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Medical Treatments: Issues and Options for an Expanded Federal Role" Using Bardach's Eightfold Path"
The objective of this work in writing is to assess the work entitled "Research on the Comparative Effectiveness of Medical Treatments: Issues and Opinions for an Expanded Federal Role" using Bardach's Eightfold Path.
Bardach's eightfold path includes specific steps for assessment including: 1) Defining the problem; 2) assembling some evidence; 3) Construction of alternatives; 4) selection of criteria; 5) projection of the outcomes; 6) confrontation of the trade-offs; 7) decisions; and 8) telling the story.
Defining the Problem
The work entitled "Research on the Comparative Effectiveness of Medical Treatments: Issues and Opinions for an Expanded Federal Role" was published by the Congressional Budget Office in November 2007 and is focused on the rising health care costs and the challenge that these represent for the federal government and private payers alike. It is noted in this work…
(2) Creation of a commission to monitor he activities of the center; and (3) Make provision of authority to spend $300 million between 2008 and 2010 and an additional $375 million annually following 2010 by annual per capita fee of about $2 imposed on private health insurance premiums to being in 2011.
VIII. Telling the Story
It is noted that there is very little available in the way of hard evidence concerning which treatments "work best for which patients and whether the added benefits of more-effective but more-expensive services are sufficient to warrant their added costs -- yet the current health system tends to adopt more expensive treatments even in the absence of rigorous assessments of their impact." (GAO, 2007) The recommendations are clear in this study in that a determination of the drive for comparative effectiveness of treatment is set out for implementation by the GAO (2007).
The working of the department leads to the overall success of the other programs and plans aimed by the country in delivering medical services to the country. Moreover, delivery of medical services to the marginalized and women involved approaches that consumed less amount of finances from the government and other support organs.
Question 2: Important agencies at the federal level which impact on delivery of medical services to the Americans
There are several agencies situated at the federal level that serve in delivery of medical services to the people of the United States of America. One of the agencies is the Emergency Medical Services in the United States of America. This body provides services to the people in need. Emergency services are those delivered to the people who enter into an instance of medical need out of hospital. In most cases, such cases are acute and in distinctive need of…
Murray, J.E. (2007). Origins of American health insurance: A history of industrial sickness funds. New Haven: Yale University Press.
Niles, N.J. (2011). Basics of the U.S. health care system. Sudbury, MA: Jones and Bartlett.
Shi, L., & Singh, D.A. (2010). Essentials of the U.S. health care system. Sudbury, Mass:
Jones and Bartlett Publishers
From there, health care providers are becoming more assertive in denying services based on their religious beliefs (Friedman 2007). This debate has been going since a doctor refused medical treatment to a gay man. The dispute arose in 2000 after San Diego-area doctors Christine Brody and Douglas Fenton refused to artificially inseminate Benitez, a lesbian who lives with her partner, Joanne Clark, in Oceanside, north of San Diego (Parker 2007).
What distinguishes the case of Guadalupe Benitez is that the physicians involved refused to provide a medical procedure to one patient that they readily provide to others, says Jill Morrison, legal counsel to the National Women's Law Center, an advocacy group that works to protect women's rights in the workplace, schools, sports, and health care. "Usually, providers who object to certain services object to them for everyone: 'I won't provide contraception.' In this case, they don't object to the service,…
2007). Medical treatment & Religion. Retrieved November 5, 2007, from Website: the Stockholm School of Economics in Riga & Latvijas Mobilais Telefons Debate Club
Bridge, Caroline (1999). Religious Beliefs and Teenage Refusal of Medical Treatment. The Modern Law Review, Vol. 62, No. 4
2004). Child Welfare vs. Parental Autonomy: Medical Ethics, the Law, and Faith-Based Healing. Theoretical Medicine and Bioethics.
elief System: Epicurean vs. Stoic
People over 65 should be prohibited from having major medical treatment such as open - heart surgery. Health care efforts would be better directed toward preventative care for children. From this standpoint this work intends to examine the belief of the Stoic and of the Epicurean and finally to form a personal opinion and state the same.
Stoicism is a term derived from the Greek "stoa" which refers to the columns or "colonnade" such as one sees in the replicas of Grecian architecture or on the front of colonial style homes. Zeno, a teacher taught his followers in the "stoa poikile" in Athens and the name stoics was applied to this group. Followers were inclusive of Marcus Aureoles, Seneca and Epictetus.
The thinking or logic of the "Stoic" was the same as that of Aristotle but with a different twist adding that:
"Stoic Logic" Internet Encyclopedia of Philosophy
The Handbook of Epictetus. Translated by Nicholas White. Indianapolis: Hackett Publishing Company, 1983.
Walton, Stephen (1997) THE MANUAL: "How to Control Everything You Can" a modern rendering of the Enchiridion of Epictetus [Online] available at:
Patient's ight to efuse Medical Treatment
My topic is a patient's right to refuse treatment. Is it ok ethically to do so? Do they have the right to refuse treatment? DO healthcare worker have to abide by these wishes, or treat these patients anyway regardless of their wishes?
This paper focuses on a patient's inherent right to refuse medical treatment: just because a doctor or any other medical professional believes that a certain arena of medical care is in a patient's best interest, doesn't mean that the patient has to engage in this treatment. ather, every step of the way, the patient absolutely has the specific right to engage in concerted and proactive choices about his treatment, even if the medical professionals around him disagree. This paper will discuss and examine the pillars and nuances of this concept, and how more healthcare professionals ought to be aware of and follow…
Grifitth, R. (2014). Respecting a patient's wish to refuse life-sustaining treatment. British Journal of Nursing, 332-339.
LAC. (1983). The Right to Refuse Treatment. American Journal of Public Health, 918-921.
Mair, J. (2010). Respect for autonomy; or the right to die? Health Information Management Journal, 46-52.
Plawecki, L.A. (2009). When "no" means no: elderly patients' right to refuse treatment. J Gerontol Nursing, 16-8.
Constipation, Hypertension, Seizure
This is the infrequent or difficult bowel evacuation (Mayo Clinic Staff, 2012). While there are no strict standard for bowel elimination, it is generally believed that fewer than thrice a week constitutes constipation. Stools are usually hard and dry. Other common symptoms associated constipation include excessive straining during bowel evacuation, a sense of rectal blockage, a sense of incomplete evacuation and the need to perform manual measures to evacuate the bowels. Constipation may be the consequence of insufficient fluid intake or dehydration, inadequate fiber in the diet, foregoing elimination, irritable bowel syndrome, lack of physical activity, illness, abuse of laxatives and certain medical conditions. Those more likely to develop constipation are older adults, those who are sedentary, confined in bed, dehydrated, on low-fiber diet, on certain medications and undergoing chemotherapy. It is more common in women and children. Causes for alarm include fewer…
Makoff, D. (2012). High blood pressure. MedicineNet: MedicineNet.com. Retrieved on March 7, 2012 from http://www.medicinenet.com/high_blood_pressure/page
Mayo Clinic Staff (2012). Constipation. Mayo Clinic: Mayo Foundation for Medical
Education and Research. Retrieved on March 7, 2012 from http://www.mayoclinic.com/health/constipation.DS0063/METHOD=print&DSECTION=all
PubMed Health (2011). Seizures. ADAM Medical Encyclopedia: ADAM, Inc. Retrieved
Case Involving a Medical Dilemma
Nurses usually experience ethical dilemmas while carrying out their work of providing care to different patient populations. Ethical dilemmas arising during nursing practice are largely attributable to the complex processes involved in healthcare delivery. An example of a landmark case involving a medical dilemma is the case of a 17-year-old girl in Connecticut, Cassandra C, who refused to continue receiving chemotherapy. Cassandra was diagnosed with Hodgkin lymphoma at Connecticut Children’s Medical Center in September 2014. Following her diagnosis, doctors recommended chemotherapy as a suitable treatment approach that would help save her life. However, with her mother’s support, Cassandra refused this treatment approach for her potentially curable cancer resulting in a medical dilemma that ended up at the Connecticut Supreme Court. In a unanimous decision, the Connecticut Supreme Court ruled that the teenager cannot refuse chemotherapy on the premise that she is not mature (Viale, 2015).…
Hevia, M. & Schnidrig, D. (2016, December). Terminal Patients and the Right to Refuse Medical Treatment in Argentina. Health and Human Rights Journal, 18(2), 247-250.
Viale, P.H. (2015, March-April). Refusal of Therapy: When Is It Appropriate? Journal of the Advanced Practitioner in Oncology, 6(2), 96-97.
Medical Use of Marijuana
Increasing use of medical marijuana
Having looked at the various areas that medical marijuana has been brought into use and the various forms in which marijuana is administered, it is also important to take note of the various challenges that come with it. There have been various researches that have been conducted that covers the medical as well as the ethical side of the medicinal marijuana, and there have been a dilemma in the balance of the two sides on whether to institutionalize the drug or to stop it, and even on whether the medicinal use can be made to work without the proneness to abuse as is the case at the moment.
