Health care fraud and abuse within the Veterans Administration system Essay Example

Health care fraud and abuse within the Veterans Administration system Paper The VA was established in the year 1989. The main aim of its establishment was to provide federal benefits to the US military veterans and their respective families. The agency is perceived to be the second largest of the fifteen cabinet departments. It provides financial assistance, health care and burial benefit programs. It covers around sixty million people who are namely;  Ã‚   veterans, their respective family members and the veterans survivors. VA’s annual budget is higher than 90 billion dollars although it is seeking around $ 125 billion for next year (2011). Sixty billion dollars from its budget is stipulated for health benefits and the remaining is directed towards pensions and disabilities. Other benefits of VA include home loans, educational assistance, vocational rehabilitation for the disabled veterans and life insurance. The predecessor of VA was the veteran’s administration which had been established in 1930. VA is divided into, veteran’s health administration, national cemetery system and veteran’s benefits administration. It facilitates the management of the veterans hospitals or clinics and also disbursement and eligibility of the disability pensions (Answers.com. 2010). We will write a custom essay sample on Health care fraud and abuse within the Veterans Administration system specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Health care fraud and abuse within the Veterans Administration system specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Health care fraud and abuse within the Veterans Administration system specifically for you FOR ONLY $16.38 $13.9/page Hire Writer The VA has is plagued with many fraud cases which result from deception, poor system guidelines and many more other causes. This research proposal is going to discuss the top reasons as to why the VA is plagued with these fraud cases. Public recognition Lack of public recognition is perceived to be one of the top reasons as to why the VA is plagued with fraud. This is because no monitoring is done on the kind work of being done by men and women at the VA’s office. Vital work is basically done without much public recognition. This brings about schemes which are aimed at creating fraudulent claims for 100% disability that resulted in retroactive lump-sum payments to the deceased veterans. For example in the year 2001 a former supervisor at VA’s Atlanta regional office was sentenced for a 13- year imprisonment and also ordered to pay more than 11 million dollars as restitution for her taking part in a scheme to pay benefits in the name of deceased veterans. This calls for the undertaking in a number of corrective measures which must include technology-based and procedural controls than can quickly prevent and quickly identify similar frauds and stronger responsibility for the VA managers. Public recognition will require all the work of the veterans to be publicized and exposed in the notice boards and internal WebPages. Dysfunction of the system The second top reason as to why there is increased fraud in Veteran Affairs the dysfunction of the system which openly tends to invite fraud. Congress has also facilitated to the systems dysfunction because it has pressurized the VA into making it easier for the veterans especially when it comes to the settling of the disability claims. The VA has also currently proposed changes which will simplify the acts of deception from the veterans. Fraud emanating from deception is depicted by the higher number of veterans from Afghanistan and Iraq coupled with Post Traumatic Stress Disorder thus making for it easier for the veterans to fake the disease. Medicalnewstoday.com,(2010) describes this deception emanating from the disorder as â€Å"profitably working the levers of sympathy for the wounded and obligation to the troops, and exploiting the sheer difficulty of nailing a surefire diagnosis of a condition that is notoriously hard to define. Each of these cases represents potentially millions of dollars in tax-free benefits over the veterans lifetime benefits that may continue while the veteran works and even into retirement. This deception is facilitated by the lack of availability of the clinicians who perform these disability evaluations. This is because the clinicians assume that it is not their responsibility to assess the patient’s stories. The new rule (making it easy for the veterans to settle their disability claims) should be thoroughly researched on traumatic and PTSD. With reports indicating that the number of Vietnam War veterans who committed suicide to be more than those who died in the battle field, much of the funds should be directed towards the treatment of the veterans. Most of the military women and men in uniform are usually stigmatized when they try to seek help for the demons in their brains or minds that forces them to contemplate suicide as the way out. It will therefore be important for the health specialist to evaluate every veteran once he or she comes from the damage (Medicalnewstoday.com, 2010). Trained staff The other top reason for fraud in VA is lack of a well trained staff. A staff which has no basic concepts of what they are doing may result into poor outcome or negative output when it comes to production. Fraud comes in on the side of auditors who have no explicit knowledge of auditing. Fraud is facilitated by construction works due to the excessive prices paid in major construction. This overpayment for constructions work should be returned to the reserve fund. Audit fraud is also facilitated by some contract award actions, adminstration, contract awards and administration must be enhanced to en sure that no excess prices are paid for construction work. To improve construction contracting the VHA should ensure that contracts always result better or reasonable prices for the work which is already completed. Contracts which are in the interests of the state government are efficiently controlled to prevent waste, fraud, mismanagement and abuse. Contracting fraud was facilitated by the fact that the contractors aren’t enlightened enough to use the available resources to ensure that price determinations are adequately supported and reasonable and fair prices are achieved. Fraud is facilitated by the fact that the staff lacks the appropriate knowledge in the department’s information system. When the staff have the problem of obtaining accurate data from the information system the department basically overestimates the sum total of the reimbursements that it assumes that it will recover. For example in the year 2001 the department ended up retaining a consultant to help in billing of outstanding charges estimating that he could recover around d six million dollars, however the consultant ended up recovering a maximum of 450,000 million dollars. The VA aggravated its problems by collecting the reimbursements because it really missed training opportunities since the department and the homes have used money inefficiently in the past. Lack of training has resulted into an absence of the billing experts and also knowledge at the department insufficient training accompanied by poor management and lack of executive management sponsorship has immensely contributed to deficiencies and also errors in the department’s information system thus giving birth to a system that doesn’t work efficiently as it should. The department has tried to correct the cash flow problems but unsuccessfully. It always request loans from the general fund to enable it cover some of the timing differences cause by delays the department’s reception of federal funds or reimbursements. . Health care providers can minimize the fraud audits by training their staff well this is because it is always very easy for the poorly or untrained staff to make billing mistakes. Detailed records should also be very well kept by providers incase of any questions arising from the auditing process. Signature stamps should also be given very special considerations before they are given or used by others. Providers should safely keep the billing profiles cooperate with auditors and also take care with the collection efforts. Economic recession is also perceived to be another major reason as to why there is fraud in the veterans affairs. This is because it has caused many insurance frauds which are also evident t in veterans’ affairs. Recession is making everything so expensive that many people cannot afford. Due to this the veterans have found their salaries too little to accommodate their leisure and family needs and that is why some have been caught committing frauds through the insurance. To solve this VA should work hand in hand with the insurance fraud unit which provides focused and specialized efforts towards combating of specific crimes. Disaffection The other reason for fraud in the veteran affairs if veterans disaffection. This is because many veterans just like all the other employees see themselves threatened therefore turning into latent malefactors. This is because fraud has become an equal employer for all. Most of the veterans engage in this behavior because the can rationalize their acts to self or themselves. To discard this veteran’s disaffection which is causing fraud the VA must have special people who can maintain the organizations tradition of excellence. For this special people to be available the VA has to compete with other employer in order to attract them. VA is aware of the fact that its kind of employees become valuable over time and to keep the around then they should be offered a truly benefits package and superior compensation. The VA has been working hard to control employee disaffection for it offers a competitive salary and superior array of benefits for the veterans and their families (4.va.gov, 2009). Indifference to internal control The other reason of fraud in veteran affairs is indifference to internal control. This is because the department has poorly manage its cash and that of its three homes for it has failed to pursue some reimbursements to which it is entitled. Most of its funding for its department homes comes from the States General Fund and additional funds comes from the US department of veterans affairs from the fees paid by the residents belonging to the homes and reimbursement which is paid by Medicare. The department estimates that it loses more that 15 million dollars in state and federal funds due to some of the homes had become ineligible for reimbursements. The VA doesn’t take advantage of all the cash sources available. It also has inadequate implementation and use of its billing management information system thus causing additional loss of money. This is because billing errors and also inadequate documentation of costs the department some of the additional reimbursements for those services that the home supplies to its veterans. The VA department has also compounded it difficulties in cash flow by failing to promptly submit its claims for various reimbursements. Internal control basically controls to the fraud because it doesn’t address the lack of resources that effectively manage the fiscal operation of the veteran’s home. This makes the veterans department to poorly prepare inaccurate management reports. The other weakness of the department is that it doesn’t utilize many of the tools and also reports available in its information system. For example in the year 20012 it is estimated that homes didn’t use around 35 of   the system   modules purchased by the department including a   cost accounting module that would   have given the department   a valuable tracking and budgeting tool. Fraud is also facilitated by the fact that the veteran’s affairs department doesn’t extremely conduct limited reviews on its internal controls. For instance it is true that the VA doesn’t frequently keep current its policies and procedures manuals. It also doesn’t frequently produce some precise accurate operational reports which it could use as one of its management tools. To solve the problem of indifference in internal control the department should ensure that it has the ability to bill for the services which are provided by its three homes. This can be facilitated through the continuous seeking of recertification of its homes so that they can bill for Med-Cal and Medicare reimbursements it can also follow up some of the claims submitted to the secondary insurance providers to ascertain that it has received the reimbursements and submit or issue claims to the secondary insurers that it had not billed in the past. To ensure that there is prompt billing of charges the department should continue to mainly focus of the clearance of its backlog claims and also ensure that the staff performs all the assigned tasks so that claims can be billed promptly. To ascertain whether the consultants who assist when billing are a cost effective solution to some of its problems related to cash flow, the department should make use of the results of its current contractor as the basis to make analysis on the benefits and costs of continuing to hire the consultants. The department should also assess whether payments from medi-cal and Medicare and additional assortment of federal reimbursements will adequately or efficiently cover the cost of the consultants. The department should also take some steps in ensuring that adequate resources and tools are for controlling the fiscal operations are established. One of the steps is the development of periodic management reports which include aging reports of accounts receivable and regular reconciliation of the report with the department’s accounting records to assist the department in evaluating its cash flow and that of all its three homes. The reports however should not cover reimbursement, unbilled claims and accounts receivable. The other step is to ensure that there is a regular review of the department’s internal controls with the aim of ensuring that the department fulfils its missions and also that it keeps proper control over liabilities, expenditure, assets and reimbursement. The third step is to ensure that there are adequate training opportunities for the department employees and  Ã‚   especially the reimbursement staff to inform them of the current developments in Medicare policies and regulations (Bsa.ca.gov, 2001).

