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Respond to the following:
• What emergency action level would pertain to the Three Mile Island accident? Give reasons for your answers.
• What was the most significant effect of the 2011 Virginia Earthquake on the North Anna nuclear plant?

 

swot analysis for strategic planning in healthcare
read the attachment on Community hospital healthcare systems and use the attachment on the strategic plan for CHHS. Using specific examples in regards

to Community Hospital Healthcare systems,

1. Identify the major internal stakeholders and describe their role in your strategic plan.
2. Explain the basic internal trends, key uncertainties, and additional research needs.
3. Identify the quantitative or qualitative methods needed to analyze the project.
4. Describe internal barriers, including structural political policy and other barriers, to be addressed. How will you overcome these barriers?
5. Analyze the financial performance and position of the company. How will the plan enhance performance and financial sustainability?

Communicate in a manner that is consistent with professional expectations; create a document that is clearly written, well-organized, and generally free

of grammatical errors.
swot analysis for strategic planning in healthcare
Page 35
COMMUNITY HOSPITAL HEALTHCARE SYSTEM: A STRATEGIC MANAGEMENT CASE STUDY
Amod Choudhary, City University of New York, Lehman College CASE DESCRIPTION
The primary subject matter of this case concerns strategic management of community hospitals in the United States. This case has a difficulty level of

five; appropriate for first year graduate level students. This case is designed to be taught in four class hours and is expected to require twenty-four

hours of outside preparation for students. For the graduate student, it should be a half semester long group project with a presentation and report at

the end of the semester .
CASE SYNOPSIS
This case study analyzes the turbulent social, legal and technological issues that are affecting today’s suburban community hospitals in United States.

The soaring health care costs, increasing number of uninsured or underinsured patients, reduced payments by government agencies, and increasing number

of physician owned ambulatory care centers are squeezing the lifeline of community hospitals whose traditional mission has been primary care.

Furthermore, with the enactment of Patient Protection and Affordable Care Act in March 2010, community hospitals are facing new challenges whose full

impact is unknown. This case study would help students learn about Strategy Formulation including Vision and Mission Statements, internal and external

analysis, and generating, evaluating & selecting appropriate strategies for a healthcare organization.
COMMUNITY HOSPITAL HEALTHCARE SYSTEM
With the enactment of Patient Protection and Affordable Care Act in March 2010 (Health Act), and President Obama’s professed goal of making heath care

in the United States more accessible and affordable, the next few years are sure to be very turbulent in the healthcare industry. The Health Act is

expected to provide healthcare coverage to 95% of Americans, which will include an additional 32 million persons nationally (New Jersey Hospital

Association, 2010). The Health Act goes into effect in 2010 with many of its requirements not becoming effective until 2019. Directly because of the

enactment of the Health Act, insurance premiums are expected to increase anywhere from 2% to 9% depending on who is quoting them (Wall Street Journal,

2010). The Health Act requires children to remain on their parents’ health plans
Journal of the International Academy for Case Studies, Volume 18, Number 1, 2012
Page 36
until age 26, eliminates copayment for preventive care, bars insurers from denying coverage to children and adults (in 2014) with pre-existing

conditions, eliminates lifetime caps on insurance coverage, and requires setting up of insurance exchanges in all states (by 2014) through which

individuals, families and small business can buy coverage (Adamy, 2010; Pear, 2010).
United States spends approximately $2 trillion annually on healthcare expenses (Underinsured Americans: Cost to you, 2009). This amount is more than any

other industrialized country in the world and counts for 16% of the U.S. GDP. This percentage is higher than any developed country in the world

(Johnson, 2010). Despite the substantial healthcare spending, access to employer-sponsored insurance has been on the decline among low-income workers,

and health premiums for workers have risen 114% in the last decade (Johnson, 2010). Furthermore, healthcare is the most expensive benefit paid by U.S.

