Hipaa Violation

Course Project Rough Draft MGH HIPAA violation case Jennifer Brummage Medical Law and Ethics In the health care business, there are certain standards and laws that have been put in place to protect our patients and their personal health information. When a health care facility fails to protect their patient’s confidential information, the US Government may get involved and facilities may be forced to pay huge sums of money in fines, and risk damaging their reputation. The Health Insurance Portability and Accountability Act (HIPAA) was established in 1996. This Act was put into place in order to improve the efficiency and effectiveness of the health care system. The HIPAA law includes a Privacy rule and a Security Rule. Hospitals, Doctors, and employees in the medical field are expected to adopt the national standards and aim to keep patient information confidential. When a hospital or medical employee fails to meet the standards set, lawsuits can ensue and they can be fined large sums of money relating to the incident. The Privacy Rule establishes national standards to protect individual’s medical records and other personal health information and applies to health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically. The Privacy rule requires appropriate safeguards to protect personal health information. The rule also gives patients’ rights over their health information, including rights to examine and obtain a copy of their health records. The Security protects individual’s electronic personal health information that is created, received, used or maintained by a covered entity. The Security rule requires appropriate administrative, physical and technical safeguards to ensure the confidentiality, integrity, and security of electronic protected health information. The Office for Civil rights (OCR) is responsible for enforcing the HIPAA standards. When a complaint is filed, it is the job of the OCR to investigate. OCR may also conduct compliance reviews to determine if the health organization is in compliance with the HIPAA laws. When the OCR accepts a complaint from an individual, they will notify the person and the covered entity named in it. Then both parties will submit information about the incident. The OCR will review the information to determine whether or not a violation has occurred. When violations have occurred and have been proven, the US Government will impose a fine that they see appropriate. When Health organizations such a private medical practices, hospitals, and clinics fail to meet the standards described in the HIPAA act, investigations, bad press, and fines are surely to follow. There have been a number of cases in the past few years that have been investigated for HIPAA violations. One of the more recent and highly publicized cases was that of Massachusetts General Hospital (MGH). On March 6, 2009 is was reported that an employee of MGH had removed from the hospitals premises a folder of documents that included the private healthcare information (PHI) of approximately one hundred and ninety two patients. The employee had removed the folder from the hospital’s medical records room, so that she could bring her work home with her in order to complete some paperwork. The information that was included in these files were documents that had billing encounter forms that contained the names of the patients, their date of birth, social security numbers, addresses, phone numbers, medical record number, the patients diagnoses and proposed course of treatment, their provider and the providers address and phone numbers. The folder also contained documents that included the practices daily office schedule for three days and the medical record number for 192 patients. The employee was aware that she was not permitted to remove this confidential information from the hospital premises. In doing so, she violated the HIPAA law. On March 9, 2009, the employee who removed the documents from the hospital was commuting to work on a subway train. According to the complaint that was filed, the employee had removed the folder containing the documents from her bag and placed them in the seat beside her. The documents were not in an envelope and they were bound only by a rubber band. Upon exiting the train, the MGH employee left the documents on the subway train. The documents were never recovered. This incident was later reported to the Office of Civil rights (OCR) by a patient who was informed by the hospital that his medical records had been lost by an employee and left them on a subway train. The One hundred and ninety two patients involved had been patients of the hospitals Infectious Disease outpatient practice, which includes HIV/AIDS patients. The fact that the patients involved in this case were potentially AIDS patients, made the violation that much more serious. Investigators had to take in to account that these people had their medical records lost, and in those records were their phone numbers and addresses and possibly their place of employment. If these documents fell into the wrong hands, the potential for destroying the patients’ lives was very high. Had a person with malicious intent got ahold of their information, they could have harassed the patient and possibly spread their personal information around, which could have had devastating consequences. The Office of Civil Rights began their investigation of Massachusetts General following the March 2009 Complaint. Because of the potential violations that MGH faced, they agreed to pay the United State Government $1,000,000 to settle potential fines. MGH is one of the nation’s largest and oldest hospitals. The Hospital is highly regarded and respected, and many hospitals took notice when the investigation into possible HIPAA security law violations began. In addition to agreeing to pay the United States Government one million dollars, the hospital and the General Hospital Corporation agreed to sign a Resolution Agreement with the United States Department of Health and Human Services (HHS). The agreement required that the hospital develop and implement a comprehensive set of policies and procedures to safeguard the privacy of its patients. In signing this resolution agreement, it was the HHS hope that other hospitals and clinics throughout the nation would recognize that the OCR is very serious about investigation every claim that is filed with them. The OCR wants other hospitals to see that if a violation has occurred and a patient’s privacy has been violated, there will be consequences. The OCR wanted to make an example out of Massachusetts General Hospital. In addition to the fines and the signing of the resolution agreement, OCR and HHS asked MGH to enter into a Corrective Action Plan. The HHR wanted the hospital and its employees to not only be held responsible and made an example out of, they also wanted the hospital to raise the awareness of its employees. The Corrective Action Plan (CAP) was designed to develop and implement a comprehensive set of policies and procedures that ensure the patient’s private health information is protected when Removed from the hospitals premises. It was to ensure that the employees were trained and informed of the new policies and procedures so that future mistakes could be prevented. The hospital was also required to have the Director of Internal Audit Services of Partners HealthCare System Inc. to serve as an internal monitor who will conduct assessments of MGH’s compliance with the CAP and render semi-annual reports to the HHS for a 3 year period. It was the mistake of one person that caused so many changes in MGH’s system. It was a costly mistake, but ultimately is has helped the United States Government make hospitals aware that if the standards set are not followed then there will be consequences. The HIPAA laws that are set in place are meant to protect patients. Even the US Government and the employees of MGH are someone’s patients, and they would also want their privacy respected. Hospitals across the nation, private practices, doctors and healthcare facilities should take notice, they need to make sure their employees are trained and informed of the policies and procedures regarding patient’s privacy and security. Every hospital in the nation should raise their own standards so that they are above the ones set for them. Patients will take notice and be appreciative and more trusting when receiving care. In conclusion, this HIPAA violation could have possibly been prevented had MGH implemented the Action Plan in the beginning. The hospital should have had a program that required all employees to take prior to starting work with the hospital. Had the employee that left the documents on the subway been through a class on HIPAA laws and the correct way of handling PHI, maybe the incident never would have occurred. Hospitals should hold a class as part of the hiring process to thoroughly train their employees on this issue. It could be used as a preventive measure and save the hospital from large fines in the future. References * FierceHealthcare. com, HIPAA violations. Feb 25 2011 (54198) * HHS. gov. News Release MGH HIPAA violation. Feb 24 2011 * US Department of Health and Human Services. HIPAA Law, July 19, 2011 * Zigmond J, Modern Healthcare, ISSN: 0160-7480, 2011 Feb 28; Vol. 41 (9), pp. 13 * http://www. hhs. gov/ocr/privacy/hipaa/understanding/index. html

