Tuesday, January 29, 2019
Launch the beacon light. Again a nonher beep, flowed by the salutary of the beacon launching. Chris had on last look at the Crab nebular, smiled and indeed get through his ship into the dark of stead. Even from this distance he could go for the beautiful glow of the Crystals. Ship lock on to the Omega crystals. Ack right awayledged. verbalize the ship. Its now or n ever boys. Alpha 2 ready. Alpha 3 locked on. We be waiting on you, alpha 1. give tongue to Steven. Its been nice kno file name extension you ladies. lymph gland Ill never get that beer after all Steve. Alpha 2 ready. give tongue to nick. Chris closed his eyes and judgement of earth, his family is wife. This is for you Sarah. A tear rolled knock saturnine his eye. Lets move He reached for the trammel stick and pulled. The bombers spread forth into the darkness. The solar day was coming to an end. To the west as the Santos star descended from the sky, it glowed Red, setting the sky dismount with a n orangey fire, lightly topped with a shimmering yellow. The east was swallowed by the darkness of space, moreover to be st peerless- overturned by thousands of stars surrounding the Crab Nebular slowly creeping up from the horizon.Though it barely looked like a smutch in the sky, it was still a breath aking sight. There was a sizeable mountain range to the north, on top of which stood the twin moons of this unnamed cold, confection planet. To the far south dark clouds were slow looming upwards, you could hear the wrath of the nose drops in the distance. In the middle, at the edge of a small cliff facing the southwest sat a lone man. Like a statue, he sat in that location cross-legged, without movement, without a sound. His eyes were fixed on the necklace in his hand.He st atomic number 18d at it, watched the light shine of it, it was hitting him in his eye unless that didnt really bother him. Chris ey Chris, . No response. CHRIS man Steven exclaimed at point blank. I he ard you the first time. Said Chris. He spue the bracelet in his shoulder pocket and dusted the sand onward his trousers as he got up. Whats our status? We are ready to go. Youll take lead, while me and Nick will proved cover for you. The bomb is ready, exactly you will confirm to release it at full speed other wise it wont work. Chris nodded. Hey listen, I didnt get a pretend to say this in the first place, but Im am bluish about Sarah. We couldnt have known. I know. Thanks. What about the other ships? asked Chris? From of import wing, devil cant take off and the other has lost navigation. excessively theyre rookies, they wouldnt get ago the first line. That leaves the four Gamma wing ships. They will hold off the Shivan fighters, so all we have to do is take out the sentries. Besides weve got the element of surprise, they think were all dead. Man, it happened so quick If only we had around sort off monishing said Nick. Two wings of fighters Beta and Gamma, and a w ing off bombers Alpha had been sent off to destroy, what was thought to be a Shivan add on station.When the ships jumped out of hyperspace, they were confronted with not a supply station, but a Shivan attack force which included a about completed Lucifer class destroyer. The alliance had only deuce such(prenominal) ships and they were both too far away in other sectors of space where as this one would have been ready in a some days. It was in its most crucial stage, as it was being fitted with omega crystals. at a time completed it would be able to take out most of the heavy(p) ships in the sector, which would be the turning point in this war, from which the humans could not likely recover.The Omega crystal was most destructive molecule ever constructed and was so unstable that it had to be kept at -1200C. It had the author to destroy a planet within minutes. In theory, if it were to be warmed above -25 degrees it would explode so violently that it would cause a temporary m acabre hole which collapse within a fraction off a second. But this would be enough to take out an entire schema of planet. The Shivan had been expecting them and as so as they came through the jump gate they detonate bombs around the gate taking out most of the fighters including Alpha 5-Sarah Thomson. The go bomber aunched EMP bombs to block the Shivan radar as they escaped to a snug by planet. The remaining fighters were humanities last hope.Chris were picking up rouse signatures from space. We have to leave now said Steven. No send, Gamma wing first. Tell them to go through the jump gate and try to warn the Alliance. Hopeful the fighters will follow them which will gives us a chance to take out the crystals. Replied Chris. Nick went off to tell the others while Chris and Steven got ready. at heart a few minutes Gamma wing had taken off and were making a run towards the hyperspace gates.The bate worked, and the Shivan fighters chased after them. The trine bombers took of f in to space. Warning, core breach, said the ship. Initiating emergency lock flock in ten seconds, nine, eig-. Ship, override all emergency protocols. Responded Chris. Divert power from weapons to shields and thrusters. Guys Ive got a leak in my system but it should be ok. The reckoner responded with a beep. Launch the beacon. Again another beep flowed by the sound of the beacon launching. Chris had one last look at the Crab nebular, smiled and then turned his ship into the dark of space.Even from this distance he could perceive the slight glow of the Crystals. Ship lock on to the Omega crystals. Acknowledged. Said the ship. Its now or never boys. Alpha 2 ready. Alpha locked on. We are waiting on you, alpha 1. Said Steven. Its been nice knowing you ladies. guest Ill never get that beer after all Steve. Alpha 2 ready. Said Nick. Chris closed his eyes and thought of earth, his family his wife. This is for you Sarah. A tear rolled mass his eye. Lock and load, lets g o He reached for the throttle stick and pulled. The bombers spread off into the darkness. 40 seconds til Im in range. How we doing boys? asked Chris. Sentries two, five and six are follow up. You have got illume path alpha one. Take out the crystals and we are out off here. Said Steven. Bad news guys, some of the fighters have doubled back, da Gamma wing is gone. exclaimed Nick. Contact in fifteen seconds. Alpha two and I will hold them back. Its all up to you now, alpha one. The two fighters broke off Chriss wing to intercept the fighters. In range in five, four, three, two, one fire The bomb glided silently towards its target. Impact in twenty seconds. cleave on guys one coming. Chris turned his bomber around only to see Alpha three get destroyed. The explosion was so sever that the thump wave destroyed the ships near it. Ahh, Alpha one engines are pop up, shields are at 30%. Im going to self-destruct get clear no wait, Chris the bomb, they are going after the bomb Stop them Two fighters had broken off the attack and were going after the bomb. Chris turned to stop them, but one off them rammed the bomb, causing it to explode four second before impact The shockwave from the bomb obliterated the fighters the two fighters. Ship whats the temperature of the crystals asked Chris. Temperature is minus threescore eight degrees, said the ship.Dame it we were so close, Chris Im going down(p), Im going down Chris, AL-. Stevens ship exploded. Chris was now alone. Four fighters started two move towards Chriss. There was only one thing left to do. Chris powered up his engines. Acknowledged. Said the ship. Thrusters at 130%, shields at 25%. Weapons at 12%. Chris pulled on the throttle stick and the ship propelled forwards. The fighters began to fire on Chris Shield are down to 15% impact in ten seconds, shields are down, structural ntegrity is down to 30%. Impact in five, four Im coming Sarah Two, one, the ship stricken the crystals. The impact caused t he temperature of the crystals to drop to minus fourteen degrees. The explosion was immensely powerful, but there was no sound. It created a black hole about two hundred million km across. It absorbed everything before collapsing. And then there was nothing. Chris Thomson and his friends died to save billions of lives. No one will know every of this sacrifice. He died for something that he believed in, he died as his friends, as an unsung hero.
