1. Classify patients into 4 tiers based on number of claims. (6 po.docx

1. Classify patients into 4 tiers based on number of claims. (6
points)
a. Tier 1 (High-Risk) (75-100 percentile); Tier 2 (Rising Risk)
(50-75percentile), Tier 3 (Med Risk)(25-50%) Tier 4 (Low
Risk) (0-25%)
b. Add a new column to the Beneficiary table that indicates the
tier of the patient
c. Add a new column to the beneficiary table that calculates
patient age in 2019 (2019 – Year of birth)
d. For each tier identify ( using Pivot table )
i. Average and Median Claim count and claim amount
ii. Percentage of the population with each type of chronic
condition
iii. Percentage of population in different age ranges (65 -74, 75-
85, 85+)
e. Write a narrative description of each tier and Health IT
recommendations for providing services that can reduce costs
and improving quality of care (about 150 words)
File too large to upload – can I email it to you?
Writing Assignment 1
Self-Ethnography & Analysis of an Unfamiliar Space (5-8 pp.)
Description of Assignment Goals
An ethnography is a piece of writing that describes a particular
group, community or subculture (this genre of writing is
most common in Anthropology, though other fields also perform
ethnographic writing). Self-ethnography asks you to
analyze yourself in relation to someone or something, usually a

broader societal context. For this assignment, you will
position yourself in an unwelcoming or unfamiliar space and
aim to analyze and reflect on your own positionality and
sense of belonging.
Your goal with this assignment is to identify a place that you do
not belong in because you do not belong to the
community who inhabits the space naturally. This can be high
stakes (a community that you actively don’t belong to) or
low stakes (something merely unfamiliar), though the higher the
stakes the more likely you’ll have something interesting
to write about.
The goal of you entering and inhabiting the space is to achieve
productive discomfort; in other words, using your feelings
of a lack of belonging, and the discomfort that results, to think
through yourself and others. Note: If it’s hard to find
someplace that you don’t belong, that’s something to reflect on
in itself.
Do note that you may need to ask permission to access the space
you choose. Please be mindful of those whose space
you’ll be visiting, and keep in mind that this is, at its core, an
assignment aimed at self-reflection and not at describing
unfamiliar actions of others. In other words, you should
approach this not as a means to describe unfamiliar or “alien”
others, but rather to reflect on how it feels to inhabit a space not
meant for you. You are the main subject of description
and analysis, not the people you’re with.
Feel free to be active. Although it’s easy to think of this
assignment as asking you to sit quietly and observe, you’ll
likely
have more success if you engage with whatever activity is going
on in the space. Furthermore, if appropriate, you’re
welcome to ask questions of those who are there, and include

quoted dialogue in your final paper.
This assignment is quite open-ended both in terms of how you
approach it, what you discuss, and how you analyze your
findings. This is on purpose: this assignment, different than any
research-based writing you’ll be doing from here on out,
challenges you to make choices as a writer in a type of writing
that is likely unfamiliar to you. On every level, therefore, you
should be looking to engage with your discomfort, rather than
dismiss it, and to transfer skills to unfamiliar genres.
Using Short Assignments 1, 2 and 3, consider the communities
you are a part of and those you do not belong to. The
knowledge of how you belong to certain groups can inform the
types of spaces you seek out. You are welcome to borrow
some of the reflection you’ve done in these assignments and/or
in your weekly journals when completing this paper.
Feel free to set up an appointment to meet with me to discuss
brainstorming for this assignment, or to workshop a draft.
Because making substantial revisions is a part of the grading in
this class, remember to save original
copies of any drafts you complete, whether or not they’re for
the due date. In other words, save your
paper outlines, rough drafts, etc.
Regardless of how you choose to set up and execute your paper,
your paper should:
o Have a descriptive component: Your readers should be able to
access the space you’re writing about even if they
have never been there. As such, you should be showing them the

space through examples and descriptive
language rather than telling them about it. You should also be
describing your relation to this space on similar
terms: your readers don’t know you, and have no access to how
you respond to this space.
o Have an analytical component: You should be walking your
readers through your findings, and connecting these
findings to your description. These findings can include broad
reflections on how it feels to inhabit a space you
don’t belong in, how the space relates to those you’re more at
home in (in other words, does it fulfill a role for
this community that is akin to one for yours), whether this
feeling of non-belonging is common or uncommon
for you and why, etc.
o Move beyond yourself: Though this assignment is, at its core,
a self-reflection, you should aim to produce writing
that is both accessible and appealing beyond you and those who
know and care about you. How does what
you’re talking about connect to a broader audience?
o Have an underlying significance: In your concluding
paragraph or concluding section, you should strive to reach
a broad audience most explicitly. Why does what you’re saying
matter? What do you hope readers walk away
with? How should your readers think about the world differently
as a result of your paper?
Formatting Requirements
Length: Your paper should be between 5 and 8 pages. Note that

