ShantanuT01/DACTYL-Pretraining huggingface dataset:
Summary The International Statistical Classification of Diseases and Related Health Problems (known as ICD) is a significant issue in the healthcare system maintained by the World Health Organization to provide a clear guide on how to make a correct diagnosis and manage healthcare properly. There are several versions of the classification developed in different periods. The current paper aims at discussing the benefits and challenges of the transition from ICD-9 to ICD-10 and explaining the main characteristics of ICD-10 in regards to hospitals, payers, and staff. Benefits of ICD-10 over ICD-9 People get access to a more expansive and detailed system within the frames of which such activities like coding, billing, or reimbursing became possible. ICD-10 has a number of benefits over its predecessor. Manchikanti, Falco, and Hirsch (2013) say that ICD-10, as a medical classification with certain disease codes, the description of signs and symptoms, and patient complaints, affects payers and providers considerably and “is expected to exceed both the Health Insurance Portability and Accountability Act (HIPAA) and Y2K in terms of costs and risks” (p. 86). In comparison with ICD-9, ICD-10 has an easier way of comparing mortality and morbidity facts and improved quality of information about diseases (Centers for Disease Control and Prevention, 2015). The facts about disease severity, the complexity of conditions, and laterality are available. The sections about pregnancy and postoperative periods are considerably improved as well. ICD-10 has 69,000 codes with a detailed description of a disease compared to ICD-9 with its 14,000 codes with some brief facts about a particular disease. ICD-10 Potential and Real Challenges ICD-10 is also characterized by challenges for hospitals, staff, and payers. These real and potential problems should be identified as soon as possible to overcome serious troubles in the future. The changes in the healthcare infrastructure are based on the necessity to re-evaluate clinical documentation and the processes of insurance claims. Hospitals may face management challenges like the necessity to inform people about the innovations, spend certain time on learning the system, and meet the deadlines set by CMS. More detailed descriptions lead to different diagnoses and classifications of diseases. The staff has to learn the innovations within a short period of time. This switch to ICD-10 requires more organizational changes. The process of ICD-10 mapping is the main challenge for the payers, who prefer to use GEMs. Payers have to add or delete several codes to get non-problematic access to the new coding system. Hospital Activities for October 2015 Implementation To get ready for October 2015, the date of an implementation of a new ICD-10, many hospitals try to take certain steps and learn better the possible challenges and misunderstandings that can take place. The major activities of hospitals are as follows:  1. Software upgrading;  2. The evaluation of clinical documentation;  3. The analysis of the already known nuances of the ne
Introduction The Ethan Couch care is one of the most famous recent examples of the use of affluenza defense in criminal court. Essentially, affluenza defense argues that the person has “a diminished sense of responsibility due to his [or her] wealth, pampered childhood, and absentee parenting” (Zurcher par. 3). The case of Ethan Couch, a 16-year-old teenager from a wealthy family, gained national attention in 2013. On 15 June that year, Ethan was drunk driving, lost control of his car and hit several pedestrians, four of whom died in the incident (Zurcher par. 2). In this case, the wealth of the teenager’s family was used to his advantage and presented in court as a mitigating circumstance. The lawyers argued that having been raised in a wealthy family, Ethan had little sense of the consequences of his actions, which led to irresponsible behavior that harmed people (Zurich par. 3). The judge agreed with the defense, deciding for the teenager to be sent to a high-end California drug rehabilitation center, paid by the parents (Zurich par. 1). Ethan received no jail time for killing four innocent people, which lead to a national uproar, both in the press and among the public (Zurich par. 1-2). Indeed, the sentence was too soft for the nature of the crime and its consequences. Moreover, the case highlighted the biased nature of the United States justice system: the entire affluenza defense rests on the fact that people from wealthy backgrounds should not be held responsible for their actions in the way that middle or low-class people are. The ethical and moral controversy that surrounded the case and the defense argument used can be described using two philosophical theories: brute-luck egalitarianism and moral relativism. Brute-Luck Egalitarianism The theory of brute-luck egalitarianism stands on three main principles. First, that the outcomes of actions that are not deliberate are unjust (Knight 1061). Second, that the outcomes of deliberate gambles are unjust (Knight 1061). Lastly, the theory argues that results are just in the cases where the individual’s choices are not influenced by his or her luck (Knight 1061). In the case with Ethan Couch, brute-luck egalitarianism can be applied in his defense. Here, the family’s wealth can be viewed as an example of luck or gamble; in this way, if Ethan’s actions are seen as the direct outcome of his family’s financial status, the damage incurred as a result of these actions is unfair. Apparently, the affluenza defense presented the case in a similar light, linking the teenager’s drunk driving, which was the ultimate cause of the incident, to his family’s position and his upbringing. Therefore, the strategy of the affluenza defense in Ethan Couch case can be best outlined as the following sequence. First, the lawyers connected the crime directly to the family’s wealth. Second, they utilized the brute-luck egalitarianism theory, effectively arguing that since the family’s affluence was not the result of Ethan’s deliberate actions or choices, then the crime should not be treated as such, too. Moral Rela
