Economics And Healthcare Environment Samples †MyAssignmenthelp.com

Question: Discuss about the Economics And Healthcare Environment. Answer: The main objective of this assessment is to explore various economic concepts, funding framework and casemix-based management information systems and its application within the environment of health care sector. This assessment highlights that nurse managers plays vital role in the health care environment. They are in pivotal position as they ensure the provision of clinical as well as effective healthcare. The economic concepts applied in the context of health care delivery are also explained in this study (Andel et al. 2012). This assessment also provides an overview about the activity based funding and its application as incentive to drive efficiency, enhance accountability and improve access to health care. The last section of assessment reflects on the kinds of casemix based management information system that are offered for nurse managers. In fact, the information used for financial planning as well as management and quality enhancement is also critically analyzed in this asses sment. As individuals have become highly concerned about increasing cost, the economic concepts have attained higher currency in communitys healthcare consideration. Efficiency includes the primary economic theory of opportunity cost, which refers to the total value of best alternatives foregone for producing or attaining better health care service. Hollingsworth (2012) opines that if value of present health care service is greater than the value of alternative use then the present one is said to efficient. On the contrary, Folland, Goodman and Stano (2016) states that if value of other alternatives is larger than the present health care service, then the current one is said to be inefficient. Furthermore, one of the economic assessment techniques that are also used in the context of health care service is cost effectiveness analysis (CEA). This type of analysis mainly evaluates on whether the total amount spent on specific program or any healthcare treatment can provide healthier lives of the patient. In addition, the outcome of this program is also measured in health status that includes- decrease in disease, gain in life years etc. But the difficult part of this analysis arises when it compares various health care services for detecting difference in total expense adds to same benefit in health (Muennig and Bounthavong 2016). There are three basic limitations of CEA are given as follows- The first limitation is that the requirement for estimating outcomes in health units generally limits efficiency and hence cannot be utilized for comparing dissimilar programs. For example, the program that is aimed at reinstating sights of the patients is usually not compared with the program that treats foot ulcers under cost- effective analysis (Drummond et al. 2015). The second limitation is that natural units of health captures single dimension of outcome of programs. For example, the measurement of patient life years attained ignores their quality of life that is considered as another dimension of program outcomes (Hollingsworth 2012). Apart from this, economic efficiency can also be examined with the help of technical and allocative efficiency. Technical efficiency is basically attained through implementation of cost effective process with least inputs. This efficiency is mainly concerned with conversion of inputs that includes labor services into outputs ((Eckermann and Coelli 2013). This kind of efficiency is estimated as distance to frontier. Likewise, allocative efficiency is attained through selection of health programs that are health efficient in order to yield biggest possible improvements in patients health (Folland, Goodman and Stano 2016). Moreover, allocative efficiency is usually estimated through comparison of various frontier points in order to improve the populations heath status. Overall the efficiency estimates the impact of both the technical as well as allocative efficiency. For example, our health center consumes considerable amount of local allocation of human as well as financial resources. Additionally, efforts have also been given to provide effectual health care delivery owing to primary health centre endorsement provided by government. In order to increase the technical efficiency in this specific health centre, they utilized full time skilled staff for measuring the services or input provided by them. In fact, the nurse managers of this health centre also help to increase efficiency through their appropriate implementation of practical tools (Lowe et al. 2012). As a result, this increase in overall efficiency has improved the health care delivery service in this centre over the last few years. Activity based funding and its utilization in health care service. Activity based funding (ABF) refers to the process of funding healthcare in which the providers are basically allocated funds depending on the volume as well as type of services provided by them to the patients (Rosenberg and Hickie 2013). This has become one of the international standards for funding healthcare and thereby referred to as service-based funding, patient- centered funding and casemix funding. ABF is generally implemented by the health care centers with the objective of creating incentives for enhancing productivity as well as efficiency and improve transparency in healthcare funding. The funders of health care system who adopts this type of funding leverage information from financial as well as clinical data captured