Tuesday, November 26, 2019

Fall Back On Fitness Essays - Physical Exercise, Self Care, Holiday

Fall Back On Fitness Essays - Physical Exercise, Self Care, Holiday Fall Back On Fitness Fall Back On Fitness As we head into the cooler autumn months, we undoubtedly expect that the upcoming holiday seasons surrounding Thanksgiving, Halloween, and (yes, already) Christmas will lead to our spending more and more time indulging and less and less time keeping ourselves healthy and fit. This doesnt have to be the case. We are not bears, and regardless of what one may think, we do not need to store up extra fat so that we may hibernate for the winter! Awareness of the potential pitfalls of the holiday season can prevent the pounds from sneaking up on you. Treat yourself to an early gift by purchasing a journal in which you can keep a daily record of your eating, exercise and stress behaviours. Keep an eye on your journal entries so that youll notice your less than healthy behaviours and make changes before you get overwhelmed. One suggestion is to weigh yourself once a week during the holiday season. One study of weight loss over a 50-week period found that some study participants gained 500 percent more weight per week during holiday weeks as compared to non-holiday weeks. But the good news: Participants who consistently monitored and recorded their own behaviours were able to lose weight during the holidays. (Published in Health Psychology, July 1998.) The next suggestion is to remember that your body needs movement more than ever during the holiday season. Exercise releases tension, expends the calories of those holiday goodies, increases your energy levels so you can shop til you drop, elevates your mood so you can combat holiday-related depression and be the life of the party, and gives you the gift of time for yourself. Here are some great ways to fit exercise into the busy fall season: Exercise first thing in the morning before you begin your busy day. Try to plan holiday activities around family and friends, instead of around food. Tell family and friends to bring walking shoes and comfortable clothes to your celebration. Then take a 30-minute walk together. You can do it in shifts so someone's always basting the turkey! Get into a routine now, before the holidays strike! Those who have previously developed a solid exercise habit will make the time to exercise even when they feel like they are too busy to find the time.

Friday, November 22, 2019

Top 5 Worst Sources to Find Professional Writers for Hire

Top 5 Worst Sources to Find Professional Writers for Hire Top 5 Worst Sources to Find Professional Writers for Hire When it comes to dealing with academic papers, students often search for professional writers for hire to help them cope with their assignments. The first thing that they pay attention to is the price, and it becomes their biggest problem. While it is possible to find a good writer for a low cost, you have to search for them thoroughly. There are many questionable sources that would be happy to take your money and give you a plagiarized paper (or nothing!) in return. Watch out for the following 5 worst sources to find professional writers for hire. 1. Social Networks Don’t look for writers on social networks. Writers promoting themselves on social media are less likely to be reliable. While you may be able to read â€Å"reviews,† these can easily be fabricated by friends of the self-proclaimed writer or by fake social media accounts that the writer has created him/herself. It is quite tempting to hire an ‘experienced’ writer while you’re browsing Facebook, but the moments you save will pale in comparison to the headache of getting back a poor quality paper. 2. Forums Don’t hire a writer from an unreliable forum. If you can’t read reviews about writers’ previous works, if they demand full payment in advance, or if they refuse to provide you with a formal contract, then you risk to throw away your money for nothing. Instead, look on platforms that provide you with a resume for each writer, reviews from their past clients, and a guarantee that you’ll be satisfied with their work before you pay them. 3. Friends of the Friends Don’t hire a writer who’s been recommended by a friend (or worse, by a friend of a friend). Every person is happy to speak well of their friends, but they may not be really good at the kind of writing you are looking for. This creates a doubly awkward situation. First, you will feel bitterly toward the friend who gave you a poor recommendation, and then, you will have a poor quality paper that you spent good money on, but can’t turn in. It is uncomfortable for everyone involved. 4. Suspicious Websites Don’t hire a writer from a reputable platform who’s sent you a generic application. If you’ve found a reputable website to hire a writer, but then they have sent you an impersonal application, they may not be as well suited to write your paper as you might hope. What you want to see is a personal note that indicates that they understand the requirements of your paper and have experience with writing such type of paper in the past. If you get a generic application from an otherwise promising profile, considering sending them a follow-up message to get samples of their work. 5. Job Board Don’t hire a writer from Craigslist or another local job board. Professional writers have their own website, or at the very least, their own profile on a reputable marketplace for clients to match with writers. If a writer is posting on Craigslist, they may be desperate for money as well as too happy to make false claims about their abilities. It’s a great place to get a used bike or kitchen table, but the worst place to find a trusted ally in getting your writing assignments completed. Be aware of all the traps that you can get into. Do not allow the self-proclaimed writers spoil your grades as well as your reputation. Seek for reliable sources to hire truly professional writers for your pieces.

Thursday, November 21, 2019

Accounting Essay Example | Topics and Well Written Essays - 250 words - 15

Accounting - Essay Example In the temporal method, accounts and cash receivables are the main and only assets changed in the current exchange rate. Longer term debt and accounts payable are also changed at the current exchange rate. Due to the reasons that polish zloty liability amounts change at exchange rate surpasses the zloty asset amounts changed in the exchange rate, there is an existence of a net liability exposure. Measurement loss in the third of part 1 increases due to two reasons: there a net asset exposure in the balance sheet and depreciation of the polish zloty against U.S dollar in the second year. Account and receivables accounts are the main assets changed at the exchange rate. As there is no longer term debt in this part, the only liability changed at the exchange rate is accounts payable. As the polish zloty assets amount changed at the exchange rate surpasses polish zloty liability amount changed at the exchange rate, there exists an exposure of net asset in the balance

Tuesday, November 19, 2019

Media and Education Personal Statement Example | Topics and Well Written Essays - 1000 words

Media and Education - Personal Statement Example This report declares that there are diverse ways in which students at the college level can be able to practice serious reflections. Students should practice reflection by not utilizing internet while carrying out their assignments. They should learn to reflect on what they had learned during their class time and apply in their assignments. Assignment being part of the learning process should be given after a lecturer has tackled the topic. This will enable students think and reflect what they have been taught, and handle their tasks well. Use of technological devices such as calculator should be avoided and enable the students to reflect, think critically on tasks, and tackle them effectively. Simulation mode of study should be employed in colleges; these modes of study allow the student to apply what they had acquired during classroom and apply in an environment similar to the actual environment. This paper makes a conclusion that technology has rendered communities incapable to think and reflect rationally. Technology has come up with ways of doing things in shortcut and does not pose a challenge to individuals. Student are the ones affected most, with the presence of internet and communication system, it leads in students utilization of technology more than carrying out tasks on their own. For instances, mathematics are calculated using calculator instead of a student to think critically and reflects on what they were taught in class. Technology also has harbored individual’s creativity as most of the activities are carried through internet.

