AUTISM

There are very many counselling approaches which can help in the treatment of people who are autistic. These approaches may include psychoanalytic approaches, cognitive and behavioural approaches and humanistic approaches. When autistic people are counselled in the right way, this makes it easier for them to respond positively, and thus being able to benefit positively.

The following are counselling approaches used to deal with autistic problems:

Psychoanalysis

This is a form of psychological approach which is used in order to aid people to combat behavioural and emotional problems (Kapur, 2011). This approach is therefore centred on the idea that people are not aware of the factors which determine their behaviours and emotions. This approach therefore determines how conscious factors which affect relationship between people and their partners. Psychoanalysis session takes a duration of 50 minutes, for a period of 5 times a week. During this session, the patient is allowed to lie either on the couch or on the bed, while the analyst sits behind the patient, thus observing the patients reactions. While the patient lies on the couch, she expresses her feelings verbally, thus allowing the analyst to be able to interpret his or her problems.

Hypnotherapy

            This approach utilizes hypnosis, which is a transformed state of consciousness. Hypnosis is consequently utilized for treatment of terminal conditions, and also for stopping specific habits (Kapur, 2011). In addition, it can also be employed in the reduction of anxieties, and to also ease symptoms related to autism.

Cognitive Therapy

            This therapy mainly deals with the thoughts and perceptions, and how these can lead to effects in feelings and behaviour of an individual. Through reconsidering the negative thoughts, a person can be able to learn more ways of thinking positively, thus changing their feelings and behaviours towards certain thoughts (Kapur, 2011).

Cognitive Behavioural Therapy

            This approach combines both behavioural approaches and cognitive approaches. This therapy therefore focuses on an individual’s emotions, thoughts, actions and physical feelings, and it therefore provides a solutions as to how individual’s effects can have effects on other people (Kapur, 2011). This approach therefore allows people to be able to understand how deal and relate with one another.

References

Kapur, M. (2011). Counselling children with psychological problems. Delhi: Pearson.

www.interactingwithautism.com/section/treating/spee

Using the Data/Information/Knowledge/Wisdom Continuum

Introduction

Nursing informatics can be described as the  specialty  that particularly integrates science in the practice of  nursing with  additional  and analytical science information  in the  identification,  description , management and  the  communication  of  acquired  information, wisdom as well as  knowledge in nursing practice (Benton& Giovagnoli, 2006).  Nurses  in particular  utilizes  the acquired  data, wisdom, information  and well as knowledge  continuum in daily  practices  in developing  clinical  judgments in the  provision of  accurate  and  responsible patients  care.  In  the healthcare and nursing  sector , knowledge, data and information are  considered  to be the  most  significant aspects  in ensuring  credibility  and  integrity of healthcare operations (Benton& Giovagnoli, 2006).  With the  rapid  technological growth  all  these  terminologies are  vital  in  enhancing  continuous  significant information flow within the healthcare  industry. The paper  is targeted at the identification  of  information, data, wisdom,  and knowledge  continuum  in the establishment  of  effective  diet and surgical  intervention  in the management  and treatment of childhood obesity.

From investigation and observations it is apparent that innovative and advanced technologies are essential in the conversion of raw data into significant information.  According to the  recent  investigations  the  procedure  of data knowledge wisdom and information  is an information revolution  with the assistance  of  cognitive  progress  procedure (Kirch, 2008).  Knowledge is of specific and unique assistance to the advanced practice of nursing and the entire healthcare system.  Nurses can utilize informatics in obtaining knowledge or wisdom.  Informatics is essential since is assists nursing practitioners in the growth of skills that are necessarily in obtaining knowledge as well as data (Kirch, 2008).  This is useful in effective data management.  Via informatics  nursing practitioners  are  equipped with the  capability  of acquiring the  needed knowledge  which can be utilized in  solving complex  health  issues (Kirch, 2008). the  general  application  of nursing knowledge  that  is obtained  from  informatics  is  of assistance  in the  provision of  successful  healthcare  to  the  patients  as well as the general  community.  In that from informatics nurses gains the capability of obtaining higher wisdom (Kirch, 2008).

Clinical Question

How  best  can information, data, wisdom and knowledge continuum  be utilized in  advanced  nursing practice  in establishing better  diets or medical  intervention as a treatment, prevention  and a management  option towards  obesity? Based on the recent reports by national nutrition and health survey an approximation of 25 percent of young children is characterized by overweight (Benton& Giovagnoli, 2006).  Obesity during childhood disposes young children  to increased  risks  of inadequate  illnesses  resistance  like  renal illnesses, liver  failure hypertension, diabetes and so  much  more without the exclusion of heart failure (Benton& Giovagnoli, 2006).  The particular disorder is influenced by numerous factors that include lifestyle, social or environment, metabolism as well as genetics.  For  several years now the healthcare  providers  have  continuously worked in the development of an effective  medical practice that  may  be useful  in the prevention  of the  occurrence as well as  obesity  treatment (Benton& Giovagnoli, 2006).  Several  surgical  and therapeutic strategies  have been  established  to be  highly  effective  in the  management  as well as  control of high weight  in  children  at  their early development  so that  the  some  long-term  and shorter  complications of the  disorder  that posses  medical complexity  can be  handled  effectively.  This strategies are additional popular for their ability to decrease BMI which in general is of use in controlling the growth of weight (Benton& Giovagnoli, 2006).  

