An after tax economic analysis of home equity conversion for the elderly

The FHA program to insure reverse mortgages has brought additional attention to the use of home equity conversion to increase income to the elderly. Using simulation, this study compares the economic consequences of the FHA reverse mortgage with two alternative conversion vehicles: sale of a remainder interest and sale-leaseback. An FHA insured plan is devised for each vehicle, structured to represent fair substitutes for the FHA mortgage. In addition, the FHA mortgage is adjusted to allow for a 4 percent annual increase in distributions to the homeowner. The viability of each plan for the homeowner, the financial institution and the FHA is investigated using different assumptions for house appreciation, tax rates, and homeowners' initial ages. For the homeowner, the return of each vehicle is compared with the choice of not employing home equity conversion. The study examines the impact of tax and accounting rules on the selection of alternatives. The study investigates the sensitivity of the FHA model to some of its assumptions.^ Although none of the vehicles is Pareato optimal, the study shows that neither the sale of a remainder interest nor the sale-leaseback is a viable alternative vehicle to the homeowner. While each of these vehicles is profitable to the financial institution, the profits are not high enough to transfer benefits to the homeowner and still be workable. The effects of tax rate, house appreciation rate, and homeowner's initial age are surprisingly small. As a general rule, none of these factors materially impact the decision of either the homeowner or the financial institution. Tax and accounting rules were found to have minimal impact on the selection of vehicles. The sensitivity analysis indicates that none of the variables studied alone is likely to materially affect the FHA's profitability. ^

Stressors, mediators, and health care outcomes of home enteral nutrition in family caregivers and their older adult care recipients

Family caregivers manage home enteral nutrition (HEN) for over 77% of an estimated 1 of every 400 Medicare recipients. Increasing usage of HEN in older adults combined with reliance on family caregivers raises concerns for the quality, outcomes, and costs of care. These concerns are relevant in light of Medicare limitations on nursing assistance and non-reimbursement for nutrition services, despite annual costs of over $600 million. This study applied stress process theories to assess stressor, mediator, and outcome variables salient to HEN and caregiving. In-home structured interviews occurred with a multi-ethnic sample of 30 caregiving dyads at 1–3 months after discharge on HEN. Care recipients were aged ≥60 (M = 68.4 years) and did not have dementia. Caregivers were aged ≥21, unpaid, and lived within 45 minutes of care recipients. Caregivers performed an average of 19.7 tasks daily for 61.9 hours weekly. Training needs were identified for 33 functional, care management, technical, and nutritional tasks. Preparedness scores were low (M = 1.73/4.0), and positively correlated with competence, self-rated quality of care and positive feelings, and negatively with overload, role captivity, and negative feelings (Ps < .05). Caregivers had multiple changes in lifestyle and dietary behaviors. Lifestyle changes positively correlated with overload, and negatively with preparedness and positive feelings. Dietary changes positively correlated with number of tasks, overload, role captivity and negative feelings, and negatively with preparedness (Ps < .01). Fifty-seven percent of caregivers aged >50 were at nutrition risk. Care recipients fared worse. Average weight change was −4.35 pounds (P < .001). Physical complications interrupted daily enteral infusions. Water intake was half of fluid need and associated with signs of dehydration (P < .001). Physical and social function was poor, with older subjects more impaired ( P < .04). Those with better prepared or less overloaded caregivers had higher functionality and QOL (P < .002). Complications, type of feeding tube, and caregiver preparedness correlated with frequency of health care utilization (Ps < .05). Efficacy of HEN in older adults requires specialized caregiver training, attention to caregivers' needs, and frequent monitoring from a highly skilled multidisciplinary team including dietitians. ^

Two Decades Out of the Whirlpool: Past (and Possible Future) United States Interventions in Latin America [Student's Paper Series]

This paper examines the history of U.S. interventions in Latin America and attempts to explain their frequency by highlighting two factors – besides security and economic interests – that have made American interventions in Latin America so common. First, immense differences in size and influence between the United States and the States of Latin America have made interventions appear to be a low risk solution to crises that threaten American interests in the region. Second, when U.S government concerns and aspirations for Latin America converge with the general fears and aspirations of American foreign policy, interventions become much more likely. Such a convergence pushes Latin American issues high up the U.S. foreign policy agenda because of the region’s proximity to the United States and the perception that costs of intervening are low. The leads proponents of intervention to begin asking questions like “if we cannot stop communism/revolutions/drug-trafficking in Latin America, where can we stop it?” This article traces how these factors influenced the decision to intervene in Latin America during the era of Dollar Diplomacy and during the Cold War. It concludes with three possible scenarios that could lead to a reemergence of an American interventionist policy in Latin America. It makes the argument that even though the United Sates has not intervened in Latin America during the twenty-two years, it is far from clear that American interventions in Latin America will be consigned to the past.