if you’re having trouble reaching the length minimum,
you can add a second space to your paper. I do believe,
however, that you should need 5 pages to successfully describe
and analyze one space and your feelings within it, so make sure
you have depth in all components if you do two spaces.
Genre: The way you structure this paper, and the tone you use,
is very much up to you. This paper works as a personal
narrative (see examples by Clarendon and Allen, but you can
also write it as a story) and as a more distanced reporting of
facts (which would sound more like journalistic writing, like
Gladwell).
General formatting: Use size 12, Times New Roman font with
1” margins. It should have a title, and the first page
should include a heading with your name, the course name and
number, the instructor’s name, and the due date. The
paper should have your last name and the page number in the
right-hand header space. It should be stapled.
Due Dates:
First draft (unpolished, but complete in length) due Thursday,
February 27th for workshop
Note: Adding elements (conclusion, etc.) that were not in first
draft does not count as revising
Final draft due Thursday, March 5th in portfolio with Writer’s
Memo
GAO 1
GAO 8

Self Reflections on where I’m not belong
The human brain is designed in such a way that it always
functions to protect us. In doing so, the brain always ensures
that we are in a state of comfort by structuring our mindset and
thought processes to things and surroundings that are familiar to
us. The moment the brain detects that it is in an unfamiliar
environment, it always works to revert to familiarity. However,
sometimes we have no choice but to be in unfamiliar spaces. In
this case, the brain cells release chemicals that communicate to
the body and mind that we are in trouble, leading to a massive
release of adrenaline. It is the reason why many of us are likely
to become anxious, stressed, and depressed when they are in
unfamiliar spaces.
As a human being who is in the development process of life, I
must admit that I have been in an unfamiliar space. Here, we are
going to major on personal experiences of research based on
me. I am going to position myself in an unwelcoming or
unfamiliar space and aim to analyze and reflect on my sense of
non-belonging.
When one starts to feel that he or she does not belong in a
particular environment, it becomes an unwelcoming space. It is
as a result of being in a place where you find the environment
being contrary to the one you are used to. For instance, in the
university, when you do not do parties, drinking or never
smoke. You are allocated to a hostel that your roommates have
no problem in smoking in the room or bringing their friends
overdo drink and play loud music. These can often get
uncomfortable to one who does not do these things and is often
overpowered with his or her opinion since the majority is
comfortable with the situation. Hence the environment becomes
unwelcoming to the person or feels you do not belong to that
place.
In my experience, the place I felt I never belonged to was my

high school.
My high school named Zhengzhou Foreign Language
School, and it ranks third among all senior high schools in
China. When I first visited this high school, I was a junior high
school student, and I was very much looking forward to it.
Because everyone knows that the students who attend here are
among the best, the student who comes out of this high school
can go to a first-rate university.Not only do students like me
look forward to this school, but also parents. In order to give
their children a chance to enter this high school, many parents
arrange a lot of homework for their children when their kids just
a junior high school student. What's more, some parents have
spent a lot of money to buy the house near the school when their
children are in primary school, and they are very strict with
their children since they are young, all in the hope that their
children can get the admission letter from the school.
It can be said both lucky and unlucky,after I finishes the
high School entrance examination in my last year of my junior
high school, I received the admission letter from the Zhengzhou
Foreign Language School by virtue of my excellent test scores.
When the way of things one is used to sudden changes, not to
your favour, one feels like a piece of a puzzle that does not fit
in that position. It is either you work to adapt and overcome or
be left out. Before my senior high school, I attended my junior
high school at Xuchang Middle School, located in a small city
named XvChang. At the time, my grade always ranked top ten.
In China, each junior high school has three levels include the
seventh grade, the eighth grade, the ninth grade, and each grade
have around twenty classes.I was proud at that time because I
could get the first place in academic examination of two
thousand people in one grade. These great results and rankings
also inspire me. So, in my last year of my junior high school , I
did a good job in the senior high school entrance examination: I
got the 7th place in my hometown city. I can’t believe that I can
got the 7th place in thirty thousand students. Because of my
excellent performance, I received more applause and

