Saturday, March 14, 2020
Tectonic Plates and The Plate Tectonics Theory essays For millions of years, tectonic plates have been determinate of changes in the physical face of the earth, and they continue to do so today. These massive plates move underneath the surfaces of the oceans and the continents, producing earthquakes, volcanoes and uplifts. This paper will discuss the composition, movement and history of tectonic plates, the theory of plate tectonics and its history, and tectonic plates affect the surface of the earth today and will continue to do so in the future. The earth is divided into three main layers: the core, the mantle and the crust. The core is further divided into the solid inner core and the liquid outer core. This layer is mostly iron and nickel and is extremely hot. The mantle is divided into the lower and upper mantle and is composed mostly of iron, magnesium, silicon, and oxygen. The outermost layer, which contains all life on earth, is the crust. This layer is rich in oxygen and silicon as well as aluminum, iron, magnesium, calcium, potassium, and sodium. It is in between the crust and the mantle that we find tectonic plates. The outermost layers of the earth are divided into two categories based on their physical properties. The asthenosphere is the lower of these categories, composed of clastic or flowing mantle. The upper layer is known as the lithosphere and contains both the top, rigid layer of the mantle and the crust. The lithosphere is what makes up the tectonic plates. The composition of these plates is b ased on their location. Plates under the surface of the ocean are made of mostly of basalt, while continental plates are comprised of rocks such as andesite and granite. It is generally believed that there are 12 plates that make up the earths surface. The majority of these plates are a combination of oceanic and continental lithosphere, while the Nazca, Pacific and Juan de Fuca Plates are made up of mostly oceanic lithosphere. Most of the continents ha...
Wednesday, February 26, 2020
Local Anesthesia - Essay Example In states wherein the application of local anesthesia is allowed, the dental hygienist is initially authorized by the dentist of the dental clinic to administer the reagent to the client (DeAngelis and Goral, 2000). The application of local anesthesia has been delegated to dental hygienists because this procedure is not frequently employed, with exception to a few particular dental scenarios (Wilkins, 1994). However, majority of the cases wherein local anesthesia was administered to the client indicated satisfaction in the dental services that they received. It is thus apparent that the administration of local anesthesia to clients of a dental clinic experiences significantly less pain than those who were not given any local anesthesia. It has been reported that local anesthesia is usually administered during periodontal practice, with approximately 10% of clients needing this reagent. The utilization of local anesthesia presents a number of discrepancies in terms of its frequency and reasons for use. Firstly, it has been reported that the administration of local anesthesia by dental hygienists are more often performed based on the request of the client, as compared to the frequency of request by the attending dentist. It is thus possible that some of these cases could have been conducted without the need for a local block. Secondly, the frequency of use of local anesthesia by dental hygienists varied among states, thus there may be additional reasons that could influence the options of the client, dental hygienist and dentist. The application of local anesthesia has also been associated with a number of side effects, including that of a toxic reaction to the reagent (Brand et al., 2009). Other associated reactions may be linked to the loss of sensitivity of the mouth area, thus resulting in a change in the quality of service of the client soon after a dental proc edure has been performed. Given such discrepancies with regards to the utilization of local anesthesia by dental hygienists, this study would thus want to address the issue of local anesthesia administration in two specific states, namely Connecticut and Washington. It should be understood that Washington carries a longer history of implementation of local anesthesia, as compared to Connecticut. It would thus be important and informative to determine whether there are any differences in the frequency of use of local anesthesia in these two states. In addition, the satisfaction of both dentists and dental hygienists from the use of local anesthesia would be examined in this study. Any information that would be gathered from this investigation may provide a better understanding of the reasons and factors that influence the administration of local anesthesia to dental clients. This study will be performed by collecting the perceptions of dentists and dental hygienists on the issue of the administration of local anesthesia. A battery of questions that are related to the use of local anesthesia during dental services will be presented in questionnaires that will be given to study participants. One limitation of this investigation is that the study population may be fully represent the entire country, yet the particular features of each