Leadership Development Perk or Priority

CONTENT S. NO| TOPIC| 1| Introduction about the case| 2| Analyse the problem with the case using OB theories and concepts. | 3| How should Barton make her case for executive education? | 4| Reflection upon our experience of working in a group. | 5| Conclusion| 6| Referencing| ABSTRACT Karen Barton, Zendal Pharmaceuticals (senior vice president of HR) ,was annoyed when COO Palmer scorched her executive education budget by 75%.The first thought that came to Barton mind that it was a mistake, but it wasn’t a fault as Palmer patiently told Barton, sales were down by 26% and there was $300 million debts Zendal took on when it acquired Premier Pharmaceuticals, as a result Barton’s budget wasn’t the only one being cut. Palmer added that it wasn't clear what would be the return on investment of her proposed program or any of her current ones for that event. Barton's analysis had been extremely short on Quantitative benefits.Barton complained to a friend Carlo Freitas, he ad of the medical devices division about this, but Freitas disagreed: â€Å"If you want dollars, you have to show how you fit in with management's plans. You must be deliberate to fight for the resources with rest of us†. Barton bristled: â€Å"Don't you see that my department is connected to all the others? Every division benefits from the HR budget. † But she noticed that Freitas was correct. She needed to make the case that duplify her budget was a clever act even in tenacious times. Q1. Analyse the problem with the case using OB theories and concepts.Ans. Analysing the case we find the following concepts: 1. Conflict concept: â€Å"It is a disagreement between two people or group over some major issues†. In the case there is a disagreement between Palmer and Barton regarding the importance of executive education due to which Barton’s executive education budget was cut by more than 75%. 2. Understanding concept: â€Å"It relates to showing/exchanging of one’s thought with that of others†. Here Barton takes helps of her friend Frietas in order to take some decision regarding the executive education.Now regarding this decision Freitas tells her that she should provide justification for as how will executive education somewhere lead to profit of the company. 3. Communication concept: â€Å"Communication is process by which information is transmitted between individuals and/or organization so that an understanding of response results†. Barton knew about the interests of the executive towards a particular program communication with them and also encouraged the executives for enrolling in the respective program they liked. 4.Organization development concept: â€Å"It is a long term strategic which focuses on the whole culture of the organization in order to bring about planned changes† In this case Barton took a step ahead for the executives’ education for executives in the company. Barton as the mana ger of HR department was wondering as how executives can be provided with the training (organizational department). For this she took two steps: (a) Initiatives for two types of employees: * New Hires – who had to be bought up in a quick and speed way. * First level supervisors – these are high potential performers.An average enrolment was between 25 and 30 employees. (b) Low key approach : Barton’s team adopted an initiative to collect information on various programs at different B schools. Barton has encouraged executives to speak to the attendees first and look over the course materials those people had brought back. According to her this was a good way to determine whether the executives need fits with the programs theme. 5. Motivation concept: it is one of the most important concepts that best fits in the matter. Motivation Motive Motivating Engagement in work behaviourActivating needs and providing needs satisfaction on environment Needs in individuals In this case all the executives under Barton were being motivated by her for enrolling in the best suited programs and also she asked them to enrol in the programs which discouraged they felt were poor or below average. THEORIES: 1. Vroom’s theory of expectancy: â€Å"Theory deals with the variables of motivation and their interrelation†. Employee Effort Performance Reward According to the block line diagram of VTOE we can correlate the case as: (a) Employee : executives b) Effort : that are made by Barton (c) Performance: all the performance criteria can be given to Barton and her team members. (d) Reward: enrolment of executives as managers and some increment of position. 2. Leadership theory: â€Å"it is the process of influencing others towards the accomplishment of goals. It is the ability of a manager to induce subordinates to work with confidence and zeal† Behavioural theory of leadership: â€Å"this is related to the behaviour of the leader that it is some where related to what the leader does instead of hi traits†.According to the above theories of leadership we can relate to our case study as follows: Barton instead of acting as a manager acted as a leader thinking of the welfare of various executives who could be projected by executive thinking. Q2. How should Barton make her case for executive education? Ans. Barton should have focused on creating a quantitative ROI that the other executives buy into or should have revised her training program so that it does have measurable outcomes for a quantitative ROI.In order to make her case for executive education to palmer she should have explained or shown the turnover and ROI calculation as shown below.. Turnover ROI calculation: Total number of employees = 5,000 Turnover rate per year = 5% Turnover cost per employee = $20. 000 (termination,staffing,training etc) 5,000*. 05*20,000 = 5,000,000 Therefore, estimated cost of turnover per year = $ 5,000,000 Number of executive = 50 5,0 00,000/50 = 100,000 i. e estimated cost of turnover per executive = $ 100,000. Total number of employees = 5,000Reduced Turnover rate per year = 4% Turnover cost per employee = $20. 000 . 5,000*. 