encouragement from my teachers and friends. The head teacher
and principal are also proud that I can be admitted to
Zhengzhou Foreign Language School.
I still remember the first time I entered the Zhengzhou Foreign
Language School as a freshman. The school's square is very
elegant, and each teaching building is solemn and enthusiastic
brick red, the students and teachers here to this iconic colour
named "Harvard Red.". Compared with other high schools, its
facilities and laboratories are the most advanced with the best
environment. I like the study room in the school, and the study
room is surrounded by transparent glass, where you can see the
flowers and scenery near the school, all of these always
inexplicable let a person's mood is bright. From the first day of
school, it brought me too much expectation. I also think this is
going to be a new beginning in my life.
But what I never expected was that this was where my
nightmare began.
Zhengzhou Foreign Language School was a school that had
pride in producing top-performing students (?)Those that
managed to secure their position there had one of the best
grades in the province. It was a battlefield for top performances
in the province. Smart students, in terms of intellect, battled
each other in exams across the years in the school. That was the
purpose of Zhengzhou Senior High School. Bring out the best in
our province. This was high pressure as it gave them a
conducive competitive field for them to be the best in the
province. I was not left out. It was either you work hard to sail
with the top or fail at exams n sink with those at the bottom.
Though in my previous school, （conjunction）I had never
experienced this before, ass I had achieved good grade with
ease. This was a different environment. A change to what I was
used to before. I was ranked from the first monthly high school
entrance exam to the middle and back of the class.
I could not accept the reality that I was an ordinary student.

Ordinary student here, to me, means that you do not appear
among those high scoring grades. Back at junior high school,
there were a dozen top students in a class in junior high school,
and I could still be ranked first and second. I could also be
ranked in the whole students in this level. Failure to me was not
an option. I also had pride in excelling, being among the top
students and know what it meant being at the top. Now I was
ranked thirtieth or fortieth to the class, a total of sixty people.
This got me depressed.
After seeing this situation in the first year of high school, I
began getting aggressive. I was aggressive to my studies and my
study schedules. During these depressing times, I was studying
till late in the night. I used to spend most of my time in studies
all in the name of having my name ranked among the best. As
always with life, there are good times and bad times. But I did
not have this understanding at that time. Due to the pressure I
had and aggressiveness I took to my studies, I got a lower grade
in the second monthly exam than the first one. This got me
more depressed than before and more aggressive towards my
studies.
I stayed at this status for two and a half years. In the first year
of high school, I studied until one o'clock in the evening and on
the second year, increases my study hours into the night. I was
pressuring myself too much to be able to match my fellow
students who rode the top of exam score charts. On the third
year of high school, I began studying until four or five o'clock
in the morning. By now you can tell this was getting worse and
not good for me. I was adopting unhealthy study habits. Then
after, sleep for an hour or two before I woke up for classes.
Most times, I could sleep for one hour then wake up at six in the
morning. I was missing a lot of sleep hours. In turn, instead my
grades going up, they deteriorated. My body was getting
exhausted because I had pushed it beyond its limits.

When schools closed or went for a break, while other students
went for holidays during the school breaks, I did not. I didn't
travel for a whole two or three years. I had no vacations or
holiday getaways. During these times, I went to the preparatory
course or I went to review my past exam results and worked to
improve them. As you notice from the beginning of my high
school years, I had created an unconducive environment for
myself. Not only that, the change in environment that I felt not
comfortable with was making me push myself too much. These
experiences hit my mind and body very hard. They had deeply
affected me not realizing what I was doing to myself. My late-
night studies, my less sleeps and no breaks for my body took a
great toll of me that I had not realized before. It was coming.
My body began responding to the mistreats I had given it for the
past few years. This was in my third senior year at Zhengzhou
Senior High School. At this time, my classmates used to take
ten minute breaks to make up less sleep every day. But as usual,
I never made sleep my agenda. Instead, I kept pushing myself
harder. I did not realize I was pulling myself apart. Tearing and
wearing-off my body.
I started experiencing some discomfort at the cervical spine
area. I ignored it for a while not knowing what was in store for
me. Then the discomfort reached for the lumbar vertebrae. This
followed with more pain than discomfort. I could feel how
exhausted my head was. Sometime, headaches and felt like my
brain was burning out. Since I did not pay attention from the
beginning, the pain increased compressive to the nerves. My
concern rose when pain was intense and kept increasing. This
was not over.
My fingers began swelling. Then followed the whole hand. It
would swell inexplicably when it was pressed against the
nerves. This was my right hand. Though all this had begun to
worry me and sought medical attention, I was not yet worried

