GENDER DIMENSIONS OF CONCEPTS


Birth Control/Eugenics
Eugenics is a social philosophy that advocates genetic improvement of human population. The idea encourages breeding and reproduction by fit people, and discourages reproduction an even advocates sterilization of people with less desired traits or negative traits or unfit people. The application of the principle of eugenics can be traced in ancient Greek societies and modern eugenics movement re-emerged in United Kingdom and spread to other parts of Europe and America. The idea has been politicized and many countries have adopted the principle to improve genetic qualities and health of their citizens.
As measures of birth control Pills were developed during 1920s, and subsequently came use of condoms. Even Margaret Sanger advocated use of pills in support of eugenics, the methods of adopting the most common techniques, namely pills and condoms are highly discriminating towards female. Any contraceptive use disturbs the normal rhythm of child bearing by females as it is crucial for a woman to be within the ideal child-bearing age in order to deliver the new born without being subjected to age-related risks. Even continuous use of pills may medically damage health and mental wellbeing of a woman. But men are not subjected to such deprivation and even spared of swallowing pills. Birth control techniques are highly gender sensitive that discriminate against women.
Biological Determinism
Biological determinism follows from the overlapping of two separate concepts; sex and gender. While sex  denotes males and females on the basis of physical features, sex organs, chromosomes, and hormones, gender denotes males and females on the basis of social factors, namely social position, behaviour, power, and identity. This segregation was made by the feminist ideologues to counter the philosophy of biological determinism that is biology is the destiny.
It has been argued by biological determinists that metabolic state determines the sociological, psychological, and behavioral traits of human beings. Propagators of biological determinism argue that in male metabolism kinetic energy is released and in female metabolism potential energy is stored. Thus women conserve energy that makes them passive, conservative, slow, and uninterested in social activities including politics. On the other hand, males break-down the protein and release heat that make them energetic, active, and interested in social matters including politics. On the basis of this difference of metabolism between males and females, biological determinists not only differentiate between men and women on the basis of behaviours but also try to justify the structure of the society that deprive women from enjoying equal political rights with men. They argue that biologically women are incapable of taking political responsibilities and it would be futile to confer them political rights, as men should enjoy, as they are pathologically did-interested in political activities.
Social Determinants of Health
Social determinants of health (SDOH) are certain social and economic conditions of individuals and their distribution among the population. Income, wealth, power, food security, intake of nutrition are the social determinants of health. It is argued that social determinants have greater influence on the risk of disease or accidental death than individual factors like behavioral risks and genetics.

Discrimination on the basis gender in social determinants is no less pronounced. Social factors such as childhood development, schooling or lack of it and degree of participation in public life on the part of women determine how far they are aware of health problems and their remedial measures. It is as clear as day-light that sub-ordination of women by men on almost all societies in the world determines respective roles of men and women in domestic and public life although the degree of such sub-ordination in between countries and regions within the same country.
It is seen from empirical studies that educational level of mothers and their degree of autonomy have positive correlation with nutrition status of the family. In Latin American, and African countries boys are seen to have greater access to nutrition than girls on the presumption that boys are the future bread-earners for the family. Studies show gender discrimination in food and healthcare allocation in many Latin American countries.
The Hegemony of Biomedicine
Biomedical health care system enjoys hegemonic position in developed as well as developing societies. Hegemony of biomedicines has affected the complementary or alternative medicine (CAM) to a great extent. Hegemony of biomedicine is the result of medicalisation that includes de-socialization of diseases and explaining social phenomenon in medical terms.
Studies show that there have been differences in treatment of men and women in different areas clinical and academic medicines.
In mainstream biomedical treatment sector, gender is intertwined with biological sex. But gender is wider in connotation than biological sex. In biomedicines life conditions, financial autonomy, positions and influence in society in the lines of masculinity and femininity are to be considered in matters of professional encounters and theorizing medical conditions of men and women. Hence lack of awareness of gender aspects on the part of medical practitioners can lead to gender discrimination in administering biomedical treatment. Differences between men and women as regards investigation and treatment are found by many studies. In treatment of ailments like coronary heart disease, HIV/AIDS, Parkinson’s disease and others investigation and treatment show negative bias for women. On the other hand, negative bias for men is reported in treatment of migraine and depression.
It is also evidenced that apart from gender discrimination in investigation and treatment in biomedicine, gender bias also exists in medical education, career as medical practitioner, and medical research.
Health and Intersectionality
Intersectionality is a feminist concept that focuses on the intersection of different oppressed groups of people. The identities of human beings determined by history and other social relations give rise to their oppression. Some feminist scholars define intersectionality as a process by which social status, race, and gender of people lead to their inferior social status.
Gender identities of human beings are highly responsible in determining vulnerability to health diseases. It is well documented that men are less likely to seek medical advice as compared to women. The reason behind such behaviour is the hegemony of masculinity and the notion that men are stronger than women. Expressing physical or emotional weakness is dichotomous to the concept of masculinity. A study by London School of Economics shows that masculinity cannot fully justify such behavior of men but culture and race also play role in shaping this behaviour.
Gender bias can also be noticed in the services provided by the health service. Research undertaken by World Health Organization shows that doctors are more inclined to treat depression in women than in men. But this cannot be preceded by assumption that men are more prone to depression as compared to women. Women are more prone to depression and men are more likely to encounter substance-abuse problems. World Health Organization opines that women’s vulnerability to social and economic shock places women at risk of depression.
Social Model of Disability
The social model of disability says that disability is created by the structure of society rather than personal impairment. It explores ways of removing barriers for the disabled so that they can live lives equally as able persons. Feminist thinkers have pointed out that social model of disability is open to gender bias. They argue that disabled men and disabled women often enjoy different social status. Many socially disabled feminist writers have long discarded the notion that socially disabled women are doubly oppressed than disabled men because patriarchy operates in conjunction.
Disabled people are identified with people without gender. Thus gender has little to do with social disability. But in reality the image of social disability cab be intensified with gender identities like disabled women have a sense of passivity and helplessness where as disabled men can create corrupted masculinity. The images of helplessness and corrupted masculinity have real implications in education, employment, personal relationships, etc. The gender bias of social disability shows sustained patterns of differences between men and women. It is found that more women than men fall in the category of disabled persons. It is so because large proportions of elderly people are elderly women with disabilities. While disabled persons are poor but it is documented that disabled women are poorer than disabled men.
Privatization of Health Care
Rapid privatization of healthcare has resulted in hospitals focusing on the urban educated women with financial means. Overall healthcare services for women remain inferior as compared to that for men. In addition to that corporate healthcare services are more and more privatized in which only urban women are targeted and rural women with severe health issues are neglected by the privatized healthcare sector. Privatization of healthcare services has transformed public institutions to commodity-base institutions. Works have been taken away from professional staff to low-paid casual staff.
Privatization of healthcare services has given rise to new kind of gender discrimination. Women constitute high percentages of paid and unpaid staff and are also most frequent recipients of healthcare services. Most of the nursing, dietary, and housekeeping staff are women who have lost jobs due to restructuring of healthcare business. As the healthcare services moves from public to private domain, it ceases to remain an insured service.
Privatization is the major part of reform of healthcare services and governments are saving money at the cost of women both as patients as well as service providers. Privatization of healthcare has resulted in fall in access to healthcare for rural women, and reduced income and job opportunities for women in the healthcare sector
ADHD within the USA