04*20,000 = 4,000,000 Therefore, estimated cost of reduced turnover per year = $ 4,000,000 Number of executive = 50 4,000,000/50 = 80,000 i. e estimated cost of reduced turnover per executive = $ 80,000. Saving per executive = $ 20,000 (100,000 – 80,000) Cost of training per executive = $ 12,000 Financial benefit per executive = $ 8,000 ROI = 20000/12000*100 = 167% Return for each dollar invested. Productivity ROI calculation : Number of sales specialists= 250Annual sales contribution each specialist = $ 50,000 Increase in productivity = 6% 250*50,000*. 06 = 750,000 Number of executives = 50 750,000/50 = 15,000 Estimated benefit of increased productivity per executive = $15,000 Sales increase per executive = $ 15,000 Cost of training per executive = $ 12,000 Financial Benefit per exe cutive = $ 3,000 ROI = 15,000/12,000*100 = 125 % Return for each dollar invested Therefore total ROI according to her revised executive program is as follows .. Turnover: Savings per executive = $ 20,000 Cost of training per executive = $12,000Financial bebefit per executive = $ 8,000 ROI = 167% Productivity: Added impact on contribution per executive = $ 15,000 Cost of training per executive = $ 12,000 Financial benefit per executive = $ 3,000 ROI = 125% ROI = 35,000/12,000*100=292% Return for each dollar invested Therefore by showing this calculation Barton should have explained how her program can provide financial benefit per executive with less cost of training per executive and with greater ROI for each dollar invested.. Reflection upon our experience of working in a group. Ans.For us working in a group was very beneficial as it gave us the chance to work together with new charm and refreshing ideas. Although in the beginning it was very challenging for all of us but despite o f that we worked together which at last helped us in increasing our view points towards the case study and resulted in a Better research work with thoughtful solutions for the case. Each member in our group was very motivative and gave his or her 100 percent in completing our work. Like all typical groups, in our group also there were good and bad events and moments. i. sometimes we had conflict among us over different views , but Whatever the scenario was, we learned a lot from each other and at last were very comfortable working with each other. CONCLUSION Leadership has been a major topic in management and business literature over the last few years. The rapid changes in business, technology, political and social factors has required the development of effective leadership skills. As a result leadership development programs have become an increasing priority for business and government organizations. Therefore Barton should have done a more thorough evaluation in order to Identif y the strengths and weakness of her executive development programs, * Identify the trainees which benefited the most from her program * She should have determined the costs of the program and its financial benefits to the organisation * Moreover she should have compared the costs and benefits of her training versus non training investments , the costs and benefits of different training programs to choose the best program out of it and then should have presented her case to Dave Palmer mentioning all the benefits of her executive development rogram and should have tried to convince palmer not to cut that major chunk from her program as it would be a fruitful investment for the organisation in the long run and would surely help its organisation perform well in the future. REFERENCING Margie Parikh, Rajen Gupta. (2011). exploring communication as a behaviourial process. In: Shalini negi,Sneha kumari  Organisational Behaviour. new delhi: tata mcgraw-hill education private limited. 285 .Margie Parikh,Rajen Gupta. (2011). managing conflict,stress and negotiation. In: Shalini negi,Sneha kumari  Organisational Behaviour. new delhi: tata mcgraw-hill education private limited. 307. Margie Parikh, Rajen Gupta. (2011). understanding decision making as a process . In: Shalini negi, Sneha kumari  Organisational Behaviour. new delhi: tata mcgraw-hill education private limited. 332. Margie Parikh,Rajen Gupta. (2011). understanding motivation.In: Shalini negi,Sneha kumari  Organisational Behaviour. new delhi: tata mcgraw-hill education private limited. 139. Margie Parikh,Rajen Gupta. (2011). understanding motivation. In: Shalini negi,Sneha kumari  Organisational Behaviour. new delhi: tata mcgraw-hill education private limited. 141. Margie Parikh,Rajen Gupta. (2011). understanding leaders. In: Shalini negi,Sneha kumari  Organisational Behaviour. new delhi: tata mcgraw-hill education private limited. 519-523.

How would you define quality in healthcare If you had to explain the Essay

How would you define quality in healthcare If you had to explain the importance of safety and quality reports to someone outside of healthcare, how would you do this - Essay Example As a result of quality healthcare, the staff can get a good working environment. Such an environment can include good administration and management, right and standard equipments, and good working schedules (Altman, 1996). Safety and quality reports ensure that the information contained in them is accurate. It ensures that privacy is maintained at all cost. Security of the information ensures that no unauthorized persons can get access to it. It encourages transparency since the information will be recorded accordingly, and no alterations will be made (Ginzbery, 1991). There is also easy access to the information. To be able to explain to the public about how safety and quality of reports is important, I would organize forums and workshops with healthcare experts, and allow them to teach people, and let them share information to their patients and the public. Use of media such as talk shows, writing articles, or use of charts with diagrams and explanations can also be helpful (Altman, 1996). With this entire framework being put in place, the public will be able to appreciate the importance of quality services not only to the healthcare sector, but in other sectors, as well. It will lead to effectiveness, efficiency, good customer care, and professional staff in the nursing environment (Ginzbery,