about how I carry out my studies and if it would affect me. This
was because I was left-handed. I used my left hand to write. My
right hand followed. It started slowly. Writing was slow and
painful all through. Then one day I woke up and it was swollen.
I could no longer write. I had to cancel my plans to attend class
or anything else. I was in much pain to concentrate. It alarmed
both my parents and I. I now had realized what I had done to
myself.
To how far we are, you can see what kind of state I had put
myself into. I was in a new environment brought by my
irresponsibility to take care of the situation that I was in
previously. I had to be hospitalized for a few days and had some
few days to recover at home. I did not go to school for a while.
My classmates progressed and gained more mileage with their
studies. Everyone at school knew about my condition. Some
said I was not ready for this school; I could not match their top
performances and I should have quit a long time ago. This got
me more depressed during my recovery. There was again, in an
environment that was unfamiliar and unwelcoming to me. I felt
like an 'alien' to my own school.
My parents realizing how difficult it was for me, they had me
transfer and study abroad. Still on recovery, it was hard to carry
out some class tests. My hands were not a hundred percent
healed. A test consisting of two and a half hours felt really
long. I could only do a few questions, get exhausted due to my
condition and leave the class. My morale for excellence was
completely gone. I felt like the ordinary student stature that I
was trying to run from by pushing myself too hard. I felt like a
loser for those remaining two and a half years. I felt very
inferior to the rest of my school and I didn't care about my
appearance at that time. I was avoiding attention. If I wasn't
strong general perseverance at that time, my heart was really
super nauseous to that environment. That was my problem
though.

I had lost myself to this unfamiliar and unfriendly environment.
Avoiding attention, quiet in class, the fire and passion I had
previously burned out. No matter how much I wanted to bring
myself to I how I was before, my body did not respond.
Everything else felt ordinary. No competition, no more pushing
myself to attain that good grade that I once pushed myself for.
My teachers and classmates were good to me. It was not like at
Zhengzhou Senior High School. But my confidence was long
gone and considered myself a poor student in class. I was
neither among the top nor those fighting to get there. I felt so
low of myself even though my class teacher was very optimistic
about me. She could often praise me of my work in class and the
assignment I handed out. This did not change the state either.
It felt more off an embarrassment than praise to me. It made
more inferior because I was not working hard like I should, but
there she was with the praises. This made me draw myself more
away from class. My participation which was poor was already
deteriorating further. This was not only the case in school but
also at home. My parents could see how affected I was. How I
was drawn back from everything. Even though now I was free
during school breaks for holidays, the holidays and vacations
we made never felt like the holidays before. The ones that I
could get home with my good grades at junior high, to celebrate
with my happy parents with big smiles on their faces. Now I had
nothing to give for their smiles. It was what I told myself when
I was behind my closed bedroom door. The only people I could
confide to be my parents by then, even though I had good
friends next to me.
As far as my experience above, you can conclude that when one
is an unwelcoming environment, it is what actions you take that
will get to help you out. Like the example I gave above, before
my narrative experience, he or she who is the only one
uncomfortable with the place, should consider reaching the
accommodation's office and have the hostel changed to a

favorable one. This will help one ease out to the unfamiliar
environment without harm. In our case above, I took haste to
want to compete with the rest without taking into conscious of
my limits. I wanted to work harder, push myself beyond the rest
to be among the top, instead of knowing what kind of my
environment is and what kind of measures are more
efficient.Different kind of environments have different
measures.
Why is Ethnography important to us, one would ask.
Ethnography offer excellent insight into how social
anthropologists undertake their fieldwork. More, so provides
insights on different unfamiliar environments of different
individuals or groups of people. Helps study their culture, ways,
how one reacts to different situations with different people.
Where ethnographies focus on particular practice- such as a
religious ceremony or culinary ritual- the researcher will place
in practice in its full context to give a holistic, rich multi-
faceted account.
When I look back on myself at that time, I think I was childish,
solid and stubborn. And I don’t allow myself to give up. In
fact,this kind of spirit is very good for people, but I was so
stubborn at that time. So my stubbornness resulted in both
physical and psychological damage. The following are some of
the facts that I feel most in need of self-reflection.
First of all, accept the perfect and imperfect self. However, it
was hard for me to face my heart in high school. I often hide my
inner fragility in that time and imagine that I was Iron Man can
overcome everything. I can't accept my imperfection. This
feeling like I can separate myself into two parts, one part is a
perfect person, and the other part is an imperfect person. I focus
on my perfect part and everyday use its energy, however, the
imperfect part is always ignored by myself. But what I never
thought was that the human being’s heart could not be
separated, and the imperfect half of myself which be abandoned
by myself has been crying in my heart. If the imperfect half