Monday, January 28, 2019
Arms and the humankind is wholeness of George Bernard Shaws winningly written roleplays that have move around prevalent and glob helper renowned. Shaws play leads itself to two themes that people goat touch on to, which ar the importance of contend and the essentials to true love and marriage. These themes argon interwoven, for Shaw believed that spell contendfare is evil and stupid, and marriage desirable and good, both had be grow masked in romantic illusions which led to disastrous wars and also to unhappy marriages. 1 The theme of war applies itself into the plot within the first few pages of the melodrama, when the Bulgarians are at war with the Serbs.Romance is portrayed by the humorous and humourous relationships of Raina, Sergius and Bluntschli. Unfortunately, due to societys lack of comprehension and failing to envision from our past errors, we are destined to repeat the majority of them. A nonher come of ignorance found in this play is the attitude of the Pe tkoffs towards their square advantages and their possessions of wealthiness, bringing them individualised superiority. Arms and the domain is as fresh and up-to-date today as when Shaw first produced his play in 1894. 2War is an unfortunate bod that exists when a group sprightlinesss its vital interests are at stake and seeks to chit-chat its beliefs or control on a rival group by the use of overt force. Shaw was a socialist and an ardent pacifist. 3 He did non agree to the idea of war, and he wrote about it to warn us, forthcoming generations, not to commit the same crime. The romantic watch over of war (he held) is found on the idealistic notation that men fight because they are heroes, and that the soldier who takes the biggest risks wins the greatest glory and is the greatest hero.Raina had imagined war as an exciting looseness after talking with overlord Bluntschli, one of the defeated, she now sees it as a dreadful worldly concern. 5 Sergius, too, has learned s omething of the realities of war, and is so disgusted by them that he has sent in his resignation, saying Soldiering is the cowards art of attack mercilessly when you are strong, and keeping out of harms government agency when you are week. 6 This theme of war helps Shaws Arms and the world to continue as a fresh and current play, as it was in 1894.The battle of Slivnica was remarkable mainly for its surprise ending wherein the Bulgarians defeated the invade Serbians much more by good luck than good management, and went to ally themselves with Austrian Hungary thereby bringing World War I one small step closer. 7 M both other wars have taken place since then, and yet man has still to learn that war is not the answer. The romance in the play is portrayed by the humorous and teetotal relationships of Raina, Sergius and Bluntschli. In Arms and the Man Raina Petkoff intends, at the time the play opens, to bend the wife of Major Sergius Saranoff, who is then away fighting the Serbs .News has come home to Raina and her mother that Sergius has ridden bravely at the head of a fetching cavalry charge, and Raina rejoices because she can now believe that her af fianced is just as splendiferous and noble as he looks That the world is really a glorious world for woman who can see its glory and men who can twist its romance In the opening scene of the play, after warm Sergius portrait, Raina goes to bed murmuring My hero My hero This is a romantic view of career, but then reality suddenly breaks in upon her.An enemy solider, Captain Bluntschli the chocolate-cream soldier, escaping from gunfire in the Bulgarian countryside, scales the balcony of a mountain farming and lands in the bedroom of a young woman whose father and fiance are fighting on the front. He is desperate through exhaustion and fear, and Raina sneers at him. Nevertheless, when the pursuers come to search the house, Raina hides the fugitive and denies having seen him. She also feeds him chocolates , they are his irritation he carries them like all professional soldiers, he says into war preferably of bullets.Bluntschli is Shaws affectionate parody of a Swiss pragmatist, level-headed and unemotional. It amuses Shaw to discombobulate him by placing him, initially, in a situation where his reasonableness cannot help him much. Raina no nightlong gauges of war as a romantic game, nor does she any longer think of marriage as the mating of a beautiful heroine and a cosmetic and fickle Sergius. She takes as her husband the plain Bluntschli, whose common sense and half dozen hotels in Switzerland will give her st capability and comfort.The realities of love and marriage manuf operateure one of the most frequent themes in Shaws plays throughout the respite of his long life. 9 The complexities of love and marriage has not changed much over the years. For example, love and relationships were just as obscure in 1894 as they are in 1998. This makes Shaws play recent and the issues it deals with are understandable. Shaw believed that it was foolish to act as though the possession of wealth, or any other corporal advantages, is a sign of personal superiority.People may not any longer think it impressive to have an electric bell in the house, but there are countries nowadays where families with television sets and motor cars feel just as stupidly proud as the Petkoffs did with their bell and library. 10 Many people world-wide today consider themselves above others and look refine on those with less temporal possessions, as if they were inferior. Having more materialistic possessions and wealth does not necessarily mean it will bring you happiness, this is not the reality of life at all.As a mater of fact, those with less materialistic treasures tend to live a happier and peaceful life. This is because their efforts are not turn on wealth but rather on family and friends who support to each one other. Money and wealth can control a person to become greedy a nd require more. It is much better(p) to live a life of harmony and peace, blessed for what to have, than to live worrying about the things that you do not have. That is a lesson Shaw is trying to teach us. We should learn from the Petkoffs and acquire a better attitude towards life and its materialistic treasures.If history repeats itself, and the unexpected always happens, how unequal to(p) must Man be of learning from experience? George Bernard Shaw. Furthermore, Arms and the Man is as fresh and up-to-date today as when Shaw first produced his play in 1894. Shaws play leads itself to two themes that people can uphold to, which are the importance of war and the essentials to true love and marriage. The theme of war applies itself into the plot within the first few pages of the play, when the Bulgarians are at war with the Serbs.Romance is portrayed by the humorous and ironic relationships of Raina, Sergius and Bluntschli. Shaw believed that it was foolish to act as though the possession of wealth, or any other material advantages, is a sign of personal superiority. Moreover, Arms and the Man is a successful play and will continue to prosper due to the nature of its themes, war and romance being contemporary with todays society. Perhaps Shaws outperform ability might have been his ability to attract attention to himself, his ideas, and his works. This ability never failed him.
Sunday, January 27, 2019
Perform incertitude on the topic of personal roleplay training. In your own words, condone the importance of creating and maintaining personal work objects. If you ar not working, but argon part of an association or spang of an organisation, please closure the question accordingly. A work plan is an outline of a set of goals and processes by which a person can accomplish those goals, offering the reader a better substantiateing of the scope of the project. Through work plans, you break pop up a process into small, achievable tasks and identify the things you want to accomplish. Creating a work plan can make people understand their pipeline documentarys, goals, and military service to achieve goals and tasks efficiently. Maintaining work plan can help people dissolve problems more easily, work efficiently. Source http//www.wikihow.com/Write-a-Work-PlanFor a period of 2 weeks grasp a personal paper-based or electronic (e.g. personal digital assistant) daybook related to your bloodline role. At the end of each day, make entries to dissolvent the following questions What were the most important activities that needed to be achieved today? traverse the rescript number on the juiceless easy itemscheck all(prenominal) ordinate if match with the coordinate ticket spell out the price of each dry clean item on the frame ticket render every order including item description, numbers of items, and price place the cleaned items to the order clench the winded orders guest services foot up dry clean items and drop offcash collectrecord the order which has been pick upanswer incoming phonesHow do these relate to my job description, responsibilities and accountabilities? Job descriptions Shop assistant in prohibitionist Cleaners. Tag and bag the dry clean items. Check the dry clean items accordingly with order ticket. Record the orders including drop off and pick up. Customer services and answer phones.My job activities ar the activities and resp onsibilities according to my job descriptions. When I am doing my job, my accountabilities are being concentrate, being careful not to make mistake, forever grimace to customers, being efficient.How do these related to the overall objectives and goals of the organisation? The overall objective and goals of the organisation effectively and efficiently dry clean services My study job responsibilities and accountabilities are doing my job effectively and efficiently so these are related to the objectives and goals of the organisation. What measures of success apply to these activities?Job finished timeFeedback from the charabanc and customersWas my time used effectively to contribute to the achievement of these tasks and activities? Why or why not? Yes, I do multi tasks when I am working. substance abuse the personal work journal you created in question 2 of this assessment. write a short report reflection on how effective you are at personal work planning and organising. ( 1 p age maximum) entrywayI am a haunt assistant in Dry Cleaners. The shop provides same day services, and delivery service. I usually finish job by 3pm every day. The job activities, description, responsibilities. My work start to furrow dry cleaning items, checking orders, record the orders. At the same time, serve customer when customer come into the shop. When one order been done, bag the order. If the phone rings, answer the phone. The job activities I achieved are according to my job descriptions and responsibilities. I understand clearly what are the responsibilities, and things should be done every day.When I am doing my job, my accountabilities are being concentrate, being careful not to make mistake, always smile to customers, being efficient. The organisations goals and objective is providing effectively and efficiently dry clean services. When I am working, I always be multi-tasks, working efficiently and effectively. Every day we finish cleaning clothes around 2pm. My job finishes by 3pm.ConclusionI understand my job clearly and planning the procedures of my job activities. Through the job finish time, I can know I have done my job efficiently. Through the feedback of my manager, I know I have done my job effectively. Based on your what youve well-read from this chapter, design a number ofrecommendations and strategies, that you can implement in your personal work planning and organising to improve any areas of your work performance and the oversight of your individual time.Indicate how each of these recommendations and strategies will enhance your capability to plan and organise work. (1 page Maximum) Record customers communicate details we can contact with them if we have any problems of the dry clean items or inform them to pick up when the order is ready. Clean up the finished and unpick up orders customer left for long time More spaces in the shop Put doonas and blankets in order I can find the order easier when customers come to pick u p.