Sunday, November 17, 2019

Elements of Reading Essay Example for Free

Elements of Reading Essay Reading is the process of making sense from print; comprehension is the goal of all reading. Comprehension is constructed by the reader, so no one understanding will match another’s, but how readers apply strategies as they process text influences the depth of understanding. There are four elements of reading: word identification, fluency, comprehension, vocabulary. We will begin with word identification, since it is the foundation of the reading process. Word Identification  Several terms are associated with the identification of words: word attack, word analysis, word recognition, decoding. These are often used interchangeably and suggest the act of translating print into speech through the analysis of letter-sound relationships. Each term is connected with what is commonly called â€Å"phonics†Ã¢â‚¬â€a tool to analyze or attack words—which focuses attention on words parts and builds on phonemic awareness. â€Å"Word recognition† suggests a process of immediate word identification i. e. words retrieved from memory. It includes the concept of sight words (or sight vocabulary) and suggests a reader’s ability to recognize words rapidly/automatically by making an association between a particular spelling/pronunciation/meaning by applying an internalized knowledge of letter-sound relationships. Word recognition together with word attack skills leads to word identification. Many children develop knowledge about print before entering school through purely visual cues. These children enter first grade fully ready to analyze words, but others do not. They rely on your explicitly-planned lessons. Ehri’s study (as cited in Vacca, Vacca, Gove, Burkey, Lenhart, McKeon, 2003) claimed that there were developmental phases in word identification, whose characteristics could be readily identified, as children progressed. †¢The pre-alphabetic stage includes visual clues, such as those found on cereal boxes, traffic signs, and restaurant logos (stop sign, Burger King, KFC, McDonald’s). †¢The partial alphabetic stage, emerging during kindergarten and grade 1, includes some knowledge about letter-sound relationships (â€Å"S† looks and sounds like â€Å"Sammy, the snake†). †¢The full alphabetic stage includes enough knowledge about segmenting sounds (/c-l-o-ck/) to unlock the pronunciation of unknown words. †¢The consolidated alphabetic stage includes the ability to analyze multisyllabic words, using onsets and rimes. Fluency Fluency is the ability to read text in a normal speaking voice with normal intonation (the rise and fall of the human voice) and inflection (the pitch, stress and pauses). In the context of literacy, one is â€Å"fluent,† who can read with expression and comprehension. Students who are fluent have automaticity. They do not devote attention to decoding, but focus on the construction of meaning. Problems in fluency are a major contributing factor to students’ lagging achievement. They often arise due to the lack of early contact with literacy or diverse linguistic background. Repetition is key to increasing fluency. A mixture of six methods helps to increase fluency. †¢Predictable text: Children can rely on their intuitive knowledge of language and sense to read with less and less assistance. Ex. Max’s Pet †¢Repeated readings: Children can practice reading aloud alone, with a classmate or parents, and to the principal. †¢Automated reading: Children can listen and read along with a tape, a CD, or a computer program. They can also record themselves, listen, and repeat until fluent. †¢Choral reading: Children need to hear mature readers with expression. The oral reading of poetry with various voice combinations builds on a natural interest in rhythms and highlights the beauty of tonal qualities in spoken English. In choral reading, all fluency levels can participate in unison, take parts, or read refrains without embarrassment. †¢Readers’ Theater: This oral presentation of drama, prose or poetry involves children of all ages reading literature to audiences of children. With a few props, perhaps, but no costumes and no memorized lines, the emphasis is on what the audience hears. †¢Sustained Silent Reading (SSR): Classes and sometimes entire schools establish a daily, fixed time period for silent reading of self-selected material. Teachers also read, and there are no content-related questions asked. Stories (or a copy of them) can be sent home for rereading, after students have become very familiar with them by rereading during class. The goal is to increase the â€Å"pleasure principle† and enable children to become lifelong readers. Comprehension To understand text, a reader actively searches for meaning and responds to text as s/he decodes. Readers learn to monitor their own comprehension through metacognition. The dimensions of active reading comprehension involve specific questioning skills that require readers to â€Å"grapple with text† in order to organize their background knowledge, clarify ideas and support opinion. †¢Question/Answer Strategy †¢Ask questions that elicit questions in return. Such questions stimulate interest/arouse curiosity; they draw students into the story. Ex. Not â€Å"What is this picture about? † but â€Å"What would you like to know about this picture? † †¢Question/Author Strategy †¢Students engage in dialog with the author: What is the author trying to say? What does the author mean? Is x consistent with what the author told us before? †¢Think-Aloud Strategy †¢Teachers model the think-aloud process initially in order to help students learn to make inferences, using clues from the text and background knowledge to make logical guesses about meaning. K-W-L (What do I Know? What do I Want to learn? What I Learned) is one kind of graphic organizer, which is a visual to help students summarize and organize expository information. Building an awareness of underlying story structure enables students to organize information from narratives, so that they can better anticipate and make sense of what they read! †¢Simple structure: †¢Setting (Where? When? ) †¢Characters (Who? ) †¢Plot (Problem for which characters take action) †¢Complex structure: †¢Setting (Maybe more than one) †¢Characters †¢Plot (Two or more episodes with a chain of events; flashbacks, sometimes! ) Organizers are available commercially, but most teachers have a collection they may be happy to share. Vocabulary English has the largest vocabulary in the world: 600,000one million words. Students learn about 88,000 words by ninth grade in order to process text. It’s been estimated that children learn about three-four thousand words per year, which averages 16-22 words per day. Do we teach every single word? No; students acquire vocabulary on their own through usage, not via systematic instruction. What are words? They are labels for concepts, mental images of something. Ex. The word â€Å"picnic† will call to mind different ideas for everyone. We organize concepts into hierarchies by common features or similar criteria in order to make sense of complexity in our environment. Ex. The concept of â€Å"dog† has common characteristics, despite different breeds and behaviors. We have five vocabularies: listening, speaking, writing, reading, and body-language. The listening vocabulary develops first and is the largest until middle school, when the reading vocabulary becomes and ultimately remains the largest vocabulary. Our job as teachers is to promote students’ conceptual understanding of key vocabulary words, because learning words and expanding vocabulary has a strong influence on comprehension. What is the best means to teach vocabulary? Through multiple, varied encounters with words. Six principles to guide vocabulary instruction include featuring key words: †¢that convey major ideas in literature and content areas; †¢in relation to other words to develop shades of meaning; †¢in relation to students’ background knowledge; †¢in pre- and post-reading activities; †¢taught systematically, in depth, and reinforced; †¢that interest you: telling stories about the origin and derivation of words helps to create student interest in words. We organize knowledge into conceptual hierarchies, and vocabulary study is a key factor.