Ulysses Simpson Grant essays

Ulysses Simpson Grant essays Ulysses Simpson Grant was born April 27, 1822 in Point Pleasant, Ohio to a very patriotic family who boasted American roots for generations. In 1839 Grants father enrolled him in the U.S. Military Academy, West Point. Grant was quoted later to saying, A military life had no charms for me, to get through the course, secure a detail for a few years as assistant professor of mathematics at the Academy and afterwards obtain a permanent position as professor at some respectable college... His record at West Point was not very good, regardless he graduated 21st in his class in 1843. After, he was commissioned to be the Second Lieutenant of the Fourth U.S. Infantry, he was sent to Jefferson Barracks, near St. Louis, Missouri. In St. Louis Grant met his future wife, Julia Dent. In September 20, 1845 Grant was promoted to Full Second Lieutenant in the Mexican War. He participated in the battles of, Palo Alto, Resaca de la Palma and Monterrey. After the Mexican War, Ulysses returned to Missouri to start a family. On August 22, 1848 he married Julia Dent. Together they had four children. In the Civil War, Grant served as the Major General in the Regular Army. He successfully aided in the defeat of the South. On April 9, 1865 General Robert E. Lee of the Confederate Army surrendered to Grant. Because of his overwhelming popularity at the time, Ulysses Grant was encouraged to run for the presidency. So, in 1868 Grant ran against Democrat, Horatio Seymour and won 214 out of the 294 Electoral votes. Grant was not a politician, and didnt have the full comprehension of the job of President. The people that he appointed for Cabinet and other posts were given to personal friends and wealthy men who helped him with is campaign. While in office Grant tried to enforce the 14th Amendment (all native born persons were citizens) and the 15th Amendment (gave voting rights regardless of race or c ...

