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Medication errors are unfortunately not some of those rare events. The National Patient Safety in the year 2008 revealed that approximately one in ten patients always experience medication harm though most of these mistakes usually are unreported as the staff will never realize that there is an error that has occurred (Lodewijk, Swamy & Andy,2005). Medication error is any error that is realized during prescribing process, dispensing, when preparing, monitoring, administering and giving medicine related advice regardless of whether or not harm has occurred or not. The issue dealing with medication administration in a healthcare setting has been the main focus of research and scrutiny since medication errors do contribute directly to the mortality and morbidity of the patients (Tissot et al, 2003, pp. 264-268; Barker et al, 2002, pp.2314-2316). The desire to offer patients with the most optimum as well as safe care does fuel the academics and practitioners to create some strategies that are meant to reduce likelihood of administrating errors that occur. According to the American Hospital Association, some of the major medication errors are the incomplete information meant for patients, unavailable information on drugs, miscommunication on drug use, lack of correct labeling of drugs and environmental factors for example noise, heat, lighting, interruptions that distract the health practitioners from their tasks (Lodewijk, Swamy & Andy,2005,  pp. 111). This paper seeks to evaluate an article on medical error in order to get more limelight on the same.

Elen et al (2001, pp. 496-504), in their article ‘factors contributing to medication errors: a literature review’, gives a deep analysis on nursing and some of the medication errors that occurs as well as the causes of these errors. They start by acknowledging the fact that drug administration is one of the most important and sensitive role of the nurse. They assert that medication errors are a global problem and there ought to be a multidisciplinary approach to reduce the errors in the medical field. Drug administration is one of the roles of a clinical nurse though pharmacists and doctors are also involved. All the registered nurses are fully accountable for their practice which comprise of preparing, administering medications, checking, updating their knowledge on medications, monitoring the treatment effectiveness, reporting some of the reactions that are disturbing or adverse and teaching their patients in drugs (Elen et al, 2001, pp. 1365-2702).

According to the authors, medication error is any dose of medication which is different from the order of the physician and written in the chart belonging to the patient of from the procedures and hospital policy. Some of the errors are the error of omission, wrong rating error, taking of unauthorized drugs, wrong dosage, wrong dose preparation and incorrect technique of administrating the drugs. The authors cite Wolf (1989, pp. 8) who asserts that medication errors are mistakes that are usually associated with the IV solutions and drugs which are made during prescription, dispensing, transcription, preparation as well as distribution.

Ellen et al asserts that mathematical proficiency is a major prerequisite in the performance of most functions nursing for example intravenous regulation, medication calculation as well as the intake and the output calculation. One of the factors that lead to medication errors is poor skills in mathematics among nurses. Most of the student nurses do not have efficient mathematical capability that is required to function as real registered nurses. In a study done it showed that approximately 9% and 38% of students in the nursing field could not pass the mathematical proficiency exams. Also the study showed that 110 of the registered nurses among them 81% could not calculate the medication doses. Most nurses have a problem with the conceptual, mathematical, as well as the measurement abilities thus leading to medical errors during practice. The other factor is lack of knowledge that accounted for around 29% of all the 334 errors that had occurred in a period of six months (Elen et al, 2001, pp. 1365-2702). Other factors were length of the shifts. The nurses who had numerous shifts were more likely to make errors.  The other is workload which can lead to medical error as shortages of the nursing personnel can have adverse effects.  Others are interruptions and distractions, quality of the written prescriptions by the doctors and finally, the nurses who are new in a medical setting are likely to err because of the new environments though they are likely to report the errors as compared to those who are more experienced.

Some of the preventative measures that ought to be used in order to decrease such incidences are testing nurses’ knowledge on medications during the orientation periods as well as thorough orientation of the mathematical capabilities. Ellen et al affirms that nurses should be aware of the right actions to take, side effects as well as a correct dosage of all the drugs they administer. Some of the recommendations that have been articulated in the article are increasing more knowledge on the medications through the nurses updating their intellect on drugs to curb the issue of medical errors.

The authors acknowledged the fact that medication errors are a major problem that is associated with the nursing practice. Some of the factors they identified are managerial problems, personnel, mathematical aptitude of the nurses, workload, staffing levels, nursing care systems and others. There is need for the educators to offer in service education that is related to medicine. There is however need for more action on this subject to avoid risk related cases.

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Responsibility taking is a very important aspect in business. Though the letter of engagement the contract is clearly spelt out to show the extent to which the contract will cover. Besides, the letter presumes to transfer some mandate in the management of the businesses’ affairs to a third party who would be an independent expert or an independent accountant in handling matters of accounting nature.

Legal redress in the Hoffman et al’s (2007, p 9) perspective is not only requires sufficient evidence but also relevant expertise. Some litigation may require that an expert in the area is sought to offer expertise advice and incidental evidence on the same. Unlike a consultant, the expert will only offer the requisite information that would be required towards the making of judgment by the court. The consultant on his part only gives information that is required to carry out an activity.

The independent expert normally receives relevant information from the parties in the litigation and reorganizes the information into meaningful and relevant pieces. Based on the gathered information coupled with the expertise he has, the expert makes communication to the parties he terms incidental for the information gathered.  The independent expert ought to be a nonpartisan individual without any vested interest in the matter under litigation.

The independent as the term suggests implies that a person who is meant to only offer sufficient information on the matter under litigation any remain independently so even during the process of litigation. According to Federal Court of Australia (2008), the expert for example may be required to gather information on issues of human rights violate or otherwise and submit to the relevant government agency for a further follow up.

The expert will always study the national policies besides the identification of the areas of concerns and undertakes a thorough audit of the cited areas. Besides, the expert will take consideration of the registers within the area of concerns and undertake a thorough analysis of the registers for the purpose of using them in any litigation if the case does require such evidence. The regulatory framework, according to Justice Peter McClellan (2007, p 26) of the state is also an area of concern for the independent expert as most of the litigation may require the analysis of the policies that provide the guiding principles for the framework.

Investigative of forensic accounting is also incidental in the litigation process. In the event of such anticipation, an independent accountant would always be sought. The accountant will always review the litigation in the light of the dispute in question or the principles being investigated. Under normal circumstances the accounting experts according to O’Connor, (2005, p 35) are retained to undertake a thorough quantification, calculation and commendation on the economic damages and losses that would have been suffered. The accountant is particularly sought in cases of criminal and civil cases.

The forensic accounting has always been classified under categories. These categories will determine the drafting of the letter of engagement. The categories are inclusive breach of contract or torts, business of personal disagreements, valuation of businesses, claims concerning professional negligence and crimes relating to fraud.

The aforementioned types of litigation Hoffman et al (2007, p 21) asserts that requires the accountant has sufficient information on the business and a thorough understanding of the business reporting system. In addition, the accountant should have vast understanding of the accounting procedures and principles. The understanding of the investigative and gathering techniques is equally important for the accountant to prepare for any such litigation.

The federal government, Federal Court of Australia (2008), may sometimes request for the income tax returns. In such cases, the independent accountant may have to prepare a report on the income of the client. This will be done by first writing the letter of engagement that will set out the terms of engagement and the between the client and the independent accountant. Within the letter the independent accountant will always specify he relevant information that may be needed of the information on which clarification may be sought.

The letter also specifies for the client the legal requirement that the client may have to ascribe to. In additions the letter will specify the legal responsibility that the client will have to take in the event that he contravenes the legal expectations. O’Connor (2005, p 63) argues that the letter ensures that no information is overlooked by both the client and the independent accountant and the right statements are prepared from the provided information.

Forthwith, it therefore becomes imperative that one understands the difference between an accountant and an expert accountant. While the accountant would be referenced mainly to a residential chief accounting officer, Peter McClellan (2007, p 24) argues that the expert accountant on the other hand will refer to an expert accountant who handles the firm’s statement only of a specific nature. For example, the resident accountant will handle all the financial matters of the firm while the expert accountant will only handle matters that would be incidental in the preparation of income tax returns. The expert accountant, Dunn et al (2002, p 54) asserts should also handles issues only on the request and as a contract with the client; the accountant on the other hand has the responsibility of handling the financial matters of the firm on as they arise basis.

