Ten Steps Of Billing Process Health And Social Care Essay

Measure One. Pre-register the patients. Obtain or verify the patient ‘s demographics. Gather the patient ‘s name, reference, phone figure, day of the month of birth, the nature of the medical job, the insured ‘s name, reference, phone figure, relation of the insured to the patient, type of insurance, insured ‘s ID figure. Determine if referrals are needed or is a anterior mandate needed? Verify referral or mandate phone Numberss provided on the card, co-pay sum, co-insurance, and whether the medical job is due to an car accident, or a work related accident. This information helps to find if a commercial insurance is primary or if another insurance is primary. Information obtained at pre-registration is important to the charge procedure and decreases denials ( Deutscher, 2008 ) . Measure Two. Establish the fiscal duties for the visit. Verify insurance eligibility and find how much to roll up up forepart from the patient. Insurance and all other information demands to be check at each visit because patients may reassign from one insurance program to another, move or alteration occupations. Eligibility can alter month to month on certain types of insurance therefore these types must be verified on each visit. This is besides where an account of the installation ‘s policy on fiscal affairs is given to the patient ( Deutscher, 2008 ) . Measure Three. Check-in the patient. Obtain the medical history and demographics of new patients. Confirm with returning patients that all information is right and up to day of the month. At this point, their record should be checked for any past charges still unpaid. If the patient ‘s insurance will non be covering this visit, or if the patient is without insurance, have the patient mark a release accepting duty for the entire sum due of this visit. Some installations collect co-pays at this point ( Deutscher, 2008 ) . Measure Four. Check-out patients. Enter the medical and process codifications for the visit to set up a charge with the patient or the patient ‘s insurance. Give them all prescription, lab faux pas or referral paperwork they might necessitate for ordered work. Schedule a follow-up assignment if necessary. Besides record any minutess for this visit ( Fordney, 2008 ) . Measure Five. Reappraisal coding conformity. Obtain CPT and ICD-9 codifications from the doctor ( s ) . Verify that all information is right before come ining it into the computing machine system. All codifications should be checked for mistakes. Everything in the study should logically associate together so the insurance company understands the necessity for the medical charge applied ( Fordney, 2008 ) . Measure Six. Check charge conformity. When it comes to a charge conformity program, the stairss in the charge procedure have to be done right by the regulations and ordinances set by the conformity program. The medical records must hold the right codifications for the charge to be right. A conformity program prevents fraud from happening, and helps happen and fix mistakes in medical certification and charge. Documentation must besides follow the regulations of the conformity program as good ( Fordney, 2008 ) . Measure Seven. Prepare and transmit claims. This is largely done electronically now, and the transmittals of claims have to be HIPAA compliant. This transmittal besides involves the insurance company or the clearinghouse directing a reception of recognition of the claim filed ( Fordney, 2008 ) . Measure Eight. Monitor payer adjudication. This involves maintain an aging study which shows all outstanding claims in columns, based on how many yearss old they are in 30 twenty-four hours increases. At 30 yearss, the procedure of naming on or resubmitting the claim begins ( Fordney, 2008 ) . Step Nine. Generate patient statements. Monitoring of patient balances is every bit of import. This is handled by directing monthly statements to patients with balances owing ( Fordney, 2008 ) . Measure Ten. Follow up on patient payments and handle aggregations. Identify which statements have gone out more than one time. If it has been sent three times so it ‘s of import to allow the patient know that his or her history is in danger of being sent to aggregation ( Fordney, 2008 ) . 1.a. Brush signifiers. The brush signifier is known by several different names, such as superbill, charge faux pas, and routing signifier. This signifier is printed out and attached to the patient ‘s wellness record at the clip of check-in. Besides the identifying information, it besides contains the procedural and diagnostic codifications and whether the patient should return for an assignment. This is a combination of a measure, an insurance signifier and a rout-system used in both computing machine and paper based systems. For computerized systems, this signifier can be scanned to input the charges and diagnoses into the patient ‘s history and medical record. Some have barcodes that can be read to input the charges and diagnoses into the patient ‘s history and medical record. Some medical patterns use the brush signifier as a routing sheet and as an bill to the patient. When used as a routing sheet, it becomes a beginning papers for insurance claim informations. The brush ‘s process and diagnostic codification subdivisions should be updated on reprinted twice a twelvemonth, based on alterations, add-ons, and omissions of procedural and diagnostic codifications ( Fordney, 2008 ) Explanation of Benefits. The Explanation of Benefits ( EOB ) , besides referred to as remittal advice, is a papers issued saying the position of the claim. This is sent by the remunerators to both the donees and suppliers. EOBs provide the necessary information about claim payment information and patient duty sums. Every wellness insurance company, including HMOs, is required to supply the insured or subscriber with an Explanation of Benefits in response to the filing of a claim. EOBs are non required when service is provided by a take parting supplier who receives full reimbursement straight from the insurance company, but will be provided upon petition. Each EOB must include the undermentioned: name of the supplier of the service, day of the month of service, designation of the service, supplier ‘s charge, the sum or per centum collectible after deductibles, co-payment and any other decrease of the sum claimed, telephone figure or reference where an insured may obtain elucida tion, information on how to register an entreaty of a denial of benefits, including the applicable timeframe to register ( Fordney, 2008 ) . Advance Beneficiary Notice. An Advance Beneficiary Notice ( ABN ) is besides known as a release of liability. When a patient is to have a service or an point from a take parting supplier or suppler, that might be denied for medical necessity by Medicare, the supplier or provider must inform the patient and have him or her agree to pay for the denied service in progress. Every infinite on the ABN must be filled in before giving it to the patient to subscribe. Suppliers on the other manus, are non required to give the patient an ABN for services or points excluded from Medicare coverage. ABNs merely use if the patient is in the original Medicare program, and non in a Medicare private wellness program. If the patient does non acquire an ABN to subscribe before the service or point from the supplier, it is non specifically excluded from coverage, and Medicare does non pay for it, so the patient does non hold to pay for it. If the supplier does give the patient an ABN that is signed befor e service or given the point, and Medicare does non pay for it, so the patient will hold to pay the supplier. Medicare considers the appropriate usage of ABNs a conformity issue. When directing in a claim, the HCPCS qualifier -GA must be added to the appropriate codifications to bespeak that the patient has signed the release ( Fordney, 2008 ) . Remittance Advice. Electronic remittal advice ( ERA ) is an on-line dealing about the position of a claim. It gives information on claims paid or denied, and sends a ground to the charge specializer. Managed attention programs pay by either a capitation system or based on the services given to the patient with a statement of remittal or account of benefits ( EOB ) . In the system when payment is based on services rendered, and a statement of remittal or EOB is generated, such statements will enumerate services that have been rendered to patients and normally indicate the sum billed, sum allowed, sum paid, and any co-payment to be made by the patient. By and large patients under managed attention programs do non have an EOB. With Medicaid, if a supplier wants to have an ERA, so a signifier must be completed and sent to the financial agent. If a supplier is utilizing the paper system, so Medicaid will direct a remittal advice ( RA ) with all Medicaid payment cheques. Medicare sends a p ayment cheque along with a nationally standardised papers to take parting doctors called a Medicare RA. On the front side of the RA are position codifications that are the same countrywide, stand foring the ground a claim may non hold been paid in full or was denied, etc. These codifications are defined on the rearward side of the RA. Non-participating doctors besides receive an RA with payment information about unassigned claims ( Fordney, 2008 ) . Engagement Contracts. Participating suppliers ( par ) has a contractual understanding with an insurance program to render attention to eligible donees and so measures the 3rd party straight. The 3rd party remunerator pays its part of the allowed sum, and the supplier measures the patient for the balance non paid by the insurance company, after the excluded part is adjusted off the history. There are some programs though where the take parting supplier is called a member, and they may accept the payment as payment in full, or may be free to measure the patient for any unpaid balance, depending on the contract ( Fordney, 2008 ) . 1.b. Adjudication procedure for remunerators and suppliers. Once a claim has been sent to the patient ‘s wellness program, the remunerators review the claims through the adjudication procedure. Through this procedure the remunerator puts the claim through a series of stairss to find if it should be paid or non. After these stairss are completed, the remunerator decides to either pay the claim in full, to merely pay some of it, or to deny it wholly. Upon this, a study is sent to the supplier along with payment. If the patient has more than one insurance program, the primary program will direct the balance of the claim to them. Suppliers have contracted agreements with each remunerator hence what the remunerator pays out may non fit the supplier ‘s fee. Most suppliers so adjust/write off the difference of their fee to what the remunerator pays out. It is every bit of import for the supplier to supervise the claims. The faster the supplier can have payment the better his or her bottom line becomes. To supervise the claim during adjudication, the supplier must cognize the sum of clip the remunerator is allowed to take to react to the claim, and how long the claim has been in procedure. Suppliers have to register the claim within a certain sum of clip after the service, and remunerators have to treat clean claims within the claim turn-around clip agreed upon in the engagement contract ( prompt-pay Torahs ) . Aging is the 3rd portion of claim followup. Producing an aging study lets the supplier cognize how long the remunerator has had the claim. HIPAA 276 is the enquiry that is sent to obtain information on the position of a claim and HIPAA 277 is the response returned by the remunerator. From here the supplier must cognize the timetable for subjecting a corrected claim and how to register a 2nd claim if necessary, how to feed back if a claim has been denied for losing or wrong informations, and how to manage a petition for more information or certificati on ( Valerius, Newby & A ; Seggern, 2008 ) . 