Monday, February 10, 2020
Corporate Finance - Coursework Example However, the application of the IRR technique revealed that the project has an IRR of 20.2% which is less than the rates FCL uses to discount their investments. In consideration of the rate of inflation and the fact that there seem to be no basis for using a 21 per cent and a 26 per cent rate of inflation as suggested in a meeting, the recommendation was made to invest in the project. The basis for this suggestion was that the investment would facilitate an increase in the companyÃ¢â¬â¢s efficiency. Furthermore, it would help to improve FCLÃ¢â¬â¢s image and so allow the company to obtain more contracts and thus increase its revenues. Introduction Investing in a project is not a simple matter. It involves an assessment of different options. If the project relates to an asset for a new idea, this requires consideration of a number of different options which are completely new to the organization. However, if it involves a new piece of equipment to replace an existing one, it requir es consideration of the equipment in use compared to the alternative. FCL is considering whether to replace an old crane which has five (5) years left to be put out of commission with a new ALII Crane. The ALII would allow the company to get additional opportunities in the market which the old crane would not be able to facilitate. It would also be able to produce items faster which mean a faster turnaround time and less production backlog for the company. Purchasing a new piece of equipment normally involves a large capital outflow and so the companyÃ¢â¬â¢s ability to obtain funds is normally one of the main considerations. However, since financing the project is not a challenge, the focus here is not on obtaining money to finance it. Some of the things to be considered include cash flow and the ability of the company to generate enough revenue to make a profit or to break-even with this investment. Additionally, the project needs to be appraised to determine whether the investme nt will generate the required returns. The project will be assessed in terms of its net present value (NPV) over the ten year period, the payback period and the projects internal rate of return (IRR). Break-even analysis It is important to consider the ability of the company to generate the volume of sales necessary to break-even. The breakeven point is the point at which the company neither makes a profit nor a loss (BPP 2011; Horngren et al. 2000). This is a measure that is frequently used to measure risk in a business (Singh and Deshpande 1982). The ability to generate a profit or to break-even is not the only important issue and so the timing of FCLÃ¢â¬â¢s cash flow is also of paramount importance. Cash Flows A projects cash flow is very important. In order to determine the feasibility of the investment the cash flows will have to be evaluated (Emory et al. 2007; Titman et al. 2011). In fact, Popescu (2008) indicates that cash is the lifeblood of a business; therefore, it is i mportant for the people who are placed in authority to pay special attention to cash inflows and outflows and their timing. Cash will flow inwards from sales revenue while cash will flow outwards to pay for expenses that will be incurred on the project. The focus should be on incremental cash flows that are generated from the use of the
Thursday, January 30, 2020
From a close study of the opening of the novel Essay From a close study of the opening of the novel; and with reference to other stages throughout, discuss the relationship of George and Lennie, commenting on how it relates to the theme of loneliness By Matthew Keane In the novel, the two main characters, George and Lennie, have a parent-child relationship, as George leads the way for Lennie; he also gives him advice and teaches him. Lennie follows all advice that George gives him. The idea of a teacher-student relationship is evident because George shows all signs of intelligence; he gives all the advice, and has all the ideas. Lennie on the other hand, is mentally challenged, and needs all the advice that George can give him. Lennies mental capability is reflected in his descriptive appearance, he is often compared to animals, his actions and reactions are childlike, and he also has a bad memory. However, Lennies bad memory can lead to friction, as George can lost his temper with him because he often has to remind Lennie several times before he can remember. Overall, theyre more like father and son than equal adults. From the first time they are introduced, we immediately get the impression of one being a follower and another being a leader, we can tell this by the line, They had walked in single file down the path, and even in the open one stayed behind the other The word even in this sentence signifies that no matter what, George will always lead Lennie, even though there was plenty of space for Lennie to walk next to him, he still stayed behind George. The reader is given an immediate insight to Lennies character when Steinbeck uses animal imagery; most of his actions are compared to animals, Lennie dabbled his big paw These animal comparisons tells the reader that Lennie shares the innocent qualities, as most of his actions are made on impulse, and