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Citation 1 Beliveau, Richard, and Denis Gingras. Green tea: prevention and treatment of cancer by nutraceuticals. Lancet 364.9439 (2004):1021-22. Print. Credibility This article was published in the Lancet, which is a resourceful scholarly source. Beliveau is a leading Ph.D. scholar in the field of cancer research at the University of...
Introduction In today’s competitive business scenario, it has become critical for organisations to give priority to customer service and satisfaction. Such priority is more crucial for the service industry such as health care. Due to increasing competition, private sector companies engaged in health care are forced to prioritise customer service....
Abstract The use of Electroencephalography (EEG) has become a core factor in determining the levels of aspect for growth and development in the management of mental health Over the years. Electroencephalography has been used by many health practitioners in the diagnosis of diverse brain conditions and ailments such as epilepsy,...
Introduction Any dysfunction in the frontal and the prefrontal cortex is assessed through numerous methods. One of the methods is the Wisconsin Card Sorting Task dubbed WCST. The Wisconsin Card Sorting Task test is a set-shifting neuropsychological test. Specifically, WCST is used to assess the human executive functioning (Monchi et...
How important is it to involve users and in what aspect(s) of the design or what stage of the selection process would you seek their involvement? Potential users of computers in a health care facility setting should be involved in all decisions regarding the introduction of computers in their workplace...
Introduction Assisted suicide denotes measures by which a person or a group of people assist another person to voluntary bring about his or her own death. It may also describe how a doctor helps a terminally ill person to die. Assisted suicide In many cultures, suicide has remained the best...
Speech and language disorders refer to disorders in communication that arise from difficulties in hearing, language development, speech, and fluency (Cook and Friend 46). Examples include stuttering, dysarthria, voice problems, language expression disorder, and phonological disorder. These disorders usually range from small problems of sound replacement to difficulty in comprehending...
“Disease Warriors” Documentary and Epidemiology Summary of the documentary “Disease Warriors” The episode Disease Warriors describes the work of healthcare professionals, trying to prevent the spread of contagious diseases and help patients who suffer from various illnesses such as AIDS. This film shows that vaccination can be the key to...
MHC Self-proteins from non-self proteins are viral that are distinguished by the major histocompatibility complex (MHC). This component is an important molecule involved in body immunity. The molecule signifies foreign molecules that may be present in the human body system. The paper intends to analyze the importance of MHC molecules...
Background of the problem “Overwhelming facts reveal that racial and cultural minority groups are more likely to receive poorer quality health care than white Americans, even when factors such as insurance status are controlled” (American College of Physicians 2010). As the country’s population continues to grow and diversify, the health...
Literature Review Electronic health record (EHR) is an application of information technology in the collection, storage, retrieval, and utilization of data derived from patients or the general population. Hayrinen, Saranto, and Nykanen (2008) define EHR as “a means of repository of patient data in a digital form, stored, and exchanged...
Bipolar Disorder In this paper, it is preliminarily asserted that, over recent times, there have been several debates regarding the intricacies of bipolar disorder (also called manic depressive disorder). It is further stated that, to a great extent, immense progress has been made in terms of treating this order. However,...
The Language Hemisphere Notably, there exists a dogmatic assumption that the left hemisphere controls language. Nevertheless, this is a gross oversimplification of the matter. In this case, the two hemispheres are involved in language processing (Banich, 2004). However, the left hemisphere has a relative advantage of performing the role than...
Market structure According to the US government report of 2007, the market structure for both the prescription drugs (brand-name drugs) and generic drugs are changing significantly. It notes that for the last four decades there, is a small increase, in demand, for prescription drugs due to the increasing use of...
Introduction Respiration is the process of exchanging gases between the environments and organisms during which the thoracic volume changes to develop a specific mechanism of pushing the air out of the trachea and pulling the next portion of the air in the trachea. The elements of the mechanism are expiration...
Introduction Although the increasing incidence of autism has been linked to some aspect of vaccination – perhaps thimerosal – the scientific evidence does not strongly support a causal relationship; instead, the causes for the increase may arise, for example, from improved recognition and diagnosis of this still poorly understood condition....
Assessment ARDS, or the acute respiratory distress syndrome, reveals a complicated reaction to the lung injury. It is characterized by excessive alveolar-capillary permeability, diffuse alveolar damage, and pulmonary edema. The pathology is accompanied by impaired gas exchange and severe hypoxemia (Matthay 6). Because ARDS is a syndrome, but not a...