Cause and effect for the popularity of fast food restaurants, And how Essay - 1

Cause and effect for the popularity of fast food restaurants, And how it is effecting us - Essay Example Direct links can be observed between the habitual use of fast food, the portion sizes, and the soaring increases of the proliferation of these types of restaurants. The hurried pace of life within the United States and the high profitability of fast food has caused the streets to be filled with these types of restaurants and has consequently contributed significantly to the increases that can be observed in the rates of obesity. The leading competitor in the fast food industry is McDonalds with 19% of all sales in the fast food industry going to this restaurant chain. The second corporation is Doctor’s Associates, Inc. which owns Subway at 10% of the revenue, with Yum Brands, which owns KFC, A&W, Long John Silvers, Pizza Hut, Taco Bell, and Yum Restaurants coming in third. The top seven competing fast food restaurants only hold 45% of the market, with McDonald’s holding 19% of that share making them the most powerful fast food restaurant in the United States (McDonald’s MCD). Therefore, looking at McDonalds has the best value in assessing the position of fast food for the American public The profitability of fast food restaurants in balance with the quick resource of food has created a large industry of fast food within the United States. With the ease of drive-through windows, the speed of food delivery, and the high levels of advertising engaging the viewers with the value of fast, high calorie fatty foods, the American public is up against a difficult temptation. In 2007, the McDonald’s corporation made 22.8 billion dollars, with Doctor’s Associates, Inc bringing in 11.3 billion dollars (McDonald’s MCD). McDonald’s stays on top by actively pursuing areas of marketing development, market penetration, product development, and diversification. In the 2007 annual report, McDonald’s discussed the advantages and marketing purposes of adding healthy choices to their menu, however despite these changes 75%

The Cold War and U.S. Diplomacy Essay Example | Topics and Well Written Essays - 1000 words - 3

The Cold War and U.S. Diplomacy - Essay Example Britain declared that it could no longer manage aid to those key nations. Both Turkey and Greece were potential targets for the Soviets to carry them in as Communistic satellites. The legislature appropriated $400 thousand to support the doctrine implementation. This was moreover to the $3 billion cash dollars financial loan which the US had made to Britain in 1946 (Gurman, 2012). The diplomatic doctrine followed by the president According to Roskin et al (2010), In April 1945Truman, the Vice President of USA was elevated after the fatalities of Franklin D. Roosevelt to the United States presidency. During Truman’s time frame as president he faced many problems, yet identified many doctrines as alternatives to these problems. His most essential contribution up to now is the Truman Doctrine, which targeted on containing the development of communism everywhere. It was targeted straight at the Soviets, led by Stalin who had been an ally of the USA during World War II. However, th e USA and the USSR were divided by a large ideological beach. So the only factor that organized the associates together was the need to eliminate Adolf Hitler and the Nazis (Kuniholm, 1980). Given their actual variations, when Adolf Hitler was eventually eliminated in 1945, a Cold War was perhaps inevitable. Truman certainly hated communism and faced that it was the responsibility of United States to prevent the development of those ideas. During the Cold War, Truman identified convenience and organized peace which held back Communist development and made cost-effective and government balance through the Truman Doctrine, the North Atlantic Treaty Organization and the Marshall Plan (Graebner, 2002). Effects of the diplomatic efforts of United States and other countries Gurman (2012) pointed out that in 1946, an American diplomat known as George Kennan sent to his superiors in California a long memorandum that was later known as "The Long Telegram." Developing his research upon his ow n outcomes of Communist problems, made from his publish in the US Embassy in Moscow, Kennan analyzed that the Communist Cooperation was normally curved on improving its position of impact all over the whole world. In considering how the Individuals should react, Kennan had written, "It is obvious that the main factor of any United States strategy towards the Communist Cooperation must be that of a long-term, firm and cautious containment of Russian extensive propensities† (Roskin et al, 2010). Kennan's concept of containment became the platform for the foreign policy of United States during the Cold War. Though the Truman Doctrine, considered in the narrowest feeling, only used to the economic downturn then unfolding in Turkey and Greece, in practice it dedicated the United States to a foreign method of containment by attractive resources of United States towards preventing the spread of Communism anywhere on the whole world (Kuniholm, 1980). In support of Truman's method of c ontainment, George C. Marshall the Secretary of State put the Marshall Plan forth. Marshall fearful of Europe, which had faced so much devastation in

Chinas Transition to a Market-oriented Economy Essay

Chinas Transition to a Market-oriented Economy - Essay Example This paper is one of the best examples of objective analysis of the macroeconomic situation in China through the recent years of macroeconomic transformation. Being the most populous country in the world, China set out to transform its economy from a centrally planned one to a market oriented one in 1978. This transformation came after the regime of Mao and is seen to take place in two stages: between 1979-1993 came the first stage and the second stage began in 1994 to presently. The two stages are primarily differentiated by the 1989 Student Movement. Multinational Corporations developed interest in China and, since it presented unique marketing issues and challenges. These MNCs anticipate the growth and expansion of these economies and have thus endeavored to expand their operations to them. The greatest challenge facing China’s transition is structural impediment existent within the economy particularly with state-owned enterprises and state-owned banks; where both have interrelated problems that the state continues to intervene in their investment decisions and capital allocation. The state sector has set up several state-owned enterprises with supposed policy loans from the state-owned banks to prevent bankruptcy. The Chinese government has directed large amounts of funds into infrastructure and other projects leaving the budget at deficit levels; all this in a bid to fuel economic growth. The transition has been riddled with corruption primarily in the central and regional governments as well as in the commercial sector. This has made it difficult to undertake relevant projects beneficial to the public and not specific individuals. Beijing officials have attempted to end this by running public anti-corruption campaigns and holding trials of senior party officials in public. Nonetheless, it has continued to exist and this has made the public averse to social reforms. This has created the problem of rising inequality and in turn an overpowering middle class; which results in a shrinking workforce

