Examine the Reasons for Changes in Birth Rates and Family Size Since 1900 free essay sample

Since 1990, there has been a declining trend in birth rates and family size. The birth rate refers to the number of live births per 1000 of the population per year. There have been incidents of baby booms during the 20th century, where the birth rate has suddenly increased. These include after both world wars and during the 1960s. However, overall the birth rate has been decreasing. There are a number of social factors responsible for these changes. Firstly, the changing position of women in society has been partially responsible for the decline in birth rate and family size. The changes include greater equality changes between women and men, more education and work opportunities for women, easier access to divorce and wider availability of contraception and abortion, allowing women to control their fertility. as a result of these changes, women are seeing other possibilities in life other than marriage and childbearing. Many women are delaying child birth and putting their careers first. We will write a custom essay sample on Examine the Reasons for Changes in Birth Rates and Family Size Since 1900 or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page this leads to them having children at a later age and consequently being unable to have several children. Furthermore, a change in social attitudes mean some women are not having children at all. In addition to this, many sociologists argue that a decline in infant mortality rate leads to a decline in birth rate. They argue this because couples are not having children to replace the ones they have lost in infancy, as infant death is much rarer. In 1990, 15% of babies born died before their first birthday. Today, the infant mortality rate stands at only 5%,a great decrease from 1990. The decline in infant mortality rate is linked to a number of factors including improved healthcare, better nutrition for both babies and mothers and better care for mothers and their children through agencies such as antenatal and postnatal clinics. The decline in infant mortality, it is therefore argued, has a direct impact on the birth rate. Furthermore, birth rate and family size have decreased since 1900 as children have become an economic liability. Previously, children had been sent out of work to earn an income, such as chimney sweep boys during the Victorian era. However, laws banning child labour and the compulsory education extending means that children are not aloud to earn an income. Instead they remain economically dependent on their family for longer. Additionally, childrens material expectations have risen, meaning the cost of maintaining children has too. Increasing child expenditure has led to a reluctance from couples to have large families, thus the birth rate has decreased. The child-centered attitude that has now become prevalent in society is a final reason for a declining trend in birth rate and family size. The social construction of childhood has led people to view childhood as a unique, important period in a persons life. In relation to this child-centered attitude, parents attitude has shifted from quantity to quality when it comes to their family. This means people prefer to have a smaller family size so they can spend more attention on children during their important life stages. Overall there has been a steady decline in birth rate and family size since 1990. This has been due to a number of social factors including the changing position of women, the decline in infant mortality rates, changes in child laws and social attitudes towards childhood as a social construct.

Why Men Are Typically Taller Than Women

Why Men Are Typically Taller Than Women While studying genetic factors behind different traits in men and women, University of Helsinki researchers have identified a genetic variant on the X sex chromosome that accounts for height differences between the sexes. Sex cells, produced by male and female gonads, contain either an X or a Y chromosome. The fact that females have two X chromosomes and males only have one X chromosome must be taken into account when attributing the difference in traits to variants on the X chromosome. According to the studys head researcher, Professor Samuli Ripatti, The double dose of X-chromosomal genes in women could cause problems during the development. To prevent this, there is a process by which one of the two copies of the X chromosome present in the cell is silenced. When we realized that the height associated variant we identified was nearby a gene that is able to escape the silencing we were particularly excited. The height variant identified influences a gene that is involved in cartilage development. Individuals that possess the height variant tend to be shorter than average. Since women have two copies of the X chromosome variant, they tend to be shorter than men.

School Bullying in California Research Paper Example | Topics and Well Written Essays - 500 words

School Bullying in California - Research Paper Example Current policy Jigsaw Classroom This is a cooperative learning technique with a three decade track record of reducing racial conflict and increasing positive education outcomes. In this strategy just like in the jigsaw puzzle, each student’s part is essential. For example, students in a history class are divided in to may be five groups and the task being to learn about World War 2. In one jigsaw group John can be responsible in researching about the rise to power of Adolf Hitler, May assigned to cover concentration Camps, Alex to cover Britain’s role in the war, Mike to research on the contribution of the Soviet Union. Eventually every student comes back to his jigsaw group and will try to present a well-organized report to the group. Thus if a member does not like the other he cannot do well on the test that follows (Barrows, 1998). This therefore encourages listening, engagement and empathy by giving everyone an essential part to play in the academic activity. Policy Makers Metro Center offers technical assistance that utilizes consultation methods which builds strong-client consultation relationtionship that result in sustained change and improvement. Thus district and school representatives take an active role in coming to understand and assess their own concerns rather than having to rely solely on the knowledge and skills outside experts.

