The impact of Homeland Security on our daily lives in America Term Paper

The impact of Homeland Security on our daily lives in America - Term Paper Example The wide set of measures incorporated into homeland security for enhancing the economic sustainability and safety of the communities in America would have an impact on the way the communities continued their existence (Bullock, Haddow & Coppola, 2012). Responsibilities as envisaged in homeland security lay dispersed among a hundred different government agencies, reducing the speed and flexibility required for an efficient homeland security. Therefore, it was felt that it would be better to create the umbrella Department of Homeland Security to overcome the patchwork of government activities through the tens of government agencies. Thus, the Department of Homeland Security was formed armed with policies, regulation, and programs to provide homeland security (President Bush, 2002). Impact of Homeland Security The people of America have for long enjoyed a legal tradition that upheld individual civil liberties and resisted any infringement of the state on the civil liberties of its citiz ens. The measures provided to the Department of Homeland Security in the form of more intrusive surveillance, increased policing powers, reduction in the restrictions on search and seizure, easier wiretapping, and intrusion of privacy run against the grain of civil liberties. It was only after the fear of the September 11, 2001 attack had diminished did the realization dawn that one of the key areas that the impact of homeland security was being felt lay in the domain of civil liberties (Miller, 2003). The courts have for over a long period of time recognized the President of the United States as the constitutional authority to uphold and protect national security. Such an authority carries with it wide discretionary powers. Since homeland security has been created by the President to uphold and protect national security, the courts would be reluctant to infringe on the provisions of homeland security, as it would run against the grain of the recognition granted to the President as the constitutional authority for upholding and protecting national security (Nicholson, 2005). Intrusion and invasion are key words in the procedures and regulations of homeland security that are being experienced by the citizens of America. As a consequence of homeland security the airport security has been tightened. Full body scanners greet passengers at airports. In case that is not sufficient invasive-pat downs are a feature at the various airports around the country. The Secretary of homeland security has not only justified these enhanced security measures at airports, but also maintains that no changes need be expected anywhere in the near future (Airlliner Security, 2010). Expanded surveillance is a part of the initiatives under homeland security. This expanded security has led to the use of closed circuit televisions (CCTV) in public places, public transportations, and immigration offices. Easier access to individual records is another feature, whereby the Federal Bureau of Investigation (FBI) can seek and receive any personal records of any individual. This provides powers for accessing the financial records, medical histories, Internet usage, travel patterns, and any other records. Such information was formerly considered private information, but homeland security has removed the privacy element of these records. More intrusive is the expansion provided in the wiretap law. Even if an individual is not engaged in

Assessment of The Current Economic Situation in the US Essay

Assessment of The Current Economic Situation in the US - Essay Example This essay offers a brief informative review of the developments in the US economy after the financial crisis of 2008. The United States economy growth rate has declined considerably, after the economic crisis. The number of unemployed persons remains high. The slowing economic growth remains a concern due to the negative impacts it has had on the GDP. United States is considered to have the most technologically advanced economy with an approximated GDP of about $48, 000. The private sector dominates the economic sector with the government purchasing most of its goods and services from the private sector. One of the major disasters facing United States is the high level of unemployment, which is attributable to the 2008-2009 economic recessions. The economic recession is considered to be the worst economic crisis after the great depression. About 8.3% people remain unemployed within the U.S. The number increased after the 2008 recession as most companies tried to reduce their workforce as an attempt to counteract the inflation. In the attempt to offset the increased unemployment, the federal government enacted the American Jobs Act. The Act aimed at creating ways to prevent the slowed economic growth The United States financial sector remains fragile with increasing budget deficits. The gross domestic product remains delicate. Attempts to cut down on financial spending affected the revenues negatively. The slowed economic growth has the disadvantage of subsequent increase in unemployment but diminished possibility of inflation.

