Discuss the types of data and reports that would be useful to the medical director for managing specialist utilization; discuss how this might differ in different types of plans.

Answers

Answer 1

Plans of all or some of the following categories are available at each metal level (Bronze, Silver, Gold, and Platinum), depending on how many are available in your location.

In the realm of medical administration, committees help to delegate some tasks and enable field input into procedure, policy, or even the case-specific interpretation of current policy. The following committees are examples of committees: peer review committee, utilization review committee, medical advisory committee, and credentialing committee.

Exclusive Provider Organization (EPO): A managed care program where treatments are only covered if you utilize hospitals, medical centers, or specialists in the program's network (except in an emergency).

Health Maintenance Organization (HMO): A form of health insurance policy that often restricts coverage to medical services provided by physicians who are employed by or under contract with the HMO. Except in cases of emergency, it often won't pay for out-of-network treatment. You might need to reside or work within an HMO's service region to qualify for coverage. HMOs frequently focus on wellness and prevention and offer integrated care.

Point of Service (POS): A kind of health insurance where you pay less if you utilize participating hospitals, physicians, and other healthcare providers. In order to see a specialist under POS plans, you must obtain a recommendation from your primary care physician.

Preferred Provider Organization (PPO): A form of medical insurance where you pay less if you utilize doctors and hospitals in the network of the plan. Without a reference and at a higher fee, you can use medical facilities, hospitals, and other providers outside the network.

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Related Questions

Within fire departments where construction regulation has been fully integrated, chief mechanical, plumbing, and electrical inspectors and their staffs report to the?

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Within fire departments where construction regulations have been fully integrated, chief mechanical, plumbing, and electrical inspectors and their staff report to the: building inspectors

What are fire departments?

A fire department or fire brigade is an organisation that provides fire prevention, fire suppression, rescue, and hazardous materials mitigation. It is also known as a fire authority, fire district, fire and rescue, or fire service in some places.

Putting out any fires that may be present. In the event of localised fires, protecting human life and property. in the event of a traffic accident, people's protection and rescue, and. protecting and saving people during other emergencies.

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Avl trees are not guaranteed to be height-balanced. true /false

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False since AVL tree is a self-balancing binary search tree.

What are AVL trees?

An AVL tree is a self-balancing binary search tree in computer science. It was the first thing of its kind ever made. If there is ever a moment when the heights of any two child sub trees of a node in an AVL tree diverge by more than one, rebalancing is carried out to restore this attribute.

What are the advantages of AVL tree?

The AVL tree's height is consistently balanced. Never exceeding log N, where N is the total number of nodes in the tree, the height never increases. When compared to straightforward Binary Search trees, it provides a better search time complexity. AVL trees are capable of self-balancing.

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attorney general ken paxton joined with 15 other states in filing an amicus brief in the supreme court supporting which policy created by president donald trump?

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Attorney general ken Paxton joined with 15 other states in filing an amicus brief in the supreme court supporting the travel ban created by President Donald Trump.

Abraham Lincoln has taken the best ranking in every survey and George Washington, Franklin D. Roosevelt, and Theodore Roosevelt have continually ranked inside the top five even as James Buchanan, Andrew Johnson, and Franklin Pierce had been ranked at the bottom of all four surveys.

The Secretary of trade shall understand the rights of employees to a good deal together via representatives of their very own choosing and engage in concerted sports for the cause of collective bargaining adjustment of grievances, or other mutual useful resource or protection, provided that such sports Abraham Lincoln is regarded via many people as the greatest president to ever keep office within the records of America, and his reputation is simply nicely deserved.

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spiritual traditions followed by ancient chinese included, most importantly, honoring choose... . if not honored, they might bring trouble to the family. previous next

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Spiritual traditions followed by ancient Chinese included, most importantly, honoring ancestors. If not honored, they might bring trouble to the family.

Your immediate lineal relatives who lived a long time ago are known as your ancestors. Earlier members of the same family or species might also be referred to in a broader sense. Examining the nature of ancestors effect can teach us a lot about our current situation and the way we are living.

Keeping in mind our ancestors offers us courage. Everybody should be remembered. It brings our living and deceased family closer to us. It aids in our self-understanding.

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A study is said to have internal validity if the researcher can be relatively confident that ____

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Internal validity is defined as the researcher's ability to be reasonably certain that changes in the independent variable caused changes in the dependent variable.

Internal validity is the degree of certainty that the causal relation being tested is reliable and unaffected by other variables or factors. The extent to which study results can be implemented (generalized) towards other situations, groups, or events are referred to as external validity.

