What would a physician utilize if he/she wanted to know if a treatment is covered under an insured’s plan and at what rate it will be paid?
-Prospective review
-Concurrent review
-Comprehensive review
-Supplementary chart

Answers

Answer 1

If a physician wanted to know if a treatment is covered under an insured’s plan and at what rate it will be paid, the physician would utilize the prospective review.

Prospective review would be the process that a physician would utilize if he/she wanted to know if a treatment is covered under an insured’s plan and at what rate it will be paid. A prospective review is a process that reviews an insurer's decisions regarding coverage for medical procedures before the procedures are performed. It is a process of evaluating the necessity and appropriateness of medical treatments before they are given. Prospective reviews are used to avoid unnecessary treatments that could cause financial harm to patients and to prevent unneeded expenses.

The main goal of this method is to determine whether the treatment is necessary, cost-effective, and appropriate for the patient.

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Related Questions

A nursing is caring for a client who is 1 day postoperative following abdominal surgery. What is the first action the nurse should take after discovering that a client’s wound has eviscerated?

Answers

The first action the nurse should take after discovering that a client's wound has eviscerated is cover the exposed abdominal organs with sterile saline-soaked sterile dressings.

Evisceration refers to the protrusion or exposure of abdominal organs through a wound. It is a serious complication that requires immediate attention. The nurse's first action should be to cover the exposed abdominal organs to protect them from further damage and reduce the risk of infection.

Using sterile saline-soaked sterile dressings helps maintain a moist environment, which can help prevent tissue drying and provide a temporary barrier against contamination. This initial step aims to protect the client's abdominal organs while awaiting medical intervention. Following this action, the nurse should promptly notify the healthcare provider to ensure timely evaluation and appropriate management of the evisceration.

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Search the Internet for a personal health record (PHR) site and a site that is specifically set up with the consumer in mind. Review these sites to (a) experience their functionality, (b) assess their user-friendliness, and (c) assess their implications for consumer, health care providers, and health information systems. Include your opinion on how these sites may impact health information systems.

Answers

A Personal Health Record (PHR) is an online tool that allows individuals to manage their health information in one secure location. PHRs may include a variety of information, such as medical history, medication lists, test results, allergies, and insurance information. PHRs can be accessed by patients and their caregivers, and may also be shared with healthcare providers to improve care coordination.

There are several PHR websites available online, such as Microsoft HealthVault, WebMD Health Manager, and Cerner HealtheLife. These websites offer various features to manage and store health information, including medication reminders, appointment tracking, and sharing capabilities.

One of the key implications of PHRs for consumers is the potential for greater control over their health information. By managing their health information in a PHR, individuals can ensure that their medical data is accurate and up-to-date, and they can also share this information more easily with healthcare providers and caregivers. However, there are concerns about the security and privacy of PHRs, and consumers need to be careful when choosing a PHR service and sharing their information.

PHRs also have implications for healthcare providers and health information systems. By providing patients with access to their health information, PHRs can improve patient engagement and help patients take a more active role in their healthcare. This can lead to better health outcomes and lower healthcare costs. However, integrating PHRs with existing health information systems can be a challenge, and there are concerns about data standards and interoperability.

Overall, PHRs have the potential to impact the healthcare industry by empowering patients to take control of their health information. However, the success of PHRs will depend on factors such as the security and privacy of these systems, their user-friendliness, and their interoperability with existing health information systems.

A Personal Health Record (PHR) enables people to maintain their health information in a single, secure location.

PHRs may contain a range of data, including a person's medical history, a list of current medications, test results, allergies, and insurance information. Patients and their carers can access PHRs, and sharing PHRs with healthcare professionals can help with care coordination. There are several PHR websites online, including Cerner HealtheLife, WebMD Health Manager, and Microsoft HealthVault. These websites include a variety of tools for managing and storing health information, such as reminders for taking medications, appointment tracking, and sharing options.

Personal Health Record might provide users more control over their health information, which is one of its major effects. People who manage their health information in a PHR may make sure that their medical data is correct and current and can more readily communicate this information with carers and healthcare professionals. Consumers should exercise caution when selecting a PHR service and disclosing personal information due to worries about the security and privacy of PHRs.

