Super Leadership Is A New Form Of Leadership Education Essay

Super Leadership Is A New Form Of Leadership Education Essay INTRODUCTION Super Leadership is a new form of leadership for the era of knowledge-based enterprises distinguished by flat organizational structures and employee empowerment. A super-leader is one who leads others to lead themselves through designing and implementing the system that allows and teaches employees to be self-leaders. Super-leaders help each of their followers to develop into an effective self-leader by providing them with the behavioral and cognitive skills necessary to exercise self-leadership. Super-leaders establish values, model, encourage, reward, and in many other ways foster self-leadership in individuals, teams, and wider organizational cultures. The purpose of this paper is to develop and test a model of super leadership and creativity. This paper will practically contribute to the literature on super leadership and creativity by examining the relationships between them. This study is in continuation to the study conducted by DiLiello and Houghton (2006) in which a model was suggested that the employees having strong super leadership qualities will have more creative and innovative potential. Moreover, they will also practice a high level of innovation and creativity, when they feel a strong support from their supporting workplace. In a broader perspective, super-leadership is an effective mean of developing a shared and pervasive environment that support idea generation and creative problem solving. Succinctly, it is believed that an organization that encourages super leadership is likely to experience higher levels of creative and innovative processes among its employees which can flourish useful ideas and ultimately enhance organizational effectiveness. Significance and Rationale of the Study The question arises that why super leadership phenomenon is important? The answer is that the function of leadership is to produce more leaders, not more followers. Employee self-leadership is the key to success in the new economy. So, having super-leadership, followers are treated in a proper way and thus turn into super leaders. If super leaders are successful in providing strategic alignment and coaching people, they develop followers who are productive, work independently, and need only minimal attention from the super leader. The rationale of this paper is to test and present results based upon a hypothesized model about the relationships between Super-leadership and idea generation/creative potential. In short, our model will test the hypothesis as if strong Super-leaders are more likely to have higher levels of idea generation/creativity potential than weak Super-leaders are. Such a model may be of great benefit to organizations that are looking forward to change due to market dynamism through the creativity and innovation of human resources of Super-leaders. As argued by Neck and Manz (1996), pragmatic Super-leadership research studies advocates that employees having Super-leadership line of action, enhances their individual performance and, at large, organizational performance, than an employee who does not practice Super-leadership approaches. In current era of rapid globalization, Super-leadership strategies enhance organizational capacity to flourish in the face of the challenges of the twenty-first century. Research Objectives The bulk of the literature on management and leadership tends to focus primarily on the dynamics of the common organization. This study will be a welcome addition to the abundant literature on Leadership Studies in organizational settings. At some level, one of the minor intentions of this study is to trigger an impetus that will prompt other academics and scholars to take on the topic of leadership and management at a wider range and with more comprehensive objectives. The main focus would be to explore the link between super leadership behavior and creative potential through idea generation for a innovative and creative culture within organization. Research Questions The research questions in this case are presented as follows: What is the relationship between super leadership and creativity potential? How super leadership provoke an employee to perform at its best level? REVIEW OF LITERATURE Why to shift from traditional leadership to Super-Leadership? Super-leadership, sometimes also called as Self-Leadership, may be defined as the way to lead others is by leading oneself (Manz and Sims, 2001). The main difference between traditional leadership management concept and Super-Leadership is the main focus on followers rather than leader itself, and especially the belief of improving followers capacity to lead who are effective self-leaders. Therefore, concisely, super-leadership is the way of leading others to lead themselves. As argued by Sims Manz (1996), for super leadership behavior to be implemented, a leader has to adopt 10 most significant shifts from traditional approach of leadership in order to move towards super leadership approach. First thing first, the leader helps out the team members/group to switch from external observation to self-observation. Secondly, the focus is on moving from designated goals to goals that are self developed. Thirdly, organic control is exercised by team/group members i.e. external reinforcement for task performance changes in to internal reinforcement with an addition of external reinforcement for self-leadership behaviors. Fourthly, leadership prefer to motivation techniques not only based on external compensation but also based on the natural rewards associated with work. Another step is that the leader shifts the group to focus on self criticism rather than external criticism from the organization, which often creates bad impact upon team/group members. Sixthly, there is a move from external problem solving towards self-problem solving techniques. Seventhly, there is a shift from external job assignments to self-job assignments. Also, leadership moves from external planning to self planning and from external task design to self-design of tasks at step eight. Ninth step focuses that any problem or issue arises should be treated as an opportunity instead of threat by the group/team members. Finally, commitment to organizations vision rather than its compliance only is more important that leadership needs to help the employee to create. Having focused to improve employees effectiveness, self-leadership phenomenon attempts to concentrate on various issues that an organization might come across in this era of rapid globalization. Supervisors and work conditions can have some sort of control mechanism in a work place (Manz and Sims, 1980) but the inner drive that initiate organic control, or intrinsic motivation to work, take place from within the person (Herzberg et al., 2003; Manz and Sims, 1980; Sergiovanni, 1992). It is always stressed that true leadership comes from within and at the end, achievement streams from follower self-leadership (Sims Manz, 1996). It is asserted that one can lead in a