in routine basis (Heslop 2012). There are generally three components of ABF, which are needed for this funding procedure to operate. These components include- pricing, costing and commissioning, which are described below: Pricing- Prices are generally set for each diagnosis related group (DRG) depending on hospitals average cost of activities in DRG. The prices are set in such a way so that it can maximize huge benefits to patients and incentivize objectives of health care. This ABF system allows the health care funders to overview the service delivered for the paid price. Commissioning-The ABF system needs assessment of negotiation between providers as well as funders for setting proper activity level. This procedure is termed as commissioning. However, this process helps the funders to achieve increased financial control by setting proper activity goals (O'Reilly et al. 2012). Costing- For ABF system to operate, the health care providers should have the ability to determine unit cost. However, this information permits the providers to know the reason for making surplus or deficit under ABF system. The basic objectives for using ABF as incentive is to increase accountability, improve access to health care and drive efficiency. For driving efficiency in health system, ABF can be used to incentivize innovation in care system by reorganizing care funding and motivating providers to revamp themselves regarding patients care pathway. The ABF system will create environment that incentivizes the providers to innovate new health care delivery system for improving the efficiency and quality of health care (Ozcan 2014). Since ABF permits health centers to earn difference between service cost and amount of ABF payment, it drives the efficiency of health system to administer their total revenues. However, implementation of efficient utilization of resources leads to reduction in cost of activities as per patient basis. The financial incentives for health care system also lead to improved access. Adoption of ABF system selectively enhances services to the patients where cost of patients care is less than funding amount (Witter et al. 2012). Some of the nations observed decreased access for costly patients especially with chronic disabilities. Although access to health care can be improved through ABF system, improper management can lead to rise in issues regarding this. Moreover, the ABF system can increase accountability through establishing process metrics, developing predictive care pathways, exploring reimbursement models and developing incentives as well as competencies within the health care system. The health service provision activities that are funded under the ABF includes-Travel of patients and medical rescue services, aboriginal liaison as well as support, sub-acute care including rehabilitation as well as palliative care, outpatient services, acute inpatient admissions, services under emergency department (Sutherland, Repin and Crump 2012). Casemix refers to the scientific procedure of producing information relating to health care, which builds upon patient care categorization for managing health care. The casemix data provides information regarding patient episodes, funding in health care and workforce planning (Lambert et al. 2014). The information systems that is connected to casemix can be termed as costing systems, hospital information systems, grouper software, departmental systems, workload information systems for nurses, executive information system etc (Bardhan and Thouin 2013). Casemix based management information systems provides clinical as well as financial data on which the managers takes their decisions regarding staff planning, clinical patient care etc. Nurses are also known as knowledge workers because they utilize knowledge to their practice in clinical as well as managerial fields. Now- a days, the role of nurse managers has expanded from clinical coordinator to varied practices that includes service planning in allocation of budget. The nurse managers apply principles of knowledge management for delivering efficient service and advancing service provision. The information system generally assists the health care centers with knowledge management data of which the casemix gas been important component. In fact, casemix has been widely recognized as tool to increase efficiency of nurse managers (McHugh and Stimpfel 2012). The types of casemix based information systems that is provided for nurse managers includes- profile of patient by Diagnosis Related Groups ( DRG), service cost by DRG, average length of stay (ALOS) by DRG, unit ALOS, worst performing DRG , ALOS by outliers etc. In several Australian health care services, casemix based funding also refers to as activity based funding in which the funding model basically funds services depending on outputs by using price unit for various patients or types of cases. These health care centers uses casemix based funding as vital funding framework for reimbursing patient care cost. The casemic information system utilized by acute health care centre in Australia is AN- DRGS ( Australian National Diagnosis Related Groups). In Australia, the clinical coders utilizes coding categorizing system for grouping inpatient separations into homogenous groups also known as AR- DRG ( Australian Refined Diagonsis- Related Groups) categorization system (Duckett and Willcox 2015). In fact, the information attained using this system allows clinicians manage as well as improve process of care and increase efficiency in service provision. The casemix based information can be used