Pilot Study of Uncontrolled Diabetics
In the treatment of diabetic cases, the HgA1C test is administered to determine the patient's glucose level. The test is used to assess the glucose level in the patient's blood after ingesting glucose or after hours of fasting. The test after ingestion is called the oral glucose tolerance test while the test after fasting is referred to as the fasting glucose test. This measures used in this test has recently been approved as a more accurate test allowing medics to articulate the ideal long-term measures to manage the ailment in patients. This paper reviews studies conducted to assess the impact of diabetes self-management program in a free care clinic on patients HgA1C.

The key to management and reduce fatality cases among type 2 diabetes patients is by providing self-care education and learning the material to the patients. This assertion was made in the study by (Gamboa…...

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References

Cadzow, R. B., Vest, B. M., Craig M., Rowe, J. S., & Kahn, L. S. (2014). "Living Well with Diabetes": Evaluation of a Pilot Program to Promote Diabetes Prevention and Self-Management in a Medically Underserved Community. Diabetes Spectrum, 27(4), 246-255.

Gamboa Moreno et al. (2013). Impact of a self-care education programme on patients with type 2 diabetes in primary care in the Basque Country. . BMC Public Health, 13(1), 521-528.

Johnson, C., Ruisinger, J. F., Vink, J., & Barnes, B. J. (2014). Impact of a community-based diabetes self-management program on key metabolic parameters. . Pharmacy Practice, 12(4), 499-503.

Khanna et al. (2012). Hemoglobin A1c improvements and better diabetes-specific quality of life among participants completing diabetes self-management programs: A nested cohort study. . Health and Quality of Life Outcomes, 10, 48-54.

Policy Brief: Parental Influences on Child Obesity and Dental Caries
POLICY BIEF

Parental Influences on Child Obesity and Dental Caries

Obesity represents a major health and economic threat to Australia by degrading the lives of countless citizens and costing the nation about $58.2 billion in 2010 alone (Crowle & Turner, 2010, p. 32-33). This reality has motivated Australian policymakers to increase the amount of dollars allocated to researching this preventable condition by 5.4-fold between 2003 and 2011 (NHMC, 2012). A related preventable disease, dental caries, causes untold suffering and represented 10% of all health care spending in 2004/2005 (ACP Paediatric and Child Health Policy Committee, 2013, p. 8). Both of these health issues have had a major impact on child health, which is the primary focus of this policy brief. Most of the research considered here is concerned with children and early adolescents. This issue is examined through the lens of parental influence;…...

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References

AIHW. (2011). Dental decay among Australian children. Research report series no. 53. Cat. No. DEN210. Canberra: Australian Institute of Health and Welfare. Retrieved from  https://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737419600 .

Crowle, J. & Turner, E. (2010). Childhood Obesity: An Economic Perspective. Melbourne: Media and Publications, Productivity Commission. Retrieved from  http://www.pc.gov.au/__data/assets/pdf_file/0015/103308/childhood-obesity.pdf .

Hooley, M., Skouteris, H., Boganin, C., Satur, J., & Kilpatrick, N. (2012a). Obesity and dental caries in children and adolescents: a systematic review of the literature published 2004-2011. Systematic Reviews, 1:57, doi:10.1186/2046-4053-1-57.

Hooley, M., Skouteris, H., Boganin, C., Satur, J., & Kilpatrick, N. (2012b). Parental influence and the development of dental caries in children aged 0-6 years: A systematic review of the literature. Journal of Dentistry, 40, 873-885.

Community-based participatory research (CBP) is a new form of research that strives to create more meaningful and equitable partnerships between researchers and the community. Previously, the relationship was more along the lines of a transactional association. The community members were not involved in planning health interventions or designing research projects. However, some researchers have realized that community members can add a significant level of local expertise in some matters. By allowing these stakeholders to become more engaged in the project, it creates new potentials for insights that were previously unimaginable. This approach has been defined as:
"Community-based participatory research (CBP) is an approach to health and environmental research meant to increase the value of studies for both researchers and the community being studied. This approach is particularly attractive for academics and public health professionals struggling to address the persistent problems of health care disparities in a variety of populations (identified by…...

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References

Las Neuces, D., Hacker, K., DiGirolamo, A., & Hicks, L. (2012). A Systematic Review of Community-Based Participatory Research to Enhance Clinical Trials in Racial and Ethnic Minority Groups. Health Services Research, 1364-1386.

