Mother:Hold your tongue. Do not say rude things that are unnecessary--whether they are true or false. Saying things that will further agitate a situation will do nothing to improve your relationship with your Mother.

Be appreciative of the things your Mom (or parents) do for you. They took the time to raise you and provide for you. Be sure to thank them when they do something nice for you. This will let your Mom know that you appreciate her.

Know when to step away from a conversation that could turn toxic. If you sense that tensions are rising, say that you are aware of her opinion and simply walk away. Be sure to physically separate yourself from tension; take a walk, a bike ride, or go into your room and listen to music. Take deep breaths to calm yourself.

Do not share your entire world with Mom. If you know that she sorely objects to the amount of money you spend on your car, do not bring it up in conversation. Understand that she will likely never understand your view on certain subjects and avoid them in conversation. This does not pertain to subjects that must be discussed, like children, spouses, abuse or other serious family matters.

Agree to disagree. No matter what, Mom will always think she knows what's best for her baby...you will always be her baby. Tell her that she is entitled to her opinion, but that you feel differently. Include a statement like "Thank you for your advice, Mom, but I have decided that having children does not fit into my life plan." Expressing your opinion in a calm fashion will make her feel like you aren't attacking her.

Take your space when you need it. If you know your Mom needs a few days to recover from an argument, don't pressure her to talk about it too soon. Doing so may cause tensions to continue to rise.

If you decide to keep certain matters private from your Mom, stick to it. Even if she needles you to discuss a private subject, politely tell her that you do not want to talk about it. If you stick to your guns, she may be frustrated at first but soon learn that her meddling is to no avail.

Don't let your mother insult you, even in an argument. It is not okay for someone to say cruel things to you, even if she is your mother. Certain boundaries should never be permeated. Show your mother the same respect and refrain from insulting her or cussing at her.

Fathers

Is a father a key figure in his daughter’s development? “The role of a father’s absence on the reproductive and psychological behavior of their daughters has been a subject of considerable interest from a developmental, psychological, sociological and evolutionary perspective”. It seems for many girls that “inevitably our fathers determine how we view the opposite sex, the outside world and ourselves”. Further, “the bond between father and daughter is one of the strongest in the world...[and] if the father and mother are the right role models, the daughter will grow into an independent young woman”.

A Father’s Influence and Involvement

The relationship between a father and his daughter is in jeopardy. “In one recent study only thirty percent of fathers believed that active involvement in their daughter’s life was vital to her health and well being”. Following this cultural norm, fathers seem to spend more time talking with, giving advice to, and sharing more with their sons. Also, in a study of college women conducted over a 15-year period, Nielsen found that her subjects wished that their relationship with their father was emotionally and personally closer so they could more closely and comfortably communicate about such personal issues as marital problems and divorce, drug and alcohol use, financial matters, depression, eating disorders, and sex before marriage.

It therefore seems that a father indeed has influence on his daughter and on her development as a whole person. A daughter will be a different kind of person depending on the level of involvement her father has. The question now remains: In what specific ways, or in which areas of life, does a father influence?

Assessing the FriendshipThink about why you fought. Maybe you had a recent fight that put your friendship on the rocks. Think deeply about whether your friendship is worth saving. Do you think your anger will subside, or is this really the end?[1] Ask yourself these questions to better understand your situation:

Was your disagreement a one-time occurrence or has been ongoing? If your disagreement has continued for some time, think realistically about whether it will eventually fizzle out.

Does the issue itself matter more to you than the friendship? Depending on the disagreement, your principles may or may not be more important to you than your friend.

Could you ever "agree to disagree" on this issue? If you can agree to reach a compromise, your friendship will likely survive. If not, you may need to end things.

Decide whether you're growing apart. Sometimes friendships don't end with a fight, but with a fizzle. Has it been awhile since you felt like calling up your friend for a chat? Do you find yourself making excuses not to hang out? If so, ask yourself whether you or your friend could do anything to save the relationship, or whether you even want to.

How long have you known each other? It's important to weigh how much time you have already invested in the friendship against how much time you are willing to invest in the future. If you are very old friends, the friendship might be worth saving, even if it's not as fun as it used to be. Having someone in your life who has known you forever is valuable.

Do you still have fun together? Maybe you don't need to completely end the friendship, but just take as step or two back. Instead of pressuring yourselves to hang out once a week, try calling each other up less frequently. That way the time you do spend together will be more precious, and you won't get tired of each other's presence.Think about how your life will feel without your friend. Does it make you sad to imagine life without the person, or does it make you feel relieved? If you already know that you'll be happy to get rid of the drama, boredom, or other negative feelings that you associate with this person, ending it is a good idea. If you feel a twinge of sadness and aren't truly sure this is what you want to do, consider other options.