2. Claims Processing Hospital/Facility Claims Processing Claims Transmission: The infirmary forwards the medical claims to the medical charge squad via a messenger or as scanned paperss. The medical claim must be supported by patient inside informations such as demographics, superbills, charge sheets, insurance confirmation informations, a transcript of the insurance card and any other information refering to the patient ( Fordney, 2008 ) . Retrieval and Checking of Medical Claims: The medical charge staff accesses the medical claims and back uping paperss. All paperss are checked for illegible or losing paperss and the infirmary charge office is notified instantly so that they can re-scan and direct losing paperss ( Fordney, 2008 ) . Medical Cryptography: An of import measure in claims treating is to repair the process and diagnoses codifications for each patient based on criterions such as CPT ( Current Procedural Terminology ) and ICD-9 ( International Classification of Diseases, Ninth Edition ) . The degree of service determines the 5-digit process codification, while the diagnosing codification is based on the medical diagnosing made by the physician ( Fordney, 2008 ) . Charge Creation: Medical Billing professionals will so make appropriate medical claims based on charge regulations refering to specific bearers and locations. All medical claims must be created within agreed turnaround times – by and large 24 hours. A thorough audit and checking of the completed medical claims is done at multiple degrees. The medical claims are checked for right and complete information, right process and diagnosing codifications, and the genuineness of all other relevant information about the patient, since incomplete/incorrect information is one of the individual most common grounds for rejection of medical claims ( Fordney, 2008 ) . Medical Claims Audit: A thorough audit and checking of the completed medical claims is done at multiple degrees. The medical claims are checked for right and complete information, right process and diagnosing codifications and genuineness of all other relevant information about the patient since incomplete/incorrect information is one the individual most common ground for rejection of medical claims ( Fordney, 2008 ) . Medical Claims Transmission: Medical claims created are filed for follow up before they are sent electronically to the claims transmittal section with all relevant information on each medical claim ( Fordney, 2008 ) . Claims Submission to Insurance Agencies: The audited, listed and recorded medical claims are printed out and dispatched to allow Insurance Agencies or governmental sections, with any fond regards or back uping paperss that may be required for colony ( Fordney, 2008 ) . Follow-up and Settlement: This involves the concluding phases where the medical charge squad follows up systematically with the insurance companies and payment bureaus until the concluding colony is disbursed ( Outsource2india, 2010 ) . Reprinted from Outsource2india, 2010 Physician/Provider Claims Processing Data entry of patient demographics, mentioning doctor, CPT and ICD Codes, and Modifier ( s ) is entered into the medical charge package Scan the paperss for charge mistakes and rectify them if needed Adjudicate client claims for truth Preparation of Explanation of Benefits ( EOBs ) Submit and file the claim with the insurance company Follow up on the claims with the insurance company Apprise biller of the position of the claim Process denied claims and re-adjudicate them for claims entry ( Outscource2india, 2010 ) Comparison of Commercial, Managed Care and Federal Insurance Plans Commercial wellness insurance covers medical disbursals and disability income for the Insured and are sold for by net income bearers. Policies vary in sums harmonizing to the types of specific coverage that they provide. It is besides coverage that provides two types of benefits – disablement income and medical disbursals ( answers.com ) . Managed Care Insurance feature is the inducement for the insured to remain within a specific web of wellness attention suppliers. Managed attention plans fall into 3 basic types: HMO, PPO, and POS. HMOs provide medical intervention on a postpaid footing, which means that HMO members pay a fixed monthly fee, irrespective of how much medical attention is needed in a certain clip period. A PPO is made up of physicians and or infirmaries that provide medical service merely to a specific group and a system where the patient pays no deductible and normally merely a little co-payment when they use a wellness attention supplier within their web ( answers.com ) . Federal Insurance plans. One of the most outstanding characteristics of the Federal Employee Health Benefit Program ( FEHBP ) is the picks it allows. There are three types of programs: fee-for-service and preferable supplier organisation ( PPO ) , normally offered combined, HMOs, and high deductible wellness insurance programs and other consumer-driven programs. In the FEHBP, the federal authorities sets minimum criterions and if met by an insurance company, allows it to take part in the plan. The consequence is legion viing insurance programs that are available to federal employees. The FEHBP has frequently been proposed as a theoretical account for national wellness insurance and sometimes as a plan that could straight inscribe the uninsured ( opm.gov ) . Major Payment and Reimbursements A Prospective Payment System ( PPS ) is a method of reimbursement in which Medicare ( CMS ) payment is made based on a predetermined fixed sum. The payment sum for a peculiar service is derived based on the categorization system of that service, such as diagnosis-related groups ( DRG ) for inpatient infirmary services.A DRGs have been used in the US since 1983 to find how much Medicare pays the infirmary, since patients within each class are clinically similar, and will utilize the same degree of hospital resources ( Fordney, 2008 ) . In the prospective payment method, payment rates for health care services are established in progress for a specific clip period. Two types of prospective payment methods are per-diem and case-based payment. In per-diem, the 3rd party remunerator reimburses the supplier with a fixed rate for each twenty-four hours a covered patient is hospitalized. In instance based, 3rd party remunerators reimburse suppliers per instance instead than for each service or per diem ( Casto, Layman, 2006 ) . CMS besides uses separate PPSs for reimbursement to acute inpatient infirmaries, place wellness bureaus, hospice, hospital outpatient, inmate psychiatric installations, inmate rehabilitation installations, long-run attention infirmaries, and skilled nursing installations ( CMS.gov ) . Another state – Spain During the 1980 ‘s alterations came to the Spanish health care plan. First they started with a societal security system that assured wellness attention coverage for merely the working and retired people while a combination of common and private organisations ensured basic attention for the remainder of the population. It was n't until 1997 that DRG coding came into drama for hospital reimbursement. Previously wellness attention was reimbursed harmonizing to a per contact system based on Basic Assistance Units ( Cots, Salvador, Chiarello, Bustins, Castells, ( n.d. ) ) . DRG payment systems were foremost used in Catalonia in 1997. They adopted the CMS DRG coding version. Hospitals received an sum per instance depending on the comparative mean DRG weight of all infirmary discharges. The infirmary comparative ration is multiplied by a fixed sum that is published yearly. Catalonia Health sets the discharge monetary values for each comparative resource strength ( IRR ) and the construction comparative index ( IRE ) every bit good as two burdening per centums. IRE reflects the infirmary ‘s construction degree, while the degree of the infirmary ‘s ingestion of resources ( IRR ) is defined by DRG discharge weights coded with CMS DRGS ( Cots, Salvador, Chiarello, Bustins, Castells, ( n.d. ) ) . Outline Different PPS in the United states Physician attention groups ( PCHs ) PPS method for physician services in ambulatory scenes visit based classified services harmonizing to clinical similarity and scene includes patients from all age groups and from parts of the universe with instance mixes of diseases and differing forms of health care bringing Pediatric Modified Diagnosis Related Groups ( PM-DRGs ) for newborns and paediatric patients developed by National Association of Children ‘s Hospitals and Related Institutions All Patient DRGs ( AP-DRGs ) categorizations for neonatal, paediatric, bad obstetrical, multiple injury, organ graft, and ventilator-dependent patients allows accurate comparings of patients in footings of length of stay, resource ingestion and results International refined DRGs ( IR-DRGs ) inpatient categorization system designed for footing of payment of international health care Clinical hazard groups ( CRGs ) predicts future health care outgos capitated payment system includes all age groups fee for service reimbursement and episode of attention reimbursement based on unit of payment ( Casto, Layman, 2006 ) Acute Inpatient PPS each instance is categorized into a diagnosis-related group ( DRG ) each DRG has a payment weight assigned to it, based on the mean resources used to handle Medicare patients in that DRG basal payment rate is multiplied by the DRG comparative weight. Home Health PPS Medicare pays place wellness bureaus ( HHAs ) a preset base payment adjusted for the wellness status and attention demands of the donee payment is besides adjusted for the geographic differences in rewards for HHAs across the state. instance mix accommodation for the wellness status, or clinical features, and service demands of the donee provide HHAs with payments for each 60-day episode of attention for each benefit Inpatient Psychiatric Facilities PPS paid under the infirmary inmate prospective payment system ( PPS ) certain types of forte infirmaries and units were excluded from PPS because the PPS diagnosing related groups do non accurately history for the resource costs for the types of patients treated in those installations Facilities originally excluded from PPS included rehabilitation, psychiatric, kids ‘s, malignant neoplastic disease, and long term attention infirmaries, rehabilitation and psychiatric infirmary distinguishable portion units, and infirmaries located outside the 50 provinces and Puerto Rico ( BBRA ) ( Pub.L. 106-113 ) , directed the development of a per diem PPS for inmate psychiatric services furnished in infirmaries and exempt units. Inpatient Rehabilitation Facilities PPS authorizes the execution of a per discharge prospective payment system ( PPS ) , utilize information from a patient appraisal instrument ( IRF PAI ) to sort patients into distinguishable groups based on clinical features and expected resource demands. Separate payments are calculated for each group, including the application of instance and installation degree accommodations. Long-Term Care Hospital PPS a per discharge system with a diagnosis-related group ( DRG ) based patient categorization system reflects the differences in patient resources and costs the Secretary shall analyze, and may supply for, accommodations payments to DRG weights, country pay accommodations, geographic reclassification, outliers, updates Skilled Nursing Facilities PPS payment rates are adjusted for instance mix and geographic fluctuation in rewards screen all costs of supplying covered SNF services ( everyday, accessory, and capital-related costs ) . Inpatient PPS PC Pricer infirmary is paid a fixed sum for each patient discharged in a Diagnosis Related Group ( DRG ) fixed sum is intended to cover the cost of handling a typical patient for a peculiar DRG. The PPS Pricer package, calculates discharges from October 1 through September 30 for a given financial twelvemonth ( CMS.gov ) . 6.Local Medical Review Local medical reappraisal policies are developed to assist suppliers and providers in subjecting right claims for payment. Local policies outline when and under what conditions a service, point, or supply is considered medically sensible and necessary, every bit good as the methods contractors will utilize to reexamine claims. These policies are the foundation of the reappraisal procedure. They define the service, decides when a service is sensible and necessary, outlines any coverage standards or specific certification demands, provides specific coding or modifier information and provides mentions upon which the policy is based. CMS requires that local policies be consistent with national guidelines, hence utilizing an consultative commission of medical professionals within Medicare and the medical community, LMRPs is developed. Once they are developed and implemented, LMRPs so provides the determination devising standards for any claim reappraisal and payment determinations. With e ach province holding its ain Medicare contractor, A consequences in each province holding its ain LMRP Local Medical Review Policies ( LMPR, 2010 ) . 7.HIPAA Privacy and Security Rule HIPAA privateness regulation applies to protected wellness information ( PHI ) in any signifier or medium while the Security Rule covers merely PHI that is electronically stored or transmitted by covered entities. The Security Rule ( SR ) has a broader enterprise than the confidentiality focal point of the Privacy Rule. This Security Rules aims at guaranting the unity and handiness of electronic PHI excessively. The Security Rule has to turn to issues such as informations backup, catastrophe recovery and exigency operations. SR has to do certain that covered entities that collect, maintain, use or transmit PHI in electronic signifier must build sensible and appropriate administrative, physical and proficient precautions that guarantee unity, handiness and confidentiality. Such processs must supply protection against any moderately awaited menaces or jeopardies. The Security Rule besides includes a criterion for electronic signatures ( Fordney, 2008 ) . 