Assignment On AHCA Medicaid Work Requirement Policy

To: Mandy Cohen, MD, MPH From: Liza Rebold Date: 11/11/2017 Re: Advisement on AHCA Medicaid Work Requirement Policy North Carolina should not adopt a work requirement for able-bodied adults (ABAWDs) to its Medicaid program. States that expanded Medicaid have seen effective outcomes by providing needed care to uninsured people whose health conditions have been barriers to employment. 2017 data shows that in NC, 80% of adults on Medicaid live in a family with at least one worker and 48% are currently working without being required to do so as a condition of coverage. The purpose of mandating a work requirement for Medicaid is to offset the work disincentives that come with such social assistance programs while continuing to diminish†¦show more content†¦Further, the NC Justice Center found that employment does not even keep people out of poverty. Nearly two and a half million North Carolinians who have a job are still earning poverty-level incomes. Work requirement will leave vulnerable individuals without needed resources Exemptions from the work requirement for Medicaid are limited, given only to the permanently disabled (on SSI or SSDI), pregnant, the sole parent of a child younger than age six or disabled, or those who are under 20 and still in school. According to the Health Affairs Journal, 11 million Medicaid enrollees could be a risk of losing coverage under this policy. 29% of Medicaid enrollees report they are not working because they are caring for a family member, 33% have an uncovered disability, 5% have a temporary health problem, and 17% are going to school. These subcategories of individuals are put at a disadvantage through the work requirement policy. Through the same report, it is found that 30% of those at risk for losing health care lack a high school diploma; those with limited education already have sparse employment prospects, and the proposal essentially disincentives further education to begin with. Additionally, 63% would be women, who are already more likely than

International Adoptees And Its Effects On Children

As adoption has become an increasingly mainstream option for couples looking to expand their families, international adoption agencies increasingly encourage families to explore Eastern Europe, Asia, Africa, and South America for potential adoption matches (Carlson, Hostinar, Mliner, Gunnar, 2014; van Londen, Juffer, van Uzendoorn, 2007). Unfortunately, many international adoptees (IAs) struggle with the transition into their new families and cultures; an issue that research suggests can be contributed to severe deprivation in early life (Carlson et al., 2014; van Londen et al. 2007). Researchers and aid agencies have observed that many international orphanages struggle to provide healthy, nurturing environments for institutionalized†¦show more content†¦Attachment Patterns in Post-Institutionalized International Adoptees In their 2007 study, van Londen et al. (2007) examined attachment patterns in post-institutionalized adoptees from China, Taiwan, South Korea, Colombia, and Ethiopia to determine if post-institutionalized adoptee populations experience higher rates of insecure and/or disorganized attachment than non-adoptee (NA) groups. To assess attachment in post-institutionalized adoptees, van Londen et al. (2007) recruited 70 adoptees from the aforementioned nations and their adoptive families via collaboration with three Dutch adoption agencies. Only traditional two-parent families for whom the adopted infant was their first child were accepted into the study (van Londen et al., 2007). Further, all adoptees must have been placed with their adoptive families prior to 12 months of age and must have lived with their adoptive families for a minimum of four months prior to participation in the study (van Londen et al., 2007). To determine the influence of institutionalized care on later attachment and development, van Londen et al. (2007) reviewed the adoptive mothers’ maternal sensitivity towards the infants and assessed the infants’ attachment pattern. To decrease potential biases, all assessments were completed during a series of two videotaped in-home interviews, as the researchers felt participants would behave most naturally in their own environment (van Londen et al., 2007).Show MoreRelatedChinese Children Showed Improvements On Cognitive And Language Skills After Being Adopted853 Words   |  4 PagesSummary: Chinese children showed improvements on cognitive and language skills after being adopted. However, even though Chinese children were the leading internationally adopted group in many countries, â€Å"less is known about their attachment and socio-emotional outcomes† (Cohen Farnia, 2011, p.67). In addition, Cohen and Farnia believed that studies on Chinese adoptees were not measuring these children’s growth efficiently. Hence, Cohen and Farnia see the needs of studying Chinese adoptees’ attachmentRead MoreEffects of Early Deprivation on the Development of Institutionalised Chil dren1686 Words   |  7 PagesEffects of Early Deprivation on the Development of Institutionalised Children Abstract Deprivation is defined as a reduced fulfillment of an essential desire or need. Studies on the development of children reared in institutions and orphanages help us to look at the effects of deprivation. Institutionalised children are reported to perform poorly on intelligence tests and to be slow learners with specific difficulties in language andRead MoreReactive Attachment Disorder ( Rad ) Essay1351 Words   |  6 PagesDSM-III (American Psychiatric Association, 1980). In the DSM-IV. The disorder is defined by aberrant social behavior that appears in early childhood and is evident cross contextually(1994). The disorder describes aberrant social behaviors in young children that are believed to derive from being reared in caregiving environments lacking species-typical nurturance and stimulation, such as in instances such as maltreatment or institutional rearing. (First, M., Tasman, A. 2010) . In cases of RAD twoRead More International Adoption Essay example1739 Words   |  7 P agesInternational Adoption      Ã‚  Ã‚  Ã‚   When a mission team from south Florida arrived in Camp Haitia, they saw what to them was the most poverty stricken land on earth. Some of the men were literally ill at the sight of the filth in the rivers, on the land, and covering the children. Because Haiti is one of the poorest nations in the world, families do not even have enough to provide for their children, and many of them are left to fend for themselves. The mission team witnessed them bathing in pollutedRead More An Examination of Factors Contributing to Identity Development and Adjustment 3100 Words   |  13 Pagesclass couples.Therefore, many internationally adopted children grow up in an environment with ready access to resources, with adults who are able to support them financially and emotionally.In such narrow socioeconomic circumstances, the question then arises: What accounts for those internationally adopted children and youth who do not adjust well?What factors contribute to the normal, health y development of these individuals?Examining international adoption also brings up this point:Is there reallyRead MoreInternational Adoption1992 Words   |  8 PagesRunning head: INTERNATIONAL AND INTERCOUNTRY ADOPTION International and Intercountry Adoption The University of Akron International and Intercountry Adoption The birth of a child represents a milestone in the life of families. For those who are not able to conceive a child by natural means, adoption often comes as an alternative and rewarding way to build a family and fulfill individuals’ desire to experience parenthood. Whether for biological or personal reasons, many have taken the pathRead MoreEssay An Analysis of Ethical Dilemma of International Adoption2458 Words   |  10 Pageshave steadily extended since the World War II, Korean War and Vietnam War, where many children became orphans. As a response to them winners, especially Americans, started to adopt children from the war-torn countries (Wilkinson 1995, 174). Thus, it was a start point for international adoption. Intercountry (international or transnational) adoption is defined as adoption, where child is removed to the adoptees’ country. In recent times motives to adopt internationally are explained as charity ofRead MorePersuasive Essay On Adoption871 Words   |  4 Pagesconsidered. Adoption is an amazing gift for couples who are unable to have children. There are many problems that couples face when they cannot conceive. It is heart-wrenching for couples who need to endure years of trying and hoping, only to see their efforts fail or end in miscarriages. Thankfully, there is a way for these childless couples to become parents through adoption. â€Å"There are approximately 1.5 million adoptees under the age of 18 years in the United States, accounting for just over 2%Read MoreKorean Adoptees As Asian Americans1799 Words   |  8 PagesAdoptions: Racialization of Korean Adoptees as Asian Americans The practice of Korean transnational adoption has a history of more than fifty years that includes multiple layers that overlap. One history is specific to the end and aftermath of the Korean War and another is the history of racialization of Korean adoptees as Asian Americans, and as a part of an ongoing history of American transracial adoption. This paper will address the history of racialization of Korean adoptees and the way they are viewedRead MoreAttachment Theory On The Relationships Between Parents And Children And Primary Caregivers2037 Words   |  9 PagesAttachment theory concentrates on the relationships between parents and children or parents and primary caregivers. According John Bowlby, the author of attachment theory, attachment is inborn and is as essential for survival as food, water, and air; it is an emotional, object specific relationship that develops towards a primary caregiver (Bowlby, 1969). Through series of experiments Bowlby explained the nature and the role of physical proximity of a child to a caregiver as a secure base for exploration

