Tips and Ideas on How to Write an Accounting Essay

The integral aspect of writing an accounting essay is to ensure the content is factually accurate and informative. The opinions must be supported by the latest figures, financial reporting, and facts. The layout and presentation matter a lot if you want to write winning essays.   Therefore, it is imperative to follow a clear structure to present your facts correctly. The best way to understand more about essay structure is to find out more detailed info regarding the type of essay you are writing and its content. Know What Is Accounting Essay to Write It Perfectly Well, accounting is an essential business process, which deals with the flow of funds between shareholders and business units. Therefore, when you are writing an accounting essay, you need to factor in the process of funds transfer. You need to know what to write and how to package and present it properly. It is imperative to understand the conventions and accounting concepts to follow when completing this type of assignment. How to Write a Good Accounting Essay for an A+ Grade Essay writing is not a difficult undertaking. All you need is to be organized and know what you want to achieve. Economics is a complex discipline where single-sided methods do not work. Various steps can be incorporated to ensure you come up with a good write up within the deadline. Consider this: Organize your time The first step is being able to manage time. Students make a big mistake by allocating all their assignments for the last day. It does not allow them to have ample time to do proper research and find the right information for their write-ups. Schedule your time to write every part of your work properly Introduction Before answering any question in your essay, ensure you establish a precise understanding of the questions to be addressed. Highlight the objectives of the paper. Outline for your reader that which you want to reach a conclusion for. The introduction helps you shape the end goal of your work to the reader. Resource planning and structure Once you have made your audience know what you what to present, the next step is to follow a structured approach in writing your paper. It helps you to write the essay in a precise manner. This is because it outlines the essay coverage area, the points to write and the approach to use in answering the question. For example, a good accounting paper will consider three aspects namely: The accounting concepts, current developments in accounting standards and the financial reporting standards. Ensure you get the facts right. Choose the resources to use It is important because it helps you compile a good list of reference material to back up the opinions and views. Note the bulk of reference materials depend on the nature and length of the essay. Inclusions of calculations This area is vital in making your content concrete. Though, you should only include graphs, figures, and chats if it is appropriate for the subject you are undertaking and adds value to what you are presenting. It is because not all accounting areas require such information. Conclusion and recommendation Summarize the discussion in this section. To make it tangible, outline the result of any calculation or analysis done. The conclusion also gives a chance to express your opinions regarding the findings. However, it should be in line with the questions raised. How to Start an Accounting Essay Easily Accounting paper is complicated not only to the novice but also to advanced students. The unique nature of accounts makes it a bit unbearable if you do not have the right facts. The good news is even if you are a beginner; it is possible to deliver a well-written paper. Many students have had good grades because of professional help form academic writing companies. Note the quality of any write up is greatly determined by your topic. The start point of writing an exclusive essay is to select the right topic. Therefore, how can one know he or she has picked a superior topic? It is simple, do background research on it. Find the available information and identify a gap to focus on. It will allow you easy time writing the essay because you know the key areas of your focus. It is almost impossible to write exceptionally without doing proper research. So, allocate enough time for background study. Learn How to Structure an Accounting Essay Correctly This type of essay is not different from others. They follow the same structure. It is required you order your points well and present them logically. The initial thing is to write a good introduction. The purpose of introducing your work is to address the topic and to identify your reader. The level of language use must correspond to the intended audience. After the introduction, you need to have a body that presents your arguments. How your order your points is vital. Ensure you have your points articulated in a smooth flow. Each paragraph should have an individual thought. Many students write poor essays because they crowded different points in one paragraph. What You Need to Know About Accounting Essay Introduction So much depends on the initial lines of any paper. The first sentences you write are crucial in any academic writing piece. Your readers form a perception from them. If you have a poor introduction, all your work will go to waste. Even the professor will award low marks because he or she will not be impressed from the start. Remember you only have one chance to make the first impression in writing. Hence take the introduction seriously.   A successful introduction must: Attract the reader’s attention Prepare the reader for your essay Give context for your paper If the introduction performs these functions, your work is complete. It will be impressive and catchy. Learn How to Write Accounting Essay Body Professionally Many professional writing companies are available online. They have different information concerning essay writing. It makes many students wonder the type of essay structures they have to follow.   Are you in a dilemma? Are you looking for a service that will help you nail the right essay structure? It is possible to find help. We have been on the market for over five years. We understand various universities and colleges regulations and what they expect from scholars. With the information, we have helped many students hand in well-written essays that earn them A+ grade. For instance, the body should have various paragraphs where each section carries an individual thought. The paragraph should have topic sentences that express the major points of focus, other sentences should explain it and provide a relevant example that demonstrates the articulated points. Learn What Makes an Accounting Essay Conclusion Credible It is important to note that the accounting essays conclusion is not just a summary of the evidence provided in the body. It is the part where you have to leave the last impression and give a sense of accomplishment to your reader. It should be brief but exact with all necessary accents. To make a good conclusion; Restate the thesis statement Get the main points from the body and summarize them precisely Conclude by answering the main question of the essay Do not make a general conclusion rather be specific. Ensure you give the final comment about the topic in answering the thesis statement. In case you get problems completing the entire or a section of your essay, seek professional help from writing agencies like our own. We are available online, and therefore, the help you are looking to write your essay like a pro is a click away. Many students rely on us because we have put together a great team of professionals who work on various types of essay. We have experts in more than 100 disciplines. There is no undoable task when you contact us. The expertise of many years helps us to compile A+ grade accounts essays by following the right accounting essay structure. Do you need a well-compiled paper? Do not hesitate, fill out the order form.

