Category Archives: Articles

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The Moroccan health care system contains a combination of public and private financing and delivery

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The Moroccan health care system contains a combination of public and private financing and delivery. In this regard, it is similar to health systems in other developing countries in which the government assumes responsibility primarily for basic public health activities and for management and organization of the health sector. The Moroccan government, largely through the Ministry of Health (MOH), is a main provider of services.
Despite this, access to care remains difficult, mainly for Moroccans with low income. To improve the well-being of the population, access to high-quality care and reduce disparities in access and financing between income groups and poor people. The Moroccan government has launched RAMED Medical Assistance Regimen in 2012. It is a healthcare system based on the principle of social assistance and national solidarity in favor of poor individuals, who do not benefit from any other health insurance. It allows those people to have free health care services in public hospitals as well as state-provided health services. (Ministry of health, 2013).
Regardless of the effort made by the government, to facilitate health access for the poor population but, is still a group of poor people having no social safety yet. In respect of, some problems and challenges facing the health system particularly in term of medical frames, infrastructure, management, and governance.The writer chooses this topic because access to health, plays a significant role in the well-being of the individual and it contributes to the reduction of poverty. Focusing on the RAMED system as public health insurance for poor people. We will define RAMED system, discuss the reasons that prevent the entire Moroccan population to benefit from this type of health coverage and give the suitable solutions to overcome these obstacles.
To achieve universal health coverage in order to guarantee better access to health care services has been a permanent challenge the country has tries to overcome in the previous decade. It has nonetheless made a significant advance in covering a majority of the population under the RAMED system.

RAMED was first launched in 2009 in the region of Beni Mellal, before being prolonged to the rest of the country in 2012. The system, which targets the low-income population, with the objective of facilitating health care coverage to 8.5 million people, Through this 28% of Morocco’s inhabitants, an estimated group of 4 million people experiencing an extreme poverty . To benefit from this system those people must confirm that they do not own any other health insurance and have the following criteria: for the residents of urban areas, having an annual income less than 3,767 dirhams per individual assessed after weight the reported income. But an individual with annual income of 5650 dirhams is considered vulnerable. For people living in rural areas, to determine if they belong to vulnerable or poor by owning (an agriculture land, cattle, any type of personal transportation or farm equipment).The RAMED system allows to those people to benefit from totally free care, whereas 4.5 million who are vulnerable will be required to pay 120 dirhams as an annual fee, provided at 600 dirhams per year and per family. But in December 2015, the number of RAMED beneficiaries increased to 9.2 million people, exceeding its initial goal. While this proposes that more beneficiaries than primarily planned are able to get health services at affordable rates. Even if the effort made by the government to cover poor and vulnerable but, would not overtake 50% of the 33 million Moroccan citizens, that means approximately half of the Moroccans pay directly from their pockets for health services or they do not benefit to avoid financial problems. Morocco Ministry of Health, (2016).People under RAMED system benefit from a wide range of care such as
Medical and surgical hospitalization, medical consultation, mother and baby care, physical therapy, functional rehabilitation.
As an example of Morocco by the RAMED have selected this system that specifically target poor and vulnerable populations, such as in Egypt the Social Pension Health Care Programme, whereas others have chosen a universal program, eventually a national system whose purpose is to register the entire population, containing the poor similar to Ghana with the National Health Insurance Scheme  and PhilHealth in the Philippines. In the case of the Indian state of Andrah Pradesh, there is the Aarogyasri Community Health Insurance Scheme, where the poverty’s status determines those who are eligible to benefit from the system based on the criteria. Thus, the target is to make the 70% of the population living under the poverty line. (Joël. A,et al.2015)
The estimated budget for RAMED is 2.7 billion dirhams where 75% is financed by the government, 19%of annual fees from beneficiaries and the residual 6% from the local authorities. Categories are determined while the heads of families filled out a form which must contain information on the number of subordinates, the family structure, the income and their property. Based on the applications filed an appropriate decision will be taken from the dedicated committee, to give eligible people a three-year family card allowing for free care.

In addition to being able to facilitate access to health care for poor people, RAMED’s principle advantage is the qualityof services offered. This program effectively presents the same kind of care is given to people covered by AMO (compulsory Health Insurance). This is a unique aspect of the program as, in most countries where two such systems remain; the advantages offered to taxpayers are more expanded than those present to the poor population.Although, the RAMED system is succeeded to cover the target population. However, certain limitations face the system few months after its implementation.