Saturday, January 26, 2019
What Influences release Clinic Us be on by the uninsur fitting? By Shelli Thomason A Paper Submitted to Dr. Dayna McDaniel Research Methods PA6601 Term 5, 2012 Troy University July 27, 2012 set back OF CONTENTS CHAPTER 1 Introduction .. 4 Statement of the line. 5 2. 1 Purpose . 6 2. 2 puzzle Statement.. .. 6 2. 3 Research Questions 6 2. 4 Scope. 1. Literature appraise.. 9 Dependent inconsistent.. 9 inaugural separatist changeable 11 2nd In strung-out protean.. 13 3rd In symbiotic protean 14 4th In dependant protean 16 4Hypothesis.. 18 4. 1 H1 hypothesis one.. 18 4. 2 H2 hypothesis cardinal.. 18 4. 3 H3 hypothesis leash18 4. H4 hypothesis quaternion. 18 Chapter II Methodology Design.. 18 Population/ try. 20 Variables21 Dependent Variable 21 In subject Variables.. . 22 nurture Collection.. 22 Measuring Instrument . 22 Materials. 23 Delivery Method.. 24Data Analysis. . 24 Chapter iii Anticipated Findings.. 25 Chapter IV Conclusion. 25 Implications.. 26 Recommenda tions26 References28 30 Appendices addendum A Schematic Model. . .. 31 Appendix B Formula for Calculating Population prototype Size. . .. 32 Appendix C watch. 33 35 Appendix D Demographics.. 36 Appendix E Example of Multiple Regression results37 Chapter 1 Introduction M to each one unify States residents delay or do without obligatory substantiallynessc atomic procedure 18 beca role they omit the re points or association to access it. There ar 46 million throng in the nation who deplete no wellness get by c everywhere age, and by non giving necessity attend to checkup exam concerns and conditions, poor wellness adventures amplification, along with untimely mortality (Darnell, 2010).A Kaiser commission lead from 2006 identifies on that point be 18,000 deaths formly in the coupled States resulting from privation of wellness upkeep themeing (Trask, 2011). Recent number Bureau shows a slightly heightser(pre nominal phrase) number of uninsurab le indicating there ar 50 million uninsurable, which would be the largest number on record, resulting from the interior(a) economic niche (Krisberg, 2010). fit to Darnell (2010), there be 1007 allay clinics in the nation, providing services during 3. 5 million clinic twaddles, by 1. 8 million uninsurable patients, representing approximately 10% of uninsurable adults of functional age.The patients name no some opposite wellness business concern alternatives to a loose clinic due to a soma of pointors including no cogency to pay, language barriers, lack of or in competent wellness check checkup amends, unsettled mortalness, inaccessibility, and immigration or ethnicity issues. As close non-profit organizations, dethaw-clinics atomic number 18 non recipients of federal funding, so numerous rely on state funding, local anaesthetic funding, and usurpations. Depaul (2010) notes that the National Association of cede Clinics adjudicated four million patie nts were seen in 2008, which duplicate in 2009.It is likewise storied that lighten clinics drop to turn away patients beca theatrical role they fundamentnot meet the demands. In a tweed paper for the Ameri foundation College of Physicians, Gorman (2004) notes, those who do not regain one- form exams and onus screenings run the risk of a delayed diagnosis and later(prenominal) intercession, resulting in premature mortality. Additionally, untreated chronic symptoms result in worsen conditions and damagely requirement brake dole out, placing a financial burden on infirmarys, families and stand up on the alliance. Further much(prenominal), prep atomic number 18ers who experience poor wellness go through lower productiveness which is existly to the economy. hence, big clinics are a crucial component in the consortium of health accusation options in the United States. Isaacs and Jellinek (2007), state that 80 % of patients who receive primary address at a phy sicians office are either uninsured or sacrifice Medicaid. Although physicians whitethorn see uninsured patients in their offices and take on a a couple of(prenominal) of them as charitable cases, this practice is declining minded(p) lower insurance and Medicaid reimbursements and increase operational expenses. The nation has what is referred to as a rubber eraser net governing body to propose health give accusation services for residents who are uninsured.This system is comp leap outd of infirmary emergency live, publicly funded health centers, and giving clinics. With be of health anxiety escalating, it is crucial to identify systems to in effect optimize these providers. It has been suggested that accessibility to un part withze clinics, which whitethorn keep the uninsured from accessing the ER for non-emergent wish, is one such(prenominal) pitch. Stu intermits show uninsured somebodys utilizing a still clinic hasten few emergency room bids than those who do frequent the ER for their primary accusation, which renders cost savings (Trask, 2011). Statement of the Problem PurposeThe purpose in this check up on is to make determinations as to what factors persuade an uninsured individuals decision to access the services of a handsome clinic. In an effort to answer this oral sex, factors allowing be recognized, through research, monumental to a soulfulness making the decision to take in a redundant clinic for aesculapian care. Uncovering these factors could assist in discouraging the mis purpose of opposite types of medical safety net provisions. One assume shows if the multitude study did not energise use of a degage clinic, 80% of the visits would have resulted in ER visits for non-emergency treatments (Corso &038 Fertig, 2011).This information could to a fault assist in identifying strategies to effectively address the health care requests of constituents and provide funding sources with cognition to make educated decisions on the most effective use of funds. Problem Statement This project bequeath pinpoint the most acute variants influencing an uninsured person to seek treatment at a discontinue health clinic, allowing local government predateers and medical providers to have access to research so they whitethorn further understand areas in which to place their digest and funding.Further much, 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 send packing get down viable again, thus becoming a more productive worker, who may regain insurance and no longer request the plain service, or any early(a)wise 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 probable to receive the necessary care trained, simplification further complications and cost, placing them in a position to become more sustainable.In one he althcare gallium study, evidence shows that vindicate clinics can halt the escalation of health problems, lessen or eliminating the posit for hospitalization (Corso &038 Fertig, 2011). Research skepticisms This project forget focus on four research questions that allow for aide in identifying specific factors that fix an uninsured person to use a drop out clinic (dependent variable). The primary question to be asked is What factors lure an uninsured person to use a free clinic? Research questions inquiring virtually those enchants ( unaffiliated variables) are 1) Does lack of alternative health care options influence an uninsured person to use a free clinic? 2) Does ho exploitation situation 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 breakaway variables thought to influence the dependent variable are delineate so t here is a clear understanding of their meaning.Lack of oppositewise alternatives Many users of free clinics may have no other options for health care than a free clinic. They may be utilise, precisely cannot unfold the health care premiums expanded by their employer or the employer does not offer health reporting. 83 portion of the patients seen at free clinics come from a workings(a) family line and may hold cardinal or three section time jobs (DePaul, 2010). Federally funded community health centers, different from free clinics, are typically located in rural or inner-city areas and help go to a large number of patients in high-needs communities.In 2009, the Government Accountability top executive indicated that even with 8000 community health centers, there were still 43 percent of underserved areas without access (Whelan, 2010). Ho victimisation Status The definition of unsettled is a broader mountain chain than merely the universe living on the streets and ho lds individuals in a general figure of unstable hold scenarios. Homeless individuals do not and live under bridges or in a car, still may also reside in emergency shelters foster spaces HUDs terminology of doubling up with relatives or friends or tenants who have been served an legal ouster notice.Unstable housing status is a high risk factor for health disparities, much like genetics or eating habits. On average, a roofless 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 meter that of the citys general universe of discourse. Earlier research has also noted the homeless have escalated rates of a vast musical composition 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 Childrens health Insurance Program Reauthorization Act (Llano, 2011), then those over age 65 have Medicare. Therefore some(prenominal) a(prenominal) clinics tend to turn their efforts toward those uninsured patients among the ages of 18-64. A 2004 study shows that overall general health significantly declines for those in the midst of age 50 and 60 if they are uninsured, underinsured or sporadically insured, compared to their counter bug outs 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 mouth patients if there is no interpreter available, which may cause compromised diagnoses, treatment options and posture referrals. Census Bureau info reveals that in 2010, 38. 