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RSwisher_ESSAY-1

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ENGL 102

Insert DateStory Elements “Hills Like White Elephants”

Ernest Hemingway’s fictional story, “Hills Like White Elephants,” is an example of a short story that embraces many literature elements. In as much as the storyline is set in a single day, the events in the story signify a lot in the American context.

In terms of setting, the story is set in the country of Spain. To be precise, the storyline is set in the train station located in the Ebro Valley in Madrid. Evidence of this setting can be seen from the story through the constant reference of the native country of Spain as well as “Ebro” which is a river in the Northern part of Spain. Plot, in the world of literature, can be defined as the series of events that an author uses so as to tell a story and to bring out the sequential flow of events. The plot is centered on the young couple at the train station that is having a normal conversation regarding the scenery that is observed from a far. However, the topic of discussion is beyond than simple. There is extreme symbolism that is represented by the simple conversation. The constant disagreements and differing opinions between the boy and girl shows that it is more than just a simple conversation.

The narration style that is adopted by Hemingway in the story is quite unique and embraces the idea of creativity. In the story, the main narration point of view is the third-persons point of view. The third person’s point of view is presents an objective angle of the story. Critical for the story is that the third person objective point of narration is used to conclude and give a true evaluation of what the characters thoughts and experiences. There is more detail of the feelings and the thoughts of the characters in the story that is brought out through the use of the third person point of narration.

Perhaps the greatest element that comes out evident from the story “Hills Like White Elephants,” is the extensive use of symbolism. Symbolism in literature works can be defined as stylistic device that means something more than what is seen on the surface. The obvious use of symbolism in the short story is first seen through the use of characters. The description of hills and valley is purely symbolic. The valley side that is viewed as dry and without a shade is representative of the wrong decision of abortion that may cause barrenness and infertility due to abortion. On the opposite side, there is a valley that is green with the Ebro river that is symbolic of life and fertility. The female character girl represents the naivety and innocence that is held by a majority in society regarding important matters such as abortion while on the contrary the male counterpart in the story represents a strong view on the subject matter. Other than that, there are many instances that represent symbolism. The plot of the story being set on the train station is an illustration of the fact that the couples lives is on the move and can take a serious change owing to the decision taken.

Essentially, “Hills Like White Elephants,” is a story that represents beauty in terms of the elements that are employed. All in all, the various elements that are employed in the story make it a masterpiece worth implementation in real life.

Works Cited

Mays., and Kelly J.. The Norton Introduction to Literature (Digital Portable Edition), 11th Edition. “Hills Like White Elephants” W. W. Norton & Company, 2014. VitalBook file.

Uses of an expansion card

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Uses of an expansion card

Computers have evolved as the most useful human invention in modern day world. There are more advancements being invented in the computer technology, such as expansion cards, to improve the ability of computers to perform more functions. An expansion card is an electronic circuit that is added to expansion slots on a motherboard to aid a computer perform more functions. They are keyed which means that they are designed specifically for This paper thus seeks to identify the types of expansion cards and their functionality as far as computers are concerned.

With the continuous inventions, there are different types of expansion boards that have been designed for to enhance different capabilities. Some of the most commonly used expansion cards include; modems, graphics/video cards, network cards, television cards, host adaptor and post cards. Modem cards are basically used to modulate analogue carrier signal to decode digital information as well as demodulate the information to reveal the transmitted information. Video/ graphics cards are expansion circuits that aid a computer in generating a supply of output images to a display. The advantage of this is they provide an accelerated rendering of 3 dimensional scenes and 2 dimensional graphics. The cards assist in the improvement of display on a computer to produce enhanced display and animated features (Dean & Tamara, 240). Another important expansion card is the sound card. This circuit device aids in improving the input and output signals o and from a computer under a control of a computer program. Network cards are used to enable the interconnection of several computers. This is aided by the use of a network card which enables setting and maintaining of a local area network (LAN) for a group of computers(Morley & Charles, 69). These expansion cards are generally used to enhance certain capabilities in a computer depending on the use.