Thursday, November 14, 2019

What Title? Essay -- essays research papers

A Clockwork Orange : Chosen Evil vs. Forced Morality   Ã‚  Ã‚  Ã‚  Ã‚  What becomes of a man stripped of his free will? Does he continue to be a man, or does he cease? These are questions that Anthony Burgess tries to answer. Written in the middle of Burgess’ writing career, A Clockwork Orange was a reflection of a youth subculture of violence and terrorization that was beginning to emerge in the early 1960s. The novel follows Alex, a young hoodlum who is arrested for his violent acts towards the citizens of London. While incarcerated, Alex undergoes a technique in which his free will towards acts of a barbaric - or even harmless - nature is taken from him, then is forced to face the world once more as a machine-like creature. In A Clockwork Orange, Burgess explores the controversial idea of whether it is better to be forced into morality, or choose evil as a life path.   Ã‚  Ã‚  Ã‚  Ã‚  Like most of Burgess’ other novels, A Clockwork Orange explores the conflicts between good and evil, the spirit and the flesh (Galens). The novel- a satire detailing the violent exploits of a futuristic gang - was published in 1962, and is narrated in Nadsat - a language pasted together from Russian and American slang - by fifteen year old Alex.   Ã‚  Ã‚  Ã‚  Ã‚  The original American edition of A Clockwork Orange came out without the last chapter. In the Americanized version, there were only twenty chapters, as opposed to the twenty-one - a number that signifies adulthood. This chapter was cut out due to the fact that the publisher thought it was too sentimental (Galens).   Ã‚  Ã‚  Ã‚  Ã‚  Though Burgess says that A Clockwork Orange is neither his best nor his favorite book, the novel established Burgess’ international reputation. Stanley Kubrick contributed to his international fame, with a 1971 film adaptation of the novel. The film won Burgess numerous new readers. The film also secured the A Clockwork Orange as the most controversial novel in English literature (Galens).   Ã‚  Ã‚  Ã‚  Ã‚  Before and after A Clockwork Orange was published, Burgess wrote steadily, publishing eleven novels between 1960 and 1964. He edited and published many more works, including novels, screen plays, autobiographies, critical studies, and an opera. None ever achieved the notoriety that A Clockwork Orange received (Galens).  ... ...ex â€Å"matures and begins to [grow] weary of his violent ways† (Galens).   Ã‚  Ã‚  Ã‚  Ã‚  One of the more fascinating aspects of â€Å"A Clockwork Orange† is the language that Burgess invents. Known as Nadsat, it is derived from British, Russian, and American slang, rhyming words, and Roma, or gypsy talk. The patterns and rhythms of Nadsat in A Clockwork Orange convey a sense of rhythm about to be destroyed (F).   Ã‚  Ã‚  Ã‚  Ã‚  John Anthony Burgess Wilson was born in 1917. He was born in Manchester, England, to Joseph (a cashier and pub pianist) and Elizabeth (Burgess) Wilson (Galens). Both Bugess’ mother and sister died of the flu in 1919. He was raised by a maternal aunt, and later by his stepmother.   Ã‚  Ã‚  Ã‚  Ã‚  Once he went on to college, Burgess studied English at Xaverian college and Manchester University. He graduated with a degree in English language and literature (Galens).   Ã‚  Ã‚  Ã‚  Ã‚  During World War II, Burgess served in the Royal Army Medical Corps. â€Å"With World War II and the prospect of total annihilation†¦the fear that haunted the ivory towers of philosophers became a part of every living being.† (F). Unfinished?†¦