One of the measurement challenges is governance; the Ministry of Health is the only decision-making form which assigns discretionary resources. The regional health agencies rely on the localize decisions made in the capital city of Rabat. Communities do not take part in system implementation.

More than that, the procedure of identifying the poor remains ambiguous; the lack of coordination between the registration system and the resolution of the Local Permanent Commission that means some people in vulnerable status is not properly determine; moreover the administrative complication of the documentation that has to be submitted in order to benefit from RAMED system obviously excludes some group of people such as the illiterate and those in more outlying areas. Furthermore, the registration system applied to target poor people is not yet able to precisely determine the eligible population. Errors of exclusion and inclusion persist and the inducement to join RAMED seems limited.

Additionally, the unequal distribution of medical public services between cities; the elevated rate of bed and physician per 1 000 people and some medical services are located only in big cities like Casablanca and Rabat. Well, the problem is the RAMED will not be effective if a poor have to bear the travel and the expenditure to get cured also, the lack of financial supplies to finance the system. Therefore, access to medical care provided by public and university hospitals remains reliant on the contribution of the vulnerable.  (HYPERLINK “https://www.moroccoworldnews.com/author/youssef-sourgogmail-com/”Youssef sourgo,2014)
The health information system in Morocco is directed by a national plan developed in 2005 to enhance information literacy; introduce a modern mode of data collection, and rationalize the community and management of quality information. However, equivalent systems of data collection continue to exist and the transferring of information from the circumference to the center remains to be a challenge. A recent assessment of civil registration and vital statistics declare that several gaps and areas require an improvement.

According to Mohammed Hamouiyi, former head of the emergency department at the MS told OBG. , the issue now is the increased workload that follows the expanded coverage by RAMED, taking on to consider the shortage of medical frames, and its influence and impact on the quality of care being delivered.

To overcome all these challenges the Moroccan government should ensure that care services covered by RAMED are accessible, especially in rural areas where there is lack of framework and medical professional.

The Moroccan government should increase the number of public resources devoted to health care to spread coverage, meet the population’s care demands, and develop the field of the benefits package. The government will also need to modify the division of public resources through regions, providers and provide a pledge for financial commitments to local authorities, particularly in rural areas.

Refine and justify the process for beneficiaries from RAMED cards, as well as enhance the process of eligibility to cover the entire target population, determine the difficulties of renewing eligibility and the cause that pushes for the beneficiaries not to renew RAMED cards.
To conclude, Morocco established RAMED insurance to enable access to health care services for the majority of the poor and vulnerable population and protect them from financial hardships. The system proved its effectiveness by achieving the eventual goal to cover 8.5 million population, despite that a large part of the population is still not covered because of many challenges.

To achieve universal health coverage for the vulnerable and poor population; RAMED system must still be consolidated to achieve more improvements.


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Unit 10 support the well-being and resilience of children and young people in residential childcare

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Unit 10 support the well-being and resilience of children and young people in residential childcare.
10a. understand the well-being and resilience of children and young people.
10a.1.Explain factors that impact on the well-being of children and young people.
There are several factors that can have a positive impact a young person’s well-being. These factors consist of:
• Having the conditions to learn and develop: Children need to be given the conditions to learn and develop. This includes cognitive and emotional development, adopted through access to play in the early years and high-quality education in school, and physical development, for example through a nutritious diet. School is a key area of children’s lives where experiences vary greatly and negative
• Having enough of what matters: Children’s well-being is affected by ‘having enough’ and ‘fitting in’ rather than being rich or gathering material goods purely for its own sake. Family circumstances, household income, and parental employment are key factors which determine whether children have access to those items and experiences.
• Having positive relationships with family and friends: Children want and need positive, loving relationships with the people closest to them. Overall, the strongest driver of low subjective well-being is where children experience weak and uncaring relationships with their family or carer. The structure of the family itself has only a small effect on a child’s well-being. Children also need positive, stable, relationships with their friends, with social isolation a strong driver of low levels of well-being.
• Having opportunities to take part in positive activities to thrive: A healthy balance of time use is as important for children as it is for adults. The need for a balance that suits the individual needs of children means that they should be actively involved in decisions about how they spend their time.
• Having a safe and suitable home involvement and local area: Children need safe and suitable environments at home and in their local area. Where children are unhappy in these environments, often through feeling unsafe, feeling that they have a lack of privacy, or feeling that their home or local area has inadequate facilities, this has a strong association with lower levels of well-being.
• Having a positive view on themselves and an identity that is respected: Children need to see themselves in a positive light, and deserve to feel, and be, respected by all adults and other children. Our evidence shows that how children feel about their appearance, whether they are being bullied, and whether they believe that their voice is being heard and opinions respected, are key drivers of their well-being.