O’Connor (2005, p 24) asserts that subject to the legal requirements or in spite of the same, the expert has no mandate to question the integrity of the accounting system for as long as it is outside its engagement mandate. The discovery of irregularities and defalcations is utterly out of the mandate of the accountant expert even where such exist. The expert may only render services such as would be incidental in the preparation tax returns for the firm.

Consultancy and expertise have sometimes been used interchangeably. However, there is a very elaborate functional difference between the two. The function of the expert will extend to the making of judgment strictly based on the facts. The testimony prepared in any legal proceedings by an expert within the mandate of Hoffman et al (2007, p 35) will be largely factual and with due logical support. The consultant on the other end has the mandate of offering options to any stalemate; the option will take both positive and negative orientation.

The expert will always be widely recognized as having techniques and skills that can be used in offering decisions that are justly, rightly and wisely informed. APES 215, (2004, p 31) records that experts are normally accorded status and authority by their peers with respect to particular and very specific domain. The expert will generally have extensive ability and knowledge on a domain and the knowledge will strictly be based of extensive empirical research.

Expert knowledge on the other hand is the capabilities amazed through experience or the occupation the person is undertaking. Besides, the expert may be by virtue of the training undertaken, the profession, publications or education or the credentials the person may be having through work experiences and accreditation and honorary.

Expert witnesses, Dunn et al (2002, p 55) argues should audit, analyze and inspect records, statement and transactions of financial nature. There also prepare and undertake a thorough review of statements that concern inventories assets and liabilities of business. InCalifornia, the experts serve as forensic consultants and expert witness in courts. Cases such as those that relate to inheritance may require the presentation of the valuation of the deceased’s estate value in court, this call for the services of an expert account.

Accounting experts also provide testimonies and reports prepared in an expert manner to the judges for purposes of litigations. Lawyers, insurance firms, attorneys and government agencies may also find the testimonies and the reports incidental. These records according Dunn et al (2002, p 55) will be used in court arbitrations and trials inCalifornia. Within the strength of this argument, independent experts become a very integral component of the Californian legal system.

Legal suites involving the contesting of wills find the services of the independent expert quite insurmountable. In cases of this orient, the complainant and the defendant alike may find it paramount to engage the services of the expert. The expert would be an expert accountant who may undertake the valuation of the estate for the purposes of presenting the information to the courts as part of the defense.

Businesses may be taken to court either by an individual or the government for tax evasion. In circumstances of this nature, the services of the expert accountant may also be sought as was mentioned earlier.  The expert accountant will come in to undertake a thorough audit of the financial position of the firm and prepare a report that would be presented to the court as part of evidence. While the resident accountant will provide any requisite information the evaluation of the position will strictly be left to the expert accountant.

Individuals sometime retire and have a lot of pains having their retirement benefits processed. The services of the independent expert would also assist in speeding up the process of benefits processing. The independent experts will adequately interpret the laws according to Dunn et al (2002, 49) concerning the payment of dues for retirees and collect information from their client, subject to the signing of the letter of engagement. Forthwith, the independent expert will advice the client and defends the client in a court of law concerning the suite that would have been prepared against the agency in charge of payment of the dues.

Hoffman et al argues (2007, p 32) that independent accountants have been termed as very effective inAustralia. Surveys show that the independent witnesses make litigation inAustraliarelatively fast and effective. While there have been a few cases cited inSydneywhere independent accountants were compromised to give misleading information. Nevertheless, according to the survey by Hoffman et al (2007, p 23) 95% of the independent experts have provided very incidental information to the legal system.

The isolated cases in the provision of information by the independent experts have been very exclusive to cases of estate valuation. Apparently the independent had been compromised by the clients to give information that would have the litigation rulings go in their favor. While these cases seem isolated, they have acted as eye openers for the judicial system in the largerAustralia. The isolated cases notwithstanding, the role of independent experts in the judicial system inAustraliaand world over remains crucial is the meting of justice.

The letter of engagement according to the ASAE 3000 (2006) has a number of issues that are made clear to both the client and the independent expert. To begin with the letter seeks mandate from the client on taking responsibility on behalf of the client on a particularly matter. Within the letter the independent expert will specify the information that he deems incidental and that will need to be furnished with the client. This information will be used in the preparation of the requisite documents, and assists in avoiding to overlook any pertinent information.

The letter of engagement according to Hoffman et al (2007, p 23) also seeks to clarify the legal responsibility of the client in the entire process. The letter acts a contract between the independent expert and the expert accountant through stating the terms of reference. Ideally, the independent expert through the letter of engagement assures the client on their commitment to pursue defense for their client to the very letter based on the information provided by the client. However, it needs to be appreciated that the independent expert is never an advocate for the client, rather, the expert only provide factual incidental information that can assist in the defense for the client.

Any contract according to the APES 215, (2004, p 43) will always indicate the monetary terms. Within the letter of engagement the independent expert specifies the fee that is to be paid by client on the commencement of the services and at the termination of the services. The letter also shows the duration of the contract with the specific area of coverage. The letter binds the parties through the signing of the letter once the client understands the inherent terms of engagement.

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The major question that haunts most minds is the future of democracy in a world that is full of unanswered questions and a world that has been torn by religious and ethnic strife. It is a world that has been stained by globalization instead of creating a great sense of oneness among different people thus bringing up barriers to amplified political and economic integration. This paper aims to discuss two articles; a case for consolidating democracy that was produced byPolandandUSAgovernments and ‘has democracy has a future’ written by Arthur Schlesinger, JR.

‘A case for consolidating democracy’ is a document that addresses on the existence of a spreading democratic malaise and also it highlights on the actions that would help to consolidate the already established democracies and also promote the spreading of democratic government. The second article by Arthur, he points out on the fact that democracy’s main threat is the social, economic and political forces. Arthur maintains and affirms that racial, religious and ethnic differences do undermine the democratic states. According to Arthur’s argument, democracy is defective and does not solve all problems that people wants to be solved. He attributes his reasoning to Madison who wrote that the division of the poor and the rich in the society is a global happening and it leads to division of interests which later leads to violence. The only thing that can assure freedom in a democratic nation is only checks and balances.

The authors’ main perspective in the article ‘a case for consolidating democracy’ is the fact that democracy is quite important and it is not just a tool for the rich people but for all citizens. However, despite the fact that democracy is crucial, bad governance and irrational policies have undermined the economic development. Democracy helps to foster good governance and true democracies can help a lot to remove all the corrupt, bad and ineffective leaders. The author asserts that good governance helps in fostering development and therefore will need a clear, accountable democracy and not just a matter of representative democracy.

The major bias that does influence the author of this article is the fact that he has represented the rule of law to be weak. He affirms that vast corruption do undermine the government, threats the economic and political stability and also separates the citizens and the leaders. He affirms that corruption is the major problem that has affected democracy but this is biased because there are other major factors like poor governance, lack of unity among leaders and poor leadership among others. These are some of the main issues that the author of this article has missed out. The author should have at least told us that in order to get an invisible democracy then a system of cosmic process will help in producing successful results. The author makes it clear that the most important factor to all the democracies is political will to enhance governance.

It is amazing how the author to an extent has revered and praised the democratic government. There is too much cynicism towards the leaders which is understandable and also epidemic. The author of this article has left a lot of information on how democracy can be reformed and only concentrated on a few.

The first means to reform democracy is by pushing the states in order to mandate the voter registration. Everyone knows that the major barrier to voting is the fact that citizens ought to register themselves first. The second means of reformation is creation of a voter registration list national wide. The third means is by finding more prospects of introducing all the underrepresented groups to the voting system. Other forms of reform are reaffirming in the law that voting is a major and crucial right, helping the poor to also participate in the campaigns for the funding and others.