Introduction The immune system is involved in protecting the body against attacks that would culminate in disease. The lymphatic system is composed of thousands of lymphatic vessels responsible for filtering plasma back to the blood. It also interacts with the lymphoid system that is crucial in the immunity of an...
Introduction The cardiovascular system is a collection of organs in charge of the movement of blood in the body. This system is made up of the heart as well as an arrangement of veins, arteries, and capillaries. In this paper, I look at the anatomy and physiology of some components...
According to the Health Belief Model (HBM), what is the Decision-Making Process that a Person goes Through before Taking a Health-Related Action? The Health Belief Model (herein referred to as HBM) is used to explain the behavior of patients with regard to accepting or rejecting preventive healthcare or adopting healthy...
Brain imaging technologies are essential since they help one to understand the role and relationships between various parts of the brain. There are several brain imaging technologies such as computed tomography (CT), Functional Magnetic Resonance (FMR), Functional Magnetic Resonance Imaging (FMRI). Notably, CT is a brain imaging technology that uses...
Corpus Callosum is a band of white matter that connects the right and the left hemispheres of the brain. This band acts as a pathway through which communication takes place. In addition, the development of agenesis in the corpus callosum results in congenital disorder (Hetts et al., 2006). Agenesis is...
Introduction The cloning process is a successful scientific practice especially when scientists in Scotland managed to clone a mammal. Indeed, the process is simple that provided a possibility to clone a human being. Nevertheless, there have been ethical issues concerning whether human cloning could be officially authorized or not. Moreover,...
Bipolar disorder is a type of psychological disorder or mood disorder characterized by severe feelings of sadness, loss, failure, hopelessness, and rejection. People suffering from this disorder are often seen to swing back and forth between phases of irritability and good moods. The movement from mania to depression can be...
Introduction As a student at Pierce College, I have come to realize that the dietary practices that an individual adopts play a huge role in their physical and mental well being. Healthy eating is the biggest contributing factor to an individual’s well being and it is associated with an increased...
Ethics in Your Work Place Ethics refers to the code of conduct that governs the activities or behavior of professionals in a given field or employees in a given organization (Seth, 2010). The code of conduct is usually set by the organization or the regulating body in the profession. Ethics...
Abstract This paper is a research proposal comparing childhood obesity in the United States of America and Saudi Arabia. The paper starts by defining the purpose statement of the research: to establish the rate of obesity between the US and Saudi Arabia, the causes, and how to overcome it. Then...
Introduction Diabetes mellitus is an endocrine disease that occurs quite often in patients of different ages and is characterized by hyperglycemia syndrome, which is a result of insufficient insulin production. With undue treatment, this disease can affect blood vessels, nervous system, and metabolism of patients. The purpose of this paper...
Abstract Purpose: The purpose of this paper is to explore communication strategies that can enhance novice nurses’ capacity to work in acute care psychiatric settings. Methods: An integrative literature review was conducted to analyze selected research articles that studied the barriers to effective communication that novice nurses encounter. Findings: Nurses...
Medication errors are the medical errors related to prescription of drugs and other medications. Despite many interventions aimed at reducing their incidence in diverse settings, medication errors are still a burden to health care. However, the majority of adverse events related to medication errors can be prevented in case of...
To succeed in the field of public health medicine, one needs to master a variety of skills and competencies. Particularly, the foundational abilities outlined by the Council on Education for Public Health (CEPH) are crucial for the future public health nurses. The present paper aims to perform the self-assessment and...
The nursing practice is guided by strict codes of ethics which promote beneficence and protect the patient. These standards, often legally supported, provide a framework which the nurses use to provide ethical and professional care. However, the complexities of the healthcare system and patient demands may create morally ambiguous situations...
Even though following the prescriptions of doctors and strict adherence to the course of treatment are mandatory conditions for the recovery process, excessive attachment to certain drugs may become a problem. In particular, prescription drug abuse is the issue that is relevant today and should be discussed at the state...
Introduction Ross, Fitzpatrick, Click, Krouse, and Clavelle (2014) point out that there is a need for resilient and proficient nursing leadership that fosters organizational and personal change. Nurses’ role in making ethical, legal, and moral decisions is crucial as they are the first people with whom individuals can discuss their...