As pointed above, there are different functionalities for the different expansion cards. Different professions would use different cards because of the uniqueness of the profession. Designers are poised to use auto cards to draw and design. On the other hand, for information technology students can find network cards and modems useful not only in the course of study but also in their profession. This is because the expansion cards would enable them access information from the internet as well as the need to use more than one computer.

Work Cited

Morley, Deborah, and Charles S. Parker. Understanding Computers: Today and Tomorrow: Comprehensive. Boston, Mass: Course Technology Cengage Learning, 2012. Print.

Dean, Tamara. Network+ Guide to Networks. Boston, Mass: Cengage Course Technology, 2009. Print.

RSwisher_Poetry-essay

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Poetry Essay

English 102:

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The poem begins with the speaker describing an individual by the name Mike, who is listening to a poem on the radio (Line 1). The speaker goes on to say that, the poem playing on the radio is assisting Mike to stay awake as he drives home describing the distance that he had to drive. He continues to assert that Mike taps his hand to some beats available in the poem. The speaker takes a twist and brings the wife to the picture, expounding that she is lonely, and falls asleep when attempting to read a novel while waiting for the husband (Line 5-Line 10).

The speaker continues with the poem to give examples of individuals who found poetry interesting. She gives an example of Naomi, who claps to the rhyme turned on by her father. She uses the word rhyme to show that the song is a form of poem (Line 15-Line 20). The speaker then questions the notion if poetry made nothing happen.  In the last stanza of the poem, the speaker gives examples of people who swear that poetry has no impact on their lives, but who admit it has a little. The poem ends with a claim from the speaker that the poems can save individuals from the occurrences around the globe.

One can analyze the poem in three major elements. Situation and setting is one element that one can analyze this poem. The poem begins with the speaker describing an individual driving for a distance (Line 1). The setting is meant to discredit the fact that poetry makes no difference, as it shows how poetry keeps the driver occupied in his driving. The reality that the driver taps to the rhythm of the poem indicates that he is attentive and his mind is in the poem he is listening to from the car radio. Moreover, the situation that he is driving for a distance indicates that the driver could have chosen to listen to something else but he chose poetry.

One can also use structure to analyze the poem. The poem has rhyme in several instances which make it interesting to read and easy to comprehend. The rhyme is more prevalent in the last stanza where words like small and all being the last words of the sentence (Line 27-Line 30). There is also proper use of punctuation marks. The poet utilizes continuation marks to create suspense in the poem. There is also use of exclamation marks in the poem. The speaker uses this marks in the last two lines of the second stanza to create emphasis that indeed poetry makes this happen. The use of opening and closing quotation marks to quote the title of a book sets apart the title from other parts of the poem (Line 8).

The tone of the poem is also an element that one may use when analyzing the poem. The tome at the beginning of the poem is relaxed with the speaker explaining the soft nature of poetry. In addition, poetry keeps the driver on course when driving. The tone changes to a wishing tone as the speaker continues. The speaker wishes that the president had listened to another poet who asserted that poetry had made nothing happen. However, the tone changes to a reassuring tome at the end suggesting that poems can still save individuals from the numerous occurrences in the universe (Line 30). The changes in tone are to make the poem interesting and moving to the reader.

 

 

 

 

 

 

 

References

JULIA ALVAREZ “Poetry Makes Nothing Happen”, Mays., and Kelly J.. The Norton Introduction to Literature (Digital Portable Edition), 11th Edition. W. W. Norton & Company, 2014. VitalBook file.

Life of an Army Wife

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Life of an Army Wife

When I got married to my husband I by no means thought about the jobs and responsibilities that would befall on me as an Army wife. All the rules and restrictions that have to be followed by the army soldiers had to be followed by their spouse as well. No one could possibly explain in words how separation, deployment, moving, culture, and adjusting your education can affect one’s life until they actually walk a mile in an army wife’s shoes. My life has changed so much from the start of my journey and the sad bit is that the journey has barely begun and there is a lot more to ahead.