Introduction to Game Theory Essay Example for Free

Introduction to Game Theory Essay Nobel Prize Citation, 1994: Game theory is a mathematical method for analysing strategic interaction. Problem What is strategic interaction? (Singapore Management University) Introduction to Game Theory Fall 2012 2 / 18 An Example of a Game | Flat Tire Two SMU students, Al and Bob, very con dent about their midterm exam performance in ECON 206, decided to attend a party the weekend before the nal exam. The party was so good that they overslept the whole Sunday. Instead of taking the nal unprepared on Monday, they pleaded the professor to give them a make-up exam. Their excuse was a at tire without a spare and any help. The professor, surprisingly, agreed. On Tuesday morning, the professor placed them in separated rooms and handed them the test. The test had just one question: Which tire? (Singapore Management University) Introduction to Game Theory Fall 2012 3 / 18 The GPA Rat Race All of you are now enrolled in ECON 206 that will be graded on a curve. No matter how well you do in absolute terms, only 33. 3% of the students will get As, and only 33. 3% of the students will get Bs. Therefore, you must work hard, not just in absolute terms, but relative to how hard your classmates work. All of you are smart enough to recognize this, and after the rst lecture you all hold a secrete meeting where all of you agree not to work too hard. What will happen in the end? (Singapore Management University) Introduction to Game Theory Fall 2012 4 / 18 Why Are Professors So Mean? Many professors have rigid rules not to give makeup exams and NEVER to accept late homework assignments. Students might think the professors are so hardhearted to behave in this way. The truth is. Most professors are actually very kindhearted (for example. ) They are willing to give their students every reasonable break and accept every reasonable excuse But most professors also know that this is a slippery slope (for example, ) | if they set very exible rules, what may happen? (Singapore Management University) Introduction to Game Theory Fall 2012 5 / 18 Another Example | Strategic Interactions vs. Individual Decision Problems Underlying story: two students (Alice and Bob) are taking a course together. There are three e ort levels for each student: work hard (utility = 5), work sometimes (utility = 2), shirk (utility = 0). Consider the following two grade schemes. Grade Scheme A: A students nal grade only depends on her own e ort level | if a student works hard, she will get an A for sure (utility = 10); if she works sometimes, she will get a passing grade (utility = 5); while if the student shirks, she will fail the course for sure (utility = 0). Individual Decision Problem E ort Level Utility Disutility Net Work Hard 10 5 Work Sometimes 5 2 Shirk 0 0 (Singapore Management University)

