Category: Health & Medicine 13691

Temporary assistance for needy families (TANF) is a program under which states are given block grants to use for their own programs to assist needy families and children, reduce the reliance of needy parents by promoting job training, prevent pregnancies among single individuals, as well as encourage the development and preservation of two-parent families (Center on Budget and Policy Priorities, 2021). The policy can be explored from the perspective of the institutional theory of public policies that focuses on more profound and resilient aspects of social structures. It takes into account the procedures in which structures, norms, and routines are seen as the standards of authority for social behavior. Specifically, TANF expects to create a framework of social norms and expectations that improve the capacity of the population to become self-sufficient without relying on social support in the long run. The strength of using institutional theory to understand TANF is concerned with the possibility to determine the ways in which the regulative and normative elements can be used in order to establish stability in social life. The limitation is that the theory cannot explain who should be included in TANF programs and how such programs should be carried out to achieve social expectations. Within the theory, it is expected that economic and political forces influence the regulative, normative, and sociological factors, and TANF seeks to create higher expectations of society by encouraging positive development and adherence to improved processes. Moreover, institutional change is possible as a function of power relationships, available resources, and relevant factors, all of which coordinate and communicate to safeguard their own interests.

Obamacare or the Affordable Care Act (ACA) aimed to offer affordable health insurance coverage for the entire population of the US. Moreover, it was introduced for protecting consumers from being subjected to insurance company tactics that may increase costs of care or restrict access to it (Garfield, Orgera, & Damico, 2021). The importance of the policy was concerned with the fact that insured individuals would worry less about the expenses of healthcare and would be more engaged in preventative care instead of treating conditions once they are already severe. It is possible to explore ACA from the standpoint of group theory, which suggests that public policy is a result of a group struggle from the organized masses. ACA was developed as a response to the limited access to healthcare by the disadvantaged groups of the population, which do not have enough resources to address the barriers on their own (Garfield et al., 2021). To some extent, this group can be classified as a political interest group that has its specific expectations of society. The advantage of using the theory to address ACA is that it can show how the social demands of particular groups can result in actions for addressing their demands. The limitation of group theory when applied to ACA is that it does not consider the poor and disadvantaged as groups, thus creating a significant barrier to the understanding of the policy as it is closely related to targeting individuals of a lower income. Since a policy is often seen as a process that reflects the interests of dominant rather than disadvantaged groups, it could be interesting to see how the group theory will apply to policies implemented specifically to target such groups.

References

Center on Budget and Policy Priorities. (2021). Policy basics: Temporary assistance for needy families. Web.

Garfield, R., Orgera, K., & Damico, A. (2021). The coverage gap: Uninsured poor adults in states that do not expand Medicaid. KFF. Web.

Anaesthesia is a Greek term whish refers to minus feeling and analgesia refers to without pain. The modern anaesthesia is thought to date from 16^th October 1846, when a Boston dentist called William Morton administered ether successfully to a young man whose operation for a tumor on his neck was done before an assembly of prominent medical men at the Massachusetts medical hospital (Stoelting, 2001). During those days, the world experienced slow communication. However, despite the slowness of communication during that time, the rate of spread of anaesthesia across the globe was remarkable. Ether had been applied in England for dental extractions by December 19^th, 1846. John Snow followed this up in 1847 by becoming the first professional anaesthetist and a prominent personality in early anaesthesia to write a book about ether. In the same year 1847, a professor of midwifery in Edinburgh, James Simpson pioneered the use of chloroform as an anaesthesia agent in obstetrics. During that period, anaesthesia had experienced spirited rejection especially from religious quarters. John Snow managed to overcome religious and other oppositions against anaesthesia when he administered chloroform in 1853 to Queen Victoria at the birth of King Leopold. For the next 100 years, ether and chloroform were to remain the most popular anaesthesia agents. In 1951, Halothane was synthesized by suckling and its first use publication actualizing in 1956 (Simpson, 2001).

The application of nitrous oxide as an anaesthesia agent had some instances of success during those times. However, when Wells demonstrated unsuccessfully its use in 1845, at the Massachusetts General hospital, its weaknesses as an agent and difficulties in devising equipment led to virtual disappearance form the anaesthesia scene for some years. Its popularity began to regain when Joseph Clover, a prominent early proponent of anaesthesia, applied it as a relatively pleasant induction before ether anaesthesia (Stoelting, 2001).

Klikovitch of St Petersburg was the first to use nitrous oxide to relieve pain at childbirth in 1880 (Dowd, 2001). He became popular at the introduction in 1934 of Minnitts nitrous oxide-air machine. The mixture of these gases and air, are now obsolete and Entonox now provides inhalational analgesia in labor. Tunstall was the first to describe it and 1961; the British Oxygen Company produced it. The introduction of muscle relaxant drugs has since seen the overall importance of nitrous oxide in anaesthesia. This is because nitrous oxide agent gives excellent operating conditions under light, general anaesthesia (Stoelting, 2008).