When my husband was first assigned to South Carolina for his basic training we were not living together, but we were spending time together for almost a year before he finally had to leave. August 24, 2010 was the date when my husband had to leave for his basic training and this was very tough for me because I was not used living my life separated from him. As I bid him farewell, I could not help myself from tearing up, but I had to keep calm so as not to make the situation harder than it already was for both of us. We both had along journey and this was only the beginning so we had to be strong so as to endure the tough times that were ahead.

Deployment is a word that is familiar to many, but does not affect people as much as it affects a military family. All army soldiers are usually deployed anywhere in the world three to five times throughout their career depending on the time one is enlisted in the military. This necessitates the wife to uproot her family with her husband and move from one place to another as well as locations that are overseas. Most women would not have the capability to handle this kind of a lifestyle and this is what makes military women very extraordinary. Going to Iraq or Afghanistan that are war zone areas is something that every family dreads and this is usually the first or second place that one is assigned to after joining the army. The soldiers were required to stay in deployment for a long period of time which had implications of high suicide rates by the soldiers and the fact that one is away from their family for a long time. Owing to these issues, the time had to be reduced from one or two years to nine months at a time.

Army families have life a little harder when it comes to moving from one place to another and this can either be around the United States or the entire world. There are a number of adjustments that have to be made especially concerning school, housing, environment, language and food. When my husband received his orders assigning him to South Korea, it was quite a shock at first, but I was relieved that he was not being assigned to Iraq or Afghanistan. If he had to go to one of those countries, bringing his family along with him would not have been an option. He would be leaving to South Korea with out me at first and I had to stay behind and move back in with my parents until we could get the paperwork started for me to come along with him. It was not easy for me as it was for him to just take off. Spouses have a large package of paperwork that has to be filled out by a doctor indicating that the medical records are up to date. After filling the paperwork, it has to be turned into my husband’s chain of command which could take three to nine months to be approved.

I had not lived in a country where my language was not the national language or had a mixed selection of culture. California, Texas, and Pennsylvania were nothing compared to where I was about to begin my life. I had to pack all the things that I intended to carry, but I was not allowed to carry everything, just two large suitcases and a carry on. Every country has different regulations about moving and South Korea happened to be one of the countries with a few more regulations in comparison to others. My flight was over fifteen hours long and we had to make a stop in Tokyo before arriving in South Korea. I knew things would be different there, but I was not prepared for what I saw when on arrival to the airport. I had never felt so lost now that everything was no longer in English and my phone was not even working so it was impossible for me to call my husband for help. I tried to spot those people who looked American so that I could ask them where I needed to go, but even they were from a different country and could not communicate in English either. My heart was now racing as I walked round in circles for about an hour looking for an information desk. Finally, I found an information desk that belongs to the military where I got the assistance that I required.

My husband came shortly after to pick me up and take me to where his military base was which was about two hours drive from the airport. There was a lot to be done the following day which included my registration into the system in order to go on base; shop at the grocery store and make purchases at the PX; a small Wal-Mart. Everything took several hours which dragged the entire process to over a week, but finally I was successfully registered. It was now possible for me to get around town now that I had started getting familiar with the surroundings. Dongducheon, South Korea was a much smaller town that was more Americanized with more people communicating in English and this is where my husband and I were going to be living for the next two years.

Throughout my stay in the different States in the United states, I noticed that all people are different having different accents, different words, slang words , cultures, rules, traditions and different forms of dressing due the variations in climate. In California and Texas, people dress very lightly as compared to other places because of the weather that is experienced there. However, In Pennsylvania; which is a really cold state and it only gets warm for three or four months, People dress in warm clothes and jackets for the extreme cold weather. I still remember when I used to live in Pennsylvania, it got so cold that I had to wear two pants, gloves and sometimes two sweaters and a jacket. I believe that Pennsylvania could also be among the most dangerous states because of the ice which has caused lots of accidents through the winter. Alternatively, People from Pennsylvania are really friendly, since the first day I arrived at Hazleton city all the American were really nice to me. People say that not everyone is like that in that city, but I had a good experience with the people there.

