Munch N’ Crunch Snack Company is considering two possible investments: a delivery truck or a bagging machine. The delivery truck would cost $53,252.28 and could be used to deliver an additional 47,000 bags of pretzels per year. Each bag of pretzels can be sold for a contribution margin of $0.38. The delivery truck operating expenses, excluding depreciation, are $0.52 per mile for 16,000 miles per year. The bagging machine would replace an old bagging machine, and its net investment cost would be $54,765. The new machine would require three fewer hours of direct labor per day. Direct labor is $15 per hour. There are 250 operating days in the year. Both the truck and the bagging machine are estimated to have seven-year lives. The minimum rate of return is 9%. However, Munch N’ Crunch has funds to invest in only one of the projects.

a. Compute the internal rate of return for each investment. Use the above table of present value of an annuity of $1. If required, round your present value factor answers to three decimal places and internal rate of return to the nearest percent.

Third time asking this question. Please read the question fully and answer it fully as well. Thank you.

You are an ethnobotanist conducting a study with the Yagua Indians of the north Peruvian Amazon. After working with your study communities for a year, you have documented the medicinal use of more than 200 plant species and have both collected vouchers and taken copious notes on how the plants are prepared and used. Unfortunately, you have also noted some threats to the persistence of both the medicinal plant traditions and the ecosystem itself:
•    Of the communities studied (total population: 900 people), only 6 elderly people had extensive knowledge of medicinal plants in the area and the younger generations knew of the uses of the 10 most popular medicinals.
•    There are signs of loggers cutting down forests just 50 miles south of the traditional Yagua land. If the loggers continue north, they will encroach on the Yagua traditional hunting grounds and sacred forest sites, where many of the medicinal plants are collected.
•    The Peruvian government has installed a small health post in a neighboring village and many people are abandoning the use of traditional remedies in favor of the medicines provided at the health post.
•    One of the most popular medicinal plants still used by the Yagua is also being collected for sale to passing river barges that take it to market in the city. Over collection of the plant is threatening its survival in the region.

In order to promote the protection of both the traditional ecological knowledge and plants of this region, you need to design a conservation action plan to present to the Yagua council of elders. In your action plan, you need to present detailed strategies that will help them to conserve their traditions and plants, addressing the four issues listed above. Explain both your role and their role in these conservation efforts. Use examples from your reading and video assignments to back up your argument.

Grading rubric
•    Present solution for each issue (4 points)
•    Overall rationale and feasibility of your action plan (3 points)
•    Use of examples from your reading and video assignments to strengthen your argument (3 points)

For this assignment you are provided with four scenarios. For each scenario, you are required to answer the following question:

What are the access-to-care issues in the given situations? Suggest at least two solutions to address the access-to-care issues in these scenarios.

Scenarios:

Mr. A is a 30-year-old African American male. His employer provides for his health insurance, which covers emergency room visits, hospitalization, and some preventive-care services such as yearly physicals. Whenever he schedules appointments for preventive-care services, he has to spend one to three hours at the doctor's office. Additionally, he has to schedule follow-up appointments for laboratory tests after each office visit.

Mrs. B is a 30-year-old African American woman with two children. She is employed at a workplace that does not provide the employees with health insurance. Mrs. B and her children make frequent visits to the emergency room for healthcare services.

Mr. C is an unemployed 52-year-old Asian male who has not seen a doctor in at least eight years. He speaks limited English. He has been experiencing some health problems. He was recently told about a free clinic located within a couple of miles of his apartment. There are no Asian healthcare providers at the local health clinic. He has some concerns about healthcare provided by anyone other than Asian healthcare providers.

Mrs. D and her husband, a middle-aged Caucasian couple, recently moved to a rural community. They are both on medications for chronic health conditions, which require them to go for bimonthly doctor visits. Their car recently broke down and there is limited bus service in their community. They are having a difficult time going for their appointments and obtaining their medications. They are also less motivated to seek care because they have some major disagreements with the primary care doctor who is a young woman in her early thirties.