In the current  technological development  in nursing  informatics  is useful  in the  provision  of tools that  enhances  faster  data search  that  simplifies  the general procedure  of  the treatment  of information (McGonigle & Mastrian, 2015).  This strategy is meaningful as it offers essential data that is utilized in the development of suitable decisions.  Technological advancement  has  developed  the  nursing  practice over  the  period  by ensuring  that  has been transformed  to be more   based  on  evidence practice. This has thus developed the healthcare quality by increasing reliability as well as full credibility over time (McGonigle & Mastrian, 2015).  In the world today  the  performance of things  has changed  and  the manner  in which everything  is handled  is no  longer  traditional  as technological  advancement  has  swiped  practices for the better.  Nursing  operations are  now  conducted  with the objective of  discovery of better  interventions and not  just based  on  needs  or  how  practices  are based  as traditions stands.  With the current advancement  medical  practitioners  are fully  able  to  look  for the appropriate electronic information from the  distinct evidence  sources that is  chosen critically  to offer science advancement that is necessary in  solving  the issue.  Nursing  informatics  are  useful  in healthcare  as the  assist the  general  data integration,  knowledge  as  well as  information in support on nursing  operations (McGonigle & Mastrian, 2015). From this perspective  nursing practitioners  are thus equipped  with the capability  of settling  for  accurate  decisions  that are  grounded  on the  best approaches  of managing children’s obesity.

Data Information Knowledge and Wisdom Continuum

 Based on the recent  studies,  assessments, surveys  and researchers  findings  the terms  information,  data as well as knowledge  are utilized in the allocation  of nursing and healthcare  meaning.  Effectiveness of the systems cannot be established without the utilization of the aspects (McGonigle & Mastrian, 2015).  Based  on modern informational  technology period, the terms  offers  developed  chances  to the  health care  sector  in the  maintenance  and  assurance of  continuous  information flow  within a given working surrounding.  The primary thought  of the continuum of wisdom, information, knowledge and data  can best  be described  as  the general  innovation  of  healthcare  wisdom based on the existing pressure to develop.  The interventions can be of usefulness in the growth of the healthcare associations that enhances smooth flow of healthcare activities (Ball & Hannah, 2011).  It is apparent  that  the nursing practice  particularly in the  modern society necessitates  greater  integrity  of data that  may  be essential  in  development and the establishment  of effective  strategies. This s objected  at offering  enhanced  and effective  healthcare operations and it can only be accomplished  through  the  collective  gathering  of  information and  converting it into medical usefulness (Ball & Hannah, 2011).

Nursing and Healthcare Databases

Innovation as well as growth of the modern technology has created different transformations in all sectors.  Automatic and  databases  medical  records  are useful  in  providing  organization  and efficiency in  managing  patients  information (Ball & Hannah, 2011). This additionally contributes to the smoother running of the industry.  The efficiency  can be utilized  in managing  childhood  obesity through  advocating  appropriate services to  all the involved  patients to  prevent  long-term adult  complications( McGonigle & Mastrian, 2015).

Summing up, in nursing practice and particularly in establishing better medical interventions to obesity prevention and treatment science is essential.  This is because it helps in the gathering, analysis, interpretation as well as the general conclusions applications.  The acquired information as well as knowledge can be  transformed  to  wisdom to identify  the  revolving factors behind the obesity  issue and how  best  it can  be  solved medically.  Obtaining knowledge from the gathered information can be transformed into wisdom in making responsible decisions.

            References

Ball, M. J., & Hannah, K. J. (2011). Nursing informatics: Where technology and caring meet. London: Springer.

Benton, S., & Giovagnoli, M. (2006). The wisdom network: An 8-step process for identifying, sharing, and leveraging individual expertise. New York: American Management Association.

Kirch, W. (2008). Encyclopedia of public health. Dordrecht: Springer.

McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge.

Ethical Dimensions of Research Study

Health related medical research and all investigative research are associated with some primary ethical considerations.  The primary  ethical  issues  that are involved  in the  assessment  of research  are  confidentiality and anonymity respect,  privacy respect, beneficence which implies that the participants are  not supposed to be harmed  and  more  importantly  informed consent (Shamoo & Resnik, 2009).  Informed consent implies that the participants must be intelligent, knowing and engage in the research voluntarily with clear description of the research and its intensions.  This is the primary mean through which the autonomy of participants is enhanced.  In addition the participants should not be harmed and rather they should benefit. Their privacy and confidentiality should not be violated since they are entitled to anonymity (Davis, 2008).

Homeless  individuals  who are  characterized  by severe mental  disorder  are  actively  being  recruited  by  pharmaceutical corporations  on contract basis  in testing experimental medicines. Most of the individuals are willingly participating in the exercise because they hold the belief that it is a technical activity that occurs in the medical industry.  The reality is however different since they are  not given details  regarding the research and the  outsourcing of  participants is aimed  at  reducing the involved costs  and period  of  assessment which is working for  the corporation (Perry, 2014).

From the  case  it is  clear  that the primary  ethical  issues  regarding  medical  ethics  during research  are being violated.  Despite the fact that the participants  play  part knowingly  their understanding  can be doubted  by their severe  mental disorder  and the fact that the companies  fails to inform them on how the  experiments are  being utilized.  The  benefits  are  obtained by the corporations while  the  minority  groups  rights such as  privacy,  confidentiality and anonymity are not  maintain.

            References

Davis, S. (2008). Handbook of Research Methods in Experimental Psychology. Oxford: John Wiley & Sons.

Perry, S. (2014). Recruitment  of homeless people  for drugs  trial  raises serious ethical  issues. Retrieved from https://www.minnpost.com/second-opinion/2014/08/recruitment-homeless-people-drug-trials-raises-serious-ethical-issues-u-bioet

Shamoo, A. E., & Resnik, D. B. (2009). Responsible conduct of research. New York, NY: Oxford University Press.

Research-Based Evidence

Study 1

The study by Hoviattalab et al., (2015), was primarily conducted in order to establish the sort and the level of the prevention intervention strategies that are conducted by nurses for hospitalized patients who are at a high risk of attaining pressure ulcer. This was based on the fact that evidence based prevention strategies of pressure ulcers have been provided with low record of hospitals adherence.  The study was an observational study that utilized a nonparticipant observational research design in collection of the required data.  The observational study was based on investigating whether the hospitalized patients who hold a risk of having pressure ulcers are given the necessary measures to prevent the occurrence.  The study utilized a population sample of 32 patients who were particularly adults who had or were on the risk of pressure ulcer who were continuously observed during all surgical and medical wards shifts in two major general hospitals (Hoviattalab et al., 2015).