The army offers orientation to all the spouses for them to be aware of what is happening in South Korea and on base. On my first and last orientation we were notified that all the restrictions and rules that governed the soldiers also applied to the dependants. I thought why should we do the same if we are not soldiers? All people on a military base including soldiers, spouses and their children had to follow the same rules. I always try to follow the rules to the best of my ability because if I do not, my husband will have to be responsible for my actions. The life of army wives is not easy because we are also required to do evacuation training in case of an attack by North Korea. There are always rumors of attack by North Korea, but I have been here for almost two years and thank God nothing has happened yet. My sincere appreciation goes to Penn Foster and the army that is paying for my tuition I was able to carry on with my studies. I am happy that I will be finishing this course soon and I will have all the time to finish my Veterinary Technician Program with Penn Foster as well.

School has kept me very busy and I have not really had the time to learn all the traditions of South Korea. I am already aware of some few things about their culture, but to be honest I do not like it. They do not appreciate people talking in the train or dogs barking unless it is during the night. They also do not like it when one has a tattoo, they get scared a will not stop pointing fingers and staring. I can not wait to go back to the United States, but I am glad I met many army wives and got to visit very exciting places in South Korea.

Conclusively, living life as a military wife is not a simple affair; it is without doubt creditable and admirable. Being the wife to a military man is often considered to be a very dignified position, at the same time taking immense pride in the courageous men and women who have dedicate their lives to serving our great nation. Many army wives often move one state to the other as well as overseas together with their husbands and children when the army orders them to. Most women would not agree to this kind of a lifestyle where one keeps moving and this is what makes military wives so very special. There are various support groups that army wives can join when going through a difficult time dealing with the drastic changes in the family, as well as having a husband that is deployed in the war in places like Iraq and Afghanistan. It’s really stressful to be an army wife, but now that I have friends everything is going a lot smoother.

Technology Transfer Research Paper

Insert NameCSIA 459

Jan. 23, 2015

Technology Transfer Research Paper

In today’s world cybersecurity is a very important factor in everyone’s day to day life. Cybersecurity must be implemented in most daily task such as checking your bank account statement online, checking your work email and ordering the newest songs using Itunes. The qualitative data value of cybersecurity is known in the private industry and also in the government sector. But what most people don’t realize is that to make sure that these daily task are secure. There is a research and development process that all these products need to go though in order to be called safe and be able to safeguard the information the customers trust with them. In the research and development process there are three major parts that need to be completed. There is The Technology Development Life Cycle, Technology Transfer Process and Marketing to Funding Sources.

The Technology Development Life Cycle CITATION Bra02 l 1033 (Branscomb & Auerswald, 2002) has five stages that take an idea from invention to innovation. The first stage is the basic research stage. In this stage an idea is developed. Corporate and government research is started. The outcome of this stage is a patent is requested and granted to protect against intellectual property theft of this idea. The next stage of the life cycle is the Proof of Concept/ Invention stage. In this stage the goal is to create a prototype of the invention. Also testing the prototype and collecting raw data. At this stage the company might include getting initial investors and technology labs involved to help fund and manufacture the prototype. The next stage in the life cycle is the early stage technology development stage which is also known as (ESTD). This stage is very important to the invention because at this stage the goal is to get business validation. This is telling the business that they can profit in investing in this new technology. This is where they gather up all the data that was collected and package the results from the testing of the prototype to present to potential investors such as venture capitals. The next stage in the life cycle is the product development stage. During this stage the company must work out any bugs and get the technology ready to hit the market. Depending on the problems and the budget that is set the company might have to get other venture capitals to invest in the technology or go back to the ones that have already signed on to get more money to fix issues. The final stage in the life cycle is the production/ marketing stage. In this stage the company might get corporate investors involved to help market the new technology. Also, give out the specs so other companies to subcontract and make add-ons for the new technology. An example of that is Apple might say we are coming out with a new Iphone so here are the specs and a prototype of it, you can use this to make an aftermarket keyboard or app for the phone. This leads us into the Technology Transfer Process.