10a.2. Explain why it is important to for children and young people to develop resilience.
Resilience is important for a number of reasons; it enables us to develop mechanisms for protection against experiences which could be overwhelming, it helps us to maintain balance in our lives during difficult or stressful periods of time and can also protect us from the development of some mental health difficulties and issues. Some of the various benefits to becoming more resilient are listed below.
• Improved learning and academic achievement.
• Lower absences from education or study due to sickness.
• Reduced use of risk taking behaviours such as excessive drinking, smoking or use of drugs.
• Increased involvement in community or family activities.
• A lower rate of mortality and increased physical health
10a.3. Describe attitudes and approaches that support children and young people to develop their well-being and resilience in a residential setting.
Working within wings as a care worker, it is principal that staff provide the young people with the correct care and support to help enhance each person’s well-being and resilience. Staff can support the young people to develop this by;
• providing and sticking to rules and boundaries so that the young people know what is expected from them
• staff to provide opportunities and experiences so that the young person can achieve something and feel pride and accomplishment
• staff to consistently use praise and acknowledgement of the young person’s success
• encourage each young person to express themselves and for staff to take an interest in whatever the young person desires to do.

10a.4. Describe ways of working with key people to enable them to support well-being and resilience in children and young people.
Within wings setting, the young people work closely with our professional therapeutic team. This can provide the correct support each young person may need to enhance their well-being and resilience. Staff members can also work closely with the therapeutic team to design certain plans and techniques which will help the young person. working closely with key people within the organisation will provide the young people the appropriate care possible and support they require to succeed.

10b. be able to support the development of children and young people’s social and emotional identity and self-esteem.
10b.1. Explain why social and emotional identities are important to the well-being and resilience of children and young people.
It is crucial that a child or young person develop social and emotional identities as it helps children and young people to recognise and value their place in family, the community and wider society. Having clear social and emotional identities also develops a sense of belonging as well as the ability to form positive relationships. Children and young people who feel emotionally secure are more likely to have a positive disposition to learning. Children and young people who have strong social and emotional identities can easily fit into peer groups without feeling out of place. This helps children and young people as they can build friendships easier and quicker as well as brush off peer pressure, resulting in the young person to think for themselves and choose right decisions.
10b.5. Explain how planning and decision making offer a way to develop a child or young person’s social and emotional identity and self-esteem.
Within our setting at Wings, we as staff regularly encourage our young people to get involved with planning and organising activities or events for themselves and others. By allowing the young people to get involved with this it is providing them the opportunity to make positive decisions which will stay with them for the rest of their lives. By helping to organise and plan positive activities and events they will feel confident in the future to do this again as well as have pride in their ability and achievement. As staff members, they may need to map out the possible outcomes for both positive and negative decisions to enable the young person to fully understand the impact he/she has on their decision making. This is very important to explore the possible outcomes with the young person, so they can develop their understanding as well as refer to this process in the future whenever they become involved in a similar situation. This gives the young person the control they desire on their lives. By giving them opportunities like this and working with the young people in decision making they are enhancing their confidence and sense of control.

10d. be able to recognise and respond to signs of distress in children and young people
10d.1. explain why children and young people may communicate distress through behaviour rather than verbally.
Some children in care have experienced significant trauma. Often difficult behavior results in an excessive focus on control rather than understanding meaning. Trauma theorists confirm the common perception that children in care are often functioning at a different developmental level than would be expected by their age. At the heart of trauma is terror. However painful their family experiences have been, children in care suffer further loss of everything that is familiar to them when they are removed from home. They must cope with new routines and rituals, a different rhythm to their day and strange people who behave in ways that are unfamiliar and therefore is frightening. Traumatized children often test whether adults caring for them can accept and survive them even at their most challenging. Some challenging behaviors may be children’s attempts to manage distress and to soothe themselves. Self-injury, overdosing and substance misuse all help children find respite from overwhelming feelings. Children may also engage in risk-taking behavior to fill the emptiness they experience or create a skewed sense of belonging. Children familiar to terror may, at times, find calmness and order very disconcerting. In response they may recreate the adrenaline-charged situations they have been removed from, by engaging in violence and other anti-social behavior.