Monotype printmaking Essay Example | Topics and Well Written Essays - 500 words

Monotype printmaking - Essay Example However, the blankets required in the etching press are different from those used on the lithography press. In line with this, the etching press requires the use of three blankets with each blanket varying in thickness, type, and their functionality being different (Banister, 1969) Monoprints and monotypes are similar in many aspects. However, there are underlying differences between these two that result to variations that set them aside from each other. In this case, a monoprint has a reusable matrix, which is used to produce a different result from the first one obtained. Conversely, monotypes involve permanent marks on the matrix with the possibility of obtaining at most two impressions (Monoprints.com, 2012). In effect, the fundamental difference between these two prints regards the plates used by the artist since an artist working on a monotype uses a clean plate that is unetched while an artist working on a monoprint uses etched plates such as fabric or lace. Consequently, the plates used determine the number of patterns an artist produce with a monotype producing one pattern while there is a repetition of patterns for a monoprint. Scale and proportion, in visual arts, are used to show the relative size of one figure in relationship to another figure. According to Lauer and Pentak (2007), scale is another word for the size of a figure and it is in reference to the size of an object when compared to other objects. In line with this, it is important to point out that scale is crucial in providing the focal point of the object. On the other hand, proportion is the relative size of an image. In this case, proportion is the size measured against another image or against an image that exists in mental form or standard (Lauer & Pentak, 2007). In art, artistic objects are representations, abstracts, or non-objective form of objects. In this case, objects in art are in representational form in instances whereby an artist produces a piece of work that

Contemporary Trust Law Assignment Example | Topics and Well Written Essays - 2500 words

Contemporary Trust Law - Assignment Example If there are no beneficiaries with equitable interests in the trust assets, there is in theory no one "in whose favour the court can decree specific performance": Morice v Bishop of Durham (1804) 9 Ves.399. The complexity, of course, with this approach is that it frustrates the requirements of a settler or testator, who may want to profit a legitimate public object or useful social experiment which does not fall stringently within the definition of charity. A trust, for example, for the promotion of a particular sport (such as angling or yacht racing) is not charitable unless linked to education: Re Nottage [1895] 2 Ch. 649 and Re Clifford [1912] 1 Ch. 29. Similarly, a trust to be relevant income for the purposes of research into a proposed new alphabet also falls outside the description of charity: Re Shaw [1957] 1 W.L.R. 729. To what extent, however, is it legitimate to use the mechanism of a trust for the haulage out of mere purposes where there are no beneficiaries vested with equitable ownership in the trust property The law that a valid trust "must be for the benefit of individuals" (Bowman v Secular Society Ltd [1917] A.C. 406, 441, per Lord Parker) is not complete. A trust for charitable purposes is valid even with the absence of an equitable beneficial owner to put into effect the trust. Here, of course, it is the Crown (acting through the Attorney-General or the Charity Commissioners) who takes on the role of parens patriae on behalf of the public at large. Apart from this, there are several well-known "inconsistent" exceptions, classified by Lord Evershed M.R. in Re Endacott [1960] Ch. 232, where the trustee may perform the terms of the trust if he so wishes, but the court will not compel him to do so. These so-called "trusts of imperfect obligation" comprise (1) trusts for the creation of monuments and graves; (2) trusts for the saying of masses; and (3) trusts for the maintenance of particular animals. They will be valid (though unenforceable) provided they do not offend the rule against continuous trusts. Presumably, in the dearth of a beneficiary, the trustee is mutually the legal and beneficial owner of the trust property so that, if he fails or refuses to carry out the trust, the property will relapse back to the testator's residuary estate upon a resulting trust as to both the legal and equitable title. In reality, there is no trust here at all, rather a meagre power to apply for the stated purposes, with a contribution over or a resulting trust in evasion of exercise of the power. There are, of course, other cases where there may be a conviction despite the lack of an equitable owner. The understandable example is that of a discretionary trust in favour of a large class which is too large to list but, nevertheless, theoretically certain in definition. In the same way, there is no equitable title to the estate of a deceased person until such time as the administration is completed. The personal representatives are simply the legal owners during the administration

Crime Prevention Through Environmental Design Essay

Crime Prevention Through Environmental Design - Essay Example local community on police and ultimately decrease crime and associated fear, police officers can initiate programs to train local community members to deal with the criminal and crime spot, these programs may also include additional control and improved surveillance over surroundings physically, and implementation of community based policing program (www.publicstrategies.org, 2002). CPTED provides the fundamental principles and guidance with regard to solution of certain problems and determination of potential participants and make them part of problem solving process. It also addresses the fact that crime is associated with the environment and states the possible solution to decrease the probable occurrence of crime prevalence in the local areas. The main agenda of this process is to formulate a tool that will be readily available to police officers and community members in order to cope up with crime situations and combat with resulted fear in the problem areas (Center for Problem Oriented Policing, n.d.). CPTED and SARA both address problem solving techniques in order to prevent crime in problem related areas. CPTED deals with identification of criminal activities with in the local area and factors indicating the prevalence of these activities. SARA is also a crime reduction program that deals with scanning, analyzing, responding and assessing crimes and aims to decrease the impact of crime (SARA model,

Learning in adulthood Research Paper Example | Topics and Well Written Essays - 2000 words

