Competency Goal Functional Areas Essay

To set up and keep up a sheltered, sound learning condition. I keep youngsters solid by observing their wellbeing every day. I inquire as to whether they have any bungles and if so how they got them and I put them on a day by day wellbeing list, I additionally do this via cautiously watching youngsters, looking for indications of ailment, ensuring inoculations are modern. I likewise keep kids solid by keeping the room clean. Kids are educated and ready to use sound judgment on the best way to remain solid like washing hands subsequent to heading off to the restroom, cleaning out their nose or hacking into their hands, when we roll in from outside and before after lunch. I additionally protect kids by making and condition where youngsters gain the information that permits at that point to settle on fitting decisions. I ensure exercises are protected and formatively proper. The youngsters are urging to use sound judgment by having conversations, giving exercises, and perusing books that discussion about wellbeing issues I attempt to make a fun and safe condition where kids can learn and develop. I give and age fitting condition to the kids. I do this by setting up a week by week exercise plan, giving exercises to offspring of every formative level. I have exercises that are for inside the homerooms which are for net engine aptitudes, for example, bean sacks, instruments, move music, and all sizes of squares. I additionally have fine engine exercises, for example, huge and little globules to string, Lego’s, locking blossoms, stencils, scissors, colored pencil and markers. I likewise permit time for the youngsters to work on composing abilities like their names and letters additionally to draw wonderful pictures. Competency Goal 1 Functional Area 1: Safe In request to help give a situation which is alright for the kids in my consideration, I do the accompanying to forestall and diminish wounds: I keep all tidying supplies and synthetic concoctions kept up and out of the children’s reach, to abstain from harming or different wounds. I am likewise guaranteed in First Aid and CPR which give me the information to deal with any wounds or mishaps. I know about the study hall and focus crisis departure methods in the event of a fire or other crisis. I keep up an effectively open and current rundown of crisis numbers and furthermore all the parent numbers. I review all toys and hardware, as often as possible for the duration of the day to guarantee that they are alright for use. I show safe utilization of play area equipment.Functional Area 2: Healthy In request to give and condition that advances wellbeing, and forestalls disease and which shows youngsters great sustenance and practices that advances health, I do the accompanying: I keep the toys and the rooms clean. I wash my hands and wear gloves when dealing with food. I wear gloves if and when youngsters need assistance when heading off to the restroom, cleaning their noses; all together not spread germs. I additionally show the kids how to wash their hands subsequent to utilizing the washroom, cleaning their nose, rolling in from outside, while telling them that, it is to washing their hands. I likewise follow centers’ strategies for debilitated youngsters to keep different diseases from spreading all through the inside. I additionally read books about social insurance and discussion about setting off to the Doctor and Dentist. I additionally share the significance of solid nourishments like products of the soil.

Risk Assessment for Auto Fishing Group - MyAssignmenthelp.com

Question: Talk about theRisk Assessment for Auto Fishing Group. Answer: Presentation The Information security danger or hazard evaluation is a consistent just as an on-going technique of finding, forestalling and adjusting data security troubles. The hazard assessment or evaluation is a constituent part, or strategy for the hazard the executives technique intended to outfit the proper planes of security for the data strategies. The Information danger assessment is a piece of powerful security rehearses and is required by pretty much every association to fabricate the associations data wellbeing approaches. Data Security Management Hazard Assessment Subjective and Quantitative Risk Assessment Assessing the relative peril for each shortcoming is capable by methods for a methodology named as hazard evaluation. As showed by customary and however a genuine perspective, the information security organization of Auto-Angling Group must start with a quantitative danger assessment. Such an examination works fine on a fundamental level, yet it barely works essentially (Bernard, 2015). The standard essentials, lack of protection organization, and abstract risk assessment can merge to give a viable choice. Quantitative examination plays out the asset valuation with genuine qualities or checks which may be difficult to appoint specific characteristics so the Auto-angling Group could use abstract evaluations instead of using scales and specific appraisals. The abstract risk assessment influenced assessment is that it composes the perils and recognizes the zones for brief change in watching out for the vulnerabilities (Management of Information, 2017). The disadvantage of the abstract or subjective examination is that the subjective appraisal doesn't give specific quantifiable estimations of the greatness of the security impacts, in this way, bringing in a cash sparing preferred position assessment of any recommended controls troublesome. Then again, the quantitative impact assessment is that it gives an estimation of the impacts' degree, which can be used as a piece of the cash sparing favorable position examination of recommended controls inside the Auto-angling Group. The burden is tha t, dependent upon the numerical degrees used to communicate the estimation, the significance of the quantitative impact assessment may be dim, requiring the result to be deciphered in an abstract manner (Bucur-Marcu, 2013). Hazard Controlling Procedures for chance control which Auto-angling Group must apply Auto-angling Group must decide controls and ensures to reduce the peril displayed by each threat or shortcoming match with an immediate or high danger level as recognized in the Risk Determination Form (Wangen, 2017). While perceiving a control and a protect, the Auto-angling Group must consider: Data Security district of the Auto-angling Group, for example, the executives, specialized and operational offices must be guaranteed with the data security approaches and the arrangement and auxiliary parameters important for the use of assurances in the association's condition (Risk Management: Controlling Risk, 2017). Regardless of whether the costs or the expense of the resistance is comparable with its diminishment in peril. Auto-angling Group must pick one of the five crucial techniques to control the perils Protection: Applying shields that crash or decrease the remaining uncontrolled danger. Transference: Shifting perils to various extents and furthermore to outside substances. Relief: Reduce the abuse of information assets which cause powerlessness or shortcoming. Acknowledgment: Understanding the results of leaving a peril uncontrolled and subsequently truly perceiving the danger and its outstanding parts without an undertaking at control. End: Removing just as proceeding with the data obligation from the Auto-angling Groups working condition (Risk Management: Controlling Risk, 2017). Hazard Appetite Before Auto-angling Group can or should proceed, they have to understand whether the current degree of shields or controls perceived close to the completion of the peril evaluation plan to achieve a degree of danger organization that it can recognize. The proportion of the peril that the rest of the parts after each current control are completed is extra or remaining danger (Tregear, 2012). The Auto-angling Group may very well accomplish that point in the risk organization handle process that they investigate the documented extra peril, fundamentally state, Truly, our firm can clearly live with that, just as after that record everything for the future threat organization review cycle. The KPMG approach to manage describing danger hunger incorporates the comprehension of the Auto-fishings key goals, portraying peril profiles for every genuine current various leveled activity and furthermore for the future fundamental game plan, portraying a danger edge for each profile, ultimately, an nouncing the conventional peril craving decree (Risk Management: Controlling Risk, 2017). Rules and Techniques for Risk Control The senior organization, and the mission owners of Auto-Angling Group, knowing the potential dangers and endorsed controls, may pose a few inquiries from itself, for example, when just as under what conditions would it be prudent for them to make a move? When would it be a good idea for them to can complete these controls to direct the dangers in the data security and guarantee the information of the Auto-Angling Group? This technique is also clarified in the going with reliable rules, which give bearings on exercises to direct dangers from deliberate perils: At the point, when a hazard or weakness exists in an indispensable data asset of the Auto-angling Group, the affiliation must realize the security controls or shields to diminish the likelihood of the hazard or helplessness being abused (Saleh, Refai and Mashhour, 2011). At the point, when the aggressor's potential pickup is more unmistakable than the costs of the ambush Auto-angling Group, at that point they should apply confirmations to manufacture the aggressors cost and lessen the attacker's pickup by using the particular and regulatory controls. At the point, when the potential incident is huge, the Auto-angling Group must apply plan guidelines, basic layout, and specific and non-specialized protections to keep the level of data ambush, along these lines the association can doubtlessly diminish the potential for the data misfortune (Risk Management: Controlling Risk, 2017). Documentation The System Documentation Phase gives a delineation of the structure and the data it handles, as preparing assets used to fulfill the Auto-angling Group business missions. This stage develops a structure for coming about the hazard assessment stages. The system owner gives the structure recognizing evidence, including the structure portrayal, business limit and assets (Management of Information, 2017). The ISO 27000 course of action fuses a standard for the execution of appropriate Risk Management. The 27005 records or report joins diverse hazard the executives strategies: Hazard Assessment Hazard Acceptance Hazard Treatment End This examination presumes that the productive hazard the executives plan or program thoroughly relies upon the more elevated level organization's devotion, the total cooperation and the help of the association's IT gathering. The ability of the hazard assessment gathering, which without a doubt have the aptitude to apply the danger examination strategy to a specific site and system and give monetarily astute safeguards that address the issues of the Auto-Angling Group. It has been contemplated that the support and consciousness of people from the customer gathering, must follow strategies just as agree the completed controls to shield the data of Auto-Angling Group; and a persistent appraisal and assessment of their IT-related crucial. References Bernard, R. (2015). Data Lifecycle Security Risk Assessment: A device for shutting security gaps.Computers Security, 26(1), pp.26-30. Bucur-Marcu, H. (2013). The Institutionalization of Security Risk Assessment.Connections: The Quarterly Journal, pp.118-124. The executives of Information. (2017). . Hazard Management: Controlling Risk. (2017). . Saleh, Z., Refai, H. what's more, Mashhour, A. (2011). Proposed Framework for Security Risk Assessment.Journal of Information Security, 02(02), pp.85-90. Shamala, P., Ahmad, R. what's more, Yusoff, M. (2013). A calculated system of data structure for data security chance evaluation (ISRA).Journal of Information Security and Applications, 18(1), pp.45-52. Tregear, J. (2012). Hazard Assessment.Information Security Technical Report, 6(3), pp.19-27. Wangen, G. (2017). Data Security Risk Assessment: A Method Comparison.Computer, 50(4), pp.52-61.