Fraud and Highest Embezzlement Case Free Essays

Embezzlement: Attempting to Find the Easy Way Out Name School Envy and greed has existed since the beginning of time. Maybe we are born with those traits or maybe we are taught through life’s lessons. The rich are perceived as having a carefree un-stress-filled life. We will write a custom essay sample on Fraud and Highest Embezzlement Case or any similar topic only for you Order Now The reality shows and news stories of the wealthy buying yachts, taking lavish vacations with their Barbie doll mate, summer homes that are actually castles and extravagant parties. The rest of the world seems to be the servants of the wealthy. How can society not be envious or greedy to obtain what the few have in their life? Part of society is happy with their position in life; just being able to pay the bills, and take care of their family is what drives them. However, the other part of society wonder, â€Å"How have some individuals been gifted with monetary wealth? †, and their resentment builds. The â€Å"Get Rich† schemes are created. The individuals trying to make the quick buck will pressure their friends and family into buying the Mary Kay, Tupperware, or lending money to place bets on Sport games or a gambling weekend at the casino. All this under the assumption that they will make a great deal of money, and earn the respect of the wealthy elite. The most well know form of money schemes is embezzlement. An understanding definition of embezzlement comes from Global Legal Resources; it states: Embezzlement is a criminal offense which involves the fraudulent and secret misappropriation of money or assets by an agent to who the property has been entrusted. This occurs when a person obtains possession of the goods or money in legal, proper manner, but then appropriates them for his/her use without the rightful owner’s permission. Six (6) cases of embezzlement stand out in Modern day History. The first case is about Yasuyoshi Kato in 1997 who managed to steal $132 million from Day-Lee Foods, Inc. of Santa Fe Springs, California. At the time, Yasuyoshi was the Chief Financial Offer of Day-Lee Foods. He managed to keep the game up for six (6) years by fraud and forged checks. Yasuyoshi, a Japanese citizen, wrote checks to himself and his wife, from the various companies’ accounts over the six (6) years. He even was so arrogant that he took out bank loans under the company’s name and manipulated the accounting books to cover the theft. Yasuyoshi bought umerous luxury homes, a citrus ranch, premium vehicles, unstable business ventures that failed, jewelry and extraordinary animals. He blamed his wife in court on the reasoning on why he performed the embezzlement. Stating she was always unsatisfied. Yasuyoshi was even so ignorant that when he was asked where the money was coming from, he stated he was a secret inventor of Nintendo. In 1997, Yasuyoshi Kato plead g uilty to six felony counts. They ranged from mail fraud (Statute 18 U. S. C. Section 1341) to wire fraud (Statute 18 U. S. C. Section 1343). In the end, he was sentenced to 63 months in a federal state prison and an additional five years of probation. This was the maximum sentencing at this time. (Marquet, 2010) The second largest case of embezzlement was Gilbert Beesmyer of Guarantee Building Loan Association of Hollywood, California. He was found guilty in December of 1930 (Statute 18 U. S. C. Section 981), and length of the fraud is unknown but assumed to be less than one year. Beesemyer was able to steal the equivalent of $100 million in 2010 dollars using his position within the company as the founder, general secretary and manager. The Guarantee Building and Loan Association went broke because of Beesemyer’s actions. He stole the money in form of overdraft penalties, and repeatedly stated he planned to repay the money. Even though he was sentenced to 10 to 100 years to the San Quentin prison, he was released under parole in 1940. The community that had invested in Beesemyer’s bank was destroyed. Businesses failed, 2,500 families went broke, individuals went to asylums and thirty committed suicide. In the end, Beesemyer was able to live his life out to the fullest at age 97 in Baltimore Maryland. Marquet, 2010) Ricardo Carrasco, a Uruguayan national, was able to embezzle $97. 7 million from the BankBoston Corp located in Boston Massachusetts. As the same as the Beesemyer’s case, officials were unable to determine the length of the fraud. He was uncovered in 1998 at the age of 41. Yet, Carrasco suspected that the bank officials finally caught on to him, so he went into hiding. Carrasco starte d his association with the BankBoston Corp in 1977 at the Uruguayan branch. In 1998, the bank transferred him the Boston location. Carrasco executed fraudulent loans to an Oldemar Laborda in Argentina. Oldemar Laborda has been known for having a highly suspicious past. The FDIC ordered Carrasco to repay $73 million. The bank wrote off $66 million and even offered a $10,000 reward for information leading to his arrest. But to this day, he remains a fugitive. (Marquet, 2010) The Chief Operating Officer of Tenens Corp. , dba Essex Street Associates of Beverly Massachusetts embezzled for seven years the amount of $72. 3 million. John Doorly started with the company as a clerk, and with hard work, was able to rise to the CFO position. The clients trusted him, the company trusted him. In the seven years, he transferred assets from the clients trust accounts to his own personal accounts. Doorly established personal credit cards that the company unknowing paid for. He even overcharged clients in the excess of $61 million for his services and so-called expenses on over-seeing their accounts. Doorly spent the money on gifts for his wife and mistress, and apartment for his son, vehicles, travel, airplanes and numerous failed business ventures. He forged the statements that were mailed to the clients, and even went as far as to deceive the outside auditors. Doorly’s new assistant, Kim Borans, was the one who found irregularities in the accounts. She immediately went to one of the officers of Tenens Corp to report her findings and suspicion of embezzlement. Doorly was fired and a forensic internal audit was conducted of his accounts. On March 201, Doorly was sentenced to 17-1/2 years to a federal prison. (Marquet, 2010) The fifth highest embezzlement case is Ausuf Umar Siddiqui, the vice president of Merchandising and Operations of Fry’s Electronics located in San Jose, California. He pled guilty of vendor fraud and kickbacks in the theft of $69 million. The scheme began in January 2005 and ended when he was finally caught in November 2008. Siddiqui had a base salary of $225,000 a year and was the supervisor of 120 employees in purchasing department. His department was responsible for purchasing merchandise on all Fry’s 34 locations. Siddiqui even went as far is to set-up a dummy vendor where he could embezzle the money. He stole the money to satisfy his gambling habit and the need to live the high life. At the time Siddiqui was caught he was being sued by three casinos, Planet Hollywood, Palms Casino and Trump Taj Mahal, for outstanding debt on gambling. Venetian Resort and Casino in Las Vegas reported that he gambled $17. 9 million dollars with them alone. An investigation showed that his gambling debt over a ten-year period is approximately $167 million. (Marquet, 2010) A case the hits close to home is the Koss Corporation. Sjuata Sachdeva was the Chief Financial Officer of Koss Corporation located in Milwaukee Wisconsin. She began her career with the company as a temporary worker, and within one year was promoted to vice president of finance. Over a span of twelve years, Sachdeva was able to embezzle $40. million by fraudulent funds transfers. She approved at least 204 wire transfers of funds from the company bank accounts to her personal American Express credit card. Also, Sachdeva issued more than 500 cashier’s checks from the company’s accounts to pay for personal lavish expenses. On top of this, she informed other Koss employees to make fraudulent entries into the company’s books to conceal her theft. The theft was only caught after American Express notified Koss of unusally high volume of large transactions. Sachdeva used her illegally obtained money for a vacation home in Hawaii, a new Mercedes Benz, luxury travel, furs, designer shoes, art and jewelry. She had purchased some many items that she had two storage containers rented in Milwaukee. During the investigation, some luxury stores come forward stating that she had purchased items ans asked the store to hold the item for her until she came and picked it up. However, she never showed up. Sachdeva even had enough nerve to hold various fundraisers to flaunt her wealth in hopes of joining the socialate circle of Milwaukee. The Board of Trustees of Cardinal Stritch University was so impressed with her that she was offered a position to sit on their board. To cover her theft, Sachdeva informed her friends that her husband, a pediatrician, made a couple million a year, and she made only half a million and they both came from wealthy Indian families. On Sachdeva’s sentencing day she made a statement of, â€Å"I stand before you today truly remorseful. You have been my family, my friends, and my co-workers for many years. I know you have been deeply hurt by my dishonesty in ways that I never intended. For eleven years she will sit in prison for her greed and envy. (Marquet, 2010) In every case examined, the US Code that has been violated is Chapter 31: Embezzlement and theft. Twenty-nine Sections of the Code have been created to cover every type of theft from public money, property or records to major theft of livestock. The state sentencing of embezzlement ranges anywhere from 45 months for felonie s, six months for misdemeanors or 38 months of probation and including repayment of money and fines. The sentencing is determined by the monetary amount that is stolen. (US Code) The Federal Government oversees accusations of embezzlement for public agencies, banks, US courts, credit agencies and any program that received money from the Federal Government. Yet, Federal punishment is anywhere between two years to 30 years in prison. However, if the dollar amount of the embezzlement is less than $1000, then the sentence will be less than one year with a fine of only $1000. (Embezzlement Cases) People always are caught when it comes to greed and envy. The embezzler’s keep stealing thinking they are good enough to keep getting away with it, or maybe it is the lavish lifestyle that blinds them to the consequences. Why are the not happy with the large amount of salary that they receive as income from their careers? It is always more and more until they sit behind metal bars with nothing but a prison issued jumpsuit and a boyfriend named ‘Butch’. References Country. (n. d. ). Embezzlement Law. Lawyers, Attorneys, Law Firms A– Find Legal Information. Retrieved April 20, 2012, from http://www. g. org/embezzlement. html Embezzlement Cases. (n. d. ). Defending your rights in the criminal justice system. Retrieved April 20, 2012, from http://www. defending. com/embezzlement-cases Marquet, C. (n. d. ). The Top 10 Embezzlement Cases in Modern US History. Marquet International. Retrieved April 20, 2012, from www. marquetinternational. com/pdf/top_10_embezzlement_cases_in_us_history. pdf US Code – Chapter 31: Embezzlement and theft. (n. d. ). US Code. Retrieved April 20, 2012, from http://codes. lp. findlaw. com/uscode/18/I/31 How to cite Fraud and Highest Embezzlement Case, Essay examples