Arthur in his article has pointed out on all the failures of the democracy and the reasons behind its failure for example the economic, moral and the political failures of democracy which led to totalitarianism, the computerized nation which affects the democratic politics, capitalism and others. He has however pointed at all the negative issues to do with democracy and has failed to offer solutions to democracy and how it can be corrected. He asserts that though democracy has a future, it is not usually the great future that was predicted during the triumphalism moment and it might not survive the centuries to come (Arthur, 1997).

That is a biased statement on the grounds that the author is so sure that democracy will not survive in centuries to come. Who is he to allege that it will not survive? He should give on some of the solutions to save democracy instead of dwelling only on the problems. Some of the factors that he could have incorporated are the strengthening of laws, curbing of corruption, introduction of firm governance and others. His main perspective is that democracy must withstand all the pressures to do with technology, race, capitalism and spiritual frustrations.

The two articles have given limelight to the issue of democracy and one evident issue is the fact that democracy today is not as appealing as it ought to be and there are various issues that need to be addressed in order to have a democratic nation that people would approve.

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Since HIV and AIDS epidemic began, more than half a million people have already died inUSAbecause of AIDS (Steven, 2007, pp. 1221-1228). Currently there are over one million people who are living with AIDS inUSAand approximately fifth of them are not aware that they are infected thus posing a very high risk of transmission (Clark, 2006).  The response of American’s towards AIDS has been producing some mixed results. Efforts to prevent HIV have not always been successful since each year around 56,000 people get infected (Mary, Harold, Joseph et al, 2010, pp. 105). In the year 2009,WashingtonDChad a prevalence of 3% infection among people who were 12 years and above (Michael, 2010, pp. 11). Discrimination and stigma towards people suffering from HIV is still persisting as thousands of people who are uninsured thrash about to access antiretroviral therapy and HIV care. Though HIV and AIDS is affecting and do affect all people inUSAthe impact and prevalence have been graver among some certain groups. This paper aims at analyzing and giving in details the distribution of AIDS inUSAby race and ethnicity and the social reasons behind the difference in prevalence.

During the early years of the HIV and AIDS epidemic, the most vulnerable groups inUSAwere homosexuals, Haitians, hemophiliacs and the injecting drug users (Blake. 2003, Pp. 81). Today, AIDS have continuously been affecting these groups though it has been a very serious problem among the black Americans as well as Latino and Hispanic population (Kathy & John, pp. 68).  It is not usually the individual behavior that determines individuals risk to HIV inUSAbut rather the individual’s sexual network. The black males are at high risk of infection because of the high prevalence of this particular community and the main tendency they have of choosing similar racial partners.

Wealth status also is a main determinant of the likelihood of infection inUSA. In a study done in the year 2010 by the Centers for Disease Control and Prevention, it revealed that inUSAthe poorest neighborhoods that lived in the urban areas had a prevalence of 2.1% among the heterosexuals (CDC, 2010). During this time, ethnicity and race did not account for the differences within the poverty groups that were studied.

The African American has been disproportionately affected by HIV epidemic in years. Today, the black Americans do account for approximately 51% of all AIDS related cases of deaths (William, Carlos & Robert, 2005, pp. 1313). Both the African American male and females are at high risk of being infected through homosexuality, injection of drugs and other factors like high levels of poverty, lack of effective healthcare as well as stigma that does surround homosexuals.

Poverty which is a major contributor to AIDS has affected most African Americans. Poverty as well as disadvantaged upbringing causes the youths to drop out of school thus preventing them from accessing stable employment and as a result losing their self worth. Nearly quarter of all Black Americans live in poverty (Linda, David & Caroline, 2008, pp 42).  Social background has also resulted to poverty thus leading to infection. Some of the social contextual factors for example racism have led to unemployment and inability of the Black Americans to get mortgage.

Stigma as well as discrimination has led life to be quite difficult for the people who live with HIV since it prevents public discussions and also leaves the people afraid to get tested.

Prisons have also contributed to the spread of AIDS onUSA. Approximately one in 20 black men is in prison (Paul, 2007, pp. 5). Most black males get infected in jails and hence infect their female partners when they are released.  The other social issue that has brought a major difference is the genetic factors. Most people of European descent have small genetic mutation and make them immune to resistance to HIV (James, 2008, pp. 13). It affects 10% of Caucasians. The Native Americans are less affected by HIV than the African Americans though they lack the CCR5 receptor mutation. (James, 2008).

Today, more than 230,000 black Americans have already died because of AIDS (Bethune, 2005, pp. 1-4). Approximately 40% of all deaths and of more than one million people who are living with HIV and AIDS inUSAalmost half of them are blacks (James, 2008). The estimated risk of infection of people with HIV is 1 in 16 for the black males and for the black females is 1 in 30 (Cynthia, 2010, pp. 272). On the other hand for the whites the risk of infection is 1 in 104 for the males and for the female is 1 in 588 (Cynthia, 2010, pp. 273). InWashingtonDCwhere there is high AIDS prevalence, 76% of all those who have been infected are all African Americans.

Hispanics or Latinos are also disproportionately affected by HIV epidemic inUSA. The number of deaths have remained stable since 2000 though there have been a decline in AIDS mortality. Some of the identified social factors that have led to the Latino community to be immensely affected by HIV are cultural factors, language barrier, and lack of health care, migration patterns which have led to barriers to treatment of HIV. The Hispanics do represent around 15% of the total population though they account for around 17% of all people living with AIDS and 17% of new infections (Dianne, 2007, pp. 255). The rate of new infections among the Latinos is double that of the white men and for women it is four times that of the white female (Dianne, 2007). In the year 2008, among 37 states, the number of American Indians who were diagnosed with HIV was 220. Other groups like Asian, Black Americans, Hispanics, Native Hawaiian, Whites and multiple races were 444, 21,289, 7,121, 33, 11,777 and 384 respectively (CDC, 2010). There have been few cases of AIDS that have been reported among the smaller communities and hence they require social and medical services that do burden the rural health system (Shari & Patricia, 2008, pp. 11-19).

Disparities have emerged among various groups inUSAbecause of various social factors. The African Americans have been most affected followed by the Latinos and the whites. Some of the social factors are stigma, poverty, homosexuality, discrimination, prisons, genetic factors, lack of health care, injection of drugs and others. To curb or reduce cases of new infections something ought to be done in order to address these social factors.

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Diminished responsibility usually serves to reduce the charges of murder to those of manslaughter. The defense of a diminished responsibility is available inAustralian Capital Territory. In Australia diminished responsibilities comprise of three main elements whereby the accused person must be abnormal, the abnormality must have risen from a certain specified cause and finally the said abnormality must have impaired the defendant’s capacity to comprehend his initial actions (David, 2001, pp. 10). Abnormality of the mind can be as a result of various factors. The mental health can be caused by factors such as injuries or diseases. In theAustralian Capital Territory, the court orders detention in custody until the Mental Health Tribunal says otherwise (Ian, 2005, pp. 479). This paper aims at analyzing the major legal consequences in treating patients without their consent.

Informed consent is usually a phrase that is used legally to show the consent that a person offers meets some standards. Informed consent is usually given basing on a patent implication, facts as well as bearing on the future consequences of a certain action. There are some acts which can not take place unless there is an informed consent. In a situation where people are usually considered to be unable to give consent because may be they are mentally ill or underage, another person for example the legal guardians or parents can come in. In some cases where a person is given insufficient information in order to come up with a reasoned decision, there are always some serious ethical issues that do arise from that.

Consent is usually quite complex when it comes to evaluating since neither the consent expressions nor expression of the comprehension of the implications might mean that a rational consent was given. In a country likeAustralia, a patient centered approach is usually taken. The informed consent of the jurisdictions hence requires that risks to be disclosed as well as the risks that are of relevance to the patients. The approach combines both the subjective as well as the objective approach.