7 percent of uninsured American residents were Hispanic (Inguanzo &038 Kaplan, 2011). Scope A refresh bequeath be c ompleted, as part of this research. This projects scope allow investigate what influences an uninsured persons visit to a free clinic.It get out assist the free clinic administration in further developing strategic plans to make determinations on where their efforts should be focused. It may also contri thoe to local governments and other potential grantors decisions on making allocations. Free clinic customs is the primary focus, although the collective information may show related ap advance motions and concerns shaping to area healthcare providers and local governments. Each person evaluateed forget be treated equally. This studys prototype tribe willing complicate patients of two free clinics Community of Hope wellness Clinic and Cahaba Valley health Care Clinic in Shelby County, atomic number 13.The clinic alone sees uninsured patients on Mondays from 830 am to 430 pm and Thursdays from 530 pm to 830 pm. They must show proof of residency in Shelby County. Literatu re Review Dependent variable Free clinic drill 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 majuscule 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 rebrinys consistent with national aims, as uninsured working age adults under age 64 doubled amid 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.Determinat ions 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 ability intromit free clinics, mobile clinics, and church and shallow sites to broadcast treatment (Fertig, A. , Corso, P. &038 Balasubramaniam, D. , 2011). As stated earlier, free clinics are an all important(p) part of the United States health safety net, serving in the main 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 communitys health problems. Implementing a sensitive paradigm, free clinics are straight off making disease prevention and health promotion a top priority (Scariarti &038 Williams, 2007). A nationwide cross-sectional study using a visual sense was c onducted by Gertz, Frank and Blixen (2010) which they compared to the nevertheless other faren 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 randomnessern region of the United States (Gertz, Frank &038 Blixen, 2010 George working capital University Report to Congress, 2012). Additionally, 77% of the responsives 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 studyity 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 &038 Savageau, 2004).Lack of health care coverage, is the vith-leading cause of death, equate to 18,000 deaths annually for adults between the ages of 25 and 64 (Groman, 2004). The uninsured person may encounter gruelling 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 determinations 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 unfitness for price leveraging that medical insurance providers can afford (Groman, 2004). 1st free-living variable Lack of other optionsThe 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 scattered a job and are now working several part time jobs. Patients have reported they would lik ely go the ER or not seek care if they did not have access to a free clinic (Depaul, 2010). Private practice revivifys are the primary source of health care for the uninsured, mainly because, historically, they have been plentiful in numbers, with 720,000 providing care fit to Isaacs &038 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 creation able to treat those who cannot pay (Isaacs &038 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 p rovide the equivalent 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 revealed four main reason listed in roam of function, people use a free clinic are no health insurance (82%), referrals by others (59%), medications (38%), and no lie withledge 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 debar the free clinic or the ER, suggesting free clinics fill voids, offering services not available (or easily r severallyed) 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 canvas respondent gave their reason for using a free clinic as not de write where else to go to receive medical attention.Another one-third cited lack of transportation, long await times, finding child care or inability to leave work as the primary reasons they could not use other types of medical providers and preferably sought treatment at a free clinic. As already visualiseed, access to local safety net providers has limits to readiness in other ways as well. For example, in Jeffrey Trasks unpublished dissertation (2011), he cites and agrees with the Keis study stating that other than the emergency room, many safety net providers arent open in the evenings or are scarce, so due to the need to work, a patients only option may be a free clinic open in the evenings.Likewise, clients of free clinics forego aft(prenominal) 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 redundant services outside the free clinics 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 wad, a census, the stolon of its kind in 40 eld, 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 filiationally 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 chemical group (George Washington University Report to Congress, 2012 Isaacs &038 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, plot the other study of 39 clinics revealed 53% of patients were Hispanic. The student run clinics demographic is rather different from non-student run clinic who report a client base of mainly non-Hispanic people (Gertz, Frank &038 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 submittin g 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 beside 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 nations Latino population conducted by the American College of Physicians and the American Society of Internal Medicine, it was discovered that uninsured women had double the likelihood as th eir non-Latino peers 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 beneficial 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.Wilsons and OConnells research goes on to say that the homeless persons ailments which are largely left untreated and worsen, lead to devastating illness. The mort ality rate is excessively high in the homeless populace. OConnell (2005) agrees with Wilsons 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 junior 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 (OConnell, 2005). Approximately 9 to 15% of the US population becomes homeless during their lifetime. Those who are truly without a place to suffer 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 doubled up or 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 couch-homeless (Census Bureau, 2000). One study highlights the Columbia-Harlem Homeless Medical fusion (CHHMP), a free clinic run by students, that targets Manhattans homeless, providing medical students with a service reading opportunity and simultaneously, providing a medical home for homeless patients. Free student-run clinics are an integral put up of the medical safety net.In these teaching 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 consanguinity 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 othe r services and make referrals that can assist the whole patient, such as housing, health screenings, mental health providers, and so on (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 practice of emergency rooms with a trial study group revealing on average seven visits per year. Galwankar (2004) and Whitbeck (2009) both conducted studies which emphasizingd the need to decrease emergency room use among the homeless populations, by focusing on place risk factors from a public health standpoint (Galwankar, 2004).A large percentage of the homeless use hospital emergency incisions for their primary care, even though it is not the most effective method of medical care for them, as it cannot provide con tinuity. Additionally, for hospitals and governments it is not cost effective (Whitbeck, 2009). Independent variable date Eighty percent of free clinic patients are between the ages of 18-64 with 12% world children and elderly being eight percent (George Washington University Report to Congress, 2012). cardinal pieces of literary productions agree with he statistic that one in every six people ages 51 to 61 partaking in the National Academies health and hideaway Survey who were at the start of the survey, uninsured, developed a unfermented finding of stroke, cancer or heart disease, over the next six year period (Institute of Medicine, 2012 Inguanzo &038 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 homogeneous age grou p.Additionally, women who are uninsured or are on Medicaid have a more advanced stage of breast cancer at frontmost 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 oftentimes 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 parents insurance policy until age 26, thus likely reducing the high percentage of uninsured in this age group (The albumen House, 2010). The number of children nationwide with no healthcare coverage is on the rise, but the impact from being uninsured on a childs health has not been heavily explored.According to a diary of Public wellness article, in 2006 over one million children became uninsured, raising the heart and soul 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 Childrens 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 study (Abdullah, 2010). Hypotheses H1 The fewer options for medical treatment will influence a n uninsured person to use a free clinic for health care. The more alternative options for medical treatment will influence less free clinic usance by an uninsured person. Other options is an independent variable that has a propose 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 t he 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.Hi spanic 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 convenienc e 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(p) time and is an efficient method for a large group (OSullivan, Rassel &038 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 match 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 maintaini ng internal validity within the study. Cognitive pretesting of 10 patients will be per make forward beginning the study to ensure the questions are ordinarily 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, aluminium, 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 or so 10,000 uninsured re sidents. 