O'Toole, T., Felix, K., Chin, M., Horrowitz, C., & Tyson, F. (2003). Community-based Participatory Research: Opportunities, Challenges, and the Need for a Common Language. Journal of General Internal Medicine, 592-593.

Stone, U., Wallerstein, N., Garcia, A., & Minkier, M. (2014). The Promise of Community-Based Participatory Research for Health. American Journal of Public Health, 1615-1624.

Viswananathan, M., Ammerman, A., Eng, E., Garlenhner, G., Lohr, K., Griffith, D., . . . Whitener, L. (2004). Community-Based Participatory Research: Assessing the Evidence: Summary. AHRQ Evidence Report Summaries.

Diabetes is one of the major non-communicable diseases today. In the U.S., approximately 9% of the general population have diagnosed or undiagnosed diabetes, with a further 37% estimated to be pre-diabetic (CDC, 2016). The disease increasingly imposes a significant morbidity, economic, mortality, and psychological burden on individuals, families, communities, healthcare organizations, as well as the government. This paper discusses a number of issues relating to diabetes. These include: past and present funding initiatives; past and present quality initiatives; the relationship between diabetes care quality and healthcare coverage; and diabetes care in the U.S. and UK.
Funding Initiatives

In the U.S., initiatives aimed at preventing diabetes are funded by both the government and private entities. Public funding is executed through the Division of Diabetes Translation (DDT), a unit of the Centers for Disease Control and Prevention (CDC) (CDC, 2016). DDT funds health departments at the state and local government level in support of…...

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References

Agency for Healthcare Research and Quality (AHRQ) (n.d.). Index of diabetes quality improvement initiatives. Retrieved from: resources/tools/diabguide/diabqguideapg.htmlhttps://archive.ahrq.gov/professionals/quality-patient-safety/quality-

Casagrande, S., & Cowie, C. (2012). Health insurance coverage among people with and without diabetes in the U.S. adult population. Diabetes Care, 35(11), 2243-2249.

Centers for Disease Control and Prevention (CDC) (2016). Diabetes programs and initiatives. Retrieved from:  https://www.cdc.gov/diabetes/programs/ 

Crosson, J., Ohman-Strickland, P., Campbell, S., et al. (2009). A comparison of chronic illness care quality in US and UK family medicine practices prior to pay-for- performance initiatives. Family Practice, 26(6): 510-516.

Health Care Communication
Background- Within the modern nursing paradigm, there must be a clear link between a health outcome and the process that helps ensure those outcomes. Typically, outcomes are classified in terms of preventability, impact, severity and an overall holistic view of the client's safety issues. Positive behaviors that impact individuals either rescue or protect patients from potential or actual events. This is also part of the issue with modern communication and dissemination of information to patients, stakeholders, and the community (Burns and Grove, 2005).

At the heart of healthcare as an institution is, of course, the need to care for the sick and the injured. However, in the contemporary model of healthcare, effective communication during a crisis is not only important, but also vital. Communication by healthcare professionals takes the concern and worry out of the situation; offers a quicker resolution, makes better control of information possible, earns the trust…...

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REFERENCES

Alligood, et.al. (2002). Nursing Theorists and their Work. Philadelphia: Mosby.

Burns, N. And Grove, S. (2004). The Practice of Nursing Research. St. Louis:

Elsevier.

D'Antonio, P., et al., eds., (2007). Nurses Work: Issues Across Time and Place. New York:

ichard Mitchell and Professor Daniel Dorling from the University of Leeds and Dr. Mary Shaw from the University of Bristol on the parliamentary constituencies of Britain revealed a number of social policy scenarios. The study traced the impact of the variations to society that might be brought through the effective execution of three social and economic policies. Firstly, they examined the efficacy of the policy of modest redistribution of wealth to counteract the health inequalities. During the decades 1980s and 1990s there were a considerable variation in the wealth possessions of rich and poor reflected in the major variations in their health enumerated by mortality rates. The study revealed that by returning to the inequalities in wealth of 1983 about 7500 deaths annually could have been prevented. (educing health inequalities in Britain)
The study assessed the impact of such policy to be most effective in the Birmingham Ladywood constituency in…...

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References

Health inequalities kill thousands" (27 September, 1999) Retrieved at   Accessed 3 September, 2005http://news.bbc.co.uk/1/hi/health/456807.stm .

Introduction to health inequalities" Retrieved at Accessed 3 September, 2005http://www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/HealthInequalities/HealthInequalitiesGeneralInformation/HealthInequalitiesGeneralArticle/fs/en-CONTENT_ID=4079644&chk=8WiiZg.