Local analgesia was discovered in 1884 when the effect of cocaine applied typically to the eye was described by Koller. In 1899, Bier carried out for the first time a spinal analgesia for a surgical operation. In 1901, Sicard and Cathelin of France carried out the first epidurals independently. The lumbar approach was used for the first time to the epidural space in 1921 by Fidel Pages, a Spanish Military surgeon (Stoelting, 2008). The Dean of London hospital had since 1907 used continuously used spinal analgesia. However, the 1940s marks the real interests in continuous regional techniques, when continuous spinal analgesia through a malleable needle was performed by Lemmon. The first continuous spinal analgesia through a catheter introduced a needle was developed in 1945 by Tuohy. Tuohy also designed during the following year, a needle with a tip specially designed for the purpose (Simpson, 2001).

Hingson and Southworth of the United States were the first to carry out continuous lumbar epidurals using malleable needles. Curbelo of Havana became the first to use a ureteric catheter to carry out continuous epidural analgesia with the help of Tuohy needle. Since the late 18^th Century, tracheal intubations have been used as a means of resuscitation using tubes made of metals covered with leather (Simpson, 2001). It was until McEwen of Glasgow used for the first time a tracheal tube for giving anaesthesia in 1880. The 1960s marked the era of modern anaesthesia as a result of new drugs being developed and accessibility of new techniques and equipments to monitor (Stoelting, 2008).

In sum, the technical advances brought about the evolution of technical anaesthesis. This paper has discussed the origin of anaesthesia to the modern anaesthesia.

References

1. Dowd, M. (2001). The History of Medication for Women. Philadelphia: Informa Health Care.
2. Simpson, Popat, & Carrie. (2001). Understanding Anaesthesia. Sydney: Elsevier Health Sciences.
3. Stoelting, Hines, & Marchal. (2008). Stoeltings Anaesthesia and Coexisting Disease. Sydney: Elsevier Health Sciences.

Executive Summary

Early diagnosis of glaucoma enables an ophthalmologist to provide more effective treatment and control the progression of the illness. Patients notice the symptoms when the damage is significant; therefore, much research has been conducted on the diagnostic methods. There are several systems which recognize glaucoma, and doctors usually determine which one is more suitable for the patient after an examination. Optic Nerve Imaging is a technique which helps to detect optic nerve changes over time through documented images. The paper offers an even more effective approach to determine glaucoma by combining image-based and disease-related elements. The features of both methods were enhanced, which improved the analysis of the Optic Disc and Optic Cup texture.

Introduction

Glaucoma is an incurable eye disease affecting eyesight significantly by damaging the optic nerve head. High eye pressure occurs as a result of drainage canals being blocked. Warning signs and symptoms appear later in the disease when the optic nerve is already destroyed. A timely diagnosis of the illness helps doctors provide effective treatment and prevent blindness, as the eyesight cannot be recovered once glaucoma progresses further. Al-Akhras et al. (2019) have proposed an integrated and accurate system to diagnose glaucoma through automated disease detection. The purpose of their paper is to offer a more efficient method of diagnosing the disease by implementing both image-based and disease-related features. The authors claim that the combination of those elements will provide more information and resources to determine the condition (Al-Akhras et al., 2019). The study provides an integrated and innovative approach to diagnosing glaucoma more efficiently and promptly.

Main body

The method of the work conducted by Al-Akhras et al. consists of three major parts: image-preprocessing, extraction of features, and classification of elements. Retinal fundus images were collected for experimentation from three hospitals. Different techniques were implemented to obtain features; optic disc and optic cup were obtained by the methods proposed by other researchers (Al-Akhras et al., 2019). Image-based features were enhanced by adopting both the red and the green image channels. Disease-based features were also improved, which detects the optic cup and the optic disk segments better. Support Vector Machines (SVM) and Artificial Neural Networks (ANN) algorithms were used for developing an automatic diagnosis system and detecting the images with glaucoma. In the light of the reported methodology, the proposed techniques were successful in detecting high percentages of specificity and accuracy.

The technique distinguished thirteen images out of one hundred and six samples to be with glaucoma. Ophthalmologists proved the results to be accurate and corresponding to the real diagnoses. SVM and ANN successfully differentiated glaucoma by the use of specificity and sensitivity. As a result, with SVM, when the analysis was done according to both features without data normalization, the highest classification accuracy was 87.74%, and the specificity was 100% using the Gamma value of 0.25. The sensitivity value of 23.08% was reached with the help of the Gamma value of 1. With data normalization, the highest classification accuracy of 80.19% and specificity of 91.40% were retrieved using a Gamma value of 0.25. The Gamma value of 0.8 showed the highest sensitivity value of 30.77. The ANN accuracy of 98% was reached both with and without data normalization (Al-Akhras et al., 2019). The outcome indicated that the combination of the proposed features proved to be more effective when utilized simultaneously.