Medicinal marijuana has neither medical nor ethical standing within the contemporary society where drug abuse is one of the biggest worries of governments across the world and the alternative medicines that medical research…
Medical Advances in Cancer Treatment Research
This paper discusses the medical advances in cancer treatment research. The writer explores several treatment options and compares them to treatment options of the past. There were two sources used to complete this paper.
There was a time when a diagnosis of cancer meant a death sentence. The word still strikes a chord of fear among the millions each year who are told they have it, but in recent years there have been many advances in medical science that allow many who would have died from the disease to live long and full lives. There are more cancer survivors now than ever before and treatment options continue to be made available.
In the past there were only two options for the treatment of cancer. One could have surgery and one could be given a course of radiation treatments. The surgery was for the purpose…
Medical ID Theft and Securing EPHI
Medical Identity Theft
Medical information can be stolen by 1) the bad guys getting sick and using a victim's information to obtain services, 2) friends or relatives use another friend's or relative's information to obtain treatment, 3) when professionals, such as physicians, fabricate services that did not exist, 4) organized crime, and 5) innocent or not so innocent opportunists (Lafferty, 2007). ad guys that get sick can take a victim's insurance information to obtain services for treatment. Professionals can fabricate false claims to cover medical errors. Opportunists have access to patient data and the ability to steal, use, or sell that information.
Effective security requires clear direction from upper management (Whitman). Assigning security responsibilities and access controls with audit controls to organizational elements and individuals helps to place accountability on individuals. They must formulate or elaborate security policies and procedures based on the organizational…
HIPAA Security Series. (n.d.). Retrieved from HHS.gov: http://www.hhs.gov/ocr/privacy/hipaa/administrative/securityrule/techsafeguards.pdf
Hoffman, S. & . (2007). SECURING THE HIPAA SECURITY RULE. Journal of Internet Law, 10(8), 1-16.
Lafferty, L. (2007). Medical Identity Theft: The Future Threat of Health Care Fraud is Now. Journal of Healthcare Compliance, 9(1), 11-20.
Whitman, M. & . (n.d.). Case B: Accessing and Mitigating the Risks to a Hypothetical Computer System, pages B1-B24 .
Treatments for Rosacea
Rosacea is a medical condition characterized by reddening of the skin. The face primarily will turn red in hue. Sores may appear on the skin as well. The face may also swell to some degree. It is an unfortunate condition where patients not only have to deal with the illness itself, but also with psychological ramifications from feeling unattractive due to the skin pigments or lesions. Although there is currently no cure for Rosacea, scientists have researched various treatments to help patients suffering from the condition.
In the article, "Treatment of Rosacea with Intense Pulsed Light," researchers Papageorgiou et. al consider how ultra violet and pulsed light might positively treat skin conditions like Rosacea. During this particular experiment, the researchers tested 34 patients who were given treatments every three weeks for a total of twelve weeks. More than 70% of patients experienced at least a 50% reduction…
Lee, DH, Li, K.K., & Suh, DH "Pimecrolimus 1% Cream for the Treatment of Steroid-
Induced Rosacea: an 8-week Split-Face Clinical Trial." British Journal of Dermatology. (158:5). 2008. 1069-76. Print.
Papageorgiou, P.P., Clayton, W.W., Norwood, S.S., Chopra, S.S., & Rustin, M.M. "Treatment of Rosacea with Intense Pulsed Light: Significant Improvement and Long-Lasting Results." British Journal of Dermatology. (159:3). 2008. 628-32. Print.
Sharquie, K.E., Najim, R.A., & Al-Salman, H.N. "Oral Zinc Sulfate in the Treatment of Rosacea: a Double-Blind, Placebo-Controlled Study." International Journal of Dermatology. (45:7). 2006. 857-61. Print.
In this case, that power dynamic was only exacerbated by the fact that the entire MSICU nursing team had never received training in management of the type of clinical issues presented and by the fact that they were excluded from any consultation in connection with a post-operative management plan.
Therefore, it is recommended that the institution immediately implement a policy of "see something, say something" according to which all members of healthcare teams are encouraged to speak up irrespective of power differentials. Furthermore, that protocol must include a statement of policy insulating any member of a healthcare team who does voice a legitimate concern in good faith from any retaliation or other negative response that could conceivably deter such diligence. Finally, the record of this case also indicates the immediate need for protocols requiring all members of the healthcare team to identify themselves to other members of the team, especially…
Bosk, Charles L. (2003). Forgive and Remember: Managing Medical Failure.
Gawande, Atul. (2008). Better: A Surgeon's Notes on Performance.
Groopman, Jerome. (2008). How Doctors Think.
Timmermans, Stefan. (2003). The Gold Standard: The Challenge of Evidence-Based
Alcohol and drug abuse is not limited to any socioeconomic category, race, religion, or gender. Finding the right drug, the right type of support group, and the right type of intervention can be a long and difficult process. For example, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) offers special resources for recently-deployed combat officers, teens, and even obese individuals, all of which are tailored to meet the different challenges that life circumstances, age of life, or biology can pose that predispose an individual to addictive behaviors or affect an addict's treatment plan.
However, improving opportunities for jobs and treating communities as well as individuals seems essential to aiding those who are disproportionately affected by addiction. All addicts feel the effects of tolerance and physiological and psychological dependency to some degree, depending on the nature of the drug and their biology (Oakley & Ksir, 2003, pp45-46). But while social…
Adrian, Manuella. (2001). Do treatments and other interventions work? Some critical issues.
Substance Use & Misuse, 36 (13): 1759-1780
NIAAA. Alcoholism. Getting the Facts. Retrieved October 8. 2010 at http://www.niaaa.nih.gov/
Oakley S. Ray & Charles Ksir. (2003). Drugs, society, and human behavior. New York:
CAEFS takes the position that women with mental health problems do not belong in prisons and that the treatment, support and assistance they need should be provided to them in the community, rather than in prison.
The above statement clearly outlines central problem areas that should be the focus of investigation. As this study and others emphasize, women who enter prison with mental issues and problems require intensive support. However, this is at present not the case and many women prisoners who suffer from mental problems are not afforded the necessary support and adequate intensive therapy. Some critics also suggest that alternatives be investigated for women with mental issues. "... The public need for the appearance of retribution may deter government from considering alternatives to sentencing persons with mental disabilities to imprisonment." www.elizabethfry.ca/submissn/dawn/17.htm" (ibid)
Another factor which relates to mental and psychological issues is that women experience stress…
Bilchik, Shay, Cyntha Seymour, and Kristen Kreisher. "Parents in Prison." Corrections Today Dec. 2001: 108+. Questia. 17 Feb. 2005 http://www.questia.com/ .
Bjorhus, Jennifer. "Getting into Prison." Columbia Journalism Review July-Aug. 1994: 14+. Questia. 17 Feb. 2005
Medical Case Study
Florence (F) is a 43-year-old woman who is two days post-operative, following an appendectomy. She has a history of arthritis, and currently takes 10mg of prednisone daily. She is allergic to penicillin. She weighs 46 kg (101.5 lbs.) and is 168cm tall (5'6"). This puts her slightly underweight for her age and height, at least 18-25 pounds (Height and Weight Chart, 2010). While doing a route in dressing change, nurse notice a yellow discharge emanating from the wound.
Identify and discuss the importance of obtaining information during a nursing admission in relation to post- operative assessment. In modern healthcare, a nurse must first and foremost try to understand and utilize a systematic and synergistic model of data collection and assessment. Human beings are complex creatures, and the more data one has, the easier it will be to ensure that a proper diagnosis is made. A systematic assessment…
Height and Weight Chart. (2010). HealthCheck Systems. Retrieved from:
Prednisone and Other Corticosteroids: Balance the Risks and Benefits. (2011). The Mayo
Clinic. Retrieved from: http://www.mayoclinic.com/health/steroids/HQ01431
Treatment and Management of Cancer
Obligations of community health nurse in providing healthcare
The high demand for healthcare services, especially to those managing dreadful illnesses such as cancer, there is a dire need to understand the health promotion strategies and also ensure quality lives. Here, is a discussion assisting to analyze how best to improve health and better management of dreaded conditions like diseases such as cancer. Those affected will learn to adopt the right measures that will help to improve functional abilities, and what to practice in case self-care is not an option. The mandate of community health nurses will be scrutinized, to help acquire general knowledge on efficient management of diseases.
Cancer is a disease, which has characteristics of growths that cannot be controlled, and also the abnormality of how rapidly the cells are spread to other organs. Cancers vary in their areas of…
These examples highlight that technology is always a tool, a way of enhancing human judgment -- we must not mistake it as a replacement for good nursing practice.
After all, the use of a computer is no substitute for a medical education. Anyone who works in a hospital can see this -- the increased accessibility of information through the Internet also means that patients often come in, convinced that they are suffering from a serious illness, allergy, or condition, based more upon a diagnosis Googled on WebMD, rather than upon the fact that they saw a doctor! If a computer alone was required to diagnose, everyone would have a degree!
