Interview with policy marker Essay Example | Topics and Well Written Essays - 1000 words

Interview with policy marker - Essay Example Such patients have to be making about 1800/year, and be diagnosed with mental disability. Income is all the same the major factor as they have to be making 1800/year According to the Healthy People 2020 report, one of the main aims is to reduce the homeless people. How does your facility do to ensure the same? The homeless patients are kept in boarding homes, or in other shelters How do the boarding homes, halfway homes, or shelters help in maintaining the individuals’ stability? Patients in these homes have access to continued care, they are seen by a psychiatrist on weekly basis who are paid by the government. This is in accordance with objectives the Healthy People 2020 program that aims at increasing medical practitioners contact with patients. According to you, what is the main drawback preventing your clients from receiving care? And what role should the government play in increasing the care given to your clients, as outlined under the Access to health services Objectiv e in the Healthy People 2020 project? Sometimes it gets frustrating to give essential care and shelter to a patient with no insurance cover. Funding becomes the biggest drawback; this patient population is mostly ignored due to mental illness. Therefore, shelters have serious limitations in receiving and caring for fixed number of patients according to availability of funds in issues related to behavioral health. In an epidemiology study carried out by Pratt (2012), data from a 2007 National Health Interview survey of 23, 393 adults indicated that 35% of adults with a history of mental illness had a history of homelessness. Do you believe this is a reality? And what can be done to reduce this problem? The future of the homeless depends on the ability of the government to offer more funding. The homes carry out a census of the homeless at the beginning of each year, aimed at determining funds required to assist each of the homeless. The problem is that the shelters are greatly underf unded, which is major challenge. One of the legal implications in accessing health care services is the requirement that Insurance coverage is the principal means of measuring whether one gets adequate access to healthcare among the general population, limiting the chances of the above mentally ill patients, who are usually unemployed to obtain such important services (Healthy People 2020). 2. Policy Maker Question Asked Response obtained Eno- Obong E. Senior case manager with VA community based care These questions focused on the objectives of Healthy People 2010 to improve access to community based education programs in aiding to reduce hospitalization and management of chronic diseases. 1. 1 Health is more influences away from the facility where most of the population spends most of their time. As a case manager working for the patients in the community is this statement true? I concur with this statement from my experience in the field. Before, we recorded much higher emergency visits even after implementing the home health nurse program. However, with no education on how to manage chronic diseases and access to community resources, patients still continued to be sick. The facility therefore helped in exacerbation on the long term health needs of patients accessing such community health based resources. What is the most critical service that you give to the community to reduce emergency visits, and ensuring increasing access to

Report Essay Example | Topics and Well Written Essays - 500 words - 12

Report - Essay Example Notably, this case represented a miscarriage of justice. The evidence presented by Krex’s attorney pointed to his innocence. This evidence engrossed two trial expert witnesses who had alluded to Mr. Klex’s innocence and a justification professional witness, a world renowned handwriting expert, who noted that Mr. Klex was innocent (McLaughlin 1). Courts should take measures to maintain both the veracity of convictions and the moral force of their burden of proof. In Mr. Klex’s case, the judge denied a caregiver from speaking on behalf of Mr. Klex’s satisfactory character and his attribute as a loving and a caring husband (McLaughlin 1). This court failed on its part of burden of proof. This is among the many reasons for wrongful convictions for deeds people did not do. Over the past three years, more than eleven convicts have been exonerated on account of actual innocence based on evidence. In order to establish the innocence of an accused, the courts require assistance from an expert in fields such as science. In the case of Mr. Klex, the judge refused to hear out a renowned forensic handwriting expert who acknowledged that Mr. Klex was innocent (McLaughlin 1). If many of the cases in Pennsylvania were to be reviewed, there would be some cases where those convicted are innocent in the sense that they did not partake in the crime. In order to guarantee that such instances do not recur, it is essential for the Pennsylvanian criminal justice system to consider all the recommendations contained in the report of the advisory committee on wrongful convictions. Who would object to efforts of eliminating wrongful convictions? What would be eviler than taking guiltless citizens, tarnishing their lives and punishing them for offenses they did not commit? After having studied why innocent men and women were wrongfully convicted and doomed, the advisory committee established that some of the basis of wrongful convictions