Link BG; Phelan JC. (May, 2005) "Fundamental Sources of Health Inequalities" Policy

Challenges in Modern Health Care. pp: 71-84. Retrieved at   Accessed 4 September, 2005http://www.rwjf.org/research/researchdetail.jsp?id=1944&ia=141 .

Two elements that are extremely useful in the examination of health care. In this regard therefore, quality is also differentiated along SES. Persons who are higher on the socioeconomic ladder experience better "desired health outcomes."
The access to quality health care also has cultural and SES elements to it. Dressler & Bindon (2000) identify cultural consonance as a factor in determining blood pressure in African-American communities. The implications of this work are that cultural elements play a big role in health care quality and access. Whites tend to have greater access to better health care than minority groups. This access is in terms of the proximity of quality physicians, medical services, and facilities.

The ethical implications of the differential access to health care are troubling (Kulczycki, 2007). This is primarily because a health care discussion is a life and death discussion. Quality health care is the right of every citizen, and…...

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References

Dressler, W.W., Balieiro, M.C., & Dos Santos, J.E.(1988). Culture, Socioeconomic Status, and Physical and Mental Health in Brazil Medical Anthropology Quarterly, New Series, 12

(4): 424-446.

Dressler W.W., & Bindon, J.R. (2000).The Health Consequences of Cultural Consonance:

Cultural Dimensions of Lifestyle, Social Support, and Arterial Blood Pressure in an African-American Community American Anthropologist, New Series, 102

Healthcare Challenges
Technology is one of the main drivers of change in healthcare, and it is up to healthcare organizations to join the rest of the world in adopting new technologies to run their industry better. In most industries, something like electronic record keeping has been done for decades and nobody was wringing their hands about it. It is absurd that this is even an issue for healthcare companies. The best thing is to stop talking about this as if it is an "issue" or a "challenge," and just get it done. If you were to design the health care system from scratch, of course everything would be electronic. The development and adoption of these technologies will improve the quality of healthcare immensely, so the only real question is not how will this challenge affect healthcare, but how quickly can healthcare get its act together and join the 21st century. In…...

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References

Kumbroch, D. (2014). Affordable Care Act creates big demand locally for healthcare workers. WHNT. Retrieved November 17, 2014 from  http://whnt.com/2014/09/17/aca-creates-big-demand-for-healthcare-workers/ 

Wister, A. (2009). The aging of the baby boomer generation: Catastrophe or catalyst for improvement? Health Innovation Forum. Retrieved November 17, 2014 from http://www.healthinnovationforum.org/article/the-aging-of-the-baby-boomer-generation-catastrophe-or-catalyst/

(Menzel, 1990, p. 3) Fisher, Berwick, & Davis alude to the idea of integration in health care, with providers linking as well as creating networks of electronic medical records and other cost improvement tactics.
The United States and other nations over the last twenty or so years, have begun a sweeping change in health care delivery, regarding the manner in which health information is input, stored and accessed. Computer use in the medical industry has greatly increased over the last thirty years the culmination of this is fully networked electronic medical record keeping. (Berner, Detmer, & Simborg, 2005, p. 3) the electronic medical record trend began in the largest institutions first, as hospitals and large care organizations attempted to reduce waste and improve patient care, while the adoption has been much slower among physician's practices and smaller medical institutions. (Hillestad, et al., 2005, pp. 1103-1104) Prior to this time medical…...

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Resources, and Utilization

Health Care oles in Communication
Communication is a fundamental piece of health care education and has been shown to improve health outcomes, patient compliance, and patient satisfaction. Quality health care emphasizes knowledge and utilization of communication skills. Health care professionals often express anxiety and lack of confidence and are deficient in a creating a situations that are conducive to open and candid communication with patients (Kameg et. al., 2009).

Effective communication involves gathering information, establishing a relationship or connection with a patient, and supporting the person through words and other non-verbal forms of interactions. Effective communication involves not only the interactions between the staff and the patient but also the interactions between staff and the interactions between the staff in front of the patient. Many times the high demand for services in a health care facility cause the staff to overlook the importance of good communication skills and enables situations to arise…...

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References

Beer, J.E. (2003). Nonverbal Communication: Communicating across cultures. Cultures at work. Retrieved May 29, 2011 from  http://www.culture-at-work.com/nonverbal.html 

Coiera, E. (2006, May). Communication systems in healthcarre. Clinical Biochemist Reviews. nursing.Vol. 27, Issue 2, 89-98. Retrieved May 28, 2011 from  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1579411/ 

Gamble, T.K. & Gamble, M. (2006). Communication works. Burr Ridge, IL: McGraw-Hill.