Modern states in the Middle East are the product of colonial violence Essay

Modern states in the Middle East are the product of colonial violence. Discuss with reference to two countries in the region - Essay Example The earlier caliphate and later empires and sultanates were the political factors that unified Muslims before colonialism (Khadduri 1951, p. 11). Colonialism is to blame for the rise in the ‘nation-state’. This is majorly because the colonizers used arbitrary and ad hoc means to create nation-states that were only meant to serve some of their particular interests. Good examples to explain this concept are how Kuwait, Lebanon, Syria, Iraq and Jordan were created. Kuwait was created as a result of the interest that the British had in the oil that was present in the Persian Gulf. Lebanon, on the other hand, was carved out of Syria to create a state that was friendly to Arab Christians. In the case of Jordan, it was created as a present to King Abdullah for the assistance he offered to the British during the 1st World War (Khalil 1990, p. 54). The manner in which most of these territories were being re-carved led to increased tensions that were centered on the territorial, l inguistic and ethnic differences that existed among Muslims previously. With this in mind, it is correct to point out that modern states in the Middle East are a product of colonial violence. This paper will discuss this notion with a focus on how Iraq and Syria were created as a result of colonial violence. ... From that day, Iraq was referred to as the â€Å"State of Iraq†. The state was to begin operating like an independent state because it was forced to break away from the ties that it had with the rest of the Middle East. The British went ahead and brought King Faisal, who was a Hashemite, to be the ruler of the new established State of Iraq. The French, who were the colonial masters in Syria, had forced Faisal out of Syria (Omissi 1990, p. 2). The British went further and appointed elites from the Sunni Arab people to head major government authorities and ministries. In 1932, Iraq was granted independence by the British after long persuasions by King Faisal. The British, however, did not give up the military bases or the transit rights for their troops. King Faisal died a year later, in 1933, and was succeeded by King Ghazi. During King Ghazi’s time, military coups were the order of the day. He eventually died in 1939 and was succeeded by his underage son (Tripp 2002, p. 28). Syria, on the other hand, has a unique history because some of its sections between 1098 and 1189 AD were under the Germans, Italians, English and French. This was mostly during the crusades that characterized that period. Previously, the region that is today Syria was under army of the Arab Rashidun in 640 AD (Batatu 1999, p. 21). After the period of the crusades, Syria was taken over by the Ottoman Empire in 1516. The French came in later in 1920 and established an independent Kingdom known as the Kingdom of Syria. The Kingdom which did not last for long was under the leadership of Faisal 1 who belonged to the Hashemite family. The Battle of Maysalun is blamed for the short existence of the Kingdom of Syria which only lasted a