Further enhancements are recommended for detecting glaucoma through automated diagnosis. The data should be documented and collected by hospitals, educational and research centers to provide enough information for groundwork. The study was limited because of the short supply of the existing database. The accuracy of the data is not entirely reliable, as the technologies used to detect glaucoma cannot recognize faulty information entry during the examination and diagnosing. Minute errors in segmentation can also cause misinterpretations and affect the diagnose outcome. The technological and informational limitations occurring during the experiment enquire more improvements in the sphere of glaucoma automated diagnosing.

Conclusion

The work proposed an advanced methodology for diagnosing glaucoma in the earliest stages to provide better treatment and avoid the damaging consequences of the disease. Image-based and disease-related features were offered to be combined in screening the patients. An automatic diagnosis system was developed by SVM and ANN, and sample images were classified into normal and those showing the signs of glaucoma. Automated screening detects early changes in the images during regular checks, which can be taken by the patients themselves, learning the right angle and using the system. Further improvements are necessary for the areas of enough database availability and technology to obtain effective outcomes.

Reference

Al-Akhras, M., Barakat, A., Alawairdhi, M., & Habib, M. (2019). Using soft computing techniques to diagnose glaucoma disease. Journal of Infection and Public Health, 1-8. Web.

Introduction

Pressure ulcers are skin injuries that occur after a prolonged absence of movement or a persons inability to reposition themselves in order to relieve pressure from certain bone areas (Joyce et al., 2018). Many interventions concerning this disease are implemented, with some being more effective than others. Reportedly, more than 3 million people in the United States are affected by pressure ulcers in the healthcare setting (Qaseem et al., 2015).

The leading causes of such disease in patients are immobility and continual bed rest that leads to pressure ulcers (Koh et al., 2018). Perpetual lying in the same position deprives a particular body part of oxygen and nutrient, which then causes injuries (Moore & Cowman, n.d.). Pressure damages frequently occur within health facilities due to adverse care, consequently not only drastically harming the well-being of patients but also causing significant financial troubles (Li et al., 2020). Therefore, the forestalling of pressure ulcers must be prioritized in health facilities with people who are unable to move.

Multiple interventions demonstrate to have a beneficial impact on the prevention of pressure ulcers; however, one solution must be determined to be the most effective. Therefore, a vital need to study various interventions to avoid this injury is needed. In this paper, the comparison of repositioning practices and pressure-relieving matrasses concerning pressure ulcers decrease will be discussed. This research will help with ascertaining the most suitable method for preventing pressure ulcers.

Repositioning

Patients with pressure ulcers require specific interventions in order to recover from an injury. In the management of ulcers, repositioning is an essential component on the path to recovery. The discomfort caused by oxygen deprivation causes a healthy person to reposition, although failure to do so causes wounds and further tissue damage (Moore & Cowman, n.d.). In the cases of patients inability to move in a timely manner, assistance is required. Therefore, each person must have consistent movement in order not to develop a pressure ulcer.

Repositioning, in the case of the pressure ulcer, is not a novel intervention, in fact, it was described in medical literature by Robert Graves in 1848 (Moore & Cowman, n.d.).

The author describes how these types of injuries can be prevented and managed through readjusting interventions. However, until these days, repositioning was not scientifically proved to be an effective way of recovering from a pressure ulcer. Thus, despite the lack of empirical research, it continues to be implemented as one of the fundamental methods in management strategies of pressure ulcers in the healthcare system.

The Singapore hospitals conducted a research and discovered that one of the most effective interventions to prevent patients from acquiring pressure ulcers inside the hospital is their repositioning every 2-4 hours (Koh et. al, 2018). Such methods distribute the bodyweight of the patient and balances the level of their nutritional status.

Moreover, the international practice guidelines also encourage healthcare facilities to imply regular repositioning to their strategies of preventing pressure ulcers (Li et al., 2020). Consequently, such intervention is evidently a primary recommended method of treating and preventing pressure ulcers.

If talking about the frequency of repositioning, no specific recommendation was found in the research. Even though the general advice is to reposition once every 2 hours, each individual is different. Some patients can stay in the same position for hours, while others need movement more frequently than every two hours.

An example can be repositioning at night: doing it every two hours disrupts a healthy sleep and can cause further problems. In addition, people with wounds or joint conditions experience severe pain with every movement. Hence, the timing of a patients repositioning should be strictly individual based on a comprehensive assessment; otherwise, there is a high chance of injuring a person more severely.

