Battle Over Water For Farmers Or Wild Fish In Southern Oregon Essay

Battle Over Water For Farmers Or Wild Fish In Southern Oregon - Essay Example Sides of the Oregon Crisis However in 2001, the Indian tribes, federal wildlife managers and environmentalist all came forth with conflicting claims to Klamath basin’s water, culminating in a fierce battle for water. The crisis began in the spring of 2001 when the National Marine and Fisheries as well as America’s â€Å"Fish and Wildlife Service† demanded that the Bureau of Reclamation, the agency in charge of water distribution from Klamath Reclamation Project, should cut off water supply to farmers so that the basin’s water could stay upstream to sustain the shortnose suckerfish and Lost River fish (Anderson, 2002). Following the cut off, infuriated farmers began to demand that the canals be opened to release water into their farmlands. Bowing to pressure, the Bureau of Reclamation went ahead and released water into farms (Becker, 1999). The crisis took another complicated turn in 2002 owing to three notable events; Firstly, in February 2002, the National Academy Of sciences released a report asserting lack of reliable premise for cutting off water to farmers in 2001 in order to sustain the habitat of endangered species† (Meiners & Shaw, 2003). Secondly, in the summer of 2002, there was an increase in water demand that exceeded the supply. And thirdly, the Bureau for Reclamation was still under pressure from farmers not to cut off their supply.

Philosophy Essay Example | Topics and Well Written Essays - 500 words - 61

Philosophy - Essay Example As for Robin Penslar and Aaron Ridley, utilitarianism is teleological moral theory which asserts that the correct action is a function of its consequences ("the greatest good for the greatest number") which can be predicted. The consequences of the good must be distributed as widely as possible; the person making moral choice should look not only for personal good or for whom they care about, but also for welfare. The choice made is provided by the rationale and logical argument and a person can use it on an individual basis. According to this ethical theory, the correctness of behavior is determined by its final use. The supporters of the theory say the utilitarian principle is the only moral criterion of human acts, and this principle is to ensure that we should always seek to maximize the predominance of good over evil. The ethics of utilitarianism defines natural process in a person coming into antagonism with itself in consciousness. According to the utilitarism morality is based upon the common good (happiness for most people) which Bentham called the common benefit, of course, distinguishing it from self-interest, or personal benefit. Under the principle of common benefit he understood the principle of action selection and evaluation of acts, which focuses on the greatest possible benefit. If the act concerns the interests of the community, we are talking about the benefits (happiness) of community, if it is about the interests of the individual, so, the benefits of the individual is a predominant thing. Utilitarism is also a theory directed against selfishness. The admissibility of pleasure or profit made in each case is determined by whether they contribute to a higher purpose. The definition (assessment) of phenomena and events either good or bad is also based on that principle. And according to the theory a person should (bearing in mind the supreme moral principle) strive to provide at