Evaluation of Risk Due to Noise Hazard and Control

Question: Discuss about the Evaluation of Risk Due to Noise Hazard and Control. Answer: Introduction Physical hazards can be any factor that can cause harm to the body without actual physical contact with the body. There are number examples which come under the category of corporal hazards like continuous loud noise and vibration, radiation, heights, pressure, extreme temperatures (Loftis, 2007). Noise and vibrations linked with each other as it originates from a vibrating object. Noise and vibrations have related physics as they are transmitted in the form of waves. The noise hazards have grave health impacts and most of the workplaces expose to noise, the louder it is, and it can cause more damage to the extent of temporary to permanent loss of hearing. This report discusses the potential risk of the physical agent noise to employees at the organization Ooredoo, Qatar and specifies the prevention and control approach that should be implemented. Organizations require a noise management plan as noise inconvenience will not go away if ignored and they are likely to get worse if not d ealt. The purpose of this paper is to lead through those measures. Evaluation and Potential Risk Noise is the most common physical agent causing occupational health hazards. This physical agent can be found in industrial and manufacturing environments, while farming, in cafeterias and permanent auditory loss, is the key health concern. Infuriation, constant worry, and interference with verbal communication are the key concerns in noisy offices, schools, and computer rooms. Potential hazards to the employee can be a hearing loss depends on the force of the noise, its extent, and how repeatedly the exposure occurs. This physical agent is an undesired sound which could cause damage to the health of the employees or hearing impairment. Different kinds of noise have kind of effects on the health of the employees at workplaces. The key areas having noise troubles are recognized, including the music and entertainment segment. Some of the chronic health effects due to exposure to the noise hazard at workplace over the years may lead to irreparable hearing failure if the everyday sound e xposure level gets to or go beyond 85 dB(A) (Osha.gov, 2016).Consequent exposure to blare causes the symptoms to be getting appalling over a period. Noise can be issue at the place of work if there is a ringing or humming sound in the ears when workers have left work or people have to shout to their co-workers who at arms length from them. Deafening blare can be the grounds for hearing loss both gradually, and by exposures in a given time period. Harm can happen instantaneously by exposure to extreme reverberation produced by a likely to explode sounds like firing of guns, explosion or cartridge operated equipment. Noise is the menacing of the entire industrial noxious waste, concerning all industry and basis of harsh hearing failure in many countries. Anybody could be vulnerable to unwarranted noise levels. People employed in loud workplaces, industrial units and plants, cell phone companies, and the sharp ear-splitting environments such as repair of roads, airports, and erection site are most vulnerable to this peril. The potential risks faced by workers at the organization Ooredoo, a cell phone company in Qatar. There has been an increasing demand for quicker cell phone service and network speeds have resulted in an increase in communications tower work that has resulted in increased risk for workers in Ooredoo. Over the last decade, mobile phone usage has matured exponentially with the introduction of better communication processes and systems and better phone. Nevertheless, how much people use cell phones these days, that doctor testify that most of hearing loss among users. Too much use of cell phones can cause the dangerous of health hazards for its user like hearing loss, neuroendocrine disruption, hormonal imbalance, and c ancer amongst the many harmful effects. Some of their potential risk faced by the workers of Ooredoo could be the dangerous radiation emitting from the cell phone towers (?liwi?ski, 2013). The workers are bared to the following risk of the auditory system, permanent and temporary audio failure, tinnitus, hearing impairment, noise management steps in the area of work, closed spaces, hurdles, and different kinds of unsafe working environment. Laws and Regulations The Qatar State Environmental Protection Law (2002), Annex (3/ 5th), provides maximum allowable ambient noise limits in Qatar. Noise disorder is created with the appliances and apparatus used especially the generator sets, should not increase more than the maximum limit of dB levels, as per rule when sleeping it should not more than40 dBA max; entertainment 45 dBA is the limit; Eating outlets up to 45 dBA . Vibration restrictions can be according to the BS 6841 (*d,e) (Osha.gov, 2016). A member of staff or employee is under obligations by the set of laws to use the hearing guard, a company or service provider shall make available permit hearing protectors. Where feasible, the company or the contractor shall make sure that a hearing protection is provided under the subsection which diminish the sound levels received into the workers ears can be up to 85 dBA only(Qf.org.qa, 2016). The Qatar Labour Law endorses the minimum standard of rights and advantages for employees to which the employers must adhere as well as the obligations of employees working in Qatar. The Laws of country safeguard the workers against the health hazards and following are some of the rules are put in place. The corporation should provide wide-ranging medical insurance to its workers. The company shall make available all-inclusive medical insurance to his workers. The company will be responsible for the compensation of Workers health insurance. Workers, who are at risk to the work-related perils, shall undergo regular health checkups in accordance with the recognized medical rules and the expenditure to be borne by the organization (Sudan et al., 2013). The company is required to pay the salaries and wages to its workers if they are undergoing any medical treatment caused due to occupational hazards as per the law (Kopke, 2007). The criterion for health care conveniences in the boarding and lodgings of workforce are also established. The noise hazard signage should be appropriately used. Where noise levels, whether ambient noise or occupational noise, exceed limits s tipulated in the Qatar State Environmental Protection Law (2002), appropriate hazard signage should be posted to inform workers, students, visitors, contractors and others who might be exposed to this physical agent. The language of this signage should be understood by everybody and also notify the concerned of the requirement of the protection (Canfeng, Shujie, and Dong, 2012). Training shall be imparted to the workers exposed to noise hazard above the limits stipulated in the Qatar State Environmental Protection Law (2002) and such training would be provided during induction. Prevention and Control Strategy Exposure to hazard and its prevention and control in the workplace requires knowledge and inventiveness. Effective control usually does not necessarily require expensive and complex measures (Jacques, 2009). Risk control can be achieved through right technology, which can be very simple. It can also consist of simple improvements and changes such as placing an impermanent barrier between an ultraviolet source and an employee, or training staff in secure work practices(Tak, Davis, and Calvert, 2009). The physical agent -noise, is a considerable physical vulnerability, which can be curbed by a range of methods (Price, 2012). The effect of clamor danger can be compacted by settling types of gear and frameworks that have been built, outlined, and worked to work indistinctly; by encasing or protecting commotion making hardware and by taking definite steps so that paraphernalia is in good state and suitably maintained with all damaged and unstable parts reinstated; by keeping noisy apparatus and machinery at higher levels to decrease the disturbance. Furthermore, the workplaces should also install silencers, mufflers, or baffles. The organizations should hire an occupational hygienist who should be able to foresee the potential health hazards that may result from workplaces business processes and its operations and equipment used, and accordingly advise the organization on planning and designing their hazard free workplace (Stanbury, Rafferty, and Rosenman, 2008). The hygienist should be able to distinguish and understand, in the work environment, the happening (real or impending) of chemical, physical and biological causes and stresses, and their interactions with other aspects, which could have an effect on the health and welfare of personnel. Constant evaluations, throughout the environmental monitoring and health supervision, should be the part of any risk prevention and control strategy (Menounou and Papaefthymiou, 2009). The strategy to be followed for prevention and controlling the risk posed due to noise should have the following three stages. Firstly should be observation at the workplace by the workers or employees and to recognize the problem, find out the simple and straight forward solutions for risk identified and seek assistance and aid when required. Secondly, to analyze the hazard with the help of an occupation health consultant which is more complex but would the right information. (Reza Monazzam and Momen Bellah Fard, 2011). To prevent noise in affecting the workers, the noise path should be customized by erecting enclosures around the machines and equipment to curb the amount of noise that is being emitted in the workplace setting. Barriers can also be put up to block the path of the noise or disturbance and also by positioning the noise sources far away from the workers. A few strategies to control commotion at source are a case, by utilizing the sound-deadening or suppressing, clamor boundaries, and disengagement. To get the authoritative commotion control measures e.g. preparing and training, work pivot, upgrading the lists to reduce the quantity of representatives being presented to clamour (Chalupka, 2013). To make accessible a defensive gear and contraptions (PPE) case, ear covers, and earplugs. Then again, if specialists are always required to carry PPE to lessen the danger of listening to misfortune from a commotion contact that surpasses the introduction standard, then an audiometric testing fr amework must be set up in the association (Kurmis and Apps, 2007). The next step in prevention and controlling is reviewing the measures implemented regularly and revised or updated regularly, to the measure are working as planned and minimize the risk of exposure to the physical agent being discussed and to continuously maintain the workplace environment (Lin, Nassar, and Evans, 2013). To control the hazard the regular noise surveys should be scheduled to understand the concerns of the noise levels. Keeping the workers informed regarding where the noise exposure is above the upper exposure action value and offered relevant information regarding from hearing protection is procured or can be provided, make available appropriate training and instructions on right fitting, maintenance and suitable storage space (Stanbury, Rafferty, and Rosenman, 2008). Assessing the utility of hearing protectors the SNR method. The SNR is the simplest prediction way, and it uses the SNR value repeatedly provided with their products by hearing protection sellers. The measurement that is required is of the C-weighted sound pressure level at the working spot. The SNR value is subtracted from the C-weighted level to get a prediction of the A-weighted protected level Conclusion The example of auditory health hazards could be acoustic trauma, tinnitus, hearing impairment, temporary or permanent. To handle the with noise hazard, there is a need to follow a methodical series of steps and continuously evaluate monitor, re-implement if required and control it. Noise could be safety risk which can distract attention. It can go down out the sound of an out of order machine, an alarm indicator or somebody shouting. People find that this physical agent adds to the weariness of work and also makes it difficult to focus. Productivity can be impacted as a result. Failing to take action on the predicament of noise, jeopardize the hearing damage and add on costs as per the serious fines under the Health and Safety in Employment Acts of various countries. Workers can lodge a claim for compensation with the ACC for hearing dent caused by noise at the workplace, which will have consequential financial penalties for the organization. Rehabilitation costs are incurred if a wo rker or employee needs to be retrained and relocated. Organisations should allocate funds on the management of noise which could attract an investment, to ensure dependable occupational health and safety practice in the workplace; to comply with legal obligations and to reduce the organizations liability through compensation or claims. To provide a safer, more dynamic and satisfying working environment; minimize the chances of workforce hearing being afflicted with hearing disorders and improve the image the workplace or organization in acting responsibly towards its workers (Dube, Ingale, and Ingale, 2011). References Canfeng, Z., Shujie, Y. and Dong, L. (2012). Comprehensive Control of the Noise Occupational Hazard in Cement Plant.Procedia Engineering, 43, pp.186-190. Carruth, A., Robert, A., Hurley, A. and Currie, P. (2007). The Impact of Hearing Impairment, Perceptions and Attitudes about Hearing Loss, and Noise Exposure Risk Patterns on Hearing Handicap among Farm Family Members.Workplace Health Safety, 55(6), pp.227-234. Chalupka, S. (2013). Preventing Noise-Induced Hearing Loss in Firefighters.Workplace Health Safety, 61(9), pp.420-420. Dube, K., Ingale, S. and Ingale, L. (2011). Hearing impairment among workers exposed to excessive levels of noise in ginning industries.Noise and Health, 13(54), p.348. Jacques, J. (2009). Methodology for noise control at the workplaceEuropean and International standards.Noise Control Engineering Journal, 57(6), p.613. Kopke, R. (2007). Pharmacological approaches to the prevention and treatment of cochlear injury due to noise.Audiological Medicine, 5(1), pp.66-80. Kurmis, A. and Apps, S. (2007). Occupationally-Acquired Noise-Induced Hearing Loss: A Senseless Workplace Hazard.International Journal of Occupational Medicine and Environmental Health, 20(2). Lin, J., Nassar, M. and Evans, B. (2013). Impulsive Noise Mitigation in Powerline Communications Using Sparse Bayesian Learning.IEEE Journal on Selected Areas in Communications, 31(7), pp.1172-1183. Loftis, M. (2007). Sources of Noise-Induced Hearing Loss.Workplace Health Safety, 55(11), pp.476-476. Menounou, P. and Papaefthymiou, E. (2009). Use of Noise Barriers for Helicopter Noise Mitigation.Noise Vibration Worldwide, 40(5), pp.10-21. Osha.gov. (2016).Safety and Health Topics | Occupational Noise Exposure | Occupational Safety and Health Administration. [online] Available at: https://www.osha.gov/SLTC/noisehearingconservation/ [Accessed 1 Dec. 2016]. Price, G. (2012). Impulse noise hazard: From theoretical understanding to engineering solutions.Noise Control Engineering Journal, 60(3), pp.301-312. Qf.org.qa. (2016).Qatar Foundation | Home Page. [online] Available at: https://www.qf.org.qa [Accessed 1 Dec. 2016]. Reza Monazzam, M. and Momen Bellah Fard, S. (2011). Design of Optimal Noise Hazard Control Strategy With Budget Constraint.International Journal of Occupational Safety and Ergonomics, 17(4), pp.463-464. ?liwi?ski, A. (2013). Assessment of Ultrasonic Noise Hazard in Workplaces Environment.Archives of Acoustics, 38(2). Stanbury, M., Rafferty, A. and Rosenman, K. (2008). Prevalence of Hearing Loss and Work-Related Noise-Induced Hearing Loss in Michigan.Journal of Occupational and Environmental Medicine, 50(1), pp.72-79. Sudan, M., Kheifets, L., Arah, O. and Olsen, J. (2013). Cell Phone Exposures and Hearing Loss in Children in the Danish National Birth Cohort.Paediatric and Perinatal Epidemiology, 27(3), pp.247-257. Tak, S., Davis, R. and Calvert, G. (2009). Exposure to hazardous workplace noise and use of hearing protection devices among US workers-NHANES, 1999-2004.American Journal of Industrial Medicine, 52(5), pp.358-371.