Importance of Good Hand Washing

Importance of Good Hand Washing Dorvil Hand Hygiene Hospital acquired infection is a major issue and it can affect the quality of life for any one (Marije, Marlies, Martin, Michel, and Richard, 2007). It is very important that health care staff continue to properly use good hand washing techniques (Maskerine and Loeb, 2006). In order to assist with this issue program developers made use on theories. The theory models used in the literature were Social Cognitive Theory, Health Belief Model and Trans-theoretical Model. Constructs were used to design the programs and were effective in helping the population because it did reduce the high incidence of hospital acquired infections. Although these theories have been used to help solve the issue they have not been quite successful in maintaining a low rate of incidence (Creedon, 2008). Health Belief Model may further improve the program in addition to decreasing or eliminating acquired infections with the help of these constructs; perceived susceptibility, perceived severity, perceived benef its, perceived barriers, cues to action and self-efficacy. Health belief model helps explain the reason why people perform certain behaviors. The constructs emphasizes that health behavior is determined by one’s beliefs about a disease and the approach to decrease the occurrence (Hayden, 2014). Hayden (2014, pg31) states, that personal perception is influenced by the whole range of intrapersonal factors affecting health behavior including but not limited to: knowledge, attitudes, beliefs, experiences, skills, culture, and religion. If the health belief model is further used it may help to get a better understanding for the noncompliance of hand hygiene. Changing the behavior will enable a successful outcome and decrease the risk for all patients in the hospital setting. In this case, Health Belief Model provides a way to understanding and predicting how healthcare staff will behave in relation to their health as well as the patient and how they will comply with health care policies. Promoting hand hygiene in the hospital field will help to eliminate high rates of hospital acquired infections (Maskerine and Loeb, 2006). This theory based program will hopefully engage the HCW to change their perceptions and eventually use what is learned to effectively practice good hand hygiene. This health care program is designed using the constructs of the health belief model. This program proposed is developed to help reduce healthcare acquired infections by improving hand washing techniques among hospital staff, mainly in registered nurses, respiratory therapists, nursing techs and physicians. This program will help engage the health care staff by using media( video) and mock scenarios to educate and answer survey questionnaires based on the constructs; perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action and self-efficacy. It will consist of 50 HCW from 4 different hospitals, two with low HAI rates and two with high infection rates. Consent from the employees as well as the hospital will be needed for the process. During the program the staff will be split into groups and will work with those individuals that are part of the group. Before advancing into teaching, the healthcare workers will be placed into a mock hospital setting and each will be given a title and job description to perform. This process is to determine how many times and during what times hand washing or alcohol based sanitizer is used. Secondly a survey questionnaire will be given. Third, a video will be presented to educate about the consequences of poor hand washing compliance and how it also affects them as well as the patient. The staff will be able to engage in discussion and state what was done wrong in the video, why it was done wrong and things that should be changed. One of the videos will consist of a recording of the mock scenario performed by the healthcare workers. Lastly, the mock will be repeated to acknowledge if the sta ff did anything different from the first scenario. After reviewing the results of the program, an evaluation will take place to determine whether the program was effective and whether there were significant changes. There are many programs in the world