The Work of the Prophets order Essay Example for Free

The Work of the Prophets order Essay Introduction   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Prophets of the Old Testament times are known to be people who speak for God. They are God’s messengers whose sole job was to proclaim the word of the Lord to His people. In short, they are God’s mouthpiece. There are however misconceptions and confusions as to the exact work of the prophet. This essay will try to elaborate on the true work of the prophet. Certain Confusions   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The work of the prophet is commonly misconceived by many well-meaning people. Most of these, revere, and regard the Bible as the Word of God, and therefore authoritative in life. However, confusion has wreaked havoc in their understanding of the true nature of prophetic writings because these people misunderstood the prophets themselves. A wrong perception of the personalities of these messengers of God has led to wrong interpretations of their writings. One prevailing false impression of the prophets generally is in the area of their mental state. Usually, they are perceived as people who were not in their normal state of mind especially while they were receiving their prophecies from God and while they were fulfilling their task of prophesying to Old Testament kings and the people of Israel. Their whole personalities, as well as their public functions, are veiled with mystery or paranormal occurrences. For example, some think that these prophets of Old were people who from time to time would experience some kind of a trance, a state of dazed existence, at certain occasions to receive their messages, much like the pagan prophets of Baal and other ancient religions of those times. This is a false notion of a biblical prophet, of course (Pratt Jr, thirdmill.org). Prophets have come to be known as such, not because they are primarily mystics who during several special occasions went through beyond normal encounters with God, but because they are messengers of God who proclaimed God’s word to Israel and remind them at certain times the forgotten laws of their Lord. Prophets are prophets because God must have His choiced spokespersons to deliver His word to His people. And so, they are normal persons with normal personalities like any other ordinary citizen of Israel. In fact, they have come from all walks of life in the nation of Israel. Some of them were statesmen like Isaiah, Jeremiah, and Daniel. Others like Zechariah came from levitical backgrounds; Amos, on the other hand was a shepherd and a farmer. Certain marks distinguished these people as prophets of God: they were chosen by God (Jer.1:5), they were people with heightened sensitivity to the holiness of God and the evils of men (Am.8:4-6), and they were people whose words they carry were not really theirs but God’s, hence, they were able to predict future events. As to the hyper-sensitivity of biblical prophets to evils in society, they were somewhat beyond the normal. The otherwise normal occurrences in life such as falsehood, injustice, hypocrisy, misery, etc., were magnified in their consciences by their knowledge of the laws of God (Heschel, 1962). With regards to sin, because it is the major problem with which God has been dealing with His people Israel since their inception, the prophets were so keen to highlight. Jeremiah prophesied doom for the non-repentance of Israel (Jer.1:16), and that they would eventually go into exile for their sins. The prophesy was historically fulfilled during the reign of Nebuchadnezzar (597 BC). In spite of the imminent judgment of exile on the people of God, the prophets pronounced a yet coming day when God would show His long-term eternal plan to redeem His people through the Messiah who would come first as a Suffering Servant (Isa.52-53). Through the coming Messiah, God would deal with the sin problem decisively and restore His people by making a New Covenant with them not like the one which God made in the time of Moses (Jer.31:31-33). Through the prophets then, God has clearly revealed His permanent hatred of sin, His righteousness, and everlasting plan for His people. References: Heschel, Abraham J. 1962. The Prophets: An Introduction. Harper Row Publishers. Holy Bible. New King James Version. 2002. Pratt, Richard Jr. http://thirdmill.org/seminary/catalog/herm/hgup/detail.asp/site/iiim/category/catalog

Plastics and Our Environment Essays -- Environmental Impact Ecology Es

Plastics and Our Environment Works Cited Missing Plastics today play an important part in cutting-edge technologies such as the space program, bullet-proof vests and prosthetic limbs, as well as in everyday products such as beverage containers, medical devices and automobiles. Recycled plastics are used to make polymeric timbers for use in picnic tables, fences, and outdoor toys, thus saving natural lumber. Plastic from 2-liter bottles is even being spun into fiber for the production of carpet. They are such a valuable resource, that, as a society, we have become dependent on plastics. It is essential that we develop programs to assure this resource will always be available in the future. Plastics are being used in so many different ways. Whether you are aware of it or not, plastics play and important part in your life. Plastics' versatility allow it to be used in everything from car parts to doll parts, from soft drink bottles to the refrigerators they are stored in. From the car you drive to work in to the television you watch when you get home, plastics help make your life easier and better. So how is it that plastics have become so widely used? How did plastics become the material of choice for so many varied applications? The simple answer is that plastics are the material that can provide the things consumers want and need. Plastics have the unique capability to be manufactured to meet very specific functional needs for consumers. So maybe there's another q...