Out of Challenge, Opportunity: Central America's Electric Sector & Key Issues and Recommendations for Enhanced Regional Electric Integration

Taken together, the six nations of Central America count a population of roughly 40 million people and an energy market equal in size to that of Colombia, sufficient to benefit from economies of scale. The region has traditionally been a net importer of hydrocarbons, and hydroelectricity has dominated electric generation. But more recently, thermoelectric generation (diesel and fuel oil) has greatly increased as a percentage of the regional generation market. Progress has been made across the region’s electric sector, beginning with reforms in the 1990s and the 1996 signing of a regional treaty aimed at the development of a regional energy integration project – the Central American Electrical Interconnection System, or SIEPAC. A fundamental SIEPAC goal is to set up a regional electric market and a regulatory system. Indeed, after many years of development, SIEPAC is poised to open a new chapter in Central America’s electric infrastructure and market. But this new era must contend with critical issues such as the need to consolidate the regional electric market, political issues surrounding the venture, and security concerns. Moreover, local conflicts, in different degrees, have become priorities for policymakers, and these are possible barriers to completing the project. The goals of the SIEPAC project and of deepening the broader electric integration process are possible if national and regional decision makers understand that cooperative decision making will produce better results than separate national decision making. Enhanced regional understanding and cooperative decision making, combined with an effort to reorient the terminology and dialogue vis-à-vis energy efficiency in Central America, form the core recommendations of this paper.

Take the "Con" Out of Consulting in the Food Service Industry

Consultants can help a food service operator with almost any problem which needs solving. Howeve6 the manager must "manage" the consultant. The author offers a design for planning for hiring and evaluating the work of anyone given the job of analyzing existing systems and diagnosing problems.

Taking the Bite Out of Higher Payroll Costs

Congress, in an attempt to help underemployed individuals, has once again passed a job hiring tax incentive program called the Work Incentive Taw Credit. This article will provide a brief review of the law and offer planning tips for hospitality firms which wish to reduce their payroll costs.

Children with special health care needs: Comparison of the effects of home care setting, prescribed pediatric extended care setting, and long-term care setting on child and family health outcomes and health care service use

Technological advances during the past 30 years have dramatically improved survival rates for children with life-threatening conditions (preterm births, congenital anomalies, disease, or injury) resulting in children with special health care needs (CSHCN), children who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who require health and related services beyond that required by children generally. There are approximately 10.2 million of these children in the United States or one in five households with a child with special health care needs. Care for these children is limited to home care, medical day care (Prescribed Pediatric Extended Care; P-PEC) or a long term care (LTC) facility. There is very limited research examining health outcomes of CSHCN and their families. The purpose of this research was to compare the effects of home care settings, P-PEC settings, and LTC settings on child health and functioning, family health and function, and health care service use of families with CSHCN. Eighty four CSHCN ages 2 to 21 years having a medically fragile or complex medical condition that required continual monitoring were enrolled with their parents/guardians. Interviews were conducted monthly for five months using the PedsQL™ Generic Core Module for child health and functioning, PedsQL™ Family Impact Module for family health and functioning, and Access to Care from the NS-CSHCN survey for health care services. Descriptive statistics, chi square, and ANCOVA were conducted to determine differences across care settings. Children in the P-PEC settings had a highest health care quality of life (HRQL) overall including physical and psychosocial functioning. Parents/guardians with CSHCN in LTC had the highest HRQL including having time and energy for a social life and employment. Parents/guardians with CSHCN in home care settings had the poorest HRQL including physical and psychosocial functioning with cognitive difficulties, difficulties with worry, communication, and daily activities. They had the fewest hours of employment and the most hours providing direct care for their children. Overall health care service use was the same across the care settings.

The effects of school mobility in pre -assessment grade levels on student performance and school accountability in urban Title I schools