better way if able to develop and use individuals skills and capabilities at workplace (Manz and Sims, 1980). As advocated by Manz (1986) and Manz and Neck (2004) as organizational members are trained and permitted to utilize self-leadership strategies, a candid control mechanism is put in action. Finally, the Super-Leader must develop an environment where employees are free to fail and improve after taking risky decisions and can learn in a true sense. However, risk must be calculated enough and apposite autonomy to fail is of vital importance. We can say that the Super-Leader should promote learning, if the mistake took place in team/group members. Yet again, the Super-Leader must exercise a balance approach in terms of risk taking behaviors i.e. to become aware when one can let mistakes occur or otherwise (Sims Manz, 1996). Intrinsic Motivation The key to stimulate creativity in organization is to foster individuals creativity, for which the easiest human element is to alter an individuals motivation. Majority of empirical research findings in line with this statement are reported from the field of social psychology of creativity and are referred to in the literature as the intrinsic motivation principle. According to Amabile (1988), an intrinsic motivation of individuals towards a task/job has two sides. First, the persons natural preference towards such type of activities. Secondly, the way individual perceive and know the reasons to undertake that task, which is dependent upon external social as well as environmental factors. This second element is the simplest way to affect creativity of an individual and by using motivation i.e. intrinsic one, is one of the easiest approaches to do so as motivation needs less amount of time/money to boost up a creative individual. Moreover, the task or assignments that more complex and challenging with a freedom to decide on how to carry out assigned tasks are expected to foster intrinsic motivation that, sequentially, increases creativity (Amabile, 1988). Amabile (1996, 1997) comments that intrinsic motivation is one of the perspiration phases of the creative process that individuals may seek to bypass, moving too quickly to the more intrinsically motivating idea generation phase. On the other hand, rigid adherence to rules and regulation has a tendency to negatively affect creativity. For case in point, Amabile (1998) pointed out that rigid rules and centralized decision making reduces creativity as intrinsic motivation to do task reduces creativity. Due to centralized decision-making and rigid control, information flow within organization reduces as well. As creativity needs free access to information, this will, in turn, reduce the generation of new ideas. Similarly, in another study by Amabile (1997), intrinsic motivation arises when the task itself is a source of interest, enjoyment, self-expression, and personal challenge. Likewise, Ryan Deci (2000) pointed out that intrinsic motivation is a result of internal reinforcement to perform a task rather than in response to external reinforcement. A prior research foundation shows that formal organizational controls restrict individual freedom and thereby dampen intrinsic motivation required for creativity (Amabile, 1996; Shalley, Gilson, Blum, 2000). George and Zhou (2001) established in empirical terms that those individuals who demonstrate meticulous behavior at workplace and are particularly unremitting attitude towards workplace compulsions display low levels of creativity. In addition, intrinsic motivation is more indomitable on interesting tasks and less importunate on uninteresting tasks that require discipline and concerted effort (Gagne and Deci, 2005). Besides, creativity is improved by positive affect (Davis, 2009; Grawitch Munz, 2005) as a positive affect promote a forward move rather than evasion (Carver, 2001; Erez Isen, 2002), which ultimately improve individuals perception to perceive a task as an opportunity rather than a threat (Higgins, 1997) and to deal with issues rather than retreat (Amabile et al., 2005; Frederickson, 2001; Seo, Barrett, Bartunek, 2004). Much of the literature cited above created a foundation that intrinsic motivation is a basic ingredient for creativity, and that intrinsic motivation is hampered if the formal and rigid control in organization is simultaneously implemented. Self Efficacy According to Bandura (1998), perceived self-efficacy is defined as a firm belief about ones capability to give desired performance that ultimately affects their lives. Self-efficacy beliefs reveal that what people feel, think and how they can be motivated. A super leadership strategy augments to improve self-efficacy perceptions and refine regulation processes, having significant impact on individual task performance (Houghton Neck, 2006). According to Konradt, Andreßen and Ellwart (2009), self-leadership impact on individual performance was partially mediated by self-efficacy perception, while autonomy characteristics showed no significant effects. Neubert and Wu (2006) showed a strong positive effect on creativity and work role performance. Carmela, MÃ ©tier, and Weisberg, (2006) and DiLiello and Houghton (2006) have found that self-leadership is a strong predictor of innovation as perceived by coworkers and managers. DeRue and Morgeson (2007) posited that individuals with general self-efficacy attribute success to ability and failure to insufficient effort. Chen, Gully, and Eden (2004) indicated that general self-efficacy is a motivational belief or judgment about personal capabilities that influences personal action in a wide variety of situations. Self-efficacy beliefs develop over time and through experiences (Maddux, 2002). Self-efficacy refers to beliefs about personal capability to produce a desired effect by individual action (Bandura, 1997). Self-efficacy helps explain the behaviors people will engage, how long they will persist, and how much effort they will expend to reach their goals (Satterfield Davidson, 2000). People with high self-efficacy may be more likely to overcome difficulties through self-initiated change, more likely to be goal-directed and more persistent in the achievement of that goal (Maddux, 2002). Self Determination Individuals will be intrinsically motivated if the task increases their feelings of competency and self-determination (Deci 1975). Self-determination means having the freedom to be in charge of your own life, choosing where you live, who you spend time with, and what you do. It means having the resources you need to create a good life and to make responsible decisions. It also means choosing where, when, and how you get help for any problems you might have (Cook, Petersen, Jonikas, 2004). As far as self determination of employee is concerned, behavior focused strategies are about enhancing ones self perception of personal performance during task resolution, in order to adjust self behavior towards task achievement. Through self observation, self setting of goals and objectives; self reward administration; self punishment and self cueing; it maximizes