for improving quality of care by firstly emphasizing diversity of systems and implications occurring from differences. Furthermore, the existing categorization schemes is assorted in two dimensions- First dimension involves the requirements of data, with systems that are sorted into that requiring primary collection of data and uniform hospital discharge data set( UHDDS). Second dimension includes the timing of patient evaluation. This mainly encompasses the patient stay in hospitals and hence this system can be used after discharge. The caeemix based information can be used for financial and management planning by combining activity of patient with resource consumption information in terms of financial data (Heslop 2012). The financial data mainly includes per day cost, each outpatient attendance cost, specific procedure cost such as dialysis or mechanic ventilation etc. The models of casemix usually records activities per patient depending on system that permits different kinds of patients relating to resource utilization. There are certain concerns regarding quality of care that can be raised under casemix based management that includes- satisfaction of patients, measurement of outcomes to be determined from the administrative data, access to health care and other technical factors (Middleton et al. 2013). These concerns are discussed below: Patient dissatisfaction can occur at health care center if clinical status of patient is poor on discharge. In addition, patient satisfaction can be low at health centre where severity deteriorates following admission. Access to health care can be poor owing to inappropriate admission at the health centers (Gulliford and Morgan 2013). Problem can occur with technical execution if the clinical status worsens following some particular procedural performance. Such concerns can be addressed in the following manner: Firstly, monitoring the result of care for assessing present status as well as time trends in impact of care Secondly, providing data to medical team as well as offering incentives for their work Thirdly, designing as well as implementing new health care delivery process based on the requirements of the patients (Tinetti, Fried and Boyd 2012) Fourthly, implementing effective technology systems, which will alert the providers in specific time in case of critical information Fifthly, adoption of telecommunication application, which can improve patients access to appropriate information The systems of health care globally are facing several challenges involving ageing population, variation in disease, increase in complex condition, rising health care cost etc. The nurse managers also face challenges to develop understanding of funding framework and financing arrangements that is being utilized in their health care center (Hendricks and Cope 2013). However, adoption of activity related funding framework utilizing casemix categorizing systems mainly needs development of financial management competencies. Therefore, analyzing casemix and converting into management information is needed by providers for making financial decisions. However, for nurse managers, casemix based information can be difficult although it benefits them to manage resources in transparent manner. In Australia, the funding arrangements, governance for health care and overall health care structure experiences huge reforms (Duckett and Willcox 2015). References Andel, C., Davidow, S.L., Hollander, M. and Moreno, D.A., 2012. Theeconomics of health care quality and medical errors.Journal of health care finance,39(1), p.39. Bardhan, I.R. and Thouin, M.F., 2013. Health information technology and its impact on the quality and cost of healthcare delivery.Decision Support Systems,55(2), pp.438-449. Drummond, M.F., Sculpher, M.J., Claxton, K., Stoddart, G.L. and Torrance, G.W., 2015.Methods for the economic evaluation of health care programmes. Oxford university press. and Performance Evaluation(pp. 3-14). Springer, Boston, MA. Duckett, S. and Willcox, S., 2015.The Australian health care system(No. Ed. 5). Oxford University Press. Eckermann, S. and Coelli, T., 2013. Including quality attributes in efficiency measures consistent with net benefit: creating incentives for evidence based medicine in practice.Social Science Medicine,76, pp.159-168. Folland, S., Goodman, A.C. and Stano, M., 2016.TheEconomics of Health and Health Care: Pearson International Edition. Routledge. Gulliford, M. and Morgan, M. eds., 2013.Access to health care. Routledge. Hendricks, J.M. and Cope, V.C., 2013. Generational diversity: what nurse managers need to know.Journal of advanced nursing,69(3), pp.717-725. Heslop, L., 2012. Status of costing hospital nursing work within Australian casemix activity?based funding policy.International journal of nursing practice,18(1), pp.2-6. Hollingsworth, B., 2012. Revolution, evolution, or status quo? Guidelines for efficiency measurement in health care.Journal of Productivity Analysis,37(1), pp.1-5. Lambert, M.L., Silversmit, G., Savey, A., Palomar, M., Hiesmayr, M., Agodi, A., Van Rompaye, B., Mertens, K. and Vansteelandt, S., 2014. Preventable proportion of severe infections acquired in intensive care units: case-mix adjusted estimations from patient-based surveillance data.Infection Control Hospital Epidemiology,35(5), pp.494-501. Lowe, G., Plummer, V., OBrien, A.P. and Boyd, L., 2012. Time to clarifythe value of advanced practice nursing roles in health care.Journal of advanced nursing,68(3), pp.677-685. McHugh, M.D. and Stimpfel, A.W., 2012. Nurse reported quality of care: a measure of hospital quality.Research in nursing health,35(6), pp.566-575. Middleton, B., Bloomrosen, M., Dente, M.A., Hashmat, B., Koppel, R., Overhage, J.M., Payne, T.H., Rosenbloom, S.T., Weaver, C. and Zhang, J., 2013. Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA.Journal of the American Medical Informatics Association,20(e1), pp.e2-e8. Muennig, P. and Bounthavong, M., 2016.Cost-effectiveness analysis in health: a practical approach. John Wiley Sons. O'Reilly, J., Busse, R., Hkkinen, U., Or, Z., Street, A. and Wiley, M., 2012. Paying for hospital care: the experience with implementing activity-based funding in five European countries.Health economics, policy and law,7(1), pp.73-101. Ozcan, Y.A., 2014. Evaluation of Performance in Health Care. InHealth Care Ozcan, Y.A., 2014. Evaluation of Performance in Health Care. InHealth Care Benchmarking and Performance Evaluation(pp. 3-14). Springer, Boston, MA. Rosenberg, S.P. and Hickie, I.B., 2013. Making activity-based funding work for mental health.Australian Health Review,37(3), pp.277-280. Spetz, J., Harless, D.W., Herrera, C.N. and Mark, B.A., 2013. Using minimum nurse staffing regulations to measure the relationship between nursing and hospital quality of care.Medical Care Research and Review,70(4), pp.380-399. Sutherland, J.M., Repin, N. and Crump, R.T., 2012.Reviewing the potential roles of financial incentives for funding healthcare in Canada. Canada: Canadian Foundation for Healthcare Improvement. Tinetti, M.E., Fried, T.R. and Boyd, C.M., 2012. Designing health care for the most common chronic conditionmultimorbidity.Jama,307(23), pp.2493-2494. Witter, S., Fretheim, A., Kessy, F.L. and Lindahl, A.K., 2012. Paying for performance to improve the delivery of health interven-tions in low-and middle-income countries.status and date: New, published in, (2).

The Mystery of Best Research Paper Writer That Nobody Is Talking About

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How to Choose Essay Writing Topic

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Corey Booker College Papers - How to Win Essay Writing Competitions

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College Essay Sample on Implicit Associations

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The comparison of My Last Duchess and The Laboratory Essay Example

The comparison of My Last Duchess and The Laboratory Paper Both my last duchess and the laboratory are based on women; therefore it is surprising that the writer of both poems was Sir Robert Browning. However when looked at closely there is evidence of the complexity of women which is viewed in a male perspective. After thorough observation it has become clear that in these two poems Browning emphasises the following feelings; Love, Paranoia , Arrogance and Betrayal. The ominous and menacing atmosphere of these two poems reveal these abstract nouns in negative lights and sinister situations; hidden amongst these is the powerful sense of control, whether it’s the need to control a situation or person. In ‘My last Duchess’ this sense of control is reflected in the Duke and his obsession in power, although him and the Lady in ‘The Laboratory’ share this desire, the woman in the apothecary seems to have a stronger, more manic need for it than the duke. Throughout both poems it is quite clear that Browning and layered his poems with deep emotions causing the reader to explore different meanings to the story, but the more you layers you uncover the darker the meanings get†¦ While reading these two poems the influence of a male perspective is vividly shown which is to be expected as the author of the monologue is Sir Robert Browning. We will write a custom essay sample on The comparison of My Last Duchess and The Laboratory specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on The comparison of My Last Duchess and The Laboratory specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on The comparison of My Last Duchess and The Laboratory specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Two types of women are illustrated in the poems, in Browning’s monologue of ‘My Last Duchess’ it seems that the duke enjoys protecting the girl and wrapping her around cotton wool which may explain his jealously when his bride received other gifts. However In ‘The Laboratory’ the angry wife seems to be deranged as a result of being ignored from her husband. Either way the poems both reflect on the dominance of the male in a relationship, indicating the reason of taking advantage of their partner. This may also be why men think they can cheat on their spouse, which drives them towards the deranged state that is portrayed in The Laboratory. Throughout both poems Browning covers four main emotions; love, paranoia, betrayal and arrogance, which act as base for romance; not the stereo-typical type, in fact this may the kind of romance that maybe experienced in everyday life. Both monologues show the narrator in negative light, that is true, but there are two perspectives here to analyse. Lets take My Last Duchess as an example; the duke may as well be portrayed as a jealous, arrogant, controlling murderer who enjoys to abuse his power. Or you can view him as victim who is trapped in his own authority and his 900 year-old name. Hence forth when he sees his bride happy and smiling all the time while he is miserable, the duke may act out of jealousy or maybe even depression. Now if we take the two outlooks of The Laboratory we will recognize the same situations here. If the woman in the apothecary was a villain then readers would see her as an envious, paranoid, vengeful