Free Essays on My Philosophy

Who am I? My Philosophy of life over the recent long periods of learning â€Å"philosophy,† according to its, is amazingly dubious and befuddling. It very well may be identified with anything to do with thought, observation, and even essential human presence. Nonetheless, over the notes, readings and class conversation I have been a piece of as the months progressed, I discovered that way of thinking is basically the investigation of information. It is likewise portrayed as the adoration for shrewdness. Thus, in further characterizing way of thinking, maybe it is simpler to just state what it could possibly include as opposed to attempting to locate a solid and firm definition. Theory incorporates the investigations of rationale, morals, mysticism, and epistemology. Rationale manages the standards and frameworks of thinking. We find and decipher data by this strategy. Morals includes the standards of ethics and the judgment of â€Å"good† and â€Å"bad† direct. In this present reality where individuals are killing, taking and hurting one another, it’s elusive the positive qualities in individuals now a days. The individuals who are doing these things need assistance. That’s where individuals with great ethics can step in ideally and change the manner in which they think. I believe that individuals are made at first great and afterward go make their own temperament, which is the thing that Plato thought. He accepted that when you are conceived, you are brought into the world with a â€Å"clean slate.† I can concur with this by what I have realized In chapel with my religion, and I feel that anybody that has faith in God can accept this. Presently a few of us have it superior to other, which can truly hurt our odds to do well in this world. On the off chance that you where conceived in an awful neighborhood with a great deal of savagery and medications, at that point hung out all with an awful group, odds are you will end up being a terrible individual. That why these children should be placed the correct way. Aristotle said that everybody lived to be cheerful, that is something that I thoroughly concur with. Despite the fact that various things make various individuals ha... Free Essays on My Philosophy Free Essays on My Philosophy Who am I? My Philosophy of life over the recent long stretches of learning â€Å"philosophy,† according to its, is incredibly ambiguous and confounding. It very well may be identified with anything to do with thought, recognition, and even fundamental human presence. In any case, over the notes, readings and class conversation I have been a piece of as the months progressed, I discovered that way of thinking is essentially the investigation of information. It is likewise portrayed as the adoration for intelligence. Subsequently, in further characterizing way of thinking, maybe it is simpler to just state what it might possibly include instead of attempting to locate a solid and firm definition. Theory incorporates the investigations of rationale, morals, transcendentalism, and epistemology. Rationale manages the standards and frameworks of thinking. We find and decipher data by this strategy. Morals includes the standards of ethics and the judgment of â€Å"good† and â€Å"badâ €  direct. In reality as we know it where individuals are killing, taking and hurting one another, it’s elusive the positive qualities in individuals now a days. The individuals who are doing these things need assistance. That’s where individuals with great ethics can step in ideally and change the manner in which they think. I imagine that individuals are made at first great and afterward go make their own temperament, which is the thing that Plato thought. He accepted that when you are conceived, you are brought into the world with a â€Å"clean slate.† I can concur with this by what I have realized In chapel with my religion, and I imagine that anybody that has confidence in God can accept this. Presently a few of us have it superior to other, which can truly hurt our odds to do well in this world. On the off chance that you where conceived in an awful neighborhood with a great deal of viciousness and medications, at that point hung out all with an awful group, odds are you will end up being a terrible individual. That why these children should be placed the correct way. Aristotle said that everybody lived to be upbeat, that is something that I absolutely concur with. Despite the fact that various things make various individuals ha...