employers (Johnson, 2010). Despite this outlay, approximately 49 million Americans are uninsured and about 25 million underinsured–those who incur high

out-of-pocket costs, excluding premiums, relative to their income, despite having coverage all year (Abelson, 2010; Kavilanz, 2009). Overall, the

healthcare industry in America is besieged with high cost, uneven access and quality (Flier, 2009). The intractable issues of high cost, uneven access

and quality have made everyone unhappy from patients, hospitals, doctors to employers.
The American healthcare industry is composed of approximately six major interest groups: hospitals, insurance companies, professional groups,

pharmaceuticals, device makers, and advocates for poor (Goldhill, 2010) with the Physicians–part of the professional groups– having the biggest

influence on the industry. Although hospitals constitute only 1 percent of all healthcare establishments–hospitals, nursing and residential care

facilities, offices of physicians & dentists, home healthcare services, office of other healthcare practitioners, and ambulatory healthcare centers–

they employ 35% of all healthcare workers (U.S. Department of Labor, 2010).
Community Hospital Healthcare System
Community Hospital Healthcare System is a not-for-profit organization located in Monmouth County, New Jersey. With its 282 beds and 2400 employees

including 450 physicians, Community Hospital serves approximately 340,000 residents in four suburban counties of central New Jersey. The Community

Hospital Healthcare System is a holding corporation made up of (i) Community Hospital Medical Center, (ii) Applewood Estates, (iii) The Manor, (iv)

Monmouth Crossing, (v) Community Hospital Healthcare Foundation Inc., and (vi) Community Hospital Healthcare Services, Inc. (a for-profit-corporation).
Community Hospital Medical Center (Community Hospital) is a general, medical and surgical community hospital offering an array of primary and secondary

services, including: cardiology services, magnetic resonanceimaging (MRI), diabetes services through Novo Nordisk Diabetes Center, emergency services,

endovascular surgery, inpatient psychiatric
Journal of the International Academy for Case Studies, Volume 18, Number 1, 2012
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services, maternity care (single room) and special care nursery, oncology, radiation oncology, rehabilitation, short stay unit, Sleep Disorders Center,

Women’s Health Center, and dialysis unit. Community Hospital Medical Center operates a Family Medicine Residency program in affiliation with the Robert

Wood Johnson/UMDNJ Medical School.
Community Hospital has been selected as one of the best places to work in New Jersey by NJBiz–a business publication–and landed at 20th place among

100 best places to work in healthcare by Modern Healthcare magazine in 2009. The American Nurses Credentialing Center has re-designated Community

Hospital Medical Center a magnet status for excellence in nursing and patient care in 2010 (Community Hospital Healthcare System, 2009 Annual Report).

Only 6% of hospitals in U.S. hold Magnet designation and only 3% have earned re-designation one or more times (Community Hospital Healthcare System,

2009 Annual Report). Community Hospital is also a designated Primary Stroke Center. Finally, a nationally recognized firm has ranked Community Hospital

among the top 5% of hospitals in the U.S. for patient satisfaction (Community Hospital Healthcare System, 2009 Annual Report).
Applewood Estates is a continuing care retirement community with 290 apartments, 20 cottages, 40 residential health care units, and 60 bed skilled

nursing facility.
The Manor provides nursing services for 123 elderly residential units including sub- acute, rehabilitation and intravenous therapy.
Monmouth Crossing provides assisted facility for the elderly consisting of 76 units. Community Hospital Healthcare Foundation Inc. seeks and invests

funds for the benefit of all components of the Community Hospital System except for the Community Hospital Healthcare Services, Inc.
Community Hospital Healthcare Services, Inc. is a for-profit entity that provides related services or participates in joint ventures of related services

that do not meet criteria for being tax- exempt. Examples include an ambulatory diagnostic imaging business and a public fitness club. It also holds

certain real estate in support of the Community Hospital.
Vision–an organization of caring professionals trusted as our community’s healthcare system of choice for clinical excellence.
Mission–to enhance the health and well-being of our communities through the compassionate delivery of quality healthcare.
Community Hospital’s mission and vision is borne out of six Strategic Imperatives– known as pillars. They are: (i) growth and development, (ii)

community involvement & outreach, (iii) physician integration, (iv) customer service, (v) high performance and (vi) renown. According to John Gribbin

(personal communication, August 16, 2010), CEO of Community Hospital, use of technology underpins each of the six strategic imperatives and is used to

achieve goals pertaining to the Strategic Imperatives.
Journal of the International Academy for Case Studies, Volume 18, Number 1, 2012
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COMMUNITY HOSPITAL DILEMMA
Traditionally community hospitals have defined themselves to be center of Primary care, i.e., place for general medical and surgical care.