he doesnt think about what hes doing. Lennie also has a childlike innocence, because he has the mind of a child and again doesnt think about his actions. However, Lennies animal-like behaviour shows that he can have an unpredictable nature, as his acting on impulse can have unexpected results. The childlike qualities that Lennie displays can sometimes lead to friction between him and George. This happens when Lennies memory loss causes George to lost his temper frequently, So you forgot that already did you? I gotta tell you again do I? Jesus Christ, youre a crazy bastard This happens frequently in the novel, this quote is taken just after the bus driver drops them off at the wrong place, George has a reason to chastise Lennie about his poor memory, these outbursts also show that he is in control of Lennie. Steinbeck reinforces the point about who is in control of the relationship by the description if when Lennie keeps a dead mouse in his pocket, and George forces Lennie to give him the mouse. Lennies closed hand slowly obeyed. George took the mouse and threw it across the pool to the other side, amongst the brush The tone used by George Give it here! clearly shows that he is in control. When Lennie retrieves the mouse from the bushes, George shows he is in control by snapping his fingers, and then Lennie immediately returns the mouse. There is another purpose in this episode, which is to show us Lennies irresistible urge to pet things; as later on in the novel it has an important role, as the urge lands him in trouble when he accidentally kills Curleys wife by breaking her neck. So this part in the novel his significance to tell us about Lennies urge to pet soft things. The stroking of soft things symbolises that Lennie wants a soft and easy life, and doesnt want the hard life that he has now. Lennie wishes for something soft that represents the desire for something finer, to be held onto in literal reality leads to tragic consequences of Curleys wifes death, made more poignant, almost dramatic irony takes place at the moment the news arrives that confirms that the ranch is theres. Clearly without George around, Lennie has no control. This control that George has over Lennie also means that Lennie is totally dependant on George. As a result, George often seems angry or upset at Lennie. In the opening, George seems easily angered because of the bus driver, we can tell this by the tone that he speaks to Lennie in, Youre a crazy bastard This brings the negative side of the relationship to the surface, If I was alone, I could live so easy This proves that George can see Lennie as a hindrance to his life, that without Lennie, George wouldnt have to always look after him. George also bring up the subject of what happened in Weed, just to make Lennie feel bad, Jus wanted to feel that girls dresswell, how the hell did she know you just wanted to feel her dress? Also he makes Lennie feel bad by saying that its Lennies fault that they both lose their jobs, I got you! You cant keep a job and you lose me ever job I get This long passage acts as a warning to what happens later in the barn with Curleys wife, we also learn of what happened in Weed, How the hell did she know you jus wanted to feel her dress? She jerks back and you hold on like it was a mouse. She yells and we got to hide in an irrigation ditch all days with guys looking for us This shows us Lennies urge to touch soft things, such as a dress, or Curleys wife hair. The incident with Curleys wife has an uncanny resemblance to what happened in Weed, as while stroking Curleys wifes hair, she gets scared and tries to scream, Lennie tries to stop her screaming and holds on to her, but he unfortunately breaks her neck. Although George is quick to anger, he doesnt want to hurt Lennie, when George realises he has hurt Lennies feelings, he immediately feels bad, His anger left him suddenly, He looked across the fire at Lennies anguished face, and then he looked ashamedly at the flames The true nature of their relationship is revealed as father and son when George apologises to Lennie and then explains to him, No look! I was jus foolin, Lennie. Course I want you to stay with me. Trouble with mice is you always kill em He then tries to reason, First chance I get, Ill give you a pup. Maybe you wouldnt kill it. Thatd be better than mice. This passage ends with George re-counting theyre shared dream, Well have a big vegetable patch and a rabbit hutch and chickens This last phase of the opening chapter clearly shows how George also gets much from this relationship. The unreserved love that Lennie extends to George sets them both apart from the other drifters and farm hands who generally have nothing. Guys like us, that work on ranches, are the loneliest guys in the world. They got no family. They dont belong no place. Even though, while angry, George tells Lennie that he could behave like the other men, If I was alone I could live so easy.when the end of the month came I could take my fifty bucks and go into town and get whatever I want His true feelings are revealed later while George is telling slim why he and Lennie are so close, he tells Slim of how one time he abused Lennies trust, while swimming in the Sacramento river, he tells Lennie to dive in the water, even though he cannot