Internal validity lends certainty and trustworthiness to the conclusions of a causal relationship. An experiment could perhaps not demonstrate a cause and effect link between two variables unless it has high internal validity.

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The question was incomplete. Check below the full question

A study is said to have internal validity if the researcher can be relatively confident that

a. the same results would occur if the experiment were replicated.

b. changes in the independent variable caused changes in the dependent variable.

c. the operational definitions used in the study were good ones.

d. the sample was representative of the broader population of interest.

what are problems of provinces no 1​

Answers

Answer:

Explanation:

Province One has the prospects of becoming the richest among the seven because of its geography and economic potential.

In terms of geography, it has mountains, hills and plains and it touches both India and China.

Economically, it has Sagarmatha and several other tallest mountains for mountaineering, has several scenic places for general tourism, like Ilam, Dhankuta, Solu etc, is closest to Kolkata, the nearest port, has a good concentration of industries along the Dharan-Jogbani corridor, and has a lot of fertile land in Sunsari, Morang and Jhapa.

Personality traits that may be effective in one situation may be detrimental in another. this illustrates the fact that?

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Personality traits that may be effective in one situation may be detrimental in another. This illustrates the fact that. no one trait is always right or wrong.

What are personal qualities?

A personality trait is anything about a person that regularly affects their tendency to think, feel, and act in certain ways. Instead than being the result of singular events, personality traits are indicative of permanent behavioral and emotional patterns.

The theory identifies extraversion (also known as extroversion), agreeableness, openness, conscientiousness, and neuroticism as the five major personality traits.

People's distinctive thought, feeling, and behavior patterns are reflected in their personality traits. A person who scores highly on a certain personality trait, such as Extraversion, is likely to be gregarious in various contexts and over time. Personality traits imply consistency and stability.

It should be noted that a trait that's effective in one situation may not be effective in another situation.

Therefore, Personality traits that may be effective in one situation may be detrimental in another. This illustrates the fact that. no one trait is always right or wrong.

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the dsm-5 definition of a mental disorder highlights how disorders are dependent on the relationships between people and do not merely exist within the diagnosed individual.

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The DSM-5 definition of a mental disorder highlights how disorders are dependent on the relationships between people and do not merely exist within the diagnosed individual. true

The Diagnostic and Statistical manual of mental Disorders, Fourth edition DSM-5 is the official guide of the Yankee Psychiatric association. Its reason is to provide a framework for classifying disorders and defining diagnostic criteria for the issues listed.

In  DSM-5, every mental disorder is conceptualized as a clinically vast behavioral or psychological syndrome or pattern that occurs in an individual, and this is associated with present distress painful symptoms,s or disability impairment in a single or extra essential area of functioning.

A mental disorder is characterized by a clinically widespread disturbance in a character's cognition, emotional law, or behavior. it also includes related distress or impairment in vital regions of functioning.

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How is our modern system of conveyancing related to the idea of seisin in english common law?

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Seisin's connection to the contemporary conveyancing system is that it influenced the growth of the law of deeds, estates, as well as future interests.

Seisin (or seizin) signifies the legitimate ownership of a medieval fiefdom or expense, in other words a home in land. seisin, in English medieval society, a term that came to mean a kind of ownership that acquired believability with the progression of time. Seisin was not proprietorship nor was it simple belonging that could be laid out by the capture of land. Seisin had a place with somebody who utilized the land or practiced privileges over it.

In a disagreement regarding seisin the champ would be the person who demonstrated he had plowed the land or regulated equity in the period preceding the suit. His case was reinforced assuming his predecessors had held the land and in the event that he could demonstrate it by the declaration of witnesses.

Real seisin existed when a freeholder was in control of the land or on the other hand in the event that another person was holding it for him. Seisin in regulation was the right of a main successor to seisin over the land regardless of whether he had not really claimed it.

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The ______ principle states that once the threshold has been crossed, the action potential either fires or it does not.

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The all-or-nothing principle states that once the threshold has been crossed, the action potential either fires or it does not.

What is all-or-nothing principle?

The all-or-none law can be described as the principle which states that the strength of a response of a nerve cell or muscle fiber  can be referred to , as one that depend on the strength of the stimulus.

It should be noted that if  stimulus is above a certain threshold, a nerve or muscle fiber will fire, hence all-or-nothing principle states that once the threshold has been crossed, the action potential either fires or it does not.

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The co-occurrence of different disorders, whereby individuals who have one mental disorder also suffer from another, is identified by the dsm as ____. group of answer choices

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The co-occurrence of different disorders, whereby individuals who have one mental disorder also suffer from another, is identified by the dsm as a comorbidity group of answer choices.

