

Discussion 7- economics-pricing strategies Assignment

Discussion 7- economics-pricing strategies - Assignment Example Since producers have no control over the market prices, they can only control how much they produce. For production, firms in pure competitive market evaluate both the prices for selling their goods and the cost of production. If the analysis leads to greater profit maximization margin, the firm increases its production. Firms in a competitive market maximize profits or minimize losses by evaluating marginal revenues against marginal costs (Reynolds, 2011). Since there are many producers, each makes up a small portion of the total market. No particular producer can influence market prices. The demand curve for the various producers in pure competitive markets is completely elastic (horizontal). Producers in pure competitive markets are price takers. Such producers have the power to sell their products as much as they can produce. If competitors change their prices in pure competitive markets, consumers are willing to switch their demands to the most competitively priced products. In such a case, cross-price elasticity increases since consumers have other available options at better offers. If one producer raises the price, demand goes to

The Physics Behind Parking :: physics science cars vehicles

Background: After a long day of cruising through town with your buddy, the two of you have grown quite an appetite. You spot a McDonalds at the top of a very steep hill. Unfornately a local biker gang must of had the same idea. Encredibly, the only available parking spot is on the street, uphill of nearly 15 Harleys. There are no other restaurants for 100 miles in all directions. Famished, your friend skillfully manuvers his car to the side of the road. The breaks shudder as the car comes to a stop on the hill. He holds the brake, puts it into first, and shuts off the car. Problem: Biker's don't take kindly to people messing with their bikes. Your friend is about to let off of the brake. Being the physics major you are, you have to decide whether it's safe to park or safer to go hungry. Your friends car is pretty old, and the e-brake hasn't worked for years. The car will be held in place solely by the moter. There are two mean looking bikers smoking outside entrance. They are watching you so there probably wouldn't be time to make a run for it. Known What You Know: Your buddy's car is classic, and I'm sure he would want to make more than an educated guess. I've done a little investigating to help you out a bit. I took a torque wrench to the motor, and resists it resists aproximately 46 ft*lbs of torque at the crankshaft. After the compression bleeds down this number is reduced to 38 ft*lbs. The cars rear differential has a 3.73 to 1 gear ratio and a manual transmission with a 3.35 to 1 ratio in first gear. The tires are 28 inches in diameter and the gross weight of the car is approximately 2100 lbs. The hill is often travelled by truckers, and on the way up you noticed a sign that said the hill was at a 26 degree angle with the horizontal. Summary: When the car is at rest this means it is in a system of static equilibrium. Gravity is pushing forward on the car, and the tires are pushing back on the car via the reaction force of friction in the motor. The steeper the hill, the greater the force of gravity acting on the car, the greater the reaction force in the motor must have. As stated before, the maximum torque that can be applied to the motor before it rotates is 38 ft*lbs.

Understanding of Poverty in Ireland Today

What is your understanding of poverty in Ireland today? What would you identify as possible responces? My understanding of poverty in Ireland today is that it is multifaceted and covers a range of social issues such as lack of education, social exclusion and marginalisation. In the main body of this essay I will discuss my understanding of poverty and put forward sever al responses to these issues. I will examine how people with physical disabilities and mental health problems, one parent families, the unemployed and members of the travelling community are more susceptible to poverty.Firstly I’d like to define the two main types of poverty in Ireland today which are as follows. Consistent poverty and secondly Relative poverty/at risk of poverty. People in consistent poverty have a combination of relative income poverty with relative deprivation. This means having an income below 60% of the median and also experiencing enforced deprivation. This means being on a low income and not being able to aff ord basic necessities such as new clothes, not having the money to buy food such as meat or fish, not being able to heat your home, or having to go into debt to pay ordinary household bills.Approximately 5% of people in Ireland fit into this category. People in Relative poverty. This means having an income that is below 60% of the median income (the median is the mid-point on the scale of incomes in Ireland). In 2010, that was an income of below â‚ ¬207. 57 a week for an adult. Whilst people who fall into this category may be able to pay their rent they may not be able to cover the costs of utility bills or perhaps not be able to afford to go out for a meal once a month or to participate socially.Approximately 15% of people in Ireland fall into this category. According to the Combat Poverty Agency the people most at risk from poverty in the following order are lone parents, the unemployed, people with disabilities or mental health problems, children and the elderly. The effects of poverty in Ireland include social exclusion from normal activities leading to alienation preventing them from developing their skills and talents , lack of access to mainstream financial services which in some cases will lead to people using illegal mone y lenders who charge igher interest rates which in turn puts them in more debt, long term effects on their mental health leading in some cases to depression due to their lack of a sense of self worth or belonging and physical health problems due to bad nutrition, inability to gain well paid jobs, and in the case of children, bullying at school which in turn may cause depression or suicide or that they may drop out of school early. Lone parents are 3 times more likely to be in poverty than the rest of society as a result of expensive childcare and lower levels of education which leads in turn to low paid work.They find it extremely difficult to access adequate childcare which in turn means they are unable to f urther their education. Also the financial cost of transition from social welfare to employment inhibits them. They would lose their medical card which is a big issue for any parent who then cannot afford private healthcare on a low wage. They are thus socially excluded. People with physical disabilities have no way to improve the quality of their lives. They may not be able to work at all and must exist on a small sum given to them by the social welfare department. They also require home help just to do menial tasks.In many cases they rely on a parent or other family member for this support which also puts the carer in a position where they can not work enough hours if any at all to earn a wage that would be considered adequate. This in turn leads to the carer becoming at risk of falling into poverty. These people are among the most vulnerable people in society and are stuck in a poverty trap. They are excluded socially not only because of their physical limitations but also becaus e they cannot afford to do many things other people take for grante d. I personally believe that cutting the payments they receive is a cruel and inhumane thing to do.If we do not stand up for the weakest people in our society then what does that say about us. People with mental health problems are also stuck in a similar situation to people with physical disabilities. They survive on a meagre social welfare payment with no chance of employment or improving the quality of their lives. Again these people are stuck in a poverty trap and are among the most vulnerable people in society. These people are also socially excluded from many activities other people take for granted which in turn can lead to exacerbation of their mental health problems.People who are unemployed live on social welfare payments. Unlike people with disabilities or mental health problems they do have the ability to work and would much prefer to be working where possible. There are some government funded initiative s to help people in this category to up skill but unfortunately there are still not enough jobs to go around. People in this category may have a mortgage and/or children to support therefore they are at greater risk of falling into poverty. Members of the travelling community suffer from poverty in a few ways.Firstly they are stigmatized by the rest of society and find it difficult to secure employment because of bias and also because of the fact that they are moving from place to place. Many of the children in this community leave school early thus leaving them with a lack of education and furthering their risk of poverty. They also suffer from a higher rate of mortality than members of the settled community. The children are often bullied in school because they are seen as different and therefore find it harder to settle into life at school.My responses to the above mentioned issues would be as follows: Tackling any problem involves finding the root of the problem and working from that point forwards therefore I believe that early intervention would be a key strategy to alleviate some of these problems. The children today will become the parents of tomorrow so I think that targeting children in schools with programmes designed to raise awareness of the social issues involved in poverty and to try and educate them to think in a more sociological way would benefit not only them as individuals but society as a whole.Putting in place more effective support networks with more government funding for people who are struggling may help to stop people moving from relative poverty to consistent poverty. For people in consistent poverty I think that they need to be helped by directly giving them as much aid as we can give and more importantly try to give them opportunities to help themselves. Nobody wants to have to beg , most would prefer to be g iven an opportunity to make their situation better. Raising awareness in the general community would help also.Realising th at there are many complicated reasons why people end up in poverty and that they are not just a bunch of lazy drop outs would help us to empatise with them more. Also I believe that government policy should be studied in a manner that makes sure that it does not contribute to the creation of poverty. Conclusion: I have discussed in the above paragraphs my understanding of poverty in Ireland today. In the previous paragraphs I have talked about some of the different groups of people who are affected by poverty and also the effects it has upon them.I have also outlined a few responses to these problems. Overall my understanding of poverty leads me to conclude that poverty has been around and will continue to be an issue into the future despite the good work that government and many other agencies do as it is a complex issue with no easy solutions. Furthermore in my understanding it is the way our society is organised under the capitalist framework that also contributes to this problem . We are living in a society today where the gap between the rich and poor is increasing. This is in part caused by the mechanisms of the Capitalist economy.Capitalism tends to push people towards poverty through seeking to pay the lowest possible wage to an employee in return for a higher profit margin. They will also close a factory and relocate it to a different country where the labour rates are even l ower as it is more profitable to do so rather than keep the workers in Ireland employed. In a capitalist system property rights take priority over human needs. For example there are many empty houses in the so called ghost estates in Ireland and also many homeless people but the people who own these buildings have no intention of letting the homeless make use of the buildings.This is perfectly legal in our society. Poverty also benefits capitalism because it means that there will be many who in desperation will settle for any job no matter how little the wage. Therefore poverty st ems from the way that capitalism works. I believe that we need to look at changing the system of government to share more equally the benefits of our labours. We must ask ourselves is this acceptable in our modern society with the high moral standards we expect of each other.