Abstract The final paper covers the main activities and functions that were integrated by the public health professional while working on the HIV prevention campaign. The target population selected for the project was young adults in Chicago, Illinois. The reason for choosing that group was that is included some of...
Introduction The ever-changing technology has transformed several sectors of humanity that include education, business, and health. Notably, the wise implementation of technological advancements introduces beneficial outcomes for consumers and service providers in various entities. One of the sectors that have enjoyed the benefits accrued from technology is healthcare. Calvillo, Román,...
Introduction The Roy Adaptation Model (RAM) is one of the most commonly used conceptual theories of nursing. Understanding its ideas can help medical professionals improve the quality of care they provide and enhance patients’ self-evaluation and mental health. This paper aims at researching the RAM, describing its main concepts, and...
Any healthcare employee needs to adhere to a variety of regulations. Public health professionals have many competencies to follow in case they wish to be considered high-skilled and responsible. The present paper aims at self-evaluating and discussing the skills, knowledge, and abilities across the foundational competencies set up by the...
The selected public health issue serving as the basis for the intended final capstone project is HIV prevention. The target group is composed of young adults from Chicago, Illinois. The problem is closely related to the paper because it will help to develop and introduce a public health campaign, which...
Introduction A wide variety of nursing research tools such as surveys, can be used in order to gather information on the views and opinions of a specific group of people on a particular clinical or organizational issue. This data is contributed to the nursing knowledge base, which can be used...
Introduction Although a drop in the nurse-to-patient ratio (NPR) is typically viewed as a reason for concern in the healthcare system, high NPR can also affect patient outcomes negatively (Jarrar, Rahman, & Shamsudin, 2015). With the rise in the number of nurses per patient, the threat of mismanaging patient information...
Introduction Ethics in medical professionals is guided by different standards. These principles include justice, beneficence, and autonomy. The widely used conceptual framework is that of utilitarianism (Cherkowski, Walker, & Kutsyuruba, 2015). This moral law dictates that good actions are the ones that maximize happiness. The above principles will also be...
Introduction This paper describes an evidence-based project to move my facility from recorded reports to bedside handoffs. Currently, nurses routinely complete their shift-to-shift documentation outside the patient room, a practice that limits patient/family involvement and is prone to communication errors that raise the potential for sentinel events. The stakeholders and...
Abstract The realization of effective and efficient processes in the health-care sector is a critical aspect of bolstering the delivery of high-standard services. Incorporating technological innovations into the field of health care is identified as a critical approach to facilitating positive results in the sector. The topic of electronic health...
Introduction Generalized anxiety disorder (GAD) is one of the most frequent mental disorders all over the world. It belongs to the category of anxiety disorders and is considered to be a “highly prevalent, chronic, costly and disabling mental disorder” (Cuijpers et al., 2014, p. 131). GAD can develop as an...
Introduction In clinical practice, there are many patients who may have several health problems and require special assessment and treatment. As a rule, there is one main health problem and several co-morbid conditions which may influence the development of the primary disease and the effects of a chosen treatment. In...
Indians came to America in three major waves of immigrations and brought their authentic culture and traditions. Despite the assimilative processes which had a significant impact on the Hindu Americans, Indian culture still has a substantial impact on different spheres of their life. For example, Hindu Americans demonstrate some peculiarities...
Introduction The use of appropriate leadership strategies delivers desirable results promptly. Different theoretical concepts in organizational leadership support the power of ethical, moral, and legal practices. Ethical and moral standards in an organization foster evidence-based practices such as collaboration, teamwork, and support (Ericsson & Augustinsson, 2015). The targeted legal standards...
Introduction: Defining the Process of Cause and Effect The process of cause and effect can be described as a relationship between issues where one is the outcome of the other. The principle of causation incorporates two interdependent elements: action and reaction. When only one cause is involved, the process is...
Introduction Collaboration in health care can remarkably improve patient outcomes and the delivery of care. Many studies have been conducted on the topic, and much evidence has been obtained from practitioners that demonstrate the positive effects of collaborative behaviors not only among health care providers but also among providers, patients,...
Patient Initials: not identified. Subjective Data: The patient is a 52-year-old American of Irish descent who presented with an ambiguous complaint of not feeling well. Chief Complaint: According to the patient, for the last two days, he has experienced “shortness of breath.” (Case Study, n.d., p. 1). The patient also stated...