Technology Transfer Process which is also called the transfer of technology is what I would call a technology hand off or a pass down. During this process government and non-government companies get together and pass on existing technical knowledge, skills, and methods of manufacturing technologies to each other. These Technology Transfer’s help grow new markets in the private sector. In a way the government is giving away the blueprints or groundwork on things that they started working on and are no longer funded to work on. A prime example of this is when “President Obama is calling on NASA to cancel the program that was to return humans to the Moon by 2020 CITATION KEN10 l 1033 (CHANG, 2010)” By stopping that program private companies call for a technology transfer so they can continue the research and development of a way to get people on the moon. That way the government can give the companies their current research so their company can analyze what the government has already done and not waste time and money on doing the same things over. This is a way to keep the innovation building. It is the process of sharing of knowledge. “Technology transfer is the process by which existing knowledge, facilities, or capabilities developed under federal research and development (R&D) funding are utilized to fulfill public and private needs. CITATION Tec15 l 1033 (Technology Transfer, 2015)” This brings us to the funding.

First, we need to look at the willingness of government to fund cybersecurity. The President has started to look to that future. Other government entities should follow suit. The Vice President recently announced a Department of Energy grant of $25 million. Thirteen historically black colleges and two national labs will benefit from this grant. “The new initiative, titled the Cybersecurity Workforce Pipeline Consortium, will serve as a classroom-to-workplace bridge so student at partnering schools…have a clear path to entering the tech industry. CITATION Wil15 l 1033 (Williams, 2015)”

After reading I found the following statistics to show the need for funding. “Nearly 43 million cyber-attacks were detected in 2014, 48 percent more than the year before. Those breaches cost the U.S. economy almost $500 billion a year for companies to recoup funds and rebuild their network security. Experts believe that trend will continue with breaches happening more frequently and security software advancing to better detect them. To combat that, business and the federal government are investing more money, over $71 billion in cybersecurity, CNBC reported. CITATION Wil15 l 1033 (Williams, 2015)”

Now that we know the President is on board. Let’s see if any other government is on board. According to The Hill, if we pass the “Cromnibus”, the FBI gets 8.3 billion, the Department of Justice gets $722 million, DHS funds are frozen at last year’s rate and Department of Energy would get $304 million.

So now we know the government is invested. Let’s look at the Venture capital. The Hewlett Foundation funds MIT Cybersecurity Policy Initiative to the tune of $45 million. The Hewlett foundation is donating $65 million this year alone to better cybersecurity. At Hoc funded $8.2 million, HyTrust funded $34.5 million, Tanium funded $90.81 million, Kaspersky Lab funded an unknown amount. They are located in Russia and Shape Security funded $66 million. It seems these five companies donated the most to cybersecurity. So clearly the Venture Capital seems to be invested. So how do you get funding?

It seems that government funding is going to colleges to educate the new generation on cybersecurity. The Venture Capital is concentrating its money on what’s happening now. Venture capital exists for one reason, more money. It’s about immediate gain. If they put out money to fund cybersecurity, they expect to reap the benefit now and reap them big. The government is of the thought pattern that young, new minds will get the education and come up with more innovative ways to help cybersecurity. You can apply for grants and /or lobby your government on Capitol Hill. Venture Capital needs to be shown a need that you researched and developed a prototype and then that you solved the problem in theory. Then funding will come.

What I have learned during my research is that it is a long detailed process to get new cyber security technology from being just an idea in a college students mind to being implemented in government environments and private homes all across the world. There are a lot of battles that need to be fought and hills that need to be climbed during the journey. It takes a lot of dedication to this idea so innovation can come to life. It takes good marketing to get investors to invest in new technology. Also, I have learned that the U.S. government is willing to invest in the schools that teach the knowledge of innovation. And the venture capitals are willing to invest in making technology that they can use right now.

Works Cited

BIBLIOGRAPHY Branscomb, L., & Auerswald, P. (2002, Nov.). Between Invention and Innovation An Analysis of Funding for Early-Stage Technology Development. Retrieved from http://www.atp.nist.gov: http://www.atp.nist.gov/eao/gcr02-841/gcr02-841.pdf

CHANG, K. (2010, Feb 1). New York Times. Retrieved from http://www.nytimes.com/: http://www.nytimes.com/2010/02/02/science/02nasa.html?_r=0

Technology Transfer. (2015). Retrieved from http://www.utrs.com: http://www.utrs.com/technology_transfer.html

Williams, L. C. (2015, January 16). ThinkProgress.Org.

