Healthcare Reform and Its Impact on the Delivery System

If you are in the healthcare industry, you have probably heard some rumblings about the Health Care Reform of 2010, coolly referred to as Affordable Care Act, or Obama care. The Patient Protection and Affordable Care Act (PPACA) was enacted by the United States Congress and signed by President Barack Obama. The Affordable Care Act (ACA) became public law in March 23, 2010. The health care reform was enacted with the goals of â€Å"increasing the quality and affordability of health insurance, lowering the uninsured rate by expanding public and private insurance coverage, and reducing the costs of healthcare for individuals and the  government† (Frost and Sullivan, 2011). The law is passed by US congress provide universal access to healthcare, control the rising costs of healthcare, regulate the private insurance industry through online marketplace and improve the quality of healthcare. The purpose is to â€Å"make healthcare choices more consumers friendly and easier to unde rstand. It is intended to make sweeping changes to healthcare in the United States† (White, 2013). The law also â€Å"requires insurance companies to cover all applicants within new minimum standards and offer the same rates regardless of pre-existing conditions or sex.Additional reforms aimed to reduce costs and improve healthcare outcomes by shifting the system towards quality over quantity through increased competition, regulation, and incentives to streamline the delivery of healthcare† (Monheit, 2010 ). The Congressional Budget Office projected that â€Å"the ACA will lower both future deficits and Medicare spending† however upheld â€Å"the law in promoting strategies and solutions to encourage health care reform that lowers cost, improves quality, and expands access to health care† (CBO, 2013).According to U. S Chambers of Commerce, â€Å"the United States spends $2.  7 trillion a year on health care. More than 170 million Americans receive healt h insurance through voluntary, employer-sponsored plans. The government was on the hook for $38. 6 trillion in unfunded liabilities for Medicare in 2011 as a result of the entitlements created by the health care reform law† (U. S. Chambers of Commerce, 2013). For the purposes of this research, it may be a good idea to have a common understanding of the recent legislation and Health Care Reform Act.I plan to highlight its impact on the delivery system at Montefiore Medical Center, thoroughly discussing its effect on access, cost and  quality, with special focus on how the recent legislation and health care reform will affect the health care facility. Montefiore Medical Center is a health care facility which is covered by the Health care reform. Health care reform compliance at Montefiore Medical Center is a central concern of their delivery system. The health care reform is a law that needs continuous regulation. Montefiore Medical Center and other health care facilities such as private clinics, home healthcare providers and small healthcare associated businesses, are in a prime position  to comply with the healthcare reform, and the law must ensure that these healthcare institutes are rigorously controlled, and are in compliance of the affordable care act.The Healthcare reform and all its provisions are already making the facility â€Å"find new ways to increase facility efficiency, better manage care and streamline costs† (Montefiore. org, 2012). One item the facility is focused on is renovating to cut down on operating expenses because of the impact of the healthcare reform. In a study by Amadeo Kimberly (2013) about access to healthcare on the delivery system  found that â€Å"more than 600,000 new young people became insured as of May, taking advantage of the Act's provision that children up to age 26 could be covered by their parents' insurance.†Rather than â€Å"employer-sponsored insurance offering the sole source for guarante ed issue insurance, coverage for preexisting conditions, and generally affordable coverage,†(Geyam, 2012) many employees may have alternative sources of coverage through expansion of Medicaid eligibility or premium subsidies through the state or federal exchanges. A report by economic experts at the Health and Human Services Department (HHS) noted that â€Å"the health  care remake will achieve the aim of expanding health insurance – adding 34 million Americans to the coverage rolls† (HHS, 2013).This shows that on the potential positive side of the health care reform, there would be a continuous increase in access to healthcare. This increases â€Å"profits for the insurance companies, which should translate to lower premiums, since the new insures pay into the system but require fewer health services† (Kimberly, 2013). Geyam (2012) observed that â€Å"the healthcare reform will extend insurance coverage by 32 million people by 2019 (including 16 millio n on Medicaid);Will provide subsidies starting in  2014 to help many lower-income people afford coverage; will eliminate cost-sharing for many preventive services; will provide new funding to increase the capacity of community health centers; will put in place some limited reforms of the insurance industry, such as prohibiting exclusions based on pre-existing conditions and banning annual and lifetime limits; and will establish a new non-profit Patient-Centered Outcomes Research Institute charged with assessing the relative outcomes, effectiveness and appropriateness of different treatments. †As a result, millions of previously uninsured people will soon have access to healthcare, causing an increase in the number of potential patients requesting treatment from healthcare facilities such as Montefiore Medical Center. Healthcare costs are expected to â€Å"rise 7. 5 percent in 2013, even with healthcare reform,† according to a study by Price water house Coopers (2012). The Affordable Care Act focuses â€Å"more on getting people insured than on lowering costs overall,† says Jeff Munn, vice president of benefit policy development at Fidelity (2013), â€Å"But it's going to take a while to see if those provisions work,† he says..Another analysis by Barina (2013), also found that â€Å"the law falls short of the goal of controlling runaway costs, rising projected spending by about 1 percent over 10 years. That increase could get bigger, however, since the report also warned that Medicare cuts in the law may be unrealistic and unsustainable, forcing lawmakers to roll them back† (p. 18). The rapidly rising costs of health care keep going up unabated. Under the health care reform, the market still rules on prices. The cost of health care will increase by about â€Å"20 percent because of new technology and new initiatives† (Wright, 2010).In addition, analysis by both the Congressional Budget Office and the CMS actuary shows that â€Å"the health care reform will substantially reduce the federal deficit, only slightly increase national medical spending (despite an enormous expansion in insurance coverage), begin to reduce the growth rate of medical spending, and introduce various new initiatives that may lead to more fundamental reductions in the long-term rate of health care cost growth† (CBO & CMS, 2010). The health care reform will not solve our health care cost problems, but it is a historic and cost effective step in the right direction.It will introduce a range of payment and delivery system changes designed to achieve a significant slowing of health care cost growth. Throughout the health care reform debate, consumers and providers alike at Montefiore Medical Center and other healthcare facilities asked how they would be affected by the new law. Given how many types of facilities make up the delivery system, it is likely that the effects of reform will not fix all problems. Any â€Å"hosp itals that have historically provided more care to uninsured patients is likely to gain the most in terms of revenue increases for the mostly  uncompensated care they have been providing to these patients† (Berenson and Zuckerman, 2010).The Healthcare providers in the hospital and other healthcare facilities understand that their former ways of doing business are bound to change because of the healthcare reform. As observed by Berenson & Zukerman (2010) â€Å"the introduction of new, marginal incentives is designed to move in the direction of rewarding better performance. † In this way, there is a modest move in the direction of paying for value rather than volume.As indicated by Cutler David (2013), â€Å"the law begins to change how providers are paid and care is delivered, so that  they are rewarded not for the volume of services they provide but for the value they offer. † Of greatest effect is the expectation that future provider revenues will have less to do with patient volumes and more to do with clinical outcomes, quality and cost efficiency. Most hospitals will likely benefit financially because of the coverage expansions. â€Å"Providers that get good results for their patients and keep costs in check stand to be rewarded with performance bonuses, shared savings and other revenue enhancements† (Monheit, 2010).Those providers  that fail to do these things can expect financial penalties which will affect revenues and ultimately tarnish a provider's credit profile. â€Å"Accountable care may still be gestational in most areas of the nation, but the concept appears to be taking hold and will eventually replace large portions of our existing fee-for-service system† (Berenson & Zukerman, 2010). Moreover, the health care reform will also call for more care to be provided outside of the hospitals with specific provisions focusing on increasing the quality of preventative care. This will likely result in a major rise i n demand for ambulatory, or outpatient care.At the same time, Montefiore Medical Center and other hospital care facilities will shift a greater focus on critical care patient. In conclusion, the health care reform, Patient Protection and Affordable Care Act (PPACA), commonly called the Affordable Care Act (ACA) or Obamacare, may make some marginal gains in the area of access, cost and quality, but will not remedy all access, cost and quality problems in the health care delivery system. Experts also believe the added demand of the health care reform will mean a major increase in job openings within the healthcare industry.Some  predict as many as â€Å"250,000 to 400,000 jobs annually over the next ten years – as well as an increase in scope and location of available jobs† (Katz, 2013). For example, hospitals like Montefiore Medical Center will be staffing more critical care nurses while registered nurses and other patient care positions may have more opportunities at outpatient sites, such as clinics or other non-critical medical facilities. The health care reform changes are right around the corner and subsequently there will likely be a lot of transformation happening in the healthcare delivery system over the next few years.

