Speech Audiometry Essay Example | Topics and Well Written Essays - 3000 words

Speech Audiometry - Essay Example Use of hearing aids of many types and formats can bring normalcy and comfort to patient short fallings relates to listening and recognition of words which may result in improvement of professional capabilities, understanding relationships with others, self-confidence and self-satisfaction. Many researches were conducted in past and still going on for effective detection of primary listening disabilities. Scientists study speech as auditory signal to test new equipment. Since the advent of speech audiometry, it has helped in differentiating hearing aids from one another and so has come to be known as the basic assessment of the ability of hearing. Due to the significance and accuracy of its results; it has also been considered as the foundation in the hearing aid evaluation of the majority of speech. Hence, speech audiometry became the centre of evaluation in audiology and the primary methods used now are the same that were used in the 1920's. The research for speech audiometry has not only been vastly useful but also is revolutionary in regard to the technological advances. Communication ability of a person is considered very important thus, continual research on the subject has been going on for the past 60 years and more. The credit not only goes to the scientists but even to the military investigators, industrial development and clinical audiology researchers. In rel History: In relation to the hearing aid fitting procedure, speech audiometry serves its purpose through assessing the effect of occlusion, analysis of intelligibility, evaluation of quality, and degree of loudness. Comparative hearing aid assessments also used speech audiometry as the main evaluation of performance. In the late 1940s, speech testing started being used for evaluating and differentiating hearing aids due to its advancement speech audiometry quickly became the preferred method to evaluate real-ear hearing aid performance. Speech testing assesses how amply speech is understood. Surveys conducted in the 1970s show that almost 85% of audiologists were using speech testing when fitting hearing aid. But after almost 30 years it was realized that these methods were not reliable enough to secure investment by selecting hearing aids in a large amount of clinical time. As the 1980s rolled on, use of speech audiometry in hearing aid fittings dropped to an exceptionally low level. All this was caused because it was seen that hearing aid dispensing is a much less time consuming process than speech testing and fitting approaches were the ones comprising of functional gain rather than speech audiometry. It also lacked the sensitivity to distinguish small differences on an individual basis in hearing aid performance. The benefits received were limited in regard to the time taken to get to them. Due to the technological advancement of that time, the industry started using in-the-ear hearing aid fittings as they effectively eradicated the comparative hearing aid evaluation approach altogether. Recent Research: Eventually in the 1990s, speech testing was on the whole, rarely used for hearing aid differentiation and aided speech testing was

Principles Of American Bible Society Research Paper

Principles Of American Bible Society - Research Paper Example The virtues are not values like honesty or loyalty that one recites in grade school. These virtues mentioned in Galatians are the hallmarks of maturity that one should seek when looking for a spiritual mentor. For one, the aforementioned virtues are not deliberately adopted by a person to become his personal virtue since it is the Spirit that implants these virtues within a person. Looking at the background of these verses, these virtues were listed to serves as concrete examples that contrasts the acts of the flesh such as â€Å"envyings, murders, drunkenness, revellings† (Gal.5:21). It is also significant to state that â€Å"the flesh lusteth against the Spirit† (v.17). which explains that since people are made of flesh, it is natural for humans to lust for vices like wine, gossip, money, or illicit sex. But, when a person has spiritually matured, he has struggled over this vices and starts exhibiting the virtues mentioned. What makes these virtues grow? Walking in faith with God makes these virtues thrive within ourselves. Therefore, when one is a matured Christian he or she manifests the virtues in his way of life. It is conclusive to say then that a Christian who has attained spiritual maturity will reflect these virtues in his daily affairs whether it be at work, or at leisure time. Among the virtues that were listed as fruits of the Spirit, I chose love, joy, and peace. I consider them as hallmarks of maturity since they are the basic foundation of all virtues yet they are the hardest to cultivate when one does not walk in God’s word. The first virtue is love which is known as â€Å"agape† in Greek. This love2 is as â€Å"agape† refers to brotherly love that should exhibit mercy and benevolence.

Social Identity Theory And Self Categorisation Theory Sociology Essay

Social Identity Theory And Self Categorisation Theory Sociology Essay Social Identity Theory was established by Tajfel and Turner with the aim of trying to understand the psychological basis of intergroup discrimination. Tajfel and Turner (1979) tried to identify conditions which would lead members of a specific social group to behave in a biased matter towards an out-group, in favour of the in-group which they were a member of. It is seen as a discursive approach. The main principle of Social Identity Theory is that people often categorise and define themselves and others into a number of different social groups and strive to have their group valued more highly than other groups (Tajfel Turner, 1985). Consistent with Tajfel and Turners (1985) claim, it is believed, by other psychologists, that social identities are formed to boost self-esteem and encourage a sense of certainty (McGregor, Reeshama and So-Jin, 2008). To explain the phenomenon of how individuals evaluate themselves and others as part of an in-group or an out-group, Social Identity Theor y identifies three mental concepts: social categorisation, social identification and social comparison (TaÃ…Å ¸demir, 2011). Social categorisation relates to individuals assigning people to social categories in order to understand and identify them (Tajfel Turner, 1979). This results in the world being divided into them and us, or an in-group and an out-group. In the second concept, social identification, people adopt the identity of the social group they have categorised themselves into. This also involves developing an emotional attachment to ones identification with the group and self-esteem will be closely linked to group membership (Tajfel Turner, 1979). The final concept, social comparison, relates to an individual comparing the group they identify with with other groups. To retain ones self-esteem, their group must be viewed in a more positive light than other groups (Tajfel Turner, 1979). Several psychological studies have supported the fact that individuals create so cial categories in order to boost self-esteem. An example of this being when individuals learn that their social group is unacceptable to society, they tend to perceive the out-group as unacceptable as well (Ford Tonander, 1998). Haslam (2001) has identified two types of strategies individuals use to boost their groups status: social conflict and social creativity. Social conflict refers to the in-group undermining the social status of the out-group. This can be done in a violent manner or by way of protests. Social creativity relates to the in-group emphasising group features which they flourish on, by way of advertising these strengths. Haslam (2001) argues that when the in-group does not feel at risk and feel their status is largely secure they will engage in social creativity rather than social conflict. However, when members of the in-group feel threatened they will readily engage in social conflict. A core principle of Social Identity Theory is that ones social identity is no t fixed and cannot predict ones behaviour. Instead, the context and the in-groups salience in the context decides which aspect of an individuals identity is influential in a situation. According to Social Identity Theory, individuals are more inclined to identify with a certain social group if they feel uncertain. Support for this claim comes from McGregor, Reeshma and So-Jin (2008). In their study, participants were required to describe personal conflicts which were caused by unresolved personal problems (uncertainty task). In an attempt to assess out-group derogation, Canadian participants read statements which were critical of Canada, written by a foreign person. The extent to which the Canadian participants disliked and disagreed with the foreigners statement was measured, providing an index of out-group derogation. Additionally, each participant completed a measure of structure requirement. McGregor, Reeshma and So-Jin (2008) found that individuals who sought structure and clar ity were more likely to show out-group derogation after completing the uncertainty task. However, this research used participants from a Western country the same results may not have been generated if Eastern participants took part in the study. The assumptions from these results cannot be generalised to people from different cultures. It can be argued that Social Identity Theory is effective in its claim that people have a biased perception of their own social group compared to other groups, that is, explaining in-group bias. Evidence of this can be seen in the results of Mullen, Brown and Smiths (1992) study into the in-group bias hypothesis. Further support of the claim that identity processes underlie the in-group bias is a report illustrating that members of a social group have higher self-esteem after engaging in discriminatory behaviour (Rubin Hewstone, 1998). Rubin and Hewstone (1998) demonstrate that people show an intergroup distinction to feel good about themselves and the social group which they identify with (Brown, 2000). Brown, Maras, Masser, Vivian and Hewstone (2001) observed that English passengers on a ferry had been refused travel by the actions of French fishermen the out-group and so displayed generally less favourable attitudes towards French people. This supports Social Identity Theorys social comparison concept, in that the English passengers identified so strongly with their national group that they viewed the French in a negative light which in turn, resulted in them retaining their self-esteem. However, Social Identity Theory does have a number of issues which have proved problematic when trying to account for group influence. The theory assumes that a positive social identity is based on positive intergroup comparisons (Brown, 2000). It does make sense to assume that there should be a positive correlation between the strength of group identification and the level of in-group bias. This hypothesis has been tested over the years and still remains of interest to psychologists worldwide (Brown, 2000). Subsequent psychological studies investigating this correlation have shown little support for Social Identity Theory. According to Brown (2000), 14 studies were analysed and the overall correlation between group identification and in-group bias was +0.08, and while 64% of correlations were positive, the mean correlation was not very strong (+0.24). It can be argued, however, that this correlation hypothesis was not actually stated by Tajfel and Turner (1979) when they were develo ping the Social Identity Theory. It is clear from Social Identity Theory that people are motivated to have an in-group bias by the need to see themselves, and the group they identify, within a positive light. Thus, it can be assumed there is a causal link between intergroup distinction and self-esteem. Abrams and Hogg (1988) summarised this concept positive in-group differentiation leads to increased self-esteem and people with low self-esteem show more differentiation in order to boost levels of self-esteem. Social Identity Theory is essentially a theory relating to group differentiation, that is, how members of a specific in-group make this group distinctive from, and better than, an out-group. Therefore, groups which see themselves as similar should be keen to show intergroup differentiation (Brown, 1984). This hypothesis has been tested vigorously over the years with different results. Some studies have generated results which contradict Social Identity Theorys hypothesis Jett en, Spears and Manstead (1996) found that groups that viewed themselves to hold similar attitudes and equivalent status showed more intergroup attraction and less bias then dissimilar groups (Brown, 2000). However, some studies support Social Identity Theory as they have found that intergroup similarity does lead to intergroup differentiation especially if both groups are extremely similar (White Langer, 1999). The concept of social identity as described by Social Identity Theory could be altered by way of having a greater greater acknowledgement of the diversity of social groups that can represent ones social identity. Self-Categorisation Theory also focuses on the concept of intergroup differentiation as a function of identity (TaÃ…Å ¸demir, 2011). Self-Categorisation Theory is seen as a cognitive theory of behaviour within intergroup contexts and offers explanations about the cognitive processes underlying an individuals self-categorisation and intergroup differentiation processes (Turner, 1999). The theory is seen to be a more elaborate, extended version of the original Social Identity Theory (TaÃ…Å ¸demir, 2011). Turner et al. (1987) argue that Self-Categorisation Theory deals with the social-cognitive basis of intergroup behaviour. Self-Categorisation Theory explains how people form a self-identity in terms of the social categories which they belong to. This also leads to people discriminating between their own category members and people in other categories. The meta-contrast principle explains this process. The meta-contrast principle explains that any number of individuals in a cert ain situation are likely to categorise themselves as a social group when they view differences amongst each other less than the differences between themselves and others in the same situation (Turner, 1985). For that reason, when inter-group differences are more stark than intra-group differences (high meta-contrast ratio), it is believed that people define themselves based on their membership of social groups and they differentiate between the in-group and out-group (Turner, Oakes, Haslam McGarty, 1994). Self-Categorisation Theory states that when individuals identify with a social group, they experience depersonalisation. That is, they perceive every member of their group as interchangeable on a certain level (Turner et al., 1957). Self-categorisation cognitively assimilates the individual to the in-group prototype and so depersonalises self-conception (Hogg and Terry, 2001). Therefore, it is assumed that each group member, including the individual themselves, share the same valu es and morals and so they tend to adhere to group norms (Hogg and Reid, 2006). According to Hogg and Terry (2001), this transformation of self-identity is the process which underlies group phenomena as it brings self-identification in line with the relevant in-group prototype in a certain context. Many psychologists, such as Simon (2004) and Deaux (1993) have challenged this assumption of depersonalisation. A study was conducted by Swann, Gomez, Seyle, Morales and Huici (200) who found a contradiction to the assumption of depersonalisation. In their study, individuals who felt their personal and social identities were linked did not adhere to the norms of the in-group. Instead, they engaged in rebellious behaviour to protect their group even when their identity was threatened. Self-Categorisation Theory promotes the idea that when people self-categorise themselves, they tend to think of themselves more as a member of a social group, rather than as individuals. This includes them bel ieving that they share the same characteristics associated with their group and they behave in ways that they feel members of their group should act. This process is called self-stereotyping (Mackie, Smith and Ray, 2008). As result of this, self-categorisation increases similarity in the in-group. This is because every member of the social group takes on attributes which are seen as characteristic of the group and so every member develops identical qualities. One could argue, therefore, that Self-Categorisation Theory provides an insight into the fact that the group has become part of ones self. Support of this comes from a study by Smith and Henry (1996) who found that group members perceive themselves as like their social group. Although both theories, Self Identity Theory and Self-Categorisation Theory, are different, one could ague that they are similar to an extent. This is because both theories explore how identities are internalised and are used by individuals to define themselves. However, there are several differences between Social Identity Theory and Self-Categorisation Theory and the way in which they account for group influence. Self-Categorisation Theory focuses more on the cognitive processes of categorisation in a social context whereas Social Identity Theory offers a more discursive approach. Discursive psychologists have been critical of Social Identity Theory over the years. They criticise the theorys assumption that group conflict and differentiation is caused by a worldwide psychological process. Additionally, they feel that the theory is limited as it does not have ecological validity since much of the research into the theory is conducted in Western cultures. There has been an intercultu ral study conducted by Wetherell (1996) who found that children who come from other cultural backgrounds do not discriminate between groups, unlike North American children. Self-Categorisation Theory does not place as much emphasis on the role of self-esteem, unlike Social Identity Theory. Social Identity Theory emphasises the process of self-categorisation into a group and Self-Categorisation Theory emphasises the process of self-stereotyping and identifying oneself based on a social group. According to Taylor and Moghaddam (1994), Self-Categorisation Theory ignores socio-structural factors and is devoid of the passion involved in real-life conflicts. The theory describes humans in the image of thinking machines. Therefore, one contrast between Social Identity Theory and Self-Categorisation Theory is that the latter can be criticised for not paying enough attention to motivational and affective issues. One flaw of Self-Categorisation Theory is that it concentrates on identity forma tion in adults but no attention has been given to the development of identity in infants. There has however been research into this, using the main principles of Self-Categorisation Theory and applying it to children (Barrett, Wilson and Lyons, 1999). One could therefore argue that Self-Categorisation Theory is not efficient when it comes to explaining group influence on children. A success of Social Identity Theory is that other psychologists have used its principles in an attempt to explain extremist social movements. Reicher, Haslam and Rath (2008) explained how the ideas promoted by Social Identity Theory were able to explain Nazism. In conclusion, it is clear that both theories share similarities, but there are also a number of differences between the two. Self-Categorisation Theory has a more cognitive approach to group influence whereas Social Identity Theory has a more discursive approach. Further research into Social Identity Theory could involve people from Eastern countries to give the theory more ecological validity as currently, the majority of studies have used Western participants. Self-categorisation theory focuses too much on the formation of identity and group influence in adults and so more research could be done on children to see if the same assumptions apply.