On the grounds of the research can be concluded that repositioning remains a fundamental strategy for nurses to prevent pressure ulcer, however such method requires severe changes (Moore & Cowman, n.d). It must be individualized, as the research shows that repositioning every 2 hours is not a universal treatment. Thorough examination of a patient must be conducted to determine the frequency of assistive repositioning to consequently establish proper medical care.

Pressure-Relieving Mattress

Pressure-Relieving matrasses is another intervention that is used for preventing pressure ulcers, not less than repositioning. These types of mattresses have specific chambers that are automatically filled with air (Qaseem et al., 2015). The distinct feature of such mattresses is that the air pressure frequently changes, which helps with relieving pressure in the body. However, similar to rearranging, little research is available regarding the benefits of such intervention on the forestalling of pressure ulcers.

From the retrieved information, it is known that pressure-relieving mattresses supposedly lower the risk of pressure ulcers (Qaseem et al., 2015). Such mattresses are generally used in hospitals or nursing homes to accommodate the patients who face the potential risk of pressure ulcers. Mattresses with special form not only provide a soft surface to rest but also equally distribute the pressure on the area and consequently reduce it on highly vulnerable body parts.

Alternating pressure mattresses are commonly used among patients that are in grave danger of developing pressure ulcers, impaired patients  individuals with no ability to move. Such bedding aid individuals in the healing of wounds, and in the case of progressed pressure ulcers, reduce it in size over time. For that matter, in clinical treatments, pressure-relieving mattresses help with preventing pressure ulcers and recovering from it.

Thus, the drawback of such pressure-relieving mattresses is they are too soft, which poses difficulty to move for certain people. During a prolonged period of lying on such a bedding can make patients sink in it that consequently limits their physical abilities to change positions. For impaired people, such surfaces may even possess a high risk if they are not able to reposition without supporting people. Therefore, the change in such practice is crucial; mattresses must be individually chosen according to the patients health conditions.

The evidence to prove the harmful features of a pressure-relieving mattress is insufficient due to the few reports with no significant research, though reportedly, not many injuries were fixated for such a support surface (Qaseem, et al., 2015). In one of the investigations, even after the conducted analysis, the significant impact of pressure-relief mattress was not confirmed (Joyce, Et al., 2018). Therefore, due to the lack of background and proven possible discomfort hospitals cannot put pressure-relieving matrasses everywhere, but individually implicate them as a part of the recovery process from pressure ulcers.

Conclusion

Concluding, prevention, and treatment of pressure ulcers requires a multidisciplinary approach with the use of different workable strategies. After analyzing the impact of repositioning and pressure-relieving mattresses on the effects of fighting pressure ulcers, it was discovered that empirical research is lacking, and no particular conclusion can be made.

However, from the collected information, one can conclude that bot interventions need a change and most importantly individual approach. As for the efficiency, periodical repositioning might show more impact in fighting pressure ulcers than pressure-relieving mattresses as any movement encourages wound healing and distribution of pressure better than any assistive surfaces. Therefore repositioning should show a better effect in preventing pressure ulcers.

References

Joyce, P., Moore, Z., & Christie, J. (2018). Organisation of health services for preventing and treating pressure ulcers. Cochrane Database of Systematic Reviews, (12). 

Koh, S. Y., Yeo, H. L., & Goh, M. L. (2018). Prevention of heel pressure ulcers among adult patients in orthopaedic wards: An evidence-based implementation project. International Journal of Orthopaedic and Trauma Nursing, 31, 40-47. 

Li, Z., Lin, F., Thalib, L., & Chaboyer, W. (2020). Global prevalence and incidence of pressure injuries in hospitalised adult patients: A systematic review and meta-analysis. International Journal of Nursing Studies, 105, 103546. 

Moore, Z., & Cowman, S. (n.d.). Repositioning for treating pressure ulcers. Cochrane Database of Systematic Reviews, (1). Web.

Qaseem, A., Humphrey, L. L., Forciea, M. A., Starkey, M., & Denberg, T. D. (2015). Treatment of Pressure Ulcers: a Clinical Practice Guideline from the American College of Physicians. Annals of Internal Medicine, 162(5), 370. 

The images that can be distinguished the most from the Topic 10 video are the posters from the book of Giambattista della Porta that show the similarity of human faces to animal faces. These posters illustrate the idea that a person whose facial features are similar to a particular animal will share the same characteristics that are inherent in the given animal. This seems to me highly interesting since I did not imagine that such things could be taken seriously. I assumed that, in ancient times, there was an idea that a person can adopt the characteristics of animals and their qualities. However, I did not know that such a relationship was developed at a scientific level in the 17th century.