MLA Format in Essays

MLA Format in Essays MLA Format in Essays MLA Format in Essays: Expert Tips on Proper Formatting When it comes to academic essay writing, MLA format in essays is definitely one of the most frequently assigned by professors. Normally, students have to format in MLA style those essays that are written in Literature, Liberal Arts and Humanities. Overall, during the years of college or university, students are assigned numerous types of MLA essays. Still, even though the citation style is widespread, some students cannot perfectly cope with all of its peculiarities and features. More so, it is understandable that it is hard to keep in mind all rules and specifics when it comes to formatting and writing academic papers in general. The very first reason why students face challenges with the process of organization and MLA style essay formatting is because some students tend to skip classes, and thus they have a gap in their knowledge and overall subject acquisition. The second reason is that students may be unable to find relevant information on what is MLA essay format, particularly its specific rules. Third, students may simply lack sufficient time on studying the principles of MLA essay formatting, which can also negatively impact the overall quality of writing. So, to avoid mistakes and ensure that your target audience does not get any negative impression from your writing, do not hesitate and buy a cheap MLA style essay from our service. Apart from getting custom help, you can also get guidelines on formatting as well as find some specific MLA essay example that you will find most useful.

A cooperation between kv connections bv kenniscentrum zorg nederland - Free Essay Example