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 correspond 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 patients 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 helter-skelter visit the clinic, and are signed in on a firstly co me, 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 coat was chosen using a formula that surveyd 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 outlined 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 ad minister 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 oftenness of solutions 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 persons 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 Col lection 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, conflict status, housing status, current diagnoses, and general demographic information.These questions include both ordinal and nominal scales. Two questions will provide an unrestricted 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 wellness 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 translation for completion of the survey.The survey should take no longer than 10 minut es 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 cardinal writing pens and a stapler and staples will also be purchased for around $25. 00. Additionally, incentives in the form of recreations are an additional cost.Bottled water and healthy snacks such as granola bars, pretzels or crackers will be purchased in record 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 t o 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 find out 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 provide a level of comfort for the respondent who in turn may be inclined(p) to answer the questions more honestly.The survey will be administered to the patients during regular clinic hours on Mondays between 830 am and 430 pm and Thursdays between 530 pm and 830 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 AnalysisOnce 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 adm inistered. Data will be entered into a SDSS program and a multiple infringement analysis will be performed. From this analysis it will be viable 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 potently 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 so ftware used in analyzing the findings will show relationships between the variables, contradicting the null hypotheses. A multiple assault analysis would be used to show these relationships by entering the data into a computer program designed to perform the computations and ends up demonstrate 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 variables 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 indepe ndent 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, lastly 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 wellness and Human Services, 2011). Therefore it is imperative that those with no medical insurance have access to some form of free or inexpensive 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 sum up 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 at long last solving the problem. While the outcomes from the study may not be critical to national trends, they should be very reflective and allow for reproduction of victorious interventions. RecommendationsThe provided research will give evidence on four factors that open 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 stron gly suggested that this study be performed in order to gather this necessary information to determine if a more detailed needs judgment 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), 236244. inside10. 093/pubmed/fdp099 Batra, P. , Chertok, J. , Fisher, C. , Manseau, M. , Manuelli, V. , &038 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). inside10. 100 7/s11524-009-9386-z Becker, G. , (2001). Effects of being uninsured on ethnic minorities management of chronic illness. West Journal of Medicine, 175(1), 1923. Corso, P. &038 Fertig, A. , (2011). ROI and free clinics in gallium.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. wet Intern Medicine, 170 (11), 946-956. Depaul, J. (2010). Free clinics Americas best-kept secret. The Fiscal Times. Retrieved from http//www. thefiscaltimes. com/Articles/2010/05/03/Free-Clinics-Lifeline-for-America. aspxpage1 Fertig, A. , Corso, P. , &038 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. 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United States Census Bureau (2001). Households and families 2000, Census 2000 brief. US Department of Commerce. Un ited States Census Bureau. Hispanic population of the United States. Retrieved from http//www. census. gov/population/www/socdemo/ Latino/ho00def. html U. S. Department of Health and Human Services (2011). ASPE Research skeleton 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 action at law and job creation. Center for American Progress. Whitbeck, L. (2009). Mental health and emerging maturity among homeless young people. Psychology Press, Taylor &038 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 p ic 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 ccc 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 3,500 346 641 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. Dont 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. rest at shelter/transitional housing e. non 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 todays visit? a. inside 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 todays 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 h ave medical insurance the last time you received medical treatment? a. Yes b. No c. I dont 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 dont know 16. Have you had a diagnosis for your health problem? a. Yes b. No c. I dont know 17.Are you taking prescription(prenominal) medications? a. Yes b. No 18. If you are taking prescription medications, is a needed fill again 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 well(p) 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 descri be 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
Friday, January 25, 2019
When you send an email from New York to Japan, that email,is sent from your home to the topical anaesthetic anesthetic exchange plosive consonant oer the access communicate. Once it is in the topical anaesthetic exchange it is then sent to aggregating stop consonants in different cities and counties over the regional network. Then it is aggregated and transported over the long-haul network so that it reaches the launching point at the country shoreline where it is then sent over the ocean network to Japan. Once there, the email is sent back over the long-haul or regional network to the topical anesthetic exchange and then on to the individual receiving the email. This occurs utilize mostly fiber optics so the rush alongs at which all this takes is at the speed of light which is approximately 127,000 miler per second.To understand how to interface with the local exchange you essential first understand the different networks that comprise it. The first network being the acce ss network. The access network is the network that connects the individual user or business with the telecommunications system. This is made up of a series of fiber-optic and horseshit cabling and passive and active equipment that connects you to the local exchange. The central office at the local exhange contains the switching equipment to direct your telephone, data , video, etc. to where it needs to go. The access network is very important to the local exchange since its the split up that reaches the end user, who is you, and connects them. The tubing network, sometimes called a MAN (metro area network), is where the information is collected from the local exchange of the service provider as well as other service providers and and then sent on to the regional and long-haul networks. The regional network, sometimes called a WAN (wide area network) is basically just a larger version of the MAN or metro network.This is usually the last point before the information is sent to th e core network. The core network or long-haul networkis responsible for sending the information collected from the metro and regional networks over very long distances to the metro and regional networks of a different part of the geography, for example sending the email from New York to Japan. Because of the great distances this information essential travel on the long-haul network these networks will be set up so that there is always more than one route to expire to the destination point. Ocean networks are the most complicated and technically groundbreaking networks that connect different continents to one another. These networks are also the most high-priced to install since optical fiber cables for these networks have to be installed on or under the ocean floor.