Brief Definitions It is often the case that incredible natural landscapes and landforms become so commonplace if humans live nearby that they cease to inspire natural grandeur and interest. Nevertheless, such areas remain areas rich in both biodiversity and geophysical dynamics. One such ecosystem has been chosen for discussion in this paper. It should be emphasized that the term ecosystem used in this paper is considered a natural community characterized by a constant cycle of energy and resources, the presence of consumers, producers, and decomposers, as well as the interconnection of biotic and abiotic components (Knapp, 2020). The area chosen in this work is a mountainous terrain, which is a three-hundred-meter wooded green hill, which is dominated by trees. This ecosystem is familiar to the author because of its close proximity to home: thus, the author has visited this upland area several times and studied flora and fauna. Exploring Aspects of the Ecosystem Flora and Fauna The biotic component of the selected ecosystem is a unique combination of animal life unique to biogeocenosis. In fact, the mountainous terrain near the house is represented by wild fauna, characteristic of the classic Canadian coloration. Here one can find small animals that feed mainly on the bark of trees or fruits of small plants: these include hedgehogs, wild hares, and cats, some species of local birds. At the same time, mountainous terrain has a structured trophic chain, so phytophages become victims of zoophagous of the first and then of the second level, as shown in Figure 1. It should be noted that the figure gives information about some dangerous animals, be they gray wolf, bison, or grizzly. The auth
Introduction Tobacco use, including smoking, has become a universally recognized issue that endangers the health of the population of our entire planet through both active and second-hand smoking. Pro-tobacco arguments are next to non-existent, while its harm is well-documented and proven through past and contemporary studies (Jha et al., 2013). Despite this fact, smoking remains a widespread habit that involves about one billion smokers all over the world, even though lower-income countries are disproportionally affected (World Health Organization [WHO], 2016). In this essay, I will review the dangers of tobacco use and consider some of the remaining pro-tobacco arguments to demonstrate that no reason can explain or support the choice to smoke, which endangers the smoker and other people. The Dangers of Smoking Almost every organ and system in the human body is negatively affected by tobacco, which is why smoking is reported to cause up to six million deaths on an annual basis (WHO, 2016, para. 2). The figure is expected to grow and increase by two million within the next fifteen years (Centers for Disease Control and Prevention [CDC], 2016a). Smoking can cause cancer in at least sixteen organs (including the respiratory and digestive systems), autoimmune diseases (including diabetes), numerous heart and blood problems (including stroke and hypertension); in addition, it damages lungs, vision, and bones, and leads to reproductive issues (including stillbirth) (U.S. Department of Health & Human Services, 2016). Moreover, nicotine is addictive, and its withdrawal symptoms include anxiety, which tends to cumulate and contribute to stress (Parrott & Murphy, 2012). Other symptoms may involve mood swings and increased hunger, as well as thinking difficulties (Centers for Disease Control and Prevention [CDC], 2016b). Sufficient evidence also indicates that smoking is correlated with alcohol use and that it is capable of affecting one’s mental state to the point of heightening the risks of development of disorders (Cavazos-Rehg et al., 2014). In the end, smoking reduces the human lifespan, as a result of which smokers are twice as likely as non-smokers to die between the ages of 25 and 79 (Jha et al., 2013, p. 341). Fortunately, smoking cessation tends to add up to ten years of life for former smokers, if they were to give up smoking before they turned 40 (Jha et al., 2013, p. 349). Similarly, the risk of developing mental issues also tends to be reversed to an extent, but it is not clear if it becomes completely eliminated or not (Cavazos-Rehg et al., 2014). The CDC (2016b) also report