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Why do you need your heart when you’ve already got lungs?

Answers

Answer:

your heart pumps blood up to your lungs

Explanation:

Describe three key patient-privacy related concerns the typical hospital or other healthcareorganizations face.

Answers

There are three key patient-privacy related concerns the typical hospital or other healthcare organizations face. They include breaches of privacy by staff, theft of patient information and lack of proper encryption of electronic health records. These concerns threaten the privacy and security of sensitive information about patients that is essential for proper diagnosis and treatment. These concerns can be alleviated by having effective policies and procedures in place and providing adequate training to healthcare staff.

One of the primary concerns related to patient privacy is breaches of privacy by staff. Employees in healthcare facilities may gain access to sensitive information about patients that they are not authorized to access. They can share this information with others, either intentionally or unintentionally, leading to a breach of privacy. This can damage the trust that patients have in the healthcare facility, and can lead to legal action being taken against the facility.Theft of patient information is another key concern that hospitals and healthcare organizations face. With the rise of electronic health records, hackers can access sensitive information about patients from remote locations.

They can use this information for identity theft, financial fraud or other illegal activities. To prevent this from happening, healthcare organizations must implement effective security measures such as firewalls, antivirus software and encryption.The third key concern related to patient privacy is the lack of proper encryption of electronic health records. This can result in the unauthorized access of sensitive information about patients, which can then be used for malicious purposes. To address this concern, healthcare organizations must ensure that their electronic health records are properly encrypted to protect against unauthorized access.

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For any baseball players, or who knows the answer:
How many stitches are in a baseball?

Answers

Answer:

108

Explanation:

Answer:

108 stitches for baseballs and 88 to 96 stitches for softballs

Explanation:

A nurse is providing care to a neonate. place the following steps in the order that the nurse would implement them to properly perform ophthalmia neonatorum prophylaxis. all options must be used.

Answers

A nurse must wash their hands, gather the necessary supplies, locate the neonate's eyes, apply ointment to the inside of each eyelid, and properly dispose of the materials in order to administer ophthalmia neonatorum prophylaxis.

The steps in the correct order that a nurse would implement them to properly perform ophthalmia neonatorum prophylaxis:

Wash your hands thoroughly with soap and water.Gather the necessary supplies, including a tube of erythromycin ophthalmic ointment, a sterile cotton swab, and a pair of gloves.Identify the neonate's right and left eye.Gently pull down the lower eyelid of the neonate's right eye.Apply a small amount of erythromycin ophthalmic ointment to the inside of the eyelid.Repeat steps 4 and 5 for the neonate's left eye.Dispose of the gloves and any used supplies properly.Document the procedure in the neonate's medical record.

Here are some additional options that the nurse may need to consider:

If the neonate is born by cesarean section, the nurse may need to delay the administration of ophthalmia neonatorum prophylaxis until after the cord is clamped and cut.

If the neonate has any signs of infection, such as redness, swelling, or discharge from the eyes, the nurse should notify the neonate's healthcare provider.

By following these steps, the nurse can help to prevent the development of ophthalmia neonatorum, a serious eye infection that can lead to blindness.

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Complete question :

A nurse is providing care to a neonate. place the following steps in the correct order that the nurse would implement them to properly perform ophthalmia neonatorum prophylaxis. all options must be used.

Gather the necessary supplies.Wash your hands thoroughly with soap and water.Identify the neonate's right and left eye.Apply a small amount of erythromycin ophthalmic ointment to the inside of the eyelid.Gently pull down the lower eyelid of the neonate's right eye.Repeat steps 4 and 5 for the neonate's left eye.Dispose of the gloves and any used supplies properly.Document the procedure in the neonate's medical record.

How do viruses reproduce?

by taking over the machinery inside a host cell to make more viruses

by sharing DNA with other, nearby viruses

through binary fission

through sporulation

Answers

Answer:

I believe it's the first one. Viruses need to infect cells in order to mulitiply.

