History

I believe that one of the biggest events that have shaped life today would be slavery. Slavery was a terrible thing and people were treated extremely unfair but I feel like if we didn’t have this terrible part of history we would not be where we are today. It has been said that history repeats itself and slavery is a good example of history repeating itself.  Around 1640 African Americans were discriminated against for having a different color of skin and being from a different part of the world. For many years black were treated extremely badly. They had no rights. They couldn’t vote, they couldn’t get an education, and basically had no say in how there life would go. They were ordered to do all the work for their slave owner and were beaten or killed if they didn’t comply with what there master said. Any baby being born into slavery was automatically a slave. From the moment they were born to till the day they died they would be a slave. All children born of any Negro or other slave shall be slaves, as their fathers were, for the term of their lives. (Source 2)

Any freeborn women that have already married Negros shall serve the master of their parent till they are thirty years of age and no longer (Source 3) so it is clear that basically there was no of escaping unless you were one of the very lucky ones to escape and go into hiding but that was not very common. No master, mistress, overseer, or other person what so ever, that hath the care and charge of any negro or slave,  shall give the Negros and other slave leave on Sundays, holidays, or any other time, to go out of their plantations, except such negro or other slave as usually wait upon them at home or abroad, or wearing a livery; and every other  negro or slave that shall be taken hereafter out of his masters plantation, without a ticket, or leave in writing, from his master or mistress, or some other person by his or her appointment, or some white person in the company of such slave, to give and account of his business, shall be whipped… (source4). Year’s later slavery ended. People came to realize that no matter what color of skin you had every one shall be treated equal.

 I am happy to see that people have learned from our past and have learned to accept people for who they are rather than by the color of their skin.  I do not believe that slavery was a good thing at all by any means but I defiantly don’t think we would be where we are today had we not experiences that terrible part of history. People say that things have to get worse before they get better and I believe that this is the case.

Today we have an African American president and I think that is amazing that people have changed their mind that skin color really doesn’t matter. I know there are still people that will never get over the whole racial problem but I feel like history has accomplished so much sense then and we should not dwell on the dreadful past and continue to make positive changes in the current times. People like Martin Luther King Jr and Rosa Parks would be so happy to see how African Americans have respect and are being treated fairly and that all men shall be treated equal.

Computer 1020 070

I'm Staci Alvey and i am currently finishing up my fifth semester at SLCC. I hope to become a radiology tech. I have not decided what exactly what in that field i will pursue but i know it will be awesome. I have always had a huge interest in the medical field and have always wanted to learn more about the human body. I have enjoyed computers and plan to take what i have learned in this class and use it in my everyday life. I know that in the future i will use a computer in my job and it will be very helpful to know what i am doing.
Here are some assignment that i have done in class....
 
Word Assignment

Table of Authorities

Cases

Cornelius v. Gipe, 625 S.W.2d 880, 882 (Mo. App. 1981)………………………………………2 Florida Physician's Ins. Reciprocal v. Stanley, 452 So.2d 514, 515-16 (Fla. 1984……………...4

Washington v. Barnes Hosp., 897 S.W.2d 611, 619-21 (Mo. banc 1995)……………………….2,4

 

            IN THE CIRCUIT COURT OF GREENE COUNTY, MISSOURI

 

MARCEL BRADFORD, a minor, by his                              )

next friend, Trust of the Ozarks,                                )

                                                                                                )

                                                            Plaintiff,                      )

                                                                                                )

vs.                                                                                            )           Case No. 104CC0091

                                                                                                )

HILLCREST MEDICAL CENTERS,                                  )

                                                                                                )

                                                            Defendant.                  )

                                               

DEFENDANT'S RESPONSE TO PLAINTIFF'S FIRST MOTION IN LIMINE CONCERNING FREE PUBLIC BENEFITS

 

            In point 3 of his first motion in limine, plaintiff seeks to preclude evidence of collateral source payments.  Plaintiff attempts to categorize the evidence into two groups:

            Group 1:          Medicaid

            Group 2:          Goods and services provided by the public schools.

Plaintiff claims that evidence of Medicaid is subject to the rule, while the Missouri Supreme Court in Washington v. Barnes Hosp., 897 S.W.2d 611, 619-21 (Mo. banc 1995) has held that evidence of programs and therapies available through the public schools are not subject to the collateral source rule. 