Tuesday, November 12, 2019

Changing Landscape of Health Care Essay

Unless you have been living on another planet somewhere, the changes in health care taking place in this country have become hard to ignore. With all the debate over recent health care reform, it is sometimes difficult to know who is right, and who is wrong. How can there be such a wide gap in opinion on â€Å"Obama care†? How are these reforms changing the landscape in health care, and how are we to survive these changes? To begin, let’s look at how all these changes began. The Patient Protection and Affordable Care Act The Patient Protection and Affordable Care Act was passed in the senate on December 24, 2009. It passed in the house on March 21, 2010, and was signed into law by President Obama on March 23rd, 2010. It was then upheld in the Supreme Court on June 28, 2012, and the landscape of health care has been changing ever since. Few would argue that health care reform was needed, as the cost of health care had been out of control for some time in this country. However, many in the health industry feel that although the intent may have been honorable, the repercussions of reform-compliance is wreaking havoc in the health care industry and may lead to even further problems. The Trickledown Effect Most of the issues surrounding the changing landscape of health care are a direct result of health care reform. Changes in legislation have produced a trickledown effect, beginning with the small rural hospitals. For example, one such opinion is expressed by Dr. Scott Litten in a blog on the website Physicians Practice, where he states: While the intent of the ACA was good, the aftershocks [of the passage of The Affordable Care Act] are changing the very way we practice medicine. Small  hospitals in rural areas will be the first ones to enact changes. Reimbursements are not increasing and the new penalties that hospitals across the nation face for readmissions within 30 days, the decreasing numbers of actual admissions, and the increasing numbers of outpatient observation admissions are forcing all facilities to lay off personnel and decrease services provided. Coupling this with the fact that fewer patients are coming to doctor’s offices for services produces a very steep decline in revenue. (Litten, 2013). According to Dr. Litten, this decline in revenue is just the tip of the iceberg. Businesses are facing a similar problem. Insurance premiums are rising, forcing employers to pass this cost on to the employee, making it more expensive each time they receive health services. This in turn discourages trips to the doctor’s office, and the cycle is repeated. Contributing to this decline, Medicaid also has been slow to increases coverage, forcing many practices to no longer accept Medicaid patients. Dr. Litten believes the changes practices are facing have produced a perfect storm for our healthcare industry. And to top it all off, the sluggish economy is causing everyone to cut back on regular spending, which has a trickledown effect on medical practices and hospitals alike. He further sees no change in these effects in the near future, and believes physicians will continue to struggle with how to provide quality health care with less resources. The Wide Gap in Opinion Prior to the passage of the Affordable Care Act, most Americans would have agreed health care reform was needed in this country. However, the wide gap in opinion on whether â€Å"Obama care† is a good or bad thing seems to center on how this legislation may lead to an even greater problem: government controlled health care. One anonymous physician blogger put it this way: â€Å"The Affordable Care Act was nothing more than a huge power grab by the government, the Executive branch in particular. All of the resulting chaos is planned, which will ultimately force out private insurance and thereby establish a single payer system (government) with physicians becoming part of the public service union. When that comes to pass, I’ll retire or maybe set up a â€Å"boutique† practice working 2-3 hours/day; 2-3 days/week for the  patients who can afford it. My selfish concern is: who will be there to take care of me when I need it? Fortunately, I will be in a position to pay for a concierge doctor. Welcome to British style medicine. (Anonymous, 2013). Even advocates of â€Å"Obama care† express concern that nothing in it addressed malpractice costs and tort reform, economic price feedback loops, or increased responsibility on behalf of the consumer. Another blogger states â€Å"It, [The Affordable Care Act] means more people are eligible for subsidized coverage which will add to the long term deficit issues and healthcare costs unless other changes are made.† (Litten, 2013). These issues, along with others that may arise before full implementation of The Affordable Care Act are realized, will need to be addressed if we are indeed to be successful in attaining affordable health care for all Americans. Adapting to Change How are we as an industry and a people to survive these changes? Mark Twain once said â€Å"It’s not progress that I mind, it’s the change I don’t like,† and the same can be said of the health care industry. People in general are opposed to change, especially when they do not have a good understanding of the issues. But â€Å"Obama care† is here to stay, and understanding the intent, specific benefits, and potential for positive reform is the first step in adapting to these changes. We have the ability to research and investigate the many options available to us as both consumers and providers of health care. Knowing what health care reform means on a personal level as well as a business level will not only help us understand and adapt to health care reform, but we may also find that there are many way this reform may indeed work to our benefit in the long run. References Litten, S. J. (2013, May 24). Health Care Reform is Changing the Landscape in Medicine. Retrieved from Physician Practice Web site: http://www.physicianspractice.com/blog/healthcare-reform-changing-landscape-medicine

