What does Reagan mean when he says, “government is not the solution to our problem; government is the problem?” What are those problems?

Reagan’s first inaugural address

Min word count 200

You should not use any outside sources beyond the actual document to complete these assignments. Your submissions are intended to be your own analysis and reflections, not based on what you found on the internet or work you did with another student in the class (either past or present).

Riding a wave of dissatisfaction with the country’s economic problems and apparently diminished strength in world affairs, Ronald Reagan was elected president in 1980. An excellent public speaker, Reagan reshaped the nation’s agenda and political language effectively than any other president since Franklin D. Roosevelt. He made conservativism seem progressive, rather than an attempt to turn back the tide of progress. His 1981 inaugural address reflected how he made freedom the watchword of what came to be called the Reagan Revolution – an effort to scale back the scope of government, lower taxes, and rekindle the Cold War. Americans, he insisted, should look to their own efforts, not to the government to solve the country’s problems. Doing so would reinvigorate the American tradition of respect for “freedom and dignity of the individual.” He ended by invoking the time-honored idea that the United States has a mission to serve as a “beacon” of freedom for people throughout the world. In his public appearances and state papers, Reagan used the word “freedom” more often than any other president before or since.

Read the attached document and answer the following questions:

How does Reagan define freedom?

What does Reagan mean when he says, “government is not the solution to our problem; government is the problem?” What are those problems?

Ronald Reagan Inaugural Address.docx

Based on the results in Table 1 above, what might be a recommendation for improving the internal validity of the stepping test?

. Measurement Internal and External Validity

Below is an example of a study to determine the reliability of a new “step test” to measure functional ability. The step test involved having each subject step forward as far as they could with one leg three times. The time (seconds) it took to perform the 3 repetitions was recorded. 241 healthy subjects aged 18-65 completed the study. One rater tested all subjects. Distance (cm) is a continuous variable so ICC and paired t-test was used to compare reliability between trials.

Table 1. Average Time (seconds) and Standard Deviation (SD) by Trial and p-values between Trials.

1. Based on mean changes from trial 1 to trial 3, and the paired-test p-values, describe internal validity concerns in terms of the type of bias that may be present?

2. Based on the results in Table 1 above, what might be a recommendation for improving the internal validity of the stepping test?

What types of clients and professionals can you generalize these results to? Is this concept internal or external validity?

• The following vignette is from: Rozenfeld, 2017. Test-retest reliability of myofascial trigger point detection in hip and thigh areas.

BACKGROUND: Myofascial trigger points (MTrP’s) are a primary source of pain in patients with musculoskeletal disorders. Reliable MTrP palpation is necessary for their diagnosis and treatment.

OBJECTIVE: To evaluate intra- and inter-rater reliability of MTrP recognition in hip and thigh muscles.

DESIGN: Reliability study.

SUBJECTS: 21 soldiers and officers referred to a military outpatient clinic in Israel (15 males and 6 females, mean age 21.1 years) with lower extremity musculoskeletal pain. Inclusion criteria: 18-30 years old. Exclusion criteria: history of fibromyalgia.

METHODS: Two experienced physical therapists performed the examinations and were blinded to the subject medical condition and previous MTrP evaluation. Each subject was evaluated four times (twice by each examiner) in a random order. The evaluation was performed on both legs and included a total of 16 locations in several areas of the quadriceps and gluteus muscles.

STATISTICS: The outcome of current presence of a MTrP was dichotomous (yes, no). Kappa was used to determine intra-rater reliability for each physical therapist (intra-rater reliability) and between physical therapists (inter-rater reliability)

RESULTS: Below are Kappa values for different areas of the quadricep muscle.

Physical Therapist 1    Physical Therapist 2    Inter-rater

Rectus femoris            -0.04                            -0.02                            -0.04

Middle VMO                 0.66*                            0.77*                            0.64*

Distal VMO                  0.53*                            0.73*                            0.73*

Middle VL                    -0.02                            0.23                             -0.04

Distal VL                      0.46*                            0.64*                            0.63*

* p<0.05

VL=vastus lateralis; VMO=vastus medialis oblique

Answer the following questions based on the above results:

1. What statistical test was accomplished by having each physical therapist perform two exams on each subject?
2. Which physical therapist demonstrated higher intra-rater reliability?
3. Which muscle demonstrated the highest inter-rater reliability?
4. If a physical therapist had limited time to perform a clinical exam for active MTrP in the hip and thigh muscles, what specific areas would you recommend?
5. What types of clients and professionals can you generalize these results to? Is this concept internal or external validity?

Interpret the following statistics from reliability studies.   Check all results that reflect good reliability.

Measurement reliability. For attributes that are measured on a continuous scale, two common reliability statistics are correlation (r) and paired t-test. The intra-class correlation coefficient (ICC) is interpreted the same way as the Pearson correlation coefficient (e.g. larger ‘r’ means stronger correlation between two different measurement methods, or higher reliability). A paired t-test can be used to compare the difference in value between two measurement methods on the same set of subjects. If the paired t-test p-value is <0.05, the two measurement methods are significantly different in how they measure the same attribute (i.e., “poor” reliability).

For categorical variables (such as diagnosing or predicting a condition as yes/no), a common reliability statistic is Cohen’s Kappa. Kappa measures category agreement between two raters. Kappa usually ranges from 0 to 1 (it is possible to get a kappa <0, but it is not common). Although there are many ways to interpret Kappa values, a common method is as listed below (Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977:33;159-174).