1. Prevalence of stimulant use for ADHD within the US
The Attention Deficit Hyperactivity Disorder is treated with the stimulant drugs in conventional medicine not only in the US but also in other countries. However, the lack of popularity of alternative treatments is one reason which can be deemed as a cause of prevalence of stimulant use in States.  As compared to other countries the success rate of the drugs in the US in both long term and short term dosage is high and this rate is 70% in adults and 80% in children and teens (Young & Myanthi Amarasinghe, 2010). The alternative treatment is taken only as an option in the treatment of ADHD when some other illness of physical condition prevents the use of the stimulant drugs. The glaucoma, anxiety and other symptoms can get worse with stimulant use and result in tics or involuntary muscle spasms. Moreover, other side effects like the high blood pressure or headache is often removed after a short time after starting the stimulant therapy so the stimulant use prevalence in US can be justified as it is the most reliable way to control ADHD.

2. Evidence based alternative therapy

According to the American Academy of Paediatrics the use of behavioural therapy to supplement the stimulant therapy has proven to be reliable method of training to cure specific habits created by the ailments. This training worked best with the children and the teens whose brain development is not yet complete. The behavioural modification and parental training for the children have been useful in providing better outcome for the patients. Setting up goals and rules for the children to cut down on erratic behaviour has been proven successful in many studies. The evidence of the success of the behavioural therapy lies in behaviour modification in children and cognitive behavioural therapy in the adults (Safren et al., 2010). The use of the behavioural therapy to supplement the stimulants use and complement them has been popular for some time and the Nonpharmacological nature of the therapy and lack of side effects make it the perfect tool to aid the treatment of ADHD.
Goniometers