Insightful post (2)

Insightful post! I enjoyed reading your post. I like how you have extensively explained the aims of Burroughs when writing the piece “From Junky.” I concur with you that after reading Burroughs’ excerpt, we notice that things are not always as they seem. He explains about the rot in 103rd and Broadway. He talks about peddling and abuse of drugs, especially Heroin. William talks about how Heroin is smuggled from Mexico and abused on Broadway. Definition of Heroin is a drug that is commonly abused worldwide, and it derives from opium. He vividly describes how peddling activities occurred in his neighborhood. Burroughs also talks about drug addiction and its effects.

Insightful post

Insightful post! I have enjoyed reading your post and I like the way you have discussed your knowledge about antisocial personality disorder. I tend to concur with you that antisocial personality disorder involves an irresponsible, often criminal, and impulsive behaviour.

However, I would like to compliment you on the fact that you have taken the time to discuss and highlight some of the similarities and differences between antisocial personality disorder and other personality disorders.

I recognize that there is always a need for further research in this regard, since the condition can cause irreversible damage to both the individual and any relationship he may be involved in at the moment. I find it interesting that you have not necessarily agreed with the fact that antisocial personality disorder is the same as sociopathy, but you have highlighted the obvious difficulties in diagnosing these conditions. In my opinion, it is very difficult to diagnose anyone with any personality disorder, but this is especially true of people who are unable to accurately assess their own feelings and emotions.

I am pleased that you have recognized how similarities exist between antisocial personality disorder and some other disorders such as narcissistic and borderline personality disorders. You have not only made connections to other disorders but you have also highlighted how differences exist between them. It appears fair to me that they are still different diseases; they just share some common traits which provide a few pointers as to their phenomenology.

Insightful post (3)

Insightful post! I tend to agree with you on most of your points. There are numerous changes that tend to occur in an adolescent’s body. The brain also tend to change significantly during this stage. It’s important to know the physiological changes that can be expected when someone is an adolescent. I think one change we don’t talk about enough is synapses. Synapses are connections between neurons that act as the point of communication. They’re responsible for communicating information throughout the brain and they grow stronger as they’re used. Reading, writing, and solving math problems will slowly strengthen them.

I find it interesting that you have noted that when the prefrontal cortex is developing, the amygdala is what the adolescent will rely on, which makes decisions and solves problems. In some ways this makes sense, because most psychologists would agree that adolescents are impulsive and start to make decisions based on the amygdala, rather than the prefrontal cortex. I have also noticed that even when my children get older, they use their prefrontal cortex to help solve problems, but tend to rely more on the amygdalae as well. If a child thinks something is wrong with his or her teacher or parent they may react faster and more aggressively as opposed to using their thoughts and reasoning to come up with an appropriate response. All of this ties back in with your post, because if they are not using their prefrontal cortex on a regular basis now, eventually they will be forced to rely fully on it later in life. From the conversation with your 17-year-old cousin, it is clear that an adolescent’s body and mind tend to change a lot. Their thought process tend to develop greatly and thus enhance their decision making strategies and planning.

Insomnia and Sleep Apnea Sleep Disorders

Insomnia and Sleep Apnea Sleep Disorders

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Sleep Disorders

Sleep disorder is a term used to refer to conditions that affect sleep timing, duration, and quality and affect the individual’s ability to function properly when awake. Sleep disorders tend to lead to other medical issues and some may signify underlying mental health problems. The American Sleep Disorders Association published the first classification for sleep disorders in 1979. However, the understanding and knowledge of sleep health have transformed tremendously in the last four decades. Over 100 specific sleep disorders are known today and today’s classifications are based on criteria such as symptoms, causes, physiological effects and other criteria. Common signs of sleep disorders include difficulty falling asleep, trouble staying awake during daytime, circadian rhythm imbalance, and unusual behavior that disrupts sleep.