8.Classifications, Taxonomies, Terminologies and Terminologies Taxonomies are defined as the scientific discipline of categorization. These are the numeral and alpha supplier forte 10 figure codifications which are assigned to sort each wellness attention supplier. Taxonomy codifications are necessary because some institutional suppliers may non take to use for a alone national supplier figure for each of its subparts. The type of forte could impact the doctor ‘s wage depending on the contract with the remunerator ( Fordney, 2008 ) . Categorizations are legion in the claims processing. There is the categorization of diseases, and categorization of patients – outpatient, inmate, and ambulatory patients, to call a few. Everything is put into a categorization which if used and understood, helps the claims processor with truth ( Fordney, 2008 ) . Terminologies are footings abbreviated to initials. In claims insurance there are EOB, ERA, HMO, DRG, CPT, APG, AVG, MDC, AMA, CMS, EDI, ED, etc. It ‘s the alone linguistic communication spoken by claim processors. A terminology can hold several significances therefore it is of import to cognize which terminologies are non acceptable to a installation. Besides, when in uncertainty, inquire a physician or other medical professional what the abbreviation means ( Fordney, 2008 ) . In claims treating nomenclatures such as EOBs ( Explanations of Benefits ) , EOMB ( Explanation of Medicare Benefits ) , ERA ( Electronic Remittance Advice ) , RA ( remittal advice ) are illustrations. These are words that are easy understood throughout the profession ( Fordney, 2008 ) . Office of Inspector General OIG undertakes countrywide audits, every bit good as probes and reviews to reexamine the claim entry procedure of suppliers and reimbursement forms of the plans. The presence of an OIG conformity plan can significantly relieve imposed punishments in the event of an OIG audit or other finds of deceitful charge activities. A comprehensive auditing and monitoring plan will assist minimise the hazard of fraud and maltreatment by placing hazard countries ( igo.state.gov ) . Quality Improvement Organization in Michigan MPRO is a non-profit-making organisation and serves as the quality betterment organisation ( QIO ) for Michigan since 1984. It is contracted with the Centers for Medicare & A ; Medicaid Services. Its charge is: Work with Michigan Medicare suppliers to better the quality of attention for its endorsers. Promote all Michigan Medicare suppliers to follow grounds based medical specialty in all scenes. Protect the unity of the Medicare Trust Fund, by doing certain that Medicare pays merely for goods and services that are medically necessary that are performed in a proper medical scene. Protect the endorsers by look intoing their ailments and entreaties. QIO besides provides advisory services, medical and utilization reappraisals, informations analysis to federal bureaus, province Medicaid and public wellness bureaus, health care installations, and private wellness programs and 3rd party remunerators. QIO consists of a mixture of physician referees, clinical quality betterment and patient safety experts and statisticians. QIO serves infirmaries, nursing places, place wellness attention, physician offices and managed attention scenes ( MPRO.org ) . MPRO ‘s wellness attention quality betterment plans include legion preparations and go oning instruction events for Michigan suppliers across all scenes. Many events are free and Continuing Education Creditss are besides available. MPRO assists Michigan Medicare suppliers ( free of charge ) to better the quality and bringing of their wellness attention by the execution of evidence-based medical specialty that improves procedures and results. Areas of coverage include: Beneficiary Protection Patient Safety Prevention To better quality, safety and efficiency, MPRO publishes booklets for Medicare donees, explicating their rights as a donee ( MPRO, org ) . Other countries of service include: Breast Cancer and Cervical Cancer Control Program ( BCCCP ) Independent Medical Review Informal Dispute Resolution ( IDR ) Long Term Care Remediation Care Compliance Solutions for Long Term Care Providers Medicaid Fee-for-Service Utilization Review Program External Quality Review ( EQR ) MPRO is carry oning a Care Transitions undertaking in the mid Michigan country ( specifically, Clinton, Eaton and Ingham counties ) to measurably better the quality of attention of Medicare donees who transition between attention scenes. MPRO focuses on bettering coordination of attention between suppliers and across the continuum of attention by advancing seamless passages from the infirmary to place, skilled nursing attention, place wellness attention or other suppliers to forestall evitable readmission to the infirmary ( MPRO.org ) . The end of the Prevention Theme is to better the quality and frequence of preventative wellness attention services in order to optimise beneficiary quality of life and wellness attention efficiencies ( MPRO.org ) The Prevention Theme focuses on the undermentioned clinical subjects: Breast Cancer Colorectal Cancer ( CRC ) showing Influenza Immunizations Pneumococcal Immunizations Professionalism in Health Care Professionalism – Hard to specify, but you know it when you see it. Medical moralss are non Torahs, but criterions of behavior by and large accepted as moral guidelines for behaviour, by which a professional may mensurate the decorousness of his or her behavior in relationship with patients, doctors, colleagues, the authorities, and insurance companies. Acting with ethical behaviour agencies to transporting out duties with unity, decency, honestness, competency, consideration, regard, equity, trust, and bravery. The American Medical Association ( AMA ) adopted a codification of moralss for the benefit of the wellness professional in 1980. The Internet Health Coalition developed an eHealth Code of Ethics to protect patient ‘s information on the Internet ( Fordney, 2008 ) . An person must hold a assortment of features or qualities to work good as an insurance charge or coding specializer. Some of these qualities are: Strong critical thought and comprehensive reading accomplishments Logical and practical mind every bit good as a originative job convergent thinker Good organizational accomplishments Detail oriented One ‘s properties, accomplishments, personal image and behavior all contribute to professionalism ( Fordney, 2008 ) . Webster ‘s Collegiate Dictionary defines professionalism as â€Å" the behavior, aims or qualities that characterize or mark a profession or a professional individual † . All professionals portion common features and a codification to stay by. But it is non what we do as a professional, but how we do it, that defines the medical professionalism. It is the unconditioned lovingness of the patient, irrespective of their ability to pay or their station in life ( Fordney, 2008 ) . Most everyone knows instinctively what is meant when they hear the words â€Å" he ‘s so professional. † This evokes an image of high competency and high moralss ; person commanding regard. All countries of professionalism has a codification of behavior, it is non alone to the medical profession. This codification is the moral compass that keeps us on the consecutive and narrow. It will be our moralss that will separate us as a true professional ( Fordney, 2008 ) .Standards of Ethical CryptographyCoding professionals should: Apply accurate, complete, and consistent cryptography patterns for the production of high-quality health care informations. Report all health care informations elements ( e.g. diagnosing and process codifications, nowadays on admittance index, discharge position ) required for external coverage intents ( e.g. reimbursement and other administrative utilizations, population wellness, quality and patient safety measuring, and research ) wholly and accurately, in conformity with regulative and certification criterions and demands and applicable functionary coding conventions, regulations, and guidelines. Assign and study merely the codifications and informations that are clearly and systematically supported by wellness record certification in conformity with applicable codification set and abstraction conventions, regulations, and guidelines. Question supplier ( physician or other qualified health care practician ) for elucidation and extra certification prior to code assignment when there is conflicting, uncomplete, or equivocal information in the wellness record sing a important reportable status or process or other reportable informations component dependant on wellness record certification ( e.g. nowadays on admittance index ) . Garbage to alter reported codifications or the narrations of codifications so that significances are misrepresented. Garbage to take part in or back up cryptography or certification patterns intended to unsuitably increase payment, measure up for insurance policy coverage, or skew informations by agencies that do non follow with federal and province legislative acts, ordinances and official regulations and guidelines. Facilitate interdisciplinary coaction in state of affairss back uping proper cryptography patterns. Advance coding cognition and pattern through go oning instruction. Garbage to take part in or hide unethical cryptography or abstraction patterns or processs. Protect the confidentiality of the wellness record at all times and garbage to entree protected wellness information non required for coding-related activities ( illustrations of coding-related activities include completion of codification assignment, other wellness record information abstraction, coding audits, and educational intents ) . Demonstrate behaviour that reflects unity, shows a committedness to ethical and legal cryptography patterns, and Fosters trust in professional activities ( AHIMA.org ) . Revised and approved by the House of Delegates 09/08. All rights reserved. Reprint and cite merely with proper mention to AHIMA ‘s writing. The Federal Register The Federal Register is the day-to-day official diary of the Federal Government of the United States that contains public notices of authorities bureaus. The Federal Register is compiled by the Office of the Federal Register ( within the National Archives and Records Administration ) and is printed by the Government Printing Office. Since it is a publication of the U.S. Government, there are no copyright limitations on the Federal Register. It is in the public sphere and contains proposed new regulations and ordinances, Final regulations, alterations to bing regulations, and notices of meetings and adjudicative proceedings. This is a good mention for alterations in the wellness industry and maintaining abreast of approaching alterations. Example of a concluding regulation: Health Insurance Reform: Alterations to Electronic Data Transaction Standards and Code Sets AGENCY: Office of the Secretary, HHS. Action: Concluding regulation. Summary: In this concluding regulation, we respond to public remarks received and finalize commissariats applicable to electronic informations dealing criterions from two related proposed regulations published in the May 31, 2002, Federal Register. We are besides following proposed alterations to implementation specifications for wellness attention entities and others. In add-on, we are following alterations to implementation specifications for several electronic dealing criterions that were omitted from the May 31, 2002, proposed regulations. Effective Dates: These ordinances are effectual on March 24, 2003.A §164.500 [ Amended ]6. A § In 164.500 ( B ) ( 1 ) ( four ) , take the words †including the appellation of wellness attention constituents of a covered entity † .A § 165.501 [ Amended ]7. In A §164.501, the definitions of the undermentioned footings are removed: Covered maps Disclosure, Individual, Organized wellness attention agreement, Plan sponsor Protected wellness information, Required by jurisprudence, and Use.A § 164.504 [ Amended ]8. In A §164.504, the undermentioned alterations are made: a. The definitions of the undermentioned footings are removed: Common control, Common ownership, Health attention constituent, and Hybrid entity. B. Paragraphs ( B ) through ( vitamin D ) are removed and reserved. Authority: Sections 1173 and 1175 of the Social Security Act ( 42 U.S.C. 1329d-2 and 1320-4 ) . Dated: January 13, 2003.Tommy G. Thompson,Secretary. [ FR Doc. 03-3877 Filed 2-13-03 ; 8:45 am