women with a disintegrating marriage; on the other hand she could also be viewed as a victim. A mentally unstable women deranged by betrayal, public humiliation and lack of attention from her husband. Adding on to the victim hypothesis the women may be controlled by her partner, maybe a threat of divorce? To avoid public humiliation she would do his bid? She could have had enough of the commands and decided to take her own actions? It is likely that the victim theory to be the correct one for just by the womens presence in the apothecary symbolizes her lifestyle. Why? Due to the ban and death sentence that comes with it, an apotheosis sells and makes poison at a extremely high price, implying her wealth ,lifestyle and status. That may be why she is so self-conscious, scared what people may think. Thus the woman at the apothecary and the duke are not at all un-a-like. The sharing of dark qualities is very clear in the two monologues because after you read both the room feels trapped in a eerie atmosphere. This may be due to the cleverly picked choice of words which give the poems both a feeling of passion and mystical madness. In The Laboratory Browning incorporated very delicate and feminine nouns whereas in the other verses he demonstrated the use of masculine sounds. In the fourth verse of the poem the women is simply awed at the products in the shops, â€Å"That in the mortar you call it a gum? Ah, the brave tree whence such gold oozings come! And yonder soft phial, the exquisite blue, Sure to taste sweetly, is that poison too? † The soft, feminine sounds let the poem take a lyrical and enchanting twist but when one focus on the words the whole thing becomes maniacal and macabre. When you listen you can her the adrenaline and crazed tone as she watches with wonder on ponders on the beauty of it all. This is what establishes that sinister ambiance. The verse above has the same principle but the masculine sounds of the words some how blunted and make the women’s intentions more direct, increasing the impact of the shudder-some effect that follows. â€Å"Grind away, moisten and mash up thy paste, Pound at thy powder, I am not in haste! Better sit thus, and observe thy strange things, Than go where men wait me and dance at the Kings. † Again by analysing Browning’s choice of words for his My Last Duchess monologue you can tell that in between the lines is the emotion of envy. The Dukes anger and pain are also made clear of, why is this? It seems that the duke feels trapped in his own wealth, power and status. He can-not be free of societys pressure for if he does 1000 great deeds and one mistake surely that one mistake will never be forgotten. Unless, he demands authority through fear. But how can society fear the duke when it seems that his newest wife never takes her role seriously? How can they fear him when all she, his other half, does is smile at everyone and accept foolish gifts such as mules and cherries? How dare she compare his gift, a 900 year-old name, with a four legged animal? It had to stop or the duke would lose his command and supremacy. He had to make an excuse for her death. And he succeeded. Was his love for her true? No. That is clear in the poem, its as if you can picture his smug grin, his satisfied tone when he says; â€Å"Whene’er I passed her; but who passed without Much the same smile? This grew; I gave commands; Then all smiles stopped together. † Punctuation can tell us much in poem. How the person is feeling, their tone of voice or intensions. In The Laboratory the poet has cleverly used his knowledge to pinpoint all of the above. For example when he has inputed commas and thus adding pauses it builds up tension and suspense encouraging interest and curiosity from the reader. Dashes are also used for pauses but they have a completely different effect, in fact when a dash is used it is either followed with a question mark or a exclamation mark. This indicates that the woman is excited and full of adrenaline but also impatient as she wants the task to be done with. On the other hand with My Last Duchess Browning cleverly used the same punctuations but caused them to produce different effects. By combining dashes and exclamation marks with the text we get a taste of the dukes bitterness and anger which he is trying hard to conceal. Those are when we see the real duke. In the monologue the duke tends to quote people but hinting sarcasm or making them a victim of ridicule. When using the comma the poet makes sure that the duke sounds composed, but also as if he is trying very hard to keep emotion out of his voice. Surprisingly by using the same technique of punctuation Browning has created to entirely different mind-frames for both narrators. In The Laboratory the women doesnt seem to care about expressing her feelings whereas in My Last Duchess the duke can think of nothing else other than concealing his emotions and thoughts. In conclusion My Last Duchess and The Laboratory are very similar. They both cover the four main emotions (love, paranoia, arrogance and betrayal) which results into the common eerie atmosphere. Their structures are the same but the perspectives of the characters are different ever though they may live the same wealthy lifestyle and last but not least both poems are focused on women. Whether its to do with deranged wives or abused ones, the poems reflect on the dominance of men in the world and the little things womenkind do to break loose from that firm hold. It may be poisoning lovers or refusing to be tamed. Whatever it may be this is a mans world but surely it is time for a change?

