RIVER COMMUNITY HOSPITAL

Section 1

In order to assess hospital financial performance, financial ratios and the statement of cash flows will be considered. To begin with, profitability ratios assist in assessing the ability of the hospital to generate revenue as compared to the expenses incurred and other associated costs it incurred during each year. With these ratios, in case the value obtained is relatively higher than the previous period indicates that the organization is doing well. On the other hand, if the value of the ratios obtained are low, it implies that the hospital have been incurring more expenses (Nikolai et al., 2010). Considering the values of the profitability ratios obtained, it clearly indicates that the hospital have not managed to do well by keeping track of the amount that is spent in handling its day-to-day health care activities. This is because the numbers have been decreasing considerably since the year 2011.

The liquidity ratio is the basically the computations used in measuring the ability of the hospital in settling out its short-term debts when they fall due. Conversely, these ratios assist in determining the how many times the hospital covered its short-term obligations using liquid assets and cash. In case the value obtained is greater than 1, it suggests that the current or short-term obligations of the hospital are managed as required. Basically, a higher liquidity ratio shows that the hospital has higher profit margins of safety that it possess to meet the current liabilities. In other words, higher liquidity ratio shows that the hospital is in a good financial base hence it is less likely to fail or fall into financial constraints (Baker & Powell, 2005). For example, all the current ratios of the hospital for the three years are more than 1. Despite that, it has been declining slightly since 2011. This suggests that the hospital have not been effectively meeting its short-term obligations.

Debt management ratios assist in measuring the manner in which the hospital has been using its financial leverage as well as its capacity of avoiding monetary distress in the long-run. In other words, it is the mechanism of measuring how the operations of the hospital have been coming from debt unlike from other sources, such as stock and funds (Baker & Powell, 2005). This implies that it is one of the measures amongst many of the risks as well as the likelihood of the hospital to default. Considering the debt to equity values obtained from 20111 to 2013, it is clear that the hospital had tried to manage its financial distress although not that effectively.

Asset management ratios offer a means for measuring the success of the hospital in measuring its assets so as to enhance an effective provision of healthcare services. In other words, they offer a clear picture of the success of the credit policy of the hospital as well as the manner in which it manages its inventory. By considering the values of the total asset turnover and fixed asset turnover, it is a clear indication that all the values are less than 1. This implies that the management authority of this hospital had not managed to utilize fixed assets so as to generate revenue (Brigham & Ehrhardt, 2008).

Therefore, the general analysis of all the asset management ratios suggests that have not been in the position of translating its assets into providing effective health care services. The reason for desiring high asset turnover ratios is because it offers an insight of the strategies used by the hospital in generating revenues from the healthcare services it offers to patients.

On the other hand, the values of the net revenue indicates that the hospital have been encountering more expenses in financing its day-to-day health care provision activities as compared to the revenues generated. Conversely, the values of total assets and total liabilities of the hospital ($ 45.738 in 2011, $ 52.964 in 2012, and $ 54.275 in 2013) have somehow remained at bar for the three years although they have not increased significantly. Lastly, the value obtained from the ending cash and investment indicates that it had decreased significantly from $5.069 in 2012 to $2.795 in 2013, a percentage decrease of 44.861%. Thus, the general indication of these values is that the management authority of the hospital had to had the capacity of improving its performance as far as the provision of health care services is concerned (Fridson & Alvarez, 2002).

The graph below can be used to summarize the performance of the hospital from 2011 to 2013

                        Y-axis

                           100

                              80

                             60

                             40

                             20

                                                                                                                        X-axis

                                                 2011               2012                2013

Section 2

Analyze current practices in health care reimbursement

As far as the health care reimbursement is concerned, the modern system is complex framework used to obtain payment and services. It should be noted that the rules governing the modern healthcare reimbursement system also keeps on changing frequently. The government payers equally changes in daily basis. Although the healthcare payers have several healthcare reimbursement strategies, they carry out various contracts with health systems and individual practices. These contracts are negotiated periodically (Buchanan & Minor, 2001).

In addition to that, payers are offered a maximum allowed payment for individual CPT code. This is the initial point that assists in determining the amount to be paid. Next, the payer is allowed to adjust the maximum allowed payments using the ‘claim edits’. The importance of the ‘claims edits’ is that it enables the payers to disqualify payment/s for some services provided as well as the ‘payment rules’ for reducing payments for certain services provided. 

Moreover, the establishment of large health care systems as well as the continuation with the private insurance coverage by self-funded workers is also another practice which is affecting the modern healthcare reimbursement system.  These changes have been happening rapidly throughout all the healthcare stakeholders (Buchanan & Minor, 2001).

2. Using current literature, describe health care reimbursement models, including capitation, fee for service, aggregated caps, and consumer self-pay.

Capitation – in using this healthcare payment model, the per member per month (PMPM) is used to assign all patients based on their lifestyle, sex, race, age, and so on. The rate of payment is purely dependent on the projected usage regardless of whether or not the patient visits will be more or less. As compared to the bundled payment models, the truth is that the healthcare professionals have an incentive of helping patients to avoid costly tests and procedures. The objective behind this is to enable them to maximize their reimbursement. This implies that specified services are the ones which are paid for on the basis of capitation (Langenbrunner et al., 2009).

Fee-for-Service – considering the conventional healthcare payment models, the modern fee-for-service systems requires payers or patients to compensate the healthcare provider for the services offered to him or her. In this situation, there exists no incentive to hospitalization, prevent formulate and implement preventive healthcare strategies or to guarantee a person to take some cost-saving measures (NOT, A. V. A. I. L. A. B. L. E, 2017).

Aggregated caps _ this refers to the amount which is set by the Centers for Medicare and Medicaid Services (CMS) each year to assist in figuring, in aggregate, the maximum amount which the hospital will be compensated for the Medicare hospice services. Moreover, this model assists in limiting the total aggregate payments any hospital can get each year (Langenbrunner et al., 2009).

Consumer self-pay _within this model, when a patient or patients cannot manage to pay for the healthcare services they receive, the days of the account receivable (AR) of the hospital goes up, revenue shortfalls, bad debts escalate, and cash inflow slows down. The general impacts of self-pay are one of the burdening issues that hospitals do struggle with so as to reduce costs as well as increase revenue in return. This model suggests that coming efforts for collecting past due medical debts have the potential of limiting resources being wasted (NOT, A. V. A. I. L. A. B. L. E, 2017).

3. Assess one specific current initiative related to the role of government in reimbursement structures

Regulator _ the federal government has the main duty of shaping the various aspects of the modern health care sector.  Recent literatures suggest that there is a wider variability in terms of the quality of services by the health care institutions. Similarly, the majority of the health care services offered to patients are have been perceived to be effective but the only issue is that the benefits are not overwhelming as they should be (Nathanson, 2005). This is also what makes resources to be used unnecessarily. A certain proportion of patients also receive improved health care which is consistent with the best practices of the hospital. Therefore, efforts to foster the continued improvement of such services are what make the government to step in as the regulator of the reimbursement structures.

Additionally, it is through acting as the regulator that makes it possible for the federal government to establish minimal health care standards. It is because of these effective regulatory requirements which make it easier for the government to offer protection to beneficiaries from impaired, incompetent, and inadequately trained physicians. Conversely, as a regulator, the government protects patients from health care institutions which lacks the necessary processes and capabilities of offering standard health care services.  Despite the fact that the regulatory floors can at times be raised, thus lessening the distribution of health care services by quality, the aim of the regulatory approaches established by the government entails culling standard providers that is to shorten the left tail of such a distribution. In this case, it evident that the governments have set its regulatory requirements at all levels so as to satisfy the needs of all health care providers. Lastly, acting as the regulator of the hospice reimbursement structures assist in creating efficient reporting mechanisms of the hospital.

4. Offer a prediction for the future of health care reimbursement, in terms of the government's role in reimbursement structures

As far as government’s role in reimbursement structure is concerned, in the near future, it is expected that the government will make key insurance companies to merge. The idea behind this is to assist in reshaping the health insurance market. The government will also have the potential of encouraging business organizations to serve as the taste cases for any type of government preferred reimbursement model, such as bundle payment (Brown, 1992). This is what will assist in determining the extent of insurance coverage as well as the organization offering it.  Improved health care quality standards will be formulated and implemented for the purpose of making the existing the reimbursement models more effective. 

References

Baker, H. K., & Powell, G. E. (2005). Understanding Financial Management: A Practical Guide. Oxford: Blackwell Pub.

Brown, M. (1992). Health care management: Strategy, structure, and process. Gaithersburg, Md: Aspen Publishers.

Buchanan, R. J., & Minor, J. D. (2001). Legal aspects of health care reimbursement. Washington, DC: BeardBooks.

Fridson, M. S., & Alvarez, F. (2002). Financial statement analysis: A practitioner's guide. New York: John Wiley & Sons.

Langenbrunner, J., Cashin, C., O'Dougherty, S., & World Bank. (2009). Designing and implementing health care provider payment systems: How-to manuals. Washington, D.C: World Bank.

Nathanson, M. D. (2005). Health care providers' government relations handbook: Shaping policy to win. Sudbury, Mass: Jones and Bartlett Publishers.

Nikolai, L. A., Bazley, J. D., & Jones, J. P. (2010). Intermediate accounting. Australia: South-Western/Cengage Learning.

NOT, A. V. A. I. L. A. B. L. E. (2017). ADVANCED PRACTICE NURSING: Essentials of role development. Place of publication not identified: F A DAVIS.

Background / Significance of the Problem

According to recent international studies, it is estimated that there are approximately 322 million people suffer from chronic depression. (WHO, 2017) “Mood disorders, including major depression, dysthymic disorder, and bipolar disorder, are the third most common cause of hospitalization in the U.S. for both youth and adults aged 18–44” (Agency for Healthcare Research and Quality, The Department of Health & Human Services. (2009).

Statistics in 2015 demonstrated that overall 6.7%, equivalent to 16.1 million, of all U.S. adults, had at least one major depressive episode. As of sex women, 8.5% had a higher rate of depression than men, 4.7%. The rate of depression decreased by age from 10.3% among youth aged 18-25 to 4.8% among adults aged 50+ (NIMH, 2017).

District of Columbia stands as number one for the state prevalence of youth with the major depressive episode at 8.69%, in numbers 3000 (Mental Health America, 2016). “In DC, 72 percent of adolescents in Medicaid managed care diagnosed with depression had an unmet need for depression care”(Chandra, Blanchard, and Rudder 2013). “In Prince George’s County, two of every five children ages 6 through 19 experienced one or more mental health risks (such as anxiety, difficulty sleeping, or depression)” (Chandra et al. 2009). “Fairfax County students have depression and suicide contemplation rates higher than the national rates, and suicide is the leading cause of death among youth there” (Partnership for a Healthier Fairfax 2011) “In DC, 60 percent of adults enrolled in Medicaid managed care with a diagnosis of depression have an unmet need for depression care” (Chandra, Blanchard, and Rudder 2013).

There are those times when everyone feels low or sad, yet usually, these feeling fade away soon. In contrast to daily life mood swings, depression,  also called “clinical depression” or a “depressive disorder”- is a mood order where how people feel, think and handle daily activities, such as sleeping, eating, or working is affected by distressing symptoms. There are different types of depression. However, overall, to be diagnosed with depression, the symptoms must be observed almost every day for at least 2 weeks (NIMH, 2015).  Depression does not look same in everyone. It affects different people in different ways. The way women, men, older adults, younger children, older children, and teens experience depression varies notably. The examples can be easily found in almost every setting of daily life from schools to universities, workplaces, even at homes. There are different forms of depression. Some forms may not exhibit great differences or some may develop under unique circumstances. Some of the forms of depression are a Persistent depressive disorder, perinatal depression, psychotic depression, seasonal affective disorder, bipolar disorder. It can be treated by numerous means including medication, psychotherapy, and brain stimulation therapies (NIMH, 2016).

“Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship with a credentialed professional who has completed an approved music therapy program.” (AMTA) In therapeutic relations, music is used as a means to address the physical, emotional, cognitive, and social needs of individuals. In evaluating the qualities and requirements of every client, the qualified music therapist gives the particular treatment including making, singing, moving to, or potentially tuning in to music. Through melodic exposures in the therapeutic setting, clients' capacities are fortified and exchanged to different parts of their lives. Music treatment additionally gives alternatives for communication that can be useful to the individuals who think that it is hard to convey what needs be in words. Research in music therapy underpins its viability in numerous areas, for example, general physical rehabilitation and facilitating development, expanding individuals' motivation to noticeably involve with their treatment, giving emotional support to customers and their families, and giving an outlet to the expression of emotions. (AMTA)

After music therapy gained noteworthy support and interest, new associations emerged in the early 1900s. Even though they were short-lived, in 1998 The American Music Therapy Association (AMTA) was formed as a merger between the National Association for Music Therapy (NAMT) and the American Association for Music Therapy (AAMT) whose purposes were similar but their philosophy, education, and approach varied. Since then AMTA is the intellectual home to students, graduate students, member music therapists and other supporters.