Nike Nike, Inc. - 3411 Words

Nike was originally named Blue Ribbon Sport when Bill Bowerman and Phil Knight founded it in 1964. In 1971, the company was renamed to what is known today as Nike, Inc. The word â€Å"Nike† is taken from the goddess of victory in Greek mythology. The company’s focus was to sell running shoes priced at low cost that was made by a Japanese manufacturer. In the 1970s, the company incorporated and started selling shoes under the Nike brand with its trademark logo, the â€Å"Swoosh† designed by Carolyn Davidson. By the 1980s, it had gained 50% market share in the United States. Today, Nike has over 700 stores worldwide along with corporate offices in 45 countries and is considered part of the textile industry that engages in selling of footwear, apparel, sporting equipment and accessories. According to Forbes, Nike was named the most valuable business in sports and reported revenues over $25 billion in 2013 with assets worth over $18 billion.1 Nike contracts ou t the manufacturing of its products and in the past it has chosen to do so in countries across the globe in South America, North America, Eastern Europe, Africa, and Asia. Nike often chooses suppliers in low-wage countries so that the company can keep the production cost low. Nike Inc., although headquartered in Beaverton, Oregon, outsources the production of its products around the world. Overseas, Nike pays the local minimum wage in the respective countries. However, the issue is that often the minimum wage in theseShow MoreRelatedNike : Nike, Inc.1965 Words   |  8 PagesNike, Inc. NIKE, Inc. â€Å"was founded by William Jay Bowerman and Philip H. Knight in 1964 and is headquartered in Beaverton, OR† (Nike, Inc.). NIKE, Inc. concentrates on NIKE Brand and Jordan Brand products divided in seven key categories: Nike sportswear, football, action sports, women and men’s training, basketball and running. The operating segments for its Brand are: North America, China, Japan, Western, Central Eastern Europe and Emerging Markets. Its wholly-owned subsidiaries include ConverseRead MoreNike And Challenges Of Nike Inc. Essay1349 Words   |  6 PagesSummary Nike was founded in 1972 by Philip Knight and Bill Bowerman. The focus of this report would be an analysis of how Nike’s manages and delivers its service to its customers. It also looks into Nike’s emphasis on its product quality and innovative design to meet the ever changing consumer preferences. By looking at its current strategies that Nike adopt and its appropriateness, this report will provide you a better understanding on how consumer see Nike and challenges that Nike Inc. faces.Read MoreNike Inc.4013 Words   |  17 Pagesis Nike Inc. I chose to do my research on Nike because I am for one, very much interested in Nike, and secondly I am very interested in Nike s clothing, shoes, and accessory line. br brBasketball players want to be like Mike, but shoe companies want to be like NIKE. NIKE is the worlds #1 company and controls more than 40% of the US athletic shoe market. The company designs and sells shoes for just about every sport, including baseball, volleyball, cheerleading, and wrestling. NIKE alsoRead MoreCompany Overview: Nike, INC1106 Words   |  4 PagesNike, Inc. is the world’s leading designer, marketer and distributor of athletic footwear, apparel, equipment and accessories for a wide variety of sports and fitness activities. NIKE, Inc. sells, distributes and licenses its products in approximately 200 countries around the world. NIKE focuses its products in seven key categories: Running, Basketball, Soccer, Men’s Training, Women’s Training, NIKE Sportswear and Action sports. NIKE sells products through its NIKE Brand and Affiliate Brands (ConverseRead MoreNike s Business Model : Nike Inc.1430 Words   |  6 PagesNike Inc. is a multinational athletic sportswear corporation that produces a wide range of both menâ €™s and women’s footwear, clothing, equipment and accessories. It is also globally the largest seller of such garments, selling to approximately 19,000 retailers in the USA, as well as in 140 other countries around the world. Of course with such territory Nike has become a huge target to a broad range of campaigning non-governmental organizations and journalists as significant representation of businessRead MoreTaking a Look at Nike Inc.974 Words   |  4 PagesBrief Overview Nike, Inc. is a multinational corporation that designs, develops, markets, and sells athletic footwear, apparel, equipment, and accessories for a variety of sports and fitness activities. In 1964, it started its empire as a company that distributed Japanese running shoes, Tiger, in the United States with the name Blue Ribbon Sports in 1964. Nike founders—Bill Bowerman and Phil Knight—had a great coach-student relationship when both were still at University of Oregon; Bowerman wasRead MoreAn Evaluation Of Nike Inc.5734 Words   |  23 PagesNike Inc: Eric Eichman Patten University 7/10/15 NIKE INC 2 Table of Contents 1.0 Introduction ............................................................................................... 4 2.0 Copies of the Nike Inc’s financial statements ................................................ 6 3.0 An evaluation of Nike Inc’s financial stability ............................................... 8 a. Nike Inc’s financial stability ......................................................................Read MoreNike Inc. Case Study2161 Words   |  9 PagesNike, Inc. : Case Study in Operations Management MGT 441 Prepared for: Dr. Davidson, Concord University Prepared by: Jeremiah Nelson Johnathan Coleman Emily O’Dell December 4th, 2012 Introduction Low-cost, time-efficient manufacturing of goods is a key feature of a successful production company in today’s competitive global economy. Operations management, often abbreviated in the business world as OM, is defined as â€Å"...the set of activities that creates value in the form of goodsRead MorePrinciples of Marketing: Nike Inc9497 Words   |  38 PagesNike’s pricing Strategies 20 Price versus Promotion Matrix 21 Price versus Quality Matrix 22 Place (Distribution) 23 Nike -Direct Marketing 24 Nike - Indirect Marketing (Wholesalers amp; Retailers) 25 Value added services – Intermediaries 25 Distribution strategies 25 Promotion 26 Nike’s promotional strategies 27 Communication Model 28 SWOT ANALYSIS OF NIKE INCORPORATED 30 Strengths: 30 Strong Brand Image 30 Supplier Diversity 30 High Growth 31 Weakness: 31 Recent SetbacksRead MoreStrategic Analysis of Nike Inc12147 Words   |  49 PagesPositionÂ…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â….p.30 Strategic PlanÂ…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…..p.33 ConclusionÂ…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…...p.38 LIST OF EXHIBITS Sales Trends GraphÂ…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…p.5 Net Income Trends GraphÂ…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â….p.5 Nike Board of Directors TableÂ…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…...p.11 Table of Key Financial RatiosÂ…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…...p.22 Net Income Trend GraphÂ…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â….Â…..p.24 Primary Strategic Match Position ChartÂ…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…..p.30 Industry

The Happy Family Lives Of Canada Essay - 1654 Words

While gay and lesbian people are as diverse as everyone else, their shared experience of discrimination seems to unite them. The blog I have chosen to focus on for this analysis is a married lesbian couple with two children. Jen and Allison are two lesbians who had their first child in January 2011 and had their second child in December 2012. The happy family lives in Canada. Canada is internationally seen as the leader in the development of equality regarding to the lesbian, gay, bisexual, transgender, and plus community compared to any other country including the United States of America. In July 20, 2005, Canada became one of the countries in the world to allow same sex marriage while in the Unites States a federal law passed on June 26, 2015 that allowed same sex marriage across the States (Rau, 2015). Jen and Allison have always have a strong support system from the moment they both decided to come out, but that does not mean they have not faced discrimination. The couple decid ed to settle in Canada due to America being more conservative. Blog Abstract Jen was born and raised near Pittsburgh, Pennsylvania. While Allison, was born and raised in Toronto, Canada. They met for the first time at a concert in London, Ontario, Canada. From that moment on, a romance was born. The started doing long-distance dating in 2001. The couple would take turns traveling to see each other. Jen would drive six hours to see Allison, and Allison would make a twelve hour trip by theShow MoreRelatedMammitas Garden Cove Essay984 Words   |  4 PagesCyril Dabydeen, the author uses the literary techniques questions, tone, and flashbacks to convey the main characters view on place. Max believes that he will have better opportunities in Canada rather than in his home country. This short story details his views on his life at this point, and how he is doing in Canada. The prompt immediately begins with the question, â€Å"Where d’you come from?†. This tells the reader that Max is not from the current country or setting in which the story takes place. ThroughoutRead MoreWhy Polygamy Should Remain Illegal1328 Words   |  6 Pagesup to 5 years in prison but prosecutions are rare. Despite the religious beliefs, polygamy should remain illegal and should be enforced strictly. Polygamy brings on various legal complications and greatly damages children and women in polygamous families. Women play a major role in polygamous communities; from raising the children, to being the epicentres of the polygamous marriages. Polygamy should remain illegal to help save women from these abusive relationships, jealousy and getting marriedRead MoreGlobal Health Issue Project : Canada Essay1562 Words   |  7 PagesGlobal Health Issue Project: Canada Canada is the second largest country by total area in the world, extending from the Pacific to the Atlantic Ocean and north into the Arctic Ocean. Canada has ten Provinces and three Territories, bordering the United States on the South and Northwest sides. Ottawa is Canada capital city located in Ontario. Canada became its own country July 1, 1867 with the creation of the Constitution Act. Currently, Canada is home to a little over 36 million people, ranking asRead MoreEssay about McDonald’s Contribution to the Environment and the Community1726 Words   |  7 Pagesthis restaurants name? There are different food choices, career opportunities and community commitments within this corporation. Some may think McDonald’s is the greatest food service retailer or perhaps the worst company that could have evolved in Canada and the United States. The content entailed in this report shall inform you that there are more then just hamburgers and french fries in the world of McDonald’s. The major topics covered are McDonald’s contribution to the environment, and to theRead MoreBeing A Second Generation American Woman956 Words   |  4 Pagesfelt I was being brought up by my mother to be a â€Å"happy homemaker.