Learning in adulthood - Research Paper Example I was particularly interested in being able to know how learning could be facilitated at my age, considering all the constraints that I face. Thus, in all honesty, I was really looking forward to this course. Below is a summative expression of the things that I have learned in this course. I first provided a brief introduction to the significance of adult learning theories and proceeded to discussing the learning theories that I learned in the course. I then moved on to a discussion of the concept of adult development and the relationship between intelligence and aging. I concluded this paper with the significant realizations that I have gained upon completion of this course. Introduction to Adult Learning Theories Adult learning is one of the areas of modern educational psychology the aim of which is to increase adult’s interest in learning to the maximum level so as to provide the most effective outcomes for the learner. Knowledge acquisition of an adult is quite different f rom that of a young learner. Since adults are concerned with much more things than just acquiring an education, that is, a job and family responsibilities, many challenges tend to be associated with this learning process. Fortunately, there are a number of adult learning theories that can aid in the delivery of adult education and therefore increase the rates of success in this area. The succeeding sections will present a discussion of the special characteristics of adult learning. In particular, it will focus on the challenges faced by adult learning, and the theories that offer insights into the process of adult learning. In addition, certain references will also be provided towards the author’s own experiences in the field of adult learning. The challenges of adult education Adults are preoccupied with more responsibilities than young learners. They have family responsibilities to fulfill and job requirements to accomplish. As such, adult education is mostly done on a part -time basis and is even referred to as part-time learning. Adult education is affected by a number of challenges such as attitudinal barriers, institutional barriers, and situational barriers that make successes in this area quite difficult to come by. Adults tend to face education with negative attitudes that make them lack the confidence to pursue their studies. Oftentimes, this is further aggravated by prior learning experiences which lead them to think that education only reflects a teacher’s needs and not the learner’s importance. When adults take their courses with mostly young people, they tend to feel that they are in the wrong place at a wrong time, and end up feeling isolated and stressed with the experience. Institutional barriers also extend a certain level of challenge for adult learners. Institutional barriers come in the form of difficult schedules and policies set by some schools. For example, some schools insist that learning can only be done when two parties are present. Because adult learners have jobs and family responsibilities to attend to, they tend to be unable to become punctual and present in their classes and are thus given negative marks by their instructors. Even where learning is done online, learners face great difficulties to meet the set targets. Another common challenge to succeeding in adult learning is the presence of situational barriers. These are personal issues that prevent a learner from making up for a class. For instance, one may be financially unstable or unable to afford the expenses of textbooks, tuition, and transport in the midst of requirements for family support. Time management is another factor that makes the process of

How the Depiction of Hindu Women in the Holy Vedas affects Societys Essay

How the Depiction of Hindu Women in the Holy Vedas affects Societys View of Them - Essay Example The above statement is probably tied to the depiction in the Hindu Holy Scriptures as dependents on men and beasts of burden. Both Abdul Khasem and Col Gurnam Singh have written articles pointing out some parts of Hindu scriptures that disparage women. Moreover, they appear to have different motives for writing these articles. Col Gurnam Singh writes seeks to provide actual proof from the Vedas on how Indian women were exposed to cultural, social, and economic problems right from the Vedic age and down through the centuries. Abdul Khasem, however, seeks to address Hindu fundamentalists and show that Islam is not the only religion that has reason to draw concerns over its depiction of women and their role in society. THEMES AND CONFLICTS IN BOTH ARTICLES Singh first addresses common issues that are mostly experienced by women in Hindu society such as female infanticide, sati, dowry burning, and other types of social suppressions. Singh contends that when such disturbing incidences, wh ich the Indian government keeps alleging have been wiped out, keep taking place, it is not because of the excuses commonly offered by Indian politicians. According to Singh, in the recent past, every excuse from corruption, social degeneration, and even ‘evil’ influence by Muslim and Christian factors has been used to explain why women are often mistreated in shocking ways within Hindu society. Singh then moves on to describe special sects such as â€Å"the Digambara  sect of Jainism and its deeply held belief that no woman can enter into a state of Moksha- which essentially describes a type of ‘oneness’ with god† (Singh). Singh further uses the words of revered Hindu saints such as Sankra Deva, who allegedly lived in the fourteenth century and was recognized as a Hindu saint, Yogi Gorakh Nath, and Sant Tulsidas to depict how misogyny is actually an accepted part of the Hindu religion. These three Hindu holy men all disparaged womankind and made sl anderous statements about the role of women in the degeneration of humankind as a whole. The theme of Abdul Khasem’s article is also based on the disparagement of womanhood in the Hindu scriptures; moreover, Khasem uses actual verses from the Vedas to prove is claims. Whereas Singh addresses the issue of the Hindu religion’s belief that women have filthy souls and so can actually contaminate men and cause them to lose their focus on the path to righteousness, Khasem addresses how through the discussion of practices such as sati, the unintelligent nature of women, and unnatural acts of bestiality forced upon female figures in the Vedas, the supposedly holy Hindu scriptures appear to want to inspire in the reader a feeling a kin to revulsion at the existence of all women. Khasem also addresses the fact that Indian gods (such as Indra) have asserted â€Å"that woman has very little intelligence† (Khasem). Such statements, naturally, will be used to consign women to drudgery with the excuse that they would cause unnecessary problems if they were allowed to exercise their minds in performing more intelligent tasks. In Hindu society, motherhood is the most glorified status a woman can aspire to, according to the Veda. In modern society, most Hindu women, particularly successful business women or women who have careers outside the home, appear to be uncomfortable about challenging this belief. It is not uncommon for women to become mothers and resign from high paying jobs at the peaks of their careers. In spite of the fact that such women claim to be modernized, they are uncomfortable about speaking on the choice to resign from lucrative positions to be stay at home mothers. This is an indication that they have been indoctrinated to accept the belief that if they cannot be mothers and the primary

Bioterrorism Research Paper Example | Topics and Well Written Essays - 1750 words

