Athena, a 60-year-old woman, has noticed that her 85-year-old mother, Dorothy, is becoming increasingly isolated and unhappy. Dorothy does not want to spend time with her friends and every time Athena visits, Dorothy seems to want to cut the visit short. Athena knows that Dorothy has experienced changes in her vision over the last 10 years. Dorothy complains to Athena that her peripheral vision seems limited and she is unable see very well in the dark. Her doctor tells her that she is developing macular degeneration, which will further affect her vision. Also, she is having a hard time hearing what people are saying, especially at social gatherings or a restaurant. Athena understands that the senses change with age and she believes that many of the changes experienced by her mother are common for her age. But Athena is concerned about her mother’s psychological state. She doesn’t really understand why her social behavior and emotional well-being have changed. Describe how sensory related changes that occur with aging can lead to changes in quality of life, including social behavior and emotional well-being, as has happened with Dorothy. Be sure to describe the impact of both hearing loss and loss of vision.

Bullet point with brief explanation is fine. Describe in relation to late adulthood

Prompt

Ortelere, a retired teacher, has built up a substantial amount of funds in her retirement plan before she retired because of "involutional psychosis" (a form of mental illness).

She has previously specified that a lowered monthly retirement benefit would be paid to her so that her husband would get some benefit from the retirement plan if she died before he did.  After her mental problems began, she changed her payout plan and borrowed from the pension fund (....ok, lady, you're getting the money based on 'your' decision! We have relied on 'your' decision 'today'. Positions are changing, parties will be 'affected' based on 'representations'.)

As a consequence of the changes she made, her husband lost his rights to benefit. Two months after she made the changes, she died. The husband sued to reverse the changes his wife made, claiming she was not of sound mind when she made them.

• Will the changes in the plan be voided? Previously in Chapter 10 you only have the concept of 'consideration' and in chapter 11 we have 'competency'. Even if you argue competency, don't you find this very difficult to prove?
• Explain your answer. This is a good one, have some fun with this. You 'could' argue both sides, who has the stronger position?..... no free lunch, eh? Going to need an 'empathetic judge'?

Exercise 16-44 Comprehensive Cost Variance Analysis (LO 16-5, 6)

NSF Lube is a fast-growing chain of oil-change stores. The following data are available for last year’s services:
  

NSF Lube performed 474,700 oil changes last year. It had budgeted 432,200 oil changes, averaging 15 minutes each.

Standard variable labor and support costs per oil change were as follows:

Fixed overhead costs:

Annual budget $1,036,200

Fixed overhead is applied at the rate of $2.50 per oil change.

Actual oil change costs:

Required:

a. Prepare a cost variance analysis for each variable cost for last year. (Do not round intermediate calculations. Indicate the effect of each variance by selecting "F" for favorable, or "U" for unfavorable. If there is no effect, do not select either option.)

b. Prepare a fixed overhead cost variance analysis. (Indicate the effect of each variance by selecting "F" for favorable, "U" for unfavorable, and "None" for no effect.)

Calculating the Direct Materials Price Variance and the Direct Materials Usage Variance

Guillermo's Oil and Lube Company is a service company that offers oil changes and lubrication for automobiles and light trucks. On average, Guillermo has found that a typical oil change takes 30 minutes and 6.4 quarts of oil are used. In June, Guillermo's Oil and Lube had 920 oil changes.

Guillermo's Oil and Lube Company provided the following information for the production of oil changes during the month of June:

Actual number of oil changes performed: 920

Actual number of quarts of oil used: 6,600 quarts

Actual price paid per quart of oil: $5.10

Standard price per quart of oil: $5.05

Required: 1. Calculate the direct materials price variance (MPV) and the direct materials usage variance (MUV) for June using the formula approach. If required, round your answers to the nearest cent.

MPV $__________ Unfavorable

MUV $__________ Unfavorable

2. Calculate the total direct materials variance for oil for June. If required, round your answer to the nearest cent.

$__________ Favorable

3. What if the actual number of quarts of oil purchased in June had been 6530 quarts, and the materials price variance was calculated at the time of purchase? If required, round your answers to the nearest cent.

What would be the materials price variance (MPV)?

$ ___________Unfavorable

What would be the materials usage variance (MUV)?

$ ___________Unfavorable

An Illinois state program evaluator is tasked with studying the intelligence of soon-to-graduate high school students in a number of Chicago-area high schools.

One of the specific questions that needs to be answered is, “How do the students of Collins High School, one of Chicago’s lowest-rated high schools in terms of academic achievement, fare in intelligence compared to students of Lincoln Park High School, one of Chicago’s highest-rated high schools in terms of academic achievement?”.

To conduct this study, the program evaluator administers the Wechsler Adult Intelligence Scale, 4th Edition (WAIS-IV) to one 12th grade class from each high school in the Chicago area (if you are interested in learning more about the WAIS-IV, click here).