behavior effectiveness and helps reducing negative issues related with the task (Houghton Neck, 2002; Manz Neck, 2004; Neck Houghton, 2006). Self Regulation Self-regulation refers to thoughts, feelings and actions that are planned and adapted to the attainment of personal goals (Zimmerman, 2000). As described by Schunk and Ertmer (2000), Self-regulated learning includes: Setting goals for learning Concentrating on instruction Using effective strategies to organize ideas Using resources effectively Monitoring performance Managing time effectively Holding positive beliefs about ones capabilities. Self-regulation can be improved through appropriate guidance, modeling of effective strategies and creating supportive and challenging contexts (Boekaerts and Corno, 2005; Perry and Vandekamp, 2000). Many of these strategies develop from early childhood well into adolescence (Boekaerts, 2006). Self regulation is a complex notion. It allows us to consider the interrelationships between key concepts such as self-efficacy and motivation within a single framework, rather than exploring these areas in isolation. Even though several theories suggest that employees draw from a broad repertoire of behavioral strategies to enhance their creative performance (e.g., Ford, 1996; Frese, 2000; Rank et al., 2004), there are only a handful of studies that have empirically investigated how employees behavioral strategies facilitate creative performance. In a study, Binnewies, Ohly, Sonnentag (2007) found that employees, who engage in effective communication, perform more creatively. Similarly, there is cumulating evidence that employees use proactive strategies such as feedback-seeking behavior and voice behavior to enhance their creative performance and/or make suggestions for change (e.g., De Stobbeleir, Ashford, Buyens, 2008; Van Dyne Le Pine, 1998). Such findings highlight the self-regulatory potential of employees in the creative process. We expect different proactive strategies to be crucial in the different phases of the creative process. For example, it may be that factors such as communication and feedback-seeking behavior are critical for idea generation, as feedback from other people with relevant knowledge and experience might help to improve and refine the initial idea the creative person came up with. Similarly, one could expect that proactively targeting people in the organization will be related to successful idea promotion. Existing contacts with people from top management might be used to speed up the process of acquiring resources and spreading the word in the organization might help to acquire the political power needed. Idea Generation and Creative Potential Idea generation to be one coherent phase of the creative process (Kanter, 1988; West Farr, 1989). Zhou (2008) substantiated the interpersonal character of idea generation as highlighted in recent literature on creativity. Furthermore, the creation of ideas instigates the interaction between the individual and its social environment. For idea generation, the broader (organizational) context needs to stimulate interpersonal contacts as much as possible. An open, helpful, somewhat informal culture, in which people can easily call on others, facilitates formal and informal social connections and idea generation. Creative Culture Everybody has a role to play as citizens and consumers, culture and creativity, at the same time, help deliver new, more sustainable ways of living and working. Creative people can assist in exploring and presenting a different world, if and only if, their skills and expertises are properly exploited and recognized as one of the major means of transformation. In todays era of rapid globalization characterized by enormous economic, social and environmental challenges, the development of a genuinely creative culture should play a part to deal with such type of challenges. So, it can rightly be said that the culture that we create, will determine our fate. As matter of fact, organizational culture has been acknowledged as an important precursor of creativity. A creative organizational culture necessitates to focus on quality, communication, work groups, cross-departmental collaboration and visible support for change and innovation (Kanter, 1988; Pillinger West, 1995). It pertinent to mention that the impact of organizational culture on the different phases of the creative process has not yet been empirically investigated. It can be assumed, however, that organizational culture with its strapping influence upon all processes in the organization (Cameron Quinn, 2005; Ekvall, 1996; Sharman Johnson, 1997) is crucial and vital during the entire creative process. THEORETICAL AND CONCEPTUAL FRAMEWORK A hypothesized model of the relationships between super leadership and idea generation and creative potential is shown in Figure 1. Research hypotheses for each of the relationships will be developed. The new hypothesized model suggests that a strong basis to build work environments that support of idea generation and creativity at the individual, group and organizational levels by practicing super leadership among the members of organizations. Theorists like (Manz and Sims, 2001) have suggested a relationship between super leadership and creativity. Based on the prior research done, a hypothesized relationship that can clearly be plotted between creativity and self-leadership is given as below: Figure 1 Research Questions/Hypotheses The research questions in this case are presented as follows: What is the relationship between super leadership and creativity potential? How super leadership provoke an employee to perform at its best level? Because a strong super leader is predicted to be a self-motivated, self-determined, self-regulated, having a broad sense of self-efficacy, the hypothetical theoretical model proposes the following relationship in terms of hypotheses as presented below: H1: High level of Intrinsic Motivation leads to super leadership behavior among employees. H2: High level of Self-Determination leads super leadership behavior among employees. H3: High level of Self-Efficacy leads to super leadership behavior among employees. H4: High level of Self-Regulation leads to super leadership behavior among employees. H5: Demographics Characteristics of employees serves as moderating variables that augments super leadership behavior among employees. H6: Super leadership behavior greatly gives rise to idea generation and creative potential of employees. H7: Idea generation and creative potential among employees stimulate and invigorate creative culture within organizational settings. METHODOLOGY The research will be approached based on an interpretivism view. Interpretivism is the necessary research philosophy for this study because it allows the search, of the details of the situation, to understand the reality or perhaps a reality working behind them. The study will be exploratory in nature because it aims to determine the present facts as well as facts that are not yet explored about the phenomenon. Exploratory research will enable the study