The Awakening Essay -- essays research papers

In the Awakening, by Kate Chopin, Edna Pontellier is a married woman with children. However many of her actions seem like those of a child. In fact, Edna Pontelliers ¡Ã‚ ¦ life is an irony, in that her immaturity allows her to mature. Throughout this novel, there are many examples of this because Edna is continuously searching for herself in the novel. One example of how Edna ¡Ã‚ ¦s immaturity allows her to mature is when she starts to cry when LeÆ’Vonce, her husband, says she is not a good mother.  ¡Ã‚ §He reproached his wife with her inattention, her habitual neglect of the children. If it was not a mother ¡Ã‚ ¦s place to look after children, whose on earth was it? ¡Ã‚ ¨(13). Edna, instead of telling her husband that she had taken care of her children, began to cry like a baby after her husband reprimanded her.  ¡Ã‚ §Mrs. Pontellier was by that time thoroughly awake. She began to cry a little ¡Kshe thrust her face, steaming and wet, into the bend of her arm, and she went on crying there, not caring any longer to dry her face, her eyes, her arms, ¡Ã‚ ¨(13,14). These tears made Edna look as if she was still a child and that she is tired of being treated as a child by her husband. These tears also showed her she did not like where she was, a sign of maturity. Her tears symbolize her first awakening. Although the next morning, after Edna had cried the night before had to go and say good-bye to her husband because he was leaving on a business trip. Edna acted immaturely around him again when he gave her half the money he won the night before.  ¡Ã‚ §Ã‚ ¡Ã‚ ¥It will buy a handsome wedding present for Sister Janet! ¡Ã‚ ¦ she exclaimed, smoothing out the bills as she counted them one by one, ¡Ã‚ ¨(15). Edna is spoiled by all of her husbands money. Another example of how Edna ¡Ã‚ ¦s immaturity allows her to mature is when Edna swam like a baby when she went swimming for the first time, and she had over estimated her power.  ¡Ã‚ §Once she turned and looked toward the shore, toward the people she had left there. She had not gone any great distance ¡Kshe made no mention of her encounter with death and her flash of terror, except to say to her husband,  ¡Ã‚ ¥I thought I should have perished out there alone. ¡Ã‚ ¦  ¡Ã‚ ¥You were not so very far, my dear; I was watching you. ¡Ã‚ ¦Ã‚ ¡Ã‚ ¨(48). This shows the reader that Edna is still like a baby in that her husband was watching her while she was swimming. Edna had no idea that she could even... ...g, and it was late ¡Khe filled his match safe, but did not light his cigarette until he left her, after she had expressed her willingness to go to the races with him again, ¡Ã‚ ¨ (125). By her staying with Arobin, and defying her husbands ¡Ã‚ ¦ wishes, which is immature, she is in a way maturing  ¡V this demonstrates the irony in Edna ¡Ã‚ ¦s life, to be mature she must first be immature. She is learning to make decisions on her own.  ¡Ã‚ §Madame Lebrun might have enjoyed the outgoing, but for some reason Edna did not want her. So they went alone, she and Arobin, ¡Ã‚ ¨ (127). Again Edna is acting immaturely, and foolishly by going with Arobin alone, which will help her to mature. In conclusion, for Edna Pontellier to mature, she had to first act immaturely which made Edna ¡Ã‚ ¦s life a complete paradox, continually contradicting itself.  ¡Ã‚ §The voice of the sea is seductive, never ceasing, whispering, clamoring, murmuring, inviting the soul to wander in abysses of solitude ¡Kthe water was deep, but she lifted her white body and reached out with a long, sweeping stroke. The touch of the sea is sensuous, enfolding the body in its soft, close embrace, ¡Ã‚ ¨(189). Edna ended her life in the sea, her final awakening.