Health Communication. (2010). Health communication. Healthy people 2010: Objectives for improving reproductive health. Office of Disease Prevention and Health Promotion. Retrieved May 29, 2011 from  http://www.hhs.gov/opa/pubs/hp2010/hp2010rh_sec2_healthcomm.pdf

Healthcare in the United States: Where We Have Been, Where We Are Going
The current healthcare crisis in America is not one that happened over night. It is one that has been building for more than a quarter century. There was a time in America when healthcare was a stellar institution: research, cures, technological advances, and treatments. The focus of healthcare was maintaining and improving the quality of life. Then, during the early 1980s, managed care became an entity between the physician, the patient, and the healthcare provider of hospital services. It began subtly, but has, today, become one of the most aggressive and successful business ventures of our time; and it has been the unmaking of a once stellar and progressive American institution.

Managed care is a "distinctly American" product (Birenbaum, 1997). It was legislation introduced by the Nixon Administration with the intent to regulate healthcare and to maintain control over…...

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Reference List

Bernstein, A.B., Hing, E., Moss, A.J., Allen, K., Siller, A., and Tiggle, R. (2003). Health Care in America: Trends in Utilization. Hyattsville, MD: National Center for Health Statistics.

Birenbaum, A. (2002). Wounded Profession: American Medicine Enters the Age of Managed Care. Westport, CT: Praeger.

Birenbaum, A. (1997). Managed Care: Made in America. Westport, CT: Praeger.

Committee on Health Care Access and Economics Task Force on Mental Health (2009). Improving Mental Health Services in Primary Care: Reducing Administrative and Financial Barriers to Access and Collaboration. The Official Journal of the American Academy of Pediatrics, March, 30, 2009, pp. 1248-1251.

Lastly, the sixth issue is that the hospital has no relationship with an HMO. They have not been able to come to an agreement with Kaiser Permanente. This reduces revenues, reduces traffic flow and creates a problem where Kaiser is building a new hospital in the area that will directly compete with EMC.
3. Perform a financial analysis of EMC. Based on the analysis, where is the company strong and where is it weak?

EMC's financial position is weak. The company is faced with a steep decline in its cash position, which makes it difficult to invest in the future. The company is also relying on its investments for cash flow, and the current investment climate makes this a challenge. EMC has seen a strong increase in net patient revenue in 2002, reversing a flatlining trend. However, operating expenses have been a long-term increasing trend, and ballooned in 2002. Salaries and…...

" (AAF, nd)
The Health Maintenance Organization further should "…negotiate with both public and private payers for adequate reimbursement or direct payment to cover the expenses of interpreter services so that they can establish services without burdening physicians…" and the private industry should be "…engaged by medical organizations, including the AAF, and patient advocacy groups to consider innovative ways to provide interpreter services to both employees and the medically underserved." (AAF, nd)

One example of the community healthcare organization is the CCO model is reported as a community cancer screening center model and is stated to be an effective mechanism for facilitating the linkage of investigators and their institutions with the clinical trials network. It is reported that the minority-based CCO was approved initially by the NCI, Division of Cancer revention Board of Scientific Counselors in January 1989. The implementation began in the fall of 1990 and the program was experiencing success…...

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Principles for Improving Cultural Proficiency and Care to Minority and Medically-Underserved Communities (Position Paper) (2008) AAFP -- American Academy of Family Physicians  http://www.aafp.org/online/en/home/policy/policies/p/princcultuproficcare.html 

Volpp, Kevin G.M. (2004) The Effect of Increases in HMO Penetration and Changes in Payer Mix on In-Hospital Mortality and Treatment Patterns for Acute Myocardial Infarction" The American Journal of Managed Care. 30 June 2004. Issue 10 Number 7 Part 2. Onlineavaialble at:  http://www.ajmc.com/issue/managed-care/2004/2004-07-vol10-n7Pt2/Jul04-1816p505-512 

Darby, Roland B. (2008) Managed Care: Sacruificing Your Health Care for Insurance Industry Profits: Questions You must ask before joning an HMO. Online available at: http://www.rolanddarby.com/br_managedhealth.html

Health Care Communication
As the nation's health care resources become more and more strained, health care professionals are being asked to do more with less. They are being pressured to find cheaper ways to improve the quality of health care they deliver. Given the current circumstances, this sounds difficult and even unreasonable, but it may not be entirely impossible.