Saturday, November 9, 2019

Experiment 1: Calorimetry

Experiment 1: Calorimetry Nadya Patrica E. Sauza, Jelica D. Estacio Institute of Chemistry, University of the Philippines, Diliman, Quezon City 1101 Philippines Results and Discussion Eight Styrofoam ball calorimeters were calibrated. Five milliliters of 1M hydrochloric acid (HCl) was reacted with 10 ml of 1M sodium hydroxide (NaOH) in each calorimeter. The temperature before and after the reaction were recorded; the change in temperature (? T) was calculated by subtracting the initial temperature from the final temperature. The reaction was performed twice for every calorimeter. The heat capacity (Ccal) of each calorimeter was calculated using the formula, C_cal=(- H? _rxn^o n_LR)/? T[1] where ? Horxn is the total heat absorbed or evolved for every mole of reaction and nLR is the number of moles of the limiting reactant. The ? Horxn used was -55. 8kJ per mole of water while the nLR was 0. 005 mole. Table 1. Average Ccal from recorded ? T values. Trial? T, (oC)Ccal, (J)Ave Ccal, (J) 112. 2126. 82202. 91 21. 0279. 00 213. 093. 00108. 50 22. 3124. 00 310. 5558. 00558. 00 20. 5558. 00 412. 0139. 50244. 13 20. 8348. 75 513. 093. 0081. 38 24. 069. 75 612. 0139. 50209. 25 21. 0279. 00 712. 111. 60111. 60 22. 5111. 60 813. 093. 00116. 25 22. 0139. 50 Different heat capacities were calculated for each calorimeter (Table 1). After calibration, a reaction was performed in a calorimeter by each pair. A total of eight reactions were observed by the whole class. The temperature before and after the reaction were recorded. Then the change in temperature was calculated. Eac h reaction was performed twice to produce two trials. The experimental ? Horxn for each reaction was solved using the formula, H? _rxn^o=(-C_cal ? T)/n_LR [2] where Ccal is the heat capacity previously calculated for each calorimeter. The percent error for each reaction was computed by comparing the computed experimental ? Horxn to the theoretical ? Horxn using the formula, % error=|(computed-theoretical)/theoretical|? 100% [3] Table 2. Comparison of calculated ? Horxn and theoretical ? Horxn. RxnLRTrial? T, (oC)? Horxn, (kJ/mol)Ave ? Horxn, (kJ/mol)Theo ? Horxn, (kJ/mol)% Error 1HCl13. 5-142. 04-131. 89-132. 510. 47 23. 0-121. 75 2HOAc11. 3-26. 34-41. 61-56. 0924. 65 22. 7-56. 89 3HOAc11. 8-189. 61-203. 16-52. 47287. 18 22. 0-216. 70 4HNO311. 5-73. 24-70. 80-55. 8426. 78 21. 4-68. 36 5Mg13. 0-118. 67-138. 45-466. 8570. 34 24. 0-158. 23 6Mg15. 5-559. 4-635. 72-953. 1133. 30 27. 0-712. 01 7Zn13. 0-43. 80-43. 80-218. 6679. 97 23. 0-43. 80 8CaCl210. 00. 00-5. 8113. 07144. 47 20. 5-11. 63 There were differences in experimental and theoretical values of ? Horxn as shown by the percent error for each reaction (table 2). The discrepancies were caused by many factors. One factor was the loss of heat. The heat may have bee n released when the thermometer was pushed or pulled during the reaction. The heat may also have been lost because the calorimeter is not totally isolated. Another factor was the dilution of the solution. The pipette or test tube may still have been wet when used. However, the concentration used in solving for values was the concentration of the undiluted solution. Another factor that may have contributed to the difference in the experimental and theoretical values was human error. It was manifested when reading the thermometer or measuring chemicals with different instruments. The factors aforementioned are the limitations of this experiment. References Petrucci, R. H. ; Herring, F. G. ; Madura, J. D. ; Bissonnette, C. General Chemistry, 10th ed. ; Pearson Education: Canada, 2011; Chapter 7. Appendices Appendix A Comparison of Observed and Theoretical Heats of Reactions RxnLRTrial? TnLRqrxn? HorxnAve ? HorxnTheo ? Horxn% Error 1HCl13. 500. 00500-710. 19-142. 04-131. 89-132. 510. 47 23. 000. 00500-608. 73-121. 75 2HOAc11. 250. 00515-135. 63-26. 34-41. 61-56. 0924. 65 22. 700. 00515-292. 95-56. 89 3HOAc11. 750. 00515-976. 50-189. 61-203. 16-52. 47287. 18 22. 000. 00515-1116. 00-216. 70 4HNO311. 500. 00500-366. 19-73. 24-70. 80-55. 8426. 78 21. 400. 00500-341. 78-68. 36 5Mg13. 000. 00206-244. 13-118. 67-138. 45-466. 8570. 34 24. 000. 00206-325. 50-158. 23 6Mg15. 500. 00206-1150. 88-559. 44-635. 72-953. 1133. 30 27. 000. 00206-1464. 75-712. 01 7Zn13. 000. 00764-334. 80-43. 80-43. 80-218. 6679. 97 23. 000. 00764-334. 80-43. 0 8Na2CO3/ CaCl210. 000. 005000. 000. 00-5. 8113. 07144. 47 20. 500. 00500-58. 13-11. 63 Appendix B Sample Calculations Calibration of Calorimeter 10ml 1M NaOH + 5ml 1M HCl n. i. e. : OH-(aq) + H+(aq) ? H2O(l)? Horxn= -55. 8kJ LR: HCLnLR= 0. 005mol Grp 1 Trial 1 ?T= 2. 2oC Sol’n: C_cal=(- H? _rxn^o n_LR)/? T C_cal=(-(-55. 8kJ)(0. 005mol))/(? 2. 2? ^ o C)? 1000J/1kJ ?(C_cal=126. 82 J) Determination of Heats of Reaction Neutralization Reaction Rxn 4 Trial 1: 10ml 1M NaOH + 5ml 1M HNO3 n. i. e. : OH-(aq) + H+(aq) ? H2O(l) LR: HNO3nLR= 0. 005mol ?T= 1. 5oCCcal= 244. 125 J Sol’n H? _rxn^o=(-C_cal ? T)/n_LR H? _rxn^o=(-(244. 25J)(? 1. 5? ^o C))/0. 005mol? 1kJ/1000J ? ( H? _rxn^o=-73. 24kJ) Reaction between an Active Metal and an Acid Rxn 5 Trial 1: 15ml 1M HCl+ 0. 05g Mg n. i. e. : 2H+(aq) + Mg(s) ? Mg+2(aq) + H2(g) LR: MgnLR= 0. 00206mol ?T= 3oCCcal= 81. 375 J Sol’n H? _rxn^o=(-C_cal ? T)/n_LR H? _rxn^o=(-(81. 375J)(3^o C))/0. 00206mol? 1kJ/1000J ?( H? _rxn^o=-118. 