Movement is a contributory factor in the procurement of physical therapy to an individual through the assessment of movement of a person from one angle to another; it is possible to top know whatever angles they are going to cover and how to deal with problems that they are facing. Therefore, the movement of a patient is critical to their well-being. In the case of an injury or an accident, individual requires experts who have the proper knowledge in carrying out relevant activities to ensure that they are in the best state of health. Through, the use of related tools, experts get to know whatever contingencies they can put up to help with the definition of a healthy individual (Armstrong et al. 1998). Thus, the use of the Goniometer tool for the assessment of patients in different ways.
A goniometer while used in the medical realm refers to an instrument which helps in the calculation of angles to be rotated at precise positions. Through the toolkit, the medical practitioners get to know of different perspectives that an individual can move. The word has its origin from two Greek words which were fashioned to bring it to being. The Greek words Gonia meaning Angle and Metron meaning measure are brought together to provide a name for the tool which was first described by Gemma Frisius in the year 1538. There are different applications of the tool in the society and it can impact differently on how an individual patient is handled.  It is applied in numerous sectors in the society, but regarding the study; the most relevant application is in the medical field.
 In the medical field, the tool is used for the recording of initial and subsequent movements for different motions. The tool in most cases is used in the offices and stations of disability experts and evaluators. The tool is important in determining the extent of invalidity to an individual. Nonetheless, the tool is also used in the medico-legal areas. The ability to document issues that are presented as well as well as the creation of a look into some of the signs that might lead to a certain condition.
 Physiotherapy employs the use of the tool in determining the progress of their patients and how they should handle the psychical activities related to the patients. The measurement of the joint angles in the body of the patient makes the specialist know whatever activity they should undertake and any interventions that might be helpful to the individual in the course of their business. The measurement of the initial movement made by the patient and subsequent movements reveals the path to recovery for a person as well as an excellent rehabilitation procedure to show that their efforts are bearing fruits. The tool helps the therapists in conducting an analysis of the different joints in the bodies of individual patients, then accessing their various possibilities to revive. Through the use of the tool, a therapist knows whatever intervention will help in creating a real patient progress. A therapist must have comprehensive knowledge of the human anatomy before using the tool. With the tool, one must have a perfect place to measure and put the device on (Armstrong et al. 1998). These target sections of the body will help the therapist to determine whatever motion areas are and what improvements can be made to them.
The use of the tool has different hitches that are recognized by individual testers. Certain errors come with the repetitive measurements. Therefore a provision of between 5 to 10 degrees of error in the tests. Nonetheless, the reliability and accuracy of the tools are intra-tester related. The individual who is handling the tool should have a good system that helps in the creation of a manner of reading. For those persons who have less experience, there are higher chances that they will conduct errors with the tool. For those with a relatively extensive experience, there are lower chances that they will make mistakes using the tools. Thus, there are certain considerations which should be achieved in the reading of statistical data from the machines.
 The goniometers are made in different ways. Different models address the needs of different segment markets. The reliability of the tool, as per certain experts lies in their forms. The universal goniometer, on the other hand, is either plastic or a metal tool with 1-degree enhancements. The arms of the tools can go up to 12 inches to enable them to have a correct imprint on the landmarks for measurement. In the modern times, on the other hand, certain additions have been made to the tradition goniometers. The traditional tools have been enhanced by the creation of a technological platform help with the efficiency of the tools. The inventions of smartphones have enabled the creation of applications that perform like the goniometer. Some of these applications include the Goniometer pro and the knee Goniometer. These applications utilize the in-built accelerometers in mobile phones to help estimate the angles of the measured joints. These tools have ben of huge aid and improvement to the traditional goniometer as they function in a similar accuracy and model to the universal goniometer.
Reliability: In most cases, reliability refers to the ability of the tool producing consistent results over a period. The reliability of the tool is crucial on carrying out activities that will be of great benefit to the development of good results for the therapy. Thus, it is instrumental to consider the reliability of the goniometer.
In a study conducted by Jones et al. (2014), the reliability of the machine against the reliability of the goniometer app was tested in different ways. The reliability of the machines was tested in a sample population of 36 volunteers who came up to help with the testing of the reliability of the instrumental that makes it easier to identify and create better ways to helps the patients in motion, The mean age of participants who were involved in the study was 60.6 years. The participants performed different movements in the assessments and made it easier for them to know whatever activity they would do next (Brosseau et al. 2001). These activities were programmed to help with the establishments of the reliability of the results from the two kinds of goniometers. The universal goniometer was utilized for this model also to help with the establishment of its results. The two different kinds of goniometers had no much difference in the results that they pushed across. However, the goniometer application in the phone was greatly reliable in comparison to the universal goniometer (Jones et al. 2014). There were Pearson correlations of 0.96-0.98, while there were also intra-class correlations of 0.97-0.99.  This showed that there was a high confidence rate in the results of the devices. The standard errors from the processes were low. Thus it could be simpler to use the apparatus in determining different issues within the society. Through the goniometer, it is established that the two apparatus had a greatly positive nature, which depended heavily on the individuals who were performing the procedure (Jonsson & Johnson, 2001). Through the skill that a doctor possessed, the reliability and accuracy of the instrumentals changed considerably.
In a different study which was conducted by Milanese et al. (2014), the intra and intertester reliability of the Universal Goniometer and the Goniometer application was assessed in between students and trained individuals (Milanese et al. 2014). The assessment was conducted by the evaluation of the measurements of the two groups to determine the individual differences in the measurements. In both instances, the results were greatly reliable but there as a difference in the results which were provided from one group to another. These results showed that the handling of the devices is instrumental in the foundation of better results for the patients and a greater accuracy in the management of the issues presented.
The reliability of different kinds of goniometers used do not pass the 5 degrees mark. Therefore, most of the tools are having a high confidence level in whatever they carry out. This is regardless of whatever tool as applied to the function. The use of different individuals, on the other hand, brought about different marks in the machines. These differences were instructional in the development of even greater reliability tests. The goniometer tests highly when it comes to reliability, and at the same time, it has a great consistency from one measurement to another when used by a person.
Validity:  Validity of an instrument shows the degree to which it measures whatever it was meant to do. This indicates that the tool conducts a measurement of whatever it was required to do to help with the development of even better results.
There are different instruments which are used in physiotherapy to ensure that the joints of a patient are measured. The use of different goniometers affect the results of the same. Therefore, the validity and accuracy of whatever is intended to be measured are highly dependent on the individual practices that are adopted (Jones et al. 2014). The use of the universal goniometer reveals that there are minimal errors in the measurement of different body parts. These results bring out the underlying zero errors, and with well-trained practitioners, the errors are at some levels reduced to significant portions. Therefore, it is notable that the zero mistakes that are accrued are due to differences that are arrived at in the creation of a better way to approach the issues that are pertinent to the measurements.