A Literary review of William Shakespeare's play Othello Essay

A Literary survey of William Shakespeare's play Othello - Essay Example He is commendable from multiple points of view, and appears to have had a chaste existence before the intruding of Iago in his relationship with his better half Desdemona. Regardless of all his courageous characteristics, there is one thing that ends up being his ruin: Othello can't liberate himself from the partiality against his religion and race which he faces, and this makes him over-touchy to analysis and excessively rushed in shielding his respect. Iago portrays Othello at the very beginning of the play as â€Å"The Moor† (1.1.39) and Roderigo calls him â€Å"the-thick lips† (1.1.65) before we have gotten an opportunity even to meet him, and this lays everything out of a general public which judges individuals by the shade of their skin. In Shakespearean occasions English crowds would infrequently have seen a dark man, thus this component of contrast would have been something intriguing and maybe additionally a touch of stunning to them as well. Plainly Iago doesn 't care for Othello. The men of Venice presume that he has utilized black magic, which isn't admissible for Christian residents and a Senator asks â€Å"Did you by backhanded and constrained courses/Subdue and toxic substance this youthful maid’s expressions of love/Or came it in response to popular demand and such reasonable inquiry/As soul to soul affordeth? (1.3.111-113) Against such an outrageous proposal, Othello reacts with an answer that would stresses his own boldness and her own openly given love for him: â€Å"She cherished me for the risks I had passed,/And I adored her that she pitied them. This just is the black magic I have used.† (1.3.166-168) Othello needs to resemble the remainder of them, effective in his activity and content with his better half, whom he cherishes. Sadly, this is correctly what Iago despises, on the grounds that Iago is desirous and feels that individuals who are not Venetians and Christians ought not appreciate the advantages of a respectable position. At the point when Iago sets up his arrangement to deceive Othello by imagining that Desdemona is unfaithful, he is focusing on where Othello is generally powerless. His unadulterated and delightful spouse is, to Othello, the most valuable thing in his life. For Othello, Desdemona’s love means acknowledgment in this new world, and her customary honesty and magnificence are simply the characteristics that he can't have, due to his appearance and foundation. Through her, he feels content with the and fruitful finally after numerous long stretches of hardship. This is a sort of pride, yet a great many people would excuse him for this since he is a loyal spouse and obedient worker of the court. One of the fascinating parts of the play is the way that Othello trusts Iago’s allegations, and doesn't trust in the dedication of Desdemona. His response to the allegation is outrageous and he can barely talk before tumbling down in a daze. (4.1.42) His trustwo rthiness and honesty are no utilization to him notwithstanding such trickery, and the alleged information totally overpowers him with the goal that everything he can consider is vengeance. The incongruity of the play is that it is his high good measures, and his connection to respect and obligation that make him so bigoted of assumed betrayal. Toward the finish of the play, when Desdemona is dead and Othello is going to execute himself he attempts to disclose this Catch 22 to himself and to the crowd. He needs to be recognized as he might have been, a man of high respect yet in addition one who committed an unpleasant and vicious error: â€Å"An decent killer, maybe,/For nothing I did in abhor, however all in honour.†

The Risks of Snorting Cacao Powder

The Risks of Snorting Cacao Powder Addiction Addictive Behaviors Print The Risks of Snorting Cacao Powder By Naveed Saleh, MD, MS twitter linkedin Naveed Saleh, MD, MS, is a medical writer and editor covering new treatments and trending health news. Learn about our editorial policy Naveed Saleh, MD, MS Medically reviewed by Medically reviewed by Steven Gans, MD on January 26, 2020 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on February 06, 2020 R Tsubin/Getty Images More in Addiction Addictive Behaviors Caffeine Internet Shopping Sex Alcohol Use Drug Use Nicotine Use Coping and Recovery Club goers in Europe and the U.S. are snorting lines of raw cacao powder, used to make chocolate, as well as taking cacao pills and drinking cacao-infused drinks for their latest “natural highs.” Unlike phencyclidine (PCP or angel dust), MDMA (ecstasy or Molly), and cocaine, cacao isn’t considered a controlled substance by the U.S. government; in other words, sniffing cacao isn’t illegal. Furthermore, there’s only scattered and scant research on the neurological effects of cacao and chocolate. In an attempt to contextualize the