Unfortunately, under the current health care industry practices, general medical and surgical care which form the core of a community hospital tend to

be less profitable than specialty care–heart, trauma and, transplant centers. Additionally, while primary care is increasingly viewed as the long-term

solution to U.S. health crisis, many argue that the Health Act does little to change the economics of specialty vs. primary care. For community

hospitals like Community Hospital, this is not good news. Community Hospital’s mission is primary care, but it is challenged as to how to develop other

services that which are complementary to its mission of primary care that effectively subsidize its commitment to primary care.
Based on market share, Community Hospital faces two direct competitors and other peripheral competitors as it tries to maintain its position as the

community’s healthcare system of choice for clinical excellence and meeting the health delivery needs of residents in central New Jersey.
Shore University Medical Center (SUMC)
Shore University Medical Center is a 502 bed regional medical center that specializes as the region’s only advanced pediatric clinical care hospital.

SUMC is also a Level II Trauma Center, with an affiliation with the University of Medicine and Dentistry of New Jersey — Robert Wood Johnson Medical

School. It is located in Neptune, NJ and competes with Community Hospital in eastern region of Monmouth County, NJ.
SUMC is part of the three-hospital member Meridian Health Systems. SUMC has also received the prestigious Magnet award for nursing excellence three

times. It has been designated by J.D. Power and Associates as a Distinguished Hospital for Inpatient Services (2006) and received the New Jersey

Governor’s Award for Performance Excellence (2005). With their Meridian partner hospitals, SUMC has also received the following awards: FORTUNE’S “100

Best Companies to Work For” (2010), Best Places to Work in New Jersey” for five consecutive years by NJBiz, New Jersey’s Outstanding Employer of the

Year in 2003 and 2009, One of the top 100 Most Wired Health Systems in the United States for 10 consecutive years, and John M. Eisenberg Award for

Patient Safety, one of the highest recognitions in the nation for hospital quality.
University Hospital (UH)
UH is unique among the three hospitals because of its size and breadth and depth of medical services provided and specialties offered. UH is a 610-bed

academic medical center and
Journal of the International Academy for Case Studies, Volume 18, Number 1, 2012
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a teaching hospital of UMDNJ-Robert Wood Johnson Medical School in New Brunswick, NJ. UH competes with Community Hospital in the northern and western

part of Monmouth County and eastern and northern Middlesex County. Since it is a teaching hospital, UH provides services and speciality care that

Community Hospital would not be able to provide even it desired to do so. UH is a Level 1 Trauma Center, with a separate Bristol-Meyers Squibb

Children’s Hospital (BMSCH) with research and rehabilitation facilities. Moreover, UH specializes in cardiac procedures including heart transplants, has

a cancer hospital, offers state of the art robotic surgery and provides kidney transplant services.
UH is recipient of many awards and recognitions: (i) one of America’s best hospitals according to U.S. News and World report, (ii) “Hospital of the

Year” by NJBiz, (iii) top-ranked cancer programs, (iii) recognized exceptional U.S. hospitals in quality and safety, (iv) recipient of Magnet Award for

nursing excellence, (v) award for excellent stroke care by American Heart Association, and (vi) high patient satisfaction ranking by the patients of

BMSCH.
Tables 1 to 5 below provide data that should be used to determine the competitive advantage/core competencies of Community Hospital. The tables

represent data and ratios about hospital finance (tables 4 & 5), safety and mortality rates (tables 2 & 3), and patient experience (table 1).
Table 1: Hospital Experience Survey (%)
CMC SUMC UH NJ Avg.
Patients who reported that their nurses “Always” communicated well. 74 75 73 72
Patients who reported that their doctors “Always” communicated well. 78 75 76 76
Patients who reported that they “Always” received help as soon as they wanted. 60 59 59 56
Patients who reported that their pain was “Always” well controlled. 69 69 67 66
Patients who reported that staff “Always” explained about medicines before giving it to them. 59 57 58 55
Patients who reported that their room and bathroom were “Always” clean. 64 62 64 66
Patients who reported that the area around their room was “Always” quiet at night. 48 49 49 50
Patients at each hospital who reported that YES, they were given information about what to do during their recovery at home. 77 76 81