Qualitative research Essay

PREPARING A CASE STUDY: A Guide for Designing and Conducting a Case Study for Evaluation Input By Palena Neale, PhD, Senior Evaluation Associate Shyam Thapa, PhD, Senior Monitoring and Evaluation Advisor Carolyn Boyce, MA, Evaluation Associate May 2006 P AT H F I N D E R I N T E R N AT I O N A L T O O L S E R I E S Monitoring and Evaluation – 1 PREPARING A CASE STUDY: A Guide for Designing and Conducting a Case Study for Evaluation Input By Palena Neale, PhD, Senior Evaluation Associate Shyam Thapa, PhD, Senior Monitoring and Evaluation Advisor Carolyn Boyce, MA, Evaluation Associate. May 2006 Acknowledgements The authors would like to thank the following Pathfinder employees and partners for their technical inputs into this document: Emmanuel Boadi (Pathfinder/Ghana), Anne Palmer (Futures Group International), Ugo Daniels (African Youth Alliance (AYA)), Veronique Dupont (Pathfinder/Extending Service Delivery (ESD)), Cathy Solter, Lauren Dunnington, and Shannon Pryor (Pathfinder headquarters). Jenny Wilder and Mary Burket are also thanked for their inputs and assistance in editing and producing this document. 2 PATHFINDER INTERNATIONAL: WRITING A CASE STUDY. What is a Case Study? A case study is a story about something unique, special, or interesting—stories can be about individuals, organizations, processes, programs, neighborhoods, institutions, and even events. 1 The case study gives the story behind the result by capturing what happened to bring it about, and can be a good opportunity to highlight a project’s success, or to bring attention to a particular challenge or difficulty in a project. Cases2 might be selected because they are highly effective, not effective, representative, typical, or of special interest. A few examples of case study topics are provided below—the case studies would describe what happened when, to whom, and with what consequences in each case. Case Study Examples Shifting Attitudes of Youth-Serving Service Providers Uniqueness/Point of Interest Your program was able to change service providers’ attitudes towards dealing with Adolescent Sexual and Reproductive Health (ASRH) needs in an environment where provider’s attitudes have been a barrier to young people accessing SRH services. Your program was effective in introducing YFS to the MOH and in institutionalizing an YFS curriculum in a setting where the MOH did not provide YFS. Your program was able to integrate HIV prevention in several FBO service delivery points in an environment that normally does not include or welcome HIV prevention activities. Your program built the leadership capacity of youth to advocate, promote, and participate in decision making around ASRH. This transpired in a setting that did not include ASRH on the agenda nor encourage youth participation in general or in decision making in particular. Integrating Youth-Friendly Services (YFS) in the Ministry of Health (MOH) Integrating HIV Prevention in Faith-Based Organization (FBO) Health Services Delivery. Developing Youth Leadership in Tanzania 1 2 Yin, Robert K. (2003). Case Study Research: Design and Methods. Thousand Oakds: Sage Publications. Case refers to the unit of analysis or topic chosen for study (i. e. , the individual, organization, or program). PATHFINDER INTERNATIONAL: WRITING A CASE STUDY 3 When is a Case Study Appropriate? Case studies are appropriate when there is a unique or interesting story to be told. Case studies are often used to provide context to other data (such as outcome data), offering a more complete picture of what happened in the program and why. What are the Advantages and Limitations of a Case Study? The primary advantage of a case study is that it provides much more detailed information than what is available through other methods, such as surveys. Case studies also allow one to present data collected from multiple methods (i. e. , surveys, interviews, document review, and observation) to provide the complete story. There are a few limitations and pitfalls however, each of which is described below. Can be lengthy: Because they provide detailed information about the case in narrative form, it may be difficult to hold a reader’s interest if too lengthy. In writing the case study, care should be taken to provide the rich information in a digestible manner. Concern that case studies lack rigor: Case studies have been viewed in the evaluation and research fields as less rigorous than surveys or other methods. Reasons for this include the fact that qualitative research in general is still considered unscientific by some and in many cases, case study researchers have not been systematic in their data collection or have allowed bias in their findings. In conducting and writing case studies, all involved should use care in being systematic in their data collection and take steps to ensure validity3 and reliability4 in the study. Not generalizable: A common complaint about case studies is that it is difficult to generalize from one case to another. But case studies have also been prone to overgeneralization, which comes from selecting a few examples and assuming without evidence that they are typical or representative of the population. Yin, a prominent researcher, advises case study analysts to generalize findings to theories, as a scientist generalizes from experimental results to theories. 5 3 4 Validity refers to the degree to which a study accurately reflects or assesses the specific concept that the researcher is attempting to measure. Reliability is the extent to which an experiment, test, or any measuring procedure yields the same result on repeated trials. 5 Yin, Robert K. (2003). Case Study Research: Design and Methods. Thousand Oaks: Sage Publications. 4 PATHFINDER INTERNATIONAL: WRITING A CASE STUDY. What is the Process for Conducting a Case Study? The process for conducting case study research follows the same general process as is followed for other research: plan, collect data, analyze data, and disseminate findings. More detailed steps are given below. 1. Plan †¢ Identify stakeholders who will be involved. †¢ Brainstorm a case study topic, considering types of cases and why they are unique or of interest. †¢ Identify what information is needed and from whom (see â€Å"What are Potential Sources of Information? † and â€Å"What are the Elements of a Case Study? †). †¢ Identify any documents needed for review. †¢ List stakeholders to be interviewed or surveyed (national, facility, and beneficiary levels) and determine sample if necessary. †¢ Ensure research will follow international and national ethical research standards, including review by ethical research committees. For more information, please see the International Ethical Guidelines for Biomedical Research Involving Human Subjects, available at http://www. cioms. ch/frame_guidelines_nov_2002. htm. 2. Develop Instruments †¢ Develop interview/survey protocols—the rules that guide the administration and implementation of the interview/survey. Put simply, these are the instructions that are followed to ensure consistency across interviews/surveys, and thus increase the reliability of the findings. The following instructions for the should be included in the protocol: †¢ What to say to interviewees when setting up the interview/survey; †¢ What to say to interviewees when beginning the interview/survey, including ensuring informed consent of the respondent (see Appendix 1 for an example); †¢ What to say to respondent in concluding the interview; †¢ What to do during the interview (Example: Take notes? Audiotape? Both?); and †¢ What to do following the interview (Example: Fill in notes? Check audiotape for clarity? Summarize key information for each? Submit written findings? ). †¢ Develop an interview guide/survey that lists the questions or issues to be explored and includes an informed consent form. Please note that you will likely need interview guides/surveys for each group of stakeholders, as questions may differ. †¢ Where necessary, translate guides into local languages and test translation. PATHFINDER INTERNATIONAL: WRITING A CASE STUDY 5 3. Train Data Collectors †¢ Identify and train data collectors (if necessary). (See â€Å"Training Tips for Data Collectors†6. ) Where necessary, use interviewers that speak the local language. Training Tips for Data Collectors Staff, youth program participants, or professional interviewers may be involved in data collection. Regardless of what experience data collectors have, training should include: †¢ An introduction to the evaluation objectives, †¢ A review of data collection techniques, †¢ A thorough review of the data collection items and instruments, †¢ Practice in the use of the instruments, †¢ Skill-building exercises on interviewing and interpersonal communication, and †¢ Discussion of ethical issues. 4. Collect Data †¢ Gather all relevant documents. †¢ Set up interviews/surveys with stakeholders (be sure to explain the purpose, why the stakeholder has been chosen, and the expected duration). †¢ Seek informed consent of each respondent (written or documented oral). Re-explain purpose of interview, why the stakeholder has been chosen, expected duration of, whether and how the information will be kept confidential, and the use of a note taker/tape recorder. †¢ If the respondent has consented, conduct the interview/survey. 5. Analyze Data †¢ Review all relevant documents. †¢ Review all interview/survey data. 6. Disseminate Findings †¢ Write report (see â€Å"What are the Elements of a Case Study? †). †¢ Solicit feedback. †¢ Revise †¢ Disseminate 6 Adamchak, S. , et. al. (2000). A Guide to Monitoring and Evaluating Adolescent Reproductive Health Programs. Available at http://www. pathfind. org/site/PageServer? pagename=Publications_FOCUS_Guides_and_Tools. 6 PATHFINDER INTERNATIONAL: WRITING A CASE STUDY What are Potential Sources of Information? Case studies typically rely on multiple sources of information and methods to provide as complete a picture as possible. Information sources could include: †¢ Project documents (including meeting minutes) †¢ Project reports, including quarterly reports, midterm reviews †¢ Monitoring visits †¢ Mystery client reports †¢ Facility assessment reports †¢ Interviews †¢ Questionnaire/survey results †¢ Evaluation reports †¢ Observation †¢ Other What are the Elements of a Case Study? Case studies do not have set elements that need to be included; the elements of each will vary depending on the case or story chosen, the data collected, and the purpose (for example, to illustrate a best case versus a typical case). However, case studies typically describe a program or intervention put in place to address a particular problem. Therefore, we provide the following elements and example on which you might draw: 1. The Problem i. Identify the problem ii. Explain why the problem is important iii. How was the problem identified? iv. Was the process for identifying the problem effective? 2. Steps taken to address the problem 3. Results 4. Challenges and how they were met 5. Beyond Results 6. Lessons Learned. PATHFINDER INTERNATIONAL: WRITING A CASE STUDY 7 1. The Problem: It is essential to identify what the problem was. Specifically: i. Identify the problem. For example, certain FBO leadership was opposed to including HIV prevention activities within their programming. Specifically, they felt that prevention activities would promote sex among youth and thereby increase the incidence of HIV. In addition, the FBO felt that the promotion of condoms as a form of prevention was morally wrong. ii. Explain why the problem is important. Following the same example, to provide a comprehensive response to HIV/AIDS, prevention activities are an important part of HIV programming, in addition to care and support. Addressing moral and religious concerns and objections of FBO leaders in order to incorporate this component greatly expands the prevention effort and offers a greater breadth and depth in HIV programming. iii. How was the problem identified? It is likely that program staff will have an idea of what general problems exist. For example, YFS is not integrated in the MOH, FBOs do not include prevention activities, youth involvement does not occur, etc. What was likely missing and required exploration were the details around this general problem. In the case of working with FBOs, an initial project planning meeting was held to discuss the specifics behind the problem. It was revealed during this process that certain FBOs who conducted care and support activities did not offer prevention activities, specifically condom promotion. The primary reason given was religious objections; another reason identified but not explicitly stated was stigma. iv. Was the process for identifying the problem effective? After additional one-on-one discussions with FBO leaders, it was determined that the leaders had concerns based on moral and religious grounds regarding prevention efforts, particularly promoting condoms. Furthermore, discussions revealed that a number of leaders had limited and/or erroneous information regarding transmission and prevention options. 8 PATHFINDER INTERNATIONAL: WRITING A CASE STUDY 2. Steps Undertaken to Address the Problem: What was done (activities/ interventions/ inputs), where, by whom, for whom? In the case of integrating prevention in FBOs, an illustrative outline of steps undertaken to address the problem is given below: What was done? Phase 1: Sensitization Sensitization of leadership: activities included reviewing FBO policies and bylaws by program staff in order to demonstrate to leadership that there were no constitutional objections to prevention activities. Project staff engaged liberal FBO leaders to supply quotes from the Bible to build their evidence-based argument to convince other leaders that there was in fact no biblical basis for the preclusion of prevention activities. Sensitization of facility managers: meet with managers to discuss leadership approval and present evidence-based arguments on why integration activities can be included. Sensitization of community: work with groups to explain that these activities have been approved by the FBO leadership and where they can go to receive services. Phase 2: Integration Facility assessments Selected facilities Project Staff, FBO representatives Local Implementing Partners (IPs) Project Staff, Facility Managers Contractor FBOs, Project Staff Facility Staff District/ National Project Staff FBO leaders Where? By Whom? For Whom? Facilities Project Staff Facility Managers Community catchment areas Project Staff Community members Training of service providers Selected facilities Conduct staff orientations Facilities Facility Staff Physical infrastructure improved Phase 3: Outreach Identify peers that you want to work with Training Provide Tools Supervision Phase 4: M&E Reassessments Facilities Facility Selected facilities Facilities Facility Staff IPs Project Peer supervisors Beneficiaries Peers Peers Peers Sample of selected facilities Project Staff, Facility Management, Youth Trained mystery clients Project Staff, Peer Supervisors. Facility, Project Staff Mystery client interviews Monitoring visits Facilities Facilities, Peers Facility staff, Project Staff PATHFINDER INTERNATIONAL: WRITING A CASE STUDY 9 3. Results: What were the results of your intervention, particularly the significant or unique results? For example: your activities resulted in the FBO including HIV prevention activities in their programming, which contributed to an increase in condom distribution. Or, your activities resulted in youth-serving service providers adopting a youth-friendly attitude which contributed to improved services and an increase in youth visits. Church leadership may have made a commitment and modified policies to include ASRH activities, leadership talking about the issues publicly. Facility managers may make financial commitments to refurbishments, training, etc. 4. Challenges and how they were met: This focuses on what challenges or difficulties you encountered and what you did to overcome them. One of the challenges in working with FBOs may have been dealing with Catholic FBOs and your response could have been to negotiate with them to include certain prevention activities like abstinence, and/or providing a referral point to youth who may want to get information about condoms. Another possible challenge is that not all FBOs who you had hoped to work with were willing to come on board and this required additional attention. 5. Beyond Results: Are the results mentioned above sustainable? Why or why not? For example, an integrated approach to programming (which included a strong policy and advocacy component) created an enabling policy environment with strong stakeholder support that can be nurtured and leveraged beyond the project duration. 6. Lessons Learned: What lessons were learned: programmatic, technical, financial, process, etc.? For example, the experience showed that it was imperative for project staff to have a very solid understanding of government policies to speak to these issues with key stakeholders. In addition, it was important to have a good understanding of the various religious beliefs in addition to their respective policies and by-laws for developing and delivering advocacy arguments. How are Case Studies Presented? Case studies are flexible in that they can be presented in a number of ways—there is no specific format to follow. However, like all evaluation results, justification and methodology of the study should be provided, as well as any supporting information (i. e. , copies of instruments and guides used in the study). Case studies may stand alone or be included in a larger evaluation report. If presented as a stand-alone report, the following report outline is suggested: 1. Introduction and Justification 2. Methodology a. How was the process carried out? (Describe the process of selecting the case and data collection sources, as well as how data was collected. ) b. What assumptions are there (if any)? 10 PATHFINDER INTERNATIONAL: WRITING A CASE STUDY 3. 4. 5. 6. 7. 8. 9. 10. c. Are there any limitations with this method? d. What instruments were used to collect data? (You may want to include some or all in the appendix. ) e. What sample(s) is/are being used? f. Over which period of time was this data collected? The Problem The Steps Taken to Address the Problem The Results The Challenges and How They were Met Beyond Results Lessons Learned Conclusion Appendices Where Can More Information on Case Studies be Found? Information on Case Study Research Adamchak, S. , et. al. (2000). A Guide to Monitoring and Evaluating Adolescent Reproductive Health Programs. Available at http://www. pathfind. org/pf/pubs/focus/guidesandtools/PDF/Part%20II. pdf. Patton, Michael Q. (2002). Qualitative Research & Evaluation Methods. Thousand Oaks: Sage Publications. Stake, Robert E. (1995). The Art of Case Study Research. Thousand Oaks: Sage Publications. United States General Accounting Office, Program Evaluation and Methodology Division. (1987). Case Study Evaluations. Available at http://161. 203. 16. 4/t2pbat22/132683. pdf. Yin, Robert K. (2003). Case Study Research: Design and Methods. London: Sage Publications. Examples of Case Studies Cornwall, A. and Welbourn, A. (2002). Realizing Rights: Transforming Approaches to Sexual and Reproductive Well-Being. London: Zed Books. Population Council. Quality/Calidad/Qualite series. Available at http://www. popcouncil. org/publications/qcq/default. htm. SRI International. (2001). The Organization of Learning in Community Technology Centers: Learning with Technology in Six Communities. Available at http://www. americaconnects. net/research/SRI_case_study_report. pdf. PATHFINDER INTERNATIONAL: WRITING A CASE STUDY 11 Appendix 1: Sample Informed Consent Form Key Components: †¢ Thank you †¢ Your name †¢ Purpose †¢ Confidentiality †¢ Duration †¢ How interview will be conducted †¢ Opportunity for questions †¢ Signature of consent I want to thank you for taking the time to meet with me today. My name is ________________________ and I would like to talk to you about your experiences participating in the African Youth Alliance (AYA) project. Specifically, as one of the components of our overall program evaluation we are assessing program effectiveness in order to capture lessons that can be used in future interventions. The interview should take less than an hour. I will be taping the session because I don’t want to miss any of your comments. Although I will be taking some notes during the session, I can’t possibly write fast enough to get it all down. Because we’re on tape, please be sure to speak up so that we don’t miss your comments. All responses will be kept confidential. This means that your interview responses will only be shared with research team members and we will ensure that any information we include in our report does not identify you as the respondent. Remember, you don’t have to talk about anything you don’t want to and you may end the interview at any time. Are there any questions about what I have just explained? Are you willing to participate in this interview? __________________ Interviewee __________________ Witness __________ Date ______________________________________ Legal guardian (if interviewee is under 18) 12 PATHFINDER INTERNATIONAL: SAMPLE INFORMED CONSENT FORM Pathfinder International 9 Galen Street, Suite 217 Watertown, MA 02472 USA Tel: 617-924-7200 Email: Information@pathfind. org 05/06/500.