            While defendant does not agree that any Missouri appellate court has directly held that Medicaid is subject to the collateral source rule, defendant does not plan to introduce evidence that Medicaid has paid for certain medical expenses in this case.[1]

  Defendant also agrees that goods and services provided by the public schools is not subject to the rule.  However, to the extent plaintiff is attempting to recast Washington v. Barnes Hospital as holding that the availability of free public school programs is the only exception to the collateral source rule, defendant disagrees.  There are other free public programs and therapies that are available outside the public school programs that will be available to Marcel that should also not be considered collateral sources.  Programs that will likely be at issue in this case are those provided through the Missouri Department of Mental Health, Division of Mental Retardation and Developmental Disabilities ("MRDD") after Marcel turns 18.

            The State of Missouri has an extensive system of care and treatment options for individuals with developmental disabilities. The only criteria for eligibility is they have a developmental disability which is defined as attributable to:

            1.         A. Mental retardation, cerebral palsy, epilepsy, head injury, autism or a learning disability related to a brain dysfunction;

            2.         Is manifested before the person attains age twenty-two (22);

            3.         Is likely to continue indefinitely;

            4.         Results in substantial functional limitations in two (2) or more of the following six  (6) areas of major life activities: self care, receptive and expressive language development and use, learning, self-direction, capacity for independent living or economic self sufficiency and mobility; and

            5.         Reflects the person's need for a combination and sequence of special, interdisciplinary or generic care, habilitation and sequence of special, interdisciplinary or generic care, habilitation or other services which may be of lifelong or extended duration and are individually planned and coordinated.

 

9 CSR 45-2.010(2)(F).  Eligibility is not conditioned on indigence.[2]

 

            In this case, Marcel will meet this criteria.  He has already been documented as having cerebral palsy  prior to the age of twenty-two.  Plaintiff's own experts state this is likely to continue indefinitely, and results in substantial functional limitations in more than two of the six areas of major life.   Evidence that these public programs are available as an alternative to Dr. Elam's private one-on-one attendant care  projections in his life care plan are relevant and admissible.

            In Washington v. Barnes Hosp., 897 S.W.2d 611, 619-21 (Mo. banc 1995), the Missouri Supreme Court extensively re-examined the collateral source rule.  The court began its analysis with the statement that "the collateral source rule is not a single rule but rather, a combination of rationales applied to a number of different circumstances to determine whether evidence of mitigation of damages should be precluded from admission." Id.   In analyzing the rationales that supported the rules application, the court reviewed decisions from other states.  In reaching its decision that public school benefits where not subject to the collateral source rule, the court rejected contrary views from other states, and  adopted the reasoning of the Florida Supreme Court in Florida Physician's Ins. Reciprocal v. Stanley, 452 So.2d 514, 515-16 (Fla. 1984), emphasizing:

The policy behind the collateral source rule simply is not applicable if the plaintiff has incurred no expense, obligation, or liability in obtaining the services for which he seeks compensation.  This is further made apparent upon comparison of the present case with a situation in which the collateral source rule is frequently applied, that of the defendant who seeks a reduction in damages because the plaintiff has received insurance benefits.  It is a well-settled rule of damages that the amount recoverable for tortious personal injuries is not wholly or partially indemnified for the loss by proceeds from accident insurance where the tortfeasor did not contribute to the payment of the premiums of such insurance.  This rule is usually justified on the basis that the wrongdoer should not benefit from the expenditures made by the injured party in procuring the insurance coverage.  In a situation in which the injured party incurs no expense, obligation, or liability, we see no justification for applying the Collateral Source rule.  We refuse to join those courts which, without consideration of the facts of each case, blindly adhere to the collateral source rule, permitting the plaintiff to exceed compensatory limits in the interest of insuring an impact upon the defendant.

 

Id. at 620-21 (Emphasis added).  The Missouri Supreme Court also stated: "[w]e reject the concept that the collateral source rule should be utilized solely to punish the defendant.  Id. at 621.