Explanation:

Reflecting on food environment ?
Answer please

Answers

Answer: Children in these environments were more likely to desire “restricted” foods, Many strategies can contribute to healthy food environments. These include: Applying nutrition standards in childcare facilities, schools, hospitals, and worksites. Providing incentives for supermarkets or farmers' markets to establish their businesses in underserved areas.Food consumption and production have a considerable impact on the environment. To be good, food needs to be responsibly sourced and consumed, as well as healthy. Food production contributes, for example, to climate change, eutrophication and acid rain, as well as the depletion of biodiversity.

Explanation:

When a baby has drown, if you give them 2 breaths and 30 chest compressions, what should you do to the babys mouth and how should your chest compressions look? make it as simple as u can pls.

Answers

Answer:

rhey should look thin and the babys mouth should be open please mark brainliest??!!!

Explanation:

Answer:

You press with one or 2 filanges for compression and you should blow in the babys mouth like mouth to mouth but don't do to hard or to soft.

Explanation:

In fatal motor vehicle crashes, the majority of people killed are:__________

Answers

In fatal motor vehicle crashes, the majority of people killed are drivers and passengers of motor vehicles. This is according to the National Highway Traffic Safety Administration (NHTSA), which is part of the United States Department of Transportation.

A fatal motor vehicle crash is a traffic accident in which one or more people die as a result of their injuries. Car crashes that cause fatalities are usually classified as fatal motor vehicle crashes. Motor vehicle accident is a significant cause of death and injury in the United States and worldwide. The NHTSA's Fatality Analysis Reporting System (FARS) is the most comprehensive database of fatal motor vehicle crashes in the United States.

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Can someone help me please ?

Answers

A. Apple has a lot of good natural sugars. Peanut butter has good fats and proteins.

Helpppppp againn.....

Answers

Answer:

purple highlight= 1st box

green highlight= 2nd box

blue highlight= 3rd box

Explanation:

Which of the following is an accepted health benefit of soy?

A. Stronger bones

B. Reduced risk of cancer

C. Enhanced attention span

D. Lower rates of heart disease

Answers

Answer:

D. Lower rates of heart disease

Explanation:

omega-3 fats prevent heart disease and omega-3 fats are found in soy.

Answer:

Correct

Explanation:

:)

Which of the following is a way to protect your reproductive health?
Use backup contraception most of the time.
Use a condom most of the time.
See a doctor only when you have symptoms of a disease.
Abstain from sex.

Answers

Answer: Abstain from sex all together.

Explanation: It is proven that condoms and other types of contraceptives are not going to work 100% of the time. Having sex, even with protection, can lead to STDS and pregnancy. Some STDs can cause your reproductive system to decline in health and in some situations, fail altogether.

you have eaten a high-carbohydrate meal for lunch. explain the digestion and metabolic fate of this carbohydrate for the next 5 hours, including an hour of running at the end of this time frame.

Answers

The high-carbohydrate meal that you consumed for lunch will be broken down and digested into glucose molecules in your body. The glucose molecules will then be transported through your bloodstream to the cells in your body. The cells will then utilize the glucose for energy production through cellular respiration. The digestion and metabolic fate of this carbohydrate for the next 5 hours, including an hour of running at the end of this time frame are explained below:

After the consumption of the high-carbohydrate meal, the carbohydrates present in it are first broken down into simpler glucose molecules in the mouth and small intestine by the process of digestion. These glucose molecules then enter the bloodstream and are transported to the cells in the body for energy production. The cells use the glucose for energy production via cellular respiration. The glucose can be used for immediate energy production, converted to glycogen and stored in the liver or skeletal muscles or converted to fat and stored in adipose tissue.In the case of excess glucose molecules, the cells convert glucose into glycogen and store it in the liver or skeletal muscles for future use.

During an hour of running at the end of this timeframe, the glucose stored in the liver or skeletal muscles is broken down into glucose molecules and transported to the cells for energy production. The body uses glycogen stores and blood glucose during exercise. When glucose stores are depleted, the body starts utilizing fats as an energy source. This glucose is then used for energy production during exercise. In summary, high-carbohydrate meals are metabolized and stored as glycogen and fat in the body and utilized for energy production during exercise.

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whats one core value you would not compromise on to resolve a conflict I need it fast please I will give brainliest

Answers

The answer in my opinion is integrity

1. what are your lifestyle goals? (is your free time more important to you, or is a large salary more important?) explain.