The Clique

The Clique Free Online Research Papers The Clique the only thing harder than getting in is staying in. This quote written on the back cover of The Clique novel is what truly caught my attention and convinced me to read the book after hearing good reviews from my friends. This book turned out to be a dissapointment to me however it held good interest at the time due to the authors use of cynical yet gentle sense of humor throughout the story. In my opinion this book stretches the average mean girl story to a whole new level and allows readers to view their world in a whole new lifestyle. The book The Clique stretches the average mean girl scenario to a whole new level. Everyone has seen, heard, read or even experienced the typical mean girl story where theres the head mean girl(s) usually with sidekicks that happen to be gorgeous, popular , rich and snobby. Also tending to have the jock boyfriend and so called perfect life. Then theres the lovable loser that becomes a victim to this mean girl and thus continuing the antagonist and protagonist story. In The Clique novel author Lisi Harrison takes this played out story and brings into life with contradicting and animated characters. This novel gives you the ability to see through the eyes of top notch queen bee Massie Block mean girls eyes and through the lovable loser Claire Lyons. This book also allows readers to view their world in a whole new lifestyle. The setting of the book was in Westchester County, New York and in modern day(2000-2010).This made the novel seem more realistic and felt like you were actually experiencing everything with the detailed description of settings and characters. The plot of the story was basically about Claire Lyons and Massie Block. Claire is just any average teeneager that by her fathers friendship with Massies father ends up moving into Massies guesthouse. Massie, who is queen bee to OCD or Octavian Country Day School happens to be the opposite of Claire being raised in the rich and snobby lifestyle of her families mansion. I dont want to go in depth of the story but in combination of these two characters leads to plenty humor and drama which makes it a real page turner. Not only did this story ameliorate the mean girl scenario and allow readers to view their world in a whole new lifestyle it stayed true to the average teen story with the popular morals of be yourself and the ups and downs of boy crushes. In basic conclusion I recommend this novel to any girly girl or person in need of a good laugh and to teen girls that always wonder what its like to be a mean girl. Id probably rate this with 4 out of 5 stars because of the constant grammer errors throughout the novels and because it strangely makes the readers feel as if in that moment they want to be a mean girl like Massie with the perks of being pretty, popular, rich, snobby and insanely clever. Research Papers on The CliqueHarry Potter and the Deathly Hallows EssayThe Masque of the Red Death Room meaningsMind TravelHonest Iagos Truth through DeceptionThe Fifth HorsemanEffects of Television Violence on ChildrenStandardized Testing19 Century Society: A Deeply Divided EraThe Hockey GamePersonal Experience with Teen Pregnancy

How to Write a Personal Statement for Graduate School

How to Write a Personal Statement for Graduate School A personal statement for graduate school is an opportunity to showcase  what you will bring to the graduate program and to explain how the program  fits into your larger career goals. Some programs will ask you to write a single essay covering both your personal background and what you wish to study in graduate school. Others, however, will require both a personal statement and a statement of purpose.  The  personal statement should focus on you and your background, while the  statement of purpose should focus on your research or what you plan to study in graduate school. Follow these strategies to craft a stellar personal statement that will stand out in admissions offices.   Key Takeaways The personal statement provides an opportunity for you to share information about yourself and your academic interests to graduate admissions committees.The personal statement should discuss your academic background as well as relevant work and research experiences.When talking about your previous experience, be sure to highlight the skills that you learned and how your past experiences have led you to be interested in graduate study.Your first draft of your personal statement doesn’t need to be perfect. Give yourself time to revise and proofread your essay, and be sure to seek feedback on your draft from others. Structuring a Personal Statement Your personal statement should include an introduction and a summary of your previous experience (including your coursework, research experience, and relevant work experience). Additionally, if you’re not covering these topics in a separate statement of purpose, you should also discuss why you want to go to graduate school, what you wish to study as a graduate student, and why this particular graduate program is right for you. Starting Your Essay Personal statements can begin in a few different ways. Some students start their essay by discussing their personal background or sharing a compelling anecdote that explains why they are interested in graduate school. Other students simply begin their essay by talking plainly about their academic experiences and interest in graduate school. There’s no â€Å"one size fits all† answer here, so feel free to choose the introduction that works best for your essay. Sometimes, the introduction of a personal statement is the toughest part to write. If you’re experiencing writer’s block, remember that you  don’t  have to start with the introduction.  