77
Patients who gave their hospital a rating of 9 or 10 on a scale from 0 (lowest) to 10 (highest). 68 62 66 60
Patients who reported YES, they would definitely recommend the hospital. 69 68 74 64
This table provides data from a survey that asks patients about their experience during a recent hospital stay. http://www.hospitalcompare.hhs.gov/

August 11, 2010.
Journal of the International Academy for Case Studies, Volume 18, Number 1, 2012
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Table 2: Hospital Mortality Rates Outcomes of Care Measures
CMC SUMC UH
Death Rate for Heart Attack Patients No different than U.S. National Rate No different than U.S. National Rate No different than U.S. National

Rate
Death Rate for Heart Failure Patients Better than U.S. National Rate Better than U.S. National Rate No different than U.S. National Rate
Death Rate for Pneumonia Patients No different than U.S. National rate No different than U.S. National Rate No different than U.S. National

Rate
Rate of Readmission for Heart Attack Patients No different than U.S. National rate No different than U.S. National Rate No different than U.S.

National Rate
Rate of Readmission for Heart Failure Patients Worse than U.S. National Rate No different than U.S. National Rate No different than U.S. National

rate
Rate of Readmission for Pneumonia Patients Worse than U.S. National Rate No different than U.S. National Rate Worse than U.S. National Rate
This table measures the hospital mortality rates for the three hospitals and compares those results with U.S. National Mortality Rates.

http://www.hospitalcompare.hhs.gov/ August 11, 2010.
Table 3: Recommended Care/Process of Care: Hospital Overall Scores (%–higher score is better)
CMC SUMC UH Top 10% of Hospitals scored equal to or higher than Top 50% of Hospitals scored equal to or higher than
Heart Attack Overall Score 96 99 98 100 97
Pneumonia Overall Score 93 96 83 99 96
Surgical Care Improvement Overall Score 90 97 95 98 95
Heart Failure Overall Score 89 97 91 100 96
This table compares Heart Attack, Pneumonia, Surgical Care and Heart Failure Care among the three Hospitals and other hospitals in State of NJ. New

Jersey Department of Health and Senior
Services, Web.doh.nj.us/…/scores.aspx?list…, downloaded August 13, 2010
.
Table 4: Ratios and Indicators
CMC SUMC UH
Average Length of Stay (days) 3.6 4.6 5.0
Medicare Average Length of Stay (days) 4.7 5.7 6.5
Occupancy Rate for Maintained Beds (%) 78.8 77.7 82.1
Operating Margin Ratio (%) 2.4 2.9 0.1
Total Margin Ratio (%) 8.7 9.3 8.6
Current Ratio 3.97 2.23 1.51
Modified Days Cash on Hand Ratio 241.6 194.4 250.2
Net Patient Service Revenue 6,206 7,287 8,653
Total Expenses per Adjusted Admission 6,286 7,405 8,783
Charity Care Charges as percentage of total Gross Charges 4.0 4.4 5.0
Provision for Bad Debt as Percentage of Net Patient Service Revenue 1.9 4.3 5.0
This table provides ratios for Utilization, Financial Health and Operational Performance for three hospitals. FAST Reports, New Jersey Hospital

Association.
Journal of the International Academy for Case Studies, Volume 18, Number 1, 2012
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Table 5: Key Statistics for Community Hospital
2007 2008 2009
Beds 271 276 282
Births 2,026 1,869 1,749
Emergency Department Visits 60,344 60,828 64,460
Family Medicine Center Visits 18,424 20,046 19,482
Health Promotion Visits 53,291 51,072 50,880
Patient days (including same-day surgeries) 83,968 82,533 76,635
Physical/ Occupational Therapy Treatments 92,911 106,856 122,871
Radiology/Imaging Procedures 125,117 130,108 127,913
Surgeries 15,092 14,033 13,309
Employees 1,664 1,743 1,770
Uncompensated Healthcare 10,537,747 10,885,754 10,390
Bad Debt 2,750,418 2,930,189 3,561,270
Senior Living Communities Occupancy Rates (avg. in %) 90.5 91.4 89.3
This table provides key statistics for Community Hospital for past three years. 2007- 2009 Community Hospital Healthcare System Annual Reports.
Outlook
The population of Monmouth County, NJ is set to increase from 646,088 to 657,798 from 2009 to 2014. The median age will also increase from 40 to 41, and

per capita income will increase from $40,189 to $42,166 during the same period (North Carolina Department of Commerce, 2008). The CEO of Community