Aspects Of A Vehicle Clutch System

Aspects Of A Vehicle Clutch System P1 P2: Demonstrate the knowledge understanding of the fundamental aspects of a vehicle clutch system. A clutch connects disconnects one rotating mechanical component from another: a clutch transmits torque from the engine to transmission. Most light vehicle use a single plate clutch to transmit torque from the engine to the transmission input shaft, the fly wheel is the clutch driving member. The clutch unit consists of a friction type disc with two friction facings a central splined hub. A pressure plate assembly consists of pressed steel cover with a segmented diaphragm spring a release bearing with a selector fork. The amount of torque a clutch can transmit depends on the co-efficient of the friction between the friction facings their mating surface, thus increasing the diameter of the clutch increases it torque capacity as does increasing the spring force. The transmission input shaft passes through the centre of the pressure plate. Its parallel spleens engage with the internal splines of the central hub, on the friction disc allowing torque to be transmitted from the flywheel, through the friction disc to the central hub to the transmission. When the clutch pedal is depressed, the movement is transferred though the operating mechanism (this being cable, hydraulic or electronic system), to the operating fork release bearing, the depressing movement acts on the releasing bearing moving it forward pushes the centre of the diaphragm spring towards the flywheel, the pressure plate disengages, thus drive is no longer transmitted. Releasing the pedal allows the diaphragm to re-apply it clamping force thus engaging the clutch thus restoring drive. This control is necessary when placing the transmission into gear; the transmission input shaft must be disconnected from the engine. Types Of Clutches: Single Plate Transmission Most modern vehicles use single plate clutch system to transmit torque from the engine to the transmission input shaft, the clutch unit is mounted on the flywheel, allowing the unit to rotate with the flywheel. A single plate clutch unit usually consists of a friction plate with 2 friction facing a central splined hub, a pressure plate assembly which consists of a pressed steel cover, a pressure plate with a machined flat face, a diaphragm spring, release bearing release fork. Pressure Plate: It mounts on the flywheel. It consists of four main parts is more correctly called a clutch cover assembly. These parts are the pressure plate itself, the springs (or spring, if a diaphragm type), the clutch cover, the release arms. There are two basic designs of clutches usually referred to by the spring type. This diaphragm is located inside the clutch cover on 2 fulcrum rings, held by a number of rivets passing through the diaphragm. The diaphragm type clutch works well in lightweight, low geared vehicles. It is not the best clutch for high RPM use as the diaphragm spring will stay flat or released from the centrifugal force generated by the RPM. Clutch Disc/Friction Plate: This is the driven part of the clutch. It has a friction material riveted to each side of a wavy spring. This is attached to a splined hub that the transmission input gear protrudes into. There are basically two common types of friction material used for clutch lining. These are organic metallic. The organic is best for all around use. The metallic is preferred by some for severe duty applications but requires high spring pressures is hard on the flywheel pressure plate friction surfaces. Clutch Release Bearing: As its name implies, this is the bearing that releases the clutch. Because the release bearing only works when the clutch is being released it usually lasts quite a long time. However, improper linkage adjustment can wear the bearing prematurely. Normally there should be a minimum clearance of 1/16à ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ã‚  between the face of the bearing the three release fingers or diaphragm spring of the pressure plate when the clutch is engaged. Clutch Release Fork: This is the arm or lever that the linkage operates that moves the release bearing. There are several different styles of release arm. The most common type the can be found in a vehicle is the fork type. Bell housing: This provides a mounting place for the transmission, as well as a means of aligning the transmission to the engine. In some applications it also has a structural mounting function. Operating Mechanism: The movement at the pedal is transferred through an operating mechanism to the clutch assembly; the mechanism may be mechanical or hydraulic. Mechanical system uses a combination of levers cables thus offering more flexibility, thus making this system very common. The cable operated control (Image) for a front wheel drive vehicle; the outer cable is fixed to the pedal to the pedal box inside the vehicle to the clutch housing in the engine compartment, the inner cable connects between the upper end of the clutch pedal an external lever on top of the clutch housing. This lever is connected to a vertical shaft, supported in the housing attached internally to a release fork, which carries the release bearing. In hydraulic clutch control, the pedal acts on a master cylinder, connected by a hydraulic pipe and flexible hose, to a slave cylinder, mounted on the clutch housing. The slave cylinder operates the clutch release fork. This vehicle uses a centre valve master cylinder. With the pedal in the off position, the centre valve is clear of the inlet port and fluid can flow to or from the reservoir, into the cylinder. Dual Clutch Transmission There are two basic types of transmissions, manuals which require a driver to change gears by depressing a clutch pedal, automatics which do the shifting work for drivers using clutches, torque converter sets of planetary gears. But the dual clutch transmission brings the best of manual automatic transmission. A dual clutch transmission offers the function of two manual gearboxes in one, a dual clutch gearbox, uses two clutches but has no clutch pedal, instead electronics hydraulics controls the clutches. Has in result one clutch controls the odd gears (First, Third, Fifth Reverse), which the other controls the even gears (Second, Fourth Sixth), although the gear controls may vary from designs to manufacturers. Gears can be changed without interrupting the power flow from the engine to the transmission. A dual clutch unit usually consists of a friction plate with 2 friction facing a central splined hub, a dual clutch case, pressure plate assembly which consists of a pressed steel cover, a pressure plate with a machined flat face, a diaphragm spring, release bearing release fork. Wet Clutch: Like torque converters, wet clutches use hydraulic pressure to drive the gears. The fluid does its work inside the clutch piston. When the clutch is engaged, hydraulic pressure inside the piston forces a set of coil springs part, which pushes a series of stacked clutch plates and friction discs against a fixed pressure plate. Single Plate Clutch Vs. Dual Clutch Transmission: Single plate clutch offers many advantages drawback over its counterpart dual clutch transmission: Advantages: Low manufacturing costs Lightweight Spare part easily accessible Easy maintenance comparing to dual clutch transmission Reliable due to few components Disadvantages: Unreliable in heavy duty vehicles High clutch wear (requires more slip to pull away from a dead stop) Drop of RPMà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒ ¢Ã¢â‚¬Å¾Ã‚ ¢s during quicker up shifts Dual clutch transmission offers many advantages drawback over its counterpart single plate, as listed: Advantages: Very reliable in heavy duty vehicles. Robust system compared to the rack pinion Quick precise gear change without loss of RPMs Improved MPG (miles per gallon) range Disadvantages: Heavier in weight compared to single plate transmission Large amount of components High manufacturing costs Complex in fitting in a vehicle Maintenance required frequently When comparing the two both systems, each system has its advantages drawbacks, but in the end each system has certain properties which are suitable for the vehicle is intended for, but when putting in real world application dual clutch does have some advantages over single plate transmission, due to its ability to improve MPG range, which could be a big factor for manufacturers to opt with dual clutch system over single plate over for high end to sport car, but due to its high manufacturing costs components weight , dual clutch system may take time to take over single plate system has the most common system, so in conclusion the single plate may be good system for possible next five years, but dual clutch may become common after, due to its single highest factor of improved MPG range.