Visual Rhetoric in Persepolis

Nils Tangemann Josh Holland English A SL C-Code Section: Part 3 Works read: Satrapi, Marjane. Persepolis. Pantheon. New York. 2003 Question: How and why is a social group represented in a particular way? The Display of Revolutionists in Marjane Satrapi’s Persepolis In Marjane Satrapi’s Persepolis there are several important social groups that all play a role towards creating the whole picture that describes little Marji’s everyday life in 1970s Iran. The nature of the revolution during that time created a huge divide between the different social groups.This was dominated by different opinions that were expressed using violence, intimidation and other mental and physical threatening methods. Satrapi uses visual representation and plot devices in her graphic novel Persepolis to expose the hypocrisy of the Islamic revolution. First of all, the author displays all members of the army and Islamic revolutionary groups without any distinction from each other; they are o ne homogenous group. Secondly, a story about the corruptness of policemen and government officials is used to demonstrate how detached those people act towards their fake values that they preach to other people.Lastly, the fact that the army is recruiting new soldiers through a method that is obviously aimed at non- or less-educated youth shows that the regime is scared of the higher educated population knowing that they will not have a chance in recruiting this social group because of their opposition. An aspect of the novel that comes to mind immediately when reading the text is Satrapi’s choice to display the members of the revolutionist Islamic regime in a different way than the family or friends of ten year old Marji.While the individuals that are a direct part of Marji’s social life are displayed in great detail, the revolutionists are always shown in a more general fashion, therefore not distinguishing those characters. An example of this can be found in the cha pter â€Å"The bicycle† when the burning down of a cinema by police forces is described (Satrapi 14). Using this technique, the followers of the regime are displayed as individuals that do not have an individual opinion, but rather blend into the crowd of people and go with the mainstream ideology hat is prevalent during the current political situation. This makes this social group stand out in such a way that the reader considers them generally as less educated and unable to question the political views that society has. The fact that Satrapi shows the persons that lean towards the more communistic political opinion in greater detail than revolutionists shows her political beliefs, therefore furthering the idea that this novel can be considered a memoir. In addition, the policemen of the revolutionary regime are depicted as corrupt and detached from their values.When the family almost gets caught having alcohol in their house, the policemen accept money from Marji’s f ather and leave again without checking his flat (Satrapi 10). If the actual religious core values of the regime were important to those policemen, they would not have left the site without checking, since the possession of forbidden substances is obvious to them. This depicts how separated the followers of the regime are from their own values that they promote.Satrapi tells the reader this story because she wants to expose the hypocrisy with which the government officials and therefore also the police operates. In this case, the author uses a plot device to express her political opinion. She makes the conscious decision to include this memory in her novel because it illustrates her opposition to the government and demonstrates a strong reason why using these policemen as bait. Similarly, in Marji’s description the army uses techniques that clearly aim for the less educated and poor people to join the military.A plastic key on a chain is distributed to the less educated in ord er to convince them that they will go to heaven if they fight for their country. Satrapi uses the dialogue between her mother and their housekeeper to indicate how upset the upper social class us about the strategy that the government uses to persuade the innocent youth of Iran (Satrapi 99). The government clearly aims for the young adults that do not have much of a choice other than joining the army and dying at a young age.On top of that, they are also naive enough to believe that the key will bring them to heaven. Mrs. Nasrine tells the story of how her son is being convinced to go to the army (Satrapi 100). The family helps to convince Mrs. Nasrine’s son that the government is spreading lies (Satrapi 101). Marji’s mother is debunking the myths of the government in front of everyone’s eyes. The author uses this technique to express her own, negative opinion for the government and the manner in which they treat the young adults and not caring about their lives .In conclusion, certain techniques of visual rhetoric and plot devices can be detected in the novel and are utilized to express the personal opinion of the author whilst displaying the revolutionary government as incompetent and unqualified. The followers of the regime are displayed homogenously without distinct characteristics or an individual opinion. The police that is associated with the government is corrupt and the methods of recruiting new soldiers for the army are only intended for uneducated and naive people because others cannot be tricked into the belief of going to heaven.The author makes great use of this technique not only when describing the revolutionists, but also when she is delivering her own opinion about how women were treated in Iran during her childhood. When deciphering these methods and finding the hidden comments on the social structure we really see the author in her mid-forties who is writing. The novel far expands from the view of a ten year old and is n ot only a story of a childhood, but also a critical commentary on moral issues and personal opinion. [Word count: 958] Citation: Satrapi, Marjane. Persepolis. Pantheon. New York. 2003.