Benjamin Cardozo Leaders program Essay

The final spot in the University of Buffalo’s graduating class of 2011 should be offered to me because I embody the values of hard work, dedication, determination, and self-discipline that are essential in succeeding as a college student and later as a professional in my field. I have always had plans for a successful future – in younger years I had thoughts of pursuing the medical field, like my sister, but have since decided that being successful means following my own interests and dreams. I have been fascinated with how things work for as long as I can remember; automotive design holds a special attraction for me. During my junior year of high school I came to the realization that adulthood and the ‘real world’ are fast approaching, and got serious about outlining my plans for the future. Now, as a graduating senior, I am on the verge of proving to everyone else what I have always known – I am going to make something BIG out of myself. After careful and diligent examination of my personal interests and values, I have decided that my optimum career choice is to be a self employed mechanical engineer. In this profession I will be able to exploit my passion for how things work, while designing my own creations – and being self employed will allow me to reach my full potential, limited only by my dream, drive, and education. Knowing that the quality of my education is essential to achieving my lifetime aspiration will continue to provide me with a hunger for the acquisition of the knowledge and experience of my professors and future student colleagues. I plan to embellish my studies of mechanical engineering with a second concentration in business management, to culminate in an M. B. A. which I believe will help me acquire the knowledge necessary to run a profitable and successful business. It is my true dream to do for the world of mechanical engineering what Bill Gates did for computing and what Sam Walton did for discount retail – to become an industrial giant through knowledge, drive, and a passion for doing what I love. The University of Buffalo needs me on campus because of my experience in leadership, through the Benjamin Cardozo Leaders program, my strong work ethic – as evidenced by my current employment, and my passion for mechanical engineering. I pledge to use this spot to the best of my ability to simultaneously increase my academic knowledge and to uphold the positive public image that the University of Buffalo portrays. My background in athletics, as well as my high school and employment experience have all increased my people skills, and I plan to hone them even further in collaborating with fellow students and being involved in mentoring programs that import to teenagers how important goals, drive, and education are in the accomplishment of great things. I believe strongly that this college will help me accomplish great things, and it is my intent to accomplish great things while I am there.

Everything You Need to Know for Your Upcoming Summer Vacation

Everything You Need to Know for Your Upcoming Summer Vacation It’s the time of year you’ve been waiting for: summer vacation! Time for you to kick back on the beach with a cold beverage and forgot about all of your responsibilities. Unfortunately, preparing for your upcoming summer vacation can be just as stressful as your normal responsibilities. Taking a vacation reduces stress and improves your overall productivity. So the last thing you need is to be stressed out and offset the positive benefits of your vacation.Fortunately, there are many approaches you can take when planning your summer vacation. You can book a cruise or tour. That way, someone else will plan everything for you. If that’s not your cup of tea, you can find a packaged deal, where expenses are lumped together. Either way, there are a lot of options for you to consider.With that said, here’s everything you need to know in order to be better prepared and lessen the stress of getting ready for summer vacation.Source: [BusinessInsider]

Song of Solomon by Tony Morrison essays

Song of Solomon by Tony Morrison essays Toni Morrisons Song of Solomon is considered to be by critics and readers alike one of the most significant novels of the African American literature. It is the creative result of one of the most acclaimed writers of the American cultural scene. The author draws her inspiration and writing motivation from a deep cultural heritage which is quite obvious throughout the novel. In doing so, she makes use of different literary techniques and details which enable her to perfectly express her intensions by drawing up individual and well defined characters and at the same time present her all around perspective on life. In order to best capture the profound meanings of the novel in its entirety, it is important to analyze specific elements of the literary construction. The major theme of the writing can be identified in the desire to fly. It can be said that indeed this is the axis mundi of the novel. The symbolist approach of the flight as means of escaping is used in two parallel constructions, thus creating a repetition at the level of two different generations. The major character in this repetition is Solomon, who is also the one known for his escape from slavery. Solomon was the first black person to escape slavery. The story was that he flew back to Africa. However, his escape has more significance for the structure of the novel. He is seen as a hero by the local community and this perspective also justifies the name of the novel. O Solomon dont leave me here, Cotton balls to choke me. O Solomon dont leave me here, Buckras arms to yoke me. Solomon done fly, Solomon done gone. Solomon cut ac ross the sky, Solomon gone home (Morrison, 1987). It represents mans desire for freedom, from constrains of the society and of the injustice and hardships of life. The same idea is repeated when Robert Smith decides to fly from the roof of the Mercy Hospital. However he fails to achieve his goal...

An Overview Of Quality By Design Engineering Essay

An Overview Of Quality By Design Engineering Essay Since there is immense competition globally and growing impact of Information technology, the pharmaceutical industry should need to improve its performance. The industry should implement newer technologies that can effectively reduce cost of production and at the same time improves product quality and regulatory compliance. Quality by Design is a newer approach that has been offered by the United States Food and Drug Administration (USFDA) which if understood well and implemented properly can save considerable amount of time and cost and at the same time can improve final product quality and regulatory compliance which can increase the speed of product to reach in to the market. This article discusses the background of quality by design concept, Building blocks of Quality by Design, and its approach across the product life span and benefits that it offers. Introduction: In 2002, the U.S. Food and Drug Administration (FDA) published a guidance document for pharmaceutical companies o n cGMP for the 21st century. This guidance document expressed a strong desire that companies should build quality, safety and efficacy in to their product. This concept is now known as Quality by Design (QbD). Till now, the meaning, benefits and impact of quality by design is confusing to many people. Some says that it is a newer way to develop drugs, biologics and devices; some says that it can shorten the production cycle; some says that it provides more business flexibility but no one knows what it is exactly. Some people do not even know that where, when and how should it be applied? Initially there are so many companies who tried to adopt Quality by Design concept but confusion gave way to frustration. Background of Quality by Design: Quality by design (QbD) is the concept first developed by the famous quality expert named Joseph M. Juran in his 1992 book called â€Å"The New Steps for Planning Quality in to Goods and Services†. He believed that quality could be planned in the very first stage of the production rather than final testing. The concept was first used in automobile industry. There is one article published in June 2007 titled â€Å"Elucidation: Lessons from the Auto Industry† says that Toyota Automobiles was the first company who implemented many Quality by Design concept to improve their automobiles in 1970s. That is why we can say that Quality by Design concept is new only for FDA regulated industries and not for other industries like technology, aeronautics, telecommunications etc. In other words, we can say that the computer we use, the phone we answer, the airplane we ride, the car we drive and the camera we use are all products of Quality by Design but we cannot say that whatever tablet we ingest and whatever biologics we use are the products of Quality by Design. In 1990s, many of the medical device manufacturing company has implemented Quality by Design aspect which resulted in reduced risk and manufacturing cost and at t he same time increased patient safety and product efficacy. From the success of QbD aspect in medical device manufacturing, the FDA officials felt that this concept has to be applied to drugs and biologics also. So, the internal discussion in FDA started in late 1990s and finally they published a concept paper in 2002 on cGMP in 21st century. With the huge help of some pharmaceutical companies, pilot programs were started to share the Quality by Design application and process understanding with the other companies.