Music therapy has proven to be effective in treating depression (Erkkilä et al., 2011), (Maratos A, Crawford MJ and Procter S., 2011). Some of the major health benefits of music therapy are; it reduces anxiety and physical effects of stress (Kemper &Danhauer, 2005), improves healing (Guzzetta, 1989), can help manage Parkinson’s and Alzheimer’s disease (Raglio et al. 2015), (Aldridge, 1994) reduces depression and other symptoms in the elderly stress (Kemper &Danhauer, 2005), helps reduce symptoms of psychological disorders including schizophrenia (Jeon, Gang, & Oh, 2017).and improves self-expression and communication (Scholer, 2010).

References

Agency for Healthcare Research and Quality, The Department of Health & Human Services. (2009). HCUP Facts and Figures: Statistics on Hospital-based Care in the United States, 2009. Retrieved January 16, 2015, from http://www.hcup-us.ahrq.gov/reports/factsandfigures/2009/pdfs/FF_

The agency for the healthcare research and quality (AHRQ) has the mission of improving the safety, quality, effectiveness, and efficiency of the healthcare for the Americans. In order to fulfill the goal, AHRQ sponsors the healthcare costs and utilization project (HCUP), a healthcare family database and the related software, statistical information, and products to provide information for the policy makers, researchers, public and the system leaders. With the partnership with the state, industry and federal organizations, the agency has developed from the single database to an inpatient hospital care and into the six states, the national level which covers the ambulatory surgery, pediatric encounters, inpatients and the emergency department. Due to this reason, the HCUP has been recognized as the biggest all-player source of the hospital history data in the United States.

The database of HCUP continues to grow since 1988 due to the new information regarding the patient information and other services offered in the hospitals. The inpatient database currently includes 95 percent of the whole of hospitals in the United States. The agency is built in order to understand and provide more help to the challenges which occur in the health care centers in the United States.

American Music Therapy Association.(n.d.). Retrieved from https://www.musictherapy.org/about/history/

The article establishes the idea that music could be the answer to healing the behavior and health have been there since time in history. During the past century, musicians from all communities took their skills both the professional and amateur to the hospital to play music to the fallen soldiers during the First and Second World War. The war heroes were suffering physically, emotionally and mentally and the music was used to heal some wounds which were developed after the war. The change in the people was notable both emotionally and physically and this led to the doctors to order the involvement of the musicians in their hospitals. Soon the hospital's musicians were required to undergo some sort of training before the entry and this led to the growth of demand for the musicians in hospitals.  

Aldridge, D. (1994). Alzheimer's disease: rhythm, timing, and music as therapy. Biomed Pharmacother, 48(7), 275-281.

In this article, the active music-making is regarded as the one method that reduces the activities of failure in a patient suffering from Alzheimer’s. Evidence indicates that the life quality of Alzheimer’s affected people improves significantly with music therapy which is accompanied by the social benefits of the sense of belonging that is obtained through having a communication with other people. The therapy of music when it is based on treatments which are clear in terms of the objectives will reduce the patient’s prescriptions of the tranquilizing medications; the use of the hypnotics is reduced, and the goal of rehabilitation is reduced. Self-expression, mood improvement, the organization of mental status and the speech development are highly influenced by the music. Alzheimer’s disease has seriously reduced and this can be accounted for the music therapy.     

Chandra, Anita, Janice C. Blanchard, and Teague Rudder. 2013."District of Columbia Community Health Needs Assessment." Washington, DC: Rand Corporation

In the article, the District of Columbia healthy communities collaborative (DCHCC) signifies a collaboration that exists among the District of Columbia hospitals and the health centers of qualified federals. In response to the community commitment and the affordable care acts, the DCHCC tasks itself with conducting a community health needs assessment which will guide the decisions about how and where to have resources allocated and implement the most necessary health care systems for populations. The assessment described in this sense is the analysis of the existing demographic, hospital data, health status, emergency discharge data and the hospital. The analysis of the data is run hand by hand with the analysis of the current stakeholder with regards to the health needs and the health policy including the investment priorities. The assessment provides a demonstration of the many issues which were identified previously such as mental health, obesity, sexual health, and asthma. Despite the high rate of insurance, the health care services are never evenly distributed within the ward which creates a high significant challenge in accessing. The services need to be expanded to have improved health care’s systems and effective coordination between the social and health care services to assist in system navigation.  

Chandra, Anita, Carole Roan Gresenz, Janice C. Blanchard, Alison Evans Cuellar, Teague Ruder, Alex Y. Chen, and Emily M. Gillen. 2009. "Health and Health Care Among District of Columbia Youth." Washington, DC: Rand Corporation.

The report indicates the findings obtained from analysis of health care and the health of children within the District of Columbia and has identified the areas which need improvements. This study was practically funded by the medical center for children for improvement of better services offered. The report makes clear objectives to the policy makers within the district and the surrounding local areas including the organizations and individuals who care about the issues related to the health of the youth.

Erkkilä J, Punkanen M, Fachner J, Ala-Ruona E, Pöntiö I, Tervaniemi M, Vanhala M and Gold C. (2011). Individual music therapy for depression: Randomised controlled trial (PDF). British Journal of Psychiatry; 199: 132-139.

In this article, music therapy has been established to be highly effective in the treatment of stress and depression and the involved studies have indicated success in the use of music to treat health issues. The major concern is the determination of the essence of music therapy compared to just care in the treatment of stress and depression in the working class people. The participants were randomized to get the music therapy at a minimum of three months. The clinical measures included anxiety, depression, alexithymia, quality of life and general functions. Results indicate that getting the music therapy and the care indicated success compared to the ones who were receiving the care only. The conclusion is that the level of stress and depression reduced to significant levels after the music therapy making it evident that music does work.    

Guzetta, C. E. (1989). Effects of relaxation and music therapy on patients in a coronary care unit with presumptive acute myocardial infarction. Heart &Lung: the Journal of Critical Care, 18(6), 609-616.

In this article, the essence of music and relaxation is examined on how well they combine in reducing stress in the patients. In this study, at least 80 patients were assigned randomly to relaxation, the control group, or the music therapy. The music therapy and the relaxation groups participated in at least 3 sessions over the 2 days. Stress and depression are evaluated by the heart rates, cardiac complications, peripheral temperatures and the qualitative evaluative data of the patients. According to the data analysis, lowering the apical heart rates and having the peripheral temperature raised, there is more success in terms of relaxation and the music therapy patients compared to the controlled group.      

Jeon, G. S., Gang, M., & Oh, K. (2017). The Effectiveness of the Nanta-Program on psychiatric symptoms, interpersonal relationships, and quality of life in forensic inpatients with Schizophrenia.ArchPsychiatrNurs, 31(1), 93-98.

In this article, the purpose is to have an examination of how effective the Nanta-program is on the psychiatric symptoms, quality of life and interpersonal relationships in the forensics of the inpatients affected with schizophrenia. The method applied is the quasi-experimental method which employs a nonequivalent control group and the pre-posttest design is conducted. The patients were 38 inpatients from South Korea where 18 were the experimental group and the 20 were the controlled group. The experiment was conducted over 12 weeks in just 12 sessions which took 90 min per session. Data analyzed through the t-test. The results indicate that the experimental group had improved in the psychiatric symptoms and some improvements on the interpersonal relationships after the 12 weeks of music therapy. There is no significant change in the quality of life in both experimental groups. This indicates that the program is effective for the improvement of the symptoms and the interpersonal relationships of the schizophrenia victims.      

Kemper, K. J, &Danhauer, S.C. (2005) Music as therapy.South Med J, 98(3), 282-288.

The article is aimed at explaining and describing the expectations which are related to the use of music from the viewpoints of nurses, parents and the physicians. The questionnaires used were given to 836 people who were retrieved from the university hospital. More than half of the people preferred having the recorded music compared to the live music in the research. They all expected that personal preference of the music could be of benefit to the staff, parents, and infants. The parents indicated that the live music is more preferred for the infants while the staff indicated that music of choice is more preferable. This shows a difference in the expectations of the parents and the staff in music choice.  

Maratos A, Crawford MJ and Procter S. (2011). Music therapy for depression: it seems to work, but how? (PDF) British Journal of Psychiatry; 199: 92-93.

In the article, evidence with regards to music therapy is obtained on how it can be used in improving the health of people who suffer from depression. According to a research done in 2004, BBC listeners indicated that the only way to have the reduction of depression is by listening to the song by The Smiths. It is, therefore, appropriate to continue listening to music and reading some articles as a way of relieving some stress. There are challenges involved in having the evaluation of music and this can be evaluated using the complex intervention of music therapy which is associated with the treatment. The attention should be granted on fidelity since it is borne out of the results which do not compare between the therapists. This indicates that the agent of change is not in any case likely to be the personality of the therapist, nature of the patient but the music.   

Mental Health America.(2016). Retrieved from http://www.mentalhealthamerica.net/issues/mental-health-america-prevalence-data

The article highlights the ways in which the government of America promotes the mental health of its citizens. The government advocates for early identification of mental health issues. According to a study carried out across the country, one in five citizens has a mental health illness. Due to rising levels of drug abuse, the mental health of the youth is deteriorating at a faster rate. The government has put up more psychiatric hospitals and centers where people suffering from mental illnesses can get help. However, there is need to increase the mental health care providers in these centers.

National Institute of Mental Health.Major Depression Among Adults. (n.d.).Retrieved  from https://www.nimh.nih.gov/health/statistics/prevalence/major-depression-among-adults.shtml

The article states that most of the adults in the United States who have mental disorders suffer from major depression. A major depressive incidence is a period of two or more weeks in which an individual expresses the loss of interest and a depressed mood that causes problems such as lack of sleep and changes in their normal functioning. It is estimated d that 16. 1 million adults in the USA experienced an episode of major depression in 2015. The national health mental institute carried out a survey regarding major depression across the country. The survey covered household residents who were 18 years and above. However, 30% of the sample population failed to complete the survey. Many of the people who failed to respond to the surveys suffered from major depression.

National Institute of Mental Health.Depression. Retrieved October 2016, from https://www.nimh.nih.gov/health/topics/depression/index.shtml

The article defines depression as a disorder that causes extreme sadness in a person. Depression affects how people carry out their daily activities like eating, sleeping and working. Depression occurs in different forms. Perinatal depression is a form of depression that affects a mother during pregnancy and after giving birth. Perinatal depression is characterized by anxiety and exhaustion that hinders the mother from functioning normally. Dysthymia is a form of depression that lasts for two years or more. People who suffer from dysthymia may extreme episodes of major depression. Seasonal affective disorder affects individuals during the months of winter. The symptoms of depression disappear during summer and spring. Psychotic depression is characterized by delusions and hallucinations. Individuals who have this form of depressions are consumed by poverty, guilt or illness. People who suffer from bipolar disorder sometimes experience low moods and other times they experience irritable moods. Generally, depression is characterized by a feeling of hopelessness, loss of interest in activities, decreased energy, weight changes, suicidal thoughts, low self-esteem, body pains, persistent digestive problems and feeling restless. Depression is mainly caused by physical illnesses, family history of depression, trauma and stress. Depression is treated with therapy and medications. People suffering from extreme depression are given anti-depressants.

 Partnership for a Healthier Fairfax. 2011. Community Health Status Assessment: Community Report. Fairfax, VA

This report focuses on quality of life, risk factors, and the health status of the FairFax community. A subcommittee was formed to collect and compile the data. As one of the most populated counties in the country, FairFax community has many assets and community resources. Generally, the county has a high per capita income and has ethnically diverse residents. However, a section of the population has high unemployment levels, poor health, and low socio-economic status. This difference in the quality of life presents a challenge during provision of services. The ethnic and racial minorities within the FairFax community are at risk of contracting diseases and dying early. The community members, business owners, community-based organizations and the authorities came together to improve the overall health of the county members through various projects such as housing projects.

Raglio, A., Attardo, L., Gontero, G., Rollino, S., Groppo, E., &Granieri, E. (2015).Effects of music and music therapy on mood in neurological patients.World J Psychiatry, 5(1), 68-78.

The article states that depressive disorders have severe effects on people who suffer from epilepsy, stroke and Parkinson’s disease. In clinical practice, these disorders are rarely treated and thus they put the patients at risk of dying due to further cerebral damage. Music therapy has great effects in patients who suffer from neurological disorders. In addition to having an emotional impact on the patients, music encourages socialization. The music listening therapy does not require the presence of a trained therapist. This form of therapy further promotes recovery in neurological patients.

Scholer, M. (2010).Receptive music therapy with persons suffering from a physical handicap.BullSocSci Med Grand DucheLuxemb, 1(1), 193-203.

The article states that music is a therapeutical tool that improves, maintains and restores the emotional, physical, and mental health of individuals. Listening to music intimately to gain pleasure and wellbeing are referred to as receptive music therapy. A study was done on music listening behaviors of physically challenged persons. The statistical results proved that a musical experience yielded positive outcomes in their lives. Personal interviews with the participants showed that receptive music therapy should be adapted in all psychiatric hospitals and centers.

U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Mental Health. (2015). Depression (NIH Publication No. 15-3561). Bethesda, MD: U.S. Government Printing Office.