Knee Injuries

Knee Injuries The knee is a complex Joint which can flex and extend for movement and Is a weight bearing joint. The knee is part of a kinetic chain directly affected by motions and forces occurring and transmitted from the foot, ankle, and lower leg. The knee then transmits forces to the thigh, hip, pelvis, and spine. The knee Is has four major ligaments which controls stability. The medial collateral ligament (MAC)and lateral collateral ligament (LLC) are on the sides of the knee and prevent the Joint from sliding sideways.The anterior excruciate ligament (CAL) and posterior excruciate ligament (PC) form an â€Å"X† on the inside of the knee and prevent the knee from sliding back and forth. These limitations on knee movement allow the knee to concentrate the forces of the muscles on flexing and extension. The knee also has two shock-absorbing pieces of cartilage called menisci that sit on the top surface of the tibia. The menials allow the femoral condole to move on the tibia surface without friction.Range of Motion * Loss of motion is likely from: Effects of Injury * Trauma of Surgery Effects of Inflammation Ligaments do not heal completely for 18-24 months so waiting is not an option * Early range of motion can minimize harmful changes * Controlled movement should be initiated early and based on patient tolerance and healing constraints Exercises * Active assisted knee slides: use good leg supporting injured knee to regain flexing and extension * Wall slides to regain flexing and extension * Active assisted knee slides on wall * Knee extension with foot support (towel) regain extension (flex knee towards floor) * Knee extension in prone with ankle weight to regain extension (on stomach) * Groin stretches * Kneeling thrusts * Knee extensors stretch * Side-lying knee extensor stretch with sports cord * Knee feeler stretch (on back) * Knee feeler stretch with sports cord (on back) * Knee feeler stretch on wall * Ankle pleasantness's stretch 1 OFF * Prima ry goal: Return of normal strength, endurance, and power to musculature surrounding the knee * Overload is necessary to strengthen but not over aggressively to cause further injury or repeat * Recovering knees need protection and strengthen programs made for a health knee can compromise the integrity of the injured knee. Strengthening contain.

Noise Pollution Essay Example | Topics and Well Written Essays - 1000 words - 1

Noise Pollution - Essay Example Sound is made up of longitudinal waves that travel through air and cause certain materials to vibrate and create sound. The common characteristics of sound are intensity, frequency, amplitude and velocity. Sound cannot travel in outer space because it is a vacuum. (Ron Kurtus, 2009) According to Kurtus atoms and molecules that float in outer space are too far apart to actually cause any vibration or sound. A loud explosion in outer space would hardly be heard because of the vacuum. Unlike electromagnetic waves that easily travel through space through electrical and magnetic fields, sound waves are caused due to vibration of matter. (Ron Kurtus, 2009) The intensity of sound varies from human to human due to varying hearing sensitivity and therefore cannot be generalized. Sounds which could be normal for some could be harsh for others. Sound frequencies ranging between 1000 Hz and 5000 Hz seem most sensitive to the human ear. However, a normal human ear with the right hearing ability has the lowest threshold of approximately 4000 Hz for comfortable hearing. When sound intensity goes beyond this threshold it tends to impact on the ear causing damage. Such intense sounds include loud explosions, blasts, crashes and noise from heavy machinery etc. Prolonged exposure to such intensity of sounds is liable to lead to permanent damage. Sound intensity is described as the average rate of sound energy flow across a perpendicular surface in the line of propagation. Sound intensity is measured by special units, namely, bel and decibel which are logarithmic. If there is an increase of 1 bel, the intensity of the sound increases ten fold. An i ncrease of 1 dB increases the intensity by approximately 25% and the change in audibility can hardly be detected. The threshold for human hearing is 0 dB sound intensity. The intensity of sound decreases as distance is increased. (www.physicsclassroom.com) The frequency of

Advanced HealthCare Management Essay Example | Topics and Well Written Essays - 500 words