Diagnosis of Middle Ear Disorders Using Wideband Energy

Diagnosis of Middle Ear Disorders Using Wideband Energy CLINICAL DIAGNOSIS OF MIDDLE EAR DISORDERSÂ  USING WIDEBAND ENERGY REFLECTANCE A Doctoral Thesis Presented to The Graduate College of Missouri State University In Partial Fulfillment Of the Requirements for the Degree Copyright 2008 by [Alaaeldin Elsayed] CLINICAL DIAGNOSIS OF MIDDLE EAR DISORDERS USING WIDEBAND ENERGY REFLECTANCE Communication Sciences and Disorders ABSTRACT Accurate diagnosis of middle ear disorders in adults and children is a challenging task because of the complexity of disorders. Wideband energy reflectance (WBER) technique provides simplicity and accuracy in diagnosing middle ear disorders across wide frequency range. This research is expanding the studies of WBER to investigate the middle ear function in normal and pathological conditions of the middle ear in adults and children. Findings showed that WBER not only can distinguish abnormal from normal middle ear function but also can characterize different middle ear disorders in adults and children. Several specific WBER patterns were established in a variety of middle ear disorders among adults and children that will help in early diagnosis of such pathologies. The ER pattern was including significant higher ER in the children control group than the adult control group at 0.5 kHz and 1 kHz, abnormally high or shallower in otosclerotic ears, abnormally low in ears with TM perforati on and abnormally low ER with deep notch in ears with hypermobile TM. In presence of negative middle-ear pressure, elevated ER at ambient pressure is also expected. Results also showed that standard tympanometry was less sensitive in diagnosing middle ear disorders when compared to WBER especially in otosclerotic cases. Further studies are still required to validate the clinical use of ER in larger number of individuals with confirmed middle ear disorders. KEYWORDS: wideband energy reflectance, otosclerosis, otitis media with effusion, eustachian tube dysfunction, tympanometry. This abstract is approved as to form and content Wafaa Kaf, MD, MS, PhD Chairperson, Advisory Committee Missouri State Universit CLINICAL DIAGNOSIS OF MIDDLE EAR DISORDERS USING WIDEBAND ENERGY REFLECTANCETITLE OF THESIS By Alaaeldin Elsayed A Doctoral Thesis Submitted to the Graduate College Of Missouri State University In Partial Fulfillment of the Requirements For the Degree of Doctorate, Audiology ACKNOWLEDGEMENTS I would like to thank so many who encouraged me along this dissertation. First and foremost, I am thankful to God for all his blessings. I am very grateful to Dr. Neil DiSarno for all his support and kind caring throughout my graduate school education. Further, I am indeed grateful to Dr. Wafaa Kaf, my doctoral advisor, for her guidance, encouragement, and support throughout this work. In addition, I would like to show appreciation to my committee members for their helpful comments and direction for this dissertation. Special thanks also to the faculty and secretarial staff of the Department of Communication Science and Disorders. Thanks to Dr. Walid Albohy, and Dr. Ahmad Alhag for their help in collecting data for this study. Special thanks and appreciation for my wife Enass and my children Mohamed and Nada, your love and delightful spirits has kept me going forward. DEDICATION This work is dedicated To My dear parents, My beloved Enass, Mohamed, and Nada, Who made all of this possible, for their endless encouragement and patience. REVIEW OF THE LITERATURE Hearing mechanism and the middle ear Sound transmission. The hearing process includes the transmission of sound energy through the auditory canal to the tympanic membrane (TM). This sound energy results in vibration of the TM with an equal atmospheric pressure on both sides of the TM. The mechanical vibrations are, then, transmitted from the TM to the air-filled middle ear space and ossicles (malleus, incus and stapes), which further amplify the sound energy and transmit it, via oval window, to the fluid-filled inner ear. At the inner ear, the mechanical vibration is converted into electric waves and transmitted as nerve signals that are interpreted by the brain as sounds. Mechanical properties of middle ear. The middle ear is an air-filled cavity that connects the outer ear canal to the labyrinth of the inner ear. This connection is established through the middle ear ossicels-malleus, incus and stapes. The malleus is attached to the TM by its handle; the incus bone lies in the middle between the malleus and the stapes while the footplate of the stapes is attached to the oval window of the inner ear. The middle ear cavity is also connected to the nasopharyngeal cavity through the Eustachian tube (Musiek and Baran, 2007). The Eustachian tube is important in maintaining an equal pressure on both sides of the TM and ventilation of the middle ear cavity. The tube also drain the middle ear into the nasopharynx (Channell, 2008). Figure 1 demonstrates schematic representation of the anatomy of the ear. When the sound pressure moves the TM the mallus and incus consequently move together as one unit around a pivotal point. In doing so, both bones act as a lever; the lever arm formed by the manubrium of the malleus is slightly longer than that of the incus (about 1:1.3 ratio). In turn, the rotation of the long process of the incus around its pivotal point leads to the back and forth (piston-like) movement of the stapes footplate in the oval window of the inner ear. The movement of the stapes footplate is directly proportional to the frequency and amplitude of the sound waves. This route of sound transmission is called the ossicular route. Acoustic route is another way of transmitting sound waves directly from the TM and the oval window to the cochlea. The direct acoustic stimulation of the oval and round windows, by passing the ossicles (acoustic route), plays a part in sound transmission In normal ears both routs are functioning but the upper hand is for the ossicular route (Voss, Ro sowski, Merchant, and Peake, 2007). From the above information, it appears that the middle ear plays important role in the hearing process. The middle ear mainly helps to correct the impedance mismatching between the air-filled middle ear and the fluid-filled cochlea and to transform the acoustic energy at the TM into mechanical energy that will eventually be transferred to the inner ear. The Impedance matching function of the middle ear is carried out by three mechanisms: the lever action of the ossicles of the middle ear, the area difference between the TM and the area of the stapes footplate, and the buckling of the curved TM. An outcome of these mechanisms is that the vibration obtained from the large area of the TM is focused to the much smaller oval window of the inner ear (21:1 area ratio), resulting in a differential pressure between the oval window connected to scala vestibuli and the round window connected to the scala tympani. This pressure differential is critical in maximizing the flow of sound energy and activation of the cochlear structures (Cummings, 2004). Accordingly, middle ear disorders are expected to affect the normal transmission of sound, resulting in conductive hearing loss (discussed below). An illustration of the anatomical structure of External, Middle and Inner ear. Modified from Medline Plus Medical Encyclopedia: Ear anatomy. In addition to correcting the impedance mismatch between the air-filled middle ear and the fluid-filled cochlea, the middle ear also protects the inner ear from loud sound via the acoustic reflex. This mainly occurs as a result of reflex contraction of the two middle ear muscles, the tensor tympani and the stapedius, in response to loud sound leading to increased stiffness of the oscicular chain, and hence diminished sound transmission (Allen, Jeng, and Levitt, 2005). Given that the acoustic reflex mainly decreases the transmission of low frequency sounds thus, it improves speech discrimination in loud, low-frequency noisy environments. Unfortunately, the reflex does not protect the ear against impulsive sounds as gun shots due to prolonged latency in muscle contraction (Lynch, Peake, and Rosowski, 1994). Pathophysiology of middle ear disorders To further understand the pathology of middle ear disorders, it is important to consider the middle ear system as a vibrating mechanical system. Such a system is composed of three elements: mass, stiffness, and friction. When the mass and stiffness components are equal, so-called resonant frequency of the middle ear, it is expected that the amplitude of vibration of the middle ear is at maximum. On the other hand, when there is an increase in the mass without change in stiffness or friction the resonant frequency is lowered and the amplitude of vibration is lowered at frequencies above the resonant frequency. In contrast, when there is an increase in the stiffness component of the middle ear the resonant frequency increases and the magnitude of vibration reduces for frequencies below the resonant frequency (Roeser, Valente, and Hosford-Dunn, 2000). Middle Ear Disorders are a variable group of pathological conditions that includes, for example, middle ear infection (Otitis Media with Effusion: OME), chronic otitis media with perforation of the TM, Eustachian Tube Dysfunction (ETD), ossicular disruption or dislocation and or/ otosclerosis. Such middle ear disorders may lead to conductive hearing loss due to their effects on mass, stiffness, and/or friction elements of the normal middle ear. Perforated TM is induced by chronic otitis media or trauma to the ear. As a result, the normal structure and the function of the TM are altered. The degree of hearing loss is directly related to the size of the perforation (Voss et al., 2000) The perforation leads to equalization of pressure on both sides of the membrane which consequently leads to disturbance of the ossicular route and hearing loss (Voss et al., 2000). Normally the inward movement of the stapes is followed by an outward movement at the round window (push and pull mechanism). In the presence of TM perforation, this push and pull mechanism of the ossicles is disturbed and the sound waves energy reaching the oval window is reduced. Ossicular dislocation usually follows a violent trauma to head or as a consequence of chronic otitis media and/or cholesteatoma. Disarticulation of the incudostapedial joint due to traffic accident was the most common pathlogy of ossicular disruption(Yetiser s, 2008). With the exception disruption due to chronic otitis media, the dislocation of the ossicles may or may not be accompanied by TM rupture. The injury results in loss of the impedance matching mechanism of the middle ear and a conductive hearing loss of about 40-60 dB (Merchant, Ravicz, and Rosowski, 1997). Otosclerosis is a progressive disease of bone resorption and reformation that affects bones derived from the otic capsule. The etiology of the disease is not fully understood. The disease leads to osteodystrophy and fixation of the stapes in the oval window. Among the most accepted eatiological factors is genetic factors and viral infection. Otosclerosis is characterized clinically by progressive hearing loss, tinnitus and vertigo (Menger and Tange, 2003). Both conductive and sensory neural hearing loss has been reported in otosclerotic patients (Ramsay and Linthicum, 1994). Otosclerosis may affect the cochlea and other parts of the labyrinth as well (Menger and Tange, 2003). The resulting fixation of the footplate of the stapes leads to increased stiffness of the ossicular chain early in the disease. Increased stiffness of the middle ear affects the transmission of low frequency sounds. At later stages of the disease, the bone starts to grow adding a mass effect. This increase in ma ss of the middle ear affects the transmission of high frequency sounds as well (Shahnaz and Polka, 1997). More disorders include inflammatory conditions of the middle ear such as otitis media (OM) and media with effusion (OME), chronic otitis media, and cholesteatoma. OM usually results from upper respiratory infections or allergies that lead to obstruction of the Eustachian tube (Channell, 2008). As a consequence, negative pressure develops in the middle ear resulting in otalgia due to stretching of the TM and mild hearing loss due to the increased stiffness of middle ear transmitting mechanism. If the negative pressure inside the middle ear is not relieved, a transudate accumulates inside the middle ear. The condition is then called OME. The hearing is further affected by the mass- friction effect. The degree of hearing loss depends on the type and the amount of the transudate. The combination of fluid and pressure in the middle ear was found to reduce TM movement at the umbo by 17 dB over the auditory frequency range (Dai, Wood, and Gan, 2008). Middle ear function measures Tuning fork testing. The tuning fork testing is one of the traditionally used qualitative hearing tests. They are used to examine the conductive component of hearing loss (external or middle ear pathology). Several tests have been descried including: Rinne, Schwabach, Bing, and Weber tests. For Rinne test, the vibrating tuning fork is held against the skull, usually on the mastoid process bone behind the ear to cause vibrations through the bones of the skull and inner ear. To cause vibrations in the air next to the ear, the vibrating fork is then held next to, but not touching, the ear. In the test the patient is asked to determine if the sound heard through the bone is louder or that heard through the air. The results of the test are categorized as positive, negative, or equivocal. A negative Rinne test is indicated when the sound is heard louder by bone conduction than by air conduction which suggests a conductive component of the hearing loss. Although Rinne test was found to be highly specific in one study; the same author has suggested that it should be carried out only as a pack up test for pure tone audiometry in audiological evaluation of hearing loss (Browning and Swan, 1988; Thijs and Leffers, 1989). The Schwabach tuning fork test compares patients bone conduc tion to the normal examiner. Bing tuning fork tests determines the presence or absence of the occlusion effect. Weber tunning fork test determines the type of a unilateral hearing loss. While Rinne test compares air conduction to bone conduction in the same patient. Although the tuning fork testing is easy and reliable; it is still a subjective test that depends on the response of the patient and the degree of hearing loss. Additional drawbacks are that tuning fork testing is a qualitative and not a quantitative test, and does not diagnose the etiology of the conductive hearing loss. Pure-tone Audiometry. Pure-tone Audiometry is a behavioral test that measures hearing threshold. The test has been used to diagnose type and degree of hearing loss for more than one hundred years. During test setting, the patient is subjected to different tones to test the hearing mechanisms via air-conduction and bone conduction. Typically, the normal level of pure tone audiogram air and bone conduction will lie between 0-15 dB HL for children and 0-25 dB HL for adults. According to Northern and Downs (1991), the degree of hearing loss can be classified in adults as (0-25 dB HL) within normal limits, Mild (26-40 dB HL), Moderate (41- 55 dB HL), Moderate-Severe (56-70), Severe (71-90 dB HL) or Profound (91 + dB HL) hearing loss. In children it is classified as normal (0-15 dB HL), Slight (15-25 dB HL), Mild (25-30 dB HL), Moderate (30-50 dB HL), Severe (50-70 dB HL), Profound (70 + dB HL) hearing loss. This classification is applied to PTA of 500, 1000, and 2000 Hz (Roeser et al, 2000). Different types of hearing loss are interpreted by comparing air conduction