† When I was finally able to date, I was 18 in college. I never keep secrets from my parents, so when it was time for the â€Å"sex talk† it was interesting. My health insurance is under my father’s name so I felt obligated to tell them that I was planning on going on birth control. I didn’t want them finding out that I was sexually active through the Kaiser bill. My mother was not happy. She had never used birth control in her life. FranklyRead MorePolygamy in Canada Essay1059 Words   |  5 PagesWithin Canada we have a generous amount of freedom but this leads to the abuse of o ur system. This is especially true with regards to polygamy in Bountiful, BC. Because women are susceptible to mental abuse in polygamist relationships it should continue to be illegal in Canada. If this law is in enforced it would help women to be freed of the oppression caused by male domination, eliminate the need for women to suppress feelings that conflict with the ideals of the polygamy life, and aid in avoidingRead MoreHofstede s Six Dimensions Of Culture1119 Words   |  5 Pageschildren are taught obedience by their parents. Canada has a score of 39 and Ukraine – 92. Canadian culture is leaning towards equality, which means people establish hierarchy for convenience; money is distributed more even in society and superiors/managers depend on employees. By contrast, Ukrainian culture has a high score: often corruption, uneven money distribution, revolutions needed to replace government. 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The time and the place have a significant effect upon the language used. This helps to create an overall mood that is d ominated by Southern prejudices, interpersonal ignorance and simplicity; for example, Sister says ?Nigger girl? (1031) words that now demonstrate racism but atRead MoreFamilies Should Be Planned Essay913 Words   |  4 Pages Every family differ from each other, each family has its own unique ideas, rules, and beliefs. Families are important because they are the very first people that anyone would interact with and they would adapt any attitude from their family.Every person tends to have the same ideas and beliefs as their family does and people generally follow the same paths as their family does. Parents are the base and the foundation of their family and the house. Both mother and father play the biggest role

Essay about Critique of the Communist Manifesto - 861 Words

Assignment No. 3: Critique of the Communist Manifesto Karl Marx and Freidrich Engels Communist Manifesto is one of the worlds most influential pieces of political literature. The manifesto was created for the purpose of outlining the aims and goals of the The Communist League. The Communist League was made up of radical proletariats who were fed up with the bourgeoisie social order and sought to overthrow them. The manifesto is known to have been written by Marx and assisted and edited by Engel therefore the many ideas and theories expressed by this work are known as Marxism. Marxism has many poignant views on changing society and its class structure, and what needs to be done to achieve these changes. The Marxism theories do fall†¦show more content†¦The manifesto continues with Marxs belief that capitalism is very unsteady and that this class struggle between the bourgeoisie and proletariat is inevitable under this system. But Marx explains that the only means for communism to spread in a society ruled by capitalism and clas s distinctions is by revolution. A problem with Marxism is that this whole concept reflects on creating an imaginary future which is filled with all the answers to the problems of the workers in modern society. The only way people will be able to reach this future is by forfeiting all their personal hopes and dreams for the sake of the proletariat class. Marx undermines the fact that all people do not share the same desires, and that his idea of upheaval of the bourgeoisie might not entice the public as a whole. Especially since Marxism revolutions will meet a violent event in time, where the bourgeoisie and proletariat will clash. This conflict is not the most convincing means for change (for individuals who seek a peaceful way of living). As well Marx never gives a good description for how the proletariat should govern the state once they take power. John Locke proposes in the Second Treatise on Government that The earth, and all that is therein, is given to men for the support an d comfort of their being. Which raises the question how could someone differentiate common propertyShow MoreRelatedMarxist Critique Of The Communist Manifesto, Marx And Engels2021 Words   |  9 PagesMill’s Liberal Response to Marx’s Communist Critique of Capitalism Yujun Huang In The Communist Manifesto, Marx and Engels present the flaws of the modern capitalistic society by pointing out its unfair ruling class, the phenomenon of alienation, and excessive individuality in order to emphasize the aim of Communism of eliminating economic gaps between the social classes. According to On Liberty, Mill would respond to Marx by agreeing with Marx’s fundamental ideals and disagree with his socialistRead MoreMarx, Mill And Freud s Critique Of Political Economy And The Communist Manifesto Essay1133 Words   |  5 Pagestackle the topic of freedom in unique ways, but their messages are fundamentally the same and continue the ideas that we encountered in the esoteric texts as well as in The Matrix: . First, we have Karl Marx’s Capital: Critique of Political Economy and The Communist Manifesto, where we encounter the proletariat, or the working-class people regarded collectively. In these two texts, the latter of which was co-authored by Frederick Engels, we learn that the proletariat is enslaved just like the peopleRead MoreCommunism Created By Karl Marx And Friedrich Engels799 Words   |  4 Pagesthis is when his interest and critique of religion and government began. When he went to university he joined the Young Hegelian movement, and he produced a radical critique of Christianity (Kreis, 2000). After the critique in the Young Hegelian movement he became an editor for Rheinische Zeitung powerful liberal newspaper. After some controversial articles by Marx the Prussian government shut it down. He then went to France. During his time in France he became a communist and set down his views inRead MoreCommunist Manifesto, And Estranged Labor1173 Words   |  5 Pagesalwa ys put down. When I think of a communist society I envision North Korea. A society that most people do not know much about other than the fact that people have zero rights, everything is monitored, only propaganda is released, and it is overall a horrible way of life. The first time my eyes were open up to the idea that communism may not be all that bad was reading Marx’s â€Å"Communist Manifesto† and â€Å"Estranged Labor.† Marx successfully challenged the critiques put forward on such a controversialRead MoreMarx And Engels s Critique And Critique Of Capitalism1669 Words   |  7 PagesThe specialised critique of capitalism found in the Communist Manifesto (written by Karl Marx and Fredrick Engels), provides a basis for the analysis and critique of the capitalist system. Marx and Engels wrote about economical in relation to the means or mode of production, ideology, alienation and most fundamentally, class relations (particularly between the bourgeoisie and the proletariat). Collectively, these two men created the theory of Marxism. There are multiple critiques of Marxism thatRead MoreConflict Theory, Karl Marx, and the Communist Manifesto Essay1321 Words   |  6 PagesConflict Theory, Karl Marx, and The Communist Manifesto In order to understand Marx a few terms need to be defined. The first is Bourgeoisie; these are the Capitalists and they are the employers of wage laborers, and the owners of the means of production. The means of production includes the physical instruments of production such as the machines, and tools, as well as the methods of working (skills, division of labor). The Proletariat is the class of wage-laborers, they do not have their ownRead MoreKarl Marx And The Communist Manifesto1453 Words   |  6 PagesIn the Communist Manifesto, a document that first proclaimed the ideology of communism itself, Marx declared that the â€Å"history of all hitherto existing society is the history of class struggles† (Marx, Karl and Frederick Engels). As a man who spurred resentment of governments and inspired revolutionaries, Karl Marx is often regarded as a man who led to the rise of 20th century tyrannical dictators such as Stalin and Mao to take power. His ideas are regarded as fai lures and, by some, are seen asRead MoreThe Communist Manifesto By Karl Marx And Friedrich Engels1255 Words   |  6 PagesThe Communist Manifesto was written by Karl Marx and Friedrich Engels to begin explaining Communism and its goals. The Manifesto suggests that history acts according to what is called â€Å"class struggle.† The â€Å"means of production† are what truly defines the class relationships according to Marx and Engels (Marx 2002). Inevitably, the classes conflict and become hostile, no longer moving fluidly (Spalding 2000). 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Marx and Engels – though Engels primarily took care of editing and revising, Marx did a large amount of the writing – would write The Communist Manifesto for this group. After the manifesto was published, it became one of the most well-known as well as influential pieces of philosophy, and is the reason

What Influences Free Clinic Usage by the Uninsured Free Essays

string(73) " eliminating the need for hospitalization \(Corso Fertig, 2011\)\." What Influences Free Clinic Usage by the Uninsured? By Shelli Thomason A Paper Submitted to Dr. Dayna McDaniel Research Methods PA6601 Term 5, 2012 Troy University July 27, 2012 TABLE OF CONTENTS CHAPTER 1 Introduction †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. We will write a custom essay sample on What Influences Free Clinic Usage by the Uninsured or any similar topic only for you Order Now 4 Statement of the Problem†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 5 2. 1 Purpose †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 6 2. 2 Problem Statement†¦.. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 6 2. 3 Research Questions†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 6 2. 4 Scope†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 1. Literature Review†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã ¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 9 Dependent variable†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 9 1st Independent variable†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 11 2nd Independent variable†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 13 3rd Independent variable†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 14 4th Independent variable†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 16 4Hypothesis†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦18 4. 1 H1: hypothesis one†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 18 4. 2 H2: hypothesis two†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 18 4. 3 H3: hypothesis three†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦18 4. H4: hypothesis four†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 18 Chapter II: Methodology Design†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. †¦ 18 Population/Sample†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 20 Variables†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦21 Dependent Variable†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 21 Independent Variables†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. †¦Ã¢â‚¬ ¦. †¦Ã¢â‚¬ ¦22 Data Collection†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. †¦22 Measuring Instrument†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ †¦Ã¢â‚¬ ¦. 