Educational Research Essays - Behaviorism, Addiction,

Educational Research Single-Subject Critique Establishing Discriminative Control of Responding Using Functional and Alternative Reinforcers During Functional Communication Training Wayne W. Fisher, David E. Kuhn, and Rachel H. Thompson Appropriateness of research question or purpose: The purpose of this research was interesting and of value as it focused on problems that often occur when Functional Communication Training (FCT) is in use. This study sought to find effective solutions as desired ". . .response[s] may be weakened and destructive behavior[s] may reemerge . . ." when reinforcements of communication are delayed or denied due to impossibility or inconvenience of the caregiver or instructors ability to provide said reinforcement in a timely manner. ". . .procedures are needed to increase the effectiveness of FCT in situations in which it is impractical or impossible to deliver a given reinforcer." Research design and design rationale: This study was broken up into 4 phases (the fourth phase ". . .was completed with only 1 participant in only one condition because of time limitations on the participants' hospital admission.") Phase 1: Functional Analyses and Descriptive Assessments. Alternating treatment with no baseline design. "During this analysis, a test condition . . .and a control condition were compared using a multi-element design." Phase 2: Communication and Discrimination Training. Phase 3: Treatment Evaluation of FCT with Discriminative Stimuli. Between series, alternating treatment (ABAB) design was used to compare FCT + EXT vs. ACT + EXT in two conditions for one participant (Amy) and in one condition for one participant (Ned). Phase 4: Independent Effects of FCT and EXT. Between series, alternating treatment and a final treatment design was used to compare FCT/ACT (w/o EXT) vs. EXT alone with the final series being strictly FCT/ACT (w/o EXT). The order of presentation for Amy's discrimination training were ". . .stimulus-present and stimulus-absent periods [that] were alternated every 30 s for the duration of the 10-min session. For Ned, ". . .one SD at a time was presented for 1 min. The order of the first three SD presentations in a given session was randomized, without replacement; thereafter, the order remained constant." Phase 1 was "conducted to test the hypotheses generated by the results of. . .descriptive assessments. . .to determine whether . . .destructive behavior was multiply maintained by both attention and access to tangible items, but under specific stimulus conditions [for Amy]. . .[and whether] destructive behavior was maintained by . . .attention [for Ned]," therefore this specific phase of the test did not require a baseline. Once these results were established, and training had incurred, the rationale for design for Phases 3 and 4 were to show contrast between the various interventions. Overall study limitations: I think this study covered it's bases well and the only limitation I can rightly see is one that is prone to single-subject research, that is, the use of only two participants. It would have strengthened this study further too if the researchers had been able to complete the final Phase 4 on both of the participants.