This booklet focuses on depression, its symptoms, and ways of prevention. Sadness is experienced by everyone. However, extreme sadness causes a depressive disorder. Signs of depression are persistent sadness, increased fatigue, pessimism, difficulty in concentrating and making decisions, oversleeping, insomnia and restlessness. Depression is caused by factors such as brain chemistry, genetics, trauma, a difficult relationship, and other disturbing life events. Diseases such as cancer and diabetes can also lead to depression. There are different types of depression. Persistent depression disorder refers to an extreme sadness that lasts for two or more years. Postpartum depression affects new mother after they give birth. Psychotic depression is characterized by hallucinations and delusions. Major depression severely affects a person’s ability to carry out normal activities. According to research, depression occurs more in women than in men. Teenagers are more likely to suffer from depression compared to children. Older people suffer from depression due to various old age illnesses such as diabetes. Depression is treated with therapy and use of anti-depressants.

 World Health Organization (WHO). (2017). Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: World Health Organization

The article indicates the reliable up-to-date approximation of the proportion of the general population who are affected by the different health conditions or diseases which is a critical inclusion in the planning and evaluation of the health policy. Studies indicate that the psychiatric disorders are now being undertaken through a wide range of the low, middle and high-income parts of the world which have had a contribution to the understanding of how common these kinds of disorders are in the world. The proportions of depressions in the year 2015 are approximated to be around 4.5 percent. Depression is identified to be more prevalent to females with 5 percent and males 3.5 percent.

Varying by the age, the older adulthood is approximated to be at 7.5 percent amongst the females who are aged 55 years to 74 years and at 5.5 percent for the males. Depressions can also occur among the adolescents and children who are below 15 years but who have a lower level than the older age groups. More than 320 people are affected by depression in the world today. More than half of the number thrives in south-east Asia and the western Pacific which reflects a high number of the regions. The number has drastically improved with at least 18 percent from 2005 to 2015.      

Long-Term Care Program

People of any particular age group might require the long-term care services during their lives but the neediest persons in the society are the aged and the aging populations. The long-term care services may include the medical care and living accommodations which are to be provided by the skilled team from the health care who may have proficient languages in addressing the common issues affecting the elderly (O'Shaughnessy, 2014). If a person in the community has some difficulties in addressing the daily routines, then this indicates that the time to have professional long-term assistance has arrived and it is the best option for the society.

Currently, there are many types of the long-term care services at our disposal in order to provide the best kind of assistance for the aging population in the community. Most of the services are formulated in a way that the user maintains a high level of independence as possible while still receiving the daily tasks such as grooming, bathing, preparing meals, dressing or even eating. Some of the common types include: assisted care living facility which is a residential care kind of setting that combines support services, health care, and housing. Finally, a continuing retirement care community which is a care setting with independent living, skilled nursing and assisted living on the site.

The already available kind of long-term care services in the community is the home care services where most of the community members are well aware that the aged need to be taken care of in their homes. This is a good step since it indicates the possibility of embracing more services from outside the community. Outside the community, there are the nursing services which can help the population in dealing with the issues affecting the continuity of life (O'Shaughnessy, 2014). The nursing care will have some professional help and most of the community members might be trained for the same.

The source of information for the services and the program for the population in the community is the health insurance group. The group has the capacity to identify and provide accurate information with regards to the program and the services to be offered for the sake of the population long-term care. This will also enable the community to be well aware of the improvements and developed way of dealing with long-term care program.  The information obtained will be used in developing new and well-equipped strategies for making sure that the program is successful in the community.   

The program will provide the information to the potential clients through certain programs that will enable the community and any interested party to gain information with regards to the program. Such programs include having free education to the community which will be unbiased and very confidential. The skilled persons are trained in such a way that they can be able to assist the population in choosing the correct program or services to enroll in including the drugs, and health care plans. Filing of the program claims and other insurance requirements will be provided by the long-term care service professionals.  

There are many ways of passing vital information to the community. Some of the ways include education, qualitative, mixed and quantitative methods. Using education, the community will be well aware of the issues affecting the community and the available ways of dealing with the issue. Most of the community members know how to read and write and this indicates that teaching them on vital issues will not be a big problem. Using the quantitative method, the program will have to engage and conduct a survey on how many people understand, can get involved and the possible outcome of the survey after delivery of the information. The qualitative method can also be used to pass the information to the community. Considering the immediate response of the information provided can help stir up the passing of information from one person to the other (O'Shaughnessy, 2014). The mixed method involves the engagement with the community members since they are from different language groups which can be hard to define the best method to pass the information. One of the best methods will be the use of notifications to the populations through the communication devices such as mobile phones and other devices since most of the community members own one or two.

Community programs available for the long-term care services include the nutritional programs. This is a program that is directed to ensure that the community members take the best nutritional care for the elderly and other needy individuals. This will assist in reducing the chronic diseases which might affect the population. Adult health care day is another program that is used by the community in ensuring that the members stay safe and away from serious conditions (Rubin & Babbie, 2016). This is a program which provides health care services to the adults and other older persons who suffer from cognitive, mental conditions or chronic medical disabilities and who are at the risk of requiring medical assistance.

Prevention of diseases and healthcare promotion is one of the social programs for the long-term care. The chronic conditions and diseases such as stroke, diabetes, cancer, arthritis, heart diseases and obesity are some of the common problems which are preventable. Many of the aged members of the community can suffer from the above conditions since they are limited on how they can start the programs. The program seeks to prevent and reduce any risks of chronic conditions in the population involved in teaching strategies and techniques which can manage and delay these problems (Rubin & Babbie, 2016).

Legal assistance is one of the most beneficial educational programs for the long-term care programs. There are legal services that are available for the population through the program which will help the population learn more on how they can be able to access some of the services in the program which are meant for the population mostly the aged (Espeland et al., 2014). These legal issues can be elder abuse, consumer fraud, pensions, housing, social security, protective programs, nursing homes and the conservatorship. In most cases, these services are never according to the standards since the elderly or the disabled cannot be able to access or fight for their fair share and therefore the program deals with these issues on their behalf.

The educational and social programs are great benefits to the society both in the long term and short term range. The long-term benefits of the program and services are that the community will enjoy numerous benefits from engaging in the activities. The community member will have an increased lifetime since the social programs will lengthen the survival levels of the involve parties. Social programs act as the recreational services for the community meaning that the problems which might affect the members are brought to zero chances. Chronic diseases are also eliminated through educating the society the need for enrolling in the social programs provided by the program.

The federal and state governments are mostly the highest sources of funds for the programs. The first funding for the social services by the federal government was done in the year 1952 for the older adults and this program is part of the social services for the community. Also, the older American act was established and it is currently undertaking the funding for the program. The program is meant to take care of the older and the disabled in the population and this could be a better chance for the society to enjoy such services. The funds support the community and the funds from community organizations support the community-based organizations and services.

Reimbursement, in this case, focuses on the quality and the costs of the long-term care. Evaluating the cost or the repayment levels can be a comparatively simple and straightforward task but when it comes to evaluating the quality, this becomes an issue. The method which can be used is the staffing level method which evaluates the staff and gets close to the accurate cost of the programs (Espeland et al., 2014). The impact of the program could be reduced chances of having more programs which can undertake the social requirements and instead combine all services into one offer and use it to take care of the society. Having low staffing means that the quality of services offered will also below for the populations. For example, the home care services will have an impact since most of the services will now be undertaken by the homeowners. The community will have to join in and take care of its members as it is required. Assisted care services will, however, be less of an option since the needy population cannot line up for the same services which are offered by few professionals. Many will lose hope even before the program stabilizes.

The certification and licensure board has the responsibility of licensing the long-term services facilities and also certifying that the facilities are according to the required standards and measures. These requirements include the name, address, city, state, county, telephone number, number of beds, number of residential facilities and the specific details of the professional levels of its participants and staff. These details will ensure that the facility runs according to the standards and is legally recognized by the government of the day (Cherry & Jacob, 2016).

Current trends include having an increase in the number of needy and elderly residents. It is estimated that by the year 2030, the number of people in America who will be above the age of 65 will double and this will increase the demand for the residents of aging populations. New technology being embraced in the long-term care programs in many cities (Cherry & Jacob, 2016). This technology is beneficial in ensuring that there is a hiring of people who have the talent and capacities to provide care for the populations. The program fits into this trends since there will be a lot of engaging the trends to see to it that it is a success. Through acknowledging talents in the population, the trends will be embraced within the program.

Through the community program, the population has gained a lot from making simple steps such as cooking individually to moving up and about. The program has been a success since the recreational services such as jogging and other social services have helped reduce the risks of many diseases. The health standards for the community have also been improved by the program.         

References

Balk, E. M., Earley, A., Raman, G., Avendano, E. A., Pittas, A. G., & Remington, P. L. (2015). Combined Diet and Physical Activity Promotion Programs to Prevent Type 2 Diabetes Among Persons at Increased Risk: A Systematic Review for the Community Preventive Services Task ForceCombined Diet and Physical Activity Promotion Programs to Prevent Diabetes. Annals of internal medicine, 163(6), 437-451.

Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. Elsevier Health Sciences.

Espeland, M. A., Glick, H. A., Bertoni, A., Brancati, F. L., Bray, G. A., Clark, J. M., ... & Ghazarian, S. (2014). Impact of an intensive lifestyle intervention on use and cost of medical services among overweight and obese adults with type 2 diabetes: the action for health in diabetes. Diabetes Care, 37(9), 2548-2556.

Monette, D. R., Sullivan, T. J., & DeJong, C. R. (2013). Applied social research: A tool for the human services. Cengage Learning.

O'Shaughnessy, C. (2014). National spending for long-term services and supports (LTSS), 2012.

Rubin, A., & Babbie, E. R. (2016). Empowerment series: Research methods for social work. Cengage Learning.

Technology to Improve Outcomes

Patient care in post-hospitalization is problematic and the problem emerges from poor monitoring. Poor monitoring cause ‘ameliorable adverse events’ which are preventable with follow-up care and monitoring (Piette et al, 2016). Some methods which are used for monitoring include hospital-based nurse where clinicians calls patient to enquire the progress. However, this method is not effective as it is costly and call back programmes are not effective. Today, rural health care providers face challenges in follow-up care and monitoring in post-hospitalization.  According to Pitte et al (2016), about 20%-30% patients are readmitted   for the first 30days post-discharge. Rehospitalization is increasing the health cost as the total cost spent in 2004 was $17.4 billion. Patients are readmitted due to adverse outcomes   which are caused by poor self-care regiments. Adverse outcomes are also contributed by lack of clinical monitoring and lack of adequate resources which may help the caregiver avoid rehospitalization (Piette et al, 2016). Due to lack of follow-up and monitoring, patients conditions may get worse either due to drug interaction among other errors that might occur during treatment.  To address these challenges, quality post-discharge care such as effective communication between patients and community providers and constitute of care.

            The new technology available for post-hospitalization is Interactive Voice Reponses (IVR) for increasing communication between patients and clinicians. This technology has marginal cost and all patients regardless of location can access it. The  automated telephony system  play a significant role in  health care  in that  they identifies health issues  from post-discharge  and receives  valid and reliable data. In addition, the technology services various purposes in that clinician offer post-discharge care and diagnoses possible problem through screening (Piette et al, 2016). If clinician finds a ‘screen positive’ patient, follow-up and monitoring are conducted. IVRS is effective as it minimizes the number of rehospitalization and saves time.

             According to Lim et al (2015), post-hospitalization require continuity of quality care to patients.  However, the care transitions are hindered by ineffective inter-organization collaborations. Inadequate continuity increases the risk of rehospitalization and other adverse events. In post-hospitalization, knowledge transfer involves clinicians, patients, community providers and medical professionals. In other words, knowledge is transferred in a complex environment   and the people involved lack existing relationship. In the organizational boundaries, effective community in transferring the knowledge is important in order to improve the patients’ condition (Lim et al, 2015). Lim at al recommends health information technology such as online communication, personal health records and more. Generally, health information technology such as electronic health record (EHR) in post-hospitalization is effective in that patients, health care professionals and community providers increase safety though interaction. Electrical medical records (EMR) are effective for real-time access and flexible database.   Electrical medical records in the ambulatory care provide a flow of information, improve quality and minimize cost. The technology plays a significant role in improving the standardization of care and real-time monitoring (Lim et al, 2015).

Other new technologies to improve post-hospitalization include Mobile Health (mHealth).  This is a mobile telecommunication technology in health care system.  The National Institute of Health Consensus affirmed that mHealth will improve healthcare given that 91% of   adults in adult can access mobile phones and 61% can afford Smartphone (Arya et al, 2014). MHealth is effective in that in health care, privacy is valued and this tool will allow the patient and health care provider share information. Health support the decision making approach between the patient and care providers. Through patient-provider interaction, patients receive easy-to follow procedures and satisfaction. Patients are also empowered by the accurate medical information and real-time connectivity (Arya et al, 2014). In monitoring patients’ health, healthcare providers should implement this technology in that   the app is cost-effective and paper-based document are eliminated and replaced new by technology and information.

 Patient communication serves an important role in managing and controlling patients’ health.  Even though traditional forms which are used in hospital for communication are effective, technology needs to be implemented in order to achieve effectiveness.  In other words, the traditional methods should enhance using information technology not only to improve quality care but also to avoid readmissions. For example, health IT tools play important role in making decision and self-management (PR, 2017).  Automated tools allow patients and healthcare providers reduce cost, save time and more importantly improve health. PR (2017) asserts that ‘Patient Registry’ is a tool which helps the healthcare provider receives standardized information based on patient’s status after hospitalization.  The tool is effective in monitoring outcomes and improving health care. Patients and heath care provider creates collaborative partnership where they engage in information-sharing (PR, 2017).