Physician and Nursing Shortages Essay

Healthcare reforms including Obama Care, formally named the Patient Protection and Affordable Care Act greatly impacts physicians and nursing shortages. There are several provisions which could direct impact physicians and nurses through incentives for potential recruitment, grants, training and retention. Through potential initiatives, the act may indirect effects that may question or present new reimbursement alternatives and models of health care delivery options. Healthcare reforms will allow millions of additional working as well as no working Americans to obtain healthcare coverage and this may challenge and highly impact physicians and nurses workforces across the United States. Many healthcare facilities have already reported high vacancy rates for technicians, pharmacists, maintenance staff, housekeeping staff and radiology technicians and laboratory technologists. Today, fair percentage of the American population, roughly 20%, lack proper access to needed primary care becau se there is an ongoing shortage of physicians. Some doctors, almost 30% are declining to accept new patients whom are insured with Medicaid. The changing demographics of the United States today and perverse reimbursements are direct impacts from the physician shortage. The looming physician and nursing shortages will inevitably hinder the health care system that is already being tax as well as alter the way patients and their physicians interact because the doctor-to-patient ratio will continue to be raised which will hurt patient outcomes. All workers within the healthcare arena play a vital part in making the healthcare system successful. Physicians and nursing shortages definitely create problems for every department and for all other workers within their system. Worldwide shortages that the United States are currently experiencing may create dangerous and unacceptable care to patients. Shortages additional enable work environments that do the foster retention of highly experienced and  qualified healthcare professionals, resulting in high turnover and revolving worker pool. Physicians and nursing shortages present c hallenges that do not help the workforce in healthcare organizations worldwide. These challenges include inadequate incentives which may attract students to join the profession, understaffing in various medical professions, as well as inadequate training facilities, and primary care being undervalued. Obama Care relies on primary care providers to coordinate care in the hopes of lowering costs and improving outcomes. â€Å"If the population growth, aging and demand for care created by the newly insured, it is estimated that by 2025, the U.S. will face a shortage of 30,000 primary care physicians, nearly 5,000 of which are attributable to the expansion of insurance under Obama Care.† (Howard, 2013) The health care system involves a network that is a combination of hospitals, employers, insurers, physicians, patients and various other stakeholders. A significant change impacting one component will reshape the entire system. Stakeholders are greatly concerned because the qualities of health care as well as the cost of care. Health care reforms will need to a ddress changes that are missing in policy outlines which should make primary health care more rewarding and appealing to potential new nursing and physician staff and which will also help to maintain the nursing and physicians that are already practicing. Additional the current supply of primary health care physicians will continue to fall behind the increasing patient demands. This will also result in stakeholders presented with the problems of increasing shortfall during the next decade within the primary care physicians. The availability of primary care is consistently and positively targeted to continued improvement with patient outcomes, raising health costs, lower utilization of health and reduced mortality rates. The Affordable Care Act set forth millions of dollars to address the problems and concerns that are associated with existing physicians shortages. The Affordable Care Act also has provisions that are aimed to improve the education, ongoing training as well as to help with the recruitment of nursing, physicians, doctors as well as other health care personnel. In addition, there are provisions in place that help to increase workforces’ cultural competency, enhance faculty training of healthcare professionals, and diversity. The provisions also play a vital role because of the fact they are put into place to examine innovative  reimbursement and care delivery models that highlight primary care services value and offer in improvement in the patient care coordination. On an average, primary physician groups may see about four or five patients within an hour, probably about one patient every fifteen minutes. Because of increase productivity and cost restraints and pressures, this number could increase dramatically. This trend, unfortunately, will be matching the burden of physicians declining incomes and job market. A lessor number of physicians earn what physicians earned many years ago. Primary health has been affected more as compared to services rendered. Additionally, the shift to a bundled fee for performance from the fee for service reimbursement system for force solo practicing physicians and small group practices into forming or partnering into larger practices. Physicians and nursing staff are not surprised by many of the findings. The Doctors Company, the largest physician-owned medical malpractice insurer in the nation in 2012, released results from a survey in which more than 5,000 physicians participated in across the nation commented on the future of health care reform. A result of the survey concluded that 60% of the respondents concluded that the pressures of trying to increase patient numbers will probably have a negative effect on the level of care physicians whom have the opportunity to provide services. The study concluded that 51% of the physicians thought that their ability to successfully keep positive relationships with their patients and grow patient relationships would be negatively affected. Lastly, the study concluded that out of 10 physicians, nine are disillusioned by the concerns with the shortages so that several of the physicians actively discourage family and friends from pursuing careers in medicine. Unfortunately, this is a shocking reality of what many of us already know, and statistics presented from the study would