to help improve conditions within communities. Although there are so many, people need to know whether they are effective and beneficial. Milstein and Wetterhall (2013 pg. 3) states, â€Å"The systematic use of evaluation has solved many problems and helped countless community-based organizations do what they do better. Community Health and development programs are evaluated to help clarify program plans, improving communication among partners and Gather the feedback needed to improve and be accountable for program effectiveness (Milstein and Wetterhall, 2013). When an evaluation is done, people are able to see their mistakes. It provides insight on whether to use a different strategy to improve what the program intended. Thus this will help improve the efficacy of the program. Evaluation can also determine whether the participants of the program were at all affected, empowered, and if participants retained knowledgeable facts. â€Å"Evaluation is a powerful strategy for distinguishing programs and interventions that make a difference from those that dont. It is a driving force for developing and adapting sound strategies, improving existing programs, and demonstrating the results of investments in time and other resources. It also helps to determine whether the process taking place is worth the co st† (Milstein and Wetterhall, 2013, p25). The framework serves for further improvement with the use of best practice which supports steps and standards that can be used in most settings. Because the framework is purposefully general, it provides a stable guide to design and conduct a wide range of evaluation efforts in a variety of specific program areas (Milstein and Wetterhall, 2013). To evaluate the program’s effectiveness, direct observation can be done as well as tracking the infection rates of the hospital from where the healthcare workers are employed. Permission by the Hospital committee would be needed to obtain data. During the process of the program direct observation can be used during both mock scenarios to determine if the healthcare staff retained what they learned and if it was used. Throughout the program direct observation will take place and a recording will be kept of the times the healthcare staff used hand washing techniques. This will be formed into a data graph to be evaluated at the end. The survey taken by the healthcare staff will also be reviewed to define if perceptions, attitudes and knowledge are still the same. This program will be compared with other programs to determine what worked and how many people effectively used hand hygiene. Comparing with other programs allow visual of their process to determine whether the same resu lts were produced. The best way to determine whether a difference was made is to review the infection rates of the hospital before and after the program was initiated. This will produce whether there was improvement and if the program made an impact to significantly decrease the infection rates. It will allow determination of beneficial factors to the healthcare workers as well as the patients. By evaluating the program and the effect on the hospital it will determine whether goals and objectives were met. This will allow for changes to be made to the program and new work plans to take effect based on data reviews, experiences and surveys. References Creedon, S.A. (2008) Hand hygiene compliance: exploring variations in practice between hospitals. Nursing Times; 104: 49, 32-35. Hayden, J. (2014). Introduction to Health Behavior Theory. Sudberry, M: Jones and Bartlett Publishers Marije, C B., Marlies, H., Martin, P. E., and Michel, W., Richard PTM G.. (2007). Planning and Studying Improvement in Patient Care: The Use of Theoretical Perspectives. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690312/ Maskerine, C. Loeb, M. (2006)Improving adherence to hand hygiene among health care workers. Journal of Continuing Education in the Health Professions. Vol. 26 Issue 3, p244-251. 8p, 0894-1912 DOI: 10.1002/chp.77 Milstein, B. and Wetterhall, S. CDC Evaluation Working Group. (2013). Recommended framework for program evaluation in public health practice. Atlanta, GA. Retrieved from http://ctb.ku.edu/en/table-of-contents/evaluate/evaluation/framework-for-evaluation/main