Hospital worries that with each passing day the continued viability of his hospital becomes difficult. Moreover, he believes that the Health Act will

hurt Community Hospital’s bottom line by about a $1 million per year. However, the CEO believes that Community Hospital is well positioned to meet its

challenges and will succeed, albeit with hard work, talented employees and some luck.
Federal government through Medicare and Medicaid provides Community Hospital’s revenue of about 45%. Generally, Medicare and Medicaid payments to

hospitals are approximately 20% less than the actual cost (Arnst, 2010). Remaining revenue of Community Hospital comes mainly from insured patients.

Community Hospital, like most hospitals across the country receives most revenue from treating complex health care diseases such as surgeries and

procedures that require hospital stay and care. Ominously for Community Hospital, due to diffusion of health care technologies, services with most

revenues are moving away to private surgery centers owned by physician groups. Additionally, the enactment of the Health Act will lead to reduction of

approximately $1 million to Community Hospital’s bottom line. The challenge for strategists at Community Hospital is to provide primary care and charity

care (NJ law requires every hospital to medically stabilize anyone–regardless of insurance or ability to pay–and treat those patients to the full

extent of services offered by the hospital) in a weakened economy with increasing charity care expenses and rising bad debt. The strategists must find
Journal of the International Academy for Case Studies, Volume 18, Number 1, 2012
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new sources of revenue to allow Community Hospital to support its mission while secure enough funds to meet its commitments to primary and uncompensated

care.
CONCLUSION
Community Hospital is in a challenging environment due to changing demographics, highly regulated health care industry and having an uneven playing

field compared with physician owned surgery centers. Matter of fact, one-third of the nation’s community hospitals had operating losses in 2008

(Nussbaum & Tirrell, 2010). Patients with good jobs and appropriate health insurance are leaving the region, while physicians are taking high revenue

procedures to privately owned surgery centers. Additionally, with the reduced Medicare and Medicaid reimbursements and increasing charity care/bad debt

cost; Community Hospital needs to create a new sustainable business model. Please prepare a strategic plan that will steer Community Hospital through

the turbulent times ahead.
REFERENCES
Abelson, R. (2010). Bills Stalled, Hospitals Fear Rising Unpaid Care. Retrieved February 9, 2010, from

Adamy, J. (2010). Health Insurers Plan Hikes. Retrieved September 7, 2010, from www.wsj.com.
Arnst, C. (2010, January 18). Radical Surgery. Bloomberg Businessweek, p. 40.
Community Hospital Health Care System. 2009, 2008, 2007 Annual Reports. Freehold, NJ.
Flier, J. (2009). Health ‘Reform’ Gets a Failing Grade. Retrieved November 17, 2010, from
www.wsj.com/…/SB1000142405274870443
Goldhill, D. (2009). How American Health Care Killed My Father. Retrieved January 20, 2010, from
www.theatlantic.com/doc/print…/health-care
Johnson, T. (2010). Healthcare Costs and U.S. Competitiveness. Retrieved January 31, 2010, from
www.cfr.org/…/healthcare_costs_and_us_co…
Kavilanz, P. (2009). Underinsured Americans: Cost to You. CNNMoney.com. Retrieved January 31, 2010, from
http://CNNMoney.com
North Carolina Department of Commerce. (2010). Monmouth County (NJ) January 2010. Retrieved January 31,
2010, from https://edis.commerce.state.nc.us/docs/countyProfile/NJ/34025.pdf
New Jersey Hospital Association. (2010). FAST Reports. Princeton, NJ.
New Jersey Hospital Association. (2010). Memorandum to Chief Executive Officers. Princeton, NJ.
Nussbaum, A., & Tirrell, M. (2010). Health Reform is Dead. Let’s go Shopping. Bloomberg Businessweek, p.49. Pear, R. (2010). Health Plan Won’t Fuel Big