Hinduism Paper Essays - Shabda, Reincarnation, Salvation, Hinduism

Hinduism Paper Essays - Shabda, Reincarnation, Salvation, Hinduism Hinduism Paper HUM/130 Hinduism Paper The spiritual expressions of Hinduism range from extreme asceticism to extreme sensuality, from the heights of personal devotion to a deity to the heights of abstract philosophy, from metaphysical proclamations of the oneness behind the material world to worship of images representing a multiplicity of deities(Fisher, 2005, pg. 71) .While Hinduism lacks a uniting belief system, one belief held by almost all variations of Indian religion is an openness and acceptance for all beliefs and practices. In addition, it is clear that Hinduism is much more than a traditional religion; rather it is way of life. One way in which this concept is exemplified is by the popular Hindi term, dharma. Dharma refers to a broad complex of meanings, encompassing duty, natural law, social welfare, ethics, health, wealth, power, fulfillment of desires, and transcendental realization (Fisher, 2005, pg. 71). The foundation of Hinduism can be linked to Vedas. Vedas are the religious scriptures believed to tran scend human time. Reincarnation and karma are also doctrines sacred to all forms of Hinduism. Originating in India in 1500 BCE, Hinduism has evolved into a collaboration of many different belief systems. The religious tolerance held by all Hindu people has been a uniting factor and strength used by all Indian people when faced repeatedly with adversity throughout the years. In early years, Hinduism played the role of peacemaker in a country rich with racial, religious, ethnic, and cultural diversity. While there is no uniting belief system, freedom of belief encouraged tolerance throughout the land. Today, Hinduism remains a vital part of Indian life. Religious rituals and beliefs are not only beneficial to the way of life but provide protection for necessary earthly resources. Hinduism seeks a goal of liberation from Earthly existence. In order to achieve this goal a sense of duty must be followed that has provided India protection against violence and warfare, allowing the culture to survive. The concept of Karma believed by all forms of Hinduism dictates that, every act we make and even every thought and every desire we have, shapes our future experiences (Fisher, 2005, pg. 77). In turn believers in Hinduism follow a code of ethics outstanding to most humans. These future experiences are not only affected in this earthly life but will follow through future reincarnations. Rebirth takes many forms, not just as humans. Throughout each form the inner self remains intact. Rebirth in the form of a human is a rare opportunity to advance ones self towards the ultimate goal of liberation. Liberation provides a stop to samsara, also known as the constant cycle of life, death, and rebirth. When ones self has been liberated rebirth will stop and ones self will be merged with an absolute reality. At this point, moksha is achieved providing liberation from space, time, and matter through realization of the immortal Absolute (Fisher, 2005). Hinduism life is viewed as a constant journe y towards the ultimate liberation from Earthly existence. It is as if Hinduism describes Earthly life as an undesirable test. If the self can demonstrate control and ability to stay positive, one day Earthly suffering will come to an end and the self will be free and only then true happiness occurs. This constant search for liberation fully demonstrates how Hinduism is much more than a religion; rather it is a way of life. Every moment of a Hindu believers life is spent working towards liberation. While followers of the Hindu religion widely range, all Hindu people possess a sense of sensuality that calls for a non-violent way of life. Hinduism promotes religious tolerance and freedom of choice. The only stipulation encouraged is to be true to oneself and kind to others. Hinduism is much bigger than an organized religion. Rather, it is about finding and encouraging the best self one can, by encouraging a sense of selflessness. It is clear that Hinduism provides a positive way of life and influence on society that others could learn from. By lacking unifying beliefs, Hinduism has created a harmonious balance among humans for many years, demonstrating how a diverse and open belief system can act as a peacemaker in society. Reference Fisher, M. P. (2005). Living religions (6th ed.). New Jersey:

Information Systems in Organizations - Case Study Essay

Information Systems in Organizations - Case Study - Essay Example Also, this system can act as a getaway to financial costs by exposing the organization to other sources of revenue to help them maintain flawless exchanges. Algorithm is fast assuming popularity in the trading world and it is common for any other client to ask for it. It brings with it many benefits including cutting down transaction costs and giving freedom to managers conducting any transactions to be fully responsible for the respective trading processes. These trading features allow for analysis of all quotes and trade in the stock markets. However, it also poses great risks. In case a trader fails to choose the appropriate feature then there will a lack of visibility and transparency during execution of orders (Avison, 2003). Use of programmed trade as from the case study can be linked to a resultant flush crush. The system handles a very large amount of information including trading information such as algo-trading which includes the use of an electronic platform to enter trading orders, with an algorithm in place that determines the features of the order. It also has the ability to handle huge volumes of data from messages. It is capable of handling up to a million messages per second which is highly beneficial. With this ability to handle such amount of information, the customers are able to get efficient services and this gives credit to the company and opening up a way of increasing their profits. Also the ability to handle one million messages per minute allows the system to give attention to countless users and ensures that there are no communication delays. This in the long term results to satisfied and loyal customers. The main functions of an information system include assembling, processing, retrieval and dissemination of information. In using this kind of system, there will be minimized overload since it has very high processing speed as compared to physical

Religion and Theology. Hinduism and Buddhism Assignment

Religion and Theology. Hinduism and Buddhism - Assignment Example It was not until the 19th century when the British colonial administration in India started referring to Hinduism as a form of religion. Hinduism was used as a description for the various religious beliefs and practices of the majority of Indian people (Rinehart, 2004). Despite the dynamics that he religion has undergone, the religion is believed to be more than 4000 years old, tracing bhack to the early Indian valley civilization. Traditionally, the religion is believed to be timeless, as the old people found it in practice. Fundamental spiritual beliefs Hindus believe in in one Supreme Being according to their traditions is both imminent and transcendent. According to the Hindu religious beliefs, the Supreme Being is both their creator and is of Unmanifest reality who deserves their respect (Rinehart, 2004). The Hindus believe in the divinity of the four Vedas, which are the oldest and most ancient elements of scripture in the world. Further, they venerate the Agamas as revealed in an equal measure. They treat these as primordial hymns of God which forms the bedrock of Santana Dharma, a form of an eternal religion. According to the Hindu beliefs, the soul reincarnates, evolving through many beliefs. However, the reincarnation trend stops after the resolution of all karmas. They also believe in moksha, which is the liberation from the rebirth cycle that takes place after the end of the reincarnation process. Since the process is continuous and evolutionary in every soul, not a single soul can be denied of its destiny (Fisher, 2014). Spiritual Practices of Hinduism In Hindu, an individual’s personal spiritual practice is referred to as sadhana which is used to refer to the means of accomplishing individual goals. It recognizes adhikara, which means that every person holds a very unique position in life that is different from that of other people. Therefore, God exists in different forms, which gives people the freedom to feel attracted to one God and lea ve the rest. Similarly there are different forms of yoga, just like there are different forms of God, which are not similar to one another. Therefore, the Hindu spiritual practice varies from one person to another. Spiritual practices to the include prayer, meditation, going on pilgrimage, bathing, fasting, practicing acts of charity, chanting mantra, reading of the scripture and performing ones’ daily work. How Hindu is practiced today Many Hinduism traditional practices have remained to date (Fisher, 2014). However several adjustments have been made to suit the religion in the modern context. For instance, in schools years, Brahmacharga is a common practice that focuses on instilling knowledge and developing the character of the people. How Hindu is practiced around the world Due to immigration to different parts of the world, the Hindu religion and its practices have also spread all over the world to areas such as Nepal, Bangladesh, Sri Lanka, Guyana, Trinidad, Tobago, Fij i, Mauritius, among others. Rinehart (2004) points out that the various practices of the religion practiced in these areas include sadhana, which is an individual practice of cultivating spirituality and Japa, which is a silent or an audible practice of repeating a mantra. Buddhism Origin It is believed that Buddhism originated from the teachings of Siddhartha Gautama, who was known as the Buddha in the years between ca 624-544. In his teachings, Gautama was opposed to the idea of man having an immortal soul. Moreover, his teachings did not touch on any Supreme Deity. In his teachings, Buddha insisted that man could overcome greed, hatred and delusion to attain enlightenment practicing the Four Noble Truths and

Hedge Funds-who is the winner(literature review) Essay

Hedge Funds-who is the winner(literature review) - Essay Example In the later part, we give an analysis, consult other authors and available literature in the field, and critically assess Brown’s article on hedge funds. The phrase â€Å"hedge funds† alone has not been well defined. Dr. Grenville, Deputy Governor of the Reserve Bank of Australia could not mention the proper definition. The Bank of Australia, in a paper submitted to the Australian House of Representatives, indicated that it was very concerned about the activities of highly leveraged financial intermediaries known as â€Å"hedge funds†. The paper stated that they were concerned that the funds made money â€Å"by attacking an exchange rate that has already overshot, so that it overshoots even further.† Through published actions and short selling, a bandwagon forms, then the funds would pull out. The Bank paper further stated that this was what happened to the ERM crisis that hit the British Pound in 1992, the Asian currency crisis in 1997 and speculative attacks on the Hong Kong dollar peg in 1998. With their action, the funds were holding the small countries hostage. (p 301) Brown (2001) pointed out that the International Monetary Fund reported that in the 1990s, there were financial intermediaries that had been investing steadily into South East Asia. There was a net inflow of about US$20 billion into the region over and above portfolio and direct investment; this was up to 1995 and 1996 when it increased to US$45 billion per annum. Then, there was a collapse of the Baht and the Ringgit in 1997 (the start of the Asian financial crisis), and a sudden outflow of US$58 billion. It was then perceived by the central bankers in the region that the collapse in the currency had everything to do with an attack on the currencies of the region by well-financed international speculators. Hedge funds could be the cause of the Asian financial crisis. One of those who believed on this was Dr. Mahathir bin Mohamad when he said,