Don't get me wrong -- I use technology every day in my life, and thank my lucky stars, and my patient's lucky stars, that it is so ubiquitous. When health care providers wish to communicate, the use of cell phones…
Nurses are required to make many immediate decisions in their assigned duties. Unfortunately, in recent years, patient care has often been compromised as a nursing shortage crisis has escalated to epic proportions. Increased patient loads have resulted in often hasty nursing decisions as responsibilities and hours worked have increased. Although precious time must be spread thin to accommodate higher numbers of patients, nurses must exercise their morals through consistency in ethical behaviors. According to Peggy Chinn (1), "Many ethical issues, such as end-of-life decision making, have increased in complexity. Other issues, such as advocacy and choice, have changed in certain respects but are more clearly centrally situated within nursing's ethical domain."
As a result, nurses are held accountable for a variety of decisions in nursing practice and in many instances, a patient's life depends on such decisions to survive. Gastmans (496) states that "Generally, the goal of nursing…
Chinn, P. (2001). Nursing and ethics: the maturing of a discipline. Advances in Nursing Science
Erlen, J. (2001). Moral distress: a persuasive problem. Orthopaedic Nursing 20(2): 76-80.
Erlen, J. (2001). The nursing shortage, patient care, and ethics. Orthopaedic Nursing 20(6):
Gastmans, C. (2002). A fundamental ethical approach to nursing: some proposals for ethics education. Nursing Ethics 9(5): 494-507.
How can eliminating abbreviations reduce errors?
In the medical profession, time is everything. To make documentation as expeditious as possible, a series of abbreviations have been accepted in records. This has been considered an acceptable practice as much as calling a registered nurse an "RN." The problems occur when people are unclear about the abbreviations mean or if a set of letters can have more than one meaning. For example, there is the abbreviation "CA" which means cancer and then "Ca" which is calcium. Another example is "a" which can mean both "artery" and "before" (Medical 2011-page 1). It is very easy to misread abbreviations when medical staff is in a hurry. Imagine the problem if a "q.w." which is take weekly was confused for a "q.v." which is take as one wishes. If the terms were written out rather than abbreviated, these potentially dangerous situations could be…
Berman, Jules. (2008). "Specified Life." Biomedical Informatics.
Greenall, Julie (2006). "Safe Medication Practices." Hospital News.
"Medical Abbreviations Glossary." (2011). JD-MD.
In spite of research gaps, medical robotics is a growing trend in the United States.
Advances in Medical Robotics (Diana, 2011)
Hybrid Assistive Limb 5 (HAL5) is an artificially powered ecoskeleton that helps double the amount of weight someone can carry unaided.
DaVinci Si HD Surgical System performs minimally invasive surgery through superior visualization and greater precision, with incisions of one to two centimeters causing less pain and speedier recovery. It reduces the hospital stay to one half and costs one third less.
Sofie incorporates force feedback allowing a surgeon to feel the pressure they apply making sutures and pushing tissue aside. Sofie is expected to develop in five years.
Cyberknife Robotic Radiosurgery System is a non-invasive alternative to surgery for treatment of cancerous and non-cancerous tumors.
Nursebot is designed to specifically help elderly deal with daily activities allowing them to live at home.
RIA is designed to…
Davies, B. (2006). Essay: Medical robotics -- a bright future. The Lancet, vol 368, doi:10.1016/S0140-6736(06)69929-7, S53-S54.
Diana, a. (2011, Jan 29). 12 Advances in Medical Robotics. Retrieved from InformationWeek Healthcare: http://www.informationweek.com/healthcare/patient/12-advances-in-medical-robotics/229100383
Huang, G.P. (2006). Robotics and clinical research: Collaborating to epand the evidence-based for rehabilitation. JRRD, 43(5), xiii-xvi.
Seaman, a. (2013, Jan 4). Racial gaps in access to robotic prostrate surgery. Retrieved from Yahoo Health: http://health.yahoo.net/news/s/nm/racial-gaps-in-access-to-robotic-prostrate-surgery
Initial Patient Analysis
Discomfort in lower back.
Patient is a 78-year-old woman presented as disheveled, with bug bites throughout her body, and exuding a foul odor. Cognitively, she orients only to her name with a BMI of 30 and a minimal understanding of the English language. She is able to nod "yes" or "no" to questions, but calls the nurse "Mother." She is unsteady on her feet, and has a fine "pill-rolling "tremor in her left hand. He legs are quite cool to the touch, hairless, and toe capillary refill is greater than 2 seconds.
Past Medical History
Unknown, but patient appears to be in distress both physically and psychologically.
Poor, disheveled, may not be receiving adequate care or living in an environment with enough food or warmth. BMI of 30 is technically obese, which also may indicate the patient is not…
Hypoglycemia. (2012). Web MD. Retrieved from: http://symptoms.webmd.com/#./conditionView
Michael, K. And Shaughnessy, M. (2006). Stroke Prevention and Management in Older
Adults. Journal of Cardiovascular Nursing. 21 (55): 521-26.
Mohr, J., et al. (2004). Stroke: Pathopshyciology, Diagnosis and Management. New York: Churchill Livingstone.
S. Census Bureau) It is clear after having reviewed this information that this area is quite needy in provision of alcoholism treatment and intervention.
VI. Treatment Program Community Marketing Process
In the initiative of reaching the community both through media and public relations as tools to raise awareness the organization will be enabled to alert members of the community about the services available. Promotions, marketing, public relations and media advocacy are all critical specifically as these are all integrated with the business sector and as well adapted by nonprofit organizations. In the attempt to market or advertise to the community the available services all venues of the media should be sought and the mass media in the form of newspaper and magazines and other printed material as well as media through television and radio broadcast communications and finally through the Internet's provision of electronic media. Communication with the media should…
Ervin, N.E. (2002). Advanced community health nursing practice: Population-focused care. Upper Saddle River, N.J.: Prentice Hall. ISBN# 0-8053-7364-0.
Bensley, R.J., & Brookins-Fisher, J. (EDs). (2003). Community health education method: a practitioners guide. (2nd ed.). Boston, MA: Jones and Bartlett. ISBN# 0-7637-1801-7
Andreasen, A.R. (1995). Marketing social change: Changing behavior to promote health, social development, and the environment. San Francisco CA: Jossey-Bass. ISBN# 0-7879-0137-7
Medicaid EPSDT and AOD Treatment Services Policy Brief entitled Resources for Recovery: State Practices that Expand Treatment Opportunities" Medicaid EPSDT and AOD Treatment Services" (O'Brien, et al., 2005) National Program Office, Technical Assistance Collaborative, Inc. Online located at: www.resourcesforrecovery.org
According to the work of Fulford (1994) in an Oxford Practice Skills Project eport "Three elements of practice (ethics, law and communication skills) are approached in an integrated teaching programme which aims to address everyday clinical practice. The role of a central value of patient-centered health care in guiding the teaching is described. Although the final aim of the teaching is to improve the actual practice, we have found three 'sub-aims' helpful in the development of the programme. These sub-aims are: increasing students' awareness of ethical issues; enhancing their analytical thinking skills, and teaching specific knowledge. (Hope, 1994)
In the work of Miles, et al. (1989) entitled "Medical Ethics Education: Coming of Age it is stated that "medical ethics education is instruction that endeavors to teach the examination of the role of values in the doctor's relationship with patients, colleagues and society. It is one form of a broad curricular…
Fryer-Edwards, PhD (2005) Tough Talk: Helping Doctors Approach Difficult Conversations - Resources for Teaching- Domains for Small Group Teaching Prelude 3 Department of Medical History and Ethics University of Washington School of Medicine.
Siegler, Mark MD (2001) Lessons from 30 Years of Teaching Clinical Ethics AMA Journal 2001 October.
St. Onge, Joye (1997) Medical Education Must Make Room for Student-Specific Ethical Dilemmas" Canadian Medical Association Journal 15 Apr 1987, 156(8).
Hicks, L. et al. (2001) Understanding the Clinical Dilemmas that Shape Medical Students' Ethical Development: Questionnaire Survey and Focus Group study. BMJ Journal 2001;322-709-71- 24 march 2001.
Treatment of Heart Failure in Nursing Home Residents
Heart failure (HF) symptoms may occur because of systemic and pulmonary congestion, structural defects arising on account of HF, structural defects leading to HF, or from treatment complications. At first, studies addressing the issue of heart failure focused on HF patients and decreased left ventricular contraction. As a result, therapies were tested within this patient cluster. This patient cluster's agreed description is HF with LVSD (left ventricular systolic dysfunction) (NCGC, 2010).
In order to treat chronic HF, non-pharmacological as well as pharmacological therapy ought to be utilized for patients. While this condition is quite frequently witnessed among patients living in nursing homes, whether the suggestions put forward in the pharmacological therapy guidelines are implemented within this cluster of patients is unclear (Daamen, et al., 2016).
Owing to the lack of awareness of the precise prevalence of chronic HF, this phenomenon is…
Barents, M., Horst, V., Voors, A., Hillege, J., & Jongste, M. (2008). Prevalence and misdiagnosis of chronic heart failure in nursing home residents: the role of B-type natriuretic peptides. Neth Heart J., 123 -- 128.
Davidson PM, Cockburn J, Newton PJ, et al. (2010). Can a heart failure-specific cardiac rehabilitation program decrease hospitalizations and improve outcomes in high-risk patients? Eur J. Cardiovasc Prev Rehabil. 2010;17:393 -- 402
Dinkelaker S. (1999) Can A Nurse-Managed Medication Discharge Planning and Follow-Up Program Affect Readmission Rates of Patients with a Diagnosis of congestive Heart Failure?