Advanced HealthCare Management - Essay Example Conversely, a team may be defined as comprising a group of individuals. In such a way, it can be determined that a group can only develop into a team if there is a drive to reach some form of coordinated consensus or particular goal. Within such an understanding, the reader can come to the appreciation of the fact that the ultimate evolutionary goal of each and every group is to arrive at the â€Å"team† stage of development. Furthermore, an added level of differential exists between formal and informal groups. As one might expect, formal groups are created and/or maintained as a means of fulfilling certain and specific tasks with relation to the needs and demands of a particular entity and/or organization. Such a level of conscious and deliberate creation helps to constrain and formalize them into units that would not otherwise naturally exist or be spontaneously evidenced within the professional/business/or corporate environment. However, informal groups are the result of the spontaneous forces that can encourage individuals to come together while working to develop a variety of goals. Informal groups can be predicated on either useful or un-useful metrics. An example of a useful metric could be the fact that an informal group could come together as a means of tackling an extant problem that all stakeholders had come to notice (Hongseok et al, 2004). Conversely, an un-useful means by which such an info rmal group could be created would be based on a shared dislike for an individual or group of individuals. Although these organizational standards and means of application for teams, formal, and informal groups are all different, it must be understood that they each have their place in seeking to speak to the needs of the individuals and organizations that create and sponsor them. Hongseok, O., Myung-Ho, C., & Labianca, G. (2004). GROUP SOCIAL CAPITAL AND GROUP EFFECTIVENESS: THE ROLE OF INFORMAL SOCIALIZING TIES. Academy Of Management Journal,

Terrorism Term Paper Example | Topics and Well Written Essays - 2250 words

Terrorism - Term Paper Example Similarities and differences with insurgency Insurgency is not a conventional war or terrorism. It shares with terrorism the use of force to obtain a political end. Difference that arises between the two is the degree of violence. Terrorism does not lead to political change on its own but insurgency tries to bring forth change use of force of arms. Insurgents use ways like hit and run attacks and laying ambushes on the security forces. Insurgency unlike terrorism gets significant support from a large portion of the population. Insurgency is a movement or a political effort that has an aim. The major difference between terrorism and the insurgency is the intent of their activities. Insurgency contains nothing inherent that will need the use of terror. However, there exist other successful insurgencies that used terrorism and the terror acts, other formed into conflicts where the tactics of terror and terrorism became predominant. Other insurgencies renounced the use of terrorism total ly in their movement. The choice of using terrorism is to inspire increased resistance, destroying the government efficiency, and to mobilize support (Sageman 20). The goal of an insurgency is, to adequately challenge the present government for the control of the entire or a portion of its territory. Insurgents can also force different political concessions in sharing of political power. Insurgencies, however, need the tactic or active support of a portion of the involved population. The insurgents could also require support from foreign countries. This, however, does not bother them at all. A terrorist group does not need and minimally has empathy or support of a big fraction of the population. While the insurgents describe themselves frequently as guerillas or insurgents, the terrorists will never refer to themselves or their organization as terrorists. They describe or portray themselves using political or military terminology such as activists and freedom fighters. Terrorism dep ends on public impact, and relatively conscious of the benefits of avoiding the negative impacts of the term terrorists’ when identifying themselves (Simic 15). Terrorism acts do not try to fight the government forces directly, but will tend to change the perceptions as to the legitimacy or the effectiveness of the government in question. They achieve this by ensuring the greatest knowledge of terrorist acts of violence. The terrorists do not attempt to control any region, as this identifies them to a location which reduces their security and mobility. The terrorist avoid direct confrontations with the forces of government. Insurgents can have something to achieve from clashing with the government forces, like proving that they can efficiently challenge the government military and test their effectiveness. Terrorist organizations have nothing to gain from clashing with the governments. The terrorists groups will not engage in anything that resembles a fair fight or a war itse lf. They use ways that will neutralize the powers of the conventional forces. Terrorists tactics include; bombings of civilian targets where the military spend off duty time, ambushes of conveys that are not defended and the assassinations of poorly guarded individuals (Sageman 24). Insurgencies do not need the targeting of civilians, despite the fact that they expand the required legal definition of combatants to include the police and other security personnel

Narrative Essay Example | Topics and Well Written Essays - 750 words - 5

Narrative - Essay Example Together with teammates, Bolt recorded the world record for the 4x100m relay. Bolt is the current Olympic champion for the three sporting events; 100m, 200m, and 4x100m relay. In the 2012 London Olympics, Bolt won the 100m gold medal at 9.63 seconds. He thus set a new 100m Olympic record, and also defended the gold medal that he received during the Beijing Summer Olympics in 2008. The 2012 Summer Olympics was an international sporting event that illustrates the Olympics Games tradition. The Olympics Games are organized and managed by International Olympics Committee (IOC). The sporting event occurred in London, the United Kingdom. The 2012 Summer Olympics were conducted between July 25, 2012 and August 12, 2012. Approximately 10,000 athletes participated in the event, from 204 National Olympic Committees. The main broadcaster for the event was the Olympics Broadcasting Services. During the event Usain Bolt proved his position as the historically greatest sprinter, because of the effective retention of the 100m gold title (Rosner & Shropshire 454). Bolt’s win in the 2012 was very memorable due to various reasons. The win occurred during the weekend that Jamaica celebrated the 50th Independence anniversary. The 9.63 gold medal win created a celebratory mood in Jamaica because it illustrated the shortest athletic competition in the history of the Olympics Games. The two main noticeable athletes in the competition were; Usain Bolt and his fellow countryman Yohan Blake. The Jamaicans are very fierce competitors in the racing track, but Bolt emerged as the best by winning gold. Bolt accomplished another feat by retaining the 100m Olympic gold title. The athletic effectiveness of Bolt was doubted by many people, because of a season that had cases of defeat and injury. During the 2012 Olympics he performed the second fastest time ever, and thus defeated Yohan Blake and Justin