 In examining the validity of the Universal goniometers, other tools are used to show some extent of accuracy in the measurements. The use of the radiographs to demonstrate the accuracy of the tools is an instructional way to determine the different issues dealing with the validity of the data. The PG revealed an excellent validity of information. This was tested in the knee joints where different movements were measured. The Universal Goniometer (UG), on the other hand, showed a high vilify of results in the extension positions of the joint (Brosseau et al. 2001). This shows that the different tools have different areas where they are highly valid compared to others. The validity of the instruments is exhibited in how they carry out their duties and the deliverance of even better ways to determine the values of the positions. Through these tools, clinicians will have the capability of determining the rightful angels to which a motion should be conducted and in carrying out follow-up activities for those in therapy. 
All American Boys


All American Boys
The current paper is concerned with the racism portrayed in All American Boys by Jason Reynolds and Brendan Kiely. This story is clearly depicting the condition of Black boys in America. Rashad was a sixteen-year-old pupil who was mistakenly accused of stealing. His classmate Quinn had witnessed the entire matter of brutal beating. He was beaten by Police Officer, who is accidently brother of Rashad’s best friend. Entire story is seen from the perspective of Rashad and Quinn (Dennis). For this research paper, quote from Martin Luther King Jr. has been chosen. Martin Luther has depicted that “If we are to have peace on earth… our loyalties must transcend our race, our tribe, our class, and our nation; and this means we must develop a world perspective” with the help of this quote, it has been understood that everyone in the world should maintain peace. Rashad stated that police officials told his friends the he had been caught due to stealing; police officer also added that Rashad did not want to surrender and caused several public annoyances. He was beaten by police officers and his entire body was covered with vermin. “Police Officer explained to my Folks that I had been caught stealing. Not only that, but I had also been charged with resisting arrest and Public nuisance (p.44)”. Rashad stated that he was not only tortured but also mentally punished for such crime, which was not done by Rashad. Rashad was harassed physically as well as mentally. When the authors state “Truth is I was feeling two ways. Physically, I Obviously didn’t feel great, that’s for sure, clearly shows Rashad’s experience in police station (p.45).
In addition to this Rashad was in hospital due to several bruises on his face. He was sent to hospital, because he was severely beaten by police officers. In the middle of every collision, the only thing that could charm him is the Voice of Clarissa to which he was fascinated. He liked to have company of Clarissa and waited for Clarissa. He feels soothing while communicating with Clarissa. Everything moved him. He loved the way she spoke to him, treated him, and respected him. His emotions are depicted as “Knock, Knock. The door opened and there was Clarissa pushing my lunch cart in” (p. 86) which also shows his hidden respect and affection for Clarissa. Rashad did not like to expose his emotion in front of his parents. Therefore, he behaved stiffly in front of his parents and engaged himself in his daily work. Even, he did not like Pastor to come in. Rashad had demonstrated the word “exactly” because media is imprinting wrong information in the mind of the viewers. “Rashad?” my mother called through the crack in the door”.
From inside, Rashad wanted to narrate everything in front of everyone but he was incapable in doing so. News and media are portraying everything wrongly; even, they are using several racist term against him. He tried to explain the exact matter of that day. “I knew exactly what I was drawing. The only thing I could. I was going to re-create the scene, what had happened to me, what was playing constantly on the news, on the page”. As Rashad was seeing this news while he was in hospital, Clarissa was present at that time and being the modest woman, she did not want to hurt emotions of Rashad. Therefore, she stated that the news was complete out of track. It did not show any valuable detail. Clarissa was trying to motivate him and distracting him from the news.
                      “Clarissa glanced as the TV again. Then back to me.” When Rashad was returning from school; Rashad was a genuine schoolboy and he had no anxiety for anyone particularly. He loved to stay mutually everyone around him. He had left with no respect for Paul still when Paul waved him he waved him back. Rashad thought that may be Paul was repenting and thinking that he had done wrong with Rashad. “He waved me and I waved him back”. Paul was repenting and telling Rashad that media is spreading wrong news against him. Anybody should not try believe this. “Paul sniffed again. His eyes were bloodshot.” His mother is in search of a good lawyer so that his son is able to get justice. “My mother did eventually show up with the lawyer she found Wednesday evening”…..“This is the Lady who was in the store. She was here today”. The storekeeper had come to meet him and she would be there to verify everything.
From the above analysis of the essay, it has been understood that white people torture black people for no specific reasons or causes. Quotation of Martin Luther has been chosen to understand the impact of racism in the mentality of Black people. Loyalty should be transcended through race, class, nation and tribe. People all over the world should be treated with utmost dignity and respect. This book is about the racism and how black people are treated. With the help of this book, harassment faced by racist people can be understood well. Martin has preached that people should live with peace and they should have respect for every people despite of their complexion and gender.