History of Art Therapy

Art therapy is an effective form of self expression and is now considered to be a viable psychological tool in resolving inner conflicts, and   particularly helps   in the rehabilitation of emotionally disturbed or mentally ill patients.Through the arts, thoughts,   feelings, and needs are communicated. It must be known that the cornerstone of this mode of therapy is psychoanalysis, which will be explored in detail below.Art therapy has been supplementing the psychotherapeutic programs in the hospital settings.   It is now widely used in psychiatric hospitals and rehabilitation centers, and, is practiced by qualified art therapists or by psychologists. But when and how did it begin?To begin to understand the discipline of psychology, and the role psychoanalysis played in the practice of psychotherapy in general, it is noteworthy to mention that while psychoanalysis and psychology have a common background in nineteenth century science,   they were independent of one another for a number of years because of their differences in focus or interests.Psychology was looking at sensation, perception, memory and thinking – all elements and processes of consciousness.Whereas, psychoanalysis focused on the unconscious – motivation, emotion, conflict, neurotic symptoms, dreams and character traits. Following World War II, and perhaps, due to the demands of the time, the gap between the two disciplines began to diminish, and thanks to the opportunity offered   to psychologists to train in psychoanalysis   (Hall & Lindzey, 1978).While the arts as a form of human expression have been around for thousands of years, the merger of psychotherapy and arts therapy was realized in   the 1940's during the World War II.   Adrian Hill, a professional artist, coined the term â€Å"art therapy.†Ã‚   Hill   turned to his art for his own therapy while he was recovering in a   health sanitarium for tuberculosis patients.He later had the chance to i ntroduce painting to other patients. He found out that, not only did the patients found satisfaction in their work, but they were able to use it to reveal their repressed feelings   and   trauma of the war (Borowsky,1984).It was Edith Kramer who made observations on the importance of art for traumatized children. In the late 1930s, Kramer has worked with children of refugees from Nazi, Germany, and she has observed firsthand, how the children responded to stress.The artwork of these children revealed patterns of unresolved conflicts, regression and even aggression . It must be remembered that these children   have seen the horrible damage done by Hitler (Kramer, 1971).Kramer emphasized that art expression is an emotional journey toward self-discovery.   In her approach, art as a process is a catharsis. Recreating scenes and images from one's   past traumatic experience   helps bring the unconscious conflicts unto consciousness, and once catharsis is experienced, relief a nd positive change follows (Moreno, 1946).The concept of catharsis is associated with the early psychodynamic theories.   Catharsis is defined by the American Psychological Association (2007) as â€Å"the discharge of affects connected to traumatic events that had been repressed by bringing these events back into consciousness and reexperiencing them (p. 153). In this approach, painful experiences are released in therapy, by reliving the suppressed emotions.   Its curative effect is seen in various forms – religion, medicine, literature,   theater and the arts.Margaret Naumberg founded the Walden School in New York City in 1915. She believed that children best learn and develop when they are encouraged to express themselves through creative pursuits.She just knew that art is a window to the subconscious mind, and the therapist can best understand the difficulties one is going through by utilizing art as a tool of expression. For her, what is important is what one is co nsciously or unconsciously expressing through his artwork.Theories of Carl Jung, Sigmund Freud, and the other psychoanalytic thinkers of the time seemed to have been of great influence to Naumberg's approach to art therapy. The idea that art could be used to enhance diagnosis encouraged not only Naumberg but other early practitioners to study these images and their meanings. Diagnostic drawing and protocols were later developed that led art therapy onto its clinical direction.Jung believed in the healing power of imagination and creativity. He gave   importance to archetypal symbols, and   even encouraged his patients to fantasize and to explore (Feder, 1981).It must be recalled, archetypes are thought forms that create image that correspond to normal waking life, such as an image of a mother figure, that is then identified with the actual mother. Jung pointed out that feelings are explored through a variety of ways. Flow of images are represented in drawing, painting, sculpture , music and movement .Meanwhile, Freud provided the foundation for understanding psychoanalytic processes when he discussed much about symbols in dreams through his writings.Freud believed that   dreams are predominantly visual. However, much of the dream experience is lost in the interpretation of these images into words. He believed that patients could best draw an image, what they were unable to describe in writing (Feder).Naumberg came to realize through their theories that art expression is a technique that has the innate capacity to unavel repressed material, much like verbal therapy. She recognized that one's unconscious feelings and thoughts are best expressed in images than in words. Also, to further illustrate its parallelism to psychoanalysis, take for instance the created images in artworks.These are seen as external symbols of one's thoughts and a skilled therapist could best use these images to elicit feelings, much like the idea of transference.   Integrative tran sformation   or healing is made possible when this experience is made part of an art therapy session.The concept of transference is the cornerstone of the theory and practice of psychoanalysis which originated with Freud.   Simply, transference is reacting to a person in the present as though he or she were a person in one's past. Freud opined that during therapy sessions, patients were unconsciously â€Å"transferring† the feelings and attitudes they had toward early significant figures onto their   therapist.Since then, he knew that the â€Å"transferential† relationship between the patient and the therapist is actually the curative element in psychoanalysis.

Physical Education Essay

Brief Description of Teaching Approach Used by the Teacher: Direct instruction- a lecturing method of teaching because it can cover large amount of materials in a short period of time. Teaching Aids used Strengths Weaknesses Comments on Appropriateness of the Teaching Aids used Chalk board Handouts Books White board Used as a medium for verbal communication It is economical and reusable Aid learning and increase attention and motivation and help students to follow the development of idea. Could be react for instruction, recreation or entertainment Easier to hold and does not generate dust  It does not provide a permanent record This is a role of no confidence in students note taking, some of them may feel cheated because they took notes unnecessarily. Dependent about the ideas that is written in the book The white board background can cause problems to those with vision impairment The chalk board is often neglected and it does not get the proper care it deserves. Using handouts or not is an act management not simply of information-giving books are effective to use as an instructional tool because it makes students to think and understand clearly about the lesson  is effective to use because it does not generate dust that comes from using and erasing chalks Your Analysis 1. What do you think prompted the teacher to choose the materials/learning resources that she/he used? 2. What difficulties, if any, did the teacher experience? How can this be managed? 3. Over-all, were the learning resources /materials used effectively? Why ? Why not? Charlene Atig Technology is a tool for a meaningful learning. During our observation in a particular class a teacher used chalk board during her presentation of lessons. I think teacher prompted to choose the materials/learning resources that she used was it’s because she conceived that those aids was effective and suit to her students’ needs of learning. And in other cares, maybe a teacher can’t use a power point presentation it’s because there is no availability or lack of computers those instructional materials that can be used in teaching. A teacher should facilitate evaluative process by focusing students’ attention in the effectiveness, efficiency of instructional materials. Teacher experienced the difficulty especially students showing restlessness or boredom to the presentation. So, it is often helpful for a teacher to shoe genuine interest to the students. Or if not, she need to change her strategies in teaching, aside from using visual aid, it’s better to use power point presentation because it attracts students look and attention. I can’t say that all those learning resources/materials were effective in used to the students. Teacher was still need to adjust her plans to match the changing interest and needs of the learners. During the discussion, students show boredom about the presentation of the lesson because visual aid for me describe as a dry tool to be used to the learners. Maybe, until now, that aid is effective to some but using technology can create a meaningful learning that transmits students effectively. It is much better to use power point to present well the lessons clearly including some examples especially pictures. Ellvine Pia Bonocan During our observation, the instructional materials that were used by the teacher were chalkboard, whiteboard, handouts, and books. The very common teaching aids used in classroom. I think the teacher used those instructional materials because she thought that it would be more effective to use those things or strategies. Maybe she still not used to a power point presentation. At the time that we observed, the students were reporting about a particular topic given by their teacher. I think the difficulties that the teacher experienced were: she can’t manage the class and the way her students behaved while having a reporting because some were texting and some were chatting with their classmates. I guess, for the teacher to manage those unnecessary things done by her students during the reporting would become lessen if only if she will give her full attention to her students and telling the students to listen and stop doing something while the reporting is still going on. The learning resources were somehow not effective because for me using that instructional materials nowadays is dry and boring to look at. The students won’t focus on the report because they’ll feel bored looking the same things used in reporting. There is a need to enhance the ways or strategies that the teacher applied. She must tell her students to used power point in their report so that the class would be lively and they will focus in the reporting. There will be more interaction between teacher and students. To also developed student’s participation in class activities for that matter. Annie Rose Calumpang At this time and age, teachers have a wide a choices on what instructional materials to use. However, when I visited the classroom and observed what instructional materials or teaching aids that is used by the teacher the most common instructional materials used are the chalkboard, handouts, books, and whiteboard. Teacher used these instructional materials because its inexpensiveness and it is economical and reusable. When we observed a class, that time, the students are reporting about the topic that the teacher assigned to them. The difficulty I observed in the teacher she can’t handle the attitude of the students. Some of the students are talking and got bored in the report because the reporters does not explain their report they always read without analyzing the assigned topic. To manage this, teacher should tell the students to give a copy about their report to their classmates so that they will listen to the reports. The learning resource/materials are used effectively because students learning become more interactive through applying accepted learning theory. There is an interaction between students and teacher which can enhance the student’s participation or cooperation Roxanne R. dela Cruz The teacher might think that the materials she used might attract and will stand as a reminder to the students who see it. It could be a resourceful tool to student to master such learning objects. The difficulties of a teacher would be the strategy they’ll make if they are going to present pictures or illustrations to make it more clear and can easily understood. The materials were effective more some reasons but not enough for this new generation because the school has poor learning materials it might cause students to be NOT more competent and well-prepared in the future. Reflection Charlene Atig As a future MAPEH teacher someday, I will first have my self-evaluation for the improvement of learning. I used aids that create and contain well organized Teaching aid materials. In my case, I should prefer to use slide presentation because I think this aid present an applicable future understanding about the needs of the learners and can really enhance instruction. And at the end of the activity, students can gain competence in developing and utilizing materials (slide presentation) which involve students in meaningful learning. At this point student show interest to the lesson being presented. Ellvine Pia Bonocan Being a teacher is not that easy in fact it’s enjoyable dealing or teaching different type of students. If I put myself in the place of the teacher where we had our observation, the thing that I would do similarly is to give student’s reports so that they can practice facing people or the class and to help them develop their communication skills and to build self-confidence through reporting. The thing that I will do differently is to change the teaching strategy that was used by the teacher. If I will become a teacher soon, I want to make the students or class lively in a way that the students won’t get bored in the class because that is the only or reason why students don’t want to listen to the reports or discussions. So, to minimize this, you as a teacher, you must find ways to entertain student’s interests, you should have a sense of humor so that they’ll not get bored sitting and listening to the report or discussion. You must be patient enough to find  ways or strategies that will be suit to student’s interest to make your discussion more interactive and at the same time effective. So, to awaken them, you must tell your students to make their reports using a power point presentation because nowadays this is commonly used instead of using visual aids. They should learn how to use a power point presentation in reporting not to give their financial problem but to help them discover the use of technology nowadays because in this generation it’s really needed and useful. Annie Rose Calumpang If I were on the part of the teacher, the teaching skills that I would similar to her teaching strategies are the way I incorporate the instructional materials into a lessons like giving handouts to the students about the topic and the way I applied my teaching strategies to encouraged students to be active and alert during the learning process like asking question to the students about the topic, then each of the students should have an answered to that questioned, so that, there is an interaction between the teacher and the students to make learning process became more interesting. Then the different strategy that I would do to make students motivate well in the learning process before I discussed the lessons to the students, a number of questioned about the topic can served from the students to arouse their interest and focus their attention to the topic. As a whole, learning is meaningful when it is connected to the student’s everyday life. A good teaching enhanced students to interact in different classroom activities to make teaching learning possible. Roxanne dela Cruz As a student in the field of arts I’m going to make things clear and try my best to do more original illustration. I’ll motivate my students to learn more than just the content on the objects they see. Student-centered will be my primary objective.