Critically analyse the trend towards incorporating nurse practitioners Essay

Critically analyse the trend towards incorporating nurse practitioners into healthcare systems has been evolving over the past several decades in Australia - Essay Example This evolution in advanced nursing practice in Australia and other countries is because of increasing demands on the health care system and changes in the delivery of health care which include the growing cost of acute health care; the increasing number of specializations in health care; the greater avoidance by medical practitioners of particular client groups such as people in rural and remote communities, those with chronic illness, and low socio-economic groups; and the extensive upgrade of nursing education and training. These factors fuel the development and extension of the scope of nursing practice and the consequent increase in the allocation of clinical discretion, responsibility and autonomy to nurse practitioners (Pearson & Peels, 2002). The value of nurse practitioners will be fully realized only when they also focus on advocating for changes to the social and economic conditions that are at the root of many of the medical conditions they will be required to manage. This paper proposes to analyze the development of the role of the nurse practitioner in Australia from a socio-political perspective. The nurse practitioner is defined as â€Å"a registered nurse with appropriate accreditation who practices within the professional role. The nurse practitioner has autonomy in the work setting and has freedom to make decisions consistent with his/ her scope of practice, and the freedom to act on those decisions† (NSW Health Department, 1998). By the turn of the century after several years of struggle and conflict with the medical profession to crystallize the importance of the nursing role in health care, legal recognition was proclaimed for nurse practitioners in New South Wales, Ausrtralia. This brought about legislation, authorization, acceptance and implementation of the advanced professional role and status of nurse practitioners (N.P.), practice privileges, and protection of the N.P. title in five states: New South Wales,

Inheritance Essay Example | Topics and Well Written Essays - 1500 words

Inheritance - Essay Example (a) Direct transfer to the successor: this is used within continental Europe, also other countries that have imitated their civil law systems. It also was in use under the English feudal system for land. This facet of the law hereditary from England subsisted in Qld. (b) Dual scheme of transfer: valuable and delegated succession, concerning individual representatives such as the perpetrator, the management, the public trustee, sharing the legal identity on death also supervising the property for the profit of creditors with beneficiaries. This scheme is now embraced commonly within the common law jurisdictions. The major benefit of this system is more capable supervision, through one individual or else a group of people acting together as being accountable. This is a lot easier for the creditors. 3. By way of family provision legislation below which a Court may perhaps diverge the provisions of the will of the departed if inadequate provision is made for the wife, kids or added dependants of the departed. This restricts the testator's liberty of testation1. Case 1 ) Alex needs to draft a will , firsthand within that will he needs to specify that he intends to , give as gift to his sister one of his , Chattels personal: These are the tangible goods, which can be stroked like the fixtures, clothing, wristwatches and so on. He will need to specify Contingent legacy, which is a gift within a will which relies on a specific incident taking place. As a Trustee Claire and Doreen hold his property and maintain it on his behalf. Form Alex can use his Will, which would be a legal document to leave as a gift his painting when he dies. Legally, a trust is a link which subsists when an asset is taken by individuals known as the Trustees for the advantage of another individual known as the beneficiaries. The Trustees have the power and lawful rights of the assets however they are required to use their powers only for the advantage of the Beneficiaries. As by law no gift is made when the Trust is recognized, there are no inheritance tax inferences. Now in this case because the situations recognizes a trust , Alex can besides his will also do the following to make sure the gift is given to his sister after his death: Alex must think about utilizing the element of a Discretionary Gift Trust. In this way Alex can hold on to plasticity over the selection of the eventual Beneficiaries i.e. the individuals who will obtain the profits below the trust. These Beneficiaries consist of the Settlor's wife, keeping in view the fact that she too is not the Settlor, children and grandchildren, brothers as well as sisters plus their matter as well as any individual designated by the Settlors to the Trustees in script. This means, Alex can do this by initially drawing a will and then convening a discretionary gift trust, both of these acts will make it easier for his sister to be receive the gift he wants her to have