Stability and bioavailability of different erythromycin derivatives :: essays research papers

1. Introduction Erythromycin is one of the most common used macrolide antibiotics. Over the years after Abbott introduced Erythrocin ® (erythromycin stearate) into the market, several generics and new brands have been introduced – generics in the form of different drug formulations and new brands in the form of different erythromycin salts. All these derivatives have the same pharmacodynamics and mechanism of action, but differ tremendously in their pharmacokinetics. This paper will give an introduction and a brief overview in the different stabilities and pharmacokinetics of the erythromycin salts and an introduction into new approaches in the field of macrolide antibiotics. Table of Contents 1. Introduction  Ã‚  Ã‚  Ã‚  Ã‚  2 2. Erythromycin – a brief chemical description  Ã‚  Ã‚  Ã‚  Ã‚  4 2.1 Crystal structure and hygroscopicity  Ã‚  Ã‚  Ã‚  Ã‚  7 2.2 Mechanism of action  Ã‚  Ã‚  Ã‚  Ã‚  8 3. Derivatives of erythromycin base  Ã‚  Ã‚  Ã‚  Ã‚  9 3.1 Erythromycin stearate  Ã‚  Ã‚  Ã‚  Ã‚  10 3.2 Erythromycin ethyl succinate  Ã‚  Ã‚  Ã‚  Ã‚  10 3.3 Erythromycin estolate  Ã‚  Ã‚  Ã‚  Ã‚  11 3.4 Comparison between erythromycin base and estolate  Ã‚  Ã‚  Ã‚  Ã‚  13 4 Chemical derivatives of erythromycin  Ã‚  Ã‚  Ã‚  Ã‚  13 4.1 Roxithromycin  Ã‚  Ã‚  Ã‚  Ã‚  13 4.2 Clarithromycin  Ã‚  Ã‚  Ã‚  Ã‚  14 4.3 Azithromycin  Ã‚  Ã‚  Ã‚  Ã‚  14 4.4 Dirithromycin  Ã‚  Ã‚  Ã‚  Ã‚  15 4.5 Flurithromycin  Ã‚  Ã‚  Ã‚  Ã‚  16 4.6 Comparison of properties among the newer macrolides  Ã‚  Ã‚  Ã‚  Ã‚  17 5 Discussion and conclusions  Ã‚  Ã‚  Ã‚  Ã‚  19 References  Ã‚  Ã‚  Ã‚  Ã‚  21 2. Erythromycin – a brief chemical description Figure 2.1 Advertisement for eryped ® [3] Erythromycin belongs to the chemical group of macrolide antibiotics (macros [greek] = great, -olid as the suffix for lactones). It's microbiological activity mainly covers bacterial infections of the respiratory tract and other infections with gram positive bacteria. In the case of erythromycin base, the 14-linked lactone ring (Erythronolid) is conjugated with one basic amino sugar (Desopamine) and one neutral sugar (Cladinose). Figure 2.2 Erythromycin base showing the aglycon (red), the basic amino sugar (green), and the neutral sugar (blue) [2] Erythromycin was first discovered in 1952 in Streptomyces erythreus. The spectrum of activity is equal to penicillin. The antibiotic activity is linked to the presence of the desoxy sugars. There are three known forms of erythromycin. The structure of erythromycin-A is the most common used in formulations and differs from erythromycin-B in the hydroxyl-group in position 13 of the lactone ring. Erythromycin-C is missing the methoxy-group in the cladinose sugar. [8] Stability problems first were discovered when Erythrocin ® was found to contain not the declared amount of erythromycin stearate. The first stability problem with erythromycin is because of its deliquescence. This could be prevented if erythromycin is stored under accurate conditions. Erythromycin has a poor water solubility and solutions decompose quicker if temperature is increased. Figure 2.1 shows the chemical degradation of erythromycin. The formation of the hemiketal is a dehydration and leads to the inactivation and loss of antibiotic activity. This step is highly pH sensitive. Figure 2.3 Chemical degradation and inactivation of erythromycin [4]