Answers

My lifestyle goals revolve around finding a balance between work and leisure time. Both my free time and a good salary are important to me, and I don't believe that one has to be sacrificed for the other. My ideal lifestyle would involve a well-paying job that allows me to pursue my hobbies and interests outside of work. I value my free time and the ability to enjoy it, but I also understand the importance of financial stability and job satisfaction.

In my opinion, prioritizing one over the other can lead to an unbalanced lifestyle. If I were to focus solely on earning a high salary, I may find myself working long hours and sacrificing my leisure time. This could result in burnout, stress, and a lack of enjoyment in life. On the other hand, if I only focused on my free time and neglected my career, I may struggle financially and not have the resources to fully enjoy my hobbies and interests.

Therefore, I believe that finding a job that provides a good balance between salary and leisure time is crucial. By doing so, I can maintain a fulfilling lifestyle that allows me to pursue my passions while also being financially secure.

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Which interactions are most likely to result in disagreements with extended family? Check all that apply


Making financial decisions


Balancing work and family time


Spending time with in-laws


Disciplining siblings who compete with each other


Sharing different opinions regarding raising the kids

Answers

Interactions that are most likely to result in disagreements with extended family include the following. Making financial decisions Sharing a joint bank account or splitting the expenses of a family reunion might lead to financial disputes.

Balancing work and family time: Work can place a strain on family life and lead to stress and resentment.Spending time with in-laws: Disagreements over how much time should be spent with in-laws or who gets priority can cause rifts.Disciplining siblings who compete with each other: Disagreements about how to discipline siblings who compete with each other or who is to blame for an altercation can lead to conflicts.Sharing different opinions regarding raising the kids: Different parenting styles, educational values, or lifestyles can cause disagreements.

A healthy and respectful relationship between extended family members is crucial to maintain familial relationships. Family counseling can be helpful for families experiencing disagreements that they cannot resolve on their own. Additionally, respecting other people’s opinions and being willing to compromise can help prevent disputes from escalating. People may have diverse perspectives, but it is possible to reach a mutual understanding with extended family members. In conclusion, these are the interactions that are most likely to result in disagreements with extended family: making financial decisions, balancing work and family time, spending time with in-laws, disciplining siblings who compete with each other, and sharing different opinions regarding raising the kids.

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This is a question about Football. After 4 downs have passed and they have failed to make it over the 10 yards required the ball will be turned over to the ___________.


1. Referr

2. winning team

3. defensive team

4. jump ball

Answers

3. defensive team!!!!
The answer is 3. Jump ball is for basketball, the ref doesn’t get the ball, he’s not playing? And the it’s not fair for it to be turned over to the winning team

Surgery rooms should be cleaned daily whether they need it or not.

a. true
b. false

Answers

The given statement "surgery rooms should be cleaned daily whether they need it or not."  is True because surgery refers to a medical procedure which is performed on a patient for the purpose of treating a certain condition. During a surgery, the patient is under anesthesia.

Surgeries are mostly performed in hospitals or medical clinics. These procedures require a sterile environment to prevent infection or the spread of bacteria. Proper sanitation and sterilization are essential in this environment.What is the importance of cleaning surgery rooms?It is important to clean surgery rooms to prevent infection and the spread of bacteria. Proper cleaning can prevent the accumulation of bacteria and fungi in the rooms. Daily cleaning is necessary even if the surgery room is not used regularly. Surgical tools and equipment need to be cleaned and sterilized as well. Staff working in the surgery rooms also need to ensure they are following proper hygiene practices to reduce the risk of contamination.

Therefore, surgery rooms should be cleaned daily whether they need it or not is true.

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Visual processing is the rate at which the human brain accepts, decodes, and _____.

A-transmits images
B-transforms images
C-translates images
D-transfers images


WILL MARK BRAINLEST -JAYVEE

Answers

The correct answer would be transmits images

Which statement best describes the difference between genetic diseases and genetic disorders?
O Genetic diseases are caused by problems with DNA, and genetic disorders are caused by problems with genes.
O Genetic diseases are related to dominant genes, and genetic disorders are related to recessive genes.
O Genetic diseases can be passed on to many generations, and genetic disorders can be passed on only to a single
generation
O Genetic diseases have measurable symptoms, and genetic disorders may not affect day to day life.