By the time you’ve finished writing the rest of the essay, you may have a much better idea of the type of introduction your essay needs. Summarizing Your Previous Experience In your personal statement, you’ll want to talk about your previous academic experience and how it has prepared you for graduate school. You can talk about courses you’ve enjoyed (especially any advanced coursework), research projects you may have worked on, or internships and work experience that are relevant for graduate school. When describing  your previous experience, be sure to not just write about what you did but also what you learned and how the experience contributed to your interest in graduate school. For example, if you gained research experience by assisting a graduate student with their research project, don’t just describe what the project was about. Instead, be as specific as possible about skills you picked up (for example, gaining experience using lab techniques or a particular academic database). Additionally, write about how your past experiences sparked your curiosity and helped you decide that graduate school is the right choice for you. Remember that you can also talk about non-academic experiences such as volunteer work or part-time jobs. When you mention these experiences, highlight how they show transferable skills (i.e. skills that will also be valuable in your graduate program, such as communication skills or interpersonal skills). For example, if you supervised a group of students as a camp counselor, you might talk about how this experience helped you develop leadership skills. If you had a part-time job while in college, you might talk about challenges you resolved at work and how they demonstrate your problem-solving ability. If you faced significant obstacles  while in college, your personal statement can also be a place to discuss the experience (if you feel comfortable doing so) and its influence on you. Writing About Why You Want to Attend Graduate School In your personal statement, you should also talk about your future goals: what you want to study in graduate school, and how this ties into your larger goals for your future career. Graduate school is a big commitment, so professors will want to see that you have thought through your decision carefully and that graduate education is truly necessary for the career you want to pursue. When talking about why you want to go to graduate school, it’s good to be as specific as possible about why the school you’re applying to would be a good match for your career goals. If you’re applying to a program that involves a significant amount of research (such as PhD programs and some Master’s programs), it’s important to talk about the research topics you’re most interested in studying while in graduate school. For programs involving research, it’s also a good idea to read the department’s website to learn about faculty members’ research topics and then customize your personal statement accordingly for each school. In your personal statement, you can mention several professors you might want to work with and explain how their research matches up with what you’d like to study. Mistakes To Avoid Not proofreading. In graduate school, writing will be a big component of your academic career, especially if your program involves writing a Master’s thesis or doctoral dissertation. Taking the time to proofread shows professors that they can be confident in your writing ability.  Sharing overly personal information. While sharing a personal anecdote can help to  illustrate your interest in graduate school, disclosing information that is too personal can backfire. In a survey of psychology graduate admissions committee chairs, some professors pointed out that sharing overly personal information can make applicants look unprofessional. And as Harvard’s Office of Career Services points out, interviewers  may ask you follow-up questions about your personal statement in interviews. So if it’s not something you’d feel comfortable sharing in a face-to-face setting, it’s best left out of your personal statement.Writing too much. Keep your essay brief : if the essay prompt doesn’t give a specific word/page limit, 1-2 pages is generally a good length. (However, if the program you’re applying to specifies a different length, be sure to follow their instructions.) Vague language.  Be  as specific as possible about why you want to pursue graduate school and which topics you want to study. As UC Berkeley’s Career Center explains, you should avoid using words like â€Å"interesting† or â€Å"enjoyable† unless you elaborate on them further. For example, don’t just say that you find a topic interesting- share a compelling research finding you learned about or explain why you’d like to contribute to knowledge in this area as a graduate student.Not asking for help. You don’t need to write a perfect essay on the first draft. Seek out trusted mentors, such as professors and graduate students, and ask for feedback on your essay draft. You can also seek out on-campus resource centers at your college for additional personal statement feedback and support. What A Successful Personal Statement Looks Like Some of the most compelling admissions essays are ones in which students are able to draw a clear connection between their past experiences (coursework, jobs, or life experiences) and their motivation for attending graduate school. If you can show readers that youre both well-qualified and passionate about your proposed course of study, you’re far more likely to capture the attention of admissions committees. If you’re looking for inspiration, read  sample graduate admissions essays. In one  sample essay, the writer talks about the shift in her academic interests- while she initially studied chemistry, she is now planning to go