Globalization and Boundless Market Essay Example | Topics and Well Written Essays - 750 words

Globalization and Boundless Market - Essay Example It is the productivity of every nations combined. Information on world's outputs is based on economic data obtained from different countries through international regulatory institutions like the International Monetary Fund, who is involved in the monitoring of economic and financial developments (IMF, 2008) and the World Trade Organization, who oversees nearly 150 countries and 97% of world trade (WTO, n.d.). The indices can be represented by the regular economic parameters such as Gross Domestic Product or Gross World Product (GWP), per capita production, employment rate, and others. World production is greatly affected by trading. Without trading a nation would not strive to produce more of its products where it has comparative advantage. Without the demand from other countries, every nation only produces goods enough for the domestic need. Oil producing countries, for instance, strive to generate greater productivity because of world demands for oil. Food and other agricultural supplies are needed by countries who cannot produce them due to climatic conditions. Other countries provide surplus of labor and expertise. Because of this, world trade is an essential component for increase in world's production. In fact volumes of world trading is a good indicator of the soundness of the world's economy. When world trading is low the world economy is generally down. General pattern of international trade International trade, which forms the bloodstream of the world economy, represents the flow of goods and services from one nation to the other. There are several patterns suggested in terms of trading or import-export arrangements. One of the patterns is that, the nation who lacks the capability to produce a good needed by its constituents buy it from another nation who produce or specialize its production due to comparative advantage such as lower production cost or availability of raw materials. Likewise, the nation that has surplus of a particular product can supply it to others in need. Dean (2004, 312) referred this arrangement as inter-industry specialization. Another pattern referred by the same author describes the intra-industry specialization (313). Two nations who specialize the same industry trade their products. As an example, the US and Japan both manufacture cars but they both trade their respective cars models. Import and exports, however, have their controls and limitations based on regulations and standards. Different countries have their own product quality indices, trade taxes, and other barriers. Attempts however were made to unify regulations and eliminate barriers to world trade. These resulted to the forming of the World Trade Organization. With the molding of the WTO the world embark in a global exchange of goods and services from agricultural to high-end industrial outputs with limited restrictions. As part of its advocacy the World Trade Organization claimed, "It is the only international organization dealing with the global rules of trade between nations. Its main function is to ensure that trade flows as smoothly, predictably and freely as possible." The Consequence of no-trading Trade sanctions sometimes happen in the world scenario. It occurred many times in the history as a consequence of disciplinary actions against a hostile

'To live is to be photographed (Sontag 2004). Does photography have a Essay

'To live is to be photographed (Sontag 2004). Does photography have a special role in the mediation of our lives, and how, according to Sontag, is this role changing - Essay Example There is a big role of photography in the conception of the history of the world. Photographs have historically provided an objective record of the events of the real world. They have served as a key in confirming the ravages of the Civil War for the public. â€Å"Roland Barthes, a preeminent theorist of photography, said that photograph is the "sovereign contingency," meaning it is dependent on something else happening† (Huds, 2013). In the earlier times, photography was considered as the domain of only the rich people in the world. The power of photography was spread to the general public’s hands after the invention of the instant camera by the Eastman Kodak company (Huds, 2013). Using this camera and the cheap 35 mm film, it was possible for any individual, rich or poor, to capture an image by clicking the camera, thus making photography evolve as the most popular art form. Photographs do play a special role in the mediation of our lives. There is an insuperable powe r in photographs that helps them determine what can be recalled in the events. Photography brings the memories of childhood back to us. Photographs help us recall a sad or happy moment that we can share with others. The power of picture is that it captures a single moment’s quintessence and makes it permanent so that it can be reviewed over and over again. Photographs help us keep record of our past as well as present. ... r is to convey the actual fear and horror prevailing in the battle-field to the people in an attempt to discourage the occurrence of wars in the future. Once, a photographer said, â€Å"I thought I was going to save the world with my photographs† (The Free Library, 2013). Thousands of photographs of the Vietnam War were taken and almost all of them were viewed by people in different parts of the world within only few days of their being made. Those photographs were basically meant to be seen as soon as possible. The photographs were disturbing and affected people emotionally and psychologically. They made the audiences feel sickened. It is a fact that some photographs, particularly those of the war, are intentionally taken to shock the audience because the images recalled are the ones that are the most horrifying and compelling. Such photographs are imprinted on the minds of the audience. A memorable photograph is one that has an impact. It is a form of a visual impression tha t awakens the individual looking at it in a positive or a negative way. A horrifying photograph spurs anger and frustration in the audience. It evokes an emotional response that makes the audience think upon the context that reflects from the photograph. A photographer making a documentary focuses the camera at the real world to capture the drama of life, death, and all that lies in between the two. The audiences have been brought quite close to the important events of the world by the photojournalists. They have helped the audiences see the world as it is in reality rather than the way it is projected in the news. The medium of photography has even made the armchair participants completely aware citizens of this world. In the present age, the importance of photographs cannot be overestimated.

Classical Liberalism Essay Example | Topics and Well Written Essays - 750 words - 1

Classical Liberalism - Essay Example Locke attempted to protect some areas of personal life from governmental action. People should not be deprived of their property rights by the state. The acceptance of the government authority over people is to ensure that the latter protects their property and liberty. In ancient times, people enjoyed full-fledged freedom and liberty; and the state should endeavor to provide these rights (Stein 21). The Lockean perception states that the fundamental duty of the state is to protect private property. However, this theory has been discounted because the state has extended protection to only property that it creates and to the extent to which it deems to be sufficient. The state is the bestower as well as the depriver of property. Consequently, the restrictions imposed by the state on land use become an intrinsic part of the land (Epstein 129). A state that controls private property is akin to a dictatorship. Moreover, a state that strictly protects the right to private property, cannot address crises effectively. For instance, during times of war, natural disasters and economic depressions the state is empowered to control private property. However, classical liberalism requires the state to operate under certain limitations, while seizing private property. Therefore, a classical liberal society cannot survive in a real time environment and it cannot build gigantic projects like the Tennessee Valley Authority. Such classical liberal societies cannot deal with the Texas farmers in drought situations. There will be no technological advancement in a classical liberal society. It cannot launch expedition to outer space, and there would be no scientific experiments (Rockwell). The sole ruler of a society is its legislation, therefore, it is irrelevant as to who wins in the elections or who emerges as the president. Communities develop by themselves, and the future of the people is determined by their actions.