Equity Essay Example | Topics and Well Written Essays - 1000 words

Equity - Essay Example Executive Summary: Owens & Minor Inc. Ticker: OMI Recommendation: Hold Price: $29.78 on 31.03.2010 Price target one year: $34.95 Highlights: A fortune 500 company headquartered in Richmond, Virginia. Wide distribution network throughout the United States. The provider of the broadest selection of branded products. Unique, superior products are offered through non competitive partnerships with leading manufacturers of health care products through cost effective product line labeled Medichoice, OM direct etc. Supplier assortment, community participation and sustainability are the guiding principles of the firm. Hospitals and Ambulatory surgery centers are the principal customers of the firm. Financial Summary: Market capitalization of $ 2.04 billion in 31.3.2010. The first quarter of 2010 saw an increase in the net income of the firm by 98% as compared to the previous year. Operating earnings in the firm increased by 23.3% as compared to the first quarter in the previous year 2009. Cas h and cash equivalents as on 31.03.2010 was $ 146.4 million. A review of the firm’s earning growth rate indicates an average earning growth of 5.4% over the past ten years. Dividend yield of the stock of the firm as on 31.03.2010 was 2.1%. Qualitative analysis: Company profile and industry overview: Owens & Minor makes sure hospitals are organized for main surgeries. â€Å"Its services include logistics, supplier management; analytics inventory management, outsourced resource management, clinical supply management, and business process consulting† (Owens & Minor Inc (OMI: New York) Par. 1). A primary dispenser of surgical and medical supplies, the industry takes about 200,000 products from 1,200 producers. Products distributed by Owens & Minor contain surgical dressings, intravenous and endoscope products, syringes, needles, sterile procedure trays, gowns, sutures and gloves. Owens & Minor consumers are chiefly health systems and hospitals and the purchasing associatio ns that serve them. It distributes products to about 4,400 health care contributors from above 50 distribution places from corner to corner the US. SWOT analysis: Strength: Owens & Minor offers a range of information investigation tools and consulting services and outsourced resource management. Weakness: In the recent times, their overall profits are down. Opportunities: The opportunities open to the Owens & Minor are measured in terms of its future development prospects. Threats: The company needs to evaluate prospective partners, vendors and suppliers. Porters 5 Competitive Forces: Porters 5 competitive forces consist of supplier power, threat of new entrants, and threat of substitutes, degree of revelry and buyer power of Owens & Minor. The healthcare supply chain expertise, joined with a continued responsibility to investing in information technologies and to bring a bounty of benefits to health provider customers and supplier partners alike. Threat of new entrants is a probabi lity of reaction from existing competitors and barriers to entry of the Owens & Minor. It consists of economies of scale, product differentiation, capital requirements and governmental and legal barriers of the Owens & Minor. Major Owners: Table 1 shows the major owners of Owens & Minor. Financial Statements Analysis: Ratio Analysis: I. Short term solvency or liquidity ratios a) Current ratio: Current ratio is defined as ratio of current assets to current liabilities. It is computed as follows. Current

Theories of knowledge and The Matrix Essay Example | Topics and Well Written Essays - 1250 words

Theories of knowledge and The Matrix - Essay Example For example, with the power of vision a person can perceive height and width of three dimensional objects with ease but would have trouble knowing the depth (Thornton, 1987). The classic case of a mountain can be presented to clarify this idea because it is easy to see the height of the mountain and know how wide it is by sight alone but to realize that the mountain also has a certain depth and also extends deep into the ground has to come from the inferences made by the mind. This is in fact the central proposition made by Berkeley that people can never know what an object really is or they can never understand reality through their senses. The objects around us and the reality we see is only a perception which depends on our senses. Therefore, all we know about objects are our perceptions of those objects. Of course we can also imagine about things which never existed or imagine certain situations which can not exist given the physical laws of the universe (Thornton, 1987). However, such imaginations are weak perceptions and have little bearing on the real world. On the other hand, real objects and things continue to remain present in our ideas even if we do not see them as their perception is strong. The false reality is not false for the human inhabitants of The Matrix since it is the only reality they know. The information gathering which they do to function in their world comes from the same sources which provide information to other characters within the matrix, i.e. Neo, Morpheus or Trinity. The only difference is that the human inhabitants are getting signals sent to their brain from a supercomputer which is controlling how their reality functions. On the other hand, the characters which are free from the Matrix are using their natural abilities to experience the real world. Morpheus explains this quite clearly when he defines the reality of the Matrix by questioning what Neo considers to be real. Morpheus says, â€Å"What is "real"? How do you define

A Critique of Plato's Just Society Using the Notion of Fairness From Assignment

A Critique of Plato's Just Society Using the Notion of Fairness From John Rawls - Assignment Example The most explicit discussion of the tripartite part of the soul and the primacy of reason therein occurs in the fourth book of the Republic (435b). One of the first preliminary aspects of the soul is that although the parts of the soul are distinct in their virtues, Socrates also stresses that in the functioning of these parts, the soul must be considered as a â€Å"whole† [Plato, 1992, p. 436a]. What is implied by this, is as follows? If for example, one desired food, and this desire originated in the appetites, it would still require reason both to discern the means of satisfying this desire, but also it would require reason to know when one has had enough for the sake of health in which case, reason would act upon the ‘will’ to suppress desire, so to speak. This is a ‘chain of command’, so to speak, which will be explored both as it is outlined in this section of the Republic, but also in terms of how this is established in the three classes of the state [Haworth, 2004, p. 13]. Further, it is important to similarly stress that the appetites are as necessary for the reason for the sake of surviving. In other words, someone who had no appetite would starve, just as someone who had no ‘will’ or ‘spirit’ would have no discipline to stop eating or drinking. Thus, Socrates stresses that although the reason is given privilege within the scheme of the soul, he also stresses that all three aspects constitute the ‘whole’, and this ‘whole’ is necessary for surviving. In some ways, his position on the soul can be said to be a refutation of Thrasymachus position from the beginning of the dialogue where he argues that the just society is the one ruled by the â€Å"stronger† [Adams and Dyson, 2003, p. 4].  Ã‚  

Black Studies The Urban Dilemma Essay Example | Topics and Well Written Essays - 500 words

Black Studies The Urban Dilemma - Essay Example With this rationale, they think that they have the right to impinge on the 'space' of other people. In his book entitled Black Corona: Race and the Politics of Place in an Urban Community, Steven Gregory (1998) enlightens the reader on the issue of contested space by using the experiences of the African American community in a New York setting collectively called Black Corona. In Gregory's work, we are made aware of a consultation conducted by an all-white Neighbourhood Stabilization to address the issues of latchkey kids, drug dealing and the lack of parental guidance. Although this consultation was designed to improve the security and safety of the whole community, the discussion and decision was left mostly to the white participants as the black participants were effectively prevented from participating. The blacks shied away from the discussion because they were implied to be the root of the problem. It was their kids who were menacing the library. It was their coming when the drug problem emerged. It was them who were mostly single parents. They were the problem and the white s had the right to correct them. The larger picture of what occurred in the consultation was that t

Sales Management Essay Example | Topics and Well Written Essays - 1500 words - 5

Sales Management - Essay Example There is a growing body of evidences that argue about the nature of sales ethics and claims in to be oxymoron; however, another school of thought believe that sales ethics are practically followed within the business world and opposes the impression that these are only formal expressions of the company values to built its better image3. The following essay aims to discuss the general conception about the sales ethics that deem them as oxymoron. In this regard, the essay also explores different situations where the sales personnel have to decide whether to practically follow the described ethical values and principles of their company or prefer the interest of company in terms of increasing sales volume. The essay basically opposes the notion that sales ethics are oxymoron and provides the arguments to support this standpoint. The essay strives to explain how sales ethics can act beyond the formal descriptions to support the products and companies’ image. At present there are large inspections about the companies’ business that puts pressure upon them to fulfil the ethical requirements and follow the basic ethical principles. These principles ought to be straight forward, reasonable and clear so that the companies could deliver the same values to the customers. The companies are expected to respect these values because it is generally accepted notion that the societies giving due attention and value to these principles can prosper and develop significantly. Hence, the issue of the fulfilment of the ethical values becomes very important in this scenario and the companies have to draw a clear line between the theory and practice of the ethical values4. The customers of today’s technology driven world have more choices in front of them as compared with the consumers of the past. The international availability of products options have made them more demanding and

Treatment-Based Drug Courts Significantly Reduce Criminal Recidivism Annotated Bibliography

Treatment-Based Drug Courts Significantly Reduce Criminal Recidivism Rates - Annotated Bibliography Example These programs are developed with an aim of reducing crimes that are usually committed because of drug abuse (MacKenzie 2008). Within the programs, people are offered training based on their skills with the aim of making the sign in the community. Through the education offered in these programs, people change their habits and develop positive thinking (MacKenzie 2008). Individuals who undergo proper training in the programs are not likely to get involved in criminal activities. While those who do not get training end up going back to prison because of committing crimes (Vacca, 2004). Despite the development of these programs in most societies, there is limited research conducted on the effectiveness of the program (Vacca, 2004). It is typically very problematic to determine the effectiveness of these programs because of different judicial procedures used in most of the programs (Vacca, 2004). It also very difficult to determine the factors that affect the programs within the rehabilitation centers (Vacca, 2004). This study will, therefore, test the hypothesis Treatment-based drug courts significantly reduce criminal recidivism rates. Participants in this program most of the time are given counseling services and educational training services that help them change (MacKenzie 2008). The researcher will use a meta-analysis of several studies collected that combines the importance of an association between the study variables (Vacca, 2004). This method is the most suitable because they can be used to describe the efforts made by the respondents under investigation.