to law school. This essay is successful because the writer clearly explains why she is interested in switching fields and demonstrates her passion for studying law. In addition, the writer highlights transferable skills that will be relevant to the legal profession (such as explaining how working as a resident assistant in her college dorm helped her to develop interpersonal skills and gain experience resolving conflicts). This provides an important take-home lesson for writing a personal statement: you can talk about past experience that isn’t directly related to academics, as long as you explain how this experience has helped to prepare you for graduate study. Writing a personal statement for graduate school can seem like a daunting task, but it doesn’t have to be. By demonstrating your qualifications and enthusiasm and seeking feedback on drafts from professors and other on-campus resources, you can write a strong personal statement that shows who you are and why you’re a good candidate for graduate school. Sources and Further Reading â€Å"4 Sample Graduate School Essays.† CSU Channel Islands: Career Leadership Development. https://www.csuci.edu/careerdevelopment/services/sample-graduate-school-admissions-essays.pdfAppleby, Drew C., and Karen M. Appleby. â€Å"Kisses of Death in the Graduate School Application Process.† Teaching of Psychology 33.1 (2006): 19-24 https://www.researchgate.net/publication/246609798_Kisses_of_Death_in_the_Graduate_School_Application_Processâ€Å"Applying to Graduate School.† Undergraduate Resource Series, Harvard University: Office of Career Services (2017). https://ocs.fas.harvard.edu/files/ocs/files/applying_to_grad_school_0.pdfBrown, Joseph L. â€Å"‘Tell Them Who You Are and Why You’ve Applied’: Personal Statements.† Stanford University: Office of Multicultural Affairs. https://oma.stanford.edu/sites/default/files/Personal_Statements.v6_0.pdfâ€Å"Graduate School – Statement.† UC Berkeley: Career Center. https://career .berkeley.edu/Grad/GradStatementâ€Å"Personal Statement.† Harvard University: Office of Career Services. https://ocs.fas.harvard.edu/personal-statement â€Å"What’s a Good Statement of Purpose?† Stanford University: Graduate School of Education. https://ed.stanford.edu/sites/default/files/Statement-of-Purpose.pdfâ€Å"Writing the Personal Statement.† UC Berkeley: Graduate Division. http://grad.berkeley.edu/admissions/apply/personal-statement/â€Å"Writing Your Graduate School Application Essay.† Carnegie Mellon University: Global Communication Center. https://www.cmu.edu/gcc/handouts-and-resources/grad-app-sop

Community Paper Research Example | Topics and Well Written Essays - 750 words

Community - Research Paper Example 524 8,186,453 8,829,383 281,421,906 293,045,739 Source: http://oasis.state.ga.us/oasis/qryPopulation.aspx Population by RACE 2004 The newer books might have these listed as non-Hispanic, White etc. Feel free to change. (Newton) County Black Hispanic White Native Americans Asian Other # % # % # % # % # % # % 24,451 22.08 2,376 1.87 55,312 74.20 183 0.21 903 0.72 70 0.11 State of Georgia Black Hispanic White Native Americans Asian Other # % # % # % # % # % # % 2,612,936 28.48 598,322 5.32 5,862,978 62.65 27,457 0.22 229,741 2.10 11275 0.14 United States Black Hispanic White Native Americans Asian Other # % # % # % # % # % # % 2,349,542 28.7 35,305,818 12.55 194,552,774 69.13 2,068,883 0.74 10,123,169 3.60 467,770 0.17 LEVEL OF EDUCATION Age 25 + High School 13,601 34.75 1,486,006 28.65 52,168,981 28.63 Associates 1,610 4.11 269,740 5.20 11,512,833 6.32 Bachelors 3,715 9.49 829,873 16.00 28,317,792 15.54 Graduate 1,977 5.05 430,305 8.30 16,144,813 8.86 Source: http://quickfacts.census.g ov INCOME BY HOUSEHOLD (Newton) County Georgia United States Year 2000 2000 2000 # % # % # % 200,000 308 1.40 70,843 2.36 2,502,675 2.37 MEDIAN INCOME (Newton) County Georgia United States 2000 44,875 41,901 41,990 Source: http://quickfacts.census.gov HEALTH STATISTICS Legend: T=Total W=White AA=African American O=Other Ethnic Group Use the following two forms for Mortality and Morbidity rates that are specific to your target population. _ (Deaths and percent of deaths; SIDS) ____________MORTALITY RATE per 100,000 population ***Change years for your data if necessary!!!!** Georgia (Newton) County T W AA T W AA 2000 113 44 69 2 0 2 2001 112 60 51 1 0 1 2002 141 78 59 4 2 2 2003 104 50 54 2 1 1 2004 130 68 59 1 0 1 (Source: For US, Health United States, Statistical Abstract of the US, [will need several years], MMWR, Prevention Profile.) For GA/County, use Georgia Vital Statistics for the year requested. _ (Sexually transmitted disease cases and rate) ____________ MORBIDITY RATE per 1 00,000 populations Georgia (Newton) County T W AA T W AA 2000 52,642 5,006 30,015 216 38 124 2001 53,258 4,795 25,479 296 47 147 2002 55,347 5,916 31,868 347 62 175 2003 55,624 6,239 30,802 380 63 202 2004 52,388 5,277 26,340 371 42 157 (Source: For US, Health United States, MMWR, Prevention Profile, Local and State Health Departments, CDC) The focus of this paper is on AIDS as a community health issue in Newton County, the state of Georgia in the United States. There lacks a representative national system of surveillance of the prevalence of AIDS infections (Prachakul, Grant and Keltner,

Summarizing Enter Right,Exit Left By Joshua Foer Essay