O RECEIVE CREDIT, YOUR ORIGINAL POST MUST BE MADE AT LEAST 24 HOURS BEFORE THE DROP BOX CLOSES TO ENABLE YOUR CLASSMATES ADEQUATE TIME TO MAKE RESPONSES. You should post an ORIGINAL RESPONSE to ONLY ONE of the following discussion questions (minimum of 2 paragraphs - 10 points) and RESPOND to TWO other posts (minimum of 1 paragraph - 5 points each). Your original post must be substantiated with AT LEAST TWO topics discussed in the related chapter (include the page number(s) in parentheses within your post). Your responses must consist of more "meat" than 'I agree', or 'Good point.' All discussion posts will be evaluated on content, not just completion. Be specific and be thorough. The posts are a significant part of your class grade. 1. The chapter discusses the practice of serial wardrobing, where people return an outfit after they wear it for a special occasion such as a formal. What do you think of this practice? Is it okay to use an expensive product once and then get your money back? 2. Today many consumers pursue a ‘decluttering lifestyle.’ Should marketers encourage this trend toward simplicity even though it stresses buying less stuff that marketers sell? What marketing opportunities do you foresee if this trend spreads? Support your comments. 3. Car owners can now let insurance companies monitor their driving using new technology in exchange for lower rates. For example, customers who sign up for Progressive’s TripSense program get a device the size of a Tic Tac box to plug into their cars. The device will track speed and how many miles are driven at what times of day. Every few months, customers unplug the device from the car, plug it into a computer, download the data, and send them to the company. Depending on results, discounts will range from 5 to 25 percent. Would you be willing to give up personal privacy in exchange for lower prices? Support your opinion.  

Circuit:Low pass and High Pass

The nature of lake is that there is a giant explosion of what are called “midges” in the mid to late summer. If you haven’t been around and seen these bugs:

Your car gets covered so bad that you can’t see out the windsheild after driving 10 miles! They get everywhere; don’t open your door at night as they flood in! Now althought this is seen as a menace from bug hell, there are some not so obvious advantages which come from this menace. Who see the bugs, catch them and feed them to their young. And Who “see” bugs through sonar,their voices are their “eyes and ears”.

Professor from the Environmental program is trying to get an estimate of the population of bats that are around the lake to quantify the relationship and population dynamics of bats to the severity of the menace. Now bats are night creatures you see, well he can’t see so well as it is night! He is at a conundrum for how to measure the number of bats in a given area. Very difficult to do as you can’t visually (unless you have a light, yet this will probably throw off the count of bats as the bugs are attracted to the light, hence bats also, yet this would lead to an unnatural or not normal distribution of bats!) so he must be away from the street lights further down the road and the lights from cars with that blasting stereo to drowned out the new street performance muffler shouldn’t affect the natural distribution of bats. The second issue is that bats don’t fly in formation, they come from all directions almost randomly. Prof. has come to you for a solution to his bat count problem. Using the knowledge you have gained, come up with a simple design to help Prof. count his bats. Describe your solution and reasons why you chose this solution. Include any calculations and a concluding paragraph of what you have learned in this problem.

Circuit:Low pass and High Pass

The nature of lake is that there is a giant explosion of what are called “midges” in the mid to late summer. If you haven’t been around and seen these bugs:

Your car gets covered so bad that you can’t see out the windsheild after driving 10 miles! They get everywhere; don’t open your door at night as they flood in! Now althought this is seen as a menace from bug hell, there are some not so obvious advantages which come from this menace. Who see the bugs, catch them and feed them to their young. And Who “see” bugs through sonar,their voices are their “eyes and ears”.

Professor from the Environmental program is trying to get an estimate of the population of bats that are around the lake to quantify the relationship and population dynamics of bats to the severity of the menace. Now bats are night creatures you see, well he can’t see so well as it is night! He is at a conundrum for how to measure the number of bats in a given area. Very difficult to do as you can’t visually (unless you have a light, yet this will probably throw off the count of bats as the bugs are attracted to the light, hence bats also, yet this would lead to an unnatural or not normal distribution of bats!) so he must be away from the street lights further down the road and the lights from cars with that blasting stereo to drowned out the new street performance muffler shouldn’t affect the natural distribution of bats. The second issue is that bats don’t fly in formation, they come from all directions almost randomly. Prof. has come to you for a solution to his bat count problem. Using the knowledge you have gained, come up with a simple design to help Prof. count his bats. Describe your solution and reasons why you chose this solution. Include any calculations and a concluding paragraph of what you have learned in this problem.

create a case study from the interview with Dr. Steven Safyer, President & CEO Montefiore Health System.