Think about what it would take to keep the friendship alive. Friendships can take as much time and effort as any other kind of relationship. If you choose to keep yours alive, you'll need to be willing to invest a lot of energy to do so.

Teacher

I have collected here, without examples or detailed explanations, a collection of practices that constitute excellence in college teaching. These elements represent the broad range of effective actions teachers take, and requisite conditions that teachers establish, to facilitate learning. I have tried to make this listing intentionally brief and can be scanned to serve more as a reference to the scope of excellent teaching techniques than as a source of enlightenment. For information on items that are unfamiliar, either post an email or refer to the citations.

Recognizing that teaching is both art and science, I advance this list of dimensions of excellence as a starting point for discussions about the performances that we as teachers strive for and may help each other obtain. While the skills of teaching are widely researched and described, they are rarely rewarded, mostly, I think, because we don't share this common language about best practices. Instead of directly addressing learning to teach well, we often erroneously assume new teachers know how to teach because they used to be students.

Becoming an excellent college teacher is a continuing life-long professional challenge, the dimensions of which often go unrecognized. In the general mind, doctors and lawyers are professionals, teachers are not. I believe we could change our semi-professional status if we could agree upon a list of Best Practices such as this one and help each other achieve them. It would help us achieve three goals:

1. College teachers could find consensus on an ever-evolving definition of what constitutes best practices in this amorphous and complex endeavor.

2. Senior faculty could assume a responsibility to develop additions and modifications to the best practices list and actively transmit those practices to new faculty.

3. We all could ensure that our colleagues and institutions apply the set of best practices for the ultimate welfare of the learners. If faculty could ever come to agree upon a performance list such as this one, our institutions could marshal the resources to accelerate its attainment, clarify the objectives for acquiring tenure, and offer salary rewards for an individual's continued reflective review of teaching practice.

Observe the needs and problems of an aged person with a report

Every year, thousands of Medicare patients who spend time in the hospital for observation but are not officially admitted find they are not eligible for nursing home coverage after discharge.

A Medicare beneficiary must spend three consecutive midnights in the hospital — not counting the day of discharge — as an admitted patient in order to qualify for subsequent nursing-home coverage. If a patient is under observation but not admitted, she will also lose coverage for any medications the hospital provides for pre-existing health problems. Medicare drug plans are not required to reimburse patients for these drug costs.

The over-classification of observation status is an increasingly pervasive problem: the number of seniors entering the hospital for observation increased 69 percent over five years, to 1.6 million in 2011.

The chance of being admitted varies widely depending on the hospital, the inspector general of the Department of Health and Human Services has found. Admitted and observation patients often have similar symptoms and receive similar care. Six of the top 10 reasons for observation — chest pain, digestive disorders, fainting, nutritional disorders, irregular heartbeat and circulatory problems — are also among the 10 most frequent reasons for a short hospital admission.

Medicare officials have urged hospital patients to find out if they’ve been officially admitted. But suppose the answer is no. Then what do you do?

Medicare doesn’t require hospitals to tell patients if they are merely being observed, which is supposed to last no more than 48 hours to help the doctor decide if someone is sick enough to be admitted. (Starting on Jan. 19, however, New York State will require hospitals to provide oral and written notification to patients within 24 hours of putting them on observation status. Penalties range as much as $5,000 per violation. )

To increase the likelihood of being formally admitted, “get yourself in the door before midnight,” advised Dr. Ann Sheehy, division head of hospital medicine at the University of Wisconsin Hospital in Madison, Wisc. A new Medicare regulation — the so-called “pumpkin rule” — requires doctors to admit people they anticipate staying for longer than two midnights, but to list those expected to stay for less time as observation patients.

Although the rule applies now, Medicare officials won’t enforce it until April 1, having already pushed the deadline back. The American Medical Association and the American Hospital Association have called the pumpkin rule “impossible” to comply with and have urged that enforcement be delayed again until October.

“It doesn’t make any sense,” said Dr. Sheehy, who studied how the rule would have affected admissions at her hospital over an 18-month period and published the results in JAMA Internal Medicine. “Some patients will be admitted because they came in at the right time of day, not because they have more complicated medical problems.”

The two-midnight rule doesn’t change Medicare’s three-midnight rule, the one limiting post-hospital nursing home coverage. Officials at the federal Centers for Medicare and Medicaid Services declined comment for this story because of pending litigation seeking to eliminate observation status.