Daamen, M., Hamers, J., Gorgels, A., Tan, F., Schols, J., & Rocca, H. (2016). Treatment of heart failure in nursing home residents. J Geriatr Cardiol., 44 -- 50.
As mentioned earlier, the desired outcome of nursing care is comfort and there are many articles in which the researchers have talked about the needs of the patients and the things that alter the comfort of the patients. Kolcaba suggested that the cancer patients who are terminally ill can benefit from comfort care as it pays attention to the perspective and needs of the patients. Through such kind of care, the patient is not only provided with pain relief, but the depression of the patient is also addressed adequately. As she said that patients who are not in pain but are depressed seek comfort in the transcendental sense as well as in the psycho-spiritual sense (Kolcaba, 1992 p 4). In some of her works, she has explained the use of the instruments and their application by the nurses. Kolcaba reckons that the instruments presented by her to evaluate the comfort…
Kolcaba K. (1994). A theory of holistic comfort for nursing. Journal of Advanced Nursing, 19(10): 1178-1184.
Kolkaba, K. (1992). Holistic comfort: Operationalizing the construct as a nurse-sensitive outcome..Advances in Nursing Science, 15 (1), pp. 1-10.
Kolkaba, K. (1997). The primary holisms in nursing..Journal of Advanced Nursing, 25 pp. 290-296.
Kolkaba, K. And Fisher, E. (1996). A holistic perspective on comfort care as an advance directive..Critical Care Nursing Quarterly, 18 pp. 66-76.
Treatment History Of Cystic Fibrosis
The field of pediatric nursing is a particularly large one in which its members may find themselves having to counsel both young patients and their families suffering from a myriad of diseases. Cystic fibrosis (CF), in particular, is a debilitating disease that strikes many young people. In the first years following its discovery, many children could not expect to make it to their teen years. Today, with advances in the management and care of this disease, patients are living into their 40s. It is even possible that there will one day be a cure.
This paper will look at CF from a historical perspective. The timeline of its discovery and research will be briefly presented, as will a few of the significant "milestones" in the history of the treatment of CF and what these mean for people battling this disease.
References to cystic fibrosis were…
Author not available. (1994). Genetic Therapy Possible Cure for Several Diseases. Morning Edition (NPR).
Baroni, M.A., Anderson, Y.E., and Mischler, E. (1997). Cystic fibrosis newborn screening: Impact of early screening results on parenting stress. Pediatric Nursing. 23, 143(9).
Hopkin, Karen. (1998). Understanding Cystic Fibrosis. Jackson, MS: University Press of Mississippi.
Orenstein, David M. (1997). Cystic Fibrosis: A Guide for Patient and Family. 2nd ed., Philadelphia, PA: Lippincott-Raven.
ithin the profession itself, there are many ethical debates, pertaining to medications, such as prescribing psychotropic drugs like antidepressants to adolescents, the correct times to use palliative care at the end of a patient's life, the ethics of emergency contraception and giving 'the morning after pill' and contraception to adolescents without parental consent. For pharmacists engaged in research, the appropriate use of animals in research and whom to include or exclude in clinical trials may be another issue of personal concern (Applelbe 2008). In all cases, to dispense medication means one must dispense good judgment, not simply pills and potions.
Pharmacy Ethics and Decision Making. (2008). Foreword by Gordon E. Appelbe. First edition.…
Pharmacy Ethics and Decision Making. (2008). Foreword by Gordon E. Appelbe. First edition.
London: Pharma Press.
Patient Centered Medical Homes (PCMH) are often confused as being actual "homes" for patients to be admitted in and given medical treatment and care. PCMH is actually a health care model based on which health care is provided to patients, under the supervision of physicians. The PCMH model of health care provides patients with continuous, comprehensive medical care, in order to increase the chances of achieving the goal of benefitting the patient with as much attention and medical care in order to maximize his/her health outcomes.
Over the years the PCMH model of health care has become widely adopted and preferred. This is because of the philosophy and approach that the model adopts in organizing and delivering the health care initiatives. The PCMH model is based upon delivering medical care and attention to patients with team-based health and medical experts that are focused strongly on the quality and the safety…
109-432, P.L. (2006, December 20). TAX RELIEF AND HEALTH CARE ACT OF 2006. Public Law 109-432 (109th Congress) .
Backer, L.A. (2009). Building the Case for the Patient-Centered Medical Home. Family Practice Management 16 (1), 14-18.
De Geest, S., Moons, P., Callens, B., Gut, C., Lindpaintner, L., & Spirig, R. (2008). Introducing advanced practice nurses/nurse practitioners in health care systems: a framework for reflection and analysis. Swiss Medical Weekly (138), 621-628.
NASHP. (2013, April). Medical Home & Patient-Centered Care. Retrieved from The National Academy for State Health Policy: http://www.nashp.org/med-home-map
Those who suffer from it become red in the face, with their skin extremely agitated. Moreover, "they may have flushing of the face, when they are hot, drink alcohol or hot drinks, or eat spicy foods. This flushing causes the face to appear red" (AZ Network, 2013). Blood vessels under the skin often become visible along with the flush of redness experienced by rosacea sufferers. These symptoms tend to get worse with time, with multiple cyclical outbreaks.
A number of treatments exist to try to counter act the effects of rosacea. Here, the research suggests that "you can help keep rosacea under control by keeping a record of things that cause it to flare up. Try to avoid or limit these triggers as much as you can" (AZ Network, 2013). Understanding what triggers a flare up can be crucial in helping to avoid them. Yet, medical treatments also prove effective,…
AZ Network. (2013). Rosacea: Facial redness. News Medical Net. Web. http://www.news-medical.net/health/Rosacea-Facial-Redness.aspx
Clinical Reference Systems. (2004). Rosacea. Columbia University. Web. http://www.cumc.columbia.edu/student/health/pdf/R-S/Rosacea.pdf
Cole, Gary W. & Stoppler, Melissa Conrad. (2012). Rosacea. EMedicine Health. Web. http://www.emedicinehealth.com/rosacea/article_em.htm
MacKenzie, Debora. (2012). Rosacea mat be caused by mite feces in your pores. New Scientist. Web. http://www.newscientist.com/article/dn22227-rosacea-may-be-caused-by-mite-faeces-in-your-pores.htmlt
Health Care Situation: Medical Error Due to Doctors' Bad Handwriting
Identify a health care news situation that affects a health care organization such as a hospital, clinic or insurance company.
I have identified the following health care news situation as the topic of my paper: "Poor Handwriting of Doctors and its implied risks for the Patient, Hospital and Medical Malpractice Insurance." Poor handwriting of physicians resulting in poor legibility of entries into patients' medical records carries very dramatic risks for all above-mentioned interest bearers. It can result in severe health danger for the patient and - in extreme situations - even cause a patient's death. Doctors' bad penmanship has long been seen a problem within organized medicine and the patient safety movement. Three American Medical Association (AMA) policies dating back to 1992, urge doctors to "improve the legibility of handwritten orders for medications" and review all orders for accuracy and…
Berwick, Donald M. & Winickoff, David E. (1996). The truth about doctors' handwriting: a prospective study. BMJ Vol. 313 (21-28 December 1996). 1657-1658. www.bmj.com/content/313/7072/1657.full, accessed 21 August 2011.
Bruner, Anne & Kasdan, Morton.L. Handwriting Errors: Harmful, Wasteful and Preventable.
1-4. www.kyma.org/uploads/file/.../Harmful_wasteful_and_preventable.pdfSimilar, accessed 22 August 2011.
Gallant, Al. (22 November 2009). For a secure electronic health record implementation, user authentication is key. 1-2). searchhealthit.techtarget.com/.../User-authentication-is-critical-for-pl.., accessed 24 August 2011.
1993). Within medical settings in particular, physicians and supervisors are often too over-burdened with their myriad formal responsibilities to take note of minor irregularities in protocols and procedures. Because coworkers are often in the best possible situation to notice inadequacies, it is important for all levels of employees to be equally involved in the overall CQI process.
Optimal implementation of an effective CQI process also requires a culture of openness to suggestion and confidentiality with respect to reporting more serious issues such as those that result from negligence or willful misconduct on the part of co-workers.
11. The textbook states that "an organization's most vital component in costly resource is its staff." With this being the case, the human resource function plays a very important role. Should the human resource function be part of the senior management team?
In terms of policy implementation and organizational philosophy, the human resources function…
Horine, P.D., Pohiala, E.D., Luecke, R.W. (1993) Healthcare Financial Managers and CQI: Implementing Continuous Quality Improvement; Healthcare Financial Management.
Humphry, D. (1991) Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying. Secaucus: Carol Publishing
Russell-Walling, E. (2005) Fifty Management Ideas You Really Need to Know. London: Quercus
There are several barriers to treatment that someone with schizophrenia might encounter. Those barriers can be loosely classified as personal, institutional, and social, although these three areas often intersect. Stigmas and a lack of understanding of the disease remain key barriers to treatment.