Liberalism and its critics Essay Example | Topics and Well Written Essays - 1000 words

Liberalism and its critics - Essay Example Having discussed that liberalism puts forward the interests of fighters; critics claim that liberalism is also an ideological system of struggle that stands for things like unprincipled peace. As a result, critics maintain that liberalism brings about something called political degeneration in different individuals and units within a party and within revolution organizations. Additionally, Mao puts across that liberalism gives rise to or creates decadent. In terms of manifestation, liberalism manifests itself in a number of ways. For instance, liberalism lets things flow freely or slide in the name of friendship and peace despite the fact that a person has made a mistake (66). This happens mainly because this person might be an old subordinate, a fellow townsman, a loved one, or a close friend. Based on this revelation, Fredonians should pursue liberalism with caution as it might end up dividing the society into halves. Moreover, it is worthwhile for the people of Fredonia to refrain from liberalism as they have very little knowledge about it thus making it unwise to take up the weapon of liberalism against the foreigners and aristocrats. Citations maintain that the so-called â€Å"Patriots† have limited knowledge concerning liberalism. This shows that they do not have insights into this kind of action, which makes them unaware of damages that might befall them in case they happen to opt for liberalism. As depicted by Mao, liberalism involves indulgence into irresponsible criticism that takes place privately as opposed to voicing out suggestions and ideas as well as cause for action to the organization (79). Truthfully, advising Fredonians to refrain from liberalism is a pragmatic way of avoiding further oppression as it shows no regard for principles of collective living but follows individual inclination. Revolution History explains that, since Middle Ages, there has been an existence of so cietal struggles. Karl Marx and Friedrich Engels assert that, presence of the oppressor and the oppressed, patrician and the plebian, free people and the slave as well as the master of guild and the journey was and still is the causal factor behind revolutionaries (85). These authors point out clearly that, revolution could act as a weapon against certain inhumane actions but in most cases, its results are unimaginable. Generally, revolution either comes along with re-construction of the involved society in bits or at large or results to rampant ruin of almost every contending class. Fact findings establish that history based on epochs of revolution bring out undesirable end product as all societies involved suffered a manifold of gradation in terms of social ranks (91). For example, in ancient Rome, revolution resulted to slaves, knights, patricians, and plebeians. In order for â€Å"The Patriots† to kick out foreigners and aristocrats, it is advisable for them to revolution ize their nation despite criticism. This is because for them to attain reforms there must

Precis Essay Example | Topics and Well Written Essays - 500 words - 3

Precis - Essay Example This article throws light on a critical issue of which I had very little knowledge earlier. It opened my eyes to the negative side of globalization that basically triggered deforestation of the Amazon. Though the author has partially blamed the local people that are involved in logging and cattle ranching; but in my opinion, the government is solely responsible for not keeping its laws strict enough for people to avoid committing environmental crimes. The government has introduced Plano Amazonia to develop the Amazon forests which would further increase the rate of deforestation. Loggers and cattle farmers work together and keep moving the agricultural frontier upwards after having deforested some parts of the Amazon. At the cost of deforestation, Brazil has become the largest beef exporter in the whole world. With the efforts of environmentalists, the big exporters of soya bean and beef have pledged not to buy from growers in the Amazon, which is commendable and would save the Amazo n forests to a great deal. The congress has approved a land reform bill that claims to end illegal farming and environmental crimes but environmentalists are wary of it. Illegal land holdings are prevalent in the Amazon. The new law aims to introduce land regularization and eventually stop deforestation but it is very difficult for the weak Brazilian state to enforce it. Environmentalists have proposed commercializing the products of the forests, which would benefit the local people as well. Amazon fund have been set up by the Brazilian government and many countries, the UN and private companies shall donate to put an end to deforestation. Building roads through the forests to connect far off areas is essential for economic development, despite the effect that it would contribute to deforestation. Efforts are underway to preserve the forests as a

Research paper 2 Example | Topics and Well Written Essays - 500 words

2 - Research Paper Example y, I chose these two buildings because the architects who designed these building were revolutionary professionals in American architecture hence their impact on modern architecture. My intention is to compare these two structures to Tikal architecture from a visual interpretation, that is, a visual analysis of these structures. The various architectural styles and patterns employed in early days as well modern days depict a society’s way of life especially religious life. For instance, the tikal architectural design were adjusted in such a way to incorporation nature and worship of God The Wayfarers Chapel was designed by Lloyd Wright and was completed in the year 1951. This architectural structure is located at Rancho Palos Verdes, California. This structure is mostly notable because of its modern unique architectural design and its location at the cliffs of the Pacific Ocean. In fact, it is part of the Swedenborgian Church of America and is used as a memorial to its founder, Emanuel Swedenborg. Lloyd Wright, the architect given credit for this structure began designing it in the late years of the 1940s and construction began in the year 1949 and lasted for several years until the year 1951 when it was completed. In developing this design, Lloyd wanted to create a serene environment where travelling Christians would take a rest and be close to nature and to God. His inspiration came from the Redwood forest in California. He had visited a restaurant within the forest with tree branches bending over the building and he was awed by this scenes. Similar to most of Lloyd Wright’s building the structural incorporates the natural landscape into its design and features magnificent modern designs. The design for this building is a â€Å"tree chapel† set amongst trees, a natural sanctuary. This is a quintessential structure of organic architecture. The architect used glass to allow natural light, natural growth, the adjacent sea and the sky to create the sense of a

Analyze the ways in which at least three supporting characters Essay

Analyze the ways in which at least three supporting characters contribute to the readers understanding and assessment of the cha - Essay Example Jay Gatsby - Analytical Elaboration Perhaps, the most important character of â€Å"The Great Gatsby†, for the purpose of aptly analyzing and understanding Jay Gatsby, is that of Daisy Buchanan. As a matter of fact, for all people reading this novel, it would be almost impossible to form the right opinion about Jay Gatsby without relating him to Daisy. When Jay Gatsby is viewed by separating him from all other chief characters of the novel, one would conclude that he is an out and out materialistic man with hardly any morals. But this contention is far from the truth. There are several positive facets of the central character, and which can be best understood only when they are viewed in relation to Daisy Buchanan. Before Gatsby leaves for participating in the Second World, Daisy gives him a commitment that she would await his return. But later, she broke her word and married Tom Buchanan, a wealthy man. This particular action of Daisy was in no way less than a devastating expe rience for Gatsby, who then decided to amass lot of wealth solely for the purpose of making sure that Daisy returns to him. In these materialistic pursuits, Gatsby indeed deviated from the accepted ethical norms. Had she (Daisy) chosen to sincerely wait for the return of Gatsby from the War, he would have been an entirely different man.

Rites of Passage Essay Essay Example for Free

Rites of Passage Essay Essay Jetty Rats is a novel written by Phillip Gwynne that all young boys should read. It deals with the rites of passage and issues that all boys are faced with at some point in their lives. It is presented in an entertaining book but realistic which makes it easy for readers to understand. The issues and rites of passage discussed in this essay include family, friends, experiencing a first kiss (with Jasmine) and obtaining a first ‘real’ job (funeral). The story is told from the prospective of Hunter, (main boy) a thirteen year old boy with a dream of catching a record breaking Mulloway and getting more famous and richer then Rex Hunt. The first problem is the family. When Hunter was eight years old his dad went missing while fishing on the rocks. He had broken the golden rule of rock fishing: â€Å"Thou Shalt Not Fish On Your Own†. Hunter was certain his father would return after the accident he would â€Å" wait for him. Sit underneath the ‘VACENCY’ sign until mum tells me to come inside†. He didn’t want accept the fact that his father was gone forever until the end of the story when he finally decided to throw out his dad’s rusty old razor, even though his mum had tried to throw it out before but he kept getting it back. The writer has included this problem in the story in a realistic way. He explained the pain Hunter and his mum went through during the tough years, which made the story easier to understand. The writer has also expressed the importance families have stick together through tough times where there is no hope.

Democracy - Essay Essay Example for Free

Democracy Essay Essay Introduction Democracy, it is generally believed, had its roots in Ancient Athens. We know it spread its stems to most of Europe and later to parts of Asia by mid 19th century , mostly in the form of parliamentary democracy. But in the context of this paper,we are not interested in the histrocity of the idea or concept of democracy, but in the idea itself. That is to say we want to analyze the meaning of democracy and its different forms, study its efficiency (so to say), ponder over its limitations and compare it to other forms of government. Whether democracy was conceived of in Athens, Sparta or India is not a topic of interest in this paper (although there may be references to historical events in the evolution of the idea when pertinent). What does democracy mean? Democracy comes from the greek â€Å"rule of the people†. But as I searched for a definition of democracy in the course of research for this paper, a consistent defintion of it seemed to elude me. So we must examine some of these definitions and try to find a core to the idea of democracy, if there exists one. Bunch of different ideas and quotes are out thr on internet put about 4-5 of them here and discuss if them from a current or historical perspective..ive written down one for u: â€Å"The right to dissent without repercussions to ones personal well-being is the core value of Democracyâ€Å" * Nathan Sharansky Discuss quotes such as this to evaluate how these ideas are implemented in practice.. All this should take up about 500 words..  The only core value seems to be people get to elect their governement..how much of the peoples rights are respected after that greatly varies.. Forms of democracy Representative..constitutes parliamentary and liberal(most democracies are  these) Constitutional Direct Socialist Totalitarian ..discuss all thseabout 300 words.. A critique of democacy An illusion There was no stone-pelting, nothing.There was no curfew They fired indiscriminately. (http://www.independent.co.uk/news/world/asia/kashmir-burns-again-as-india-responds-to-dissent-with-violence-2045905.html). The above was said by Abdul Rashid, a Kashmiri youth whose friend was gunned down by Indian army officials for holding a peaceful, nonviolent, anti-government rally in the summer of 2010. But this was not an anomoly in the process of democracy in India. Kashmir still remains the most militarized zone in the world with about a half a million troops on active duty (for the sake of comparison, the United States had about 165,000 troops in Iraq at its peak)(i read these figures on cia.gov..i dont remember the exact link ). How is that a government for the people is killing its own citizens for holding a nonviolent demonstration? How is such a huge militarization of a province in a democracy justified? Even a basic understanding of the ideas of freedom and liberty that democracy ent ails shows how abhorrent these actions are. But these things happen, not just in India, but in other developed counties like the United States (Japanese americans in 1942), where the rights of their citizens are violated just when they would want to exercise them. So one must ask, are democracies really for the people? A study of history of goverment brutality in countries like India and the United States seem to suggest otherwise. The almost forceful takeaway of land by the Indian goverment in eastern India from farmers (actions which directly led to the Naxalite-Maoist insurgency, something the current prime minister of India called the single biggest internal security challenge ever faced by our country.( http://www.ploughshares.ca/libraries/ACRText/ACR-IndiaAP.html)), seem to suggest otherwise. The locking up of Japanese Americans in internment camps in 1942 by Franklin Roosevelt and the Unites States government seem to suggest otherwise. The indiscriminate shooting of  unarmed, nonviolent Kashmiri youths (some as young as 9 years old)shouting â€Å"azadi!azadi!†(â€Å"freedom!freedom!†) by Indian security officials seem to suggest otherwise. One gets the idea. So maybe people like Vilfredo Pareto and Gaetano Mosca are correct after all. The masses are always characterized by apathy and division, the powers to be by drive and unity (Femia, Joseph V. Against the Masses, Oxford 2001). Maybe all democracy does is shift the power scale, from domination by a despotic leader to manipulation by a democratic government. Maybe the people don’t really have much of a say after all. Maybe it’s just an illusion. Majority rule Majority always gets its way..discuss gay rights..civil rights in us..womens rights historically..religious parties like shiv sena in Mumbai..rising intolerance of secularism in india..majority rule can get tyrannical and the minority issues ignored when people get to decide resolutions to minority issues. The irrational voter â€Å"The best argument against democracy is a five minute conversation with the average voter.† – Winston Churchill Talk about how the common man is largely ignorant about serious issues and hence can vote against his/her interests..u can greatly discuss the recent midterms in us to make this pointbasically ur sayin if we must solve economic issues we talk to economist..if we must solve environmental issues we talk to climate scientists..if we are talking abt what to teach in science class we take the consensus of scientist not what the common people of the state think (talk abt teaching creationism in schools..a lot of states in us have majority of it people wanting creationism be taught as science even though almost no scientist believe it to be science)not everything should be up for a vote.. Economically Ur a better person to write abt this Idealistic Show how its hard to apply democratic principles in practicecorrupt officials..apathetic citizens..uprisings etc.. Instable Frequent elections make the government instableshitload of examples on the internet abt this.. Best we have? â€Å"It has been said that democracy is the worst form of government except all the others that have been tried.†- Winston Churchill Compare democracy to other forms of governments like dictatorships, communist states, anarchist, socialist,etc..define and discuss each with respect to western liberal democracy..ive done some of it for anarchist Anarchist Anarchists are those who advocate the absence of the state, arguing that common sense would allow people to come together in agreement to form a functional society allowing for the participants to freely develop their own sense of morality, ethics or principled behaviour. (from wikipedia). One such current society is Somalia, and it would not be hyperbole to suggest they are not doing very well. The lack of a state and police have led to nationwide lawlessness, violence and spiralled the country into utter chaos. I think Somalia really characterizes the severe consequences of not having a state and is not a direction one would want their country to go in. Giving people all the power has resulted in the most powerful and the most brutal of them to take power and the rest of people losing all freedom(ironically).