to look at the problem in both descriptive and exploratory manner. It will look into the problem by exploring the views of different sets of respondents, as well as by exploring different literatures related with the study. This paper analyzes potential factors of super-leadership and creative culture were analyzed using LISREL 8.8 and SPSS 14.0 softwares. The study is comprised of testing certain hypotheses and overall proposed model analysis using Structure equation modeling technique. Data and Sample As the Electronic Media especially TV Channels are directly related and linked to idea generation and creativity, which leads to creativity in such organizations/firms, a representative sample from Electronic Media especially TV Channels in Pakistan, has been selected based on random sampling basis from a list of TV Channels available on web. A total of 200 respondents have been targeted as a sample for this study from different TV Channels functioning within and outside Pakistan. Measure/Instrument Development Questionnaire has been developed by the researcher for this study to be used as the survey instrument. The questionnaire developed was divided into two main parts, the first part being demographic profile of an employee such as Age, Gender, Experience, Job Position, Organizational size etc and the second part was based on super-leadership and creative culture dimensions/characteristics. The various items on Super-leadership dimensions include certain factors such as intrinsic motivation, self-determination, self-efficacy and self-regulation. The items are adapted from various creativity studies. Moreover, items for idea generation and creative potential and creative culture were developed from few creativity-based studies such as Eisenberger and Aselage (2008), Eisenberger Rhoades (2001) and McNeely Meglino (1994). Moreover, all the measure have been developed and pre-tested for its reliability and validity through face and content validity by the group field experts and professionals. Also, standard statistical test used for questionnaire reliability testing. The responses for 49 items scale, after pilot testing, were calculated on five points Likert-type scale, which ranges from 1-5 i.e. Strongly Disagree to Strongly Agree. By using different scales developed by the researcher for demographic profile of an employee, which has different ranges between two-points (e.g. gender) to five points (Likert Scale), the data from respondents was collected in five weeks. Reliability and Validity of Instrument The reliability and validity analysis for the scale measures used in empirical research is of prime importance due to several reasons. This ensures the results and finding and its predictive power which means a clear prediction about the proposed hypotheses (Flynn et al., 1994). Similarly, Nunnally and Bernstein (1994) suggested that for testing unidimensionality of data, to check internal consistency and reliability of items used in the measures, Cronbachs alpha statistics is basic tool to calculate and generally, its value should be above the acceptable threshold of 0.70. Moreover, George et al. (2000) explained that Cronbachs alpha is the basic criterion for reliability issue of scales being utilized. Foregoing in view, the items of scale in each construct as mentioned below were tested using coefficient alpha value for each construct as exhibited in Table 1. Table 01: Reliability Statistics Constructs Cronbachs Alpha 1 Intrinsic Motivation Items .81 2 Self-Determination Items .76 3 Self-Regulation Items .83 4 Self-Esteem Items .88 5 Idea Generation and Creativity Items .84 6 Creativity Culture Items .82 As a mater of fact, the Cronbachs Alpha values for measure items used in this study are ranging from 0.76 to 0.88 as shown in Table 01, which exhibits reliability of measures developed. This totally in line with argument of Bagozzi and Yi (1988) that combined reliabilities measures of constructs used in particular study must exceed the 0.70 only then results can be relied. Besides, in order to check potential multicollinearity issue in the data to confirm discriminant validity of construct used, the correlations of possible related constructs were also computed. This recommended by Hair et al. (1998) by arguing that no single pair of measures should have correlations among them more than the criterion i.e. 0.9 and above. So, the computed values exhibited below portray that multicollinearity in the data construct is not reported among the study constructs that we used. The correlations values are shown in Table 02 given as follows:- Table 02: Correlations LC RATP TR EV MOS Interest Gender Education LC 1 RA TP -0.1473 1 TR EV 0.0508 0.1421 1 MOS 0.1212 0.1749 0.6144 1 Interest 0.0338 -0.0329 0.0650 0.1890 1 Gender 0.2258 0.0596 -0.0507 -0.0859 -0.0105 1 Education 0.1245 -0.0503 0.1232 0.0408 -0.0183 0.0285 1 Idea generation -0.0661 0.2992 0.5910 0.6554 0.0561 -0.0334 0.0102 As a result of the various tests performed to check the unidimensionality of data, its reliability and discriminant validity confirm internal as well as external validity of the instrument used for data collection. Procedure Survey questionnaire, interview and observation will be used in order to gather primary data from the respondents. Surveys are the most common form of research method for collection of primary data (Commonwealth of Learning, 2000). A questionnaire was used for collecting data from employees of Leading TV channels. An attempt was made to increase the likelihood of obtaining the true score on need for autonomy, general self-efficacy, and self-leadership strategies rather than scores with systematic error by reducing evaluation apprehension (Donaldson Grant-Vallone, 2002; Podsakoff, MacKenzie, Lee, Podsakoff, 2003). Respondents were assured of anonymity, and they were informed that there was no right or wrong answers (Podsakoff et al.). The questionnaires were administered in a group setting at the start of class sessions and respondents took approximately 15 minutes to complete the survey. By following sampling technique of random sample, a questionnaire with closed-ended statements was administered initially to HR Manager of the TV channels via email and a web link, where questionnaire was online available, was forwarded to them for giving responses from potential respondents. Initially, the response rate was very low i.e. 10 % of potential 200 respondents. So, in order to expedite the data collection process, the HR, marketing and creative department were contacted via phone so that to get an appointment for self administered survey. Self-report information was also gathered from respondents regarding gender, age, and tenure. In order to address issues of self-report bias, Podsakoff and Organ (1986) suggested that researchers may reorder the items on the questionnaire so the criterion variable follows the independent variables. This scale reordering procedure was intentional as an attempt to reduce self-report bias, because all the variables in the study were obtained from the same respondents using a single survey.