Sample details Pages: 31 Words: 9278 Downloads: 6 Date added: 2017/06/26 Category Statistics Essay Did you like this example? A cooperation between KV Connections BV Kenniscentrum Zorg Nederland Introduction This research is conducted within the framework of a graduation thesis at Rotterdam University for the study Trade Management aimed at Asia. On behalf of the company KV Connections BV is a research done about the medical concept Benchmarking on outcome for the Mental Health Care in China. The Chinese government has invested a lot of money over the past years for healthcare reform. They want to improve public health and rural health services, implement initiatives to improve hospital management to raise quality of patient care and develop plans to establish and build a national health infrastructure. In order to raise living standards in China, it is important to improve the health care system. China wants to give its citizen a better medical protection provision and a higher quality of patient care. Beside of this, it is also important to reduce the financial cost so that people in China have an affordable, high-quality health care. Don’t waste time! Our writers will create an original "A cooperation between kv connections bv kenniscentrum zorg nederland" essay for you Create order The principal KV Connections BV has more than 20 years of international experience as agent, consultant, project manager and financial advisor in China. They see a lot of potential and opportunities in the Mental Health Care in China. In cooperation with Dr Geert KampschÃÆ'Â ¶er (a medical expert and entrepreneur) of Kenniscentrum Zorg Nederland they started an interesting medical project focus on China. The implementation of this medical project should lead to improving professional quality, better patient care and reducing cost. The main question for thi. thesis research can be defined as follow: How can benchmarking on outcome be introduced for the Mental Health Care in China? Theoretical sub questions: What is the medical concept benchmarking on outcome? What are the advantages and disadvantages of benchmarking? Empirical sub questions: Where is the market potential in China? What is already present in China with regards to performance indicators and benchmarking outcome? Who pays for the health care in China? How important is the insurance or payor structure in China? Is there a partner who can work together with us for this project? The purpose of this research is to write a business plan in which the steps are clearly defined that KV Connections BV and Kenniscentrum Zorg Nederland must take for introducing this medical concept in China. The research is limited to the Health Care sector of The Netherlands and China. Other countries are not listed in the research. Since the Health Care sector in big cities are better developed than in the small villages, both companies prefer to focus on the metropolitan cities in China. A region analysis will be done between those major cities. Based on the selected region or city a detailed research will be conducted about the Health Care sector in China. Relevant parties in China will be contacted for this medical project. The contact will be proceed by email and telephone. The Managing Director Mr Nando van Ketwich of KV Connections BV has arranged a business trip to China to discuss about the possibilities for this national medical project. Verder uitbreiden per chapter en aanpassen volgens opbouw rapport This report consist of several chapters. In order to get a clear view of this research, chapter 1 will give some general information of the company KV Connections BV. It starts with a short history followed by the companys vision, mission and values. The organisation structure will be further explained in the last part of this chapter. Chapter 2 describes the theoretical framework of benchmarking on outcome for Mental Health Care. It starts with an introduction of the definition benchmarking. Chapter 3 describes the literature review. Scientific reports by other researchers will be analysed and used for this thesis research. Chapter 4 describes the methodology that is capable for providing valid answers to the theoretical and empirical sub questions. The research is based on findings of interviews and several case studies. Chapter 5 describes the final results and the analysis of the research. Chapter 6 describes the final conclusions and recommendations. Thesis author: Lie Fung Cheung 45 Benchmarking on outcome for MHC in China A cooperation between KV Connections BV Kenniscentrum Zorg Nederland Chapter 1. Theoretical framework of benchmarking on outcome for the Mental Health Care This chapter describes the theory of benchmarking on outcome for the Mental Health Care. The following questions will be answered in this chapter: What is the medical concept benchmarking on outcome? What are the advantages and disadvantages of this medical concept? 1.1 Introduction The purpose of Kenniscentrum Zorg Nederland (KZN) is improving the professional quality of Mental Health Care (MHC) by an independent party who focuses on treatment outcome and creating transparency in the treatment results. This is achieved through measuring the effect of the treatment by groups of patients with reliable and scientifically valid instruments and comparing results with reference data (benchmarking). The definition of benchmarking : Benchmarkingis the process of comparing ones business processes and performance metrics to industry bests and/or best practices from other industries. Dimensions typically measured are quality, time and cost. Improvements from learning mean doing things better, faster, and cheaper. Benchmarking involves management identifying the best firms in their industry, or any other industry where similar processes exist, and comparing the results and processes of those studied (the targets) to ones own results and processes to learn how well the targets perform and, more importantly, how they do it. The outcome of a benchmark is a measurement number that says something about the performance. KZN is a Trusted Third Party (TTP) and stands as an independent party in the middle of the MHC Market. KZN has two types of customers: health care providers and insurers (payors). KZN provides information about the achieved treatment outcome in MHC to both customer groups. Health care providers get detailed information about the performances. Health care providers can benchmark internally (locations, departments or even comparing practitioners) based on the information provided by KZN and benchmark externally by comparing itself against the national average. Health care insurers (payors) get more aggregate information and they can benchmark the treatment outcome and response level for purchasing care providers. Benchmarking is not an end in itself but a way to find out in which parts an institution is performing very well and where the institution is performing below average. In most cases there is an identified room for improvement. The benchmark result should provide leads for improving the institutions or departments results. 1.2 Benchmarking and routine outcome monitoring This type of Benchmarking can be extended into routine outcome monitoring (ROM). With ROM the practitioner can follow the progress of a patient during the treatment and adjust the treatment if necessary. ROM is the finger on the pulse of the individual patient. Benchmarking itself is always about aggregated data and the finger on the pulse of an institution of department. When an institution has ROM in a good order, the collected data will constitute good basics for benchmarking. ROM and benchmarking lead together into better quality care: ROM because it becomes faster clear whether a treatment is catching on at an individual client; benchmarking because it is clearer how institutions, departments and practitioners are performing in comparison with a national average. By identifying what above average performing departments or practitioners do differently than departments or practitioners who score under the benchmark, it will become clear what the essential factors are which ensure a better treatment outcome. 1.3 Method of KZN KZN ensures reliable data and use tools, methods and techniques with a scientific basis. KZN investigates periodically at random the reliability of the data submitted from the field. KZN stands for: Standardization and harmonization of outcome data so that data from different types of patients, different types of treatment or different health care providers are directly comparable. Creating more value for healthcare providers by giving insight in its own treatment results, both for departments and practitioners of the institution specifically and for the organization as a whole, which are also directly comparable to the national average. Creating more value for health insurers (payors), because outcome data from different providers (according to the same methodology of collecting, delivering and comparing data) can be the main performance indicator of MHC. The effectiveness of treatment in the healthcare is made visible by determine the level of complaints before and after treatment and the outcome, in terms of decrease in complaints- and to compare it with the national average. The complaint level is measured by scientifically validated questionnaires. In the MHC are various questionnaires in use[3]. KZN makes use of existing traditions in the MHC in the field of formally measuring complaints and create its own instruments. However, there are certain minimum requirements for the instrumentation in terms of reliability and validity. KZN has a Scientific Council which is responsible for the decision to allow new instruments to be added to the set for benchmarking. This is a broad policy in allowing the different measuring instruments means that scores of different instruments need to be made comparable. KZN does this by using the normalized T-score. Scores are converted to a standardized score with a mean of 50 and a standard deviation of 10. The treatment outcome is measured by the decrease of complaints in other words the difference between the score of pre- and post-test. In order not to compare apples with pears, there are national benchmarks determined for different groups of patients and treatments. Among others, the scheme of DSM-IV is monitored. KZN has the Questionnaire Module (VLM) for patients filling out the questionnaire and managing data and then the Benchmark Report Module (BRM) to provide insight into the treatment outcome in groups of patients. For data transfer, KZN realizes a link between its own platform (software) with the system that is in use at the institution, for example with the Electronic Patient Files or ROM-applications. Because of this automated link, the administrative costs within the institution will not increase. 1.4 KZN reports KZN provides from the BRM two types of reports, response reports (meta data) and reports relating to the treatment outcome. The response reports provides insight into the proportion of patients in which a pre-test has been realised and proportion which a post-test has been realised. This report provides insight into the degree of measuring activity within the institution. This is also a good indicator whether the data are representative enough for the institution. The second report of the BRM shows the average effect that is achieved in groups of patients from one institution and compared it with the national average. Both results, response and effect size, support each other: a high response rate increases the reliability of the outcome data. With a high response it is possible that the results are distorted by selective (for example, patients with a disappointing therapy response have not done a post-test). The MHC institution needs to start the process to adopting a culture of measuring treatment outcomes. The response reports provides insight in the insurer in the degree of success of implementation of measuring (ROM) within the institution. 1.5 Output benchmark report module Below are reports from the benchmark report module further explained. Response Report Below shows an example of the response report, intended for internal use by an institution. The report consists of two graphs and is intended to make visible to what extent the institution is measuring. How successful the measuring process is progressing, will be ultimately noted at the proportion of patients both with a pre- and post-test. Explanation: In the graph above it shows the proportions of patients: Both with a pre- and post-test Only a pre-test Only a post-test No measurement has taken place In the top bar we see the KZN benchmark with regards to the response (the average among all institutions of KZN) in The Netherlands. And then from top to bottom the results for an individual institution (Institution A), a location (Location P) within the institution, with four practitioners (Practitioner A, B, C, D). Right of the bars is the number of Diagnosis pathways shown of which the data have been collected. In the above picture of the response report, the progress in time for this institution is made visible as the KZN benchmark line. This reveals that within this institution, the proportion of patients with both a pre- and post-test has increased over time and on a greater extent than the KZN benchmark. This institution is successful in implementing pre- and post-test in relation to all institutions within the KZN database. Besides the graph shows the difference with the KZN benchmark (the yellow line in the graph) which is overtaken for the first time in March. The above report is based on all patients of the institution. Within the Benchmark Report Module it is also possible to display the same report for a specific selection of patients. It is possible to make selections such as all patients with an anxiety disorder or for example all patients with a mood disorder. The reports which are available for the health insurer or payor is functionally very similar to that of an institution, even though only institution level data are presented (the breakdown in location, department and practitioner is not provided). The health insurer or payor can make various institutions comparable. 