Sales Management Essay Example | Topics and Well Written Essays - 1500 words - 5

Sales Management - Essay Example There is a growing body of evidences that argue about the nature of sales ethics and claims in to be oxymoron; however, another school of thought believe that sales ethics are practically followed within the business world and opposes the impression that these are only formal expressions of the company values to built its better image3. The following essay aims to discuss the general conception about the sales ethics that deem them as oxymoron. In this regard, the essay also explores different situations where the sales personnel have to decide whether to practically follow the described ethical values and principles of their company or prefer the interest of company in terms of increasing sales volume. The essay basically opposes the notion that sales ethics are oxymoron and provides the arguments to support this standpoint. The essay strives to explain how sales ethics can act beyond the formal descriptions to support the products and companies’ image. At present there are large inspections about the companies’ business that puts pressure upon them to fulfil the ethical requirements and follow the basic ethical principles. These principles ought to be straight forward, reasonable and clear so that the companies could deliver the same values to the customers. The companies are expected to respect these values because it is generally accepted notion that the societies giving due attention and value to these principles can prosper and develop significantly. Hence, the issue of the fulfilment of the ethical values becomes very important in this scenario and the companies have to draw a clear line between the theory and practice of the ethical values4. The customers of today’s technology driven world have more choices in front of them as compared with the consumers of the past. The international availability of products options have made them more demanding and

How did the two World Wars affect Africa and Africans Essay Example for Free

How did the two World Wars affect Africa and Africans Essay There were different implications and effects that were caused by the World War I and II to African and Africans as well. Many lives were lost and many were rendered useless. Though there are a lot of things that were achieved during this period, there are others that brought about great problems to people. In 1940, German armies were motivated to believe that Africans were in deed their enemies and there was a need to address the issue. With engaging in war with France, and France had several blacks in their army, they were the main target and they were being killed more than their white counterparts. German was fighting people who were below the Nazi, or who Nazi believed they were mutilating their colleagues (Raffael, 596). The effects of the war brought both the positive and negative effects to Africans and Africa as well. Nazi hierarchy had already begun to kill those who they thought were below their Aryan. This was a great suffering for Africans because they were being killed mercilessly. Even they are among their French counterparts, there was no African who was captured and imprisoned but instead they were killed. The other problem was that the Geneva regulations were not applicable to Africans. This was because, the Nazi rule and theory was that the rules were only applicable to the whites but not Africans, thus raising another effect to the African as they were killed without any word or anyone to defend them. Though there were some of the German militaries who were supporting Africans and defending them, those who were Nazified had not respect to Africans. This helped the African soldiers show their heroism as they were trying to defend themselves and in most cases being placed in the front line in the battle, they had to try their best and defend their combat. They believed that African culture believed that whenever an African gets his enemy, he would use coupe-coupe, which was believed was a deadly weapon compared to other short range weapons. They also believed that Africans were already on the attack positions and they would not hesitate attacking their rivals. They used this as a justification of killing Africans (Raffael, 600). In Africa, Africans had already learnt that there is nothing special with the whites and there is nothing whites can do blacks cant do. Africans developed resistant powers and they were now defending their land against occupation by whites. Africans were fighting for freedom and independence. This was not going well with whites in Europe as the information they were getting is that Africans are mutilating their people, raping their women and killing others. This brought about the justification of the Germans illegal activities of killing blacks and mutilating them ‘This charge became an ob- session of some German officers and soldiers and helped to justify the killings of black soldiers and the no-quarters policy in some battles with the’ (Raffael, 600). Most of the African Countries, though they had already suffered a lot, they had already started fighting whites and they managed to get their independence and have their own governments without of the colonial rules.

Analysing The Use Of Electroconvulsive Therapy In Prisons Psychology Essay

Analysing The Use Of Electroconvulsive Therapy In Prisons Psychology Essay An inmate with depression may provide many difficulties into the penal system. Among other things depression may make an inmate more prone to violent as well as suicidal tendencies. In cases such as this it is important for an inmate to receive swift treatment as, in this state, they are a hazard to themselves as well as others. Electroconvulsive therapy is a treatment method that has been used to effectively treat individuals with severe depression for many years. It has been found to treat the illness faster and more effectively than many other depression treatment options. This manuscript briefly discusses depression within the penal system as well as goes into detail about electroconvulsive therapy and how it is effectively employed to assist those suffering from severe depression. An inmate within the penal system suffering from a mental illness presents unique challenges to the staff as well as fellow inmates within these facilities. Statistics indicate that inmates suffering from a mental illness are more prone to disciplinary problems within the correctional system and are also more prone to recidivism after release (James Glaze, 2006). One may surmise that, as the severity of the illness increases, the identified risks increase accordingly. This makes it extremely important for the staff of the facility to treat the illness in the quickest and most effective way possible. The standard first-line treatment for most mental disorders involves pharmacological or psychotherapeutic treatments or a combination of both (Potter, Rudorfer, Manji, 1991). In some cases pharmacological and psychotherapeutic methods take too much time or the inmate may not be able to tolerate the medications. In cases such as this, there are other methods which may be utilized in orde r to treat the inmates mental illness. This manuscript will focus upon the mental illness of depression while briefly discussing the effects it introduces into the penal system. It will also identify and discuss the method of electroconvulsive therapy and how it may be a prudent method for treating severe cases of depression within inmate populations. Due to time constraints the issue of informed consent in permitting treatment is not discussed. Literature Review In order to compose a manuscript upon the subject of depression and electroconvulsive therapy, a solid definition was needed. Definitions were provided through the use of the Merriam-Webster Online dictionary for electroconvulsive therapy (Electroshock Therapy, 2010) and from WordWeb for depression (Depression, 2010). Additionally, the DSM-IV provided the symptoms which accompany a diagnosis of major depressive disorder (American Psychiatric Association, 2000) while the United Kingdom Advocacy Network (1995) provided a list of mental illnesses which ECT has been used to treat. James and Glaze (2006), through the Bureau of Justice Statistics, also provided statistics upon the mental illnesses and symptoms which are found within the penal system of the United States. It is upon this information that the manuscripts conclusions are partly based. The history of electroconvulsive therapy is discussed within the manuscript. Finger (2006) discussed how experiments upon the effects of electricity upon the brain can be traced back to Benjamin Franklin. Electroconvulsive therapy did not take its current form until 1938 when Cerletti and Bini started using electricity to treat those with mental illness (Endler, 1988). Weiner and Krystal (1994) discuss how the mainstream use of ECT declined greatly after the discovery of psychotherapeutic drugs in the 1950s and 1960s. Even though this is the case, Scott (2005) discusses how ECT is still the primary course of treatment for cases of severe depression. ECT has been proven to be an effective means through which depression is treated. Janicak, Davis, Gibbons, Ericksen, Chang, and Gallagher (1985) as well as Rudorfer, Henry, and Sackheim (1997) found that ECT performed better in controlled studies than any other form of treatment for depression. Other studies have shown that ECT also outperforms antidepressants in average effectiveness (Abrams, 1997) as well as the speed of its effects (Rudorfer, Henry, Sackheim, 1997). While the administration of ECT is an effective treatment of depression, it is not curative. Sackheim, Haskett, Mulsant, Thase, Mann, Pettinati, Greenberg, Crowe, Cooper, and Prudic (2001) found the relapse rate of ECT patients to be around 90% within the first six months after treatment. The chance of relapse can be lowered by either a continuation of treatment through the use of mood stabilizers and antidepressants (Sackeim, 1994) or through maintenance ECT treatments for approximately four to six weeks after the initial sessions (Rasmussen, 2003). Gagne, Furman, Carpenter, and Price (2000) found that the best results were produced through a combination of psychotherapeutic drugs and maintenance ECT sessions. Due to the controversial nature of ECT, the process of administration is briefly discussed within the manuscript. This was provided jointly by the Royal College of Psychiatrists (1995) as well as the Salford Community Health Council (1998). In this way, the facts about ECT may be better understood and controversial feelings about the treatment may be alleviated. As with any treatment, ECT produces certain side effects within the patients who choose to undergo this form of treatment. One such side effect includes memory and cognitive impairment. Scott (2005) discusses how this is a common side effect that is associated with ECT sessions. While this may be the case, Lisanby, Maddox, Prudic, Devanand, and Sackeim (2000) found that the memories that are lost are more likely to be of an impersonal nature rather than personal. It has been reported by Calev (1994) and Weiner (2000) that patients suffering from cognitive and memory losses improve substantially once the treatments are completed with few patients complaining of residual effects. Discussion Severe Depression in Inmate Populations Depression, as defined by WordNet, is a mental state characterized by a pessimistic sense of inadequacy and a despondent lack of activity (Depression, 2010). A survey conducted in 2006 by the Bureau of Justice Statistics on mental health problems of inmates within the penal system provides insight into the possible impact that depression may have upon those within the penal system. The survey found that within the 12 months prior to the conduction of the survey 23.9% within state prisons, 16.2% within federal prisons, and 30.4% within local prisons had experienced five or more symptoms indicative of major depressive disorder (James Glaze, 2006). Symptoms that are included within a diagnosis of major depressive disorder include thoughts of revenge, persistent anger or irritability, or whether the individual has ever attempted suicide among other symptoms (American Psychiatric Association, 2000). Symptoms such as these may cause an inmate to act out violently against fellow inmates or staff as well as forcing staff to place the inmate under a suicide watch. This requires the institution to spend precious resources which may be better utilized elsewhere within the compound. In cases such as this, it would be helpful for the institution to have a treatment option at their disposal which could treat the inmates suffering from these symptoms swiftly with few side effects allowing them to integrate into the penal system with as few difficulties as possible. Electroconvulsive Therapy Electroconvulsive therapy (ECT) is defined by Merriam-Webster Online as the treatment of mental disorder and especially depression by the application of electric current to the head of a usually anesthetized patient that induces unconsciousness and convulsive seizures in the brain (Electroshock Therapy, 2010). Early experimentation on the effects of electricity upon brain function may be traced back to Benjamin Franklin (Finger, 2006). ECT, as it is recognized today, was first used to treat mentally ill patients in 1938 by Cerletti and Bini (Endler, 1988) at which point it became a mainstream treatment. In the 1950s and the 1960s, psychotherapeutic drugs were discovered (Weiner Krystal, 1994) replacing ECT as the premiere treatment for certain forms of mental illness though its use continues to this day. ECT has been utilized to treat a large array of conditions including (United Kingdom Advocacy Network, 1995): Various neuropsychiatric conditions Mania Schizophrenia Post-natal depression Anxiety Hypomania Post-traumatic stress disorder Puerperal psychosis Currently, the only condition that ECT is the primary form of treatment for is that of severe depression (Scott, 2005). This is due to the fact of the severe symptoms caused by severe cases of depression such as extreme suicide attempts, suicidal thoughts, and refusal to eat. As is evidenced above, ECT has been proven time and time again through research and practice to be an effective means to treat several different psychological disorders. In fact, there have not been any controlled studies conducted where any other treatment has outperformed the effectiveness of ECT in the treatment of depression (Janicak, Davis, Gibbons, Ericksen, Chang, Gallagher, 1985; Rudorfer, Henry, Sackheim, 1997). It has been calculated that the average response rate of patients with major depression to ECT treatment is 70% to 90% compared to the response rate of antidepressant medications which are most commonly the primary treatment prescribed for depressive disorders which is 60% to 70% (Abrams, 1997). There has even been evidence presented showing that ECT produces the desired effects faster than that of antidepressants (Rudorfer, Henry, Sackheim, 1997). While the facts discussed above provide a strong argument for the use of ECT as a primary treatment for individuals suffering from severe depression, just as with antidepressants, it is not a curative treatment. Relapse in patients that have undergone ECT sessions have been found to be around 90% within six months after treatment (Sackheim, Haskett, Mulsant, Thase, Mann, Pettinati, Greenberg, Crowe, Cooper, Prudic, 2001). Therefore, in order to maintain the benefits of ECT sessions, it is necessary for a patient to receive future treatments within in the form of antidepressants and/or mood stabilizer medications (Sackeim, 1994) or weekly maintenance ECT sessions for approximately four to six weeks (Rasmussen, 2003). Gagne, Furman, Carpenter, and Price (2000) found that patients that received a continuation of a combination of the two treatment options were less likely to suffer from a relapse than those patients who received only antidepressant treatment. Therefore, if the patient i s administered the proper treatment options after the cessation of regular ECT sessions the patient should continue to reap the benefits that were provided during the initial sessions. Administration As one may presume, ECT is a precise treatment method which, if administered improperly, may inflict more damage to an individual rather than aiding in their recovery. Researchers continuously review data as well as run tests on the many different aspects of ECT and how each one affects the outcome of an individuals ECT session. This section briefly summarizes the procedure that is followed when administering ECT to an individual. During the administration of ECT the first thing that happens is an anesthesiologist administers a general anesthetic as well as a muscle relaxer. This causes the patient to fall asleep as well as causes all of the patients muscles to relax preventing the muscles from convulsing during the administration of the electrical shocks. As the anesthetic is administered the patient is also given oxygen which continues for the duration of the session. After the induction of sleep, a small electric current is passed through the brain of the patient through two small pads that are placed in specific regions on either both sides or the same side of the scalp causing mild convulsions within the brain. Once the procedure is over it may be necessary for the patient to undergo more sessions of ECT in order to receive the most positive effect possible from the treatments (Royal College of Psychiatrists, 1995; Salford Community Health Council 1998). Side Effects As with any form of treatment through which something is being administered to an individuals body, ECT does produce certain side effects. The side effects most concerning to individuals during the decision of whether or not to partake in ECT are that of memory and cognitive impairment. Individuals upon which ECT has been administered have been found to suffer from amnesia in respect to events that happen both before and after an ECT session (Scott, 2005). While this may be the case, research has shown that the event memories that are lost are more likely to be of an impersonal rather than personal nature (Lisanby, Maddox, Prudic, Devanand, Sackeim, 2000). However, it has been reported that after the completion of a course of ECT, the patients memory losses improve substantially with a few patients reporting residual difficulties (Calev, 1994; Weiner, 2000). Conclusion Severe depression may introduce many different problems into an inmate population such as violent as well as suicidal tendencies. These are two propensities which a prison staff tries to suppress as quickly as possible. It has been found that sometimes, in severe cases of depression resulting in strong suicidal urges, psychotherapeutic drugs may not take effect quickly enough. In cases such as this, ECT may be the wisest treatment option available. Studies have found that ECT treats severe depression faster and more effectively than standard drug treatments which, in cases of violent and suicidal tendencies within the inmate population, is of the utmost importance. Once the initial ECT sessions have been completed, it should not be difficult for an inmate to receive continued treatments, both psychotherapeutic as well as ECT, to maintain the same positive effects that were produced by the initial treatments due to their incarcerated state. In this way, the inmate who suffered from th e severe depression may be reincorporated into the prison population without posing a risk to themselves or others due to mental illness.