Other recommended information management tool is DISEASE MANAGEMENT PROGRAMS – these programs are effective in that patients who suffer from chronic illnesses learn self-care practices   and this reduces cost, rehospitalization and emerging visit (PR, 2017).   For example, patients with chronic illness such as debate need regular healthcare services which also increase health care expenditure. To avoid these effects, disease management programs is an effective approach with aid the patients in managing the chronic condition, avoid complications and hospitalization. Thus, the health care system should implement   this programme in order to help patients who suffer from chronic illness such as asthma, hypertension, diabetes and more (PR, 2017). The role of this program is to educate patients on how to manage their condition by offering them guideline from clinical evidence.

Reference

Arya, M., Kumar, D., Patel, S., Street Jr., R. L., Giordano, T. P., & Viswanath, K. (2014). Mitigating HIV

Health Disparities: The Promise of Mobile Health for a Patient-Initiated Solution. American

Journal Of Public Health, 104(12), 2251-2255. doi:10.2105/AJPH.2014.302120

Lim, S. Y., Jarvenpaa, S. L., & Lanham, H. J. (2015). Barriers to Interorganizational Knowledge Transfer in

Post-Hospital Care Transitions: Review and Directions for Information Systems Research. Journal

Of Management Information Systems, 32(3), 48-74.

doi:10.1080/07421222.2015.1095013

1. (2017, May 30). Innovative Patient Registry to Provide Important Insights into the "Real World"

Management of Metastatic Colorectal Cancer. PR Newswire US.

 Piette D. John., et a. (2016). Improving Post-Hospitalization Transition Outcomes through Accessible

Health Information Technology and Caregiver Support: Protocol for a Randomized Controlled

Trial. US National Library of Medicine National Institutes of Health 5(5): 240.doi:  10.4172/2167-0870.1000240

Alzheimer's disease (AD) Research Proposal

Introduction

Alzheimer’s disease (AD) is accounted to be the most diagnosed causative force of dementia being responsible for over 50 percent of all dementia cases in America and across the globe (Alzheimer Association, 2017). AD is a rather progressive brain disorder that mainly affects intelligence judgment as well as behavior, language difficulty and the loss of memory. Alzheimer falls under the dementia category. Dementia can best be described as a disorder that is acquired from intellectual impairment of substantial severity that affects social or psychological functioning based on the dysfunction of the brain (Turkington & Mitchell, 2010). The dementia of Alzheimer normally incorporates the impairment of memory, cognitive shortfalls, and impaired functioning. Alzheimer affects the aging populace most from 50 years (Alzheimer Association., 2017). The illness is mainly known based on its severe amnesia and further shortfalls in functioning, language, focus and constructional capabilities.

Research Questions

1. What are the general effects of Alzheimer’s illness?
2. What are some of the available treatment options and diagnosis?
3. What is the leading statistics leading the illness in America and close the globe?

Hypothesis

Alzheimer is accounted to be the sixth leading death cause among the aging population in America and mainly affect men and women in close rates.

Specific Aims

The purpose of this report is to establish the general Alzheimer’s effects and demographics in America. In addition, the research will seek to determine the existing treatment options and the acquired outcome.

Background and Literature

Alzheimer’s illness currently affects over 5.5 million older persons in America (Lu & Bludau, 2011). Despite the fact that it is rare cases diagnosed in persons between forty and 60 years it is more common in persons exceeding 65 years that affecting the quality and the extent of their living up to 75 years. With every five years above 65 the occurrence double (Lu & Bludau, 2011). Alzheimer is today the most common drive of institutionalization for the long run care as it destructs the productive life of those that are affected thus frustrating families both psychologically and emotionally. It is highly likely for patients with Alzheimer to experience personality and judgment impairment based on the dysfunction of the major parts of the brain. Alzheimer affects both genders but women are the most affected which is attributed to psychological issues and illnesses such as depression. It is projected that the number of those that are affected with increased up to 16 million by 2050 as for every one minute one individual in America acquires Alzheimer (Lu & Bludau, 2011).

Alzheimer is psychologically and socio-economically expensive (Turkington & Mitchell, 2010). In that, it is not only those that are diagnosed with the disorder that is affected but also their families in general as most of them are forced to leave their occupations to offer care to the victims. This leads to emotional and financial stress as the primary sources of income are blocked. It is accounted that in 2017 Alzheimer and other dementias cost accounted for 295 billion dollars for healthcare services (Alzheimer Association, 2017). The general cost is bound to rise to $1.2 trillion dollars in less than 20 years (Alzheimer Association, 2017). The uninsured persons are the most affected based on the high cost of treatment and the high living expenses due to high need of care. When compared to several chronic illnesses such as heart failure Alzheimer accounts for more deaths (Lu & Bludau, 2011).

Methodology

The study will utilize a mixed methodology following a descriptive design. In that, a qualitative research will be conducted by selecting 50 people affected by the Alzheimer at the moderate stage where the signs are apparent as the sample population. This population will be utilized to establish the general effects of the illness and the effectiveness of the current treatment options. The selection criteria will be to utilize an equal number of men and women above the age of 65 years. Consent forms will be signed by guardians to ensure that the responses are confidential and the participation is voluntary. Data will be acquired through questionnaire filling and interviews.

Conclusion

Alzheimer Disease is accounted to be among the leading death causes among the aging population in America affecting men and women in close related rates. Amidst at least three aged individuals one is bound to die due to Alzheimer's. Based on reports the illness leads to the deterioration of health among those affected thus increasing the vulnerability of the rise of other illnesses such as heart issues and depression. The effects of the illness cannot only be ignored as a common aspect of aging as its effects are beyond aging. Most families are suffering both financially and psychologically due to this illness and the number is bound to rise in the coming years.

References

Alzheimer Association. (2017). 2017 Alzheimer’s disease Facts And Figures. Retrieved from http://www.alz.org/facts/

Lu, L. C., & Bludau, J. (2011). Alzheimer's disease. Santa Barbara, Calif: Greenwood.

Turkington, C., & Mitchell, D. R. (2010). The encyclopedia of Alzheimer's disease. New York: Facts on File.

Consent Form

Dear participant,

My name is…………………. A student at…………… and I am requesting you to participate in a research project about Alzheimer’s disease. We are seeking for you to complete a questionnaire being administered to Alzheimer’s patients. The primary objective of this survey is to gain knowledge in regard to the effects of Alzheimer’s disease and the effectiveness of the current treatment options. The survey will mainly focus on asking questions related to the illness and its effects on victims and family. It is our belief that the data acquired from the study will be useful for individual’s understanding in regard to the illness and the role of the society and policy developers in addressing the issue.

Your response to this survey will be accounted as confidential and no personal data will be linked with the analysis. Complete privacy is guaranteed and the report will only be used for educational purposes. Your participation is deliberate as you may draw your participation in any state without any explanation. The survey will only take 20 minutes.

For further information regarding the study please contact ………………

By signing below you will agree to participate

Signature……………

Date …………….

Literature review

Autism

Autism consists of developmental disorders in form of poor social skills in children and their lack of interest in interacting with people or other activities (Shire et. al 2015).  These children may not have communication abilities which are essential in interaction with other people and in quality life. The lack of communication is complicated by difficulties in showing and perceiving social clues and various emotions (Srinivasan et. al2016). Though the cause of this autism is not clearly defined, it may result from multi-factorial causes including the environment and genetics (Chien et. al 2015).

Social skills and Communication deficits forms a major aspect of Autism Spectrum Disorder and affects a person’s ability to fully participate in the community and more so the school environment (McIntyre et. al 2017). Emerging technologies are used to support educators in developing differentiated content for students with varying abilities (Vincent et. al 2015). The use of classroom based technology such as robots together with other conventional instructional practices can help educators especially of early childhood learners to offer access to various activities that support communication skills development (Sartorato, Przybylowski & Sarko, 2017).

Communication

 The person with this condition may rely on intervention treatment therapies that use various strategies and tools that will stimulate them to interact and hence, communicate with other people (Donehower, 2017).  Studies have shown that it is common for children with autism to perceive different stimuli like different type of sound even though majority of these studies largely focus on communication and social skills (Valadão et. al 2016).  Robots are used in stimulation of development of communication skills like tactile, verbal and imitation sensitivity.  The design of such robots involves various features that are useful in various social therapies since it can convey emotions, form a relationship with a person and even communicate socially (Shick, 2013).  The tool is therefore, a social robotic that teachers can use in classroom to help students with autism. As a social robot can have many positive effects for such students. This is because an autism patient many at times may perform better while interacting with a social robot partner as compared to a human agent. The Autism partners have been shown to have many social behaviors towards a given social robot while interacting with it, whereby during robotic sessions, the patients portray less repetitive and even stereotyped behaviors (Valadão et al. 2016). The social robots are also able to enhance spontaneous language while the autism patient is undergoing therapy sessions.

Romibo social robot

In classroom, the Romibo robot assists in improving the communication ability of autistic children through various ways. The robot has the ability to deliver prompts that are delightful and praise to engage the student, and it has instant play date which is important in modeling the communication process (Shick, 2013). The student is encouraged by the simple appearance and a behavior that is predictable which makes the student to feel safe. The notion of using a robot that is child-size and attractive to the teacher and student is positive since it may motivate the interaction of student with the robot (Santatiwongchai et. al 2016). A social robot also involves a balanced similarity between itself and human, so that it does not appear too human while at the same time, it is not too mechanical like hence making it attractive to the student (Hansbøl, 2015).  The interaction makes it possible for the robot to stimulate a student in a positive way in terms of communication skills since the robot may be used repetitively until the desired results on students is achieved (Donehower, 2017).  The student is also able to engage in more social activities, and such skills can be translated to interaction with his or her peers (Alimisis, 2009). The interaction is even more important in development of verbal communication in students with autism.

One research has shown verbal communication being exhibited by a specific child in the study in an occasional manner according to opinion of a third party involved in the robotic session. In the same study, children with autism are recorded to have responded to the commands of a mediator often, while an observation of non-verbal communication was also made such as pointing fingers, hands and even gestures. This goes a long way to show the effect of interaction between a student and social robot like Romibo on their communication skills. The robot therefore, acts as mediator during the interaction between the child – student- and the educator who is an adult and his peers (Snow, 2015). As an interactive tool, the Romibo robot can move using two wheels and it is light enough to be carried by even a child attending early education (Shick, 2013). With a simplified human-like face, and two computerized screen eyes, the robot can follow hold a gaze of a person and follow their face while blinking to prevent tension due to the stare (Origami Robotics, n.d). This allows for improved interaction that a teacher can use to enhance the language skills and since they have little overwhelming effect on the child, then imitation is easier. This shows the role of robot in enhancing communication skills between autistic students and teachers or peers.

References

Shire, S. Y., Goods, K., Shih, W., Distefano, C., Kaiser, A., Wright, C., ... & Kasari, C. (2015). Parents’ adoption of social communication intervention strategies: Families including children with autism spectrum disorder who are minimally verbal. Journal of autism and developmental disorders, 45(6), 1712-1724.

McIntyre, N. S., Solari, E. J., Grimm, R. P., Lerro, L. E., Gonzales, J. E., & Mundy, P. C. (2017). A comprehensive examination of reading heterogeneity in students with high functioning Autism: Distinct reading profiles and their relation to Autism Symptom Severity. Journal of autism and developmental disorders, 47(4), 1086-1101.

Chien, M. E., Jheng, C. M., Lin, N. M., Tang, H. H., Taele, P., Tseng, W. S., & Chen, M. Y. (2015). iCAN: A tablet-based pedagogical system for improving communication skills of children with autism. International Journal of Human-Computer Studies, 73, 79-90.

Sartorato, F., Przybylowski, L., & Sarko, D. K. (2017). Improving therapeutic outcomes in autism spectrum disorders: Enhancing social communication and sensory processing through the use of interactive robots. Journal Of Psychiatric Research, 901-11. doi:10.1016/j.jpsychires.2017.02.004

Shamsuddin, S., Yussof, H., Ismail, L. I., Mohamed, S., Hanapiah, F. A., & Zahari, N. I. (2012). Humanoid Robot NAO Interacting with Autistic Children of Moderately Impaired Intelligence to Augment Communication Skills. Procedia Engineering, 41(International Symposium on Robotics and Intelligent Sensors 2012 (IRIS 2012), 1533-1538. doi:10.1016/j.proeng.2012.07.346

Shick, A. (2013). Romibo robot project: an open-source effort to develop a low-cost sensory adaptable robot for special needs therapy and education. In ACM SIGGRAPH 2013 Studio Talks (p. 16). ACM.

Srinivasan, S. M., Eigsti, I. M., Gifford, T., & Bhat, A. N. (2016). The effects of embodied rhythm and robotic interventions on the spontaneous and responsive verbal communication skills of children with Autism Spectrum Disorder (ASD): A further outcome of a pilot randomized controlled trial. Research in autism spectrum disorders, 27, 73-87.