            While the specific issue addressed in Washington v. Barnes Hospital was evidence relating to the availability of public special education services, the issue in Florida Physician's Insurance Reciprocal v. Stanley, the Florida case adopted by the Missouri Supreme Court, also included the "availability and effectiveness of free or low-cost charitable and governmental programs available in the community." 452 So.2d at 515.  In the Florida case, the plaintiff "brought a medical malpractice action against the [defendants] for the retardation and cerebral palsy [plaintiff] has suffered from birth." Id.  Defendant cross-examined plaintiff's damage experts on the availability of free or low cost services from governmental and charitable organizations that were available to people that had mental retardation and cerebral palsy as children.  Id.  These are the same benefits that are at issue in the present case.  The Florida court held:

[Defendants] claim that evidence of free or low cost services from governmental or charitable agencies available to anyone with specific disabilities is admissible on the issue of future damages.  We agree....  Governmental or charitable benefits available to all citizens, regardless of wealth or status, should be admissible for the jury to consider in determining the reasonable cost of necessary future care.  Keeping such evidence from the jury may provide an undeserved and unnecessary windfall to the plaintiff.

 

Id. at 515.   As the Missouri Supreme Court adopted the Florida court's reasoning in Washington v. Barnes Hospital, it is apparent it would reach the same result with regard to the admissibility of evidence of other public programs, in addition to the public school special education programs, available to anyone with specific disabilities on the issue of future damages.

            The public programs available through MRDD are, in effect, an extension of those available through the public schools.  They replace those provided by the public school after the child turns 18.  Just as in the case of public school benefits, the plaintiff did not purchase the benefits available through MRDD, nor work for them as an employment benefit, nor contract for them.  Hence, the "benefit of the bargain" rationale does not apply.  Just as in the case of public school benefits, the MRDD programs are funded by tax dollars.  As the Missouri Supreme Court stated in Washington v. Barnes Hospital,  "[w]hile to some extent public schools are funded by plaintiffs' tax dollars, they are also funded by defendants' tax dollars and no windfall results to either." Id. at 621.   The same is true for MRDD benefits. As the court emphasized in Washington v. Barnes Hospital:  "[a]s the injured party [Marcel] incurs no expense, obligation, or liability, we see no justification for applying the Collateral Source rule."  Moreover, these free public programs are available to any child that has been documented to have a developmental disability before age 22, and is not contingent on indigent status (as in Medicaid benefits) or having been earned through military service (as for veteran's benefits), or through work credits (as for social security or medicare benefits.)

            Accordingly, these free public benefits available to people, like Marcel, after they turn eighteen and have cerebral palsy can be considered by the jury as alternatives to Dr. Elam's private one-on-one attendant care  projections in his life care plan.  Plaintiff's motion in limine to this extent should be denied. "Plaintiffs, of course, may respond to this evidence with arguments of its inadequacy, the risk of its continued availability, etc." Washington v. Barnes Hosp., 897 S.W.2d at 621.

 

                                       THE GRISWALD LAW FIRM, P.C.

---

[1]The only case cited by plaintiff concerning Medicaid payments is Cornelius v. Gipe, 625 S.W.2d 880, 882 (Mo. App. 1981).  In that case, the court expressly said: "Even assuming without deciding that the argument [that mentioned the availability of Social Security, Medicare, and Medicaid] violated the collateral source rule, the argument clearly bore on damages, and by reason of the defendant's verdict, Cornelius was not prejudiced."  In Washington v. Barnes Hosp., 897 S.W.2d 611, 620 (Mo. banc 1995) the court specifically noted this was dicta. 

[2]If the recipient has annual adjusted gross income exceeding one hundred thousand dollars ($100,000) he shall be assessed a charge for case management services, and the charge shall be the lesser of actual cost or one-fourth (1/4) their monthly ability to pay.  9 CSR 10-31.011(3).  This has no application in this case as plaintiff's experts state Chavon will be permanently unemployable. 

Excel Assignment

 

Mid-Sized Passenger Car Ratings
Model	Efficiency	Affordability	Appearance	Durability	Acceleration	Overall Rating	Ratings
Matador	8.2	9.0	7.0	8.0	8.4	8.1
Imperial	7.5	8.5	6.5	7.5	8.0	7.6
Reliance	6.7	6.8	6.3	5.5	7.5	6.6
Captivator	9.0	7.5	8.2	9.2	8.3	8.4
Overall Category	7.9	8.0	7.0	7.6	8.1	7.7

Biology Lab Reflection

Detection of infectious disease outbreaks in hospitals

 

“The World Health Organization has estimated that, globally, 8.7% of hospital patients develop hospital acquired infections”. Infections acquired in a hospital are also called nosocomial infections. “In the US alone, 2 million people developed a hospital acquired infection in the last year”. About 90,000 of these patients die as a result of their infections. Hospital-acquired infections can be caused by bacteria, viruses, fungi, or parasites.

