Writing a good persuasive essay

Friday, August 28, 2020

Online Essay Writers

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Wednesday, August 26, 2020

27 Best Writing Books Images

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Wednesday, June 3, 2020

Sommali Women and Diabetes - Free Essay Example

Since the early 2000s, Maine has seen quite a substantial rise in immigrant and refugee population growth. To put it into perspective, the total population in Portland, Maine between 2000 to 2010 had increased only by 3% while the racial and ethnic minority population in Portland had increased by 80% (____). Maine has typically admitted a large percentage of its refugees from heavily Muslim populated countries like Somalia and Iraq but as of recent, with the immigrant policies and bans being enforced by the Trump administration, it has significantly lessened the numbers of people entering America overall. Nonetheless, with migration brings an increased susceptibility to chronic diseases like diabetes, especially for Somali women. Somali women The relationship between migration and diabetes can be examined through the refugee and immigrant experience of acculturation to their host country. And as a result, health-related factors like obesity, dietary acculturation, physical inactivity and lack of access or utilization of modern health services become strong causal determinants for this public health issue. On top of the predisposition to having insulin resistance many migrants in non-Western countries have risen in conditions of poverty and their bodies have been ?programmed to tackle hunger and starvation. The result is that later in life, when exposed to the obesogenic environment of the country of immigration (high-fat diet and sedentary lifestyle), they are particularly prone to stock energy reserves and thereby gain weight (Montesi). This is especially true for Somali immigrants as majority of them are refugees fleeing from their country that is still amidst a civil war today. On top of this predisposition to gaining weight, adjusting their dietary habits is another main concern. The traditional Somali diet is centered around pasta, rice, other carbs, meat, camel and goat milk, and tea with a lot of sugar. Its not the most balanced diet but when combined with a more sedentary lifestyle than the lifestyle they knew in Africa, it can lead straight to obesity and diabetes. A sedentary lifestyle is common and convenient especially when the wintery Maine climate, lack of motivation and time are barriers to getting active but according to a focus group study on Somali women and their views on physical activity, these barriers in addition to tradition and religion hold Somali women back. These obstacles originate from their steadfast following of the Islamic faith. According to Somali customs, wearing revealing and skin-tight Westernized clothing when males are present is forbidden, haram. So the traditional Somali clothing for women is a full-length dress and a hijab which is difficult to get active in (Gerthi). Whether it is done deliberately or not, differences in socioeconomic status and barriers formed by the culture of medicine and healthcare in America put ethnic minorities like Somalis at a higher risk of being under-treated. And even though the probability of developing a chronic disease is higher in foreign-born individuals, they are still more likely to not have their own health insurance coverage. Plus, many believe not making use of drugs and primary care services is a cheaper and healthier alternative yet underutilization of drugs and primary care services especially for the foreign-born can be anything but cost-effective. In fact, it would most likely produce higher hospitalization rates in the long run due to disease progression and other complications. Especially with Somali immigrants, there is a clear stigma associated to trusting anything related to modern science because of their strong cultural and religious beliefs. EXPAND All in all, more efforts should be made to positively encourage screening and treatment programs, to adapt education programs to specific cultures, and to grow community engagement. The social determinants of this public health problem are related to how resources are communicated and the advantages and disadvantages to which people are exposed. Certain populations experience consistently lower health statuses than others and require more attention to understand and relieve them of their health issues. Among these, immigrants and particularly refugees constitute a large group of people who have serious needs in regards to their health. Many refugees experience extreme hardship prior to and during flight from persecution, famine and war in their country of origin and continue to experience difficulties upon resettlement in a host country, all of which seriously affect their health status. FIX: linguistic factors (lack of communication and language barriers being a determinant in immigrant health) play a significant role in the understanding and self-management of diabetes in these populations. health care professionals whose ethnic backgrounds often differ from most of their immigrant patients are frequently unaware of communication barriers that make comprehension and adherence to medical treatments very difficult for immigrant groups FIX. And once again, Refugees and immigrants of every race and religion can be found in any region of the world. They give up everything they know in fear for their lives home, belongings and loved ones for an uncertain future in an unfamiliar land.