apparent highs derived from cacao, let’s take a more detailed look at what cacao is composed of as well as the research attempting to explain its effects, vis-à-vis chocolate, on the central nervous system. Composition of Cacao The cacao bean contains more than 50% fat. Other components of cacao include protein and other nitrogen-containing compounds, such as theobromines and caffeine. Between 20 and 25% of the cacao bean is sugar or carbohydrates.?? As any health-conscious person likely knows, cacao is rich in antioxidants, including flavonoids like epicatechin and catechin. When the cacao bean is processed into cocoa powder and chocolate by means of fermentation and roasting, it loses much of its antioxidant content. Cacao contains multifarious other compounds with potential biologic and psychoactive effects including:?? PhenylethylamineSerotoninTryptophanTryptamineTyramineTyrosineAnandamideSalsolinolTetrahydro-b-carbolines Several of these compounds are metabolized by the body before they ever make it to circulation.?? Specifically, the biologic amines serotonin, tryptophan, phenylethylamine, tyramine, tyrosine, and tryptamine are broken down by monoamine oxidases in the kidneys, liver, and intestines. (People who are deficient in monoamine oxidases must avoid chocolate so as not to develop headaches and high blood pressure.) Potential Cognitive Effects of Snorting Cacao Powder It’s a stretch to call cacao or chocolate a drug. However, because chocolate cravings are somewhat similar to symptoms of substance dependence, some researchers have been inspired to examine the mechanistic effects of chocolate on the brain.?? Anandamide Compounds: Two analogs of anandamide are found in chocolate. These anandamide analogs are similar to cannabinoids (marijuana) and may result in euphoria. Instead of directly causing euphoria, however, these anandamide compounds exert a more circuitous effect by inhibiting the breakdown of endogenous anandamide  which are already produced in the body.?? Serotonin Effects: Serotonin moderates a number of physiological processes in the body, including sleep, impulse control, and appetite.?? For a long time, experts hypothesized that serotonin linked food cravings and mood and that craving for chocolate and carbohydrates somehow sated serotonin deficienciesâ€"especially in those people who are depressed.?? In fact, studies involving people with seasonal affective disorder and atypical depression somewhat support this hypothesis.?? Nevertheless, the phenomenon of chocolate craving as a biological response to depression is most obviously undercut by the fact that many people with melancholic depression don’t crave food at all. Another reason the hypothesis that chocolate consumption is linked to serotonin and positive mood may be flawed has to do with research that suggests serotonin levels are raised only after consumption of foods that are less than two percent protein; calorically, chocolate is five percent protein.?? Research published in 2013 also suggests that the mood benefits of chocolate and carbohydrates occur independently of serotonin, suggesting that these mood benefits are likely much more complex than can be explained by serotonin alone.?? Opioid Effects: People who are dependent on heroin and other opioids often crave sweets like chocolate.?? Additionally, other physical states including pregnancy, menstruation, alcohol dependence, and eating disorders also change endogenous, or intrinsic, opioid levels in the body. These associations have led experts to suggest that opioids and chocolate are associated in some way. Research from 2010 tends to support this hypothesis. Specifically, endorphins, which are opioids, are released after eating delicious foods like chocolate. Moreover, the release of such endorphins after eating chocolate or something else that’s sweet and palatable appears to produce analgesia, or pain relief, as well as mood elevation.?? Moreover, the analgesic effect of sweet stuff like sugar solutions and chocolate can be reversed by naltrexone, an opioid antagonist which is also given to people who experience heroin opioid dependence.?? Catechin and Epicatechin: The flavonoids catechin and epicatechin present in cacao rapidly make their way into circulation after consumption of chocolate. Furthermore, based on animal studies, epicatechin and catechin cross the blood-brain barrier and accumulate in the brain. This accumulation of flavonoids may exert beneficial cognitive effects.?? Cerebral Blood Flow: In order for our brains to function well, we need good cerebral blood flow or circulation. Proper cerebral circulation is necessary to supply glucose and oxygen to the brain and clear waste products. Research suggests that cacao, wine, grapes, berries, tomatoes, and soy are all polyphenol-rich foods that promote vasodilation of brain blood vessels and thus enhance brain circulation. These brain effects may help explain improved