Valadão, C. T., Goulart, C., Rivera, H., Caldeira, E., Bastos Filho, T. F., Frizera-Neto, A., & Carelli, R. (2016). Analysis of the use of a robot to improve social skills in children with autism spectrum disorder. Research on Biomedical Engineering, 32(2), 161-175.

Santatiwongchai, S., Kaewkamnerdpong, B., Jutharee, W., & Ounjai, K. (2016). BLISS: Using Robot in Learning Intervention to Promote Social Skills for Autism Therapy. In Proceedings of the international Convention on Rehabilitation Engineering & Assistive Technology (p. 16). Singapore Therapeutic, Assistive & Rehabilitative Technologies (START) Centre.

Hansbøl, M., (2015). Tema 2: Robot technologies, autism and designs for learning. Tidsskriftet Læring og Medier (LOM), 8(14).

Donehower, C. (2017). An Analysis of Robot-Assisted Social-Communication Instruction for Young Children with Autism Spectrum Disorders. Retrieved from: http://etd.fcla.edu/CF/CFE0006736/Donehower_Dissertation_FinalSubmission.pdf

Alimisis, D. (2009). Teacher education on robotics-enhanced constructivist pedagogical methods. School of Pedagogical and Technological Education (ASPETE).

Snow, C. C. (2015). Creativity and the Autistic Student : Supporting Strengths to Develop Skills and Deepen Knowledge. New York: Teachers College Press.

Vincent, J., Taipale, S., Sapio, B., Lugano, G., & Fortunati, L. (2015). Social Robots From a Human Perspective. Cham: Springer.

Origami Robotics, (n.d).Romibo: A socially assistive robot that engages and encourages young learners. Retrieved from: https://www.origamirobotics.com/

Advantages and Disadvantages of One Drug to Treat Gastrointestinal System

 Gastrointestinal

A digestive system is a group of organs which coordinate to break down food into tiny particles which can be easily be converted to energy and primary nutrients. The food passes through an elongated tube known as gastrointestinal tract or alimentary canal. Buccal and sublingual drugs have various advantages. They are quickly absorbed by the capillaries under the tongue without entering into the digestive system. Buccal and sublingual drugs are absorbed directly into the bloodstream. When one has trouble swallowing medication, buccal and sublingual forms of administration can be good alternatives as they do not need swallowing. Also, the drugs are not easily absorbed into the stomach. Therefore, digestion is not affected in any way. On the other hand, sublingual and buccal drugs have disadvantages. Activities such as eating, smoking and drinking can easily change how the drugs are absorbed into the gastrointestinal system and their efficiency. This form of administration is not suitable for drugs that require slow processing into the digestive system. Buccal and sublingual irritate sores in the patient's mouth due to their chemical components which reacts with saliva in the wound (Mignani, El Kazzouli, Bousmina, & Majoral, 2013).

The oral route is the most common ways of administering drugs. It is mostly used for the neutral types of drugs. It may be used in the gastrointestinal system in the forms tablets, capsules, and powders. It is very convenient and cheap. Most people use it because their safety is guaranteed. One of the disadvantages of oral administration is that most of the drug goes to waste as it does not reach the target tissues. A lot of the drugs taken orally are destroyed by acidic gastric juices such as insulin. It cannot be administered during emergencies as it heavily relies on absorption for the drug to take effect. Gastric irritation can be caused by the interaction of the drug with the system and its enzymes. Drugs containing iron may lead to discoloring of teeth (Mignani, El Kazzouli, Bousmina, & Majoral, 2013).

Drugs administered through the rectal route are usually either in solid form or liquid form, for example, the enema is mostly administered through this method. Unconscious or uncooperative people may force this route to be used. The rectal route can easily avoid vomiting and nausea. The drugs cannot be easily destroyed by enzymes, therefore, giving them a chance of reacting entirely and reaching target tissues. If a drug is known to be irritant, this route is the most preferred. Most people do not prefer this way making it unpopular. Another disadvantage is that they are systematic acting drugs which are rare and expensive. These drugs administered through the rectal route have a 50% first pass metabolism which can interfere with the gastrointestinal system (Jannin, Lemagnen, Gerould, Larrouture, & Tuleu, 2014)

References 

Mignani, S., El Kazzouli, S., Bousmina, M., & Majoral, J. P. (2013). Expand classical drug administration ways by emerging routes using dendrimer drug delivery systems: a concise overview. Advanced drug delivery reviews, 65(10), 1316-1330.

Jannin, V., Lemagnen, G., Gerould, P., Larrouture, D., & Tuleu, C. (2014). Rectal route in the 21st century to treat children. Advanced drug delivery reviews, 73, 34-49.

Adding Kangen Water Machines to Hospitals

Abstract

There is the need to ensure that the agents are convinced and independently directed in a way that would guarantee that they exhibit in concurrence with the guidelines, goals, qualities, and mission of the affiliation. The framework required the endured and regarded criticalness of preparing, through contracting, interest, correspondence, and socialization in the ensuring of the privilege and exact game plan of the exercises of the laborers toward accomplishing the targets of the Association (UPMC Pinnacle, 2017). In view of the late advancement in the plan of organization in the firm, there has been the prerequisite for the venture to contract staff and specialists according to the set down approach. This training would be incredibly immense in giving the best organizations to the customers has essentially squashed the undertakings to battle in the business, and this at that point requires the sticking to the basic procedure where these strategies were finished by choosing put individuals in this division of the economy.

The creator has many character qualities that are supplemented by his undertakings and voyages. The basic ones are his leeway, his knowledge or disarray, and his astonishing caution. His shrewdness and politeness help him to make due each and every through hi trips yet his preference, for the most part, harms him. All through the story unmistakably one of the creator' tremendous character qualities is interested. One example of his leverage was the time when he went to the place that is known for the Cyclops. He said that he anticipated that would go see what the Cyclopes took after in light of the way that he didn't know whether they were "wild savages, and raunchy, or all around arranged and god-dreading men. Another case of his leverage was the time when he goes to the place that is known for the Sirens. He incited his men to tie him up so he would not be fascinated by the Sirens' melodies. He said that on the off chance that they would bomb hopelessly, he may need to see what executed them (Babič, Gunde-Cimerman, Vargha, Tischner, Magyar, Veríssimo & Brandão, 2017). From his excited talk, it is to a great degree discernible that consumption and criticalness created the creator. In spite of the way that at long last the writer was bolstered by the celestial creatures, Ino and Athene, the essayist examined the writer' cautious and deliberative character by outlining his measuring every choice on the best way to touch base on an island. His character allowed him to avoid the allurements and greed every through hello voyage. Quick was not only the creator' quality, it was in like manner the typical for the Odyssey, strikingly with the valiant and brave characteristics of The Illiad.

The sudden invigorate blended the creator from his gobbling up life. Through this scene, the skilled worker depicted and advised the social event of observers that blessed individuals are not extraordinary. The creator, disregarding his understanding, in like way had deficiencies. Everyone passed on in the midst of that tempest, alongside the most fortunate of the stunning, the creator, who was in the meantime making due to the fate of his life. The since a long time earlier expected that landing of the creator would Ithaka accomplished. The next day, Telemachos announced his departure and surged home without making any stops (Hemery, Keyes Jr, Garaio, Rodrigo, Garcia, Plazaola & Sandre, 2017). The father and tyke took off back to their home in Ithaka meanwhile. The pinnacle of the story was best in class now the two voyagers, both more experienced than some time as of late, were coming back to a comparative place for a comparative reason. Their diverse outings completed when the creator revealed his identity. The two essential characters met at the pinnacle of the story and figuratively continued with the experience of destroying the suitors together. The created up Telemachos combat with his father to pound each one of the suitors. Telemachus, no longer fragile or ignorant, took after and executed the creator plot against the suitors perfectly. The creator, solid and respected, wiped out the abusing souls off his property.

 Introduction

Kangen water is attained through a process referred to as electrolysis that ionizes water by infusing the acidity and alkaline levels that are relevant to particular needs. The process balances P.H levels in ionized water and makes it ideal for health purposes. Kangen water has drawn some controversy in its use, with a section of health professionals citing that there is no tangible data that can prove the efficacy of the said water in the treatment of illnesses. The reason is that there have been no studies to substantiate the claims of its efficiency and conducted structured follow-ups towards the same (Cerbu, 2013). However, a larger section of health practitioners think otherwise and recommend this water to their patients. In spite of the lack of a wide range of empirical data, it is imperative to note that the health issues that are prevalent today are caused by the acidity and alkaline levels in the human body. Even cancer, which is one of the fatal illnesses of today, is significantly brought forth by acidic conditions in the body. The P.H level affects how the brain works, digestion, and a range of complicated health issues from which individuals today suffer. Hence, the healthcare industry has come to the conclusion that water that is ionized with the appropriate alkaline and acidity conditions could be the long-lasting solution to improving the health of individuals today.

Kangen water can be traced to the Japanese healthcare system in the 1950s. In this period, Japan experiences immense acidic rain that originated from China. The result was that water remained contaminated and thus affected a majority of the populace who developed serious health conditions as a consequent of the high levels of acidity. Hence, health practitioners and scientists alike embarked on the journey towards finding a solution that would restore the health of the people. In the course of many experiments, the experts stumble upon waters that had high alkaline P.H levels in India (Yanagita, 2016). They then realized that this is the answer to the acidity problem in Japan after testing it and discovering its healing components. The practitioners thus returned to Japan and started initiatives to make the water ionized with alkaline conditions. It is important to note that the word “Kangen” denotes to “back to the origin.” The health practitioners thus named their water Kangen because they wanted to return to the origin of water that was not polluted and destroyed by the high levels of acidity from different chemicals that are continually introduced to the natural environment. The process of electrolysis had been in existence for decades, having been introduced by Michael Faraday in the 1880s. Russia performed research and development on the project but Japan is the country that eventually put it on the market. Since then, hospitals in Japan have adopted the technology as a possible solution to numerous health conditions. The Japanese Ministry of Health has been on the front row in affirming the use of Kangen water to treat diseases and promote the health of Japanese people (Ravishankar & Zhu, 2016). More than 100 hospitals in the country have since adopted the use of ionized water, with a projection of much more joining in this endeavor in the next 5 years. However, many hospitals abroad are still quite skeptical about this technology, especially since follow-up data on patients is very limited. Others even argue that the Japanese Ministry of Health has only been responsible for approving the water as a safe option, but has not substantiated claims regarding its efficacy in promoting the health and well-being of patients.

The problem that this proposal will focus on is the presence of acidic imbalances in the body as a possible cause of the many health problems that individuals face today. The proposal presents the acidity problem as one that can potentially be eliminated by the use of ionized or Kangen water (Myers, 2014). However, the obstacle to solving this problem still lies in the lack of trust in this technology that prevents many hospitals from adopting the same. All health professionals are aware of the fact that many processes and cell functioning in the body are dependent on a healthy alkaline environment. Normal water has been linked to enabling the balance of P.H levels, but recent eating habits and the introduction of many chemicals in the human body make this option insufficient. Researchers opine that a high acidity level corrodes the body system and slowly weakens major body organs with time (Cerbu, 2013). Water alone would not suffice in ridding the body of this issues, which thus demands a solution that is long-lasting and can prove to be effective within a short time. Hence, the solution lies in the use of Kangen water that would remedy many health issues that patients have in hospitals. The water can promote healing and restore body cells that have been damaged by too much acidity. Moreover, Kangen water can be used for sterilization and elimination of potential infections if hospitals apply the appropriate acidity levels in the water (Cozad & Jones, 2003). Kangen water machines have the potential of being the answer to diseases, infections, and healing in hospitals if it applied appropriately and embraced as a solution that seeks to restore the cells in the body to their natural form.

According to Babič et al., (2017) Kangen Water machines refers to the devices that are utilized in filtering tap based water and also ionizes it in order to generate alkaline water through the process of electrolysis. The benefits of the ionized water cannot be ignored since they are particularly substantial in regard to health and can be utilized in improving the general life’s quality for patients in hospitals. In other works adding the machines in hospitals within the American setting can help in improving the healthcare system. However, despite the number of benefits such as cost saving and efficiency which are associated with the alkaline water the machines are yet to be adopted in the American hospitals. Since the primary objective of the reformed healthcare system is to enhance life for each and every individual the hospitals should acquire this machines and in turn improve the system and life for Americans. Ionized water has the ability to effectively enhance the life of an individual in a number of ways particularly in reference to health (UPMC Pinnacle, 2017). In essence, alkaline is proposed for distinct patients in need of boosting minerals for recovery.

Gerber, (2015) asserts that in America the healthcare sector is among the industries that are embracing technological innovation in solving issues, creating efficiency, enhancing services quality and decreasing the operating expenses. Currently, the general level of the adopted technology in the healthcare system has been effective in extending life-span and the quality of life for everyone. In that, it is through technology that fresh diagnostic and treatment options have been achieved. However with this growth comes high operating expenses in general an aspect that might be deterring hospitals in American from acquiring Kangen water machines (UPMC Pinnacle, 2017). It is rather surprising that unlike other machines that offer close benefits the machines are affordable and the installation and use are easy and friendly thus, it is easier for the adoption to fit within the set operating budgets.