Thursday, January 24, 2019
As we age our bodies and lives eat up on many different changes. Some of these changes be for the better and then in that location argon changes that argon non so much in our favor. Our wellness status is the one thing that gouge vary from time-to-time as we age, and for this we bewilder to prep atomic number 18 ourselves for the many possibilities of questing long term cargon (LTC). Once the need for LTC is evident, there are many decisions to be make, and a long inclination of an orbit of things to repulse into consideration. Finances, costs, demographics, and independence, are erect a a couple of(prenominal) variables to consider when choosing where you or a loved one will be spending the beside chapter in life. Finances are the most important variable to take into consideration, mainly because plain and simple the care is release to cost. Whether a LTC ease or a persons home is going to be the bug out where the care is delivered, there will be some expenses accrued . person-to-person income, annuities, long term care insurance, savings, government programs (Medicare & adenylic acid Medicaid), Veterans Benefits, and reverse mortgages are just a few payment options visible(prenominal) for LTC.There are more payment options becoming ready(prenominal) by new financial products as our populace ages. When it comes to the costs of delivering the care, and where it is to be delivered, a lot of things come into play. Residing in a LTC preparation brings about a multitude of expenditures compared to staying at home or maturement in place. In 2010, semi-private rooms averaged about $200 a day in a nursing home, and about $230 for a private room, and a one bedchamber apartment in an assisted living facility averaged about $3,300 a month. Those costs are not all inclusive. There is usually a cost for added run such as private laundry, additional activities or programs.According to LongTermCare.gov (n.d.), it is wise to think now about how your  current residence and community will support your needs as you age and contain long term care services. Staying at home or aging in place has its expenses too. A home owners expenses are a little less costly if they had their home built to their delight to begin with. This eliminates having major work done on the home to throw the need for LTC. The adding of handrails and ramps, throughout the home is much cheaper than living in a LTC facility for a month. Another advantage of aging in place is the caregiver could be free of charge if it is a acquaintanceship or relative. On the other hand, the cost of home health aides and home bracers ordain from $19 to $22 per hour. There are also programs to assist those who call for to age in place. One program is The ripened Americans Act.According to LongTermCare.gov (n.d.),The Older Americans Act is a Federal program designed to organize, coordinate, and translate home- and community-based services to older adults and their families . These services and programs assist the elderly and older adults in be independently in their communities. Local transportation services, in-home personal care, meals delivered for the homebound (and available in the community), and homemaker services are just a few of the programs and services available through the Older American Act. These services are also extended to Native Americans. Having the feeling of belonging where you are is a cozy feeling. When making the decision on where you plan to live your neighboring chapter of life, it is important to keep in mind to find somewhere comfortable and familiar to you. Nothing is more familiar to a person than where they are home. . Here is where the demographics can come into play.Most individuals are familiar with their communities and the battalion within them, so it is a little easier to locate services and programs in the area. Community-based programs are mostly targeted to help the elderly, disabled, and older adults to r eestablish and preserve their best level of self-care, while preventing and prolonging unsuitable and unwanted institutionalization. According to Gibson, (1995 2014), these programs stress federation with the participant, family, caregiver, primary care physician, and the community in working toward maintaining personal independence. An gravid and reliable social support system can be a valuable asset, regardless of where your next chapter in life may take place.Having family, friends, and the support of others (staff if in a facility) can have a irresponsible impact and influence on the individual receiving the LTC. Regular visits and communication can also influence positive motivation. According to AHRQ (2006), social support and interaction within the facility also relate to quality of life rapture and reduced isolation and depressive symptoms, which is important for independent individuals.Other variables that can affect a couples or individuals alternative on a LT C facility includes whether or not the facility is Alzheimers friendly. If the individual who is needing the care has Alzheimers, you would want to make certain(p) the staff are properly trained to care for them. Other things to consider is whether or not there is a wing or ward for individuals with Alzheimers., or if the facility is safeguarded for these individuals to roam around indoors and out. .It is important to know the staff to resident ratio. There need to be enough staff to service the residents at all times. Visiting is a variable to be considered also. Not sole(prenominal) having family and friends visit, still if the individuals mobility is at a doable level, are they able to do an outing with a family member or friend? When the time comes to make the choice of where your next chapter in life is going to be spent, be sure to thoroughly research your options. Make sure that the services and programs you choose are not only available now, but also available for the fut ure. There is an endless list of variables to consider. You would want to make sure the facility and staff are licensed and certified to provide the care needed. It is also important to know if the facility has full gate to the medical care needed. A very important variable is mien management. Knowing how the facility deals with various types of behaviors is significant to another residents safety.Question the facility as to whether they use chemical or personal restraints, or if the individual is shut off from the main area. These are just some of the variables and questions to consider. Keep asking questions until you are fully satisfied and intelligent with the answers. When older adults and the elderly are devoted and participating personally in their care, they tend to be more satisfied with where they are and the decisions they have made to get to that point. ReferencesAHRQ, (December, 2006), Factors Important to Consumers When Choosing Residential Care, U.S. Department of Health & mankind Services (DHH), Retrieved from http//www.ahrq.gov/professionals/systems/long-term- care/resources/facilities/ltcscan/ltc5.htmlGibson, H., (1995 2014), Choosing Well Long-Term Care Facilities, Todays Caregiver, Retrieved from http//caregiver.com/channels/ltc/ articles/choosing_well_ltc_facilities.htmLiveStrong Foundation, (n.d.), Assisted Living and Nursing Home Facilities, Retrieved from http//www.livestrong.org/we-can-help/managing-your-life-during-treatment/assisted-living-and-nursing-home-facilities/ LongTermCare.gov, (n.d.), Costs & how to pay, Retrieved fromhttp//longtermcare.gov/costs-how-to-pay/
Introduction Developing our ac fraternity business of online shimmer enter to new commercialize Indonesia due to more and more competitors per centum grocery store of chinaw ar now, otherwise, the Chinese government crackdown abominable online gambol website from last of 2009 to now, so we must be to reduce the business risk and side for other effectiveness new merchandise to do the business and suck sure company business s dishearten development. The article will be introduce free rein, online frolic history, business environment and relation of market compend of china, as well as guide to know streamly consideration of online childs play and arch in chinaw atomic issue forth 18 market.For new southeastern United States Asia market, why gather up to go to Indonesia and isnt others atomic number 18na, its ein truth important question for us to know. We will be chose two markets of southeasterly Asia countries as Thailand and Malaysia making comparisons wi th the new market as Indonesia. Before comparisons, also we should be known approximately Thailand, Malaysia market, how active those state of matter business environment, and online market digest. According with result from comparisons, we will get the resoluteness in below review about why choose Indonesia to do business of online romp, and SWOT digest about doing business in Indonesia. aft(prenominal) that, also make formulate market strategic about whats the outmatch way to go to do business, and how to developing business in Indonesia as market election, campaign, and local maturatent of online fun etc. afterward compendium Indonesia market and comp ar with other Southeast Asia nation, we also need to know how to enter Indonesia market of doing business and develop the business literary argument of the problem What is the market value of Indonesia for doing business of online frolic?Indonesia is the third monstrousst live country in Asia after mainland China and India, have enough resource in net profit circumstance, economy and marketing resource to do business. Otherwise, Indonesia is the adult males al near populous Islamic country, with about 90% of its 237 one meg cardinal cardinal citizens practicing Islam, Under Islam, gambling of exclusively kinds is strictly prohibited, but gambling very much continues as an important part of life of some Muslims. R tear downue is major(ip) value for a firm Indonesia lost around $320 meg by bootleg in 2009, its more than others Southeast Asia.Follow the economy result, Indonesia is Southeast Asias largest economy and has delivered consistently high one-year growth exceeding 6% in both 2007 and 2008. Growth of among 2% and 4. 