The ability of giving a rational consent is usually governed by the requirement to be competent. In the jurisdictions of the common law, the adults are usually presumed to be competent to go ahead and give consent. However, the presumption is usually rebutted in scenarios where by there is an issue of mental illness and other incomptencies.

There are instances whereby the patients refuse to consent because of religious grounds and other issues for example the age.  For example in the Australian jurisdictions, there is a certain legislation that does allow some treatment forms for the minors without having the parents’ consent. In most parts ofAustralia, blood transfusion can be as well be given without the parental consent in case the child is in danger or in an emergency situation (Staunton & Mary, 2007, pp. 137). The standard consent inAustraliais usually established by common law. At common law incase of lack of individual consent to the medical treatment usually renders medical practitioners to be liable of damages of assault as well as battery (John & Philip, 1983, pp. 211). However, any emergency situation is usually an exception to the common law rule (John & Philip, 1983).  Emergency situations are circumstances where medical treatment is always required to save individuals life or better still prevent some grave injuries to health.

The medical practitioners should offer consent to the patients explaining to them the magnitude of their problems and what ought to be done. Before they embark on any serious treatment with the patient, they should first have the consent of the patients . However, in other cases of emergency consent is not required. Incase of breach of consent, the doctors are liable of damages.

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Manifest destiny was one of the 19^th century American beliefs of the fact thatUSA was meant to expand across North American continent from Atlantic seaboard all the way toPacific Ocean.  Manifest destiny and advocates believed on the fact that expansion was not just wise but quite inexorable and apparent. Between 1800 and 1850 the Americans experienced a marked change as far as national unity was concerned. The expansion boosted national unity between 1800 and 1823, the treaty of 1818 andLouisiana Purchase boosted the national unity as it helped spur up the era of wonderful feelings and also displayed loyalty.  It also marked the downfall of the federalists who were reduced to mere sectionalists. The expansion also helped in simulating the economy thus there was peace. However, the expansion also destroyed the national unity because of the outstanding issues of slavery and to an extent there was disunion between various groups (Ray & Martin, 1982). It separated the country leading to the Mexican American war. It led to the widening of the gap between the poor and the rich people.

Q2.      The industrial revolution was of great benefit to the economy and the economic development ofUSA. It showed the inventions of the weaving and spinning machines thus increasing theAmerica’s growth. It transformed the economy into a modern urban state of industrialization. Industrializations inUSAled to the expansion of the transport industry which had a great impact on economy (Margaret & Howard, 2005, pp. 478. The electricity was harnessed and there was improvement of the refining process and leading to an accelerated production. Generally there were transitions from the hand made products to the machine made. The home made products were also transformed to factory productions. Industrial revolution created more jobs to the citizens thus leading even to the printing of more money and growth as far as economy is concerned.

Q3.      In the 19^th century, a new industrial order led to the reshaping of theUSA. Some new systems like technology, resource development, transportation, invention, communications, labor, corporate management, finance and others boosted the industrial productivity and growth. Businesses expanded to curb the costs as well as competition and control efficiency and increase control. Workers found job satisfaction, power and the free time also reduced as the numbers of people in the factories mushroomed. The life of Americans was boosted. The new order was welcomed with mixed reactions of most Americans accepting it and being happy. They accommodated it and accepted some low paying jobs as well as lay offs and the creation of unions as they bargained for better wages. However, others rejected it through some mechanisms like absenteeism, slowdowns as well as quitting through forming radical unions for example Knights of Labor. The immigrants were the most favored by the industrial order and took advantage of it while most Americans responded rationally (Dominic, 2003, pp.6).

Q4.      In the American history, the term Gilded are is the era of rapid population and economic growth inUSAduring the era of post civil war. Many social, economic and political shifts were already taking place in the gilded age. One of the most crucial shifts in the architecture that took place in the great depression ended the state buildings and creation of public spaces for example parkways and parks.  The shift and the changes that took place were rather smooth. Through the designing of the country’s estate, the landscape architects had a prospect and opportunity of experimenting with a vast range of some design constructs. The architecture profession at this era thrived.  This impacted a lot in Americans coming to an understanding about themselves (Roosevelt, n.d).  It drove them closer to God and helpedUSAseparate fromEurope.  Spanning sinceJefferson’s time to transcendentalists up to today, the public space has had a major significance on Americans. The public spaces included city parks, state parks, parkways and others. The public space was created through the New Deal.  It led to issues like leisure and changes in aesthetics (Roosevelt, n.d). The public space was meant to relieve the urban stress caused by commercialization and industrialization for example the parkway.  These were also places that the Americans could redefine themselves. Some principles of picturesque naturalism were created and during this era of great depression, there were road constructions. The government also offered various jobs to those people who were unemployed so that they could build the required facilities. People participated in some leisure activities in the public spaces thus life was much better.

Q5.     The progressive era inUSAwas an era of reform that basically flourished during 1890s to 1920s.  Keeping the issue of corruption from politics was the main agenda of the progressive era. The progressive movement was essentially an effort of curing many ills that the American society developed during industrial revolution. It was driven by reformers that were focused on change both politically and socially. The success as far as progressivism was concerned owed so much to the publicity that was generated by writers, muckrakers who detailed on the horrors of urban slums, poverty, corruption, child labor and factory conditions. One of its success is that the reforms helped to pave way for the regional planning divisions and promoted local control as well as planning professionalisms ( Elisa, 2002, pp. 11). It also helped in unleashing a new pattern of the suburban development.  Despite some of the success it brought like cubing some social evils like child labor and others, it however had its weaknesses and failures. They differed in their analysis of the problems and how they were supposed to solve them (Thomas & William, 2007).  Other failures were failures of the planning system that comprised of divisions of planning authority.

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Hobbes is remembered as one of the greatest philosopher of late 16^th century and 17^th century. Hobbes was basically concerned about the political and social order. He sought to answer the question on how the human beings can avoid fear of civil conflict and live together at peace with one another. The focus of his study was on right of the individual, character of political order and the men natural equality. To explain his ideas he used the concept of ‘sovereign power’ and ‘state of nature’. According to Hobbes, a true legitimate political power should be made through people’ consent and be a representative of all being ruled by such a government. His viewed liberal law as one which allows people to do all that is not explicitly forbidden by such law.  Hobbes was a proponent of the materialism which claims that all things are constitute of material which result to material interactions. (Morgan 2005).

Hobbes proposed that people should be their obedience to group or person who they will empower to decide on their behalf on both the social and political issues. The group or person to be obeyed is what he referred as ‘sovereign power’. He claimed that, if this did not happen, state of nature will take its course and will be the only option to the people. To him, the state of nature is comparable to civil war where there exists universal insecurity, human cooperation is impossible and all people have no reason to dread about violent death. (Morgan 2005).

Much of Hobbes work was influenced by the conditions in which he lived in. England was undergoing through political, religious, military and economical upheavals.  The rich and the poor were all largely divided.  Inequality prevailed in the country while the upheavals of civil wars lead to rise of strong political and religious groups.  Hobbes was opposed to any challenge against the king.  Hobbes intellect was driven by two aspects. He was opposed to religious authority and theories that defended and accepted such authority. He was also interested in emerging scientific methods and geometry. These two aspects determined how he presented his views. Hobbes proposed that religious disputes should always be kept out of politics. According to him, the subjects duty to God should not override their duty to obey the sovereign power but it should also be the role of the sovereign authority to determine which religious believes suite its subjects. He used deductive science that always borrowed conclusions from basic principles. Based on human motivations and action he was able to propose a political system that he thought will ensure civic peace and disposition mankind in fulfilling their civic duty. (Morgan 2005).