For countries such as Japan where the Kagen water machines have been adopted at a high rate, they are currently boosting the increased improvement in hospital-based operations that have been achieved (Gerber, 2015). The adoption of the machines demonstrates that the healthcare system in the United States is ready and willing to utilize the helpful and most beneficial technology to enhance the lives of patients and the public in general. By offering ionized water to the patients in hospitals this leads to decreased intervention expenses and efforts. The ionized water serves as the primary supplement for different medical interventions since it is useful in achieving a number of functions simultaneously. The utilization of the water is essential in saving the general expenses for acquiring antioxidating medicines, energy drinks as well as dehydration meds (Gerber, 2015). In addition, the process of processing healthier and cleaner water is conserved.

Some of the benefits of Kangen water might include having several antioxidants which are essential in neutralizing dangerous radicals. In addition, since the water is alkaline this helps in fighting against the development of acidity in the body (Hall, 2017). This leads to better body moisturizing due to increased smaller molecules. With increased support for healthier metabolism, this triggers the capability of the body to heal faster. Kangen water is mainly proposed for individuals lacking adequate energy and tiresomeness, digestive issues, skin problems, chronic illnesses such as diabetes, muscle problems and skin illnesses (Hall, 2017). Medical experience in the Japan healthcare setting has demonstrated that in most cases Kangen water has enhanced the wellness of the patients that have previously failed to respond to different pharmaceutical treatment that includes hypertension, digestive issues, liver impairment, kidney failure, respiratory and metabolism disorder. In addition, it is indicated by studies it has been verified experimentally that Kangen water constrains cancer cells duplication (Hall, 2017).

Some of the benefits that have been recognized in regard to Kangen water are easing chronic diarrhea and vomiting, eases surplus gastric acid, lessens digestive abnormalities and constrains unusual fermentation within the digestive system. This means that by consuming the water the body is expected to respond more positively due to its high level of base which is effective in neutralization of acid in the stomach. For most patients suffering from chronic illnesses are subjected to digestive abnormalities due to the low capability by most organs to respond. If the digestion process is ineffective this leads to the forming of gases in the stomach that creates more infections that can affect life’s quality and treatment responses. In addition, diarrhea can occur due to infectious fermentation and incomplete digestion. Such complication will ultimately lead to the loss of appetite, weight and ultimate death. This is not what the system is centered on since its primary objective is to enhance health wellness. Through the use of alkaline water digestive issues can be reduced and the responsiveness of major organs enhanced such as the kidney which will lead to general wellness. The challenges that comes with chronic illnesses cannot be ignored since the government is forced to spend more in creating a balance amid cost and wellness. More hospitals are adopting Kangen machines for water purification  everyday particularly in Asia as a primary part of the general treatment since this benefits are not only addressing the challenges that comes with chronic illnesses.

Medical Uses of Kangen Water in Hospital Treatment

According to Hall (2017), Kangen water is utilized in the fast reduction of the levels of blood sugar among diabetic patients. One of an essential treatment option in regard to diabetes is based on dietary control. In most cases, however, the treatment on the basis of controlling diets is not adequate nor effective. Changes in dietary might result in lower levels of sugars in the blood gradually, leading to reduced energy and inappropriate responses to infections or treatment. It has however been observed by most hospitals that close to 80 percent of patients suffering from diabetes who have been prescribed and engaged in Kangen water intake demonstrated reduced sugar levels within the first fourteen days of acquiring treatment (Gerber, 2015). This has made it very possible for the reduction of the general level of diabetic treatment prescriptions being administered. In addition, to stabilizing sugar levels the cost of treatment goes down since medical needs are minimized.

Hemery, et al (2017) another use is to increase the therapeutic ability of gangrene which is caused by diabetes. It is only patients that are in the last stage of this illness that might not show the much positive response to alkaline water treatment after several months of use. It is reported that with a month of the water consumption as generated by the machines patients are fully recovered from gangrene particularly those that adhere to the set diet control. In addition Kangen water results in fast normalization of increased uric based acid state for patients with respiratory issues (Hall, 2017). Most hospitals from the developed regions that are utilizing the machines have recorded a decrease and increased uric acid state standardization between two up to four weeks after beginning to consume the Kangen water based on prescription. More so, increased health improvement particularly for patients suffering from liver cirrhosis and hepatitis.  It is believed that Kangen water consumption is highly effective in the treatment of both acute, chronic hepatitis and cirrhosis (Hall, 2017). From a representing case research conducted among male patients over sixty years demonstrated adequate improvement after a month of consuming Kangen water. It is after the achievement that medical treatment and diet was withdrawn to allow the patients to acquire more benefits while consuming the water. It is asserted that with a 6 months continuous Kangen water treatment the liver normally returns to its standard functioning. It is usual for aging people and those that are characterized by chronic illnesses to suffer from prolonged high blood pressure without the condition acquiring any standardization. This comes with a rather fast healing of the stomach and other infections within the duodenum. Kidney functioning is normalized which ultimately leads to better kidney functioning and lowered menstruations challenges in general. In that, the water is purified and characterized by fewer particles and this deters the formation of acidic gas that might affect health (Gerber, 2015).

Preddie, (2012) asserts that despite the absence of adequate empirical data in support of the general use of Kangen water and the general health benefits. It cannot be doubted that chronic illnesses remains to be the primary issue within the current health sector and thus there is a need not only to look for a more effective option but adopt those that are technologically advanced such as Kangen water machines. Chronic treatment is not only expensive but it is psychologically demanding. The complications that arise with the illnesses can be standardized through the consumption of alkaline water. Even cancer and ulcers which is one of the most common illnesses of today are essentially created by acidity and body stability change. The high P.H level affects the general functioning of the body including the stomach, brain as well as respiratory. Hence, the healthcare industry has come to the conclusion that water that is ionized with the appropriate alkaline and acidity conditions could be the long-lasting solution to improving the health of individuals today (Preddie, 2012).

Conclusion

Kangen Water machines are devices that filters tap water and ionize it to give alkaline water through electrolysis. The ionized water has significant health benefits which can help in improving patients’ quality of life in most hospitals. Since the machines are not currently present in American based hospitals, it is recommended that these hospitals need to acquire the machines and consequently improve the healthcare system in the United States. Based on the above analysis it is apparent that Kangen Water Machines is not just a means of improving the life’s quality of the patients and public but will also lead to increased efficiency and reduced operating expenses. It is thus, recommended that similar to other countries that have enhanced their services quality the American hospitals should also utilize this technology as well as the machines to exploit the benefits. Since America is well equipped with regard to technology and resources adopting the machines will not affect the healthcare financial stability rather the associated benefits will outweigh the adaptation expenses. This technology will improve the general healthcare systems as well as increase the confidence of the public in regard to accessing health services. Kagen water machine is essential as it purifies, ionizes, and breaks down as well as alkaline water. The more the alkaline water that an individual consumes the higher the healthier they become. Alkaline and ionized water are useful in boosting body minerals that are highly essential in patient’s recovery and resistance to infections and allergies. The machines are not only effective but they will result in the general reduction of the general healthcare based treatment thus improving wellbeing.

References

Babič, M. N., Gunde-Cimerman, N., Vargha, M., Tischner, Z., Magyar, D., Veríssimo, C., & Brandão, J. (2017). Fungal Contaminants in Drinking Water Regulation? A Tale of Ecology, Exposure, Purification and Clinical Relevance. International Journal of Environmental Research and Public Health, 14(6), 636.

Gerber, S. (2015). 9 ways of gathering meaningful data about your customers. The Next Web. Retrieved 15 October 2017, from https://thenextweb.com/entrepreneur/2015/05/20/9-ways-of-gathering-meaningful-data-about-your-customers/

Hall, H. (2017). The SkepDoc: pH mythology: separating pHacts from pHiction. Skeptic (Altadena, CA), 22(2), 4-6.

Hemery, G., Keyes Jr, A. C., Garaio, E., Rodrigo, I., Garcia, J. A., Plazaola, F. & Sandre, O. (2017). Tuning sizes, morphologies, and magnetic properties of mono-vs. Multi-core iron oxide nanoparticles through control of added water in the polyol synthesis. arXiv preprint arXiv:1701.05858.

Preddie, N. (2012). 5 types of data you should gather when doing market research. Free Accounting, Invoicing, Payments, Payroll and more – The Wave Blog. Retrieved 15 October 2017, from https://blog.waveapps.com/small-business-market-research/

 UPMC Pinnacle. (2017). Kangen Water™ | Health Resources | Wellness Library | UPMC Pinnacle. Pinnaclehealth.org. Retrieved 15 October 2017, from http://www.pinnaclehealth.org/wellness-library/blog-and-staywell/health-resources/article/40192

Discussion 4

"The Flexner Report" 

‘The Flexber Report’ transformed the medical education and led to development in terms of biomedical model, scientific knowledge, clinical training, academic psychiatry, laboratory-based pathology and more. The major impact in American medical education was on the academic model where universities and hospital were transformed to incorporate modern medical knowledge (FLEXNER, 2010). In writing the report and bringing transformation, Flexner focused on a science-based medical education which was associated with scientific paradigm and research on medical education. During the period of 1890s, the State funding, company-based plans and the insurance corporation assisted in the development of biomedical research. The monetary support also benefited the academic psychiatric department and medical schools. In the reformation, Flexner established the Standardized and individualized learning, integrated knowledge, inquiry and improvement and professional identity. General impacts of "The Flexner Report" on American medical education are based on original research- stated that medical schools should conduct a critical research in learning medical and scientific facts (FLEXNER, 2010).  He also pointed that medical practice should be based on scientific method   such as well-planned experiments in diagnosis and hypothesis. Other reformation was on entrance requirement which was a minimum of two years training.  

  In the light of ‘The Flexner Report’, there is a great improvement in the medical education today.  Medical education adheres to the scientific knowledge and human physiology   in teaching and research.  Remarkably, physician in modern healthy care are qualified and medicine is a well-respected profession today (FLEXNER, 2010). This is a remarkable development in that physicians shifted from individual and curative to social and preventive.  Today, health care providers adhere to health-oriented principles associated with quality and quantity in medical training, social obligation and collaboration. Generally, there is an improv in medical education where educated system focuses on scientific research (FLEXNER, 2010).

Reference

FLEXNER  ABRAHAM. (1910).  MEDICAL EDUCATION IN THE UNITED STATES AND CANADA. THE

CARNEGIE FOUNDATION FOR THE ADVANCEMENT OF TEACHING.

Unit 5 Individual Project the US Health Care Economy

Patient’s decision

The patients are customers consuming various healthcare services offered by providers and their decisions can be influenced by such providers. The decision made by the patent can influence by the health care facilities and even the physicians.  In case of health care facilities, the patient’s decision will be determined by the services quality of services to be offered and whether they will satisfy their health needs. The consumer engagement level with the physicians and the information they provide to them will contribute towards the decision made and especially if they are happy if such information provides the desired care (Abraham et. al 2011).  This boils down to the various personal and structural characteristics which influence how patients will select the health care centers and physicians. The significant attributes can be associated with how the care is structured including the distance between the health facility and the home of the patient.  This also includes the length of hours that physicians are available in their offices and whether the patient may be attended to by other providers within a certain group practice. The significant personal attributes of the provider relates to ability of physicians to keep the patients engaged and their professional qualifications. The provider’s demographic factors like gender and race also influence the decision of the patient especially if both the provider and patient have similar attributes (Abraham et. al 2011). The decisions involve the health facilities to visit, physician’s choice and whether to come back for these services.

The setting of the orthopedic center involves a value-based payment whose aim is to provide enough resources for provision of efficient and high quality care. The aim is to remove any issues especially in terms of finances such as penalties that may hinder the improvement of efficiency and quality services.  To ensure the growth of patient engagement with physicians, the center encourages consultation services in offices where the various tests and treatments are provided at the personal level.  In addition, the center encourages the patients to attend the facility where complete care can be provided. Health care centers or hospitals are able to offer a very inclusive medical care where a doctor will be in charge of an individual’s care. The center offers various services including consultation and outpatient treatment for those patients with various health issues including body system’s disorders, injuries corrections and even inpatient treatment services for critical conditions. The re-imbursement method used is Protective Payment System where the patient’s Medicare payment is based on amount that is fixed and pre-determined.  The method ensures quick efficient response given since it ensures since different types of the systems are used depending on the services needed by the patient.

Impact of patients and doctors decisions on insurance plans

The patients and physicians decisions have impact on the health insurance plans in terms of the type and quantity of medical consumption that patients and physicians expect.  This is because such factors affect the type of covers that patients or even the physicians chose.  Normally , the patients makes their recommendation to these patients and the importance of having the insurance cover for specific medical needs which they may address in coming days (Santilli & Vogenberg, F2015).  It is important to note that the choice of health insurance depends on the particular anticipated utilization while on the other hand the choice of the health insurance plan determines the utilization.  Such kind of interdependence indicates that providers of health insurance including the government have to consider these issues. They have to keenly monitor the change in trends in terms of expected health needs of various patients and hence come up with insurance plans that align to the demand resulting from the ever changing patient needs. The cost sharing aspect also influences the health insurance plan especially when insurance policies are being formulated. The expected medical needs like outpatient medical services determine the extent to which cost sharing is to be done.  In case the anticipated needs of the patient are many, their net price will be more in comparison to those who anticipates few needs (Santilli & Vogenberg, F2015).