motivation, attention, concentration, memory, visual tasks, and other cognitive and cerebral benefits of cacao.?? Interestingly, flavonoids present in cacao may also decrease blood-vessel endothelial senescence in those who eat it, suggesting anti-aging effects. In other words, chocolate may help make your brain younger. Flavonoids may also protect neurons from damage caused by neurotoxins, reduce inflammation of neurons, and improve learning, memory, and cognitive function.?? Dopamine Effects: People no longer eat predominantly to satisfy energy deficits but rather eat mostly for pleasure. If you’ve ever had dessert at a restaurant after stuffing yourself on appetizers and the main course, you may agree. The mesolimbic dopaminergic system is involved in the effects of drugs of misuse. Consumption of cacao and chocolate may also activate the body’s dopamine receptors.?? This activation is likely not specific to chocolate per se and caused by the consumption of other foods, too. The Link Between Chocolate and Mood In one research study funded by the Australian National Health and Medical Research Council and a grant from Pfizer, Australian researchers examined chocolate craving in people with depression, atypical depression, and certain personality traits (neuroticism). Hyperphagia, or excess eating, is a prominent symptom in those with atypical depression.?? Researchers analyzed online survey responses from 2692 participantsâ€"soliciting data on depressive symptoms, demographics, treatments of depressive episodes, personality constructs, and whether chocolate was craved when depressed. All survey respondents were more than 18 years old, with the average age being 40 years old. Research participants experienced depressive symptoms for two or more weeks. About 71% of the survey respondents were women, 74% had taken antidepressant medications in the past, and 78% had received counseling or other forms of psychotherapy. Among survey respondents, 54% reported food cravings, with 45% craving chocolate specifically. Additionally, among those respondents who craved chocolate, 61% attested to the capacity of chocolate to improve their mood. Chocolate cravers also said that chocolate made them feel less annoyed and anxious. Researchers also found that chocolate was craved by people with neuroticism and that chocolate craving was indicative of atypical depression. Although results from this study generally point to the improved mood among people who consume cacao-derived chocolate, there are some issues that limit the applicability and generalizability of these findings. First, the results of this study were self-reported and not validated by the researchers. Second, the participants had depression and possibly neuroticism, and the researchers didn’t examine people without depression and neuroticism. In other words, these results don’t automatically apply to people without depression or possibly neuroticism. Presumably, many club-goers who snort cacao don’t have depression or neuroses. What It All Means We might never know exactly whether the “natural high” experienced after snorting lines of cacao is, in fact, specific to chocolate or a placebo effect. According to the National Center for Biotechnology Information (NCBI): “The placebo effect is defined as a physiological response following the administration of a pharmacologically inert ‘remedy.’ The word placebo means ‘I will please,’ and the placebo effect has a long history of use (and abuse) in medicine. The reality of the effect is undisputed.”?? Research suggests that cacao and chocolate do exert some mood and cognitive effects. The mechanism of such activity likely involves various neurotransmitters and so forth. In other words, there’s probably no one single reason why these substances elevate mood.??     There are issues, however, with the claim that snorting cacao is natural. Except for your fingers, sticking anything up your nose is unnatural and, unless directed by your physician, refrain from snorting anything. Even over-the-counter (OTC) nasal decongestants can have adverse effects if used excessivelyâ€"notably the development of rebound congestion which can result in a vicious cycle of dependence for the user.?? A couple of concerns that come to mind when people snort foreign substances are inflammation and infection. Foreign substances introduced into the respiratory tract can cause inflammation that, in turn, can predispose a person to infection.?? If a person often engages in late-night clubbing, drinking, illicit drug use, and cacao sniffing, the immune system can get run down and predisposed to respiratory infection, especially in the presence of inflammation.   Please note that these concerns are specific to sniffing cacao and don’t necessarily apply to cacao pills or cacao-infused drinks, which apparently also lead to anecdotal highs. Nevertheless, it’s always best to use caution whenever you buy something novel and unregulated.