be even higher if the exact survey questionnaire was conducted today. While the many projected newly insured patients that will enter the health care system may obtain their insurance coverage through available st ate ran exchanges, many new patients may still find themselves unable to afford potential discounted policies. This will cause many to look for coverage from Medicaid out of urgency and because they may feel as though they have no choice. Primary care physician payments have been reduced in the past and we can look for them to be continually reduced maybe even more in the future. Many  physicians are unhappy with the fact that they may owe over 160,000 when they finish medical school. Many potential physicians do not find this attractive because many will have salaries that are likely to be less than the cost of their education. Many physicians in this case will find it more attractive and enticing to become specials which again will attribute to the physicians and nursing shortages. Physician assistants and nurse practitioners may have to step up in fill in. Physician assistants are qualified personnel that have been license and qualified to provide needed preventive care options. Physician assistants have an important role in the management of chronic disease prevention and management, administering blood sugars testing and interpreting blood sugar levels. When physicians have only a short time, less than 10 minutes or so to see a patient, sometimes they encounter issues which may leave no choice but to pass responsibilities to their , who are able, to practice with the supervision of the physician in most states. â€Å"Under the proposals, issued with a view to impending physician shortages, it would be easier for hospitals to use advanced practice nurse practitioners and physician assistants in lieu of higher-paid physicians.†(Pear, 2011) Because these change, hospitals could benefit by seeing savings which would be immediate. Legislation within several states at this time is seeking to extend the physician assistant’s autonomy by enabling the assistance to independently practice without of physicians, but under certain guidelines and protocol s. Many Americans may find this legislation to be filled with controversy, but many may feel that the legislation is needed to increase productivity of physician assistants, nurse practitioners and primary-care physicians whom will ultimately have responsibilities because of the growing shortages. Doctor-patient relationship will definitely change because of the shortages. In the past, patients were granted appointment times that could last up to 60 minutes, these days are gone because patients are rushed out because of people waiting to be seen in addition. This doesn’t mean service will go down or the quality of medical care will not be like it was. Even though many people have doubts and are not optimistic, I feel the quality of medical care and health service will improve. Research also indicates the quality of patient care will improve performance measurements will prove this in the future. The Patient Protection and Affordable Care Act will impose  changes that may be dis ruptive in the delivery of primary care. The act allows expansion of primary care access to physicians, millions of new patients, and policymakers will be faced with increase pressure to resolve primary care practitioner’s shortages. Even though controversy surrounds the Affordable Care Act enactment, the government should do more to drive motivation among physicians, nurses and professional medical associations. They can also embrace medical societies that may offer strategy initiatives suggestions that will help to meet the nation’s primary care needs. Physicians have experience some success to this date with embracing the changes to primary care, such as supporting laws that allows primary care practice to be perform by non-physician practitioners including assistants and nurse practitioners. Some physicians have realized that they may benefit from the integration of primary care practice from population health needs. Many physicians have realized that the environment now created is beneficial, it helps the m. Many physicians have chosen to stop being against non-physician practitioners and are welcoming them to work with them. Physicians can also offer problem solving and physicians should take initiatives to foster policies and develop solutions which addresses primary care shortages. Initiatives can involve no more opposition of non-physician practitioners with primary care providers (in the past medical organizations as well as physicians did show opposition to this). Additionally, physicians should embrace changes with the delivery of primary health care including the shifting of some responsibilities to the practitioners. Lastly, because of the Affordable Care Act focuses with prevention and wellness, physicians should realize that opportunities exist to the integration of the primary care practice with population health. Many Americans will have coverage with the expansion of health insurance coverage. With the nation’s continued growth and new covered Americans the drive the demand for primary care to levels will definitely exceed existing capacity levels. The millions of newly insured Americans who may not had access to primary care will definitely be looking for primary care now with the enactment of the act. Because of this, there will more than likely be disruptive and unwelcome changes in the delivery of primary care. Important ethical issues are presented with health care reform. The recently 2010 enacted Patient Protection and Affordable Care Act have  ignited ethical debates over some minor and major controversial topics. Why do many feel as though reform within the health care system such a controversial issue? Politicians seek to gain advantages over their worthy opponents which fuel the policy debate. Differences which are important to us all, with values and moral beliefs are the underlying issues of political differences. To help comprehend the moral paramete rs of debate within health care reform, it may be beneficial to start by analyzing the primary goals of the nation’s health care system. Individuals and as the society want and have high expectations with our health care system. The United States health care system has been shaped by fundamental desires and goals. The American people will accept nothing less those exceptional, high levels of quality care which provides excellent health