 The health insurers have to understand the changes and dynamisms of demands of a customer so as to develop insurances plans that will allow attractive cost sharing so that customers will not feel disadvantaged. If they do not respond to such aspects in the market and remodel their plans, there is the risk of customers shifting to competitors. Other loses include may include loss of efficiency, risk-sharing and others that may arise if the health insurance providers adjust their plans in an effort to enhance the various insurers. These losses indicate the effects the needs and demands of customers on the formulation of insurance plans in a market where there are many options. While trying to accommodate the physicians and patients and their preferences, the providers have to ensure that their plans are re-insured against any prospective risk that may occur any time (Santilli & Vogenberg, F2015).

Impact of government regulations on healthcare economy

The regulations adopted by the federal and state governments have various effects on the relationship between the patient and physician and the health care economy.  These regulations interfere with the how the physician and patients relate in an effort to improve the health of the patient and the working conditions for the physicians.  The regulations are likely to hinder the special positions that a physician is accorded in the society, which is a very important principle in the health sector.  The regulations affect how a physician relates with the patient and hence the regulations introduced may hinder service delivery. The regulations comes in terms of licensing and enforcement programs for the physicians and especially when dealing with the patients with an aim of protecting the interests of the patient. The government regulation on patient relates to expenditure on health care products and services (Larrat, Marcoux & Vogenberg, 2012). 

The various regulations have to an increased growth of health economy that is more advanced technology and even collection of personal data. This has led to a situation where health care providers including physicians are more interested in such aspects at the expense of the patients’ treatment and life-saving efforts.  Such advancements are majorly costly and even complicated and for the health care providers to have an edge in addressing the needs of customers they have to invest heavily. Otherwise they risk being overlooked by patients who deems the advancement in technology as a means of improved health services. Hence, in responding to customers’ needs they have to consider the changes in technology (Larrat, Marcoux & Vogenberg, 2012). The health care economy has seen the emergence of organizations with that are devoted to complying with regulations while neglecting care provision. The orthopedic center has to rise above such standards in order to have effective response.

References

Larrat, E. P., Marcoux, R. M., & Vogenberg, F. R. (2012). Impact of Federal and State Legal Trends On Health Care Services. Pharmacy and Therapeutics, 37(4), 218.

Abraham, J., Sick, B., Anderson, J., Berg, A., Dehmer, C., & Tufano, A. (2011). Selecting a provider: what factors influence patients' decision making?. Journal of Healthcare Management, 56(2), 99-116.

Santilli, J., & Vogenberg, F. R. (2015). Key strategic trends that impact healthcare decision-making and stakeholder roles in the new marketplace. American health & drug benefits, 8(1), 15.

Individual health and wellbeing

Introduction

This paper aims at discussing the health and wellbeing of an individual and highlights how the physical, mental, social and emotional aspects. A plan on how the health and wellness of a person can be promoted is discussed with support from theoretical firework on the same. Using the scenario provided, the paper uses a theoretical perspective to highlight how the conditions of individuals can be improved and hence, achieve optimum health and wellness. The paper consists of a literature review on benefits of promoting individual health, bio-psychosocial factors contributing to James wellbeing an activities and strategies that can promote his health and wellness.

Literature review

 Individual health promotion involves a process of enabling a person to improve control over his or her health. It involves moving beyond the behavior of an individual towards a broad range of interventions including environmental and social interventions.  Maintaining the health and physical wellbeing of an individual is important since it helps in mitigating or reducing burdens related to unhealthy conditions which include inability to function properly at work, schools and performing normal responsibilities expected (Jetten, Haslam  &Alexander, 2012,1). It also helps in reducing or preventing burden related to health care provisions including financial, social and mental burdens that not only affect the patient but people close to them and care givers (Loewenstein et al. 2017, 53). The most important reason for maintaining personal health and wellness is to prevent any case of deaths from communicable and non-communicable illnesses and diseases. Physical wellness ensures that an individual has proper care of his or her body for best health and functioning (Edwards et. al 2016, 4). The promotion of physical health involves encouraging physical activity, good nutrition, while mental wellness keeps the body of a person at its prime working condition. When a person achieves optimal level of physical health, they are able to nurture the responsibility for their health (Brownie, 2006, 113).

The benefits of physical health include normally functioning body organs and tissues, reduction in risk of diseases and increased energy in the body. Social health ensures that an individual ensures that the ability of a person’s interaction with others and environment is maintained and this builds satisfactory interpersonal relationships (Cowley, Kiely & Collins, 2016, 373). Mental health ensures that a person’s learning ability and intellectual growth is maintained and the person is able to take on life experiences, formal structures like school attendance and related learning (Thornton &Brunton, n.d, 10).  The life experiences and formal structures ensure that mental health is enhanced. Emotional health gives someone the ability to control their emotions, so that amidst various challenges they encounter in life, they can remain calm while looking for solutions. Moreover, one is able to express such emotions in the right way which is important in achieving comfort (Pockett, R., 2013, 123).

Bio-psychosocial factors contributing to James’ wellbeing

In the case, James health concerns relates to psychosocial factors brought about by the failure to find a job close to Molly so that he can offer the right support. The increasing worries, low mood, irritability and loss of temper may have led to increased to alcohol intake and smoking. The changes seen in James relate frustrations to get a suitable job and inability to offer support to his pregnant wife as he could wish. His health problems could be viewed from the bio-psychosocial approach. The bio-psychosocial approach involves a framework that is integrative and comprehensive and whose aim is to understand the health and function of a human (Velupillai, 2008, 126). The basis of this approach is that human beings as organisms are considered innately bio-psychosocial whereby the psychological, biological and their social dimensions are inseparably intertwined.  In this case, the psychological, socio-cultural and biological approaches affect the health outcome and behavior of a person (Kivimäki, 1997, 858). The health outcomes as indicated in the behavior James portrays can be attributed to social and psychological factors including the health status of molly, his wife, and inability to find a suitable job which means he cannot relocate. For James, these factors represent pathways which have led to his increased alcohol consumption and the new desire to resume the smoking habit. Many psychosocial aspects mutually influence one another to cause alcohol abuse and such causes should not be viewed as independent from the biological factors.  Hence, increased alcohol intake is best perceived as resulting from various bio-psychosocial influences combined together (Sundin et. al 2014).  The psychosocial factors that have lead to the worries, irritability and mood disturbances for James includes the lack of suitable job, anxiety about Molly’s health and pregnancy and the feeling of inability to provide the necessary support. These factors are most possible culprits of the new behavior, increased alcohol intake and even smoking. Mood disturbances have been related to increased alcohol intake especially during withdrawal, so that when one is not drinking, they report cases of irritability, depression, poor concentration and even anxiety (Moksnes, U.K., Espnes et.al Haugan, 2014, 33). The challenges affecting James are psychosocial stressors since they involve strains and negative life experience.

Psychosocial stressors have been known to be risk factors for smoking tobacco including the relapse behavior, through various mechanisms. A person may result to smoking as a coping behavior and in this case, nicotine acts as self-medication for the stress. Increased exposure to psychosocial stressors may lead to reduced self-regulation necessary in controlling the urge to engage in smoking (Heaney, Carroll & Phillips, 2014, 466).  In the past, observational studies have shown that stressful events linked to relationships or work can results to high prevalence of smoking and alcohol consumption (Niaura, 1988, 133). This is in comparison to people who have not experienced the life stressors.  In this case, James may have resumed smoking as a way of coping with inability to find suitable work or to support his wife. In addition, the health and wellness of his children may have acted as a psychosocial factor by piling pressure on him to maintain the wellbeing of the entire family members.  In addition, stressful events life has been related to increased intake of alcohol among the adults. The stressful life experience related to work or biological factors of a close family member have been shown to lead to alcohol disorder or over-consumption (Brown, 2002, 180).  The use of alcohol as a way of coping with or reduce stress is a major cause of drinking since it has been found to capable of minimizing tension state when not overly consumed. Stress as a psychosocial factor has, therefore, been given as a reason for increased drinking habit. In addition, increased alcohol use can lead to increased mental health factors such as irritability. In this case of James , whereas failure to find suitable work and the condition of his wife may lead to stress and hence the drinking behavior , the alcohol and related withdrawal may be the cause for low mood and irritability. The worries that he may harbor inside may be the cause of increased drinking since more pressure to provide health and wellness care for his family results to more pressure and hence, stress. The exposure to the psychosocial stressors is the main culprit in poor health and wellness for many people (Schofield & Beek, 2005, 1285).

Activities for health and wellness plan

 To improve the health and wellbeing of James, it is necessary for him to engage in activities that will reduce the impact of psychosocial stressors, so that to reduce or eliminate the stress levels and hence, smoking and alcohol consumption. Meaningful activities should aim at improving the wellbeing of people and should go beyond pleasure to meet the psychological needs that are fundamental in individual health and wellness (Sudlow, 2015). A health plan should keep a person physically active so as to deal with and mental problems since those with such health issues are likely to engage in excessive alcohol drinking, smoking and even poor diet.

The activities include engaging in physical exercises consisting of gyms, volunteering and walking groups. Engaging in excises help helps an individual to remain active, reduce anxiety and feeling of isolation (Trost et. al 2014, 1).  The other activity is sporting, which involves activities that James would do on his own or in a team for fun or competition. Sporting helps in improving body energy and reducing the chances of developing various diseases related to overweight and inactivity (West &Griffin, 2017, 1). The two activities help in improving the tolerance of the body to stress given that exercising acts as a stressor. As a stressor, sports induce the production of adrenaline and cortisol which are stress hormones (Millington, 2014, 491). By purposely making the body to experience stress through regular physical activities, one is able to build resilience over a period of time (Osborne, 2017, 1).  The health benefits for the physical activities include reduction in anxiety and hence, happier mood, reduction of stress feelings, an improved sense of calm and clear thinking (Ryan, 2015, 8). The volunteering and sporting activities will assist James socially by increasing connection with people and this may provide an opportunity for finding work in nearby place and hence, be able to care for Molly and the family.

 In addition, a program on alcohol and smoking reduction will be important in helping James to abandon the behavior. The program should involve intervention and counseling which are important in sensitizing the negative effects of smoking and excessive drinking. The program will help James to make a decision to quit which is the first step in stopping the behavior.

Strategies for promoting individual health

 The strategies to be used in promoting and improving the health of James should focus preventing and treating the effects of bio-psychosocial factors including work related stress , worries and anxiety related to his wife’s and family’s wellbeing.  These strategies include clinical interventions, encouraging adherence and addressing the behavioral and psychological risk factors.   The clinical intervention approach involves counseling and education whose aim is to primarily prevent the effects of negative behavior (Biron & Karanika-Murray, 2014, 85). Through this approach, James can be made to understand the risks resulting from high alcohol intake and smoking and this can lead to reduction of the behavior. Clinical psychological interventions are also helpful in promoting the coping skills of a person, providing the necessary emotional support and this improves the quality of life (Cacioppo et. al 2015).  Encouraging adherence as a strategy is important since it provides an opportunity to match the provided counseling or advice and the general healthcare outcomes (Watkins and Scaturo, 2013, 75). For instance, failure to take any medication that may ease the effects of alcohol intake may be shown through the resulting symptoms.  A person should be made to understand the consequences of non-adherence or failure to follow the recommended healthcare advice.

The other strategy involves dealing with the various psychosocial factors that poses health and wellness risk to James.  The psychosocial factors involves offering the appropriate treatment to stress and depression including psychopharmacologic and psychotherapeutic treatments which are necessary in enhancing coping and reduction of the effect of life stressors or any medical condition emerging from such (Amsterdam, Hornig & Nierenberg,2007, 264).   Dealing with behavioral factors that expose would expose James to health risks involve offering advice which health behaviors to engage in. Addressing the behavioral factors may involve providing some cues that will keep an individual on toes or even remind them of their needed efforts to abandon their risky behavior. This involves offering the right support to ensure that a person is totally committed to change their behavior and embrace behavior that will promote their health outcomes (Amsterdam, Hornig & Nierenberg, 2007, 264).  

Conclusion

Individual health promotion involves a process of enabling a person to improve control over his or her health and wellness. The bio-psychological factors relate from internal and external stressors that and such factors mutually determine the health and wellbeing of a person. They may lead to negative behavioral change and poor outcomes such as excessive drinking and smoking as an individual tries to cope with the situation. Engaging in physical activities comes with physical and mental health benefits since it reduces health risks and enables one body to cope. The strategies adopted for promoting individual health should focus on prevention and treatment. There is a need for further research so as to assess how bio-psychosocial factors relate in bringing about poor individual health outcomes.

References

References

Thornton, L. and Brunton, P.,(n.d). Healthy Living in the Early Years Foundation Stage. Optimus Education eBooks.  9-10

Pockett, R., 2013. Promoting health and well-being in social work education [Book Review]. Advances in Social Work and Welfare Education, 15(2).123.