Bioterrorism - Research Paper Example This paper will study through previous researches and three different journals the barriers for the community health nursing for surveillance and identification of diseases caused by bioterrorism agents. Defining Bioterrorism: Bioterrorism is a form of terrorism in which different biological agents are released in order to make the people, plants or animals sick in masses. The consequences are in a number of deaths. These bioterrorism agents are usually viruses, bacteria, or toxins. However, these agents are present in the surrounding already but they are modified and reworked in a way that their ability is increased and that they also become resistant to the current medicines available so that there is no cure for them. The mediums usually used in order to multiply these bioterrorism agents are water, air and food sometimes. One of the major reasons for bioterrorism is that, that terrorist adopts this kind since it cannot be detected quickly and easily. These agents take time to rea ct, sometimes days and sometimes even weeks (A†¡ankaya & Kibaroglu, 2010). The significance of the study: The subject of bioterrorism in the community health sector in the US was not of major concern until 2001. The use of ‘Anthrax’ has created a serious fear of bioterrorism among the communities. Moreover, these bioterrorism attacks have also created realization and a sense of consideration for the healthcare department particularly community health nurses that their role during such attacks are very significant. Therefore proper education and training are very important factors for the community health nurses in order to overcome the chaos at the time of any bioterrorism attack (Mellehovitch, 2004). Bioterrorism and Community Health Nurses: Across the US, the issue of bioterrorism among the public health sector has become a core issue. Usually, the public and the US community rely initially on these primary healthcare departments for the inspection of any disease or unusual biological conduct. The community health nurses are the center of attention for this entire process and for delivering their services. However, cases have been observed where the lack of training and education among the health care nurses to handle and manage any bioterrorism attacks were observed, creating chaos and panic as a result. Not only this, the shortage of community of health nurses was also observed while any attack of bioterrorism. It is very obvious that the community health nurses need training for the bioterrorism preparedness so that they are ready to handle and are pre-prepared if their community is attacked by bioterrorism in a professional manner (Rebmann, 2006). According to a research journal on bioterrorism by the Journal of American Medical Association (JAMA) it was observed that many of the community healthcare staff and nurses did not follow any formal training or education in order to manage or handle any bioterrorism attack. Out of the hundreds of nurses interviewed by (Gerberding & Hughes, 2002) very few of them took courses and fhealth careation in community healthcare and for bioterrorism. While the remaining nurses made complaints to the researchers that were not able to conduct their studies on bioterrorism because of the shortage of the staff who will take coverage of their nonattendance. As a result they had to take help and lessons from those nurses

Road Safety Rules Essay Example for Free

Road Safety Rules Essay Road traffic safety refers to methods and measures for reducing the risk of a person using the road network being killed or seriously injured. The users of a road include pedestrians, cyclists, motorists, their passengers, and passengers of on-road public transport, mainly buses and trams. Best-practice road safety strategies focus upon the prevention of serious injury and death crashes in spite of human fallibility[1] (which is contrasted with the old road safety paradigm of simply reducing crashes assuming road user compliance with traffic regulations). Safe road design is now about providing a road environment which ensures vehicle speeds will be within the human tolerances for serious injury and death wherever conflict points exist. The basic strategy of a Safe System approach is to ensure that in the event of a crash, the impact energies remain below the threshold likely to produce either death or serious injury. This threshold will vary from crash scenario to crash scenario, depending upon the level of protection offered to the road users involved. For example, the chances of survival for an unprotected pedestrian hit by a vehicle diminish rapidly at speeds greater than 30 km/h, whereas for a properly restrained motor vehicle occupant the critical impact speed is 50 km/h (for side impact crashes) and 70 km/h (for head-on crashes). —International Transport Forum, Towards Zero, Ambitious Road Safety Targets and the Safe System Approach, Executive Summary page 19[1] As sustainable solutions for all classes of road have not been identified, particularly lowly trafficked rural and remote roads, a hierarchy of control should be applied, similar to best practice Occupational Safety and Health. At the highest level is sustainable prevention of serious injury and death crashes, with sustainable requiring all key result areas to be considered. At the second level is real time risk reduction, which involves providing users at severe risk with a specific warning to enable them to take mitigating action. The third level is about reducing the crash risk which involves applying the road design standards and guidelines (such as from AASHTO), improving driver behaviour and enforcement. Road traffic crashes are one of the world’s largest public health and injury prevention problems. The problem is all the more acute because the victims are overwhelmingly healthy prior to their crashes. According to the World Health Organization (WHO), more than a million people are killed on the world’s roads each year.[3] A report published by the WHO  in 2004 estimated that some 1.2m people were killed and 50m injured in traffic collisions on the roads around the world each year[4] and was the leading cause of death among children 10 – 19 years of age. The report also noted that the problem was most severe in developing co untries and that simple prevention measures could halve the number of deaths.[5] The standard measures used in assessing road safety interventions are fatalities and Killed or Seriously Injured (KSI) rates, usually per billion (109) passenger kilometres. Countries caught in the old road safety paradigm,[6] replace KSI rates with crash rates for example, crashes per million vehicle miles. Vehicle speed within the human tolerances for serious injury and death is a key goal of modern road design because impact speed affects the severity of injury to both occupants and pedestrians. For occupants, Joksch (1993) found the probability of death for drivers in multi-vehicle accidents increased as the fourth power of impact speed (often referred to by the mathematical term ÃŽ ´v (delta V), meaning change in velocity). Injuries are caused by sudden, severe acceleration (or deceleration), this is difficult to measure. However, crash reconstruction techniques can be used to estimate vehicle speeds before a crash. Therefore, the change in speed is used as a surrogate for acceleration. This enabled the Swedish Road Administration to identify the KSI risk curves using actual crash reconstruction data which lead to the human tolerances for serious injury and death referenced above. Interventions are generally much easier to identify in the modern road safety paradigm, whose focus is on the human tolerances for serious injury and death. For example, the elimination of head on KSI crashes simply required the installation of an appropriate median crash barrier. For example, roundabouts, with speed reducing approaches, encounter very few KSI crashes. The old road safety paradigm of purely crash risk is a far more complex matter. Contributing factors to highway crashes may be related to the driver (such as driver error, illness or fatigue), the vehicle (brake, steering, or throttle failures) or the road itself (lack of sight distance, poor roadside clear zones, etc.). Interventions may seek to reduce or compensate for these factors, or reduce the severity of crashes that do occur. A comprehensive outline of interventions areas can be seen in Management systems for road safety. In addition to management systems, which apply predominantly to existing networks in built-up areas, another class of  interventions relates to the design of roadway networks for new districts. Such interventions explore the configurations of a network that will inherently reduce the probability of collisions.[7] Interventions for the prevention of road traffic injuries are often evaluated; the Cochrane Library has published a wide variety of reviews of interventions for the prevention of road traffic injuries.[8][9] For road traffic safety purposes it can be helpful to classify roads into ones in built-up area, non built-up areas and then major highways (Motorways/Freeways etc.) Most casualties occur on roads in built-up areas and major highways are the safest in relation to vehicle mileage. Reported Road Casualties Great Britain for 2008 show that the vast majority of injuries occur in built-up areas but that most fatalities occur on non built-up roads.[10]