These microorganisms may already be present in the patient's body or may come from the environment, contaminated hospital equipment, health care workers, or other patients. About 25% of these infections can be prevented by healthcare workers taking proper precautions when caring for patients. Infections spread both by touch and through the air. Healthy people can usually fend them off, or may get only mildly sick from them, but someone with a compromised immune system or an open wound will be at risk for getting very sick .Infections that become clinically evident after 48 hours of hospitalization are considered hospital acquired. Infections that occur after the patient is discharged from the hospital can be considered healthcare associated if the organisms were acquired during the hospital stay. The infections usually develop in a surgical wound, or the urinary tract or lungs. Decreasing the number of hospital acquired infections is the number one priority for all medical personnel. If the infection is found early on, it is much easier to treat and contain.

 Along with the obvious precautions, such as hand washing and sanitizing common areas, it is important to record and document any form of infection that had be detected. Hospitals are developing new procedures and new software to help keep infections low or even nonexistent. A WHONET-SaT scan or BAC Link is a data conversion utility that standardizes data from existing microbiology systems into WHONET-SaT formats. WHONET is used by 1000 laboratories world wide.  This was originally developed for geographical disease surveillance to assess the statistical significant of community cancer cluster. The device is used to chart any infections that have occurred in the hospital by calculating the amount of infections in a specific area that have developed within days of each other. The information is then studied to detect what type of infection may be able to be spread around due to improper infection control.

“Microbiology- based cluster detection systems should use automated statistical methods to optimize cluster identification, lessen surveillance burden, and expand cluster detection to all pathogens across all hospital locations and services”. Tests run daily to record any new infections to see any significant details that may show any similarities between any infections developed within the same amount of time. This will help to prevent any spreading of infection.

Hospital acquired infections are very common and very serious. Infection can lead to death if not properly treated. It is important to follow the infection control protocols in each facility to help reduce the spreading of infection. Software may prevent the spreading of infection if studied on a daily bases.

English 1010 Final Issue summary

 When given the assignment to write an issue summary, I had no idea what to write about.  After thinking of things I have great passion and great understanding about, I have decided to write about a heart condition called Atrial Fibrillation.

My interest in the medical field was sparked by my family’s heart condition. Due to the excessive amount of family members affected by A Fib, I have developed a great curiosity of the heart. Because of this I would like to pursue a career in the Radiology field. The field consists of many different job opportunities. I have often thought it would be an amazing to be an Echocardiograph Technician, also known as an echo tech. An echo tech takes images of a person’s heart. So many of my family members are affected by this condition and I decided that I would write my final assignment on determining whether A Fib is hereditary or if it was caused by poor life choices.  I was very curious about this subject and started doing research.

Is Atrial Fibrillation hereditary or caused due to poor life choices

When five out of six of my father’s siblings were diagnosed with Atrial Fibrillation, I began to wonder if it was hereditary. Being that mostly all my family members had developed it, or if poor eating and poor life choices contributed to the condition. Could lack of exercise contribute to developing this dangerous heart condition? Can I develop the condition because my dad has been diagnosed with it? After wondering what causes this condition I decided I needed to find out.

“Atrial fibrillation is the most common heart rhythm disorder in the U.S., affecting more than 2 million adults”. The amount of people being diagnosed with the condition is rising and scientists predict that about 5.6 million Americans will have the disorder by 2050. This year alone there will be over 340,000 new cases in the US. A-Fib is the most common heart arrhythmia(NHLBI).

After researching online databases, I have gathered information that supports both viewpoints. The two main viewpoints I have researched is the idea that A Fib is hereditary. The other viewpoint would be the idea that A Fib is caused by poor life choices such as, excessive smoking, excessive drinking and eating unhealthy eating. I feel it is important for me, as well as others to know if they are at risk for this condition. I would also like to know the main causes of A Fib. Knowing that there may be multiple reasons that a person develops the conditions, I can now look further into what really causes A Fib.