thresholds to bone conduction thresholds. When the air conduction threshold elevated to a maximum around 60-70 dB HL in the presence of normal bone conduction threshold, this type of hearing loss is called conductive hearing loss. In sensorineural hearing loss the pure tone audiogram shows both air and bone conduction thresholds are elevated and with a 10 dB HL or less in between. Mixed hearing loss displays elevation in both air and bone conduction thresholds, but with the bone conduction threshold at better intensities than the air conduction by 10 dB HL or more. In both conductive and mixed hearing loss, the difference in air and bone conduction thresholds is called air-bone gap; and it represents the amount of conductive hearing loss present (Roeser et al, 2000). The use of pure-tone audiometry provides quantitative information regarding the degree and type of hearing loss. However, it does not diagnose the cause of hearing loss and cannot be used in infants, young children, and difficult-to-test subject. Mannina (1997) reported that the diagnosis of middle ear disorders in school-aged children is less efficient when using pure-tone audiometry alone. To improve the diagnosis of middle ear disorder, Yockel (2001) demonstrated that the addition of tympanometry to audiometry does improve the diagnosis of OME than using audiometry alone. Assessing Middle ear function is a very important step in early diagnosis and treatment of conductive hearing loss. Since the usually used subjective tests, the tuning-fork and pure tone audiometry, cannot identify the etiology of underlying middle ear disease, other objective measures such as acoustic immittance are needed for differential diagnosis and accurate diagnosis of specific middle ear disorders. Acoustic Immittance. Several objective measurements of middle ear function have been developed over the last four decades. Various anatomical structures of the middle ear represent complex network system that affects the sound presented to the ear. Not all the sound represented to the middle ear is delivered to the cochlea, but some of the power is absorbed by the bony structure of the middle ear (Zwislocki, 1982). Acoustic Immittance using tympanometry assess the middle ear status by measuring the transmitted sound energy to the middle ear. Acoustic Immittance provides objective information about the mechanical transfer function in the outer and middle ear. Acoustic Immittance is defined, as the velocity with which an objects moves in proportional to an applied force, while Acoustic Impedance (Za) is the opposition offered by middle ear and the TM to the flow of energy. Mathematically acoustic admittance (Ya) of a system is the reciprocal of impedance. Acoustic Immittance refers collectively to acoustic admittance, acoustic impedance or both (Tympanometry. ASHA Working Group on Aural Acoustic-Immittance Measurements Committee on Audiologic Evaluation, 1988). Investigators have found that abnormalities in the middle ear transmission might be reflected in the acoustic condition of the TM (Allen et al, 2005). Acoustic Immittance can be measured to single probe-tone frequency (single frequency tympanometry) or to series of multiple probe frequencies (multifrequency tympanometry). Single frequency tympanometry. Tympanometry is one of the earliest objective methods used to evaluate middle ear function. Tympanometry measures the acoustic immittance of the middle ear as a function of changing the air pressure in the ear canal. A single probe tone tympanometry is the conventional measure of middle ear function in response to low frequency probe tone, 226 Hz, under varying static air pressure. Evaluation of the acoustic immittance of normal and different middle ear disorders was done by Otto Metz, 1946, and confirmed later by Feldman, 1963 (Katz, 2009) In 1970, James Jerger began to incorporate immittance measurement into the routine audiological evaluation. Jerger classified tympanograms as type A, B, or C depending on the shape of the tympanogram (with or without peak) and location of the peak when present. Type A is the normal tympanogram with the peak at or near the atmospheric pressure (+25 to -100 daPa). Type A is further divided into subtypes Ad and As for high and low peaked type A tympanograms respectively (Feldman, 1976). Type B tympanogram has no peak and relates to middle ear effusion, infection with normal ear canal volume, or due to large TM perforation with large ear canal volume. Type C is a negatively shifted tympanogram that reflects Eustachian tube dysfunction, a precursor of serous OM, mostly evolved from type B (Katz, 2009). Since 1970, single frequency Tympanometry is the conventional clinical middle ear measure because it is a non-invasive, objective, and cheap indicator of many middle ear pathologies in children and adults. Unfortunately, low frequency probe tone tympanometry has high false negatives in infants younger than seven months (Holte, Margolis, and Cavanaugh, 1991). This is explained by the movement of the infants ear canal wall with pressure changes in the external ear canal due to immaturity of the bony part of the external auditory canal. In addition, tympanometry was found to be relatively insensitive to many lesions that affect the ossicular chain of the middle ear (Lilly, 1984). Furthermore, Keefe and Levi (1996) reported false positive tympanometry results compared to energy reflectance, a recent middle ear function measure. They found normal middle ear energy reflectance at higher frequencies in infants with flat low probe tone tympanometry. Multifrequency tympanometry. Multifrequency Tympanometry (MFT), which was first introduced by Colletti in 1976, measures middle ear impedance using multiple frequency probe tones ranging from 226-Hz to 500 Hz and up to 2000 Hz (Colletti,1976) . Similar to previous discussion about the three elements of the mechanical system of the middle ear, admittance of the middle ear has three components: stiffness (compliant susceptance), mass susceptance and conductance (resistance). A tympanometric pattern was developed by Vanhuyse and colleagues in 1975 that helped in interpreting the underlying middle ear pathology using MFT. The Vanhuyse tympanometric pattern is based on the assumption of the shapes and locations of reactance (X) and resistance (R) tympanograms. Using a conversion equation the model can predict the shapes of susceptance (B) and conductance (G) tympanograms. Vanhuyse et al proposed four normal patterns: 1B1G, 3B1G, 3B3G, and 5B3G as shown in Figure 2. 1B1G pattern is the normal tympanogram with a one susceptance (B) and one conductance (G) peak. It occurs when reactance (X) is negative and its absolute value is greater than resistance (R) at all pressure used (the ear stiffness is controlled). As the probe frequency increases the curve becomes more complex and notched. 3BIG model has three peaks of susceptance (B) and one conductance (G) peak. It represent negative reactance (X) with an absolute value greater than resistance (R) at low pressur e and smaller than resistance (R) at high pressure. The third model (3B3G) appears when the ear is mass-controlled. In 3B3G model the reactance is positive and less than resistance (X R) at low pressure and becoming negative at high pressure (Margolis, Saly, and Keefe, 1999). Figure 2. A graphic presentation of the model presented by Vanhuyse, Creten and Van Camp (1975). The resistance (R) , negative resistance (-R) and the reactance (X) tympanograms is shown in the upper left corner of each panel. Negative R is shown to compare the magnitude of the reactance X. The corresponding admittance (Y), (lower left corner), susceptance (B), (upper right corner) and conductance (G), (lower right corner) are also shown in each panel. Four patterns are presented and classified according to the number of extrema in the susceptance B and conductance G tympanograms. The pattern (1B1G) in panel one shows both susceptance and conductance have single extrema and reactance is negative. The pattern (3B1G) in panel two shows conductance G is single peaked with three extrema in susceptance B, reactance X is still negative but its absolute value is greater than resistance at high pressure. The pattern (3B3G) in panel three shows three extrema in susceptance B, conductance G, and admitta nce Y tympanograms, reactance Y is positive but less than resistance R . The pattern (5B3G) in panel four shows five extrema in susceptance B tympanogram and three extrema in conductance G, and admittance Y tympanograms, reactance Y is positive and greater than resistance R at low pressure. Because of the use of measuring middle ear function to several probe tone frequency, MFT is considered superior to single frequency tympanometry in detecting high impedance pathological conditions of the middle ear such as middle ear effusion, otosclerosis, and cholesteatoma. Such pathological conditions were not detected by conventional tympanometry (Colletti, 1976, Keefe and Levi, 1996, Shahnaz et al 2009). Several studies have shown that MFT has higher sensitivity and specificity in detecting middle ear pathologies such as TM mass or adhesions (Margolis, Schachern, and Fulton, 1998). Also, MFT is more sensitive than single frequency tympanometry in identifying normal and abnormal middle ear condition in neonates (Shahnaz, Miranda, and Polka, 2008). However, MFT is of limited clinical use for several reasons: long testing time, limited frequency range, and unreliable data above 1000 Hz (Allen et al, 2005). The use of wideband energy reflectance is shown to address the above limitat ions of MFT. Wideband energy reflectance. The wideband energy reflectance (WBER) is a new technique that has been introduced recently to evaluate middle ear dysfunction (Keefe, Ling, and Bulen, 1992). Simply the idea of WBER is that incident sound to the ear is transmitted through the ear canal and TM, some of this sound energy is absorbed through the middle ear and cochlea and part of it is reflected back (Figure 3). The energy reflectance (ER) is defined as the square magnitude of pressure reflectance ÂÂ ¦R(f) ÂÂ ¦2, which represents the ratio of the sound energy reflected from the TM to the incident sound energy at frequency (f). ER ratio ranges from one to zero (1.0 = all incident sound energy is reflected, and 0.0 = all sound energy is absorbed) (Allen et al, 2005). ER is an indicator of the middle ear power to transfer sound (Feeney, Grant, and Marryott, 2003). Energy reflectance (ER) measurers middle ear function over a wide band of frequencies (0.2- 8 kHz). ER is the ratio of the reflected energy (red arrow) to the incident energy (yellow arrow). When all incident sound energy is reflected back ER ratio equals one. When all incident sound energy is absorbed ER equals zero. Red arrow represents reflected sound energy; yellow arrow represents incident sound energy; green arrow represent absorbed sound energy. Modified from Medline Plus Medical Encyclopedia: Ear anatomy. WBER measures middle ear function using a chirp stimulus at 65 dB SPL over a wide frequency range, typically 0.2 to 8 kHz and at fixed ambient pressure (Feeney et al, 2003) . Normative data has shown that most incident acoustic power is reflected back to the ear canal (ER ratio closes to 1) at frequency range below 1 kHz or above 10 kHz that also show poor hearing threshold or at frequencies below 1 kHz and above 4 kHz (less efficient middle ear function) (Keefe, Bulen, Arehart, and Burns, 1993). More specifically, 50% of the acoustic power is transmitted to the middle ear between 1-5 kHz frequency range, indicating that the most effective middle ear transfer function (ER is at its lowest values, closer to one) occurs around 1-5 kHz (Allen et al, 2005; Keefe et al, 1993; Schairer, Ellison, Fitzpatrick, and Keefe, 2007). WBER has been used in measuring normal middle ear function and middle ear disorders using ambient pressure (Allen et al, 2005; Feeney et al, 2003; Shahnaz et al., 2009). In other studies the researchers used pressure to measure the acoustic stapedial reflex (Feeney and Sanford, 2005; Schairer et al, 2007). Development of the middle ear in infants was also investigated using WBER (Keefe and Abdala, 2007; Keefe e al, 1993; Keefe and Levi, 1996). Wideband energy reflectance in neonatal screening Keefe et al. (1993) and Keefe and Levi (1996) reported that the acoustic response properties of the external and middle ear varies significantly over the first 2 years of life. These changes, mostly physical changes, are responsible for the mass-dominant infants middle ear system with lower resonant frequency. The main components of this mass-dominant effect is the pars flaccida of the TM, ossicles, and perilymph in the cochlea (Van Camp, Margolis, Wilson, Creten, and Shanks, 1986). The mesenchyme in infants middle ear may add to the mass effect (Meyer, Jardine, and Deverson, 1997). This is completely in contrast to adults middle ear, which is a stiffness-dominant system at low frequency (Holte et al, 1991; Keefe and Levi, 1996). The TM, tendons and ligaments, the space between the mastoid and the middle ear cavity, and the viscosity of the perilymph and the mucous lining of the middle ear cavity constitute the stiffness component of the middle ear (Van Camp, Margolis, Wilson, Creten , and Shanks, 1986). Recently, Shahnaz (2008) have compared MFT and WBER findings between normal adults and normal-hearing neonates in the neonatal intensive care units (NICU), who passed the neonatal hearing screening test. The researcher found maximum absorption of the incident energy at narrower range of frequencies (1.2 2.7 kHz) in normal babies compared to adults (2.8 4.8 kHz) (Shahnaz, 2008; Shahnaz et al, 2008). This preliminary normative data from 49 neonatal ears reflects the potential diagnostic benefits of the WBER test in detecting middle ear effusion in neonates. Wideband energy reflectance in otosclerosis Although the main definitive diagnosis of Otosclerosis is during surgery, an accurate preoperative audiological diagnosis is very important indication for surgery. Still, pure-tone audiometry has its own limitations that prevent accurate diagnosis of otosclerosis. Also, standard 226 Hz tympanometry is usually within normal type A tympanogram in most otosclerotic patients (Jerger, Anthony, Jerger, and Mauldin, 1974). While multiple frequency tempanometry may be helpful in diagnosing otosclerosis, it adds little information to the diagnosis (Probst, 2007). On the other hand, the WBER responses in three ears of otosclerosis fell outside the 5th to 95th percentile of the normative data and presented a distinctive pattern for the disease (Feeney et al, 2003); which suggests that WEBR is a sensitive middle ear measure. In a recent study WBER was found to be helpful in distinguishing 28 otosclerotic ears from normal and/or other causes of conductive hearing loss. A significantly higher ER w as found in otosclerotic ears at frequency range of 0.4- 1 kHz as compared to normal ears. In the same study WBER was found to be more sensitive in diagnosing otosclerosis than the conventional 226 Hz tympanometry and the MFT (Shahnaz et al., 2009). Wideband energy reflectance in other middle ear pathology Hunter and colleagues (2008) found higher sensitivity of WBER in detecting otitis media in infants and children with cleft palate (Hunter, Bagger-Sjoback, and Lundberg, 2008). Feeney and colleagues in 2003 studied WBER at ambient pressure in 13 ears with different middle ear disorders and comparative normal. Different middle ear disorders were involved in this study included: four ears with OME, one ear with ossicular discontinuity, two ears with otosclerosis, two ears with hypermobile TM, two ears with perforated TM, and one participant with bilateral sensorineural hearing loss. The results suggested a distinctive WBE