Spending, Report Says. Retrieved September 9, 2010, from
www.nytimes.com/2010/09/../09health.html…
New Jersey Department of Health and Senior Services. (2010). Hospital Performance Report. Retrieved August 13,
2010, from http://web.doh.state.nj.us/…/scores.aspx?list…
U.S. Department of Labor, Bureau of Labor Statistics. Career Guide to Industries:
2010-2011 Edition. Retrieved January 31, 2010, from http://www.bls.gov
Wall Street Journal (2010). Sebelius has a List. Retrieved September 13, 2010, from www.wsj.com
Journal of the International Academy for Case Studies, Volume 18, Number 1, 2012
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Delivering healthcare in America
What is meant by health care financing in its broad sense? What impacts do various financing options have on different population segments that are reliant

upon the health care delivery system?

 

Introduction
The financing of the health care system is an extremely complex set of processes known to drive services in the USA. American consumers often over-utilize

the traditional health care system and expect a quick fix to physical and mental problems. Furthermore, the use of emergency rooms for health care

provision for the uninsured is a high-cost solution to the issue of underinsured/uninsured people and access to health care. Currently, private and public

health care insurance is represented by several modalities and is discussed in the context of fiscal impact.

Health care finance is a branch of finance that helps patients and health care beneficiaries pay for medical expenses in the short and long terms. Health

care finance (Health insurance companies) affect patient care indirectly by driving what tests, medications, and procedures doctors can use to diagnose and

treat patients and even which patients doctors can care for.

Expenditures and Components
The one large system of financing health care is health insurance, usually provided by employers or the government. Doctors use the insurance system to

derive how much they will be paid. Such financing represents who has access to health care and what programs are developed, such as Home Health Care. The

fraction of payment due lends consumers to use more services because the full cost is reduced. These issues, related to overspending and use, are of major

concern in overall system delivery.
Influencing of Financing Model
There is a strong nexus between cost control and health care financing. The influence of financing model, as developed by Shi and Singh (2008), classified

insurance as the pivotal variable. Insurance drives demand for services and higher utilization. Based on the experience of other nations and this model,

health care costs would need to be controlled by rationing services. Government programs, such as Medicare (for the elderly), control costs by limiting the

types of services available.
Medicaid
Medicaid, or Title XIX of the Social Security Act, is comprehensive health insurance for children, the blind, disabled, or elderly and are considered

indigent. Both the federal government and states pool resources to fund the large pool. Financial allotments represent 11% of overall spending. States

define who qualifies according to need. Each state administers their own program, thus the services differ between states. The Federal government partners

with states to provide some ancillary services such as prescription drugs, home care, etc.
Conclusion
Several factors, such as providers, purchasers, and politics, influence the costs and financing of health care. Nearly 50 million people are uninsured,

impacting the current system of access to care in the most expensive form: visiting the emergency room. Several insurance processes exist, yet health care

costs are exceeding spending projections and inflating our gross domestic product over 20%.
References
Shi, L. and Singh, D. A.(2008).Delivering health care in America (4th ed.). Boston, MA: Jones and Bartlett

 

Explain German alliance behavior before 1914 and its decisions to support Austria-Hungary in 1914 (sources: lecture notes, Fromkin)

Write about Nigerian Cultural stereo typing in portray of press relating it to how leadership is critical to innoivation.

Considering An Assessment of Leadership Role in Fostering Organizational Cultural Components for Enhancing Innovation in the Nigerian Public

Sector. Write about Cultural stereo typing in portray of press relating it to how leadership is critical to innovation. Please do not give

background about Nigeria and culture; just go straight to the point. Thank you

 

Clinical experience
Practicum Synthesis Objective 5- Describe how health care is organized and financed, including the implications of business principles, such as patient and systems cost factor while examining the roles and responsibilities of regulatory agencies and their effect on patient care, workplace safety, and the scope of practice.
Determine what type of organization your practicum site is and how they are reimbursed. Try to obtain an annual report online to view their overall financial performance reported to the public. Discuss with your preceptor or other professional at the practicum site, the patient and systems that factor into reimbursement. What is the impact of regularly agencies on the site and the care they provide? If possible, take a look at how the site is organized. Is it bureaucratic or matrix? How does this organization impact the practice and care provided?
Practicum Synthesis Objective 6- Use interprofessional and intraprofessional communication and collaborative skills to deliver evidence based patient centered care and incorporates effective communication techniques, including negotiation and conflict resolution.
Think about any interactions or/and meetings you observed; How did different healthcare professionals communicate and collaborate? What kind of communication techniques did you observe? Describe any observations of negotiation or/and conflict resolution. Describe how health care professionals communicate to include patients in their care and make care more patient-centered.