Based on the study, it was established that the hospitals were utilizing a collection of prevention measures in line with the medical standards as observed. The most utilized preventive measures were particularly patient’s minimization exposure to moisture and patients cleaning. These measures were particularly undertaken to more than 90% of the patient’s population in both hospitals.  The least utilized measures were relative and patient’s education, evaluation and nutritional status recording (Hoviattalab et al., 2015).

However the study was limited by time as well as accuracy because it was primarily based on observation.  In addition the study was based on limited data sample thus requiring more justification of the findings. This would have resulted in few errors but the findings cannot therefore be doubted.  The conclusion of the study shows that preventive pressure ulcers measures were not implemented fully thus highlighting for the necessity of further research.  This is to establish the challenges that hinder hospitals from utilizing the measures fully (Hoviattalab et al., 2015).

Study 2

The study by Banks et al., (2013), was mainly purposed for the estimation of the economic impacts of the use of nutrition intervention to patients who are at a risk of having pressure ulcer while receiving standard care in hospitals.  The study utilized statistical methods that were created in order to present a prediction of the avoided cases of pressure ulcers, the number of days that the patients spent on their beds and the general economic cost.  This was conducted for the public hospitals located in Australia Queensland between the year 2002 and the year 2003. The study utilized input parameters that were specified with adequate distribution probability fitting (Banks et al., 2013). This was conducted  based on the  annual  number of discharges, pressure ulcers rate, pressure ulcer independent impact  based on the stay duration, nutrition support  cost ,  the risk of pressure  ulcer and the intervention that was utilized  in handling the  issue.

The study involved a total of one thousand re-sampled that were conducted expressed as the probability output of distribution. The research model utilized was able to predict 2896 cases of the avoided pressure ulcers cases with an economic saving of approximately 2,869, 529 and bed stays days of 12, 397 full days. These results were based on the utilization of a nutrition pressure ulcer prevention support intervention in comparison with the standard care offered to patients.  The study was however limited to information and recent findings because it was based on the previous prevented pressure ulcer cases.  The study concluded that  nutrition intervention is considered  and predicted  and the most effective in terms  of cost  as a method  of pressure  ulcer  prevention  in  patients at risk (Banks et al., 2013).

Study 3

The study by Roberts et al., (2015), was conducted to investigate nutrition intervention as a pressure ulcers prevention, related conducts as well as the aspects that impacts the intake of nutrition in hospitalized patients who are at a risk of obtaining pressure ulcers.  The study utilized an observational method in collection of the necessary data. Low nutrition intake is a common occurrence in hospitals and thus this is a primary risk factor for having pressure ulcers. However  nutrition  care  conducts that  associates with the  identification as well as the treatment  of  malnutrition has not yet been evaluated among those hospitalized patients who are at a risk  of  having  pressure ulcers.  This study described nutrition care in details as an intervention strategy of hospitalized patients getting pressure ulcers and the factors that hinders the general intake of nutrition within the particular group.  The study was performed within two wards in two distinct hospitals in Australia Queensland (Roberts et al., 2015).

Adult hospitalized patients who were at a risk of obtaining pressure ulcers which is influenced by reduced and monitored mobility were observed 24 hours daily.  This was conducted in order to determine their oral intake on daily basis like intervention, documentation and nutritional screening.  The study additionally used independent t-tests as well as chi-squared testing in analyzing the intake of diet and the core-related nutrition care data.  With the utilization of logic regression to analyze data dietitian referral predictors were established (Roberts et al., 2015).

The study participants were 241. The nutritional screening that was observed was for 142 patients which equaled t0 59%.  In 34% and 71% cases respectively height and weight weighing were documented (Roberts et al., 2015).  69 of the total population of the patients utilized in the study were received for a referral diet (Roberts et al., 2015).  Those that were predicted for referral diets were selected based on long stays at the hospitals and low index mass of the body (Roberts et al., 2015).  On the average nature, patients utilized 72 and 73 percent protein and energy that was provided on average nature.

The study concluded that practices of nutrition care in the inclusion of those that are engaged in nutritional limitation, malnutrition screening on the risks as well as general documentation always seems to be limited to those hospitalized patients at the risk of having pressure ulcers.  A major  proportion of this group of the patient are involved  in inadequate eating of the main meals thus developing the risk of malnutrition  further as well as pressure ulcers (Roberts et al., 2015). The study was limited to information and accuracy because it was based on observation which is associated to errors.

Study 4

The study by Sardo et al., (2015), was conducted  in analyzing  the  Braden  scores scales  as well as sub scores  evaluated  in  hospitalized  adult persons  in the association off their duration stay, diagnosis  and features. The Braden scale is mainly utilized international for the assessment of pressure ulcers as well as the support of preventative interventions implementation by nurses. The study utilized a retrospective design cohort evaluation of electronic health records from the admitted patients in the year 2012.

The study utilized 8147 patients who were linked with gender, age, duration, discharge and the kind of admission that was served (Sardo et al., 2015).  Those that demonstrated low scores from the Braden design were women, older individuals, medical unit’s hospitalization emergency admission and prolonged stay (Sardo et al., 2015).  These results were mainly affected by the rate of mobility activity and nutrition.  The study was however limited to reliability and accuracy because it was conducted on recorded health cases which raised the probability of an occurrence of errors.

The study conclusion showed that one third of the population held high pressure ulcers risk during the admission stage thus resulting in the development of preventive care strategies (Sardo et al., 2015).  It was thus recommended for nurses to pay more attention to aging patients as they held low scores. In addition  pressure  ulcers can be described as  preventable,  and frequent happening among hospitalized  patients and  better intervention  methods such as nutrition and  reduced exposure to moisture would help (Sardo et al., 2015).

