Abortion

Abortion is the process of terminating a pregnancy whereby the fetus is removed so that it cannot survive outside the uterus. I strongly disagree with abortion because first, it is against my religious beliefs and again it promotes having unprotected sex, and lastly it is an act of murder. The fact that a person knows that even if they get pregnant they will easily terminate it makes them act carelessly in their intimate relationships. Unsafe abortion is a major cause of death making it a very risky procedure. It leads to psychological torture due to some of the experiences women go through. I believe that the fetus is human and has the right to live and through abortion, it gets terminated, denying it the human right to life. I believe that abortion should be highly unacceptable and should be legally banned.

Abortion is one of the safest procedures in medicine when it is done correctly. Safe abortion reduces maternal deaths and also reduces single parenthood. It allows young women to accomplish their objectives and be ready to start a family. In cases where a woman’s health is at risk, or in a rape case, abortion should be considered as a health measure. Abortion should be accessible to women since it is their right to make their own decisions concerning their bodies and what they want at a particular time. Abortions are a result of unintended pregnancy and therefore helps to avoid situations such as raising a child in poverty and denying them a good life. Whether to or not to have an abortion should be left to the woman to decide because it is her choice to decide if she should carry a pregnancy to full term or not.

DRAWING INFERENCES ABOUT POPULATION MEANS AND PROPORTIONS

Introduction

Various applied researchers have used chi-squarestatistic for more than a hundred years. For example, a researcher might conduct a test to determine the effectiveness of cholesterol treatment. The researcher maywant to know whether there is evidence that the treatment is effective. This paper addresses how the researcher can use chi-square results to make valid conclusions. The following five approaches have been used: giving out the procedures for testing hypothesis, formulating the null and alternate hypothesis, determining the test statistic to be used, calculating the p-value, and determining whether to reject or accept the null hypothesis.

Question

A researcher conducts a test on the effectiveness of a cholesterol treatment on 114 total subjects. Assuming the tails of distributions are normal distribution, is there evidence that the treatment is effective?

Table 1

1. Procedure for testing hypotheses.

This problem can be solved using the chi-square statistic. Chi-square is a non-parametric test designed to check differences in the groups where the dependent variable is assumed to be a categorical variable (McHugh,2013). Chi-square is assumed to be robust to the distributions of the given data.

Procedure

Step 1: State the null hypothesis

The null hypothesis is a conjecture that is used in data analysis to propose that certain characteristics of a population are similar. This hypothesis helps us to state what happens if the experiment does not make any difference. The null hypothesis is mostly denoted by H0.

Step 2: State the Alternate hypothesis

In this step, outline the alternate hypothesis. The alternate hypothesis is the opposite of the null hypothesis, in other words, it is used to propose that there is a difference. The alternate hypothesis is mostly denoted by HA.

Step 3: Set the alpha ()

The following contingency table can  be constructed from the hypothesis test above

Table 2

It is important to set the alpha before the experiment to avoid Type I Error (Pereira and Leslie, 2009).. In most cases, the value is 0.05. This value establishes a 95% confidence level.

Step 4: Collecting the Dataset

The data can be collected through observational or experimental designs. In this paper, the data was collected using experiments.

Step 5: choose and calculate the test statistic

The test statistic is chosen by identifying the objective of the analysis and the type of data involved. F-statistic is calculated when we have categorical treatment level means. The computed F value is mostly denoted as Fcalculated.

Step 5: Identify the acceptance and rejection region

Most test statistics have a critical value which helps to reject or accept the null hypothesis. The F value is mostly obtained from the tables. It is referred to as F-critical. The figure below shows the acceptance/rejection region, F distribution, and F-critical("1.2 - The 7 Step Process of Statistical Hypothesis Testing | STAT 502", 2020).

Figure 1

Step 7: Conclude on the Null hypothesis

The calculated p-value gives the probability of having a bigger F_calculated than what was observed. If the F_calculated=, then the p-value is said to be equal to alpha(). If the F_calculated values are large than the p-values, we move to the rejection region and the p-value become less than the alpha (). Therefore, the following decision rule will hold:

If the p-value is less than, then we reject the Null hypothesis (H₀) and accept the Alternative hypothesis (H_A).

2. Formulating the null and alternative hypotheses.

H₀: Cholesterol levels and cholesterol treatment are independent.

H_A: Cholesterol levels and cholesterol treatment are not independent.

3. Calculating the Test statistic

Degree of freedom =

The expected frequency for each cell is given by

E₁₁ =  = 33.403

E₁₂ =  = 22.596

E₂₁ =  = 34.596

E₂₂ =  = 23.403

Table 3

Table 4

The test statistic can be computed as follows

4. Calculate the p-value. Show your work.

For the Chi-square distribution, the critical value can be found in the tale of probabilities.

Degree of freedom =

Alpha = 0.05

The appropriate critical value is 3.841, therefore, the decision rule is as follows: Reject the Null hypothesis if

Using the chi-square distribution table, we get the p-value as 0.0792 with 1 degree of frequency.

5. Discuss whether there is enough evidence to reject the null hypothesis.

In this analysis, we set our alpha to be 0.05. The p-value is more than our set alpha (0.0792 > 0.05) hence we do not reject the null hypothesis. Therefore, we can say that cholesterol level and cholesterol treatment is independent of each other.

References

McHugh, M. L. (2013). The chi-square test of independence. Biochemia medica: Biochemia        medica,             23(2), 143-149.

Pereira, S. M., & Leslie, G. (2009). Hypothesis testing. Australian Critical Care, 22(4), 187-191.

1.2 - The 7 Step Process of Statistical Hypothesis Testing | STAT 502. (2020). Retrieved 12 June 2020, from https://online.stat.psu.edu/stat502/lesson/1/1.2

Economic Issues in the Healthcare System

Introduction

Health economics is involved with issues that are related to competence, impact, value, and actions in the production and consumption of health and healthcare. Economic issues in the healthcare system are the challenges that the system is facing in terms of finance. It is an issue because while healthcare managers want to offer affordable and quality services, the costs of healthcare are rising rapidly.

The economic issues that are affecting and changing the healthcare system include increased costs, poor or stagnant quality of services, inadequate medical practitioners, insurance covers, information technology, and e-health. Because of how expensive healthcare is, not everyone can afford it. Because of this, the healthcare costs affect both individual finances and the economy of the country Institute of Medicine (2003). Inadequate medical practitioners make accessibility to healthcare difficult because the more available they are the easier they are accessed. When the cost of healthcare rises, employers tend to reduce their costs by reducing the coverage and escalating the load to the employee. These economic issues make it difficult and people are not able to access healthcare.