If you or a family member land in the hospital as an observation patient and think you should be admitted, it’s better to act sooner than later.

“I would talk to anyone who would listen to me,” said Terry Berthelot, a senior attorney at the Center for Medicare Advocacy, which offers a free self-help packet for observation patients. “Make as much noise as you can, because it’s much easier to change your status while you’re still in the hospital than to go through Medicare’s appeals process later.”

Ms. Berthelot suggests asking your regular physician to speak with the doctor treating you in the hospital about why you need to be admitted, based on your medical condition and risk factors.

“It’s got to be a medical argument,” said Ms. Berthelot. “You can’t say, ‘Mom will need rehab after this,’ or ‘We can’t take her home because no one can stay with her.’”

If that doesn’t work, sometimes a strongly worded letter or call from a lawyer describing the patient’s medical needs can be effective.

In some cases, help from a professional can make a difference. Shari Polur, an elder-law attorney in Louisville, Ky., recently hired a geriatric care manager to persuade a local hospital to admit her client. Since admission status can change from one day to the next, the manager, who is also a registered nurse, called the hospital every morning to make sure the patient was still officially admitted until she could be transferred to a nursing home.

If the situation isn’t resolved while you’re in the hospital and you require follow-up care at a nursing home, you’ll have to pay the bill of often thousands of dollars up front. At that point, Ms. Berthelot suggests, you should file what amounts to a special doubled-barreled appeal with Medicare.

It’s not for the faint of heart: the process is long and arduous, and it requires beneficiaries to first receive and pay for the care — often an expensive proposition — before seeking reimbursement.

And the legal arguments can be tangled. The Medicare appeals process typically addresses disputes over whether certain treatments or services rendered should have been covered. Observation patients have actually received hospital coverage and services a doctor says is medically necessary — so they don’t really have anything to appeal, said Marc Hartstein, director of Medicare’s hospital and ambulatory policy group, at a recent briefing in Washington.

“My limited understanding of this is that the patient cannot appeal a decision not to order or not to do something,” he said.

But observation patients may claim that they received treatment usually provided to admitted patients only in a hospital. Therefore, the hospital incorrectly billed Medicare for an outpatient service instead of for inpatient services. The patient should have been admitted and therefore qualifies for nursing home coverage.

“It’s absolutely confusing as heck,” said Michael Sgobbo, an elder law attorney in Charleston, S.C., who recently won an appeal on behalf of a 98-year-old woman who will be reclassified as an admitted patient. That means Medicare will pay her nursing home bill of nearly $10,000.

Lawyers at the Center for Medicare Advocacy recommend fighting observation care on two fronts.

First, follow the appeal instructions in the Medicare summary notice, a quarterly statement of services. Circle the charges on the statement from the hospital and explain that these items were inappropriately billed under Medicare’s Part B as outpatient services. They should have been billed under Medicare’s Part A for hospital services, because the patient received treatment that could only have been provided in a hospital. Mail the statement within 120 days (from the date on the statement) to the address provided for appeals.

Second, after challenging the hospital’s observation designation, file a separate appeal to seek reimbursement for the nursing home charges, said Ms. Berthelot. To begin, ask the nursing home to bill Medicare. You should receive a Medicare summary notice indicating that it did not pay the nursing home charges because the patient didn’t have the required three-day hospital stay. Circle those charges, and explain that the beneficiary was hospitalized for three days and received an inpatient level of care. Then send it within 120 days to the address provided for appeals.

Be prepared to dig in. If either appeal is denied, you must appeal again to the next level, following the instructions in the denial letters.

“Both appeals can take at least a year and are fraught with difficulty,” said Ms. Berthelot. “The reality is that most people can’t get through and those who do, get lucky.”

Some observation patients appeal and never get decisions, warned Diane Paulson, senior attorney at Greater Boston Legal Services. Some of her clients’ cases were dismissed because they were not admitted to the hospital — the very point they were challenging.

“You can’t appeal if you don’t have a denial,” she said. When that happens, the case falls into “a black hole.”

But the chances of winning improve as you continue to appeal, as Nancy and George Renshaw, of Bozrah, Conn., discovered. After spending nearly four years going through the process, a Medicare judge decided last February that Mr. Renshaw’s father should have been admitted to the hospital instead of classified as an observation patient. Medicare finally paid his nursing home bill, and in November the Renshaws received a refund of $4,410.

“I was shocked,” said Ms. Renshaw. “I never expected to see a penny of it.”