      Works Cited

Jason Reynolds and Brendan Kiely. All American Boys. New York: Simon and Schuster. 2015. Print.
BUIDING AN ETHICAL CORPORATE CULTURE
An ethical corporate culture has always consisted with the leaders as well as employees that has adhered respective code of different ethics determined in the respective entity. The corporate ethics can also be considered about the response to the internal as well as external motivation.  According to Ferrell and Fraedrich (2015) the business activities and all the policies have considered determination regarding the controversial issues likewise, corporate governance as well as trading made through inside approach. Moreover, determination of bribery, discrimination and corporate social responsibilities has been endeavoured by the aspects of ethical corporate culture of the organization.  It has been stated that every organization has always possessed some of the primary values as well as different rules of ethics among the employees have the feasibilities to follow it. It has been revealed from the different aspects of code concerning the ethics will be valueless considering the aspects of the top officials of the management which have failed to delineate the models of ethical behaviours. Each and every organization has to offer proper training regarding the ethics so as to ensure effective organizational behaviour in the entity. This has been perceived from the aspects of setting up seminars with the help of effective workshops and also ethical training programs.

Creation of Ethical Corporate Culture

It is quite evident that the having a corporate culture has always emphasized the ethical behaviour which could easily short down accumulating the misbehaviour possessed by the organizations operating their business in today’s economic environment. Different research has showcased the aspects entailing about the fact that even though an organization has developed its culture which prolifically emphasized the aspects of pertaining actions that are right assumes costly methods has always comes down to the respective leaders that have started with the high-level officials of the firm which is considered with all the ethical consequences for the actions that they have propounded. In accordance to Jondle et. al (2014) it can be perceived that there are some of the invincible procedures which the management of any organization must follow so as to pertain much more corporate cultures ethically. 
It can be said that there are instances of being a role model and should be visible enough. Employees has the affability to look towards behaviour possessed by the top-level management officials as a model which is acceptable behaviour in the respective workplace where effective diligence have been pertained. It is quite important for all the employees to adhere an optimistic message that will lead the subordinates to possess the corporate culture in a right direction to ensure proper working efficiency in the organization.
Besides, the ethical ambiguities can be decreased through creating as well as disseminating all the corporate codes of ethics. This will be justified through communicating the ethical expectations among the employees.  It can be stated that the overall corporate values as well as the ethical rues has always been followed by the employees to deliver the importance in gathering different perception of the organization.
In addition to this it will be considered to be insignificant if all the management officials that are headed with top positions will fail to strengthen the ethical behavioural models. Apart from this, offering the ethical training through understanding the corporate culture is quite necessary to reinforce the standard of conduct in the organization. This will be perceived through the aspects of setting up seminars, different effective workshops, and different programs of ethical training. The clarifications regarding the practices are often not permissible and thus probable ethical dilemmas have to be perceived to generate significance. On the other hand, performance appraisals regarding the managers has also included the evaluation considering how the decisions can be measured reflecting hindering possibilities concerning the code of ethics of the organization. The appraisal should have included the means delivering the aspects for achieving all the goals. This has meant the significance of visibly reward towards the ethical acts as well as punishing the unethical individuals.
                 Schwartz (2013) proposes that some of the protective mechanisms have been introduced to pertain the needs for determining formal mechanism through which the employees can always reveal the problems faced due to ethical dilemmas. The employees should have to report regarding the unethical behaviour possessed without justifying the fear concerning reprimand. This has always included the aspects of creation made by the ethical counsellors and officers in a corporation.

Strengthening the conduct ascertained in the organization culture

This is an exceptionally basic truth from essential operand moulding that any school rookies would find out about in their early on brain science course. Additionally, it is a truth that has been known for eras. On the off chance that you need conduct to proceed with, then strengthen it. On the off chance that you need conduct to suspend, don't fortify it. This is a truly basic truth yet it is frequently difficult to do and difficult to recall for some associations and people alike. Also, it is positively simpler said than done. Associations must be careful and deliberate about what practices they need to strengthen and what practices they don't need fortified. Moral conduct must be unmistakably fortified with the goal that it will keep on occurring (Guiso, Sapienza, & Zingales, 2015). Dangerous exploitative conduct has not to be fortified if the association wishes to stifle these undesirable practices. Offering open doors for acknowledgment, honours, and social fortifications for alluring moral practices can go far to advance the sorts of moral culture wanted in any association. Positively, these prizes or fortifications must be keenly considered and conveyed with cautious thoughtfulness regarding both proposed and unintended outcomes of utilizing them.

Building the aptitudes concerning the critical thinking procedure

Associations can do an extraordinary arrangement to centre their consideration around creating moral abilities and critical thinking systems. Instead of just expressing what sorts of practices are normal or not, foundations must help with the well-ordered methodologies for creating viable moral basic leadership and conduct aptitudes and systems for settling moral predicaments or inconveniences. Workshops, simple to utilize reference materials, progressing and promptly accessible counsel from associates or coaches are quite recently a portion of the numerous ways foundations can help with preparing understudies and staff to best utilize the apparatuses that are accessible to them to take an interest in better and more attentive moral basic leadership (Wang & Rafiq, 2014).
Furthermore Schneider, Ehrhart, & Macey (2013) argue that if an association needs to make a culture of morals they should make certain that individuals have the apparatuses that they have to do as such. These incorporate satisfactory and proper preparing, meeting, displaying, and supervision. These apparatuses likewise incorporate having the capacity to convey inner and outside to the association specialists into connect with staff at all levels of preparing and critical thinking also.