History of the Industry The pharmaceutical industry is a relatively new industry, the origins of which can be traced to the mid-19th century. Until that time, there was no mass production of drugs; apothecaries relied mainly on natural remedies, which were ineffective in solving the most prevalent health issues of...
Introduction The present paper follows the progress of the development of an in-service education program that is meant for twenty-six nurses of the Emergency Unit of the King Fahad Medical City, which is located in Riyadh, Saudi Arabia. In particular, the paper uses the information gained through the learning needs...
The Definition of Medication Errors In spite of the fact that the United States spends more on healthcare than any other developed nation, the quality of health care remains low. One of the areas of concern is patient safety and the impact of prescription errors. In order to understand the...
Introduction Psychotherapy has gradually evolved during the past few decades closing the bridge with the medical world. Increasingly, studies are stressing on the biological substrate evidenced in human disorders. It has been claimed that neurological or chemical mechanisms are responsible for the disorder. On the other hand, Biopsychology has come...
Innovative technologies are an essential component of effective healthcare services. While the importance of healthcare experts’ knowledge is not to be underestimated, technological advances also allow for a wide range of opportunities to address health issues and provide the needed services. The devices that assist nurses in making clinical decisions...
HPI A 48-year-old patient visited the health facility with complaints of poor vision and the inability to distinguish between different colors. He also stated that his life was in danger because many witches were after him. The patient had been diagnosed with type 2 diabetes five years ago, which had...
In discussions concerning the future of healthcare, certain subjects such as innovations and information technology become paramount. The concerns of the future of health care signify digitalization, enhanced connectivity, and improved relationship between medical professionals and patients, which will lead to better medical attention (Brende et al., 2017). Patents will...
The paper provides a detailed diagnosis of the disorder manifested by the patient in case study 18. Theoretical orientations and historical perspectives on the diagnosis, risk factors, as well as evidence-based and non-evidence-based treatment strategies for the disorder are presented. A separate annotated bibliography indicating the relevance of different sources...
Introduction Postgraduate education is aimed at enhancing one’s knowledge skills, and it is frequently a means of gaining better professional results. Nurses, as well as specialists working in many other spheres, have an opportunity to enter doctoral programs through which they can obtain greater expertise. The present paper will analyze...
Medical and technological innovations, as well as changes in health care policy, have produced radical advancements in the delivery of health care services. Notwithstanding these robust improvements, health care leaders are hard-pressed to find solutions to complex challenges which the US health care system is going to face. Over the...
Nurse practitioners (NPs) should use various theories to develop appropriate care delivery models. Adult-gerontology nurse practitioners (AGNPs) possess adequate competencies that guide them to provide comprehensive medical support and care to adult patients. This discussion describes how I can apply Jean Watson’s Theory of Human Caring in my practice as...
Introduction Because dementia has no cure, quality of life acts as a vital treatment objective for patients with the condition. Non-pharmacological treatment methods to cope with the behavioral and emotional variations linked to dementia are essential, attributable to the adverse impacts of pharmacological approaches. Depression in people with dementia could...
Introduction This paper is about “Improving Sepsis Collaboration through computer documentation.” Preventing and treating the life-threatening infection that is sepsis requires one of the most rapid reactions from healthcare professionals regarding time. Thus, identifying and documenting sepsis cases becomes another critical step in the patient’s healing process, requiring a specific...
Introduction Nurse practitioners (NPs) use their competencies and philosophies to meet their patients’ health needs. In order to function optimally, these professionals should borrow numerous ideas from existing theories and models. Such a practice can empower them to become skilled providers of exemplary medical services and care. The paper below...
Introduction Quantitative and qualitative research articles provide different types of data and results to analyze and apply to practice. It is important to critique the effectiveness of these two approaches with reference to the articles which address the topic of spreading infections while using central venous catheters in acute dialysis...
Article Bradbury‐Jones, Caroline, et al. “Promoting the Health, Safety and Welfare of Adults with Learning Disabilities in Acute Care Settings: A Structured Literature Review.” Journal of Clinical Nursing, vol. 22, no. 11/12, 2013, pp. 1497-1509. The paper is a structured literature review which includes articles that were obtained from four...