BOOP :: essays research papers

Bronchiolitis Obliterans Organizing Pneumonia: BOOP   Ã‚  Ã‚  Ã‚  Ã‚  The characteristic of organizing pneumonia is the appearance of granulized tissue in the distal bronchioles. BOOP can be classified by 1) its cause 2) the cause is undetermined 3) its cryptogenic organizing pneumonia (idiopathic type). About one-half of all cases of BOOP are idiopathic. BOOP on x-ray can also be confused with chronic eosiniphillic pneumonia (CEP). The difference between the two is that BOOP has consolidation in the lower lobes of the lung and CEP consolidation is found in the upper lobes. The definitive diagnosis of BOOP comes down to tissue biopsy.   Ã‚  Ã‚  Ã‚  Ã‚  Conditions that cause BOOP are radiation therapy, infections, drugs/toxins, connective tissue disease, immuno-supressed states, and miscellaneous conditions. The radiation therapy causes BOOP when there is a cancer in the bronchi or breast cancer and the ipsilateral lung develops BOOP. The only common type of infection that causes BOOP is pseudomonas aeruginosa. The other types are coxiella burnetili, mycoplasma, pneumocystis carinii, influenza A, measles, HIV, Chlamydia, plasmodium and parvovirus B19. When BOOP occurs in conjunction with drugs/toxins the common drug causes are minocin, cephalasporins, acebutolol, sulfasalazine, macrodantin, cordarone, tegretol, Dilantin, and betapace. The toxins include L-tryptophan ingestion, sauropus androgynous vegetable poisoning, gold, paint aerosols, nylon flock worker’s and silo filler’s disease, free-base cocaine, and smoke inhalation. Connective tissue diseases include rheumatoid arthritis, ankylosing spond ylitis, ulcerative colitis, Crohn disease, systemic lupus, biliary cirrhosis and thyroiditis. The immuno suppressed causes are commonly due to organ transplantation, cancer, ARDS and AIDS. One of the miscellaneous causes of BOOP is menstrual and pregnancy related. Clinically, BOOP affects ages 40-70 but has been reported in children. The course commonly follows a flu-like symptoms, illness lasting 1-4months with persistent non productive cough, dyspnea on exertion, low grade pyrexia, malaise and weight loss. BOOP can be assumed over pneumonia when there is no response to antibiotics, there are lung crepitations, and PFT will show a restrictive pattern with decreased DLCO and exercise related hypoxemia. Chest x-ray is a good indicator but CT scan is more concise. The only treatment for BOOP are steroids and all other therapies are supportive (i.e. Oxygen, ventilator).   Ã‚  Ã‚  Ã‚  Ã‚   Bronchoscopy is a common procedure when BOOP is suspected. When a biopsy is taken there is usually an increase in the normal amount of lymphs 20-40%, eosinophils 5%, neutrophils 10% and macrophages present.

Narrative and Opinion in Notes of a Native Son Essay -- James Baldwin

Choices James Baldwin is considered to be one of the great writers of modern time. There are many characteristics of his writing that could be used to show his talent but the one that is most often cited is his ability to interweave narrative and opinion seamlessly into his essays. One example of this ability is in his â€Å"Notes of a Native Son† essay. He interweaves narrative of his father and his death with his opinions about the relationship between blacks and whites at that time. James Baldwin uses contrasting ideas such as public vs. private, father vs. son, and past vs. present to switch back and forth between the narrative and his opinions. The major contrasting idea that Baldwin uses in the essay is the contrasting idea of public life vs. his own personal private life. The first paragraph starts by giving the date of his father’s death, then moves to telling about the Detroit riots and then brings them together in the end of the paragraph by stating that they â€Å"†¦drove my father to the graveyard through a wilderness of smashed plate glass† (63). This shows how both their personal life had been ‘shattered’ and also the town around them. But this is only a hint of how Baldwin switches between his personal, private life and his public life in society. However, he always manages to pull what seems like two completely opposite ideas together into one combined thought. By drawing similarities between his public life and his private life, Baldwin is able to create the sense that the problems facing society were very similar compared to those that he faced on a personal level. Be cause of this Baldwin is able to make his opinions apply to the reader on a more personal level. The best example of Baldwin usi... ...art when taking a stance on an issue. That way you are sincere in your decision and you stand behind it. But he is also saying in the rest of the essay that when you are deciding if you should take a side or when you decide what side you are going to take, you must not rely on merely the past or the present. You must not merely on the word of society or the word of your private family. And you must not rely on the words your father says because you are his son. You must look at the entire picture, both past and present, both public and private, and both your thoughts and your father’s when you make a decision on a subject. Only in this way will the world ever be fair and just, and without racial tensions. Works Cited Baldwin, James. â€Å"Notes of a Native Son.† 1955. James Baldwin: Collected Essays. Ed. Toni Morrison. New York: Library of America, 1998. 63-84.