Family and Juvenile Delinquency

Family and Juvenile Delinquency The family is the foundation of humanity. Children who are rejected by their parents, who grow up in homes with considerable conflict, or who are inadequately supervised are at the greatest risk of becoming delinquent. Adolescence is a time of expanding vulnerabilities and opportunities that go along with it, widens social and geographic exposure to life beyond school or family. Family is one of the most influential institutions in socializing a child. Being raised in a single parent home can lead to delinquency, regardless if it was because of divorce/separation, death, or incarceration. The outcome of the childs life is considerably different compared to a child who has a stable life with both parents. With only one parent, a child may receive only half the guidance given by two parents. This usually results in the child making wrong decisions like getting involved with other risk factors such as school problems or dropping out. The way we are socialized by our surroundings has a dramatic impact on whether we become delinquents. The composition of families is one aspect of family life that is consistently associated with delinquency. Children who live in homes with only one parent or in which marital relationships have been disrupted by divorce or separation are more likely to display a range of behavioral problems including delinquency, than children who are from two parent families (Thornberry, et al. 1999). Children who witness marital discord are at greater risk of becoming delinquents. Previous research has demonstrated associations between exposure to parental divorce and marital conflict while growing up and childrens psychological distress in adulthood (Amato Sobolewski 2001). Social learning theory argues that aggressive behavior is learned; as parents display aggressive behavior, children learn to imitate it as an acceptable means of achieving goals (Wright Wright 1994). When parents are divorced and there is just one parent to take care of the child, the child is quick to feel just half there. If it is the mother who has the child, she may have to work to support him, and she would not be able to be home when he comes home from school. If he comes home and finds the home empty, he would not stay there, but he will go out with his peers. The gang will then get bored and look around for something to do. This will lead to stealing possibly, and these activities can go on until they end in murder or drug addiction. Parents teach children to control unacceptable behavior, to delay indulgence, and to respect the rights of others. On the contrary, families can teach children aggressive, antisocial, and violent behavior (Wright Wright 1994). This statement alone could easily explain how the juvenile may end up becoming a delinquent. Wright and Wright (1994) suggest positive parenting practices during the early years and later in adolescence appear to act as buffers preventing delinquent behavior and assisting adolescents involved in such behavior to desist from delinquency. Gorman-Smith and Tolan (1998) found that parental conflict and parental aggressiveness predicted violent offending; whereas, lack of maternal affection and paternal criminality predicted involvement in property crimes. Familial characteristics suggesting familial antisocial behavior or values such as family history of criminal behavior, harsh parental discipline, and family conflict have been among the most consistently linked. In another study conducted by Gorman-Smith and her colleagues, data show that children are more likely to resort to violence if there is violence within relationships that they may share with their family (Gorman-Smith, et al. 2001). In the realm of family functioning there is a theory known as the coercion theory, which suggests that family environment influences an adolescents interpersonal style, which in turn influences peer group selection (Cashwell Vacc 1996). Peers with a more coercive interpersonal style tend to become involved with each other, and this relationship is assumed to increase the likelihood of being involved in delinquent behavior. Thus understanding the nature of relationships within the family, to include family adaptability, cohesion, and satisfaction, provides more information for understanding youth (Cashwell Vacc 1996). The cohesiveness of the family successfully predicted the frequency of delinquent acts for non-traditional families (Matherne Thomas 2001). Family behaviors, particularly parental monitoring and disciplining, seems to influence association with deviant peers throughout the adolescent period (Cashwell Vacc 1994). Among social circumstances which have a hand in determi ning the future of the individual it is enough for our present purpose to recognize that family is central (Wright Wright 1994). Juby and Farrington(2001) claim that there are three major classes that explain the relationship between disrupted families and delinquency; trauma theories, life course theories, and selection theories. The trauma theories suggest that the loss of a parent has a damaging effect on children, most commonly because of the effect on attachment to the parent. Life course theories focus on separation as a long drawn out process rather than a discrete event, and on the effects of multiple stressors typically associated with separation. Selections theories argue that disrupted families are associated with delinquency because of pre-existing differences in family income or child rearing methods, for example (Juby Farrington 2001). Communication also plays a big role in how the family functions. Clark and Shields (1997) state that the importance of positive communication for optimal family functioning has major implications for delinquent behavior. They also discovered that communication is indeed related to the commission of delinquent behavior and differences are shown within categories of age, sex, and family marital status. Klein and Forehand (1997) suggest that the prediction of juvenile delinquency in early childhood depends on the type of maternal parenting skills that are imposed upon the child during early adolescence. Muehlenberg (2002) poses the question of how do children from single parent family homes fare educationally compared to children from intact two parent families. In most cases, delinquents have been viewed as individuals who come from less intact families, often referred to as broken homes. Typically, the term broken home has been structured to mean children residing in single-parent households or any type of household other than a household in which both biological parents are present (Rankin, 1983; Geismar Wood, 1986). In contrast, an intact family usually refers to a nuclear family arrangement in which both biological parents reside in the household with their biological children (Kierkus Baer, 2002). Intact family arrangements differ from other modern-day family arrangements including single-parent arrangements, two-parent arrangements involving a stepparent, extended family member arrangements, and the adoptive/foster family arrangement (Wells Rankin, 1986). Since 1970, the proportion of American households that have children who live with both parents has declined substantially. In 1970, 64 percent of African American children lived with two parents, compared with 35 percent in 1997; comparable figures for white children are 90 percent and 74 percent, respectively (Lugaila, 1998). According to some estimates, as many as 40 percent of white children and 75 percent of African American children will experience arental separation or divorce before they reach age 16 (Brayand Hetherington, 1993) and many of these children will experience multiple family disruptions over time (Furstenberg and Cherlin, 1991). Sometimes the focus is taken off the mother and shifted towards the father. The lack of emphasis on the role of fathering in childhood conduct problems is especially unfortunate given that there are several reasons why fathers can be expected to be particularly significant in the initiation and persistence of offspring offending. For example, fathers are particularly likely to be involved with sons who are at higher risk than daughters of delinquent behavior (Flouri Buchannan 2002). Popenoe(1997) states that fatherlessness is a major force behind many disturbing US social problems. The institution of marriage acts as cultures chief vehicle to bind men to their children. The absence of fathers from childrens lives is one of the most important causes related to childrens well being such as increasing rates of juvenile crime, depression and eating disorders, teen suicide, and substance abuse. Two parent households provide increased supervision and surveillance of property, while single parenthood increases likelihood of delinquency and victimization simply by the fact that there is one less person to supervise adolescent behavior (Wright Wright 1994). Children, regardless of whether they are a product of a single parent or dual parent household, are more likely to become juvenile delinquents if there is a minimum amount of quality time spent with the guardians. Guardians actually need to be parents rather than just provide for the child. Parents provide structure which entails rules, encouragement, and any type of consistent adult behavior that a juvenile can use as guidelines throughout his or her own adolescent years. Although a majority of delinquents are from single parent households, delinquency is fostered by a lack of parental/juvenile interaction. Monitoring the child is also a major contribution towards the creation of delinquency. By spending time with a juvenile as a family through family activities, it not only provides that necessary supervision for being aware of the whereabouts of the child, how the child is functioning emotionally, and how he or she is doing as an adolescent, it creates positive interaction with th e parents that is needed for a healthy upbringing. Reference Page Amato, Paul and Juliana M. Sobolewski. 2001. The effects of divorce on adult childrens psychological well-being. American Sociological Review. 66: 900-921. Cashwell, Craig S. and Niccholas A. Vacc. 1996. Family Functioning and Risk Behaviors: Influences on adolescent delinquency. School Counselor. 44: 105-15. Geismar, L.L., Wood, K.M. (1986). Family and delinquency: Resocializing the young offender. New York: Human Sciences Press. Gorman-Smith, Deborah and Patrick H. Tolan. 1998. Relation of family problems to patterns of Delinquent involvement among urban youth. Journal of Abnormal Child Psychology. 26: 319-34. Gorman-Smith, Deborah, Patrick Tolan, Ashli J. Sheidow, and David B. Henry. Partner Violence and Street Violence among Urban Adolescents: Do the Same Family Factors Relate? Journal of Research on Adolescence.11: 273-95. Hagan, John and Holly Foster. 2001. Youth violence and the end of adolescence. American Sociological Review. 66: 874-899. Immarigeon, Russ. 1996. Families know best. State Government News. 39: 22-4. Juby, Heather and David P. Farrington. 2001. Disentangling the Link between Disrupted Families and Delinquency. British Journal of Criminology. 41: 22-40. Kierkus, C., Baer, D. (2002). A social control explanation of the relationship between family structure and delinquent behavior. Canadian Journal of Criminology, 44 (4), 425-458. Klein, Karla and Rex Forehand. 1997. Delinquency during the transition to early adulthood: Family and parenting predictors from earlyà ¢Ã¢â€š ¬Ã‚ ¦ Adolescence. 32: 61-81. Muehlenberg, Bill. 2002. The case for two-parent family Part II. National Observer. 53: 49-58. Popenoe, David. 1997. Life without Father. New Jersey, US: Annual Conference of the NCFR Fatherhood and Motherhood in a Diverse and Changing World. Prochnow, Jane E. and James V. DeFronzo. 1997. The impact of economic and parental characteristics on juvenile misconduct. Journal of Emotional Behavioral Disorders. 5:119-128. Rankin, J. H. (1983). The family context of delinquency. Social Problems, 30, 466-479. Thornberry, Terence P., Carolyn Smith, Craig Rivera, David Huizinga, and Magda Stouthamer-Loeber. September 1999. Family Disruption and Delinquency. Juvenile Justice Bulletin. 1-7. Wells, L.E., Rankin, J.H., (1986). The broken homes model of delinquency: Analytic issues. Journal of Research in Crime and Delinquency, 23, 68-93. Wright, Kevin N. and Karen E. Wright. 1994. Family Life, Delinquency, and Crime: A Policymakers Guide. Research Summary. Washington DC: OJJDP. 4-21.