1.6 Report treatment effect Explanation: In the graph above are the results of the treatment shown, as presented to the health insurer or payor. The x-line displays the difference score of the outcome indicator for pre- and post-test. The standing line at 9,6 is the KZN benchmark for The Netherlands. The average for the treatment effect is 9,6 points; patients are scoring average for the pre-test T=50 and for the post-test T=40,3. There can be seen that the results for two of these six providers left out of the Dutch average. This is especially clearly visible at institution D. At four institutions are the results right out of the benchmark line, most visible for institution B. Left of the benchmark means an effect left behind the Dutch average, right of the benchmark means better impact than the average. The colors of the bars in the graph reflects an outcome scores relative to the benchmark. If this difference is less than 5% of the benchmark, the bar has a blue color. If this difference is more than 5%, the color will be respectively green and yellow. In analogy with the response report, it is also possible for reports regarding to the treatment outcome to demonstrate graphs for specific selection of patients. Certain DSM-IV groups can be selected, but also selections based on specific patient characteristics such as gender, age or ethnicity. In this selection is a KZN benchmark shown, relating to one specific selection of patients. This applies for at least 400 observations (of the selection) which is present in the KZN database. If between 200 and 400 observations are available in the database, the KZN benchmark will be shown as a dotted line. With less than 200 observations, the benchmark line wont be shown because the numbers fall short. The management of an institution can, in contrary to the health insurer or payor, gain a more detailed overview in the respective treatment effects. Besides the institution in general it is also possible to make the average treatment effect visible at the level of locations, departments and practitioners through the KZN application. Explanation: The report above is intended for institution A. In this wayÂÂ   you have a much more detail level of the results. This is an example of the results that a manager of a location can request in order to see which treatment outcomes their practitioners achieved averagely. This example involves four practitioners on location P of the institution A. This institution achieves an effect which is almost equal (9.4) to the national average (9.6). Location P of this institution scores an average effect that is better than the national average and moreover higher than the average of the institution. In this example it is primarily due to the average treatment effects which is obtained by practitioner A and B. 1.7 Report treatment effect over time Explanation: Above graph shows the progress over a period of one year for the average outcome of the treatment offered by 5 providers (Institution A to E). This example is once again a report which is only available for the purchaser of health insurance. The yellow line shows the national average, the KZN benchmark. There can be seen that the results in February 2009 for all providers, except for institution C has been slightly decreased. In the summer are apparently better results achieved, especially for the benchmark. Everywhere is a gradual increase of the effect. A similar report in time, but with a detailed overview of the institution is delivered by KZN to the providers. 1.8 Advantages of benchmarking The company will have an objective view of their competitive position By comparing your company with other successful companies, you can get a good overview of your companys market position. It gives an idea on how this situation has arisen and on what issues you can improve this position. Internal and external processes can be improved It is quite possible that processes within your business are going well. However, it is important to remember that this business can always be improved. This also applies to your buying and selling process. The question we often ask is: how do you improve these processes? You can do this by looking at other companies that perform such process better than your company. Realistic goals can be achieved through benchmarking Many companies set their goals based on intuition. There is a risk that the target is based on nothing. By looking at the performance of better performing competitors it helps you to establish realistic goals. Your company is free in specifying the problem that needs to be solved in order to achieve the goals. Companies look less at themselves Companies are strongly focused on itself. Benchmarking helps the company gain better understanding of their competitors in the way they are performing. It helps you explaining to employees why and how the competitor has better performances in certain areas. The company gains better understanding of their strengths and weaknesses Benchmarking allows you to explain your strengths and weaknesses. For benchmarking you have to demonstrate why a certain point is a strength or a weakness. 1.9 Disadvantages of benchmarking Benchmarking is not always a success. If you start working with data it can result in many problems. In practice there are many differences between the comparing companies, for example in customer requirements. This is particularly when the benchmark is applied outside its own industry. The bigger these differences, the more difficult it is to apply benchmarking for its own company. Collecting and comparing data can waste a lot of time, because of the following questions: Are we talking about the same business? How can we get the requested information? Which benchmarking performance indicator does the companies applies we want to compare with? Do we really want to implement the actual improvements into the company even when it needs much energy and time? Thesis author: Lie Fung Cheung 45 Benchmarking on outcome for MHC in China A cooperation between KV Connections BV Kenniscentrum Zorg Nederland Chapter 2. Literature review This chapter describes the literature review. It will start with the explanation of mental health followed by important news topics related to the health care in China. https://writing.wisc.edu/Handbook/ReviewofLiterature.html https://literaturereviewsamples.blogspot.com/search/label/Cancer https://educatie-en-school.infonu.nl/taal/6663-scriptie-verslag-van-een-literatuuronderzoek.html https://english.gov.cn/2011-03/23/content_1829806.htm https://english.gov.cn/2011-03/21/content_1828516.htm https://www.chinavitae.com/vip/index.php?mode=topictopic=reform https://www.hmohelp.ca.gov/dmhc_consumer/br/br_mentalhlth.aspx https://www.ehow.com/list_7491685_skills-mental-health-care-workers.html https://www.scriptiebegeleidingingroningen.nl/literatuurstudie-van-de-scriptie/ https://www.skipr.nl/actueel/id4805-ggz-nederland-en-zn-zetten-kwaliteitsbenchmark-op.html https://countrystudies.us/china/38.htm https://www.consultancynieuws.nl/whitepapers/benchmark-ziekenhuizen-financiele-positie-zorgwekkend/ China healthcare overview from Technomic Asia 2.1 What is mental health? https://mentalhealth.about.com/cs/stressmanagement/a/whatismental.htm https://www.medicalnewstoday.com/articles/154543.php Mental health can be defined as mental illness, which refer to a wide range of mental disorders that can be diagnosed by a health care professional. It refers to a persons cognitive and emotional well-being; the way we are thinking, feeling and behaving. A person with mental health has an absence of a mental disorder. Mental health can affect a persons daily life, relationships and physical health. Experts often say we all have the potential for suffering from mental health problems, no matter how old we are, whether we are male or female, rich or poor, or ethic group we belong to. Forms of mental illnesses Examples Anxiety disorders This is the most common group of mental illnesses. The patient has a fear or anxiety which is linked to certain objects or situations. Most people try to avoid exposure to whatever triggers their anxiety. Panic disorder The person experiences sudden paralysing terror or imminent disaster. Phobias The person has disproportionate fear of objects or fear of being subject to the judgment of others. Obsessive-compulsive disorder (OCD) The person has constant stressful thoughts (obsessions) and a powerful urge to perform repetitive acts. Post-traumatic stress disorder (PSTD) The person thinks that his life or other peoples lives are in danger. Mood disorders This is also known as affective disorders or depressive disorders. Those patients share disturbances or mood changes. Approximately 80% of patients with depressive disorder improve significantly with treatment. Major depression The person has extreme or prolonged periods of sadness. Bipolar disorder The person has manic depression. Dysthymia The person has a chronic feeling of ill-being and lack of interest in activities he once enjoyed. Seasonal affective disorder (SAD) The person has a major depression, which is triggered by lack of daylight. Schizophrenia disorders This is a single disorder or a group of related illnesses which has to be fully determined. It is a highly complex illness where most patients are between 15 and 25 years of age. Positive symptoms Delusions, thought disorders and hallucinations. Negative symptoms Withdrawal, lack of motivation and a flat or inappropriate mood. Table 3. The most common forms of mental illnesses. 2.2 Ministry of Health (China) promotes measure 7 Ministry of Health requested an appointment clinics to promote medical institutions such as universal measures 7 to achieve good service. Xinhua Beijing April 12 (Xinhua Zhou Tingyu) 12 Ministry of Health held a national health system carry out three-good one satisfaction activities will be deployment of video and telephone, to request an appointment clinic medical institutions in general to promote and optimize service processes and improve service levels, efforts to achieve good service. The depth A Good activities to enhance professional style building, the Ministry of Health recently issued notice to the health system in the country decided to carry out the good service, good quality, ethics is good, people are satisfied, Miyoshi A satisfactory activities. Vice Health Minister Ma Xiaowei said that in 2011, Miyoshi a satisfactory range of activities, various medical institutions at all levels, focusing on more than two public hospitals. Health surveillance, disease prevention and control and other health institutions should be combined with the actual organization activities. In 2011 Ministry of Health requires health care institutions through the following seven specific measures to achieve good service: First popularized appointment treatment services. In all three A-level general hospitals nationwide to implement a variety of ways appointment clinics, urban community health services a priority referral clinic appointments, and strive to the end of 2011, urban communities, the amount of referral clinic appointments accounted for 20% the proportion of local patients referral appointment rate of 50%, of which dentistry, prenatal care, referral and other postoperative review appointment rate of 60%. Second is to optimize the Hospital of the environment and processes. Registration by appointment, reasonable arrangements for outpatient and emergency services, outpatient and emergency and simplify the admission, discharge service process, the implementation of first treatment, after the balance sheet model, providing convenient access service and other test results, and strive to make reasonable arrangements, enthusiastic service, process smoothly and continuously promote the improvement of medical services. Third is convenient to carry out extensive outpatient services. Qualified to carry out weekends and holidays tertiary hospital out-patient, out-patient power to enrich, extend clinic hours; to encourage, support tertiary hospitals to primary care medical staff to carry out medical practice and health institutions. Fourth, the promotion of quality care. National tertiary hospitals to carry out a comprehensive quality care, 50% of the hospitals of quality care ward covers more than 50%, 40% of the prefectural (city) level II hospital and 20% of the county hospital to carry out secondary quality care. Improve the preparation and implementation of professional nursing staff and internal income distribution policy. Five is to improve the medical examination, mutual recognition of test results mechanism. Quality control in intensive care on the basis of medical examination and vigorously promote the same level, the mutual recognition of test results, and promote reasonable inspection, reduce patient treatment costs. Sixth, carry out the volunteer service in the hospital activities. Gradually improve the volunteer management system and working mechanism suitable for China to actively explore new forms of volunteer service, new content, new models. Seven is to establish a sound mechanism for third-party mediation of medical disputes, and medical liability insurance system, medical complaints seriously implement the approach, strict implementation of the first complaint responsibility system, in-depth activities to establish safe hospitals campaign to crack down on medical seek to build a harmonious relationship between doctors and patients. In addition, Ma Xiaowei also required that all medical institutions should strengthen quality control, standardized treatment behavior, continuous improvement, quality of care, efforts to achieve good quality; to strengthen medical ethics education, vigorously carry forward the noble medical ethics, serious industry discipline, efforts to achieve good ethics; to deepen professional climate appraisal, and actively accept social supervision, and efforts to achieve satisfaction of the masses. 