The Modigliani-Miller Proposition I Theory (MM I)

The Modigliani-Miller Proposition I Theory (MM I) 1. Introduction According to many research of corporation finance, the capital structure decision is one of the most fundamental issues facing to the executives and management level. The corporate finance is a specific area of finance dealing with the financial decisions corporations make and the tools as well as analysis used to make these decisions. The discipline as a whole may be divided among long-term and short-term decisions and techniques with the primary goal being maximizing corporate value while managing the firms financial risks. Capital investment decisions are long-term choices that investment with equity or debt, and the short-term decisions deals with the balance of current assets and current liabilities which is managing cash, inventories, and short-term borrowing and lending. Corporate finance can be defined as the theory, process and techniques that corporations use to make the investing, financing and dividend decisions that ultimately contribute to maximizing corporate value.Thu s, a corporation will first decide in which projects to invest, then it will figure out how to finance them, and finally, it will decide how much money, if any, to give back to the owners. All these three dimensions which are investing, financing and distributing dividends are interrelated and mutually dependent. The capital structure of a company refers to a combination of debt, preferred stock, and common stock of finance that it uses to fund its long-term financing. Equity and debt capital are the two major sources of long-term funds for a firm. The theory of capital structure is closely related to the firms cost of capital. As the enterprises to obtain funds need to pay some costs, the cost of capital in the investment activities is also the main consideration of rate of return. The weighted average cost of capital (WACC) is the expected rate of return on the market value of all of the firms securities. WACC depends on the mix of different securities in the capital structure; a change in the mix of different securities in the capital structure will cause a change in the WACC. Thus, there will be a mix of different securities in the capital structure at which WACC will be the least. The decision regarding the capital structure is based on the objective of achieving the maximization of shar eholders wealth. With regard to the capital structure of the theoretical basis, most well-known theory is Modigliani-Miller theorem of Franco Modigliani and Merton H.Miller (1958 and 1963). Yet the seeming simple question as to how firms should best finance their fixed assets remains a contentious issue. 2. Modigliani-Miller Proposition I The Modigliani-Miller Proposition I Theory (MM I) states that under a certain market price process, in the absence of taxes, no transaction costs, no asymmetric information and in an perfect market, the cost of capital and the value of the firm are not affected by the changed in capital structure. The firms value is determined by its real assets, not by the securities it issues. In other words, capital structure decisions are irrelevant as long as the firms investment decisions are taken as given. The Modigliani and Miller (1958) explained the theorem was originally proven under the assumption of no taxes. It is made up of two propositions that are (i) the overall cost of capital and the value of the firm are independent of the capital structure. The total market value of the firm is given by capitalizing the expected net operating income by the rate appropriate for that risk class. (ii) The financial risk increase with more debt content in the capital structure. As a result, cost of equity increases in a manner to offset exactly the low cost advantage of debt. Hence, overall cost of capital remains the same. The assumptions of the MM theory are: 1. There is a perfect capital market. Capital markets are perfect when investors are free to buy and sell securities investors can trade without restrictions and can borrow or lend funds on the same terms as the firms do investors behave rationally investors have an equal access to all relevant information capital markets are efficient no costs of financial distress and liquidation there are no taxes 2. Firms can be classified into homogeneous business risk classes. All the firms in the same risk class will have the same degree of financial risk. 3. All investors have the same view for the investment, profits and dividends in the future; they have the same expectation of a firms net operating income. 4. The dividend payout ration is 100%, which means there are no retained earnings. In the absence of tax world, base on MM Proposition I, the value of the firm is unaffected by its capital structure. In other words, regardless of whether a company has liabilities, the total risk of its securities holders will not change even the capital structure is changed. As the weighted average cost of capital unchanged, so must the same as the total value of the company. That is VL = VU = EBIT/ requity where VL is the value of a levered firm = price of buying a firm that is composed of some mix of debt and equity, VU is the value of an unlevered firm = price of buying a firm composed only of equity and EBIT is earnings before interest and tax. Whether or not the company has loans or the loans for high or low, investors are all accessible through the following two kinds of investment on their own to create the desired type of earning. 