67kJ) Displacement of One Metal by Another Rxn 7 Trial 1: 15ml 1M CuSO4 + 0. 5g Zn n. i. e. : Cu+2(aq) + Zn(s) ? Zn+2(aq) + Cu(s) LR: ZnnLR= 0. 00764mol ?T= 3oCCcal= 111. 6 J Sol’n H? _rxn^o=(-C_cal ? T)/n_LR H? _rxn^o=(-(111. 6J)(3^o C))/0. 00764mol? 1kJ/1000J ?( H? rxn^o=-43. 80kJ) Precipitation Reaction Rxn 8 Trial 1: 10ml 0. 5M Na2CO3 + 5ml 1M CaCl2 n. i. e. : CO3-2(aq) + Ca+2(aq) ? CaCO3(s) LR: Na2CO3/ CaCl2nLR= 0. 005mol ?T= 0. 5oCCcal= 116. 25 J Sol’n H? _rxn^o=(-C_cal ? T)/n_LR H? _rxn^o=(-(116. 25J)(? 0. 5? ^o C))/0. 005mol? 1kJ/1000J ? ( H? _rxn^o=-11. 63kJ) Appendix C Answers to the Questions in the Lab Manual There are many possibilities that explain the discrepancy of the experimental and theoretical values of ? Horxn. First, heat might have been lost to the surroundings. This is possible whenever the thermometer is pulled out or pushed in the calorimeter during the reaction. Also, the calorimeter might not have been thoroughly isolated. Second, the solution might have been diluted in the test tube or pipette. They might have been wet when used with the solution. Lastly, the discrepancies might have occurred due to human error. The students might have misread the thermometer when taking the temperature or the pipette when measuring the solutions. a. It is important to keep the total volume of the resulting solution to 15ml because any more or any less than that of the volume can contribute to the absorption or release of additional heat therefore affecting the ? Horxn. b. It is important to know the exact concentrations of the reactants to solve for their number of moles and to find out the limiting reactant. c. It is important to know the exact weight of the metal solids used to solve for their number of moles and to find out whether one of them is a limiting reactant. Also, the weight is needed to solve for the heat capacity of the solid when the specific heat is given. 200ml 0. 5M HA + NaOH ? -6. 0kJ LR: HAnLR= 0. 1mole H? _(rxn,mol)^o= (-6. 0 kJ)/(0. 1 mol) ?( H? _(rxn,mol)^o= -60 kJ) HA is a strong acid. OH-(aq) + H+(aq) ? H2O(l)? Horxn= -60 kJ/mole Calibration:15ml 2. M HCl + 5ml 2. 0M NaOH? T=5. 60oC LR: NaOHnLR= 0. 01mole Reaction:20ml 0. 450M CuSO4 + 0. 264g Zn? T=8. 83oC LR: ZnnLR= 0. 00404mole n. i. e. : OH-(aq) + H+(aq) ? H2O(l) n. i. e. : Cu+2(aq) + Zn(s) ? Zn+2(aq) + Cu(s) C_cal=(- H? _rxn^o n_LR)/? T C_cal=(-(-55. 8kJ)(0. 01mol))/(? 5. 60? ^o C)? 1000J/1kJ ?(C_cal=99. 6 J) H? _rxn^o=(-C_cal ? T)/n_LR H? _rxn^o=(-(99. 6J)(? 8. 83? ^o C))/0. 00404mol? 1kJ/1000J ? ( H? _rxn^o=-218. 0 kJ) OH-(aq) + H+(aq) ? H2O(l)? Horxn= -55. 8kJ ?Hof,H2O= -285 kJ ?Hof,OH-= ? ?Horxn= ? Hof,product – ? Hof,reactant -55. 8 kJ = ? Hof,OH- – (-285 kJ) ?( H? _(f,? OH? ^-)^o=-218. 0 kJ) Experiment 1: Calorimetry Experiment 1: Calorimetry Nadya Patrica E. Sauza, Jelica D. Estacio Institute of Chemistry, University of the Philippines, Diliman, Quezon City 1101 Philippines Results and Discussion Eight Styrofoam ball calorimeters were calibrated. Five milliliters of 1M hydrochloric acid (HCl) was reacted with 10 ml of 1M sodium hydroxide (NaOH) in each calorimeter. The temperature before and after the reaction were recorded; the change in temperature (? T) was calculated by subtracting the initial temperature from the final temperature. The reaction was performed twice for every calorimeter. The heat capacity (Ccal) of each calorimeter was calculated using the formula, C_cal=(- H? _rxn^o n_LR)/? T[1] where ? Horxn is the total heat absorbed or evolved for every mole of reaction and nLR is the number of moles of the limiting reactant. The ? Horxn used was -55. 8kJ per mole of water while the nLR was 0. 005 mole. Table 1. Average Ccal from recorded ? T values. Trial? T, (oC)Ccal, (J)Ave Ccal, (J) 112. 2126. 82202. 91 21. 0279. 00 213. 093. 00108. 50 22. 3124. 00 310. 5558. 00558. 00 20. 5558. 00 412. 0139. 50244. 13 20. 8348. 75 513. 093. 0081. 38 24. 069. 75 612. 0139. 50209. 25 21. 0279. 00 712. 111. 60111. 60 22. 5111. 60 813. 093. 00116. 25 22. 0139. 50 Different heat capacities were calculated for each calorimeter (Table 1). After calibration, a reaction was performed in a calorimeter by each pair. A total of eight reactions were observed by the whole class. The temperature before and after the reaction were recorded. Then the change in temperature was calculated. Eac h reaction was performed twice to produce two trials. The experimental ? Horxn for each reaction was solved using the formula, H? _rxn^o=(-C_cal ? T)/n_LR [2] where Ccal is the heat capacity previously calculated for each calorimeter. The percent error for each reaction was computed by comparing the computed experimental ? Horxn to the theoretical ? Horxn using the formula, % error=|(computed-theoretical)/theoretical|? 100% [3] Table 2. Comparison of calculated ? Horxn and theoretical ? Horxn. RxnLRTrial? T, (oC)? Horxn, (kJ/mol)Ave ? Horxn, (kJ/mol)Theo ? Horxn, (kJ/mol)% Error 1HCl13. 5-142. 04-131. 89-132. 510. 47 23. 0-121. 75 2HOAc11. 3-26. 34-41. 61-56. 0924. 65 22. 7-56. 89 3HOAc11. 8-189. 61-203. 16-52. 47287. 18 22. 0-216. 70 4HNO311. 5-73. 24-70. 80-55. 8426. 78 21. 4-68. 36 5Mg13. 0-118. 67-138. 45-466. 8570. 34 24. 0-158. 23 6Mg15. 5-559. 4-635. 72-953. 1133. 30 27. 0-712. 01 7Zn13. 0-43. 80-43. 80-218. 6679. 97 23. 0-43. 80 8CaCl210. 00. 00-5. 8113. 07144. 47 20. 5-11. 