2.3 China pledges more efforts to reform health care BEIJING Chinese Vice Premier Li Keqiang said the country would fight the toughest battle to reform the health care system in 2011, as he called for practical measures towards accomplishing the reform. Li made the remarks while addressing a national meeting on deepening Chinas reform of health care system on Tuesday, according to an official statement sent to Xinhua on Wednesday. Citing the reform as a key project that involves public interests, Li called for efforts to ensure the peoples universal access to basic medical insurance and basic health care services. Li added that China would largely raise the level of government subsidies for medical insurance schemes in both rural and urban areas and increase government spending on public health care services this year. Efforts would be made to let insured people get a higher ratio of reimbursement for their inpatient medical treatments as well as for their outpatient medical treatments for severe diseases, Li said. He added that the basic medicine system, which aims to ensure affordable access to crucial drugs for patients, should be implemented across government-run grassroots hospitals and clinics in 2011. Furthermore, Li said that comprehensive reforms including the separation of medical treatment services and medicine sales would be initiated in government-run hospitals in 16 cities this year. 2.4 Health care in China China has stunned the world with its rapid economic growth in recent years, showcased through theglittering skyline of Shanghaiand the global events like the 2008 Olympics. But while thecountry has amassed tremendous wealth, China still trails the developed world in its ability to provide even basic health care for its people. With its massive 1.3 billion population, Chinas health care expenditures are miniscule compared to Western nations. China spent less than 5 percent of its GDP on health care in 2005, compared to roughly 16 percent spent in the United States and 10 percent in Canada, according to theWorld Health Organization. The amount of government spending on health care is really low. Its less than $10 per person, per year, said Drew Thompson, director of China studies and Starr senior fellow at the Nixon Center. Per person expenditures in the U.S. have topped $6,000 in recent years. Despite Chinas Communist government, health care remains largely the responsibility of individuals. Out-of-pocket expenses are extremely high in comparison to average earnings. A single hospital visit nearly matches Chinas annual income per capita. Health Insurance Not Mandated Health insurance is not mandated, though the government does have health insurance programs that provide coverage to some 90 percent of the population. The programs include an employer-based system, a program for urban residents, and another program covering the rural population. For the most part, the programs do not cover the basic care. At the moment, most programs in the provinces across China provide primarily in-patient care service, said Dr. Gordon Liu, professor of economics at Peking University. Basically, the goal is to protect you from having catastrophic problems. As a result, much of the Chinese population doesnt even receive basic medical care. Theyre still paying largely out of pocket, which causes them to delay going to the doctor, Thompson said. People dont go to the hospital until theyre really sick. Theres no preventative services. But even with the financial disincentive, there still is a shortage of care. Usually, Chinese people would have to wait many days to get registered, or you have to know someone to get registered before you are diagnosed and treated, said Liu. We have a supply shortage meaning beds, the doctors, good hospital facilities are not enough to meet the demand by people. Health Care in China: Doctors Rarely Have PhD For those who do seek care, treatment rarely approaches anything close to awestern standard of care. Though quality medicine is available for Chinas wealthiest people, most residents receive treatment from physicians who have received little medical training. Just one percent of Chinese doctors have actually received a PhD, while many have only basic training, similar to pre-med classes in the U.S. The quality of education, experience and technology, by and large, is not up to world standards, Thompson said. Part of the reason for the shortage of well-trained doctors is that theres little financial incentive for Chinas best and brightest to go into the field. While much of Chinas economy has become market-based in recent years, medicine has not made the same transition and doctors salaries are tightly controlled by the state. 2.5 Chinas healthcare is the lowest in the world Chinese health officials said that those who complain about Chinas healthcare system policies only see the American healthcare system as superior and fail to notice that healthcare in America suffers from it being market-oriented instead of patient- oriented. However, Chinas healthcare system also has faults such as its focus on money instead of service and discrimination. Chinas and the United States healthcare systems differ greatly. Hospitals in the United States, for example, must provide emergency medical treatment to walk-ins, and low-income patients can receive reduced or free medicine. Foreigners who reside in the U.S also have a right to free medical treatment as a walk-in. Patients in China, however, must pay first before receiving medical treatment, and as a result many dying patients are denied much needed medical treatment. Some patients have even died in front of the hospital because of their inability to pay. In 1998, a report disclosed that about one-third of Chinese people were unable to receive medical treatment, with the statistic being higher in poor, rural areas in China. Discrimination against the poor is a definite problem in China that precludes many people getting medical attention. Farmers, for example, only receive 15.9% for healthcare expenses from the government even though they comprise 80% of the population. The government spends approximately $130 for citizens living in cities, while farmers only receive $10.70. Qualified medical personnel and updated equipment is also a serious problem in rural areas. Chinese health officials agree that only one-third of the public healthcare system is operational and that huge expenses are caused by poor bureaucratic decisions. The real problem for Chinas poor healthcare policies is money. The government spends money on project such as the Shan Zhou No. 5 rocket project, missiles and nuclear weapons and is unwilling to invest in education and healthcare even though improvement in those areas would help our future. According to the World Health Organization (WHO) the Chinese health system ranked 144 out of 191 countries, and is even below Iraq in providing good medical treatment. (In addition, China ranks 188, the 4th place from the last, for the line item equity in sharing a doctor most likely has something to do with doctors per patient ratio.) The Chinese health system is out-dated, and this was especially noticeable during the outbreak of SARS. The Canadian government, concerned about Chinas healthcare policies, warned that the outbreak of SARS disease could return for the next spring. The Chinese government covered up the highly contagious and deadly disease, which caused worldwide panic. After WHO seriously criticized the Chinese government, they donated $100 million in hush money to the WHO. Many people cannot help but ask the government: Where is the money to improve our outdated medical and healthcare system? Chapter 3. Internal analysis The first part of this chapter begins with a short history of KV Connections BV followed by a description of the companys vision, mission and values in the second part. The organisation structure will be illustrated in the third part and the final part consist the marketing mix of the organisation in order to get a good view of their marketing operations. 3.1 History of KV Connections BV KV Connections BV (KVC) is established in 1991 by Mr Nando van Ketwich as a private limited company. Their core business is creating business ventures for Interim Management, International Business Development and Project Management with exclusive partnerships in Europe and Asia. KVC understands the value of personal relationship building, which isÂÂ   an important element of success and for establishing a strong business presence in Asia. During the past 20 years KVC has been acting as an agent, a consultant, project manager and financial advisor in China. More detailed information for the projects they have done is described in table 1. Projects topics Examples Security Safety KVC and Beijing Konre assisted Kusters Engineering in setting up a project in China to provide an environmental friendly technology for the disintegration of used banknotes. This project resulted in multi-million dollar contracts for equipment and it has a large spin-off for various Dutch companies. Because of this project, Kusters Engineering has a unique long-term position in China. Renewable Energy KVC has been searching for more than 10 years to introduce Dutch technology in renewable energy in China. Finally KVC get in touch with Composite Technology Centre (CTC), who has the know-how in designing and producing high-tech blades for wind turbines of more than 1 MW. Currently, KVC has a leading role in the national wind energy platform which is designed in The Netherlands and produced in China with a long term position. Land Reclamation Management With the help of KVC for engineering, the feasibility studies for land reclamation in the Chinese province Fujian has been completed by famous water management companies. The main purpose for this project is to build a harbour with minimal environmental disturbance. This project has expand on a nationwide basis in China. Fish Food KVC cooperates with their counterparts Shandong Fishery Co. (SNFC), China Aquatic Products Processing and Marketing Association (CAPPMA)ÂÂ   for upgrading the fish quality in China. The purpose of this project is to have better quality food on the market, improve the lifespan of food and develop more international trade of fish and food products. China Inroads China Inroads (CI) provide local support for implementing business plans and they act as a personal guide who creates business possibilities for people. Their Chinese partners offering services at local rates. The Chinese and Dutch management team make China more accessible for people who wants to create new business opportunities. Trade Development Large volumes of security paper have been sold to ChinaÂÂ   through KVCs intermediary; printing equipment and service; source of spare parts. Financial Support Training KVC has provide financial training and coaching to government, financial, commercial and private institutes; technical services for financial institutes; financial planning for budgeting, funding and acquisitions. Table 1. KVCs Projects with examples. 3.2 Mission statement Vision Creating profitable business ventures through mutual understanding between China and Europe. KVC wants to become the company who cooperates with Chinese partners for profitable projects which has an important contribution to the world. When KVC establish a partnership they will take the values of the organisation into it. Mission Doing useful things for a better world. Values Long term thinking Experience Respecting people and cultures Patience and trust Honest and hardworking people 3.3 Business definition The business of KVC can be defined by using Abells business definition model. KVCs business scope is shown as a cube in figure 1. All the elements in table 2 together forms the product-market combinations of KVC. The three dimensions in figure 1 describes the following: Customer groups : who are the customers/target group of KVC? Customer needs : what are the needs of KVCs customers? Technologies : which products/services will KVC use to satisfy their customer needs? Customer groups Customer needs Technologies A1 Government institutions B1 Security T1 Setting up a project with partners A2 Banks and large companies B2 Environment protection T2 Investing knowledge A3 Private industries B3 Renewable energy T3 Wind energy investing A4 State owned enterprises B4 Safety T4 Cooperating with counterparts in China A5 SMEs B5 Training T5 Providing financial training and coaching A6 Asian companies B6 Financial management T6 Providing support for implementing business plans A7 Training institutes B7 Business opportunities in China T7 Develop better quality food for the market A8 Hospitals B8 Management health care system T8 Benchmarking on outcome Table 2. Description for figure 1. 3.4 Organisation structure KVCs organisation structure can be characterised as a line organisation, because of its simplicity and coordination capabilities. Employees within the organisation gets their work from one person, the Managing Director. The Managing Director and founder of KVC is Mr Nando van Ketwich. He has 45 years of international experience, which 30 years in greater China. In addition, he has the knowledge for working with high-level and quality companies in the Netherlands, France, Hong Kong and the USA. There is a unity of command within the organisation which means that employees should report their progress and results to the Managing Director, who has gain a lot of knowledge in the past years in order to control the different departments (projects). The impact of managing multiple departments projects can result in work overload. KVC has totally 10 employees working in different (partner)offices in: The Netherlands Beijing Shanghai 3.5 Marketing mix 3.5.1 Product 3.5.2 Price 3.5.3 Promotion 3.5.4 Place 3.6 BCG matrix 3.7 Product life cycle Chapter 4. External analysis https://www.internationaalondernemen.nl/exporteren/exportplan_intro.asp https://www.netmba.com/strategy/pest/ 4.1 Macro-environmental factors https://www.netmba.com/strategy/pest/ https://www.intemarketing.nl/marketing-analyses/destep https://members.fortunecity.com/marwinroije/word.doc/beleidsplan.html 4.1.1 Demographic 4.1.2 Economic 4.1.3 Social-cultural 4.1.4 Technological 4.1.5 Ecological 4.1.6 Political 4.2 Porters five forces 4.2.1 Supplier power 4.2.2 Buyer power 4.2.3 Threat of substitutes 442.4 Threat of new entrants 2.2.5 Degree of rivalry 4.3 Ansoffs matrix https://www.marketingteacher.com/lesson-store/lesson-ansoff.html https://www.mrdashboard.com/AnsoffMatrix.html 4.4 Region analysis in chapter research? Metropolitan cities in China Hong Kong Beijing Shanghai Thesis author: Lie Fung Cheung 45 Benchmarking on outcome for MHC in China A cooperation between KV Connections BV Kenniscentrum Zorg Nederland Chapter 5. Research https://www.sasked.gov.sk.ca/docs/social/psych30/support_materials/research_methods.htm https://www.jpsimbulan.net/thesis-writing-guide/how-to-write-a-thesis/how-to-write-chapter-3-of-a-thesis-basic-format/ https://educatie-en-school.infonu.nl/diversen/6386-scriptie-beschrijven-van-een-empirisch-onderzoek.html wat is onderzoek toelichten? toelichten waarom enquete niet van toepassing is, goed beargumenteren! Enquete is niet van toepassing, wegens de volgende redenen: Het gaat om een totaalpakket in de vorm van een dienst/software dat wordt geleverd aan ziekenhuisinstellingen. 5.1 Kinds of research methods https://www.scn.org/cmp/modules/rsh-krm.htm https://www.allesovermarktonderzoek.nl/Marktonderzoek/Onderzoeksmethoden/Onderzoeksmethoden.aspx https://www.wisegeek.com/what-are-the-different-types-of-survey-research.htm https://managementhelp.org/research/research.htm https://www.statpac.com/surveys/research-methods.htm Research methods Explanation Interview The interview method of research involves a face-to-face meeting with an person, who has to answer a series of questions asked byÂÂ   the interviewer. This method gives you a better understanding of the story behind a participants experiences and the interviewer can collect in-depth information/data about the topic. Types of interviews: 1. Informal, conversational interview The questions are not predetermined because it depends on the individuals priorities. The interviewer goes with the flow during the interview. 2. General interview guide approach The interviewer collects information from each interview based on questions in the same general areas. This interview allows a degree of freedom in getting information from a person. 3. Standardized, open-ended interview The interviewer asks the same open-ended questions to all persons. This interview can be easily analysed and compared to others. 4. Closed, fixed-response interview The interviewer has to ask all persons questions with fixed answers or alternatives. This interview is very useful for people who has less knowledge in conducting interviews. Types of questions topics: 1. Behaviours What has the person been doing? 2. Opinions/values How does the person think about the topic? 3. Feelings How does the person feel about the topic? 4. Knowledge What are the facts of the topic? 5. Sensory What has the person seen, touched, heard, tasted or smelled? 