Edwards, E.A., Lumsden, J., Rivas, C., Steed, L., Edwards, L.A., Thiyagarajan, A., Sohanpal, R., Caton, H., Griffiths, C.J., Munafò, M.R. and Taylor, S., 2016. Gamification for health promotion: systematic review of behaviour change techniques in smartphone apps. BMJ open, 6(10).4.

Loewenstein, G., Hagmann, D., Schwartz, J., Ericson, K., Kessler, J.B., Bhargava, S., Blumenthal-Barby, J., D'Aunno, T., Handel, B., Kolstad, J. and Nussbaum, D., 2017. A behavioral blueprint for improving health care policy. Behavioral Science & Policy, 3(1), pp.52-66.

Jetten, J., Haslam, C. and Alexander, S.H. eds., 2012. The social cure: Identity, health and well-being. Psychology Press. 1

Velupillai, Y.N., Packard, C.J., Batty, G.D., Bezlyak, V., Burns, H., Cavanagh, J., Deans, K., Ford, I., McGinty, A., Millar, K. and Sattar, N., 2008. Psychological, social and biological determinants of ill health (pSoBid): study protocol of a population-based study. BMC Public Health, 8(1), p.126.

Brownie, S., 2006. Why are elderly individuals at risk of nutritional deficiency?. International journal of nursing practice, 12(2), pp.110-118.

Schofield, G. and Beek, M., 2005. Risk and resilience in long-term foster-care. British Journal of Social Work, 35(8), pp.1283-1301.

Cowley, J., Kiely, J. and Collins, D., 2016. Unravelling the Glasgow effect: The relationship between accumulative bio-psychosocial stress, stress reactivity and Scotland's health problems. Preventive medicine reports, 4, pp.370-375.

Heaney, J.L., Carroll, D. and Phillips, A.C., 2014. Physical activity, life events stress, cortisol, and DHEA: preliminary findings that physical activity may buffer against the negative effects of stress. Journal of aging and physical activity, 22(4), pp.465-473.

Niaura, R.S., Rohsenow, D.J., Binkoff, J.A., Monti, P.M., Pedraza, M. and Abrams, D.B., 1988. Relevance of cue reactivity to understanding alcohol and smoking relapse. Journal of abnormal psychology, 97(2), p.133.

Brown, R.A., Lejuez, C.W., Kahler, C.W. and Strong, D.R., 2002. Distress tolerance and duration of past smoking cessation attempts. Journal of abnormal psychology, 111(1), p.180.

Kivimäki, M., Vahtera, J., Thompson, L., Griffiths, A., Cox, T. and Pentti, J., 1997. Psychosocial factors predicting employee sickness absence during economic decline. Journal of Applied Psychology, 82(6), p.858.

Sundin, J., Herrell, R.K., Hoge, C.W., Fear, N.T., Adler, A.B., Greenberg, N., Riviere, L.A., Thomas, J.L., Wessely, S. and Bliese, P.D., 2014. Mental health outcomes in US and UK military personnel returning from Iraq. The British Journal of Psychiatry, pp.bjp-bp.

Moksnes, U.K., Espnes, G.A. and Haugan, G., 2014. Stress, sense of coherence and emotional symptoms in adolescents. Psychology & Health, 29(1), pp.32-49.

West, L.R. and Griffin, S., 2017. Sport and exercise medicine in the UK: what juniors should know to get ahead.1

Millington, B., 2014. Amusing ourselves to life: Fitness consumerism and the birth of bio-games. Journal of Sport and Social Issues, 38(6), pp.491-508.

Trost, S.G., Blair, S.N. and Khan, K.M., 2014. Physical inactivity remains the greatest public health problem of the 21st century: evidence, improved methods and solutions using the ‘7 investments that work’as a framework. 1

Osborne, H.R., 2017. ‘Keeping you active’: the Australasian college of sport and exercise physicians. British Journal of Sports Medicine. 1

Sudlow, C., Gallacher, J., Allen, N., Beral, V., Burton, P., Danesh, J., Downey, P., Elliott, P., Green, J., Landray, M. and Liu, B., 2015. UK biobank: an open access resource for identifying the causes of a wide range of complex diseases of middle and old age. PLoS medicine, 12(3), p.e1001779.

Ryan,K., 2015. National Association for Mental Health.8. Retrieved from: https://www.mind.org.uk/media/2976123/how-to-improve-your-wellbeing-through-physical-activity-and-sport.pdf

Biron, C. and Karanika-Murray, M., 2014. Process evaluation for organizational stress and well-being interventions: Implications for theory, method, and practice. International Journal of Stress Management, 21(1).85.

Cacioppo, S., Grippo, A.J., London, S., Goossens, L. and Cacioppo, J.T., 2015. Loneliness: Clinical import and interventions. Perspectives on Psychological Science, 10(2),.238-249.

Watkins Jr, C.E. and Scaturo, D.J., 2013. Toward an integrative, learning-based model of psychotherapy supervision: Supervisory alliance, educational interventions, and supervisee learning/relearning. Journal of Psychotherapy Integration, 23(1).75.

Amsterdam,J.,  Hornig,M.,  Nierenberg,A.,  2007. Treatment: resistant mood disorders. [Place of publication not identified], Cambridge Univ Press. 264

Breast and Prostate Cancer

Introduction

Cancer is one of the most common diseases today especially in the United States. This is according to research which indicates that many people especially those under the influence of smoking and taking excess alcohol are at the risk of contracting the disease. Statistics try and provide the total number of people who have been diagnosed with cancer and in our case the breast for the females and prostate for the male gender. Although cancer among men and women is on the rise, the organs which are affected are very different in terms of the physiological and anatomy function where both parts require the gonadal steroids for them to develop and the tumor which arises from this process is the typical hormone (Blein et al., 2014). Many of the current advances when it comes to understanding the development of cancer for the breast and prostate have given a way for new and advanced strategies for treatment. Many organizations are working to see to it that the effects and the advances of cancer in both men and women have been brought down and patients have an improved health.

A process called metastasis follows which is a process where the cancer cells start to travel into other parts of the body and immediately starts the damaging of the tissues and body organs (Siegel et al., 2013). For men, prostate cancer is one of the leading types of cancer which is diagnosed in men primarily in America every year. Prostate cancer is growth of cancer cells in the prostate gland which is a gland that is responsible for the formation of semen. The prostate is evidently the most common and dangerous type of cancer in men. Typically, some types of cancers grow significantly very slowly whereas others grow very fast and very aggressively and they spread to other body organs very quickly.

Summary

Symptoms of breast cancer include swelling or lumps under arms, discharge or change in nipple skin, change in size, feel and shape of the tissue of the breast, no painful masses or lumps and flattening of the breast. The symptoms of prostate cancer can vary in a person where some men do not show any until it develops in years. Some of the symptoms include having a frequent urination, blood spots in the semen or urine, discomfort during urination or ejaculation, weak urination, difficult to start or stop urination, and intense pain in the hips and thighs. Certain conditions can cause the enlargement of prostate cancer (Edwards et al., 2014). These terms are benign prostatic hyperplasia (BPH) and prostatitis. BPH, as it is popularly known, is as a result of prostate growing very large. The BPH causes some symptoms through the creation of pressure in the urethra or bladder or both. This condition is widespread in the senior men, and it is a relatively benign condition.

Diagnosing cancer is very important to allow a person start first medication on ways to prevent it from growing. This is however positive for the people living with breast cancer but disadvantageous for the people living with prostate cancer who will start having side effects immediately they start on medication (Siegel et al., 2013). Preventing cancer is very important for those who are not yet diagnosed with cancer as it helps them live a life free from disease. The affected individuals should try their very best and ensure medical attention is provided early enough. In many cases, alcohol and smoking are associated with cancer, and therefore people should not engage in either or reduce the activity. 

Preventive services

Screening mammography decision for the women after the ages of 50 should be very individual as a starting point. Chemotherapy is an effective method of treating prostate cancer. This is done through reducing the chances of the ability of the affected cells from growing. Chemotherapy is offered by the medical oncologist after some time (Edwards et al., 2014). Systemic chemotherapy is very common since it gets into the bloodstream and reaches the cancer cells distributed throughout the body. In many cases, screening of prostate cancer is considered not to prevent any deaths, therefore, recommending the services. Chemotherapy, radiotherapy, and surgery are some of the examples of preventive services for people living with cancer. When it comes to breast cancer, women above the ages of 50years benefit from the program compared to the younger women.

Considering the data for cancer screening in females, it is evident that there are minimal chances of harm than the benefits, therefore, an efficient method for cancer patients (Blein et al., 2014). For some time, breast cancer diagnosis is crucial since it prevents the late preventive methods which have more side effects. Removing of the breast cancer is more comfortable than handling prostate cancer, and therefore breast cancer screening is more important. Compared to breast cancer, people living with prostate cancer have a chance of experiencing more side effects than the people living with breast cancer.

Factors which might impact decisions related to preventive services

Women who feel it is to their advantage to start the screening early might choose to begin the process of biennial screening can start between the age of 40 to 49. The benefit to harm balance is most likely predicted to improve as a woman moves from the early 40s to the late 40s. Ethnicity is another factor that affects the preventive measures in, especially women. The African American society is known to assume the medical process and start gaining the interest after delays. This in return causes the higher death rate among the African American (Welch et al., 2016). At the more advanced levels of breast cancer, the African American women start seeking medical attention, and at this stage, there is very little which can be done. The availability and access to health care services for the whites give them access to medical care as compared to the African Americans who do not have the advantage of medical treatment. Having access to primary health care provider is very advantageous since treatment is guaranteed at the early stages (DeSantis et al., 2014). Men who are above the age of 70 should and are required to be tested under specific circumstances such as during the higher than median prostate-specific antigen which is measured below the 70 years.

Ethnicity also is a factor that affects the preventive services of prostate cancer. The whites are the most affected by the disease as compared to the backs or the Hispanics. White men are related to being very active in alcohol-related fields whereas the blacks have been related to being very obese. Such factors have influenced the level of cancer survivors in the United States. The fact that the whites did not want to stop taking excess alcohol indicated the possible factor for the many deaths of prostate cancer victims (DeSantis et al., 2014). This increases the probability of whites who are still undertaking medical services to die of prostate cancer. Among the blacks, the rate of death is highly caused by being very obese in the process. Obesity is a factor that affects blacks, and this increases the chances of prostate cancer being a killer disease.

Treatment options

Local treatments are very available which involve treating the tumor without affecting the other body organs. They can include surgery and radiotherapy. Systemic treatments are also available where drugs are required since the drugs have the capability of reaching the cancer cells anywhere in the body (Welch et al., 2016). The drugs can be given through the mouth or into the bloodstream such as chemotherapy, hormone therapy, and targeted therapy. In many cases, the effects of breast cancer treatment vary. Long-term effects include having an early menopause, infertility, sexuality issues, depression, fear of recurrence and fatigue. Short-term effects include experiencing loss of hair and one fighting to cope with the loss, nausea and occasional vomiting, toenail and fingernail weakness, pain in the muscles, fatigue, and anemia.

At the early stages, surveillance and waiting is the most preferred type of treatment. The active form is preferred by many men as it allows the men to have a long life expectancy and can benefit from a curative therapy in case the disease worsens. The side effects related to the treatment of prostate cancer include having difficulty in the urinary control and also a dysfunction when it comes to erecting (DeSantis et al., 2014). The ability to control the urine was lowered therefore causing a person to do it at anytime and anywhere. Erections became very weak to sustain an intercourse whereas many others indicated a moderate sexual functioning. These effects are usually caused by the drugs and the surgical processes that men undergo to remove the tumor.  These effects are mainly caused by the drugs, and the methods involved treating cancer. Most of these facts are as a result of the chemotherapy. 

References

Blein, S., Berndt, S., Joshi, A. D., Campa, D., Ziegler, R. G., Riboli, E., ... & Diver, W. R. (2014). Factors associated with oxidative stress and cancer risk in the Breast and Prostate Cancer Cohort Consortium. Free radical research, 48(3), 380-386.

DeSantis, C. E., Lin, C. C., Mariotto, A. B., Siegel, R. L., Stein, K. D., Kramer, J. L., ... & Jemal, A. (2014). Cancer treatment and survivorship statistics, 2014. CA: a cancer journal for clinicians, 64(4), 252-271.

Edwards, B. K., Noone, A. M., Mariotto, A. B., Simard, E. P., Boscoe, F. P., Henley, S. J., ... & Eheman, C. R. (2014). Annual Report to the Nation on the status of cancer, 1975‐2010, featuring prevalence of comorbidity and impact on survival among persons with lung, colorectal, breast, or prostate cancer. Cancer, 120(9), 1290-1314.

Miller, K. D., Siegel, R. L., Lin, C. C., Mariotto, A. B., Kramer, J. L., Rowland, J. H., ... & Jemal, A. (2016). Cancer treatment and survivorship statistics, 2016. CA: a cancer journal for clinicians, 66(4), 271-289.

Siegel, R., Naishadham, D., & Jemal, A. (2013). Cancer statistics, 2013. CA: a cancer journal for clinicians, 63(1), 11-30.

Welch, H. G., Gorski, D. H., Albertsen, P. C., Andriole, G., Crawford, E., Grubb III, R. L., ... & Roobol, M. J. (2016). Trends in Metastatic Breast and Prostate Cancer. N Engl J Med, 374, 596.