However, Ruiz-Palomino et. al (2013) proposed that the organization has also cumulated their staff that can give a point of convergence to getting apparatuses and assets to better help with moral discussion. Another essential and imperative standard obtained from early on brain research is the idea of prompt restorative input. Unless associations offer opportune and keen remedial criticism with respect to conduct they will improbable make a culture of morals. Support for conduct that is wanted and remedial input for conduct that is not coveted is basic to help make and manage a culture of moral conduct and thought. This restorative criticism should be led in the soul of coordinated effort and instruction as opposed to as far as discipline or rebuke. Coordinated effort and training consider more openness and less retentiveness when criticism is given. Prompt input is basic to expand through the downplaying of the issue conduct also.

Conclusion

In conclusion, authoritative pioneers must try to do as they say others should do and make certain that they demonstrate for others the wanted practices that they wish to support inside their associations. The possibilities have changed in accordance to the most elevated principles of morals are wanted inside an association then high profiles pioneers in that association much exhibit these guidelines and be blameless in such manner. Their activities frequently will talk louder than their words with regards to making a more moral environment inside their associations.





Cost of Schizophrenia


In the Schizophrenia disease patients suffer from brain disorder. In this disease, the patients also suffer from delusions, hallucinations, disorder for thought and movement (Hamann, et al, 2007). According to the survey report of National Hospital Ambulatory Medical Care, in the time duration of 2009 to 2011 about 382,000 patients of the emergency department of the hospitals are suffering from the disease of Schizophrenia (Hamann, et al, 2007). The survey report also states that men are greatly affected by the disease as compared to the women. The researchers also include the mental homes, nursing homes, psychiatric hospitals for conducting their survey work (Hamann, et al, 2007). For getting effective idea about the disease Schizophrenia, and for analysis of the cost of the treatment of the disease, the researchers conducted a study. This disease is classified as the serious health problems. The study is based on the CEE or Central Eastern Europe.

Background

A serious health issue among the people is Schizophrenia. This study will be helpful for the researchers to get suitable idea about the total costs of the research work (Olivares, et al, 2009). The researchers conducted their research work in Central and Eastern Europe or CEE.

Methods

To make research in effective manner, the researchers analysed medical histories of the patients; they also analysed the major costs associated with the treatment of the disease (Olivares, et al, 2009). The researchers considered the medical reports of the data of the 961 patients of the disease for getting idea about the research process. Among the 961 patients, around 45.1% patients are female. The mean age of the patients are around 40.7 years. They also made a set of questions for taking necessary information from the respondents. The researchers also asked questions to their respondents about the history of their disease, treatment processes, and costs of the treatment process.

Findings

It has been observed that Schizophrenia also has an impact on the financial levels as well as health aspects of the people. Data were collected from 961 respondents of the research work. As the respondents of the study belonged to the countries of the CEE, so the results of the research helped the researchers to compare the costs of the treatment of the disease among various countries. Small variations in the mean ages of the patients were seen in the chosen countries.  The highest mean value of the age of the patients were found in Poland which is 42.1 years, the lowest mean value of the ages of the patients in Croatia which is 39.2 years (Olivares, et al, 2009).
It was observed that the largest number of female patients of the country Estonia is suffering from Schizophrenia. The respondent patients of the research work spent around 25.3 days in the hospitals for the treatment process. The research work also stated that the government spent a portion of their GDP or gross domestic products for the treatment processes for the disease. The researchers also included private medical centres besides the governmental health care centres for conducting their research work.  Besides the inpatient services in the hospitals, the patients also require outpatient hospitality services for the treatment of the disease (Fenton and Schooler, 2000).
In addition to this identifying the various costs of the treatment process of Schizophrenia, the researchers also analysed  the total cost of the treatment of  Schizophrenia.  From the analysis of the researchers, the total cost of treatment is the combination of the costs for inpatient costs as well as outpatient costs (Fenton and Schooler, 2000.).

The researchers asked various types of questions to their respondents like total days spent in the hospital for the treatment of the disease, and the number of hospitalization. Besides the patients, the other members of the families of the patients are also suffering from various issues due to the Schizophrenia. Effective treatment procedures should be taken for the proper treatment of the disease (Fenton and Schooler, 2000). The Schizophrenia disease also leads to influence the social aspects of the patients. 

Schizophrenia is considered as one of the serious health issues and as per the WHO (World Health Organisation), the disease is ranked among the serious health problems. The total cost of the treatment of the disease Schizophrenia can be sub divided in to two major types like direct costs and indirect costs (Cuffel, et al, 2016). Besides the direct expenses for the treatment process of the disease, the indirect costs of the health problem also contributes a large portion in the total costs of the treatment of the disease (Green, 2006).

In addition as per the researchers, around 4% relatives of the patients who are suffering from Schizophrenia disease had to stop their own work for providing necessary support to the patients. The disease is also considered as one of the top ten diseases that cause disability of the patients. The total cost of the treatment of the disease varies from country to country (Green, 2006).
The researchers also give a statistical analysis in the context of major diseases that caused disability among the people (Green, 2006). From the analysis of the below table, the top ten major diseases can be easily understood. These diseases rank in the top that caused disability for the patients. 
 