Metro Ethernet :: essays research papers

Metro Ethernet Disclaimer; this is intended to be an introductory technical article; certain details have been excluded in the interests of space and clarity. Network design examples are presented to illustrate specific technical points and are not intended to fully complete. Historically WAN’s (Wide Area Networks) and LAN’s (Local Area Networks) have relied on independent technologies. At a physical layer WAN technologies today continue to be based largely on legacy TDM systems that were built initially to support voice, video and early data communications in a reliable fashion. WAN connectivity over distance often requires the use of regenerators and meet points between multiple Telco suppliers that may span the globe. Without strict adherence to standards, these connections would not function. WAN technologies depend on highly complex and expensive equipment, which can guarantee inter-operability and â€Å"five 9’s† reliability required to support the millions of paying customers utilizing the network. Meanwhile, the advent of early PC’s and the recognition of the value in networking devices together gave rise to Local Area Networks. These LAN’s were developed from a business customer perspective, which placed more emphasis on costs and ease of use over reliability. There were a number of different competing LAN technologies, two of the most common being Token Ring (IBM) and Ethernet (everyone else). The triumph of Ethernet in the marketplace, to the extent where it is included in every PC, game console and some refrigerators, provides a consistent and relatively inexpensive way to build internal networks with relative ease. As the internal PC networks continued to grow and thrive a need to connect disparate facilities together resulted in development of bridges, gateways and ultimately routers for the sole purpose of connecting LANs to other LAN’s located anywhere from several miles to several thousand miles apart. These devices allow disparate interface types to be connected by performing the necessary modifications to the signal and protocols to allow WAN and LAN equipment to understand one another. Because LAN Ethernet and WAN TDM networks were so vastly different in their technical make-up these intermediary devices were needed to allow inter-communication to occur. While the benefits of enterprise connectivity are great, they come at the cost of special hardware, software and application complexity as the speed of the network can change by a factor of 100 between a client and the server (100 Meg bit per second Ethernet to 1.5 Meg bit per second WAN).