Flood Coping Mechanisms

Flood Coping Mechanisms Adaptive Strategies of household in terms of flood coping mechanism. Introduction Background of the problem International and national literature related to the problem to be studied Floods are defined as extremely high flows of river, whereby water inundates flood plains or terrains outside the water-confined major river channels. Flood hazard is measured by probability occurrence of their damaging values, conceived generally as flood risk, or by their impact on society, conceives usually as the loss of lives and material damage to society (Rossi et al., 1994). Flood is natural events that can occur at any time and often able to create loss and damage that can be suffered by property, population and environment. Flood event cannot be prevented, but it can only be controlled and reduced the impact. Flood came relatively quickly, so we must have the effective strategies in order to reduce the impact from flood event. Flood is the most damaging event in Indonesia. Of total disaster in Indonesia, 57.43% is floods. Those events cause 587,190 affected people and 68 casualties (Badan Nasional Penanggulangan Bencana (BNBP/National Coordinating Board for the Management of Disaster), 2008). Geographically, Sampang is located in Madura Island and included as plain area because it has elevation almost the same as sea level. Due to this physical condition, Sampang, as a waterfront city, has been suffering with flooding almost every year. Combination between high intensity of rainfall and high tide of sea, improved water discharge of Kamoning River and then inundated several areas in Sampang. The triggering factor is small holding capacity of Kamoning River. The strategies from local community to cope the flood are mostly developed by the initiative of affected community in inundated area. For instance, they have added the floor height or the number of floor in order to avoid the water flow and save their belongings. The coping activities that have been done by local community revealed due to the disability of local community to move in safer area. Besides, those coping strategies also have uniqueness related to the physical condition of this area. It means that the strategies can be explored through several perspectives, e.g. the magnitude of flood, income, education, etc. By elaborating the existing adaptive strategies in Sampang Regency, it is expected that the general and specific description of flood coping strategies can be obtained as an effort to establish the recommendation in case of local government policy in facing with a given flood. 1.2. Statement of Problem Flood becomes a major issue for the local government of Sampang Regency because it is one of the most frequent and most disastrous natural events. Tremendous losses and damages as results of severe flood have been occurred. Historically, Sampang City already has been stricken severe flood in three times which were in 1921, 1991 and 2002. The most flood disaster in Sampang was in 2002, where a third area of Sampang was affected and caused more than 14 casualties, many damaged houses and public infrastructures, and many evacuated people. The recent of flood occurrence in Sampang were in 2008 and 2009, where the flood event has a little damaged. The flood occurrences in this regency demanded the awareness both from local community and local government for conducting disaster reduction actions. Those actions were aimed to minimize the impact of flood. One of those actions is flood investigation in terms of flood characteristics and coping strategies. The action is intended to gather information related to the characteristic of flood, how the affected community survive with flood, and the coping strategies that have been done by the local government. The collected information about flood and flood coping strategies will be useful as an important input to arrange capacity improvement in disaster reduction process. On the other words, local community and local government will be involved in establishing the more appropriate flood coping strategies, particularly by examining flood characteristics and existing flood coping mechanism. Moreover, it can be decided whether the existing flood coping strategies are adequate or not. There are many parts of Sampang Regency which are often stricken by flood every year, but the study about flood has not been done yet. Besides, more detail of local community’s strategies in overcoming the flood is not established. Local government commonly only calculated the losses and damages without investigating the flood characteristics and coping strategies done by local community. Find the thesis with Sampang as study area. Research Objective General objective of this research is to identify the adaptive strategies of household to cope the flood event and local government actions in supporting the strategies. The general objective is then elaborated into four specific objectives, as follow: To identify the characteristics of the flood. To explore the adaptive strategies of household to cope the flood. To recognize influencing factors of selected adaptive strategies. To identify the government strategies in terms of reducing the flood impacts. Research Questions The main question of this research is what are the adaptive strategies of households to cope the flood event and how can local government support the adaptive strategies in reducing the impact of flood Sub questions are: What are the characteristics of the flood event? What are the adaptive strategies of household to cope the flood? What are the factors that influence the selecting adaptive strategies? What have done by local government to cope the flood in term of reducing the impact of the flood event? Research Method * Make the adaptations necessary to adjust the text according to your own situation: Type of Research The type of research is an explanatory research which seeks to identify the adaptive strategies of household to cope the flood event and local government actions in supporting the strategies of household. This research will use qualitative and quantitative method. 2.2. Data Collection Literature study Secondary data will be collected mainly from government institutions, various data will be collected is listed on the following table: Table Secondary Data No Data Type Source 1 Annual report of JFP Perum year 2008 JFP, Perum of JFP 2 Documentation of tidal flood (picture and report) JFP, NJM 3 Fisheries statistic year 2008 JFP, BPS, Perum of JFP, NJFA 4 Spatial Plan NJM 5 Flood Preventing Program JFP, NJM Flood Preventing Program JFP, NJM Secondary data such as (reports, articles, etc) will be collected through a literature study from (governmental agencies, private, other). The sources of secondary data are shown in the following table X; 2.2.2. Fieldwork Primary data will be collected through a fieldwork for (duration, time of the data collection and place (s)). The research instruments will be a combination of an (in-depth interview, survey with questionnaires, others). The choice of key respondents (government officials/ experts, others) for interviews (with semi-closed interviews, closed interviews, etc) is based on a (purposive or other way of sampling). Further, the list of respondents to be interviewed is shown in the table X1; The research population at which the survey about (perception or other issue) using (questionnaires and/or other instrument) will be applied to (citizens, NGOs, etc..) The sampling technique for selecting respondents from citizens is a (purposive, random, or other) sampling. Considerin g that time and finance are the main limitations of the research, the expected number of respondents is X . The dissemination of questionnaires will be done by (visiting offices, schools/campuses and association centers of respondents, by using internet or other means). The list of respondents is presented in the following table X2; 2.3. Data Analysis How your collected data will be analyzed, techniques to be used for the analysis (statistic methods: means, percentages, frequency distribution, etc)) and for the display and organization of the collected data (tables, matrix, graphic (type)). Unit of Analysis, Variables and Indicators Unit of analysis of this research is the †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ Variables and indicators are summarized in the following table X3; 2.6. Research Design In order to have a clear guidance about how to do the research, it is necessary to make a research design. The research design consists of some stages as is shown in the following figure X The thesis report will be structured into X chapters. Those six chapters are as follows; Chapter 1 includes the background of the problem, problem statement, justification of study, research objectives, research questions and hypotheses. Chapter 2 deals with literature review/conceptual framework used in the research. Chapter 3 describes the general condition of the research area. Chapter 4 explains the research method. Chapter 5 discusses the results/findings of the research. Chapter 6 is concerned with conclusions and recommendations Time Framework Table X; Important dates and deadlines Budget Table X; Budget of research Reference List Appendix 1; Copy of the Interview Questions to be used in the field visit Appendix 2; Copy (s) of the Questionnaire(s) to be used in the field visit. Appendix 3; Map of the research area. CHAPTER III RESEARCH METHOD Research method used deals with the goals and objectives achieved in this study. It consists of pre field, data collection method and data analysis method. Preparation This stage has main purpose to prepare some certain materials which will be used in the field data collection. There are three main activities, which are literature review, design survey, and questioner. The literature review is a process to obtain research background justification and to formulate research questions. Then, it is harnessed as a guide in the research process. The literature review itself yields a theoretical background that provides framework analysis of the research. It also organizes such kind of research which should be accomplished in order to achieve the research objective. Data Collection The data needed for the research analysis are primary and secondary data. Primary data collection interview both household and contact person in particular community (government official, community leader, NGO, etc). Questioner distribution will be held by considering the number of samples taken. In this case, the number of samples is obtained by using the following equation (Public Work Department): n = [image] Where : n = The number of samples N = The number of population (3 Sub district 29337) d = The level of significancy for about 10% (it represents all population) Regarding to the equation, the number of samples used is 100 samples (see the following calculation): = 99,66 = 100 On the other side, the secondary data are gathered from literature review and previous research reports. Secondary data are the available statistical data compiled from those institutions. The result of this fieldwork is a database containing all information related with people perception on flooding, physical aspects (structural types of buildings and building contents) and socio-economic aspects (age, gender, occupation, income, educational level, length of stay and housing status) and people’s coping mechanism due to flood. Data Analysis Method The method of analysis is a descriptive analysis that explores and investigates the data. Questionnaires were double checked for differences and corrected, and individual and housing records linked using SPSS software. The main variables collected from the households interviews such as : height of water level during flood, and the duration, flood history, coping mechanism, and the socio –economic were analysed. From the analysis, it is expected to find a new integrated flood management that is possible to apply in overcoming flood hazard in Sampang Regency. The output from this analysis process will be utilized as a guide to develop a new flood management system. Research Question Variables Indicators Data Source Interview Question Numbers What are the characteristics of the flood event? Characteristic of flood History of Flood Cause the Flood Flood Depth Flood Duration Interview (using questionnaires) with households, and observation The Impact of Flood Physical Damage Infrastructure House/Building Appliance Furniture Outside properties Economic Income Occupation Disruption in business Social Injuries sustain Illness suffered Loss of life Interview (using questionnaires) with households, and observation What are the adaptive strategies of household to cope the flood? Economic Reconstruction of house with the reinforced material Preparing place for storage at the higher place Storing basic food items such as : rice and sugar Building dikes in front of house using sand bags Repairing minor damage of the appliance Repairing important damage to the house Fixing things Continue working Purchasing cheap food Repairing minor damage of the appliance Repairing important damage to the house Saving money Interview (using questionnaires) with households. Technological/structural Construction of house with the reinforced material Closing the door and windows properly to avoid water Do nothing Securing house entrance to avoid debris Cleaning the house by draining Repairing minor damage of the appliance Repairing important damage to the house Fixing things Cleaning the canal surroundings the house Interview (using questionnaires) with households. Social Cleaning the house and surroundings Continue patrolling the neighborhood Helping other’s community member in doing work Guarding the house to ensure safety belongings Searching relief materials Evacuating the family, especially children and elderly to the safer place, Preparing temporary place at friend’s or relative’s place Preparing place for storage at the higher place Cleaning the canal surroundings the house Interview (using questionnaires) with households. What are the factors that influence the selecting adaptive strategies? Physical Infrastructure Geographic Location Interview (using questionnaires) with households. Economics Status of Property Income Occupation Interview (using questionnaires) with households. Social Household’s size Household’s structure Interview (using questionnaires) with households. What have done by local government to cope the flood in term of reducing the impact of the flood event? Structural Build dykes, Build dam, Build reservoir, Improve infiltration of rainfall into the ground. Interview with local institutions which have duties related to disaster coping mechanism Non structural An early warning system Regulation Interview with local institutions which have duties related to disaster coping mechanism The sample was chosen from households affected by coastal erosion/flooding and the ones who knew the details of adaptation strategies. A sample of 40 households was selected randomly.