Medicaid Fraud

Medicaid Fraud HCS/545 July 9, 2012 Medicaid fraud comes in many forms. A provider who bills Medicaid for services that he or she does not provide is committing fraud. Overstating the level of care provided to patients and altering patient records to conceal the deception is fraud. Recipients also commit fraud by failing to report or misrepresenting income, household members, residence, or private health insurance. Facilities have also been known to commit Medicaid fraud through false billing.The Medicare and Medicaid fraud and abuse statute provides that an individual who knowingly and willfully offers, pays, solicits, or receives any remuneration in exchange for referring an individual for the furnishing of any item or service (or for the purchasing, leasing, ordering, or recommending of any good, facility, item, or service) paid for in whole or in part by Medicare or a state health care program (i. e. , Medicaid) shall be guilty of a felony; this is known as the â€Å"anti-kickba ck† statute (Mackelvie, 2004).Medicaid fraud affects taxpayers, recipients, and health care organizations. Measures to reduce Medicaid fraud are necessary. Individuals, facilities, and providers commit Medicaid fraud in several ways. One of the most common ways providers commit fraud is billing for services never provided. For instance, a physician may bill Medicaid for x-rays or lab work that the patient never received. Another way is double billing. Double billing occurs when both Medicaid and a private health insurance are billed for the same services.Medicaid is secondary health insurance to private health insurance and should be billed only for the charges that the primary health insurance does not pay. A third way providers commit Medicaid fraud is billing for phantom visits; charging Medicaid for seeing a patient who has not been seen. Providers have committed Medicaid fraud by billing for unnecessary tests and billing for more expensive procedures when a limited or les s comprehensive procedure was performed. Facilities such as pharmacies commit fraud by substituting brand name drugs for generic drugs and billing Medicaid for the brand name drug.Still other facilities receive kickbacks and file false cost reports. Kickbacks involve receiving payments or services for referral of patients to other facilities or providers where the patient will receive unnecessary services to generate additional income. False cost reports are seen in nursing home cases of fraud and involve owners filing charges for their own personal expenses. Individuals enrolled in Medicaid programs commit fraud by hiding resources, assets, and income.They also commit fraud by denying spouses live in their households or failing to report marriage to continue receiving Medicaid benefits. Individuals with private health insurance who fail to report this insurance and continue using Medicaid benefits are committing fraud. It is an abuse of the Medicaid program when individuals who cou ld obtain coverage on their own instead enroll in Medicaid to cover their medical expenses. Also the federal government stipulates that an individual cannot receive Medicaid in more than one state at the same time.Often, individuals move to another state and fail to report or close their Medicaid benefits with the state in which they were residing. Some individuals want to maintain coverage in more than one state because benefits differ from state to state and some individuals will travel between neighboring states using their Medicaid benefits. This constitutes Medicaid fraud. A program to fight Medicaid fraud has cost the United States at least $102 million in auditing fees since 2008 while identifying less than $20 million in overpayments, investigators found (Wayne, 2012).According to the National Association of Medicaid Fraud Control Units (2012), Medicaid provider fraud costs American taxpayers hundreds of millions of dollars annually and hinders the very integrity of the Medi caid program. Medicaid fraud affects recipients, providers, health care facilities, and taxpayers. Fraud increases the costs of providing benefits to Medicaid recipients. To compensate for such fraud, states must either raise taxes or decrease services in other areas. Those who most need Medicaid services may not be able to obtain benefits because resources are not available.For patients, Medicaid fraud could mean tampering with their medical records, which could put their health at risk. People can get hurt when doctors or other providers give less or more care than needed just to make more money. Also the public is more skeptical about social service programs as more incidents of Medicaid fraud occur every day. Providers and facilities who commit Medicaid fraud can face penalties from state and federal governments. Federal or state authorities may investigate allegations of fraud depending on where the fraud was reported, the laws broken, and the amount of money involved.The stric tness of penalties levied by state governments varies from state to state. Federal laws such as The False Claims Act, Anti-Kickback Statute, and Social Security Act are laws that address fraud and abuse. Title XI of the Social Security Act contains Medicaid program-related anti-fraud provisions, which impose civil penalties, criminal penalties, and exclusions from federal health care programs on persons who engage in certain types of misconduct (Staman, 2010).Under federal regulations, providers convicted of fraud are excluded for a minimum of five years from receiving funds from any federally funded health care program, either as a health care provider or employee (National Association of Medicaid Fraud Control Units, 2012). The False Claims Act imposes penalties on anyone who knowingly submits false claims for payment through a governmental program. Penalty for conviction under this Act is a fine not exceeding $10,000 or an imprisonment of up to five years, or a combination of the two (Centers for Medicare and Medicaid, 2011).The Anti-Kickback Statute makes it a criminal offense to knowingly and willfully offer, pay, solicit, or receive any remuneration to induce or reward referrals of items or services reimbursable by a Federal health care program (Centers for Medicare and Medicaid, 2011). Violations of this law are punishable by up to five years in prison, criminal fines up to $25,000, administrative civil money penalties up to $50,000, and exclusion from participation in federal health care programs (Centers for Medicare and Medicaid, 2011). There are other federal laws to address fraud and abuse of government programs such as Medicaid.These penalties are a reactive measure to control abuse of Medicaid, but proactive measurements are needed to discourage providers, individuals, and facilities from committing fraud. On October 27, 1977, President Jimmy Carter signed the legislation that provided each state with the opportunity and resources to establish a Medicaid Fraud Control Unit (MFCU) to investigate and prosecute provider fraud (National Association of Medicaid Fraud Control Units, 2012). The MFCU investigates Medicaid provider fraud and misuse of Medicaid recipients’ funds.The jurisdiction of the Medicaid Fraud Control Units is limited to investigating and prosecuting Medicaid provider fraud, MFCU’s do not investigate recipient fraud. States must also take initiatives to curtail fraud. Many states are looking to use new technology as a means to prevent fraud. One such technology is biometrics. Biometric technology compares a user’s feature such as a fingerprint. This technology has the potential to prevent recipient fraud by eliminating card sharing as well as preventing provider fraud by reducing phantom billing and other forms of fraud.New York, for example, has integrated targeted data mining and risk analysis into its fraud-fighting tool box. In Texas, a few simple process changes and new pattern analys is and recognition efforts moved the state closer to ‘real–time analysis’ and significantly increased the amount of fraud identified (National Conference of State Legislators, 2012). States must develop continually ways to prevent Medicaid fraud and protect the resources provided for recipients. Controlling Medicaid fraud will be a continual task.The burden falls not on just the federal government, but also state governments, facilities, providers, recipients, and citizens. States should fully commit to working with federal policymakers and agencies to improve the integrity of the Medicaid program. Clarity is needed to define federal and state government roles in maintaining integrity of the Medicaid program. Collaboration and communication between Medicaid and Medicare is needed to reduce fraud. States should evaluate the utility of existing tools used to fight Medicaid fraud. Incentives for providers, recipients, and citizens to report suspected fraud must be m ade available.Abuse of Medicaid affects everyone and costs will continue to rise if measures are not taken to use better the resources available in the Medicaid program. References National Association of Medicaid Fraud Control Units. (2012). What is Medicaid Fraud?. Retrieved from http://www. namfcu. net/about-us/what-is-medicaid-fraud Mackelvie, C. F. (2004). â€Å"The impact of fraud and abuse regulations – Medicare and Medicaid fraud and abuse statutes. Retrieved from http://findarticles. com/p/articles/mi_m3257/is_n10_v46/ai_13413481/pg_6/? tag=content;col1 Wayne, A. (2012). Medicaid Fraud Audits Cost Five Times Amount U. S. Found. Retrieved from