What do you mean by comorbidity?

Comorbidity refers to having multiple illnesses (either physical or mental) concurrently. Comorbidity can be caused by a wide variety of factors. There is often overlap between some disorders, such as obesity and diabetes or anxiety and depression. There are numerous potential explanations for why particular diseases frequently coexist.

Anxiety is a comorbidity or not?

The comorbidity of anxiety disorders with other severe mental illnesses and with one another is very high. As our profession develops, we have the chance to seek therapy trial designs that take these comorbidities into account.

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the theoretical framework provides the structure for the study by linking the abstract to the empirical.

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The theoretical framework contains what pioneers in your field of examination say regarding your exploration question, about the issue you intend to explore.

Briefing :

The issue you intend to explore and could try and incorporate ideas of how to tackle that issue, remembering how to decipher the discoveries for your information.

What is the theoretical framework?

A theoretical framework is an essential survey of existing hypotheses that fills in as a guide for fostering the contentions you will use in your own work.

Hypotheses are created by specialists to make sense of peculiarities, draw associations, and make forecasts. In a hypothetical structure, you make sense of the current hypotheses that help your examination, showing that your work is grounded in laid out thoughts.

At the end of the day, your hypothetical system legitimizes and contextualizes your later exploration, and it's a vital initial step for your examination paper, proposition, or exposition. A balanced hypothetical system gets you in a good position later on in your examination and creative cycle.

In embodiment, the hypothetical structure contains what pioneers in your field of examination say regarding your exploration question, about the issue you intend to examine, and could try and incorporate ideas of how to take care of that issue, remembering how to decipher the discoveries for your information.

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Given a chance to study the homeless population in chicago, symbolic interactionist would focus primarily on ______

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'Given a chance to study the homeless population in chicago, symbolic interactionist would focus primarily on the daily interactions between the homeless.

According to Macionis, symbolic interactionism is "a framework for building theory that sees society as the product of everyday interactions of individuals." It is a sociological theory that grows out of practical considerations and alludes to specific effects of communication and interaction in people to make images and normal implications, for deduction and correspondence with others. In other words, it provides a frame of reference for understanding how people engage with one another to form symbolic worlds, which in turn determine how people behave. It also provides a framework for understanding how recurring interactions between people preserve and create society. Between exchanges, meaning is created and recreated through the interpretation process.

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Do you think based on the nichols book that this patient might benefit from family therapy, and if so, which theory would you use?

Answers

Family therapy remedy draws on structures questioning in its view of the circle of relatives as an emotional unit. while structure thinking—which evaluates the parts of a gadget with regards to the complete—is implemented in, it indicates conduct is both often knowledgeable via and inseparable from the functioning of one's circle of relatives of origin.

Own family therapy concept establishes a chain of herbal interactions within and between families that builds brotherly love and balance. Many researchers have validated that positive fine moves in regular lives can help assist thriving children.

More healthy communication: circle of relatives systems therapy can assist identify communique problems, energy imbalances, and dysfunctional styles that affect the properly-being of each family therapy as well as the functioning of the entire family unit.

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Research indicates that humans can form an initial impression of others based solely on their facial appearance in less than ______ milliseconds.

Answers

Research indicates that humans can form an initial impression of others based solely on their facial appearance in less than 100 milliseconds.

Who is a researcher?

A researcher can be defined as the person that collect data or information from a group of population  and then analyze and evaluate the data before reaching a conclusion.

People can tent to form an initial impression of others people which can either be good or bad based on the people facial appearance or physical features without actually knowing them.


Therefore Research indicates that humans can form an initial impression of others based solely on their facial appearance in less than 100 milliseconds.

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How many
state
supported
colleges for
women were
there in
antebellum
Mississippi?

Answers

Answer: 21 colleges

“The great state of Mississippi has available 21 of universities and colleges that will allow one to pursue all their dreams and more.”

what kind of research is saanvi conducting if she tracks participants over several years, assessing them on her variable of interest once every six months

Answers

Saanvi  is conducting longitudinal research if she tracks participants over several years, assessing them on her variable of interest once every six months

This is further explained below.

What is longitudinal research.?

Generally, If Saanvi follows the same participants over the course of many years and evaluates them on the variable of interest once every six months, she is undertaking what is known as longitudinal research.

In conclusion, Both a longitudinal study and a cross-sectional study are examples of observational research. To reiterate, researchers do not meddle with the lives of the people they study.

A longitudinal study, on the other hand, involves the researchers making several observations on the same people over the course of a period of time, which may often extend for many years.

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Common sources of new business opportunities include ________, ________, and ________.