Phobic Disorders: Symptoms, Treatments and Research :: Phobic Disorders Research Paper

1. Introduction Although phobic disorder is certainly common, it has been more difficult to establish the extent to which it should be considered a "serious" mental disorder from a public health perspective. Recent studies in understanding the behavioral, molecular, and anatomical bases of fear extinction in animals and humans are leading to new knowledge about the nature of fear and new treatments for anxiety disorders that affect millions of Americans (news release from SFN). In those people who suffer from phobic disorders (specific phobia, social phobia and agoraphobia) excessive and inappropriate fear and anxiety comprise the core symptoms of the disorder. Collectively, these disorders are the most common forms of psychiatric illness, surpassing rates of mood disorders and substance abuse A study by Michael Davis, PhD, at Emory University (SFN News Release) that determined how human brain can used to treat such disorders. He found that a receptor for a particular protein called the N-methyl-D-aspartate (NMDA) receptor in a brain region called the amygdala is critical for the extinction of conditioned fear. Many medical professional believe and it also has been proved true in many cases that combination of drugs therapy and behavioral therapy has the most successful results. 2. Phobia - Definition The term ‘Phobia’ was not used on its own until 1801 and in late 19th century it slowly gained acceptance in the sense it has today. The word ‘Phobia’ comes from the ancient Greek word ‘Phobos’, meaning â€Å"flight†,â€Å"fear† and â€Å"terror. Phobia is a condition, which is described as an intense, obsessive, persistent and unrealistic fear of an external object or situation or feeling. In some cases avoiding such objects or situations that cause anxiety makes difficult to lead a normal and healthy life. There are hundreds of different types of phobias with technical name for each. 3. Symptoms The symptoms of phobias are the same as those that would occur when facing an actual threat, leading to a reaction. In addition, there are other symptoms that go beyond the more "normal" fear response. Typical symptoms include:  ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Anxiety reactions such as sweating, trembling, nausea, rapid heartbeat, worry, dread, or terror  ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Intense fear of the object or situation, beyond an actual threat of danger  ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Intense fear of being watched or judged (social phobia)  ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Uncontrollable reactions that consume the mind and body  ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Avoidance of the object or situation to an extreme that it may result in isolation  ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Use of alcohol or substance in attempt to control feeling of anxiety

Week Presentation Notes

People with psych problems Like depression and anxiety have Increased likely hood of â€Å"bad trips† Hallucinogenic Properties: -Hallucinations (no rope on table, but a snake is on the table) -Illusion (rope on table is a snake) -Delusions (fixed false belief) -Interrogated Amnesia (Wake up next day, can not remember what happened) – Kinesthesia (crossing of the senses, see sounds, hear colors etc†¦ ) Hallucinogens and Brain Chemicals -Serotonin (5-HTH Receptor) -Some effect on dopamine, nor-epinephrine, acetylene's) sleep, Serotonin depleted brain afterward Physical Effects Increased Blood Pressure/Heart Rate -Inseminating -Blurred Vision -Enlarged Pupils -Sweating -Diarrhea -Muscle Cramps -Dehydration After effects of usage: -Confusion -Fatigue -Depression -Damaged Serotonin Neurons (with frequent abuse) Serotonin depletion (For next 2 weeks) Includes numbness in emotions LSI – 1938 Sand's PharmaceuticalsFBI tested as a mind control drug in sass Timothy L eary, sass way to get in touch with your feelings sass resurgence of use, with the advent of the rave (urban people in ass/ass, and homosexuals) sass much more into high school/teenage use Northern California is where most USA LSI made in alcohol type solution, put it on blotter paper 1 1 lbs of material can supply the entire country Slows reaction times and Judgment, suicide in bad trips, confusion causes suicide also. Ecstasy The most popular drug currently, mix of amphetamine and psychedelic, sass use for weight loss. SASS psychiatrist studied use in treatment of PATS, patients reported it helped them get in tough with their feelings and explore the traumas DEAD in mid sass outlawed it sass rave scene Effects; Energy, empathy, love, dance, sexual desire southwest raves, 2-3 day long dances, 2-3 people die from temp issue Not taken then sat on couch or as only drug at the same time Mostly pill form.No regulation, made in homemade lab, no idea what is in it, sometimes put ephedrine , or PC. Sometimes just pure chalk. Unpredictable, next day very depressed/suicidal, tolerance, mental ere high, physically not so much. Astatine, anesthetic, put you out of surgery, vets use it, most of the time people steal from medical. Euphoria, no pain, lots of amnesia, used as date rape drug PC also anesthetic, not usually used in medicine anymore, unpredictable, bizarre behavior, very hard to titrated the dose, from pleasant to seizures etc.. Aggression and suicide Are they addictive, generally more psychological addictive then physical, but do have some physical. Can they cause psych disorders?Thought about cause of psychotic disorders or dementia, it is possible, there is a higher risk Main danger is the increase in teenage use, 1 in 10 have used in the last month, they are cheap, easy to hide, don't realize the seriousness of the drugs. Are they treatable? No med BUT treatment centers do treat. Usually go because of another drug. Change of lifestyle is important for treatm ent, no more raves or clubs it is easier to abstain. Controversy of Astatine in psychiatry, can give for acute suicidal, immediate assistance. Can divert a lot of hospitalizing for suicidal ideation. Can be opening Pander's box, mainly because of drug seeking. Inhalants Todd Clement, MD Adolescent and Adult PsychiatristInhalant abuse, 1000 commonly used household items also laughing gas, sometimes even gasoline vapors! Active ingredient is Talking, very damaging to the brain, very cheap to obtain or have around the house. Dangerous for children How it's Done -Sniffing (directly from container) -Huffing (soaking rag and then putting in mouth, socks, gloves) -Bagging (spray in bag then breath in) -Ballooning (in Balloon similar to bagging) -Spraying (spray into mouth into the throat) -Sleeking (spray it or pour it into cuff, and can use throughout the day) 12-17 largest users, 4th most abused substance (behind alcohol, nicotine, marijuana) in 4 High School say they have used, 1 in 10 8th graders have tried What made you start?A friend or older kid talked into it Hispanic kids particular at risk, and Kids that spend a lot of time home alone Children/teens don't usually note the risk Young adults also use, low social-economic status and less educated, may be because they are a cheap high â€Å"Quick Drunk† few seconds to get to brain Mental Effects -Mood Elevation -Reduced Inhibitions -Excitement -Impulsiveness -â€Å"out of Body' experiences -Drowsiness/laryngitis -Dizziness -Slurred Speech -Balance Problems Dreamy stupor at high doses- violent or suicidal High lasts only about 30 minutes After use irritable headache tired DANGERS -Sudden Sniffing Death Syndrome (Suffocation/Asphyxiation, displace 02 in brain) – Asphyxia from vomiting -Coma -Seizures -Suicide -Brain Damage (brain uses 25% of 02 supply, cutting off even for a few minutes will kill cells) Sends signal to heart, so increase Blood flow (increased HER and BP), small capillaries will pop from surge, then 3-4 cells die since that is the only feed for them.Outline: Is the toxic substances, can destroy the mainline sheath, that helps it work eight, like electrical lines and there coverings, Brain looks like an MS patients, Can damage hearing vision and cerebellum (destroys balance) Nitrates: sometime also toxic substances 12-17 brain still develops, so can derail developments Brain damage, hearing loss, sense of smell, damage speech, heart attack, Nausea/ Vomiting, Liver damage, kidney damage, Bad pain quickly, not Just 12-17 years old getting addicted, Dental Field or Anesthesiologist abuse nitrous, Long Term Effects – Permanent Memory Problems, dementia at early age, effects hippo-campus (helps consolidate memories) Tremors Balance Problems Emotional Instability Can it be treated, yes BUT, most treatment centers don like, due to failure rate, and long term recovery needs, really a gateway for other use How can I keep my Child safe?Know what is in your house, keep it out of there reach and keep an inventory, educate your children of dangers, know what they are doing especially if they are home alone ALTO, know where they are spending their money Bottom line, know your kids and watch them Patient with problems, encourage them to get help, intensive outpatient treatment is good. How do I know if my child is using? Chemical odor on breath/clothes -Rags or empty aerosol cans -Paint Stains on clothes/body -slurred speech/poor balance, appearing drunk -change in personality -Change in Grades Prescription Drug Abuse Michael R. Eyeless, MD Eyeless and Crawford Consulting ACE Addictions and Recovery Series This is probably the one that goes to church on Sundays.

Resource File and Personal Theory Paper Essay

Behavior Person-Centered Theory is a theory that focuses on the individual person and the behaviors (appropriate and inappropriate) so that not only will the person be independent of self esteem issues but, he or she will learn behaviors that promote positive attitudes. Instead of just looking at the behaviors this theory, looks at the person as a whole (the behaviors positive and negative, his or her feelings about themselves and the people around him or her, and the triggers that make him or her behave in negative ways. I believe in this theory because it does not just focus on one aspect of the person such as the negative behaviors and triggers, it looks also looks at the positive behaviors and triggers. By doing this you are able to learn what makes a person react the way he or she does and if the actions are deliberate or if the actions are true reactions to the situations or stimuli. Some people have a tendency to show you what they think you want to see or hear (manipulation) but if you learn what actions trigger what reactions (good and bad) you can teach the individual how to avoid those situations or stimuli. The theorist and theory that I relate to the best is Yalom and the interpersonal group therapy. I relate to this theory because it focuses on problems in current relationships and situations while examining the ways in which those particular problems are reflected within the members of the group. It is always important for patients to know that he or she is not the only person going through the kinds of situations the patient may be facing. When a patient learns that he or she is not alone in the world (concerning the types of problems being faced) it allows the patient to better relate and discuss what it is he or she is going through and as a group solutions can be developed. What surprised me the most about the theories learned in class was that a single  theory can treat more than one problem or person. I always believed that everyone was subjected to the same theory no matter what the situation was. I was also surprised to learn that not all people are placed in in-patient facilities if the doctor feels that something else should be done. This was very apparent in the case where the lady whose husband was cheating on her, tried to kill herself numerous times and the doctor decided to treat her as an outpatient instead of committing her. Since being in this class, I have learned that not all theories apply to all people and situations. One theory can be used to treat a multitude of people and situations. Not all people are committed for actions some may deem psychotic it is up to the attending physician whether or not the person is committed to a facility.