Answers

I believe the answer is the second choice

Answer:

A. Genetic diseases are caused by problems with DNA, and genetic disorders are caused by problems with genes.

Explanation:

Took the test

nurse is assessing a school-age child whose blood glucose level is 280 mg/dl. which of the following findings should the nurse expect?

Answers

she should expect lethargy

With a blood glucose level of 280 mg/dl in a school-age child, the nurse can expect to find symptoms of hyperglycemia. These may include increased thirst (polydipsia), frequent urination (polyuria), fatigue, and possibly blurred vision.

Hyperglycemia is a condition characterized by high blood sugar levels and is commonly associated with diabetes. Prompt intervention and management of blood glucose levels are necessary to prevent complications and maintain optimal health in the child.

A blood glucose level of 280 mg/dl indicates hyperglycemia in a school-age child. Hyperglycemia is often associated with symptoms such as increased thirst (polydipsia) and frequent urination (polyuria) as the body tries to eliminate excess glucose. The child may also experience fatigue and may have difficulty concentrating. Blurred vision can occur due to the osmotic effects of high blood sugar levels on the lenses of the eyes. It is important for the nurse to promptly assess and address the child's elevated blood glucose levels to prevent complications and maintain optimal health.

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What risk for unstable blood glucose r/t insufficient diabetes management aeb excessive urination.

Answers

Unstable blood glucose is a serious health condition that arises due to insufficient diabetes management. There are a variety of factors that contribute to unstable blood sugar, one of which is excessive urination. Let's take a closer look at the risk associated with unstable blood glucose r/t insufficient diabetes management aeb excessive urination.

Unstable blood glucose occurs when a person's blood sugar levels fluctuate dramatically. It may result from an imbalance between the amount of insulin a person requires and the amount of insulin they produce. Uncontrolled blood sugar can cause a wide range of symptoms, including excessive thirst, fatigue, headaches, and nausea.

One of the primary reasons that excessive urination may be related to unstable blood glucose levels is because of the way that glucose functions in the body. Glucose is a type of sugar that the body uses for energy. Insulin, a hormone produced by the pancreas, helps the body absorb and use glucose.

In conclusion, the risk for unstable blood glucose r/t insufficient diabetes management aeb excessive urination is that it can lead to dehydration and urinary tract infections. If you're experiencing excessive urination and other symptoms of unstable blood glucose, it's important to seek medical attention to get your blood sugar levels under control.

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___ are drugs that have limitations on their ownership or use by a government and are illegal in certain
situations (meaning a person is not allowed to have them).
contraband
confiscations
Illegal drugs
repossessions

Answers

Answer:

Hi, sorry if im late. Here's your answer! Illegal drugs

Explanation:

Hope this helps! Have a good one.

A patient develops a dry, nonproductive cough and is diagnosed with bronchitis. Several days later, the cough becomes productive with mucoid sputum. What may be prescribed to help with symptoms?
Antibiotic therapy
Bronchodilator treatment
Mucokinetic agents
Antitussive medication

Answers

the answers is antitussive meditation

Mucokinetic agents may be prescribed to help with symptoms when a patient develops a productive cough with mucoid sputum after being diagnosed with bronchitis.

Bronchitis is an inflammation of the bronchial tubes, often caused by a viral infection. Initially, bronchitis may present with a dry, nonproductive cough. However, as the condition progresses, the cough may become productive with the production of mucus or sputum. In such cases, mucokinetic agents can be beneficial.

Mucokinetic agents are medications that help in thinning and loosening the mucus in the airways, making it easier to cough up and clear from the lungs. These agents can facilitate the removal of excessive mucus, relieving symptoms such as chest congestion and productive cough.

It is important to note that bronchitis is typically caused by a viral infection and does not require antibiotic therapy unless there are specific indications, such as a secondary bacterial infection. Bronchodilators may be used if there is evidence of bronchospasm or airflow obstruction. Antitussive medications, on the other hand, are generally used for dry, nonproductive coughs and may not be as effective for a productive cough with mucus.

Therefore, in the case of a patient with bronchitis who develops a productive cough with mucoid sputum, mucokinetic agents are likely to be prescribed to help alleviate the symptoms.