Terrorism In North Africa :: Terrorists, Role Of United States

North Africa is a huge area that is becoming a safe place for terror groups. Are we facing another failed state? What should be done about it? Should the United States send troops to North Africa to prevent it from becoming another Afghanistan? The Jan. 16 attack on the natural-gas installation at In Amenas, Algeria, like the Sept. 11, 2012, raid on the U.S. facility in Benghazi, Libya, was the work of al-Qaida affiliates operating in the Sahel, a region in North Africa defined by both the Sahara desert and centuries of tribal warfare. Its latest iteration, responsible for more than 100,000 deaths, has been the decade-old Islamic insurgency in Algeria. The conflict has received little international attention — until an attempted rescue of the In Amenas hostages by Algerian Special Forces resulted in 37 deaths, including several Americans. The Sahara, the largest desert between the two poles, has been both an obstacle and a route for invaders — from the Romans to the French Foreign Legion. Although Timbuktu was long a center of learning and commerce, back to the golden empire of Mansa Musa, the region is now a neglected part of the world –making it an ideal safe haven for terrorists. The sands respect no borders and erase divisions between Algeria and Mali, a fact traditionally exploited by desert nomads and lately by jihadists led by al-Qaida in the Islamic Maghreb. Until French forces recaptured the main towns, AQIM had controlled northern Mali for 10 months and ran the area under Shariah law. The jihadists’ pronounced goal, shared by Salafists and other radical Muslim groups, is to recreate the Caliphate of Islam’s glory years of the eighth century, when it controlled territory from Andalusia to India. Their confidence is not unfounded. Neither Mali nor its neighbors possess the capabilities or the will to defeat the Islamist insurgency. If, as President Francois Hollande recently announced, France will declare victory and withdraw its troops, the conflict threatens to continue metastasizing over time. Local media have reported that the rebels have attracted recruits from other Islamist movements, such as the Boko Haram in Nigeria, and from countries as far away as Canada, as well as weapons from Libya. A precipitous withdrawal by the French would solidify the Islamists’ belief that, if the Prophet could create his Caliphate from the sands of Medina, they can recreate it from the sands of Timbuktu. The situation is further complicated by the region’s oil and natural gas wealth.

Students and School Uniforms Essay -- essays research papers

  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Students and School Uniforms   Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  The implication of school uniforms on the public school system would make a dramatic positive change for the students now and in the future. Currently the public school system allows casual dress code attire throughout the United States. Differing from private school institutions, where uniforms are mandatory. School uniforms are beneficial to the students and to the parents of these students. Secondly, uniforms provide structure and unity within the schools. Lastly, school uniforms make the environment in which the students conduct in for approximately 6 – 7 hrs. of their day a safer place.   Ã‚  Ã‚  Ã‚  Ã‚  How much does it cost to dress for school? The prices in the fashion market targeted to school age children are on the rise yearly. â€Å"The $28 billion children's apparel market experienced continuous growth from 1998 to 2003 up 32%† (Key note publications, 2003), this statistic showing the growth in spending on fashion clothing for young children. The clothing market now being a large expense for parents of these children. The purchasing of school uniforms is proven to be less expensive than the competitive fashion market at this time. School uniforms are typically purchased yearly, with the growing child. This lessening the amount of money spent on uniforms and attention paid to the fashion market’s competiti...