            References

Banks, M. D., Graves, N., Bauer, J. D., & Ash, S. (2013). Cost effectiveness of nutrition support in the prevention of pressure ulcer in hospitals. European Journal Of Clinical Nutrition, 67(1), 42-46. doi:10.1038/ejcn.2012.140

Hoviattalab, K., Hashemizadeh, H., D'Cruz, G., Halfens, R. J., & Dassen, T. (2015). Nursing practice in the prevention of pressure ulcers: an observational study of German Hospitals. Journal Of Clinical Nursing, 24(11/12), 1513-1524. doi:10.1111/jocn.12723

Roberts, S., Chaboyer, W., & Desbrow, B. (2015). Nutrition care-related practices and factors affecting nutritional intakes in hospital patients at risk of pressure ulcers. Journal Of Human Nutrition & Dietetics, 28(4), 357-365. doi:10.1111/jhn.12258

Sardo, P., Simões, C., Alvarelhão, J., Costa, C., Simões, C. J., Figueira, J., & ... Melo, E. (2015). Pressure ulcer risk assessment: retrospective analysis of Braden Scale scores in Portuguese hospitalised adult patients. Journal Of Clinical Nursing, 24(21/22), 3165-3176. doi:10.1111/jocn.12927

Mountain East Medical Center leadership shift in the purchasing department

            Mountain East Medical Center today received resignation letter from Wilkinson, the head of the purchasing department requesting to resign effectively. His resignation is effective immediately. He will be replaced by the assistant head of the department, Johnny Toler, who has been with the hospital for 13 years.

            Wilkinson was a 1972 graduate of the state university’s school of hospital administration. He came to Mountain East Medical Center in 1975 after working for a small rural community hospital as purchasing chief. He will take a job as a purchasing agent with City Memorial Hospital.

            Toler’s background is in pharmacy. He began as an assistant druggist in the hospital pharmacy 13 years ago and was moved to the purchasing department in 1978 as an assistant after the hospital pharmacy closed. Toler’s wife, Carolyn, is head of the gynecology department at MEMC. They have two children.

            Hospital administrator Harry Illscott had this comment: “Bob’s abilities will be greatly missed at this hospital, but I know that Johnny Toler is a person we can all depend on to do whatever is necessary to keep his department going. I have great faith in him and in this hospital.”

You can find out more from the hospital’s website, www.Mountain East Medical Center.org

The grand opening for new doughnut factory in Repton, Alabama

            Repton city officials had been bargaining for the new plant for two years. At least 12 small towns in Tennessee, Georgia, and Mississippi also wanted to be the site of the new plant. Repton was chosen because of its desirable location, the low interest rates local banks offered for development, and the willingness of city officials to help build roads and sidewalks, waste disposal facilities, and recreation areas near the plant.

            Repton currently has a 14 percent unemployment rate, slightly below the state average. However, its main industry, a shoe factory, is reducing its payroll by half at the beginning of next year. Construction on the $3 million doughnut factory is slated to begin on March 31. A tentative completion date of November 15 is set, and the factory should be in full operation by the beginning of next year.

            The plant will provide 700 jobs for local people, and more than 100 families are expected to be brought in to work for the company. The plant will make and package doughnuts for shipping to all parts of Alabama.

For more information, please visit the company’s website.

Reflection Journal: International Children’s and Women’s Health 

In 21^st century, international organizations and policies play a significant role in improving health. The organizations create public health goals for caring maternal and children’s health (Poku & Whitman, 2011). First, these organizations act a global strategy and provide life-saving interventions and ensure the health systems are of high quality.   In addition, they are capable of making a difference by supporting health plans, eradicating poverty, ensuring environmental sustainability, and ensuring integrated delivery of services where women and children access universal care, improving monitoring, capacity building  and ensuring skilled health workers (Neumann et al, 2016).  For example, Health People 2020 fulfills the objectives through community participation and ensuring quality care. MDGs also ensure that community is full engaged in creating a healthier nation (Poku & Whitman, 2011). Both organizations ensure women and children access quality care and education on how to care for the babies. Through such programs, the organization reduces child mortality and maternal death. Other point is that MDGs and Health People 2020 provide health rights principles which the government and health care providers follow in improving children and women’s health. Principles which guide health professionals include accessibility and accountability (Neumann et al, 2016). Last, these organizations are important to women and children’s life in that this vulnerable population recognizes their human right. Since organizations have set fundamental principles, women and children are now able to access standard of health (Neumann et al, 2016).

  In order to improve children’s and women’s health, Millennium Development Goals should create a multidisciplinary partnership. Through collaborating, global movement and professional expertise maximization, it will be easier to achieve the MDGs (Amieva & Ferguson, 2012).  Health People 2020 should improve women’s and children’s health by   using the approach of cost-effective analysis. In other words, this organization should increase investment in addressing health priorities (Neumann et al, 2016).

Reference

Poku, N. K., & Whitman, J. (2011). The Millennium Development Goals and Development after

2015. Third World Quarterly, 32(1), 181-198. doi:10.1080/01436597.2011.543823

Amieva, S., & Ferguson, S. (2012). Moving forward: nurses are key to achieving the United Nations

Development Program's Millennium Development Goals. International Nursing Review, 59(1),

55-58. doi:10.1111/j.1466-7657.2011.00944.x

Neumann, P. J., Farquhar, M., Wilkinson, C. L., Lowry, M., & Gold, M. (2016). Lack of Cost-Effectiveness

Analyses to Address Healthy People 2020 Priority Areas. American Journal Of Public

Health, 106(12), 2205-2207. doi:10.2105/AJPH.2016.303361

AUTISM

There are very many counselling approaches which can help in the treatment of people who are autistic. These approaches may include psychoanalytic approaches, cognitive and behavioural approaches and humanistic approaches. When autistic people are counselled in the right way, this makes it easier for them to respond positively, and thus being able to benefit positively.

The following are counselling approaches used to deal with autistic problems:

Psychoanalysis

This is a form of psychological approach which is used in order to aid people to combat behavioural and emotional problems (Kapur, 2011). This approach is therefore centred on the idea that people are not aware of the factors which determine their behaviours and emotions. This approach therefore determines how conscious factors which affect relationship between people and their partners.