Frankistein novel
This assignment will provide evidence for assessment criteria 3.1.1, 5.1. This assignment will be graded on 1.Understanding of the Subject, 2. Application of Knowledge, 6. Autonomy and Independence and 7.Quality.

A textual analysis of 1,500 words. Your analysis should cover the following aspects:

• Explore the significance of where the extract is in the novel. What has happened before that makes this an important part of the story?
• Describe how Shelley gradually introduces the ideas in the extract. Explore how her use of language makes an impression on you.
• Consider how Shelley introduces the pressures Frankenstein is experiencing in the extract

 

Social and Emotional Intelligence

What ideas or phrases come to mind when you hear the term intelligence? Prior to the current emphasis on emotional and social intelligence, individuals

tended to associate intelligence with one measurement: intelligence quotient or the IQ. While the IQ focuses on intellectual abilities, emotional

intelligence focuses on an individual’s awareness of his or her feelings and the feelings of others, and social intelligence focuses on an individual’s

interpersonal skills (Zastrow & Kirst-Ashman, 2016, pp. 506-509).
To prepare for this Discussion, read “Working With People With Disabilities: The Case of Andres” on pages 28–31 in Social Work Case Studies: Foundation

Year. Consider what you have learned about social and emotional intelligence in this week’s resources as well as what you learn about the person and

environment as it relates to young and middle adulthood.

Post a Discussion that includes the following:
An explanation of how social and emotional intelligence are related to cultural factors
An explanation about how you, as a social worker, might apply the concepts of emotional and/or social intelligence to the case of Andres
An explanation of how social workers, in general, might apply social and emotional intelligence to social work practice. (Include a specific example in

the explanation.)

Working With Clients With Disabilities: The Case of Andres
Andres is a 68-year-old male originally from Honduras. He is married and the father of two grown children: a daughter who is married with one child and

a son who is unmarried. Andres lives with his wife in a brownstone in an upper-class urban neighborhood, and they are financially stable. He relies on

Medicare for his health insurance. Andres is a retired child psychiatrist who completed medical school in Honduras and committed his career to working

with Latino children and families in a major metropolitan area. Andres’ wife is a clinical psychologist who still maintains an active practice. Andres

has a good relationship with his children, seeing them at least once a week for dinner, and his granddaughter is the light of his life.
Approximately 6 years ago, Andres was diagnosed with a rare brain tumor and Parkinson’s disease. Prior to his diagnosis, Andres was still on staff at a

hospital, jogged daily, and had plans to travel with his wife. In a short time, Andres’ health deteriorated significantly. He now uses a cane and

walker to ambulate. His speech is slow and soft. He requires assistance to get dressed and eat at times due to severe tremors and the loss of dexterity

in his hands. Andres has fallen on multiple occasions and therefore cannot go out alone. He suffers from depression and anxiety and is currently on

medication for these conditions. Andres spends a majority of time at home reading. He has lost contact with many of his friends and almost all of his

professional colleagues.
Andres presented for treatment at an outpatient mental health setting. His daughter suggested it because she was concerned about her father’s worsening

depression. Andres came into treatment stating his family thought he needed to talk to someone. He complied, but was unsure if treatment was really

necessary. Andres agreed to weekly sessions and was escorted to each session by an aide who helped him at home.
While Andres had difficulty stating specific goals in the beginning, the focus of treatment became obvious to both of us early on, and we were able to

agree to a treatment plan. Across multiple spheres of his life, Andres was struggling with accepting his illness and the resulting disabilities. In

addition, he was extremely socially isolated despite the fact that he lived with his family and they were supportive of his medical needs. Finally,