The Healthcare system in the United States, Germany, and Canada differ when it comes to finances, payment structures, and the role of the government. The United States has the highest GDP per capita and also the highest spending per capita in healthcare followed by Germany and lastly Canada Ridic, Gleason & Ridic (2012). Advanced technology in the United States makes the healthcare system more powerful compared to the rest of the countries. Data shows that the Canadian and German systems are seen to be more effective than the United States due to low costs and more services offered. In both countries, there are no financial obstacles and the health status is higher.

Conclusion

Economic issues in the healthcare system are characterized by the challenges that the system faces while trying to give the best services. These challenges have an impact on people’s finances and the country’s economy. In terms of finances and expenditures, different countries differ in how they spend and get finances. Comparisons between the United States, Canada and Germany has shown that the United States has the highest expenditures in healthcare.

References

Institute of Medicine (US) Committee on the Health Professions Education Summit; Greiner AC,

Knebel E, editors. Health Professions Education: A Bridge to Quality. Washington (DC):

National Academies Press (US); 2003. Chapter 2, Challenges Facing the Health System

and Implications for Educational Reform. Available from:

https://www.ncbi.nlm.nih.gov/books/NBK221522/

Ridic, G., Gleason, S., & Ridic, O. (2012). Comparisons of health care systems in the United

States, Germany and Canada. Materia socio-medica, 24(2), 112–120.

Research Essay

Qualitative research in pandemic times

Introduction

 Covid-19 is a global pandemic that is not only affecting economic, social and health segments but it has also altered how researchers conduct research. The social distancing measures have forced the researchers to re-design their projects and instead of using quantitative research in the form of face-to-face interaction, they are using online qualitative research.  In this time of Covid-19, online qualitative research is widely used to understand what people are saying about the issue. Normally, qualitative research focuses on open-ended communication and face-to-face interaction. The researcher interacts with the individual participants and understands their beliefs and opinions about a problem. The researcher gathers detailed information and precise data and at the end of the research, and uses this information to understand the problem thereby reducing generalizability. Despite the effectiveness of qualitative research, academic researchers are engaging in online forums or rather they are working in an online environment. Even though they are enjoying benefits such as cost reduction, gathering information from a larger group, ad time reduction, online qualitative research is associated with many challenges and limitations. The paper will address the practical issues and discuss how the rule of physical distancing at this pandemic time and the use of online qualitative research will affect qualitative research as we know it. However, there is sufficient evidence that researchers can apply other ways such as document analysis methodology to collect data while considering ethical issues. As a result of the Covid-19 crisis, many things will change including how researchers conduct research. Since it is not possible to postpone data collection, researchers should use digital technology and tools that will improve understanding and also maintain scientific quality.

Traditional qualitative research

As we know it, qualitative research provides a textual description of an issue. The researcher gains a better understanding of the complex issue through people's behavior, opinions, and emotions. The researchers use three different methods such as observation- the research examines people in social settings.  In depth-interviews-the researcher uses methods such as one-on-one engagement with individuals to discuss sensitive topics. Focus-group- a researcher interacts with a group of individuals and interviews them on issues of concern (STACKS 2017, p. 198). The research uses these methods and they are effective in that the researcher interacts with the participants and understands their views about the issues at hand.  The researcher interprets the data gained from interacting with the participants. The importance of qualitative research is that the researcher gains a lived experience from gathering contextual data. (STACKS 2017, p. 198).  The data is not statistically generalizable and therefore the researcher provides an interpretive explanation from the data collected.

 In qualitative research, Austin & Sutton, (2014, p. 436) adds that clinicians use qualitative research since they address issues in social and interpersonal contexts. In these settings, numerical data is not important but clinicians want to know how patients feel about healthcare. Clinicians can interact with patients and ask them questions related to the health care.  Therefore, qualitative research provides a rich description of the information and the clinicians use this information to interpret how patients feel about the provision of care (Austin & Sutton, 2014, p. 437).  For example, in addressing the pandemic crisis or other social issues, the researcher deals with the participants' new experiences and interprets what the participant says to find conclusion. Another important point about qualitative research is that researches who lack skills or confidence can overcome the barrier by working with other more experienced researchers (Austin & Sutton, 2014, p. 440).  The research can also collaborate with members who have qualitative expertise in reading reports. In general, qualitative research helps understand complex issues since the researches pay close attention and create strong relations with the participants. 

Online qualitative research

 Having understood the traditional qualitative research, it is important to note that researchers have shifted to digital where they use online qualitative research. The global pandemic has not only affected the lives of common citizens but it has also affected how researchers do their work. In other words, the researchers have adopted a new operating strategy to collect data and understand human experience. Note that during the Covid-19 crisis, people are practicing social distancing and this means that researchers cannot use traditional qualitative research to understand the public health crisis. They are forced to use other methods to stay informed and make effective decisions. Unlike traditional qualitative research, today, researches are taking advantage of technological improvements to gathering data. Online research is providing strong engagement, simplified reporting, rich learning, and other benefits (E.O & Chee 2006, p. 267).  Since face-to-face interaction is halted, researchers are using online interviews using computer-mediated communications. Thanks to the communication technologies for enabling researchers to observe participants and collect data.

 If the rule of physical distancing remains in the place, it means that researchers will leave the traditional research and focus on online research.  In other words, researchers will stop making sense of the world and use the internet.  Note that in the traditional qualitative study, researchers use personal experience and reasoning. Researchers are interested in the physical world to gain two perspectives. First, they gain an interpretive perspective that focuses on how a person interacts with the world to create meaning (LAPAN et al, 2012, p. 2).  Researchers believe that individuals provide their own perception and they are not influenced by others to explain phenomena. This indicates that in traditional qualitative research, there is a uniqueness and the researcher uses this uniqueness to create meaning and value. Secondly, researchers use a critical perspective in traditional qualitative research. This means that individuals are influenced by the structure of society or society as a whole to say their opinions about an issue (LAPAN et al, 2012, p. 2).  In other words, individuals’   lives are directly connected to society, and therefore whatever they say is contributed by the social structures. Another important point is that researchers in traditional qualitative research adhere to the principle of beneficence or in other words, minimize harm and maximize good while dealing with participants. This means that researchers address topics that will bring benefits to the community. They show respect, competency, and confidentiality.

  In traditional qualitative research, participants have free choices. They also adhere to cultural norms, they understand the purpose of the research, and they establish trust with the researcher. The researcher gives them respect and in turn, they create a responsive and adaptable environment and this makes it possible to gather sufficient information (LAPAN et al, 2012, p. 3). Another important point is that in traditional qualitative research, participants benefit from the research in that the researchers can address complex issues by showing cultural competency. Note that the researcher acts as an agent of change and for this reason, he or she must have the cultural knowledge to address racism, oppression and other issues (LAPAN et al, 2012, p. 2). The last important point is that the traditional qualitative research promises confidentiality. This means that during the research, the information is gathered and stored by the appropriate authority and therefore, participants and researchers will create an ethical research relationship.