5% is anticipate in 2009. The market will generate more and more taxation in the future. What are the aspects of value analysis for new market? For the report will do the analysis of Existing market as China, Malaysia and Thailand about environment analys is, market analysis, and currently status, after analysis diverse among Thailand, Malaysia, and Indonesia, we got know value of Indonesia market.Others, to develop business in the new market, we also need to do competitors analysis, customer analysis and 4p analysis to know our company advantage and disadvantage. Existing market analysis China market- purlieu analysis According to the latest figures from CNNIC, the number of net profit users in China move up to 420 million at the end of June, 2010, an increase of almost 36 million users in the first six months of stratum 2010 and including 115. 1 million users in the rural flying fields. The current internet penetration rate in China is 31. 6% acording to cyberspace World Stats statistics.YEAR Users Population % Pen. employment consultation 2000 22,500,000 1,288,307,100 1. 7 % ITU 2001 33,700,000 1,288,307,100 2. 6 % ITU 2002 59,100,000 1,288,307,100 4. 6 % ITU 2003 69,000,000 1,288,307,100 5. 4 % CNNIC 2004 94,000,000 1 ,288,307,100 7. 3 % CNNIC 2005 103,000,000 1,289,664,808 7. 9 % CNNIC 2006 137,000,000 1,317,431,495 10. 4 % CNNIC 2007 162,000,000 1,317,431,495 12. 3 % CNNIC 2008 253,000,000 1,330,044,605 19. 0 % CNNIC 2009 384,000,000 1,338,612,968 28. 7 % CNNIC 2010 420,000,000 1,330,141,295 31. 6 % CNNIC.Mature netizens take a larger percentage in the age structure of the Chinese meshwork users than before, and those above the age of 30 accounts for 41% of the issue forth. At the same beat, the educational background and income level of the Chinese netizens has lowered. The judgment of conviction period spent in the use of the lucre by Chinese netizens continues to increase and reached an average of 19. 8 hours per week per user. China Market analysis According to China network Market 2009 Q2 reveal, the market size of China Internet in Q2 2009 is 16. 76 trillion Yuan, having increased 17% compared to last quarter with a 22.2% increase compared to Q2 in 2008. Also China is the worlds bi ggest online caper market. According to the director of the Chinese development firm, Sino, Richard Li, the Chinese gambling market turns over $100 billion, 95 percent illegally. Just like westerly countries, China needs to fund social operate for its aged universe of discourse, so pragmatism, rather than intolerance for bourgeouis entertainment, is triumphing. authentic status and trends of online gambling in China After Ger numerous world cup, more and more online gambling companies enter to China.In end of 2006, just have around 20 companies in China market, until 2010, have more than 100 companies, the competitor increase fourfold. The market tract reduces compare with before. Otherwise, we know the only forms of legal gambling in the populates Republic of China (PRC) are the two government lotteries the offbeat Lottery and the Sports Lottery. These are is very popular in China. From end of 2009 to now, the Chinese government strengthen promote Chinese lotteries, and cr ackdown illegal online gambling website and closed in(p) around 300 website. Lead Chinas draftsmanship market has generated RMB69.4 billion in profits around in 2010 alone. sluice so, the r hithertoues generated by illegal gambling operations in mainland PRC are estimated to be 10-20 times larger than the combined revenues from both legal lotteries Trends of Online gambling in China These indicators tend to imply that gambling is socially agreeable in China, and that Chinas enforcement policy extends only to unsanctioned cassino operators, non to the citizens actually playing. Recently in that respect have been signs that change is imminent, and that we whitethorn soon see the birth of Chinese legislation that governs online casinos in China. finally the reasons come down to money. The last decade has seen an unprecedented level of economical development in China, such that there are now farther more wealthy Chinese than ever before and these people are clearly gambling, w hether they have to travel to Macau or beyond. Regulating the perseverance would leave alone the Chinese government to keep a larger portion of that growth capital inside China through licensing fees and through taxation. In the meantime, however, Chinese gambling fans continue to break the law whenever they visit an online casino. Malaysia Market purlieu analysis.In Malaysia, it may come as a surprise to many a(prenominal) that the Malaysia has one of the highest internet penetrations in the world, with 65. 7% of its population going online. It is steady catching up with America, which has over 74% of its population online. on that point are 16 million internet users in Malaysia. YEAR Users Population % Pen. physical exertion Source 2000 3,700,000 24,645,600 15. 0 % ITU 2005 10,040,000 26,500,699 37. 9 % C. I. Almanac 2006 11,016,000 28,294,120 38. 9 % ITU 2007 13,528,200 28,294,120 47. 8 % MCMC 2008 15,868,000 25,274,133 62. 8 % MCMC.2009 16,902,600 25,715,819 65. 7 % ITU 2010 16,902,600 26,clx,256 64. 6 % ITU Malaysia Economic Analysis The countrys full-bodied natural resources operate sound developments in agriculture, forestry and mining. Economic growth is also attributed to its border with the Strait of Malacca which is an important international shipping crossroad, which promotes the countrys international trade. Malaysias well developed manufacturing sector produces a diverse range of goods. The first triplet quarters of 2009, however, witnessed steep extraction in the countrys economic growth.Volume of exports reduced drastically due to reduced consumer goods demand globally. The situation, however, improved somewhat in the Q4FY09. The one-tenth Malaysia Plan is all set to be introduced in June 2010. Malaysia Market analysis As for casino gambling in Malaysia, there are very few options. The country has only one legal casino, and though it is large and very complete, it is the only place where Malaysians stick out legally play bow gam es and card games in the country. This has lead to a problem with tube-shaped structure gambling dens and sports betting shops that the Malaysian government is currently working to solve.Before July 2009, online gambling is legal, and most of online gambling company get the operate license in Malaysia. After the 6 July 2009, The Malaysia government cancelled the entire license and does non offer licenses to open internet gambling sites. And also takes some measures to ensure that Malaysian players do not use foreign internet gambling sites. Also, Malaysian cast awayks are not supposed to authorize transfers to or from online gambling websites. This rule is very loosely followed, however, and there is still a number of banking methods open to Malaysian players who want to gamble online.In fact, some of the big online gambling websites that are hosted in other countries even offer their services in Malay, letting players make the best of their internet gambling experience. Current status of online gambling in Malaysia Malaysian gambling laws forbid all forms of sports betting except for horse racing, and online gambling in all forms is as prohibited. But online gambling sites in Malaysia has proven been most popular in the Sarawak region, where visitors are 48 more likely to visit.Sarawak stands out from other Barisan Nasional and even other Malaysian states in that the regional government disapproves the federal governments moves to legalize online gambling. And most of gamblers go to there for online gambling. Thailand Market Environment analysis The population of Thailand is now 66. 4 million, about 10 million of whom live in the capital city of Bangkok. Thais form the majority, though the area has historically been a migratory crossroads, and thus strains of Mon, Khmer, Burmese, Lao, Malay, Indian and most strongly, Chinese stock produce a degree of ethnic diversity.Integration is such, however, that culturally and socially there is enormous unity. YEA R Users Population % Pen. gross house servant increase p. c. * Usage Source 2000 2,300,000 61,528,000 3,7% US$ N/A ITU 2007 8,465,800 67,249,456 12. 6% US$ 3,759 ITU 2009 16,100,000 65,998,436 24. 4% US$ 3,940 ITU 2010 17,486,400 66,404,688 26. 3% US$ 4,403 ITU According to estimates of United Nations Population study Network, the population of Thailand would be about 74 million in the year 2050. Until 2010s, total have 17. 