Andres’ role and identity had changed in his family and the world overall.
In a mere 6 years, Andres had lost his independence. He went from being a man who jogged every day to a man who could not carry a glass of water from

one room to the next in his own home. Andres was trying valiantly to hold on to his independence. While his wife and his children were willing to

provide any assistance he needed, Andres hated the idea of asking for help. As a result, he did things that compromised his balance, and he had several

bad falls. In addition, Andres’ wife had assumed responsibility for all of the family’s affairs (i.e., financial, household, etc.), which had been

Andres’ job before he got sick. Andres struggled as he saw his wife overwhelmed by all that she now had to take on. At the same time, he did not feel

like he had the ability to reclaim any of what had been “taken” from him. Together, Andres and I identified the things he felt he was capable of doing

independently and worked on how he could go about reclaiming some of the independence he had lost. We spoke about how he could communicate his needs,

both for help and independence, to his family. We explored his resistance to asking for help. On many occasions Andres would say, “I was the one my

children came to for help; now they have to help me. I can’t stand that.”
In addition to the struggles Andres faced in his everyday life, he also had to cope with the reality of his illness. Andres was well aware that his

illness was degenerative, and with each change in his condition, this became a stronger reality. Andres frequently spoke of “a miracle cure.” He

constantly researched new and experimental treatments in hopes that something new would be found. While I never attempted to strip Andres of his hope

for a cure, we spent a considerable amount of effort getting Andres to accept his condition and work with what was possible now. For example, Andres

had always been resistant to physical therapy (PT), but during our treatment, he began PT to work on maintaining his current balance rather than trying

to cure his balance problems. Facing his illness meant facing his own mortality, and Andres knew his fate as much as he wanted to deny it. He often

spoke of the things he would never experience, like his granddaughter graduating from high school and traveling through Europe with his wife.
Andres’ treatment lasted a little bit more than a year. He demonstrated significant improvement in his ability to communicate with his wife and

children. Andres continued to struggle with asking for help, repeatedly putting himself in compromising situations and having several more falls. After

the fact, he was able to evaluate his actions and see how he could have asked for limited assistance, but in the moment it was very difficult for him

to take the active step of asking for help. Andres was also able to reconnect with an old friend who he had avoided as a result of his physical

disabilities and feelings of inadequacy. We were forced to terminate when I left my position to relocate out of state.

 

Diversity in the classroom presentation

Create a 10-12 slide digital presentation that demonstrates how diversity affects the lesson planning process.
Include the following:
1. Identify remediation and enrichment diversity considerations.
2. Identify activities that complement the remediation and enrichment considerations.
3. Include descriptions of specific activities the students might complete based on their learning needs. For example, if Johnny has an IEP for ADD, how would you modify the lesson? Or if Susie has mastery of the content based on the pre-learning assessment, what types of enrichment activities would you provide for her? Consider a range of developmentally, culturally, and linguistically appropriate strategies.
4. How you would modify the assessment tool at the end of the lesson in order to evaluate each student’s mastery of the content?
Cite and reference 3-5 scholarly articles. Add to your notebook as necessary.
Include presenter’s notes and a title slide.
While APA format is not required for this assignment, solid academic writing is expected, in-text citations and references should be presented using documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

 

The military aspect at the begging discuses the war in general then i will go through Gettysburg war in details.
a. Introduction
b. Background
c. Relationship of theories to information on the topic covered in introduction
d. Conclusions
e. References
f. Supplemental materials (if any)
The Introduction should include why this paper is being done; what is the point. The background provides a summary of the issue or topic at hand.

Present some issue, person, or event that can be explained or examined in the area of American history. Identify and explain how your topic is

related to any of the theories as presented by the instructor or by Kelly, Harbison, and Belz.
The conclusion is what you think are the critical attributes or characteristics of the issue you have examined. There should be at least six

references from journal articles, textbooks, or government publications (excluding textbooks from this course). Do not use Wikipedia as a source as

it is an open-source and thus not necessarily is not reliable.
Supplemental materials to be attached to the end of the paper may include any statistical data, research, or any graphs or tables designed to show a

specific impact or relative effect. Permission to use such material must be obtained.