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what are the most common blood-borne pathogens

Answers

hepatitis b (HBV), human immunodeficiency virus (HIV), hepatitis c (HBV) are the three most common blood borne pathogens

Describe how caffeine can affect your stress levels. How does it affect your cardio respiratory system?

Answers

ANSWER:

Caffeine is a stimulant that makes your heart rest increase, and stress increase. The reasoning for this phenomenon is caffeine stimulates your fight or flight instinct, so if you have anxiety or stress it will worsen it. Studies have shown that drinking caffeine can cause anxiety attack or make you jittery. Caffeine can facilitate the release of natural hormones that act on the heart, this hormone is similar to adrenaline causing your blood pressure to increase immensely.

As the impulse moves toward a positive electrode of the ecg it produces a:_______

Answers

As the impulse moves toward a positive electrode of the ecg, it produces a positive deflection on the graph. The electrocardiogram (ECG) is a measurement of electrical activity in the heart. ECGs are used to track heart rate and rhythm.

The heart's electrical activity is measured by a sequence of waveforms generated by the depolarization and repolarization of cardiac cells. The P wave, QRS complex, and T wave are the three waveforms that make up a standard ECG.

The QRS complex represents ventricular depolarization, or the electrical impulses that cause the ventricles to contract and pump blood. It produces a large positive deflection on the graph. The P wave represents atrial depolarization, or the electrical impulses that cause the atria to contract and push blood into the ventricles. The T wave represents ventricular repolarization, or the electrical impulses that cause the ventricles to relax and prepare for the next contraction. It produces a small positive deflection on the graph.

In conclusion, as the impulse moves toward a positive electrode of the ecg it produces a positive deflection on the graph. The electrical activity of the heart is measured by ECGs. The QRS complex represents ventricular depolarization, which produces a large positive deflection on the graph. The P wave represents atrial depolarization, which produces a small positive deflection on the graph. The T wave represents ventricular repolarization, which also produces a small positive deflection on the graph.

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Agriculture is the main sources/income of Nepal"Justify this statement​

Answers

Answer:

In Nepal, the economy is dominated by agriculture. In the late 1980s, it was the livelihood for more than 90% of the population, although only approximately 20% of the total land area was cultivable, it accounted for, on average, about 60% of the GDP and approximately 75% of exports. Since the formulation of the Fifth Five-Year Plan (1975–80), agriculture has been the highest priority because economic growth was dependent on both increasing the productivity of existing crops and diversifying the agricultural base for use as industrial inputs.

Explanation:

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Which compliment pathway involves binding of compliment to the lipopolysaccharide layer of the bacterial cell wall?a) Classic Pathwayb) Mannose-binding Lectin Pathwayc) Alternative Pathway *4. HINT: Remember the "square" means 90 degrees25 pointsThe circle with center O has a circumference of 36 units. What isthe length of minor arc AC?A. 9 unitsB. 12 unitsC. 18 unitsD. 36 units How many molecules is 6.11 moles of Zn? Write one line Linux command that performs the required action in each of the problems given below: (a) Find the difference in text between two text files File1.txt and File2.txt and save the result in a file named result.txt (b) Change the permissions of the file remote_driver.c such that the owner has the permissions to read, write and execute and anybody other than the owner can only read the file but cannot write or execute. (c) Search for the string ir_signal in the file /home/grad/remote_driver.c and print on the terminal the number of instances of the given string in the file /home/grad/remote_driver.c (d) Reboot the system after 5 minutes. (e) Display the list of processes currently being run by the user harvey. (f) Print 3 copies of a file named my_driver.c from a printer that has a name HPLaserJet4300. (g) Put the last 40 lines of the file driver_log.log into a new file final_fault.txt. Briefly explain one major difference between Schlesingers and Robinsons historical interpretation of the impact of the new deal during the Great Depression HELP ME PLEASE!!! NO LINKS!!! THE POEM IS CALLED "INVICTUS" BY: William Ernest Henley, 1875How does the poems use of darkness in its imagery contribute to the texts overall meaning? A. The poem describes night (line 1) covering the speaker, symbolic of the adversity and/or suffering he faces.B. 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