Insomnia is a sleeping disorder characterized by the recurring difficulty to remain or fall asleep despite the means and motivation to do so. Individuals that struggle with insomnia tend to encounter excessive sleepiness during the day and other cognitive impairments when awake. Insomnia is deemed chronic when the patients show the symptoms for a minimum of 3 times a week for 3 months (Patel, Steinberg, & Patel, 2018). According to recent statistics, one-third of adults grapple with some form of insomnia. Causes of insomnia include poor sleep habits, stress, eating a lot in the evening, and -tight work schedules. Other causes include post-partum and PMS. Symptoms of insomnia include having worries concerning sleep, waking up at night, having a hard time falling asleep, increased accidents, waking up too early, difficulty focusing, not feeling rested after sleeping, irritability, and daytime tiredness.

Sleep apnea is a sleep-related sleep disorder that takes place as a result of a blocked upper airway. People that have the condition wake up gasping for air or choking. Sleep apnea is also characterized by sleep apnea. Sleep apnea, like other sleeping disorders is caused by excessive fatigue and daytime dryness and numerous cognitive impairments. Sleep apnea is categorized into obstructive sleep apnea (OSA) and central sleep apnea (CSA). Sleep apnea is associated with other health issues such as heart disease and PTSD. Additionally, a link has been established between teeth grinding and sleep apnea.

Understanding the negative effects of insomnia on the mind is important. Sleep deprivation disrupts normal body and brain functioning. When one is sleep deprived, it means that they are not getting a sufficient amount of sleep. The average adult needs between seven to nine hours of daily sleep for optimal functioning. Lack of sleep especially affects cognitive functions. Insufficient sleep causes mood swings, sleep deprivation, headaches, and judgment and memory impairment. Lack of sleep also tends to cause clumsiness, weight loss, and weight gain. The effects of sleep deprivation on the brain vary depending on whether one is partially sleep deprived or total deprived. Partial sleep deprivation is when one sleeps for insufficient amount of time to rest. It goes unnoticed until the buildup of sleep deficit. Sleep deprivation has arguably dangerous and life-threatening effects. Partial sleep deprivation causes impaired and slower thinking in the prefrontal cortex (Rundo, 2019). This part is responsible for higher functions such as executive function, language, and creativity. Total sleep deprivation is when a person an entire night without sleeping. A person’s ability to finish tasks with accuracy and speed decreases with sleep deprivation. In a clinical setting, knowledge about sleep deprivation is important in helping clinicians understand their patients’ health problems and recommend the necessary help.

References

Patel, D., Steinberg, J., & Patel, P. (2018). Insomnia in the elderly: a review. Journal of Clinical Sleep Medicine, 14(6), 1017-1024.

Rundo, J. V. (2019). Obstructive sleep apnea basics. Cleveland Clinic journal of medicine, 86(9 Suppl 1), 2-9.

Value assessment

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Value assessment

Medicaid is the nation’s biggest health-insurance program , covering about one-quarter of all Americans. Over 82 million Americans were registered as of April 2021. This is up 15% from shortly before the COVID-19 pandemic began in February 2020, owing to the economy’s employment losses and the necessity under the Families First Coronavirus Response Act that states maintain continued coverage for current participants.

Medicaid participants are particularly susceptible; they include those who live in or near poverty and are disproportionately prone to negative health outcomes linked to social determinants of health. This susceptibility is a cause of widespread health disparities and adds an important dimension to Medicaid’s value evaluation and promotion. Incorporating patient preferences into value evaluation frameworks for Medicaid enrollees becomes even more critical as a result. For example, under the safety net, an underlying assumption that patients would intuitively see the importance of primary care as the preferable destination for low-acuity conditions may not hold true(Dubois &vWestrich, 2019). To avoid possible income loss during working hours, working-poor Medicaid clients may choose the after-hours availability of treatment in the emergency department or the convenience of a nearby minute clinic. Social determinants of health issues like these must be taken into consideration while designing Medicaid ambulatory care services.