MMRDA - Smart BKC EOI-4.0 Final Essays - Geography Of Mumbai

MMRDA - Smart BKC EOI-4.0 Final Essays - Geography Of Mumbai Page 1 of 18 Expression of Interest (EOI) Implementation of Smart BKC initiatives in Bandra Kurla Complex, Mumbai For: Mumbai Metropolitan Region Development Authority (MMRDA) Ref Number: Date: 10th September, 2014 In-charge, Information Technology Cell Mumbai Metropolitan Region Development Authority 2nd Floor, A wing Bandra Kurla Complex Bandra (East), Mumbai- 400-051 Tel: 022-26595919 Fax: 022-26595943 Email: [emailprotected] [emailprotected] Page 2 of 18 Table of Contents 1. Key Events and Dates...................................................................................................................................... 3 2. Introduction....................................................................................................................................................... 4 3. Vision Smart BKC 1.0 ...................................................................................................................................... 5 4. Purpose of Global EOI ..................................................................................................................................... 8 5. Qualification Criteria......................................................................................................................................... 8 6. Joint venture/ Consortium ................................................................................................................................ 9 7. EOI Selection Process ..................................................................................................................................... 9 8. EOI Submission process................................................................................................................................ 10 9. Clarifications on the EOI ................................................................................................................................ 11 10. General Terms & Conditions...................................................................................................................... 11 11. Annexure A - EOI Template....................................................................................................................... 13 Section-1: Covering Letter................................................................................................................................. 13 Section-2: Company Profile ............................................................................................................................... 14 Section-3: Financial Details of the Lead Bidder................................................................................................. 16 Section-4: Financial Details of the Consortium Partner if any; .......................................................................... 16 Section 5: Technical Approach & Case Study................................................................................................... 17 12. Annexure B Snapshots on Smart BKC 1.0 ............................................................................................. 18 Page 3 of 18 1. Key Events and Dates The EOI shall be submitted through online e-tendering portal of MMRDA only etendermmrda.maharashtra.gov.in. S. No Information Details 1) Advertising Date 10th September, 2014 2) Download Date From 10th September , 2014 to 20th October September, 2014 3) Last date of receipt of Queries/Clarifications via email to [emailprotected] 24th September 2014 4) Pre Bid Meeting 26 th September 2014 at 3.00 pm 5) Last date (deadline) for online submission of bids at etendermmrda.maharashtra.gov.in 28th October, 2014 till 6.00pm 6) EOI Transfer date 28th October, 2014 till 7.01pm to 29th October 2014 till 3.00pm 7) Place of Pre Bid Meeting Mumbai Metropolitan Region Development Authority Committee room, 6 th Floor, B wing Bandra Kurla Complex Bandra (East), Mumbai- 400-051 Tel: 022-26595919 Page 4 of 18 2. Introduction Mumbai Metropolitan Region Development Authority (MMRDA) was set up on the 26th January, 1975 under the Mumbai Metropolitan Region Development Authority Act, 1974 by the Government of Maharashtra as an apex body for planning and co-ordination of development activities in the Mumbai Metropolitan Region comprising of Mumbai and its influence area. The Authority declared under the act is a highest policy making body, having perpetual succession and a common seal with power, subject to the provisions of the Act, to acquire, hold and dispose of property, both moveable and immovable and to contact and to sue and be sued in its corporate name. At the apex is the Authority presided by the Minister of Urban Development Department, presently the Honble Chief Minister. At the second and intervening tier is the Executive Committee presided by the Chief Secretary to the State Government. The third tier is headed by the Metropolitan Commissioner assisted by the Additional Metropolitan Commissioner and other head of departments and supporting staff/officers. Organizational Overview- Snapshot MMRDA prepares plans; formulates policies and programs; implements projects and helps in directing investments in the Region. In particular, it conceives, promotes and monitors the key projects for Page 5 of 18 developing new growth centers and brings about improvement in sectors like transport, housing, water supply and environment in the Region. With the challenges of demographic change, population growth, climate change, Urbanization, it is essential that our cities allow future generations to not only sustain but also thrive. We envision a world where digital technology and intelligent design are harnessed to create smart, sustainable cities with high quality living. MMRDA being the apex Planning and Policy making body in the State has envisaged to invest in smart initiatives such as smart economy, smart buildings, smart mobility, smart energy, smart information communication and technology, smart planning, smart citizen and smart governance. MMRDA envisages developing MMR as an region that focuses on service provision to its citizen through a robust public & private sector collaboration model that embeds technology to integrate multiple infrastructure services for efficient operational bringing in revolutionary improvement in quality of life with sustainable inclusive approach. 3. Vision Smart BKC 1.0 Bandra Kurla Complex (BKC) was developed by MMRDA to create a State of the art financial and business hub. Bandra-Kurla Complex is being developed to decongest/decentralize further concentration of offices and commercial activities in South Mumbai. It facilitates built up space for operation of financial services, information technology and other ancillary services in the Bandra-Kurla Complex. Bandra-Kurla Complex (BKC) is one of the prime growth centre of Mumbai for which MMRDA is the "Special Planning Authority". Today, the complex enjoys a numero one status due to the proximity to airport and other bankinig sector. The complex is already providing more than two lakh jobs and is a magnet to absorb future growth of offices and commercial activities. The Authority has developed 19 hectares of land (E Block) with the presence of prominent institutions such as the Reserve Bank of India, Income Tax, Sales

HealthCare Fraud

HealthCare Fraud For many years the United States government has taken keen interest on the welfare of the healthcare consumers, especially in regard to healthcare fraud. Notably there have been numerous fraudulent transactions within the American healthcare system, which have had severe medical and financial implications. Specifically, the United States government has lost billion of dollars due to healthcare fraud. This is coupled with many patients who have been conned off their benefits as a result of transfer of policy to a different. As a result the United States government came up with laws to regulate the healthcare sector and minimize, as well as prosecute cases of fraud. These laws are famously referred to as The Anti-Kickback Statutes. The case of Sundown Community Hospital and Central Park Medical Group joint venture, which offered financial benefits to facilitate the agreement on the transfer to patients, a majority of whom are under Medicare plan, violates the requirement of the Anti-Ki ckback law. However, this plan can still be safeguarded if it is modeled along a different approach which fulfills the requirement of ‘safe harbor’ exemptions.Advertising We will write a custom research paper sample on HealthCare Fraud specifically for you for only $16.05 $11/page Learn More There have been a number of healthcare landmark cases, such as Feldstein v. Nash Community Health Services, Inc., which have brought forth a number of urgent concerns. Suffice to state that healthcare issues are intricate and complicated to the extent that the United States government developed a set of detailed statues referred to as the Anti-Kickback Statutes to address emergent issues in healthcare provision (Office of Inspector General, 1999; Altshuler, Creekpaum and Fang 2008). The main purpose for this law is to protect the welfare of healthcare consumers from exploitation by fraudulent healthcare providers. One of the major concerns that arise is the determination of whether any (healthcare) transaction is either a minor misdemeanor or fraud. In this regard, it is the primary objective of the prosecutor to determine whether there was intent and objective of obtaining kickbacks. Furthermore, debate still ranges on, on the definition of the terms kickback and bribe. Out of Subsequent cases, there have emerged several interpretations of the terms kickback. The United States V Hancock case assumed the broader interpretation of the term kickback as the intentional receiving of payments fraudulently. This definition does not however, address other issues of concern such as nonfinancial benefits. As a result, the congressional amendments of 1977 stipulated that Medicare fraud did not have to result in a kickback. Currently, the Social Security Act stipulates that any party in a Medicare agreement cannot offer or receive payments or any other benefits to engineer a business deal (Schwartz, 2003). Just like the Feldstein v. Nash Communi ty Health Services, Inc., the Sundown Community Hospital and Central Park Medical Group joint venture involves financial and social security privileges to employees. Sundown Community Hospital is intending to make the deal a success and as such has to put together an attractive offer to Central Park Medical Group in terms of permanent staff privileges to Central Park owners.Advertising Looking for research paper on health law? Let's see if we can help you! Get your first paper with 15% OFF Learn More This also includes monthly bonuses. Since the deal is proposed by Sundown Community Hospital, the privileges to Central Park Medical Group staff are intended to make an appeal and as such avoid any objection to the deal. Furthermore, 60% of the healthcare consumers at Central Park Medical Group are under Medicare plan. This implies that Sundown Community Hospital stands to benefit directly from the joint ownership of these consumers who are on Medicare. Such impl ications made Sundown Community Hospital to offer kickbacks in terms of indirect payments to permanent staff, to successfully engineer the deal. It can thus be concluded that such kickbacks were made willfully and knowingly to induce business. The anti-kickback statute prohibits and criminalizes any willful payments made knowingly to engineer the referral or transfer of any individual who is a beneficiary of any medicare scheme. As such the statute proposes criminal penalties for any payments made, such as in the United States v Jain to induce the said referrals and transfers, which includes prison terms and fines. Furthermore, any party found to have willfully offer or received such payments attracts criminal liability for such offenses (Romano and Fox, 2009). This case is therefore in contravention of the Anti-kickback Statutes as well as the 1996 regulation on the movement of healthcare consumers between providers, referred to as The Health Insurance Portability and Accountabilit y Act (Price and Norris, 2009). Therefore, the joint venture between Sundown Community Hospital and Central Park Medical Group cannot proceed since the two parties faces criminal charges for giving and receiving indirect payment to induce referrals of Medicare consumers. This deal can however go ahead, but under the 1972 congressional amendments which provided for certain safe harbors regulations. Within these regulations, there are certain business transactions which are can be exempted from the Anti-Kickback Statutes (Schwartz, 2003). While there are numerous safe harbor regulations, two specific one can protect this deal from criminal liability. Specialty Referral Arrangements between Providers is a regulation within the Anti-kickback Statutes that safeguards the referrals and transfer of Medicare beneficiaries between providers. Under this provision, it is possible to refer a patient from the primary physician to a secondary physician on grounds of specialized treatment.Advertis ing We will write a custom research paper sample on HealthCare Fraud specifically for you for only $16.05 $11/page Learn More The regulation also stipulates that the party to whom the patient is being referred to has the obligation of referring the patient back to the primary healthcare provider at some point during the course of the treatment (Office of Inspector General, 1999). Suffice to say that this kind of an arrangement is closely monitored to ensure that such transfers are motivated by the need for further medical treatment from specialized physician and not timed to benefit the second party financially. As such, Sundown Community Hospital and Central Park Medical Group patient transfers are only applicable on the grounds of specialized medical treatment. Furthermore, Anti-Kickback Statutes do not exempt such kind of a transaction to the extent of financial benefits if the patient is on a Federal Healthcare plan. In this case, the parties involved i n this plan have to ensure that the 60% of patients are under a state controlled medical plan before filing for exemption from the Anti-Kickback Statutes. Transfer of patients who are on any form of Medicare plan is not necessarily a fraud. As such, the parties involved may not be criminally liable for engineering patient transfer and co ownership deals on certain grounds. The Sundown Community Hospital / Central Park Medical Group joint venture is however suspect. Borrowing from rulings such as Feldstein v. Nash Community Health Services, United States V Hancock and others, the two parties involved are criminally liable since they knowingly exchanged payments as part of the business agreement. As such the deal is not motivated by medical reasons and as such need to be redesigned to avoid prosecution.Advertising Looking for research paper on health law? Let's see if we can help you! Get your first paper with 15% OFF Learn More Reference List Altshuler, M., Creekpaum, J., Fang, J.. (2008). Health care fraud. The American Criminal Law Review, 45(2), 607-664. Office of Inspector General (1999). Federal Anti-Kickback Law and regulatory safe harbor. Web. Price, M., and Norris, D. (2009). Health care fraud: Physicians as white collar criminals? Journal of American Academy of Psychiatry and the Law. Web. Romano, D. and Fox, A. (2009). What to do when you’re recruitment agreement leaves town. AHLA Connections. Web. Schwartz, J. (2003). Elaborating on sham transactions as evidence of violations of the anti-kickback statute. Journal of Law Policy. Web.