Mother Theresa :: essays research papers

Mother Theresa: Saint of the Gutters (1910-1997) A modern day savior was born to the world in 1910 in Skopje Yugoslavia. Born under the name Agnes Gongxha Bojaxhiu, she later took the name Teresa after St. Teresa, patroness of missionaries. Joining the Sisters of Loretoat the tender age of 18, she came across many events that would touch her life in the most special way; inspiring her to do many great deeds for human kinds. In 1948, Mother Teresa came across a half-dying woman lying in front of the Calcutta hospital. Through the compassion of her dear heart, Mother Teresa stayed with her until she passed into the after-life. Through this one kind act, Mother Teresa devoted her life to helping the poorest in India. She gained the name, â€Å" Saint of Gutters† from her many kind works. Mother Teresa founded the order of nuns known as the â€Å" Missionaries of Charity in Calcutta.† The group of 12 became a group of 3,000 in 50 years. That is three thousand women in India which have donated their lives to helping the poor in India around the world. Mother Teresa would not stop there. She founded the Nirmal Hriday, a home for the Dying, in a former temple located in Calcutta. This was a foundation that took the dying Indians off the street and brought them in to a nice, peaceful environment. Although Mother Teresa was not able to cure the people through some divine power, she did offer the dying Indians a peaceful place of comfort for them to release themselves into the after life in dignity. She saw the love of Jesus within every man, woman and child she brought in. No matter what ailed them, Mother Teresa still found the compassion in heart to bring them in. For 50 years she continued to help the poor, conquering many emotional times with the aid of her faith in God. The respect she received from the world won her a Nobel Peace Prize in 1979. Over the past two decades, Mother Teresa had begun to see end of her long hard journey.