Introduction Different scholars have developed numerous definitions of the term learning. However, Wright, Street, and Gousy (2011) define learning as the continuous permanent acquisition of cognitive, behavioural, and other technical and non-technical skills. Learning is a nonstop process, which commences during childhood and continues throughout adulthood. People have different learning...
Thesis “The nursing personnel contribute immensely towards the implementation and adoption of the evidence-based protocols which contribute towards the provision of quality care. The evaluation of the challenges that the nurses experience in implementing evidence-based protocols is critical to the achievement of the desired outcome of improving the quality of...
Introduction The cost of health care has grown tremendously over the past few decades, necessitating the need for the implementation of efficient strategies to cut down healthcare spending. Various scholars have come up with proposals on the best ways to deal with the ballooning cost of healthcare without compromising its...
Introduction The case study selected for review is that of Cattaraugus County Rehabilitation Center (CCRC) that is a nonprofit organization that has implemented the Balanced Scorecard for effective strategic planning and management of its operations. The analysis presented in this report argues that Cattaraugus County Rehabilitation Center used an effective...
Introduction Health care is a very important consideration for every government across the world. Generally, health care is quite broad and involves numerous stakeholders, including doctors, nurses, dieticians, and therapists among others. This paper looks at the role of insurance in managed care in the United Arab Emirates (UAE) and...
Evidence-based practice is the incorporation of the finest research evidence in medical proficiency and patient ethics. It includes categorizing sturdily researched discoveries and applying them in everyday practices so as to upsurge the excellence of patient care and bring the most profitable nursing care. Nurse managers must pay attention to...
HR Department: General Overview Human resources (HR) comprises of many functional areas, with responsibilities ranging from training and development to recruitment. The HR profession has undergone a myriad of changes in the last two decades and continues to evolve as new opportunities and challenges emerge. The modern HR department has...
Introduction Emergencies often require timely and valid decisions to prevent the apparent risk to patient health, including death. However, the policies and protocols intended to systematize the decision-making process often create complex ethical and moral issues. The following paper highlights the ethical issues in the emergency setting and outlines the...
Introduction Strategic planning is a popular concept that is widely studied and applied in all kinds of businesses, irrespective of their size and goals. Although strategic planning was first developed for use in the public sector, it is now widely used in public companies and health care organizations, such as...
Introduction Bipolar disorder is a medical condition that affects the moods of an individual. People with this condition experience extreme mood variations where at one moment they are cheerful and at the other, they are depressed and sad. The different changes in moods are referred to as episodes where one...
Introduction Behavioral health conditions account for mental and substance abuse disorders. It is estimated that by 2020, mental and substance use disorders will outperform all physical conditions as a critical source of disability globally (Williams, 2013). Data also indicate that about 26% of Americans aged 18 and more are living...
Abstract Quality in service delivery is an important aspect of healthcare provision. This study was aimed at measuring the quality of services provided by three private hospitals in the city of Riyadh. Existing literature indicates that the SERVQUAL method has been used in measuring the quality of service in the...
Introduction The continuous improvement of healthcare services is one of the definers of the hospital’s success in the market (Stamatis, 2010). The local acute care hospital understands the importance of this aspect for the success and profitability of the facility. In this case, I applied for the position of Manager...
Today, the United States is one of the industrialized countries that spend a lot of money on healthcare. However, it has not been in a position to extend healthcare services to all its citizens. It has been observed that a lot of money is spent on health services per capita...
Medicare Payment Mechanism Today hospitals and physicians are reimbursed by a range of different public and private services. The payments they provide can be both direct and indirect. Today the government tries to control healthcare costs by reducing reimbursement and establishing managed care programs for Medicare and Medicaid (Banach and...
Introduction Human resource management is an established profession. Nevertheless, it gained recognition as an independent discipline in the recent past (Gowen, McFadden, & Tallon, 2006). Despite its popularity, there is no consensus on what entails human resource management (Gowen et al., 2006). Additionally, there is no agreement on whether the...
Introduction Living in the era of technology highly affects the medical sphere. Nonetheless, despite the benefits of technological advantages, some medical institutions remain reluctant to using electronic health records (EHR). There are several reasons for this decision. One of the causes is the fact that using electronic system might increase...