swim. George then dives into the river to save Lennie, and since then George realises how much Lennie depends on George. This closeness is confirmed by Georges reaction when Curleys wifes body is found, Maybe theyll lock im up an be nice to him George also tries to defend Lennie as he knows that Lennie didnt mean to kill Curleys wife, Lennie never done it in meanness he said All the time he done bad things but he never done one of em mean' The relationship established in the opening is then illustrated throughout the novel. The first time that George and Lennie meet Curley, George protects Lennie from Curley. What the hell are you getting into it for? We travel together Oh so its that way? Yeah its that way' Also, when Curleys wife first appears, George is again careful to make sure Lennie doesnt make a mistake similar to the incident in Weed, Listen to me you crazy bastard, he said firmly, Dont you even take a look at that bitch. I dont care what she says or what she does' The idea of a father-son relationship is continued during the passage where Curley is attacking Lennie, but Lennie will not fight back until George orders him to, Georgemake um let me alone, George. This shows us that Lennie waits for George to give him permission before hell do anything. When Candy finds Curleys wifes body, George makes it clear that he will not let anyone hurt Lennie Maybe theyll lock im up an be nice to im This shows the strength of their relationship, as George knows that Lennie has done something bad, and should be punished, but he still doesnt want anyone to harm him. Unfortunately, George was unable to save Lennie from himself, and so when Lennie accidentally kills Curleys wife, George has no other option, but to shoot Lennie, he has to take this option because if Lennie was put into prison, he would be alone, with no-one to look after him properly, and condemned to a life if terror and madness. Curley, on the other hand, wants Lennie to die in pain and suffering. Shoot for his guts. Thatll double im over Slim, being the voice of authority in the novel, gives the final confirmation on the killing of Lennie, I guess we gotta get im In my opinion, the novel was very good, the shock ending was very surprising and unexpected, but a closer look throughout the novel foreshows us what happens, such signs as what happened in Weed, the mice that Lennie kills, the need to pet soft things, all of this gives the reader clues to what happens at the end. In my opinion, the relationship between George and Lennie is less than a relationship between two equal adults, and more like father-son, as one of the pair continually leads the other, while the other always follows
Wednesday, January 22, 2020
The framer's intent of setting up the American Government will never be know for sure, but it is gathered that they preferred a republic over a democracy. In the constitutional convention the drafters had to decide how much power they would entrust with the people of the United States, and how much should be controlled by representatives. They chose to have Congress Make the laws, and congress would be selected directly by the people. But another branch of government, the executive branch, needed a sole president and the framers had to decide how to choose this president. They chose from three main systems: elect the president by congress, the people, or electors. The electoral college system has been in place for over 200 years and Americans are still not sure how it works or if it is the best system. Many Americans feel they go to the polls every year and vote for the president, and in the long run they are in control of the fate of our executive branch. This third system was to have electors that could not be a member of congress vote for the president. The elector system was voted down twice, once as the electors to be chosen by state legislatures, and the other time as the electors to be chosen by direct vote. Finally it was passed under the system of letting state legislature decide how to choose the electors. Another compromise had to be made about how many electors each state would have. This was agreed upon by the electors equaling the total of the states representatives and senators. States went three main routes in choosing electors: the legislative system, where state legislatures choose the electors; a district system, where electors are selected by the people of each congressional district; and the general ticket, or a winner-take-all system, where a popular vote was held in the entire state, and the winner took all electoral votes. Many have tried to reform by making a more uniform system state by state, but the constitution is very clear that it is each state's own decision of how to choose electors. The legislative system eventually failed because of too much bargaining, promises, and payoffs. The district system eventually lost popularity because it encourages third parties. This left the general ticket system as the dominating system. However, the framers originally intended electors to be chosen by the people and then vote for what they thought was best. There are two states that still use the district system, but the remaining 48 states use the general ticket system. Most all states no longer show the electors' names on the ballot.