63 There were differences in experimental and theoretical values of ? Horxn as shown by the percent error for each reaction (table 2). The discrepancies were caused by many factors. One factor was the loss of heat. The heat may have bee n released when the thermometer was pushed or pulled during the reaction. The heat may also have been lost because the calorimeter is not totally isolated. Another factor was the dilution of the solution. The pipette or test tube may still have been wet when used. However, the concentration used in solving for values was the concentration of the undiluted solution. Another factor that may have contributed to the difference in the experimental and theoretical values was human error. It was manifested when reading the thermometer or measuring chemicals with different instruments. The factors aforementioned are the limitations of this experiment. References Petrucci, R. H. ; Herring, F. G. ; Madura, J. D. ; Bissonnette, C. General Chemistry, 10th ed. ; Pearson Education: Canada, 2011; Chapter 7. Appendices Appendix A Comparison of Observed and Theoretical Heats of Reactions RxnLRTrial? TnLRqrxn? HorxnAve ? HorxnTheo ? Horxn% Error 1HCl13. 500. 00500-710. 19-142. 04-131. 89-132. 510. 47 23. 000. 00500-608. 73-121. 75 2HOAc11. 250. 00515-135. 63-26. 34-41. 61-56. 0924. 65 22. 700. 00515-292. 95-56. 89 3HOAc11. 750. 00515-976. 50-189. 61-203. 16-52. 47287. 18 22. 000. 00515-1116. 00-216. 70 4HNO311. 500. 00500-366. 19-73. 24-70. 80-55. 8426. 78 21. 400. 00500-341. 78-68. 36 5Mg13. 000. 00206-244. 13-118. 67-138. 45-466. 8570. 34 24. 000. 00206-325. 50-158. 23 6Mg15. 500. 00206-1150. 88-559. 44-635. 72-953. 1133. 30 27. 000. 00206-1464. 75-712. 01 7Zn13. 000. 00764-334. 80-43. 80-43. 80-218. 6679. 97 23. 000. 00764-334. 80-43. 0 8Na2CO3/ CaCl210. 000. 005000. 000. 00-5. 8113. 07144. 47 20. 500. 00500-58. 13-11. 63 Appendix B Sample Calculations Calibration of Calorimeter 10ml 1M NaOH + 5ml 1M HCl n. i. e. : OH-(aq) + H+(aq) ? H2O(l)? Horxn= -55. 8kJ LR: HCLnLR= 0. 005mol Grp 1 Trial 1 ?T= 2. 2oC Sol’n: C_cal=(- H? _rxn^o n_LR)/? T C_cal=(-(-55. 8kJ)(0. 005mol))/(? 2. 2? ^ o C)? 1000J/1kJ ?(C_cal=126. 82 J) Determination of Heats of Reaction Neutralization Reaction Rxn 4 Trial 1: 10ml 1M NaOH + 5ml 1M HNO3 n. i. e. : OH-(aq) + H+(aq) ? H2O(l) LR: HNO3nLR= 0. 005mol ?T= 1. 5oCCcal= 244. 125 J Sol’n H? _rxn^o=(-C_cal ? T)/n_LR H? _rxn^o=(-(244. 25J)(? 1. 5? ^o C))/0. 005mol? 1kJ/1000J ? ( H? _rxn^o=-73. 24kJ) Reaction between an Active Metal and an Acid Rxn 5 Trial 1: 15ml 1M HCl+ 0. 05g Mg n. i. e. : 2H+(aq) + Mg(s) ? Mg+2(aq) + H2(g) LR: MgnLR= 0. 00206mol ?T= 3oCCcal= 81. 375 J Sol’n H? _rxn^o=(-C_cal ? T)/n_LR H? _rxn^o=(-(81. 375J)(3^o C))/0. 00206mol? 1kJ/1000J ?( H? _rxn^o=-118. 67kJ) Displacement of One Metal by Another Rxn 7 Trial 1: 15ml 1M CuSO4 + 0. 5g Zn n. i. e. : Cu+2(aq) + Zn(s) ? Zn+2(aq) + Cu(s) LR: ZnnLR= 0. 00764mol ?T= 3oCCcal= 111. 6 J Sol’n H? _rxn^o=(-C_cal ? T)/n_LR H? _rxn^o=(-(111. 6J)(3^o C))/0. 00764mol? 1kJ/1000J ?( H? rxn^o=-43. 80kJ) Precipitation Reaction Rxn 8 Trial 1: 10ml 0. 5M Na2CO3 + 5ml 1M CaCl2 n. i. e. : CO3-2(aq) + Ca+2(aq) ? CaCO3(s) LR: Na2CO3/ CaCl2nLR= 0. 005mol ?T= 0. 5oCCcal= 116. 25 J Sol’n H? _rxn^o=(-C_cal ? T)/n_LR H? _rxn^o=(-(116. 25J)(? 0. 5? ^o C))/0. 005mol? 1kJ/1000J ? ( H? _rxn^o=-11. 63kJ) Appendix C Answers to the Questions in the Lab Manual There are many possibilities that explain the discrepancy of the experimental and theoretical values of ? Horxn. First, heat might have been lost to the surroundings. This is possible whenever the thermometer is pulled out or pushed in the calorimeter during the reaction. Also, the calorimeter might not have been thoroughly isolated. Second, the solution might have been diluted in the test tube or pipette. They might have been wet when used with the solution. Lastly, the discrepancies might have occurred due to human error. The students might have misread the thermometer when taking the temperature or the pipette when measuring the solutions. a. It is important to keep the total volume of the resulting solution to 15ml because any more or any less than that of the volume can contribute to the absorption or release of additional heat therefore affecting the ? Horxn. b. It is important to know the exact concentrations of the reactants to solve for their number of moles and to find out the limiting reactant. c. It is important to know the exact weight of the metal solids used to solve for their number of moles and to find out whether one of them is a limiting reactant. Also, the weight is needed to solve for the heat capacity of the solid when the specific heat is given. 200ml 0. 5M HA + NaOH ? -6. 0kJ LR: HAnLR= 0. 1mole H? _(rxn,mol)^o= (-6. 0 kJ)/(0. 1 mol) ?( H? _(rxn,mol)^o= -60 kJ) HA is a strong acid. OH-(aq) + H+(aq) ? H2O(l)? Horxn= -60 kJ/mole Calibration:15ml 2. M HCl + 5ml 2. 0M NaOH? T=5. 60oC LR: NaOHnLR= 0. 01mole Reaction:20ml 0. 450M CuSO4 + 0. 264g Zn? T=8. 83oC LR: ZnnLR= 0. 00404mole n. i. e. : OH-(aq) + H+(aq) ? H2O(l) n. i. e. : Cu+2(aq) + Zn(s) ? Zn+2(aq) + Cu(s) C_cal=(- H? _rxn^o n_LR)/? T C_cal=(-(-55. 8kJ)(0. 01mol))/(? 5. 60? ^o C)? 1000J/1kJ ?(C_cal=99. 6 J) H? _rxn^o=(-C_cal ? T)/n_LR H? _rxn^o=(-(99. 6J)(? 8. 83? ^o C))/0. 00404mol? 1kJ/1000J ? ( H? _rxn^o=-218. 0 kJ) OH-(aq) + H+(aq) ? H2O(l)? Horxn= -55. 8kJ ?Hof,H2O= -285 kJ ?Hof,OH-= ? ?Horxn= ? Hof,product – ? Hof,reactant -55. 8 kJ = ? Hof,OH- – (-285 kJ) ?( H? _(f,? OH? ^-)^o=-218. 0 kJ)