Hobbes also described society as a population which should be subject to a sovereign authority. It is from sovereign authority all individuals should derive their natural rights and expect to be protected. He argued that abuse of power by the sovereign authority is acceptable as a price to peace. On the other hand, he claimed that rebellion should only be acceptable when severe abuse of power occurs. Sovereign authority should be allowed to control civil, judicial, ecclesiastical and military powers. To him, government does not exist in natural condition.  In such natural condition, it is only mother authority on child exist since the child is much weaker than the mother and need her to survive. Among the adults the case is different. Any adult is capable of killing the other. The weakest are capable of persuading others to kill the strongest when he/she is at sleep.  Adults are equal in one way or another. This makes them able to threaten one another lives. (Morgan 2005).

State of nature is unlikely to develop an authority that will order human beings lives. Based on this, he opposed the religious claims that monarchs had God given right to govern over people. Thus, it is the role of human being to free themselves from the role of nature by organizing a form of government to which they will grant powers to make social and political decisions on their behalf. He claimed that any attempt to undermine such government will lead to unsuccessful move away from disorderly state of nature that will result into social and political conflicts. (Morgan 2005).

Hobbes also claimed that cooperation of the arms supporting the government will also determine how first the society will transit from state of nature to artificial state where their affairs are run by a one sovereign authority, peace and cohesion are prevalent and all people are subjective to the orders of the government.  Any attempt by the government supporting arms to separate is doomed to bring awful consequences unless some effective authorities replace these arms. (Morgan 2005).

Hobbes asserts that peaceful cooperation will not exist at all in the absence of overarching authority. The human beings will not live in security and peacefully without a government.  In absence of the government, people will not only compete but also compete violently in effort to secure basic needs of life and also further other material gains. Individuals will challenge others and fight, which is an occurrence that will be propelled by the fear and urge to ensure personal safety. Additionally, individuals will seek reputation/glory for no reason and also be protected from others harms and ensure that others will be afraid to challenge them. (Morgan 2005).

However, his critics claim that his work viewed human beings as solely self interested.  Others argues that this view lead to misconception of how people can live together peacefully without having to submit fully to group or individuals supposed to make all their social and political decisions. His claim that only an unaccountable sovereign can ensure order in the society has also received different views. In our present world, justification of human authority is very imperative.  Some rules are also accepted by few, political and social inequalities also continue to be questioned, and religious disputes are eminent and disputed.  Thus we still live a world where rights to all need to be allowed without discrimination.  However as Hobbes concern was, there is a need to establish who will enforce this. This links to political powers. Who should be entitled to this power? This is the question which Hobbes was trying to answer.  Some critics of Hobbes’s argument that only subjection to a sovereign group or person could result into order, have been basing their argument on existence of authoritarian authorities which have lead to more disorder despite being sovereign.  John Locke also argued that human beings cannot live together in absence of persuasive and effective justifications of power. He also claimed that there should be well established systems to ensure that political authority do not overstep their authority and deny their subjects of their rights. (Morgan 2005).

Hobbes argument is that individuals are selfish, coward while others are vainglorious. Others possess all these traits. Many individuals will opt to use violence as mean of attaining their ends in cases where some forces do not exist to stop them. His claim that some individuals behave fearfully, selfishly or vaingloriously has some truth in it.  If an individual thinks somebody is a threat he/she would rather attack first. One will gather reputation, as someone who is powerful and unbeatable if he thinks to have so many potential attackers. It is the wickedness of bad people that compel good people to have recourse as they seek to protect themselves especially in war time.  He also claimed that it is also hard for covenants to take place in state of nature society. One party will tend to fail in performing its part as they are no contracts enforcing authorities. The agreement is only likely to be performed by the weakest. Trust in which much of human cooperation relies on will not exist. State of nature will not develop trust and this will not allow for many human society achievements. This argument is based on the necessity of reciprocating fairly to others.(Morgan 2005 p568).

 

As a solution to result of state of nature, Hobbes argued that government/sovereign authority should be established by the people. Such authority will set up well established framework of law, clearly stating the judgment and punishment and also provide for enforcement of such punishments. Although it may be argued that individuals may have reasonable sense of what is wrong and right, absence of government will make individuals unwilling to be subjective to this reasonable sense of right and wrong. There also exists difference among individuals of what is right and wrong. (Morgan 2005).

Additionally, individuals will naturally seek to ensure their self-preservation. Such urge may lead them to act violently against others. He also urges that, individuals under state of nature not only have the right to ensure their self preservation but also judge what will secure them self preservation. Hobbes, claims that human never judge wisely. Morals in state of nature are relative. The absence of trust and feeling of insecurity will push the individuals not to solve their misunderstandings peacefully. No one has a right to judge others doings as bad. Every person is a judge of his/her own and be ready to face the counter reaction of others. The war of every man to every man will never cease. In nature of state, notion of justice and injustice, right and wrong do not exist. Individuals have a right to everything including others’ body and lives. No authority to object any individual desire to acquire an object, ones labor, and have other person killed. (Morgan 2005).

Some Hobbes critics perceived that his claim of absence of moral constraints in human living in the state of nature was a bit misleading. They believe such individuals will only exist in the absence of social interactions where idea of what is right or wrong will never exist. They argue that, this is viewing human beings as if they have emerged from earth as mushroom does.

They also term it as a mere description of interaction of amoral and selfish human beings. (Morgan 2005).

Based on such view of state of nature, Hobbes give a case why sovereign authority is important in ensuring disorders in the society are eliminated. He claims that judgment should only be sole province of the sovereign. However his claim will only be accepted by those who are less optimistic about human judgment.  His claim that individuals have unlimited obligation to the sovereign authority is also unacceptable to those who believes in democracy where liberty maximization is emphasized as the government continues to rule over the subjects. (Morgan 2005)

Despite this criticism, it is universally agreed that peaceful coexistence among people is indispensable.  It should be sort through all means even it means sacrificing some liberty, going through inconveniences, and even making some compromises. State and law are very necessary to ensure enforcement systems in the society so as human beings may cooperate peacefully. However, it is unacceptable to have only one judge as he/she may turn out to be very faulty given that human judgment is faulty and weak.  The great concern should be how to divide power among various individuals and peacefully adjudicate moral and political judgment.  Institutions and standards that provide for compromise on different conflicting judgment should also be established. With such consideration, Hobbes work will contribute towards finding a solution to ensuring peaceful coexistence and disposing of mankind toward fulfilling their civic duty.

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There are four major socialisation agents that will determine the development trends of any child. The family is the major socialisation agent for any child. The parents model the child during their formative developmental stages. Research on how the influence of the mental health status of the parents can be contained from influencing the personality of a child is therefore long overdue.

This paper seeks to identify the extent and the frequency of influence of the mental illness of parents on the self esteem, social identity and the social relationship of a child. The paper attains this objective through a qualitative research undertaken. The paper finds a positive correlation between the aforementioned aspects; hence due leverage for the research course. The paper then makes recommendations that it does deem salient that would be incidental in alleviating the state.

CHAPTER FOUR

4.0 Research Findings and Discussions

4.1 Introduction

This chapter undertakes a thorough analysis of the research findings that were gathered via the research instruments. The data collected is analysed using charts and a summarizing statement given thereto and relative to the research hypothesis, research question and the purpose of this research. Clearly, in one way or other, the mental health of a parent or parents have an effect on the self esteem, social relation and the social identities of the children.

 

 

4.2 Analysis of the findings

4.2.1 The Effect of Mentally Challenged Parents on the Self Esteem of Children

The self worth of any child seems to be largely hampered in circumstances where the parents have some mental challenges. The research showed that those children who have parents with mental challenges tend to avoid having friends or even for those who had friends they had the least preference having them come visiting.

Children with parents who have mental challenges are not readily appreciated by the parents. Or at the very worst, the children are admonished by the parents. This makes the children have a feeling of their self worth being lowered or lacking at all. When the children were asked about whether they are appreciated by their parents, most of them felt that their parents never showed their appreciation for their worth.

 

Children with parents who have mental illnesses are not adequately appreciated by their parents. According to skinner, this affects the overall self esteem of an individual. Appreciating the child makes the child to feel being worth.