I am familiar with the concept of physiognomy, and I knew that there was an idea that the characteristics of a person can be considered based on the appearance of his face. Nevertheless, I did not know that the structure of the skull also refers to physiognomy and that, even in the 18^th and 19^th centuries, this concept was discussed scientifically. With regard to blood transfusion, I assumed that initially, even while practicing this procedure, people did not know about blood groups and their compatibility in order to provide more productive blood transfer. I did not know the history of blood banking, how actively donation was promoted during the Second World War, and that the Red Cross preferred the blood of white people. To confront contemporary medical disinformation, we should stop romanticizing the time when black people were treated as non-human. In other words, we need to stop portraying periods in history when prejudice against certain groups of people was reinforced by medical misinformation. What is more, it is essential to spread information concerning racism in medicine.

The research paper discusses how nurse staffing affects patient recovery time. The identified PICOT question is In hospital patients, what is the effect of appropriate nurse staffing compared to a large number of patients per nurse on reduction of patient recovery time within three months period?. The research question is related to the problem of staff deficiencies. The latter results from the reduced funding, aging labor force, expansion of patient intricacy, and an increase in the number of elderly patients.

The conducted analysis of academic literature reveals that scholars emphasize that nurse staffing strongly correlates with the patient recovery time and quality of the provided care. This claim could be found in the previously revised articles of Hockenberry and Becker (2016), Kim and Bae (2018), Baker, Canvin, and Berzins (2019), and MacPhee, Dahinten, and Havaei (2017). Even though these papers research questions and research methods are different, all of them propose the same idea: the staff shortage and excessive workload of nurses make the patients worse off.

Taking into consideration the conducted analysis, it becomes apparent that most of the hospitals require changes. First of all, there is a correlation between the length of working hours and patients mortality rates. According to the investigation conducted by Trinkoff et al. (2011), the longer working hours are, the bigger the frequency of patients deaths. Therefore, the administration of a hospital should actively engage nurses in discussing their working schedule to make it comfortable and efficient. Besides, healthcare policy-makers should be concerned with the reduction of nurse understaffing because it is a reason for their excessive workload and overtime working. The improvements in nurse staffing are of particular importance because this is a way to increase the effectiveness of healthcare outcomes.

References

Baker, J. A., Canvin, K., & Berzins, K. (2019). The relationship between workforce characteristics and perception of quality of care in mental health: A qualitative study. International Journal of Nursing Studies, 100, 103412. Web.

Hockenberry, J. M., & Becker, E. R. (2016). How do hospital nurse staffing strategies affect patient satisfaction? ILR Review, 69(4), 890910.

Kim, C.-G., & Bae, K.-S. (2018). Relationship between nurse staffing level and adult nursing-sensitive outcomes in tertiary hospitals of Korea: Retrospective observational study. International Journal of Nursing Studies, 80, 155164. Web.

MacPhee, M., Dahinten, V., & Havaei, F. (2017). The impact of heavy perceived nurse workloads on patient and nurse outcomes. Administrative Sciences, 7(1), 7. Web.

Trinkoff, A. M., Johantgen, M., Storr, C. L., Gurses, A. P., Liang, Y., & Han, K. (2011). Nurses work schedule characteristics, nurse staffing, and patient mortality. Nursing research, 60(1), 1-8. Web.

Fluorine is a common element abundant in the earths crust. Naturally, the mineral occurs in the soil, rocks, and water with higher concentrations in places that have experienced geologic uplift¹. Many industrial processes are dependent on fluorides due to their use. The primary source of systemic fluoride is exposure to food diets and fluoride-containing toothpaste or other dental products. One of the most important achievements of the 20th century is community drinking water fluoridation to curb dental fluorosis². However, the decline in dental caries has been alongside increased dental fluorosis prevalence and side effects of excessive fluoride exposure.

Fluorine plays a critical role in the development and maintenance of teeth and skeleton³. For teeth, excessive fluoride intake may lead to dental fluorosis, but adequate intake reduces dental caries. However, one needs to take fluoride within the limits as the effects can be detrimental to dental health. Fluorosis is a cosmetic condition that affects the teeth. It results from overexposure to fluoride during the first eight years of life⁴. This period is when most permanent teeth are developing. After the teeth come out, those affected by fluorosis may appear to be mildly colored. For example, lacy white markings might be evident which can be detected. Under severe cases, the teeth can have surface irregularities, pits that are noticeable and yellow strains. Dental fluorosis has been prevalent globally, with the United States recording a portion of 23% of people having the diseases⁵. The effect of fluorosis can be embarrassing and difficult to treat.