The following table shows the WAIS-IV scores for student from Collins HS and Lincoln Park HS (note: data were fabricated for purposes of this excersize):

First, complete the below grouped frequency table of WAIS-IV scores for each HS:

Compute the appropriate calculations to complete the following table :

What is the shape of the distribution of intelligence scores (normal, negatively skewed, positively skewed) for Collins HS? Explain how you arrived at your answer.

What is the shape of the distribution of intelligence scores (normal, negatively skewed, positively skewed) for Lincoln Park HS? Explain how you arrived at your answer.

Your Task

You will engage in a negotiation for the sale and purchase of a commercial asset such as a business or a piece of real estate.

Assessment Description

You may be nominated to represent the vendor and will receive email instructions from the vendor company CEO including:

1. Appointment to represent the company as their agent for the sale of the commercial asset;

2. Specific details about the commercial asset;

3. Information about the status of current negotiations with an alternative potential purchaser;

4. Information about a new potential purchaser;

5. Contact details of the agent appointed to represent the purchaser.

Alternatively, you may be nominated to represent the purchaser and will receive email instructions from the purchaser company CEO including:

1. Appointment to represent the company as their agent for the purchase of the commercial asset;

2. Specific details about the commercial asset;

3. Information about alternative assets the company is considering purchasing instead;

4. Information about the vendor;

5. Contact details of the agent appointed to represent the vendor.

Stage 1: Pre-negotiation (1,000 words)

You must answer the following questions:

1. What is your thinking style preference form – monarchic, hierarchic, oligarchic, anarchic – and what is your thinking style scope – internal, external? Attach copies of completed Sternberg-Wagner Thinking Style Inventories.

2. Are your thinking style preferences – form and scope – optimal for conducting this negotiation? Explain your answer.

3. What adjustments (if any) could you make to adapt to a more optimal thinking style for this negotiation?

Stage 2: Negotiation (300 words) You must:

1. Enter negotiations with your counterpart for the sale and purchase of the commercial asset;

2. Maintain a communications log that captures the date, method, items discussed, and outcomes of each communication. Attach copies of any communications that confirm agreed price

Stage 3: Post negotiation (400 words)

You must prepare a 1 page letter to your client advising the outcome of the negotiation.

4. What is your client’s BATNA? What is your client’s reservation value?

5. What is the other party’s BATNA? What is the other party’s reservation value?

6. What is the ZOPA range? What is your strategy for claiming the greater proportion of the ZOPA? Include at least fifteen academic references in your answers to the above questions with a minimum of five references coming from academic journals.

Please summarize the below two articles in you own words 150 words each article

Article 1

HIPAA Privacy Rule Thwarts Clinical Research Recruitment

Feb. 15, 2005 — Since the federal government's sweeping medical privacy rule went into effect two years ago, the additional paperwork required of academic institutions to obtain patients' consent to participate in clinical research trials has caused enrollment to plummet by as much as 50% at one institution and confusion among many others, a new editorial concludes.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) included a major provision that required covered entities (hospitals, physicians, health plans, and other entities that handle patient information) to obtain confidentiality documentation from researchers before disclosing health data. This section of the law, which took effect as part of the overall medical privacy law in April 2003, was intended to ensure that patients' protected health information (PHI) would not be inappropriately disclosed or used during the course of a research trial.

But a lack of guidance by the U.S. Department of Health and Human Services (HHS) about how to interpret this provision and the resulting variability in approaches by research institutions "could not have been what was intended by the law and is not optimal for balancing the need for confidentiality and research progress," said Roberta B. Ness, MD, MPH, chairman of the Department of Epidemiology at the University of Pittsburgh Medical Center in Pennsylvania. "To put out the rules without guidance has resulted in a lack of clarity," she told Medscape in an interview.

Writing in the February issue of the Annals of Epidemiology, Dr. Ness describes the before-and-after effect of HIPAA's rules governing medical research as it applied to patient recruitment in a single-institution, prospective study to determine the cause of preeclampsia.

In the pre-HIPAA phase of the study, called the Pregnancy Exposures and Preeclampsia Program Project (PEPP I), 2,892 women were recruited in 55 months, for an average of 12.4 women per week. The study was renewed in early 2002, but recruitment was shut down for four months while the maternity hospital at which the study was conducted decided how to comply with upcoming medical privacy laws.

Between April and September 2003, recruitment into the study took place under new rules that disallowed all waivers of HIPAA medical record review, according to Dr. Ness. (Waivers allowing an institution to use or disclose PHI for research purposes can be granted if specific conditions are met, according to the privacy rule).

Under that restriction, "the only medical records PEPP II staff could review to determine potential eligibility were for women who had enrolled into a research registry," Dr. Ness writes. "Only about 10% of women enrolled into the registry, presumably because only a clinical staff was authorized to initiate registry enrollment."

Shortly afterward, the hospital's institutional review board allowed applications for a waiver so that researchers could review medical records and flag those that represented potentially eligible subjects, as had been done before HIPAA. Recruitment was further hindered because health provider consent was required before the clinical research staff could approach potential research subjects, and when the maternity hospital merged with the University of Pittsburgh in June 2004.