6. Background/demographics What is the background of the person, such as education? Survey The survey method of research involves the use of questionnaires from a potentially large number of respondents. This is the only feasible way to gain statistically analysis of the results. Steps which are required in order to design and administer a questionnaire: Define the objective of the survey Determine the group/respondents Write the questionnaire Administer the questionnaire Interpretation of the results Types of surveys: 1. Paper surveys This survey is mostly used for conducting market research. It contains a list of multiple choice answers what is easier to process. 2. Telephone surveys This survey is done through the telephone. The telephone survey proceeds electronically and there will be no human-to-human contact. The respondents replies by pressing a number on the phones dial pad. 3. Online surveys This survey is printed in electronic form. Most Internet users are familiar with the point and click approach. The telephone and online surveys offers the flexibility in asking questions based on the respondents answer. Case study The case study method of research involves interviews, observations, experiments and tests. It helps us to understand a complex issue or object based on an in-depth investigation case and what might become important in future research. Techniques for organising and conducting case studies: Determining and defining the research questions Selecting the case studies Preparing to collect the data Evaluating and analysing the data Preparing the report Types of cases: 1. Illustrative case studies This case study describes a domain; one or two instances will be used for analysing the situation. It gives readers a common language about the topic. 2. Exploratory/pilot case studies This case study condenses the process; researchers undertake it before implementing a large-scale investigation. It helps identifying questions, developing measures and serve to safeguard investment in larger studies. 3. Critical instance case studies 4. Program implementation case study 5. Program effects case study 6. Cumulative case studies Naturalistic observation Experiments Topical Table 4.Research methods. 5.2 Interview https://www.scriptiebegeleidingingroningen.nl/interviews-analyseren/ 5.2.1 Stichting Benchmark GGZ Afwachting feedback Edwin de Beurs Company: Stichting Benchmark GGZ Website: https://www.sbggz.nl/ Place: Bilthoven, The Netherlands Date: Thursday 12 May 2011 Time: 11.00am 12.15pm Interview with: Mr Edwin de Beurs In 2006 Mr Edwin de Beurs was involved in the benchmarking project in cooperation with HSK Groep. The concept of this idea was implemented as a pilot, which they focus on two types of customers groups; health care insurers and health care providers (MHC institutions). The competitiveness between health care insurers (who is the best we can do business with) and health care providers (we are doing well) creates advantages in transparency and quality within the MHC. Stichting Benchmark GGZ has about 15 employees. The steps they have taken in order to implement the benchmarking on outcome can be described as follow: Inviting health care insurers for a meeting. Health care providers has put the impact of health care into a chart; Routine Outcome Monitoring (ROM), adjust the treatment if necessary. Stichting Benchmark GGZ has collected the data and their objective is to make averages of the data; it is always about groups of patients (homogeneous). For the exchange of ideas and decisions they will contact the foundation (a representative board of health care insurers and health care providers). The product of Stichting Benchmark GGZ is the result, that is the most important reason for choosing to work with benchmarking on outcome. The main purpose is to compare the quality of institutions. In order to improve the quality of health care, institutions have to learn by measuring; the way of treatment is not important for benchmarking because the result is the final goal. The choice to start with focussing benchmarking in the MHC is because the MHC institutions has already started with measuring in the framework of ROM using the Symptom Checklist. This all makes it a bigger chance for Stichting Benchmark GGZ to implement benchmarking on outcome and they only need to find the consensus about how they are going to measuring it. There are different performance indicators, such as satisfaction of the patient. For this benchmarking concept there will be focussed on the outcome (result).ÂÂ   It can also be divided into primary and secondaryÂÂ   performance indicator, which depends on the problem. The advantages of benchmarking on outcome can be defined as follow: Medical doctors can specialise further in their field, which can result into a better quality of health care. Working according to the Symptom Checklist helps reducing problems. The disadvantages of benchmarking on outcome can be defined as follow: The benchmarking on outcome must be performed properly. If no value is given to it, the product is worthless. It is important to demonstrate that there will be focused on the result. People wants to quickly use the data what can result into a blame culture. For example, institution A is performing better than institution B so we will work with institution A. The outcome data represents the quality of health care. Centralise the health care may result into longer distance travel for patients. In the case of implementing benchmarking on outcome in the MHC in China it is necessarily to make a start with measuring in the framework of ROM; institutions have to use measuring instruments. According to the law of arrears is China far behind the development of medical technology. The culture of measuring treatment outcomes has to be present in China before implementing the benchmarking concept. It is better to focus on the metropolitan cities such as Hong Kong, Shanghai and Beijing. There must be an independent Third Trusted Party (TTP) presented who is going to compare the results and this TTP have no interest in the outcome, for example the government. To make a good start it might be an option to implement a pilot for the upcoming two years in the metropolitan cities in China. If there is no culture of measuring treatment, we can help China establish one. The MHC in The Netherlands has approximately 1 million patients (16% of 16.5 million residents). Currently not every MHC institution is working with benchmarking on outcome. One of Stichting Benchmark GGZs objective for the year 2014 it to persuade at least 50% of MHC institutions to work with benchmarking on outcome. Beside of this, they will also continuously focus on perfecting their system and showing results. In the future there will be a possibility to expand the benchmarking on outcome to other health care sectors within The Netherlands if there is a culture of measuring treatment outcomes. 5.2.2 Shanghai University of Traditional Chinese Medicine Company: Shanghai University of Traditional Chinese Medicine (TCM) Website: https://www.shutcm.edu.cn/English/ Place: Shanghai, China Date: Monday 28 February 2011 Time: 09.00am 10.30am Interview with: Ms Wang Tianjun Dr Chian (Director of the International Cooperation Division) Dear Mrs Wang, dear Pany, Many thanks for organising the meeting a.o. with Dr. Chian at the TMF University in Shanghai. It was a great pleasure together with my partners to make aquaintance with a so prestigious Institute and talk with a famous Doctor in China. We in Holland also like to learn more from the Chinese side. I send a very short summary, copy the the famous Doctor in Holland with whom we are working at this end : Dr Geert Kampschoer. Pse correct me if I am wrong in my summary: I am not a medical doctor but a simple business man with long experience in China and Asia and by the way: as I was ill myself when in Shanghai and we went to the Rui Jin Hospital related to the Jiao Tong University School of Medicine my wife and me were very impressed by the excellent and professional way I was treatened in a very efficient way! I believe we can learn a lot from this in Holland and Europe.. After introductions we spoke about: there are 5 Hospitals like in Shuguan in China acting in the top of TCM, strategic and national decisions are made mainly by the National Healthcare Ministry in Beijing, in Beijing we had also contacted the China Medical Association who are quite active in organising exchange with Doctors on an international basis, the Ministry is acting mainly for healthcare services and wishes to develop more differentiation with medical doctors, that does not mean that there is not an open and flexible system in China, openness to private Institutions and people is increasing rapidly, the next 5 year Planning is further increasing the exchange between private and government regarding a national healthcare system, in which several private forces like producers of phamrmaceuticals and equipment are helping a lot, national concensis for healthcare in China is very strong and in some cases there is an increaesed international co-operation, Shanghai plays a prominent role in all this and privatisation becomes much more important , however national control remains essential as well, costs are mounting and some private parties are contributing on funding programmes, areas that are advanced right now in this connection is in dental, eye and heart curing, after I introduced the benchmarking it became clear that in China there is a KZN mainly on an academical basis, in the near future we could get access to this party for which we have to come up with some suggestions from this end about how we could co-operate, we have to take a view with hospital to hospital and institue to institute. I mentioned that recently a TCM club has started business in The Hague but this is 99% for acupuncture, after discussions with partners In Holland we shall be back soon! 5.2.3 Joining Minds Company: Joining Minds / Kenniscentrum Zorg Nederland Website: https://www.joiningminds.nl/ Place: The Hague, The Netherlands Date: Thursday 7 April 2011 Time: 10.30am 12.00am Interview with: Dr Geert KampschÃÆ'Â ¶er Geert KampschÃÆ'Â ¶er is a medical expert and entrepreneur who have successfully implemented the following projects in Holland in close cooperation with various partners: 1. NederlandseObesitasKliniek (NOK) The first centre in The Netherlands which offers integrated solutions for obesity prevention and treatment. 2. www.medischegegevens.nl Exchanging and sharing medical information has always been sensitive. Although patients own their medical records, they dont have readily access to it. In 2006 the founders Dr. Alexander de Vries and Dr. Geert KampschÃÆ'Â ¶er started the development of www.medischegegevens.nl. Patients have access to their medical records by logging into this secure website. The Medical Center Haaglanden has functioned successfully under this Pilot Programme by helping patients achieve a better understanding of their disease. 3. Benchmarking for mental healthcare The orientation of Western medicine has always been on professionalism and effort. Nowadays it becomes ever more important to focus on results and therefore outcome-oriented health care. Currently,only within Mental healthcare scientifical valid instruments (questionaires) are available to measure treatment. The Netherlands is the first country that was able to have a national transparent benchmarking on outcome. Geert KampschÃÆ'Â ¶er together with KV Connections BV would like to develop benchmarking for mental healthcare in China.ÂÂ   Contact with Shanghai University of Traditional Chinese Medicine and the Chinese Medical Association (Beijing) a non-profit organisation formed by Chinese medical science and technology professionals- has been established during Nandos visit to China in Feb 2011. In order to find the right counterpart in China and before we can define our strategy we need to have a better overview of the current healthcare situation in China and therefore answers to the following questions need to be covered: 4. Given the development state of MHC, it seems better to focus on the metropolitan cities in China, such as Shanghai, Beijing and Hong Kong. 5. Who pays for the healthcare in China? This counterparty is the one who is most interested in the project, because they are able to choose and guide the quality development by using outcome benchmarking. Is there a local or national Health Authority in China? Normally healthcare is paid through medical insurance for which the employer and employee pay their individual shares. There is National Health Ministry and local municipal heath bureaus in China. 6. The implementation of benchmark outcome leads to better healthcare. The results of the medical specialist or psychologist will be made transparant and compared with his colleagues. Are they doing it good or bad and what can be improved? There is benchmarek systems in hospitals, but since I work for university instead of hospital, I am not clear about how they are doing. 7. What is already present in China with regards to performance indicators andÂÂ   benchmarking outcome? How many patients? If there is a problem, how did you solve that? Is there a partner who can work together with us for this project? Maybe the local government or Ministry of Health? How important is the insurance structure or payer structure in China? There is a department in each hospital that is responsible for assesing medical performance. Better contact someone from hospital for more information.Medical insurance is covered for almost all employeed and retired people in China. Employer pay a larger share than the emplyee. 8. We can offer the concept benchmarking outcome based on scientifically valid methodology and the technology of data infrastructure, calculations and reporting. Actions: An interview for Lie Fung Cheung with Mr Edwin de Beurs (Director KZN Benchmarking) will be planned in the next weeks in order to have a better understanding of the concept; For answers to above questions KV Connections BV will contact people in her network in China. 5.3 Case study Thesis author: Lie Fung Cheung 45 Benchmarking on outcome for MHC in China A cooperation between KV Connections BV Kenniscentrum Zorg Nederland Chapter 6. Results and analysis https://ivythesis.typepad.com/term_paper_topics/2009/04/thesis-analysis-and-interpretation-of-data.html https://hubpages.com/hub/Data-Analysis-Interpretation 6.1 SWOT analysis 6.1.1 Confrontation matrix (function() { var scribd = document.createElement("script"); scribd.type = "text/javascript"; scribd.async = true; scribd.src = "https://www.scribd.com/javascripts/embed_code/inject.js"; var s = document.getElementsByTagName("script")[0]; s.parentNode.insertBefore(scribd, s); })() 6.2 Options 6.3 Implementation 6.4 Monitoring / auditing? Thesis author: Lie Fung Cheung 45 Benchmarking on outcome for MHC in China A cooperation between KV Connections BV Kenniscentrum Zorg Nederland Chapter 7. Conclusions and recommendations 7.1 Conclusion 7.2 Recommendations Korte termijn Middellange termijn Lange termijn Thesis author: Lie Fung Cheung 45 Benchmarking on outcome for MHC in China A cooperation between KV Connections BV Kenniscentrum Zorg Nederland