Hospitals and Long-Term Care Facilities Essay

Abstract Hospitals can be set up as nonprofit or for-profit facilities. The differences between the nonprofit and for profit hospitals will be discussed. Hospitals have experienced different trends in the last thirty years. This paper will identify at least three major trends that have occurred within the hospital sector. Three examples that describe and differentiate the roles of hospitals and nursing homes are providing long-term care. The conclusion of this paper will be a brief critiquing of the current state of long-term care policy in the United States. Hospitals and Long-Term Care Facilities The differences between nonprofit and for-profit hospitals: A characteristic as stated by Williams and Torrens (2008) of nonprofit hospitals is that these hospitals do not function under the realm of regular corporate law but under a special provision of the corporate law in each state. It is also noted that nonprofit hospitals also function under special federal and state tax provisions because of recognition of their community service function. Other characteristics of nonprofit hospitals are they do not have owners and their governing body is a community based board that has complete authority over operations. Nonprofit hospitals, in general, are not required to pay most of the taxes at federal, state and local levels. Under section 501C (3) of the federal tax code, the non-profits are exempt. Due to this exemption status donations made by individuals are tax deductible. Nonprofit entities are not only expected to care for the destitute and poor but they are also expected to provi de a variety of services to the community (Williams & Torrens, 2008). Now that the characteristics of the non-profit have been outlined the for-profit entities make-up will be discussed. For profit entities, unlike nonprofit ones, have owners. The owners are issued stocks and these stocks reflect the owner’s equity position. â€Å"For- profit  entities, including hospitals, may be publicly or privately held† (Williams & Torrens, 2008, p. 186). Stocks for entities for-profit that are publicly held are made available for anyone to purchase. Publicly held for-profit entities are plagued with various accountability and regulation rules that are supervised by the Securities and Exchange Commission at both federal and state level. Williams and Torrens (2008) state that privately held for-profit entities issue stock but the difference in public versus private issuing of stock is that the private for-profit stock is not available for purchase by the general public. For-profit hospitals, in the past, have been owned by the physicians who work in them but due to the astronomical costs of such expenditures as: building, maintaining and operating a hospital in today’s market the trend of physician owned for-profit hospitals is almost extinct. The majority of for-profit hospitals in the United States are part of a large multihospital chain. The multi chains of hospitals as stated by Williams & Torrens (2008) are publicly traded. For-profit hospitals do not serve only the community but they are also expected to operate at a profit so that the equity investors receive a return on their capital (Williams & Torrens, 2008). Three major trends that have occurred within the hospital sector. One of three major trends that have occurred within the hospital sector is the increase in specialty hospitals. The specialty hospitals focus on such areas as cancer and heart disease as well as profitable fields like orthopedic surgery. The specialty hospitals as stated by Williams & Torrens (2008) show an increase of being owned partially by the physicians who practice in them. Some would make the argument that the specialty hospitals provide the best care while others see these hospitals as entities that â€Å"siphon off insured and relatively healthier patients leaving the less profitable and more complicated cases to community general hospitals† (Williams & Torrens, 2008, p. 194). Concerns raised by the physicians’ ownership of the specialty hospitals include but not limited to are that the financial incentives will affect the treatment decisions (i.e. diagnostic services) and also that the physicians will treat the less complicated but yet more profitable health care cases and leave the biggest burden of caring for the less fortunate, financially challenged and uninsured individuals to the community and public hospitals (Williams & Torrens, 2008) Another trend that has occurred within the hospital sector  is in the field of technology. â€Å"Technology has shaped the physical and operational structures of hospitals, has affected the lives of patients and families, and has provided a delivery vehicle for physicians in clinical practice† (Williams & Torrens, 2008, p. 195). It is technological research that allows for the services hospitals provide for example anesthesia and antisepsis laid the ground work for surgical care and imaging technology has impacted effective intervention for individuals seeking care in a hospital atmosphere. Technology has affected a vast array of individuals: obstetric patients, those in need of pediatric care and terminally ill patients just to name a few. Advanced technology has led to development