References

1. Helmenstine T. Abundance of Elements in Earths Crust  Periodic Table and List. 2020. Web.
2. Esemag. Environmental Science & Engineering Magazine: 2018. Web.
3. Brickley MB, Mays S. Fluorosis. Fluorosis  an Overview. Science Direct Topics. 2019. Web.
4. CDC. Fluorosis | Community Water Fluoridation FAQs | Community Water Fluoridation | Division of Oral Health | CDC. Cdc.gov. 2021. Web.
5. Neurath C, Limeback H, Osmunson B, Connett M, Kanter V, Wells C. Dental Fluorosis Trends in US Oral Health Surveys: 1986 to 2012.

The article, which discusses prescribing difficulties in America, provides a strong overview of the essential disparities in treatment that concern minorities. The issue gets extensive prominence, according to the fact that many Asian, Hispanic, and Afro-American citizens, who inhabit the USA, claim that they are discriminated in medical treatment. Specifically, due to the records, the representatives of ethnic and racial minorities, especially those, who have low incomes, have less access to vaccination and proper drug treatment than the native citizens of the USA (Burroughs, Maxey, Crawley, & Levy, 2002). The authors of the article outline several factors, which predetermine the occurrence of prescription difficulties. For instance, it is suggested that low health literacy and cultural competencies disparities increase the number of problematic cases. In general, the writing prioritizes three groups of factors, which may arise with the treatment of minority groups. These are environmental, cultural, and biological issues. Thus, due to environmental factors, the responses of minorities to pharmaceutical prescriptions may be problematic, according to dietary and habit-related issues. The biological disparities encompass disease, age, and gender differentiation. Finally, culture refers to the general attitudes and beliefs, which concern medical treatment, since such disparities define responses to therapeutics in the minority groups.

Pharmacotherapeutics and Client Compliance Implications

The gained information can serve as the guidance for professional nursing practice. For instance, it has to be implied that a professional specialist, who has to prescribe certain treatment to a minority representative, must compile the information about the general biological, cultural, and environmental preferences of the patient since they may influence therapy results. That is why, it is extremely important to destroy the potential barriers, which hinder the communication between medical workers and minority clients. Thus, it is critical to learn the medical history of the client as well as his/her attitude towards specific types of therapy. Moreover, one has to clarify the outcomes and adverse effects of certain therapy operations and drugs consummation in an understandable way. If a patient and a medical worker have language barriers, it can be beneficial to refer to a translator. In other words, the article makes it clear that pharmacotherapeutics, which involves the representatives of minority groups, prioritizes individualized treatment. The contemporary technologies of DNA and drug metabolism study reveal that personalized medicine provides a positive effect on minority therapeutics, which is why, it has to be embraced in multiple clinical environments.

Recommendations Employment

The pharmaceutical practices, which are applied by the representatives of minority groups, may evoke pharmacokinetic or pharmacodynamic difficulties, due to the disparities in metabolism and drug perception. The analyzed article provides an excellent set of recommendations, which may be overtaken by a specialist to prevent any treatment problems. For instance, if I deal with a representative of a minority group, I can test the inclinations and drug responses of this person before prescribing any therapies. It may be performed in three stages. Firstly, one has to verify drug metabolism of a patient with the help of modern medical appliances so that to find out which types of medicine can hinder the clients health. Secondly, I would establish a strong communication contact with a patient and use the individualized treatment, which is described in the article, so that to disclose cultural preferences of the client. Finally, the source may be used for enhancing the patients awareness of the safety of individualized therapy, which certifies that the treatment brings consistent benefits and does not bring harm to the clients health.

Reference

Burroughs, V., Maxey, R., Crawley, L., & Levy, R. (2002). Cultural and Genetic Diversity in America: The Need for Individualized Pharmaceutical Treatment. Web.

Introduction

Canada has a universal health care system, including policies on treatment for the elderly, assisted living facilities, physical therapy, and mental well-being. However, specifically, mental health reforms in the United States and Canada have similarities and differences. Canadians believe that admittance to medical treatment should base on demand and not the capability of spending. Therefore, it is appropriate to research Canadas medical system because it might be suitable for introducing health care organizations.

Reason for Establishment of Mental Health Policy for Both United States and Canada

The creation of emotional health policies in the United States and Canada was motivated by the rise in mental disorders. Both countries have experienced an increase in mental health issues, therefore, these problems led to the establishment of dynamic well-being reforms (Grégoire et al., 2018). The United States has Mental Health America while Canada uses Canada Health Act to manage its citizens emotional health and well-being (Grégoire et al., 2018). The main aim is to handle the people experiencing emotional illness and improve general mental health.