• <0 = agreement less than “chance” (50/50 chance with a dichotomous variable, like a coin toss) – this is possible but does not occur often (Viera AJ, Garrett JM Understanding interobserver agreement: the kappa statistic. Fam Med 2005;37;360-63.)
• 0 = agreement equivalent to “chance”
• <0.4 = slight to fair reliability
• 4-0.6 = moderate reliability
• 61-0.8 = substantial reliability
• 81-1 = near perfect agreement

Use your knowledge from previous modules and module 7 lectures, and the above information to answer the questions below.

• Interpret the following statistics from reliability studies.   Check all results that reflect good reliability. (1 each, total 7)

__ r = -0.85

__ ICC = +0.9

__ Paired t-test p=.006

__ Paired t-test p=.85

__ kappa=0.2

__ kappa=0.9

For each question shown below, identify its weakness and improve the question by re-wording.

Survey Question Development. For each question shown below, identify its weakness and improve the question by re-wording.

• How satisfied are you with your diet and weight?
  1. Very Satisfied
  2. Satisfied
  3. Unsatisfied
  4. Very Unsatisfied

• What is your current age?
  1. Under 18 years
  2. 18-29 years
  3. 29-39 years
  4. 39-49 years
  5. Over 49 years

• What is the highest level of school you have completed?
  1. High school diploma
  2. Bachelor’s degree
  3. Doctorate degree

• Don’t you think that there should be a tax on soda in order to reduce the prevalence of obesity?
  1. Yes
  2. No
  3. No Opinion

• How would you rate your general health?
  1. Good
  2. Average
  3. Poor
  4. Very poor
  5. Awful

In your own words, describe your current quality of life.

. Label the following survey questions as Quantitative or Qualitative

____ A survey with 10 questions asking subjects to rate different aspects of their quality of life after a brain injury using a scale from 0-10. This survey results in a total score from 0 (poor) -100 (good).

____ A question asking persons with brain injury: “In your own words, describe your current quality of life.”

____ An open-ended question asking college students: “What are the current causes of stress in your life?”

____ A question asking college students: Rate your current stress level on a scale from 1-5

Discuss the capital structure of the company using the company’s balance sheet in the context of the Modigliani and Miller and trade off theories on capital structure and prepare a constructive critique of these theories.

Discuss the capital structure of the company using the company’s balance sheet in the context of the Modigliani and Miller and trade off theories on capital structure and prepare a constructive critique of these theories. Your discussion should involve various balance sheet items such total equity, total debt, and other relevant information. • See example paper

Estimate the share price of the company by means of the Dividend Discount and the Capital Asset Pricing models.

Estimate the share price of the company by means of the Dividend Discount and the Capital Asset Pricing models. For this task use the sensitivity analysis in relation to the variables which are hard to predict and/or accurately estimate. Comment on the reasons behind possible differences between the computed result and the observed market price citing relevant theories. • See and use Gordon’s Growth Model calculation for Fresenius SE attached • See and use sensitivity analysis for Fresenius SE attached

Evaluate and discuss the financial performance of the company over the period of analysis.

Use the “Investor Relations” section of the website from FRESENIUS SE to download annual statements covering the last 5-year period. The report structure should be as follows: 1. Evaluate and discuss the financial performance of the company over the period of analysis. As a minimum you must cover the following: a. General review of the financial statements: you must at least build a similar table with sparklines – see example – Figure 1 b. Working capital management policy: you must calculate the cash conversion cycle. Identify if the company has an aggressive or relaxed working capital management and comment. c. Dividend policy – determine how much volatility there is in the historical data for dividend payments. Is it stable or not? Analyse and comment

Write a research paper on the topic:“Healthcare Disparity in the United States and what interventions are been implemented to reduce the gaps?”

Research Paper Topic

Research Paper Topic

Proposed Title of the Paper

The proposed title of the paper is “Healthcare Disparity in the United States and what interventions are been implemented to reduce the gaps?”

                                                   Main Era and People to be Examined    

           The paper explores the era between 1980 and 2019. The dates present a period when consistent calls have been made for structural reforms to stop various forms of discrimination, mainly racial discrimination. For that reason, examining the era extends the researcher’s and audiences’ knowledge of the progress the U.S healthcare system has made to address disparity in healthcare resulting from differences such as people’s race, education, or socioeconomic status. The paper mainly explores historically marginalized groups, for example, black and Asian Americans. According to Lopez et al. (2021), the healthcare system in the U.S is overwhelmed with disparities that have an uneven effect on marginalized groups. According to the authors, the inequalities result in gaps in critical areas such as access to healthcare, health insurance coverage and poor health outcomes among particular populations. Examining this population, therefore, offers an adequate opportunity to explore how existing disparities can be addressed to meet the health needs of all people.

Finding Sources for the Paper

Sources that will be used in the paper can be gathered from books and online scholarly databases, including EBSCO and PubMed. The databases offer rich sources of relevant information and the latest research.

Difficulties with the Project

Finding relevant materials and access to resources are the main challenges experienced in the project. Preparing a high-quality paper requires learners to use relevant and credible sources upon which to provide evidence and justifications for their claims. However, with the proliferation of resources on various topics, for example, on the internet, students may be overwhelmed with the resources to use. However, the difficulty is addressed by focusing on scholarly and reliable sources and disregarding others, such as blogs.

Reference

Lopez, L., Hart, L.H., & Katz, M.H. (2021). Racial and Ethnic Health Disparities Related to COVID-19. The Journal of the American Medical Association, 325(8), 719-720.