Summarizing Enter Right,Exit Left By Joshua Foer - Essay Example One of the recent surveys conducted by CNN/USA Today/Gallup, a majority of 18- to 29-year-olds thought the war worthwhile. Moreover, the same survey also found that President Bush had a 9 percent higher approval rating among people under 30 than he did among older respondents. Even the majority of the younger supporters of Democrats supported the Iraq during its initial phase because of the trauma developed after 9/11 incident. Most of the political organizations on campus irrespective of their political ideologies have supported Iraq war earlier. The attack on Twin Towers and Pentagon was considered as an attack against the sovereignty of Americans and President Bush got immense support from the younger generation at the time when the Iraq war started. President Bush’s arguments in favour of the Iraq war, like the possession of weapons for mass destruction by Saddam and the accused links between Saddam and Al Qaeda, have inspired the younger generation a lot and around 50 percent of those surveyed under 30 said they trusted government to do the right thing whereas only 36 percent of the older Americans kept the same views like the younger generation. Many of the younger generation in America thought that America was a force for good in the world and Americans are more aware of international affairs. The opinions of the American public about the Iraq war has changed drastically as conditions in Iraq have grown more chaotic. The younger generation slowly realised that why the older generation was reluctant in extending lavish supports to the Iraq war. The revelation that American government exaggerated claims about the possession of weapons of mass destruction by Iraq has taught the younger generation that one cant always trust authority. The photos of Abu Ghraib and flag-draped coffins have taught the younger generation that the authorities were executing their hidden

Case Analysis Of Ethical Conduct

Case Analysis Of Ethical Conduct The nonprofit hospital has the duty to provide healthcare to its poor and indigent citizens. They charge these patients list prices for their healthcare services. This subgroup of the population functions without the security of healthcare benefits and is expected to pay the highest prices for their care. The hospitals that operate as their areas not for profit facility accepts tax dollars to support its operations and to provide charity care within the community. This seemingly contradictory situation becomes the ethical dilemma that faces this nation. Why are the not for profit hospitals permitted to charge the full price of healthcare services to the uninsured, and then pursue aggressive collection tactics to collect for the services? Part of the requirement of the not for profit hospitals is to provide substantial charity care to their needy population sector. The rewards for this charity care are the tax-exempt status the facility enjoys on its revenues and the ability to issue municipal bonds for capital improvements. The refusal to provide these services or to use abusive collection tactics may lead to the revocation of their tax-exempt status. Class action lawsuits have resulted in accusing nonprofit hospitals with excessively charging uninsured patients more than insured patients and utilizing questionable collection tactics. The recent result of the class action case against Resurrection Health Care Hospitals forced them to change their billing structure, reduce charges to all uninsured, and provide charitable financial assistance to patients to pay hospital charges (Clifford Law Offices, 2009). The potential 220,000 claimants will be able to have bills recalculated and receive refunds if over paid based on the new formula (Clifford Law Offices, 2009). The facility must discount hospital bills for the uninsured and provide the highest discount to those with limited funds. The assistance program limits the amount of the bill to no more than 10 percent of the patients income (Clifford Law Offices, 2009). The hospital is prohibited from placing a lean on the patients home to collect payments. These strategies give the unins ured a discount more in line with their ability to pay and are reflective of a charity care hospital. The Provena Covenant, a 270 bed hospital in Illinois, recently lost their tax exempt status when it was determined that their collection tactics were questionable (Richmond Smith, 2005). The Illinois Department of Revenue considered the facility as not charitable as a result of these practices (Richmond Smith, 2005). The Senate Finance Committee proposed legislation that would mandate nonprofit hospitals to specific levels of charity care in order to retain its tax exempt status (Schroeder, 2009). They would be required to conduct a periodic needs analysis, follow established processes for bill collections, and will not refuse care due to a patients indigent status (Schroeder, 2009). The goal of The Fair Debt Collection Practices Act is to eliminate the actions of the abusive tactics utilized by debt collectors and to protect the consumer. Several Congressional findings have provided the basis for this enactment. There is evidence that these practices are a contributing factor to personal bankruptcies, loss of jobs, marital problems, and privacy invasions (FTC, 2006). They determined that the existing laws do not adequately protect the consumer from the bill collectors abusive practices (FTC, 2006). The debt collection process can be effective without the adoption of abusive or humiliating tactics (FTC, 2006). Recent research has indicated that employees that exhibit Machiavellian characteristics tend to agree with these questionable situations (Richmond Smith, 2005). Employees that have adopted this Machiavellian personality are impersonal, rational, and strategy focused. The possibility of handling collection procedures unethically may result. The nonprofit hospital is at risk of loosing its tax exempt status from the unethical decision making processes with employees that demonstrate these traits. They demonstrate that the low Mach may benefit the billing collection process. The low Mach is subject to social influence, focuses on the person, and