Introduction Hospitals are under pressure to change and adopt new leadership models. The changes are geared towards reducing the cost incurred during the provision of health care and improve services provided to patients (Kennedy & Fiss 2009). Effective leadership in medical institutions aims at identifying the areas that are responsible...
Unlike other developed nations such as Germany, the United States does not have a universal healthcare system. Most of the implemented policies have not been able to improve the effectiveness of the country’s health sector. Consequently, the common consensus in the nation is that the healthcare system should be fixed...
To organize powerful strategic management within a health care organization, its leaders need to realize the extrinsic environment surrounding their hospital. They need to comprehend and promptly react to the crucial changes happening in this environment. Companies that are unable to prepare for alterations, disregard the external factors, or confront...
Technology has a critical impact on different spheres of life including medical providers. Continuous innovation tends to change the healthcare system. These concepts not only increase the availability of the services but also improve the quality of the provided care (Bowman, 2013). Consequently, the critical goals of this paper are...
Managed care is one of the tendencies that exist in the current U.S. healthcare market. Its original goal was to introduce a sufficient managerial mechanism to enhance the quality of the provided services while relying on the methods of cost-effectiveness (Collins, Piper, & Owens, 2013). The primary goal of the...
Organizational Context and Understanding of Quality and Patient Safety To my organization, patient safety means ensuring that harm and any negative outcomes are minimized or eliminated in any health care (Flowerdew, Brown, Vincent, & Woloshynowych, 2012). Quality management systems are critical in promoting patient safety and minimizing the risk of...
Many modern trends in health care are associated with technological progress. Two examples are exchanging health information and using personal health records. In both areas, researchers observe serious challenges, but also propose possible solutions. The present-day development of technology opens new perspectives for the exchange of information among health care...
Introduction and Background Even though the United States spends more on healthcare than any other developed nation, the quality and accessibility of health care remain low. The United States government initiated healthcare reform to address some of the most glaring issues, such as a large number of uninsured. While laws...
Dependent and independent variables Variables Socioeconomic status and susceptibility to diabetes. Reasoning In the case of the proposed research, the socioeconomic status of a respondent is the independent variable. On the other hand, susceptibility to type II diabetes is the dependent one. The rationale behind identifying these two variables is...
Abstract Sustainable management of medical waste is one of the major concerns that the Ministry of Health of Viet Nam and hospitals are trying to deal with. Most medical wastes are unique and cannot be disposed of in the same manner as normal wastes. They are infectious and can also...
Introduction and Background In the United States, the health care delivery system is characterized by diversity and complexity. The United States citizens rely on various insurance programs to pay for medical services, and the healthcare delivery system includes public and private institutions operating in for-profit and not-for-profit manner. Even though...
Impacts of EHRs in the Health Sector Technological advancements are unstoppable and unpredictable. All sectors of humanity have experienced the effects occasioned by the advancements of technology. The health sector is one of the sectors that have experienced the effects of technological advancements. Electronic Health Records (EHR) is one of...
Early mobilization therapy issue became an area of concern after researchers discovered the negative consequences of bed rest following sickness or trauma. These consequences can be versatile and dangerous for a patient’s health condition. The most prominent of them are cardiovascular deconditioning, increased risk of pressure ulcer development, muscle weakness...
21st Century Solutions Health Care Hospital is an organization that aims at delivering professional health and nursing care to the local population and promoting the use of information technologies in order to improve services and cooperation between the employees. The chosen facility has a number of qualified people who take...
Introduction Leadership is one of the core functions in every organisation or health institution. Effective leadership dictates the performance of employees in a given institution. Theorists and scholars have presented a number of theories and models that can be used by organisational managers to lead their followers (Spetz, 2014). The...
Knowledge is a common way to create value. Its role is critical in terms of corporate value and improving organisational performance, especially in the case of the creation of new knowledge through sharing with colleagues (Carlile 2002). As such, there is a popular tendency to implement knowledge management technologies in...
Abstract Health care insurance coverage is an essential element of health care that is used to enhance access to health care in the society. The coverage not only removes the disparities in health care access, but also reduces the cost of health care for different groups of people in a...
Distribution of National Health Spending by the Type of Financing Source Bodenheimer (2005) noted that 45 % of healthcare spending comes from the government, 36 % from employment, 15 % out of the pocket and 4 % from other sources. 33 % was spent on hospitals, 23 % on Physicians...