Most of the parents with mental challenges tend to use derogatory statements on their children. This makes the children have a feeling of a lowered self esteem. Parents who have mental challenges use words such as ‘stupid’, ‘lazy’ among a host of others indiscriminately. This tends to utterly lower the self esteem of the children.

 

 

The chart shows that children whose parents are mentally challenged are prone to reproach and chide. Basically, a combination of these makes the children feel devoid of any self worth.

4.2.2 The Effect of Mentally Challenged Parents on the social relationship of Children

When children with parents with mentally illnesses were asked about whether their friendship was affected by the fact that they parents had mental challenges, a large proportion of the children agreed that they had opted not to have friends because of the conditions of their parents.

 

The reason for which the children may not invite friends to their homes is because they tend to feel that if their friends visited and noted the condition of their parents their self worth would be lowered and demeaned.

The evaluation of the self worth of any individual is always based on the friends and the family of any individual. It is, perhaps, for this reason that most of the children with parents who have mental incapacity have to avoid having their friends to come and visit them.

The children who had mentally ill parents also showed dissatisfaction over the need for their friends visiting. The children thought that perhaps if their friends new about their parents, their self worth would be undermined. Overall, this has an effect on the social prospects of the children. This also contributes to the fact that most of the children who come from such families will avoids going out for social functions. The feeling is that they will be the object of reproach.

It is evident from the data that children whose parents have mental challenges will do anything to avoid social events and joints. The reason is that they feel that they may be the area of focus for their peers.

4.2.3 The Effect of Mentally Challenged Parents on the social identity of Children

Any child will always feel safe being identified with their parents. If the child is separated from their parents, the children seem to feel as being robbed of their social identity. The children who had been separated from their parents felt as missing something when they were separated from their parents.

In affirming this, the research showed that children who had parents with mental illnesses were more likely to spend their time for schooling at home to take care of their parents. Within the mindset of these children they

It is evidently clear that children whose parents have mental challenges will do anything for their parents with the presumption that they may get well and reduce their social stigma. It is from the stigmatizing experience that these children have that they will always feel empathetic for anybody with mental disability.

The data collected concerning the empathetic behaviour of the children adduced this assertion. The children whose parents have mental illnesses have increased empathy to the mentally challenged persons because they have had a real touch of how it feels being parented by such parents and have the least wish that anybody else does.

This chapter gives sufficient evidence that the self esteem, the identity and the socialisation prospects of any child whose parents are mentally ill will always be affected. This affects the approach of any child towards the way the child interacts with others and the learning process.

CHAPTER FIVE

5.0 Summary Conclusion, Discussion, Recommendation and Implication Summary

5.1 introductions

The parent child relationship, according to Uysal, is distressed if the parents have mental illness. According to Nicholson et al, Parent-child relationships are frequently distressed because mentally ill parents have very poor nurturing capabilities and this tampers a blow on the social development of the children. In addition, parents who had mental illnesses are seen as less concerned with the sociability of their children.

This study brings out clearly the effects that the trauma of having a parent who is mentally ill will have on any child. Given that the self esteem is a very cardinal aspect in the learning and the socialisation prospects of any child, this study is in all aspects justifiable. The concentration of the learner will always be hampered if the learner feels that his/her self esteem is low or if he feels his identity is threatened.

The study had sought to identify the effects of the mentally ill parents on their children’s social relationship. Clearly from the gathered data, it can be inferred that children whose parents are ill will prefer being alone. Where they make efforts to socialise, they tend to avoid having their friends meet with their parents.

5.2 Discussions

The research also had a cardinal purpose of identifying the effects of the mentally ill parents on the self esteem of the children. Because the research does show that mentally ill parents rarely appreciate their children, it is indicative that the children will tend to feel less acknowledged. Acts such as the embrasure of children lacks in such families; yet this gesture is a show of appreciation of the children. The absence of this gesture makes the child feel that his self esteem is low.

The paper had another central objective of finding the correlation between the mental illness of parents and the social identity of the children. The children with parents who had mental challenges were found to be making all the efforts to avoid social places with their peers. This hampers the sociability of the child. Given that the research addresses these salient aspects, it inherently validates its purpose.

The study had three research questions that were meant to be answered by the end of the research. The research ardently answers the three research questions that centrally guided the research. The three questions were effectively addressing the issue of the influence of parenting on the personality of the child.

It is very apparent that children whose parents are mentally ill have lower levels of socialisation. The children tend to do this because they feel having mentally ill parents is more of a social weakness or at most this condition will be equally attributed to them. This makes the children avoid in total or in part social places.  It is resultant from this that the children whose parents were mentally ill would not invite their friends to their homes, neither would they freely go out with their friends.

The children believe that if they go out with their peers, they would simply end up being subjects of discussion and scoff for their peer because of the condition of their parents. While the peers may not be aware of the conditions of their parents, the child’s subconscious convinces them that the peers are in fact aware of the conditions of their parents.

Once the children get used to avoiding their peers and social places, this affect their social relationship and equally their personality. Overall, the social development of the children is dully affected and equally affects the learning process of the children. There should be alternative ways of averting this scenario to avoid ugly personality traits resultant from this parental influence.

The evaluation of the self is normally based on how the other people evaluate the child. This starts with the parents. In cases where the parents are not able to fully appreciate the parents because of their mental illness, the child’s self esteem remain low through their life. Brem et al argue that self esteem is based both on the self and the group. Hence, if the group creates a negative impression of the child, the child feels that his worth is low.

Parents, in this context, who are not able to appreciate their children make the children feel unworthy and hence the lack of self esteem. In retrospect, parents who are mentally ill may not appreciate their children. Though the child might understand that the parent is mentally ill, it affects the child in the long run. Some of the parents who are mentally ill are recorded as having the least mode of appreciation for their children even when they do the right thing.

Mentally ill parents, the research gathers, more often reprimand their children and names call them. This makes the child live with the feeling of being unappreciated.  In addition, the children tend to end up believing that the only way out was reprimand and abuses.  Children who have the least worth directly make them feel as having the lowest self esteem. In this way, the research adequately answers the second research question on whether having mentally ill children will affect one’s self esteem.

The research equally reveals that while some of the children may not want their friends to come visiting because they do not want them to understand the condition of their parents, the children will do anything for their parents to have them recuperate. This implies that the role of the parents, despite being mentally ill, is highly appreciated by the child. The child makes efforts to stay home with the parent with a presumption that the parents may just get well.

The research also reveals that children whose parents are mentally ill have high degree of empathy than those who do not have such parents. It is apparent that children who have gone through these experiences understand the plight of those in this condition and would not wish that anyone else be in such a condition. This act of being empathetic has an effect on the personality traits of the child; hence the condition makes the sociability of the child exclusive.

The children whose parents are mentally ill also tend to feel low about their own social identity. Given that the mentally ill parents look less accommodating, the children tend to also limit their perception of others. Subsequently, they end up having accommodation of other people, particularly their peers. The lack of accommodation would be evidenced through the fact that such parents appreciate their children neither do they embrace.

During the early years of development the reinforcement of the children behaviour is of central vitality; hence ignoring this centrality just deals a blow on the personality of the child. Through the address of these salient issues, the research answers the third question which seeks to find the correlation between a child’s personality and the mental health of their parents.

The study makes the hypothesis inherent in the research alternative. In deed, the presence of mentally ill members of the family deals a blow on the social and personality development of the child. The social relationship, the self esteem and the social identity of the child is negatively impacted on with this phenomenon.

The methodology used in the research was interviews and the use of questionnaires. The data collected was analysed using qualitative methods that yielded results that were sufficiently indicative of the fact that the there was indeed an empirical relationship between the personality of a child and the mental wellbeing of the parents. While the method would have lend itself to a number of bias, the results were quite representative of the ideal state.

The bias was relatively low given that only those who had interacted with children in such circumstances were sampled to complete the questionnaires or to be interviewed. Given that the children who were in this condition were given the first priority, the research reduced any biases considerably.