accepts and follows direction (Richmond Smith, 2005). The ability of employees to show empathy with the patients would support an ethical work environment. The assignment of the appropriate discount for healthcare services for the poor or indigent patient results in the alignment of their ability to pay their bills. The adoption of higher discounts and financial assistance for the low income patient is the ethically responsible strategy for nonprofit hospitals. The strategies to create ethical behavior should include: a code of ethics, compliance program, customer complaint line, and employee training programs. The creation of an ethical work environment will promote the actions of employees to be more empathetic to their patients, thereby fulfilling the nonprofits mission of charity care. Case II: Westwood Imaging Centers The physician self referral (Stark Law) and the anti-kickback statutes are important provisions for managing potential fraud and abuse of physicians. The substantial financial incentives associated with diagnostic imaging have made them highly subject to abuse. The Westwood Imaging Centers has offered a flat rate per scan for referrals from physicians. The physician is then responsible for billing the Medicare, Medicaid, or the third party payer. Westwood has proposed to refer to the arrangement as a per use, nonrecurring lease agreement. This agreement is attempting to qualify for an exception that allows a physician to self refer if the both the equipment and procedure is conducted in the doctors office. This deal brings up the question about the legality of the self-referral to Westwood and its ethical implications. The Stark Law (I, II, and III) is the provision that governs the self-referral activities of physicians. It is illegal for a physician to refer a patient to a facility in which he or an immediate family member has a financial interest or compensation arrangement (Stark Law, 2010). The goal of the Stark legislation is to remove the potential conflict of interest from the healthcare decision process. There are exceptions to the Stark Law that many equipment leasing and management companies have targeted for business opportunities. The physician of a group practice may refer patients for imagining services (MRI, CT, or PET) that are located within their office. The most recent legislation requires the physician to further provide the patient with a written notice that these imaging services may be obtained elsewhere (Stark Law, 2010). This notice must include a list of other imaging facilities in the immediate area (Stark Law, 2010). The per-use lease arrangements that were permitted in Stark I II are now prohibited in the Stark III legislation (Stark Law, 2010). These prohibited lease agreements are considered per click or on demand leases because of the limited usage of the imaging equipment and their susceptibility to abuse. The final rule did not prohibit time-based leasing or block time leases. The cautionary note is that the leasing of very small blocks of time could cause the lease to be considered a per click arrangement and that is prohibitory. The block of time must be substantial enough to not face the risk of being considered per click usage, thereby not allowed by the Stark Law. The Westwood proposal would need to be changed from a per use agreement to a time based lease. The possible overutilization of diagnostic imaging has given rise to cleverly designed business models that cover illegal or fraudulent behavior. The anti kick back statutes prohibit the provider from receiving inducements for the referral of this reimbursable service. The lease agreement of the imaging services must not be written to appear as a kickback or highly discounted services to the physicians. The leased time must be specifically contracted and payable whether the slotted time is utilized or not. This shifts the risk of overutilization to the provider rather than the imaging service and would better control excessive referrals. The basis for the Stark Law is to prevent the conflict of interest business situations for providers, and the overutilization of these services of which the physician may have a financial interest. The possibility of a provider increasing their usage of imaging services because it will supplement their income becomes the ethical dilemma. This ownersh ip could influence the clinical decision process and increase their overall usage of more costly image testing. The overall increased utilization of imaging places a larger burden on this nations healthcare expenditure. The overutilization of imaging is supported by a recent study that estimated the number of MRIs doubled from 1995 to 2004, and the CT scanners increased more than 50 percent (MedPac, 2009). The volume of imaging services paid per Medicare beneficiary increased twice as fast as the total of all other physician services from 2000 to 2007 (MedPac, 2009). The Government Accountability Office (GAO) reported close to an eightfold variation on in-office imaging services nationwide (MedPac, 2009). The results of a recent MedPac (2009) study reveals that a physician that self refers imaging, results in significantly more total tests ordered than the non-self referring provider. He also has a higher spending per episode than the non-self referring provider. The evidence shows that the self referral of imaging has not only a financial benefit for the referring physician, but also has incr eased the overall healthcare spending. The providers should carefully review these findings when considering the proposal from Westwood. The ethical issues associated with the overutilization of image testing should be weighted against the future risk of decreased reimbursements from Medicare, Medicaid, or third party payers.