The United States is working hard to ensure a reduction in the number of emotional illnesses in the country. Mental Health America has been operating for many years, but unfortunately, it performs poorly in protecting people from emotional diseases (Teach man et al., 2019). Similarly, in Canada, these policies have not fulfilled the main objectives. Psychological care is paid for by the patient or sorted by the private third-party cover as the government does not take care of the expenses (Grégoire et al., 2018). With such heavy responsibility left to citizens, many Canadians do not prioritize mental health.

Similarities and Differences Between Canada and United Mental Health Policies

There are several similarities in the policies of the two states. In the United States, there have recently been various vital reports advocating for efforts to advance emotional health services and care for psychiatric illnesses (Reynolds et al., 2020). Similarly, Canada has also been putting efforts into national and emotional well-being care policy to re-establish the mental health delivery system (Reynolds et al., 2020). The occurrence of a psychiatric disorder is a powerful determinant of mental health service application in both countries (Reynolds et al., 2020). In the two states, deinstitutionalization has improved the administering of emotional health services (Reynolds et al., 2020). Currently, many operations serve on an outpatient basis in general health facilities and by essential treatment physicians, psychiatrists, social workers, psychologists, and psychotherapists.

Despite the similarities in mental health policies of the two countries, there are some differences which include the following aspects. First, Canada Health covers operations done by psychiatrists who are medical doctors with professional skills in psychiatry. On the contrary, in the United States, the Affordable Care Act involves detection, early intervention, and care of emotional and substance use illnesses as a vital health benefit covered by medical insurance (Castillo et al., 2019). Secondly, in Canada, mental medical services are financed by a single-payer system whose funds derive from state and provincial levies (Castillo et al., 2019). On the other hand, in the United States, emotional well-being services are facilitated through private healthcare systems. Additionally, depression in Canada demands a top-level impairment than it does in the United States (Castillo et al., 2019). This information implies that there are more advanced cases of emotional illnesses in Canada than in the US.

Differences Involved in Managing Ethical Issues

Organizational morals include formal and informal principles of behavior that direct the conduct within the health care systems. The examples of differences involved when handling moral issues include rationalization. Medical personnel provides different rationalizations to warrant behavior that appears unethical (Gelinas et al., 2017). Another difference is that when leadership engages in non-moral activities, workers may get involved in unethical issues; hence handling these situations becomes a problem. Cultural differences also make it challenging to address ethical issues, for instance, assertiveness. Employees from low assertiveness cultures emphasize seniority and experience, which results in destructing harmony (Gelinas et al., 2017). Therefore, it becomes a problem in solving ethical issues involving such staff.

Recommendation on Whether to Establish a Healthcare Organization in Canada

The United States and Canada have common areas of mental health policies. Therefore, it would be appropriate to establish a health care organization in Canada to solve mental health issues that have is not solved with this match. Although provincial administrations have essential governance over the management and delivery of public healthcare services in this country, health ministries authorize upbeat delivery and private healthcare organizations (Vindrola, 2021). On the contrary, it might not be suitable to introduce a healthcare organization because the government policies do not favor private medical care companies.

Canada has a universal health care coverage that is efficient in the delivery of mental health services. This program has improved the connection between hospitals and provincial administrations, with medical facilities almost entirely dependent on public financing (Mattison et al., 2020). Additionally, provincial and territorial ministries of health are the main third-party financers in this country (Mattison et al., 2020). This institution setup does not imply the same purchaser-provider plans as in the National Health Service used in the United States.

Conclusion

It might not be appropriate to establish a health care organization in Canada because the universal medical system does not offer a favorable environment. Most of the medical facilities are in close connection with the provincial administration. Additionally, most citizens in Canada are used to the government funding of medical treatment, which seems to be performing well in the state. Therefore, it is not recommended to introduce a medical care organization in this country.

References

Castillo, E. G., Ijadi-Maghsoodi, R., Shadravan, S., Moore, E., Mensah, M. O., Docherty, M.,& & Wells, K. B. (2019). Community interventions to promote mental health and social equity. Current Psychiatry Reports, 21(5), 1-14.

Gelinas, L., Pierce, R., Winkler, S., Cohen, I. G., Lynch, H. F., & Bierer, B. E. (2017). Using social media as a research recruitment tool: ethical issues and recommendations. The American Journal of Bioethics, 17(3), 3-14.

Grégoire, S., Lachance, L., Bouffard, T., & Dionne, F. (2018). The use of acceptance and commitment therapy to promote mental health and school engagement in university students: A multisite randomized controlled trial. Behavior Therapy, 49(3), 360-372.