Whats Medicaid And Medicare Reimbursement Health And Social Care Essay

What is Medicaid and Medicare reimbursement. In this paper you will see a glance of funding issues each province has when working with reimbursement issues. The Medicaid plan administered by single provinces but besides involves federal support and is the beginning of medical coverage for low income patients. In Georgia the population wellness direction plan was implemented to measure growing in wellness attention outgos. A non-experimental attack was used to analyse claims informations from Georgia Medicaid for all plan eligible individuals for each relevant clip period ( purpose to handle footing ) . The economic impact of reimbursement is outstanding in mention to existent cost and Medicaid cost tendencies.Introduction:Medicaid disbursement represents 15 per centum of all US wellness attention disbursement. In financial twelvemonth 2007, national Medicaid plan outgos were $ 332.2 billion, with 43 per centum ( $ 142.6 billion ) borne by provinces. Entire Medicaid plan outgos are projected to increase $ 673.7 billion by 2017 at the rate of 7.9 per centum Pr twelvemonth ( Truffer, CJ, 2010 ) . Medicaid disbursement ranks 2nd among all costs in many province budgets, accounting for 17 per centum of province budgets on norm ( Wildason DE. 2010 ) . Since the state is confronting terrible budget shortages and the growing of Medicaid disbursement is increasing many provinces have adopted cost salvaging such as decreases in supplier payments, coverage and has increased cost sharing with the enrollees. Some provinces have get downing carry oning analyzes to foretell outsourcing Medicaid reimbursement to managed attention organisations ( MCOs ) , negot8iating a planetary rate per member per month ( PMPM ) . One scheme used which is increasing is the aiming of high-cost chronically ailment or handicapped subset of the Medicaid population as execution of a disease direction ( DM ) plan to better wellness results while incorporating cost ( Flowers, L, 2010 ) . The public presentation indexs of the DM plans typically include: ( 1 ) Overall cost nest eggs ( normally based on the sum spent PMPM as compared to some baseline tendency ) ( 2 ) Component cost nest eggs ( decreases in exigency room visits or hospital admittances, as compared to the baseline and ( 3 ) Tax return to investing ( which accounts for plan costs every bit good as medical nest eggs ) . However, grounds of the effectivity of these plans within either Medicare or Medicaid populations is assorted ( Gillespie JL, 2003and Bott, DM, 2009 ) . Although DM plans target persons with specific diseases, surveies of more planetary population wellness direction ( PHM ) plans aiming clinically and socially complex disabled section of Medicaid populations are thin.MethodThe Georgia Department of Community Health contracts with 2 private sector DM sellers to organize and present population wellness outcomes direction services, the plans service the aged, blind, and handicapped population in different parts of the province. This survey focuses on the plan covering Atlanta and North Georgia. Sevenn diseases were targeted for direction ( asthma, chronic clogging pneumonic disease, congestive bosom failure, coronary arteria arteria disease, diabetes, haemophilia, and schizophrenic disorder ) , the plan result and fiscal inducements are tied to overall cost and quality results for all eligible enrollees, irrespective of disease or comorbidity. Georgia paid the North Georgia vendor a $ 13.94 PMPM capitation payment. Medicaid members enrolled in the plans received a wide array of attention services, a 24/7 nurse advice line, educational services, and member/provider analysis utilizing use and claims informations. The nucleus of the intercession squad is the registered nurse â€Å" wellness manager, † but the squad besides includes societal workers, druggists, mental wellness professions, and supplier engagement staff. Georgia ‘s proposed Balancing Incentives Program will be used to further spread out the usage of community-based long term attention services through the followers: aˆ? Expand the figure of slots in Georgia ‘s five 1915 ( degree Celsius ) Medicaid Waiver Programs aˆ? Provide an addition in reimbursement for paediatric place wellness services, thereby increasing entree to home-based, station ague services and cut down yearss spent in the infirmary aˆ? Fund three new community-based services for Medicaid receivers with serious and relentless behavioural wellness demands. The services have been proposed through State Plan Amendment. aˆ? Expand intensive community-based services to youth with serious emotional perturbations and their households. aˆ? Expand the Georgia Pediatric Program ‘s Medically-fragile Day Care service through slot enlargement and age enlargement. aˆ? Adopt Georgia ‘s 12 Aging and Disability Resource Centers as the primary point of entry for place and community services aˆ? Provide web-based preparation on community-based long term attention services available to targeted referral beginnings. The proposed budget for Georgia ‘s Balancing Incentives Program is $ 19,086,355 per twelvemonth, or a sum of $ 57,259,065 over a three-year period. Activities will get down instantly upon presentment of an award with development of statewide developing toward a no-wrong-door point of entry attack, with a focal point of entry through the Aging and Disability Resource Centers. The first five slug points above are designed to significantly spread out the usage of place and community services, cut downing the hazard of institutional attention for several diverse populations necessitating long term attention.Georgia ‘s Balancing Incentive ProgramUnderstanding of Balancing Incentives Program Aims: Since 2008 Georgia has participated in the Money Follows the Person Demonstration Grant, set uping a statewide system of passage coordination to help occupants of establishments in safely returning to their places and communities. In 2007 the State ‘s Medicaid expenditures for place and community based services ( HCBS ) comprised 30.7 per centum of entire long term attention dollars spent yearly. Georgia ‘s Money Follows the Person ( MFP ) Program has successfully transitioned 737 persons from skilled nursing and intermediate attention installations into community abodes and helped spread out the usage of community services, rebalancing the long term attention expenditures for HCBS to 40.9 % by 2010. One facet of the long term support and service system that Georgia has non yet been able to accomplish is a individual point of entry for all community-based services and plans. Entry into Georgia ‘s long term attention plans remains slightly disconnected with many poin ts of entry, some easier to happen than others. Progress toward a no-wrong-door attack was achieved in 2011 when Georgia funded a service, options guidance, provided through an interagency understanding with the State Unit on Aging. Today options guidance is provided through the Aging and Disabilities Resource Centers in all twelve regional Area Agency on Aging in Georgia, supplying direct face-to-face aid to any nursing place or ICF occupant to find available resources and services necessary to ease a successful, sustainable passage. Options Counselors provide the first contact with persons identified for inclusion in the Money Follows the Person Program and serve as a referral point for nursing installation staff as nursing place occupants self-identify for community passage through usage of the Minimum Data Set ‘s Section Q. Further, Options Counselors provide passage aid regardless of purpose to take part in the MFP Program, type of service demand, age or income degree. Despite this work, Georgia still operates several p oints of entry into LTSS, typically determined by population, disablement or type of service required.Current System ‘s Strengths and Challenges:As described above, Georgia ‘s Aging and Disability Resource Centers are more widely recognized by the populace, supplier community and the medical attention system than they were merely a few old ages ago because of outreach attempts by the AAAs, the State Unit on Aging, the State Medicaid Agency and the State ‘s Developmental Disability Agency. Part of the community acknowledgment stems from a big resource database maintained by the ADRCs that presently houses over 24,000 service resources for older grownups, grownups with disablements and persons with developmental disablements. This electronically-maintained resource database relies on parts that are regionally added and maintained by the AAAs. Each part employs information system staff who develop, update and keep the database. Therefore, all information is continually checked for contact truth and any needful alterations to the services offered. One challenge of the system is its labour-intensive theoretical account, utilizing information staff to look into and update resources. BIP Program support is exp ected to supply extra resources for the enlargement of the bing Resource Database targeted toward services specific to populations non antecedently targeted. Another strength of Georgia ‘s LTSS is its traditional usage of conflict-free instance direction. In three of the five release plans a demand of instance direction registration is the absence of association with a service bureau, an association that could function as a focussed referral point for LTSS. Georgia plans to develop construction for struggle free instance direction for the other two release plans and the other plans included in the Undertaking: community mental wellness services provided through the rehabilitation option and the Georgia Pediatric Program in-home nursing service. Since neither has included a conflict-free instance direction service in the yesteryear, this is expected to show a development challenge.Outreach and Ad:Outreach to populations in demand of long term attention has been a long clip chal lenge in Georgia. Georgia ‘s Money Follows the Person Program uses the undermentioned attacks to make out to persons in demand: aˆ? Printed stuffs such as circulars and booklets aˆ? Outreach to aim audiences: referral beginnings such as infirmaries and doctors, nursing installation staff ; older grownup groups, and protagonism organisations aˆ? Education through web sites Funding Plan: Georgia will go on to bespeak province support to fit federal Medicaid financess in order to spread out place and community services through the Balancing Incentive Plan. For more specific information on support, delight refer to the Budget Narrative contained in a separate papers.Challenges:One important challenge in Georgia will be the multiple electronic information systems built to suit points of entry. Over clip organisations in Georgia have independently developed population-specific or program-specific points of entry every bit good as electronic clinical record systems. These systems have evolved over decennaries affecting important province, non-profit-making and private resources. In some plans, there are no bing electronic record-keeping systems. To extenuate this challenge, the ADRCs began working with assorted entry points for developmental disablement services and over clip have expanded the ADRC staff expertness and resource database to include this population. Through its MFP Program Georgia has begun researching engineering options that could supply a platform for transportation of information from multiple electronic recordkeeping systems.Other Balancing Enterprises:As noted antecedently, Georgia was one of the first provinces to be awarded a Money Follows the Person Grant by CMS. Additionally, Georgia is runing one of the presentation releases for kids with terrible emotional upsets to avoid the usage of psychiatric residential intervention installations whenever possible. Technical Aid: Expectations for petitions for proficient aid autumn in the countries of: 1 ) Adopting a standardised, validated paediatric appraisal tool for kids at hazard of hospitalization or institutional long term attention because of delicate medical conditions 2 ) Researching an information engineering platform to ease the transportation of informations electronically for intents of functional and fiscal eligibility for long term attention. Long Term Supports and Services Expansion/Access to Service The followers is a description of the countries of Georgia ‘s Medicaid HCBS plans that will be expanded in assorted ways to supply extra services, serve extra Georgians, or heighten entree to services. aˆ? Expand the figure of slots in Georgia ‘s five 1915 ( degree Celsius ) Medicaid Waiver Programs. The enhanced federal lucifer available through the Balancing Incentive Program will increase admittances to the Elderly and Disabled Waiver Program, the Georgia Pediatric Waiver Program for medically delicate kids, the two Waiver Programs for people with developmental disablements, and the Waiver Program for immature grownups with terrible physical disablements. aˆ? Provide an addition in reimbursement for paediatric place wellness services, thereby increasing entree to home-based, station ague services and cut downing yearss spent in the infirmary. Georgia ‘s place wellness attention rates for station ague skilled services presently offer no derived function in rates for grownup attention and the attention of kids. Home wellness suppliers report a deficit of paediatric nurses, physical and occupational healers available to supply the attention ; therefore, worker deficit consequences in higher costs. In add-on to the higher cost of attention related to the labour market, paediatric place wellness attention is non provided every bit often as that for grownups with greater geographic distances involved in attention proviso. aˆ? Fund three new community-based services for Medicaid receivers with serious and relentless behavioural wellness demands. The services are being reviewed at this clip through State Plan Amendment. If approved by CMS, the new services will offer instance direction, rehabilitation-targeted employment services, and community life supports to persons with serious and relentless mental unwellness. BIP financess will besides be used to spread out Assertive Community Treatment and a rural theoretical account of Assertive Community Treatment for non-urban countries of Georgia. aˆ? Expand the Georgia Pediatric Program ‘s Medically-fragile Day Care service through slot enlargement and age enlargement. Georgia ‘s Pediatric Waiver plan offers medically-fragile twenty-four hours attention to kids who qualify through medical necessity finding. At this clip, Program eligibility is limited to kids age five or younger. There is a demand to spread out the age eligibility limitations, supplying after school attention for medically delicate kids who attend school but need after school attention. Budget Items to Support Balancing Incentive Program Requirements: The followers is a description of the programs for conformity with the demands of the Balancing Incentive Program and the budget deductions with budget projections if known. aˆ? Adopt Georgia ‘s 12 Aging and Disability Resource Centers as the primary point of entry for place and community services: Facilitate the add-on of services and resources specific to populations non presently included in the 24,000-service database. This enlargement of the ADRC resource database is expected to necessitate an increased figure of ADRC staff or may necessitate contracts with other points of entry for cross referral and coordination of resources. aˆ? Provide web-based preparation on community-based long term attention services available to targeted referral beginnings: Will necessitate that the Medicaid Agency purchase or subscribe to a web-based preparation bundle to suit 150 – 200 participants in on-line preparation Sessionss for the intent of cross-referral and communicating between points of entree. aˆ? Develop an outreach program and stuffs in order to raise consciousness of Georgians about the handiness of options to institutional attention. A preliminary Communication Plan includes media releases and articles, booklet and posting printing, societal media posters, and website hosting. The budget for communications is projected to be $ 150,000. aˆ? Development or purchase of an information engineering system designed to ease communicating between assorted province bureaus and other points of participant entree and eligibility finding. The State Medicaid Agency is researching the usage of the eligibility system scheduled for execution in 2014 as the platform through which approved spouses will portion demographic, fiscal and functional information for the intent of eligibility finding. An extra map of the system is that of informations sharing during cross-referral to avoid applicant confusion and facilitate admittance to service without duplicate of informations aggregation.