Atheistic Existentialism - Life Domains Essay Example for Free

Atheistic Existentialism Life Domains Essay Directions: Complete the â€Å"Atheistic Existentialism† column in the table below by filling in the cells from information provided in the textbook. Atheistic Existentialism / REALITY The only reality for an AE is the one they create for themselves†¦everything is matter – everything is connected as some form of matter or energy and in a cause and effect relationship Atheistic Existentialism / KNOWLEDGE The only knowledge comes from our own senses. Atheistic Existentialism / HUMAN NATURE To an AE – humans are allowed free-will, personalities and consciences – but don’t have any reason to do anything with it Atheistic Existentialism / HUMAN PROBLEMS Their problem is that they can’t deal with the fact that they have human personalities and tendencies – but don’t know why, or what to do with it Atheistic Existentialism / SOLUTIONS TO HUMAN PROBLEMS Humans alone have the only solution to their problem and the more they evolve the better they’ll be at fixing them, so live as if your inner desires do have some meaning and try to make an impact on the world. Atheistic Existentialism / HUMAN VALUE Truly there is no ultimate value of a human life, but Humans can have value because they create their own reality by making their own choices – good or bad. Atheistic Existentialism / HUMAN PURPOSE Our only purpose – according to an AE is that of making yourself into who or what you wish to be, otherwise there is no purpose. Atheistic Existentialism / ETHICS Ethics – Schmethics†¦As long as you make a conscience choice to do something – good or bad – you are determining what your ethics are. not living by the laws of man, or any other guide. Atheistic Existentialism / SUFFERING Nothing good comes of it – there is no purpose for it – so don’t do it. Atheistic Existentialism / MEANING OF LIFE. There is no real meaning – each individual is able to determine what life means to them by their choices to be or not to be, do or not do, etc. Atheistic Existentialism / HUMAN DESIRE Kill it! Don’t be led by your inner needs, wants, voices, it is absurd to follow these â€Å"accidental causes† of evolution because you don’t need anything more than the basics to survive. Personal Reflection Directions: Briefly summarize your personal reflection on the information that you have entered into Tables 1 and 2 in this assignment. It is interesting to see the â€Å"evolution† of these 3 worldviews. From the Naturalist who views everything as natural in it’s existence – you exist based on your senses and experiences alone to the Secular Humanist with their realization that humans are wonderful – great creatures with personalities and determinations, but it doesn’t matter†¦to the Atheistic Existentialist (AE) – who finally realizes that the innermost feelings and desires we have as humans do exist, but would be better off â€Å"killed† or cut out than to be nurtured and followed. To me It is just man’s way of not wanting to give credit where credit is do! So many people feel they have to â€Å"give up† so much to follow God. The only way Satan can â€Å"win† is to have more souls in his army than God. He finds our weaknesses and zeroes in on them to keep us from realizing the truth. Man’s ego and sense of self is historically his ruination. It’s easy to see how in these days, these 3 views – all making humans the only thing that matter and by crossing out God, satan is able to lead many astray.