Nazi Germany

Nazi Germany relied heavily on control of the mass media of communications and expression and the mighty propaganda machine played a vital role in the Nazi party. In 1933 Hitler commented that (Lee, 30) â€Å"the art of propaganda lies in understanding the emotional ideas of the great masses and finding a way to the heart of the broad masses. † Propaganda was a means to gain and keep the support of the masses and the crude and over simplified weltanschaung (psychology) projected by Nazi propaganda inspired and overwhelmed millions of Germans, promoting the ideological goals of the regime and the creation of the ‘Fuhrer myth'. Passive acceptance of the new regime was converted into active support and used to encourage Germans to pursue national socialistic goals. Through deliberate attempts to create a new social ritual, the Heil Hitler salute, Horst Wessel song and the supremacy of Militaristic uniforms were fabricated to strengthen the individuals identity with the regime. Music was carefully scrutinized and Jewish musicians such as Mendelson were removed from the list of composers, whilst special places were given to Opera's of men such as Richard Wagner as they dealt with heroic German Legends from the past. Modern art was condemned as degenerate and any war and anti nazi ideology literature were burned in the ‘burning of the books' on the 10th May 1933. Control of expression and communication is vital for a totalitarian state to be upheld and the Nazi's were successful in indoctrinating its peoples and controlling both their expression and communication. According to Kershaw a totalitarian state requires passive and isolated population who are unable to respond however Gobbels turned passive Germans into active Germans. Propaganda during the Nazi regime was totalitarian in intent, however did not fulfill a totalitarian outcome. From a cultural perspective, Nazi Germany does not fit the social attributes of a totalitarian state whereby the people of the state are a passive population. Germans were encouraged to become part of the greater Volksgemeinschat (peoples community), and this is demonstrated in the Nuremberg rallies, where over one million Germans pledged their support to the Nazi Party through their presence. â€Å"Strength of Joy† a creation company that organised concerts where people would flock together, all in support of the Nazi Regime. The emphasis on group participation in social activities infiltrated all sections of society especially the youth. Young girls form the age of fourteen joined the Bund Deutscher Madel (League of German matrons and boys were encouraged to join the â€Å"Hitler Jugend. † Hitler youth had a membership of 3 500 000 14-18 year olds, a level of voluntary participation before it became law in 1936. Social activities and education for the youth were extremely well coordinated and schools were used for the purpose of indoctrination. All subjects particularly History and Biology were influenced by both the Nazi's determinations to shape the minds of the younger generation as well as trying to achieve an Aryan Herronvolk (master race). Physical education (compromising 15% of school time), was important to encourage competition, enforce discipline and keep them young and healthy- in short pre-war training. Special schools – National Political Institute of Education- were provided for the most gifted and talented who were considered to be the future leaders of the third Reich. Despite the indoctrination of student, minority youth resistance groups still existed within the period of 1933-1942. White Rose, amongst the most effective condemned the killing of Jews as well as the ‘Swing; resistance group who opposed Hitler's beliefs that Jazz and swing music were degenerate. Both groups however were ineffective and exposing led to imprisonment or death. Despite these splinter groups, all sections of society succumbed to the Nazi's party direction for participation in both social activities and active support for the regime. The majority of the people embraced Hitler and Nazism with enthusiasm and willingness to support all of their endeavors.

Moss and McAdams Accounting Firm Essay

1. At the end of the case if you were Palmer, how would you respond? It was clear from the beginning everyone involved could have handled things more professionally in order to maximize time, and resources while maintaining a healthy and productive work environment for all employees. From the start of the project it was evident that Olds knowledge and skills were definitely in demand. Because his expertise was so in demand, when met with an organizational structure that had an obvious weak matrix structure, it caused great adversity. In this case we learn Ruby Sands had the role of functional manager and therefore ultimately made a decision that affected Palmer’s account. As soon as Palmer recognized the problems he should have addressed the issue then and presented the possible risk, moving forward the best option for Palmer is to find a suitable replacement for Olds. And accept the fact that valuable employees leave projects all the time for one reason or another. Also, Palmer should address his concerns regarding the situation on a whole to include Crosby’s unwillingness to be a team player as a way to avoid similar situations happening in the firm’s future. In conclusion, Palmer is the project manager; it is his responsibility to handle all aspects of the project to include communication. Effective communication would have lead to a better outcome. 2. Discuss what Palmer could do, if anything, to avoid losing Olds: Project managers are ultimately responsible for performance. Therefore it is Palmer’s responsibility to ensure that appropriate protocol is made between the time, cost and performance requirements of the project. In addition, the project manager is also responsible for the aspects of Leadership, such as problem solving, teamwork, negative politics and customer expectations. To avoid losing Olds, Palmer should have realized the struggles Olds was faced with, such as working extra hours to accommodate both projects and accounts, as a result the impact that it had on work-life balance took its toll on Olds and put him in a difficult position.