Understanding Child and Young Person Development

Unit title: Understand child and young person development Unit number: CYP Core 3 Question 4 4. 1 Analyse the importance of early identification of speech, language and communication delays and disorders and the potential risks of late recognition. It is essential that speech, language and communication delays and disorders are noticed early so the relevant interventions can be used to support the child or young person. Answer the questions below. 1. How can observation be used to identify speech, language and communication delays? 2. What should you do if you have concerns about a child’s development of speech, language and communication skills? 3. What would be the risks if these delays were not identified? Use your answers to help you analyse the importance of early identification of speech, language and communication delays and disorders and the potential risks in late recognition. The early years are a time for rapid learning and development in a child’s life. Language is very important to learning since it helps the child to store information in an organized way and to express the child’s thoughts. If a child has difficulty in communicating with others due to a speech and language delay or disorder the child will be at a disadvantage. The child will have many problems. The child may fail to understand instructions given by the adult and this may be interpreted as misbehaviour. For example the child has been instructed to put away the task and line up to go for the music lesson to another room at school. However the child has not understood what has to be done because of his inability to process the information. Instead the child goes and has a drink of water and takes out his lunch box. Teaching in schools is usually done through verbal description and instruction. The adult presents learning situations with the use of language or speech. Failure to understand means the child will be unable to store or use information provided. For example the child has to play a board game with three other children and so has to follow specific instructions shown by the adult according to the rules of the game. A child with language delay has limited resources for demonstrating knowledge and explaining their reasoning. For example the child wants to explain to the teacher the properties of a three dimension solid but finds it difficult to do so because of language delay. Oral language serves as a precursor to literary skills. For example the child first has to be a good communicator and then uses this skill to interact with others. Then the child uses vocabulary to understand and experience stories, songs, poems and rhymes. The child begins to enjoy reading and writing. Language ability is central to the ability to establish friendship with other children. The child has to be able to communicate and talk to his peers and form social relationships with them. For example the children use language to imagine at role play and develop social skills. There are a number of reasons why children experience difficulties and delays in speech, language and communication development. The causes may be due to ear infection where the child is unable to hear words or hear distorted sounds, or find it confusing and tiring to focus on verbal communication. The ear fluid may pose a problem for the child and sounds are muffled and not clear to the child’s hearing. The child may be experiencing specific difficulty in using their oral muscles effectively and this may affect speech. For example a child with cerebral palsy does not have much control over the mouth and the muscles around it and so cannot form the words properly. The child may say ‘b’ sound instead of ‘v’ and so the meaning of the word could be totally different-base for vase. Sometimes speech and language difficulties are passed down families. For example stammering or lisping. Problem’s during pregnancy and birth can also affect the child’s developing brain and contribute to speech and language difficulties as part of a wider developmental delay. For example a mother may experience bleeding of the placenta during pregnancy and this may affect the unborn child. The child born thus may be able to say certain sounds but not be able to speak clearly as the vocal chords may be affected or due to damage in the brain that controls language. There may be a recognised syndrome or disorder that causes language difficulty for the child and is not able to communicate with others. The child may have a lack of stimulation and support to provide the rich language experience necessary to develop speech, language and communication skills. For example at school, the setting may not have an enabling environment to stimulate the child’s different interests necessary for acquiring language. The books, music, songs and so on may not stimulate and interest the child. For most children there is no clear reason as to why there is a delay in the development of speech, language and communication skills. Therefore, an adult should never assume that the child’s speech, language and communication problems are due to hearing loss. It may be that the child is experiencing communicating difficulties that are unrelated to their hearing problems because the child may not have acquired the vocabulary necessary to express his thoughts and actions. It is important to observe the child carefully, closely and to listen to them in different situations to ensure that the teacher is clear about what their needs are, their strengths and difficulties. It is important to observe the child in a range of settings and in both structured and unstructured situations. For example the child can be observed in the classroom; playground or lunch hall and the assessor can identify the child’s needs and plan the next step for the child’s development in speech, language and communication skills. Some children who begin settings with an apparent