Action research

Action research ACTION RESEARCH, ITS BENEFITS AND CHALLENGES IN ENGLISH LANGUAGE TEACHER EDUCATION Action research in English Language Teaching is relatively a recent development which has been predominant in the literature in late 1980s and early 1990s. This essay explores the definitions, literature, benefits and challenges of action research as a method of teacher research in teacher education and development. It concludes by a critical assessment of the application of this research methodology and its sustainability in ELT. 1. INTRODUCTION There is a plethora of definitions of action research just as there is myriad literature on the subject by many scholars in many fields of human endeavour. Burns (2005) in her seminal paper on action research has explored definitions of action research by extensively highlighting the views of educators such as Denzin Lincoln (1998), Rogers (1961), Grotjahn (1987), Freire (1970), Schutz (1967) among others. She sums up that action research is a part of a quiet methodological revolution towards qualitative research approaches which impacted on the social sciences and emerged in reaction to scientific, experimental and quantitative paradigms. It encourages participative, naturalistic enquiry with its exploratory-interpretive underpinnings (Burns, 2005:57). Action research, since 1940s, and its related branches such as action science, action learning, practitioner research, participatory research, and collaborative/cooperative enquiry have been part of the new revolution towards change in human social and economic situations. Burns further explains that action research is a general movement that attempts to create meaning and understanding in a problematic social situations and improving the quality of human interactions and practices within those situations. The relevance of action research to English Language Teaching and teacher education, as we can deduce from the foregoing, is that it cuts across many disciplinary fields which include the field of applied linguistics. It is seen as a flexible research methodology suitable for research that supports change. According to Hopkins (1985: 32) and Ebbut (1985:156) the combination of action and research presupposes action as a form of disciplined inquiry in which personal attempt is made to understand, improve and reform practice. Cohen Marion (1994:186) see action research as small-scale intervention in the functioning of real world thus a closer examination of the effects of change of such intervention integrates social research with exploratory action to promote development. Lisa (2008:4) states action research involves fluid and overlapping cycles of investigation, action planning, piloting of new practices and evaluation of outcomes incorporating at all stages the collection and analysis of data and generation of knowledge. She maintains that the outcomes of action research are both practical and theoretical. The knowledge it generates has a direct and ongoing impact on changing practice for participants and on a wider audience through its publications, and application. This essay, however, focuses on educational action research (teacher action; as in Borgs paper on Conditions for Teacher Research; Condition 9: Community) with inclination to English language teaching. Thus the essay explores educational action research, its processes, purposes and characteristics in line with the views expressed by Burns (2009). The essay draws its conclusion from the challenges, status and how action research can be encouraged, maintained and promoted in English language teaching. 2. THE ORIGIN OF ACTION RESEARCH The popular belief is that Kurt Lewin is the originator of action research in the 1940s. His work was intended to change the life chances of disadvantaged groups in terms of housing, employment, prejudice, socialization and training. The combination of action and research has contributed to the attraction of this method of research to researchers, teachers, academic and educational community. Kurt was a psychologist, influenced by the work of the social philosopher, J. L. Moreno, in group dynamics and social movements in early 20th century Germany. Kurt conceived of research as leading to social action, and saw action research as a spiral of steps each of which is composed of circle of planning, action and fact-finding about the result of the action (Lewin, 1948:206, cited in Burns, 2009:58). Zuber-Skerritt (1996a) suggests emancipatory action researchis collaborative, critical and self-critical inquiry by practitioners into a major problem or issue or concern in their own practice. They own the problem and feel responsible and accountable for solving it through teamwork and through following a cyclical process of: strategic planning; actions, i.e. implementing the plan; observation, evaluation and self-evaluation; critical and self-critical reflections on the results On the basis of points 1-3 decisions could be made for the next cycle of action research. Earlier, Zuber-Skerritt (1996a:3-5) argues action research is emancipatory when it aims not only at technical and practical improvement and the participants better understanding, along with transformation and change within the existing boundaries and conditions, but also at changing the system itself or those conditions which impede desired improvement in the system/organization There is no hierarchy, but open and symmetrical communication. The emancipatory interest is based on the notion of action researchers as participants in a community of equals and as improvement to professional practice at the local, perhaps classroom level, within the capacities of individuals and the situations in which they are working. Action research is part of a broader agenda of changing education, changing schooling and changing society. A review of action research frameworks reveals several common features. An action research project seeks to create knowledge, propose and implement change, and improve practice and performance (Stringer, 1996). Kemmis and McTaggart (1988) suggest that the fundamental components of action research include the following: (1) developing a plan for improvement, (2) implementing the plan, (3) observing and documenting the effects of the plan, and (4) reflecting on the effects of the plan for further planning and informed action. New knowledge gained results in changes in practice (see also, Fullan, 2000a). Action research is often conducted to discover a plan for innovation or intervention and is collaborative. Based on Kemmis and McTaggarts (1998) original formulation of action research and subsequent modifications, Mills (2003) developed the following framework for action research: Describe the problem and area of focus. Define the factors involved in your area of focus (e.g., the curriculum, school setting, student outcomes, and instructional strategies). Develop research questions. Describe the intervention or innovation to be implemented. Develop a timeline for implementation. Describe the membership of the action research group. Develop a list of resources to implement the plan. Describe the data to be collected. Develop a data collection and analysis plan. Select appropriate tools of inquiry. Carry out the plan (implementation, data collection, data analysis). Report the results. This deductive approach implements a planned intervention, monitors its implementation, and evaluates the results. A more inductive approach, formulated by Burns (1999), is to carry out action research to explore what changes need to be made or what actions need to be taken in a specific instructional setting. Burns suggests the following interrelated activities: Explore an issue in teaching or learning. Identify areas of concern. Observe how those areas play out in the setting of the study. Discuss how the issue might be addressed. Collect data to determine the action to be taken (e.g., student questionnaires, observation reports, journal entries). Plan strategic actions based on the data to address the issue. Kemmis and McTaggerts approach focuses on implementing an action plan, whereas Burns focuses on planning for action. Commonly used data collection tools in action research projects include existing archival sources in schools (e.g., attendance reports, standardized test scores, lesson plans, curriculum documents,), questionnaires, interviews, observation notes and protocols, videotapes, photographs, journals and diaries, and narratives (e.g., stories told by teachers, see Hartman, 1998). ACTION RESEARCH IN EDUCATION Burns (2009) points out that the modern seeds of AR in educational contexts can be found in the work of John Dewey (and can be traced to Aristotle). Dewey had argued against the separation of theory from practice, and this had profoundly influenced educational enquiry in the first part of the 20th century to the present time. This has been the basis for future research by educators, academics and social scientists into their various fields with the aims of improving the human conditions. Nevertheless, in recent years a great body of literature in language teacher education has focus on teacher beliefs and reflection. Movement such as the teacher as researcher and teacher as reflective practitioner have been trying to promote the benefits of empowering teachers to take control of their professional development and curriculum development through reflection on practice. The new trend encourages teachers to carry out systematic rigorous enquiry into problematic areas of teaching, learning and curriculum in their classrooms, devise plans of action, carry out these plans of action and collect data to evaluate the revised plan in a cyclic pattern(Denny,2005:59-60). It is however noteworthy to understand that the movements teacher as researcher and teacher as reflective practitioner developed in different forms by different proponents of AR in UK, the USA and Australia, though they have much in common and strongly influenced by teacher education(Zeichner,2001 in Denny, 2005) . After all the polemics, it is obvious and important that teachers need support in order to carry on AR, streamline the research process, understand and imbibe group research ethics, ability to learn fast and become familiar with the literature on the theme of the research. Teachers on training like us, and practicing ELT/ESL with less experience or even completely unfamiliar with AR should be enlightened, given guidance on background reading in research methodology before any assignment or to initiate AR project. Where resources are available, there would be the need to organise a workshop at the beginning for a group with a varied and differing experiences to teach the principle of action research, methods of finding a focus which is realistic, selecting and designing the data gathering tools and planning the research timeline(Denny,2005). Also in line with Dennys (2005) suggestion, I feel that teacher researchers involved in group project should be also be involved in organising initial workshops and dissemination of the results of the workshop through publication. The group should include a researcher experienced in AR and with experience in applying for grants, presenting and publishing research reports. 