Power Definitions and Examples in Sociology

Power Definitions and Examples in Sociology Definition: Power is a key sociological concept with several different meanings and considerable disagreement surrounding them. The most common definition comes from Max Weber, who defined it as the ability to control others, events, or resources; to make happen what one wants to happen in spite of obstacles, resistance, or opposition. Power is a thing that is held, coveted, seized, taken away, lost, or stolen, and it is used in what are essentially adversarial relationships involving conflict between those with power and those without. In contrast, Karl Marx used the concept of power in relation to social classes and social systems rather than individuals. He argued that power rests in a social class’s position in the relations of production. Power does not lie in the relationship between individuals, but in domination and subordination of social classes based on the relations of production. A third definition comes from Talcott Parsons who argued that power is not a matter of social coercion and domination, but instead flows from a social system’s potential to coordinate human activity and resources in order to accomplish goals.

Discussion post Essay Example | Topics and Well Written Essays - 250 words - 9

Discussion post - Essay Example Some of the popular themes used in DSME include the Health Belief Model and Social Cognitive Theory. The author notes that for text messaging support, the Theory of Planned Behavior and the Health Belief Model were also utilized. However, a systematic review found that the theoretical model used in the DSME programs did not seem to have an effect on the outcomes (Steinbekk et al., 2012). Nevertheless, the Health Belief Model has been utilized both in DSME programs and text messaging support programs. I also agree with the second post by Victoria Ikoro on the management of metabolic syndrome. Metabolic syndrome has become a health crisis, especially in the western industrialized countries. Some of the predisposing factors of this condition include obesity, a sedentary lifestyle, and unhealthy eating habits (De Freitas et al., 2013). Management of metabolic syndrome involves lifestyle modifications to incorporate more physical exercise and maintaining a healthy diet. One of the ways in which the researchers have successfully initiated health behavior change and education include through the use of social and cognitive behavioral theories such as the Health Belief Model, Health Behavior Change Theory and the Social Support Theory. Interventions can use single models or a combination of several. De Freitas Jr, R. W. F., de Araà ºjo, M. F. M., Marinho, N. B. P., de Vasconcelos, H. C. A., Lima, A. C. S., Pereira, D. C. R., & ... Damasceno, M. M. C (2013). Prevalence of the metabolic syndrome and its individual components in Brazilian college students.  Journal of Clinical Nursing,  22(9/10), 1291-1298. doi:10.1111/jocn.12015 Steinsbekk, A., Rygg, L., Lisulo, M., Rise, M. B., & Fretheim, A. (2012). Group based diabetes self-management education compared to routine treatment for people with type 2 diabetes mellitus. A systematic review with meta-analysis. BMC health services research, 12(1),

The Eighth Circuit Court of Appeals Essay Example | Topics and Well Written Essays - 500 words

The Eighth Circuit Court of Appeals - Essay Example 34). To the extent that drugs are used to treat individuals to get better, it would contradict the health practitioners’ code of ethics to prepare the individual for death. Further, this case is strengthened by the reality a case for execution cannot be substantiated after realization of insanity while in prison. The initial crime committed by Singleton is supposed to take charge in this case and he should be given the antipsychotic drugs ready for execution. The essential claim premise would dictate that the claims of such an argument be supported by a plausible claim within the rubric of written laws. The claim made on the execution of Singleton is strictly supported by the written laws in the constitution (LaFave, & LaFave, 2006, p. 91). Given the fact that he committed the crime insane conditions, he is presumed to have had full knowledge of the implications of his actions at the time. In this perspective, a case for insanity that happened thereafter cannot be used to reverse a stipulated law to relinquish the previous charges. Singleton should be restored to his sane sense to realize the events of the proceedings to his execution. From the fact that the law recognizes equity to all citizens, pardoning Singleton overruns the rights of the innocent individual whose life was cut short by S ingleton’s action. Actually, Singleton did not consider his actions even when he was sane, and a medical antipsychotic would only restore his senses to understand the charges as he faces the consequences of his actions. An objection to the above argument would be based on the health practitioner’s duty to protect life. Given that the intentions of any actions dictate whether the deed is good or bad, it would be plausible to assume that treating Singleton with the intention of execution after recovery is bad. Medicine should be administered with the sole intentions of getting individuals better and relieving them of pain to realize better lives. Further, it is

Business report based on the a given case study. Highland Limited Essay

Business report based on the a given case study. Highland Limited - Essay Example Frank in order to repay the loan had to sell of his centre at Shiel Bridge. Frank Rose took help from his wife Fiona and Andrew Robertson who were willing to put in funds and thereafter Fiona and Andrew took over the running of the business. Frank Rose concentrated more on the Outdoor Centre while Fiona looked after the accounts and Andrew became the Managing Director. The business operated from small cottage. The company moved into a new location in April 2008 and one of the main customers of Highland Limited, Weir’s of Glasgow made the company big enough to get viable. The relationships between the staff were informal. But steadily the employment increased post November 2008. The company did not have enough resources to meet the demands of the market and thus the company did not make any attempt to attract new customs. Approaches to retailers were discouraged as Andrew Robertson believed that until they had the capacity to satisfy the demands of the market it would not be pr ofitable to go to the retailers. The company faced a twist when it had started operating with Stoner garment, a brand of western Oil Limited. The company was eager to supply waterproof and protective clothing to the lucrative market of about 2000 workers. This provided Highland Limited with an advantage as being a local supplier the company would be able to produce jackets according to the demands and deliver at a minimal time. Therefore Highland Limited together with Stoner Garments decided to design jackets which would be acceptable to Western Oil in terms of both quality and price. Therefore by providing garments to the Western Oil the company was able to achieve success and the legal framework adopted by the company was applying the norms and regulation. Highland Limited was a company in which philosophy and raison d’etre mattered a great deal. The company realised that although the company objectives was to maximise the profits there were also secondary objectives which the company also wished to pursue. The objectives were embodied in the company’s philosophy but never written down. There was difference in the way people saw the philosophy. Thus the factors that the organisation needs to consider in reviewing its mission statement, goals and business plans for the future is firstly the company needs to develop a mission statement, a mission statement is only the starting point of the organisation. Next task is to identify a set of goals which would accomplish the organisations missions. The company needs to establish one year plan, three year and five year plan for expanding its market share in the market. Thus to achieve the goals the company have to develop short term objectives

Work Breakdown Structure Assignment Example | Topics and Well Written Essays - 500 words

Work Breakdown Structure - Assignment Example The time frame for completing all activities at the terminal ends must be within the confines of one reporting period. If the activity may spill over to the next period, then it should be further subdivided. It is possible to contract out the terminal elements of work as single units of activities. For instance, all the activities in the above WBS can be contracted to specific individuals or groups. The terminal elements should represent work activities that realistically are not possible to break further (Miller 98). The Tree Structure Format was employed in developing the work breakdown structure. This is the commonly used format in presenting the WBS. The major advantage over other methods is that it is easy to understand just by taking a quick glance (Miller 109). Users can quickly be able to view the flow of work and what they are expected to do. The downside is that it may be difficult to create compared to others such as the Tabular Format. In project management, certain activities or whole project may spiral out of control and take longer than usual to complete. This may occur due to lack of proper planning of the scope of the project ahead of its implementation. This is referred to as the scope creep. IT projects are highly susceptible to scope creep. For example, FoxMeyer Drug, a large pharmaceutical company experienced scope creep on trying to install a multimillion IT system that would manage all critical operations. The scope of the project experienced a continuous growth until the costs became prohibitive (Schwalbe 209). The IT system also experienced billing errors. The cause of scope creep in this case was the lack of a clearly defined scope of work. There were no elaborate work limits during the initial stages of the project. Product testing could also have helped eliminate failures in the new system which resulted to errors (Schwalbe 210). Northrop Grumman, a manufacturing company experienced scope creep during implementation

Human Resource Strategies Essay Example | Topics and Well Written Essays - 1250 words