Schizophrenia is a misunderstood condition, which is one of the reasons why there may be social impediments to a person seeking treatment. Although knowledge has increased exponentially over the past few decades, the disease is still not completely understood. It is chronic, and potentially long lasting, which presents its own set of challenges to treatment (Durand & Barlow, 2013, p. 5). Treatments that have been used in the past, such as electronic stimulation, are now considered primitive and outmoded (Durand & Barlow, 2013, p. 12). There is less than a fifty percent chance that the schizophrenia is genetic, meaning that early detection is not always…
An Analysis of Moving Major Medical Treatments Offshore to educe Costs and it's Implications
Not too long ago the idea of traveling for medical treatments would have been unimaginable for most people. However, after a long streak of double digit cost increases in the medical industry in general, many procedures can be conducted on foreign shores for much less than can be performed in the United States; even when travel costs are included in the calculations. The globalization of healthcare will influence the United States healthcare system on many fronts and the increases in competitiveness should have overall positive implications for the economy. The healthcare consumers are likely the ones to benefit the most from the increases in competition however other industry players could benefit as well. Those who stand to lose the most are the firms with the most monopolistic market structures such as pharmaceutical…
Carrera, B. (2006). Globalization and healthcare: understanding health and medical tourism. Expert Review of Pharmacoeconomics & Outcomes Research, 447-454.
Connell, J. (2006). Medical tourism: Sea, sun, sand and & #8230; surgery. Tourism Management, 1093-1100.
Some of the principles of ethics that physicians are expected to abide by include:
dedication providing competent medical care, with compassion and respect for human dignity and rights (Principles of medical ethics http://www.ama-assn.org/ama/pub/category/2512.html)."
Upholding the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities (Principles of medical ethics http://www.ama-assn.org/ama/pub/category/2512.html)."
especting the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient (Principles of medical ethics http://www.ama-assn.org/ama/pub/category/2512.html)."
especting the rights of patients, colleagues, and other health professionals, and shall safeguard patient confidences and privacy within the constraints of the law (Principles of medical ethics http://www.ama-assn.org/ama/pub/category/2512.html)."
In addition physicians are expected to maintain regular educational hours to remain on top of the latest breakthroughs in medical science so that they…
Principles of medical ethics http://www.ama-assn.org/ama/pub/category/2512.html )
Treatment of Criminal Offenders
As a clinician, how can you apply the knowledge you gained from this course to more effectively serve your clients?
A connection has been established by researchers between brutal and violent susceptibility to impair a particular area of the brain. Till date, several evidence, have assisted to bring into limelight the shady aspect of human attitude and might pave the way for important interference. For instance, several types of spontaneous aggression might be a result of defective balancing of emotion within the prefrontal cortex of the brain, the centre of superior intellectual activities like judgment, analysis and substantial control of impulses. The degree of malfunctions in the core circuits of the brain related to aggressive behavior and if these circuits are capable of being repaired is of course debatable. esearchers have mentioned that individuals inclined to violence have structured blueprints in the brain that can be…
Allen, Harry E; Simonsen, C.E. (1998) "Corrections in America" New York, NY: Macmillan Publishing Company.
Gendreau, P & Goggin, C. (1996) "Principles of Effective Programming with Offenders" Forum on Corrections Research, Volume: 8; No: 3, pp: 38-40.
Hoge, R.D. & Andrews, D.A. (1996) "Assessing the Youthful Offender: Issues and Techniques" New York: Plenum.
Jacobs, B. L; Azmitia, E.C. (1992) "Structure and function of the brain serotonin system" Physiological Reviews. Volume: 72; pp:165-229.
Psychopathy: diagnosis and implications for treatment
Medical research has advanced to such an extent as to allow diseases that would have in the past been considered without a medical cure to be nowadays a limited challenge in the face of new technologies, techniques, and methods of treatment. Unfortunately some of the most difficult to cure diseases are those related to the nervous system and of physiological nature. One such case is psychopathy, a complex of states of mind and attitudes that transform the individual in particular degrees of sanity or insanity.
There have been numerous articles and research project conducted on this subject both to try to determine the nature of psychopathy as well as to provide different types of solutions for curing its manifestations and finding out the root causes of psychopathy. One such study is the one concluded by Mairead Dolan and Michael Doyle from the University of…
Dolan, M. And Michael Doyle. (2007) "Psychopathy: diagnosis and implications for treatment" in Psychiatry, volume 6, Issue 10, Oct.
Department of Veterans Affairs Medical Center, Oklahoma City, Oklahoma
Today, the Department of Veterans Affairs (VA) operates the nation's largest healthcare system through the Veterans Health Administration (VHA), including 152 medical centers (VAMCs), 800 community-based outpatient clinics and numerous state-based domiciliaries and nursing home care units (About VA, 2016). As the second-largest cabinet agency in the federal government, the VA's budget exceeds the State Department, USAID, and the whole of the intelligence community combined) with more than $60 billion budgeted for VHA healthcare (Carter, 2016). One of the VHA's largest medical centers that provides tertiary healthcare services to eligible veteran patients is the Oklahoma City VA Medical Center (OKC VAMC) in Oklahoma City, Oklahoma. Like several other VAMCs, the OKC VAMC has recently been implicated in a system-wide scandal concerning inordinately lengthy patient waiting times and misdiagnoses which may have contributed to the deaths of some veteran patients and jeopardized…
About the Oklahoma City VA Medical Center. (2016). Oklahoma City VA Medical Center. Retrieved from http://www.oklahoma.va.gov/about/ .
About VA. (2016). Department of Veterans Affairs. Retrieved from http://www.va.gov / about_va/vahistory.asp.
Breen, K. J. & Plueckhahn, V. D. (2002). Ethics, law, and medical practice. St. Leonards, NSW: Allen & Unwin.
Carter, P. (2016). How to fix the VA. Slate. Retrieved from http://www.slate.com/blogs / the_works/2016/03/25/slate_s_infinite_scroll_implementation_explained.html.
Furthermore, one of the pillars of collaborative care that will need to be firmly established is the fostering of clear dialogue and a means for strong communication within the care management planning. For instance, there needs to be a clear decision and communication of all tests ordered and when the test results will be available. One of the most important aspects of this collaborative care will be the nursing interventions which can have significant impact on the patient's health and stabilization (Allen, 2010). In fact, strategic nursing care can even minimize readmission rates of Margaret and other patients with comparable conditions (Chen et al., 2012).
Prioritize the Nursing Care Needs of Margaret
The prioritization of nursing interventions is essential, and the way in which a nurse determines this priority is going to be something unique and distinct. "Trials reviewed demonstrated a beneficial impact of nursing interventions for secondary prevention in…
Adler, H.M. (n.d.). Toward a biopsychosocial understanding of the patient -- physician relationship: An emerging dialogue. (2007). J Gen Intern Med,22(2), 280 -- 285.
Afilala, J. (n.d.). Frailty in patients with cardiovascular disease: Why, when, and how to measure. (2011). Curr Cardiovasc Risk Rep, 5(5), 467 -- 472.
Allen, J.K. (2010). Randomized trials of nursing interventions for secondary prevention in patients with coronary artery disease and heart failure: Systematic review.
Journal of Cardiovascular Nursing,25(3), 207-220.
This would likely have resulted in a long delay in raising suitable support to those health care professionals already at the disaster site.
Duties of the DMAT
The initial duties of the DMAT were to assist the nursing team at Charlotte egional Medical Centre as most nurses there had been on duty for around 40 hours. This was due to the problems which relief staff had in getting to the facility and also the problems which had been caused at the hospital due to the power failures and the structural damage that had been inflicted on the hospital (Cohen and Mulvaney). This initial aid that the DMAT provided was invaluable, as if they had not been so well prepared and arrived so early there would have been far greater pressure on the staff at the hospital, which would have greatly reduced the quality of care which the patients received.
Cohen, Sharon S. And Karen Mulvaney. "Field observations: Disaster Medical Assistance Team response for Hurricane Charley, Punta Gorda, Florida, August 2004." Disaster Management and Response 3.1 (2005): 22-27.
Mace, Sharon E., Jaszmine T. Jones and Andrew I. Bern. "An analysis of Disaster Medical Assistance Team (DMAT) deployments in the United States." Prehospital Emergency Care 11 (2007): 30-35.
McEntire, David a. Disaster Response and Recovery: Strategies and Tactics for Resilience. Indianapolis: Wiley, 2007. 156-157.
South Florida Regional DMAT FL 5 / IMSuRT South. 2007. South Florida Regional DMAT FL5. 31 October 2007 http://www.fl5dmat.com/ .
Care, Treatment, and Education Plan for a Patient with Cardiac Problems
P. Presenting with Cardiomyopathy and Congestive Heart Failure
Mr. P is a 76-year-old male with cardiomyopathy and congestive heart failure who has been hospitalized frequently to treat CHF symptoms. He has difficulty maintaining diet restrictions and managing his polypharmacy. He has 4+ pitting edema, moist crackles throughout lung fields, and labored breathing. He has no family other than his wife, who verbalizes sadness over his declining health and over her inability to get out of the house. She is overwhelmed with the stack of medical bills, as Mr. P always took care of the financial issues. Mr. P is despondent and asks why God has not taken him.