The Donner Party, Ill-Fated Settlers Turned to Cannibalism

The Donner Party was a group of American settlers heading to California who became stranded in heavy snows in the Sierra Nevada Mountains in 1846. Isolated in horrific conditions, about half of the original group of nearly 90 people died of starvation or exposure. Some of the survivors turned to cannibalism in order to survive. After those who managed to stay alive were rescued in early 1847, the story of horror in the mountains appeared in a California newspaper. The tale made its way east, circulated through newspaper articles, and became part of western lore. Fast Facts: The Donner Party About half of a group of nearly 90 settlers heading to California in 1846 starved when snowbound.Disaster was caused by taking an untested route which added weeks to the journey.Survivors eventually resorted to cannibalism.Story circulated widely through newspaper stories and books. Origin of the Donner Party The Donner Party was named for two families, George Donner and his wife and children, and George’s brother Jacob and his wife and children. They were from Springfield, Illinois, as was another family traveling with them, James Reed and his wife and children. Also from Springfield were various individuals associated with the Donner and Reed families. That original group left Illinois in April 1846 and arrived in Independence, Missouri, the following month. After securing provisions for the long trip westward, the group, along with other travelers from a variety of places, left Independence on May 12, 1846. (People would typically meet in Independence and decide to stick together for the journey westward, which is how some members of the Donner Party joined the group essentially by chance.) The group made good progress along the trail westward, and in about a week had met up with another wagon train, which they joined. The early part of the journey passed with no major problems. The George Donners wife had written a letter describing the early weeks of the trip which appeared in the newspaper back in Springfield. The letter also appeared in papers in the East, including the New York Herald, which published it on the front page. After passing Fort Laramie, a major landmark on the way west, they met up with a rider who gave them a letter which claimed that troops from Mexico (which was at war with the United States) might interfere with their passage ahead. The letter advised taking a shortcut called the Hastings Cutoff. Shortcut to Disaster After arriving at Fort Bridger (in present day Wyoming), the Donners, the Reeds, and others debated whether to take the shortcut. They were assured, falsely it turned out, that the traveling would be easy. Through a series of miscommunications, they did not receive warnings from those who knew otherwise. The Donner Party decided to take the shortcut, which led them into many hardships. The route, which took them on a southerly path about Great Salt Lake, was not clearly marked. And it was often very difficult passage for the groups wagon. The shortcut required passing over the Great Salt Lake Desert. The conditions were like nothing any of the travelers had seen before, with blistering heat by day and frigid winds at night. It took five days to cross the desert, leaving the 87 members of the party, including many children, exhausted. Some of the party’s oxen had died in the brutal conditions, and it became obvious that taking the shortcut had been a colossal blunder. Taking the promised shortcut had backfired, and put the group about three weeks behind schedule. Had they taken the more established route, they would have gotten across the final mountains before any chance of snowfall and arrived in California safely. Tensions in the Group With the travelers seriously behind schedule, anger flared in the group. In October the Donner families broke off to go ahead, hoping to make better time. In the main group, an argument broke out between a man named John Snyder and James Reed. Snyder struck Reed with an ox whip, and Reed responded by stabbing Snyder and killing him. The killing of Snyder happened beyond U.S. laws, as it was then Mexican territory. In such a circumstance, it would be up to the members of a wagon train to decide how to dispense justice. With the groups leader, George Donner, at least a day’s travel ahead, the others decided to banish Reed from the group. With high mountains still to cross, the party of settlers was in disarray and deeply distrustful of each other. They had already endured more