Many programs addressing socioeconomic determinants of health rely on care coordination and case management. Individuals with complicated care requirements, for example, are targeted for intense case management, which includes acquiring resources for basic necessities. The new managed care rules strengthen Medicaid’s bridging requirements by requiring planning in health to arrange administrations amid moves between care scenes and when enrollees get medications beneath fee-for-service Medicaid. Plans must presently collaborate with “community and social bolster suppliers” as well as fee-for-service suppliers, agreeing to the unused necessities. This last mentioned prerequisite has the potential to altogether fortify joins between clinical care frameworks and community needs; however it will almost certainly need further direction and monitoring before it can be implemented.

The care coordination prerequisites apply harder Medicaid guidelines for person-centered care arranging for enrollees with one of a kind wellbeing care needs, counting LTSS, including completing mandated assessment needs while making sure that enrollees have a primary decision-making role. The federal guidelines, like other Medicaid rules, simply provide a starting point. Advocates may persuade governments to introduce enforcement mechanisms or new regulations to improve care coordination by connecting conventional health care with community resources. Facilitated Care Organizations (CCOs), a kind of responsible care organization, in Oregon are required to work with Zone Organizations on Maturing and territorial workplaces for desable people. Enrollees must also have access to community health workers, peer wellness experts, and other unconventional health professionals to assist coordinate services, offer health education, and guarantee culturally appropriate treatment.

Service delivery system

The Medicaid program is a significant wellspring of help for these particular suppliers since Medicaid recipients make up a huge portion of the populaces they serve and on the grounds that private protection doesn’t ordinarily cover their administrations and supplies in a similar way, if by any stretch of the imagination.

Due to the high requirements of the recipient populace and the huge public interest in Medicaid, the central government and states have a significant stake in the entrance, quality, and cost of the conveyance frameworks that serve Medicaid enrollees. As enormous buyers of administrations, Medicaid programs likewise have impressive influence to shape these frameworks. Over the long haul, states have utilized adaptability incorporated into Medicaid as well as waivers to foster creative ways to deal with getting sorted out and conveying wellbeing and long haul care. Expanding complexity in states’ and medical services frameworks’ utilization of information investigation to oversee risk and clinical consideration has supported their endeavors. Also, the ACA has cultivated conveyance framework change movement in Medicaid through the formation of the Innovation Center in CMS and new government financing open doors, showings, and state choices in Medicaid (Scott et al. 2020). CMS’ State Innovation Model (SIM) drive to advance multi-payer change techniques explicitly use Medicaid, outfitting the program’s insight and development in serving high-risk populaces and its clout as an enormous payer. CMS has additionally settled the Medicaid Innovation Accelerator Program, which is giving specialized help assets to states to additional help development. States are embracing a large number of models and focusing on various populaces in their drives, yet there are consistent themes – extension of overseen care; a focal job for essential consideration and clinical homes, underlining care coordination for enrollees with complex necessities; more noteworthy combination of administrations; extended admittance to local area based long haul administrations; and a honing center around quality estimation and superior execution.

Conclusion

The “health-care-only” concept has become more obsolete as Medicaid’s scope has expanded. The modern Medicaid overseen care standards address this issue by allowing states to fund nonmedical therapies and make community investments. The rules provide key obligations in areas such as care coordination. They also make it easier for governments to conduct programs focused on socioeconomic determinants of health in other places. Medicaid cannot, in the end, bear the total cost of our social infrastructure. However, the program may and should assist in bridging the gap across health care and  general health. This entails tying Medicaid to other safety-net programs and searching for ways to improve care delivery inside Medicaid. It also entails encouraging public health and prevention rather than merely treating illness and dysfunction. Medicaid will dramatically enhance health in America if states use their new regulatory ability to pursue these activities, and even increase the threshold.

References

Dubois, R. W., & Westrich, K. (2019). As value assessment frameworks evolve, are they finally ready for prime time?. Value in Health, 22(9), 977-980.

Scott, J. W., Shrime, M. G., Stewart, B. T., Arbabi, S., Bulger, E. M., Cuschieri, J., … & Robinson, B. R. (2020). Lifting the burden: state Medicaid expansion reduces financial risk for the injured. Journal of Trauma and Acute Care Surgery, 88(1), 51-58.