Hypnotherapy

            This approach utilizes hypnosis, which is a transformed state of consciousness. Hypnosis is consequently utilized for treatment of terminal conditions, and also for stopping specific habits (Kapur, 2011). In addition, it can also be employed in the reduction of anxieties, and to also ease symptoms related to autism.

Cognitive Therapy

            This therapy mainly deals with the thoughts and perceptions, and how these can lead to effects in feelings and behaviour of an individual. Through reconsidering the negative thoughts, a person can be able to learn more ways of thinking positively, thus changing their feelings and behaviours towards certain thoughts (Kapur, 2011).

Cognitive Behavioural Therapy

            This approach combines both behavioural approaches and cognitive approaches. This therapy therefore focuses on an individual’s emotions, thoughts, actions and physical feelings, and it therefore provides a solutions as to how individual’s effects can have effects on other people (Kapur, 2011). This approach therefore allows people to be able to understand how deal and relate with one another.

Reference

Kapur, M. (2011). Counselling children with psychological problems. Delhi: Pearson.

http://www.dailymotion.com/video/x4p7fc0

Soap Note Research Paper

Introduction

The patient is a 45 years old male who presents lethargic laying supine.  He was admitted to the hospital 7 days ago based on a motor vehicle accident and come out of a comma today morning. For the last few days, he was being evaluated for any back pain. The patient performed bed mobility for at least three days with complete assistance.  He felt a mild pain that went down to his left knee with some degree of feet numbness and exhaustion. While he lies  with his  back directly the pain seems to  increase  a bit  but he has  no  issues related to urination,  chills fever,  diarrhea, nausea or even  abdominal  aches.

The patient has acquired two distinct brain concussions as well as a skull fracture on his temporal left bone. He is additionally on DX with an inclusion of an incomplete SCI paraplegia at the T1 level.  He has in the past be diagnosed and treated for chronic bronchitis and allergic asthma.  In the past, he was also a smoker which contributed to the chronic bronchitis and asthma. He is characterized by Aphasia since he lost the ability to express or even understand speech which was caused by the occurrence of brain damage.  He agreed to engage in a mumbling physical therapy to increase his mobility and physical flexibility since he is Aphasia.

He has  a weak  cervical  posture which is  on both  the  extension  and  flexion  while not on the neck brace. For the TF  he is assisted  by  at least  to persons  since his mobility  is challenged and for  the postural  spine,  changes  are conducted after  every two  hours.  His left eye has a bruise.  He was  able  to  adjust and follow  the  PTA’s finger  in a lateral movement  averagely using  the left eye but the right  eye sight  has decreased and  he often  losses  track while  attempting to utilize it.  His  chest  expansion  is one that  is  limited  because he  is characterized  by  shallow breathing  and his tone has a declarative posture. This demonstrates some risks of DVT which can be managed (Malone & Lindsay, 2006).

The patient is a retired fireman who lives in his colonial home with his wife.  Their house  is characterized  by  the  lack of  hand  railing  features  and  its  construction limits  wheelchair  ramps  and the  only  ramp  that  he can use  is one that  is located in the  garage that leads  to the house. This challenges him with mobility within the house and outside.  His family was inclusively advised to join emotional assistance to the patient and offer their participation during his hospitalization and after discharge.  Information was offered to the family in regard to TBI management program and SCI supportive group. The patient was assessed with the utilization of different techniques.  First, the coordination technique was utilized to point at the different directions using the finger which helped to examine the ability of both of his eyes. AAROMUE stretching was conducted for 10 stretches three times every day (10*3) as well as PROM to LE. This is a primary way of decreasing pooling of blood and reducing the probability of getting Edema (LeMura, 2004).  Also, PNF EU with rhythmic initiation and LE PROM technique was additionally utilized.  For the patient’s intervention,  he completed  TRX for a double period  based on his  low  capability  to performance  and the reduced  mental and  speaking  challenges.  He  is  additionally  incapable of participating  in most activities  his  mental  status  has  been established  to be decreasing.

The patient demonstrates the presence of acute distress despite the fact that he is characterized by shallow breathing and mental status diminishing. He does not have any swelling or deformity but he lacks comfort due to the reduced movement abilities.  He  will be discharged in four days time  to the  IP unit Mm. AAROM with the  tolerance of the  breathing  as well as the bed  mobility  exercises in the first  day  after the transfer.  In the second day  the ability  to  make additional  postural changes along the  cervical  section  and MMT for the  elbow flexibility  for four  or five times a day. The patient needs active EU stretching, Tot A and log for each activity and also for trunk. Bed mobility posture while sitting and stretching with an equal sitting balance for at least 5 minutes is necessary. The patient gives almost zero effort while performing any of the exercise activities and stares at a single place blankly.  He requires tactile and speech clues at all the communication levels and exercising activities. In the INP rehabilitation plan, the patient has wheel chair training.

The patient is expected to follow-up with the specialist who made the diagnosis and is taking his through the transition period.  DVT prophylaxis is the basic that will be targeted mainly on predisposing triad factors such as hypercoagulability, trauma and Venus stasis (Lescher, 2011).  The  patient  is highly  encouraged  by nurses to  get engaged  in bed  mobilization  based on his limited abilities  as well as  leg exercises with total  assistance  his  he is at  risk  of DVT and this activities  are  useful in  activating  his calf  pump muscle.  In addition breathing exercises are encourages in order to help the returning of venous (Lescher, 2011). Since he has  a shallow  breathing  this shows that  he has some  breathing issues  which  can be  managed by the  utilization  of therapy. The patient is prescribed for a full bed rest for some days to manage his respiration. However, ambulation can be adopted sooner which is useful for atelectatic ventilation around the lung environment. 