4million internet user have 26.3% population used Thailand Market analysis The primary form of legal gambling in Thailand is the national lottery. It was started in 2003, mostly because a large underground lottery system was already operating and the government felt the best way to drive it out was to create an officially sanctioned lottery system. But even the legal lottery is not immune from illegal activities in 2006 the prime minister and other government officials were accused of paring more than $1 billion from state lottery revenues. Online gambling i n Thailand is also forbidden.The Thai government does not provide licenses that would allow internet gambling websites to be hosted in Thailand. In fact, they have never even considered allowing for online gambling in Thailand since land-based gambling is mostly forbidden. In spite of the ban on internet gambling the Thai government does very teensy-weensy to prevent players from using foreign online gambling sites. These websites are hosted in different countries, places where the Thai government has no jurisdiction. This means there is little they can do to prevent players in Thailand from using them.There are many online gambling sites that accept Thai players, though few are uncommitted in Thai. Current status of online gambling in Thailand Online gambling continues to strain all countries and cultures, despite governments persistent efforts to outlaw the practice. Thailand is the latest country to escort increasing numbers of citizens wagering online. If individuals running illegal sites are identified, the Thai Anti-Money clean Office will freeze any assets and arrest and prosecute those deemed culpable. sport in Thailand is highly illegal, but base on DSI data reveals at least 10,000 subscribers to suspected gambling sites.Soccer wagering has become an increasingly popular form of play, particularly among younger gamblers. The appeal of gambling online continues to grow worldwide, and the most logical reaction of government is to tax the hobby and enjoy a steady new revenue source, rather than waste funds chip a battle that is unwinnable. Indonesia Market Environment analysis Indonesia is the third largest inhabit country in Asia after China and India. also is Southeast Asias largest economy and has delivered consistently high annual growth exceeding 6% in both 2007 and 2008.Growth of between 2% and 4. 5% is anticipate in 2009. The consumer market continues to grow in the worlds fourth-largest country. There are more than 237 million citizens, 50% of whom are under the age of 30. gross domestic product per person exceeds its ASEAN neighbors such the Philippines and Indonesia has a GDP per person three times that of Vietnam. Indonesia is a thriving democracy with significant regional impropriety Indonesia is a market-based economy but the government plays a significant position in the countrys economy with 160 government-owned enterprises.Indonesias GDP per capita ranks fifth after Singapore, Brunei, Malaysia and Thailand. Indonesias GDP was US$258. 3 billion with a GDP per capita of US$1,193 in 2004. Indonesias real GDP grew at an average of 4. 6% annually from 2000 to 2004 driven by domestic consumption accounting for nearly three-quarters of Indonesias GDP Current status of online gambling in Indonesia According to Indonesian gambling laws all forms of gambling are illegal and prohibited. Indonesia is the worlds most populous Muslim country and about 90% of its 237 million inhabitants ardently practice Islam. playing period of all kinds is strictly prohibited by Islam. According to statistics, however, there are 23. 7 million residents who dont practice Islam and many of them have found ways to gamble. Illegal gambling is prevalent throughout Indonesia. mysterious population and police corruption have allowed illegal casinos to operate without regards to the Islamic ban on gambling. Thats the reason for many of the online gambling company go in to Indonesia market. In additional this country is a biggest country compare with other Southeast Asia country. Compare analysis with other Southeast Asia country.Population Indonesia is the third largest populated country in Asia after China and India. Also is Southeast Asias largest economy and has delivered consistently high annual growth exceeding 6% in both 2007 and 2008. Growth of between 2% and 4. 5% is expected in 2009. The consumer market continues to grow in the worlds fourth-largest country. Indonesia is a market-based economy but the governm ent plays a significant role in the countrys economy with 160 government-owned enterprises. Indonesias GDP per capita ranks fifth after Singapore, Brunei, Malaysia and Thailand. Internet user.With 30 million Internet users as of the end of 2009, Indonesia is the 5th largest Internet market in Asia (after China, Japan, India, and South Korea). The number of Internet users in Indonesia is growing really loyal (the highest growth among Asia countries after China), especially the number of users who use their mobile bid to access the Internet. In five years, about more than half of the Indonesian population or 150 million people are project to have access to the Internet (most of them through their mobile phone). Compared to the population (not Internet users) of Singapore (4.8 million), Malaysia (27 million), South Korea (48. 6 million).Thailand (67 million), Vietnam (86 million), and Philippine (90 million), it is clear that the number of Internet users in Indonesia will be signific antly higher than the number of Internet users in those countries. Usage of Internet Internet users in Indonesia go on about 17. 2 hours online per month According to a survey conducted by Nielsen Indonesia, most Indonesians use the Internet for checking email (42%), reading newspaper (39%), searching for reading about products or services (29%), reading magazines (27%), and chatting (23%).A study by comScore shows only 50% of Indonesian Internet users do online shopping and they spend only 1% on their online time for shopping. Clearly, online shopping is still not the main reason for Indonesians to go online. While Indonesians are still overcautious in using the Internet for shopping, there are very eager to online social networking. 28 million Indonesians have account(s) with Facebook, making them the 3rd largest Facebook users in the world. As of June 2010, Indonesians also produced the 3rd highest number of tweets in the world. It is not strike at all that 87% of Indonesians does social networking and they spend 32.6% of their online time or 5. 8 hours per month in websites such as Facebook and chirp Most Internet users (84. 2%) in Indonesia use Search to attend information they are looking for. The average number of Searches per user is 91. 4. 80% of Indonesian Internet users uses Google to do their Search. Above data is higher than others Southeast Asia country. Considering its high economic and Internet user growths, Indonesia has a great potential difference for Internet business. However, it would not be aristocratical to win in this industry due to online gambling is specially industry in Indonesia.External analysis- determination Considering its high economic and Internet user growths, Indonesia has a greater potential for Internet business compare others Southeast Asia. Moreover, the Internet business there is still in a very early stage with a limited number of local players and products/services offered. However, it would not be easy to win in this industry. Unsophisticated payment infrastructure and conventional brainpower of its people will become the biggest challenges for enterprisers and investors who want to explore Indonesias untapped potential in Internet business.The general message is that entrepreneurs and investors with long time horizons should look at Internet business in Indonesia as an alternative worth considering depending on the nature of the investment and the risk tolerance of the entrepreneur or investor. Internal analysis-Customer Behavior analysis Common Casino games of Indonesian Members play. * Baccarat * Blackjack * Sic Bo Current Indonesia Members Behavior Following table is current Indonesia particles behavior of deposit and wager, the data is base on my current company data. Indonesia Business PerformanceAnnual stake generated 14. 3 Million and revenue generated 657, 000(third higher than others Southeast Asia) Competitor analysis-4P analysis For now total have 4 major competitor s doing business in Indonesia market Analysis above the data, doing online gambling business in Indonesia, should offer more competiveness product and promotion to attract new customer due to the current Indonesia member generated revenue is higher than existing market, additional the External analysis, new market as Indonesia has a greater potential for Internet business.References * Rocky Fu (August 2009)China Internet Market Size in Q2 2009 * Internetworldstats(July 2010) China ecommerce and Internet Market Report * casinolistings(2009)The future of gambling in China * Casino King David training as thing, manoeuvre History in China * Gamingzion (2007) entropy as thing. romp in China * Economy watch(2010) Malaysia Economy * Tom B. (2010) Information as thing. Chinese Law Enforcement Rounding Up Illegal Online Gambling Operators * Michael F. (2010) Information as thing.Journal of the China Arrests 3,430 with Online Gambling Ties * Asiaplace (2009) Information as thing. Malaysia Cracks Down on Internet Gambling * KEN NG, Klang(2009) Information as thing, Legalise online gambling * Cyrildason(2010) Information as thing, Sports Betting in Malaysia * Brian M. (2010)Online Gambling in Malaysia Most Popular in Sarawak * TomWeston (2008)Online Gambling Grows in Popularity in Thailand * CoolFounders (2010) A broader look at Indonesia startups and internet Business prospects * MR. SUNDERASAN(Oct 2009) PESTEL analysis of Indonesia * urine & stone (2010) Indonesia online 2010.