than their share of hardships on the trails, and seemingly endless problems, including bands of Native Americans raiding at night and stealing oxen, continued to plague them. Trapped by Snow Arriving at the Sierra Nevada mountain range at the end of October, early snows were already making the journey difficult. When they reached the vicinity of Truckee Lake (now called Donner Lake), they discovered the mountain passes they needed to cross were already blocked by snowdrifts. Attempts to get over the passes failed. A group of 60 travelers settled into crude cabins which had been built and abandoned two years earlier by other settlers passing by. A smaller group, including the Donners, set up a camp a few miles away. Stranded by impassable snow, the supplies quickly dwindled. The travelers had never seen such snow conditions before, and attempts by small parties to walk onward to California to get help were thwarted by the deep snowdrifts. Facing starvation, people ate the carcasses of their oxen. When the meat ran out, they were reduced to boiling ox hide and eating it. At times people caught mice in the cabins and ate them. In December, a party of 17, consisting of men, women, and children, set out with snowshoes they had fashioned. The party found the traveling nearly impossible, but kept moving westward. Facing starvation, some of the party resorted to cannibalism, eating the flesh of those who had died. At one point, two Nevada Indians who had joined the group before they headed into the mountains were shot and killed so their flesh could be eaten. (That was the only instance in the story of the Donner Party where people were killed to be eaten. The other instances of cannibalism occurred after people had died of exposure or starvation.) One member of the party, Charles Eddy, eventually managed to wander into a village of the Miwok tribe. The Native Americans gave him food, and after he reached white settlers at a ranch, he managed to get a rescue party together. They found the six survivors of the snowshoe group. Back at the camp by the lake, one of the travelers, Patrick Breen, had started keeping a diary. His entries were brief, at first just descriptions of the weather. But over time he began noting the increasingly desperate conditions as more and more of those stranded succumbed to starvation. Breen survived the ordeal and his diary was eventually published. Rescue Efforts One of the travelers who had gone ahead in October became increasingly alarmed when the Donner Party never showed up at Sutter’s Fort in California. He tried to raise the alarm and eventually was able to inspire what eventually amounted to four separate rescue missions. What the rescuers discovered was disturbing. The survivors were emaciated. And in some of the cabins rescuers discovered bodies which had been butchered. A member of a rescue party described finding a body with the head sawed open so the brains could be extracted. The various mutilated bodies were gathered together and buried in one of the cabins, which was then burned to the ground. Of the 87 travelers who entered the mountains on the final phase of the journey, 48 survived. Most of them stayed in California. Legacy of the Donner Party Stories about the Donner Party began to circulate immediately. By the summer of 1847 the story had reached the newspaper in the East. The New York Tribune published a story on August 14, 1847, which gave some grim details. The Weekly National Intelligencer, a Washington, D.C. newspaper, published a story on October 30, 1847, which described the terrible suffering of the Donner Party. An editor of a local newspaper in Truckee, California, Charles McGlashan, became something of an expert on the story of the Donner Party. In the 1870s he talked to survivors and pieced together a comprehensive account of the tragedy. His book, History of the Donner Party: A Tragedy of the Sierra, was published in 1879 and went through many editions. The story of the Donner Party has lived on, through a number of books and films based on the tragedy. In the immediate aftermath of the disaster, many settlers heading to California took what happened as a serious warning not to lose time on the trail and not to take unreliable shortcuts. Sources: Distressing News. American Eras: Primary Sources, edited by Sara Constantakis, et al., vol. 3: Westward Expansion, 1800-1860, Gale, 2014, pp. 95-99. Gale Virtual Reference Library.Brown, Daniel James.  The Indifferent Stars Above: The Harrowing Saga of the Donner Party. William Morrow Company, 2015.