22 Materials†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 23 Delivery Method†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 24 Data Analysis†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦ 24 Chapter III: Anticipated Findings†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 25 Chapter IV: Conclusion†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦25 Implications†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦26 Recommendations†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â ‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦26 References†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦28 – 30 Appendices Appendix A Schematic Model†¦. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ †¦.. 31 Appendix B Formula for Calculating Population Sample Size†¦. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 32 Appendix C Survey†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦Ã¢â‚¬ ¦ †¦ 33 – 35 Appendix D Demographics†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦36 Appendix E Example of Multiple Regression results†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦37 Chapter 1 Introduction Many United States residents delay or do without necessary healthcare because they lack the resources or knowledge to access it. There are 46 million people in the nation who have no health care coverage, and by not giving necessary attention to medical concerns and conditions, poor health risks increase, along with untimely mortality (Darnell, 2010). A Kaiser Commission study from 2006 identifies there are 18,000 deaths yearly in the United States resulting from lack of health care coverage (Trask, 2011). Recent Census Bureau shows a slightly higher number of uninsured indicating there are 50 million uninsured, which would be the largest number on record, resulting from the national economic recession (Krisberg, 2010). According to Darnell (2010), there are 1007 free clinics in the nation, providing services during 3. 5 million clinic visits, by 1. 8 million uninsured patients, representing approximately 10% of uninsured adults of working age. The patients have no other health care alternatives to a free clinic due to a variety of factors including: no ability to pay, language barriers, lack of or inadequate medical insurance, homelessness, inaccessibility, and immigration or ethnicity issues. As private non-profit organizations, free-clinics are not recipients of federal funding, so many rely on state funding, local funding, and donations. Depaul (2010) notes that the National Association of Free Clinics estimated four million patients were seen in 2008, which doubled in 2009. It is also noted that free clinics have to turn away patients because they cannot meet the demands. In a white paper for the American College of Physicians, Gorman (2004) notes, those who do not receive annual exams and preventative screenings run the risk of a delayed diagnosis and subsequent treatment, resulting in premature mortality. Additionally, untreated chronic symptoms result in worsened conditions and costly emergency care, placing a financial burden on hospitals, families and ultimately on the community. Furthermore, workers who experience poor health have lower productivity which is costly to the economy. Therefore, free clinics are a crucial component in the consortium of health care options in the United States. Isaacs and Jellinek (2007), state that 80 % of patients who receive primary care at a physician’s office are either uninsured or have Medicaid. Although physicians may see uninsured patients in their offices and take on a few of them as charitable cases, this practice is declining given lower insurance and Medicaid reimbursements and increased operational expenses. The nation has what is referred to as a safety net system to provide health care services for residents who are uninsured. This system is comprised of hospital emergency rooms, publicly funded health centers, and free clinics. With costs of health care escalating, it is crucial to identify methods to effectively optimize these providers. It has been suggested that accessibility to free clinics, which may keep the uninsured from accessing the ER for non-emergent care, is one such method. Studies show uninsured persons utilizing a free clinic have fewer emergency room visits than those who do frequent the ER for their primary care, which renders cost savings (Trask, 2011). Statement of the Problem Purpose The purpose in this research is to make determinations as to what factors influence an uninsured person’s decision to access the services of a free clinic. In an effort to answer this question, factors will be recognized, through research, significant to a person making the decision to visit a free clinic for medical care. Uncovering these factors could assist in discouraging the misuse of other types of medical safety net provisions. One study shows if the group studied did not have use of a free clinic, 80% of the visits would have resulted in ER visits for non-emergency treatments (Corso Fertig, 2011). This information could also assist in identifying strategies to effectively address the health care needs of constituents and provide funding sources with knowledge to make educated decisions on the most effective use of funds. Problem Statement This project will pinpoint the most acute variables influencing an uninsured person to seek treatment at a free health clinic, allowing local government leaders and medical providers to have access to research so they may further understand areas in which to place their focus and funding. Furthermore, an ancillary reason for study is to show that by providing an uninsured person who is truly ill with a way to achieve wellness, they can become viable again, thus becoming a more productive worker, who may regain insurance and no longer need the free service, or any other type of medical care. If a person has a resource within which to address health concerns, that does not present them with barriers, they are likely to receive the necessary care needed, reducing further complications and costs, placing them in a position to become more sustainable. In one Healthcare Georgia study, evidence shows that free clinics can halt the escalation of health problems, reducing or eliminating the need for hospitalization (Corso Fertig, 2011). You read "What Influences Free Clinic Usage by the Uninsured" in category "Essay examples" Research questions This project will focus on four research questions that will aide in identifying specific factors that influence an uninsured person to use a free clinic (dependent variable). The primary question to be asked is â€Å"What factors influence an uninsured person to use a free clinic? Research questions inquiring about those influences (independent variables) are: 1) Does lack of alternative health care options influence an uninsured person to use a free clinic? 2) Does housing status influence an uninsured person to use a free clinic? 3) Does Hispanic ethnicity influence an uninsured person to use a free clinic? 4) Does age influence an uninsured person to use a free clinic? The independent var iables thought to influence the dependent variable are defined so there is a clear understanding of their meaning. Lack of other alternatives: Many users of free clinics may have no other options for health care than a free clinic. They may be employed, but cannot afford the health care premiums offered by their employer or the employer does not offer health coverage. 83 percent of the patients seen at free clinics come from a working household and may hold two or three part time jobs (DePaul, 2010). Federally funded community health centers, different from free clinics, are typically located in rural or inner-city areas and help serve a large number of patients in high-needs communities. In 2009, the Government Accountability Office indicated that even with 8000 community health centers, there were still 43 percent of underserved areas without access (Whelan, 2010). Housing Status: The definition of â€Å"homeless† is a broader scope than merely the population living on the streets and includes individuals in a widespread range of unstable housing scenarios. Homeless individuals do not only live under bridges or in a car, but may also reside in emergency shelters; foster homes; HUD’s terminology of â€Å"doubling up† with relatives or friends; or tenants who have been served an eviction notice. Unstable housing status is a high risk factor for health disparities, much like genetics or eating habits. On average, a homeless person has eight to nine coexisting health problems (Batra et al. , 2009). A study of 6,308 homeless Philadelphians determined the mortality rate among the homeless was 3. 5 times that of the city’s overall population. Earlier research has also noted the homeless have escalated rates of a vast array of health problems (Lewis, Andersen and Gelberg, 2003). Age: Different clinics have differing eligibility for the patients they serve. Many states have the option to offer an insurance plan covering children through the passage of the Children’s Health Insurance Program Reauthorization Act (Llano, 2011), then those over age 65 have Medicare. Therefore many clinics tend to turn their efforts toward those uninsured patients between the ages of 18-64. A 2004 study shows that overall general health significantly declines for those between age 50 and 60 if they are uninsured, underinsured or sporadically insured, compared to their counterparts who have adequate health coverage (Inguanzo and Kaplan, 2011). Hispanic Ethnicity: Llano (2011) states the greatest hindrance to health care for Hispanics is the language barrier. Providers of service have difficulty communicating with Spanish speaking patients if there is no interpreter available, which may cause compromised diagnoses, treatment options and specialty referrals. Census Bureau data reveals that in 2010, 38. 7 percent of uninsured American residents were Hispanic (Inguanzo Kaplan, 2011). Scope A survey will be completed, as part of this research. This project’s scope will investigate what influences an uninsured person’s visit to a free clinic. It will assist the free clinic administration in further developing strategic plans to make determinations on where their efforts should be focused. It may also contribute to local governments and other potential grantor’s decisions on making allocations. Free clinic usage is the primary focus, although the collective information may show related trends and concerns constructive to area healthcare providers and local governments. Each person surveyed will be treated equally. This study’s sample population will include patients of two free clinics: Community of Hope Health Clinic and Cahaba Valley Health Care Clinic in Shelby County, Alabama. The clinic only sees uninsured patients on Mondays from 8:30 am to 4:30 pm and Thursdays from 5:30 pm to 8:30 pm. They must show proof of residency in Shelby County. Literature Review Dependent variable: Free clinic usage by the uninsured As stated earlier, experts concur that there are over 1000 free clinics in the nation, providing services during 3. 