benefits. Americans expects the United States to continue being the frontiers of medicine and expects the United States to continue improving the quality of health care. The American people also want and welcome having a freedom of choice which means they make their own decisions about their care. These decisions can include deciding where to receive care, if and when they do, what kind of care they get, and from which health care provider in which they seek care. Basically, Americans including myself would like to maintain our on control over our health care needs, choices and providers. We also want affordability with healthcare, we don’t want to spend all our hard earned money on health care costs and not have enough money to cover our other needs. In addition, most Americans feel as though our fellow Americans can share in the costs of providing health care benefits to us all and Americans Americans as well as the government wants to make sure that medical care costs are controlled. This is an important attribute of the cost of medical care and it’s a vital element of the health care reform enactment. Extending care access to everyone without appropriate cost control measures will be unsustainable. â€Å"The number of emergency room visits continues to rise at a rate greater than that of population growth, exemplified by an increase in emergency room visit rates from 352.8 to 390.5 per 1000 persons from 1997-2007.† (Tang, 2010) Today, the United States spends the most on health care per capita, more than any other country. Americans generally would prefer cost containment that does not reduce quality or services. Cost containment approaches are not design to interfere with the  value of health care. The PPACA have address cost containment strategies which include patient care that is accountable, patient-centered medical homes, and programs to reduce patients being readmitted and patients acquiring new conditions while admitted as well as bundled payments. The Patient Protection and Affordable Care Act have some provisions that may be negative for doctors, however in some instances patients can suffer more. However examining the positives, On a positive side, provisions as well programs can help many of us. The Affordable Care Act seeks to provide additional access to coverage, lowering health care spending and improving the quality of health care delivered services. Initiatives of the ACA aid health care organizations; doctors and providers work together to coordinate health care of patient’s beneficiaries to ensure the quality of health care continues to improve while spending and costs are lowered. Many of the elderly have begun receiving the benefits of the provisions of the law. Some of these benefits include lower payments and preventive service care. They also are seeing the benefits of Medicare prescriptions at lower drug cost. The Affordable Care Act is helping seniors by allowing annual wellness visits and preventive services in which they have no upfront or out of pocket costs, offering coverage to individuals that may have pre-existing conditions and it allows for no one to be denied coverage because of pre-existing condition and huge savings on prescription drug costs. Though the health reform law includes measurement which may address the presented and growing shortage, other provisions in the law most likely will raise the demand of primary care. For example, the law is expected to extend coverage to millions of uninsured people by 2019, which will definitely increase the demand for primary care services. â€Å"The PPACA coverage expansions are predicted to increas e the shortage of primary care physicians from approximately 25,000 to 45,000 by 2020.† (Carrier, 2012) There are several measurements that can be implemented to help improve access to primary care providers and services. Because the U.S. has a high percentage of Americans without adequate healthcare a Mobile Health Clinic or a Nursed Managed Centers can be used to attract a lot of people such as the homeless people who do not have the means to be able to go to the doctor (Whelan, et al, 2010). This will allow them to be able to see a doctor and get the proper medical attention they need to have healthier lives. One possible  approach to alleviating pressures on the primary care workforce is greater use of nurse practitioners, which could both increase the number of primary care providers and potentially free up physicians to care for more complex patients. Improving access to primary care services and having more effective public health measures are critical to ensuring that individuals have access to high-quality services at the place and time that best meets their needs. Physician assistants can we be a part of the answer as well. They are well trained, have the clinical skills, with a high level knowledge base, and be a part of the solution. The skills they bring to the table can help address the impending avalanche of patients. Not only are they cost effective with overall labor costs less than a physician, but can take the stress off of a physician needing to see a certain amount of patients per day, as to keep the productive practice (Bahrych 2011). Finally, a scholarship program for students committed to providing primary care in communities with doctor shortages should be implemented; the program can allow open residency slots to be utilized in areas with shortages. Grants and incentives should be established. Also initiatives should be in place to forgive student loan debt. I would also make the following recommendations for improvements that will increase the availability of specialty care through tele-health, bringing specialists to primary care sites, and using physician assistants to deliver specialty services; and also expand the role of primary care providers, physicians and nurse practitioners to handle more specialized health issues through consultations and ongoing training. References: Howard, Paul. (2013, July). Get Obama Care While Supplies Last. Retrieved from http://www.usatoday.com/story/opinion/2013/07/11/obamacare-doctors-medicaid-primary-care-column/2510199/ Tang N, Stein J, Hsia RY et al: Trends and characteristics and US emergency department visits, 1997 – 2007. JAMA 2010; 304: 664-670 Pear, Robert. US Moves to Cut Back Regulations on Hospitals, October 2011. Retrieved from http://www.nytimes.com/2011/10/19/health/policy/19health.html?_r=0 Bahrych, Sharon. Let Physician Assistances be Part of the Primary Care Answer, December 2011, Retrieved from