Answers

Common sources of new business opportunities include changing environmental trends, unsolved problems, and gaps in the marketplace.

The practise of earning a living or generating revenue via the production, acquisition, and sale of items is known as business (such as goods and services). Additionally, it includes "any activity or enterprise undertaken for profit." 

The owner of the business is responsible and liable for any obligations made by the business since the business entity is not legally distinguished from the owner by the use of a business name. In the event that a firm accrues debt, creditors may seize the owner's personal property. Corporate tax rates are not permitted in a firm structure. All business income is subject to personal taxation for the proprietor.

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What do people have the right to do under “natural law”?

Answers

Answer:

Make rational decisions

Explanation:

Researchers have discovered that damage to part of the brain's _____ in rats results in vertigo.

Answers

Researchers have discovered that damage to part of the brain's Cerebellum in rats results in vertigo.

What is a Researcher?

The researcher is refers to an individual who does deep investigations of the data and information available to provide credentials with facts and figures to provide results that will utilize for the new research.

A portion of your brain called the cerebellum is situated in the back of your skull, right above and below the area where your nervous system attaches to your brain. Damage to the cerebellum of the brain will impair balance, the capacity to determine distance and when to stop, and so on.

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when two groups of speakers of the same language are separated in some way, the tendency for the original group to phase out linguistic patterns which are frozen in the language of the second group is know

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when two groups of speakers of the same language are separated in some way, the tendency for the original group to phase out linguistic patterns which are frozen in the language of the second group is known as colonial lag.

What does linguistic colonial lag mean?

In linguistics, the colonial lag theory states that languages spoken in colonies tend to change less than languages spoken in their mother countries (British English). Since linguist Albert Marckwardt first used the phrase "colonial lag" in his book American English, this theory has been strongly contested (1958).

What impact did the colonial era have on dialect development?

The children of colonial founding populations may lack clearly defined peer groups and the role models they provide due to the fragmentation of transplanted speech communities; in such a situation, the influence of the parents' generation's dialects would be stronger than in more typical linguistic situations.

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What kind of nucleophile will you need to form the new bond identified in the previous two problems?

Answers

The kind of nucleophile will you need to form the new bond identified is Oa Tosylate Ob.

What is nucleophile ?

In order to create a chemical bond in a reaction, a nucleophile species offers an electron pair to an electrophile. The term "nucleophile" refers to any molecule or ion with a free pair of electrons. It is known as a lone pair when two electrons are present. In accordance with the definition of Lewis bases, nucleophiles donate electrons.

Typically, nucleophiles are negatively charged. Nucleophilic behaviour is possible even in neutrally charged molecules with electron-rich atoms. Additionally, nucleophiles exhibit particular reactions like the nucleophilic addition and substitution reactions. An electrophile and nucleophile are reacting in the example above.

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what is vaping? elaborate

Answers

Answer:

VAPING IS A ELECTRIC CRIGRETE ITS BAD FOR YOUR LUNGS DONT DO IT UNLESS U WANT LUNG CANCER

Explanation:

Answer:

Vaping is a device that heats up a liquid to create a vapour that is inhaled. Vaping devices include pens,e-cigarettes,and hookahs.

Who is credited with the first large organized empire in western europe after the fall of the roman empire? clovis i clovis ii charles martel charlemagne

Answers

The majority of western and central Europe was successfully united under Charlemagne, who was also the first acknowledged emperor to reign in western Europe following the fall of the Western Roman Empire about three centuries earlier. The Carolingian Empire was the enlarged Frankish empire that Charlemagne established.

What is Carolingian Empire?During the Early Middle Ages, a sizable Frankish-dominated empire in western and central Europe was known as the Carolingian Empire (800–888). The Carolingian dynasty, which had ruled as kings of the Franks since 751 and as the Lom bards in Italy starting in 774, was in charge of it. Pope Leo III installed the Frankish king Charlemagne as emperor at Rome in 800 in an effort to move the Roman Empire from the east to the west. The Carolingian Empire is regarded as the beginning of the histories of both France and the Holy Roman Empire, which lasted until 1806.What was the language of the Carolingians?Frankish, also known as Old Franconian or Old Frankish, was the West Germanic tongue that the Franks spoke from the fifth to the ninth centuries.

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Answer:

The answer is D

Explanation:

I got it right on the test lol

______ is an explanation supported by many tests and is accepted by a general consensus of scientists.

Answers

Answer:

Scientific theory

Explanation:

Any more questions?

How does feminist theory differ from theories like new criticism and psychoanalysis?

Answers

A theory of oppression called psychoanalytic feminism contends that men have a deep-seated psychological drive to dominate women.