Innocents Market Entry In Spain

Innocents Market Entry In Spain Introduction To evaluate the possibility of a market entry in Spain, a brief analysis concerning the company and the market will be conducted in this report. Chapter 1: Profile of the innocent company The large-scale company Innocent Ltd was founded by three friends in London in 1999, where it also has its headquarter and today employees about 275 people (Datamonitor 2009). Before they could start their business they had to find and investor, which was very difficult, as they wanted to go on a competitive market, the big drink and food industry. (Germain Reed p. 48 2009) The UK juice market is dominated by Pepsico owned Tropicana and Copella which is the parent company of the PJ smoothie brand. (Germain Reed p. 111 2009) The product range consists of â€Å"smoothies, smoothies for kids, superfruit smoothies, thickies† followed by â€Å"orange juice† and â€Å"veg pots† in 2008 and extended by â€Å"pure fruit squeezies† for kids in 2009 and a recipe book is available. (innocent 2009) The company has a strong brand image standing for natural, healthy and tasty products. They describe their main values as follows: â€Å"Natural, entrepreneurial, responsible, commercial and generous.† (p. 79) Thereby they created a USP by using only natural ingredients and this leads to a competitive advantage against their major competitors â€Å"Merrydown Plc., Kallo Foods Ltd., Princes Limited, SHS Group Ltd. and Britvic Plc.†(Datamonitor 2009) Innocent can be associated with a social and environmental responsible business, which can be seen in a large number of charity and environmental projects. In general a minimum of 10 % is given to Charity each year (Germain Reed p. 83 2009). Through developed communities on facebook, twitter und youtube Innocent is in a continuous informal dialog with their customers. The multilingual webpage provides consumers with detailed information about Innocent, their operations and an advisor page about healthy eating. (innocent 2009) In contrast innocents deal with Mc Donalds to sell the kids smoothies aroused discussions concerning the brand image. It was found that innocent had put sugar in their Juicy Water in 2007. (Daily Telegraph, 2007) There had been some controversial discussions about the production of smoothies, if they are really fresh and natural when the fruit and ingredients travel on a long way. (Donoghue, 2008) In the first three years sales increased from 2 to 16 million euro. S. 64 the predicted turnover will be between 105 and 110 million pounds in 2009. (Tryhorn Sweney 2009) Innocent is the market leader in its product segment in Europe (Daniel 2009) which serves a niche market and has an 82% market share in the UK. (IRI Infoscan 2009) In general the market decreases but in 2009 Innocents sales increased again, e.g. due to the new product vegetable potsâ€Å". (Sibun 2009) Markets Currently the company operates in the European market in 13 countries. Innocent launched its smoothies at first in the UK and then in Ireland, which was a logical step, as the market provided the lowest risk because of similar conditions. Today Ireland is innocents second largest market. (Germain Reed 2009) Innocent incrementally entered the following markets: Germany, Sweden, Northern Ireland, Finland, France, Belgium, Luxembourg, the Netherlands, Switzerland, Austria and Denmark. (Germain Reed, p. 64, 2009) Channels The company concentrates on its core competences are RD and Marketing, such as creating new recipes and their knowledge about fruit in general and creating a brand image. All the manufacturing parts of the business are outsourced to their partners, which saves them a lot of money, because they do not need to invest in technical equipment for the production process. (Germain Reed, p. 58, 2009) Moreover they have subsidiaries in Ireland, France, Denmark, the Netherlands and Germany. (Reed, 2007) Innocent has distribution partners selling their products to over 10,000 retailers. (innocent 2009) In the UK the innocent products are available in all Sainsburys, Waitrose, Somerfield supermarkets and in some branches of Morrisons, Budgens, Tesco, Safeway and Asda. Furthermore the products are available in chains such as Starbucks, Bagel Factory, Boots, Booths, Road Chef, Welcome Break, Moto, EAT, OBriens and in â€Å"independent sandwhich shops, delis, health food places and the odd meditation centre.† (innocent 2009) Furthermore premium food outlets and food halls of well known department stores should underline their image of quality food. (Germain Reeds, p.122, 2009) The latest discussion this year was the investment of Coca-Cola as a minority stakeholder with 10 20 % for 30 million pounds. It seems to be a common issue for niche companies that they need more capital to grow but at the same time need to convince people that they are still the same company with the same values. Innocent published a statement on their website. They will use the capital to invest in their European expansion. (Thryhorn Sweney 2009) Chapter 2: Analysis of the Spanish market For the assessment of the Spanish market potential for innocent smoothies it is necessary to carry out a market analysis which can be done by following the 12 C framework and Porters five forces. First of all general information about the country and a focus on the macro environmental factors is needed to get an overview about the political, economic, socio cultural, legal regulatory and technological forces a company might have to deal with in that market. Country: The Kingdom of Spain has a population of 40 million inhabitants that live in a country of 499,542 km ². (p. 10) Political forces: Spain is a member of the EU which has a close integration with other members and profits from EU economic supports that helped the nation for a better standard of living. (Country Report, p. 3) Spain has a parliament monarchy (p. 36) which is ruled by a government with a thin majority at the moment and is therefore dependent of regional parties such as the Catalan and Basque to precede new legislations. This has a negative effect on the promptness of economic processes (p. 14) The federal structure with its regional units autonomy faces difficulties with Basque and Catalonia which fight for independence and that represents a risk of political instability (p. 15) Economic forces: As every country, Spain has to deal with recession and the GDP growth is expected to be negative with 2% (p. 49) Furthermore this country has the biggest drop of all developed nations to 1.8 % in annual economic growth in 2009 (p. 17) Since 2008 the major challenges the country has to deal with are falling inflation and the level of unemployment which is very high and might increase further. (p. 17) Weak domestic demand is also a result of the crisis (p. 2) But the financial system itself is well-developed and integrated into international financial markets. Normally the Spanish banks stand for a high standard of solvency. (p. 3) Along to lines of the EU recovery plan, Spain has implemented some activities such as tax cuts and investment projects to stimulate the economy (p. 54) as well as a fiscal stimulus package that should help increasing investments. (p. 3) In general the economic crises with all its effects leads to an economic slowdown and a long-lasting recov ery period. (p. 16) Social cultural forces: The official language is Spanish, but in certain regions the people speak Catalan, Basque and Galician. The main religion is Roman Catholic which a company should keep in mind when creating advertisement. (p. 10) Spain has to face the problem of an aging population and unemployment which increases an inequality in income and causes social tension as well as the increasing immigration in Spain. (p. 4) The income differs as well between the different regions. (p. 22) The tertiary education grows which could provide the opportunities for companies to get well educated people in that country. (p. 3) Most of the population that means around 78 % of the people live in urban areas around the big cities and many of them around the capital Madrid. (p. 65) Legal regulatory forces: Improvement of legal climate was made by the Spanish government with several reforms such as reduction in tax rates and foreign investment regulations are simplified. (p. 80) Government has an important role in wage fixation (p. 2) which could be important to know if companies develop a subsidiary in Spain. In general the intervention of the government in the market is a challenge. (p. 27) Because the legal Spanish rules and trade regulations are adapted to EU standards business across borders should be easier now. (p. 80) Spain has a high economic freedom score and is on 16th place among 43 countries. Property rights, business, trade, financial and investment freedom are very strong. In contrast to that it is weak in government size, labour and fiscal freedom. (p. 83) Technological forces: Weak input form venture capitalists and private sector causes a lack of entrepreneurship and innovation. (p. 23) Compared to other EU members Spain has been not so quick in adopting technological advancements, but there are things done to change it. (p.71) For example the communication and information segment grew fast in 2002-2006 (p. 73) The environmental policies were created by following EU guidelines (p. 4) and different measures are or will be implemented to reduce impact on climate change (p. 8) Impact of hot climate and a possible gap in water supply may influence some companys production process. (p. 88) (Datamonitor Country Analysis Report Spain, April 2009) Market-specific analysis The juice market includes products from concentrate and not concentrated juice as well as fruit and vegetable drinks and nectars. (Juice Report, p. 7) Market potential: The market value for beverages constantly increases in Spain and has an overall growth of 49% from 1999 2012. (Datamonitor table 2009) The beverage industry can be divided in different categories. The smoothies belong to the soft drinks under non-alcoholic beverages. In comparison to the other non-alcoholic beverages smoothies have the highest market value growth in Europe from 1999 2012 with 458 %. (Datamonitor table 2009) To evaluate the market potential for innocent smoothies in Spain it would be necessary to gather more concrete data. Market size: Spain has a population of 40 million people (Country Report, p. 10) Fruit drinks from juice/concentrate have the highest market share with 36.3 % by value in Spain. 