Importance of Physical Education in Adolescents Essay

Introduction of the Topic In many schools around the world, there is an inadequate physical activity for students that pose a serious public health problem. Regular activity sustained over several years contributes to weight control and protection from cardiovascular disease, diabetes, and other chronic diseases (ACSM 1998). The Youth Risk Behavior Surveillance (YRBS) system provides the most complete information regarding physical ability habits of adolescents and young people. Using this system, the Centers for Disease Control and Prevention (CDC) track six youth behavior, which includes physical activity. Preliminary results from the 2001 YRBS survey (MSBE in press) indicate that 85 percent of adolescents in a certain state in the United States performed some vigorous activity at one day a week for 20 minutes, but only 27 percent indicated five or more days of moderate activity. While this study comes from only one state, the same result of physical activity levels has also been observed in national averages. This shortage of physical activity among adolescents in the U. S. was attributed to an excess of sedentary behavior. In a certain survey, an astounding 53 percent of the students surveyed reported watching two or more hours of television on a typical school night. Of those, 15 percent watched four or more hours. Such survey significantly proves no difference from other American children in their television viewing habits (MSBE in press). Physical education class is where students should be learning the necessary knowledge and skills to be physically active, yet physical education is not available to students as fully as it should be. In 2001, (MSBE 2001) published a data that majority of elementary schools in the U. S. offer physical education classes for an average of two days per week, for an average of 60 minutes per week. Half of middle school students receive physical education five days per week, for an average of 48 minutes per week for than 25 weeks during the school year. The other half unfortunately receives far less than that. According to (MSBE 2001), only 29 percent of high school students reported having daily physical education classes. In the U. S. , 29 percent of adolescents in grades 9-12 participated in daily physical education in 1999 as compared with 42 percent in 1991 (14). Participation in organized sports provides another opportunity for physical activity. MSBE (2001) found that 61 percent of 9-12 graders in Michigan reported playing on one or more sports teams. MSBE (2001) added that African-American and Hispanic high school students were less likely with 48 percent compared to Caucasians with 52 percent to play on sports teams. Despite several studies showing that most youth perform some vigorous activities, there are still a significant number of adolescents who do not participate in any regular physical activity. Their reasons include the unavailability of physical education classes, limited spots on school-sponsored teams, and the lack of resources for communities in providing recreational teams. Others, on the contrary, may choose not to participate regardless of the availability of the opportunities. Not considering the causes, it is still important to initiate efforts of getting non-participants involved in some form of physical activity in keeping them from becoming sedentary on a permanent basis. A couple of studies indicate that a total of 30 minutes of moderate physical activity performed most days of the week has a significant impact on prevention of cardiovascular and other chronic diseases (Pate et al. 1995). Provision of the proper instruction, encouragement, and motivation, such numbers is attainable by the majority of children and youth in the U. S. Background of the Topic Health care professionals have long understood the importance of physical activity in children. Traditionally, exercise has been prescribed as part of the treatment for children suffering from chronic diseases such as asthma, cystic fibrosis, and insulin-dependent diabetes (Nixon et al.1992; Rowland 1990). Regular physical activity, in many cases, has the potential to reduce both morbidity and mortality among these youngsters (Rowland 1990). Studies of health children’s exercise habits and physical fitness in the U. S. initially focused on judging muscular strength, speed, and power. In the 1950s, interest surged when researchers found that American children were less fit compared to European children, as measured by tests done by (Kraus and Hirschland 1954). These results expectedly shocked many Americans and thus prompted the formation of the President’s Council on Youth Fitness in 1956 (later became as President’s Council on Physical Fitness and Sports). From then on, the American Association for Health, Physical Education and Recreation developed a youth fitness test battery primarily designed to measure general motor performance skills such as power, speed, and agility (AAHPER 1958). More recently, testing in youth fitness has evolved into a more health-related format, superseding the emphasis on traditional motor skills (AAHPERD 1988). At the present time by far, there is no total agreement minimal criterion fitness standards, or even the question of whether physical fitness has declined significantly in recent years with regards to the majority of the youth (Blair 1992; Kuntzleman and Reiff 1992). There is, however, a consensus that children and adolescents should be involved in physical activity on a regular basis and systems of teaching/reward should encourage active participation and enjoyment by all students (Luepker 1999). Physical activity is recognized as the preventive measure for chronic disease. In view of this, Michigan issued a position statement in 1989 that emphasizes the importance of quality physical education programs in their schools during the 1990s (MAHPERD 1989s). Additionally, it was Michigan that initiated the state-wide project called Exemplary Physical Education Curriculum (EPEC). The EPEC was designed to be a public health initiative that addressed the crushing burden of chronic disease attributable to physical inactivity that would be carried out completely in the school setting. It has scientific grounding in chronic disease prevention, and uses state-of-the-art educational theory. More importantly, the EPEC curriculum equips students in understanding the importance of physical activity and in obtaining the fitness, knowledge, motor skills and personal/social skills they need to be active for life. The Center for Disease Control and Prevention (CDC) assumed leadership in a new approach during the 1990s. This new approach of CDC was aimed to increase physical activity among adolescents and adults. By then, it was highly emphasized that education about the importance of physical activity would be ineffective if the physical and social environments made it inconvenient or unsafe to exercise. The realization of this new approach was published in 1995 that describes a new