Complex Sentences in English Grammar

Complex Sentences in English Grammar In traditional grammar, a complex sentence is a sentence that contains an independent clause  (or main clause) and at least one dependent clause. Put another way, a complex sentence is made up of a main clause with one or more dependent clauses joined to it with an appropriate conjunction or pronoun. The complex sentence is conventionally regarded as one of the four basic sentence structures in English. The other structures are the simple sentence, the compound sentence, and the compound-complex sentence. For an alternative definition, see  Holger Diessels remarks in Examples and Observations below.   Examples and Observations [I]n the complex sentence John left when his sister arrived, the clause when his sister arrived is a dependent clause because it is preceded by the word when, which is a subordinating conjunction. Dependent clauses are not complete sentences; they cannot stand alone as a complete sentence. For example, *When his sister arrived cannot stand alone. Dependent clauses must be attached to independent clauses in order to form a complete sentence. In the complex sentence above, John left is the independent clause.- Denise E. Murray and Mary Ann Christison, What English Language Teachers Need to Know. Routledge, 2011Martina laughed when her mother dropped a pie upside down on the floor.Because he was so small, Stuart was often hard to find around the house.- E.B. White, Stuart Little, 1945I learned a valuable lesson about cheating after I changed a mark on my report card in the third grade.- Making the GradeIf a man does not keep pace with his companions, perhaps it is because he hears a dif ferent drummer.- Henry David Thoreau, Walden, 1854 He was like a cock who thought the sun had risen to hear him crow.- George Eliot, Adam Bede, 1859[W]hen my brother got his pants leg caught on the top of a high fence and hung upside down, weeping and muttering curses because his pants were newly torn and Mother would spank him for sure, no angel was with him.- Gary Soto, A Summer Life. University Press of New England, 1990The Scarecrow and the Tin Woodman stood up in a corner and kept quiet all night, although of course they could not sleep.- L. Frank Baum, The Wonderful Wizard of Oz, 1990)Although volume upon volume is written to prove slavery a very good thing, we never hear of the man who wishes to take the good of it by being a slave himself.- Abraham Lincoln, Fragment on Slavery, July 1854 Relative Clauses and Adverbial Clauses A complex sentence has a main clause, and one or more subordinate clauses, which come in various kinds. One kind is a relative clause, as in the [bold] parts of Jack knew the kid who shot Kennedy. They can be piled up as in Jacks the guy who shot the kid who killed Kennedy...One more common kind of subordinate clause is an adverbial clause, often stating when, how, why, or if something happened, as in the [bold] parts of these sentences: If John comes, Im leaving, or He left because he felt ill. None of the examples just given were particularly exotic, and they could all easily have occurred in conversational speech. All were, in a technical sense, complex sentences, because they contained subordinate clauses.- James R. Hurford, The Origins of Grammar: Language in the Light of Evolution II. Oxford University Press, 2012 Positioning Clauses in Complex Sentences [D]ependent clauses cannot be sentences on their own. They depend on an independent clause to support them. The independent clause in a complex sentence carries the main meaning, but either clause may come first.- A. Robert Young and Ann O. Strauch, Nitty Gritty Grammar: Sentence Essentials for Writers. Cambridge University Press, 2006 The Need for Complex Sentences Most of the sentences we use in writing or in continuous speech are complex...There is a recurrent need to expound facts or concepts in greater elaboration than the structure of the simple sentence permits.- Walter Nash, English Usage: A Guide to First Principles. Routledge, 1986 Four Features of Complex Sentences Complex sentences are traditionally divided into two basic types: (i) sentences including coordinate clauses, and (ii) sentences including subordinate clauses. The former consist of two (or more) clauses that are functionally equivalent and symmetrical, whereas the latter consist of two (or more) clauses that constitute an asymmetrical relationship: a subordinate clause and a matrix clause do not have equal status and equal function (cf. Foley and Van Valin 1984: 239)...I suggest that prototypical subordinate clauses carry the following features: they are (i) syntactically embedded, (ii) formally marked as a dependent clause, (iii) semantically integrated in a superordinate clause, and (iv) part of the same processing and planning unit as the associated matrix clause.- Holger Diessel, The Acquisition of Complex Sentences. Cambridge University Press, 2004 Complex Sentences and Metaphors Complex sentences can offer dramatic development, extending a metaphor, as Melvilles Captain Ahab reminds us: The path to my fixed purpose is laid on iron rails, on which my soul is grooved to run.- Philip Gerard, Creative Nonfiction: Researching and Crafting Stories of Real Life. Story Press, 1996