100 % fruit juice that means not from concentrate has a market share of 16.6 % by value in 2008 and the vegetable juice 21%. (Juice Report, p11) Hence there is a market for innocents smoothies but as in other countries it is only a niche market. Market growth: In 2008 the total revenue was $ 2.4 billion, that means an annually grow with a rate of 2.2 % in the period of 2004-2008 and it is expected to reach $ 2.7 million by the end of 2013. (Juice report, p. 7) Profit potential: Until 2013 the market volume is expected to grow with a rate of 2.8% annually. The market volume is expected to increase with 14.8 %. (Juice Report,p.29) The market value is predicted to grow until 2013 with a rate of 2,5 %. (Juice Report, p. 28 ) Indirect competitors: In the beverage industry, especially non-alcoholic drinks, softdrinks: concentrates, functional drinks, juices, bottled water, carbonates, tea, coffee, hot drinks, baby drinks are indirect competitors. (Datamonitor table 2009) Concentration: The Spanish drink retail market is less concentrated in comparison to other countries in the EU. (Juice Report, p. 15) It is necessary to find a statistic where the spread and number of different supermarkets or chains can be seen all over Spain, to decide which retailer could be the most effective for innocent. Therefore it is also important to keep in mind that most of the population lives in urban areas around the big cities. Culture/consumer behaviour: Spain is a typical Mediterranean country with different cultural groupings. (see socio cultural forces) How the Spanish people decide for products and what has the major influence on their purchasing behaviour should be analysed in more detail with a closer look on their lifestyle. In general it is known that they live how it comes and are more spontaneous. But one of the purchasing influences could be that the income between regions and people is really different. (Country report, p.22) Choices: If innocent should launch there products on that market requires a deeper analysis of the companys possible strengths and weaknesses in the Spanish market. As well as on the other European markets. innocent has a niche product and has to compete against global big players in the beverage industry. Their strength is the natural product with environmental and social business ethics. The analysis of suppliers is also necessary. The supplier power is not that strong because numerous operate as small companies. The fruit and vegetable growers sell to with the help of wholesalers or directly to manufacturers. (Juice Report p. 16) For innocent it could be possible to order their fruits from Spanish fruit suppliers which could also help them with their image that they support local companies in their supply chain. Competitors on the Spanish juice market are Juver Alimentacion, S.A. with a 13.3 % market share by volume, followed by PepsiCo, Inc. with a market share of 6.3 % and J. Garcia Carrion with 5.6 %. (Juice Report, p. 13) Juver Alimentaction S.L.U company has a wide range of brands and operates mainly in the Spanish market and also exclusive in restaurants. (p.20) PepsiCo, Inc. is a global player with a wide range of brands and products in the food and beverage industry. (p. 23) J Garcia Carrion produces wine, fruit juice and soft drinks operates primarily in Spain. (p. 26) Other beverage products are indirect competitors which the company has to keep in mind. New entrants is possible as well through product diversification of an operating company in this market or for example a foreign companies export products which would be innocent (Juice report p.17) How much of the Spanish juice market is from imported products and how open the consumer is to non national product needs to be find out. Consumption: Demand for juice can be found in Spain as mentioned before, the market share and value of juice is increasing. A deeper end use analysis should be made by the innocent company for their smoothies. A threat of substitutes such as other non-alcoholic drinks as mentioned before can be found on the Spanish market because switching cost would be relatively low for retailers and consumers. (Juice Report p.18) Contractual obligation: Spain is a member of the EU and therefore business practice, ways of insurance and legal obligations should be similar to the other countries innocent already operates in. (See legal + economic forces) For specific matters the company should cooperate maybe with lawyers or business people in that country. Commitments: To extend their products to the Spanish market innocent has the advantage that Spain is a country of the European Union. Trade incentives and barriers should be moderate. But as stated in the Country Report on p. 17 the EU has comparatively high import tarrifs for fruit juice which could make retailers not import juice from foreign countries. Channels: The market access would be in geographical term easy to proceed. Spain has a well developed infrastructure with ports, airports and one of the best railway systems in Western Europe (Country Report p. 24) Innocent could use most of their current supply chain which would save them time and money. The distribution system in the Spanish juice market is dominated by on-trade with 27.9 % followed by independent retailers 25.2%, supermarkets/hypermarkets 24.9 % and 22% others. (Juice Report p. 27) Communication: Media infrastructure as stated in technological forces is growing and available to reach the target group. Marketing in collaboration with retailers and on TV might be the most effective way to reach the target group. In the big cities big adverts might be also a good solution. It would be good to do further evaluation of the costs of the different modes and how often people watch TV or which media such as newspaper, internet and mobiles they use in which way. This also should include how and through which channels the Spanish people do their shopping. Innocent could also use their company cars for promotion tours. Capacity to pay: As found out in the economic forces the unemployment is high and income divers among the people and between the regions, so that it is reasonably that the capacity to pay is very different across the Spanish country and probably higher in big cities. The price level is 10 % lower than the EU average. (eurostat, p. 4)To find out more about the culture of pricing and trends, how insurance terms work and what common conditions of payment are in Spain, a more specific analysis is needed. The ECB controls the fiscal policy in Spain because it is a member of the EU. Price stability is a main intention of the central bank in Spain. (Country Report p. 59) Insurance regulator, to prevent unhealthy practice Currency: As all the other countries that innocent operates in Spain has the Euro currency as well. The Euro is at the moment a stronger currency in comparison to UKs sterling. Exchange controls nearly do not exist anymore (Country Report p.80) and restrictions are widened and adapted to EU standards. (see legal forces) Caveats: Innocent should be aware of the fact that Basque and Islamic terrorist groups have a presences in the country which might be a risk. (Country Report, p. 3) Porters five forces: new entrants, bargaining power of suppliers and buyers the threat of substitutes and the market competitors with their intensity of rivalry (Hollensen p.) are seen as moderate in the juice market in Spain (Juice Report p.15) and are included in the 12 C analysis. Some of the large chains and buying groups boost buyer power. (Juice Report p. 15) Rivalry is weakened because the 3 competitors mentioned earlier are operating in more than one segment. (Juice Report p. 19) Chapter 3 Challenges The principal challenge of the Spanish market is first of all that there are already many companies on the juice market. Innocent offers only a niche product with a relatively high price which could be difficult as a high unemployment rate and an unequal income is characteristically for the country. Furthermore the potential consumers are spread in the country side and in contrast to that a bigger concentration with people live around the big cities. Product: Innocent should think about if they have to adapt their products. It may be that the Spanish people have a different taste. The product labels need to be in Spanish. It might be that people from Catalan and Basque do not buy the smoothies because they are not in their language. The Spanish people might be not open to fruit products from the UK, as they have their own fresh fruits in the country. Promotion: Cultural difference should be taken into account when innocent creates their advertisement. Most of the Spanish population is Roman catholic. All the materials have to be in Spanish so that the people can understand them. To promote the product on this new market innocent will need to invest a lot of time and money to achieve a certain degree of brand awareness and a positive customer perception. Therefore they should first concentrate on regional advertisement and later on national advertisement. Price: They have to explain their premium price to the Spanish consumers and therefore need to create a perception by the consumer that they will benefit from this product. If they want to have a chance it this market they might have to adapt their price to common prices in the Spanish juice market. Place: Innocent has to find distributors that can supply their products to the target group. In every country innocent uses retailers and supermarket chains in the respective country. It will be a challenge for innocent to get stocked with Spanish retailers, as they need those who have a wide spread over the country and a good reputation. The space is rare on the supermarket shelves and they will need a good strategy to convince the retailers to exchange products with those from innocent. Furthermore innocent needs to find such retailers or stores that match to there brand image. When they get contracts with Spanish retailers they might also loose a certain control over the supply chain of their products. Chapter 4 Market entry modes For the first two years it is recommendable that innocent uses export modes as a market entry model. At the beginning the risk is higher that the Spanish people will not accept the smoothies. Export modes are less cost intensive and therefore present a lower risk for the innocent company. For a direct export mode the innocent company needs to build up contacts with distributors or agents in the Spanish market. In the beginning they should mainly concentrate on big cities such as Barcelona and Madrid and the urban areas around these big cities. High end supermarket chains which need to be researched in detail by innocent are most suitable for their brand image. How to go into markets? tried different versions franchise brand, joint ventures? Having team in the country, mix of know hoc innocent and local Try to get in the best outlets PR- vans out on the road Word of mouth When certain distribution level reached, regional advertising, national advertising campaign hotels Trade regulations most of the products import from EU countries without duty or not much depends on product.t preferential tariffs and EU trade barriers are also applied p. 82 â€Å"Spanish law permits foreign investment of up to 100 % of equity, capital movements liberalized, â€Å"authority of Spanish competition commission widened to make enforcement more effective p. 4 Bibliography Dan Germain, Richard Reed Innocent our story some things weve learned. 2009 London, Penguin Books Donoghue, A. (2008) Innocent Smoothiess green claims go pear-shaped. Business Green, 8 August. Sibun, J. (2009) Tough time for smoothie maker Innocent. Daily Telegraph, 8 November. (2007) Innocent has lost its innocence. Daily Telegraph, 20 May