The sampling procedure was multifaceted; randomised and then stratified. This further reduced the bias as mentioned above. The respondents were given a period of two weeks to ensure they had ample time within which the questionnaires would be completed. Those who were interviewed, selected randomly, were give a formally appointment to avoid cases of ambush.

The research’s reliability was ascertainable as the research instrument used were only destined to adduce whether mental illness of parents had any effect on the self esteem, the social identity and the social relationship of their children. Clearly, the research was very specific on what it was destined to determine. In addition, the strategies of the research were developed to ensure that under similar research objective(s) and research question(s), the research would yield similar results.

Given the tidal role of personality in the teaching learning and development processes, the research reliability was treated in high esteem. A high protocol of the research was therefore upheld. This was meant to ensure that anyone who had the interest of determining the reliability of the research was dully satisfied with the research outcome under similar research questions and objectives.

The research’s validity was measurable through the research’s central object of establishing the correlation, if any, between a child’s self esteem, social identity and social relationship and the mental wellbeing of the parents. The research instruments remained geared toward adducing this correlation.

The efficacy of the applicability of the finding from the research to other cases external to this research was also informative of the research’s validity. The research’s construct validity sufficed the research’s central object. Resultant, the research found due leverage for further research and follow-ups on the findings.

5.3 Recommendations

This research finds sufficient correlation between the state of health (mental) of the parents and the personality development traits. Traits such as self esteem, self identity and social relation are determined through the way the parents interact with their children. Clearly, parents who have mental illnesses have exclusive interaction with their children hence affecting the sociability of the children. The following recommendations are worth adoption in such circumstances.

Children whose parents are in acute mental illness condition would be separated from them early enough before they start sensing the parental shortfalls. This would assists in averting cases of children loosing their personal esteem resulting from parental reprimands.

If the parents happen to lose their mental capacity when the children are of age, the children should be separated from their parents before their personality gets devastated. Where the children are so attached to the parents to be separated, the children should be offered frequent guidance and counselling to ensure their self esteem, social identity and social relationships are not affected.

5.4 Implication for Future Research

It is apparent that however strong the child may be, there is a reasonable level of damage the mental illness of the parent has on the self esteem, social identity and social relationship of any child. Future research therefore has much on its account that would be done if the state has to be alleviated.

Most importantly, future researches need to seek to find means and ways through which the parents can appreciate their children even when they are mentally ill. This would assist boost the self esteem of the children whose parents have mental illnesses.

Future research should also seek the best counselling methods that would have the children with mentally ill parents remain socially sober despite the reprimand and the lack of appreciation from the parents.  This will assist the children socialise positive regardless of the mental state of their parents. Overall, this will assist develop the right personality traits amongst the children.

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The Boeing Company is a defense and an aerospace corporation that was founded by William Boeing inWashington. It has expanded over many years and merged with McDonnell in the year 1997. Boeing developed military jets for example B-47 Stratojet as well as B-52 Stratofortress bombers in the year 1940s and 50s. The D1-9000 is a Boeing company document which does address their supplier and the internal system. It establishes AQS tools, the supplier quality rating, the basic system and finally the advanced quality systems (AQS, 2000). The company relies immensely in common ground that a quality system is established and hence it forms a platform for a continuous effectual improvement. The Boeing Company which has been the leader of aviation and aerospace is widely known because of its skilled engineers. Millions of the commercial passengers fly their jets. Boeing has providedUSAgovernment with the best fighters and the bombers as well as the systems of missiles. It is therefore imperative to embark on some of the techniques the manufacture systems used in their company.

Computer Integrated manufacturing systems involves the entire integration of all manufacturing enterprises through using data communications and integrated systems as well as other data communications in order to enhance the personnel and organizational efficiency. The objective of CIM is to simplify the entire production design, processes as a major foundation to integration and automation. It integrates the entire productions and also does support all processes using the computer networks, business software and other technologies (Kraebber & James, 2004).

A manufacturing system involves the configuration of the computer controlled workstations where by materials are usually handled as well as machine loaded.  Most of the Boeing employees are familiar with the lean concepts, global manufacturing, and supplier relationships. An efficient and a lean manufacturing operation is the main heart of the Boeing system of production and are very useful to the commercial airplanes as far as the global market and competition is concerned. The company is liable in managing some of the defects as well as continuing to focus on quality in all the production lines in order to remain successful and competitive.

Its production system involves various elements that do work to ensure there is an output of highest quality of the cost effective services and products in the least time. Its principles which involve six sigma, lean manufacturing, value streams, the global manufacturing as well as managing all the supply relationships are some of the elements that are quite critical as far as the competition of the company is concerned.

One of their prospects comes when they are managing their value stream which involves building of the airplane. It does represent the entire production of building the airplane from the raw materials to what we can call as the finished output. One of the main methodologies that help the Boeing Company meet all their challenges is the ‘six sigma’. It helps the manufacturers in their major quest of designing, building as well as delivering perfect products through reduction of variation and defects hence enhancing quality that results in cost savings.

The ‘six sigma’ usually refers to all the manufacturing processes which produce quality at 3.4 defects in a million opportunities (Debby, 2003). For Boeing Company to integrate the manufacturing systems in their company it had to come up with a production model that catered for issues like raw materials, capital, energy and labor. As far as raw materials are concerned, they usually work with other third parties known as TMX who help in logistics that involve the allocation of the raw materials to the subtier and the major suppliers. They work closely with their supplying base in order to get a clear picture of demand across the entire industry. They have strong teams that comprise of the procurement group that belong to their major suppliers (Debby, 2003). It consistently works with their workers and suppliers in order to ensure there is a steady supply of the raw materials that are needed in the vast production.

The company has a labor team that are responsible in implementing and defining the corporate strategies in maintaining and attaining technical excellence that includes enhancing all yields of Boeing’s investments that are technologically related. The aerospace process of manufacturing comprises of a complex scenario that ought to be validated so that manufacturability can be determined as well as low production costs.

The manufacturing processes and systems are combined with the simulation of technology in order to reduce the costs. A flexible manufacturing system is a stable or flexible automation whereby various tools are usually linked together via a material handling system and hence all the system’s aspect is controlled by one central computer.

The manufacturing classification usually depends on the type of product to be manufactured and is classified according to how the merchandise is usually produced in the entire manufacturing system and how customer demand is satisfied by the production strategy. During the manufacturing system classification, the production operations are usually divided in five groups. First the aerospace company has to come up with a project and lay down the strategies that are integral and those that are of benefit to them. Then there is the job shop manufacturing whereby it is a process of production where the manufacturer receives the engineering specifications from customers and then utilizes on the intermittent method of production because of a limited demand by the customers (Kraebber& James, 2004).

The project category under classification is comprised of many parts of a similar kind in order to come up with a similar thing. The other classification is called repetitive which has various characteristics.  It makes sure that the order for the repeated business is 100% and the fact that the orders have a fixed routings on the machine production. The line classification entails delivering at a shorter time than the stipulated time of building it. Finally, the continuous classification of the manufacturing system entails more characteristics like the fact that product is quite predictable.

The strategies of production are based on some factors like the manufacturer pace and time as well as the customer’s. At Boeing Company, the production strategies were used in matching the manufacturer to their lead in order to integrate the raw materials.  They had to accept a long lead of manufacturing since engineering design was also part of the process. That is called the ETO or the Engineer to Order stage.  The other match is the Make to Order which comes after the design and engineering process has been proven. In the Assemble to Order match or stage, all the parts of the final product are carried into a finished inventory and the Company had to determine or verify it. Basically the market underwent market research whereby they lay their options, strengths and weaknesses and opportunities. During market research they analyzed other big companies that were doing well and their competitive strategies.

The second is management review whereby they had to discuss about the entire project and air their views. Design engineering is the third stage, then production engineering, manufacturing and finally the customer use. That was the main product development cycle that they used to come up with competitive products.