10d.2. Explain how to recognise when day to day activities can amount to mental health concerns that require intervention for the individual child or young person.
Within our setting at Wings, each young person behaves and responds to certain situations in a variety of ways. As a staff member it is vital that we take note of how the young person is behaving and act appropriately. By working closely with the young people and understanding their needs this allows staff to monitor and address issues quicker as we understand what behaviour they show in certain situations. With regards to recognising mental health concerns, staff usually look out for the following behaviours:
• Withdrawal
• Self-injuries behaviour
• Excessive risk behaviour
• Eating disorders
• Obsessive disorders
• Aggression
If staff indicate these behaviours from any of our young people, then this is the time when intervention is required. Staff can do this in several ways. They can speak with the child themselves if they have a positive relationship with them. This will hopefully allow the young person to open up regarding their issues and allow staff and the young person to develop coping strategies etc. Within Wings there is a therapeutic team available to help in these kinds of situations. Staff can approach the team to gather information on how to address the situation or pass on the behaviours so that the therapeutic team can step in and work with staff and the young person to resolve the issues.


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Rhino’s play a crucial role in their environment

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Rhino’s play a crucial role in their environment. Rhinos are big grazers ,eating lots of vegetation which helps shape the African landscape. Other anaimals benefit and it keeps a healthly balance within the environment.

Local people depend on the natural resources from these environments for food,fuel etc. Ecotourism can be a vital sustainable source of funds fro local communities. As one of Africa’s wildlife “big five” rhinos are a popular sight for tourists. By helping protect the rhino we’re helping its environment for the benefit of both people and wildlife for generations to come. and better life can be achieved for all of us.


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In the strong acid-weak base titration

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In the strong acid-weak base titration, 0.1 M ammonium hydroxide ( NH4OH ) was titrated with 0.1 M hydrochloric acid ( HCl ). 2 drops of phenolphthalein were added as indicator into the conical flask which contains 25mL of hydrochloric acid, the mixture in the conical flask was colourless. Ammonium hydroxide was then titrated slowly into the conical flask and the conical flask was swirled gently to ensure complete reaction between the strong acid and weak base. The titration stops when the colour of the titrand changed from colourless to pale pink. The average titrant (29.55 mL) of 0.1 M of ammonium hydroxide was added into the conical flask. Phenolphthalein was then replaced by screened methyl orange as an indicator, the initial colour of the mixture in the conical flask was red. The average titre of (26.45 mL) of 0.1 M of ammonium hydroxide was added to change the colour of the titrand from red to grey in conical flask.

In weak acid-strong base titration, 0.1 M sodium hydroxide ( NaOH ) was titrated with 0.1 M acetic acid (CH3COOH). 2 drops of phenolphthalein indicator were added into the conical flask which contains 25mL of acetic acid. Sodium hydroxide was then titrated slowly into conical flask and the conical flask was swirled gently to ensure the reaction is reacted completely. The titration stops when the colour of the titrand changed from colourless to pale pink. The average titrant (28.60 mL) of 0.1 M of sodium hydroxide was added into conical flask. By using screened methyl orange as indicator, the average titrant (2.20 mL) of 0.1 M of sodium hydroxide was added to change the colour of titrand from red to grey in the conical flask.

In experiment part II (A), pH titration curve in the strong acid-weak base titration indicates that the initial pH value of the titrand is pH 1.33. The low initial pH value is due to the strong acid, 0.1 M hydrochloric acid ( HCl ). During the titration, the pH value increases steadily but not significant as the buffer solution is being built up, when extra base was added into the acid which can resist pH change. It increases to pH 2.94 after 25.00 mL of ammonium hydroxide was added. However, the pH value increases greatly from 3.59 to 5.99 when added extra 0.50mL of ammonium hydroxide as shown in the Graph 1.1. The pH values increase slowly as extra ammonium hydroxide was added. The equivalence point, which is the steepest point of graph, is pH 4.79.

In experiment part II (B), pH titration curve in the weak acid-strong base titration illustrates that the initial pH value of the titrand is pH 2.32, the pH is higher due to the weak acid, 0.1 M acetic acid. The pH value rises progressively due to the presence of buffer solution. The changes in pH values are small even when extra base was added. It increases to pH 7.00 after 26.00 mL of sodium hydroxide was added. The pH rises from 9.03 to 10.08 as another 0.5mL of sodium hydroxide was added. Based on the Graph 1.2, the equivalence point, which is the steepest point of graph, is pH 9.915.