role for states – promoting policy and environmental interventions in preventing and controlling cardiovascular disease – along with particular recommendations for environmental approaches to increasing physical activity (King et al. 1995). Scientific Basis Several recent studies show clearly that risk factors for cardiovascular disease (CVD) and other chronic diseases are evident in childhood and adolescents (Freedman et al. 1997; Linder and DuRant 1982). Other studies also found to be related to children’s aerobic fitness and physical activity, or lack thereof (Craig et al. 1996; Tolfrey et al. 1999). Independent of nutritional habits, Dietz (1983) has found that physical inactivity has been shown to be a significant predictor and cause of obesity in children. Over the past 30 years, the prevalence of overweight among children in the U. S. has tripled. This increase in overweight resembles to a trend for sedentary activities such as computer games and stuff that replace recreational pursuits involving more physical activity (Bar-Or et al.1998; Freedman et al. 1997). Such sedentary behavior of the youth will likely be reinforced in view of the recent trends for computers in every home and classroom. Recently, a randomized trial aimed at reducing children’s television watching was designed in the hope of an increase in the adolescents’ physical activity and fitness levels (Robinson 1999). Notwithstanding the reduction of television watching time, Robinson’s study found no changes in activity and fitness. On the contrary, another study combined both an addition of physical activity and a reduction of sedentary behaviors in a weight reduction program for obese children (Epstein et al. 2000). It excluded the school-related sedentary activities (i. e. studying and homework) including only those performed during the youngsters’ leisure hours. The study found that both adding physical activity and at the same time reducing sedentary behaviors were effective in promoting weight loss and aerobic fitness in children. Family intervention approach in the treatment (not found in Robinson’s study) may have been the key component of the program. It is essential to remind that children with the lowest physical activity levels and highest percentage of body fatness are most likely to develop other risk factors for CVD, including elevated blood pressure and serum cholesterol levels (Tolfrey 1999). Nonetheless, it is encouraging to note somehow that adolescents’ lipoprotein profiles can be improved with physical activity and exercise interventions (Craig et al. 1996). In obese children, weight loss can occur and blood pressure can be lowered when physical activity is an integral part of treatment regimen (Roccini et al.1988). According to Fagot-Campagna et al. (2000), heaviest children are more likely to develop Type II diabetes compared to their leaner counterparts. Type II diabetes was seldom seen in youth prior to the dramatic increase in the number of overweight in youth in recent years. Diabetes Prevention Program Research Group (2002) published their research showing that modest weight loss and 150 minutes of physical activity per week could reduce the incidence of Type II diabetes in adults at high risk for the condition. While this study has not yet been replicated in children and adolescents, it significantly lends support for the urgency of helping the youth become physically active, most especially those with body weights that could place them at risk for diabetes. Some cardiovascular disease risk factors have the inclination to track over time (Marshall et al. 1998). That is, individuals will likely keep them through adulthood if they have risk factors as children. One concrete example is a follow-up of the Harvard growth study of 1922-1935 showing that being overweight during adolescence is a greater predictor of chronic disease development (i.e. cardiovascular disease, arthritis) compared to being overweight as an adult (Must et al. 1992). In the same way, (Taylor et al. 1999) found that sedentary lifestyle habits may be formed at a young age, and (Janz and Mahoney 1997) claimed the tendency of aerobic fitness and physical activity behaviors to track throughout childhood, and possibly into adulthood. Dennison et al. (1988) found that very inactive adolescents had the lowest aerobic fitness scores (measured by a 600-yard run) when they were youngsters. A longitudinal study in Finland showed that children who were most sedentary had the least favorable cardiovascular disease risk profile when they became adolescents (Raitakari et al. 1994). While the relationship between physical activity and fitness and their influence on cardiovascular disease risk is clear in adults, results from several studies shows that it is not known whether fitness or activity is the most important predictor for developing cardiovascular disease in adulthood (Pate and Ross 1987; Sallis 1993). Furthermore, there is no consensus on the question whether regular physical activity will result in considerable gains in aerobic fitness in children, specifically those who are adolescents (Morrow and Freedson 1994; Payne and Morrow 1993). Despite the existence of this relationship between fitness and physical activity in children, their associations are not strong based on studies of (Aaron et al. 1993; Morrow and Freedson 1994). Katzmarzyk et al (1998) explains that it is possible that large variability in children’s rates of growth and maturity make it difficult to correlate the fitness and activity variables. In addition, the lack of strong association between fitness and activity in children may be due in part to methodological problems. This is to say that, even though a number of valid and objective aerobic fitness tests have been developed, it is more difficult to quantitatively evaluate varying degrees of physical activity in young people (Freedson 1992; Pate 1993). In any event, in a review of cross-sectional studies designed to measure children’s activity levels, Sallis found that boys are approximately 23 percent more active than girls; boys’ activity levels decline 2. 7 percent per year, while girls’ decline 7. 4 percent per year (Sallis 1993). A major role that explains why children choose to be inactive is their poor self-efficacy for physical exercise. These young people believe that they cannot perform sports and exercises very well as they try to compare themselves to their peers. Self-efficacy emerged as a primary determinant of physical activity behavior that significantly varies with age, sex, and socioeconomic status. Self-efficacy is situation specific and its relationship with physical activity is often examined in relation to three components: efficacy for overcoming barriers to physical activity, efficacy for competing activities, and efficacy for support seeking. A number of research studies have shown that different aspects of self-efficacy correlate with physical activity or predict physical activity behavior in children of all ages (Allison et al. 1999; Trost et al. 1997; DiLorenzo et al. 1998). Self-efficacy, in near adolescence, appears to play its greatest role in physical activity behavior. (Pate et al. 1997; Trost et al. 1999) found that highly physically active fifth and sixth grade boys and girls have shown higher self-efficacy for overcoming barriers. More inactive children have shown less self-efficacy in overcoming barriers competing activities, and support seeking. As a matter of fact, self-efficacy for overcoming barriers is an essential predictor of physical activity in study of Trost et al. (1997) that includes mostly African-American population of fifth graders. Self-efficacy remains a strong predictor of physical activity through about ninth grade (Allison et al.1999). During the high school years of youngsters, it appears that girls begin to require more social influence in order to continue physical activity behaviors, while boys are still in need of enhanced self-efficacy (DiLorenzo et al. 1998). Due to the fact that social support appears to be an important contributor to physical activity behavior, more research should focus on this area. Nevertheless, both self-efficacy and social support are subject to parent and peer actions that need to be considered in physical activity interventions.