Where to Kayak

Ethics, Fraud, and Internal Audit at Ut Southwestern Free Essays

There are many taxpayer supported medical schools in this country, most receiving their fees for services through Medicare and Medicaid. The Department of Health and Human Services requires that medical students who have graduated to the resident status have a teaching physician physically present when performing key portions of patient service to be able to bill those services to Medicare. In fact, the patient chart must be legibly signed by the attending physician that they were present and supervising the specific service in order to bill Medicare (â€Å"Guidenlines for teaching,† 2011). We will write a custom essay sample on Ethics, Fraud, and Internal Audit at Ut Southwestern or any similar topic only for you Order Now According to an article in the Dallas News, a former employee by the name of Jack Mooney was hired in 1991 by the University of Texas Southwestern Medical Center as a reimbursement manager to make sure that all medical billings submitted to Medicare and Medicaid were properly documented and billed (Dunklin Moffeit, 2010). For example, that the teaching physicians were physically present when residents were performing services to meeting the required mandates for Medicare billing. He discovered that was not the case and took the information to his supervisors. Stricter policies were put into place for the departments to follow to make sure that all employees were following the necessary guidelines. In 1997, when Mr. Mooney was the director of UT Southwestern’s billing compliance office, he was still seeing and documenting the same problems. Mooney left the college in 1998 shortly after filing a federal whistle-blower lawsuit. The earliest documentation that can be found of UT Southwestern’s Internal Audit departments involvement comes in a 2003 when they approve of some of the college’s compliance policies, but noted that they do not have a policy in place to review reimbursement claim documents. Dallas News notes that six faculty meetings were held during 2007 and 2008 in which billing concerns were discussed. The Internal Audit Annual Reports for those years do not report any ongoing audits, but do report that they provide the billing compliance committee â€Å"independent consultation and guidance to help billing compliance activities address institution risks† (Rubel, 2008). In 2010 we finally see an internal audit performed of UT Southwestern’s billing compliance programs. The report stated that â€Å"the audit identified a significant finding in the Hospital Billing Compliance program†. As of 2010, the program had not yet implemented the 2005 Department of Health and Human Services, Office of the Inspector General (OIG) Supplemental Compliance Program Guidance for Hospitals. Although this guidance is voluntary, it is highly recommended by the OIG to help hospitals in â€Å"preventing the submission of erroneous claims and in combating fraud and abuse in the Federal health care programs (â€Å"OIG supplemental compliance†). The guidance specifically states that â€Å"hospitals should have in place procedures regarding resident rotation and monitoring†. The audit report recommends that the compliance program implement the OIG guidance, consolidation of the billing compliance groups (there are currently four), development of a single risk assessment plan with a corresponding audit plan, a monitoring system for both the risk assessment audit plan and the billing compliance audit report. Also of note in the audit report are repeated failures by the same department to meet billing practices. It is noted that these â€Å"recurring systematic failures increase the risk of exposure to potential civil damages and penalties, criminal sanctions, and administrative remedies, such as program exclusion†. The audit recommends that the failures be addressed at the department level and to develop a formal training plan to improve billing compliance. According to the report, all significant findings are tracked by the University of Texas System Audit Office to make sure that all agreed upon recommendations have been implemented. These reports are unavailable for review and there has been no further comment on the billing compliance audit in the 2011 Internal Audit Annual Report. This issue was first brought to light 20 years ago by someone that was hired to review billing compliance. We know that 7 years ago the internal audit department was aware of the issue, but as far as we can tell, no significant audit of the hospitals billing department, in relation to Medicare billing requirements, was completed until 2010. Was the hospital fraudulently obtaining money from the government? Not in so far as anyone has determined. Was the audit department aware of the issue? Yes, as far as we can tell. Did the internal auditors follow the IIA’s mandatory guidance? Yes in the completion of the audit in 2010 but it is my personal opinion, given the facts provided, that the audit should have been ompleted years earlier. ? References Department of Health and Human Services, Centers for Medicare Medicaid Services. (2011). Guidenlines for teaching physicians, interns, and residents. Retrieved from website: http://www. cms. gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/gdelinesteachgresfctsht. pdf Department of Health and Human Services, Office of Inspector General. (n. d. ). OIG supplemental compliance program guidance for hospitals (Vol. 70, No. 19). Retrieved from website: http://oig. hhs. gov/fraud/docs/complianceguidance/012705HospSupplementalGuidance. df Dunklin, R. , Moffeit, M. (2010, May 30). Feds probe alleged fraud at ut southwestern, parkland. Dallas News. Retrieved from http://www. dallasnews. com/news/community-news/dallas/headlines/20100530-feds-probe-alleged-fraud-at-ut-southwestern-parkland-. ece Rubel, R. (2008, November 03). Internal audit annual report fiscal year 2008. Retrieved from http://www. utsouthwestern. edu/media/footer_required_documents/aud it-2008. pdf Rubel, R. (2010, February 24). Billing compliance audit report. 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Phosphorus Chemical Reactions Of Phosphorus And Its Importance Essays