â€Å"increased specialization, clinical practices, expansion of specialized services, new medical and surgical specialties, and treatments for many diseases for which little curative or other care could be provided† (Williams & Torrens, 2008, p. 195). While continued advance technology leads toward continuous improved health care it also brings along with it problems, especially for the hospitals. The hospitals are immensely gratified by the increased technology and its application to improve overall general health but along with the benefits comes complications. Hospitals are expected to provide the most up to date technology but at the most effective pricing to please their customers, patients and physicians. This presents a major challenge to hospitals (Williams & Torrens, 2008) Academic medical centers are another trend that has occurred within the hospital sector. Academic medical centers are composed of medical schools and thei r primary teaching hospitals. The â€Å"academic medical centers provide tertiary, secondary, and primary care but have a principal focus on biomedical research, teaching of medical residents and medical students, and often an array of other professional training, research, and services activities† (Williams & Torrens, 2008, p. 196). Unlike other hospitals, the academic medical center does not have top priorities of financial efficiency and customer satisfaction. Great demands are placed on these facilities by physicians and researchers to provide the latest technology and staffing for the assurance of teaching and clinical investigation. According to Williams and Torrens (2008) the long-term strengths and successes of our health care systems depends largely on the success of the academic medical centers to achieve their mission. Three examples that describe and differentiate the roles of hospitals and nursing  homes in providing long term care. The nursing home facility is for patients who need extended care because they are very sick or unable to function without continued nursing and supportive services in a formal health care facility. These patients are sick and/or are in need of assistance but they are not ill enough that they require the intense treatment and care offered at a hospital. According to Will iams and Torrens (2008) about forty-seven percent of all nursing home facility care is paid for by Medicaid and residents and their families pay approximately one-third of the cost for the facility services. In recent years the length of time one stays at a nursing home has greatly decreased. Even with the decrease in stay there is still a fifty percent chance of an individual in his/her lifetime having to spend some time in a nursing facility. Both of these previous mentioned trends is reflective of the nursing facilities moving toward becoming more technologically sophisticated as well as being able to function as more of a short term temporary residence for patients in between the hospital and going home (Williams & Torrens, 2008). Hospitals are designed to take care of the more acute problems and emergencies. Hospitals provide a wide array of outpatient services. The outpatient services range from â€Å"rehabilitation to mental health counseling to outpatient surgery† (Williams & Torrens, 2008, p. 205). Unlike the nursing home facility the primary source of payment for hospital stay and services is Medicare and private insurance and very little payment comes from individuals. The current state of long-term care policy in the United States. Medicare provides financing for medical care for nearly all elderly Americans and others with certain disabilities but this does not hold true for long-term care. The majority of individuals needing long term must depend on family and friends and sometimes the community they live in. There is a lot of work to be done in the United States as it relates to the financing of long term care for every needy individual (Williams & Torrens, 2008). There is no clear and precise policy in the United States for long-term care but there are different provisions within Medicare and Medicaid that provide for long-term services for some (not all) individuals in need of it. While the financing of long-term care has been and continues to be a challenge for the United States there have been strives in the care coordination of long-term patients. The care coordination that has emerged through the years for long  term care patients appears to be relatively effective. â€Å"Quality is enhanced when information is communicated among all the professionals caring for a person, and efficiencies are achieved when duplication of services is avoided† (Williams & Torrens, 2008, p. 211). Case management, which is a process that encompasses the following: case identification, assessment, care planning, service arrangement, monitoring and reassessment enables one professional individual to work with the family to coordinate and obtain all of the services that the long term care patient may need. Case management has proven to have one of the most positive effects of improving long-term care (Williams & Torrens, 2008). References Williams, S. J., & Torrens, P. R. (Eds.). (2008). Introduction to health services: 2010 custom edition (7th ed.). New York: Cengage Delmar Learning.