1. direct invested in the companys stock borrowing 2. if shares of levered firms are priced too high, investors will try to take advantage of borrowing on their own and use the money to buy shares in unlevered firms. The use of debt by the investors is known as homemade leverage. The investors of homemade leverage can obtain the same return as the levered firms, therefore, for investors; the value of the firm is not affected by debt-equity mix. The MM Proposition I assumptions are quite unrealistic, there have some implications, (i) Capital structure is irrelevant to shareholder wealth maximization. (ii) The value of the firm is determined by the firms capital budgeting decisions. (iii) Increasing the extent to which a firm relies on debt increases both the risk and the expected return to equity but not the price per share. (iv) Milton Harris and Artur Raviv (1991) illustrated the asymmetric information that firm managers or insiders are assumed to possess private information about the characteristics of the firms return stream or investment opportunities. They will know more about their companies prospects, risks and values than do outside investors. Then it cannot fulfill the assumption of perfect market. Based on the inadequate of MM Proposition I, Franco Modigliani and Merton H.Miller revised their theory in 1963, which is MM Proposition II. 3. Modigliani-Miller Proposition II The Modigliani-Miller Proposition II Theory (MM II) defines cost of equity is a linear function of the firms debt/equity-ratio. According to them, for any firm in a given risk class, the cost of equity is equal to the constant average cost of capital plus a premium for the financial risk, which is equal to debt/equity ratio times the spread between average cost and cost of debt. Also Modigliani and Miller (1963) recognized the importance of the existence of corporate taxes. Accordingly, they agreed that the value of the firm will increase or the cost of capital will decrease with the use of debt due to tax deductibility of interest charges. Thus, the value of corporation can be achieved by maximizing debt component in the capital structure. This theory of capital structure for the study provided an important and analytical framework. According to this approach, value of a firm is VL = VU = EBIT (1-T) / requity + TD where TD is tax savings. MM Proposition II is assuming that the tax s hield effect of each is the same, and continued in sight. Leverage firms are increased in interest expense due to reduced tax liability, has also increased the allocation to the shareholders and creditors of the cash flow. The above formula can be deduced from the company debt the more the greater the tax saving benefits, the greater the value of the company. The revised capital structure of the MM Proposition II, pointed out that the existence of tax shield in a perfect capital market conditions cannot be reached, in an imperfect financial market, the capital structure changes will affect the companys value. Therefore, the value and cost of capital of corporation with the capital structure changes in different leverage, the value of the levered firm will exceed the value of the unlevered firm. MM Proposition theory suggests that the higher the debt ratio is more favorable to corporate, but though borrowing adds an interest tax shield it may lead to costs of financial distress. Financial distress occurs when promises to creditors are broken or honored with difficulty. Financial distress may lead to bankruptcy. The trade-off theory of capital structure theory in MM based on the added risk of bankruptcy and further improves the capital structure theory, to make it more practical significance. 3.1 Trade-off Theory of capital structure According to Myers (1984), a firm that follows the trade-off theory sets a target debt to value ratio and then gradually moves towards the target. The target is determined by balancing the tax benefits of using debt against costs of financial distress that rise at an increasing rate with the use of leverage. It so predicts moderate amount of debt as optimal. But there is evidence that the most profitable firm in an industry tend to borrow the least, while their probability of entering in financial distress seems to be very low. This fact contradicts the theory because if the distress risk is low, an increase of debt has a favorable tax effect. Under the trade-off theory, high profits should mean more debt-servicing capacity and more taxable income to shield and therefore should result in a higher debt ratio. 3.2 Pecking Order Theory of capital structure The pecking order theory stems from Myers (1984) argues that adverse selection implies that retained earnings are better than debt and debt is better than equity. Firms prefer internal finance and if external finance is required, firms issue debt first and issue equity only as a last resort. The pecking order explains why the most profitable firms generally borrow less because they have low target debt ratios but they dont need outside money. As in Baskin (1989), asymmetric information affects capital structure by limiting access to outside finance. Managers know more than outside investors about the profitability and prospects of the firm. Information problems are particularly acute with common stock, announcement of stock issue can drive down the stock price. 4. Conclusion The capital structure decision is one of the most fundamental issues in corporate finance. Regardless of which kind of capital structure, to achieve one of the most optimal capital structures, the company should be mixture of equity and debt and it cannot only focus on equity or debt. Equity is a cushion and debt is a sword, debt is always cheaper than equity, partly because lenders bear less risk and partly because of the tax advantage associated with debt. In general, there are differences in the capital structures of different industries; they are having their own characteristic. The most important thing is the companys liquidity is sufficient or not. In making the decision of how to allocate the fund in which type of assets, the company has to consider and compare the different factors such as NPV, IRR and payback period. In evaluating the NPV, IRR and payback period, cash inflow is fund of the vital element. Therefore the company should know how to obtain the financing and how t o invest it. They should carefully to allocate their resources to maximize the firm value. References: Baskin, J. (1989) An empirical investigation of the pecking order hypothesis, Financial Management, Vol. 18, pp.26-35 Harris, M. and Raviv, A. (1991) The theory of Optimal capital structure, Journal of Finance, Vol. 48, pp.297-356 Merton H. Miller. (1977) Debt and Taxes, Journal of Finance, Vol. 2, pp.261-275 Modigliani, F and Miller, M.H. (1958) The cost of capital, corporation finance and the theory of investment, The American Economic Review, Vol. 48, pp.261-97 Modigliani, F. and Miller, M.H. (1963) Corporate income taxes and the cost of capital: A correction, The American Economic Review, Vol. 53, pp.433-443 Myers, S.C. (1977) Determinants of corporate borrowing, Journal of Financial Economics, Vol. 5, pp.146-75 Myers, S.C. (1984) The capital structure puzzle, Journal of Finance, Vol. 39, pp.575-592