Considering Mr. P's condition and circumstance, write an essay of 500-750 words that includes the following: Describe your approach to care. ecommend a treatment plan. Describe a method for providing…
Inglis, S.C., Clark, R.A., McAlister, F.A., Ball, J., Lewinter, C., Cullington, D., Stewart, S., and Cleland, J.G.F. (2010). Structured telephone support or telemonitoring programmes for patients with chronic heart failure. Chronic Review, 8. The Cochrane Library. Retrieved from http://eprints.qut.edu.au/43722/1/CD007228_-_Structured_telephone_support_or_telemonitoring_programmes_(2).pdf
____. (2015). Heart failure (HF) and your treatment plan. John Muir Health. Retrieved from https://www.johnmuirhealth.com/content/dam/jmh/Documents/Cardiovascular/Heart_Failure_and_Your_Treatment_Plan.pdf
____. (2015). MedicineNet. Retrieved from http://www.medicinenet.com/congestive_heart_failure_chf_overview/page6.htm#what_is_the_treatment_for_congestive_heart_failure
individuals seek medical aid everyday in order to conceive a child. "Generally, worldwide it is estimated that one in seven couples have problems conceiving, with the incidence similar in most countries independent of the level of the country's development" (National Institute fo Health and Clinical Excellence, 2010). Through new technology, conceiving a child is now possible for individuals who were never able to previously. One such method is through egg donation and bioengineering. This process is for a woman who is unable to contribute a viable egg in order to produce a zygote. Egg donation has become an increasingly popular method of conception. This method should be completely illegal for several reasons.
Egg donation companies supply these eggs through donors. Donors go through a rigorous screening process. This process can include everything from disclosing medical records, meetings with psychologists, medical testing, and signing an informed consent form. Once a donor…
ConceiveAbilities. (2010, December 12). Egg Donor Compensation. Retrieved December 12, 2010, from ConceiveAbilities: http://www.conceiveabilities.com/donor_pg_4a.htm
Egg Donation: Legal-Ethical Issues. (2010, October 13). Retrieved December 8, 2010, from Med India: http://www.medindia.net/patients/patientinfo/egg_donation_issues.htm
Kara N. Maxwell, I.N. (2008). The incidence of both serious and minor complications in young women undergoing oocyte donation. Fertility and Sterility, 2165-2171.
National Institute fo Health and Clinical Excellence . (2010, March 30). fERTILITY- INFORMATION FOR THE PUBLIC. Retrieved December 10, 2010, from NHS: http://www.nice.org.uk/guidance/index.jsp?action=download&o=29271
Technology in Medicine: Distant Medical Surveillance Technology for Diabetics in the Less Developed Area of Texas
An estimated 26 million Americans live with diabetes. When not properly treated, diabetes could be fatal as it occupies the seventh position on the list of major mortality causes and it is also a strong causative factor of renal failures, sight damage and clinical limb removals among Americans. Diabetes occurrences are approximately 17% higher in less developed areas. Ethnicity and race are also major factors in determining the risk of suffering from the disease as it affects the smaller factions more. Distant medical surveillance can be very helpful in acquiring daily data about a diabetic's sugar levels, dangerous signs, feeding habits and therapy devotion. This method could help patients take their medications appropriately. Even though certain patients could decide not to adhere to their treatments and thus render this technology useless, the group who…
Balamurugan, A., Hall-Barrow, J., Blevins, M. A., et al. (2009). A pilot study of diabetes education via telemedicine in a rural underserved community -- opportunities and challenges: A continuous quality improvement process. The Diabetes Educator, 35(1), 147 -- 154.
Greenwood, D. A., Young, H. M., & Quinn, C. C. (2014). Telehealth Remote Monitoring Systematic Review: Structured Self-monitoring of Blood Glucose and Impact on A1C. Journal of Diabetes Science and Technology, 8(2), 378 -- 389.
Hale, N. L., Bennett, K. J., &Probst, J. C. (2010). Diabetes care and outcomes: disparities across rural America. Journal of community health, 35(4), 365-374.
Helseth, C. (2014). Diabetes Management in Rural Areas Takes Holistic, Community Approaches, Rural Health Information Hub. Retrieved from https://www.ruralhealthinfo.org/rural-monitor/rural-diabetes-management/ on February 18, 2017
In recent years, mental illnesses have been the focus of considerable attention from medical professionals. These are conditions that can cause disruptions in individual's moods, feelings, thinking, daily functioning, and the ability to relate with other people and things. Mental illness is a condition of the brain which results in different symptoms, as well as affecting the day-to-day life of that person and the people around him or her in different ways. The mental illnesses include borderline personality disorder, post-traumatic stress, obsessive compulsive disorder, bipolar disorder, schizophrenia, depression, and anxiety to name a few. More than sixty million people in America, i.e. one out of four adults, are going through mental illnesses in a given year. One out of seventeen people experiences disorders such as bipolar disorder, depression, and schizophrenia while one out of ten million children are going through emotional disorders and mental illnesses. Every person who…
Miles, J., Espiritu, R., Horen, N., Sebian, J., & Waetzig, E. (2007). A public health approach to children's mental health. Georgetown: Center for Child and Human Development.
(n.d.). Models of Human Service Delivery.
NAMI. (2013). Mental Illness: What you need to know. Virginia: National Alliance on Mental Illness.
NIMH. (n.d.). NIMH Plan of Research. Retrieved from www.nimh.nih.org: https://www.nimh.nih.gov/about/strategic-planning-reports/introduction.shtml
One of the most difficult situations a physician may face is one in which a parent is doing actual harm to her child even though she has the best of intentions. In this instance, the mother is engaging in the practice of 'coining' or using coins to administer oils. The boy appears to be in pain as a result of the bruises sustained by this treatment. Unfortunately, it is not unheard of for many children to suffer damage as a result of well-intentioned parental actions. Another example is that of Christian Scientist parents who refuse all medical treatment for their children or Jehovah's Witnesses who may refuse blood transfusions.
A physician's ultimate responsibility is to help the child. While it is possible to argue that some medical procedures do cause some pain and discomfort when initially administered, they do so with the purpose of ultimately reversing the course of…
Orr, R., Novotny, W., & Perkin, R. (2003). Faith-based decisions: Parents who refuse appropriate care for their children. Virtual Mentor, 5 (8). Retrieved from:
Tan, A.L. & Mallika, P.S. (2011). Coining: An ancient treatment widely practiced among Asians
Malaysian Family Physician, 6(2-3): 97-98. Retrieved from:
It would then become incumbent on the experienced coder to be able to read through the injuries and determine the accurate code to use. Another issue Kramer, Barancik, and Thode, Jr. (1990) found was that certain areas of the body lacked a code when injured to a very specific area of the body.
The training and education one needs to be a successful medical coder, and in particular a remote medical coder, is extensive. If we examine Figure 1 below, we can understand why this is so:
AAT (alpha-1 antitrypsin) deficiency 273.4
AAV (disease) (illness) (infection) - see Human immunodeficiency virus (disease) (illness) (infection)
Abactio - see Abortion, induced
Abactus venter - see Abortion, induced
Abasia (-astasia) 307.9
Abderhalden-Kaufmann-Lignac syndrome (cystinosis) 270.0
Abdomen, abdominal - see also condition
Kramer, Barancik, and Thode, Jr. (1990) found
Abduction contracture, hip or other joint -…
American Health Information Management Association (AHIMA). (2011). Quality healthcare through quality information. Retrieved from http://www.ahima.org/Default.aspx/ .
Kramer, Caroline F., Jerome I. Barancik, and Henry C. Thode, Jr. (1990). Improving the sensitivity and specificity of the abbreviated injury scale coding system. Public Health Reports, Vol. 105, No. 4, pp. 334-40.
Rodecker, Kristy. (2010). Medical billing and coding. Retrieved from http://www.medicalbillingandmedicalcoding.com/ .
Taylor, JM. (2008). [Emergency Department] Management. Experienced coders help ED create excellence. The Monthly Update On Emergency Department Management, Vol. 20, No. 11, pp. 123-5.
Right to Die
For the last few decades, the issue of a person's right to choose the time and method of his or her own death has been one of passionate debate in the United States, with emotions running high on both sides of the controversy as the meanings of liberty and freedom of choice, the morality of taking one's own life, the ethics of people involved in such actions, and the laws related to this issue take center stage in the arguments.
Since civilization began, suicide has existed in one form or another, with varying degrees of acceptance, such as the ancient Greeks who held tribunals for elderly people who requested to die, and if approved, were given hemlock and during the first century B.C. actually held annual banquets where the elderly were allowed to attend and drink poison if they felt they had lived long enough.
Brennecke, Shari J. "Right to Die: An Overview" Gerontology Manual. http://otpt.ups.edu/Gerontological_Resources/Gerontology_Manual/Brennecke.html .(accessed 12-03-2003).