The challenges and limitations posed by taking qualitative research online

             The knowledge of traditional qualitative research reveals that the rule of physical distancing and the use of new research methods will abandon the richness of data provided by qualitative research. Despite the advantages of online qualitative research as cost reduction, in-depth data, and gathering data from a large group, there are practical issues that arise from the use of online qualitative research (E.O & Chee 2006, p. 267).  Note that in online research, people use online forums to interact with other participates and researchers. It is true that the online forum is easy to use, and is accessible.  Users create passwords to keep their data confidential and users can use the platform for 6 months to 3 years. However, online forum is associated with various practical issues especially when addressing the global pandemic. At this moment, online qualitative research is associated with the following challenge and limitations;

Credibility issue

 Note that in an online qualitative study, individuals provide a high response about the global pandemic. In the beginning, they show a higher interest in the issue and they are engaged and committed to the discussion (E.O & Chee 2006, p. 270). However, after the 6 months, individuals start to drop out of the online discussion. Another credibility issue occurs as a result of the use of automatic transcripts. Note that in traditional qualitative research, the research creates face-to-face interviews and this helps the researcher understand the participant's emotional status (E.O & Chee 2006, p. 270). However, the automatic transcripts deal with written cures and it is difficult to interpret or to understand the individual facial expression.  Note that in traditional qualitative research, there is sustained involvement, or the researcher and the participants interact in the research setting and gain understanding about the issue. The research conducts peer debriefing, member checks, monitor his or her self-perceptions and use different multiple data.

Dependability issues

  Note that online qualitative researchers’ users of online forums must create user names and passwords. After 6 months, some individuals do not recall the username or password due to cognitive and psychological effects (E.O & Chee 2006, p. 272). For example, in traditional qualitative research, the data gathered is consistent. However, the data gathered through online research is unreliable due to lack of attention, and poor physical and mental performance.  In other words, participates are not consistent and this results in a lack of accurate and complete data.

Confirmability

 As we know about the traditional qualitative study, participants provide evidence and reduce personal bias. The researcher can reach conclusion as a result of gathering data from reliable sources. However, online research means that different participants have different ideas and this makes it difficult to reach an agreement (E.O & Chee 2006, p. 272.). In other words, there is no theoretical saturation due to asynchronous interaction. New information keeps on coming at separate schedules and therefore, there is no real-time participation and this makes it difficult to control the data. Therefore, in addressing global pandemic especially at this moment in time, online qualitative research is not appropriate since the research will not achieve theoretical saturation.

Transferability issue

  If researchers will continue using online qualitative research, then there will be transferability issues. In traditional qualitative research, the researcher can easily compare the results with the results of other samplers and create generalization (E.O & Chee 2006, p. 273).  However, online research produces individualized responses which make it difficult to transfer the results.  Note that participants in the online forum introduce new topics which are irrelevant to the posted topic.  Therefore, it is difficult to achieve external validity and apply the findings to other settings.

Security issues

  There are security and confidentiality issues in online qualitative research.  Information is hacked, and non-participating outsiders can access the site without passwords (E.O & Chee 2006, p. 273).  Note that many individuals spend a considerable amount of time to submit and read reviews and some of the viewers have hacking skills.

Digital methods and document analysis techniques

  The literature shows that online qualitative research is associated with potential concerns. The literature suggests that the researcher can eliminate the barriers and use document analysis to achieve credibility, and eliminate bias. For example, a researcher can use public records. This includes strategic plans, mission statements, and other records. Second, a researcher can use personal documents such as e-mails. Facebook posts, journals, and more. Third, research can use physical evidence such as handbooks, flyers, and more (MERRIAM, 2009, p.140).  Before analyzing the documents, it is important to identify the list of text to analyses, analyze skills for research, and consider ethical issues. It is important to note that document analysis can provide rich information and the researchers can review the information severally. The process of analyzing documents is cost and time effective. Also, methods of qualitative research such as focus-group may omit some data but document analysis will provide critical and comprehensive information. However, it is important to be aware that document analysis may contain limited information, especially when gathering information on the current global pandemic (MERRIAM, 2009, p.140). The information may be incomplete and may contain hidden bias. Therefore, one is required to have investigative skills and search for additional documents to find complete and consistent information.

Conclusion

 Traditional and online qualitative research plays a significant role in providing rich data and complex issues. Researchers use different research methods and the literature was discussing the qualitative research method. The latter entails the use of opinions and motivations of the participants to gain insight into the problem. Researchers gather data from group discussions, observations, and conducting interviews.  However, the global pandemic or the Covid-19 has altered the way researchers do their work. In other words, at this moment in time, researchers are unable to generate non-numerical data from people's attitudes, believes, experiences, and more. Therefore, they have shifted to online qualitative research where they use the internet to conduct the discussion. For example, the group's people use websites to discuss issues. This form of data collection is cost-effective compared to traditional research. However, it is important to note that the high prevalence of Covid-19 cases will force researches to stick to online research to know more about the current issues affecting the world. Yet, the literature finds that online research raises issues around credibility, transferability, confirmability, and dependability.  As the Covid-19 increase, online qualitative research will remain a challenge. However, the literature suggests that researchers can use document analysis techniques to gain different perspectives and methodologies about the issue and gain evidence about the issues. 

References

STACKS, D. W. (2017). Primer of public relations research. Guilford Publications

Austin, Z., & Sutton, J. (2014). Qualitative research: Getting started. The Canadian journal of

hospital pharmacy, 67(6), 436.

Im, E.O. and Chee, W., 2006. An online forum as a qualitative research method: practical

issues. Nursing research, 55(4), p.267.

LAPAN, S. D., QUARTAROLI, M. T., & RIEMER, F. J. (2012). Qualitative research: an introduction to methods and designs. San Francisco, Jossey-Bass. http://www.dawsonera.com/depp/reader/protected/external/AbstractView/S9781118118832.

MERRIAM, S. B. (2009). Qualitative research: a guide to design and implementation. San

Fransisco, John Wiley & Sons.

Discussion post

What strategies could all of us adopt to minimize barriers and misunderstandings for low literacy patients?