Ranking
Cause
In Millions ( in the percentage value)
1
Unipolar major depression
50.8 (10.7)
2
Iron-deficiency
22.0 (4.7)
3

Falls
22.0 (4.7)
4
Alcoholism
15.8 (3.3)
5
Chronic obstructive pulmonary disease
14.7 (3.1)
6
Bipolar disorder
14.1 (3.0)
7
Congenital abnormalities
13.5 (2.9)
8
Osteoarthritis
13.3 (2.8)
9
Schizophrenia
12.1 (2.6)
10
Obsessive–compulsive disorders
10.2 (2.2)


From the above table, it can be easily understood that schizophrenia is among the top ten diseases that caused disability of the patients. As per the statistical value Schizophrenia ranks nine among the serious health problems. 
As per the statistical data of the developed countries, nearly about only 1% of the total GDP or gross domestic product of the countries are spending for the treatment of the health issues of mental illnesses (Robinson, et al, 2016). As per the health policies of the countries, the government spends a definite sum of their total national income for treatment process of the health problems. As Schizophrenia is considered as one of the major health problems, so the patients also get subsidies for the treatment of the disease in the public hospitals of their counties (Robinson, et al, 2016).
Furthermore, the total cost of the expenses in the treatment of the health issues are of two categories like indirect costs as well as direct costs. In the year 1958, the concept of indirect costs as well as direct costs in the field of treatment processes in health care setting was first introduced by Rashi Fein. According to him, besides the direct expenses, the indirect costs of the health issues are also contributing to the total costs of the illnesses. As per his theory, the direct costs of the treatment of the health issues are the total expenditure for the treatment process and other necessary expenditures related to the treatment of the disease. He also describes the economic loss due to the disease of the patients.

Total cost in Canada and USA

In USA, the GNP or gross national product of the country is near about $ 4,015 billion for the year 1985. The country spends 10 % of their total national income for the treatment processes of the various health issues. Also, around 10% of the total budget of the health costs is being spent for the treatment process of the mental disease. Therefore, for the year 1985, the national spending of the USA for the treatment process of the health issues is near about $ 419 billon. According to the researchers, the estimated costs for the purpose of treatment of the Schizophrenia disease are near about $ 47.5 billion.
Item
Total costs (in $)
Federal costs (in $)
Costs in State and local level (in $)
Cost in Private hospitals (in $)
Treatment and support
42,528
$11,064
$12,115
$19,349
Mental health institutions and Federal providers
12,831
3,097
7,964
1,770
Federal providers
1,433
1,433
----
---
State and local psychiatric hospitals
5,355
777
4,337
241
Private psychiatric hospitals
1,786
270
179
1,337
Other mental health institutions
4,257
617
3,448
192
Other treatment costs
26,458
6,940
3,902
15,616
Short-stay hospitals
8,805
3,575
1,431
3,799
Office-based MDs
2,151
151
54
1,946
Other professionals
3,466
243
86
3,137
Nursing homes
10,583
2,900
2,254
5,429
Drugs
1,453
71
77
1,305
Support costs
3,239
1,027
249
1,963
Lost production
56,660
-
-
-
Morbidity
47,395
-
-
-
Mortality
9,265
-
-
-
Crime, accidents, fire, and social welfare administration
2,003
-
-
-
Time cost of family caregivers
2,500
-

-
Total expenditure
103, 691
-
-
-

The above figure describes the total costs for the various health problems in the USA in the year 1985. By the analysis of the above table, it can be said that the costs of Schizophrenia also contribute a large portion in the total costs of health issues treatment process in the country. Only the direct expenses are considered in this process of making the table of expenses for the treatment of various health issues in USA. Besides Rashi Fein, Rice and his colleagues in the year 1990 also defined the total costs of mental health issues as the combination of the two major types of costs namely direct expenditures as well as indirect expenditures.  
In the direct costs of the treatment of the mental health disease for Schizophrenia is the associated cost for the treatment of the disease. The amount spent for the purpose of drugs, hospital bills, care facilities, professional’s fees and for rehabilitation processes come under the direct expenses of the treatment of the mental health problems. Therefore, the direct costs of the treatment of Schizophrenia are the combined expenditure for medical treatment of the patients. In addition, the indirect costs of mental health issues are the loss in the productivity due to the mental health problems. The productivity loss or reductions in the outputs are also considered as the indirect costs of illnesses. Premature deaths due to the disease Schizophrenia is also considered as the indirect costs of disease.
Besides USA, the government of Canada is also spending a portion of its gross national income for the treatment of Schizophrenia.