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Category : Articles

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Prohibtionists expected other companies to skyrocket

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Prohibtionists expected other companies to skyrocket, they expected the movie theater to rise, the soda and chewing gum companies to gain more sales, but none of that happened. The entertainment industry declined, resturants failed because there wasn’t liquor to sell. Also the Eighteenth Amendment only prohibited the manufacture, sale and transportation of alcoholic beverages, it didn’t ban the possession or consumption of alcohol in the United States. The Volstead Act, the law that provided for the enforcement of Prohibition, also left enough loopholes that eventually opened doors to people being able to drink. The effects of Prohibition on law enforcement wasn’t good. The amount of money being exchanged during the era proved that there was a corrupting influence in both the federal Bureau of Prohibition and at a local level. Police officers were constantly bribed to go into bootlegging themselves. Many stayed honest, but a lot took to the bribes. The growth of Liquor trade in the U.S made millions of criminals. (Lerner)


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1

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1. Communicative Situation
In the Sonnet “Sonnet on the death of Mr. Richard West” by Thomas Grey. The Speaker grieves the death of a person dear to him and illustrates the depth of his emotional upsets.
The speaker uses first person singular deictics (“me”, “these ears”, “these eyes”, “I”, “my”). From the start, the speaker expresses his discontentment and indifference at the sight of the morning sun (in vain to me the smiling mornings shine”). The speaker voices longing and yearning for a change of his own heart so that he may feel a different emotion (“these ears, alas! for other notes repine, A different object do these eyes require.”). A feeling of sorrow and grief-stricken loneliness is also conveyed by the speaker (“My lonely anguish melts no hearts but mine”). He feels hopeless as his mourning is fruitless, which makes him feel even more depressed. (“I fruitless mourn to him that cannot hear, And weep the more because I weep in vain.”). In this section the speaker indicates the reason for his dismay, being a male person, the mourning is directed at “him” (“I fruitless mourn to him…). The addressee is not referred to directly as there are no deictics in second person, although we the speaker refers to a “him” in line 11 as part of the context, the sonnet isn’t addressed to one individual. The sonnet is in the present tense and describes the speakers present feelings in the here and now.
2. Theme
The overall theme is the speaker’s melancholy and great distress and these feelings develop as the poem progresses. There are four identifiable sections which deal with the different emotions the speaker expresses.


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Power distance

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Power distance, a concept presented by Hofstede, refers to “the extent to which the less powerful members within a country expect and accept that power is distributed unequally”. The power distance could be found in the associations, families, fellowships, and organizations and it differs from culture to culture. The types of power distance are categorized as being “high” or “low”. High power distance means that few people on the top of a society hold a lot of power which is more or less accepted by others. Individuals in social orders showing a high degree of power distance acknowledge a higher hierarchy order in which everyone has a place and no further justification is required. This illustration could be found in the Japanese and Indian culture. On the other hand, low power distance means that power is distributed more equally and people want that no one gains too much power. In cultures with the low power distance such as the US or Norway, individuals endeavor to adjust the distribution of power and demand clarifications for inequalities of power.
The views and opinions of the people concerning the power distance are deeply rooted in their culture. The amount of respect we show to authority is inculcated in us by the culture we live in. It starts in the childhood where the children learn how much deference they can show to their parents, their teachers, and finally, it affects our relationships in our professional lives. High or large power distance societies give importance to the positioned power, power that is earned by birth or by wealth. On the other hand, the societies with low power distance give importance to the earned power, a power that is earned by hard work and motivation. Moreover, power distance also affects and influences the communication process in the cultures. Whether it is verbal or non-verbal communication, the degree of power distance plays a critical role. In low power distance culture, the people are more open, confident and can challenge the authority. Whereas the people in high power distance society are more submissive to their elders, authorities and never question or challenge them.
Video links:


https://www.youtube.com/watch?v=c6STEGd8vRo


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In order to develop positive relationships you will need to communicate effectively with children

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In order to develop positive relationships you will need to communicate effectively with children, young people and adults. To do this you will need to consider how you approach people and how you respond to them. To communicate effectively we must be able to listen to one another as not listening can cause a breakdown in communication, which then can cause a breakdown in relationships. In order for children to learn at school they need to be relaxed, secure and confident, if they are in the presence of someone they have a positive relationship with this will create a positive atmosphere, making it easier for children to learn. In some cases you may have to communicate with children differently, this is if they have a special educational need, such as additional needs, speech and language delay, if they are deaf, mute or if English is not there first language. It is important that children, young people and adults feel that their values and opinions count and that they are being listened to and that they feel they can trust you. Communication allows us to share and gain information about other people, which starts to create a positive relationship. Developing positive relationship with adults is essential, as information is communicated better when you have a positive relationship with the person. As a TA it is important to model effective communication as this sets a good example for the children.


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You created a paper for presentation in your educational institution and want to check content for originality

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