 I agree with you that strategies such as the provision of information, effective communication, and structured education can minimize barriers for low literacy patients.  Carlisle et al. (2011) assert that poor health literacy prevents the patients from taking medications properly. However, health care providers and pharmacists need to make health-literacy friendly by communicating more effectively. Effective communication in this case means speaking slower, and avoid the use of medical jargon (Carlisle et al. 2011). In addition to effective communication, health care providers should provide the patients with structured education using tools such as pill cards, a telephone reminder system, and more.  Finally, health care providers should change how they provide information. For example, they should let the patients know about drug labels, use videos, brochures, and other ways of delivering clear information (Carlisle et al. 2011).  These strategies will allow the patients to manage their health and take the medications correctly.

How do language barriers stress health literacy?

 I agree with your idea that language barriers hinder effective health communication.    For example, culture affects health literacy in that patients have their values and beliefs which they use in making decisions (Singleton & Krause, 2009). Also, patients have their own body of words and they use the words to communicate. Patients use both culture and language to interpret healthcare messages and this indicates that if the healthcare provider does not understand the patient's language and culture, the patients will receive negative health outcomes.  In most cases, linguistic differences hinder effective healthcare since the patients and the clinicians do not understand each other (Singleton & Krause, 2009). Lack of proper communication is associated with negative consequences since the patients will not comply with treatment, and the clinicians will not be able to provide information related to risk and certainty.  Therefore, patients may be unable to acquire health literacy due to the failure to understand the language. The latter is contributed by cultural differences. However, the solution to this problem is that clinicians need linguistic and cultural skills for them to provide effective clinical care.

References

Carlisle, A., Jacobson, K. L., Di Francesco, L., & Parker, R. M. (2011). Practical strategies to

improve communication with patients. Pharmacy and Therapeutics, 36(9), 576.

Singleton, K., & Krause, E. (2009). Understanding cultural and linguistic barriers to health

literacy. OJIN: The Online Journal of Issues in Nursing, 14(3), 4.

 Reflection Paper

Introduction

            The experience that one gains in nursing exposes you to different experiences that only end up making you appreciate the profession even more. The first years are full of excitement and anticipation as one tries to imagine all the possibilities that lay ahead in the hope of building what ends up becoming a promising career. Some days are however full of anxiety and you find yourself dreading each shift before it even begins. The lack of experience makes beginners question even the simplest of things like the type of patient one will be assigned. There is also the fear of making a mistake which makes the experience more tasking. As days progress however, the experience helps boost confidence and the hands-on experience acts as a reassurance that the knowledge gained in school and the in-training skills taught are adequate to do a commendable job. It builds the confidence to learn how to not only avoid mistakes, but also accept that they will happen and what actions to take on the rare chance that they do occur. Throughout the experience, the importance of leadership, the importance of evidence-based practice and the best approaches to take in order to offer the best quality of care came out as the important attributes that one should aspire to possess and gain knowledge about.

Reflection on Learning from Nurse’s Answers

            Nursing is one of the few professions where success is determined by the individual, and also the role others play in ensuring tasks are accomplished. When nurses engaged with their colleagues for activities aimed at improving their profession such as study groups, it builds the spirit of teamwork and makes it easier to perform their duties. The study sessions often involve teaming up with other members of the group and discussing topics that are too complex for one person. The topics are divided among the members of the group and each presents the topic to the group, explaining how to go about resolving issues that may have made understanding it difficult. The group can then go over each topic together to ensure that each member understood the topics discussed before moving on to another subject. Team work is beneficial as it makes it easier to understand tasks that may appear complex as it gets people to brainstorm on the best approach to use in order to get the desired results.

            From the response given, the benefits of working as a team extended to the profession of nursing as it enhances the experience on how teamwork operates in a practical setting. When patients seek treatment, they move from the reception and waiting lobbies where they are attended to by various medical staff before finally seeing the doctor. Similar to study groups, hospitals rely on the cooperation among members of staff and different departments to ensure that the patient receives the highest quality of care possible. The experience of working in the study groups have a significant role on how easily nurses find it to work in teams and cooperate well with others.

Insight Gained from Conversation Regarding Leadership, Provision of Care, and/or Evidence-Based Practice

            The experience taught on the importance of how provision of care affects the quality of care offered to patients. Patients use simple gestures like a bed bath to assess the quality of care provided, regardless of whether the treatment worked or not. Although such activities are required of nurses when providing care to my patients, patient are just as pleased with the services and they expect the same quality as the quality of treatment provided. Prescribing medicine and changing IV’s are just as important as how the nurses associate with the patient.

            As a nurse, it is also important to be a responsible leader and set a good example for others. Charge nurses for example take on the responsibility of taking care of all the patients in a unit. They also act as support units as patients often make consultations regarding medication and other requirements before, during and after treatment. Nurses must also learn to anticipate problems before they occur and come up with ways to ensure that the undesirable effects do not have a big or lasting impact. In addition, nursing involves assisting each other to deal with patients that prove challenging or in cases where patients need round the clock supervision.

Analysis of Impact of Nursing History on Professional Practice Today and in the Future

            Reflecting on the events that occurred in nursing history makes it easier to deal with similar occurrences in the present as well as anticipating what could occur in the future. Attempts made to find a cure for covid-19 for instance are focusing on activities engaged in the past when researchers were trying to find a cure for diseases such as the Spanish flu and SARS. Understanding how these diseases were treated in the past could help determine how to treat current and future pandemics.

            On leadership, nurses can emulate leaders that demonstrated exemplary leadership in the past and use them as role models. Nurses can try to follow in the footsteps of other nurses who built a reputation in the past as a way of enhancing their skills. Other than focusing on learning and acquiring knowledge, nurses can also adopt practices and policies used by those in leadership positions to set a foundation from which to build on. Emulating how good leaders operated in the past and present can bring about positive change as nurses in future will have good leaders as role models and create an environment where every practitioner works on improving their leadership and this will positively impact the quality of care provided in future.

Conclusion

The experiences gained through the nursing process are important as they equip nurses with the skills needed to become better at the profession. It teaches the importance of good leadership and how interaction with patients affects their perception of the quality of care provided. Through evidence-based practice, nurses gain the knowledge and experience needed to perform their tasks with ease. Lastly, history on nursing and other medical practices is important as it makes it easier to how medicine has been used to solve medical issues in the past, developments that are happening in the present and how the information can be used to offer better quality of care in the future. my experiences taught me to rely on the information I possess as well as occurrences in the past to better understand my profession and in so doing, I will be better prepared for whatever developments occur in future.