Tuesday, January 14, 2020
The sport of baseball has produced some legendary, iconic players since its inception in the late 1800s. However, there is one particular legend that stands out from the rest: Lou Gehrig. Lou Gehrig was one of baseballÃ¢â¬â¢s greats, had a record setting career and a life claimed by a disease bearing his name. When Lou benched himself in 1939, nobody, including himself, imagined he would be dead in just two short years. Lou Gehrig was born June 19, 1903 to Heinrich and Christina Gehrig, German immigrants. They made their home in Yorkville, in the Upper East Side of New York City and eventually moved to upper Manhattan when Lou was four. Shortly after settling in their new home, Lou received his first baseball glove, a catcherÃ¢â¬â¢s mitt, for Christmas at the age of five. At the park across the street from the Gehrig home, Lou would play baseball with the older children in the neighborhood. Even though Lou was only six, he was comparable in size to the other children as he was big and strong; a very husky fellow but very shy. Like the older children, Lou would arise at five each morning and play baseball in the park until it was time to go to school. In this park is where it began for Lou Gehrig (Hubler, 1941). By the time Lou entered Commerce High School he was a big, burly young man weighing nearly two hundred pounds with extremely broad shoulders. In the park, he could hit a baseball further than anyone around. However, Lou did not participate in baseball as a school sport; he considered himself an ordinary neighborhood sandlot player. At some point during LouÃ¢â¬â¢s high school career, classmates told his teacher about how far he could hit a baseball. After hearing this information, the teacher demanded Lou show up at one of the scheduled high school baseball games. Lou did show up, heard all of the cheering, turned around, and went directly home. Lou was so terrified that he literally ran away from his first high school baseball game. The next day his teacher demanded that Lou show up for the next game and threatening a failing grade if he did not show up. Lou Gehrig was forever grateful for the teacherÃ¢â¬â¢s threat that day (Macht, 1993). LouÃ¢â¬â¢s parents wanted him to attend college even though he wanted to work and earn money for the family. Fortunately, Christina worked for a fraternity house at Columbia University managed by the universityÃ¢â¬â¢s athletic director. Because of this working relationship and a tremendous amount of studying, Columbia offered Lou an athletic scholarship and he accepted. Before the baseball season started, someone had advised Lou to go to Connecticut to play for Eastern League, a professional team, to gain more experience and he would be paid to play. While playing for the Eastern League, the Columbia University baseball coach discovered that Lou was playing professionally and therefore breaching his contract with Columbia. Lou was not allowed to play his entire freshman year as a consequence of breaching his contract (Macht, 1993). By LouÃ¢â¬â¢s sophomore year at Columbia, his fielding was erratic but his hitting improved with much practice. He was dangerous and extremely wild as a pitcher and terrible in the outfield. Finally the manager placed Lou at first base where he needed only to catch direct throws or scoop up ground balls. His hitting continued to evolve and he was hitting the ball more than 420 feet. During this time at Columbia, professional league teams were taking notice of Lou and making offers. It was not until his mother fell ill that he accepted a $1500 bonus to join the New York Yankees and dropped out of Columbia University after two years (Hubler, 1941). The new Yankee immediately became frustrated with his newfound job. He practiced with the team, watched the other players, worked out in the bullpen and everything in between. However, he never played in a game. Finally, after several weeks of warming the bench, the Yankees manager called on Lou to pinch-hit for the pitcher during a game at Washington. He struck out. A few