5 million clinic visits, by approximately 10% of uninsured adults of working age (Darnell, 2010; Gertz, Frank and Blixen, 2010; George Washington University Report to Congress, 2012). This equates to approximately 90% of uninsured adults who are not utilizing a free clinic for their medical needs. Gertz, Frank and Blixen (2010) go further to say that since 1980, when there were 30 million uninsured people, there has been a 50% increase to 45 million. From a statewide perspective, Rhode Island remains consistent with national levels, as uninsured working age adults under age 64 doubled between 2000 and 2005, citing the waning of employer health care coverage (Gerber, et al. , 2008). The yearly cost associated with uncompensated medical treatment for the uninsured in the nation was $56 million in 2008. Determinations were made to suggest that use of emergency rooms for non-emergent care, along with rising hospitalization which could have been prevented are on the rise and creating costly problems. Communities are seeking other solutions to provide health care to the uninsured, which might include free clinics, mobile clinics, and church and school sites to administer treatment (Fertig, A. , Corso, P. Balasubramaniam, D. , 2011). As stated earlier, free clinics are an important part of the United States health safety net, serving mainly the uninsured, working poor. Historically, given minimal resources and relying on volunteer health care providers, free clinics have focused on gap filling, temporary solutions to the population’s health problems. Implementing a new paradigm, free clinics are now making disease prevention and health promotion a top priority (Scariarti Williams, 2007). A nationwide cross-sectional study using a survey was conducted by Gertz, Frank and Blixen (2010) which they compared to the only other known published study of its kind by Nadkarni, et. al from 2005 to determine free clinic characteristics. Both studies revealed a mean of between 4,000 and 6,000 uninsured visits to the free clinics annually, and a third study agrees that most (67%) are located in the Southern region of the United States (Gertz, Frank Blixen, 2010; George Washington University Report to Congress, 2012). Additionally, 77% of the respondents of the Gertz, Frank and Blixen study (2010) indicated the level of care received at free clinics was superior to prior medical care received, and 24% indicated if there was no free clinic available, they would not seek care, mainly due to cost. A high number of free clinics seem to function as a fixed source of medical care for their patients. The majority of free clinics describe the service they provide to their patients as continuing, 20 percent indicate the care as recurrent, and 5 percent depicted the care as irregular, only seeing a patient once (George Washington University Report to Congress, 2012). In contrast, prior to the recent national economic recession, a study associated with the utilization of three Massachusetts free clinics was conducted to determine what factors influenced people to use the free clinics, when it appeared there were a variety of ample options for medical care irrespective of health care coverage or income level. Although the study unveiled the three free clinics saw patients who had insurance, 81% of the respondents were uninsured (Keis, DeGeus, Cashman Savageau, 2004). Lack of health care coverage, is the sixth-leading cause of death, equating to 18,000 deaths annually for adults between the ages of 25 and 64 (Groman, 2004). The uninsured person may encounter severe financial and wellness obstacles, limiting their ability to obtain medical care and many times become indebted and more ill, as a result. A study conducted by Becker (2001) found that not only did uninsured persons with chronic health conditions lack adequate health care; their illnesses were also inadequately managed. Other findings were that with deficiencies of education regarding their health, those persons who are uninsured lacked the information, understanding, and resources that would allow them to manage their illnesses more effectively. Many uninsured patients can pay more than double the cost if they are forced to use a hospital for their care, due to the inability for price leveraging that medical insurance providers can afford (Groman, 2004). 1st independent variable: Lack of other options The National Association of Free Clinics indicates they see patients they never thought would come to a free clinic, with 83% of free clinic patients come from working home, but cannot afford COBRA if they have lost a job and are now working several part time jobs. Patients have reported they would likely go the ER or not seek care if they did not have access to a free clinic (Depaul, 2010). Private practice doctors are the primary source of health care for the uninsured, mainly because, historically, they have been plentiful in numbers, with 720,000 providing care according to Isaacs Jellinek (2007). A second expert (Groman, R. 2004), agrees that free care by physicians is decreasing, which will greatly impact the medical safety net with growing numbers of uninsured. As stated earlier, the decline is largely the result of higher operating costs and inadequate Medicare reimbursement rates, prohibiting the doctors from being able to treat those who cannot pay (Isaacs Jellinek, 2007). Even though charity from practicing physicians plays a vital role in treating the uninsured, they are not stand-ins for health insurance. Because of revisions to financing and rganization of medical care systems, doctors indicate in a New York Academy of Medicine study, they are unable to provide the same class of care to the uninsured, as they provide to patients who have health care coverage (Groman, R. , 2004). A recent report to Congress indicates that free clinics overall see millions of uninsured persons who may not achieve any level of care elsewhere. One study highlighted in the report reveale d four main reason listed in order of percentage, people use a free clinic are: no health insurance (82%), referrals by others (59%), medications (38%), and no knowledge of where else to go (34%). The report also states that three quarters of free clinic patients do not have a regular method of care except the free clinic or the ER, suggesting free clinics fill voids, offering services not available (or easily reached) somewhere else (George Washington University Report to Congress, 2012). The Keis, et al. (2004) study is in accord with the report to Congress in that one-third of survey respondent gave their reason for using a free clinic as not knowing where else to go to receive medical attention. Another one-third cited lack of transportation, long wait times, finding child care or inability to leave work as the primary reasons they could not use other types of medical providers and instead sought treatment at a free clinic. As already learned, access to local safety net providers has limits to readiness in other ways as well. For example, in Jeffrey Trask’s unpublished dissertation (2011), he cites and agrees with the Keis study stating that other than the emergency room, many safety net providers aren’t open in the evenings or are scarce, so due to the need to work, a patient’s only option may be a free clinic open in the evenings. Likewise, clients of free clinics forego after care or specialty care only a hospital can offer due to costs. Trask (2011) gives the example, when an uninsured person using a free clinic needs additional services outside the free clinic’s scope of care, sometimes old or bad debt is a major obstacle to receiving necessary treatment. Finally, options are limited for people who are not legally residing in the country. A collective characteristic of a free clinic is capacity to treat any patient without documentation regarding immigration status (Keis 2004). In a 2010 national survey, a census, the first of its kind in 40 years, 764 clinics were deemed eligible out of 1188 surveys mailed. A finding from the study uncovered that free clinics are a more important aspect of the national safety net, especially in the area of ambulatory care that originally thought. However, only 188 of the clinics surveyed offered all-inclusive services, and the survey concluded that a free clinic is not a replacement for comprehensive primary care (Darnell, 2010). 2nd independent variable: Hispanic ethnicity Hispanic persons comprise approximately 16 percent of the population in the U. S. but make up 25 percent of free clinic patients. Experts agree that unbalanced degree of Hispanic patients in free clinics indicates higher rates of lack of health care coverage among this group (George Washington University Report to Congress, 2012; Isaacs Jellinek, 2007), with the latter authors citing an example from a Racine, Wisconsin clinic who had a one percent Hispanic patient base in late 1980s and a 50 percent Hispanic patients in 2006. Results were compared from two student-run free clinic studies on clinic characteristics and concurred that most of the patients were minorities. One study of 59 clinics reported that 31% of the patients seen were Hispanic, while the other study of 39 clinics revealed 53% of patients were Hispanic. The student run clinics demographic is quite different from non-student run clinic who report a client base of mainly non-Hispanic people (Gertz, Frank Blixen, 2010). Studies indicate that Hispanic persons are more likely than non-Hispanics to fail to complete the Medicaid application and miss important dates for submitting required documentation. Furthermore, 43 percent of Hispanics who speak Spanish had communication problems with physicians compared to 16 percent of Caucasians; and non-English speakers had more difficulty in comprehending doctor orders (Llano, 2011). Because of non-existent health insurance and consequently no immunizations, a considerable outbreak of rubella plagued a Hispanic community in New York in the late 90s. The outbreak spread to adjacent communities and those with insurance were just as affected. In communities with high numbers of uninsured residents, it becomes more ifficult to provide disease control, and medical personnel have fewer opportunities to identify early onset of outbreaks, hampering containment efforts (Groman, 2004). In a report examining the unmet medical needs of the nation’s Latino population conducted by the American College of Physicians and the American Society of Internal Medicine, it was discovered that uninsured women had twice the likelihood as their non-Latino pee rs to be diagnosed with breast cancer in the later stages and uninsured Latino men were four times as likely to receive a prostate cancer diagnosis compared to non-Latino men. It is suggested that Hispanic and Latino immigrants are very unlikely to have the ability to access health care services due to governmental restrictions of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, and fear that their citizenship opportunities will be compromised by attempting to secure public aid assistance (Inguanzo and Kaplan, 2011). 