Phosphorus: Chemical Reactions of Phosphorus and Its Importance Abstract: Aluminum sulfate reacts with phosphates to create aluminum phosphate and a sulfate. The conversion of the phosphate to aluminum phosphate is very important because this allows the phosphate to be easily extracted. This manipulation is used today in industrial waste treatment sights. The removal of phosphates is very important for if phosphates are not removed, they plague bodies of water by feeding algae which clog the surface waters and eventually effect every living and nonliving thing in that environment. Chemical Process: The reactions which occur are the following: Aluminum sulfate(alum) in combination with wastewater can flocculate phosphorus. The Flocculation that happens with aluminum sulfate addition is the formation of aluminum phosphate particles that attach themselves to one another and become heavy and settle to the bottom of a clarifier. The aluminum sulfate and phosphorus mixture can then be withdrawn, thereby removing the phosphate or phosphorus from the wastewater flow. Industrial Applications: The application of this reaction to the industrial world consists of a set of processes to filter out the phosphate. The setup is the following: Purpose: Restrict phosphates to aluminum phosphates for easier disposal of phosphorus. The first step in phosphorus removal is the Rapid Mix. In this stage, alum and waste or water runoff(known as effluent) is blended together as rapidly as possible with the use of a high- speed mixer called a "flash mixer." After this instant mixing, a slower moving process called coagulation and flocculation follows to allow the formation of a floc. These processes occur in a Flocculation Chamber. This floc consists of suspended and colloidal matter, mainly including the aluminum phosphate. Next, the effluent travels to a clarifier in which sedimentation occurs. The heavier aluminum phosphate settles to the bottom then pumps at the bottom of the clarifier pump out the aluminum phosphate via pipes. This aluminum phosphate is then disposed. Currently, there are no economical uses for aluminum phosphate. Also, this chemical process is similar to the process used by laundry detergents. Many detergents contain synthetic phosphates, called tripolyphosphates(TTPs). These chemicals cling to grease and dirt particles(alum in the previous example), keeping them in suspension until the wash water is flushed out of the washing machine. Impact on Society: This reduction in phosphorus is very important. This added phosphorus disrupts the natural cycle of phosphorus. One result of this is an algal blooms, or exponential growth in algae. When algal blooms occur, the surface of a freshwater lake is clouded with an almost finite amount of bacteria because of an increase in a nutrient. In this case an increase in phosphate, a favorite for algae. This deprives the bottom of the lake by cutting off light. A dense mat of algae choke off the lake. Also, phosphates are nutrients for plantlife. When fall approaches, or when phosphate levels are decreased, the algae die and fall to the bottom, changing the bottom from a silt, sand and clay bottom to a sand gravel and rock bottom. When the plants die, they are degraded by aerobic bacteria, which can deplete dissolved oxygen, killing aquatic organisms. As oxygen levels drop, anaerobic bacteria resume the breakdown and produce noxious products. All of this impairs navigation, fishing, swimming and recreational boating. Total phosphorus removal through filters after using alum as a filtering aid achieves 70 to 95 percent efficiency. Phosphates must be filtered out before the water or wastes are dumped back into bodies of water. Glossary Flocculation: The gathering together of fine particles to form larger particles. Effluent: Wastewater or other liquid -- raw, partially or completely treated -- flowing from a basin, treatment process, or treatment plant. Coagulation: The use of chemicals that cause very fine particles to clump together into larger particles. This makes it easier to separate the solids from the liquids by setting, skimming, draining or filtering. Floc: Groups or clumps of bacteria and particles or coagulants and impurities that have come together and formed a cluster. Colloidal: Very small and finely divided. Referring to solids. Does not dissolve and remains dispersed in a liquid for a long time due to small size. Algal blooms: Rapid growth of algae in surface waters due to increase in inorganic nutrients. Bibliography Kerri, Kenneth D. Advanced Waste Treatment. Sacramento, Ca.: CSU, Sacramento, 1987. Adams, Melinda. Environmental Science. Redwood City, Ca.: The Benjamin/Cummings Publishing Company, Inc., 1991.