• How does financing and reimbursement affect delivery of care? Health insurance affect health care delivery in the us that it makes providers less aware of the actual cost of health care it creates provider induced demand, this financing greatly influences how much health care is delivered.

• How does reimbursement differ in the delivery of outpatient vs inpatient care? Reimbursement varies most significantly by insurance company, more insurance compaines do reimburse inpatient and outpatient serrves very differently, but some smaller insurance companies may reimburse according to simple criteria, medicares inpatient prospective payment system reimburses a weighted fee schedule of rates by diagnosis related group based upon the average cost of cost across the mations providerrs for that particular set of health issues, and medicare outpatient reimbursement fits into one of two scenarios that is clinic( a freestanding primary ) and hospital( procedures performed wither at the hospital or at a clinis located within 35 miles of the hospital that own and operate the clinic) there reimbursed accordingly to the ambulatory payement classification.

• How do Managed Care and Integrated Systems impact the cost, access, and quality of health care delivery? Managed care and integrated systems has positive impact on the cost and access and quality of health care delivery.

• How has Legislative Health Policy impacted the delivery of care? Legislative health policy impacted the delivery of care:the health care delivery system continue to evolve by the market forces, and as do legal and regulatory changes resulting from health reform leggislation.

• What is the future of health services delivery? The future of health service delivery: insurances drop individual plans because they do not comply with some of the mandates and employers cope by reducing worker hours and negotiating new health plans and the us healthcare system will continue to evolve but no one knows the destiny.

Scenario 1: A man pulls into your driveway. He gets out of the car and starts to yell about his wife. He explains that his wife is about to give birth. She is full term in her pregnancy and 34 years old. She says that she feels the need to push and that the baby is coming. You want to help. (1) What immediate steps would you take in this emergency? (2) What questions would you want to ask the couple?

Scenario Continued: The couple says that this will be their 4^th child and that her contractions are less than 2 minutes apart. They do not know of any complication and her due date is in a couple days. (1) Describe the steps you would take in helping the women through the delivery process.

Scenario 2: You have been camping in the woods after backpacking up the mountain for about 20 miles. As you are hiking a small mountain trail you come across someone who had been mountain biking on the same path you are on. They are lying on the ground in the path holding their arm to their chest and moaning in pain. The bike has a bent tire rim and is lying against a large rock. You want to help them. (1) Describe the steps you would immediately take in this situation. (2) What information do you need to take into account because of your location?

Scenario Continued: The biker’s arm seems to be broken, but they have no major lower body injuries from the crash. They are fully conscious and able to walk, but in pain when their arm is jostled. You have your hiking backpack with you with some clothes and band aids, but no first aid kit. (1) What steps should you take to care for the individual using the supplies available to you? (2) How would you get the person further care and when would you know to stop caring for the individual?

You are the director of pharmacy at a large regional medical center. It has come to your attention that Dr. Smith, a hospital oncologist, has been prescribing medicines for cancer patients that are not labeled for cancer treatment. While "off-label" prescription is not against the law, you now recall a recent interview Dr. Smith did on a radio talk show. During that interview Dr. Smith talked about his discovery of the effectiveness of green-tea, honey and homeopathic treatments for cancer patients. Such a "holistic" approach to medicine has a certain appeal, especially to patients who have received a poor prognosis. Many cancer patients who were told they have only a few months to live by their doctors have come to your hospital from hundreds of miles away to be treated by Dr. Smith.

In addition to his work at your hospital, Dr. Smith owns and runs a clinic located in a poor Mississippi Delta community. When your hospital recently replaced its old outdated sterilizer machines, Dr. Smith asked if he could have one of the old machines for use at his clinic. Dr. Smith is well known and most of his patients like him. Last year he received an award from a religious group for his service to the poor. However, you know that Dr. Smith recently divorced his third wife. Her lawyer, known for her aggressive style and hard bargaining, won a huge alimony and support judgment worth $3 million against Dr. Smith. Rumor is that Dr. Smith is struggling financially, because he sold one of his sports cars.

How should you handle this situation? In your paper, be sure to consider the responsibilities and interests of your department, as well as the hospital. Include the issues of insurance reimbursement, standard of care, informed consent, public image of the hospital, and Medicare/Medicaid reimbursement. Are there other legal issues? Are there other moral or ethical issues?