3rd independent variable: Homelessness According to Wilson (2009), there are close to 800,000 homeless people in the nation, many of which have multiple disorders to include asthma, nutritional deficiencies, skin infections, wounds, and diabetes, to name a few. Wilson’s and O’Connell’s research goes on to say that the homeless person’s ailments which are largely left untreated and worsen, lead to devastating illness. The mortality rate is excessively high in the homeless populace. O’Connell (2005) agrees with Wilson’s conclusions with regard to high mortality rates, and that homeless people are three to four times more likely to die than the general population. The risk is greatly increased in those homeless persons between the ages of 18 and 54, and that younger homeless women are four to 31 times more likely to die than their housed counterparts. Life expectancy in the general population is 78 years of age, and falls to between 42 and 52 years of age for the homeless population (O’Connell, 2005). Approximately 9 to 15% of the US population becomes homeless during their lifetime. Those who are truly without a place to stay and are considered literally homeless may be included in this figure, although the homeless are transient and in and out of shelters. Additionally, this figure may include those who HUD calls â€Å"doubled up† or â€Å"couch-homeless†. Other developed countries have a lower rate of this ategory of homelessness than the United States (Hoback and Anderson, n. d. ). For the U. S. overall in 2000, the estimate is 1. 65% of the population is â€Å"couch-homeless† (Census Bureau, 2000). One study highlights the Columbia-Harlem Homeless Medical Partnership (CHHMP), a free clinic run by students, that targets Manhattan’s homeless, providing medical students with a service learning opportunity and simultaneously, providing a medical home for homeless patients. Free student-run clinics are an integral piece of the medical safety net. In these learning settings, the requirements of medical students and in-need patients transect with the outcome of quality medical care. The disordered lifestyle of the homeless patient requires outreach to this population and a need for relationship building. This type of need is not feasible in the medical school setting but can be met at a student-run free clinic. Students are able to deal with the human side of public health disparity and learn more about other services and make referrals that can assist the whole patient, such as housing, health screenings, mental health providers, etc. (Batra, et al. , 2009). In congruency with the independent variable of other options stated earlier, an interview study of 2578 homeless and sporadically housed persons indicated that housing instability, abuse, multiple arrests, physical and mental conditions, as well as substance abuse were contributing forces to causing heightened usage of emergency rooms with a trial study group revealing on average seven visits per year. Galwankar (2004) and Whitbeck (2009) both conducted studies which emphasized the need to decrease emergency room use among the homeless populations, by focusing on identified risk factors from a public health standpoint (Galwankar, 2004). A large percentage of the homeless use hospital emergency departments for their primary care, even though it is not the most effective method of medical care for them, as it cannot provide continuity. Additionally, for hospitals and governments it is not cost effective (Whitbeck, 2009). Independent variable: Age Eighty percent of free clinic patients are between the ages of 18-64; with 12% being children and elderly being eight percent (George Washington University Report to Congress, 2012). Two pieces of literature agree with he statistic that one in every six people ages 51 to 61 partaking in the National Academies Health and Retirement Survey who were at the start of the survey, uninsured, developed a new finding of stroke, cancer or heart disease, over the next six year period (Institute of Medicine, 2012; Inguanzo Kaplan, 2011). In agreement with an IOM report cited, a national trend study from 2007, looking at 10,088 uninsured older working age adults, found that this group is less likely to receive regular preventative screenings for breast cancer, prostate cancer and cholesterol that those with insurance in the same age group. Additionally, women who are uninsured or are on Medicaid have a more advanced stage of breast cancer at first diagnosis and lower survival rate than their counterparts who have private health coverage (Gerber, et al. , 2008). In a 2009 Kaiser report, 30 percent of people between the ages of 19 and 29, are uninsured, the highest proportion of any age group. Though the majority of these young adults are working, they experience lower pay scales, and often find health coverage too expensive for their budget. Most people in this age group reported they were in good health, but 10 percent indicated they were in poor or fair health; twice as many as those with medical insurance (Weaver, 2010). Now, in 2012, many of this age group, because of provisions under the Affordable Care Act, will now be able to remain a dependent on their parent’s insurance policy until age 26, thus likely reducing the high percentage of uninsured in this age group (The White House, 2010). The number of children nationwide with no healthcare coverage is on the rise, but the impact from being uninsured on a child’s health has not been heavily explored. According to a Journal of Public Health article, in 2006 over one million children became uninsured, raising the total to 9. 4 million, or 12. 1% of all children in the United States. The spike in numbers can be credited to decreases in employer health coverage without corresponding growths in support provided by Medicaid or the State Children’s Health Insurance Program (SCHIP) (Abdullah, 2010). One study analyzed information from more than 23 million children, under age 18, in the United States, using two large patient databases, to evaluate the effect of health care coverage status on pediatric hospital stays. The study resulted in findings that the rate of death for children who were uninsured was over 37 percent of the deaths studied (Abdullah, 2010). Hypotheses H1: The fewer options for medical treatment will influence an uninsured person to use a free clinic for health care. The more alternative options for medical treatment will influence less free clinic usage by an uninsured person. Other options is an independent variable that has a direct relationship with the dependent variable of free clinic usage by the uninsured. H2: Hispanic ethnicity will influence an uninsured person to use a free clinic for their medical care needs. Hispanic ethnicity will not influence an uninsured person to use a free clinic for their medical care needs. Hispanic ethnicity is an independent variable that has a direct relationship with the dependent variable of free clinic usage by the uninsured. H3: Homelessness will influence a person to visit a free clinic. Homelessness will not influence a person to visit a free clinic. Homelessness is an independent variable that has a direct relationship with the dependent variable of free clinic usage by the uninsured. H4: Age is a factor that influences free clinic usage by the uninsured. Age does not influence free clinic usage by the uninsured. Age is an independent variable that has an inverse relationship with the dependent variable of free clinic usage by the uninsured. Chapter II: Methodology Design This study will concentrate on one central research question: What impacts do availability of other medical care options, Hispanic ethnicity, homelessness and age have on the usage of a free clinic by people who are uninsured? These questions will pose the following hypotheses: H1: The fewer options for medical treatment will influence an uninsured person to use a free clinic for health care. The more alternative options for medical treatment will influence less free clinic usage by an uninsured person. Access to other options is an independent variable that has a direct relationship with the dependent variable of free clinic usage by the uninsured. H2: Hispanic ethnicity will influence an uninsured person to use a free clinic for their medical care needs. Hispanic ethnicity will not influence an uninsured person to use a free clinic for their medical care needs. Hispanic ethnicity is an independent variable that has a direct relationship with the dependent variable of free clinic usage by the uninsured. H3: Homelessness will influence a person to visit a free clinic. Homelessness will not influence a person to visit a free clinic. Homelessness is an independent variable that has a direct relationship with the dependent variable of free clinic usage by the uninsured. H4: Age is a factor that influences free clinic usage by the uninsured. Age does not influence free clinic usage by the uninsured. Age is an independent variable that has an inverse relationship with the dependent variable of free clinic usage by the uninsured. A schematic model illustrates the correlation between these variables. The model can be reviewed in Appendix A. The research question and problem will be answered by using a survey design study conducted by a convenience sample over a six week period. The reason behind using a cross-sectional design is that data on all variables of interest can be collected at the same time and is an efficient method for a large group (O’Sullivan, Rassel Berner, 2008). The three page survey, written at a fifth grade level, in English and in Spanish, will make inquiries and gather information about the independent variables, and about the dependent variable. Attempts will be made to approach every patient signed in at the clinics during the study period. Internal and external validity, then, are important to maintain when surveying a sample population and asking questions on sensitive issues. The goal is to ensure that the independent variables of interest indeed caused changes to the dependent variable and not something else; along with certifying the outcomes are general of the population and can be reproduced in any location. The development and reliability of the research questions are integral to maintaining internal validity within the study. Cognitive pretesting of 10 patients will be performed before beginning the study to ensure the questions are commonly understood and to confirm that the survey questions are capturing the intended outcomes. Additionally, in order to ensure external validity, the results of the study can be implemented by other governments and non-profit agencies. Population/Sample The population for this study is patients visiting two free clinics in Shelby County, Alabama, ages 19-64. This limits the population to a specific age range of persons in the county, as it has been determined that those outside this age range are eligible for coverage through government offered insurance programs, even if they have not applied for it. A Shelby County Development Services Department Profile indicates from 2010 Census data; the population for Shelby County, Alabama is 195,084 residents. Of those approximately 7% are uninsured, equating to around 10,000 uninsured residents. County demographics reveal an almost even division of males (49. 3%) to females (50. 7%). 83. 6% of the population is white, 10. 6% is Black/African American and 1. 5% is Asian (See Appendix D). An anomaly in demographics is observed in ethnicity, specifically Hispanic/Latino residents who are documented at 4. % (8,389) of the total population with an additional 4. 2% who ‘speak non-English language at home’ and 1. 