Bed mobility and repositioning  are recommended  to  increase his general  ability  to  coordinate  all the body sections which will additionally  benefit his breathing  system.  Breathing exercises will be consistent since his respiratory is characterized with breathing issues that needs proper management (Malone & Lindsay, 2006).  His sitting balance will additionally increase with breathing and trunk stabilization.   With stability, the patient will be transferred from the wheel chair to utilizing sliding board that will stable his sitting ability.  In addition,  this will  increase his ability to  move around  the  surrounding  at  ease  even after discharge given that  his  house  lacks wheel chair lamps and hands rails.  Stretching techniques and a sling looped on the thigh that will bring each leg to the opposite side for at least five times for each leg. These exercises are targeted at ensuring that the EU is strengthened to offer adequate physical strength (Malone & Lindsay, 2006).

In conclusion, in order to enhance the  communication  abilities  of  the patient  motivation can be offered through  non verbal such as  using a positive  tone, touching  them as a form of encouragement and comfort  and increasing the general health care  satisfaction.  The patient’s mobility issue is fueled by the respiratory issues and aphasia and his sight on the right eye can be enhanced through exercises.  However, the ethical issue in the case is whether the patient should be pressured to show some efforts in the activities that are targeted at improving his physical and emotional wellness.  This can be achieved without pressure by enhancing communication which will, in turn, create a good relation amid the physicians and the patients.

            References

LeMura, L. M. (2004). Clinical exercise physiology: Application and physiological principles. Philadelphia [u.a.: Lippincott Williams & Wilkins.

Lescher, P. J. (2011). Pathology for the physical therapist assistant. Philadelphia: F.A. Davis.

Malone, D. J., & Lindsay, K. L. B. (2006). Physical therapy in acute care: A clinician's guide. Thorofare, NJ: Slack.

Hospitality professionals 

Hospitality professionals are involved in helping out in the planning process especially in the organizations. As a future professional manager, having read chapters 1 to 6 have gained knowledge on how to carry out my plans in future. Through understanding the different concept such as waste management, water systems and other useful concepts, professional managers understand the environment better. The engineering department has been one of the difficult managed departments thus professional managers should ensure they know the department well before planning on how to manage it. Professional managers should ensure they have strategic plans in order to work with the chief engineers on how to manage the engineering department. Technological measures should be put in place in order to ensure that the organization does not lag behind in terms of technology. Technology is important thus professional managers should ensure they are familiar with the latest technology since the organizations depend on them for plans and advice. Professional managers should ensure they advice the organizations on where to market their products and ensure the products and services are in line with the latest technology.

The hospitality industry faces several challenges such as pollution thus managers should ensure they avoid pollution through using non pollutants and advising organizations on measures of preventing pollution. Hospitality managers should know pathogens and measures of preventing the pathogens from harming the people. The hospitality should ensure that employees work in safe organizations whereby their health is not compromised. All people should work in safe places free from pollution, pathogens and any danger that would harm their health.  In addition organizations should ensure they do proper waste management meaning that the hospitality department should ensure it advices the organization on the best waste management solutions. As a hospitality manager in future, I would advice organizations on how to reuse or recycle wastes instead of focusing on dumpsites and landfills. Landfills and dumpsites have environmental consequences thus are not the best waste management techniques.

Waste management enables organization remain safe places for employees to work therefore as a hospitality manager I would ensure that wastes are properly managed. Managing the wastes ensures that people work in safe and secure organizations free from pathogens that end up affecting their health. Proper water systems are important since they ensure that organizations get safe water free from pollution, bacteria and pathogens. Clean water is safe for human consumption thus hospitality managers should ensure the organizations get safe water which will not have a negative impact on their health. As a hospitality manager I would advise the organization to use chlorine since it is safe and ensures pathogens and bacteria are removed. Hospitality managers advise on energy management since energy is an important resource and can be expensive if improperly used. As a hospitality manager I would ensure my organization conserves energy through using solar instead of focusing mainly on electricity. Electricity is expensive and if not properly used, it would be expensive and end up being wanted. As a hospitality manager I would teach employees how to handle situations within the organization. For instance in case of a fire outbreak I would educate them on safety measures by first turning off the electricity. Through the knowledge leant from these chapters, one can become an excellent hospitality manager who will ensure organizations remain safe places and remain profitable as well.

The Country Health Profile

Introduction

Permanent residents and foreigners in Brazil, Syria and Nigeria have a constitutional right to access health care which is provided by government institutions.  The federal government is responsible in creating health policy and ensuring the availability of primary health care. There are private sectors which offer health care services in these countries.  Government-funded hospitals   face some challenges as a result of poor facilities and long waiting time compared with private hospitals. The countries are is facing health problems in that there is a high rate of communicable diseases non-communicable disease and humanitarian issues.  There is an epidemic of long-term diseases and the future generations are at risk. Health system in these countries is poor due to scarcity of resources; there is constrained budget and slow response. To address these issues, there should be a fundamental approach which will work best in sustaining health of people in the community. The purpose of this paper is to analyze the health issues facing these countries, the vulnerable population and measures taken to address this issues and recommendations.

Brazil

Non-communicable disease burden

Non-communicable diseases (NCDs) in Brazil have become a health problem.  The vulnerable population is the poorest people who receive low and middle-income (Nunes et al, 2016).  A systematic search in Brazil show that in 2007, 72% of deaths were caused by NCDs. Compared with communicable diseases which  make 24%, NCDs  are contributed by 66% disease burden. The largest contributor of NCDs is neuropsychiatric disorder.  Smoking is also a major contributor of cardiovascular and chronic respiratory diseases.  Diabetes and hypertension are higher due to lack of physical activity and poor diet (Nunes et al, 2016). There are unfavorable trends which are increasing the NCDs and so actions and policies are needed to address the challenges.

Brazil is on track with Millennium Development Goals and it assigned the document in 2003.  The purpose of the indicator was to evaluate the economic indicators in order to provide quality of life and improve health conditions. The indicator has provided equitable health systems through restructuring the health system and implementing health system strategies (Nunes et al, 2016).  However, the country is unable to address these challenges since there is lack of high-quality practice guidelines (CPGs). The health care system in Brazil lack better management due to the failure of using CPGs as a special tool for decision making, drug utilization and NCD control (Nunes et al, 2016).  A systematic research in Brazil concluded that the high level of NCDs is due to lack of multidisciplinary team, lack of concern on patients’ preferences and lack of formulation of recommendations.