delay in their skills quickly progress as the child experiences language rich activities. Other children who are shy take a while to develop confidence to speak and express themselves because the child may be shy or reserved by nature. The most reliable assessor will take into account the child’s views, parents’ knowledge of the child and observations from all professionals who are involved with the development of the child. Assessment should be a continuous process and over a period of time so that one can gather evidence to inform and enable appropriate and timely support and provision for the child. The assessor should never be tempted to â€Å"wait and see†. There is a â€Å"window of opportunity†: if a child’s speech, language and communication skills are similar to his peers by age 5 12years then the child is making good progress. If it is not, then the child needs support at an early stage over a period of 2 years so that the child can progress and be at the same level as his peers so it is always better to start now when the problem has been identified. The assessor will enquire about the child’s hearing and request a test if necessary. The assessor will check physiological factors affecting development like vision, cleft palate, motor difficulties. The assessor will show particular awareness and sensitivity to, the needs of a child learning English as an additional language. To encourage and develop the child’s speech, language and communication skills most effectively, the adult needs to position herself face to face as the adult plays and talks to the children. The adult needs to shift her gaze between the activity the child does and the child. For example when the child sees the face of the adult it allows the child to understand the facial expressions and the lip pattern help the child to understand words. The adult must make sure that the child is paying attention each time the adult talks to the child. For example at circle time the teacher must ensure that the child is facing her and not be distracted. The child must be able to concentrate and not play with a piece of string found on the mat. The adult must keep language simple and avoid long and complicated sentences when talking and giving instructions to the child. Long winded sentences confuse and distract the child and the child may not be able to follow. At group time the adult must make sure that the child is seeing the adult’s face. This will help the child to understand emotions and facial expressions when the child is being read a story. The adult must use gestures since this will help and encourage the child to become good communicators. Learning to listen and speak emerges out of non-verbal communication like eye contact, facial expressions and hand gestures. The adult must ensure that there is no background noise that will affect the ability of the child to hear what the adult is saying. If there is noise the child will distracted and lose interest in the lesson. The adult should have knowledge of the child’s use of a dummy at home and should discourage parents to use it because problems arise in speech and the child may not be able to speak and pronounce words clearly. Sucking habits impede progress in speech, language and communication skills since the child interacts less socially with his peers and people around the child. The movement of the tongue is restricted and the child does not talk as much if the child did not have the dummy in the mouth. The dummy should be given to the child at bedtime or when really required and not to keep the child quiet. The adult should talk at a natural pace. If the adult speaks too fast the child will not understand what is being spoken. If the adult speaks very slowly the child loses interest and attention gets diverted since the child has a short attention span. If a child is shouted at and given commands then the child’s speech gets hampered. Shouting, by the child is viewed as unpleasant and jarring to the ear and the lip pattern gets distorted. The child may develop a fear and become withdrawn and afraid in the adult’s presence. If an adult in the school setting is concerned about the speech, language and communication skills of a child then the adult must discuss it with the parents. The adult can approach the parents in a sensitive manner and say the child has a problem with these particular speech sounds and not say that they cannot understand what the child says. With permission the school can seek specialist help so that the child’s needs can be supported appropriately at the right time and right age keeping all the other factors that help towards the building of good speech, language and communication skills. If the child has a delay in speech development, the child will not understand language spoken to them. The child will develop a range of sound speech inappropriate for their age. The child will not develop use of words and sentences appropriate to their age. The child may use language inappropriately. For example saying phrases that do not make sense in context or repeating chunks of language without any meaning. The child may find it unusually difficult to follow rules or join in conversation by looking, taking turns, sharing, interest in a subject and so on. The child may show frustration and be upset and may withdraw from conversation due to non-fluency in language. Sometimes the parents are very anxious about the child’s speech and then this reflects on the child’s behaviour and development. If an adult observes that the child is non-fluent that continues more than 6 months then the adult have to take serious action and appropriate measures should be adopted because it has been seen that with extra support, the child makes good progress. Speech, language and communication difficulties are common among children. Early identification therefore prevents difficulties later on especially in talking, listening, literacy and making friends.