6% who ‘speak English less than ‘very well. ’ If the results of a University of Alabama at Birmingham study are applied to undocumented Hispanics in Shelby County, the total would be more accurately reported at 37,314 (Patino, 2002). Given the fact that both clinics have eligibility requirement for the pa tients they see, the sampling frame will include only people ages 19-64, who have no insurance and who reside in Shelby County or indicate they are homeless. The sample will consist of those who randomly visit the clinic, and are signed in on a first come, first served basis and are waiting to receive treatment at the clinics during the study period, representative of the near 2000 patients who actually received treatment in 2011. This total number of patients is captured from clinic data gathered and reported by the clinics. The sample will be chosen through convenience sampling methods. This method was chosen for its ease of execution and cost effectiveness, although it has a higher risk of bias. The sample size was chosen using a formula that calculated a 95 percent confidence level that the sample size will accurately represent the total population of patients. The sample size will be 563 patients. See Appendix B. Variables Dependent Variable For this study, a free clinic is operationally defined as being a privately run non-profit agency not receiving any federal funding, that offers general medical services, medication and dental care to individuals who have no health care coverage. Volunteer, licensed medical providers administer the care at minimal or no cost (Darnell, 2010). The dependent variable is measured using nominal scales, with letters of the alphabet used as labels instead of numerals. Questions in the survey that address the dependent variable specifically are Question 4 and Questions 9-13 (see Appendix C). Independent Variables The first independent variable: lack of other options, can be conceptually defined as locations where the uninsured might seek medical treatment, other than a free clinic. To measure this variable, use of other options will be measured using a series of questions asking questions related to medical care history. Since the survey will be given to uninsured patients who may not have a high level of education, literacy, or understanding of terminology, the operational definition for the second independent variable of housing status in the survey will measure living arrangements. This will be accomplished by measuring the frequency of responses using nominal scales. The third independent variable, ethnicity, especially Hispanic ethnicity, has been defined as being of Hispanic origin. Per the US Census Bureau, persons of Hispanic origin are determined on the basis of question that asked for self-identification of the person’s origin or descent. Persons of Hispanic origin, in particular, are those who indicated that their origin was Mexican-American, Chicano, Mexican, Mexicano, Puerto Rican, Cuban, Central or South American, or other Hispanic (U. S. Census Bureau). The fourth and final independent variable, used in this model is age, and is intended to measure which age groups of working age adults visit a free clinic most often; and if age is a factor for visiting the clinic. In the study, variable is operationally defined as working age adults between the ages of 19-64. Free clinics trends have shown most patients are non-elderly adults (Darnell, 2010). This will be accomplished by measuring the frequency of responses using nominal scales. Data Collection Measuring Instrument The use of free clinics by the uninsured between ages of 19-64 and the relationships of the factors that influence usage, will be gauged by using a survey comprised of 20 questions (Appendix C), consisting of issues related to accessibility, reasons for use, medical insurance status, health status, employment status, housing status, current diagnoses, and general demographic information. These questions include both ordinal and nominal scales. Two questions will provide an open-ended answer option where space will be provided to write in an answer. Some questions for the survey were extracted from previously tested and validated instruments, such as the National Health Interview Survey. The survey will be translated into Spanish, and for those who need assistance, an already on-site Spanish interpreter will assist in the introduction of the study as well as offer explanation for completion of the survey. The survey should take no longer than 10 minutes to complete. Materials The materials and expense necessary to execute the survey are marginal. Copies required for each respondent total 4 pages (one page is the introduction and confidentiality notice and three pages for the survey) each totaling 2252 multiplied by $. 05 equals approximately $112. 60. Office supplies including three dozen writing pens and a stapler and staples will also be purchased for around $25. 00. Additionally, incentives in the form of refreshments are an additional cost. Bottled water and healthy snacks such as granola bars, pretzels or crackers will be purchased in volume to reduce costs. 25 cases of water totals $180. 00 and snacks will be approximately $150. 00. Therefore the total cost to administer the survey with incentive is approximately $467. 60. The study will be given during clinic operating hours where clinic volunteers will be recruited to administer the introduction and surveys providing additional cost savings. Delivery Method In order to allow every patient in the convenience sample the same opportunity to participate in the survey, upon their arrival and egistration, a clinic caseworker will share with them a scripted introduction explaining the purpose for the survey and assure them it is voluntary and it will in no way cause them any risk and will in no way compromise their clinic visit nor treatment. The introduction will also discuss confidentiality. These measures will help to ensure internal validity since the orientation may p rovide a level of comfort for the respondent who in turn may be inclined to answer the questions more honestly. The survey will be administered to the patients during regular clinic hours on Mondays between 8:30 am and 4:30 pm and Thursdays between 5:30 pm and 8:30 pm, while they wait to be seen. To improve response rates, healthy refreshments will be provided to participants. Patients who have been waiting to register for hours, to be one of 30 patients seen during a given clinic, have likely not eaten and may welcome refreshment as incentive to participate in the study. Dr. Eleanor Singer, a population studies professor and researcher at Columbia University summarized the evidence on incentives from the standpoint of the survey literature in the use of incentives in her 2002 book. She uncovered that incentives improve response rates across all approaches. The effect has proven to be undeviating, larger incentives have superior effects on response rates. Those patients who are first in line to see a medical provider will have equal opportunity to participate in the incentive and the study upon completion of their visit. Data Analysis Once the surveys are collected the data will first be cleaned. It is very important that the data collected from the surveys be able to be interpreted properly in order to accurately measure the relationships between the dependent and independent variables. Each question on the survey will be coded with a value prior to being administered. Data will be entered into a SDSS program and a multiple aggression analysis will be performed. From this analysis it will be possible to find the correlating relationships between each individual independent variable and the dependent variable to show significance. Ultimately the computer program will show which factors strongly influence free clinic usage, which ones are less influential and which factors together may increase the relationship further. See the example in Appendix E. Chapter III: Anticipated Findings The literature that has been reviewed in relation to the variables in this study, along with the suggested approaches, in tandem offers backing to the outcomes that are expected of this study. It is anticipated that there will be a relationship between use of a free clinic by the uninsured and each of the four independent variables provided: lack of other options for health care, age, Hispanic ethnicity and homelessness. The expectation is that the computer software used in analyzing the findings will show relationships between the variables, contradicting the null hypotheses. A multiple aggression analysis would be used to show these relationships by entering the data into a computer program designed to perform the computations and ends up showing a prototype of realism (Simon, 2003). Each of the four independent variables, are believed to have direct relationships with the dependent variable. Ultimately, it is anticipated that each of the four corresponding hypotheses will be conclusive. Chapter IV: Conclusion Studies provide support for the need to address reasoning behind free clinic usage by the uninsured population. The literature review has assisted in understanding each variable’s definition, emphasizing the ideas and findings of other scholarly studies, and establishing the integrity of the links between each independent variable and the dependent variable. As an example, the Kaiser report assists with understanding of the independent variable of age being a factor in why uninsured use a free clinic for their health care needs. It showed that younger working age adults in a certain age range were the group who are most often uninsured, and that this age group is forced to use free health care or have none at all, ultimately having medical conditions worsen, thus costing hospitals and tax payers more in the end. There is currently a staggering estimated $70 billion in uncompensated medical care from 2008 alone by uninsured patients (US Dept. f Health and Human Services, 2011). Therefore it is imperative that those with no medical insurance have access to some form of free or affordable health care in their community, with free clinics being an important piece of the equation. Implications The findings of this research are expected to be beneficial to the Shelby County local government, health and human service non-profit agencies and the medical system as the study will be proving assumed information, along with providing ancillary supportive data about the health care needs and gaps to serve uninsured residents of Shelby County, Alabama. In knowing information about what factors contribute to the free clinic usage among the uninsured, the community collaborative can propose modifications, improvements and additions for programming that may assist in lessening the burden, and ultimately solving the problem. While the outcomes from the study may not be exact to national trends, they should be very reflective and allow for reproduction of successful interventions. Recommendations The provided research will give evidence on four factors that contribute to the use of free clinics for medical treatment by the uninsured population of Shelby County, Alabama thus allowing for a community collaborative to be formed from local government, health care providers, faith based community, caseworkers, immigration and homelessness advocates, university department heads and others. Therefore, it is strongly suggested that this study be performed in order to gather this necessary information to determine if a more detailed needs assessment should be conducted. While there are additional independent variables that may contribute to the usage of a free clinic, only four have been highlighted for this study. Others additional factors should be investigated to identify other challenges that strain the health care system, ultimately contributing to the occurrence of free clinic use. REFERENCES Abdullah, F. et al. , (2009). Analysis of 23 million US hospitalizations: uninsured children have higher all-cause in-hospital mortality. Journal of Public Health, 32 (2), 236–244. doi:10. 