Role Development for Advanced Registered Nurses

 The greatest role of all nursing roles is caring for patients to improve their health and wellbeing.  Nurses follow practice standards and processes to provide quality healthcare. They also have other unique roles such as policy formulation to improve the provision of healthcare. Nurses work together with nursing organizations to address health issues. Professional nursing organizations play a significant role in stating the core values of nursing or in other words, they have a stronger voice in the nursing profession. There are various types of organizations but the three important organizations that interest me are;

The American Nurses Association (ANA)

The purpose of the ANA is to provide a policy statement for the Registered Nurse.  RN, physicians, and other healthcare providers work together to develop plans of care. Thus, the ANA provides practice standards such as the Code of Ethics which the RN should follow to act fairly and professionally (Roux & Halstead, 2018). The organization also states the rights of nurses, provides professional development, participates in nursing-related decisions, provides an ethical work environment, and helps nurses access networking opportunities. 

The National League of Nursing (NLN)

The purpose of the NLN is to provide professional development to nurses in healthcare organizations.  The organization provides membership to individuals such as graduate students, nurses, administrators, and more.  It also provides the membership to school of nursing, and nursing associations that offer nursing education (Thomas et al.2016). The difference between ANA and NLN is that the former only focuses on Registered Nurse whereas the latter focus on nurse educators or all individuals who want to advance in nursing education.

The Emergency Nurses Association (ENA)

 The purpose of the ENA is to state nursing practices during urgent situations such as illnesses and injuries. Thus, the organization works together with the healthcare partners to bring solutions to the healthcare problems in emergency departments.  The organization addresses current and future emergency challenges by creating and implementing innovative strategies. It works together with ANA and other organizations to address external threats. It supports nurses to ensure that they provide quality patient care (Thomas et al.2016). To increase safety, the organization clarifies nursing practices and provides scope and standards, and valuable information.

These organizations play a significant role in personal and professional development.  First, my nursing goals are to offer patient-centered care, gain technical skills, and develop interpersonal skills. These organizations align with my goals and worldview in that they support lifelong learning by providing current practices, current technology, current resources, and opportunities (Thomas et al.2016). The organization will help achieve the above goals since they are at the forefront to provide collective means of achieving my goals. For example, I look forward to providing quality care. The organizations will assist by informing me about the up-to-date resources and information on best practices.  Secondly, I look forward to more opportunities. These organizations such as the ANA will provide network opportunities. Finally, I look forward to gaining technological skills (Thomas et al.2016). These organizations will provide networking opportunities where I will improve my professional network, and gain new clinical skills.

Topic 8 DQ 2

There are several bills in Texas and one of the bills that are being considered is costs and consumer protections. The costs of health care are high and it is contributing to serious effects on families. Patients are suffering from exorbitant medical bills that arise as a result of emergency services, ambulance rides, and more (dallasnews, 2020). The purpose of the new legislation is to protect almost 9 million Texans who are not covered by the new state law. Patient advocates have expressed the complaints and Congress is considering this bill to protect the patients.  I believe the legislation will have a positive impact on my future practice. This is because, as a nurse, I will be able to provide quality care knowing that the patients are free from financial harm. Note that if the legislation is passed or if the law states that patients should not suffer from ambulance bills, out-of-network charges, and other bills, I will provide care while considering the financial state of the patient (dallasnews, 2020).  The legislation will also impact my practice since I will now adhere to ethical obligations strictly. For example, I will ensure that out-of-network providers do not exceed the number of medical bills.  In general, the bill will increase transparency in the nursing career since I must make an informed decision while providing care. The bill will also help in minimizing the cost of healthcare by providing affordable care. 

Note that the big bills contribute to violence in the place of work. There is evidence that in 2015, there was an effort to address workplace violence. The study reported that nurses engaged in violence due to freestanding emergency centers. The bill will positively impact the collective practice of nurses in that they will work in a safe environment and positive working conditions (Brokaw, 2020). Note that if the law controls the freestanding emergency departments, and regulates the medical costs, nurses will create a positive working relationship.

  In future nursing practice, I envision myself participating in policy and politics, and engaging in legislation to improve healthcare delivery. Today, nurses have a little involvement in policy and politics due to factors such as lack of opportunity, limited time and resources, lack of support, and inadequate skills (Brokaw, 2020). Regardless of these obstacles, I envision myself transforming the healthcare system through participating in the creation of HealthCare policy. I will apply my healthcare knowledge and become politically active.  I will also join a professional nursing organization and collaborate with the officials to create policy and address healthcare challenges.

References

 Roux, G. M., & Halstead, J. A. (2018). Issues and trends in nursing: Practice, policy, and

leadership. Jones & Bartlett Learning

 Thomas, T. W., Seifert, P. C., & Joyner, J. C. (2016). Registered nurses leading innovative

changes. OJIN: The Online Journal of Issues in Nursing, 21(3).

  The Dallas Morning News @dallasnews (2020). Texas legislature’s fix to surprise health care

bills still leaves millions vulnerable.  Retrieved from: https://www.dallasnews.com/business/health-care/2019/08/19/texas-legislature-s-fix-to-surprise-health-care-bills-still-leaves-millions-vulnerable/

 Brokaw J. Jennifer. (2020). The nursing profession’s potential impact on policy and politics.

HealthCom Media. Retrieved from: https://www.myamericannurse.com/nursing-professions-potential-impact-policy-politics/

 The Soup Kitchen that Coronavirus Couldn’t Stop

The Soup Kitchen in the Church of Holy Apostles is the largest in the city. It has shown care to the hungry people despite the coronavirus pandemic. This has been their norm for many years and they do it every day and never do they have a holiday. The Soup Kitchen believes that people have to eat no matter the situation and are still serving lunch to hungry people.

The people who help in serving and performing other duties non-epidemic times are often volunteers and most of them are retirees. Currently, the helpers and security are being done by a group of lesser people who include the Soup Kitchen staff and a few volunteers. They observe protective measures such as cleaning their hands regularly, wearing gloves, and practicing “physical distancing” (Frazier 1). The reason they use the term physical instead of social distancing is that what is offered is not just food but are also connecting to people.

           Food donors are still providing the Soup Kitchen with supplies. They also got some leftovers from restaurants that were closing due to the pandemic. The kitchen is still using the leftovers in their menus. It happened too fast that they even received peeled potatoes. Every supply of food they get helps them to feed more people. Because of the loss of jobs, people who go to get food in the Soup Kitchen keep increasing each day (Frazier 1). As a result of this, the economy is getting worse by day and the Soup Kitchen is afraid that donors might stop funding them. “This is a great place”, the staff are happy to serve their guests and would not wish to be anywhere else. They would not want to see their guests fall on the wayside due to a lack of food.

In conclusion, the Soup Kitchen provides hungry people with food even with the existence of the coronavirus. Despite the food, they also feel like it is a way of connecting to people. The food donors provide the soup Kitchen with supplies and this enables them to feed more people. The staff love to serve their guests and call the soup Kitchen a great place.