In carrying out all these strategies, they had to have some corporate goals, visions and missions in order to perform all the financial functions and also plan. The customers are the main target and they had to watch out on the competitors too.  During the stiff competition they underwent, the company announced in the year 2003 about 787 and the fact that it was to be assembled in its factory which was inEverett.  Instead of having to come up with a complete aircraft, the final assemblies do employ about 800 to around 1,200 people who are to join completed subassemblies and also integrate some systems.

Steps taken in order to realize mass customization is in two areas. One is the Product Design for the Mass customization and then the Mass Customization manufacturing system. Things like aircraft and automobiles are quite complex and the Mass Customization Manufacturing usually faces divergent challenges in achieving critical goals of the reduced production cost and lead time.

The Boeing Company is one of the most successful Companies globally. For it to apply the manufacturing systems it underwent various processes in order to gain acceptance from the customers. It has gone various phases of competition with other successful companies. The manufacturing system is quite beneficial as it offers effective finished output despite the issue of time constraints.  Finally the manufacturing system enables the possibility of the customer coming to the product.

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Fraud, waste and abuse prevention in Medicare is a hard task that needs full commitment of those entrusted in it. It should encompass government oversight, key compliances processes, training and disciplinary procedures.

For any of these actions to succeed types of fraud, waste and abuse in Medicare should first be understood. Fraud, waste, and abuse include comes in terms of false claims. It practically means asking the government to pay an item or service that was not or should not be provided. It is an attempt to steal from the government. It is an attempt to defraud the government. False claims include request for payment s for altered, forged prescriptions: Shorting, which entails partially filling the prescription quantity prescribed but at the same time charging for full prescription with no arrangement to pick up the remainder: Submitting the same claim twice or double billed prescription: Claims that are submitted to multiple payers for same prescription: Claiming for a more expensive brand name prescription drug when a generic was dispensed: Prescription of drugs supposedly dispensed as written although they were not:  and finally improperly keeping an overpayment. (University of Phoenix .n.d.)

False Claim Act is one of the federal government efforts to prevent this crime.  This act prohibits consciously presenting false payment claim to the federal government, forcing someone else (e.g. a plan sponsor or pharmacy Benefit Manager) to submit a false claim for payment to the federal government, making or using false documents to get a claim paid by the federal government, scheming to get a false claim paid by the federal government, avoiding or decreasing obligation to pay or reimburse the federal government through making or using a false record. In addition to this, the False Claim Act also protects who reports plans to defraud the federal government i.e. the whistle blowers. The act prohibits any retaliation against employees who report or aid in investigation of false claims. It also states that there should be no negative employment consequences such as being demoted, fired and being suspended from the employment.  Additionally, the act provides for potential remedies to any retaliation which include job reinstatement accompanied with double back payment and any other necessary special damages. (University of Phoenix .n.d.)

The other measure has been federal penalties. Various federal penalties could include heavy financial penalties, criminal prosecution and exclusion from participating in Medicare and Medicaid. A company employee or an individual may also sue anyone involved in fraud on behalf of the government. To encourage such moves by individuals, the plaintiff is entitled to a share of total award while the remainder goes to the government. State false claims acts have also recently been increasing in number. Deficit reduction encourages state false claims statutes

The government has also sought anti-kick back statutes which make it a crime to knowingly and willfully offer, pay, solicit or receive any remuneration to encourage reward referrals of patients who receive items or services under government health care program coverage.  Those involved in such acts may be imprisoned, fined, excluded from Medicare and Medicaid, face very costly civil penalties,  or be prosecuted under various similar state laws. (University of Phoenix .n.d.)

It is possible to bring dispensing and billing complaints against pharmacies: such complaints may be against deceptive marketing about plan benefits, cases where billing for drugs is not provided, billing to someone else plan card, illegal substitution of drugs, overcharging and other issues related to pricing,  asking extra uncompensated amount from  the beneficiary, any gift given as an incentive to enroll in a particular plan and directing beneficiary to a certain plan in exchange for payments by that plan.(University of Phoenix .n.d.)

 

Setting up of compliance programs make sure that statutory and regulatory requirements are met.  This should be ensured through setting code of ethics to ensure medical practitioners are committed legal and ethical obligations, clearly specify all employees duties, and inform employees of the consequences of not performing such responsibilities. Strict enforcement of such code of ethic should be emphasized. Including compliance officer will also help prevent waste, abuse and frauds in Medicare and Medicaid. The compliance officer duties should be to enforce code of ethics, development, implementation and enforcement of the program, oversee the compliance training, development and implementation of a compliance system, following up all cases of alleged frauds and abuse, reporting any potential fraud and abuse to the relevant authorities, conducting internal audits and monitoring provision of the services as well as billing practice. (University of Phoenix .n.d.)

In addition to this, it may be necessary to establish a compliance committee depending on company size. This committee should work hand in hand with the compliance officer and also provide an oversight and direction to the compliance officer. Plans to operate compliance programs should also be instituted. This should include the reviews of the contracted pharmacies and also partnering with other non company parties in conducting the compliance activities.

Those who work under Medicare and Medicaid programs should undergo training to familiarize the trainees with issues of waste, fraud and abuse, educate them about obligations under the program, spotting and reporting fraud, abuse and waste, the rights of those who may report potential waste, fraud and abuse. The confirmation of annual training should be met. Such training may be specialized or general. Employees who are more intimately involved in providing services under federal health care programs should undergo specialized training that will focus on additional elements relevant to them. Employees who need specialized training are those who deal with dispensing drugs, filling claims, billing coding, sales as well as marketing of health care products and services.  Reporting of the cases of potential fraud, waste and abuse should also be made easy.  It may be directly to the supervisor, appropriate department or through a centralized system at place of work. Confidentiality of this information should also be assured as the law requires. Sponsors to plan may also have hotlines for reporting beneficiary or subscriber fraud, waste and abuse.  In reporting of suspected non compliance, the reporters should be urged to report much details as possible which should include the description of the of the type of conduct at issue, individual suspected of the conduct and any documentation which reflect the conduct in question. The investigation of the case may be required to call upon the reporter for more information and the outcome will dictate the necessary action, such action may include corrective measures to avoid such future occurrence, any of the stipulated disciplinary action or both. Other steps may include making a referral to federal law enforcement agency, relevant plan or authority. Follow up of any timely made complaints should be emphasized.  It should to the knowledge of all employees that they have a duty to report any suspected fraud, waste and abuse as well as cooperate in any resulting investigations. Any employee who fails to live up to such duties should be subject to disciplinary action, termination or retraining. The compliance officer together with the human resource and legal departments should work together in determining action to be taken against any employee who fail to live up to this duty. (University of Phoenix .n.d.)

It should be made a law and essential part of Medicare and Medicaid Programs Company not to retaliate to any employee who reports, potential fraud, waste or abuse in good faith. Retaliation should not be imposed and be tolerated even in cases where good faith allegations are not sustained after the investigation. The employee who reports such cases should not be subject to reprisal, disciplinary action or reprimand, fired and demoted. The non retaliation policy should however not protect poor work performance and therefore individual who report wrong doings may be subject to disciplinary action owing to poor work performance or violation of any set policy. (University of Phoenix .n.d.)

Disciplinary procedures for non compliant conduct should take the following course:  First, appropriate department should conduct an investigation which should include an interview with the potential witness, review the documentary and determine the appropriate method on a case-by-case basis. The second step will depend on the outcome of the first step. If non compliance conduct is found, some steps may be taken. Compliance officer should notify the appropriate officials, remedial action such as reprimand, suspension, retraining, moving the non compliant employee into another position or termination may be taken. Corrective action may also be taken so as to avoid occurrence of similar non compliance instance in future. It may also be necessary to notify the appropriate federal authority. Employee found not to have complied can be excluded from participating in the provision of health services under federal health care programs. (University of Phoenix .n.d.)