Materialism in The Great Gatsby Essay - 515 Words

We are living in a material world. This famous line in one of Madonnas songs entitled Material Girl will never outgrow itself. Ever since the beginnings of monetary means, the main focus of living is getting more money and to be as successful as possible. This became a huge issue during the 1920s. In this era, people made money from the stock market, illegal bootlegging and so forth. With these people hitting the jackpot, this then created a new rank called `new money. This rank, however, never overpowered `old money the most wealthiest, well-known and respected class. The possession of material wealth however, cant bring true happiness. Love is an important factor in this equation; when you dont have love, it is hard to say†¦show more content†¦Though they seemed very close with each other, marriage wasnt in the picture. `Gatsby sprang to his feet, vivid with excitement. `She [Daisy] never loved you [Tom], do you hear? he cried. She only married you because I was poor and s he was tired of waiting for me. It was a terrible mistake, but in her heart she never loved anyone except me!(137). Even though love did seem important for Daisy, it didnt top the fact that Gatsby had no money to support the both of them. This is one way that materialism proves itself to be on top. Another way is the superficial relationship that Tom and Daisy have. They are hardly Communicable towards each other and the way this is described is obvious.Daisy and Tom were sitting opposite each other at the kitchen table with a plate of cold fried chicken between them and two bottles of ale. He was talking intently across the table at her hand and in his earnestness his hand had fallen upon and covered her own. Once in awhile she looked up at him and nodded in agreement. They werent happy, and neither of them had touched the chicken or ale-and yet they werent unhappy either (152). Daisy and Tom have been married for five years and this happiness and unhappiness they do and dont feel deals primarily with the fact that their relationship is not based on love. They dont look as if they share a deep connection-a connection such as Daisy and Gatsbys. Daisy and Toms happiness is based on both of them coming from money,Show MoreRelatedMaterialism - the Great Gatsby1732 Words   |  7 PagesMaterialism America has been labeled The land of opportunity, a place where it is possible to accomplish anything and everything. This state of mind is known as The American Dream. The American Dream provides a sense of hope and faith that looks forward to the fulfillment of human wishes and desires. This dream, however, originates from a desire for spiritual and material improvement. Unfortunately, the acquisition of material has been tied together with happiness in America. AlthoughRead More Materialism in The Great Gatsby Essay1075 Words   |  5 PagesMaterialism may be defined as attention to or emphasis on material objects, needs or considerations, with a disinterest in or rejection of spiritual values. The acquisition of material wealth is often equated with happiness in this country. This is true today, and it was true during the 1920s, the setting of F. Scott Fitzgeralds The Great Gatsby. That the majority of Americans believe that wealth and happiness are the same is a result of our market economy that encourages consumption and conditionsRead MoreEssay on Materialism in the Great Gatsby905 Words   |  4 Pagessuch as money in The Great Gatsby. Daisy falls in love with Gatsby, who is a poor man at the time, and when Gatsby leaves for the war, Daisy marries Tom Buchanan, who is a rich man, because he is â€Å"old money,† meaning he will always have the money and status to support Daisy. When Gatsby returns from the war, his pursuit of Daisy’s love reveals his materialism and he eventually becomes rich for Daisy and believes that he can win her back because he now has money. The Great Gatsby demonstrates the wayRead More Materialism - The Great Gatsby Essay1687 Wor ds   |  7 Pages Materialism nbsp;nbsp;nbsp;nbsp;nbsp; nbsp;nbsp;nbsp;nbsp;nbsp;America has been labeled quot;The land of opportunity,quot; a place where it is possible to accomplish anything and everything. This state of mind is known as quot;The American Dream.quot; The American Dream provides a sense of hope and faith that looks forward to the fulfillment of human wishes and desires. This dream, however, originates from a desire for spiritual and material improvement. Unfortunately, the acquisitionRead MoreMaterialism In The Great Gatsby Analysis824 Words   |  4 PagesMaterialism The Great Gatsby, written by F. Scott Fitzgerald, illustrates the different lifestyles in regards to the upper and lower classes. The upper class is represented by â€Å"Old Money†, the people who inherited their wealth. Another part of the upper class is represented by â€Å"New Money†, the people who obtained wealth over time. Old money is more fancy and elegant, whereas new money is more showy and extravagant. Because of this, old money is considered superior to new money. The lower class isRead MoreThe Madness Of Materialism In The Great Gatsby996 Words   |  4 Pagesarticle â€Å"The Madness of Materialism† by Steve Taylor discusses psychological discord and talks about people always wanting certain objects, that they might not be a necessity (Taylor). This article is similar to the novel, The Great Gatsby by F Scott Fitzgerald because both discuss the idea of wants versus needs. Gatsby is the main character, however Nick Carraway is the narrator througho ut the entire story. They have been neighbors ever since Nick moved to West Egg. Nick and Gatsby become close friendsRead MoreEssay On Greed And Materialism In The Great Gatsby1014 Words   |  5 Pagesgrowth in an economic forum. This caused many Americans to move into the uncharted territory of the city, and make the transition into a prosperous and foreign â€Å"consumer society† (History.com). In addition, the traits of greed and materialism are ubiquitous in The Great Gatsby, as well as in the flashy 1920’s. These two characteristics give one confidence, but as demonstrated in the novel, it brings nothing but short-term satisfaction. After that, feelings of desperation to childish behaviors can accompanyRead MoreGreed And Materialism In The Great Gatsby Analysis1311 Words   |  6 Pagesprosperous and previously foreign â€Å"consumer society† (History.com). The traits of greed and materialism are ubiquitous in The Great Gatsby, as well as in the Art Deco era of the 1920’s. These two characteristics can give one confidence, but as demonstrated in the novel, they bring nothing but short-term satisfaction. After which, feelings can run the gamut from desperation to childish behaviors. While greed and materialism have the power to seem favorable, bringing an amplification of social status, theyRead MoreEssay On Money And Materialism In The Great Gatsby1994 Words   |  8 Pages Money and materialism play a large role in F. Scott Fitzgerald’s book, The Great Gatsby, which takes place on Long Island in the summer of 1922. The book follows a man by the name of Jay Gatsby who centers his life around one goal, winning back the girl of his dreams, Daisy Buchanan, who he lost five years earlier. His quest leads him from rags-to-riches into the arms of the one he loves, and ultimately, to death. This book is written from a Marxist point of view based on the fact that the bookRead MoreEssay on Love vs. Materialism in the Great Gatsby1131 Words   |  5 PagesVs. Materialism The Great Gatsby does not offer a definition of love, or a contrast between love and romance. Rather it suggests that what people believe to be love is normally only a dream. America in the 1920s was a country where moral values were slowly crumbling and Americans soon only had one dream and objective to achieve, success. Distorted love is one theme in the novel The Great Gatsby, present among all of the characters relationships; Daisy and Tom, Tom and Myrtle, Daisy and Gatsby, and

Marx Theory of Alienation Free Essays

ive, rich people use the poor as commodities. He also explained that the profit that owners earn is not justly distributed to the nation as a whole. Marx’s Estranged Labor and Private Property and Communism explain the alienation of the laborer caused by private property and how it will bring the downfall of capitalism. We will write a custom essay sample on Marx Theory of Alienation or any similar topic only for you Order Now Marx believed in communism which is a perfect life for all the individuals. In ancient times, people would live in caves and depended on nature to survive and fulfill their everyday needs. However, with time world modernized, people moved on and money became the main aspect of everyone’s life. In order to stay in power, money is very important. People give more value to money than themselves because money is what makes a person’s value. Money can buy happiness even though people spend most of their lives working for others. People’s need changed overtime, they found happiness in new things as the world modernized, unlike before their needs were satisfied by nature. In Marx’s work he briefly pointed out what a man should really be by differentiating between animals and human beings. What makes human beings different from animals is that animals can’t think like humans as Marx said, for it â€Å"produces only what it immediately needs for itself and its young† (Estranged Labor, pg. 275). Unlike animals, humans have conscious and ability to produce many things by themselves as Marx explained, â€Å"he makes his life activity itself the object of his will and of his consciousness† (Estranged Labor, pg. 276). Humans are creative. Therefore, human life has a purpose for man and in this intellect he is free and universal. Marx argued that human nature is nor good nor evil but dialectical because humans external objects which were plant, animal and air became into food, clothes and heating. Marx illustrated that alienated man is the opposite of the productive man because a man’s soul is to produce and create. Therefore, an alienated man is the man whose soul and existence are split, which describes that he works not for producing but for money and others. Money is a very important aspect in both the worker and the capitalist’s life. According to Marx, the real foundation of alienation is private property. The affiliation between the worker and the capitalist is defined in the capitalist society. A worker has not How to cite Marx Theory of Alienation, Essay examples