Middlefield Hospital

As the Chief Executive Office of Middlefield Hospital, it has been brought to my attention by the Chief Financial Officer that our financial performance has been deteriorating for the past six (6) months. It has also been brought to my attention that the new facility has been admitting more new patients and our admissions have been declining. The number of uninsured patients has increased over this period of time. The management team has identified some other interesting facts that are possibly hurting the reputation of Middlefield Hospital. My determination is that the financial performance of Middlefield Hospital needs to be improved.Research has shown that hospitals are operating on tight budget all over the world, and they need to find way to reduce their costs and also try to manage productivity in all areas and job categories. I have developed some strategies and recommendations for Middlefield Hospital that will help us to improve the financial performance of the hospital. I w ill individually address each of the facts discovered by the management team and discuss the proposed recommendations for each. The payer mix of Middlefield Hospital is comprised of more and more Medicare, Medicaid, and uninsured patients and fewer patients have commercial insurance.This has caused a decrease in the net income of the hospital. Therefore, I think we should considering more advertising to increase the new come. Advertising should and will attract more profitable patients. The nearby hospital that competes with Middlefield has opened a wellness center that offers a comprehensive array of preventive and wellness services to the community. Wellness centers can offer services that are very useful and convenient to the community. Some of these services are skin care and body services, which include fitness services, personal training and nutrition consulting, chiropractic, holistic medicine, and acupuncture.  (http://www. salonbuilder. com/info/wellness-centers. html)I a lso think we should open a wellness center that offers a full service fitness center to accommodate the community. We should look into the services that this other nearby hospital is providing in their wellness center, and we should extend our services to the ones they are not offering. Our wellness center should also include a retail store to allow the patients to purchases the products that we use on them. I know this will require a specially trained staff, and we will make sure that the staff is qualified with all certifications needed.Also, in lieu of the wellness center, we should offer a monthly health fair for new and existing patients. This monthly health fair will also draw new patients to the clients. Most of Middlefield’s managed care contracts are more than 2 years old. In hopes of getting a handle on the managed care contracts, I would like to assign a team of personnel to specifically handle and maintain the various managed care contracts. I would like for this team to make sure that we are getting the best out of these contracts. The team will know what our goals are before deciding on a managed care contract.Some of the goals that would be considered are: Increasing or protecting revenue Aligning with other practices that already contract with the specific Managed Care Organization (MCO) Fostering a relationship with certain MCOs Increasing/protecting our patient panel The Joint Commission survey is scheduled for next year, and there are significant problems with the hospital’s quality improvement program. To improve the quality program, each department will be assigned a staff member to follow-up with patients after their hospital stays or visits via email or telephone.We will also send out surveys to all patients for feedback on their visits. Surveys will also be available to visitors for feedback on their visiting experience at the facility and their interaction with the personnel of the facility. Follow up will be very importa nt for providing good quality care. The health plan offered to employees is getting more expensive each year. The benefits director has been asked to look for more cost effective health care plans that are more affordable to our employees. I am working on some financial incentives that I can offer to the employees to help curtail the cost of the health plans.The benefits director will also work with the health care plan providers to ensure that we are choosing the best health plans for our employees. With the strategies and recommendations I have suggested, it is hopeful that Middlefield Hospital will overcome its poor financial performance. I am looking for Middlefield Hospital to supersede its competition and excel with its reputation and performance to the communities and areas that it serves. We strive to provide outstanding health care services to all who utilize our facilities.

Free Essays on Interpetation Of Blakes Poems

The Human Abstract Blake’s poem, The human abstract, is a touching poem which attributes selfishness, cruelty, and other flaws on human nature. Blake goes on show how change can come about through finding of god. Once god is found, and holy fear sets in, the actions of deceit change and humility takes root. The poem starts with a series of short lessons. â€Å"Pity would be no more, if we did not make somebody poor; he continues â€Å"And mercy no more could be, if all were as happy as we.† Blake’s poem suggests human nature is responsible. By stealing, we are responsible for making people poor and by deceit we cheat people out of happiness. Blake’s poem follows up with more human flaws, â€Å"Then cruelty knits a snare, and spreads his baits with care.† This means to say if one holds a grudge, the negative feeling will eventually lead to expression through action. This yet again demonstrates the human nature. Blake, after exposing human sinful nature now comes to shows us the path of change through the fear of god. Blake now illustrates a person hitting bottom and discovers holy fears. â€Å"He sits down with holy fears, and waters the ground with tears; then humility takes its root underneath his foot.† Once he discover god he repents and humility takes root. This is to say one realizes his behavior and changes is unholy actions. He then goes on to say how one is mystified by God. â€Å"Soon spreads the dismal shade of mystery over his head; and the caterpillar and fly feed on the mystery.† This passage illustrates clearly the mystery of god by how a caterpillar transforms to a butterfly. There’s a simple lesson Blake is trying to teach us through this his poem. That is that people are really good. It’s just Human nature that sometimes leads us astray to fulfill our own selfish needs. Once we realize there’s a god and that he watches our every action, only then will the holy fear set in and bring about a... Free Essays on Interpetation Of Blakes Poems Free Essays on Interpetation Of Blakes Poems The Human Abstract Blake’s poem, The human abstract, is a touching poem which attributes selfishness, cruelty, and other flaws on human nature. Blake goes on show how change can come about through finding of god. Once god is found, and holy fear sets in, the actions of deceit change and humility takes root. The poem starts with a series of short lessons. â€Å"Pity would be no more, if we did not make somebody poor; he continues â€Å"And mercy no more could be, if all were as happy as we.† Blake’s poem suggests human nature is responsible. By stealing, we are responsible for making people poor and by deceit we cheat people out of happiness. Blake’s poem follows up with more human flaws, â€Å"Then cruelty knits a snare, and spreads his baits with care.† This means to say if one holds a grudge, the negative feeling will eventually lead to expression through action. This yet again demonstrates the human nature. Blake, after exposing human sinful nature now comes to shows us the path of change through the fear of god. Blake now illustrates a person hitting bottom and discovers holy fears. â€Å"He sits down with holy fears, and waters the ground with tears; then humility takes its root underneath his foot.† Once he discover god he repents and humility takes root. This is to say one realizes his behavior and changes is unholy actions. He then goes on to say how one is mystified by God. â€Å"Soon spreads the dismal shade of mystery over his head; and the caterpillar and fly feed on the mystery.† This passage illustrates clearly the mystery of god by how a caterpillar transforms to a butterfly. There’s a simple lesson Blake is trying to teach us through this his poem. That is that people are really good. It’s just Human nature that sometimes leads us astray to fulfill our own selfish needs. Once we realize there’s a god and that he watches our every action, only then will the holy fear set in and bring about a...