093/pubmed/fdp099 Batra, P. , Chertok, J. , Fisher, C. , Manseau, M. , Manuelli, V. , Spears, J. (2009). The Columbia-Harlem homeless medical partnership: A new model for learning in the service of those in medical need. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 86 (5). doi:10. 1007/s11524-009-9386-z Becker, G. , (2001). Effects of being uninsured on ethnic minorities’ management of chronic illness. West Journal of Medicine, 1 75(1), 19–23. Corso, P. Fertig, A. , (2011). ROI and free clinics in Georgia. HealthVoices, University of Georgia College of Public Health, Healthcare Georgia Foundation, Publication 51. Darnell, J. S. (2010). Free clinics in the United States: A nationwide survey. ARCH Intern Medicine, 170 (11), 946-956. Depaul, J. (2010). Free clinics: America’s best-kept secret. The Fiscal Times. Retrieved from: http://www. thefiscaltimes. com/Articles/2010/05/03/Free-Clinics-Lifeline-for-America. aspx#page1 Fertig, A. , Corso, P. , Balasubramaniam, D. (2011). Benefits and costs of a free community-based primary care clinic. Retrieved from: http://hogwarts. spia. uga. edu/~afertig/policy1/FreeClinic_JHHSArevision_singlespace1. pdf Galwankar, S. , (2004). Role of homeless and uninsured patients in overcrowded emergency departments. Retrieved from: http://www. bmj. com/rapid-response/2011/10/30/role-homeless-and-uninsured-patients-overcrowded-emergency-departments George Washington University, Department of Health Policy, School of Public Health and Health Services (2012). Quality incentives for federally qualified health centers, rural health clinics and free clinics: A report to Congress. Washington, DC. Gerber, R. et al. , (2008). A place to be healthy: Blueprint for a new free clinic for the medically uninsured of Rhode Island. Medicine Health/Rhode Island, 91(4), 105-108. Gertz, A. , Frank,S. Blixen, C. (2011). A survey of patients and providers at free clinics across the United States. Journal of Community Health, 36, 83-93. doi: 10. 1007/s 10900-010-9286-x Groman, R. , (2004). American College of Physicians white paper on the cost of lack of health insurance [White Paper]. Retrieved from: http://www. acponline. rg/advocacy/where_we_stand/access/cost. pdf Hoback, A. Anderson, S. (n. d. ). Proposed method for estimating local population of precariously housed. Retrieved from: http://www. nationalhomeless. org/publications/precariouslyhoused/index. html Inguanzo, M. Kaplan, M. , (2011). The social implications of health care reform: reducing access barriers to health care services for uninsured Hispanic and Latino Americans in the United States, Harvard Journal of Hispanic Policy, 23, 83. Institute of Medicine (2003). Hidden costs, values lost: Uninsurance in America. The National Academies Press. Washington, D. C. Retrieved from: http://www. nap. edu/catalog. php? record_id=10719 Isaacs, S. L. Jellinek, P, (2007). Is there a (volunteer) doctor in the house? Free clinics and volunteer physician referral networks in the United States. Health Affairs, 26 (3), 871-876. doi: 10. 1377/hlthaff. 23. 3. 871 Keis, R. M. , DeGeus, L. G. , Cashman, S. , Savageau, J. (2004). Characteristics of patients at three free clinics. Journal of Health Care for the Poor and Underserved, 15 (4), 603-617. Krisberg, K. , (2010). Jump in uninsured signals need to implement health reform: Economy takes a toll on health coverage. The Nation’s Health, 40 (9), Retrieved from: http://go. galegroup. com. libproxy. troy. edu/ps/i. do? id=GALE%7CA241780634v= 2. 1u=troy25957it=rp=AONEsw=w Lewis, J. H. , Andersen, R. M. Gelberg, L. , (November 2003). Health care for homeless women: Unmet needs and barriers to care. Journal of General Internal Medicine, 18, 921-928. Llano, R. , (2011). Immigrants and barriers to healthcare: Comparing policies in the United States and the United Kingdom. Stanford Journal of Public Health, Retrieved from: http://www. stanford. edu/group/sjph/cgi-bin/sjphsite/2011/06/immigrants-and-barriers-to-healthcare-comparing-policies-in-the-united-states-and-the-united-kingdom/ O’Connell, J. , (2005). Premature mortality in homeless populations: A review of the literature. National Health Care for the Homeless Council, Inc. , Nashville. Patino, F. , (2002). Material and child health services utilization by Hispanics in Alabama (doctoral dissertation). Birmingham, AL: The University of Alabama School of Public Health. Scariarti, P. Williams, C. , (2007). The utility of a health risk assessment in providing care for a rural free clinic population. Osteopathic Medicine Primary Care, 1(8). doi: 10. 1186/1750-4732-1-8 Simon, G. , (2003). Multiple regression basics. Retrieved from: http://people. stern. nyu. edu/wgreene/Statistics/MultipleRegressionBasicsCollection. pdf Singer, E. , (2002). The use of incentives to reduce nonresponse in household surveys. Survey Nonresponse, John Wiley Sons, Inc. , New York, 163-177. Trask, J. , (2011). The relationship between primary care access to free clinics and emergency room usage (Unpublished doctoral dissertation). Graduate College of the University of Illinois at Urbana-Champaign. United States Census Bureau (2001). Households and families 2000, Census 2000 brief. US Department of Commerce. United States Census Bureau. Hispanic population of the United States. Retrieved from http://www. census. gov/population/www/socdemo/hispanic/ho00def. html U. S. Department of Health and Human Services (2011). ASPE Research Brief: The value of health insurance: Few of the uninsured have adequate resources to pay potential hospital bills. Weaver, C. , (2010). How health overhaul would affect the uninsured. Kaiser Health News. Retrieved from: http://www. kaiserhealthnews. org/stories/2009/september/21/uninsured-explainer-npr. aspx Whelan, E. M, (2010). The importance of community health centers: Engines of economic activity and job creation. Center for American Progress. Whitbeck, L. (2009). Mental health and emerging adulthood among homeless young people. Psychology Press, Taylor Francis Group, New York. White House, (2010). Department of Health and Human Services. Retrieved from: http://www. whitehouse. ov/blog/2010/05/10/a-long-overdue-change-help-young-adults-get-coverage [pic] [pic] |Appendix B | | |Required Sample Size†  | | | | | | | | | | | | |   |0. 05 |0. 035 |0. 025 |0. 01 |   |0. 05 |0. 035 |0. 25 | |   | |10 |   |10 |10 |10 |10 |   |10 |10 |10 | | | |20 |   |19 |20 |20 |20 |   |19 |20 |20 | | | |30 |   |28 |29 |29 |30 |   |29 |29 |30 | | | |50 |   |44 |47 |48 |50 |   |47 |48 |49 | | | |75 |   | 63 |69 |72 |74 |   |67 |71 |73 | | | |100 |   |80 |89 |94 |99 |   |87 |93 |96 | | | |150 |   |108 |126 |137 |148 |   |122 |135 |142 | | | |200 |   |132 |160 |177 |196 |   |154 |174 |186 | | | |250 |   |152 |190 |215 |244 |   |182 |211 |229 | | | |300 |   |169 |217 |251 |291 |   |207 |246 |270 | | | |400 |   |196 |265 |318 |384 |   |250 |309 |348 | | | |500 |   |217 |306 |377 |475 |   |285 |365 |421 | | | |600 |   |234 |340 |432 |565 |   |315 |416 |490 | | | |700 |   |248 |370 |481 |653 |   |341 |462 |554 | | | |800 |   |260 |396 |526 |739 |   |363 |503 |615 | | | |900 |   |269 |419 |568 |823 |   |382 |541 |672 | | | |1,000 |   |278 |440 |606 |906 |   |399 |575 |727 | | | |1,200 |   |291 |474 |674 |1067 |   |427 |636 |827 | | | |1,500 |   |306 |515 |759 |1297 |   |460 |712 |959 | | | |2,000 |   |322 |563 |869 |1655 |   |498 |808 |1141 | | | |2,500 |   |333 |597 |952 |1984 |   |524 |879 |1288 | | | |3,500 |   |346 |64 1 |1068 |2565 |   |558 |977 |1510 | | | |5,000 |   |357 |678 |1176 |3288 |   |586 |1066 |1734 | | | |7,500 |   |365 |710 |1275 |4211 |   |610 |1147 |1960 | | | |10,000 |   |370 |727 |1332 |4899 |   |622 |1193 |2098 | | | |25,000 |   |378 |760 |1448 |6939 |   |646 |1285 |2399 | | | |50,000 |   |381 |772 |1491 |8056 |   |655 |1318 |2520 | | | |75,000 |   |382 |776 |1506 |8514 |   |658 |1330 |2563 | | | |100,000 |   |383 |778 |1513 |8762 |   |659 |1336 |2585 | | | |250,000 |   |384 |782 |1527 |9248 |   |662 |1347 |2626 | | | |500,000 |   |384 |783 |1532 |9423 |   |663 |1350 |2640 | | | | Appendix C Health Care Survey Questionnaire Circle your answer: 1. What is your age? a. 19-24 b. 25-34 c. 35-44 d. 45-54 e. 44-64 2. What would you classify your ethnicity? a. Caucasian or white b. African American or black c. Hispanic/Latino d. Asian e. Other________________ 3. What is your employment status? a. Full time employee b. Part time employee c. Self employed d. Unemployed – looking for work e. Unemployed f. Retired 4. Reason for no health care coverage/insurance? a. Employer does not offer b. Don’t work enough hours c. Became unemployed and lost coverage d. Cannot afford 5. What is your highest level of completed education? a. Did not complete High school/did not obtain GED b. High School Diploma / GED c. Technical/Trade school d. Some college e. College degree f. Graduate degree g. Doctoral degree 6. What is your housing status? a. Own home b. Rent home/apartment c. Live with family/friends d. Reside at shelter/transitional housing e. Not housed 7. What language do you speak most often at home? a. English b. Spanish c. Other__________________ 8. Are there children living in your household ages 18 and younger? a. Yes b. No 9. When was the last time you received medical care before today’s visit? a. Within last week b. Within last month c. Within last three months d. Within last six months e. Within last year f. Longer than one year 10. Where did you last receive medical treatment before today’s visit? a. Doctor office b. Hospital ER c. Public health department d. Free Clinic 11. Which best describes the reason you chose the location for your last medical treatment? a. Location b. Hours of operation c. Recommended by family/friend d. Did not know where to go 12. Did you have medical insurance the last time you received medical treatment? a. Yes b. No c. I don’t know 13. How would you rate your satisfaction level of your most recent medical treatment? a. Very satisfied b. Somewhat satisfied c. Somewhat dissatisfied d. Not satisfied 14. How would you describe your health? a. Excellent b. Good c. Fair d. Poor 15. Are you experiencing an ongoing health problem? a. Yes b. No c. I don’t know 16. Have you had a diagnosis for your health problem? a. Yes b. No c. I don’t know 17. Are you taking prescription medications? a. Yes b. No 18. If you are taking prescription medications, is a needed refill the reason for your visit today? a. Yes b. No c. Not applicable 19. How are you able to afford your medications? a. Medication assistance b. Lower cost generics c. Samples d. Self-pay full price e. I cannot afford them 20. Please discuss any other issues you are having where assistance may be needed, so referrals may be offered. 21. Please describe in detail what you hope to receive from your visit today. Appendix D [pic] Shelby County Development Services Profile Appendix E – Example of a Multiple Regression results chart [pic] [pic] How to cite What Influences Free Clinic Usage by the Uninsured, Essay examples