Juliets Monologues From Shakespeares Tragedy

Who is the protagonist of Romeo and Juliet? Do both titular characters share that role  equally? Typically, stories and plays focus on one protagonist and the rest are supporting characters (with an antagonist or two thrown in for good measure). With Romeo and Juliet, some might argue that Romeo is the main character because he gets more stage time, not to mention a couple of sword fights, too. However, Juliet experiences a great deal of family pressure, as well as an ongoing inner conflict. If we label the protagonist as the character that experiences the deepest level of conflict, then maybe the story is really about this young girl, swept up by her emotions and caught up in what will become the most tragic love story in the English language. Here are some key moments in the life of Juliet Capulet. Each monologue reveals the growth of her character. The Balcony Scene. II ii 36 In her most famous speech and her first monologue, Juliet wonders why the newfound love (or is it lust?) of her life is cursed with the last name Montague, the long-standing enemy of her family. This scene takes place after Romeo and Juliet met at the Capulets party. Romeo, infatuated, wandered his way back into Capulets gardens right to Juliets balcony. At the same time, Juliet comes out, unaware of Romeos presence, and ponders her situation out loud. The monologue beings with the now-famous line: O Romeo, Romeo! Wherefore art thou Romeo? This line is often misinterpreted as Juliet asking about Romeos whereabouts. However, wherefore in Shakesperean English meant why. Juliet is thus questioning her own fate of falling in love with the enemy. She then continues to plead, still thinking she is alone: Deny thy father and refuse thy name;Or, if thou wilt not, be but sworn my love,And Ill no longer be a Capulet. This passage reveals that the two families have an antagonist history, and Romeo and Juliets love would be difficult to pursue. Juliet wishes Romeo would give up his family but is also ready to give up hers. To soothe herself, she rationalizes as to why she should continue to love Romeo, saying that a name is superficial and does not necessarily make up a person. Tis but thy name that is my enemy;Thou art thyself, though not a Montague.Whats Montague? it is nor hand, nor foot,Nor arm, nor face, nor any other partBelonging to a man. O, be some other name!Whats in a name? that which we call a roseBy any other name would smell as sweet; Declarations of Love. II ii 90 Later in the same scene, Juliet discovers that Romeo has been in the garden all along, overhearing her confessions. Since their emotions arent a secret anymore, the two star-crossed lovers profess their affections openly. Here are some lines from Juliets monologue  and an explanation in modern English. Thou knowst the mask of night is on my face,Else would a maiden blush bepaint my cheekFor that which thou hast heard me speak to-nightFain would I dwell on form, fain, fain denyWhat I have spoke: but farewell compliment! Juliet is glad it is night time and Romeo cannot see how red she is from the embarrassment of breaking conventions and letting him overhear all she has said. Juliet wishes she could have kept up her good manners. But, realizing it is too late for that, she accepts the situation and becomes more straightforward.   Dost thou love me? I know thou wilt say Ay,And I will take thy word: yet if thou swearst,Thou mayst prove false; at lovers perjuriesThen say, Jove laughs. [...] In this passage, Juliet displays the disposition of a person in love. She knows that Romeo loves her, but at the same time is anxious to hear it from him, and even then she wants to make sure he isnt simply falsely exaggerating. Juliets Choice.  IV iii 21 In her last longer monologue, Juliet takes a big risk by deciding to trust in the friars plan to fake her own death and wake within the tomb, where Romeo should be waiting for her. Here, she contemplates the potential danger of her decision, unleashing a combination of fear and determination. Come, vial.What if this mixture do not work at all?Shall I be married then to-morrow morning?No, no: this shall forbid it: lie thou there.(Laying down her dagger.) As Juliet is about to take the poison, she wonders what would happen if it doesnt work and she is afraid. Juliet would rather kill herself than marry someone new. The dagger here represents her plan B. What if it be a poison, which the friarSubtly hath ministerd to have me dead,Lest in this marriage he should be dishonourd,Because he married me before to Romeo?I fear it is: and yet, methinks, it should not,For he hath still been tried a holy man. Juliet is second-guessing whether or not the friar is being honest with her. Is the potion a sleeping potion or a lethal one? Since the friar married the couple in secret, Juliet is nervous that he might be now trying to cover up what he did by killing her in case he gets in trouble with either the Capulets or Montagues. In the end, Juliet calms herself by saying the friar is a holy man and wouldnt trick her. How if, when I am laid into the tomb,I wake before the time that RomeoCome to redeem me? theres a fearful point!Shall I not, then, be stifled in the vault,To whose foul mouth no healthsome air breathes in,And there die strangled ere my Romeo comes? Thinking of other worst-case scenarios, Juliet wonders what would happen if the sleeping potion wore off before Romeo could remove her from the tomb and she suffocated to death.  She ponders that if she wakes up alive, she might be so afraid of the darkness and all the dead bodies, with their horrible smells, that she might go crazy. But in the end, Juliet rashly decides to take the potion as she exclaims: Romeo, I come! This do I drink to thee.