1301 US HIST The United States History Ch.23 Quiz Essays

1301 US HIST The United States History Ch.23 Quiz Essays 1301 US HIST The United States History Ch.23 Quiz Paper 1301 US HIST The United States History Ch.23 Quiz Paper Essay Topic: Literature What characterized the period Secretary of Commerce Herbert Hoover described as New Era in 1920? b.A freewheeling economy and a heightened sense of individualism Americas return to a peacetime economy in 1920-1921 was marked by? d. a 20% unemployment rate, highest to date In its efforts to create prosperity at home, the Harding administration supported? a. high tariffs to protect American businesses. President Hardings administration was characterized by c. scandals that involved many members of his administration President Calvin Coolidges economic policy included? b. reductions in government regulation of business What did the presidential election of 1924, in which Calvin Coolidge defeated John W. Davis and Robert La Follette, reveal about the priorities of American voters? a. The election results revealed voters lack of support for labor unions the regulation of business and the protection of civil liberties President Hardings most ambitious foreign policy initiative was? d. establishing a balance of naval power with Britain, France, Japan, and Italy. What was the purpose of the Dawes Plan, which was instituted in 1924? b. The plan cut Germanys annual reparations payments in half and initiated fresh American loans to Germany. Which industry formed the keystone of the American economy in the 1920s? D. The automobile industry The outcome of the shift toward repetitive assembly-line work and specialized management divisions in the 1920s was? d. a tremendous increase in business productivity and overall efficiency Who was responsible for the creation of welfare capitalism in the 1920s, and why did they use it? c. businesses created welfare capitalism to encourage workers; loyalty to the company. What did the authors of Middletown conclude from their study of life in a small Midwestern town in the 1920s? C) The United States had developed a culture in which everything hinged on money. Which relatively new industry in the 1920s linked the possession of material goods to the fulfillment of spiritual and emotional needs? D) Advertising Which element of the American economy during the 1920s lay at the heart of its fundamental lack of stability? c.Consumption Many Americans in the 1920s view Sigmund Freuds pioneering work in the psychology of the unconscious as ? A) a justification for impulsive behavior. In the United States, the flapper of the 1920s represented? d. a challenge to womens traditional gender roles Which of the following statements exemplifies President Hardings stance on prohibition in the 1920s? b.Liquor flowed freely in the White House during his administration Which of the following statements describes the Sheppard Towner Act of 1921, which gave federal assistance to states seeking to reduce high infant morality rates? a. It was womens only significant national legislative success in the 1920s One factor that diluted the influence of women in politics in the 1920s was? A) the lack of unity around the issues, which diminished women voters impact. During the 1920s, most American women who worked had? b. office and sales jobs The image of the new woman in American society in the 1920? C) was felt by all women, even those who believed in traditional gender roles. When black veterans of World War I returned home from their deployments, they found ? C. race riots and economic hardship. Marcus Garveys Universal Negro Improvement Association urged black Americans in the 1920s to? b. rediscover their African heritage and take pride in their own culture and achievements. Which of the following describes the outpouring of African American literature and art in New York City in the 1920s? d. The era in which African American literature and art flooded New York was known as the Harlem Renaissance. The rapid growth of radio in the United States between 1922 and 1929 was funded by? D. advertisers, who wanted to reach prospective customers in their own homes. What did popular culture and consumer goods have in common in the 1920s? d. Both were mass-produced and mass consumed. Which of the following statements describes professional baseball in the 1920s? d. (The game attracted players spectators from the working class) a game by and for the working class to help break out of the ordinariness of everyday life. Babe Ruth was prominent and said to have singlehandedly lightened the cares of the world. In the 1920s, Knute Rockne and Red Grange were associated with? c. college and professional football. In 1927, Charles Lindbergh became the first person to? b. fly nonstop across the Atlantic Ocean One result of the loosening of the traditional bonds of community, religion, and family in the United States in the 1920s was? c. the emergence of youth as a distinct social class with their own culture For which group of Americans did authors Ernest Hemmingway, F. Scott Fitzgerald, William Faulkner, and Sinclair Lewis speak? c. Critics of American anti-intellectualism and materialism During the 1920s, rural Americans perceive cities as? d. idyllic places where they might go to enjoy restaurants, theater, museums. The purpose of the immigration laws of the 1920s, including the Johnson-Reed Act, was to? b. place strict limits on immigration. What did the outcome of the Sacco and Vanzetti trial suggest about the United States in the 1920s? D. Antiforeign hysteria was rampant in many areas of American life. What accounted for the reemergence of the Ku Klux Klan in the United States in 1915? a. the widespread belief that blacks, immigrants, radicals, feminists, Catholics, and Jews threatened traditional American values. Which of the following describes the Ku Klux Klan of the mid-1920s? D) The KKK had a strong influence on politics in California, Illinois, Indiana, Kansas, Louisiana, Oklahoma, Oregon, and Texas. The central issue addressed by the highly publicized scopes trial of 1925 was ? b.the legality of the teaching of Darwins theory of evolution in Tennessee How did Americans respond to Alfred E. Smiths candidacy for president in 1928? C. As a symbol of all they feared- Catholicism, immigration, cities, and liberal attitudes Which words from President Herbert Hoovers 1929 inaugural address would turn out to be ironic in light of events during his presidency? a.Given a chance to go forward with the policies of the last eight years, we shall soon with the help of God be in sight of the day when poverty will be banished from this nation. When Herbert Hoover took office in 1929, he brought to the presidency ? a. modern ideas about how businesses should operate Which of the following characterized the U.S. economy when Herbert Hoover moved into the White House in 1929? a. There was a huge disparity in wealth between rich and poor.There was a huge disparity in wealth between rich and poor. Among the fist signs of economic distress in the United States in the mid-1920s was ? d. a slowdown in the new construction and in automobile sales. The fundamental cause of the Great Depression in the United States was? b. problems in the American and international economies. What did President Hoover do to offer a solution to the human problems of the depression in 1929? A) He instituted a voluntary recovery plan, protective tariffs, and some government intervention, including public works projects and small federal loans to states. The purpose of the President Hoovers Reconstruction Finance Corporation, created in 1932, was to? c. lend money to endangered American banks, insurance companies, and railroads. By the early 1930s, unemployed workers were responding to the Great Depression by ? C) becoming increasingly outraged and turning toward militant forms of protest. Which group was hardest hit by the Great Depression? d. The unemployed, tenant farmers, and sharecroppers How did the Great Depression affect the American family in the 1930s? C) It created resentment among men, who lost their jobs more often than women did. The Hoover administration responded to the World War I. veterans who asked for the immediate payment of their pension or bonus? a. by ordering the U.S. army to forcibly evict them from their camp on the edge of Washington, D.C. Which group sponsored a team of lawyers to defend the nine young black men in Scottsboro, Alabama, who were arrested on trumped -up rape charges in 1931? b.The Communist Party