Chachere, Vickie. "Judge appoints professor as guardian for brain-damaged woman in Florida." AP Worldstream. November 01, 2003. http://ask.elibrary.com/getdoc.asp?querydocid=1P1:86544618&dtype=0~0&dinst=0&pubname=AP+Worldstream&author=VICKIE+CHACHERE%2C+Associated+Press+Writer&title=Judge+appoints+professor+as+guardian+for+brain%2Ddamaged+woman+in+Florida&date=11%2F01%2F2003&query=Terry+Schiavo+and+the+State+of+Florida%2E&maxdoc=30&idx=2&ctrlInfo=result%3ASR%3Aprod.(accessed 12-03-2003)
Cruzan v. Director, Missouri Dept. Of Health." Citation: 497 U.S. 261 (1990)
Concepts: Right to Die/State Police Powers. http://www.tourolaw.edu/patch/CaseSummary.html .(accessed 12-03-2003).
Community/Organization of Interest:
Health and medical services in Bella Vista, PA, a South Philadelphia neighborhood
The cultural perspective
Bella Vista, PA, a South Philadelphia neighborhood, is a largely Italian-American ethnic enclave dominated by white, working-class residents. Although recent scholarly literature has focused upon the deficit of healthcare knowledge and services in lower-income nonwhite populations, deficits in knowledge and willingness and ability to access vital resources to improve their health still persist across population groups. For example, one study of non-Hispanic and Hispanics found that there were high levels of systemic barriers to obtain colorectal screening, including: scheduling and financial barriers; fear of diagnosis and pain; and lack of motivation amongst all study participants (Green et al. 2008). Culturally and psychologically in many communities, there is often an unwillingness to seek medical treatment in the form of screening. Even though Bella Vista is not a poor community cultural attitudes towards healthcare…
Breen, T. (2013). Overview of the 2013-2014 Medicaid payment increase for primary care services. The Advisory Board Company. Retrieved:
Brown, E.R. (et al2004). Effects of community factors on access to ambulatory care for lower-
income adults in large urban communities. Inquiry - Excellus Health Plan, 41(1), 39-56.
medical home concept and describe the principles (operational characteristics mentioned above) of the PC-MH as defined by these organizations. How does this concept differ from the gatekeeper concept of Managed Care Organizations?
According to the 'gatekeeper' philosophy of health management organizations (HMOs), physicians are intentionally given incentives to reduce access to care. This is based upon the assumption that patients will want to obtain as much care as they can receive and physicians will want to bestow that care to please patients and incur more revenue. HMOs encourage physicians to do the opposite and often financially reward physicians for cost reductions and limiting access of patients to specialists or heroic treatments. In the HMO model, physicians try to restrict access to specialists when they do not deem it necessary.
In contrast, the medical home concept is viewed as a partnership between "individual patients, and their personal physicians, and when appropriate,…
Case for change to the PC-MH Model (2011). American Dietetic Association.
Retrieved October 19, 2011 at http://www.eatright.org/HealthProfessionals/content.aspx?id=7059
Joint Principles of the Patient-Centered Medical Home. (2007). American Academy of Family
Physicians (AAFP). American Academy of Pediatrics (AAP). American College of Physicians (ACP). American Osteopathic Association (AOA)
There are also challenges that will emerge from the provision of the Fair Treatment for Experienced Act due to its impact on the Aviation safety standards and guideline principles. These impacts include stricter measures regarding safety standards which comprises giving more firm limitations for pilots that are in the age of 60 and above and this will cause more dilemmas for other senior pilots who are responsible for guiding next generation of pilots (Brazy, 2008). There are some claims that the credibility of the Fair Treatment for Experienced Act has been degraded because of its consideration of age sensitive requirements particularly with the operating pilots.
The degree of discriminatory actions was considered as a violation and as a challenge for the reason that there is a segregation of particular groups known to be prohibited by the Federal law of the United States. Political pressure can also be a challenge because…
Aviation Online Magazine (2007). Fair Treatment of Experienced Pilots Act (the age of 65 law). Claimed from: http://avstop.com/legal/fair_treatment_of_experienced_pilots_act.htm .
Brazy, Douglas (2009). Group Chairman's Factual safety Board. Accessed: http://www.exosphere3d.com/pubwww/pdf/flight_1549/ntsb_docket/420526.pdf .
FAA (Federal Aviation Authority (2008). Fair Treatment and Experienced Act. Available: http://www.faa.gov/other_visit/aviation_industry/airline_operators/airline_safety/info/all_infos/media/age65_qa.pdf .
Fritzpatrick, Robert (2011). Recent Developments in D.C. Labor and Employment Law. Retrieved from: http://www.robertbfitzpatrick.com/papers/2011-05-04-DCBarPaperRevised.pdf .
medical and ethical dilemmas, even if the activities were deemed technically legal or not questioned at the time. The fact that the studies sought to gain information from human subjects under unfair and undesirable circumstances means their results cannot be condoned and the findings cannot be accepted or used as viable study data. Each study directly crosses the line into scientific unacceptability in different ways; and while their underlying approaches raise interesting historical and philosophical questions -- that did not need to be tested to be debated -- there is no way to weed out the biases that contaminate the data.
This being said, it is generally safe to say that all of the studies were improper (unethical and/or illegal) at the time that they were being undertaken. This can be seen in the fact that in every instance the medical professionals involved were either directly or indirectly punished for…
Consumer Reports (2007). "Off-Label" Drug Use, Shopper's Guide. Downloadable at http://www.consumerreports.org/health/resources/pdf/best-buy-drugs/money-saving-guides/english/Off-Label-FINAL.pdf .
Pain Management of America (2011). Chronic Pain Treatment and Management with Medical Marijuana. Viewable at http://www.medicalmarijuana.net/uses-and-treatments/chronic-pain/.
SOURCES OF STUDIES
Jewish Chronic Disease: http://johnmueller.org/Problems/Cancer.html
Lobotomy is a popular medical procedure introduced in curing mentally ill individuals, which requires the removal of the prefrontal lobes of the cortex of the brain, the part of the brain wherein aggressive and violent behavior is triggered. However, in the movie, lobotomy is shown to have disastrous results: McMurphy's violent behavior is indeed abated, but as illustrated in the movie, the lobotomy had turned him into a 'vegetable' neither responding to his ward mates' call for attention nor displaying his usual rowdy, obnoxious, McMurphy self.
This instance in the movie is considered as patterned after the medical model of abnormal psychology, wherein "mental disorders are described as medical diseases with a biological origin" (450). ecause this is the prevalent thinking in medical science during the time the movie (and novel) was made, Nurse Ratched decided, in order to "treat" McMurphy, to let him undergo lobotomy. Subsistence to the medical…
Santorck, J. (2001). Psychology. NY: McGraw-Hill Book Co.
Treatment to Patients
The main objective of providing treatment to patients is to relieve symptoms along with decreasing the progression of the disease as well as the mortality or morbidity. However, in some cases, this objective is not fully achieved, especially in the case of the patients who are admitted to the ICU with some serious and almost always a terminal stage of the disease. For example, when old patients are admitted in the ICU, their immunity is extremely low and this is the perfect time for the opportunistic infections to make matters worse for these patients. There are many infections that are specifically associated with patients admitted in the hospitals. Pseudomonas Aurigeonosa is a micro-organism that is well documented to cause bacterial pneumonia and bacteremia in the patients who are terminally ill and are receiving treatment in the hospital setting. Since most of the patients in the ICU are…
Beekmann, SE;Diekema, DJ; Chapin, KC;Doern, GV (2003) Effects of rapid detection of bloodstream infections on length of hospitalization and hospital charges.J ClinMicrobiol, 41:3119-3125.
Boussekey, N, Leroy, O, Georges, H, Devos, P, d'Escrivan, T, Guery, B (2005).Diagnostic and prognostic values of admission procalcitonin levels in community-acquired pneumonia in an intensive care unit.Infection, 33:257-263.
Charles, PE, Dalle, F, Aho, S, Quenot, JP, Doise, JM, Aube, H, Olsson, NO, Blettery, B: Serum procalcitonin measurement contribution to the early diagnosis of candidemia in critically ill patients. Intensive Care Med, 32:1577-1583.
Digiovine, B; Chenoweth, C; Watts, C; Higgins, M (1999)The attributable mortality and costs of primary nosocomial bloodstream infections in the intensive care unit. Am J. RespirCrit Care Med, 160:976-981.
Anxiety and depression are the most commonly witnessed psychiatric disorders in adolescence. The prevalence of both anxiety disorder and depression increase in the adolescence period and progresses to young adulthood. The final result of these developments is low self-esteem. General prevalence measures for depression stand between 2 to 4%. Recurrence rates are placed at 70% in a span of five years. Point prevalence rates for anxiety disorders stand at 20% and show stability across one's life. Furthermore, anxiety and depression highly co-occur. They also occur along with other psychiatric complications (Lee & Hankin, 2009).
Self-Esteem, Depression and Anxiety
The CBT (2006) center describes self-image as a circus mirror which remolds the shape and size of a person into one that departs from the way one really looks like. These are perceptions of how we see and think of ourselves, how we think others see us, the beliefs about ourselves, our…
Presbyopia is a disorder, where the lens of the eye loses its capacity to focus. This incapacity makes it hard to see items up close. Some scholars have suggested that presbyopia means "age of sight." Presbyopia is not similar to farsightedness because it involves the loss of accommodation and ability for the eye to correct to enhance clarity at various distances. In this context, the young eye requires to change its interval or shape to focus on close objects. The capability of the lens to change shape gives the lens elasticity, which when lost results to presbyopia. When people grow old, they tend to lose this elasticity, and this explains why the eye gradually loses its capacity to focus on close objects (ennett, 2008).