Recommendation

First, healthcare providers should be provided with tools for evaluating high-quality clinical practice guidelines.  For example, (AGREE II) tool is effective in CPGs evaluation.  Other tools such as flowcharts and implementation instructions would work best in promoting adherence. The point is that healthcare provider should use high-quality clinical practice guidelines and this will be achieved through creating a multidisciplinary group, consider patients’ preferences and use selection criteria (Molino et al, 2016). Even though the country has developed health care system through Millennium Development Goals, the government should improve management and coordination of care through quality spending of public health resources (Molino et al, 2016). There are challenges and obstacles in access to health care services and so the government should use the right direction and expand the primary care coverage in order to eliminate the burden of diseases.

Syria

Humanitarian issues and complex emergencies

The country is facing humanitarian crisis where 4.5million people have emigrated from Syria to countries like Lebanon and Jordan (Akbarzadeh & Conduit, 2016). Others are internally displaced and about 70% of people are suffering due to lack of food, water and education.  Since the Second World War, Syria has faced biggest displacement and more than 12million people need assistance so that they can sustain their lives. The issue has highly affected children where 2.7million are not in school for about three years. Children are forced to carry out dangerous task to sustain their lives and the condition has affected them physically and mentally (Akbarzadeh & Conduit, 2016). There is a slow response to the humanitarian crisis and millions of innocent people are suffering from sexual violence, deadly hazards and food shortages. The vulnerable populations affected by this issue are children. According to the U.N, 2.5 million children who are under 18 have been highly affected by the humanitarian crisis. These children are half of the total refugees from Syria who comprise more than 50% (Akbarzadeh & Conduit, 2016).   

Syria is on track with MDGs following that in 2000, it committed to accomplish 8 targets and 60 indicators. The goals are to eradicate poverty, reduce child mortality, and develop environmental sustainability and more (Akbarzadeh & Conduit, 2016). In addressing the humanitarian crisis in Syria, Canada is offering a quick response to these issues. It has provided support to Syrian refugees and to date, the country has provided security assistance and addressed humanitarian issue by spending 1billion. In 2015 and 2016, 25,000 refugees were offered settlements (Canada, 2016). Canada has created social networks and organizations for the purpose of proving long-term success to refugees. Canada is collaborating with humanitarian partners in meeting the basic needs based on shelter, food and security. Canada is also offering assistance through development projects which are aimed at helping the countries with refuges cope with challenges. The crisis has not only impacted Syria but also the countries where refuges are living (Canada, 2016). Canada is offering security and stability funds for the purpose of supporting civil society, civil administration security forces and non-humanitarian aspects in these countries.

Recommendations

Canada (2016) asserts that intervention towards the humanitarian crisis in Syria should comprise humanitarian interventions, national defense and collective self-defense.  In corrective self-defense, third parties should assist and use military force in fighting the ISIS military attacks.  In national Self-Defense, Syria should defend itself from external aggression.  Humanitarian intervention means that the government in Syria should protect the country from tyranny and oppression (Canada, 2016).. Other recommendation is that since children are the vulnerable population, the UNICEF should create a friendly environment in Turking, Lebanon, Jordan and other regions where children will receive psychological support (Canada, 2016). Children should be helped in accomplishing new path through fostering social interaction and meeting their basic needs.  UNICEF organization should also create education programs so that children can learn and eliminate poverty in their future life.

Nigeria

Communicable diseases

Nigeria is facing challenges from communicable diseases such as HIV/AIDs, malaria, TB among other disease.  Nigeria is ranked as the forth country with the highest number of TB and it ranked as second country with highest HIV infection out of the countries with similar estimated incidents (Oladele et al, 2017).  TB infection is high due to nosocomial transmission. The country is not developing in terms of health system and as a result poverty and diseases are creating ill health reproductive. Poor developmental indicators are brought by socio-economic growth which is then affecting the health of people and reducing the life expectancy to 40years compared with other counties like Japan which has a life expectancy of 82years (Oladele et al, 2017).  Since there is a poor socio-economic status,   people in Nigeria   have less access to water and only 45% can aces water sources. The vulnerable population is women and their reproductive health is at risk.  There is a high maternal mortality from pregnancy risk.  

 There are many challenges in Nigeria which are hindering effective intervention to the communicable disease.  First, there are inadequate programs to address the health problems.  According to WHOM statistics which were released in 2011, per 1000 live birth, the rate of infant mortality is 86.  Per 100,000 live births, maternal mortality rate is 840 (Oladele et al, 2017).  The rates are raising due to poor response toward the health issues. Other point is that the country lacks an evidence-informed policy which acts as a tool in controlling infectious disease. There is also a high rate of HIV transmission from mother-to-child and the cause is due to poor PMTCT services.  The country face challenges in planning and implementation in that there is a heavy burden of communicable disease which makes 90% but the annual budget which is allocated in addressing the health issue is 10% (Oladele et al, 2017). The health system remains behind due to poor response on the root causes of communicable disease such as inadequate disposal, alcoholism and more. However, the country is on track with Millennium Developmental Goals with a target of reducing the higher rates of mortality by 275 per 100,000 live births and increase measles immunization (Oladele et al, 2017).

Recommendation

First, the health system should be restructured and ensure the availability of human and material resources.  In order to achieve the MDGs, there should be skilled health providers who will provide high quality care (Uneke et al, 2015). Communities who live in rural and urban areas should access affordable care.  Referral system should develop   so that patients can receive effective and efficient care. Given that the root cause of communicable disease is poor socio-economic status, there should be provision of safe water and sanitation and good infrastructure (Uneke et al, 2015). The health system should also develop an Informed Policy-Making where health care providers will gain interdisciplinary skills and create initiatives for strategic benefits. Health workers will practice new skills and gain insight as well as experiences and as a result create encouraging team (Uneke et al, 2015).