days later, during at game with St. Louis, Lou was sent to the plate again and hit a line drive for a double. The YankeeÃ¢â¬â¢s manager knew that Lou needed more playing exerpeience and decided to send him to Hartford, Connecticut, to play with the Hartford Club (Macht, 1993). LouÃ¢â¬â¢s time in Hartford proved to be beneficial. In the short time he was there, he hit 69 home runs in 59 games. In September, the YankeeÃ¢â¬â¢s first baseman injured his ankle. The Yankees immediately sent for Lou to take injured first basemanÃ¢â¬â¢s place. Lou was finally in the YankeeÃ¢â¬â¢s line-up. The Yankees went on to win the pennant that season and for the third year in a row they were in the World Series. However, Lou had joined the Yankee line-up too late in the season. He was not eligible to play in the Series unless the opposing teamÃ¢â¬â¢s manager would allow him to do so. Unfortunately, the manager of the opposition refused the request and Lou warmed the bench as he watched his team win the World Series for the first time. The 1927 season brought baseballs greatest team: The New York Yankees. The first six batters in the YankeeÃ¢â¬â¢s order made up MurdererÃ¢â¬â¢s Row with Babe Ruth in the 3rd position and Lou in the 4th or Ã¢â¬Å"clean-upÃ¢â¬ position. According to The 1927 NY Yankees (2011) the Yankees were Ã¢â¬Å"Graced with the batting phenomenon pair of Babe Ruth and Lou GehrigÃ¢â¬ (1927-MurderersÃ¢â¬â¢ Row, para. 2). Even though Babe Ruth had the most home runs during the 1927 season, Lou had the highest batting average of anyone on the famed MurdererÃ¢â¬â¢s Row. The Yankees went on to win 110 games and swept the Pirates in the World Series. The 1927 season also brought somewhat of a slugfest between Lou and the Babe. The fest was never anything but friendly between the two as they cheered each other on through the season. This slugfest was a brutal neck-and-neck, back-and-forth home run race. At times the two of them (sometimes referred to as the Ã¢â¬Å"TwinsÃ¢â¬ ) tied in home run hits, times when the Babe was ahead of Lou and other times when Lou was ahead of the Babe. This activity continued for nearly the entire 1927 season. During the last month of the season, Lou could not keep up with the Babe and eventually he fell behind him in the home run race. Lou ended the season with 47 home runs. Lou Gehrig had an astounding career with many achievements and records during his time with the New York Yankees. He played 2,130 consecutive games with the Yankees between the years of 1925 and 1939. This record stood for 56 years until it was broken in 1995. He became the first American League player to hit four homeruns in one game, won the Triple Crown in 1934 and inducted into the Baseball Hall of Fame in 1939 (CMG Worldwide, 2003). Lou currently holds several records in the world of baseball including Major League and team records for the New York Yankees. First, Major League records currently held by Lou Gehrig are four home run hits in one game, most grand slams (23) in a career, most runs batted in by a lefthander in one season, most seasons with 100+ runs batted in consecutively and most seasons with 150+ runs batted in consecutively (Baseball Almanac, Inc 2000-2011). Additionally, the current New York Yankees team records held by Lou include grand slams (23), hits resulting in double bases (534), hits resulting in triple bases (163), and runs batted in (1,995). Lou also holds several of the number two spots in the Yankees record books including second highest batting average, hits, home runs by a lefthander, on base percentage, runs scored, slugging average, and total bases (Baseball Almanac, Inc. 2000-2011). To say that Lou Gehrig had a good career with the Yankees is an understatement. The 1938 season brought some changes for Lou Gehrig. He was off to a slow start at the beginning and was not hitting like usual. By summertime several players from other teams were noticing that Lou was walking and running like an old man. It was also noted by some pitchers that LouÃ¢â¬â¢s reflexes seemed to be slow, and although