How Presbyopia Occurs
Presbyopia happens when the cornea and lens refract light so that the light appears behind the retina
People realize they have this condition…
Adnan, A.A. et al. (2013). Prevalence of refractive errors of the eye among adults in Iraq. Journal of natural sciences research, 3(4), pp. 117-124.
Bennett, M.Q. (2008). New thoughts on the correction of presbyopia drivers.Diving and hyperbaric medicine, 38(3), pp. 163-164.
Brahma, A., & McGhee, C.N. (2000).Surgical Correction of refractive errors (Review).J Royal
Soc Medicine, 93 (3):118-23
Barnsteiner JH. Medication reconciliation: transfer of medication information across settings -- keeping it free from error. Am J Nurs. 2005;05(3 Suppl):3-6.
This article evaluates the need for proper medication reconciliation across various nursing settings. This article is important as emphasis is placed on error free reconciliation which is very important for proper client service and treatment.
Bullough, Vern L. and Bonnie Bullough. The Emergence of Modern Nursing (2nd ed. 972)
This reference emphasized modern nursing and many of the practices and advances of nursing over the years. This is important as it provides a historical perspective of medical reconciliation. A historical perspective is needed to better understand improvements that will need to be made in the future.
D'Antonio, Patricia. American Nursing: A History of Knowledge, Authority, and the Meaning of Work (200), 272pp
This reference provides further evidence into the history of medical reconciliation and recommendations on improvements that should…
13. Rogers G, Alper E, Brunelle D, et al. Reconciling medications at admission: safe practice recommendations and implementation strategies. Jt Comm J Qual Saf. 2006;32:37-50
14. Snodgrass, Mary Ellen. Historical Encyclopedia of Nursing (2004), 354pp; from ancient times to the present
15. Sullivan C, Gleason KM, Rooney D, et al. Medication reconciliation in the acute care setting: opportunity and challenge for nursing. J Nurs Care Qual. 2005;20(2):95-98
According to A.J. Larner's book, "A Dictionary of Neurological signs," prosopagnosia is a neurological condition, "a form of visual agnosia characterized by an inability to recognize previously known human faces or equivalent stimuli (hence a retrograde defect) and to learn new ones (anterograde defect)" (Larner, 2010). Larner further distinguishes between two forms of prosopagnosia: apperceptive and associative agnosia. This "category-specific recognition disorder," as G, Neil Martin calls it in his "Human Neuropsychology" is often, but not always, associated with other forms of visual agnosia such as alexia or achromatopsia.
Prosopagnosia can be congenital or developmental, or a consequence of brain damage, following a stroke, a brain injury, or caused by a degenerative disease (Kinai, 2013) . There are two types of prosopagnosia: apperceptive prosopagnosia and associative prosopagnosia. This form of visual impairment has various degrees of manifestation, from mild to severe and can or cannot be associated with other…
Bowles, Devin C. McKone, Elinor. Dawel, Amy. Duchaine, Bradley. Palermo, Romina. Schmalzl, Laura. Rivolta. Davide. Wilson, Ellie. Yovel. Galit.
Cognitive Neuropsychology, "Diagnosing prosopagnosia: Effects of ageing, sex, and participant-stimulus ethnic match on the Cambridge Face Memory Test and Cambridge Face Perception Test." Available at: http://www.faceblind.org/social_perception/papers/Bowles%2009%20CN.pdf
Sperry, Roger Wolcott. Ed.Trevarthern, Colwyn B. 1990. Brain Circuits and Functions of the Mind: Essays in Honor of Roger Wolcott Sperry, Author. Cambridge University Press
Newman, Nancy J. Miller, Neil R. Biousse, Valerie. 2008. Walsh and Hoyt's Clinical Neuro-ophthalmology: The Essentials. Lippincott Williams & Wilkins
Ethical Dilemma: case study of clinical trial on a child
The field of medicine and research has been surrounded by issue of experiments in order to have the conclusive result of the effectiveness of a drug or otherwise. These results can only be obtained if the drugs are at times used on human beings with the real medical problem that the experiment seeks to find solution to. The problem of ethical dilemma often comes in at such stages on whether to go ahead to experiment on the effectiveness of the new drug or not.
Ethical dilemma refers to the situation that is deemed complex since it involves some element of mental conflict between moral imperatives that is one goes ahead and obeys one, it will mean the transgression of another (Braunack-Meyer A.J., 2001). The individual does not have a clear cut direction on which option to go for, despite there…
Braunack-Meyer A.J., (2001). What makes a problem an ethical problem? An empirical perspective on the nature of ethical problems in general practice. Retrieved November 29, 2014 from http://jme.bmj.com/content/27/2/98.full
Pier B.K., (2007). Children, Gillick Competency and Consent for Involvement in Research. Retrieved November 29, 2014 from http://jme.bmj.com/content/33/11/659.abstract
Spriggs M., (2010). Understanding Consent in Research Involving Children: The ethical Issues. Retrieved November 29, 2014 from http://www.mcri.edu.au/media/62539/handbook.pdf
Many people hate to go to the doctor's office -- especially when they know that they will be receiving an injection. However, I, along with millions of people the world over, consider ourselves very lucky to do just that, each and every month of our lives. You see, for people like me with a disorder known as "pernicious anemia," the doctor and her needle are the important link between a healthy life and a life of absolute misery. This is because, unlike classic anemia, the common form of the blood disorder that usually results in little more than fatigue, pernicious anemia can result in catastrophic changes in the body, chief among them severe neurological impairment that, in its severe form, can result in absolute madness. For those of us who suffer from this disease caused by an inherited deficiency, or caused from some disruption or disorder in the…
Intelihealth. "Pernicious Anemia." Web site. 2004. Retrieved from Web site on April 10, 2004 www.intelihealth.com/IH/ihtIH/WSIHW000/9339/20862.html
Medline Plus. "Pernicious Anemia." Medline Plus Medical Enclyclopedia. 2003 Retrieved from Web site on April 10, 2004 http://www.nlm.nih.gov/medlineplus/ency/article/000569.htm
against experimentation on animals, and some are more compelling than others. Some people suggest that the practice is immoral because choosing to experiment upon animals is directly analogous to racial or sexual discrimination; or more closely related to discrimination on the basis of mental capacity. Others contend that it is wrong because, by their estimations, no clear advances in medical research have been made through animal experimentation, and alternative modes of research are emerging. Doubtlessly, animal experimentation is a delicate moral issue, but asserting that animals should enjoy the same rights as humans within a society is a weak claim. Arguments have been formed differentiating animals from humans depending upon both their moral status and biological status. Yet, the most obvious line of reasoning is associated with the fact that granting animals the same rights as humans within society leads to many logical contradictions.
One question that needs to be…
1. Dunbar, Daniel. "The Confinement and Use of Non-Human Animals in Scientific and Medical Experiments is Morally Unacceptable." Ithaca University, 2005. Available: http://www.ithaca.edu/faculty/cduncan/250/ddunbar.doc .
2. Mitchell, Graham. "Guarding the Middle Ground: the Ethics of Experiments on Animals." African Journal of Science, Issue 85, May 1989. Available: http://www.garfield.library.upenn.edu/essays/v13p114y1990.pdf .
Interstitial lung disease is a blanket term for a big group of disorders categorized by progressive scarring of both the lung tissue supporting and between the air sacs. This tissue is called the interstitium. The interstitium consists of the region between the alveolar space and the capillaries. The scarring causes inflammation and damage in the lung tissue followed by lung stiffness, meaning the air sacs cannot expand as much as before. Lung stiffness makes it harder to breathe. People affected by the condition are not able to get enough oxygen from the lungs into their bloodstream.
Although some potential causes have been researched, there may be no underlying cause for development of interstitial lung disease. If there is no known cause, it is called idiopathic interstitial lung disease. IPF or idiopathic pulmonary fibrosis remains the most common type of this illness. Of the causes most widely recognized, cigarette smoking is…
Fischer, A. & du Bois, R. (2012). Interstitial lung disease in connective tissue disorders. The Lancet,380(9842), 689-698. http://dx.doi.org/10.1016/s0140-6736 (12)61079-4
Maher, T. (2014). Current and Emerging Treatment Options in Interstitial Lung Disease. Pulmonary Manifestations Of Rheumatic Disease, 193-216. http://dx.doi.org/10.1007/978-1-4939-0770-0_14
Moazedi-Fuerst, F., Kielhauser, S., Brickmann, K., Tripolt, N., Meilinger, M., Lufti, A., & Graninger, W. (2015). Sonographic assessment of interstitial lung disease in patients with rheumatoid arthritis, systemic sclerosis and systemic lupus erythematosus. Clinical And Experimental Rheumatology,33(4 Suppl 91), S87-91. Retrieved from http://europepmc.org/abstract/med/25665185