Wednesday, May 6, 2020

The First Modern President Of The United States - 1069 Words

The First Modern President of the United States: Theodore D. Roosevelt Some may wonder why Theodore Roosevelt would deserve the title Ã¢â‚¬Å"the First Modern PresidentÃ¢â‚¬ . He accomplished many things, and although he was liked by most, he promised he would not run a second term. In his short four years as president, Theodore Roosevelt was able to pass many acts such as: Dolliver-Hepburn Railroad Act, Extension of Forest Reserve, National Irrigation Act, Improvement of waterways and reservation of waterpower sites, Safety Appliance Act, EmployersÃ¢â‚¬â„¢ Liability Act, Regulation of railroad employeesÃ¢â‚¬â„¢ hours of labor, Establishment of Department of Commerce and Labor, Pure Food and Drugs Act, and the Federal meat inspection. Theodore Roosevelt was bornÃ¢â‚¬ ¦show more contentÃ¢â‚¬ ¦Theodore RooseveltÃ¢â‚¬â„¢s mother also died the same day in the same house, he was brokenhearted and in misery leading him to temporarily leave politics and become a cattle rancher in the Dakota s. Two years later, he married his childhood friend, Edith Kermit Carow. They had a total of five children, four boys and a girl: Theodore Ted III (1887Ã¢â‚¬â€œ1944), Kermit (1889Ã¢â‚¬â€œ1943), Ethel (1891Ã¢â‚¬â€œ1977), Archibald (1894Ã¢â‚¬â€œ1979), and Quentin (1897Ã¢â‚¬â€œ1918). Before being president, Theodore Roosevelt was many things: a member of the New York State Assembly, a U.S. Civil Service Commissioner, President of the New York City Police Board, Assistant Secretary of the Navy, Governor of New York, and Vice President from March-September 1901 when he succeeded to the presidency. Theodore Roosevelt became president on September 14, 1901 after President McKinley was assassinated on September 6, 1901. He was the youngest president the nation had ever had; he was 42 years old. He served through most of the first decade of the 1900Ã¢â‚¬â„¢s. He was determined to build a canal across the Panama. The United States helped Panama gain its freedom from Colombia. The U.S. then ma de a treaty with Panama to gain the canal zone for $10 million including annual payments. Theodore Roosevelt was very involved in foreign policy. He added the Roosevelt Corollary to the