The first viewpoint supports the idea that A Fib is caused by excessive drinking. According to studies by Doctor Kelli Miller Stacy, reporting on behalf of Web Md , it has been found that people, who regularly drink a lot of alcohol, are more likely to develop the irregular heart rhythm, than nondrinkers.(Web MD) Drinking one to two drinks daily will greatly increase your risk. Scientists have discovered that the more a person drank the higher chances of developing the condition. “Excessive amounts of alcohol use can raise your blood pressure to an Unhealthy level, causing the arteries to tighten making your heart work harder to distribute the blood. The heart becomes over worked and begins to weaken causing the abnormal electrical impulses of A Fib”.

The next point I researched was the idea that A Fib is Hereditary. Wanting to know more about the causes of the condition, I looked for information supporting the idea of it being hereditary. Dr. J Travis, scientist for the science news stated that from recent studies, scientist were able to find a gene mutation that causes Atrial Fibrillation. According to this study sixteen out of forty four family members surveyed had the linked gene for A Fib. “The investigators discovered that only those family members with A fib have a subtle misspelling of the gene's normal DNA sequence” (Travis).

Finally, the last point that supports the idea that: both poor life style choices and heredity contribute to developing A Fib. According to the oxford journal that the main causes are obesity, substance abuse, excessive exercise ,excessive caffeine use, Coronary artery disease,Heart valve disease, Chronic lung disease, Heart failure, Cardiomyopathy,Congenital heart disease, and hypertension. The oxford journal also states that children born to parents who have been diagnosed with A fib often inherit the A Fib gene. Researchers found that 30 percent of participants had at least one parent with Atrial Fibrillation. According to the National Heart, lung, and blood Institute also known as NHLBI the risk is double for those with one parent who has already developed this heart condition. The risks triple if both parents have the condition.

Before reading each viewpoint I thought that it might only be hereditary just because my family is active and I don’t see them out of shape or obese. I figured that only extremely overweight people were at high risk for any heart problems. Just like other conditions passed through my family I figured that A Fib had to be hereditary and just another thing I get to look forward to as an adult.

After reading both viewpoints I have come to realize that Atrial Fibrillation is caused from both poor life style choice and is passed from parent to child due to a gene mutation. By doing this research I know have a greater understanding of how a person develops the common heart condition. Now that I know I have a high chance of developing this condition I need to be tested by doctors for the A fib gene to see if I really inherited the condition. If so I need to learn to live with this conditon.

Works Cited

Atrial Fibrilliation: causes of not- so- lone Atrial Fibrillation." oxford journal. (2008): n. page. Print.

Schoonderwoerd, Bas, Pen Lucas, Van Marcelle, and Isabelle Gelder. "“New risk factors for  Stacey, Kelli. "Alcohol May Raise Risk of Irregular Heart Rhythm." January 17,2011. n.pag. Sirs. Web. 29 Jul 2012.

Travis, J. "Losing Rhythm." Science News January 11, 2003. n.pag. master File premire. Web. 29 2012 

                

Psy 1100 Signature Assignment

Signature Assignment

For my signature assignment I have decided to discuss our chapter nine and ten discussion. The assignment was to Imagine that the person you are now, could go back and have a conversation with the person you were when you went through puberty and entered your adolescent years. What would you say? What advice would you give? What advice would you give to your own parents about how best to parent you through adolescence? I have decided to choose this particular assignment, because I could have really used someone other than my parents to talk to for advice.  I like to be that person for others and share my experiences with family or friends that are going through puberty, and need someone to talk to. I think it is important for adolescent kids to be able to have someone to talk to. Chances are they don’t want to talk to their own parents.

 When discussing this topic I am reminded of a country song from Brad Paisley called “Letter to me”. The opening lyrics of the song say “If I could write a letter to me
And send it back in time to myself at 17”. After hearing this song I often wondered what I would actually tell myself if I were able to go back in time. I know there would be so much to say. If I knew what I know now, I might not be the same person not having to go through what I did and learn the things I have.

After completing this assignment I have realized how far I have come from that point in my life, and how much I have changed as a person. I remember thinking several times while going through puberty that life was so hard and I didn’t know how I would ever make it though.