he was swinging the bat as hard as he always had, the balls were not going nearly as far. By the end of the season his batting average was down to .295. Lou had higher expectations of himself considering his .351 average the season before (Macht, 1993). In early 1939 Lou was determined to bounce back for the upcoming season but he was developing more trouble physically. He had fallen while fishing, had problems stepping off curbs, and small items would fall out of his hands. Finally, even thou Lou would not admit something was seriously wrong, in June he visited the Mayo Clinic in Rochester, Minnesota, where he underwent numerous tests. On June 19, 1939, his 36th birthday, his doctor gave him the diagnosis of amyotrophic lateral sclerosis, a disease that attacks the nerve cells that control voluntary muscles (Hubler, 1941). Today this disease is also known as Lou GehrigÃ¢â¬â¢s disease. Lou benched himself May 2, 1939, just days prior to his diagnosis and never played for the Yankees again. By the spring of 1941 Lou was bedridden and started to have trouble breathing. Eleanor and her mother took care of Lou around the clock. By this time he could not swallow anything other than pureed food. On Monday, June 2, 17 days before his 38th birthday and exactly 16 years to the day he took over first base for the New York Yankees, Lou Gehrig passed way in his New York home with his family by his side including his devoted dog, Yankee (Macht, 1993). Lou Gehrig is a legend; a baseball icon. He was known as a decent, humble, shy and courageous man on and off the baseball field. He set many records during his career and faced his debilitating disease with nothing but courage. There will never be a number four YankeeÃ¢â¬â¢s jersey to grace a baseball field again because that number was for the one and only: Lou Gehrig.
Monday, January 6, 2020
Fifty years ago if the reception on the television went bad, first you knocked on the side, then peered in back for bad vacuum tubes and finally tinkered with loose connections. Today we unplug and restart. Tinkering with a health insurance system built on outdated assumptions is at the root of dissatisfaction with the Affordable Care Act. We donÃ¢â¬â¢t need reform, we need a restart. How we got here is worth examining. 1929: First offering of prepaid hospital insurance to members of a teachers union in Texas. Offering insurance for the employed effectively screened out unhealthy people and kept the risk low. Primary goal was to provide a steady flow of income to hospitals during the Great Depression, when hospital revenue dropped. 1942:Ã¢â¬ ¦show more contentÃ¢â¬ ¦We are trying to deliver a rapidly expanding menu of health care services with a delivery system designed for economic conditions that disappeared nearly a century ago. In 1929, health care as a learned and licensed profession was barely a decade old and couldnÃ¢â¬â¢t provide much beyond supportive care. Chronic conditions were rare; insulin was first isolated in 1922 and diabetes was often a death sentence. Sulfa became available in 1935 and penicillin wasnÃ¢â¬â¢t mass produced until 1946. The most complicated piece of equipment in the hospital was the X-ray machine, and now we have real-time neuroimaging of brain function. Story Comments 106 November 6, 2015 in City Sue Lani Madsen: We donÃ¢â¬â¢t need to reform the Affordable Care Act, we need to start over Sue Lani Madsen Correspondent You ve read 5 premium articles Print Email Tags:Affordable Care Acthealth caresue lani madsen Fifty years ago if the reception on the television went bad, first you knocked on the side, then peered in back for bad vacuum tubes and finally tinkered with loose connections. Today we unplug and restart. Tinkering with a health insurance system built on outdated assumptions is at the root of dissatisfaction with the Affordable Care Act. We donÃ¢â¬â¢t need reform, we need a restart. How we got here is worth examining. 1929: First offering of prepaid hospital insurance to members of a teachers union in Texas. Offering insurance for the employed