Uncle Dave free essay sample

My dad tried to break the news as easily as possible,â€Å"Uncle Dave has joined Chelsea in heaven†. Of my three uncles I was closest to Uncle Dave. I had to be strong for my family. My uncle was the second most important man in my life. He helped teach me how to play soccer, the sport I love, let his other niece and me use a whole can of whipped cream at a sleepover, and made me eat disgusting food like snow peas. At the one sleepover I had with my uncle, the night started with him, my aunt, his other niece Kylie and me all ordering Chinese food. We had ordered a bunch of different appetizers from noodles to chicken. Along with our food came vegetables when Kylie and I announced we did not like snow peas my uncle decided that we had to eat one in order to get our long awaited dessert, ice cream sundaes. We will write a custom essay sample on Uncle Dave or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Kylie went and ate the snow pea right away, but I had to gather the courage to eat it. I remember sitting across from my uncle while he intently watched me whileI ate the green vegetable slowly taking little bites torturing myself instead of taking one big bite. Finally after swallowing the last bite I could finally say I was ready for my ice cream. When dessert time came around he had pulled out a brand new bottle of whip cream and told us we could use as much as we wanted. By the time we had each used our desired amounts, and of course we had to play with it, the whole can was gone. Dave was a very selfless man and would help anyone in need; whether it was a stranger on the side of the road or his brother, he was always willing to help. My uncle had a painting business so he could help people by painting their house or business; he went and helped my grandparents by painting their kitchen for them but also painted the Dairy Queen in North Branford. He was also a family man and made a great impact on his family and friends. One summer we went on Vacation to Maine, and my uncle had the great idea to buy a cookie monster cake with bright blue frosting. After digging into the cake after dinner someone realized my brother and cousin had blue stained mouths, that was the joke for the rest of the day. The months to follow his death were some of the worst months of my life. My family fell apart and we had numerous obstacles to overcome. Being the oldest meant I found out about almost all of them. Hearing the fights my family had were very heartbreaking and even experiencing some of the things that happened first hand made me question why this was happening to me and my family. Hearing my family members accuse each other of favoritism and not seeing each other enough was hard because we all just lost someone very close to us and we should have been coming together as a family, loving each other, instead of fighting. Soon enough the answer to my question â€Å"Why was this happening to me and my family† became clear to me, I was setup to overcome this battle to show me that I could overcome any obstacle that comes my way; I am tough enough to push through the hardest situations and still be the strong determined girl I was made to be.

Malinche, Mistress and Interpreter to Hernán Cortés

Malinche, Mistress and Interpreter to Hernn Cortà ©s Malinali (c. 1500–1550), also known as Malintzà ­n, Doà ±a Marina, and, most commonly, Malinche, was a native Mexican woman who was given to conquistador Hernan Cortes as a slave in 1519. Malinche soon proved herself very useful to Cortes, as she was able to help him interpret Nahuatl, the language of the mighty Aztec Empire. Malinche was an invaluable asset for Cortes, as she not only translated but also helped him understand local cultures and politics. She became his mistress as well and bore Cortes a son. Many modern Mexicans see Malinche as a great traitor who betrayed her native cultures to the bloodthirsty Spanish invaders. Fast Facts: Malinche Known For: Mexican slave, lover, and interpreter to Hernan CortezAlso Known As: Marina, Malintzin, Malinche,  Doà ±a Marina, MallinaliBorn: c. 1500 in Painala, in present-day MexicoParents:  Cacique  of Paynala, mother unknownDied: c. 1550 in SpainSpouse: Juan de Jaramillo; also famous for her relationship with Hernan Cortez, the famous ConquistadorChildren: Don Martà ­n, Doà ±a Marà ­a   Early Life Malinches original name was Malinali. She was born sometime around 1500 in the town of Painala, close to the larger settlement of Coatzacoalcos. Her father was a local chieftain and her mother was from the ruling family of the nearby village of Xaltipan. Her father died, however, and when Malinche was a young girl, her mother remarried to another local lord and bore him a son. Apparently wishing the boy to inherit all three villages, Malinches mother sold her into slavery in secret, telling the people of the town that she had died. Malinche was sold to slavers from Xicallanco, who in turn sold her to the lord of Potonchan. Although she was a slave, she was a high-born one and never lost her regal bearing. She also had a gift for languages. Gift to Cortes In March 1519, Hernan Cortes and his expedition landed near Potonchan in the Tabasco region. The local natives did not want to deal with the Spanish, so before long the two sides were battling. The Spanish, with their armor and steel weapons, easily defeated the natives and soon local leaders asked for peace, which Cortes was only too happy to agree to. The lord of Potonchan brought food to the Spanish and gave them 20 women to cook for them, one of whom was Malinche. Cortes handed the women and girls out to his captains; Malinche was given to Alonso Hernandez Portocarrero. Malinche was baptized as Doà ±a Marina. It was around this time that some began referring to her by the name Malinche rather than Malinali. The name was originally Malintzine and derives from Malinali tzin (a reverential suffix) e (possession). Therefore, Malintzine originally referred to Cortes, as he was Malinalis owner, but somehow the name stuck to her instead and evolved into Malinche. Malinche the Interpreter Cortes soon realized how valuable she was, however, and took her back. Some weeks before, Cortes had rescued Gerà ³nimo de Aguilar, a Spaniard who had been captured in 1511 and had lived among the Maya people ever since. In that time, Aguilar had learned to speak Maya. Malinche could speak Maya and Nahuatl, which she learned as a girl. After leaving Potonchan, Cortes landed near present-day Veracruz, which was then controlled by vassals of the Nahuatl-speaking Aztec Empire. Cortes soon found that he could communicate through these two translators: Malinche could translate from Nahuatl to Maya, and Aguilar could translate from Maya to Spanish. Eventually, Malinche learned Spanish, thus eliminating the need for Aguilar. Malinche and the Conquest Time and again, Malinche proved her worth to her new masters. The Mexica (Aztecs) who ruled Central Mexico from their magnificent city of Tenochtitlan had evolved a complicated system of governance that involved an intricate combination of war, awe, fear, religion and strategic alliances. The Aztecs were the most powerful partner of the Triple Alliance of Tenochtitlan, Texcoco, and Tacuba, three city-states close to one another in the central Valley Of Mexico. The Triple Alliance had subjugated almost every major tribe in Central Mexico, forcing the other civilizations to pay tribute in the form of goods, gold, services, warriors, slaves, and/or sacrificial victims for the Aztecs gods. It was a very complex system and the Spaniards understood very little of it; their rigid Catholic worldview prevented most of them from grasping the intricacies of Aztec life. Malinche not only translated the words she heard but also helped the Spanish grasp concepts and realities that they would need to understand in their war of conquest. Malinche and Cholula After the Spanish defeated and aligned themselves with the warlike Tlaxcalans in September 1519, they prepared to march the rest of the way to Tenochtitlan. Their path led them through Cholula, known as a holy city because it was the center of the worship of the god Quetzalcoatl. While the Spanish were there, Cortes got wind of a possible plot by Aztec Emperor Montezuma to ambush and slay the Spanish once they left the city. Malinche helped provide further proof. She had befriended a woman in town, the wife of a leading military officer. One day, the woman approached Malinche and told her not to accompany the Spaniards when they left as they would be annihilated. She was urged to stay and marry the womans son. Malinche tricked the woman into thinking she had agreed and then brought her to Cortes. After questioning the woman, Cortes was convinced of the plot. He assembled the citys leaders in one of the courtyards and after accusing them of treason (through Malinche as an interpreter, of course) he ordered his men to attack. Thousands of local nobles died in the Cholula Massacre, which sent shock waves through central Mexico. Malinche and the Fall of Tenochtitlan After the Spanish entered the city and took Emperor Montezuma hostage, Malinche continued in her role as interpreter and advisor. Cortes and Montezuma had much to talk about, and there were orders to be given to the Spaniards Tlaxcalan allies. When Cortes went to fight Panfilo de Narvaez in 1520 for control of the expedition, he took Malinche with him. When they returned to Tenochtitlan after the Temple Massacre, she helped him calm the angry populace. When the Spaniards were nearly slaughtered during the Night of Sorrows, Cortes made sure to assign some of his best men to defend Malinche, who survived the chaotic retreat from the city. And when Cortes triumphantly reconquered the city from the indomitable Emperor Cuauhtà ©moc, Malinche was at his side. After the Fall of the Empire In 1521, Cortes definitively conquered Tenochtitlan and he needed Malinche more than ever to help him govern his new empire. He kept her close to him- so close, in fact, that she bore him a child, Martà ­n, in 1523. Martà ­n was eventually made legitimate by a papal decree. She accompanied Cortes on his disastrous expedition to Honduras in 1524. About this time, Cortes encouraged her to marry Juan Jaramillo, one of his captains. She would eventually bear Jaramillo a child as well. On the Honduras expedition, they passed through Malinches homeland, and she met with (and forgave) her mother and half-brother. Cortes gave her several prime plots of land in and around Mexico City to reward her for her loyal service. Death Details of her death are scarce, but she likely passed away sometime in 1550. Legacy To say that modern Mexicans have mixed feelings about Malinche is an understatement. Many of them despise her and consider her a traitor for her role in helping the Spanish invaders annihilate her own culture. Others see in Cortes and Malinche an allegory for modern Mexico: the offspring of violent Spanish domination and native collaboration. Still, others forgive her treachery, pointing out that as a slave given away freely to the invaders, she certainly didnt owe her native culture any loyalty. And others remark that by the standards of her time, Malinche enjoyed remarkable autonomy and freedom that neither native women nor Spanish women had. Sources Adams, Jerome R. New York: Ballantine Books, 1991.Diaz del Castillo, Bernal. Trans., ed. J.M. Cohen. 1576. London, Penguin Books, 1963. Print.Levy, Buddy. New York: Bantam, 2008.Thomas, Hugh. New York: Touchstone, 1993.