Discussion Masculinity is changing not just in the West, but worldwide as well. Director Neil Jordan represents this aspect in the 1992 movie “The Crying Game”. It shows the nature of a man who is weak despite being a revolutionary. He is shown being overshadowed by his women and love interests and this is very new concept, particularly in the Hollywood movies. This is because society has changed in recent years and along with it, the image of gender has also changed. The processes for masculinity are changing because, in part, the institution of family is itself transforming. In traditional societies, the family system tended to take the form of the extended family. In extended families, more than two generations of the same kinship line lived together, either in the same residence or in nearby dwellings. All adults in these extended families shared responsibility as a whole but the centrifugal force always stayed within the capacities of the patriarch. Then, during the Industrial Revolution, the nuclear family became the most common familial system, at least within the Western nations. In the modern world, the smaller nuclear family structure held many advantages over the traditional extended family. Nuclear families helped to promote geographical and social mobility. Smaller families also tended to spend less money simply because there were fewer individuals to provide for. (Chaudhuri, 62). This important social change would have profound effects on how man would be looked. While the nuclear family offered increased economic feasibilities, the man and wife- who now had to raise the children on their own- sometimes found child rearing to be exhausting and a burden. In addition, the children- to a considerable extent separated from most other family members- would sometimes find themselves alienated from these extended family members. In many respects, the nuclear family engenders a sense of loneliness within offspring. This had a fundamentally derailment of the male offspring psyche. In the last few decades, the number of “non-traditional” families has skyrocketed. These family structures include single-parent families and reconstituted families (nuclear families in which at least one member is a survivor of divorce). These “non-traditional” families pose special problems for children and particularly for the male child who needed support that is more moral during the growing period. Often, the head of the household in single-parent families does not possess the financial resources to take care of the offspring properly. In addition, some heads are so busy with work and other adult responsibilities that they cannot provide adequate supervision for the offspring. Reconstituted families face the difficult challenges of creatin
This paper studies trauma services available in Maryland and locally, in Silver Spring. It describes the structure and components of the system, presents the assistance offered at different levels of care, and indicates its strengths and weaknesses. The paper also estimates the degree of disaster preparedness of the local trauma system based on its capability to manage major incidents and studies the available sources of additional aid. Trauma Services in Maryland Maryland Institute for Emergency Medical Service Systems (n.d.) presents several local centers providing trauma services. The R. Adams Cowley Shock Trauma Center of the University of Maryland Medical System serves as a primary adult resource center. The Johns Hopkins Children’s Center (Baltimore City) is the center for pediatric trauma care. The Johns Hopkins Hospital also provides services for level I and level II trauma patients. Level II trauma centers include Prince George’s Hospital Center (Cheverly), Sinai Hospital of Baltimore (Baltimore City), and Suburban Hospital (Bethesda). Meritus Medical Center (Hagerstown), Maryland Regional Medical Center (Cumberland), and Peninsula Regional Medical Center (Salisbury) provide level III trauma care. The closest centers available in my area are in Bethesda and Cheverly. Structure and Components of the Trauma System According to Soto, Zhang, Huang, and Feng (2018), the staff of Emergency Medical Services is the initial source of care for injured patients. After the assessment, the patients are referred to the hospital medical professionals that provide care according to the level of trauma. For example, in Maryland, institutions of all levels have resuscitation units, operating rooms, and intensive care units available at all times (Maryland Institute for Emergency Medical Service Systems, n.d.). The assistance of trauma surgeons is offered at any time in levels I and II facilities and within 30 minutes of call for the patients requiring level III care, including on-call neurosurgeons in levels I and II. Anesthesiologists at all times are available in the level I and II care institutions but are shared with other services, and there are on-call professionals for level III traumas. Strengths and Weaknesses of Trauma Care Systems The research by Brown, Rosengart, Billiar, Peitzman, and Sperry (2016) states that Maryland has a relatively low injury fatality rate (up to 53 per 100,000 population). It means that the emergency medical services systems (EMSS) are effective in providing trauma care. The primary strength of EMSS in Maryland is that all medical professionals that are usually involved in trauma care are available either at all times or within 30 minutes of call. The main weakness of Maryland EMSS is that the state does not have maximized placement of trauma centers, which can be proven by the little number of available institutions (Brown et al., 2016). For example, people living in smaller cities have to be transferred to other locations to receive help, which may require 15 minutes to 2 hours. Disaster Preparedness Estimation In my o