Works Cited

            Introduction

            The need of assessing change in the quality of care that is provided to children who are at risk for autism spectrum disorders (ASD) take into account the need for improving as well as implementing effective digital screening forms. The quality and the significance of the electronic screening system used to assist in detecting patient screening positives especially those who were not included in the initial research (Bellman et al., 2013). The reason for that is because they require consent to opt-in. the same argument can be based on the fact that those parents who were and are not interested in the development of their child had the possibility of declining study participation

Study design

            The process that was used for the purpose of screening ASD was researched in the academic pediatric primary health care clinic. As a result of that, it was paramount to take into account the significance of incorporating automated risk evaluation.  The assessment quality metrics that were also taken into consideration included the accurateness of the screening results that were obtained from the data collected (Frey et al., 2015). The secondary screening was also to be undertaken as a means of enhancing the results being obtained. The post- and pre-intervention surveys to be conducted were to be based on the data that was to be collected from the participating physicians. Such interventions were to assist at measuring the changes in attitudes value ad feasibility of screening for ASD (Cappe et al., 2011). Chi-square tests and statistical process control charts were employed to evaluate individual changes.

Results

 The electronic medical record that was obtained as a result of screening indicated that there was an increase from 53% to 91% (37% increase, 94% Cl {13%, 63%}). This implied that a suitable action for toddler screening. There was a positive increase from 24% to 83% (59% increase, 94% CI {34%, 84%}). Out of all the physicians that participated in this survey, 89% of them accepted the fact that shifts to digital screening had the propensity of improving their medical evaluation of autism risk.

             On the other hand, the use of the tablet-based digital translation of the modified checklist for autism in toddlers-revised with follow-up (M-CHAT-R/F) resulted in the improvement of the quality and value of care that is provided to toddlers who are at a risk for developing ASD. Furthermore, the data collected during the survey indicated that there was an increase in the acceptability rate of the general screening for ASD. The continued efforts that are dedicated to enhancing as well as fostering the ASD screening process indicated it had the propensity of facilitating early and quick diagnosis of ASD. This is what had the likelihood of advancing the accuracy of examining the general impacts of screening. 

Discussion

            From the M-CHAT-R/F survey conducted, it was found out that there were a positive change and significant gains towards autism screening. The intervention process that was employed incorporated secondary ASD screening in routine care. From the previous studies, it was found out that it had the propensity of improving the accuracy of the risk evaluation for ASD. Most importantly, the gap that existed in the documentation of the positive screens appeared to could have resulted from the scoring errors on the paper forms that were not scored (Oller et al., 2010). As evidence suggests the fact that it was important to utilized automated scoring systems that have the potential of presenting risk evaluation to physicians who participate in busy primary and secondary care clinics.

            Conversely, the continued utilization of the digital format had the propensity of increasing the results of the intervention being conducted. The adaptation and recommendations for the use of modern technology have the likelihood of contributing to a monthly delay in changes in the quality of the metrics.  Therefore, it is logical to say that the automatic scoring and the digital format ultimately have the propensity of assisting the physician to evaluate ASD risks. This becomes possible to incorporate the data collected into medical or referral decisions (Bellman et al., 2013).  On the other hand, the issue regarding the maintenance of a high level of sensitivity whilst minimizing counterfeit positives on the use of the M-CHAR-R/F remains to be problematic.

            Despite that, such errors can be countered using digital screening. In the process of using digital electronic administrations of the follow-up questions, 64% percent of the initial positives were canceled as possible false positives. In this case, the 16 out of the 25 newly recognized positives were comparable with the 67% to 77% of the reported literature. The overall positive rate of the survey was found to be 1.8%. This rate can be justified as being the one that was initially and newly-recognized positives. The same result can be attributed to have the potential of fitting the initial research and prove to be the prevalence of the ASD in at least 1%.

Provisions of modifications

            Different elements of the interventions can also be utilized to expand the adaptation such as an approach. The dependence of risk categories and individual feedbacks that are always presented to physicians in a timely manner and practical manner are some of the factors that have the likelihood of improving its outcome.  The result of this intervention provided that physicians recognize the fact that M-CHAT-R/F highlighted the significance of such an intervention in toddlers (Blenner et al., 2011). It can also be stipulated that physicians often use the follow-up questions after the intervention to progress their clinical notes as compared to the time they use paper ASD screening forms. The use of the digital screening method can only be improved with the wide implementation of not only the digital screening system but with the integration of the HER. The reason for that is because they are anticipated to increase the planned improvements of the prevailing health system (Qian et al., 2012). The results obtained from the responses of the physicians ideally mirrored quantitative and qualitative results. This implies that they accurately judged the effectiveness of their screening practices.

Recommendations for M-CHAT-R/F test-takers

            As much as this digital survey is concerned, one of the ethical considerations that should be taken into account is that parents can end up responding to follow up questions in a different way whenever such questions are presented to them electronically. Because of that, it important for test-takers to understand at least all the underlying behaviors described in such questions. The test-taker should also recognize the fact that it is possible for him or her to receive screen negative responses because parents may not be willing to acknowledge the fact that their child might be at risk of suffering from autism (Cappe et al., 2011). Furthermore, it is paramount for physicians to ensure that they have engaged with parents about their responses. In so doing, it becomes possible to continue to close up questions with all their family members.

 Additionally, even though the physician might obtain screen positive questions, it is paramount for him or her to ensure that he or she has discussed the findings with each parent. Taking that into consideration implies that enough time will be dedicated to enhancing the wellbeing of the child. Considering the improvement of the screening presented using the digital framework, there is the likelihood of decreasing the number of positive results (Charman, 2003). As a result of that, it recommended for physicians to discuss that result with the parent so as to reduce the frequency of clinical visits. This is also evident taking into consideration that reimbursement will also be dependent on the time allocated to obtain such results.  Test takers should also encourage the adaptation of electronic screening so as increase self-assurance in the screen's specificity (Blenner et al., 2011). This is paramount because it will enable physicians to allocate enough time co conducting discussion regarding the significance of positive screen results with parents and/or families of any children who are a higher risk for autism spectrum disorders (ASD). Various health care decision support elements should also be based on the electronic health records (EHR) available so as to assist in promoting the significance of the screening results to be obtained at baseline time.