Now as an adult I realize that the issues that I once thought were devastating are nothing compared to the issues I have now. Now being married I can’t rely on mommy and daddy to get me through hard times and I need to figure out how to fix the problems as an adult. I am so grateful for that time in my life because I know if I hadn’t experienced all life’s ups and downs I would not be the person I am today. I know I still have a lot of growing as a person to do but that’s life and I know now I can make it through anything.

For the discussion assignment I had mentioned two major things that I would make sure to tell myself going through puberty. The first thing is body image and trying to impress others around me with dressing in the name brand clothes, painting my finger nails to match each outfit and saying and acting in strange ways to get others attention. The second is family I now know how important family is and how after high school basically the only friends you have are your family. Rather than being embarrassed by your family you should be proud to show people where you come from and who helped you become who you are.

I know that everyone experiences some sort of body image issues. Looking back I remember that I always wanted to be the girl (like on tv) that would walk into the room, and everyone stops and admires them. Ideally every girl at that age is probably thinking the same thing, and no one really pays any particular attention. I wish I could go back and tell myself not to waste time worrying about what I looked like every day, but focus more on school and the real person I wanted to be. Rather than arguing with my mom every time we would go shopping  about me needing to get Roxy t shirts I should have been worrying about what I was going to do my science project on. I know now that if I would have paid more attention in class and worrying less about passing notes to friends, I may have learned more useful information that I could use today.

 I have come to realize that after high school the only people who really care about you is your family. My dad always told me that friends will come and go in my life and the only thing that would stay constant was my family. I never believed him because of course I knew everything, and because I thought I would never have to separate from my friends. I’m here to say that my dad is a smart man and knew what he was talking about. Now that I am married I have a small group of close friends and I find myself wanting to be with my parents more often than I ever thought I would. My family is everything and I wouldn’t trade them for the world. I know trying to explain that to that my adolescent self would be a nightmare but, I would at least try to explain that parents are there to help and if you just ask them for help believe it or not they will get you through rough times, such as puberty.

In the discussion I wrote “You will later understand that it’s the person inside that matters in life’. I know this is true because I judge a person by the way they treat others and if have a big heart. In life it’s not the name brand on your shirt but the size of your heart.

Psy 1100 Final Reflection

Staci Alvey                                                                                                                           
Psy   1100-045
Laura Fields
7-25-2012

Final Reflection

            When I first learned that psychology was a required class, I no idea what to expect or what exactly I was going to learn. To be completely honest, I figured it would be one of those boring required classes like math. Come to find out it was anything but boring. I will be able to use what I have learned in my personal and professional life. The career I have chosen to pursue deals directly with people. By taking this class I now have a better understanding why people do what they do. As well as having a greater understanding in the development process of life.

            Starting from the beginning of the book, I have learned that an average person is born with forty six chromosomes. Females have the xx chromosomes, males have xy chromosomes. A person’s sex depends on whether the fathers y sperm or x sperm fertilizes the ovum. I think that it is interesting that children of low income parents have a higher chance of becoming obese. In chapter eight I learned that I come from a blended family because my parents are divorced and have been re married and I have stepsiblings and one half sibling. I found it interesting that teenage pregnancy has decreased. These are just a few examples of things I have learned throughout the course of this class.

            As a student I learned that I need to use more details when explaining what I have learned, to really show what I know. I feel like the online class has taught me some discipline because I had to push myself to complete all the assignment in a timely manner.  This class was

very organized and I hardly ever had any questions, because all assignments were very clear. I appreciate the fact that I was able to ask questions if needed, and I would have a response in an appropriate time. I really liked the fact that you can read what others about have posted. I find it interesting to hear others opinions. Also by being able to see what others posted I was able to use their ideas to spark more of my own ideas.

            I will be able to use what I have learned in my current job. When dealing with the elderly it is important to remember that they aren’t as energetic and flexible as they once were. It is important to encourage them to do range of motion exercise and mental exercise to help keep their mind and body strong.

It has been fun sharing information with my sister (who is pregnant with her first child) on the fetal development process starting from the germinal period all the way up to birth. I enjoy sharing information that people may not know such as, a baby doesn’t develop its hearing until the last trimester. One day I plan on having a child of my own and it would be helpful to know what to expect in such an amazing time.

I have enjoyed this class much more than I thought I would have. I would recommend this class anyone who is interested in the human mind and development, as well as others who are seeking a profession in the health world. I will take many things that I have learned in this class and apply it to my everyday life.