Kaiser Permanente Risk Management Executive Summary Essay

Organization Description Kaiser Permanente (KP) is the nation’s largest integrated health care delivery system. KP serves nine states and over nine million members, with an annual operating revenue in 2013 of 53.1 billion. KP is a leader in quality improvement efforts in the health care industry through participation in studies performed by the National Committee on Quality Assurance (NCQA), The Joint Commission (TJC) accreditations, and the implementation of a state of the art electronic health records system, which focuses on integration and quality of care standardization. The focus of this summary is on KP hospitals in the northern California region and will include topics such as the purpose of risk and quality management, risk identification and management, current risks, quality outcomes, organizational goals, and the relationship between risk and quality management. Risk and Quality Management Purpose General The purpose of risk management in health care is simply the process of protecting the assets and minimizing financial losses to the organization (Singh & Habeeb Ghatala, 2012). A comprehensive risk management strategy within a health care organization will include focus on continuous quality improvement (CQI). The purpose of CQI in health care, according to Sollecito and Johnson (2013), is to offer a â€Å"structured organizational process for involving personnel in planning and executing a continuous flow of improvements to provide quality health care that meets or exceeds expectations† (p. 4). Through linking the processes of risk management and quality improvement the success of both processes is more likely to be realized. Kaiser Permanente The key concepts for risk and quality management at KP are commitment to quality, patient safety, privacy protection, and fraud prevention. KP risk management and quality management programs are central to their mission, values, and culture. Methods currently utilized to support these concepts  within KP are consumer surveys, the use of an integrated EHR with evidence based guidelines and clinical decision-making functionality, stringent patient privacy regulations and processes, continuous clinical and administrative staff training programs, and participation in studies focused on standardizing national quality measures (Kaiser Permanente, 2012). Risk Identification and Management Steps While KP is a leader in health care risk and quality management there are specific steps this consultant is recommending on a continual basis that will improve risk identification and management within the organization. 1. Identify and analyze loss and exposure While there are many methods utilized within the health care industry in the identification and analysis of loss and exposure, the recommended methods for KP are as follows: a) Incident-reporting analysis b) Improvement on the current performance management process for employees to bring focus on risk mitigation and quality improvement. c) Quantitative analysis of patient complaints and satisfaction surveys. d) Review of the organizations past professional liability and workers compensation reports. e) Review of surveys completed by TJC and NCQA on other hospitals in order to identify risk areas that KP should focus on. (McCaffrey & Hagg-Rickert, 2009) 2. Research and propose alternative risk techniques To mitigate risks that are unavoidable at KP, a combination of alternative risk techniques will help reduce situations that might negatively affect the organization. A financial analysis and risk analysis should be performed in order to ascertain the likelihood of utilizing the exposure avoidance technique. This is not a likely option as the financial impact of eliminating services may out weigh the risks involved with continuing them. A loss reduction approach is more likely to be the technique chosen for this organization. The core prevention activities that must be present in the loss reduction technique are as follows: a.) Ongoing staff education b.) Current policy and procedure review and revision c.) Updates to the organizations current EHR system to ensure the data present in the clinical decision-making and evidence-based clinical guidelines technology is the most current data available. According to Chen, et al (2009), â€Å"a growing body of literature confirms the value of electronic health records (EHRs) in improving patient safety, improving coordination of care, enhancing documentation, and facilitating clinical decision making and adherence to evidence-based clinical guidelines† (p. 323). 3. Risk management technique selection This two-part process of risk management technique selection is accomplished through forecasting and application of an ongoing measurement process, which will allow KP to analyze the risk management technique with regard to outcome and cost effectiveness. Included in the measurement process both risk treatment and risk-financing techniques should be measured (McCaffrey & Hagg-Rickert 2009). 4. Implement the selected techniques Implementation of the chosen risk management techniques may include decisions on insurance coverage and policy changes, overall department workflow changes to ensure compliance with state and federally mandated regulations and guidelines, and elimination of processes that impede or hinder patient safety. 5. Monitor and improve upon the implemented risk management program In order to continue improving upon the newly implemented risk management program a comprehensive monitoring strategy should be employed. In fact, McCaffrey and Hagg-Rickert, (2009) stated, â€Å"a multidisciplinary approach to evaluating the risk management program ensures that the impact of additional opportunities to improve the risk management function are fully explored† (p. 21). a.) Prepare an annual risk management report b.) Compare the new annual report against prior years risk management data (McCaffrey & Hagg-Rickert 2009) Current Risks Three risks that KP should take special care to avoid are rejection of newly implemented risk management and CQI procedures by employees, statute and regulatory changes, and health care associated infections (HAIs). 1. Rejection Change implementation is never an easy task and without special care taken the rate of rejection to change by clinical and administrative employees is high. In order to achieve successful CQI changes the following guidelines and recommendations are presented. a.) Minimize employee rejection through easily implemented and followed CQI procedures. b.) Engage employees in planning to increase acceptance. c.) Ensure lateral linkages within the organization across specialty departments to improve communication (Sollecito and Johnson, 2013). 2. Statute and regulatory changes With the ever-changing landscape in state and federal statutes and regulations surrounding the health care industry, special attention to this risk area must be taken. In fact, Cohen (2009) stated that â€Å"health care is one of the most heavily regulated of all sectors of commerce† (p. 328). Failure to comply with state and federal statutes and regulations can bring about negative financial affects at KP, including but not limited to; fines, loss of accreditation and credentialing, and an increase in malpractice lawsuits, not to mention a decrease in quality of care. a.) Risk management and quality improvement officers stay current and involved in statute and regulation changes. b.) Mandate educational goals for risk management and quality management officers with regard to state and federal regulations. c.) Implement a monthly employee newsletter within which the risk management officer and quality improvement officer outline regulation changes. Include processes that emplo yees should expect to see implemented to maintain compliance. Include a signature page with those editions that include changes to policy and ensure all employees sign and return to the human resources department. d.) Ongoing training for clinical and administrative employees with regards to statute and regulation. The risk management and quality improvement officers will be responsible to work with the organizations education department to implement new workshops as needed. e.) Include these responsibilities in the performance monitoring strategy for the risk management and quality improvement officers. 3. HAIs Health care associated infections are a serious risk in hospitals, as noted by Sydnor and Perl (2011), in their statement â€Å"HAIs are the most common complication seen in hospitalized patients† (para. 20). Improper prevention can lead to increased costs, lengthier hospital stays, and even patient death. Additionally, a Condition of Participation (CoP) (42 CFR 482.42) by CMS mandates hospital infection control programs to adhere to specific requirements. Recommendations are as follows. a.) Implement a house-keeping checklist to ensure proper sanitization of patient rooms. b.) Implement a sanitization checklist for clinical staff that will enforce hand washing before and after patient contact. c.) Develop a committee to review and revise the KP infection prevention and control program. Revisions should focus on compliance with TJC and the Center for Disease Control (CDC) regulations. Quality Outcomes Internal and external Three internal and external factors that influence quality outcomes are organization management of interpersonal relationships between physicians and patients, patient compliance, and continuity of care. Without proper management of interpersonal relationships between physicians and patients, the organization will face degradation in trust and openness. Patients should be involved in all treatment decisions, through proper education on their diagnosis and treatment options. This will bring about patient engagement in this decision making process. While KP cannot force their patients to comply with treatment guidelines, the external influence of patient compliance is crucial to quality outcomes. Programs focused on thorough training and education of patients and family members will improve the rate of compliance, thus improving the probability of positive quality outcomes for patients. Lack of patient compliance will hinder the treatment process and lower the level of quality outcomes standards at KP. Continuity of care is another internal influence that can affect quality outcomes. Regular follow up with patients will also increase patient compliance. Without improving continuity of care, the KP organization will see a reduction in positive quality outcomes and an increased in undesired outcomes (DeHarnais, 2013, chp 5). Goals Short-Term 1. Design new regulatory and statute training programs for all clinical and administrative employees. 2. Review and revise the KP infection prevention and control program 3. Revise the performance management system to include CQI measurements and risk management procedures as performance metrics. Long-Term 1. Increase adherence to state and federal regulations and statutes throughout the KP organization. 2. Reduce HAIs by 10% throughout KP hospitals in the northern California region. 3. Improve CQI measurement and risk management policy adherence throughout the northern California region by 20% among clinical employees. Risk and Quality Management Recommendations Risk management policies 1. Quarterly peer review The Health Care Quality Improvement Act (HCQIA) of 1986 â€Å"encourages hospitals, state licensing boards, and professional societies to identify and discipline physicians, dentists, and other health care providers who, after adequate, nondiscriminatory peer review, were found to have engaged in negligent or unprofessional conduct† (Cohen, 2013 p. 333). Through ongoing screening of new and current clinicians, KP will take responsibility for offering their patients that highest quality of care and reducing the risk of employing negligent clinical employees. 2. Zero tolerance adherence policy for all employees with regard to infection control procedures Part of the CMS CoP (42 CFR 482.42) regulation is the â€Å"designation of an infection control officer and development of relevant policies that address the identification and control of infections and communicable diseases. Without full compliance with all CoPs, KP could face the loss of their Medicare provider agreement. 3. Vulnerability analysis chart and emergency plan policy. According to Rawson and Hammond (2009) â€Å"by evaluating vulnerabilities and taking appropriate preventive action, loss can be minimized in an emergency†Ã‚  (p. 506). Health care facilities should include prevention measures in their emergency plans that include the risk of terrorist attacks. While terrorist attack risk cannot be completely mitigated, it is the responsibility of the health care facility to be prepared for such an emergency. Obtain additional information on including risk of terrorist attacks from the National Institute for Occupational Safety and Health (NIOSH). Quality management policies 1. Adherence to evidence-based clinical guidelines While it has been shown that â€Å"clinicians have customarily enjoyed a great deal of autonomy in their practices† (Argawal, 2010, para 3), it is imperative that clinicians follow evidence-based clinical guidelines. If exceptions should be made the details of, the patient diagnosis and variations should be presented for peer review prior to altering treatment plans. 2. Minimum score of 88% on customer satisfaction surveys Clinicians must maintain an average score of no less than 88% on customer satisfaction surveys quarterly. In today’s health care market, measurements of quality include consumer satisfaction. In fact, Bernard and Savitz (2009) state that in todays â€Å"competitive health care environment, consumers want and expect better health care services and hospital systems are concerned about maintaining their overall image† (p. 185). Relationship between risk and quality management In the past, risk management officers and quality improvement managers worked autonomously from one another, in fact they most often reported to different superiors. However, today healthcare organizations are realizing that in order to reach quality of care goals and maintain effective risk management programs these disciplines must work together closely. An example of how risk management efforts and quality improvement efforts complement one another is seen in the reduction of medical errors. The risk management plan must consider ways to reduce medical errors, while the quality improvement plan will offer solid steps toward minimizing medical errors (Sollecito and Johnson, 2013). Conclusion This summary focused on topics such as the purpose of risk and quality management, risk identification and management, current risks, quality outcomes, organizational goals, and the relationship between risk and quality management. While KP is the nation’s largest integrated health care delivery systems and leader in CQI standardization, there is always room for improvements. This consultant understands the importance of improvement at KP, thus humbly presents this summary and recommendations to the board of directors. References Agarwal, R. (2010, May). A Guideline for Quality Accreditation in Hospitals. Quality Digest, (), 1-4. Retrieved from http://www.qualitydigest.com/inside/twitter-ed/guideline-quality-accreditation-hospitals.html Chen, C., Garrido, T., Chock, D., Okawa, G., & Liang, L. (2009). The Kaiser Permanente electronic health record: Transforming and streamlining modalities of care. Health Affairs, 28(2), 323-33. Retrieved from http://search.proquest.com/docview/204522974?accountid=458 Cohen, M. (2009). Statutes, Standards, and Regulations (chp 10) in McCaffrey, J. J., & Hagg-Rickert, S. (2009) Risk Management Handbook (5th ed.). San Francisco, CA: Jossey-Bass. DesHarnais, S. I. (2013). The outcome model of quality (chp 5) in Sollecito, W. A. and Johnson, J. K. (2013). McLaughlin and Kaluzny’s Continuous Quality Improvement In Health Care (4th ed.). Jones and Bartlett Publishers. Emily R. M. Sydnor, Trish M. Perl (2011, January). Clin Microbiol, 24(1): 141–173. Retrieved from http: //www.ncbi.nlm.nih.gov/pmc/articles/PMC3021207/ Kaiser Permanente. (2014). Kaiser Permanente, Retrieved from http://share.kaiserpermanente.org/article/history-of-kaiser-permanente/ McCaffrey, J. J., & Hagg-Rickert, S. (2009, Chp 1) Developing of a Risk Management Program in Risk Management Handbook (5th ed.). San Francisco, CA: Jossey-Bass. Rawson, M. L. and Hammond, H. Y,. (2009) Emergency Management in McCaffrey, J. J., & Hagg-Rickert, S. (2009, Chp 7) Developing of a Risk Management Program in Risk Management Handbook (5th ed.). San Francisco, CA: Jossey-Bass. Singh, B., & Habeeb Ghatala, M. (2012, August). Risk Management in Hospitals. International Journal of Innovation, Management and Technology, 3(4). Sollecito, W. A. and Johnson, J. K. (2013). McLaughlin and Kaluzny’s Continuous Quality Improvement In Health Care (4th ed.). Jones and Bartlett Publishers.

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