References

Bellman, M., Byrne, O., & Sege, R. (2013). Developmental assessment of children. BMJ: British Medical Journal, 346(7891), 31-35. Retrieved May 29, 2020, from www.jstor.org/stable/23493933

Blenner, S., Reddy, A., & Augustyn, M. (2011). Diagnosis and management of autism in childhood. BMJ: British Medical Journal, 343(7829), 894-899. Retrieved May 29, 2020, from www.jstor.org/stable/23052223

Cappe, E., Wolff, M., Bobet, R., & Adrien, J. (2011). Quality of life: A key variable to consider in the evaluation of adjustment in parents of children with autism spectrum disorders and in the development of relevant support and assistance programmes. Quality of Life Research, 20(8), 1279-1294. Retrieved May 29, 2020, from www.jstor.org/stable/41488190

Charman, T. (2003). Why Is Joint Attention a Pivotal Skill in Autism? Philosophical Transactions: Biological Sciences, 358(1430), 315-324. Retrieved May 29, 2020, from www.jstor.org/stable/3558144

Frey, A., Small, J., Feil, E., Seeley, J., Walker, H., & Forness, S. (2015). First Step to Success: Applications to Preschoolers at Risk of Developing Autism Spectrum Disorders. Education and Training in Autism and Developmental Disabilities, 50(4), 397-407. Retrieved May 29, 2020, from www.jstor.org/stable/26420349

Oller, D., Niyogi, P., Gray, S., Richards, J., Gilkerson, J., Xu, D., . . . Cutler, E. (2010). Automated vocal analysis of naturalistic recordings from children with autism, language delay, and typical development. Proceedings of the National Academy of Sciences of the United States of America, 107(30), 13354-13359. Retrieved May 29, 2020, from www.jstor.org/stable/25708720

Qian, X., Reichle, J., & Bogenschutz, M. (2012). Chinese Parents' Perceptions of Early Development of Their Children Diagnosed with Autism Spectrum Disorders. Journal of Comparative Family Studies, 43(6), 903-913. Retrieved May 29, 2020, from www.jstor.org/stable/41756276

The client is aged 50 years and is a female with an unknown female history. The patient suffers from hypertension, but the blood pressure is under control presently through her use of lisinopril. She has not smoked for the past three years, with her smoking history being fifteen packs per day. She exercises moderately three to four days per week. This paper will review cholesterol and film mammography screening recommended by the United States Preventive Services Task Force (USPSTF, 2012).

Cholesterol Screening

Cholesterol in the body causes lipid disorders. As a healthcare professional a lipid screening is recommended for this patient. Among women candidates aged 45 years and above and men aged 35 years and above, with an increased risk of coronary heart disease, the USPSTF (2012) strongly recommends the lipid disorder screening and gives it an A grade. The USPSTF recommends lipid screening for men between 20 and 35 years and females aged between 20 and 45, who are vulnerable to coronary heart diseases. The USPSTF (2018) grades the screening grade B for this population. The USPSTF does not recommend for or against the screening for men aged between 20 years and 35 and women aged 20 years and older. It grades the screening of this population grade C (USPTSF, 2018). Grades A and B mean that this screening service can be provided to all adult patients aged above 20 years with the risk of coronary heart disease. Grade C implies that lipid disorder screening should be provided to men and women aged 20 years and older, depending on their health characteristics or the circumstances.

The USPSTF (2012) has established that lipid disorder screening for men aged 35, and above and women aged 45 and above, at increased risk for coronary heart diseases, the benefits substantially outweigh the potential ills. This translates to good-quality evidence. Good-quality evidence means that the evidence of the screening has generated consistent results from representative studies conducted in the population that asses the effects of the test on health outcomes (USPTF, 2018). There is fair-quality evidence for men between 20 and 35 years and women aged between 20 and 45 who are at increased risk for coronary heart disease. Fair-quality evidence means that the evidence is of moderate strength in determining the health outcomes of the screening or evidence that may not be consistent for individuals in past studies (USPTF, 2018). There is poor-quality evidence for the screening for men between 20 and 35 years and women aged 20 years and older. Poor-quality evidence means that the evidence available is insufficient to assess the health outcomes of the lipid disorder test for the participants (USPTF), 2018).

The risk assessment of the patient involves risk factors of coronary heart diseases, including diabetes, family history of cardiovascular diseases, tobacco use, hypertension, and body mass index. Although the patient’s history and body mass index are unknown, the patient has hypertension and has a history of tobacco use. Thus, the information is sufficient to recommend the patient to the lipid disorder screening. Lipid disorder screening has enormous benefits than risks for the patient as she is older than 45 years and has an increased risk of coronary heart diseases from tobacco use. The screening test involves measuring the serum lipid level in fasting or non-fasting samples. A five-year strategic interval screening is appropriate for tests (USPTF, 2012).

Healthline provides information on cholesterol screening. The screening is recommended for persons with a family history of heart diseases, are overweight, alcohol and cigarette use, inactive lifestyles, diabetes, and kidney disorders. The test involved blood analysis. Blood is drawn, preferably early morning after overnight fasting (Healthline, 2020).

The Mayo Clinic describes cholesterol tests as a blood test that measures cholesterol and triglycerides. The data needed from patients include family history, clients weight, lifestyle, history of diabetes, dietary information, and tobacco use, (Mayo Clinic, 2020). The Mayo Clinic (2020) also recommends testing for people aged 45 years and above for men and women aged 55 years and above. Contrary, Healthline (2020) recommends testing for people aged over 35 in men and 45 in females.

Film Mammography Screening

According to the United States Preventive Services Task Force (2012), woman between the ages of 50-74 years old are recommended to receive a film mammogram every two years.  USPSTF (2012) categorized and mammograms for women ages 50-74 as grade B. Grade B is considered moderately valuable and beneficial for client screening (USPSTF, 2018). In the clinical setting providers are recommended to practice using Grade B when providing screening to this particular population. There have been enough sufficient studies to indicate that there is a moderate level of reliability to follow the guidelines for prevention (USPSTF, 2018). Women ages 40-49 are recommended to have mammography performed every couple of years depending on the patient’s situation. This particular age group (40-49) are categorized as Grade C. Grade C means moderate advantages exist and fully support mammogram screen when the individual has other risk factors to consider (USPSTF, 2018). Women 75 and older are recommended not to have mammogram screen done and are considered Grade I (USPSTF, 2012). Grade I does not have supportive evidence nor any benefits to mammography screenings. The American Cancer Society (2020) recommends women not considered high risk receive mammogram annually between the ages 40 to 54 years of age. Women that are 55 years and older are recommended to skip mammograms every other year (American Cancer Society, 2020). Clinical breast exams and self-performed breast exams are not reliable, therefore, not recommended (American Cancer Society, 2020; USPSTF, 2012). The National Breast Cancer Foundation, INC (2019) recommend women 40 years and above receive a mammogram annually or biennial. Women would do not know their family history should have routine mammograms performed as soon as possible to allow early detection (National Breast Cancer Foundation, INC, 2019). Breast Cancer.org (2020) suggests women age 40 and not at high risk older have annual mammograms along with performing self-breast exams. USPSTF (2018) rate self-breast exams as a Grade D. Grade D is considered to be lacking benefits and harm may result from this category (USPSTF, 2018).  Magnetic Resonance Imaging (MRI) or ultrasound is recommended for highly suspected cases of breast cancer (Breast Cancer.org, 2020). USPSTF (2012) MRI, digital mammography, and clinical breast exams are considered grade I and qualify as inadequate evidence without any benefits to support the need for these tests to be performed (USPSTF, 2012; USPSTF, 2018). For instance, MRI have shown false positives and are more expensive in price (USPSTF, 2012).