Thursday, November 7, 2019

Bipolar disorder (manic depression) lithium Essays

Bipolar disorder (manic depression) lithium Essays Bipolar disorder (manic depression) lithium Paper Bipolar disorder (manic depression) lithium Paper Bipolar disorder is a condition characterized by experiences episodes of alternating of mood swings, and rapid changes in the energy levels and the ability to perform activities. The individual develops period of mania (excitability) coupled with depression. This results in the individual behaving in an irrational manner. The other symptoms of bipolar disorder include anxiety, loss of temper, aggressiveness, loss of self-control, sleeplessness, sexual urges, substance abuse, abuse of others rights, etc. The symptoms (3 or more) are present at least for a week (NIMH, 2007 Merck, 2005). The precise etiology of bipolar disorder is not known, but seemingly develops in close relatives. However, external and internal factors are responsible for the development of the condition. The condition more frequently occurs in identical twins. A single gene is usually responsible for the development of the condition. Bipolar disorder usually occurs in individuals who have experienced traumatic experiences in their lives. The neurotransmitters present in the brain function abnormally. The symptoms of bipolar disorder can also occur in other disorders such as AIDS, neurosyphilis, encephalitis, head injuries, epilepsy, etc. Certain medications such as antidepressants or corticosteroid may also be responsible (Ballas, 2006, NIMH, 2007 Merck, 2005). The acute symptoms of bipolar disorder do seem to be brought under control. However, relapses of the symptoms are common. If the individual is not given an treatment, the symptoms become more intense and severe. To some extent treatment can improve the quality of life and the ability to function normally (NIMH, 2005 Merck, 2005). One of the most frequently used and effective drugs for bipolar disorder is lithium (mood stabilizing agent). It helps to lower the symptoms of mania and depression, prevent the need for hospitalization, improves the quality of life, and improves the ability to function normally. It is effective in about 66 % of the patients suffering from bipolar disorders. Some of the side effects of lithium use include thyroid problems, weight gain, kidney problems, nausea, vomiting, fetal damage (in pregnant women), etc. Nowadays, newer drugs are come out which are more effective and have lesser number of side effects. Several newer drug such s Lamotrigine and gabapentin (newer anti-epileptic agents), atypical anti-psychotic agents (such as clozapine, olanzapine, etc), and benzodiazepines are found to be more effective and causing lesser number of side effects (Lloyd, 1996, pp. 986, NIMH, 2007 Merck, 2005). A study was conducted to determine the effect of lithium prophylaxis on bipolar disorder. About 200 patients were given lithium for about 2 years. These patients were stable after 2 years of lithium prophylaxis. The drug was stopped in a quarter of the patients and continued in the remaining three-fourths. However, the chances of the symptoms recurring were found to be high in those in whom the drug was stopped. If lithium is to be discontinued, the physicians should make a decision based on the dose of the drug required to maintain clinical stability (Biel et al, 2007). References: Ballas, P. (2006). Bipolar disorder. Retrieved March 11, 2007, from Medline Plus web site: nlm. nih. gov/medlineplus/ency/article/000926. htm Biel, M. G. , Peselow, E. , Mulcare, L. et al (2007), â€Å"Continuation versus discontinuation of lithium in recurrent bipolar illness: a naturalistic study. † Bipolar Disorder, 9(5), 435-442. ncbi. nlm. nih. gov/sites/entrez? Db=pubmedCmd=ShowDetailViewTermToSearch=17680913ordinalpos=5itool=EntrezSystem2. PEntrez. Pubmed. Pubmed_ResultsPanel. Pubmed_RVDocSum Culver, J. L. , Arnow, B. A. , Ketter, T. A. (2007). â€Å"Bipolar disorder: improving diagnosis and optimizing integrated care. † J Clin Psychol, 63(1), 73-92. ncbi. nlm. nih. gov/entrez/query. fcgi? db=pubmedcmd=Retrievedopt=AbstractPluslist_uids=17115430query_hl=10itool=pubmed_DocSum Lloyd, G. G. (1996). Psychiatry, In. Edwards, C. R. A. , Bouchier, I. A. D. , Haslett, C. (Ed), Davidson’s Principles and Practice of Medicine, (17th Ed), Edinburgh: Churchill Livingstone. National Institute of Mental Health (2007). Bipolar Disorders. Retrieved March 11, 2007, from NIMH web site: nimh. nih. gov/publicat/bipolar. cfm The Merck Manual (2005). Bipolar Disorder. Retrieved March 11, 2007, from Medline Plus web site: merck. com/mmpe/sec15/ch200/ch200c. html

Tuesday, November 5, 2019

Units of Time in Spanish

Units of Time in Spanish Need to know how to refer to a particular unit of time? Here are the most common ones in Spanish, listed from the shortest period of time to the longest: el nanosegundo - nanosecond el microsegundo - microsecond el milisegundo - millisecond el segundo - second el minuto - minute la hora - hour el dà ­a - day la semana, el septenario - week la quincena - fortnight, two weeks (The term sometimes refers to a 15-day period or a half-month.) el mes - month el semestre - six months, half-year (The term can also refer to an academic semester.) el aà ±o - year el lustro - five years el decenio, la dà ©cada - 10 years, decade el siglo - century el milenio - millennium el cron - million years el eà ³n - thousand million years, billion years in U.S. English (The term also can refer to an indefinitely long period of time.) In addition, Spanish has a number of units of time that are seldom used, or are used in specific contexts. For example, bimestre and trimestre, are two-month and three-month periods, respectively, with similar month groupings possible. Similarly, bienio and septenio are two- and seven-year periods of time, respectively, with other groupings possible.

Sunday, November 3, 2019

Strategic change and quality improvement Assignment

Strategic change and quality improvement - Assignment Example 9-10). In a study conducted by Codispoti, Douglas, McCallister, & Zuniga (2004), the use of multidisciplinary teams evidently improved patient care through: improved satisfaction and management of patients; establishment of collaborative teamwork; forging effective team communication; enforcing regular patient monitoring and follow-up; and use of electronic records or other improved patient care systems (Codispoti, Douglas, McCallister, & Zuniga, 2004, p. 201). Still, in another discourse, the use of multidisciplinary teams to improve primary care was also found to be effective (Cote, et al., 2002). In this regard, the current discourse hereby aims to propose the implementation of using multidisciplinary teams in the health care setting. The paper would initially present the rationale for the proposed change; prior to detailing the benefits that the change could generate for the health care institution. Likewise, the group and members who should initiate or lead in the proposed chang e process would be determined and presented in terms of their significant contribution to the recommended transformation. A proposed timeline would also be structured, in conjunction with an evaluation process which aims to determine the gauge or measure for the proposed change’s success. ... Thus, it could be deduced that the symptoms that were initially relayed were addressed; but not comprehensively to encompass other possible avenues for recurrence or deterioration of health conditions. Therefore, rather than seeing just an attending physician to address the illness; it was evident that other members of the professional team could have been needed to provide medical advice and improve patient care. A multidisciplinary team is defined as consisting of â€Å"psychiatrists, clinical nurse specialists/community mental health nurses, psychologists, social workers, occupational therapists, medical secretaries, and sometimes other disciplines such as counsellors, drama therapists, art therapists, advocacy workers, care workers and possibly others not listed† (College of Psychiatrists of Ireland, n.d., p. 1). The definition was corroborated in the study conducted by Ababat, Asis, Bonus, DePonte, & Pham (2013) who emphasized that â€Å"multidisciplinary care conference s, have been defined as planning and evaluating patient care with health professionals from a variety of other health disciplines. Key activities that can be integrated into interdisciplinary rounds (IDRs) include summarizing patient health data, identifying patient/family problems, defining goals, identifying interventions, discussing progress toward goals, revising goals and plans we needed, generating referrals, reviewing discharge plans, and clarifying responsibilities related to implementation of the plan† (p. 1). As such, the need for multidisciplinary teams have been stressed to encompass a wider scope of patient care through covering varied disciplines and a more comprehensive health care. Concurrently, external factors which support