Tuesday, May 5, 2020

Safety And Quality Practices In Australian Health Care Ã¢â‚¬ Free Samples

Question: Discuss about the Safety And Quality Practices In Australian Health Care. Answer: Introduction The outcome of the paper is the thorough literature review on the safety and quality practices in Australian health care for pricing and funding arrangements undertaken by the IHPA and commission. The aim of the assignment is to discuss the four funding models defined by Egar et al. (2013) as used by the public hospitals in Australia. Further, the system of the National Efficient price is critically discussed. In this regard, it is discussed as to how this system may provide an incentive to improve the health status of any selected segment of the Australian population. Funding models The four overarching models used by public hospitals in Australia, which are identified by the literature review of IHPA and commission are- Best practice pricing Normative pricing Quality structure pricing models Payment for performance or safety and quality pricing The Best practice pricing is the model that refers to use of the car pathways that are based on strong evidence. The best solution is for treatment of the particular health condition and for which the hospitals would be paid a set fee. Based on the best evidence, the price for implementing this model of care is decided and an additional incentive is paid. There is a limited literature evaluating the efficacy of this model as this scheme represents the value for money. In England, the health care system had implemented the scheme of Best Practice Tariffs. However, there is limited conclusive evidence except for the findings from the National Hip Fracture Database of UK (Eagar et al., 2013). As per the literature review by the IHPA on this model, the best practice pricing has modest gains with methodological inadequacies as evidence based care pathways can be implemented for limited conditions. Normative pricing is the system where the price is used to influence the outcomes of delivery of care. It may be used in certain cases such as incentivising the day surgeries or when there is a need of more home care nurses, for a particular disability or illness, or where the patient seeks residential care. Substantial improvement was noted by implementing this pricing system in the radiology area. There is a lack of conclusive evidence on the use of this pricing system due to uncertainty in determining the cost of implementing the new model (Eagar et al., 2013). In the Quality structure pricing models, the pricing or funding is linked with the meeting of the accreditation standards by the health care providers, participation in the safety improvement activities, quality registries, and clinical benchmarking. The aim of this system to increase savings, however, there might be high initial cost. The pricing or the funding may be high for accredited hospitals and then the non-accredited counterparts. There is strong evidence that this kind of funding system leads to improvement in quality and safety (Eagar et al., 2013). However, it lacks the direct measuring of patient outcomes. The Payment for performance is the funding model that refers to pushing the care providers to improve the quality and safety by behaving in certain manner. The model uses financial incentives for positive clinical outcomes or disincentives for poor services. It aims to encourage the service givers to increase the quality through rewards and penalty. There is a lack of evidence on beneficial outcomes from this scheme. However, in England an advancing quality initiative was taken and the results showed improvement in quality scores and reduction in short-term in-hospital mortality. It means there were few deaths due to heart failure or pneumonia (Eagar et al., 2013). National Efficient price In Australia, the National Efficient price or NEP is used for identifying the contribution of the commonwealth to public hospital funding. In this system each hospital will be paid a fixed fee for each episode of care. As per activity based funding, the contributions determined by IHPA to be paid by the Australian government is the approximately 40% of the public hospital funding. The commonwealth contribution may be influenced if IHPA builds any incentives into the model for quality and safety. In case any hospital is in deficit then expecting the states to fund the deficit will hamper the potential of NEP to improve efficiency (Eagar et al., 2013). Based on the literature review all the above mentioned funding models lack strong evidence in regards to their efficacy in improving the quality and safety of the health care services. Considering the grey literature, I agree that NEP may not be able to provide an incentive to improve the health status of any selected segment of the Australian population to a great extent. It is difficult to determine the level at which the scheme actually work or is critical (Downie, 2015). It is because it is difficult to identify the onset of health condition. The major limitation of NEP includes misallocation of resources in cases the set price does not reflect the relative cost-effectiveness of these services. Further, each hospital will have losses if they give care above the fixed price. Consequently, it may result in patient dumping, and recruitment of more enrolled nurses (Sheridan, 2016). Further, it is doubtful that the major changes will be stimulated in the public hospitals of Australia in regards to safety and quality. It because the funding for the public hospital is not directed to specific clinical departments within the hospitals or to the specific hospitals. It means to have any effect; there is a need of delivering the incentives to a level of the clinical department. Bu there are no rewards for quality (Eagar et al., 2013). Since some hospitals in rural areas have disadvantage. Therefore, there is a need of considering the potential for regional disparities to improve the quality of the health care to a great extent (Safetyandquality.gov.au, 2017). Although the activity based funding has the potential to make the functioning of the hospitals more efficient, there are flaws in the manner the scheme is designed. There is a chance that the flaws may negatively influence the potential cost savings. Eventually it will result in ineffective funding system and poor change in the quality of care (Eagar et al., 2013). If the providers find that the incentives are substantial then they might change the care pathways or behaviour. Otherwise the chances are less that the clinicians would respond to incentives. Further, there are chances that the pricing will only affect some aspects of care (Safetyandquality.gov.au, 2017). Thus the only way the NEP can secure efficiency gains by stimulating the change behaviour of the health professionals. References Downie, J. (2015). Possible options for introducing quality aspects in Activity-Based Funding pricing.BMC health services research,15(2), A2. Eagar, K., Sansoni, J., Loggie, C., Elsworthy, A., McNamee, J., Cook, R., Grootemaat, P. (2013). A literature review on integrating quality and safety into hospital pricing systems. Safetyandquality.gov.au. (2017).Supplementary Briefing and Literature Update Integrating safety and quality into hospital pricing systems.safetyandquality.gov.au. Retrieved 12 October 2017, from https://safetyandquality.gov.au/wp-content/uploads/2012/12/Supplementary-Briefing-and-literature-update-on-pricing-for-safety-and-quality3.pdf Sheridan, J. (2016).Activity Based Funding: The implications for Australian health policy(Master's thesis, University of Sydney).