Book Review: Heartland the Darkest Hour

My book was Heartland the Darkest Hour. It was written by Lauren Brooke and was 152 pages long. This book was about a girl named Amy who tries to prove to everyone that she can be as good as a professional horse racer. Throughout the book she meets people, that teach her a lesson about how winning isn’t everything. Even though winning is fun, that shouldn’t be why you want to compete. You should have passion in what you’re doing, instead of waiting for fame and fortune. Amy doesn’t realize that you should have passion in what you love to do.She thinks that she is the best horse racer in the world, but that changes when a certain horse and a certain person came into her life and taught her about passion. Ty a friend of hers, had a horse that was the best Amy had seen in her life! It had every trick that had ever been in horse racing history perfected. It had the most amazing speed, and it was very rare. Amy wanted that horse so bad, because she knew she cou ld win with it. She wanted to buy it off of Ty, but he wouldn’t let her. One day Amy asked Ty why she couldn’t buy the beautiful horse, but then Ty asked her a very important question.He said â€Å"Why do you want this horse? † Amy stood there for a minute and thought about what he had asked her. The next day she felt bad because she had been selfish and only wanted the horse for fame and money, not because she loved the horse. At the end of the book, Amy realizes that she needs to have passion in all she does, because without passion â€Å"You’ll never love what your doing. † I think Amy was changed at the end because her attitude was different from the way she treated others in the beginning.At the end of this book, Amy is more kind and doesn’t think to much about her self. I would recommend this book to others because it teaches you not be bratty and selfish, but to be humble and passionate. If you like books about horses, this series wou ld be awesome for you to read. I loved this book because, I started to read it in the beginning, but I didn’t get the story. Towards the middle I finally figured out what the author was trying to say, and it was a very good inspirational message throughout the book. The End

Changing Landscape of Health Care Essay

â€Å"We do not have a health care crisis in this country – we have a health crisis with a health care system incapable of dealing with it.† ~ Mike Huckabee, Former Governor of Arkansas â€Å"We have to move from illness to wellness. Businesses will have to invest in wellness. There is no choice. It’s not philanthropy. It’s enlightened self-interest.† ~ Shrinivas M. Shanbhag, Medical Adviser, Reliance Industries, India â€Å"Our vision should be to have the healthiest people, not just the best health care, in the world. With prevention and wellness as the cornerstone of our health policy, we can be number one in both.† ~ Newt Gingrich â€Å" Shifts taking place The healthcare industry is approaching an exciting model shift in patient engagement as we move away from being a mostly provider driven industry to a consumer driven one. Much like the financial, music, and publishing industries in the past, healthcare is becoming a mobile, consumer -driven industry. In this consumer driven model, patients drive healthcare industry spending and can receive and transmit health-related data in real-time. The main causes for this shift are the Affordable Care Act (ACA) and changing health insurance coverage. These changes have allowed for greater access to, and demand for, health information through smartphones and patient portals. The use of mobile medical devices and technology also empowers patients to take on and share responsibility for recording and transmitting their own health-related data. Under the Affordable Care Act, health insurance exchanges now give patients the option to shop and compare plans in order to determine which has the best value for their individual needs. Being able to compare plans metrics such as premiums, copays, and direct payments side-by-side creates greater cost transparency than ever before in healthcare. These cost transparency and the ability to ultimately determine  which coverage is right for them gives patients the power to become active healthcare consumers, rather than passive participants in the current system. As healthcare consumers, they expect to have the best quality of care and value the customer experience above all else. Under this new model, patients are empowered to closely monitor their healthcare spending and their own health, interact with the healthcare system outside the hospital walls, and employ the use of technology to improve their conditions. Current and potential challenges Americans have seen a raise in health care expenses during the 1980s, the results were extensive; managed care were assumed by employer-sponsored health plans. To a certain extent, managed care methodologies were implemented for some Medicaid and Medicare enrollees. During the 1990s, new Medicare reimbursement policies and the well-known acceptance of managed care plans had noticeably reduced the growth rate of health care expensive. All available studies show that Health Maintenance Organizations (HMOs) and other managed care plans have provided health care of equal or better medical quality to out-of-date covered insurance plans at a lower cost. While the country’s economy grow stronger during the late 1990s, anxieties about overall health care costs diminished, â€Å"and the public became less willing to accept restrictions on the enrollee’s choice of physician and the physician’s treatment choices† (Luke, 2001). Health care recipient’s outlook à ¢â‚¬Å"turned against the concept of managed care as a result of backlash from both physicians and consumers.† (Luke, 2001) How health care is handling challenges. Many of the challenges Academic Medical Centers (AMCs) face in the current environment are well understood and widely recognized even if the solutions are not. Faster provider consolidation, both horizontally and vertically, over the past several years is reshaping the competitive landscape. Community-based providers are gaining the size and strength to drive market dynamics and negotiate on equal or better footing with payers. Competitors are also gaining new competencies, keeping and caring for more patients themselves. This has begun to impact AMCs’ referral streams and their ability to maintain market share. There are already a growing number of markets across the country where AMCs are experiencing flat-to-declining inpatient volume growth and losing their dominant market position to large,  evolving systems. Government and commercial payers are aggressively advancing value-based payment methodologies and steering patients to lower cost providers. AMCs which tend to have higher costs-to-serve than their community-based counterparts will face difficulty competing for services others also provide at acceptable levels. AMCs looki ng to thrive in this environment need to find ways to coordinate with other types of providers across the continuum to reorient the site of care to more cost effective settings and control quality, variation and outcomes. AMCs also need partners along the continuum to position themselves as primary contracting entities under population health or risk becoming â€Å"commodity† providers in their markets. AMCs must contend with unprecedented financial pressures as healthcare reform rolls out over the next several years. Conclusion Today, health care costs are on the rise. The US spends considerably more on each person for health care than are other developed countries, there are no obvious progress in the healthcare outcomes. Assessments show that in the next 30 years, health care costs will again rise at a rate faster than that of the economy. The impact of an aging population will further reflect the rising cost of health care, by the year 2030, more than 20 percent of individuals 65 years or older. At that time we will be headed for another crisis. â€Å"However, the environment has changed: As a result of the experience of the last 10 years, the public is now less willing to accept changes to the health care system, and the concept of managed care has negative connotations. Consequently, the crisis may potentially be even worse than that we experienced a decade ago if we are unable to find ways to control health care expenditures†.(Luke, 2001) References Khan, F. (2014). The Shift to Consumer Driven Healthcare. The future of patient engagement. Retrieved from: http://healthcare-executive-insight.advanceweb.com Luke, R. T. (2001). Health care in the United States: current and future challenges. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/11729444 Peterson, H. (2014). Becker’s Hospital Review. Challenging Healthcare Landscape Fertile Ground for Academic Medical Centers. Retrieved from: http://www.beckershospital review.com/strategic-planning