One simple way for medical professionals to improve the quality of health care they provide is by improving their health care communication skills. Health care communication is "The art and technique of informing, influencing, and motivating individual, institutional, and public audiences about important health issues. The scope of health communication includes disease prevention, health promotion, health care policy, and the business of health care as well as enhancement of the quality of life and health of individuals within the community." (U.S.D.S.H.S., 2000, p.11-20).

In health care, as in all aspects of life, communication is…...

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Bibliography

U.S. Department of Health and Human Services. (2000). Healthy People 2010: Volume I, Focus Area 11: Health Communication (second edition) Washington, DC: U.S. Government Printing Office.

Zachariae, R. et. al. (2003). The relative importance of physician communication, participatory decision making, and patient understanding in diabetes self-management. British Journal of Cancer, 88(5), 658-65.

Heisler, M. et. al. (2002). The relative importance of physician communication, participatory decision making, and patient understanding in diabetes self-management. Journal of General Internal Medicine, 17(4), 243-52.

Safran, D.G. et. al. (1998). Linking primary care performance to outcomes of care. Journal of Family Practice, 47(3), 213-20.

Health Disparities in Louisville KY
Health Disparities

Health inequities have become a major problem in the United States. Hofrichter stresses in Tackling Health Inequities Through Public Health Practice:

A Handbook for Action ( 2006) that, "The awareness of the existence of inequities in health, health status and health outcomes between racial and ethnic groups in America is as old as the nation itself" (Hofrichter, 2006,P. vii). As will be discussed in this paper, these inequalities have a wide range of repercussions, including social and psychological implications. A definition of health disparity is: "... The difference in the incidence, prevalence, morbidity, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups" ( Samuels, 2005).

There is also a consensus in the literature that inequalities in health and healthcare throughout the world are on the increase. This is largely due to the increasing gap between rich and poor within many…...

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References

Eliminating social and economic barriers to good health and safety: Louisville

Center for Health Equity. Retrieved from  http://www.preventioninstitute.org/component/jlibrary/article/id-278/127.html?tmpl=component&print=1 

Galvin, J.R. (2006) Diabetes. Ebony, 61 p. 157.

GradNation - Making the Connection: Health & Student Achievement. Retrieved from http://www.silentepidemic.net/Our-Work/Dropout-Prevention/~/media/Files/Our%20Work/Dropout%20Prevention/Grad%20Nation%20Action%20Forum/Steve%20Tarver%20working%20sess%20PPT.ashx

Looking for the best practices on endotracheal suctioning often involves determining whether open or closed suctioning is better.  Open suctioning requires disconnecting the patient from the ventilator, while closed suctioning allows the patient to remain connected to the ventilator.  While closed suctioning is generally preferred, it is not always the best practice, but the research investigated looked specifically at closed suctioning because of the research question presented.   

In 1999, Kinloch ran an observational study that compared oxygenation in patients that either had normal saline instilled at the start of endotracheal tube suctioning or did not have saline instilled.  Until....

While stress is a commonly used term, it is a poorly defined term that can refer to a wide scope of things, depending on the context.  Generally speaking, stress refers to the person’s response to some sort of aversive stimuli or stressor, though stress can also be used to refer to the stimuli that causes the stress.  The perception of stress appears to be related to whether a person finds a particular stimulus to be overwhelming. Therefore, a stress concept analysis can have different meanings and is personalized for each person experiencing a particular stressor.  Generally, we....

For the last decade, total quality management has been considered the gold standard in quality management in the healthcare setting.  Therefore, the question is not really whether we can apply total quality management in hospitals, but what steps hospitals need to take to implement this type of management within their organizations.

The first thing to keep in mind is that modern hospitals are not simply hospitals; they are almost all part of larger healthcare networks.  This has the potential of dramatically improving patient care, as the range of care that a patient can access through a....

1) Many studies have shown that minimum wage increases have a positive impact on reducing poverty rates. By ensuring that workers earn a wage that covers their basic needs, minimum wage laws help lift low-income individuals and families out of poverty.

2) Minimum wage laws can also stimulate economic growth. When low-wage workers have more money to spend, they are more likely to consume goods and services. This increased consumer spending can boost demand, leading to job creation and supporting local businesses.

3) Implementing a minimum wage can also improve public health outcomes. Research has found that higher wages are associated with....