Lung Cancer Screening (low-dose computed tomography)

 Women smokers are more likely to develop lung cancer and therefore, early detection is recommended to diagnose lung cancer and reduce mortality. Low-dose CT scan is the method used to screen lung cancer and the screening is associated with benefits such as reducing mortality and morbidity, increase awareness, and reduce anxiety (Huang et al. 2019).  Organizations that fight cancer state that screening should be done in settings that patients can receive comprehensive care. Patients aged 55-74 who have a history of smoking should discuss with the clinicians (Huang et al. 2019). The purpose of discussion before screening is to share the potential benefits and risks that may occur due to lung cancer screening.  The eligibility criteria include; cigarette smokers aged 55-74, 30 pack-year smoker, and 15 years of quitting (Huang et al. 2019).  However, it is recommended that further eligibility criteria should be added so that a higher population can be screened. For example, other risk factors include age and sex.  The purpose of lung cancer screening is not to diagnose but also to provide patients with chemoprevention strategies.  

Cervical cancer screening

 Tobacco-related mortality among women aged 50-70 years is high. Recent research and studies have found that smoking contributes to 11% cancer cases (Mansour et al. 2019). This indicates that smoking is a risk factor for hrHPV and also smoking has a chemical that hinders the cervical cells from fighting the infection and increases the multiplication of abnormal cervical cells. There is evidence that cancer screening supports smoking cessation and eventually improve health outcomes (Mansour et al. 2019). The relation between cervical screening and smoking cessation is that after the cervical screening, clinicians provide patients with smoking cessation advice. The patients gain knowledge about smoking and motivate them to attend the future screening.

Critique

 Lung cancer and cervical cancer screening are used to detect cancer to improve survival rates.  From the case study, the patients need different cancer screenings since smoking contributes to diseases including lung cancer and cervical cancer (Huang et al. 2019). Thus, both screening play are a similar role of identify illnesses that might have been occurred as a result of smoking. For example, women who are smokers are exposed to tobacco by-products that damages the cervix cells and lead to cervical cancer (Mansour et al. 2019). The chemicals also weaken the immune system and the body is unable to fight the infections. Similarly, smoking has many chemicals that cause lung cancer. Thus, both screening is recommended to find out if smoking has contributed to these illnesses. However, the screening differs in terms of eligibility and therefore it is important to understand the screening practices.  For example, lung cancer screening is recommended for heavy smokers whereas cervical cancer screening is recommended for young women who have started smoking.

Conclusion

 Female smokers suffer from different significant risks. Smoking is associated with high cholesterol which then increases the risk of a heart attack.  Smoking affects lung function due to airway obstruction. Tobacco smoking also associated with breast cancer and lung cancer.  On breast cancer, female smokers are exposed to tobacco carcinogens and other chemicals that affect the mammary tissue and induce breast tumors.  All these risk factors cause mortality in smokers and it is recommended to assess several cancer types in accordance with USPSTF.  Note that research and studies show that women are more likely to develop various cancers than men and therefore, screening should be done to find evidence of harm. Female smokers have a risk of developing respiratory issues, cardiovascular issues, and cancer. Female smokers who have a long history will benefit from screening and save their life.

Reference

Huang, K. L., Wang, S. Y., Lu, W. C., Chang, Y. H., Su, J., & Lu, Y. T. (2019). Effects of low-

dose computed tomography on lung cancer screening: a systematic review, meta-analysis,

and trial sequential analysis. BMC pulmonary medicine, 19(1), 1

Mansour, M. B., Crone, M. R., van Weert, H. C., Chavannes, N. H., & van Asselt, K. M. (2019).

Smoking cessation advice after cervical screening: a qualitative interview study of

acceptability in Dutch primary care. Br J Gen Pract, 69(678), e15-e23.

Health Insurance and the Labor Market

Introduction

Health insurance is an insurance cover that is meant to take care of and cover a person’s cost of medical care. The labor market is the supply and demand for labor whereby employees give the supply and the employers give the demand. Labor markets operate through the interaction of employers and employees. In the labor market, the ones employing staff are the buyers and those been employed are the sellers.

Adverse selection refers to any situation whereby one party in the contract holds information pertinent to the contract that the correlating party does not have. This asymmetrical information causes the party that does not have the pertinent information to make decisions that cause it to have adverse effects. (Siegelman 2004). Asymmetric information is perceived as a hindering factor for the effective functioning of the insurance markets. Community rating is the way of putting restrictions on the capability of insures to differ their premiums by the riskiness of their insurance. In this system, an insurer is supposed to charge an equal fee to all the individuals in a given community despite the risks standards such as age or gender among others.

           An increased wage in the labor market leads to a decline in the amount of labor whereas a decreased wage leads to an incline in the amount of labor that is demanded. An increased price for labor leads to an inclined amount in the supply of labor while a lower price leads to a low amount of supply.

Increased healthcare costs impact employment on the employer's side whereby employer-paid premiums are a cost of the business just like wages. (Cutler & Sood 2010). Employers employ and pay workers depending on their productivity and in many cases, a healthy employee will be more productive than an unhealthy one. An employee’s health status will influence their decisions to seek full-time employment, part-time, or not be employed at all. All these affect the employee’s compensation which is mainly in the form of health insurance. When the growth of health insurance premiums are reduced, employers can employ more workers and when the cost reduces, there is an impact on higher wages and salaries

Conclusion

The health insurance and the labor market have a great impact in helping to make decisions regarding the hiring of employees and determining wages and salaries. For healthcare workers, the increase in insurance premiums leads to a decrease in wages and vice versa. It influences a worker's decision to be employed fulltime, part-time, or not be employed.

References

Cutler S. & Sood N (2010) New Jobs through Better Health Care. Retrieved from

http://web.archive.org/web/20140420133310/http://www.americanprogress.org/issues/20

10/01/pdf/health_care_jobs.pdf

Siegelman P. (2004) Adverse Selection in Insurance Markets: An Exaggerated Threat. Retrieved

from https://digitalcommons.law.yale.edu/cgi/viewcontent.cgiarticle=4904&context=ylj