After HIPAA took effect, the average recruitment rate for participation in PEPP II was 2.5 women per week without a waiver, 5.7 women per week with a waiver, and 3.3 women per week since retraction of the HIPAA waiver, according to Dr. Ness.

"[R]ecruitment with a HIPAA waiver, as compared to pre-HIPAA, decreased by half; and recruitment without a HIPAA waiver fell by half again as compared to with a waiver," Dr. Ness writes. "We cannot identify other systematic explanations for these trends other than the obvious: local interpretation of the HIPAA regulations had a negative effect on the pace of our research."

The slowdown in Pittsburgh's ability to recruit additional subjects into the preeclampsia study has put the program "way behind where we should be," said Dr. Ness. "I have a long career of running prospective studies, and we have never been this far behind on a study at this juncture."

Many research institutions report being in a similar situation, Dr. Ness notes in the editorial. Nearly three quarters (72%) of the 331 U.S. investigators polled by the Association of American Medical Colleges reported that HIPAA was having an adverse effect on clinical research during the first six months after its implementation. Negative effects on patient recruitment, data access, and data acquisition were cited by more than 68% of the respondents.

An HHS advisory committee has proposed modifications to HIPAA that would better coordinate the rule's requirements with those of the Common Rule, a federal law that protects human research subjects, Dr. Ness writes. "We can only hope that the new Secretary for Health and Human Services will adopt these modifications," she concludes.

Article 2

Established by FDA to Expedite Patient Access to Medications

Approximately 10-15 years elapse between the discovery of a new drug in the laboratory and its therapeutic use in the clinical setting.^[1] One factor influencing the duration of drug development is the Food and Drug Administration's (FDA's) review of an agent's efficacy and safety data. In 2001, FDA's Center for Drug Evaluation and Research (CDER) and Center for Biologics Evaluation and Research (CBER) approved 31 new molecular entities.^[2-4] The average time from sponsor submission of a new drug application (NDA) or biologics license application (BLA) to FDA approval of these compounds was 18.6 months, an increase from 17.2 months in 2000, 12.9 months in 1999, and 12.5 months in 1998.

FDA has implemented several programs intended to reduce the review time of a new pharmaceutical and accelerate patient access to medications for the treatment of serious or life-threatening diseases. This review article provides an overview of these initiatives, with a focus on fast-track designation, priority review, accelerated approval, and orphan drug status. Imatinib mesylate (Gleevec, Novartis), which was approved for three phases (chronic, accelerated, and blast crisis) of chronic myelogenous leukemia (CML) in May 2001 and gastrointestinal stromal tumors (GIST) in February 2002, serves as an example of drug development focused on expedited patient access. The information on the clinical development and approval of imatinib was available through the Freedom of Information Act. Imatinib will be discussed throughout this review to illustrate the highlights and opportunities of each FDA program. Finally, the clinical implications of the programs will be described.

Regulatory Overview

There are multiple regulatory documents that outline the responsibilities of FDA and the industry sponsor throughout the drug development process, including the Prescription Drug User Fee Act (PDUFA) of 1992, the five-year renewal of PDUFA (PDUFA II), the recently approved PDUFA III, and the Food and Drug Modernization Act of 1997 (FDAMA). In addition, supporting regulatory documents (i.e., guidance documents) have been established that specifically relate to fast-track designation, accelerated approval, priority review, and orphan drug status. Although these four programs share features, each is a distinct initiative with different requirements. Fast-track designation relates to the interactions between the sponsor and FDA during the drug development process. Accelerated approval refers specifically to the design of studies performed by the sponsor, and priority review sets the time frame for FDA review of a submitted BLA or NDA. Finally, allowing drug manufacturers to seek orphan drug status encourages the development of drugs to treat rare diseases.

Calculating the Direct Labor Rate Variance and the Direct Labor Efficiency Variance

Guillermo's Oil and Lube Company is a service company that offers oil changes and lubrication for automobiles and light trucks. On average, Guillermo has found that a typical oil change takes 18 minutes and 6.2 quarts of oil are used. In June, Guillermo's Oil and Lube had 980 oil changes.

Guillermo's Oil and Lube Company provided the following information for the production of oil changes during the month of June:

Actual number of oil changes performed: 980
Actual number of direct labor hours worked: 286 hours
Actual rate paid per direct labor hour: $15.00
Standard rate per direct labor hour: $14.00

Required:

1. Calculate the direct labor rate variance (LRV) and the direct labor efficiency variance (LEV) for June using the formula approach.

2. Calculate the direct labor rate variance (LRV) and the direct labor efficiency variance (LEV) for June.

3. Calculate the total direct labor variance for oil changes for June.
$fill in the blank 9  

4. What if the actual wage rate paid in June was $13.00? What impact would that have had on the direct labor rate variance (LRV)? On the direct labor efficiency variance (LEV)? Indicate what the new variances would be below. If required, round your answers to the nearest cent.

Direct labor rate variance (LRV):
$fill in the blank 11  

Direct labor efficiency variance (LEV):
$fill in the blank 13