Human Resource Strategies - Essay Example Organization do not operate in vacuum, hence there are interconnectivities of interrelationships. The relationship between management and workers of organization, with the focus of how organizations' productivity can be enhanced has brought about the emergence of plethora of organizational theories. Among these are , the Frederick Taylor Scientific or Machine theory, Elton Mayo's Human Relations theory, Behavioral theory, Administrative theories, System theories, motivational theories , like McGregor's; X and Y theories, Abraham Maslow Hierarchy of Need theory and Frederick Hezberg two Factors theories, inter alia. How feasible and tenable is the proposition that "human resource strategies should be underpinned by organization development theories". This write- up will focus on this, using McDonalds Corporation as a case study to show how organization's strategy helps in contributing to its success. Human Resource Management (HRM) is the management of organization's human resources in such a way that the workers personal needs are adequately met in order that they put in their best in the attainment of the organization's objectives and long term goals. According to Sims (2002), HRM is the term increasingly used to refer to the philosophy, policies, procedures, and practices related to the management of an organization's employee. In the process of HRM, there is an increasingly emphasis on the personal needs of the organization and its members. The challenge is to create an organizational environment in which each employee can grow and develop to his or her fullest extent. Strategic Human Resource Management (SHRM) is the linking up of HRM to the strategic goal and objectives of the organization. "Strategic HR means accepting the HR functions as a strategic partner in the formulation of the company's strategies through HR activities such as recruiting, selecting, training and rewarding personnel". (Chaturvedi, 2005). Theories are abstractions from the real world situations in order to give explanation to a given phenomenon or interrelating variables. Thus, organization development theories are those theories that tend to explain how efficiently the organization's resources can be adequately managed in order that the highest productivity and the attainment of set objectives are achieved by the organization. INCORPORATING ORGANIZATION DEVELOPMENT THEORIES IN HUMAN RESOURCES STARTEGIES Scholars have argued that SHRM has no thoroughly researched theories to give explanation on how HRM is linked to the organization's strategy. In the view of Wright and Haggerty (2005), SHRM research has greatly borrowed from other disciplines' meta-theories and utilized organization theories in linking up HRM to strategic management. "existing research in SHRM had predominantly utilized Resource based Theory, the Behavioral Approach, Open System theory, and Control theory with a few authors exploring Population Ecology and Critical

Value Chain Analysis Of DHL And Aramex Assignment

Value Chain Analysis Of DHL And Aramex - Assignment Example Both secondary as well as primary data would be collected in order to present a comprehensive report to the readers. Among these major business operations, supply chain is the common element that has been considered for this report. Though supply chain plays a significant role for both DHL Express and Aramex, but DHL Express is a bigger company and supply chain is segregated for different segment such as, health care, oil and gas, etc. Aramex on the other hand is present worldwide, but yet the company is not as large as DHL, so they have a sophisticated and technology integrated supply chain. I: INTRODUCTION 1.1 Background The express transportation and logistics industry can be regarded as one of the steady growing segments in the world economy. More than 1.25 million individuals are an example, as well as primary data, recently, which is even more than the size of the petroleum and oil industry. Apart from this, it supports more than 2.65 million other jobs around the world (Oxford Economic Forecasting, 2005). There are many industries around the world which functions with the help of express service industry, such as pharmaceutical, manufacturing, financial services and other technology companies (Transport Intelligence, 2012). The global leaders in this industry are the big four companies; DHL Express, UPS, TNT and FedEx (Thompson and Martin, 2010). The aim of this report is to analyse the business operations of two well-know express transportation and logistics industry, so as to identify a common element in their business operation and compare and contrast them. The companies chosen for this study is DHL Express and Aramex. A specific focus towards the business operation and function of these companies in the Gulf countries, such as Bahrain, etc would be also taken into account. 1.2 Procedure This report will include a comparative study of two companies in the express transportation and logistics industry.

Human Resource Strategies Essay Example | Topics and Well Written Essays - 1250 words

Human Resource Strategies - Essay Example Organization do not operate in vacuum, hence there are interconnectivities of interrelationships. The relationship between management and workers of organization, with the focus of how organizations' productivity can be enhanced has brought about the emergence of plethora of organizational theories. Among these are , the Frederick Taylor Scientific or Machine theory, Elton Mayo's Human Relations theory, Behavioral theory, Administrative theories, System theories, motivational theories , like McGregor's; X and Y theories, Abraham Maslow Hierarchy of Need theory and Frederick Hezberg two Factors theories, inter alia. How feasible and tenable is the proposition that "human resource strategies should be underpinned by organization development theories". This write- up will focus on this, using McDonalds Corporation as a case study to show how organization's strategy helps in contributing to its success. Human Resource Management (HRM) is the management of organization's human resources in such a way that the workers personal needs are adequately met in order that they put in their best in the attainment of the organization's objectives and long term goals. According to Sims (2002), HRM is the term increasingly used to refer to the philosophy, policies, procedures, and practices related to the management of an organization's employee. In the process of HRM, there is an increasingly emphasis on the personal needs of the organization and its members. The challenge is to create an organizational environment in which each employee can grow and develop to his or her fullest extent. Strategic Human Resource Management (SHRM) is the linking up of HRM to the strategic goal and objectives of the organization. "Strategic HR means accepting the HR functions as a strategic partner in the formulation of the company's strategies through HR activities such as recruiting, selecting, training and rewarding personnel". (Chaturvedi, 2005). Theories are abstractions from the real world situations in order to give explanation to a given phenomenon or interrelating variables. Thus, organization development theories are those theories that tend to explain how efficiently the organization's resources can be adequately managed in order that the highest productivity and the attainment of set objectives are achieved by the organization. INCORPORATING ORGANIZATION DEVELOPMENT THEORIES IN HUMAN RESOURCES STARTEGIES Scholars have argued that SHRM has no thoroughly researched theories to give explanation on how HRM is linked to the organization's strategy. In the view of Wright and Haggerty (2005), SHRM research has greatly borrowed from other disciplines' meta-theories and utilized organization theories in linking up HRM to strategic management. "existing research in SHRM had predominantly utilized Resource based Theory, the Behavioral Approach, Open System theory, and Control theory with a few authors exploring Population Ecology and Critical

Jeffrey Skilling Essay Example for Free

Jeffrey Skilling Essay In 1975 Jeffrey Skilling received his B. S. from Southern Methodist University in applied science, and in 1979 received his M. B. A. from Harvard. He was hired by McKinsey Company as a consultant and in 1987 began working with Enron to help create a forward market in natural gas (wikipedia. org). Ken Lay hired Skilling in 1990 as chairman and chief executive officer of Enron Finance Corp. and in 1991 he became the Chairman of Enron Gas Services Co. Also, he was appointed CEO/managing director of Enron Capital Trade Resources. Skilling was promoted to second highest position in the company, president and chief operating officer in 1979. By pushing an aggressive investment strategy, Skilling helped Enron to become the biggest wholesaler of gas and electricity (biography. com). On February 12, 2001 he was named the new CEO of Enron, replacing Ken Lay. Later in 2001, during the energy crisis in California; Skilling resigned on August 14 and shortly after he sold off large blocks of his shares of Enron. Enron declared bankruptcy in December 2001. The Federal Bureau of Investigations indicted Skilling on 35 charges, which he pleaded not guilty on February 19, 2004(wikipedia. org). His trial began on January 30, 2006 and lasted four months. On May 25, 2006 he was found guilty on one count of conspiracy, one count of insider trading, five counts of making false statements to auditors, and twelve counts of securities fraud; and not guilty on nine counts of insider trading(wikipedia. org). October 23, 2006 Skilling was sentenced to 24 years and 4 months in a federal prison and was fined 45 million dollars. Skilling began serving his prison term on December 13, 2006 at a low security federal prison in Littleton, Colorado. His release date is scheduled for February 21, 2028 according to the Federal Bureau of Prisons.