Air Quality

Air Quality Essay Air Quality Dispersion Today, the air quality aspect of ARL research is by far the dominant theme, but distinctions among the themes remain somewhat vague. For example, the models developed for emergency response purposes are among those used for air quality prediction. The Air Quality and Dispersion theme is one of the strongest ties that binds ARLs components together. ARL is not heavily involved in the pure science of the business. Instead, ARL focusses on the need to assemble integrated understanding and models from all available sources, to develop the capability to predict changes in air quality that will follow changes in emissions, or that will occur as a result of meteorological factors. ARL air quality research extends to studies of atmospheric deposition essentially the coupling between the atmospheric pollutant environment and the surface below. ARL now operates the only research-grade deposition monitoring network in the nation: AIRMoN (the Atmospheric Integrated Resear ch Monitoring Network). Programs. Air Quality and Deposition Modeling Air quality models have demanded this kind of coupling for a considerable time. As a result, there are now well-developed descriptions of PBL processes in use in air quality models. ARL research products are now receiving a wider audience, within the mesoscale modeling community at large. It is recognized that modern models are invariably data assimilative, and that modern monitoring programs require coupled modeling activities for data interpretation. Model development programs are supported by a vigorous physical modeling program, located at Research Triangle Park, NC. ARL operates one of the nations major fluid modeling facilities, at which studies are conducted on the effects of mountains, buildings, and other surface obstacles on atmospheric flow patterns. Integrated Monitoring, and AIRMoN The Atmospheric Integrated Research Monitoring Network is an atmospheric component to the overall national integrated monitoring initiative that is currentl y evolving. AIRMoN has two principal components: wet and dry deposition. ARL presently focuses its research attention on ? the measurement of precipitation chemistry with fine time resolution (AIRMoN-wet), ? the development of systems for measuring deposition, both wet and dry, ? the measurement of dry deposition using micrometeorological methods (AIRMoN-dry), ? the development of techniques for assessing air-surface exchange in areas (such as specific watersheds) where intensive studies are not feasible, and ? the extension of local measurements and knowledge to describe areal average exchange in numerical models. Aerosols and visibility ARL specializes in the geochemical cycling of atmospheric aerosols, particularly the particulate component. Research groups in ARL concentrate on (a) the injection of dust and soil particles into the atmosphere, (b) the transport of particles through the atmosphere, the production of aerosol particles in the air by chemical reactions, (d) the scavenging of airborne particles by clouds and their subsequent deposition in precipitation, (e) the dry deposition of particles as air moves across different landscapes, and (f) the assembly of numerical models. Specific topics include ? the injection of dust and soil particles into the atmosphere, ? the long-range transport of particles through the atmosphere, ? the production of aerosol particles in the air by chemical reactions, ? the scavenging of airborne particles by clouds and their subsequent deposition in precipitation, and ? the dry deposition of particles as air moves across different landscapes. International ARL serves as the leader of the U.S. multi-agency effort to impose formalized and uniform quality assurance programs on the many national air quality and deposition monitoring networks that are operational around the globe. How are ozone concentrations calculated with Hysplit? Ozone is then calculated from the photostationary state equation. The IER solution is used in the operational Hysplit ozone calculation. The pollutant particles are tracked and air concentrations for each species are computed each advection time step following the usual lagrangian approaches. At the conclusion of the advection step the GRS differential equations are solved on the concentration grid (Eulerian solution), and the change of concentration of each pollutant species is applied to the pollutant mass on the particles that contributed concentration to each grid cell. -Eulerian chemistry solution on the grid dc/dt = {Equations 1 7} 1) ROC + hv -* RP + ROC Nitric oxide-ozone titration reacti on 5) RP + RP -* RP k5 = 10200 Sink for nitrogen dioxide to stable gaseous nitrates