3. MERITS AND BENEFITS OF ACTION RESEARCH Action research has made some significant positive impacts in language teaching field, especially ELT/ESL and on teachers involved in it, individually and collectively, however, the precise nature of these impacts on language teaching and learning may be difficult to ascertain in tangible concrete terms. This may not be unconnected to the argument that AR is not a research method can be sustained and replicated, because of lack of formal unified theory and training its conduct. Nonetheless, scholars such as Kemmis and McTaggart (1982:2-5, in Burns, 2005:68) claim that AR has enable teachers to develop skills in:  ¨ thinking systematically about what happens in the classroom  ¨ implementing action where improvements are thought to be possible  ¨ monitoring and evaluating the effects of the with a view to continuing the improvement  ¨ monitoring complex situations critically and practically  ¨ implementing a flexible approach to school or classroom  ¨ making improvements through action and reflection  ¨ researching the real, complex and often confusing circumstances and constraints of the modern school  ¨ recognizing and translating evolving ideas into action. Many more claims concerning the benefits of AR are made, Burns (1999: 14 15) states that the Australian teachers collaborated with her had experienced:  ¨ deeper engagements with their own classroom practices  ¨ a better understanding of research and methods for carrying out research  ¨ less sense of isolation from other teachers  ¨ a personal challenge, satisfaction and professional growth  ¨ heightened awareness of external factors impinging on their classrooms. 4. ARGUMENTS AGAINST ACTION RESEARCH Action research as a form of research is not without problems; articulation, conception and application. It has attracted a lot of criticisms; one major criticism is that research is an activity best left to academic specialists who have the training and capacity. Thus AR has no academic prestige and finesse. Jarvis (1981) is one of the proponents of this line of thinking in the language teaching field and similar views were expressed in TESOL Newsletter (2001), (see Burns, 2009:66-67). However, scholars like Borg (2002) feel differently, and reject the traditional boundaries between teachers and researchers. In fact Borg is championing the cause for teacher-researcher, has written extensively on this topic; Borg (2006) Conditions for Teacher Researcher. There is therefore need to address views such as Jarvis, if AR is to be considered as a research methodology. Many more criticisms against AR that deserve our attention are that it:  ¨ has not developed sound research procedures, techniques and methodology  ¨ is small-scale and therefore not generalizable(has low external validity)  ¨ shows low control of the research environment and therefore cannot contribute to causal theories of teaching and learning  ¨ exhibits strong personal involvement on the part of the participant and therefore is overly subjective and anecdotal  ¨ is not reported in a form that conforms to a recognisable scientific genre (Burns,2009:67). In addition to above criticisms AR has been criticised as messy, informal, and structurally unformed involving imprecise cycles of research and action. 5. CURRENT TRENDS IN ACTION RESEARCH Despite the arguments and counter arguments for and against AR as a methodology in language teaching fields, its range of activities has impacted on the participating teachers who have been engaged in it. It is now being accepted as a movement in the language teaching field, though it is not internationally widespread. This is because some essential conditions that promote AR, such as motivation, support, research knowledge, skills, and the potential for dissemination of findings are not readily available. This is in contrast to where AR has taken room, teachers are well supported, teaching in instructional contexts, such as in Australia and North America (Borg, unpublished, cited in Burns, 2009). Most ELT/ESL professional are still uninvolved in AR and despite the enthusiasm in favour of AR interest and involvement in it is on the decline. Most ELT and especially ESL teachers are not exposed to AR, and may not even have an idea of how it works. Some extensive workshops and conferences where teachers are involved in practical demonstration of teaching planning and presentation may result into AR. A case in point is my personal experience in Alfaisal International Academy, Riyadh. The Academy in collaboration with British Council organised a Training Workshop on the Teaching of Composition between the months of September and October, 2007. All participating teachers were given papers with spaces, and were asked to freely express the problems they encounter in the teaching of composition. The teachers were asked to present their views in groups and discuss the problems which include the choice of topic, sentence and paragraph development, logical arrangement of ideas, styles and soon. At the end of the month-long training most of the participating teachers were able to improve upon their composition class. The composition training was highly contextualized and localized in its attempt to investigate a situation in a specific school. We were able to convert tacit knowledge of student progress in composition writing to explicit knowledge that could be communicated clearly to other constituents, such as board members and parents. The training confirmed our individual opinions, observations, and intuitions based on investigation of our inputs in the training. If our observations were taken into considerations, it would provide impetus for changes in practice and curriculum, based on information that was systematically collected and synthesized. This information would lead to the expansion of the language capacity of the Arab ESL students through a revised curriculum that involved storytelling, sentence-level production of the language, and the use of content-based discourse-level speaking tasks. The research was participatory and collaborative, involving all of the international community English as second language teachers in Alfaisal International Academy, Riyadh Saudi Arabia. The problem is that such workshops are once-in-a-blue-moon events, wide apart and hardly sustainable. Moreover, we did not call it AR. However, it has all the features of action research. 6. CHALLENCES FACING ACTION RESEARCH AS A PRACTICE One of the major challenges of action research is to create awareness about its nature, scope, benefits in language teaching fields. Besides its inclusion as a certificatory requirement course, it should be encouraged through conferences and worldwide professional body where contacts can be maintained. Dissemination of individual and cooperative research findings would ensure the growth expansion of AR. Despite AR impacts in the language teaching learning field, more interesting challenges and tensions are still prevalent. I share Burns (2009) concerns that there are differing understandings, of ARs purpose, scope, and practices in various contexts. We should really consider finding answers to questions concerning the future directions of AR in a number of broad areas, such as: How should we envisage the primary purposes and outcomes of AR? Is it mainly a vehicle for practitioners personal and professional development, or can it also have a role in the production of knowledge for the field? Is AR simply an accessible version of research for teachers, or does it also denote an emerging paradigm with its own epistemology, methodologies and investigative practices? If so, how should standards of quality be addressed? In what ways can AR open up opportunities for collective forms of knowledge about teaching and learning that are inclusive of academic and teaching communities? What kinds of relationships between teachers, teacher educators and researchers will need to emerge to facilitate collective knowledge production? (How) can AR activity in language teaching also address broader issues of curriculum development, social justice and educational political action, thus contributing to the greater sustainability of effective educational practices? 7. CONCLUSION This research methodology, despite many contentions, criticism, arguments and counter arguments on the nature, scope and processes, is used in many fields of human endeavour such as social and health services, community development and education, to address a long history of difficulties in successfully transferring research knowledge into changes in practice. It is a means of combining the generation of knowledge with professional development of practitioners through their participation as co-researchers. It also serves as a barrier breaker between policymakers and practitioners, giving them richer insights into practice and an active role in policy development as well as its implementation respectively. This is clear in a research where teachers are involved in the identification of problem, plan on how to solve the problem in a participatory, collaborative, cooperative way. The various inputs of individual teacher researcher and all participating teacher researchers are the data t hat would inform the policy of change. Thus when teachers are part of the planning of policy and designing curriculum, its implementation and improvement would better and easier. The essay has been able to critically explore action research, teacher research, meaning, arguments and processes as a research methodology. 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