myself is a little child, I would be so sorry for him, and I
shouldn't have left him behind no matter what difficulties I met.
I should be honest with myself: Yes, I'm not a genius. I'm just
an ordinary student. Who cares? I accept all I have, and I can
face myself bravely, whether it is perfect or not perfect. I'm the
best in my heart, and that's enough.
Moreover, knowing the strengths and be confident. Although my
total score in high school did not make me confident, I was
always getting a good grade in math and physics. Besides, I
love writing novels very much. I often contribute to the school
newspaper and the famous fiction company, and my articles are
often quoted in the school newspaper. In these respects, I
shouldn't have collapsed in that environment. But at that time, I
only focused on the grades and the trouble is I only focused on
the grades of my weak subjects. I became very self-abased and
cared a lot about what others thought of me because I was afraid
of being laughed. Later I found that everyone's attention is on
their own, few people pay attention to others. In this era,
everyone is making full use of their time to improve themselves
and take responsibility for themselves. So all we can do is to
take responsibility for ourselves, use our strengths properly and
try to be a confident person.
Thirdly, let go of the past and learn how to give up something.
Whether the past makes you proud or sad, learn to let it go. In
high school, I was very stubborn because I was a top student
before. I did not take the new place in high school as a new
start. I still miss the glorious junior high school days what I
could not go back. So in this state, my heart is full, filled with
past glory and present vanity. And the real progressives will
think of themselves as an empty cup, can be filled with new
knowledge. I think that was the biggest failure of my attitude at
the time. Also, life must give up somethings, and then people
can continue to seek and build their own new life. And more
importantly, when the person thinks of himself as an empty cup,
he'll have less to be worried and more motivation to go.

Need to Fix
一，Every paragraphs has Grammar mistakes. (too long
sentences can’t understand what you were trying to say.
二，Don’t use “ you” in your essay. There are many “this” in
the essay. Most of them are very confusing. What does “this”
represent? Reader can’t understand what “this” is. Every
sentence relates to “this” need to be fixed.
三，Compress the high school experience in several large
paragraphs. Many of the text are four or five lines, and can be
appropriately changed to eight or nine lines. (Integrate the
content experience, the text is too messy. Some high school
experiences and ideas need to be compressed. Write the main,
do not talk in general, but to concise. For finger pain, you can
expand it, I see that the text of the left hand writing is not very
real, I write with the right hand. But the finger pain can be
written here, because The nerve compression of the cervical
spine seems to be because after the cervical spine is compressed
here, it will affect the spinal cord, and then it will randomly
compress other nerves, and then the swelling of the fingers will
occur. In this part, my professor hope that I expand it and write.
四，Using more Academic Vocabularies. For instance, using
another word instead of "aggressive"
五，Context connection,(between with paragraphs, beginning
and end). The first ending paragraph doesn't relate to
ethonography. The teacher said that I would delete it, so I
deleted the long one about ethonography and changed the
beginning. On the other hand, the conclusion at the end has
nothing to do with the article itself, delete it, and then add a
conclusion that fits the entire article after the content I
supplemented. Do not write useless things in this conclusion.
The content at the beginning and end are useless and useless.
They didn't play a good role in the essay. Therefore, you have
to rewrite them.
六.Missing two important point in your essay
3.Move beyond yourself: Though this assignment is, at its core,

a self-reflection, you should aim to produce writing that is both
accessible and appealing beyond you and those who know and
care about you. How does what you’re talking about connect to
a broader audience?
4.Have an underlying significance: In your concluding
paragraph or concluding section, you should strive to reach a
broad audience most explicitly. Why does what you’re saying
matter? What do you hope readers walk away with? How should
your readers think about the world differently as a result of your
paper?
I have already added these two myself because you didn't write
them, but they account for 60% of the importance of this
assignment. These two questions must go through.
七。The bold black part was added and rewritten by me. If there
is a syntax error, please modify it, but do not delete it, because
I added about four parts, all of which must be written in the job
requirements, but you didn't write. The parts are underlined
must be deleted. Then I wrote the grammar and the underlined
grammar problem. My classmates couldn’t understand the
content. They said many grammar errors in this essay. Express
the meaning of Chinese in English. After that, I couldn’t read
every paragraph. I couldn’t draw any mistakes later because
there are too many mistakes.

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