The Social Issues Of Fingerprinting Biometrics Information Technology Essay

The Social Issues Of Fingerprinting Biometrics Information Technology Essay This literature review also addresses on some areas like social and legal issues regarding fingerprint biometrics. Human factor that relates to biometric technology and some security issues for fingerprint biometric technology. Social issues There are several social issues that affect fingerprint biometric technology like misunderstanding the usage of the device of technology. Hesitation is also one of the issues relating to biometric, new users sometime hesitate to use new technology. Security concerns No system that tend to be entirely secure there are some intrusiveness in the system including fingerprint technology. But implementing fingerprint biometric system can be somewhat secure as compare to stealing and copying passwords, there is a level of security. Mainly passwords can be broken by using some software but using fingerprints for authentication will be considered more secure and reliable. Privacy Concerns The privacy concerns can be leaving the fingerprints all over the place on daily basis work we do. But when a user is involved in using fingerprint technology user might worry about the privacy. Third party involvement in data Other then privacy the concern for the fingerprint is that when the fingerprints are scanned they are stored in the digital format and are stored in the database. The data store in the database can be copied or deleted. The fear for the user fingerprint publicity or privacy can be a problem. Health concern The health concern for the fingerprint is related to the safety of fingerprint technology. While user interaction there is a direct contact between user and device sensor , user might fear of electric shock or spreading germs or might experience some kind of pain while using the device. The graph shows user uncomfortable using biometric technology Human Factors Gender Factor: As per gender woman have slim and smaller fingers with long nails as compared to males. Due to the change the fingerprint scanning device may not be able to capture a good sample or authenticate well. The shape and size differs with regards to gender. Age factor: As people age increases the fingerprint becomes lighter and there is elasticity in skin. Such a problem can result with poor acquisition of fingerprint and will not be able to match with the original samples. It also varies from the sensor and hardware that is being used. Occupational factor: As some of people do labor jobs, they might deal with lifting up heavy things and working with chemical which may result in wearing of fingerprints. This might cause problem for the fingerprint scanner to match it or capture the sample. But there are some sensors available which use the second layer of the skin to be captured. Percentage of population unable to enroll Some people cannot use fingerprint scanner as it require physical movement and finger to be scanned. Secondary research Development Methodology System development life cycle This SDLC model is used to develop a system. The process within this model makes sure that all the process is covered in it. It works in the systematic manner; if one stage is not completed we cannot proceed to other stage without completion. The phases track the information for the development planning for the project, analyzing the requirements, gathering information, designing the system, implementation and testing SDLC is a whole set of methodologies which can be applied to software development. This includes the following: Waterfall life cycle Prototyping Spiral RAD Waterfall life cycle Waterfall method is used mainly for the development of complex systems because its works according the phases and each phase need to be completed before moving forward. In this life cycle the project need to be analyzed in many different ways like analysis the time and cost. Then for the next phase requirement and analysis deals with the client requirement and also the resources required by us for development of the system. In the design phase all the logical and physical designs are developed for the system and the forwarded to the next stage for implementation as and when the implementation of system is being over the testing takes place because need to test the system or any kind of error or bugs. After the successful testing and integration the system need to be updated and maintained regularly and in the final stage the maintenance of the system is done. http://www.csse.monash.edu.au/~jonmc/CSE2305/Topics/07.13.SWEng1/html/text.html This model is considered the oldest paradigm for software development. But still it remains a very reasonable method when those requirements are well understood. It provides a very basic template into which methods for design m coding m analyzing, testing and implementation. This method still remains a very widely used procedural model for software engineering. This is a good and reliable model for developing the proposed system. Prototyping: Prototyping is the part of the process which helps in building the model of the system. It is included in analysis and system development. This process helps the developer to build a design for a system to know exactly how the system will work. During the requirement and analysis phase need to gather the data required for the system. Prototyping is sometimes intangible but still helps in enhancement of the project. The feedback that we receive from the users after developing the physical design of the system can help us in evaluate the response of the users to this system and then we can manipulate the system according to the requirements. Prototyping comes in many form its not only the physical design but can be the as low as paper sketch to any engineering design tools. Still now also some of the organization uses the paper sketch as the prototyping but some of them uses some computer aided software engineering tools to build a prototype. There are some advantages of prototyping It reduces the time in the development It reduces the development cost For the prototyping process we require user involvement Helps the developer in future enhancements Disadvantages of prototyping Much analysis not done in prototyping The expectations for the users are made according to the prototype Even developers can also be attached to the prototype Spiral: The spiral model is a process for software development. The spiral uses the top-down and bottom up technique. It combines both design phase and prototyping. This model is basically used in information technology processes. This model is the combination of waterfall model and prototype. This model is used for large and expensive projects. Steps involved in spiral Requirements are defined in detail which also involves the interviewing the users The important phase in spiral model is creating preliminary design of the system which helps the users and developer to understand the system, this phase also helps in identifying the problems and solutions towards it. The prototype is constructed from the preliminary design which represents the characteristics of the system Then evaluating the prototype in terms of weakness, strength and risks. Coming up with new requirements Planning and design for second prototype Implementing and testing the second prototype Advantages Estimations are more realistic as most of the requirements are analyzed in details It is easier to make changes in the systems as compared to others. Disadvantages Highly customized limiting re-usability Applied differently for each application Risk of not meeting budget or schedule Risk of not meeting budget or schedule RAD: Rapid application development is used in the development of the project which requires minimal planning. RAD merges various structured and prototyping techniques. This development is mainly used in engineering process. Advantages of the RAD methodology: This methodology is flexible and able to adapt the changes in the project. This methodology generally incorporates short development cycles By using this methodology there is a reduction in overall project RAD involves user participation thereby increasing chances of early user community acceptance. Disadvantages of RAD methodology: No planned cost and time; sometimes it can exceed the limit. Chances of errors are very high. Secondary Research Programming Languages ASP.Net ASP.Net is the product of Microsoft. It is the extended version of active server pages; which helps in the web development model that includes basic services required for the developer to develop the web applications. It can support various languages like VB, C++, C#, J# Jscript. Net frame work does not only limit itself to any one language which is the good about it. It works on the windows environment and also support to the web pages Web Services Web services means that we can run the applications having different web pages on different servers. We do not require combining all the pages into one server and then run the application. ASP.Net is a great future of web services. ASP.Net also supports the XML which is part of the web development. Java It is a programming language used to develop the applications .it is the product sun Microsystems. It is easier to write and develop application using this language as compared to other languages. The limitation of this language is that it limits the developer to use only one language that is java. This language also contains the API through which we can develop the applications more easily and faster. It is platform independent the programs use java virtual machines for the abstraction and do not access the operating system directly. PHP Justification of the programming language chosen Secondary Research Before starting any project we need to analyze the resources required for the system and need to have a feasibility study for the system that we are going to develop. It is very important to have a deep knowledge about the system and gather more and more information regarding the system. As there are many book available in library and some online resources also accessible to fetch the information. Internet is being widely used these days for searching any type of topic you are looking for but we need to be very careful while referring to internet as it may also come up with some wrong information which can cause problem in our system development. While selecting the source information from the internet developer need to be careful about from which website or article is being data taken, make sure that data is authenticated and is verified. The developer can refer to journals, papers and university website because they are very reliable to use. Review on similar systems There are lots of products available in the market using bio metric technology. Before starting up the project developer need to find out the similar systems that have being already developed and need to review on the similar products. All this need to be done so that developer can get clear idea about the feasibility of the system that is going to be developed. I have done the analysis on the similar systems which are available in the market. As my system is for web authentication using finger print technology which is not been developed yet in the market but there are systems that are using fingerprint technology for the authentications. I will be focusing on such systems that will be using the biometric technology for authenticating genuine user. Overview Lone wolf software, Inc was founded in 1991 which has evolved small computer resources to custom software with a client which includes most of the fortune 500 companies. Since the company have been developing systems of no just time and attendance but also for the patient disease management software, shipping software, trucking management software and much more. The Juno uses the best finger print technology which highly rated in time attendance management system. It brings the manual work to automation and faster than before like it is used in automated time and attendance terminal. It is easy to maintain and use, need not require much training procedures before using this device. It allows the user to clock in and out with just a touch of a finger. Its not only used for clock in and out but user can also view the previous records and other information like departments, projects working etcà ¢Ã¢â€š ¬Ã‚ ¦ For the audio assistance and verbal conformation speakers are attached on the board. This product also comes with the internal bell system which uses the internal speakers for a beep like common start, break time and end time. This product is capable for holding more than 1,500 templates and 30,000 transactions which makes it the perfect for any size of the company. Reason for developing such system This system is fast replacing the traditional attendance registers. Huge number of employees works under one company and its very difficult to maintain each employee daily records manually like (attendance, time in and time out). Manually it takes so much time for the employees to mark the records. The old traditional system was not easy to maintain and was also so much time consumptions, generating a report manually can take so much time using manual attendance system. Reasons for developing or using these types of systems are mentioned below: Security: These systems are considered to be most secure attendance and management system in the market. With the increase in security, your employees need to punch there finger on the sensor to enter the company and mark attendance, by this elimination of fake entry and a reduction of time theft. Moreover reduce the labour cost and saves lots of money. Accuracy: With increase in security this system also provides increase in accuracy. Besides from time theft, calculating mistakes cost can be reduced easily. The automation of report generating will be accurate. You will be able to monitor attendance, breaks, vacations; holiday hours etcà ¢Ã¢â€š ¬Ã‚ ¦ everything will be recorded correctly and fairly. Easy to Use: Automated attendance and management system are easy to use and implement. Employees can just log their attendance easily just with a touch of the finger and managers can. Conclusion This system is similar with my system as per the technology perspective, because my system is also using biometric fingerprint technology, but my system is mainly based on the web authentication system. The backend working for the system above and my system will be similar as in my system developer will be also storing the fingerprints for the users that are going to use the system. Domain Research Introduction Biometric authentication is one of the technical improvements in information technology and looks set to change the way of majority of people. Security is now days becoming an issue and need for genuine authentication has become very important. Personal use of biometric systems in authentication now days being a response for issue of authentication and security. Mostly finger print recognition is used for authentication. This paper is organized as follows: by now, the reader should be already familiar with the content of section one which consisted for the current problem faced by the internet users and need for the system followed by the study of objective , level of challenge and project planning , section two consists of literature review followed by domain and technical research .Section three will illustrate how primary research (questionnaire and the survey)and investigation was done and which methodological choices were made. Biometrics is defined as behavioral uniqueness that can be use to verify to identify an individual, which can include fingerprint verification, retinal scanning, face recognition, iris, and signature verification. Biometric authentication is automatic identification of an individual using either a biological feature they possess physiological characteristic like a fingerprint or something they do behavior characteristic like can be fingerprint, iris , face etc The process of recognition and authentication is the ability to verify the genuine user. The identification is by using any one of it or combination of the following three traditional identification techniques: Something you possess: Its mainly referred as token and it ca produced by multiple physical objects. The tokens are basically divided into two types: Manually tokens : It refers to identification process in form of human intervention , means a person will make a decision for deciding whether the identify is approved or not E.g.: On airports the authentication is done manually by verifying passports , now the airport of immigration authority takes decision regarding the traveler authentication is verified or not. Automated tokens: These token does not involve human intervention for identification. E.g. verification system like smart cards and magnetic strip cards Something you know: This refers about knowledge you possess but its a secret . Example of regular use of secrets is personal identification number (PIN), passwords etcà ¢Ã¢â€š ¬Ã‚ ¦ Something you are: It refers to more of their biological features. E.g. authentication using fingerprint, face or iris etcà ¢Ã¢â€š ¬Ã‚ ¦ The following comparison between identification techniques Tokens Can be fake and can be used without knowing to original holders. E.g. Someone can steal an identity and create a new fake ID using any others personal information. It can be stolen, lost or given to someone for usage. Passwords Can be cracked or obtained using hacking techniques or tools like password cracking. Can be told. If the password is told to a person they can get into your account and can misuse your personal information. It can be forgotten which can cause problem for an organization you are working for E.g. you are working in a organization you need to gain access to company email account urgently, forgetting password can cause you in trouble that time. Biometrics Cannot be fake Can be cracked Dealing with accuracy sometimes causes problem in biometric device like having a cut on finger, burn or excessive rubbing on hard surface can bring damage to your finger then it might not be possible that you can be authenticated by biometric system that time. Table 1: Tokens vs. Passwords. Vs. Biometric Comparison between each biometric methodology Methods Strength Weakness Suitable applications Finger print Stable over time uniqueness Needs to training user resistance Workstation access control , ATM , airline tickets , physical access control , information system control Face Universally present Cultural and religious issues physical access control Iris Stable over time uniqueness Needs to training user resistance ATM , airline tickets , physical access control Retina Stable over time uniqueness Slow read time user resistance physical access control , information system control Hand geometry Low failure to enroll small template Size of device childish finger growth physical access control , information system control, time attendance Voice Less training excellent user acceptance Changes and unstable over time Mobile phone banking Signature High user acceptance less training Enrollment tasks long and unstable over time Portable device stylus input Technical requirements