Conclusion

Brazil, Asia and Nigeria are countries with poor health system.  The health issues are brought by various factors and there is an urgent need   to address these health issues. Government, healthcare providers and communities should be in the frontline to create a workable structure with adequate and available health care in order to alleviate the adverse health issues.  In the long term, government and community should ensure quality socioeconomic status, education and reproductive health in order to achieve the set goals of health.  In addressing the health issues affecting Brazil, Syria and Nigeria, the government should join hand with health care providers and respond early to the emerging threats. They should adopt new approaches for the management as well as prevention of communicable disease, non-communicable disease and humanitarian issues. Health care provides should have a comprehensive understanding of causes of disease so that they can create future directions in protecting the population.

Reference

Akbarzadeh, S., & Conduit, D. (2016). THE SYRIAN REFUGEE CRISIS. Ethos, 24(2), 8-10.

Canada, N. (2016, March 11). Five years of crisis in Syria: Development and Peace wants Canadian

government to take greater action for peace in Syria. Canada Newswire.

Molino, C. C., Romano-Lieber, N. S., Ribeiro, E., & de Melo, D. O. (2016). Non-Communicable Disease

Clinical Practice Guidelines in Brazil: A Systematic Assessment of Methodological Quality and

Transparency. Plos ONE, 11(11), 1-15. doi:10.1371/journal.pone.0166367

Nunes, H. G., Gonçalves, E. A., Vieira, J. J., & Silva, D. S. (2016). Clustering of Risk Factors for Non-

Communicable Diseases among Adolescents from Southern Brazil. Plos ONE, 11(7), 1-13.

doi:10.1371/journal.pone.0159037

Oladele, E. A., Khamofu, H., Asala, S., Saleh, M., Ralph-Opara, U., Nwosisi, C., & ... Torpey, K. (2017).

Playing the Catch-Up Game: Accelerating the Scale-Up of Prevention of Mother-To-Child

Transmission of HIV (PMTCT) Services to Eliminate New Pediatric HIV Infection in

Nigeria. Plos ONE, 12(1), 1-18. doi:10.1371/journal.pone.0169342

Uneke, C. J., Ezeoha, A. E., Uro-Chukwu, H., Ezeonu, C. T., Ogbu, O., Onwe, F., & Edoga, C. (2015).

Enhancing the Capacity of Policy-Makers to Develop Evidence-Informed Policy Brief on

Infectious Diseases of Poverty in Nigeria. International Journal Of Health Policy &

Management, 4(9), 599-610. doi:10.15171/ijhpm.2015.100

The American Health Care Act in 2017

The raging debate about replacing the Affordable Care Act with Affordable Care Act is basically about redistribution of wealth in United States.  The debate is about how a society should provide for poor and vulnerable citizens and the amount of resources that the powerful and the rich should give to the poor. The argument should be based on the fact that health insurance is supposed to enable spreading of health care in the society, hence, the argument by the republicans that redistribution of wealth is immoral fail to acknowledge insurance is in its self-redistributive.

The Affordable Care Act ensures that the  medical cost burden is redistributed to healthy from the sick , with provisions that prohibits insurers from refusing coverage for individuals with pre-existing health conditions. The ACA makes sure that everyone can access health coverage whether poor or rich with support of new taxes (Kliff, 2017).  The effect of the replacement is that wealthy and health people will benefit while the lower-income and sicker ones will be disadvantaged. The wealth will be granted big tax breaks while many families in America will bear huge costs if the intended replacement takes place.

On the other, the American Health Care Act may come with a positive implication that includes reduction in health care costs.  Health care costs have been rising since the introduction of Affordable care with insurance firms in many states withdrawing from resulting health-care exchanges (Tumulty, 2017).It has been observed that with the previous Act, one may possess an insurance card and yet it may not be taken for coverage. What these implications imply is that a balance has to be sought between individual interest and health-care affordability.

Reference

Questions

1. Systems thinking model is an effective approach that can help a healthcare corporation in obtaining what form of elements?
2. Increased growth
3. Adequate resources
4. Slow growth and the existence of different views on the situation on how it can be handled

Answer and explanation

The answer is the indication of several perspectives to handle the issue as well as slow development over time.  When there is an issue in an organization and the options seem too many to settle for the best this calls for system thinking approach to handle growth issues.  The system is not required when the resources and growth are positive.

2. In a healthcare institution what is the general sign that demonstrates the necessity for a system thinking approach?
3. Organized and comprehensive complexity
4. Purposefulness
5. Non connectedness

Answer and explanation

            The correct answer is organized and comprehensive complexity. Organized and complete complexity  is a necessity  in managing  healthcare  institutions since  the systems normally requires  commitment  and the  subjection  of increased  effort. Purposeless and the lack of connection are wrong since the since is normally an attempt to develop directions for a situation.  This means that  it develops a purpose  thus creating the  connection  needed  in  ensuring  and sustaining  efficiency  within  the system.

3. Define patient satisfaction?
4. The degree to which the patients needs have been accomplished
5. Quality as well as affordability of healthcare given
6. A measure to the level in which the patient is content with the healthcare services which was obtained from a healthcare giver.

Answer and explanation                                                                    

            It is the measure of the patient’s contentment in regard to the services offer by the healthcare giver (Davidson, 11).  Quality and affordability  of care  are  different from satisfaction since they  involve the system in  general  and moreover  satisfaction  of needs  may not  be contentment.

4. What type of physician is characterized by high patient satisfaction?
5. Authoritarian
6. Egalitarian
7. Uninvolved

Answer and explanation

            Egalitarian  is the correct  answer  because  the  type of physicians  treats, makes  recommendations by  discussing the available options  and  allow the  patient to be involved in  creating decisions (Davidson, 12).  Uninvolved and authoritarian ones tend to treat and give recommendations based on their own authority.

            Reference

Davidson, Emily. Current issues in healthcare management in the United States and identified management issue: patient satisfaction. N.d, 1-23. pdf