Men's need to rule over women and women's meager resistance to servitude have their roots in the human mind. The term "feminism" describes a number of movements that support women's equality in social and economic rights. It also entails providing women with equal opportunity. On the other hand, a person whose beliefs and actions are based on feminism is referred to as a "feminist." Early second wave feminists like Germaine Greer, Kate Millet, and Simone de Beauvoir had extensively attacked Freud. Particularly Millett had persuadingly shown that Freudian philosophy contributed to the perpetuation of sexual difference and the idea that inferiority was a natural state.

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An example of a marketer-dominated source of information consulted during an external search is?

Answers

An example of a marketer-dominated source of information consulted during an external search is sales people.

Advertisements, business websites, sales representatives, and point-of-purchase displays in stores are just a few examples of the marketer-dominated source of information and come from companies that offer goods and services.

Consumers actively seek out information from both internal and external sources throughout the information search phase of the decision-making process in order to improve their purchasing selections. Consumers use internal search when they access previously memorized knowledge.

Consumers look for information both inside and outside the company. The customer does an internal search by recalling potential options.

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when reading an empirical journal article "with a purpose," which two questions should you ask yourself as you read?

Answers

when reading an empirical journal article "with a purpose," the main question are:

What is the overview of the article?What is the evidence support to the overview of the article?

What is journal?

The term journal refers to the research article are the based on the particular topic. The journal is the included in the introduction, method, result, discussions, and the reference.

A person reading the journal as the main purpose of the solution to the result. A person asked the two main questions are:

What is the overview of the article?What is the evidence support to the overview of the article?

As a result, the journal articles are a person read to the ask according to as preference.

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Who actually elects the President? How is it determined how many “electors” each state has?

Need Asap. I will Report if just using this question for points. (I will make sure your acct gets suspended)

Answers

In other U.S. elections, candidates are elected directly by popular vote. But the president and vice president are not elected directly by citizens. Instead, they are chosen by “electors” through a process called the Electoral College. The process of using electors comes from the Constitution.

Imagine you are a land owner in colonial america who is loyal to england. offer reasons why you believe the patriot cause is treasonous.

Answers

Colonists' reasons for selecting a certain side varied. For instance, farmers frequently voted for the cause that their landlord supported. Others may have sided with the Patriots in the expectation that their substantial obligations to British creditors would be forgiven.

What justifies one's loyalty, specifically?

Because they thought that using violence would lead to tyranny or mob rule, loyalists sought out nonviolent protest methods. Additionally, they thought that gaining independence would mean losing the financial advantages of being a part of the British mercantile system. Loyalists came from all different backgrounds.

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It takes Amanda 5/8 days to drive to her aunt's house. She has now been driving for 3/8 days.For how much longer must she drive?Write your answer as a fraction in simplest form. Please help!!! The question is in the picture below!!! Explain the difference between partitioning a directed line segment MN in a 2:7 ratioversus a 7:2 ratio. Include a specific example as part of your explanation. I need help please !! he larger of two numbers is 15 more than three times the smaller number. If the sum of the two numbers is 63, find the numbers. evaluate write your answer as a whole number or as a simplified fraction Your teacher lights a small candle and allows it to burn. At first, the candle wax melts, but then it seems to burn away and disappear. The candle also gives off smoke, heat, and light. Is this a physical or a chemical change? Explain. What is a polynomial function in standard form with zeros 1,-1, 2, and 4?_A. y = x 6x + 7x + 6x 8O B. y = x - 6x + 9x + 6x-8OC. y = x + 7x + 6x - 8OD. y = x - x + x+x-8 Speakers use elaboration in their speeches by including: a metaphor b imagery c repetition Rest in peace Queen Elizabeth II A small model car is 12 inches long and the actual car is 132 inches long. what is the scale factor of the model to the actual car?Help please How many people were trapped in miserable lives in 1900 in central andsouthern Europe? Please Help me to solve this problem!!!!!! What is meant by the phrase degrees of freedom as it pertains to the computation of the sample standard deviation?. According to research, people that are divorced are less likely to be happy than those that are married. group of answer choices true false i need help how to solve this What is one reason the weaknesses of the articles of confederation helped contribute to economic chaos following the revolutionary war?. fill in the blank question. the cost of operating two machines is as follows: machine a: $22,000 per year of fixed cost plus $6 per unit produced. machine 2: $8,000 per year of fixed cost plus $13 per unit produced. when deciding which machine to purchase, the indifference point is Estimate the bending strength of beams by bending 10 beams untll they break and recording the force at which the beams broke. Is -1/3 - 4/5 positive, negative, or zero?