This study examined the effects of student mobility and educational enrollment experiences on academic achievement. The educational progress, school enrollments and transfers of inner-city elementary students were tracked over a four-year period. Student achievement was measured by criterion-referenced reading tests administered in the second semester of the third grade. It further analyzed the degree to which the switch to different basal reading textbooks interrupted the continuity of education thereby contributing to the detrimental effects of intra-district mobility. ^ Mobility histories of 2,913 third grade students were collected to evaluate the number of times each student entered or withdrew from a Miami-Dade County Public School beginning in August 2000 through March 2004, and distinguished between transfers that occurred during the academic school year and those that occurred during summer months. Data were analyzed using Pearson correlations and multiple regressions to determine if school mobility contributed to performance on the Florida Comprehensive Assessment Third Grade Reading Test (FCAT). Transferring from one school to another was found to have a significant negative impact on student test scores. Transfers within the academic school year were more detrimental than transfers that occurred during the summer months. Third grade students who transferred into schools that used the same reading textbook series were found to have significantly higher FCAT reading scores than third graders who transferred into schools that used different reading textbooks. ^ The effects of mobility rates on overall school performance were also examined. Data was collected on 124 Title I elementary schools to determine the degree to which mobility affected school accountability scores. Title I schools with high student mobility rates had significantly lower accountability scores than schools with lower student mobility rates. ^ The results of this study highlight the impact of education and housing policy and imply a need for programs and practices that promote stability in the early elementary years. ^

I want out of the labels : how Chuck Palahniuk's characters challenge the dominant discourse

The purpose of this study was to explore postmodern identity in the work of Chuck Palahniuk. The characters within Palahniuk's text Invisible Monsters realize the manner in which identity is a construct, and their response is to oppose and redefine it. In my research, I looked at how postmodern identity is defined by some of the leading critical thinkers in the field, and then I applied their thought to Palahniuk's characters. I showed how these characters come to understand the process by which society defines them, and with that realization, they oppose its totalizing definitions. The characters deconstruct the natural attitudes society has towards identity, and they reveal that it is in some way possible to create a unique identity that is not easily definable by the ruling discourse. I concluded that his attention to identity highlights Palahniuk's concern for the place, identity, and influence of his generation.

Out of View: Stories

OUT OF VIEW is a collection of stories set in the American Southwest about people coping with loss—the death of parents, children, ideals, innocence. The characters in this collection reap or resist lessons of life as they struggle to find their place in the world. In “First Rain,” 15-year-old Tessie struggles with the loss of her father and the demands of her mother as she navigates the rocky terrain of adolescence. In “Monsters,” middle-aged Maury has to choose between a new relationship and protecting the well-being of his 4-year-old ‘daughter.’ The stories are influenced by the Western realism of Maile Meloy and the playful plotting of Ron Carlson. These stories are inspired both by the Sonoran Desert—expansive, sun-soaked, unrepentant—and by the people who live, love, and lose in the interstices between Manifest Destiny and the Reconquista.

Houseboats pushed out of the water by Hurricane Wilma, Flamingo

This material is based upon work supported by the National Science Foundation through the Florida Coastal Everglades Long-Term Ecological Research program under Cooperative Agreements #DBI-0620409 and #DEB-9910514. This image is made available for non-commercial or educational use only.

Houseboats pushed out of the water by Hurricane Wilma, Flamingo

This material is based upon work supported by the National Science Foundation through the Florida Coastal Everglades Long-Term Ecological Research program under Cooperative Agreements #DBI-0620409 and #DEB-9910514. This image is made available for non-commercial or educational use only.

Children with Special Health Care Needs: Comparison of the Effects of Home Care Setting, Prescribed Pediatric Extended Care Setting, and Long-Term Care Setting on Child and Family Health Outcomes and Health Care Service Use

Technological advances during the past 30 years have dramatically improved survival rates for children with life-threatening conditions (preterm births, congenital anomalies, disease, or injury) resulting in children with special health care needs (CSHCN), children who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who require health and related services beyond that required by children generally. There are approximately 10.2 million of these children in the United States or one in five households with a child with special health care needs. Care for these children is limited to home care, medical day care (Prescribed Pediatric Extended Care; P-PEC) or a long term care (LTC) facility. There is very limited research examining health outcomes of CSHCN and their families. The purpose of this research was to compare the effects of home care settings, P-PEC settings, and LTC settings on child health and functioning, family health and function, and health care service use of families with CSHCN. Eighty four CSHCN ages 2 to 21 years having a medically fragile or complex medical condition that required continual monitoring were enrolled with their parents/guardians. Interviews were conducted monthly for five months using the PedsQL TM Generic Core Module for child health and functioning, PedsQL TM Family Impact Module for family health and functioning, and Access to Care from the NS-CSHCN survey for health care services. Descriptive statistics, chi square, and ANCOVA were conducted to determine differences across care settings. Children in the P-PEC settings had a highest health care quality of life (HRQL) overall including physical and psychosocial functioning. Parents/guardians with CSHCN in LTC had the highest HRQL including having time and energy for a social life and employment. Parents/guardians with CSHCN in home care settings had the poorest HRQL including physical and psychosocial functioning with cognitive difficulties, difficulties with worry, communication, and daily activities. They had the fewest hours of employment and the most hours providing direct care for their children. Overall health care service use was the same across the care settings.