Introduction: Rushed Decisions and Their Negative Effects To close a financial deal, one must make sure that every argument should be weighed and considered carefully. When considering the purchase of a car, one must be aware of the legal specifics of the process, as the case of Jim and Laura shows quite clearly. Despite the fact that they seem to be the victims of at least a misunderstanding, if not a fraud, they have little to no evidence to prove that they are right and that there was no legal contract. Detecting the Elements of a Legal Contract From a legal perspective, a contract comprises four essential elements, which are “mutual assent, consideration, capacity, and legality” (Cornell University Law School, n.d., par. 1). In the suggested scenario, both sides of the argument agreed to close a deal, which means that a mutual assent took place. The consideration, which implied carrying out a discussion of the agreement, can also be detected. Seeing that both the dealer and the prospective buyers were eligible for closing a deal, the capacity requirement can also be considered fulfilled. Seeing that both parties agreed to hold a care for a day, the procedure also meets the legality requirement. Therefore, it can be deemed as a contract, though not a written one (Federal Trade Commission, n.d.). The Contract That Was Not: Analysis As explained above, the scenario described in the case under analysis meets the contract criteria. However, the lack of any evidence that could point to its existence may be viewed as an impediment to proving that the agreement took place. In other words, for the contract to have a binding power, it should have been signed as a legal document. One might argue that the contract was based on a promise that the couple misguidedly made to the dealer. However, it should be borne in mind that, in this case, the dealer should have been aware of the threats that a verbal agreement implies: “Certain promises that are not considered contracts may, in limited circumstances, be enforced if one party has relied to his detriment on the assurances of the other party” (Cornell University Law School, n.d., par. 2). Evidence and Its Assessment: Wishes and Facts One might make a very slim argument that there was a promise of a refund in case the customers decide to refuse from purchasing the car. Indeed, according to the case details, the dealer did make a promise that the couple will be eligible for withdrawing their money and receiving it back. Nevertheless, neither Laura nor Jim has the evidence that could be used in court as the proof of their statement since there was no third party that could support their claims (State Government, n.d.). Conclusion: Caution as the Means of Avoiding Fraud Therefore, the case in point can be viewed as a graphic example of fraud that, unfortunately, cannot be proven. It could be argued that Jim and Laura could take the issue to court by filing a lawsuit against the dealer. However, they must keep in mind that, when it comes to the processing, it will be their word against h
Bill Campbell’s Actions on Saving the Company Bill Campbell was an example of a great CEO and manager. He worked for several outstanding organizations, and his wise actions were always highly esteemed by colleagues and people from outside the places where he was working. The key element of his decisions always was the social awareness factor. Campbell realized that his resolutions, as well as the decisions of his colleagues, had an impact on hundreds and thousands of people. Sometimes, when a person is in business for a long time, he/she starts disregarding the needs of the subordinates. Bill, however, was not such a person. He always managed to balance the benefit for the company with the prosperity of every single individual working for that company. It is no wonder that he acquired a nickname “coach” – he was always there, always ready to help out and support, and constantly willing to find an exit even from the most complicated situation. Bill Campbell’s exclusive managerial abilities were shown many times during his successful career, but the case with Inuit stands out and gives an opportunity to discuss his empathetic feelings and his wise decision-making. Bill’s Empathy towards the Employees One of the key issues discussed at our lecture was empathy (Margolis, 2017). It is a rare quality in people, and it is extremely scarce in those involved in the business. Empathy is an ability to percept other people’s feelings and emotions and talent to treat others in correspondence with their emotional feedback (Margolis, 2017). While some people consider that business is not a place for empathy, it is, in fact, a crucial feature for a good leader. Only by understanding his/her employees will a manager realize their attitudes and be able to convince them that his/her choices are beneficial for them. Building empathy at a workplace may seem a difficult task, but it can be learned by practice. There are three key steps in developing empathetic conduct: paying attention to what people are trying to say, being aware of non-verbal signals, and being ready to face various reactions and responses (Margolis, 2017). In the case of Bill Campbell, the empathetic treatment of the employees was what saved the company at a critical point. Campbell used his empathetic skills to organize the process two times: firstly, in the situation with a layoff, and secondly, in the case with the manager who was insubordinate and contradicted his orders. When Intuit faced the need for a layoff, Campbell realized that it would be a tremendous burden. Still, he wanted to save as much faith of the employees as possible, and he wanted to show them that the company really cared ( Leadership in focus , n. d.). The pe