Social Development Essay Example | Topics and Well Written Essays - 2000 words

Social Development - Essay Example Market forces usually depend on the political goodwill and social integration for its growth. From scholarly view, cultural change in the society owes its root from globalization. Fabrication of societal norms to meet human needs has led to growth in many areas of human life. It is significant to note that integration of modern of modern technology has transformed human life. Globalization has led to development of uniform policies in global markets. Development of uniform policies influences political and social life of the society. For examples, policies that define trade between two countries influence social conditions in those countries. When policies are uniform, people are able to exchange ideas, technology, and social policies, which would in turn influence social growth.   Trade and international policies are inseparable. Identification of common need in the society has led to transformation of the society from a low-income society to high-income society. The adoption of K eynesian theories of management in financial management has influenced the financial patterns adopted by many banks and financial institutions. According to Amoore (2005:58), Global financial system favored financial interest over government planning or productive manufacturing. Thus, it opened ways for accessing credit facilities. Acquisition of financial assistance influences the economic development of a state. The power to initiate social development lies on the ability of a state to acquire financial assistance when necessary.

PABLO PICASSO Essay Example | Topics and Well Written Essays - 1000 words

PABLO PICASSO - Essay Example Born in 1881, he lived for 91 years, and devoted himself to artistic production. Picasso is most renowned for co-founding the Cubism movement along with Brasque. The 1800’s were marked with astounding impressionist paintings, but enter twentieth century, and the artwork is completely different with more focus on adding great depth to objects by breaking them up and rejoining in an abstract form. The whole concept of Cubism is analyzing objects from every angle, giving a holistic view, and being able to penetrate every reality and then depicting the entire thought in a very artistic abstract way. â€Å"Ambiguous Spacing† (Mallory, 2011) is the main characteristic of Cubist paintings, where the background blends with the object. Picasso went through some different phases in his life, and experimented with different kinds of styles which is reflected in his artwork and they are divided into different stages. The first period was identified as the Blue period which lasted f rom 1901 to 1904, and was highlighted with subdued colors. Next was the Rose Period from 1904 to 1906 which has a cheery style with red, pink and orange colors seen in his paintings. Following this was Analytical Cubism from 1910 to 1912 where he used monochrome brown and more of neutral colors. Synthetic Cubism followed which was reflected in his paintings from 1912 to 1919, and was symbolized by fragmented paper cut style paintings. Classicism and surrealism was also later reflected in his paintings, however it wasn’t a period of his life. Pablo Picasso is known to have produced around 13500 paintings in his entire lifetime, and even more drawings. In 1903, when Picasso was only 21 years of age, he painted â€Å"The Old Guitarist† in Madrid, when his very close and dear friend, Casagemas committed suicide. Picasso’s outpour of emotions is reflected in his painting, so much so that this led to the beginning of the Blue Period which was highlighted by hopelessne ss and melancholy is his paintings which were usually in shades of blue and green. This particular painting of Picasso haunts the onlookers with its gloominess; the subject of the painting is a very old, weak man, who somehow resembles a beggar sitting on the street begging for pennies while glued to his guitar. The painting has a lot of emphasis on the contours of the body of the old man giving a very dramatic look. This painting speaks for the lower-class people and emphasizes on the hardships they have to face in real-life, and is a masterpiece created by Picasso. Another painting of Picasso which later became a masterpiece is Les Demoiselles d' Avignon ((The Young Ladies of Avignon, and originally titled The Brothel of Avignon) and is known to have launched Cubism in the twentieth century. Picasso painted it in 1907, however it wasn’t displayed till 1916. This painting has also been voted as the most influential painting in a hundred years by Newsweek. It is a very artful painting which was also controversial, however it depicts Cubism in essence that different people have different perspectives regarding the same artwork. The painting illustrates five nude women in angular and disorderly shapes, with not very feminine bodies, and two wearing primitive African masks. The concept behind this painting was to depict a brothel, where the women were shown without any expressions, charm or personality. The disjointed figures were to represent the aggression and hostility of the such women, who had Iberian features. This