Hospital inpatient costs

Hospital inpatient cost is also contributing to a major part in the cost relapse of the disease Schizophrenia. From the inpatient units of the hospitals of the United States, the patients of Schizophrenia were discharged with the short time frame of 90 days. The inpatients costs of index hospitalizations were around $ 2.3 billion in the year 1986. After the post phase of discharge of the patients from the hospital within 2 years, the cost of readmission was $ 2 billion. In the context of treatment process of Schizophrenia, the major way of saving of inpatient costs is the use of suitable strategies for treatment of the disease in effective manner (Mauskopf, et al, 2011).
Cost


Cost for the Six months in the pre-depot initiation
Cost for Six months in the post-depot initiation
Total cost
$11,111.30
$7883.80
Total inpatient cost
$6696.40
$3593.20
Psychiatric inpatient cost
$5384.20
$2537.70
Schizophrenia inpatient cost
$4143.30
$2377.30
Total outpatient cost
$2862.16
$2557.77
Total medication cost
$1552.82
$1732.78

In the above table, the various associated costs for the treatment processes of the Schizophrenia disease is describe in effective manner. The costs of the treatment processes are described above are for the phases of six months in the pre-depot stage as well as in the six months phase of the post depot initiation phase (Chisholm, et al, 2008). From the above analysis, it can be said that inpatient costs contribute to a large portion in the total costs of the treatment of the disease. In the context of treatment of the diseases, the patients get necessary care from the hospitals. The costs required for the inpatient services is classified as hospital inpatient costs. For the treatment of the disease Schizophrenia, the patients also have to spend effective amount as the hospital inpatient costs as the fees for their treatment (Chisholm, et al, 2008).

Hospital outpatient costs

Besides the effective treatment processes in the hospitals the patients also needs effective care in their homes. The effective cares in the homes are classifying as the hospital outpatient services. The required cost for the outpatient services is termed as hospital outpatient costs. In along with the hospital inpatient costs, the hospital outpatient costs are also contributing a significant portion in the total costs of the treatment of the disease Schizophrenia.

Cost relapse in Schizophrenia

The relapse rate of Schizophrenia is about 3.5% on monthly basis if the patients are maintaining narcoleptics. On the other hand, this rate is 11% per month in the cases where the patients discontinue their medication process. The rate of post discharge non-compliance in the community setting is 7.6%. About 257,446 multipleepisode patients who are suffering from Schizophrenia are discharging with in short period of time of 90 days in the year 1986 from a inpatient unit of USA. The cost of index hospitalization is estimated to $2.3 billon. In the initial phase of post discharge, the economic burden is too high. For managing the noncompliance of medication, effective strategies should be taken for providing suitable treatments for pharmacological issues (Cullberg, et  al, 2006). 
The disease not only leads to create difficulties for the patients who are suffering from it but also leads to create various issues for the family members of the patients. In addition, the treatment processes of the disease also require lots of money. In the context of Schizophrenia treatment, the total costs of the treatment are divided in two major parts named as direct expenditure as well as indirect expenditure (Gilmer, et al, 2004). Direct costs indicate the costs related to the costs of professional service, medication, as well as institutional care. On the other hand, the indirect costs imply the low productivity as well as loss for the premature deaths. As per the researchers the annual costs of treatment of Schizophrenia is near about $19 billon.
Type of Inpatient facilities
index cases percentages
Mean of the length of stay ( in days)
Average hospital charge per patient (in $)
Total expenditure (in $ millions)
General
42.9
15.0
7,086
782.5
State
28.8
35.0
11,678
864.6
Veterans
14.1
24.4
8,785
318.3
MMHOs (CMHCs)1
7.7
18.9
6,347
125.3
Private
6.5
19.5
12,366
207.4
All facilities
100.0
22.6
9,252
2,298.1

The above table describes the various aspects in the hospitalization process in the year 1993 including length of stay, index sample, types of various inpatient facilities etc. In the USA, the total costs of inpatient treatment for the patients of Schizophrenia is near about $ 2.3 billion per year for the inpatient services (Gilmer, et al, 2004). Studies also states that the costs in the phase rehospitalisation is near about $ 2 billion. About 63% of the total expenses of the treatment process are due to the loss of medication. The loss of relative contribution is higher in the first year of discharge comparing to the post second year of discharge (Kilian, et al, 2002).

Particulars
Year 1                      

Year 2         
Combined
costs  due to Loss of efficacy
$ 799.7
$399.9
$1,199.6
costs of Noncompliance
$ 370.0
$ 335.1
$ 705.1
Total cost
$ 1,169.7
$ 735.0
$ 1,904.7

Above table illustrates the various costs associated in the treatment processes of the disease Schizophrenia after the post phases of discharge from the hospitals. The total costs of the treatment are the combination of the costs related to the non-compliance as well as loss of efficiency (Kilian, et al, 2002).  The data are taken from a hospital of USA and the data shows the financial report of the year 1993.  The major ways for reducing the related costs of the treatment procedures are implementation of the effective strategies for the process of managing the narcoleptic noncompliance. In addition, development of the effective processes of the pharmacologic treatment procedures also helps to the process of reduction of the total costs of repulse as well as hospital expenditures (Kilian, et al, 2002).

Conclusion

The current paper is based on the costs of Schizophrenia. In this disease, the patients are suffering from various mental problems. Proper medical treatment procedures help the patients to improve their health conditions. For conducting their research work, the researchers take 961 respondents who are suffering from the disease Schizophrenia.  The researchers take various information from their respondents about their health problems. The researchers also consider the social aspects of the patients. As per the researchers, the total costs of the treatment of the disease are the combination of the hospital inpatient costs and hospital outpatient costs. To make the results of the research work more effective, different journal articles were used.  Qualitative data collection method was also used for taking necessary information from the respondents. They asked open-ended questions to their respondents for getting effective outcomes from their study. This study helped the researchers to get effective idea about the total costs of the treatment processes of the disease Schizophrenia.



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