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Introduction

The need to promote change is included in the range of responsibilities of any nurse. However, in an environment that requires quick thinking and immediate response to the patients needs, the role of a Nurse Administrator (NA) becomes increasingly significant. By definition, STEMI patients require immediate cardiac catheterization. The reduction of the door-to-balloon time, in its turn, is defined as the time that passes from the moment of delivering the patient to the emergency department to the point where a catheter guidewire is introduced to the patients cardiovascular system (Lehme & Rosenthal, 2014). Therefore, it is crucial that an NA should promote change in the designated environment and take the necessary steps to address the patients needs within a comparatively short amount of time.

Changes: As a New Graduate

When entering the environment of the cardiac emergency room, in which STEMI patients have to be provided with the assistance that they need, a graduate NA must consider promoting change by improving the current system of the needs assessment carried out to identify the demands of the target population. Additionally, the evaluation of the capacities of the specified nursing setting has to be conducted so that the NA should be aware of the tools at their disposal. The given step is crucial in facilitating high-quality assistance to the target patients and involves asking close-ended questions regarding the capacities of the hospital. As soon as the identification of the technological opportunities, the rates of compliance with the existing rules for meeting the needs of STEMI patients, etc. is conducted, a graduate NA will be capable of promoting change in the designated environment. While the evaluation itself does not imply the immediate improvement of the services provided, it still helps outline the problems that the target setting has and informs of the way, in which the existing framework can be updated.

Changes After 2 Years of Experience

Even two years later, an NA will also have to conduct regular assessments of the service quality, thus, locating the emergent issues and managing them adequately. Furthermore, a consistent evaluation of the time spent on the provision of services related to myocardial infarction is essential (Arthur, 2014).

After 5 Years of Experience

As soon as the NA gains five years of experience working in the designated setting, it will be possible to address the time issue by reconsidering some of the details regarding the schedule. The importance of evaluating the efficacy of STEMI management is not to be underrated. It is essential that the hospital diagnostics should be up to the existing standards. Specifically, one must maintain the 12-lead ECG process impeccable so that the analysis of the issue should be flawless (Yeager, Burchum, & Rosenthal, 2015). In addition, the assessment of the cardiac biomarkers should be provided (Urden, Stacy, & Lough, 2013). By considering the quality rates of the services in question, an NA is likely to identify the paradigm of the further development of the facility.

After 10 Years of Experience

Similarly, after ten years of managing the department, an NA will have to carry out regular assessments based on the same set of questions regarding the capacities of the facility. Given the pace of technological development and the current research of the tools for improving the qualities of the nursing services, the assessment suggested above has to be updated consistently every five years. Thus, an adequate evaluation of the current state of the nursing services can be provided (Anderson, 2016).

Particularly, the use of open-ended questions as opposed to close-ended ones needs to be considered as the tool for retrieving the data in a manner as efficient as possible. On the one hand, the use of close-ended questions when designing the questionnaire will contribute to getting rather homogenous answers that can be categorized and quantified easily so that the data could be processed faster. On the other hand, the use of close-ended questions restricts the amount of data to be retrieved to a comparatively small number of options, which is essential when addressing the issue of STEMI (Lehme & Rosenthal, 2014).

Therefore, it is recommended that a combination of both types of questions should be incorporated into the survey. Moreover, ten years from starting the administrative practice, an NA must increase the number of questions, embracing every single domain of the operations related to the needs of the STEMI patients (Aitken, Marshall, & Chaboyer, 2016).

Conclusion

The significance of an NAs assistance in case of addressing the needs of a STEMI patient is obvious. By providing the corresponding services to the target audience, an NA promotes a significant drop in the door-to-balloon time process, thus, leading to a significant increase in the patients chances for recovering within a shorter amount of time and taking the procedure itself comparatively well. In other words, the number of risks that a STEMI patient faces in the course of the process, including the aggravation of the health condition, can be reduced significantly. By cutting the time spent on the procedure, an NA creates an environment, in which a STEMI patient is likely to recover at a much faster pace.

Reference List

Aitken, A., Marshall, L., & Chaboyer, W. (2016). ACCCNs critical care nursing. Atlanta, GA: Elsevier Health Sciences.

Anderson, K. M. (2016). The Advanced Practice Nurse cardiovascular clinician. New York City, NY: Springer Publishing Company.

Arthur, J. (2014). Lean Six Sigma for hospitals: Simple Steps to fast, affordable, and flawless healthcare. New York City, NY: McGraw Hill Professional.

Lehme, L. A. & Rosenthal, L. (2014). Pharmacology for nursing care. Atlanta, GA: Elsevier Health Sciences.

Urden, L. D., Stacy, K. M., & Lough, M. E. (2013). Critical care nursing: Diagnosis and management. Atlanta, GA: Elsevier Health Sciences.

Yeager, J. J., Burchum, J., & Rosenthal, L. (2015). Study guide for pharmacology for nursing care. Atlanta, GA: Elsevier Health Sciences.